One important route to restoring trust is through a commitment to transparency by all health care systems. Organizations and clinicians that act as though
... [Show More] they have nothing to hide become more trustworthy. The health care system should seek to earn renewed trust not by hiding its defects, but by revealing them, along with making a relentless commitment to improve. The transition to openness is a difficult one for our often-beleaguered health care organizations, but it is a journey worth making. In the longer run, access to information can inspire trust among patients and caregivers that the system is working effectively to ________________________.
advance health
Although trigger tools are neither perfectly sensitive nor specific, they have reasonably good interrater reliability and often identify cases of medical errors that incident reporting or administrative data-based systems miss. Since many triggers do not represent errors or even true harm, they are best used as which of the following?
a screen
One of the goals of the FDA is to protect the health of the public by assuring that the practice of reprocessing and reusing single-use devices (SUDs) is safe and effective and based on good science. The FDA has designed an approach that applies existing regulations for original equipment manufacturers (OEMs) to third parties and hospitals to minimize risks associated with reprocessed SUDs. The public expects and the law requires all medical devices to be safe, effective, and manufactured in accordance with which of the following?
Quality System Regulations
1. the growing complexity of science and technology,
2. the increase in chronic conditions,
3. a poorly organized delivery system,
4. constraints on exploiting the revolution in information technology
Four key aspects of the current context for health care delivery
Poor designs set the workforce up to fail, regardless of how hard they try
outmoded systems of work
The high standards of practice that are taught to nurses, pharmacists, and physicians have often been reinforced in hospital practice by an unforgiving system of _____________________________________________________.
Censure and discipline
co-workers are unaware that a study is taking place while another employee collects data
participant observer approach
false
T or F Many physicians believe the statistical reports
The challenges of applying information technology to health care should not be underestimated. Health care is undoubtedly one of the most, if not the most, complex sector of the economy. The number of different types of transactions (i.e., patient needs, interactions, and services) is very large. Which of the following will be required?
Sizable capital investments and multiyear commitments to building systems
Modifying training, regulatory, and legal environments is not a quick strategy for changing practice. These environments are closely interrelated with ________________.
the delivery setting
used to double-check the accuracy of medication cart filling, filling new orders, and filling prescriptions.
Observers
legally recognized report of a medication error
incident report
disadvantages of the Voluntary Incident Reporting Systems
1) Captures small fraction of adverse events
2) Retrospective review is only based on provider self-reports
3) No standardization or uniformity of adverse events reports
The Foundation for Accountability model organizes comparative information about quality performance into five categories based on how consumers think about their care
the basics
staying healthy
getting better
living with illness
changing needs
valid and reliable quality measures for priority conditions that can be used for both internal quality improvement and external accountability
A stronger and more organized evidence base should facilitate the development of ________
regulatory conflict
legal conflict
financial conflict
Support the accomplishment of innovators despite these factors:
conducts and funds research on safety and health problems, provides technical assistance to OSHA, and recommends standards for OSHA adoption
NIOSH (National Institute for Occupational Safety and Health)
5 years for insulin dependent and immediately for non-insulin dependent patients
when should screening begin for diabetic retinopathy after diagnosis?
Developed by Barker and McConnell, trained observer accompanies the person giving medications and witnesses the preparation and administration of each dose.
direct observation technique
performance measurement tool designed to help purchasers and consumers evaluate managed care plans and to hold plans accountable for the quality of their services
Health Plan Employer Data and Information Set (HEDIS)
Groups of medical reviewers contracted by the Centers for Medicare and Medicaid Services (CMS) to ensure quality control and the medical necessity of services provided by a facility.
1. conduct cooperative quality improvement projects in partnership with other quality-focused organizations.
2. conduct mandatory case review in response to beneficiary complaints, as well as educational and outreach activities
3. oversee program integrity by ensuring that Medicare pays only for medically necessary services
peer review organizations (PROs) [Show Less]