Midterm Vocab Terms Flashcards
(87 cards)
1
Q
Healthcare Organizations (HCO)
A
A corporation providing the services of multiple patient care teams, such as a hospital or clinic, supporting care providers with clinical, logistic, and strategic services.
2
Q
Mission
A
The central purpose of an organization; its reason for existence
3
Q
Population Health
A
The health of a defined group of individuals, such as a state or civil division, or insured group, measured by the incidence and prevalence of disease or infirmity
4
Q
Benchmark
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The best performance on a specific measure of which the organization is aware
5
Q
Incidence
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The number of newly diagnosed cases of a disease
To find the incidence rate number of new cases divided by the number of people at risk for the disease
6
Q
Prevalence
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The total number of cases of disease existing in a population
7
Q
Best practices
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Work processes that have been proven to achieve benchmark
8
Q
Licensed independent practitioner (LIP)
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Any practitioner permitted by law and by the HCO to provide care and services, without direction or supervision
9
Q
Credentials
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Documented evidence of licensure
10
Q
Stakeholders
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Individuals or groups who have a direct interest in the organizations success
11
Q
Opportunities for Improvement (OFI)
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Where current performance is below the benchmark. Excellent HCO seek to resolve OFIs through creating an environment where improvement is a central part of the culture
12
Q
Patient centered care
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Care that is respectful and responsive to individual patient preferences, needs, and values
13
Q
Associates
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People who giver their time and energy to the HCO and its activities.
14
Q
Value based insurance design
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Linking financial incentives to the quality and efficiency of care provided
15
Q
Certificate of need
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Approval for new services and construction, expansion or renovation of hospitals or related facilities; issued in many states
16
Q
Health insurance portability and accountability act
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Federal law that addresses issues of health insurance but also requires HCOs and their workers to protect patient information and confidentiality diligently.
17
Q
Emergency treatment and labor act pg. 13
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Federal act requiring requiring all HCOs that provide emergency care to accept all patients, regardless of ability to pay, until the patient are stabilized and can be safely moved
18
Q
Community benefit pg.14
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Services provided gratis by HCOs to their surrounding communities. Current law requires hospitals to satisfy a community benefit standard to qualify as tax exempt charities under section 501C3
19
Q
The joint Commission (TJC) pg.14
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A voluntary consortium of professional provider organizations that evaluates and accredits a wide range of HCO’s
20
Q
External auditor pg.14
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A firm certified to review corporate financial statements an attest to their accuracy
21
Q
Critical access hospitals pg.16
A
HCO’s with 25 beds or fewer without nearby competition established to provide support for rural areas
22
Q
Safety net hospitals pg.17
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Hospitals with a disproportionate share of low income uninsured patients as defined by Medicare or Medicaid
23
Q
Health system pg.17
A
A set of HCO’s in several geographic sites under central strategic leadership
24
Q
Service line pg.17
A
Patient care teams organized and coordinated around a set of familiar diseases or patient needs
25
Federally qualified health center pg.20
Services for end underserved areas or populations that offer a sliding fee scale providing comprehensive services an have an ongoing quality program and have a board of directors this is funded under section 330 of the public health service act
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Accountable care organization (aco)page 20
group of health care providers that works collaboratively and accepts collective accountability for cost and quality of care for a specific population the patient centered medical home is an accepted model for becoming an aco
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Patient centered medical home pg.20
Mechanisms for organizing primary care to provide high quality care across the full range of individuals health care needs
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Transformational culture page 21
An environment of relationships between associates and between associate's and leadership that emphasize is every associate's right to question or criticize a work related process or decision that requires every leader to respond constructively to concerns or questions that are raised by associate's
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Continuous improvement pg.21
An ongoing organizational system that identifies improvement opportunities rank orders them and systematically analyzes and improves work processes to move team performance closer to benchmarks
30
Evidence based medicine pg.23
The conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients the central concept of judicious use is that what is justifiable or reasonable to believe depends on the trustworthiness of the evidence
31
Evidence based management pg.23
Management dad incorporates well established scientific findings regarding critical thinking human judgment decision making an learning to aid managers and acquiring quality information and putting it to use the set of practices that make up evidence based management achieve better quality results in organizations by improving the practitioners knowledge judgment and competencies
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Leaders
Associate to accept responsibility for achieving and maintaining excellence by supporting team efforts and team coordination many leaders were historically called managers
33
Empowerment
The practice of encouraging associate's to speak out about opportunities to increase mission achievement giving them the ability to change the workplace associate's are empowered when they believe they can change the workplace empowerment is sustained by managers constructive responses
34
Service Excellence pg39
Consistently meeting and managing patient expectations through several means using evidence as the guiding principle strengthening empowerment an focusing leadership on supporting an improved team achievement Alternatively stated doing the right thing at the right time for the right person with the best possible outcome
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Internal customers pg.40
Associate in teams who rely on other associates in teams in the HCO
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Agency or accountability pg.41
The notion that an individual or team commits to fulfill a specific prearrange expectation or Conversely that the organization can rely on their commitment
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Rounding pg. 42
Have face to face contact and a deliberate effort to communicate at the work site clinical rounding is an important part of ongoing care of patients it occurs at the patient's bedside administrative rounding occurs when leaders meet associate's at the associate's work site
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Chief executive officer (ceo) pg. 46
The agent of the governing board who holds formal accountability for the entire organization
39
Reward
Any leadership action that is favorably received by recipients and that is offered for the achievement of or attempt at a desired result rewards include comments encouragement and recognition they all can also include payment or gifts
40
Service recovery pg. 51
A program authorizing frontline associates to make small patients or guest who have been inconvenienced. An unexpected event report must record the event, the individuals involved, and the payment
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Unexpected event report pg. 51
Written documentation of any unusual event that caused, or might have caused failure, injury loss, or property damage. The report comprises a brief description naming associates, patients, and guests involved, identifying what happened and whether injury actually occurred it is signed and dated
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Communication and resolution pg. 51
A program investigating all unexpected events involving patient or guest harm. Events are carefully studied to identify causes. It the HCO is liable, victims are offered appropriate compensation and court trial is avoided.
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Operational scorecard aka balanced scorecard pg. 68
A monthly quantitative report of activity and goals for a single team or work unit. Measures are specific to each teams needs. There is at least one reliable measure for each input dimension and each output dimension. Each measure has a goal
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Strategic Scorecard pg. 70
Measures of overall enterprise performance grouped in major dimensions – operations customers associates and suppliers and finance. The strategic scorecard provides quantitative mission achievement for the governing board, senior leadership, major subsidiaries and service lines.
45
Epidemiologic planning model pg. 75
A system to forecast specific health needs for the HCOs service community based on unbiased population forecasts, multivariate analysis of disease trends, and judgements of planning teams.
46
Leadership hierarchy pg. 80
Reporting and communication system that links each associate and each operating unit to the governing board, usually by grouping similar centers together under coordinating leadership
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Reserved powers pg. 83
Decisions in HCO systems that require approval of central governance
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Process analysis and improvement pg. 83
A rigorous system of opportunity identification, analysis, process improvement, and implementation
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Lean and six sigma ph. 84
Formal methodologies for analyzing work, designing process improvements, and ensuring that new methods are appropriately tested
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Performance improvement council (pic) pg. 85
A selected group of leaders, always including senior leadership and representatives of all exhibit 1.2 teams, charged with reviewing and ranking OFIs pursuing the most promising by forming and supervising PITs providing analytic support and identifying achievable improvement goals.
51
Inurement pg. 101
Distribution of nonprofit assets to an individual or corporation. Although individuals and corporations can be compensated for their services, compensation that exceeds fair market constitutes inurement. Inurement jeopardizes tax exemption
Trustees pg. 101
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Trustees pg. 101
Members of the governing board of not – for - profit HCOs who volunteer their time to the organization The title reflects their acceptance of the obligation to manage the HCO assets in trust for the community. They may also be called directors.
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Clinical staff bylaws pg.106
A formal document establishing the contract between the HCO and its licensed independent practitioners including the requirements for accepting individual practitioners the procedures for review of performance and discipline and the obligations of practitioners to participate in quality improvement
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Privileges pg.106
The contract between the HCO and each LIP authorizing the LIP to provide specific kinds of care to patients
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Clinical staff organizations pg.107
The organizations of an HCOs LIPs that implements evidence based medicine, establishes expectations for quality of individual LIP performance, conducts peer review and facilitates communication from LIPs to the governing body
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Long range financial plans (LRFP) pg.108
An ongoing projection of financial position showing earnings debt and capitalization for at least the next seven years
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Management letter pg. 112
Comments of external auditors to the governing board that accompany the audited financial report
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Compliance program pg.113
Programs designed to meet statutory and regulatory requirements may be based on legislation or voluntary efforts such as accreditation
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Governance bylaws pg.122
The set of procedural rules adopted by the board and followed in discussion actions the rules established procedures that protect individual members from liability.
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Patient management guidelines pg.145
Firmly established expectations that define the normal steps or processes in the care of a clinical related group of patients including recommendations intended to optimize patient care that are informed by systematic review of evidence and an assessment of the benefits and harms of alternative care options.
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Credentialing pg.151
The process of validating a professional care providers eligibility for clinical staff membership and for privileges to be granted based on academic preparation licensing training certifications and performances.
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Prevention
Direct intervention to avoid or reduce disease or disability.
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Primary prevention p156
Activities that take place before the disease occurs to eliminate or reduce its occurrence.
Examples include immunization use of seatbelts sewage treatments an restriction on alcohol sales
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Secondary prevention
Activities that reduce the consequences of existing disease often by early detection and treatment.
Examples include early detection and treatment self - examinations for cancer and routine dental inspections or Mammograms.
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Tertiary prevention
Activities that reduce or avoid complications or aftereffects in existing disease or disability.
Examples include early physical therapy for strokes re training and activities after injury.
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Residents
License physicians who pursue post graduate education in a medical specialty
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Fellow p192
Residents who pursue advanced study usually in subspecialty
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Programmatic proposals p257
Proposals for new or replacement capital equipment for major revisions of services.
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Telemedicine Pg.267
The use of medical information exchange from one site to another via electronic communication to improve a patient's clinical health status
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Community needs assessment pg.277
a process for identifying and quantifying opportunities for improvement in a community
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Data management system pg. 311
A system for aggregating an disaggregating electronic data designed to facilitate recovery and use.
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Meaningful use p315
Measurement thresholds that range from recording patient information and structured data in the EHR to integrating the information across care providers and demonstrating value in exchange for incentive payments from the Centers for Medicaid and Medicare services also known as CMS.
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Medicare access and CHIP reauthorization act (MACRA) pg.315
A cms incentive program that rewards clinicians use of certified health information technology.
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Big data pg. 316
Large and complex data sets that may be analyzed for pattern.
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Specifications page 319
in statistical analysis that identifies values for a measure by defined subsets of a population, to allow accurate comparison for each specific group
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adjustment page 319
a statistical technique to aggregate values for specified at population subsets, allowing comparison of samples from populations with differences in the relative size of subset populations.
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statistical process control page 320
a method of identifying significant changes in measures subject to random variation.
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Legacy system page 321
Outdated computer software that lacks the features found in more current versions.
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Cultural competence page 348
a set of complementary behaviors, practices, and policies that enables a system, an agency, or individuals to work and affectively serve pluralistic , multiethnic, and linguistically diverse communities
80
Position control pg351
A system of payroll control that identifies specific positions created and filled.
81
Facilities Master Plan pg.370
A document that begins with an estimate of the space needs of each service or activity proposed in the services plan
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Sustainability
Equality of not being harmful to the environment or depleting natural resources, thereby supporting long-term ecological balance.
83
Preventive maintenance page 377
care and servicing by personnel for the purpose of maintaining equipment and facilities and satisfactory operating condition by providing for systematic inspection, detection, and correction of incipient failures either before they occur or before they develop into major defects.
84
Group purchasing page 385
cooperatives that use the collective buying power of several organizations to leverage prices downward.
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National Incident Management Systems (NIMS) page 386
A systematic proactive approach to guide departments and agencies at all levels of government nongovernmental organizations and the private sector to work seamlessly to prevent protect against respond to recover from an mitigate the effects of incidents regardless of cause size location or complexity in order to reduce the loss of life and property and harm to the environment.
86
Triage
A method of sorting patients according to the urgency of their needs for care.
87
Transfer price page 393
imputed price for an item of goods or service transferred between 2 units of the same organization, such as housekeeping services provided to the nursing units. The transfer price is based on cost of individual services
