Week 2 PANCE material Flashcards
List the rights of patients
What are the 5 rights of patients related to treatment?
1) Receive tx
2) Consent to tx (accept or refuse)
3) Privacy
4) Confidentiality
5) Compassionate EOL: End of life care
What are the 5 rights of patients not directly related to treatment?
1) Respect
2) Safety
3) Protection from physical assault
4) Spiritual care
5) Participation in research studies
Patients Rights and Responsibilities: Insurance Co./Hospital
Bill of Rights
HIPAA-privacy and confidentiality-Federal law
Right to preventative care (insurance)
No price gouging for preexisting conditions (insurance)
Not unenrolled if ill (insurance)
What should patients expect during their hospital stay according to the AHA bill of rights?
-High quality hospital care
-A clean and safe environment
-Involvement in your care
-Protection of your privacy
-Help when leaving the hospital
-Help with your billing claims
What is the rest of the AHA bill of rights (i.e. not incl. hospital stay stuff)
-Current info about medical information
-Financial impact
-Persons involved
-No retribution
-Advanced directive/living will
-Privacy
-Access to Medical Record- 4/5/21- 21st Century Cures Act “Open chart”
-Continuity of care
EMTALA: Emergency Medical Treatment & Labor Act:
1) When was it enacted?
2) What does it mandate? Explain
3) Participating hospitals that offer emergency services must provide what?
1) Enacted in 1986 by Congress
2) Public access to emergency services regardless of ability to pay
3) A medical screening examination (MSE) when a request is made for examination
treatment for an emergency medical condition (EMC), including active labor
EMTLA:
1) What are hospitals required to do?
2) What if they can’t stabilize the pt?
3) What does this include?
1) Hospitals are then required to provide stabilizing treatment for patients with EMCs
2) If a hospital is unable to stabilize a patient within its capability, or if the patient requests, an appropriate transfer should be implemented
3) Urgent Cares associated with a hospital system.
Medical Screening Exam Summary:
1) What allow physician assistants to conduct MSEs?
2) A hospital’s written policies must specify what?
3) What about in regards to individual PAs?
1) The EMTALA law and regulations
2) That PAs are among the providers qualified to conduct them.
3) Individual PAs must have privileges to perform the exams
True or false: Physician assistants can certify false labor if they are acting within their scope of practice as defined by the hospital and their individual privileges.
True
True or false: Physician assistants can take emergency room call under EMTALA.
True
Can PAs transfer patients? Explain
1) The EMTALA regulations allow “qualified medical personnel” other than physicians to order the transfer of emergency patients.
2) If a physician assistant is going to certify transfer of an unstable patient to another emergency department, the law requires that the PA first consult with a physician before ordering the transfer. Subsequently, the physician must co-sign the order within a timeframe specified in hospital policy.
Explain what HIPAA is and who created it
1) The US Department of Health and Human Services (HHS) issued the HIPAA
-(aka The Health Insurance Portability and Accountability Act of 1996 (HIPAA))
2) A Federal law
3) Was the creation of national standards to protect sensitive patient health information from being disclosed without the patient’s consent or knowledge
Give 4 examples of failures
1) Proper screen-PE
2) Stabilize
3) Inappropriate transfers
4) Know the capability of services around you or where you can transport
Applies to Urgent Care Centers*
What are the 10 most common HIPAA violations?
1) Denying Patients Access to Health Records/Exceeding Timescale for Providing Access
2) Impermissible Disclosures of Protected Health Information
3) Improper Disposal of PHI
4) Emailing ePHI to Personal Email Accounts and Removing PHI from a Healthcare Facility
5) Leaving Portable Electronic Devices and Paperwork Unattended
6) Snooping on Healthcare Records
7) Releasing Patient Information to an Unauthorized Individual
8) Releasing Patient Information Without Authorization
9) Impermissible Disclosures of Patient Health Records
10) Downloading PHI onto Unauthorized Devices
Give 3 examples of HIPAA violations
1) Brigham and Women’s Hospital– $384,000 penalty for filming patients without consent
2) Peter Wrobel, M.D., P.C., dba Elite Primary Care– $36,000 penalty for delayed response to patient’s request for a copy of their medical records.
3) Parkview Health– $800,000 penalty for the failure to securely dispose of paper records containing PHI
PAs are mandated reporters; we have an ethical and professional responsibility to report suspected abuse, especially in who?
Children, geriatric, domestic partners, any vulnerable pt
What are some guidelines for mandated reporting?
-Reasonable suspicion
-PA does not investigate
-Alert parents of filing
-Have clear documentation of hx, PE, historian, all present, quotes, photos
-Sexual abuse, physical abuse, neglect, sex trafficking
How should you phrase things to the patient when it comes to mandated reporting?
“The physical examination shows concerning findings, so we have to report to XYZ to make sure the child is safe.”
“The physical examination shows unexpected findings given the history, so we need to file a report with XYZ to investigate.”
Can you fire a patient?
Yes
List the first 5 pt responsibilities
1) Are truthful and forthcoming with their physicians/providers and strive to express their concerns clearly.
2) Provide as complete a medical history as they can, including providing information about past illnesses, medications, hospitalizations, family history of illness, and other matters relating to present health.
3) Cooperate with agreed-on treatment plans. Patients should disclose whether they have or have not followed the agreed-on plan and indicate when they would like to reconsider the plan.
4) Accept care from medical students, residents, and other trainees under appropriate supervision… nonetheless, patients’ (or surrogates’) refusal of care by a trainee should be respected in keeping with ethics guidance.
5) Meet their financial responsibilities regarding medical care or discuss financial hardships with their physicians.
List the last 5 pt responsibilities
6) Recognize that a healthy lifestyle can often prevent or mitigate illness and take responsibility to follow preventive measures and adopt health-enhancing behaviors.
7) Be aware of and refrain from behavior that unreasonably places the health of others at risk. They should ask about what they can do to prevent transmission of infectious disease.
8) Refrain from being disruptive in the clinical setting.
9) Not knowingly initiate or participate in medical fraud.
10) Report illegal or unethical behavior by physicians or other health care professionals to the appropriate medical societies, licensing boards, or law enforcement authorities
What are the 3 elements of informed medical decision making?
1) Pt is acting voluntarily; no duress, fraud, force
2) Pt’s choice must be adequately informed; sufficient information on diagnoses, purpose of tests, benefits, risks, alternatives, prognosis, costs, etc.
3) Adequate decision-making capacity; cognitively & emotionally capable of weighing alternatives rationally, and understanding consequences
Define competence as a legal term
Refers to patient’s ability to act reasonably after understanding the situation
(if not competent– need guardian)
