principles of healthcare management final

teamwork

group of people with complementary skills committed to common approach for which they hold themselves mutually accountable, working together to achieve common goal

cost of teamwork

meeting time, place and food, opportunity costs, loss of autonomy, risk taking, resistance to organizational change

Tuckman stages of a team

forming, storming, norming, performing, adjourning

forming

getting oriented to the team goals and each other, finding out what the tasks are, and who they will be working with

storming

intragroup conflict, attempts at dominance, passive aggressive behavior, along with information withholding and other forms of resistance to team tasks and goals

norming

expectations and roles become codified, either formally or informally

performing

peace breaks out and team members actually begin work at hand, have open dialogue with one another and share information to accomplish teams goals

adjourning

team members have worked together over long period of time, have developed respect for one another, like each other as individuals and team as a whole

benefits of a team

improve coordination and quality of care, use of health care services more efficiently, increase job satisfaction amongst team, patient satisfaction, increased productivity

tame vs wicked problem

tame problems defined and while not easy, can be solved

wicked problems are difficult to define and not easily resolved

health disparities

differences in incidence, prevalence, mortality and burden of diseases and other adverse health conditions that exist among specific population groups in US

health inequities

avoidable inequalities in health between groups of people within countries and between countries, arise from within socities

social determinants

healthcare access, socioeconomic factors, living and working condition, geographic isolation, access to healthy food

cultural proficiency

ability and willingness to respond respectfully and effectively to people of all cultures, classes, races, age, sexual orientation, ethnic backgrounds and religions in a manner that values all

vulnerable population

groups of people not well integrated into the healthcare system

medically underserved areas and population

identify geographic areas and populations with a lack of access to primary care services

EMTALA

emergency medical treatment and active labor act, 1986 to prevent patient dumping, anti-dumping act, to prevent an emergency room from refusing treatment or transferring a patient to another facility because of inability to pay for treatment, patient must be treated

Stark Law

physician self-referral law developed to prohibit physicians from referring their patients to providers with financial interest, violation of antikickback and false claims act

stark law examples

paying physician for referral, hospital offering rental space for a physician below fair market value, a physician who receives benefits not given to other doctors or staff

patient self-determination act

federal law ensuring patients have right to make their own healthcare decisions and to refuse treatment

anti-kickback statute

law of choice for federal enforcement authorities, impose criminal liability for knowing of willful payment, solicitation or receipt of remuneration in return for referring individual to person for healthcare service

antikickback statute penalties

criminal : up to $25000 fine per claim plus 5 year prison, civil: up to $75000 per kickback plus 3x amount of kickback

false claims act

1863, as the federal governments primary civil remedy against fraudulent claims for payment, removed requirement that there be specific intent to defraud federal government - only need to show that claim submitted is false and submitted knowingly

false claims act violations in healthcare

kickbacks, falsifying records, phantom billing, misrepresenting services, medicare and medicaid fraud, unnecessary medical treatments

whistleblower act

qui tam, private citizen can bring suit against fraudulent parties on behalf of federal government in exchange for share of recovered funds

fraud and abuse

fraud is an intentional act of deception, abuse consists of improper acts that may be unintentional, but are not consistent with standard practices

principles of ethics

autonomy, beneficence, non-maleficence, and justice

vaccination

imitate an infection and stimulate bodys immune system to respond as it were real infection

herd immunity

direct protection where a large portion of population becomes immune to contagious disease, effectively protecting those not immune

workplace violence

violent acts directed towards persons at work or duty, can occur in healthcare against workers, patients, clients, visitors, residents

types of workplace violence

verbal abuse, worker to worker bullying, staking and harassment, assault and battery, homicide

disaster preparation

mitigation - minimize opportunity for damage from disaster, preparedness - which is preparing for emergency, response - responding to emergency, recovering from emergency