Week 3 Flashcards
1) Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) was developed when?
2) What is the significance of responses?
1) 2012 by Agency for Healthcare Research and Quality (AHRQ)
2) Press Ganey Associates distributor for HCAHPS-30 responses considered significant
__________________ (CMS) offers financial incentives based on quality measures, including results of HCAHPS
Center for Medicare and Medicaid Services
List the 3 main debate issues surround Press Ganey
1) Should your salary/bonus be affected by Press Ganey scores?
2) Pts who leave a poor score because of the front desk staff
3) Pts who leave you a poor score because you didn’t give them what they wanted
(not needed)
a) Ethical dilemma between pt satisfaction and practicing evidence-based medicine
What is the Press-Gainy?
The survey is designed for all (not just Medicare) adult patients discharged from general acute-care hospitals after an overnight stay.
1) The Press-Gainey survey also includes ________ screener questions and ______ demographic items, which are used for adjusting the mix of patients across hospitals and for analytical purposes.
2) The survey is _____ questions in length.
1) four; seven
2) 32
There are four approved modes of administration for the CAHPS®Hospital Survey; list them
1) Mail Only
2) Telephone Only
3) Mixed (mail followed by telephone)
4) Active Interactive Voice Response (IVR).
Give examples of an impaired provider
1) Inability to Practice medicine with reasonable safety and skill
-Medical, mental, addiction, disruptive
2) Ex-stroke provider, Parkinson’s
3) Drugs and alcohol
Failure to report to NCCPA any adverse legal action within ____ days of conviction of (including a guilty plea or no contest plea) (i) any felony; (ii) any misdemeanor related to health care practice, violence, drug offenses, sex offenses, or fraud; or (iii) any other misdemeanor with a minimum penalty of more than 30 days in jail, except for traffic infractions, first-time DUI offenses, disorderly conduct, obscenity, tax violations, or trespassing.
30
NCCPA: A PA shall practice without impairment from substance abuse and shall practice without impairment from cognitive deficiency or mental illness that, even with ___________ ____________ _________________, adversely affects their practice.
appropriate reasonable accommodation
Per AAPA: A PA’s ethical responsibility to identify
and assist impaired _____________ or report
providers
Give examples of disruptive behavior that interfere with care
1) Provider with Tourette’s
2) Issues at home
3) Relationship issues
4) Receiving phone calls/visits
5) Medical conditions
Tennessee Medical Foundation Physician’s Health Program; what does it do?
Initially focused on alcohol and drugs, now much more included
a) psychiatric disorders
b) burnout
c) stress or anxiety
d) anger and relationship issues
e) disruptive behavior
f) overprescribing
…issues that can impair a Physician Assistant’s ability to practice safe and effective medicine.
Voluntary Track [for impaired providers]:
1) What is it?
2) What does it promote?
3) Is it enforacable?
1) A confidential process of seeking assistance without required personal identification to the state licensure board whereby the potentially impairing illness is addressed.
2) A voluntary track promotes earlier detection of potentially impairing illness before it becomes functionally impairing.
3) A safe system whereby substantive non-compliance or relapse, depending on each state’s non-compliance reporting requirements, will be promptly reported to the licensure board by name.
Mandated Track [for impaired providers]:
1) What is it?
2) What does it require?
1) Mandated licensees are those required by the state medical board to participate in a PHP. A mandated referral can be via an informal referral or via a formal disciplinary process that is public.
2) In either instance the board may require quarterly progress reports. It is recommended that boards have a non-disciplinary process for referral to PHPs to encourage early detection and intervention.
List 5 things that can contribute to burnout
1) Family responsibilities
2) Time pressure
3) EHR
4) Chaotic environment
5) Low control of Pace
Approx. ____% of burnout occurs due to EMRs
50%
Define burnout
Overextended, “used up”, nothing left to give
Describe the emotional exhaustion domain of burnout
1) Diminished sense of accomplishment
2) Cynicism-(have you heard this at the nurse’s station?)
3) Negative; Hostile
4) Caring too much
5) Overcommitment
Describe the depersonalization domain of burnout
1) Feeling disconnected or detached
2) No empathy
Describe the low personal achievement domain of burnout
1) Impossible expectations
2) No positive reinforcement
3) Pt is right
4) Focus on the negative
5) Low/bad pt outcomes
6) Limits of healthcare system
7) Focusing on mistakes or what went wrong-perfectionism
8) Lack of control
Why are women more likely to experience burnout?
Strong emotional connections
Children
Work-home conflicts
Partner in non-medical profession
Which personality types (male and female) are more likely to experience burnout?
Agreeable, extraverted, conscientious
(people pleasers)
Burnout leads to higher rates of what?
Depression, suicide, substance abuse and medical errors
List the negatives of burnout
1) Patient care
2) Patient outcomes/medical errors
3) Professionalism
4) Poor work/life balance
5) Provider’s health and safety: Suicide, Depression, Work conflicts, Substance abuse, MVAs
6) Healthcare systems and organizations
