Final Flashcards
(135 cards)
1
Q
Describes the structure and processes by which responsibilities for patient care area assigned and the means by which the work is coordinated among caregivers.
A
workforce management
2
Q
describes the mechanism for documenting and reporting staffing concerns
A
workforce management
3
Q
A method or system for organizing and delivering nursing care
A
patient care delivery model
4
Q
includes the manner in which nursing care is organized to deliver the care necessary to meet the needs of the patient.
A
patent care delivery model
5
Q
The patient care delivery model encompasses:
A
work delegation resource utilization communication methodologies clinical decision making processes management structure
6
Q
A ____ approach is needed with all disciplines, focusing on continuity of care service.
A
systems
7
Q
patient care delivery model where work is assigned by tasks
A
functional nursing
8
Q
patient care delivery model where a nurse is assigned as the lead caregiver to plan and coordinate care
A
primary nursing
9
Q
patient care delivery model where a team provides care based on tasks and skills levels and competence
A
team nursing
10
Q
patient care model where a two person team prvides care to groups of patients
A
modular nursing
11
Q
patient care model where a nurse coordinates care using clinical pathways and quality criteria
A
care management nursing
12
Q
Patient workforce management includes:
A
- est. of pt. care delivery model
- ID pt. care needs & nurse interventions
- creation of core staffing schedule
- daily staffing process match w/ pt. care needs
- evaluation of value & outcomes
13
Q
4 areas of focus to complete work in a digital complex world:
A
divide knowledge work into discrete, assignable tasks
recruitment of workers based on work pieces
assurance of work quality
integration of the work pieces
14
Q
assignment of work should be based on:
A
skills, licensure & competence
15
Q
The optimal delivery model for the future is driven by ___ and ___ and ensures ___ & the achievement of ___
A
principles & assumptions; coordination of efforts; value based outcomes
16
Q
HIstorically staffing patterns were based on:
A
what was needed in the previous year
17
Q
The underlying assumption of a staffing grid or ratio-based staffing is that:
A
all patient’s are similiar in needs
18
Q
Advantages of nurse-patient ratios:
A
- considers historical average patient acuity
- provides incentives for nurses to return to bedside
- uses simple to regulate #s
- increases nurse satisfaction
- alleviates nurse stress
- marginally supported by evidence
- provides a short term solution to complex problem
19
Q
Disadvantages of nurse-patient ratios:
A
- doesn’t fix the problem
- doesn’t consider evidence for effective staffing
- may become max. staffing levels rather than min.
- does not consider variation in pt. needs
- does not consider variation in staff competence
- assumes nurses are able to meet ratios
- forces closure of some hospitals
- devalues nurse’s critical thinking
- assumes a manufacturing model is appropriate for pt. care
- shifts staffing accountability to the government
20
Q
With recent healthcare reform legislation, the emphasis has shifted from ___ model to a ____ ___ model that integrates all settings in which patient care is provided
A
event-based; continuum accountability
21
Q
The creation of DRGs was mostly for what purpose?
A
billing
22
Q
What were the areas of nurses work that were not being addressed before the patient classification system emerged?
A
patient education
family support
interdisciplinary collaboration
23
Q
The goal of a patient classification system is to provides the most ___ an d___ information specific to work that needs to be done for patients.
A
valid; reliable
24
Q
The ordering of entities into groups of classes on tha tbasis of their similarity, minimizing within-group variance and maximinzing between-group variance
A
classification
25
The level of need or dependency of an individual patient, measure in hours of care needed by skill level.
patient acuity/intensity
26
A process of grouping patients into homogenous, mutually exclusive groups to determine their dependency on caregivers or to determine patient acuity.
patient classification
27
The long-range plan that combinest he organization's goals, legislation, regulation, and accreditation requirements and planned patient demand.
scheduling
28
The real-time adjustment of the schedule based on census, acuity, and mix of available resources.
staffing
29
The comprehensive system that includes patient classification, scheduling, staffing, and budgeting system.
workforce management
30
___ are taken for cost reduction.
motion studies
31
___ are performed for cost control reasons.
time studies
32
___ focus on design
motion studies
33
___ focus on measurement
time studies
34
A ____ is designed to determinet he best way to complete a repetitive job.
motion study
35
A ___ measures the length of time it takes an avergae worker to complete a task at a normal pace.
time study
36
The technique of ___ samples work activities at systematic or random intervals.
work sampling
37
Invoels randomly observing people working to determine how they spend their time
work sampling
38
In healthcare, ___ has been the foundation for some computerized patient classification systems.
work sampling
39
The extent to which a workforce management system measures what it is designed to measure.
validity
40
The extent to which data are reproducible.
reliability
41
The 3 types of reliability include:
stability, homogeneity, and equivalence
42
The most important type of reliability for workforce management systems is:
equivalence or interrater reliabilty
43
Refers to the extent to which different nurses use the same workforce system to measure the same individual, at the same time, to derive consistent results.
Equivalence
44
A tool developed to help clinicans and hospitals monitor quality of care and utilization of services
DRG system
45
Why we need a patient classification system:
- to understand the relationship among pt. care needs, interventions, outcomes, and the skill level of caergiverrs
- to define the amount of staff needed for a situation
- to create a valid and reliable systemt hat defines and defends the work of professionals
46
___ is subjecive, but is shown to have high face validity
self-reporting
47
Uses time standards developed from past experiences.
standard data setting
48
Standard data setting is specific to the individual environment & typically the __ & ___ to detemrine for manufacturing settings.
most accurate; least costly
49
The ___ technique attempts to remedy the criticism levied against the __ technique's inability to capture professional judgment required in health care.
Expert opinion; work sampling
50
___ ___ is reliable only if the results obtained approximate teh results generated by experts, and the estimates are valid & reliable.
Expert opinion
51
Much of nursing is __ rather than ___
mind work; hand work
52
ONe solution for improving the validity and reliability of caregiver work measurement is to attach __ and ___ ___ ___ to clinical interventions in an electronic documentation system.
time; skill mix standards
53
Present when the reported patienta cuity increases slowly over time but the acutal care does not change.
acuity creep
54
Fitzpatrick & Brooks identified the role of ___ as logistician
clinical leader
55
___ ___ is mor econcerned with determining the time required for care; the ___ ___ ___ is secondary information
patient classification; patient acuity level
56
Limitations of patient classification systems:
- low validity
- misuse of the tool
- difficulty in projecting future staff needs
- failure to use the data generated
- lack of tool simplicity
57
Represents an aggregated average number and skill mix required for patient care.
core schedules
58
Responsibility derives from how wellt he wokr is done & is based on __ ___ ___ & ___
knowledge, evidence, competence, and efficiency
59
A ___ staffing model has emerged as the preferred means to support unit involvement and decision making and central records management.
hybrid
60
A hybrid staffing model develops between ___ & ___ staffing processes
centralized; decentralized
61
The right to self determination; being one's own person without constraints imposed by another's actions of psychological and physical limitations.
autonomy
62
Means that individuals are respected and allowed to make their own edecisions about issues that affect them.
autonomy
63
Refers to actiosn taht promtoe the wellbeing of others.
beneficence
64
The rbeaking or violation of a presumptive contract, trust, or confidence that produces moral and psychological conflict within a relationship betweeni ndividuals, organiizations, or between individuals and organizations.
Betrayal
65
A complete break from previously decided upon or presumed norms by one party from the others
betrayal
66
A study that questions surroundign biology, medicine, and the health professions.
bioethics
67
Brief excursions from an established boundary for a therapeutic purpose
boundary crossing
68
Crossings made based on what is best for the needs of the client.
boundary crossing
69
A deviation from the established boundary in the healthcare provider-client relationship in which the healthcare provider's needs and the client's needs are confused.
boundary violation
70
Characterized by role reversal, secrecy, and sometimes the creation of a dual relationship with the client.
boundary violation
71
Guidelines for behavior specific to a moral framework for professional practice.
code of ethics
72
The sum total of individual and collective experience, knowledge, and good sense.
collective ethical wisdom
73
A problem that confronts a person with a choice of solutions that seem or are equally unfavorable.
ethical dilemma
74
Occurs when one value is pitted against another value
ethical dilemma
75
The subtle, even unnoticed, slippage of ethical standards.
ethical erosion
76
A pervasive, subtle negative dynamic resulting from a decreased focus on values in small and often unnoticed slippages.
ethical erosion
77
slight deviations from the normalc ourse of events.
ethical erosion
78
A process that obscures the ethical dimensionso f a decision.
ethical fading
79
The philosophical study of right action and wrong action.
ethics
80
also known as morality
ethics
81
Rejects the traditional male-centered ethics that has focused on rationality, individuality, and abstract principles in favor of emotion, caring relationships and concrete situations.
ethics of care
82
Duty to keep one's promise; the quality of being faithful.
fidelity
83
Actions tahat support and promote the patients' healthcare rights and enhance community health and policy initiatives tha focus on the availability, safety, and quality of care.
health advocacy
84
The elimination of arbitrary distinctions and the establishment of a structure of practice with a proper share, balance, or equilibrium among competing claims.
justice
85
A concept of moral rightness based on ethics, rationality, law, natural law, religion, or equity.
justice
86
Care at teh end of life from which there is little hope of benefit.
medical futility
87
Withholding of such care does not encourage or speed the natural onset of death.
medically futile
88
3 causes of moral distress:
- poor-quality & futile care
- unsuccessful advocacy
- raising unrealistic hope
89
The process in which an individual tries to determine the difference betweenw aht is right what is wrong in a personal situation by using logic.
moral reasoning
90
The conventional beliefs of a particular society; the degree of congruence between what one perceives as right and one's actual behavior.
morality
91
The differentiation among intentions, decisions, and actions betweent hose that are good and bad.
morality
92
duty to do no harm
nonmaleficence
93
Theme ans of producing stronger, sustainable performance through ethical pathways consistent with the vision, mission, and values of the organization.
organizational integrity
94
A state of wholeness and peace eperienced when our goals, actions, and decisions are consistent with our most cherished values.
personal integrity
95
Rejects the esoteric metaphysics of traditional european academic philosophy in favor of more down to earth, concrete questions and answers.
pragmatism
96
According to Dewey, the ___ may be used to solve moral problems from a pragmatic perspective.
scientific method
97
According to Kant, a moral action is distinguished from an immoral action in that the person acts from a sense of __, not from inclinations of feelings.
duty
98
A guideline derived from philosophical perspectives.
principle
99
A law or rule that has to be followed
principle
100
The limits of the professional relationship that allow for a safe therapeutic connection between the healthcare provider and the client.
professional boundary
101
When a person knows what is right and does not want to do it.
rationalization
102
Refers to a process in which an increasing number of social actionas become based on considerations of teleological efficiency or calculation rather than on motivations derived from morality, emotion, custom, or tradition
Rationalization
103
The choices that conform to ethical norms or principles.
right choice
104
The degree to which one can be relied on without surveillance by the observer.
trust
105
The princple or utility or the greatest happiness principle.
utilitarianism
106
truth telling, or the duty to tell the truth
veracity
107
action taken by a person who goes outside the organizatoin for the public's best interest when the organization is unreponsive after the danger is reported thorought he organization's proper channels.
whistle-blowing
108
___ infers that one individual is vulnerable to the actions of another
trust
109
another word for errors
practice breakdown
110
The disruption or absence of any of the aspects of good practice
practice breakdown
111
Required for the basic budget:
projected work volume, operating budget, personnel budget
112
Includes required supplies, equipment, and support for the physical setting to provide patient care
operating budget
113
includes required personnel to provide and support the identified patient care.
personnel budget
114
The source of funding comes from the previous year's organizational profits.
capital budget
115
combine graphics and number to quickly display important data elements.
dashboards.
116
The greatest challenge in using dashboards is:
to identify and measure what really matters; which metrics are critical variables
117
____ variances occur in levels of ocmpetence, responses to treatments, timing of intervetnions, and communication styles.
natural
118
___ variances are those that one wants to eliminate, such as errors, lack of knowledge, or ineffetive scheduling.
artificial
119
The goal of variances is to minimizes the ___ and eliminate the ___ to improve forecasting accuracy.
natural variances; artificial variances
120
Analysis of variances is best focused at the __ level
micro
121
The point at which a meaningful interpretation can be made and a focused inervention implemented.
micro level
122
The goal of variance analysis is to strengthen the ___ and minimize ___ when a gap exists between what was available and what was needed.
accuracy of predictions; crisis management and intervention
123
Everything that has a target will have a __
variance
124
Workforce management in health care requires and understanding of the nature and complexities of the dynamics in providing:
The right nurse with the
right patient at the
right time
125
The patient care delivery model emerges from the:
organizational mission, vision, values, & structure
126
The amount of patient care staff, skill mix, and necessary support staff needed is compared to the identified patient needs.
daily staffing process
127
Variance management requires analysis of _______ as well as total variance hours.
individual caregiver variances
128
First step is to understand the _______; next step is to analyze and interpret the effectiveness of the plan specific to ability to provide patient care effectively.
components of the system and process
129
serve the function of educating employees and providing consultative services.
ethics committees
130
Addressing ethical issues and dilemmas requires:
logical, prompt, & principle based actions
131
Includes elements of anticipated volume of work, cost of the work to be accomplished, expenses required to make that work a reality
budgeting
132
advantage of focusing on combinations of metrics or aggregate metrics
value of assessing multiple perspectives
133
Disadvantages of focusing on combinations of metrics or aggregate metrics.
some prefer one metric, usually a financial metric
134
Categories of variances:
personnel, finances, technology, equipment, and time
135
interdisciplinary models of care include:
practice partnerships, patient centered care, and primary care partnerships
