Kelly Vana's Nursing Leadership and Management

5 Answer: A is correct.Rationale: Payment for health care services as a fixed dollar amount per member over a period of time is referred to as (A) traditional fee for services, so not (B) prospective payment system, (C) capitation, or (D) diagnostic related groupings.

6 Answer: B, C, D, E, and F are correct answers.Rationale: The Patient Protection and Affordable Care Act provides comprehensive health care reform through a number of initiatives, including all except (A) restricting in‐patient hospital stays. (B) Expanding health insurance coverage, (C) targeting fraud, abuse, and waste in health care, (D) increasing access to primary care services, and (E) promoting preventive health strategies, are all correct.

7 Answer: A, B, C, D, and E are correct answers.Rationale: Key factors contributing to rising health care costs in the United States include (A) an aging population, (B) advancements in technology, (C) increased utilization of pharmaceuticals, (D) rising costs of primary care, and (E) administrative costs.

8 Answer: A is correct.Rationale: The competencies for the education of health care professionals recommended by the Institute of Medicine to improve the quality of health care include all except (A) primary care settings. They do include (B) a patient‐centered approach, (C) use of health information technology, or (D) evidence‐based practice.

9 Answer: B is correct.Rationale: The link between adverse patient outcomes and cleanliness was discovered by (B) Florence Nightingale, not (A) W. Edwards Deming, (C) Isabel Hampton Robb, or (D) Dorthea Dix.

10 Answer: C is correct.Rational: The three components of health care systems are: (1) structure (resources or “structures” required to deliver health care), (2) process (quality activities, procedures, and tasks performed to deliver quality health care), and (3) outcome (the results of good health care delivery). Therefore (A), (B), and D are all incorrect.

1 Although it is difficult to modify the entire structure of health care in the U.S., what could you do to modify the process of health care delivery to improve health care quality in your organization?

2 What strategies can be used to ensure patient access to appropriate health care services in public and private health care agencies?

3 How can the five IOM health professions competencies and the need for safe, high‐quality care be achieved in health care organizations?

1 Are all adverse events inevitable?

2 How is the FDA involved in improving patient safety?

3 Do sentinel events have to be reported to TJC?

4 What are the similarities in the measures of patient safety and the measures of quality of care?

5 Should only events that harm patients be reported to external quality and safety organizations?

6 Do patients have better outcomes when they stay in the hospital longer?

7 Name three of the QSEN competencies.

8 Does blaming a nurse for an error improve patient safety?

9 Name the six aims of the health care system from the IOM Crossing the Quality Chasm 2001 report.

10 Is improving quality and patient safety expensive?

With the ongoing debate about the cost and importance of everyone throughout the nation having access to health care, regardless of ability to pay, concern continues among the disadvantaged or low income groups about their future ability to access health care services. Unfortunately, this is a common scenario for all too many Americans. As the only industrialized nation in the world without UHC, the rising costs of health care, and the challenges of being able to access care at any time or any place, many in our nation will continue to be exposed to situations where the outcomes could have been better. As nurses, we may assume that patients will do the right thing when it comes to their health or the health of those that depend upon them. With experience and understanding of health care research, we know this is not always the case. We have tremendous opportunities to make needed changes in how health care can be accessed and payed for, as well as helping patients understand how they can best navigate the health care system.

FEDERAL GOVERNMENT:

Agency for Healthcare Research and Quality (AHRQ): www.ahrq.gov

Centers for Disease Control and Prevention (CDC): www.cdc.gov

Centers for Medicare and Medicaid Services (CMS): www.cms.gov

Department of Defense (DOD) TRICARE program: www.tricare.mil

Food and Drug Administration (FDA): www.fda.gov

Health Resources and Services Administration (HRSA): www.hrsa.gov

Indian Health Service (IHS): www.ihs.gov

National Center for Health Statistics: www.cdc.gov. Search for National Center for Health Statistics.

National Guidelines Clearinghouse: www.guidelines.gov

National Institutes of Health (NIH): www.nih.gov

Substance Abuse and Mental Health Services Administration (SAMHSA): www.samhsa.gov

Veterans' Health Administration (VHA): www.va.gov

PRIVATE FOUNDATIONS AND ORGANIZATIONS:

Commonwealth Fund: www.cmwf.org

Henry J. Kaiser Family Foundation (KFF): www.kff.org

Joint Commission (JC): www.jointcommission.org

National Committee for Quality Assurance (NCQA): www.ncqa.org

National Quality Forum (NQF): www.qualityforum.org

Robert Wood Johnson Foundation (RWJF): www.rwjf.org

Malcolm Baldridge Quality Award (MBQA): www.quality.nist.gov

Visit the Centers for Medicare and Medicaid Services Innovation Center: https://innovation.cms.gov and review the innovation models and see where the partners are located. You can share your ideas here as well.

Although it is difficult to modify the structure of health care, what could you do to implement a system to continually modify the process of health care delivery to improve health care quality in your organization?

What are strategies to ensure patient access to appropriate health care services in public and private health care agencies?

How can the five IOM health professions competencies and the need for safe, high‐quality care be achieved in the current workplace?

1 Abimanyi‐Ochom, A., Jones, M., & Cheng, H. (2019). Never events. Retrieved from https://psnet.ahrq.gov/primer/never-events

2 Adams, D. F., Fraser, D. B., & Abrams, H. L. (1973). The complications of coronary arteriography. Circulation, 48(3), 609–618.

3 Agency for Healthcare Research and Quality (AHRQ). (2008b). National healthcare quality report. Rockville, MD: Author. Retrieved August 4, 2008, from HYPERLINK “http://www.ahrq.gov/qual” http://www.ahrq.gov/qual/qrdr07.htm#toc

4 Agency for Healthcare Research and Quality. (2019, September). National Healthcare Disparities Report, 2018 (Rep. No. AHRQ Pub. No. 19‐0070‐EF). Retrieved https://www.ahrq.gov/sites/default/files/wysiwyg/research/findings/nhqrdr/2018qdr‐final.pdf

5 AHA. (2019). Fast facts on U.S. Hospitals, 2019: AHA. Retrieved from https://www.ahrq.gov/sites/default/files/wysiwyg/research/findings/nhqrdr/2018qdr-final.pdf

6 AHRQ. (2006). National healthcare disparities report, 2005. Retrieved from https://archive.ahrq.gov/qual/nhdr05/fullreport/Index.htm

7 AHRQ. (2011). Types of health care quality measures. Retrieved from www.ahrq.gov/talkingquality/measures/types.html

8 AHRQ. (2019). 2018 National healthcare quality and disparities report. Retrieved from www.ahrq.gov/research/findings/nhqrdr/nhqdr18/index.html

9 Alberta Health and Wellness. (2004). Health care insurance plan. Edmonton, AL: Government of Alberta. Retrieved from www.health.alberta.ca