Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
147 Cards in this Set
- Front
- Back
|
1) Family Practice is a
a) Discipline b) A field of study c) A specialty d) Contains all true primary care physicians |
c) A specialty
|
|
|
2) Providing definitive care to the undifferentiated patient with continuing responsibility for the patient’s care describes
a) A sub-specialist b) A primary care physician c) Every physician d) An Emergency room physician e) No physician |
b) A primary care physician
|
|
|
3) The scope of practice of a Family Physician
a) Does not vary from one community to the next b) Does not vary according to the Physician’s training c) Does not vary with the needs of the physician’s patients d) Does not vary in quality from those in other specialties in critical care e) Does not include obstetrics |
d) Does not vary in quality from those in other specialties in critical care
|
|
|
4) Career opportunities for Primary Care Physicians and in particular the Osteopathic Family Physician
a) Would be extremely limited compared to other specialties b) Would not include Administration c) Would not include research d) Would include Journalism e) Would be extremely difficult to find |
d) Would include Journalism
|
|
|
5) Which of the following is usually associated with primary care physicians
a) Acute one time contact with the patient b) Seeing patients by referral only c) Coordinating care of the patient with other specialists d) Providing preventive services only e) Less cost effective care than subspecialist care |
c) Coordinating care of the patient with other specialists
|
|
|
6) When services are obtained and paid for from a “for profit organization” they are?
a) Medicaid services. b) Operational Services c) Medicare services. d) Informal Services. e) Formal services. |
e) Formal services
|
|
|
7) A 35 year old indigent mother brings her infant boy in for a well child visit. Most likely, the infant has what type of third party payer for these illnesses?
a) Capitation b) Managed Care c) Medicaid d) Medicare e) Workers Compensation |
c) Medicaid
|
|
|
8) The newly enacted Medicare Part A assists Medicare recipients with:
a. Drug benefits b. ER care c. Inpatient care d. Outpatient care e. Podiatric care |
c. Inpatient care
|
|
|
9) Evidence Based guidelines embedded in the system is related to what component of the chronic care model?
a) Clinical information systems b) Decision support c) Delivery system design d) Health systems e) Community resources and policies |
b) Decision support
|
|
|
KNOW THE DIFFERENT PARTS OF MEDICARE AND WHAT THEY ARE FOR
|
and write a card on it here!
|
|
|
10) Which of the following is true?
a) Clinical outcomes are dependent on patient actions b) Self-management is what the physician tells the patient they need to do c) Chronic care success is solely dependent on the physician during primordial care d) Self management is solely up to the patient to problem solve on their own e) The percentage of Medicare patient population with one chronic condition is 50%. |
a) Clinical outcomes are dependent on patient actions
|
|
|
11) A solo physician who sees patients in his office and handles all the needs of the patient is functioning under which of the following:
a) Unidisciplinary b) Multidisciplinary c) Interdisciplinary d) Transdisciplinary |
a) Unidisciplinary
|
|
|
What is transdisciplinary?
|
covering multiple disciplines to help, trying to use multiple disciplines that you may not be an expert in to give the best treatment you can
|
|
|
mulitdiciplinary
|
multiple physicians seeing a pt, but not really working together (pulmonologist, cardiologist, etc)
|
|
|
interdisciplanry
|
multiple disciplines WORKING TOGETHER, but each doing their own discipline
|
|
|
discipline vs specialty
|
field of study: Family medicine
specialty: Family physician |
|
|
Capatation
|
you are given a set amount for a patient and you take care of that patient using that dollar amount
aka you get 600 dollars for people using that insurance no matter how many people came in. So you would either have a ton of ppl and get screwed, or nobody would come in and you would make bank |
|
|
medicare
|
insurance for anyone who is retired over 65 or has disability for 2+ years
can vary from state to state |
|
|
1. African sleeping sickness is caused by a protozoan of the genus Trypanosoma. The disease is transmitted to humans by the bite of the tsetse fly, which has acquired the protozoan from previously biting an infected human or animal (often cattle). In a three-year time period, the incidence of African sleeping sickness was dramatically reduced in the human population. This reduction in incidence was thought to be due to widespread death of cattle due to loss of large areas of grazing land. In this situation, the reduction in people suffering from African sleeping sickness would be best related to direct alteration in which of the following aspects of disease transmission?
a. Host b. Agent c. Vector d. Environment |
d. Environment
trypanosoma: agent cc fly: vector host: human in the triangle |
|
|
The BEINGS model is a useful paradigm for
a. Allocating public health resources b. Evaluating possible etiologic factors of disease c. Determining the role of social policy in public health efforts d. Assessing the impact of herd immunity e. Establishing the benefit of intervention in disease outcome |
b. Evaluating possible etiologic factors of disease
|
|
|
For an infectious disease to occur there must be interaction between
a. Behavior factors and genetic factors b. The agent and the vector c. The vector and the host d. The agent and the host e. The vector and the environment |
d. The agent and the host
|
|
|
4. Herd immunity refers to [we did not really cover this topic much in class … do your best]
a. Genetic resistance to species-specific disease b. Immunity naturally acquired in the population c. The high levels of antibody present in a population after an epidemic d. The prevention of disease transmission to susceptible individuals due to acquired immunity in others in the population e. The vaccination of domestic animals to prevent disease transmission to humans |
d. The prevention of disease transmission to susceptible individuals due to acquired immunity in others in the population
|
|
|
What is/are the key distinction(s) between classical and clinical epidemiology?
|
clinical: individual, those who are ill, to treat disease
classical: entire community to get prevention |
|
|
if you increase prevalence what happens to PPV, NPV?
|
PPV: UP
NPV: DOWN |
|
|
if you change prevalence what happens to test accuracy?
|
NOTHING, it stays the same sucka!
|
|
|
The receiver operating characteristic (ROC) curve plots which features of the diagnostic test on the x-axis and the y-axis?
|
X axis: 1-specificity (false positive)
Y axis: sensitivity (true positive) |
|
|
The two parameters of the ROC curve most directly represented by this curve are which of the following: true positive rate, true negative rate, false positive rate, false negative rate?
|
true positive (y axis), false positive (x axis)
|
|
|
For the purposes of official reporting of deaths, what generally constitutes the proximate cause of death?
|
underlying cause, a few steps removed from a sequence of events leading to death
go take a look at the death card okay? |
|
|
if you have a relative risk of 2.7, what does this mean?
|
you have a 2.7 times greater chance of developing something
|
|
|
for a confirmatory diagnostic test, what do you want to have?
|
high specificity
minimize false positives, want it to be higher up on the line: make sure you go look at these graphs!! |
|
|
maximum sensitivity is used for what kind of test?
|
screening test
|
|
|
You are conducting a study among medical students and ask the question in your survey: “Did you at any time during your first two years two years of medical school experience symptoms of clinical depression?” What epidemiologic measure would be best represented by the information obtained from this question?
|
the presence of clinical depression
PREVALENCE at some point in that 2 years you had it |
|
|
The incidence rate of Disease “X” is 6 times greater in women that in men. However, there is no prevalence difference in Disease “x” between men and women. The best explanation for this phenomenon is
a. The crude all-cause mortality rate is greater in women b. The case-fatality rate for Disease “X” is greater in women c. The case-fatality rate for Disease “X” is lower in women d. The duration of disease is shorter in men e. Risk factor for disease are more common in women |
Pw= I x D
Pm= I x D Pm = Pw Im x Dm = Iw x Dw so if Iw is high, you can decrease Dw, or increase Im or Dm so answer is: b. The case-fatality rate for Disease “X” is greater in women |
|
|
This is a multiplicative effect of one exposure variable on another
a. Biologic plausibility b. Confounder c. Intervening variable d. Synergism e. Effect modifier |
d. Synergism
|
|
|
This must be associated with the exposure and the outcome
a. Confounder b. Necessary cause c. Sufficient cause d. Risk factor e. Biologic gradient |
a. Confounder
the confounder effects both the exposure AND the outcome remember the premature birth being the confounder, lowered number of visits to doc being the exposure, and the lowered baby weight being the outcome |
|
|
This is present when the study population resembles the larger population from which the sample was derived
a. Internal validity b. External validity c. Biologic plausibility d. Recall bias e. Synergism |
b. External validity
|
|
|
1. Discipline
|
a field of study
|
|
|
2. Specialist
|
one who devotes themselves to a special occupation or branch of learning
|
|
|
3. Specialty
|
: a particular occupation or branch of learning
|
|
|
5. Family practice
|
medical specialty based on discipline in family medicine
|
|
|
6. Family medicine
|
discipline of osteopathic medicine dealing with all aspects of care of the family from birth to death
|
|
|
7. Internal medicine
|
devoted to primary application of procedures in evaluating all body systems
|
|
|
8. Osteopathic family physician
|
practices in fields of medicine and surgery with the responsibility of the whole family
|
|
|
9. Osteopathic pediatrician
|
: focuses on infants, children, adolescents, and young adults from birth to 21
|
|
|
10. Pediatrics
|
discipline of focusing on infants, children, adolescents, and young adults from birth to 21
|
|
|
11. Primary care
|
first contact care, care over sickness and health, coordinative function
|
|
|
12. Primary care physician
|
generalist that provides care continuously to the patient
|
|
|
A primary care physician .... just read the slide
|
2. Discuss the scope of responsibility and functions of a primary care physician including, but not limited to: on going management of chronic care; providing cost effective, comprehensive and preventive care; use of interpersonal skills; confidentiality; accessibility; maintenance of diagnostic skills; role as a coordinator; role in the community and to the family.
these are the things they do |
|
|
1. Primary care physicians take care of patients in the following ways: 7
|
: CCU, ICU, OB, fracture care, home visits, minor surgeries, and ER work.
|
|
|
of 1000 people that visit a primary care physician, how many are hospitalized?
|
8
|
|
|
how many pts does a primary care physician tend to have?
|
1500-3000
|
|
|
4. Discuss career opportunities available to the primary care physician
|
1. Clinical practice, education, research, community service, administration, and journalism
2. Most family practice residents are in a family practice group 3. Most practices are owned by hospitals or health systems |
|
|
in primary care there are 5 areas that are having emerging emphasis...what are they?
|
adolescent care, geriatric care, prevention, sports medicine and occupational medicine.
|
|
|
6. Discuss physician supply in the United States
|
1. The demand for physicians parallels economic and population growth
2. Physician supply grows more slowly than that of other health workers |
|
|
1. 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 SEE PET |
|
|
2. List and describe the components of the chronic care model
There are 8 of them. this may be important since it was in like 5 lectures |
1. Community
2. Health system 3. Resources and Policies 4. Health care organization 5. Self-management support 6. Delivery system design 7. Decision support 8. Clinical information systems Come help ryan have some damn dirty crabs i dont know i'm just tryin to help! |
|
|
3. Explain and discuss how the chronic care model can improve health care
|
1. You will have an informed activated patient and a prepared, proactive and efficient team.
|
|
|
4. Describe the 8 segments of the health care population as established in the "Bridges to Health" model
|
1. Healthy
2. Maternal and infant health 3. Acutely ill 4. Chronic conditions, normal function 5. Stable but serious disability 6. Short period of decline before dying 7. Limited reserve and exacerbations 8. Frailty, with or w/o dementia |
|
|
5. Discuss the unique challenges in the care of patients with chronic diseases
|
1. Need to help the patients live a long life and enjoy that life. Need to provide an accommodating environment in which to effectively provide care. Need to stress self-management as a major component in their heath care. Cost is also often a challenge in treating a chronic disease
|
|
|
6. Explain the importance of self-management in the care of the patients with chronic conditions (3)
|
1. Empowers and prepares the patient to manage their care
2. Emphasizes patient’s central role in their health 3. Patients are experts of their own lives |
|
|
a. Continuity of care (3)
|
i. Closeness to patient
1. Closeness when patient is young aids in management as the patient ages 2. Able to address any topic, know what is and isn’t important to the patient ii. Interactions with family 1. Makes the physician alert to changing stresses, transitions and expectations iii. Familiar with patient’s past |
|
|
. c. Providing cost effective, comprehensive and preventive care
|
i. Comprehensive care --> Manages the majority of patient’s problems
ii. Cost effective care--> Need to order less lab, less likely to over or under react to presenting symptoms and results in fewer unnecessary surgeries and hospitalizations iii. Preventive care -->Ability to care and address a patient’s problems before they occur |
|
|
d. Use of interpersonal skills
|
i. Compassion, empathy, maintain dignity, provide insight, gather information rapidly, organize, listen, motivate, detect non-verbal cues
|
|
|
h. Physician's Role as a coordinator
|
i. Patient’s access to health care, overall care, care among providers, tie multiple findings and treatments into a single plan
|
|
|
3. Explain and discuss how the chronic care model can improve health care
|
a. CCM Quality Improvement
i. One year after implementation of changes over 75% of practice sites had sustained changes in care process. ii. Implementation of the CCM 1. Improves process and outcomes measured 2. Linked to improved patient empowerment and education |
|
|
What is the Medical Home idea?
|
i. Emphasis on management vs. short term treatment
ii. Continuous care vs. episodic care iii. Team concept vs. single provider |
|
|
b. What is self-management support?
|
i. The systematic provision of education and supportive interventions to increase patients’ skills and confidence in managing their health problems, including regular assessment of progress and problems, goal setting and problem-solving support
ii. Self-management support is what healthcare givers do to assist and encourage patients to become good self-managers |
|
|
c. How can the healthcare system facilitate self-management support?
|
i. Empower and prepare the patient to manage their care
ii. Emphasize patient’s central role in their health iii. Self-management strategies 1. Goal-setting 2. Development of action plans 3. Assist the patient with problem solving 4. Follow-up iv. Help develop an environment which assist the patient with self-management v. Organize resources to provide support vi. Effective self-management support means more than telling the patient what to do. It means acknowledging the patients’ central role in their care, one that fosters a sense of responsibility for their own health. |
|
|
e. 5 As
|
i. Assess
ii. Arrange iii. Advise iv. Assist v. Agree |
|
|
f. Personal action Plan
|
i. Something you want to do
ii. Describe 1. How 2. What 3. When 4. Where 5. Frequency iii. Barriers iv. Plans to overcome barriers v. Confidence rating (1-10) vi. Follow-up plan |
|
|
What are the #1 cause of death and disability in the US?
|
a. Chronic diseases are the #1 cause of death and disability in the US
i. 133 million Americans representing 45% of the total population have at least one chronic disease |
|
|
What type of pts account for 75% of the nations health care spending?
|
those with chronic disease
|
|
|
what has helped lead to a 30% increase in health care spending?
|
obesity
|
|
|
what is the correlation btw cost and quality in the US?
|
negative correlation
more expensive does NOT mean better |
|
|
the Medical Home Model is closely linked to what?
|
a. Closely linked to conceptual frameworks for transforming health care from acute and physician-centered to prevention, chronic care and patient-centered delivery system
|
|
|
d. Longitudinal care
|
i. When primary care DO’s in the osteopathic profession follow their patients over a number of years for various health care reasons.
|
|
|
a. Third party payors
|
form of payment for health care
i. Indemnity (security against loss, damage, etc) ii. Fee for service iii. Only provide what the market allows from dictionary: an organization other than the patient (first party) or health care provider (second party) involved in the financing of personal health services |
|
|
b. Private pay
|
form of health care payment
i. No insurance A. Good public service B. Right and ethical way to do it C. Helps community D. Not getting PAID for this ii. 21% of WV adults 18-64 iii. WV 10th worst “out of pocket” expense |
|
|
A. Medicare
|
form of healthcare payment
for elderly and disabled (2+ years) federally funded |
|
|
please list the parts of medicare
KNOW THIS |
A: Hospitalization
B: Medical insurance (doctor visits), out of SS check D: Prescription plan, associated fee |
|
|
What is medicaid?
|
form of health care payment
for poverty stricken people state funded WELL FARE |
|
|
Workers Compensation
|
form of healthcare payment
ii. Illness on the job or caused by the job iii. Keep separate A. Example 1. Pt. comes in with sore throat from a few weeks ago that developed into upper respiratory infection and a work related injury 2. Don’t mix together 3. Make two different notes 1. One for upper resp. infection 2. One for worker’s comp 4. You bill for technically two different visits |
|
|
if a pt comes in with a sore throat that became a upper respiratory infection AND a work related injury, how should you document it?
|
iii. Keep separate
2. Don’t mix together 3. Make two different notes 1. One for upper resp. infection 2. One for worker’s comp 4. You bill for technically two different visits |
|
|
f. Managed Care
|
i. A system of both financing and delivering a defined set of health care benefits by a defined provider network that is responsible for controlling the cost of delivering health care benefits to a defined population without compromising quality
this is an HMO, PPO, etc |
|
|
what is capitation?
|
1. Insurance company has 100 of their people come to your practice
2. They would pay you a certain amount of money per month for each person 3. You get paid for office visit at discounted rate if they come in, but also get paid for office visit if someone doesn’t come in B. Problem --> Potential for abuse |
|
|
5. Define the patient-centered medical home
|
i. An approach to providing comprehensive primary care for children, youth and adults.
ii. The PC-MH is a care setting that facilitates partnerships between individual patients, and their personal physicians when appropriate, the patient’s family |
|
|
g. Principles underlying the PC-MH (7)
|
i. Personal physician
ii. Physician directed medical practice iii. Whole person orientation iv. Care is coordinated and/or integrated v. Quality and safety vi. Enhanced access vii. Payment |
|
|
1. Describe the roles and functions of Health Care Teams and the impact these care models have on the patient and team itself.
|
1. Shift from acute-care to chronic-care
2. Need to improve the quality of care and cost effectiveness |
|
|
2. Differentiate between a group and a team.
|
1. Group: a number of persons BROUGHT together by common social standards, interests, etc.
2. Team: a group of people ORGANIZED to work together toward a common goal |
|
|
3. Describe the characteristics of an effective HCT.
|
1. Must have the capacity to adapt to changing and complex situations
2. Complementary skills 3. Well defined working approach 4. Meaningful purpose 5. Clear performance goals 6. Mutual accountability 7. Small numbers 8. Shared values |
|
|
4. Identify barriers to successful teamwork.
|
1. The process is time consuming and requires matching of schedules
2. Collaboration requires communication among team members, which takes away from patient appointments 3. May lead to an increased use of limited services and resources 4. Possible dominance of the team by the medical provider 5. On-going conflict resolution and goal reassessment 6. Confusion and blurring of role boundaries 7. Organizational barriers limit reimbursement for collaborative teams |
|
|
1. Unidisciplinary HC team
|
functioning in isolation from other disciplines, the “traditional” model, one provider works independently to care for a patient
|
|
|
2. Multidisciplinary HCT
|
members function as independent specialist who provide individual consultation and communicate minimally with each other
|
|
|
3. Interdisciplinary HCT
|
coordinated care among health care professionals from various disciplines whoa re engaged in joint decision making and communication, and who share responsibility and authority for the care of the patient.
|
|
|
4. Transdisciplinary HCT
|
characterized by flexibility and overlap between disciplines, involving deliberate pooling and exchange of information, knowledge and skills with the patient’s goals being the focal point.
|
|
|
1. Core team
|
consist of members that regularly function together on a full0time basis
|
|
|
2. Extended team
|
consist of members that provide important skills and services on an intermittent basis
|
|
|
1. Define coordinated care
|
1. Ensuring the patient receives the appropriate service at the right place at the right time, coordination and integration of service to avoid fragmentation
|
|
|
2. Describe coordinated care in the managed care environment
|
1. Provides access to required services
2. Assures the coordination of those services 3. Monitors the effectiveness of those services and whether it is meeting the need |
|
|
3. Describe the Chronic Care Model
|
1. Organization focuses on improving the care of the chronically ill
2. Linkages to community agencies and a referral system in place 3. Patients encouraged to be active in their own health and become competent in management of illness 4. Physicians use evidence based guidelines in treatment and patient care 5. Continuity b/w primary and specialty care with liaison person. 6. Clinical information systems with care reminders for physicians and patients |
|
|
4. Define informal and formal services.
|
1. Informal: service provided at little or no cost, provided in the community, providers are familya dn friends, extent of service is not known.
2. Provided by formally organized groups or organizations, usually have a cost or fee, occurs when the informal system is unable or unwilling to provide the needed service. |
|
|
6. Describe the physician's role as the coordinator.
|
1. Work as the team leader and direct patients to programs or individuals that can assist with their care
|
|
|
2. PCPs take care of
|
acute and chronic illness, end of life care, home visits, obsatrics, inpatient care, mental health, can also act as the patient’s advocate.
|
|
|
1. Third party payers
|
indemnity, fee for service, what the market will bear
|
|
|
2. Private pay
|
no insurance, WV ranked 10th worst in US for not having insurance
|
|
|
5. Contractual
|
form of healthcare payment for:
prisons, military, local health centers, academics, local tenants, hospitals |
|
|
What are the 3 main aspects of HIPAA?
|
a. Health Insurance Portability and Accountability Act
iv. Three main aspects A. Privacy B. Security C. Transactions v. The patient has the right to privacy (confidentiality) and security in all transactions. |
|
|
discussing a patient to someone outside of healthcare would be a violation of what?
|
HIPAA
|
|
|
What are some ways to enhance your practice? 3
|
Continuing Medical Education (CME)
Self Assesment Peer Review |
|
|
What is P4P
|
Pay for performance
A. Financial reward for good care B. Penalty for poor care C. Report card |
|
|
what do physicians normally focus on? patients?
|
a. Physicians
i. Qualifications ii. Competence iii. Reputation iv. Ethics b. Patients i. Bedside manner ii. Promptness iii. Time spent with patient iv. Friendly and helpful staff |
|
|
What is POEMs?
similar to? |
Patient-Oriented Evidence that Matters
i. Summary of research that measure patient outcomes ii. Address questions of day to day practice iii. May change the way a physician practices PICOs (A. Patient Intervention Comparison Outcome) |
|
|
3 criteria of POEMs?
|
A. They address a QUESTION that we face as clinicians.
B. They MEASURE OUTCOMES that we and our patients care about: symptoms, morbidity, quality of life, and mortality. C. They have the POTENTIAL TO CHANGE THE WAY WE PRACTICE |
|
|
definiton of Evidence-Based Medicine
|
A. The conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient
B. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research |
|
|
Electronic Health Records
|
i. Tracks the patient’s history
ii. Better system to document care |
|
|
1. Describe the dimensions of medical treatment in regards to biological, personal, and environment
|
a. Biologica: Conventional medicine
b. Personal:Psychological reactions c. Environmental:For the provider and the patient |
|
|
2. Define community care.
|
Meeting the health care needs of the community through services both profit and non-profit
|
|
|
3. Define coordinated care.
|
a. Ensuring the patient receives the appropriate service at the right place at the right time
b. Coordination and integration of services to avoid fragmentation c. Provider serves as interpreter and integrator |
|
|
4. What was identified as the root cause of sentinel events (unexpected occurrence involving death/serious physical or psychological injury)?
|
a. Communication issues
|
|
|
5. Describe coordinated care in the managed care environment.
|
a. Provides access to required services
b. Assures the coordination of those services c. Monitors the effectiveness of those services and whether it is meeting the need |
|
|
List the dimensions of patient centered care (5)
|
a. Awareness and respect for the patient values and culture
b. Coordination and integration of care c. Information, communication, and education d. Physical comfort e. Emotional support --> Relieve fear and anxiety |
|
|
7. Describe the Chronic Care Model.
|
a. Organization focuses on improving the care to the chronically illness care.
b. Linkages to community agencies and a referral system in place. c. Patients encouraged to be active in their own health and become competent in management of illness. d. Physicians use evidence based guidelines in treatment and patient care. e. Continuity between primary and specialty care with liaison person. f. Clinical information systems with care reminders for physicians and patients |
|
|
8. Define informal and formal services.
|
a. Informal
i. Service provided at little or no cost ii. Provided in the community iii. Providers are family and friends iv. Extent of service is not known b. Formal i. Provided by formally organized groups or organizations ii. Usually have a cost or fee iii. Occurs when the informal system is unable or unwilling to provide the needed service |
|
|
what are the benefits of case management?
|
i. Improved care provided
ii. Reduced hospitalizations, days in hospital, and emergency room visits iii. Reduced need for crisis intervention services iv. Good communication essential to facilitate optimal care and provide the patient the opportunity to reach maximal functional potential. v. Increased patient satisfaction as well as receiving facilities, families, and the community. vi. Medicare (CMS) plans to move toward and reward successful care coordination that meets specified standards. |
|
|
what are the limitations of case management?
|
i. Limited time
ii. Limited personnel iii. Requires knowledge of resources and how to access iv. Requires multidisciplinary involvement v. Requires interdisciplinary involvement |
|
|
a broker is a component of case management, please briefly describe this
|
Linkage to the needed service
|
|
|
a Gatekeeper is a component of case management, please briefly describe this
|
Must go through you for the service
|
|
|
an Advocate is a component of case management, please briefly describe this
|
plans care and ensures receipt of appropriate service
|
|
|
an Educator is a component of case management, please briefly describe this
|
services, encouraging self help
|
|
|
an evaluator is a component of case management, please briefly describe this
|
appropriate, a good service
|
|
|
1. Describe the roles and functions of Health Care Teams and the impact these care models have on the patient and the team itself.
|
a. Shift from acute-care to chronic-care
b. Need to improve the quality of care and cost effectiveness |
|
|
2. Differentiate between a group and a team.
|
a. Group : A number of individuals assembled together with a common characteristic
i. Student spouses ii. US senate iii. Passengers in an airplane b. Team : A group working together to accomplish an agreed- to task i. Football team ii. Health-care team |
|
|
3. Describe the characteristics of an effective Health Care Team
just read this..it can't hurt |
a. Must have the capacity to adapt to changing and complex situations
b. Complementary skills c. Well defined working approach d. Meaningful purpose e. Clear performance goals f. Mutual accountability g. Small numbers h. Shared values |
|
|
4. Identify barriers to successful teamwork
just read it, you never know if you will recognize somethin on the test because of stupid cards like these |
a. The process is time consuming and requires matching of schedules
b. Collaboration requires communication among team members, which takes away from patient appointments c. May lead to an increased use of limited services and resources d. Possible dominance of the team by the medical provider e. On-going conflict resolution and goal reassessment f. Confusion and blurring of role boundaries g. Organizational barriers limit reimbursement for collaborative teams |
|
|
again these will be a question:
Unidisciplinary |
i. Functioning in isolation from other disciplines
ii. The “traditional” model One provider works independently to care for a patient |
|
|
b. Multidisciplinary
|
i. Members function as independent specialist who provide individual consultation
ii. They communicate minimally with each other |
|
|
c. Interdisciplinary
|
i. Coordinated care among health care professionals from various disciplines who are engaged in joint decision making and communication
ii. They also share responsibility and authority for the care of the patient. |
|
|
d. Transdisciplinary
|
i. Characterized by flexibility and overlap between disciplines
ii. Involves deliberate pooling and exchange of information, knowledge and skills with the patient’s goals being the focal point. |
|
|
Why do we need HCTs
read this. |
• The past 3 decades have witnessed fundamental changes in the way healthcare is delivered and financed in the US and other industrialized countries. Faced w/mounting economic, social and political pressures, health care institutions have struggled to adopt methods of quality improvement to enhance both pt outcomes and cost effectiveness.
• Medicine is becoming increasingly complex, esp w/the aging of the population; such that we’re seeing a shift from acute-care to chronic-care. Physicians are realizing that they can’t provide comprehensive care for all their pts and meet the healthcare needs of the community in an autonomous or UNI model of HC. • As a result there has been increasing reliance on collaborative teamwork among various healthcare specialties in pt care. • AND most recently (you already had a lecture on this) there is the touting of the Patient-Centered Medical Home. One of the directives of this model is TEAMWORK. • HOWever they are not very clear on what that means. |
|
|
Characteristics of a dream team
|
• Well-defined working approach: the ground-rules, the nuts and bolts of how the team should work. Performance goals:
• Small numbers: the ideal team is 6-12 members. • Components of a collaborative team: a common group of pts; common goals for pt outcome and a shared commitment to meeting these goals; Member functions are appropriate to an individuals education and expertise; A mechanism for communication, A mechanism fro monitoring pt outcomes. And mech for dealing w/conflict • Trust among all parties establishes a quality working relationship that develops over time as the team mbrs become more acquainted. • Knowledge is a necessary component for the development of trust. Knowledge and trust remove the need for supervision. • Shared responsibility suggests joint decision making for pt care outcomes and practice issues w/in the organization. • Mutual respect (you will hear about this again) for the expertise of each mbr of the team should be the norm. This respect is communicated to the pts consciously and unconsciously. • Communication—needs to be 2-way—a sharing of pt information and knowledge. No one should be afraid to share info d/t fear of criticism or inferiority. Communication is to enhance each other’s knowledge and to improve pt care. • Coop and Coord: promote the use of the skills of the team members, prevent duplication and enhance productivity of the practice. • Optimism: that this is the most effective method of delivery of quality care promotes success (by-in by all team members) |
|
|
For a dream team of physicians, what size team do you want?
|
small: 6-12
|
|
|
what are 2 large barriers to team work?
|
“a successful team requires on-going conflict resolution and goal reassessment” is a barrier to team work because if failure at these tasks occur it may impair health care delivery
Reimbursement |
|
|
who is the number one member of a core team?
|
patient and family!
|
|
|
Water's Edge Game
what is the job of a health planner |
to figure out health trends and what a community needs to be safe and healthy, helps provide info to ppl who set public policy and make laws
|
|
|
Water's Edge Game
What is a classic example of understanding and resolving a social problem through the use of spatilal analysis? |
London Cholera Epidemic
some dude shut off the water when he saw ppl were dying in one area |
|
|
Water's Edge Game
job: epidemiologist, describe it |
identifiying what to look for, knowing who is at risk, and figuring out ways to stop the spread of disease
|
|
|
Water's Edge Game
what is a zoonotic disease? |
disease shared by animals and humans (ex: mad cow disease)
normally rare in humans normally due to fecal contamination of water |
