Nursing 3344-4
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Collin County Community College District *
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Course
3344
Subject
Medicine
Date
Dec 6, 2023
Type
docx
Pages
2
Uploaded by MasterMorning11527
What fields were associated w/ higher rates of license revocation?
anesthesia, general practice, and psychiatry
Facility Licensing
-similar to occupational licensing, focuses on personnel but also covers issues of
organizational structure, services offered, equipment and facility standards, safety and
sanitation, and record keeping
-Multiple states initiated certificate of need (CON) laws to control health care capacity
CON (certificate of need) laws
require state approval to expand bed count in order to avoid overcapacity, which could
stimulate unnecessary demand for hc services
In Texas, how does the Department of State Health Services define what a hospital is?
-a facility with the capability to provide round-the-clock medical care for two or more
persons, and a minimum set of medical services, including lab, x-ray, and surgery
-The department has developed rules defining minimum standards for procedures, fees,
operational requirements, inspection and investigation procedures, construction, fire
prevention and safety requirements, and potential licensure actions, including denial,
probation, suspension, and revocation (Texas DSHS).
When did external nongovernmental evaluation of hospitals begin and who started it?
-1917
-American College of Surgeons (ACS) later evolved into the Joint Commission
Accreditation
-received a large boost when Medicare was enacted and required "deemed status" for
hospitals to be eligible for reimbursement
Joint Commission
-establishes standards and audits health care organizations' compliance with these
standards
What do the JC standards cover?
-provision of care, treatment, and services (PC)
-ethics, rights, and responsibilities (RI)
-surveillance, prevention, and control of infection (IC)
-medication management (MM)
-improving organizational performance (PI)
-leadership (LD)
-management of the environment of care (EC)
-management of human resources (HR)
-information management planning (IM)
-medical staff (MS)
-nursing (NR)
Does Accreditation improve quality?
-Miller et al. (2005) sought to determine if Joint Commission scores (0-100) were
correlated with 15 quality indicators
-None of the 15 quality indicators was found to be correlated with the accreditation
score.
Credentialing
-The task of granting staff privileges falls to the credentials committee of the medical
staff
Malpractice exists to address quality problems when patients are injured. Legal action
serves what 2 purposed?
1. To compensate patients for harmful wrongs
2. To deter similar actions in the future
Economics of HC Markets
-HC reimbursement has had a significant effect on how much health care is produced
and how it is delivered
Economics in Healthcare
-HC is different
-Insurance creates a moral hazard for use
-Copays disincentives that moral hazard
-Budget constraints affect consumer decision makings
-More is not always better (diminishing marginal utility)
-Demand outstrips supply and is inelastic
Pay for performance
-is an explicit attempt to increase provider revenues for organizations that deliver high-
quality care and to decrease payments for poor-quality care.
Pay for performance 4 major issues?
1. What to reward
2. Size of the reward
3. Whether to reward high performers or those achieving greatest improvement or both
4. Whether awards will be given to individuals, teams, organizations, or all the above
Does pay for performance work?
-Studies show no big difference
-Where incentives exist for performance measures in government-owned facilities, there
is a higher prosperity for fraudulent activity
Data vs. Information vs. Knowledge
-Knowledge is what we know.
-Data is/are the facts of the World.
-Information allows us to expand our knowledge beyond the range of our senses. We
can capture data in information.
What is a process analysis tool?
A tool (often statistical or graphical) to help analyze a process
-If you can't draw a process then it isn't a process
Uses of Process Analysis Tools
1. Identify problems
2. Identify the potential/primary causes of problems
3. Identify potential solutions and select a solution to be implemented
4. Monitor implemented solution, did the solution reduce or eliminate the problem?
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