BSHA Major Field Assessment

What does EMTALA stand for?

Emergency Medical Treatment and Labor Act

What does HIPAA stand for?

Health Insurance Portability and Accountability Act

What does EEOC stand for?

Equal Employment Opportunity Commission

What is the purpose of EMTALA?

Hospitals must treat/stabilize anyone in an emergency, regardless of ability to pay

What is the purpose of HIPAA?

It protects PHI, and that includes who can access the information and how it is protected

What is the purpose of the EEOC?

It protects workplace discrimination (race, sex, disability, etc.)

What does Informed Consent mean?

Patient understands risks, benefits, alternatives, and agrees voluntarily

What is Patient Abuse?

When physical, emotional, sexual, or financial harm is inflicted on a patient. Must be reported

What does Non-maleficence mean?

Do no harm

What are the 5 Determinants of Health? 1/5

Biological (genetics)

What are the 5 Determinants of Health? 2/5

Behavioral (lifestyle)

What are the 5 Determinants of Health? 3/5

Social (income, education)

What are the 5 Determinants of Health? 4/5

Environmental (housing, pollution)

What are the 5 Determinants of Health? 5/5

Healthcare Access

What are the 3 Core Functions of Public Health? 1/3

Assessment - collect/analyze data

What are the 3 Core Functions of Public Health? 2/3

Policy Development - create health policies

What are the 3 Core Functions of Public Health? 3/3

Assurance - ensure services are delivered

Planning =

Set objectives

Organizing =

Allocate resources

Staffing =

recruit/train employees

Influencing (Leading) =

Motivate staff

Controlling =

Monitor results and correct issues

What is Strategic Management?

A long-term planning process that is analyzing environment, setting goals, implementing strategies

What contributes to Evidence-Based Decision Making?

Research evidence, clinical expertise, patient preferences

What is a Root Cause Analysis?

It identifies underlying causes of problemsW

What technique is used in an RCA?

5 Whys, Fishbone

What is Process Mapping and what does it do?

A visual diagram of workflow steps helps identify inefficiencies

What are the 8 Wastes?

Defects

Overproduction

Waiting

Non-utilized talent

Transportation

Inventory

Motion

Extra-processing

What does Defects mean?

Errors that require rework or correction

Healthcare Ex of Defects:

Wrong pt info entered = must fix chart = delays, safety risks

What does Overproduction mean?

Producing more than needed or too early

Healthcare Ex of Overproduction:

Printing extra paperwork that isn’t used = Clutter and waste

What does Waiting mean?

Idle time when nothing is happening

Healthcare Ex of Waiting:

Patients waiting for labs, provider waiting for results = one of biggest inefficiencies in healthcare

What does Non-Utilized Talent mean?

Not using employees’ full skills or ideas

Healthcare Ex of Non-Utilized Talent:

Nurse doing clerical work instead of clinical tasks = Wasted human potential

What does Transportation mean?

Unnecessary movement of items or materials

Healthcare Ex of Transportation:

Moving patients or supplies between departments unnecessarily = increases time and risk

What does Inventory mean?

Excess supplies not being used

Healthcare Ex of Inventory:

Overstocked medical supplies that expire = ties up money and space

What does Motion mean?

Unnecessary movement of people

Healthcare Ex of Motion:

Staff walking long distances due to poor layout = fatigue and inefficiency

What does Extra-Processing mean?

Doing more work than required

Healthcare Ex of Extra-Processing:

Entering the same patient data multiple times = duplications often due to poor systems

What are the IOM 6 Aims? 1/6

Safe

What are the IOM 6 Aims? 2/6

Effective

What are the IOM 6 Aims? 3/6

Patient-centered

What are the IOM 6 Aims? 4/6

Timely

What are the IOM 6 Aims? 5/6

Efficient

What are the IOM 6 Aims? 6/6

Equitable

What does PDCA stand for and what does it mean?

Plan

Do

Check

Act

A continuous quality improvement model

What is an A3?

A one-page problem-solving document. Used to organize a problem, root cause, solution, and results

What does an A3 include?

Problem Statement

Current State/Target State

Root Cause

Proposed Solution

Metrics

What does PI mean?

Promoting Interoperability, ensures EHRs improve quality and data sharing

What does HIE stand for?

Health Information Exchange

What does the HIE do?

Allows providers to share patient data across data systems

What does Interoperability mean?

The ability of systems to communicate and exchange data

What does Store-and-Forward mean?

Sends medical data for later review

Who are Key Stakeholders?

Providers

Patients

Insurers

What does CMS stand for?

Centers for Medicare and Medicaid Services

What is a High Deductible Health Plan?

A higher out-of-pocket cost before insurance pays, more patient responsibility

What is Medicare Fraud?

Billing for:

Services not provided

Unnecessary procedures

What is Point of Service Collections?

Collect payment at time of visit

What is a KPI?

It measures performance

What are Fixed Costs?

Don’t change

What are Variable Costs?

Change with volume

What is Accounts Receivable?

Money owed to organization

Days in A/R Low=

Efficient

Days in A/R High=

Poor Collections

What is the IRS 990 Form?

A financial report for nonprofit organizations

What is Step 1 in Revenue Cycle?

Registration

What is Step 2 in Revenue Cycle?

Coding

What is Step 3 in Revenue Cycle?

Billing

What is Step 4 in Revenue Cycle?

Payment Collection

Strategic Management =

Planning + Implementing long-term direction

What are the 4 stages of Competence? 1/4

Unconscious Incompetence

What are the 4 stages of Competence? 2/4

Conscious Incompetence

What are the 4 stages of Competence? 3/4

Conscious Competence

What are the 4 stages of Competence? 4/4

Unconscious Competence

Incidence =

Number of new cases in a population over time

Prevalence =

Total cases (new + existing)

T-Test =

Compares means between two groups

Pivot Table=

Tool for summarizing and analyzing data

Public Financing =

Medicaid

Medicare

Private Financing =

Employer Insurance

Individual Plans