Chapter 3 The Delivery Healthcare System

Front 1

Acuity

Back 1

clearness: minimum level or need for healthcare services that must be met for a client to be admitted to an acute care facility

Front 2

case management

Back 2

providing hight quality care while effectively using health care resources and controlling costs

Front 3

chain-of-command

Back 3

hierarchy of an organizational structure

Front 4

client

Back 4

a person who is a participate in his or her healthcare

Front 5

complementary healthcare

Back 5

methods and beliefs other than traditional western medicine

Front 6

co-pay

Back 6

predetermined fee that is charged to HMO clients at the time of an office visit

Front 7

holistic healthcare

Back 7

health care that emphasizing taking care of the whole person

Front 8

home healthcare

Back 8

a nurse monitoring a client in his or her home, often after being discharged while completing recovery from surgery or an illness

Front 9

hospice

Back 9

a facility or program of care that is specifically designed to provide emotional and physical support to end of life clients and their families

Front 10

incentive programs

Back 10

rewards given to employees by their employer for practicing healthy habits such as smoking cessation, weight loss and having regular physical examination

Front 11

managed care

Back 11

a plan for continual monetary and maintenance of an individuals health

Front 12

Medicaid

Back 12

is a joint effort of federal and state government; it's a public tax supported health insurance program for which people must qualify; again, a joint effort of federal and state governments

Front 13

Medicare

Back 13

federal health insurance program available to nearly every one over the age of 65 regardless of financial status and to younger people who qualify

Front 14

outcome-based care

Back 14

quality management in which delivery of care is judged by results achieved

Front 15

patient

Back 15

individual being treated by a healthcare provider now called a client

Front 16

prospective payment

Back 16

reimbursement for healthcare made by third party payors according to a formula or average reimbursment for average cost per case

Front 17

quality assurance

Back 17

standards of care that represent acceptable expected levels of performance by nursing staff and other staff members

Front 18

respite care

Back 18

care provided for long term for chronic clients so family members can have some time off or time away

Front 19

telehealth

Back 19

telephone nursing and health counseling

Front 20

third-party payment

Back 20

system developed to help individuals pay for the costs of medical bills usually a health insurance plan

Front 21

CQI

Back 21

contiguious (or continous) quality improvement

Front 22

DRG

Back 22

diagnosis related groups

Front 23

ECF

Back 23

extended care facility

Front 24

HMO

Back 24

health maintenance organization

Front 25

ICF

Back 25

intermediate care facility

Front 26

ICU

Back 26

intensive care unit

Front 27

JCAHO

Back 27

Joint Commission on Accreditation of Healthcare Organizations

Front 28

NLN

Back 28

National League of Nursing

Front 29

OSHA

Back 29

Occupational Safety and Health Association

Front 30

POS

Back 30

point of service

Front 31

PPO

Back 31

preferred provider organization

Front 32

QA

Back 32

quality assurance

Front 33

RUG

Back 33

resource utilization group

Front 34

SNF

Back 34

skilled nursing facility

Front 35

SSDI

Back 35

social security disability insurance

Front 36

UAP

Back 36

unlicensed assistance personnel

Front 37

Services Commonly Found in an Acute Care Facility:

Back 37

Administration

Admitting

Ambulatory Care/Outpatient Surgery

Dietary

Emergency Care

Home Health

ICU

Laboratory

Medical Unit

Neonatal

Obstetrics and Gynecology

Pediatrics

Physical Therapy

Radiology

Respiratory Therapy

Surgical Unit

Telemetry Unit

Transitional Unit/Step down Units

Front 38

Types of Ownership of Healthcare Facilities:

Back 38

Profit Oriented(Proprietary)

-Individual

-Partnership

-Corporation

Nonprofit(Voluntary)

-Church Associated(Loma University Medical Center)

-Private School Associated

-Foundation Associated(Shriners Hospital)

Nonprofit(Government)

-Federal(Veterans Administration, active duty military hospitals)

-State(university,hospital)

-County(city, or county hospital)

-City-County(city or county hospital)

Front 39

Resources for the 21st century must include the following heathcare priorities:

Back 39

-Primary care services for medically underserved populations, especially those in rural or economically depressed areas.

-Mobile services available in low population areas, such as visits from mobile mammography, magnetic resonance imaging, or computed tomography scan units by truck/plane to theses areas on a scheduled basis.

-Multi-institutional systems for the coordination or consolidation of expensive or specialized health services

-The development of institutions on a geographically integrated basis to prevent excessive duplication of services.

-Multi-institutional arrangements for sharing support services

-Uniform cost accounting, simplified reimbursement, and utilization reporting systems

-Improved financial management procedures.