advance health
One important route to restoring trust is through a commitment to transparency by all health care systems. Organizations and clinicians
... [Show More] that act as though 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 ________________________.
a screen
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?
Quality System Regulations
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?
Four key aspects of the current context for health care delivery
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
outmoded systems of work
Poor designs set the workforce up to fail, regardless of how hard they try
Censure and discipline
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 _____________________________________________________.
participant observer approach
co-workers are unaware that a study is taking place while another employee collects data
T or F Many physicians believe the statistical reports
false
Sizable capital investments and multiyear commitments to building systems
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?
the delivery setting
Modifying training, regulatory, and legal environments is not a quick strategy for changing practice. These environments are closely interrelated with ________________.
Observers
used to double-check the accuracy of medication cart filling, filling new orders, and filling prescriptions.
incident report
legally recognized report of a medication error
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
disadvantages of the Voluntary Incident Reporting Systems
the basics
staying healthy
getting better
living with illness
changing needs
The Foundation for Accountability model organizes comparative information about quality performance into five categories based on how consumers think about their care
A stronger and more organized evidence base should facilitate the development of ________
valid and reliable quality measures for priority conditions that can be used for both internal quality improvement and external accountability
Support the accomplishment of innovators despite these factors:
regulatory conflict
legal conflict
financial conflict
NIOSH (National Institute for Occupational Safety and Health)
conducts and funds research on safety and health problems, provides technical assistance to OSHA, and recommends standards for OSHA adoption
when should screening begin for diabetic retinopathy after diagnosis?
5 years for insulin dependent and immediately for non-insulin dependent patients
direct observation technique
Developed by Barker and McConnell, trained observer accompanies the person giving medications and witnesses the preparation and administration of each dose.
Health Plan Employer Data and Information Set (HEDIS)
performance measurement tool designed to help purchasers and consumers evaluate managed care plans and to hold plans accountable for the quality of their services
peer review organizations (PROs)
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
Attention to physical comfort
timely, tailored, and expert management of such symptoms.
A special case of error
The application of human factors in other industries has successfully reduced errors. Health care has to look at medical error not as a special case of medicine, but as which of the following?
The FDA has specific classifications for recalls
1. Recall is required if a product may cause serious adverse health consequences or death [FDA, Title 21, Part 7, Section 3 (m)(1)].
2. Recall is required if a product may cause temporary or medically reversible adverse health consequences or where the probability of serious adverse health consequences is remote [FDA, Title 21, Part 7, Section 3 (m)(2)].
3. Recall is required if a product associated with a situation in which use of or exposure to a product is not likely to cause adverse health consequences [FDA, Title 21, Part 7, Section 3 (m)(3)].
disadvantages of Administrative/Claims Data
- it lacks detailed clinical data
- concerns over variability and inaccuracy of ICD-10-CM codes across and within systems
- detect high proportion of false positives.
Technology includes
techniques, drugs equipment and procedures.
United States still lacks national standards for the protection of health data
capture, storage, communication, processing, and presentation of health information
Number of serious allergic reactions to medications
500,000
Incident reports
the reporting of when an error occurs is done through?
1. Population based studies
2. Medication errors in hospitals
3. medication errors in nursing homes
categories of direct costs of medication related errors
making reward and recognition routine
put it on your calendar.
errors in health care
More difficult to quantify than accidents. Practitioners reporting uncovers only a fraction of the errors that occur. [Show Less]