question

NACHRI

answer

The non-profit advocacy group for pediatric hospitals in the US. National Association of Children's Hospitals and Related Institutions.

question

minimally invasive surgery

answer

Use of fiber optics, guide images, microwaves and other technologies to do surgery rather than cutting large sections of tissue.

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ASC

answer

Ambulatory Surgery Center, normally costs 50% less than an inpatient hospital procedure because they practice line by line billing.

question

HHS

answer

Department of Health and Human Services.

question

laparoscopy

answer

Laparotomy performed with a laparoscope that makes a small incision to examine the abdominal cavity (esp. ovaries and Fallopian tubes).

question

endoscopy

answer

Inspection of body organs or cavities using a lighted scope that may be inserted through an existing opening or through a small incision.

question

phacoemulsification

answer

Method to remove cataracts in which an ultrasonic needle probe breaks up the lens, which is then aspirated.

question

arthroscopy

answer

A minimally invasive operation to repair a damaged joint.

question

natural orifice surgery

answer

Abdominal surgery where the entrance wound is through either the stomach or through the vagina.

question

single payer system

answer

Government run healthcare system. Healthcare system is made up of a) cost, b) access and c) quality.

question

altruism

answer

Helping people.

question

supply chain

answer

Taking raw materials and processing them until they become a useable good.

question

evidence based medicine

answer

Used EMR's to compile statistics to determine the "best practice."

question

compliance

answer

The % of goods and services used in hospitals that have been negotiated with the GPO's.

question

indemnity insurance

answer

"Standard' type of health insurance individuals can purchase, provides comprehensive major medical benefits and allows insured individuals to choose any physician or hospital when seeking medical care.

question

PPO

answer

Preferred Provider Organization. A prepaid health insurance plan in which providers agree to deliver services for discount fees; patients can go to any provider, but using nonparticipating providers results in higher costs to the patient. Part of managed care.

question

HMO

answer

Health Maintenance Organization. A prepaid health insurance plan in which patients receive health care from designated providers. Part of managed care.

question

national insurance costs

answer

The average US family pays $14,000 a year for insurance coverage with 3/4 being paid by the employer and 1/4 being plaid by the employee.

question

Patient Protection and Affordable Care Act

answer

This is the health care reform law. Focuses on reform of the private health insurance market; providing better coverage for those with pre-existing conditions; improving prescription drug coverage in Medicare.

question

corporate structure of hospitals

answer

1)Department Heads; 2) Medical Executive Committee; 3) Board.

question

accountable care organization

answer

A term used in the Patient Protection and Affordable Care Act to define an ideal healthcare organization able to have very low costs caused by successful capitalization on medical goods and services.

question

common law

answer

A civil law established by following earlier judicial decisions.

question

statutes

answer

Laws enacted by a state or federal legislature that in certain cases can overwrite common law.

question

executive order

answer

A rule issued by the president that has the force of law.

question

civil law

answer

Wrongs against a particular person or organization.

question

tort

answer

Any wrongdoing for which an action for damages may be brought.

question

declining reimbursement

answer

Less resources to recruit, compensate, and develop workforce.

question

declining supply of workers

answer

Shortage of skilled workers.

question

increasing population need

answer

Increased volumes of patients and workload for HSO.

question

external pressure on HSO's

answer

HR must ensure high performance in HSO.

question

National Labor Relations Act

answer

1935 law that provides bargaining units and collective bargaining in hospitals and health service organizations.

question

Fair Labor Standards Act

answer

1938 law regulating minimum wage, overtime pay, and minimum worker ages.

question

Equal Pay Act

answer

1963 law prohibits discrepancies in pay between men and women.

question

Civil Rights Act

answer

1964 law that prohibits discrimination based on gender, race, or religion.

question

Age Discrimination in Employment Act

answer

1967 law that prohibits discrimination of employees 40 years and up.

question

Occupational Safety and Health Act

answer

1970 law that requires employers to maintain a safe workplace and adhere to standards specific to healthcare employers.

question

Rehabilitation Act

answer

1973 law that protects rights of handicapped.

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Employee Retirement Income Security Act

answer

1973 that grants protection to employees for retirement benefits to which they are entitled.

question

Pregnancy Discrimination Act

answer

1978 law stating that pregnancy is considered a medical condition and prohibits exclusion of pregnancy in benefits and leave policies.

question

COBRA

answer

Consolidated Omnibus Budget Reconciliation Act: 1986 law that gives benefits like health coverage for a limited time due to various circumstances like termination, layoff, death, reduction of hours per week, and divorce.

question

Immigration Reform and Control Act

answer

1986 law that establishes penalties for employees who knowingly hire illegal aliens.

question

Worker Adjustment and Retraining Notification Act

answer

1986 law that requires employers who will make a mass layoff or plant closing to give 60 days advance notice to affected employees.

question

Americans with Disabilities Act

answer

1990 law that gives people with disabilities access to public services and requires employers to provide reasonable accommodation for applicants and employees.

question

Family Medical and Leave Act

answer

1993 law that permits employees in organizations to take up to 12 weeks of unpaid leave each year for family or medical reasons.

question

Health Insurance Portability and Accountability Act

answer

2003 law that guarantees employees protection from outside access to personal health info and limits employers' ability to use employee health info under health insurance plans

question

conceptual skills

answer

Ability to critically analyze and solve complex problems.

question

technical skills

answer

Expertise or ability to perform a specific work task.

question

interpersonal/human relation skills

answer

Enables a manager to communicate with and work well with other individuals.

question

functional organizational structure

answer

Most common organizational structure; pyramid shaped; used in larger organizations; deep vertical structures; strict chain of command ensures that communication and assignment and evaluation of tasks are carried out; used most frequently in HSO's.

question

matrix management method

answer

Administrative structure; dual authority system where individuals are assigned to complete specific work tasks; advantages are improved coordination and communication, also increases flexibility of organization to carry out work.

question

product/service line management

answer

Organized around selected services to control service delivery; Advantages are resource control, accountability, enhanced clinical quality of service.

question

environment for HSO's

answer

Entities and influences outside of the organization's boundaries.

question

open systems

answer

Organizations which are affected by, and also affect, their environment.

question

exchange relationships

answer

Transaction between 2+ organizations where something of value is exchanged and both gain value.

question

input/output management model

answer

Management acquires inputs, uses inputs to provide services, and creates outputs.

question

managers

answer

Persons appointed to positions of authority who enable others to do their work effectively, who have responsibility for resource utilization, and who are accountable for work results.

question

line managers

answer

Those that supervise other employees.

question

staff managers

answer

Those that carry out work and advise their bosses.

question

6 management functions

answer

1) Planning; 2) Organizing; 3) Staffing; 4) Controlling; 5) Decision-Making; 6) Directing

question

organizing

answer

Establishing authority and responsibility management.

question

staffing

answer

Acquiring and retaining human resources.

question

directing

answer

Initiating action in the organization by leading, motivating, and communicating.

question

controlling

answer

Monitoring, adjusting, and improving aggregate performance.

question

decision making

answer

Evaluating alternatives and making choices.

question

managerial tasks

answer

Include core tasks, routine add-ons, and specialty add-ons.

question

domains of management

answer

1) Self; 2)Team/Work Unit; 3)Organization

question

organizational culture

answer

Ingrained patterns of shared beliefs, values and behaviors, with associated symbols and rituals, that are acquired over time by members.

question

direct care

answer

Deals directly with the patients such as a hospital, nursing home, physician practice, and assisted living facilities.

question

indirect care

answer

Supports the care of individuals through products and services made available to direct care settings. Ex) Consulting firms, associations, pharmaceutical companies, and medical suppliers.

question

70%

answer

Percentage of expenditures in healthcare that go to pay the workforce.

question

contracts

answer

The most basic/important item in business relationships.

question

restrictive covenant

answer

Worst provision for the employee in a contract.

question

at will contract w/ or w/o restrictive covenant

answer

What is the best deal for employer in a contract?

question

contract with money/stability and free agency

answer

What is the best deal for you in a contract?

question

patients and skills

answer

As a physician what are your bargaining tools in a contract?

question

covenant

answer

Restriction on free agency.

question

integration clause

answer

Tells us what the whole deal is.

question

ADR provision

answer

How we're going to resolve disputes.

question

maximum notice possible and severance

answer

What provisions are best for you in a termination without cause?

question

fairness and consistency

answer

What are the 2 key principles in hiring?

question

business plan

answer

Good place to start on how to set up your practice: 1) Executive summary; 2) Mission statement; 3) Ownership/management; 4) Market analysis; 5) Financing; 6) Projected patient base/referral sources; 7) Services; 8) Location; 9) Assets; 10) Operational plan; 11) Human Resources; 12) Marketing

question

reimbursements for physician services

answer

These must be credentialed!

question

joint several liability

answer

Risk is that if one person screws up, all in the partnership are liable.

question

LLP-limited liability partnership

answer

Risk is that liability is limited individually.

question

LLC

answer

S-corporation.

question

accessibility

answer

What is the most important factor in choosing a location for your practice?

question

statute of frauds

answer

What says that leases/realty agreements must be in writing?

question

15M

answer

What is the sales maximum to be eligible for an SBA loan?

question

adverse occurrences

answer

What on your record is very bad for credentialing criteria?

question

audits and penalties

answer

In your insurance, what does regulatory liability cover the costs of?

question

D&O insurance

answer

Protects directors and officers in corporations.

question

no

answer

Can unemployment or worker's comp be waived?

question

quality

answer

In regards to suppliers and equipment what is most important?

question

7

answer

How many years must patient records be kept?

question

risk management

answer

4 philosophies: 1) Avoidance; 2) Reduction of effect--or risks; 3) Transfer; 4) Acceptance.

question

lean

answer

Main goal = reducing waste reduces risk to practice. Achieve high quality, defect-free medicine.

question

patient's death

answer

The worst waste in healthcare.

question

key LEAN principles

answer

The patient comes first. Care must be of the highest quality. Promote efficiency. ID/remove practice/treatment defects. Maximize business safety. Organize all elements of practice. Eliminate all waste.

question

less waiting time for patients

answer

What is the most important possible LEAN benefit?

question

profitability

answer

What is the biggest risk in a practice?

question

Heijunka

answer

Leveled production, no bottlenecks or waste.

question

Jidoka

answer

The safety element/be watchful for all defects.

question

5 S theory

answer

Sort Simplify Sweep Standardize Self-discipline/sustain

question

46

answer

How many million people are uninsured?

question

process engineering

answer

Focus on design, operations, control and optimization of processes through the aid of systemic efforts.

question

world class leadership

answer

What is MOST critical to LEAN?

question

safety

answer

What is everyone's job in a practice?

question

employer

answer

Who does arbitration favor?

question

25

answer

How many million people are underinsured?

question

Affordable Health Choices Act

answer

Same as house bill but more emphasis on prevention and wellness.

question

The Care Triad

answer

Quality Cost--> Access

question

98

answer

Number of thousands of patients who die each year from medical errors.

question

Hill Burton Act

answer

Instigated after WWII: most community hospitals est. as a result of this act, provided funds for community hospitals.

question

top managers

answer

(#1) CEO, Chief Executive officer, COO, owners, VP's of finance, marketing.

question

middle managers

answer

(#2) Largest category--they lead and follow at the same time, comprised mostly of dept. heads.

question

first line managers

answer

(#3) Supervisors who organize how will things get done, using resources.

question

CEO

answer

Responsibilities include: planning rather than executing, relations with governing board, external relations, leadership, ceremonial functions.

question

COO

answer

Responsibilities include: mostly internal and execution, delivers short-term expectations for cost, demand, quality, patient satisfaction, employee satisfaction; link between strategy/performance; can be chief medical officers or chief nursing officers.

question

CFO

answer

(Chief Financial Officer) Responsiblities include: finance, accounting, protections of assets, reimbursement job.

question

CIO

answer

(Chief Information Officer) Responsibilities include: information services and planning, medical records, technology, computers, electronic records.

question

CMO

answer

(Chief Medical Officer) Responsibilities include: medical staff relations, medical education, physician recruitment, top manager that takes care of all staff issues.

question

CNO

answer

(Chief Nursing Officer) Responsibilities include: nursing, staff planning, recruitment, inpatient care, top nurse plans.

question

proactive coordinating

answer

Activities that anticipate and prevent problems.

question

reactive coordinating

answer

Activities aimed at fixing structural and functional arrangements.

question

measurement and control systems

answer

Collect data and reward specific behaviors is a way to determine performance.

question

Theory X

answer

Belief that the average employee hates work, avoids work and tries to get by with doing as little as possible.

question

Theory Y

answer

Belief that most employees consider work natural and that most are eager to do the right thing, seek responsibility under the proper conditions, exercise self-control and do not need to be constantly reminded to do their work.

question

formal authority theory

answer

Originates at the top of the organizational hierarchy and is delegated downward from superiors to subordinates.

question

acceptance authority theory

answer

Addresses the role of subordinates in managerial authority in bottom up-approach.

question

DMAIR

answer

Design, Measure, Assess, Improve, Redesign

question

Fair Labor Standards Act of 1938

answer

Minimum wage, overtime pay and record keeping.

question

OSHA

answer

Workplace safety.

question

Employee Polygraph Protection Act

answer

Prohibits use of polygraph by most private employers.

question

HIPAA

answer

Health insurance coverage.

question

Nursing Relief for Disadvantaged Areas Act

answer

Permits temporary employment of illegal aliens/foreign Registered Nurses.

question

laissez faire

answer

People left to do their work—minimal amount of supervision—most useful in an organization of professionals.

question

motivation

answer

Process affecting the inner needs or drives that arouse, move, energize, direct, channel and sustain human behavior.

question

morale

answer

State of mind and emotion affecting the attitudes, feelings, and sentiments of individuals and groups towards their work, environment administration, and colleagues.

question

controlling

answer

Process that checks performance against standards--ensures that performance is consistent with plans and that the organizational and departmental goals and objectives are achieved.

question

feedback model

answer

Information on how the system is doing is obtained by the supervisor or the sensor who then monitors the system by comparing the actual results with the desired performance.

question

rolling budget

answer

Manager initially prepares the 12 month budget as he/she would in a traditional budget—when the first month of the new budget ends the manager projects that month's budget for the following year and so on.

question

flexible budget

answer

This budget is prepared with a range of activity levels so that adjustments can be made throughout the year if changes in activity levels occur.

question

traditional budget

answer

Involves projections for the following year based on current expenditures and the previous annual budget.

question

incremental budget

answer

Couples with the rolling or flexible budget—the base is treated as though it were already authorized and requires no review—adjustment amounts become the manager's new budget.

question

zero-based budgeting

answer

Used by many corporations--ignores the previous years budget--every activity submitted for funding must be justified of each budget item from the ground up.

question

tort

answer

A legal wrong or an act of omission of acting that results in injury to another.

question

respondent superior doctrine

answer

The institution--employer--is legally responsible for the negligent or wrongful acts or omission of the employee even though the facility itself is committed no wrong; the negligence of the employee is imputed to, or placed on the employer.

question

ethics theories

answer

Offer a means to explain and justify actions and service as guides for making moral decisions and thus influence behavior.

question

National Committee on Vital and Health Statistics

answer

Government agency that has led the development of basic data sets for health records and computer databases.

question

minimum data set

answer

Purpose is to recommend common data elements to be collected in health records.

question

aggregate data

answer

Data that are collected on large populations of individuals and stored in databases.

question

Uniform Hospital Discharge Data Set

answer

The inpatient data set that has been incorporated into federal law and is required for Medicare reporting.

question

performance improvement programs

answer

Both HEDIS and the Joint Commission's ORYX program are designed to collect data to be used for:

question

National Health Information Network

answer

A network of networks.

question

Health Insurance Portability and Accountability Act of 1996

answer

The federal law that directed the Secretary of Health and Human Services to develop healthcare standards governing electronic data interchange and data security.

question

state regulation

answer

Most healthcare information standards have been implemented by:

question

data dictionary

answer

A critical early step in designing an EHR is to develop a(n) ___ in which the characteristics of each data element are defined.

question

UHDDS

answer

According to this, ethnicity should be recorded as either: Hispanic, non-Hispanic, or unknown.

question

reason for encounter

answer

While the focus of inpatient data collection is on the principal diagnosis, the focus of outpatient data collection is on:

question

MDS Version 2.0

answer

In long term care, the resident's care plan is based on data collected in the:

question

OASIS

answer

Reimbursement for home health services in dependent of data collected from:

question

HEDIS

answer

Comparison of the performance of health plans.

question

XML

answer

A standard that allows data to be transferred across the Internet.

question

harmonization of standards from multiple sources

answer

As many private and public standards groups promulgate health informatics standards, the Office of the National Coordinator of Health Information Technology has been given responsibility for:

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