Exam 1 Health Care Problems

Front 1

what are strategies that hospitals use to identify and encourage physician and nurse champions to QI initiatives?

Back 1

physicians: hospital strategies include employing physicians; using credible data to identify areas that need improvement; providing visible support through hospital leadership; identifying and nurturing physician champions to help engage physician peers; and communicating the importance of physicians contributions

nurses: supportive hospital leadership actively engaged in the work; setting expectations for all staff- not just nurses that quality is shared responsibility; holding staff accountable for individual roles

Front 2

what alternative strategies would you suggest in order to incorporate nurses in QI activities

Back 2

having adequate nursing staff when resources are scare; engaging nurses at all levels from bedside to management; facing growing demands to participate in more often duplicative, quality improvement activities

Front 3

list some of the challenges in trying to incorporate nurses in QI activities?

Back 3

scarcity of nursing resources, differentially engaging nurses of all levels, nurses participation in more quality improvement activities, burden of data collection, and shorten traditional nursing education

Front 4

who uses word of mouth to locate physicians?

Back 4

consumers, older individuals and less educated. mainly those looking for a primary care physican

Front 5

list different sources for selecting new primary care physicians

Back 5

friends or relatives, doctor or other healthcare provider, health plan, internet, books, magazines or newspapers, tv or radio

Front 6

how do the sources for selecting primary care physicians differ from the sources for selecting a specialist and medical procedure facilities?

Back 6

to select a specialist physician, more used primary care physician as source: referral from primary care physician. customers mainly used doctors performing the procedure to select a facility for the procedure 68%

Front 7

list the different sources for selecting new primary care physicians

Back 7

word of mouth, referrals from primary care physicians, internet, health care plan info. (insurance company)

Front 8

how do the sources for selecting primary care physicians differ from the sources for selecting a specialist and medical procedure facilities?

Back 8

the dominant source for finding a primary physician is word of mouth. the dominant source used to find a specialist is referrals from primary care physicians. 6 in 10 people used this source for medical facilities it was 3 in 4 used recommendation from their physician

Front 9

what are the quality transparency initiatives? who are the audiences for such initiatives?

Back 9

QTI's are ways of comparing performance of doctors and hospitals. help providers improve bench marking performance against others. encourage programs to reward quality and efficiency. help patients make informed decisions about their care. individual physicians, customers, purchasers, and provider organizations are the target audience for QTI's

Front 10

what are the main elements (characteristics features) of primary care shopping and procedure facility shopping?

Back 10

-middle to older adults, usually with a higher education level. quality info is based from research evidence and had credible sites.

Front 11

what are most people concerned about?

Back 11

most people care about finding doctors who listen well, and approachable, and have a compassionate manner.

Front 12

list some of the most important factors that matter the most to consumers

Back 12

cost,quality,convenience, doctor recommendation, insurance coverage

Front 13

distinguish active vs. passive shoppers. provide examples of each

Back 13

an active shopper is one who takes time and looks at data and "looks' around to compare factors to make the best choice. a passive shopper is one who does not actively go to find information for a purchase.

Front 14

define safety net hospitals

Back 14

safety net hospitals are health system provide a significant level of care to low income, uninsured, and vulnerable populations. the suburban safety net: the health care providers and services available to low income people in the suburbs. it is not limited to individuals strictly defined as poor, or those with incomes at or below federal poverty 22 thousand for a family of four.

Front 15

what are some characteristics features of specialty hospitals

Back 15

some characteristics features are that specialty hospitals treat less-complex patients wit lower acuity and a higher proportion of patients with more generous insurance coverage. in addition physician ownership interests in specialty hospitals may result in referral patterns that shift patient volume from general to specialty hospitals.

Front 16

general hospitals respond and adapt to competition from specialty hospitals

Back 16

study respondents identified several ways that specialty hospital competition affected the financial wellbeing of general and safety net hospitals through competition for physicians and other staff, new challenges in providing ED on call coverage and decreases in service volume. respondents reported little, if any change in patient acuity in general hospitals and respondents often attributed changes in payer mix to the rising rate of uninsured people in the market generally, rather than loss of patient volume to specialty hospitals. general hospitals felt the impact of competition from specialty hospitals then safety net hospitals

Front 17

why do physicians prefer a move to specialty hospitals? 5 factors

Back 17

1) more predictable scheduling
2) more access to operating rooms and diagnostic equipment
3) efficiencies associated with focusing on single service line
4) the opportunity to see more patients at one location, reducing the inefficiency of traveling among hospitals
5) better pay

Front 18

what strategies that general hospitals have used to deal with increased competition for staff and call coverage?

Back 18

some hospitals have employed specialists or aggressively aligned with specialists who practice at multiple facilities via contractual arrangements, encouraging them to concentrate their practice at a particular hospital. general hospitals reported adapting the hospital environment to better accommodate physicians preferences like more operation rooms.

Front 19

as specialists of health services administration, where do you see the future of specialty hospitals?

Back 19

i see almost all physicians moving to specialty because of the five factors listed above. so since the physicians are moving from general to specialty, specialty will increase and general will become very small to obsolete and become more of just an emergency room

Front 20

what are the relationships between relationships between suburban poverty and access to health care?

Back 20

suburban poverty has increased in the past decade and the availability of health care services for those low-income and uninsured people in the suburbs has not kept pace.

Front 21

what are some of the challenges of suburban populations?

Back 21

suburban areas face many challenges regarding health care, compared to urban areas. there is limited access to free or low cost care for low income people in the suburbs. from the studies few suburban areas had public safety net hospitals. lack of transportation is a big factor. safety net roles are largely limited to their emergency departments, which limits access to other services

Front 22

what are some of the problems associated with access to healthcare in suburban areas?

Back 22

inadequate transportation: lack of cars, buses and trains in suburban areas lead these consumers to rely on friends/ family to drive them or public transportation which are unreliable
- insufficient cultural and linguistic competency of providers suburban areas have experienced influxes of immigrants but suburban health care providers typically lag their urban counterparts
- lack of awareness and available services
-local resistance

Front 23

what are potential solutions to overcome these problems

Back 23

decreasing reliance on emergency departments a number of hospitals support CHCs free clinics by providing direct funding, space, supplies, and services
- improving access to specialists; some urban safety net hospitals area attempting to station specialist physicians at suburban hospitals and health centers on a regular basis and to improve no show rates
-expanding primary capacity

Front 24

what are the two most important problems/challenges in employers attempt to promoting health? what are the most important concerns of employers?

Back 24

engaging enrolles in the health and wellness activities is a problem because participation is typically voluntary. employee privacy concerns also provide challenge in employers attempt to promote health. employers want their employees to participate because it will reduce absenteeism and improve productivity as well as avoid major costly medical events

Front 25

list some of the health and wellness activities

Back 25

screening (mammogram, colonoscopy)
health fairs
educational seminars
weight management
smoking cessation
fitness

Front 26

what is a health risk assessment? HRA what are problems associated with HRA?

Back 26

HRA is a questionnaire, often available online, that collects information provided by the enrollee about personal and family medical history, current diagnoses and symptoms, use of preventative and screening services and lifestyle behaviors.

Front 27

problems with HRA's

Back 27

privacy concerns. some people lie because they fear the outcomes will be unhealthy and they dont want people knowing some things.

Front 28

what are some of the problems associated with lack of employee uptake of health and wellness programs?

Back 28

most respondents agree that some type of incentive is needed to engage the employees in these programs. incentives are not only needed to get them involved but also to encourage them to actually improve their health

Front 29

who provides funding for health and wellness activities?

Back 29

funding comes from several sources. for fully insured products the cost typically is incorporated into the premium, while self insured employers typically pay a fee to the plan administrator

Front 30

what is the future of health and wellness initiative? list some of the potential indicators for evaluating health and wellness activities.

Back 30

employers are increasingly looking to the health and wellness initiatives to help support their shift to a broader consumer-based strategy of employees taking more responsibility for health care decisions and cost. these activities offer promise for engaging consumer more effectively.
- engaging larger numbers of consumers to actively participate by using incentives that minimize resistance, best achieve the desired outcomes, and appropriately address consumers privacy concerns
- demonstrating their effectiveness in improving, or at least maintaining health, including evidence of an investment pay off

Front 31

what are some of the strategies hospitals used to aid physician adoption of EMR?

Back 31

hospital strategies to aid physician EMR adoption include offering direct financial subsides, extending the hospitals ambulatory EMR vendor discounts and providing technical support

Front 32

identify factors driving hospital interest in supporting physician EMR adoption

Back 32

two key factors driving hospitals interest in supporting physician EMR adoption are improving the quality and efficiency of care and aligning physicians more closely with the hospital

Front 33

state the stark law- and the anti-kickback statute

Back 33

federal laws and related regulations, including the physician self referral law-commonly referred to as the stark law. and the anti-kickback statute, were perceived as inhibiting hospitals willingness to assist physicians. both laws are intended to prevent hospitals from offering financial incentives to physicians in return for patients referrals.

Front 34

define interoperability

Back 34

the ability of a system or product to work with other systems or products without special effort on the part of the consumer. interoperability becomes a quality of increasing importance for information technology products as the concept that "the network is the computer"

Front 35

what are some challenges to the hospital strategies in assisting physicians with EMR

Back 35

limiting budgets, hospitals' administrative and IT resources were already heavily taxed by implementing hospital-based IT systems as well as ambulatory EMRs for hospital owned physician practices
- hospitals reported that costs and technical challenges to achieve this data exchange are substantial
- hospitals varied substantially in the priority they assigned to completing this task