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36 Cards in this Set

  • Front
  • Back
list the six aims of the health care system in the 21st century
1. safe
2. effective
3. patient-centered
4. timely
5. efficient
6. equitable
*93,000 ppl died in hospital d/t med care
list and describe the components for the chronic care model
must draw circles; developed by dr. wager who says we need a group of conepts "pay for perfomance idea"
What are the challenges for a different model of care?
1. increased *longetivity, therefore*m more ppl with chronic conditions
2. emphasis on *management vs. short term treatemnt
3. increased complexity of care
def of acute care
immediate care, episodic, "cure" oreintaed (ex sore throat--given antibotics)
def of chronic disease manageemtn
management over time of the condition, continous, ongoing care, importance of quality of life...heart disese, CHF, AIDS, asthma
What is morbidity reduction and what does it have to do with prevention?
What you doing in majory of AIDS pat, chronic disease pts..tertiray prevention
What are the main demands of the 21st that every physician is involved in?
1. acute care
2. primoridal/primary prevention
3. chronic disease management-both secondary and tertiaray prevention
4. terminal (end of life) care
if there is a problem with your practice, what should you do to fix it?
we used to foucs on doctor, nmo its the system that needs to change
how many ppl in WV were told they have diabetes from 1995-2004
10.8%, its on the rise
Def of chronic illness
can include ADD; any cond that requires ongoing activites from personal and medical/ includes chronic mental and behviaor disordrders, addiction
HOw much of chronic care takes up our expdentiures?
95% (from 63% of beneficiares)
what should a physician do to help teh pt in self-managment?**
1. emphasize pt's centrla role in care
2. basic info
3. emotional support
4. strategies for living w/ci--must be a collaborative apporoach from all providers
What's the "hidden health care system" mean?
80% of what ppl do is outta our control , we do 20%
What are "good" self-managers?
ppl who are motivated to make dialy decisions to favor their health; involves taking medications; everyone self-manages-whether good or bad
t or f clincal outcomes depend mainly on the physician, the experts
f, pts are experts on their own body; provider has to be in partnership w/pt, clinical outcomes are dependent on pt actions
early definition of self-management support
including pts in their own care; encouraging pts
What are 3 main tasks in self-management support?
1. take care of illness
2. carry out normal activities
3. manage emotional changes
How should a pcp emphasize the patient's role?
1. simple message
2. consistent approach
3. cutlurally appropiate (language)--have a diverse staff
Instead of goals, a pt should have _____ plans, that are how long?
action plans that are behavior specific (s/one observes them doing it); confidence; should include stuff they WANT to do, barriers, follow ups, confiencence
you should base goals on what you want the pt to achieve
false, base goals on a pt. priorities
Goals should be achieved in 3-6 months, but aren't behavior specific
Delivery System design involves going from a reactive health to a proactive approach and includes what imp factors?
1. team approached planned visits
2. ensure regular followup*
3. be aware of health literacy and cultural sensitivity**two emerging concepts in health care
Decision Support is based off of guidelines from what:
clinical research, and these guidelines should be discuseed with pts, i should have ongoing training, involve supportive specialists
When you decide to change a practice, how are new guidelines intergrated?
thru reminders, feedback, to increase their visibiility at the time concial decisions are made
What would Clinical information systems involve?
timely reminders for needed service, summarizing the data to help keep track of plan care; electronic data base helps this
in prevention there a difference b/n *screening and *diagnostic and survelience?
screening-searching for s/thing-ex-fecal occult blood, then they come back for diagnostic testing, and surveillence-is colonscopy every 5 years
What is taking out pop machines in schools an example of?
community resources and policies-physician should be aware of ed classes obesity classes
What supports improvement at all levels of the organization?
Health systems-wants a comprehensive system change so senior leadership should make incentives available-"pay for performance" from insurance companies
What other important factor should health system prvide?
encourage pt info sharing across organization
T or F--guidelines should be changed before the system
false, --system changes first
What's an example of a quality improvement program?
the electronic data system--rapidly improving everyhing
What's PDSA?
a continous quality improvement-plan to do study act
1. plan-hypothesis
2. do-collect data
3. study-make conclusions
4. act-changes that are needed/additional test cycles
Is the CCM model effective?
yes, one year after implementation, 75% of practice sites had sustained changes in care
T or F CCM improves outcomes and pt edu
pt empowerment philosophy
pts are experts on their own live, and deine thier probs, so compliance and adherance aren't relevant concepts
Collaborative care
since we can't be there, we must have this to help pts achieve their goals