exam 3

is healthcare a right or luxury?

Video:

The best if can afford it

  1. Select a system

  • a shared public experience and private

    The public system is more compassionate and treats everyone equally

    it is very inadequate and extremely slow to change and slow to inavate

  • Private is run like a business efficiently and high volume

  • Revenue generated

    1. care about cost

  1. quality or quantity

a system thinker is a peculiarly thinker and is aware in healthcare the solution can cause additional problems

03/12/25 inproving healthcare sright from the heart ted talk video

  • approximately 40% are compliant for handwashing in hospitals

  • healrhcare providers resent change

  • 1st barriers of healthcare is a group of people called active resienter

  • 2nd healthcare barrier organization constapaters are people missing in the action of change, leadership are considered not important

  • the 3rd barrier of healthcare is the environmental medorostiy is the environment of being average

    how can you change behavior?

  • conformity and social learning

  • conformity is people act the way everyone else acts

  • socail learning occurs when the group behavior becomes a person’s individual belief

  • How can we change it?

  • we switch from a culture of medorsity to a culture of excellence

  • “the culture of any organization is shape by the worst behavior a leader is willing to tolerate” Gruenter and Whitaker

  • change via leadership is a top down approach

  • “the awareness that aires by paying attention on purpose in the present moment, non-judgmentally” Gilmartain. BMJ 2016

  • heartfulness looks at compasion, kindness, and connection

    Qi is philosophy making something better

  • Quality  care in healthcare

    is to tweak their lifestyle

  • I got room for improvement both parties (providers and patients) have to come to an understanding

  • the system thinker is a perpetual curious person

  • System thinking involves constant thinking outside of work

  • In qi knowing the right thing to do and actually doing it is 2 different things

  • Some is not a number and soon is not a time

  • Every system is designed to get the results it gets

  • In hell are it’s tough to balance pro active and reactive un healthcare

  • If you can’t be nudged towards a reflected practice

  • Seemingly small behaviors have a ripple effect in healthcare

    quilting improvement questions

  • What are you going to improve? How much?

  • How will know if a change is an improvement?

  • What changes can you make to lead to the improvement? Is addressed using pdsa documentation

  • The reflective learner is fine tuning the change based on what you learned

  • They going on to either adapt, adopt, or discard

    six dimensions of healthcare quality improvement

  • 1. Safety – making sure the intervention doesn’t cause harm, A culture of safety and healthcare is more likely in the system thinking

    1. Effectiveness – how will the treatment is carried out compared to how they were designed

    2. Equity– all about fairness

    3. Efficiency – explore the source of waste, Getting the best outcome with the fewest amount of input

    4. Timeless- System responsiveness and access, looking for subjective and objective data

    5. Patient centered endless – Center more often on patient, Putting the patient in the center is a vital dimension of quality

Hospitals is the second largest industry and the largest employer of healthcare workers in the US

Federal funding primarily care health centers sever high need and the medically underserved living in urban and rural areas

Private fund fee clinics sever those who are uninsured the unemployed and the underemployed as well as undocumented immigrants

Hospitals provide patient care, train health professionals, conduct research, and provide public education for consumers and members of the community

Hospitals are categorized by function, length of stay, and financial support or ownership

The ACA requires all insurance policies including mental health services; however only about half of those experiencing symptoms of mental health or substance use disorder see professional help

State holders are patients

Public health

Focus on community over the industrial

Emphasis prevention over medical care

Practitioners represented by diverse disciplines

Requires cooperation among federal, state, and local governments

Function collects and reports vital statistics

Medicaid funds healthcare for one and five Americans and is the largest public health insurances programs in the U.S.

capitation (workers comp) is a from of reimbursement services used as a way to control healthcare costs

Managed care organization (MCOs) are healthcare insurances programs that control healthcare costs by agreeing to provide health services in exchange for a set dollar amount for Medicare or Medicaid for each enrollee. this is more federal government

HMOs only reimburse for health services to providers and facilities within a network and require specialty referral from a primary care provider. PPOs reimburse for health services, but reimbursements is less for providers and facilities out of network. EPOs are similar to HMOs except that specialty referrals from a primary care provider are not required.

employers offer incentives for employees to participate in employer-sponsored wellness programs to keep employees healthy and control healthcare cost for the employers

demographics shifts are projected in the population, with 20% being over the age 65 by 2030 and 20% being over 85 by 2050. the population will be also be more racially and ethnically diverse nonwhites being in the majority by 2043

there are 4 parts to Medicaid part A, hospitals and short term skilled nursing homes, Part B, outpatients, home, and hospice, Part C is supplemental insurance that replaces part A and B, and Part D, medication prescriptions. all parts have deductibles and copayments.

the center for Medicaid and Medicare (CMS) is responsible for nursing home standards while individual states are responsible for monitoring facilities to ensure that standards are met

hospice services manage pain and other symptoms of dying and emotional, psychological, and spiritual support for patients and their families and grief support for survivors.

health literacy is the ability to obtain, and understand basic health information and services needed to make appropriate health decisions, those more likely to have low health literacy are lower socioeconomic status, those with low English proficiency, and older adults.

career development stretches beyond what is needed initially to enter a healthcare profession

training for healthcare students includes similarities across disciplines, referred to as a common core knowledge

healthcare professionals who act in an accountable and ethical manner in the workplace and maintain a steady composure in the face of adversity demonstrate professionalism

codes of ethics are common across virtually every healthcare discipline

vallations of code of ethics can results in being fired and lose your lieance or certificate without it being illegal

Malpractice is professional misconduct

continuing education is an integral part of career development