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CCMA CH 14
CCMA CH 14 REVIEW (Patient Care Coordination & Education)
| Term | Definition |
|---|---|
| the medical assistant coordinates care between who | medical specialist and different agencies |
| lack of care coordination has contributed to the increase in what | health care costs |
| what act has caused the value of care coordination to increase | the affordable care act |
| what is care coordination | the deliberate organization of patient care activities between two or more participants involved in an patients care to facilitate the appropriate delivery of health care services |
| what is compliance | meeting the standards and regulations of the medical practice's established policies and procedures |
| what does team based health care create between providers and patients | a partnership |
| what are two common health care delivery models that practice team based patient care | patient-centered medical home and accountable care organization |
| what type of care is used when using the PCMH or ACO models | holistic health care |
| primary care providers include who | physician, nurse practitioner, or physicians assistant |
| patients who have chronic conditions are usually assigned a what | nurse case manager |
| what is patient centered medical home (PCMH) ? | focuses on relationship between patient and personal physician ; physician takes responsibility for all aspects of health care for the patient and communicates with other providers as needed ; RD considered part of this home treatment plan |
| what is the accountable care organization (ACO)? | an association of providers and third party payers that assume defined range of responsibilities for a specific population and are held accountable financially as well as through the specific quality indications for its members health |
| what is holistic care | comprehensive or total patient care that considers the physical, emotional, social, economic, and spiritual needs of the person |
| who is the first provider the patient seeks care from | the primary care provider |
| what is one of the main goals of the primary care provider | to coordinate preventative health are services (regular check-ups, screening, tests, immunizations, health coaching) |
| PCP can be... | practitioners, internal medicine or doctors of osteopathy, or pediatricians |
| what is a specialist | a provider that diagnoses and treats conditions that require a specific area of expertise and knowledge |
| what is a Physicians Assistant (PA) | a medical professional that has similar training to physicians and are licensed to practice medicine as long as they are supervised by a medical doctor |
| what can PAs do? | conduct physical exams, provide preventative care, prescribe diagnostic tests, assist with surgical procedures, diagnose illnesses, and prescribe medicine |
| what are advanced practice nurses | nurses who have more education and experience than RNs and can usually perform the same tasks as a PA |
| what are common advance practiced nurses | clinical nurse specialist, nurse anesthetists, nurse practitioners, and nurse midwifes |
| what are RNs | licensed by individual states and have an associates or bachelors degree in nursing |
| what do RNs do | oversee the case management of patients who have complex chronic conditions and coach patients about their overall health |
| what are Practical Nurses (PN) sometimes called | vocational nurses |
| what are PNs | individuals who usually train for about a year at a community college or vocational school, receiving a diploma or an associate's degree |
| what are pharmacists | professionals who prepare and dispense medications prescribed by authorized providers ; they must be knowledgeable of individual and various combinations of medications to be able to educate patients on their use and answer questions about side effects |
| what are dentists | professionals who diagnose and treat issues relating to the teeth and mouth, educate patients on ways to prevent problems with oral health |
| what are occupational therapists | professionals who assist and educate patients on how to perform everyday tasks after physical, mental, or developmental disability has occurred |
| what are physical therapists | assess a patient's pain, strength, and mobility and then develop a treatment plan to improve any areas of concern |
| speech therapists can also be called | speech language pathologists |
| what are speech therapists | professionals who work with patients who have problems with speech and swallowing due to an injury, cancer, or stroke |
| what do speech therapists focus on | helping a person work toward improving, regaining, and maintaining the ability to communicate, chew, and swallow |
| what type of degree do psychologists have | professionals who are not MDs but have a doctor of psychology or a doctor of philosophy degree |
| what are psychologists | professionals who work with patients who are expecting mental health challenges, especially during times of stress or emotional turmoil |
| what are social workers | - assist patients and families in transition crisises - assist in a clinical or hospital setting with physical, emotional, and financial issues related to illness or injury - coordinate additional services (transportation, housing, food security, etc.) |
| what is registered dietitian nutritionist (RDN) | an expert in diet and nutrition |
| the role of patient and family members is more active in what form of health care | patient-family centered health care |
| in patient family centered health care what are the focus areas | the wants and needs of the patient and family: how the patient receives treatment, what treatments, desired outcome, and education and counseling to achieve these goals |
| what is the key to achieving full participation of patients and their families | good communication |
| what are the three goals for the Institute of Health Care Improvement (IHI) rubric for health care transformation | - improving experience of care - improving the health of populations - reducing costs of health care |
| what must occur for the IHI triple aim to be m et | all three goals must be accomplished by implementation of either PCMH or ACO |
| what does the enactment of the affordable care act (ACA) emphasize | the need for team based medicine |
| what are the three main goals of the ACA | - expand health insurance coverage - shift the focus of health care delivery system from treatment to prevention - reduce costs and improve the efficiency of health care |
| patient treatment is most often coordinated by who in the PCMH care delivery model | the primary care provider |
| why is patient treatment coordinated by the primary care provider in the PCMH care delivery model | to ensure the patient receives the necessary care when and where they need it |
| what is the goal of a PCMH | to have a centralized setting that facilitates partnerships between the patients, the provider, and the patients family |
| what is comprehensive care | an approach that cares for all patients needs, the whole physical concerns and involves the providers and entire health care team |
| what is patient centered care | positions the patient and their families as core members of the team |
| what is the focus of patient centered care | individual needs and preferences of the patient throughout the various stages of life |
| what is coordinated care | a type of care where all forms of care (specialty care, hospitals, home health service, and community services) are overseen by the provider-directed medical practice with open communication aided by information technology (EMR, EHR) |
| what are accessible services | services that include providing tools (open-scheduling, extended hours, communication with providers) through patient information web portals |
| what are quality and safety commitments | commitments that ensure the delivering of quality health care and is accessed by collecting safety data, measuring and responding to patient experiences and satisfaction |
| how do PCMHs save money | by reducing emergency departments visits, hospital admissions and readmissions, and provide an overall improvement in patient health |
| ACOs are made of what | providers who are associated with a defined patient population who are accountable for the quality and cost of care delivered to those patients |
| ACOs can include | ambulatory care, inpatient care, or emergency hospitals and clinics |
| successful transitional care occurs when | there is an appropriate coordination and continued quality in health care as patient moves from one care setting to another |
| the transition care model focuses on what | comprehensive inpatient hospital planning and home follow-up for chronically ill patients where the patient is transitioned from the hospital to home care.... |
| who often oversees patients who have chronic or terminal conditions | the nurse case manager |
| determinants of health include social factors such as | health services, individual behaviors, and genetic factors |
| behavioral determinants can often be altered by what | modifying factor (diet, exercise, smoking cessation, avoiding illicit drugs) |
| what can influence a persons overall health | the environment that they live in |
| what are physical determinants | factors that are influenced by the natural environments such as weather, housing and neighborhoods, work sites, recreational settings, toxic substances, and physical hazards |
| what are the two new payment tracks available through Medicare Access and CHIP Reauthorization Act (MACRA) | Merit Based Incentive Payment System (MIPS) and Advanced Alternative Payment Model (APM) |
| payment tracks determine what | what medicare will reimburse providers: bonuses, penalties, or adjustments based on performance scoring |
| what are the three learning styles | auditory, kinesthetic, visual learning |
| what is auditory learning | learning that occurs by hearing the information ; can be accomplished with providing information verbally while the patient listens |
| what is kinesthetic listening | involves learning through movement or performing the task ; a demonstration of the skill with return demonstration or an anatomical model the patient can touch works best |
| what is visual learning | learning that occurs by reading information and seeing diagrams or graphics: DVDs approved online videos |
| no matter the learning style of the patient you should always ask for what | feedback ; restating, repeating, and rephrasing the material |
| barriers to learning can be ____ or _____ | developmental or physical |
| if the patient is a child you should | speak in an appropriate grade or developmental language level ; do not stand over them, ask child to repeat information, and educate parent |
| what is continuity of care | continuation of care smoothly from one provider to another, so that the patient receives the most benefit and no interruption to care |
| team-based patient care: family/support | home care, informal caregivers, education and support, medications and pharmacy, and community resources |
| team-based patient care: patient | medical history, goal setting, self-management, compliance, and preferences |
| team-based patient care: providers | primary care, specialty care, inpatient care, long-term care, mental health services |
| PCP: Pediatricians | offer preventative care services and treat common pediatric conditions: viral infections and minor injuries |
| what do PNs do | health care professionals often triage phone calls ; administer medications, and assist with other clinical duties |
| psychiatrists | medical doctors who diagnose, prescribe medications, and treat mental, behavioral and emotional disorders |
| what do RDNs do | educate patients on the connection between chronic diseases and poor nutrition, assist with meal planning, and help low-income patients obtain healthier foods at lower prices |
| who are support staff | clinic coordinator, medical administrative assistant, clinical medical assistant, medical records specialist, medical billing specialist, financial counselor, scheduler |
| what do support staff do | schedule appointments, answer phones, greet patients, maintain medical records, assist providers during exams/procedures, perform measurements, process billing, complete insurance forms, perform lab/other diagnostic services, manage financial records |
| health care costs are decreased when | few hospitalizations, less testing and fewer treatments are achieved with successful patient-family centered health care |
| ACO promote wellness with | outreach programs such as smoking cessations, weight loss clinics, nutritional programs, online education available to anyone |
| social determinants of health are | education and employment opportunities, grocery stores with adequate fresh foods, minimal exposure to crime and violence, adequate transportation, exposure to mass media and emerging technologies |
| MACRA four performance categories | quality, cost/resource use, clinical practice improvement activities, advancing care information |
| medical assistant responsibilities in pre-visit planning | due dates of preventative testing, immunizations, patient care management items, and expired or soon-to-be expired prescriptions |
| medical assistant responsibilities during visit | escort patient to exam room, perform measurements and vital signs, interview patient, update health history, educate patient of preventative services and immunizations, transcribe for provider, assist provider with exam |
| what should be provided to the patient at the end of a training session? | any written m aterials |
| barriers to learning: visual impairments | provide large-print or Braille resource |
| barriers to learning: hearing impairments | speak face-to-face, provide written materials DVDs |
| barriers to learning: language | materials need to be available in patient's primary language, speak to the patient not the translator |
| 1) which of the following describe the purpose of a patient's discharge summary in a provider's office? | document information necessary for continuity of care |
| 2) A medical assistant is reviewing the chart every patient who is scheduled for an appointment later that day. What task should the medical assistant complete prior to patient's appointment? | confirm all pertinent information is available |
| 3) Which of the following actions is important for a medical assistant to take to serve patients effectively? | assist patients with locating appropriate community resources |
| 4) Which of the following community resources should a medical assistant recommend to an older adult patient who lost his partner three months ago? | organized support groups |
| 5) A patient has a new diagnosis of a malignant melanoma. When transitioning the patient's care from primary provider to an oncologist, what process is the PCP taking part of? | continuity of care |
| 6) A medical assistant is caring for a patient who has new medication prescription from a provider. What action should the medical assistant take to facilitate patient understanding and medication | review dosage and administration instructions with the patient |
| 7) Which of the following approaches should medical assistant take when discussing a patient's adherence to dietary guidelines | maintain an empathetic tone |
| 8) Recognizing patients' needs and barriers, coordinating care, and identifying resources to meet those needs best describes responsibilities of what positions? | patient navigator |
| 9) A patient centered medical home (PCMH) has five core functions and attributes. What feature is included in those functions? | comprehensive care |
| 10) A medical assistant should identify which of the following features is part of the patient centered medical home (PCMH) model of care? | focuses on evidence-based patient care and share decision making |
| 11) When reviewing a patient's medical record prior to an appointment with a primary care provider, it is important for a medical assistant to verify which of the following items is in the chart? | diagnostic test results |
| 12) Which of the following information should a medical assistant include when creating a list of community-based organizations related to a patient's physical health care needs? | physical addresses |
| 13) A medical assistant is reviewing the plan of care summary with adult son of an 81-year-old patient with dementia. Patient's son states that he's feeling overwhelmed with his mother's care. What community-based organizations should the MA recommend? | adult daycare |
| 14) Which of the following actions involves health coaching? | helping patients find community resources related to health care needs |
| 15) A medical assistant is part of the team that's caring for a patient who is being discharged from the hospital. What would contribute to a successful transition of care? | the provider just continues all medication started in the hospital and releases the information to the rest of the team |
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linju156
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