nursing assistant unit 1 chapter 1: the health care system unit 1 chapter 1: the health care system
DESCRIPTION
Health Care Delivery, Past and Present In the U.S. during the 18 th, 19 th, and early part of the 20 th century Mainly focused around the home and family “Snake Oil” “family doctor” In the U.S. during the 18 th, 19 th, and early part of the 20 th century Mainly focused around the home and family “Snake Oil” “family doctor”TRANSCRIPT
Nursing Assistant
Unit 1Chapter 1: The Health Care System
Unit Objectives:
Identify changes that have occurred in how health care is delivered Describe the different types of health care organizations Briefly explain the structure of health care organizations List some of the government and private agencies that provide oversight of the health
care system Describe how the survey process is used to monitor the quality of care given by health
care organizations Discuss how health care is paid for
Health Care Delivery, Past and Present
In the U.S. during the 18th, 19th, and early part of the 20th century Mainly focused around the home and family “Snake Oil” “family doctor”
Health Care Delivery, Past and Present
Present-day delivery of health care Mandatory education and training Required to care for those in need Multiple care locations Multiple specialties
Family Practice, Cardiovascular, GI, Endocrine, Neurology, Obstetrics, etc. Attention to holistic approach
Health Care Organizations
Mission Purpose of a health care organization Can this vary based on the type of organization Examples of different missions
To detect and treat disease To promote health by teaching people about ways to achieve and maintain physical and mental fitness To provide emergency care to people with life threatening illness or injuries
Health Care Organizations
Types of Health Care Organizations Hospitals
Severe illness or injury or requires a great deal of care and or close monitoring Acute care General Hospitals Specialty Hospitals Patients Inpatient vs. Outpatient
Health Care Organizations
Sub-acute Care Units (Skilled Nursing Units) Either in hospitals or Long-Term Care Facilities (Nursing Homes) Care focuses on rehabilitation Transition period between acute-care and home
Health Care Organizations
Long-Term Care Facilities (Nursing Homes) People who cannot care for themselves Do not need the acute-care of a hospital Referred to as residents May stay for rest of life for go home Not always elderly Special units for Alzheimer’s
Health Care Organizations
Assisted-Living Facilities Type of long-term care Residents provide most of their own care Limited assistance from staff
Medications Transportation Meals Housekeeping
Health Care Organizations
Home Health Care Agencies Skilled Nursing care in person’s home Person’s receiving care called clients Available for all ages and medical needs
Structure of Health Care Organizations
Structure of Health Care Organizations
Each division responsible for one key aspect Ensures knowledgeable leadership for each area Health Care Team
Many different people with many different types of knowledge and skills Patient, resident, or client is always the focus of the team
Structure of Health Care Organizations
Patient, Resident, Client
Physical Therapist
Housekeeping
Dietary
Nursing Assistant
Nurse
Physician
Social Services
Lab, Pharmacy, X-
Ray
Oversight of the Health Care System
Ensuring Quality Health Care Proper training and competency Standards of cleanliness and quality Safe delivery of care Availability to everyone
Oversight of the Health Care System
Ensuring Quality Health Care Cont. United States Department of Health and Human Services (DHHS)
Primary agency responsible for protecting this nation’s health Umbrella of DHHS
Oversight of the Health Care System
DHHS
NIH(National Institute
of Health)
FDA (Food and Drug
Administration)
Agency for Health Care Research
and Quality (AHRQ)
Center for Disease Control
(CDC)
Centers for Medicare and
Medicaid Services (CMS)
Oversight of the Health Care System
The Joint Commission Joint Commission on Accreditation of Health Care Organizations (JCAHO) “jay-co” Est. 1951 Standards for all types of health care organizations Inspections Voluntary Organizations must pay for inspections
Oversight of the Health Care System
They Survey Process Actual inspection Written report presented Opportunity to respond to deficiencies Failure to fix could result in:
Loss of accreditation Fines Inability to qualify for Medicare or Medicaid payments Admission ban Closure
Oversight of the Health Care System
What do I do during a survey? Always act within your scope of practice Always behave like the professional you are Make sure that your conversations are appropriate Be mindful of privacy Maintain a neat, clean working environment Always put patient’s needs first Answer questions honestly and to the best of your ability
Protecting Health Care Workers
Occupational Safety and Health Administration (OSHA) Government agency Part of the Department of Labor Created in response to public concern over increasing number of on-the-job injuries and
deaths Can impose very large fines
Paying for Health Care
Private and Group Insurance Group insurance is purchased by and group or employer at a group rate
Employee may pay certain percentage Precertification process
Health care provider must prove that patient needs services provided Managed Care System
Contracts with doctors and organizations PPO HMO
Paying for Health Care
Medicare Federal program 65 and older Younger if disabled Minimum Data Set (qualifying for long-term care) Diagnostic Related Groups (DRG’s)
Adopted by insurance companies as well
Paying for Health Care
Medicaid Federally funded STATE REGULATED Low income
May have with Medicare if financially eligible Not all facilities required to accept Medicaid