Egan’s Ch 2 Quality and Evidence Based Respiratory Care – Flashcards
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Quality is defined as
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a characteristic reflecting a high degree od excellence, fineness or grade
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quality in respiratory care encompasses
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-personnel to preform care -the method or manner of how care should be provided
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what are the elements of hospital based Respiratory care
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-medical direction -practitioners -technical direction
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Joint Commission
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gives accreditation based on standards established by professional and technical advisory committees
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What is the responsibility of the Medical Director?
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-function of the department -oversight of clinical care -policies and procedures -budget -training programs -supervise RT's -quality assurance select and promote staff
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What is the most important aspect of providing Respiratory care
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-to ensure care is being provided is indicated and that it is delivered competently and appropriately
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misallocation may consist of
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ordering therapy that is not indicated, ordering therapy to be delivered by an inappropriate method, or failing to provide therapy that is indicated
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What does the quality of RT's depend on
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-training - education -experience -professionalism
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What are the 2 levels of general practice credentialing in respriatory care
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certified expiratory therapist registered respiratory therapist
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Committee on Accreditation for Respiratory Care - CoArc
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-Respiratory care education programs are reviewed by this group -sponsored by 4 organizations -AARC, ACCP, ASA, ATS -to promote quality respiratory therapy education through accreditation services
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credentialing
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a general term refers to the recognition of individuals in particular occupations or professions
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What are the 2 major forms of credentialing in the health fields
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state license voluntary certification
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National Board for Respiratory Care - NBRC
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-the primary method of ensuring quality in respiratory care is voluntary certification or registration -independent national credentialing agency
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professional characteristics
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-completes an accredited RT program -continuing education -adheres to code of ethics -be a part of organizations
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Health Insurance Portability and Accountability Act - HIPPA
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set standards regarding the way sensitive health care information is communicated and revealed in the transmission of medical records written and verbal
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Technical Direction is the responsibility of the RT manager this entails
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safety, health and welfare to patients based on procedures, equipment and protocols
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respiratory care protocols
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-improve the allocation of respiratory care services -guidelines for delivering appropriate care treatments and services,
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how care protocols be written
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outline form or algorithms
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What are the logical practices based on for RT's to use protocols
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-extensive knowledge of respiratory care modalities -have the assessment -communication skills required to execute the protocols effectively
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what is needed for successful protocol program
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-active and committed medical direction -capable RT's -Collaboration with DR and nurses -active monitoring -responsive hospital enviroment
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Elements of an acceptable respiratory care protocol as described by the American college of chest physicians
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-clearly stated objectives -outline that includes an algorithm -description of alternative choices at decision and action points -description of potential complications and corrections -description of end points and decision points at which the Dr must be contacted -protocol program
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Respiratory therapy consult services
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-comprehensive approach for using protocols is to combine specific protocols -evaluate and treat program -structured assessment tool and care plan form
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monitoring quality respiratory care,what are some strategies to monitor quality
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-intrainstitutional monitoring practices -centralized government monitoring bodies -voluntary agencies
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intrainstitutional monitoring practices use what to assess skill check offs, knowledge and experience
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competencies,
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what does the Joint Commission require hospitals to have
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a quality assurance plan
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what are the nine steps for quality assurance plan
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-identify the problem -determine the cause of problem -rank the problem -develop strategy for resolving problem -develop appropriate measurement techniques -implement problem -resolution strategy -analyze and compile results of intervention -report results to appropriate personnel -evaluate intervention outcome
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performance improvement
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AKA-continuous quality improvement -ongoing process designed to detect and correct factors hindering the provision of quality and cost-effective health care
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Joint Commission for performance improvements
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-hospital collects data to monitor its performance -hospital complies and analyzes data -hospital improves performances on an ongoing basis
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quality monitoring benchmarks
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-monitoring the correctness of respiratory care plans -monitoring the consistency of formulating respiratory care plans among therapist evaluators -evaluating the efficiency of algorithms or protocols - evaluating the overall effectiveness of the protocol program
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monitoring correctness of respiratory care can be accomplished by using care plan audit system, who is on this care plan audit system
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therapists with experience in care an patient assessment
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what is the consult services used
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a case study exercise, simulated patient exercises
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Peer review organization
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-established by the federal government -to evaluate the quality ans appropriateness of care given to medicare beneficiaries -evaluate care provided to individuals in real time to asses and ensure compliance with federal guidelines
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Accountable care organizations (ACOs)
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model in which a group of health care providers aline as agrees together to try to meet quality targets and to receive payment as a collective entity
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cross-training
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teaching activities normally preformed by a specified discipline, not restricted by licensing to personal of another discipline
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what are protocols
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guided pathways to help direct specific aspects of a patient's treatment
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what is the primary purpose of protocols
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provide therapy to patients needing and likely to benefit from therapy but avoid delivering services to patients not likely to benefit
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what is disease management
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an organized strategy of delivering care to a large group of individuals with chronic disease to improve outcomes and reduce cost
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what are the disease management comprise of what essential components
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-integrated health care system that can provide coordinated care across the full range of patient needs - comprehensive knowledge base regarding the prevention, diagnosis, and treatment of disease the guides the plan of care -clinical and administrative info system that care help assess patterns of clinical practice -commitment to continuous quality improvement
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Evidence based medicine
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determining optimal clinical management based on -rigorous and systemic review of available evidence -critical analysis of available evidence to determine what management conclusions are most sound and applicable - disciplined approach to incorporating the literature with personal practice and experience
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parallel control randomization trail
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treatment outcome of the two groups are assessed and compared regarding the main outcomes of interest in he study
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the crossover trail
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is a type of parallel control randomization the study treatment is first administered to on group of study subject while the other group receive the control or comparison treatment then measure outcomes
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meta analysis
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identifies analyzes an summarizes the body of literature about a specific topis assessing the quality of the available evidence and greater weight on more rigorous studies
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quality respiratory care can be defined as
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the competent delivery of indicated respiratory care services
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crucial elements for quality respiratory are include
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-energetic and competent medical direction -methods for providing indicated and appropriate respiratory care -educated, competent respiratory care personnel -adequate well maintained equipment -intelligent system for monitoring performance improvement
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misallocation of respiratory care services which hinges the delivery of quality respiratory care can be deinded as
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over-ordering or under-ordering of respiratory care services and is common in current practice
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respiratory care protocols are_________ for delivering appropriate _________ ________ _______ and are widely used in current respiratory care practice
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guidelines respiratory care services
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available evidence suggest that use of respiratory care protocols can _________ of respiratory care services
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improve
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T/F is Respiratory credentialing important in respiratory care
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True
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What is the highest credentialing in Respiratory care?
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RRT, this show successful completion of the NBRC exam
