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Chapter 2

Quality Assurance and Legal Issues in Healthcare

The Joint Commission (JACHO) oldest and largest healthcare standards setting body in nation; organization that establishes standards for the operation of hospitals and other healthcare facilities and services
Center for Medicaid and Medicare Services (CMS) the CLIA federal regulations are administered by
Quality Indicators (QI) measurable objective guides set up to monitor all areas of care that tends to cause problems
proper patient identification actively involving patients in their own identification
Procedure Manual manual that describes the necessary steps to follow in patient preparation for lab tests
incident reports can identify trends for risk management
informed consent voluntary and competent permission for a medical procedure, test, or medication
Clinical Laboratory Standards Institute (CLSI) national organization that develops guidelines and sets standards for lab procedures
vicarious liability liability imposed by law on one person for acts committed by another
National Patient Safety Goals (NPSGs) The Joint Commission's annual safety requirement goals
delta check comparing current test results with previous ones
negligence failure to exercise due care
statute of limitations a law setting the length of time after an alleged injury in which the injured person is permitted to file a lawsuit
assault act or threat causing another to be in fear of immediate battery
fraud deceitful practice or false portrayal of facts either by words or conduct
Continuous Quality Improvement (CQI) program designed to nationally standardize measurements of performance
breach of confidentiality failure to keep privileged medical information private
discovery formal process in litigation that involves taking depositions and interrogation of parties involved
Good Laboratory Practices (GLPs) practices that emphasize quality assurance when in laboratory settings
battery intentional offensive touching or use of force without consent or legal justification
civil action legal actions in which the alleged injured party sues for monetary damages
due care level of care a person with good sense provides under given circumstances
defendant person whom a complaint is filed against
deposition when a party questions another under oath with a court reporter present
sentinel events an early warning policy to help healthcare organizations identify unfavorable actions and take steps to prevent them
safety manual describes chemical, electrical, and radiation safety for the laboratory
education of the employees one of the generic steps in risk management
respondeat superior/ vicarious liability let the master respond; an employer is responsible for the actions of an employee, even though the employee is the one at fault
internal report states the concern and describes the corrective action when a problem occurs
malpractice type of negligence committed by a professional; implies a greater standard of care was owed to the injured party
threshold values level of acceptable practice beyond which quality care cannot be assured
standard of care level of care and skill that provides due care to a patient
Quality Assurance (QA) tracks patient outcome through survey/audit methods; overall process that establishes policies and procedures for assured quality
Quality Control (QC) performed methods to ensure same steps are followed each time for accuracy; a component of a CQI program that is a form of procedural control
Quality System Essentials (QSE) a core set of systems essential for quality outcomes
invasion of privacy violation of one's rights to be left alone
tort wrongful act committed against one's person, property, or reputation
Patient Care Partnership/ Patient Bill of Rights Expectations patients have regarding care and treatment
Third Party Payers Governmental entities paying for healthcare on patients behalf
Medicare Elderly, Supplemental Security Income, federally funded
Medicare Low income, disabled, state and federal funding
Tri-care military/government
Arizona Health Care Cost Containment System Arizona low income
Obama Care Affordable Heath Care Act
Criminal Law concerned with laws designed to protect all members of society from unlawful acts by other; felonies and misdemeanors
Civil Law concerned with actions between to parties, such as individuals or organizations; constitute the bulk of legal actions health with in the medical office, or other healthcare facilities
refusal of consent a constitutional right to refuse a medical procedure
implied consent consent is implied by actions
informed consent voluntary and competent permission
minor consent parental/guardian consent required for medical treatment
expressed consent required before surgery or high risk procedures
HIV consent states laws specify what type of information must be given
safety process control
transit time specimen transport
self assessment internal assessment
duplicate test ordering patient assessment
sample acceptability specimen receiving/processing
wristband evaluation specimen collection/labeling
accuracy of ordering test request
employee retention personnel
Created by: LaraPacis