Health Care Core Semester Review

Chapter One: What is the job of the hospital controller? The individual responsible for managing the financial activities of a hospital. Responsibilities include accounting, working with banks to bowwow money, and supervising the collection of accounts receivables (amounts owed by patients who have received care but not yet paid the bill). What are some elements of communication? It takes two. For communication to take place one person must create a message and another person must receive, interpret, and evaluate it. The person sending the message is the sender. The person receiving the message is the receiver. Chapter Three: What is JCAHO, and what is its purpose? Joint Commission on Accreditation of Healthcare Organizations (JCAHO) is an organization that accredits hospitals and other healthcare organizations. Accreditation provides legitimacy in the eyes of the consumer, who is often unable to judge the quality of healthcare services. What is HIPPA and its purpose? Health Insurance Portability and Accountability Act (HIPPA) was enacted by the U.S. congress in 1996. One objective is to protect confidentiality of health information. What is the job of the risk management department? A department or specialty that anticipates and tries to prevent risks to employees, patients, and visitors. Slipping on an icy sidewalk would be a risk this program might address. Chapter Four: What is an on-call nurse? A nurse not assigned a specific time to work, but who agrees to be available to be called in on short notice. What does an interdisciplinary team do? Teams composed of people with different educational backgrounds to work together in the care and treatment of hospital patients. Chapter Five: What kinds of items are found in the Patient s Bill of Rights? (Brannan Community Hospital PBOR) - To know the name and professional status of all people providing healthcare - To know the name of their attending doctor - To receive complete information on their diagnosis and treatment - To be given the prognosis for their illness - To review all of the information in their medical record - To have every procedure, treatment, or drug therapy explained to them in a language they can understand - To know the possible risks, benefits, and costs of every treatment or drug therapy - To accept or refuse treatment - To prepare, in advance, treatment directives and to expect these will be honored - To appoint a person to make decisions about their care if they become mentally disabled

To have personal privacy To receive compassionate care and proper management of pain To seek a second opinion To ask that the Hospital Ethics Committee review their case

What are ethics? Ethics are the study of the principles of right and wrong What is legal? Something that is allowed by law. Just because something is legal does not always mean it is moral. What are biomedical ethics? A subcategory of ethics that concerns itself with the way that individuals behave, the manner in which they exercise their power and the impact it has on their fellow human beings. Bioethics has received increasing attention in recent years because: - New technologies that have prolonged life and changed the definition of death - A society that increasingly looks to lawsuits as a way of resolving unsatisfactory medical outcomes - An increased sensitivity to individual rights - A willingness of society to examine controversial issues, such as abortion and euthanasia What does the term free agency mean? A patient has a right to make decisions about his or her own body without outside control. Chapter Six: Describe the role of a case manager. A person who continually monitors the quality of care provided to patients in the hospital. This is usually done by reviewing medical records to see that proper procedures have been followed and the right treatment has been given. What does it mean to patient dump? The practice of transferring patients that cannot pay their bills to other hospitals What is malpractice? An act of professional negligence that injures a patient Chapter Eight: Differentiate between bias and prejudice. Bias A point of view that prevents unprejudiced consideration of an issue Prejudice implies a preformed judgment even more unreasoning than bias, and usually implies an unfavorable opinion; e.g. Prejudice against a race. Chapter Ten: What does managed care mean? An approach to cost control that includes preauthorization for expensive procedures, incentive reimbursement, retrospective (after-the-fact) quality audits, and second opinions. Chapter Thirteen: Identify several factors that have contributed to the increased cost of health care. The bigger is better syndrome, cost per patient daily, room rate, the increase in technology use.

Chapter Fifteen: What does HMO stand for and what is its purpose? Health Maintenance Organization that originally tried to control health care costs by: paying physicians and hospitals capitation instead of billed charged payments; requiring patients to use specific doctors and hospitals; providing financial incentives for patients to adopt healthy lifestyles; requiring second opinions or prior approval for expensive procedures that are often abused. Chapter Sixteen: Explain a DRG. Disease related group that is a disease grouping developed by the administrators of Medicare for payment to hospitals Chapter Seventeen: In business the term bottom line is used. What does it mean? Synonym for profit (found on the bottom line of the income statement) Chapter Twenty-One: What does a human resource director do for a job? Manage the daily operations of a hospital. Chapter Twenty-Two: What is an incident report? A form used by hospital authorities to record the facility s unusual occurrences. For example, if a person who met with an accident is admitted to a hospital, an incident report is created by the hospital authorities. A comprehensive incident reporting system facilitates in identifying potential events, claims, and lawsuits. What is the objective of a hospital billing code? A number used on a bill to an insurance company that identifies the diagnosis test, or procedure being billed. What does it mean to bundle? As it relates to hospital billing, bundling is the practice of combining the charges of many services into one bill, rather than billing individual for each service. Some insurance companies prefer bundling, others like items billed individually. Define morbidity. The number of cases of a specific disease in relation to the general population Chapter Twenty-Five: What does the term skimming mean? The practice of providing only those healthcare services that generate a profit, leaving to others (usually community hospital) the responsibility to provide services that generate a loss Chapter Twenty-Eight: What does OSHA stand for and what does it do? The Occupational Safety and Health Administration (OSHA) was created in 1970. Its mission is to prevent work-related injuries, illnesses, and deaths. It does this by issuing safety and health standards, conducting inspections and investigations, and issuing citations and imposing penalties.

If a hospital s disaster plan is activated, what line of authority is followed? 1. Administrator 2. Director of Nursing 3. Nursing Supervisor 4. Emergency Room Supervisor If a disaster plan is activated, the term code _______ is announced. Code Orange What does the acronym RACE stand for? Rescue, Activate alarm, Confine the fire, Evacuate/Extinguish (NFPA/OSHA fire safety) What does it mean to triage? The process of sorting people to determine who receives treatment first. The triage is to do the most for the most. Triage is usually performed by a triage officer, who sorts patients, but does not give care. Chapter Thirty: What is telemetry? The science of measuring something, sending the measuring by radio signal to a distinct station, and then recording or interpreting the results. In a hospital, telemetry, for example, may be used to transmit heart monitor information from a patient to a central nursing station. Chapter Thirty-Two: When we apply statistics to biological or medical data it is referred to as __________? Biostatistics