health services exam 2

patient centered care includes

patient preferences, needs, and values

quality control is

within quality assurance

what is the heart of IHI model for improvement

the PDSA cycle: plan, do, study, act

what is implementation research

adopting and integrating interventions into a clinical setting

what is dissemination research

spreading and sustaining knowledge

what attributes influence the speed and extent of intervention adoption

relative advantage, compatibility, observability, trialability, complexity

relative advantage

effectiveness and cost efficiency relative to alternatives

compatibility

the fit of the intervention to the established ways of accomplishing the same goal

observability

the extent to delink the outcomes can be seen

trialability

the extent to which the adopter must commit to full adoption

complexity

how simple the intervention is to understand

what is a needs assessment

process for needs or gaps between current and desired conditions

what does a needs assessment do?

provides justification for why decisions were made

pragmatic trials include

full range of patients in normal practice, rather than a controlled environment

mixed methods

quantitative and qualitative (depending on the study goal)

team based care

strategic redistribution of work among members of a practice team

task shifting

reassignment of clinical/non clinical tasks from one level or type of healthcare worker to another

chronic care model says that improvement requires

paradigm shift from current reactive health care model to one that focuses on avoiding long term problems

what is one component needed for the chronic care model

self management support (emphasize the patient’s role)

transitional care

ensure coordination and continuity of health care as patients transfer between locations or levels of care

what are the four pillars of transitional care

meds, record access, primary care, red flags

medication self management

know their medications

use of dynamic patient centered record

access to their health record

primary care and/or specialist follow up

schedules and actively participates

knowledge of red flags

know if condition is worsening and how to respond

SPO model

structure, process, outcome

structure

resources and environment used to deliver care (EMR, e prescribing)

process

activities/services provided to patients (screenings, med sync)

outcomes

care results - clinical, economic, humanistic

ECHO model

economic, clinical, humanistic, outcomes

to evaluate interventions and outcomes

economic

direct medical, direct nonmedical, indirect, and intangible

clinical outcomes

symptom severity, episode frequency, hospitalizations, etc

humanistic

patient experience, QALY, ability to perform daily activities

negative disconfirmation

dissatisfaction from performance being below expectations

confirmation

mild satisfaction from performance meeting expectations

positive disconfirmation

delight from performance exceeding expectations

patient expectations exist in what

zone of tolerance (below, within, above)

explicit promises

advertising, pharmacist statements, contracts

implicit promises

indirect cues suggesting service quality (price, appearance, packaging)

word of mouth

information from other patients (credible)

organizational change

internal (leadership, acquisitions) or external (regulations, payment)

kotter’s model of organizational change

people change when they see and feel the need for change, not just when they analyze data

8 steps of change

create urgency, built the team, vision, communicate, empower, generate short term wins, don’t let up, make change stick

technology acceptance model

focus on perceived usefulness, ease of use, intention to use, and usage behavior

pharmacy workflow analysis

systematic evaluation of tasks performed to produce an outcome

service blueprint

visual map of service process to understand service delivery

what does a service blueprint include

patient, employee, backstage employee, and support

what are the key lines of a service blueprint

interaction, visibility, internal interaction

the hiring process is

systematic

candidate profile should include

qualifications, experience, soft skills

interview questions include

situational, behavioral, informational, case study

orientation is

a one time event, online, general

onboarding will

last months at the job site, specific to each employee/role

steps in firing an employee

document the reason for firing

fringe benefits

support primary needs, offer array, partner with employee to stay healthy