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Study of how scarce resources are allotted among possible uses to make appropriate choices among increasingly scarce resources economics
Based on three premises: Scarcity, Choice, Preference economics
Revenue (income) minus cost (expense) equals profit business profit
For-profit businesses et Not-for-profit businesses All businesses must make profit to stay in business
Plan that provides formal quantitative expression to acquiring and distributing funds et generally based on spending from previous years budget
Direct costs, Indirect costs, Fixed costs, Variable costs fundamental costs
Money = ? Mission
describes purpose for business mission statement
establishes long-range goals for business or unit vision statement
identifies how business or unit will achieve vision and get goals developed strategic plan
Cost of health care not questioned until 1960s, Medicare and Medicaid established in 1965, New payment regulations established in 1982 to pay flat fee for service Perspectives on Health Care
Tax Equity and Fiscal Responsibility Act (TEFRA), Medicare Part A, Medicare Part B Prospective Payment System (PPS)
Index number assigned to various health services based on relative amount of resources (labor and capital) used to produce services Relative Value Unit (RVU)
Used to calculate relative cost of providing nursing care based on patient acuity levels Relative Value Unit (RVU)
The amount of money paid to a hospital for a diagnosis Diagnosis Related Group (DRG)
Health care reform began with onset of Medicare and Medicaid, HMOs began in attempt to provide cost-efficient and quality care, For-profit brokerage business, Have resulted in complex structures and processes to deliver health managed care
PPO, Contracts with practitioners and hospitals to provide health services, Rates negotiated, Nongovernment health insurance, Predominately accessed through employers,Largely HMO Models of Managed Care
Attention has shifted toward ___ and ___ and need for measurable outcomes safety, quality
Total quality improvement (TQI) and continuous quality improvement (CQI) have been initiated to assure ___ ___ cost containment
are more empowered to better understand their health care consumers
Institute for Healthcare Improvement (IHI), Developed care interventions designed to save 100,000 lives, Prevent central line, surgical site, and ventilator-associated infections, Deploy rapid response teams, Prevent adverse drug reactions, Improve care o Health Care Improvement
Development of standards for EHR on national health care agenda; important so practicing clinicians, pharmacies, and hospitals can share patient information need for nursing informatics
The ____ has highlighted need for increased patient technology and nursing informatics joint commission
Computerized order entry, Electronic health records (EHR), Patient decision support tools, Diagnostic results, Electronic prescribing, Including barcoding, Community health management, Communication and staffing, Evidence-based knowledge, Quality improvem Elements of Nursing Informatics
Health services and information delivered or enhanced through the Internet and related technologies E-Health
Delivery of health-related services and information via telecommunication technologies Telehealth
Virtual way to maintain person’s health data across lifetime EHR
Must be able to be distributed over different systems to different locations, Nurses and health care providers must be able to access data, Patient’s confidentiality must be maintained EHR
Computer functions provide for retrieval and processing of data et includes decision support (e.g., alerts, alarms for drug allergies, abnormal laboratory results) information processing
Privacy, Rights of individual to keep information about themselves from being disclosed to anyone, Confidentiality, Act of limiting disclosure of private matters, Means to control access and protect information security
Has allowed practitioners to develop minimally invasive surgical techniques and use of robotic surgery, Has allowed students to visualize in 3-D images and understand principles virtual reality
Health care providers need to evaluate accuracy or information before providing it to patients Patient Resources
_________ need way to judge quality and relevance of information provided on the Internet nonclinicians using patient resources
Development, provision, and evaluation of multidisciplinary health care services to population groups experiencing increasing health risks or disparities, in partnership with health care consumers and community, to improve health of community and its dive Population-Based Health Care Practice
People or groups of people underserved due to decreased health status and increased mortality and morbidity Vulnerable Populations
Variables that increase or decrease probability of illness or death Health Risk Factors
Differences in health care system access and quality of care for different racial, ethnic, and socioeconomic population groups that persist across settings, clinical areas, age, gender, geography, and health needs and disabilities Health Disparities
Inadequate housing, Unsafe neighborhoods, Lack of employment, Lack of educational opportunities, Inadequacy of health care, Lack of health insurance, Less access to primary care providers Causes of Health Care Disparities
Improve access to health care services, Reduce health disparities among different population groups, Reduce health care delivery costs Population-Based Health Care Goals
Interventions for population-based care are provided on three levels, Individuals, families, and groups, Systems within community (e.g., health care systems et community systems) Providing Population-Based Care
Outcomes of these interventions measured in three domains, Population health status, Quality of life, Functional health status Providing Population-Based Care
Focus of care is to improve health status of vulnerable or at-risk population groups within community, Health promotion, Disease prevention interventions, across health continuum Population-Based Healthcare
Begins with community assessment and Has three levels of practice: Community, Norms, attitudes, practices, and behaviors, Systems within community, Laws, power structures, policies, and organizations, Individuals, families, and groups,Knowledge, attitude, Population-Based Nursing Interventions
Traditional models, Start with public health and community health agencies working in partnership to carry out community assessment, Priorities identified and plan developed and implemented, Evaluation conducted after plan implemented Models of Population-Based Care
Outcomes should focus on health status, functional ability, and quality of life of at-risk population groups, Involves multidisciplinary team, health consumers, and community partnerships evaluation
After _____ completed, unmet needs of population groups determined evaluation
Influences or inspires actions and goals of others leadership
may not have to have a position of authority and people who do the right thing leaders
Process of coordinating actions and allocating resources to achieve organizational goals management
◦Information processing role and disseminate information staff needs managerial roles
can be powerful tool to assist managers in motivating behavior feedback
Feedback must be the following Frequent, Timely, Usable, Correct
Involves having vision and goals; Cooperation and teamwork leadership
◦Leader has assigned role within organization formal leader
◦Leader demonstrates leadership outside scope of formal leadership role as member of group or leader of group informal leader
Guiding vision,Passion,Integrity,Intelligence,Self-confidence,Determination,Sociability,Caring,Respectability,Trustworthiness,Flexibility leadership characteristics
Are visionary and enthusiastic,supportive and knowledgeable,Have high standards and expectations,Value education and professional development,Demonstrate power in an organization,Are visible and responsive,Communicate openly leadership values
◦Leaders need followers to lead/Followers need leaders to follow both roles needed
◦Skilled, self-directed employees who participate actively in needs of group most valuable followers
communicate and work well with others good followers
Whatever influences peoples’ choices and creates direction, intensity, and persistence in peoples’ behavior motivation
useful because they help explain why people act the way they do and how managers can relate to individuals as human beings and workers theories
◦Involves centralized decision making with leader making decisions and using power to command and control others Autocratic leadership
Involves participatory leadership with authority delegated to other democratic leadership
◦Is passive and permissive, leader defers decision making Laissez-faire leadership
◦For groups with low maturity who need direction telling
◦For groups with moderate maturity who are unable, but willing and need direction selling
◦For groups with moderate to high maturity who are able, but unsure and need support participating
◦For groups with high maturity who are able and need little direction delegating
Described as process where leaders and followers raise one another to higher levels of motivation and morality transformational theory
Leaders motivate others to behave in accordance to mutual values and empower others to contribute transformational theory
Leaders are identified as change agents, are courageous, believe in people, are value-driven, are life-long learners, and have ability to deal with complexity transformational theory
Listening,Empathy,Healing,Awareness,Persuasion,Foresight,Stewardship,Growth,Building community servant leadership
I don’t necessarily have to like my players and associates but as the leader I must love them.  Love is loyalty, love is teamwork, love respects the dignity of the individual.  This is the strength of any organization. Vince Lombardi.
Self-awareness,Self-regulation,Motivation,Empathy,Social skills emotional intelligence
Resources or structures needed to deliver quality care structure
e.g., nursing care, nurses, pharmaceuticals, hospital buildings example of structure
◦Quality activities, procedures, tasks, and processes performed within health care structure process
◦Patient satisfaction, good health and functional ability, and absence of health-acquired infections and morbidity outcome
Primary care provides integrated, accessible health care(Includes health promotion and prevention and diagnosis and treatment of illness and injury et Nurses’ knowledge, skills, and competency have been underutilized) need for primary health care
◦First contact,Longitudinality,Comprehensiveness,Coordination,Continuous foundations of primary care
Aging population,Increased utilization of pharmaceuticals,Expensive new technologies,Rising hospital costs,Types of practitioners,Cost shifting,Administrative costs contributing factors to rising costs
Private insurers,Publicly funded payers,Charitable entities,Direct payment by consumers Reimbursement for services paid in four ways:
Introduced in 1982 by federal government,Developed as way to control costs,Intent was to offer financial incentives to encourage hospitals and health care practitioners to provide more cost effective care,Hospitals paid predetermined amount of payment for Prospective payment from health care insurance
Medicare, Medicaid, Indian Health Services, State Children's Health Insurance Program (SCHIP), Veterans Affairs, TRICARE public payers for health insurance
Health maintenance organization (HMO), Preferred provider organization (PPO), Point of service plans (POS), Medicare, Medicaid (CMS) public payers for health insurance
RVU (Relative Value Unit), DRG (Diagnosis Related Group), PCS (Patient Classification System) health insurance prospective payment system
Use regulation and limitation by means of taxes and insurance premiums et Encourage managed competition@cost containment strategies
◦Use regulatory and competitive price controls reimbursement strategies (i.e. Capitation, Utilization management, Cost Shifting)
Study of human behavior in organizations, Concerned with work-related behavior,Addresses individuals and groups, interpersonal processes, and organizational dynamics and systems organizational behavior
Helps individuals become more effective employees,Those employees with high levels of organization behavior have higher commitment to organization,More likely to stay employed importance of organizational behavior
Began in late 1800s,Shifted from assembly line mentality to knowledge economy,Health care workers of today possess well-developed abilities with value and portability,Today’s work environment empowers workers evolution of organizational behavior
Bring out best in people and produce sustainable high performance over time,Pay close attention to dynamics of workplace,Known for having high quality-of-work-environments,Environments in which quality of human experience meets or surpasses employee expec high performance organization
Health care organizations that have met rigorous nursing excellence requirements of the American Nurses Credentialing Center (ANCC),Highest level of recognition,Designation involves voluntary credentialing process magnet hospitals
American Academy of Nursing (AAN),American Nurses Credentialing Center (ANCC) developed criteria for, reviewing applications, and awarding the “magnet” status to high-performing organizations,American Nurses Association (ANA) approved establishment of Mag magnet designation
Attracts and retains professional nurses magnet designation
University of Washington Medical Center in Seattle first magnet facility in 1994
Hundreds of facilities currently hold Magnet distinction, Expanded to include acute care hospitals and long-term care facilities magnet facilities
current number of magnet facilities in the US 391
ANCC American Nurses Credentialing Center
Promote quality in milieu that supports professional nursing practice,Identify excellence in delivery of nursing services to patients,Provide mechanism for dissemination of best practices in nursing services goals of the magnet program
High-quality patient care, Clinical autonomy and responsibility, Participatory decision making, Strong nurse leaders, Community involvement, Two-way communication with staff, Opportunity and encouragement of professional development, Effective use of staf characteristics of magnet nursing
Opportunities to work with other competent nurses, Good nurse-physician relationship, Nurse autonomy and accountability, Supportive nurse manager-supervisor, Control over nursing practice and practice environment, Support for education, Adequate nurse sta essentials of magnetism
Quality nursing leadership, Organizational structure, Management style, Personnel policies and programs, Professional models of care, Quality of care, Quality improvement, Consultation and resources, Autonomy, Community and hospital, Nurses as teachers, I forces of magnetism
Improved quality patient outcomes◦Increased patient satisfaction◦Reduced patient morbidity and mortality/Enhanced organizational culture◦Increased respect for nurses◦Shared decision making benefits of magnet designation
Created by: melissaaclark