Physician Consortium
PCPI- Physician Consortium for Performance Improvement
In American Medical Association PCPI is oriented to improve the quality, and value of care to the patients by various programs including maintenance of clinical performance measures which are evidence based, measurement science, improvement of the quality of care with the help of National Quality Registry Network (NQRN).(1)
NQF – National quality forum
A membership based organization that works for improvements in quality of healthcare. It implements a national strategic plan for healthcare quality measurement and reporting. This forum make sure that quality performance information is accurate and accessible for everyone in public with feedback (2).
HAC – hospital-acquired condition
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P4P- Pay for performance
Also known as value based purchasing, pay for performance allots financial incentives to health care providers or hospitals who met certain standards like measures to improve quality of life or counselling for healthy life style. In contrary this model can penalize for poor health care outcomes (11).
ALOS- Average length of stay
As name suggest it is the average number of days a patient admitted in hospital in treatment process. Calculated by dividing total number of inpatient days for all patients with total admissions in a fiscal year(12).
ADC- Average daily census
Defined as the average number of inpatients receiving health care per day. Calculated by total patient days in a particular period of time are divided by the number of days in that period
LTAC- Long term acute care
As name suggests LTAC provides specialized acute care for long term period of 20 to 30 days. Rather than traditional skilled care LTAC provides individualized and resource-intensive care(13).
SNF- Skilled nursing
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HBP- Hospital-Based Physician
As per CMS a doctor is said to be Hospital-Based Physician if they spend 90 % of their working hours in either inpatient hospital or outpatient hospital or emergency care setting. Quite often there are specialized in anesthesiology, intensive care, cardiac care , pathology or radiology(24).
EMR - Electronic Medical Record
In contrary to traditional way of recording patient information on paper , EMR is the way of recording all patient information in electronic form which make physician work easy and helps to retrieve fast without any loss.
HIXs- Health Insurance Exchange
As per Obama care act HIXs provide scope to inter changeable exchange of qualified health plans which is strictly under federal and state laws.
HIE - Health Information Exchange
Exchange of patient health information in electronic form between various hospitals or within different departments of same hospitals to avoid unnecessary tests and improve the quality of health care (25).
HEDIS- Healthcare Effectiveness Data and
The Pros And Cons Of ICD-9
701 Words | 3 PagesEveryone is probably wondering why is ICD-10-CM and ICD-10-PCS are better alternatives? Well, ICD-10 contains the most remarkable changes in the history of ICD. Its alphanumeric format provides a better structure than ICD-9, allowing considerable space for future revision without disruption of the numbering system, much more than is possible with ICD-9-CM. Replacing ICD-9 with ICD-10 it will provide higher standard information for measuring healthcare service quality, safety, and efficacy. Doing so it will provide better data for quality measurement, and medical error reduction, outcomes measurement, clinical research, clinical, financial, and administrative performance measurement, health policy planning, operational and strategic planning and health-care delivery systems design, payment systems design and claims processing, reporting on use and effects of new medical technology, provider profiling, refinements to current reimbursement systems, such as severity-adjusted DRG system, pay for performance programs, public health and bioterrorism monitoring,
Mystory: Patient Aligned Care Team (VHA)
223 Words | 1 PagesIn this domain the White City VHA scores range from ones to fives. Two of the three elements scored a five, and one element scored a one. The VHA has a clear statement and commitment to PFCC. A model, Health for Life, was developed by the Office of Patient Centered Care (OPCC), which focuses on the whole person. Veterans health care goals, not the disease, are at the center of the care.
Physician Quality Reporting System (PQRS)
565 Words | 3 PagesSince CMS implemented the Physician Quality Reporting Initiative (now known as the Physician Quality Reporting System (PQRS) under the Tax Relief and Health Care Act of 2006 (TRHCA), there have been several changes in participation sanctions, reporting mechanisms and eligibility for incentives and bonuses. During the first two years, the program was technically a temporary, renewable initiative that sought to improve the quality of both delivery and coordination of care. The initiative became permanent when the Medicare Improvement for Patients and Providers Act (MIPPA, 2008) was enacted. The Centers for Medicare and Medicaid Services (CMS) believes the sanction-based initiative will empower consumers and providers to make better informed decisions
Pros And Cons Of The Overall Hospital Star Rating
1236 Words | 5 PagesThe mission of the U.S. Department of Health and Human Services (HHS) is to “enhance and protect the health and well-being of all Americans” and fulfilling the mission by “providing for effective health and human services and fostering advances in medicine, public health, and social services” (Assistant Secretary for Public Affairs (ASPA), 2016). According to Rouse (2016), the HHS department works approximately one-fourth of federal government disbursements and distributes more grant dollars than all other federal agencies fused together. In order to provide patients to choose the right facility for their health care needs, the Overall Hospital Quality Star Rating can determine where care will be provided. The Overall Hospital Quality Star Rating is designated to assist individuals, family members, and providers to compare hospitals that summarizes existing quality measures based on the patient experience of care data ("First Release of the Overall Hospital Quality Star Rating on Hospital Compare", 2016). There are advantages and disadvantages regarding the Overall Hospital Quality Star Rating.
Health Information Exchange Research Paper
87 Words | 1 PagesHealth Information Exchange Providers across the U.S. are turning to the Health Information Exchange also known as HIE. HIE provides secure online access to patients charts among a network of providers, hospitals, clinics, doctor’s offices, and pharmacies who join in the exchange, so they can have timely electronic access to records their patients will allow them to share. For patients this means having their medical records available no matter where they go and for providers it means having instant access to life saving information when seconds count
Affordable Care Act Case Study
535 Words | 3 PagesHHS expects 90% of Medicare payments to be directly tied to quality measures by 2018. It is imperative that hospitals, urgent care clinics and frontline providers align their
Kaiser Permanente: Integrated Health Care
658 Words | 3 PagesKaiser providers receive a fixed amount of money per member, so as a cost saving measure, the system is geared toward keeping patients healthy and away from costlier and frequent service utilization. Kaiser Permanente utilizes a patient portal EMR system that they have named KP Connect. It is the largest civilian electronic medical record system, and is reported to have has improved clinical process measures and member retention, as well as elicited some operational savings and changes in utilization of
HRSA Mission Statement
648 Words | 3 PagesIn addition, the HRSA deals with compensation as a result of a harmful vaccination and “maintains databases that protect against health care malpractice, waste, fraud and
Joint Commission Research Paper
1004 Words | 5 PagesThe Joint Commission The Joint Commission has been around for many years. The Joint commission was established in 1951 as a not-for-profit organization. The Joint Commission “seeks to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value. The Joint Commission accredits and certifies more than 21,000 health care organizations and programs in the United States, including hospitals and health care organizations that provide ambulatory and office-based surgery, behavioral health, home health care, laboratory and nursing care center services (The Joint Commission, 2016).”
Jean Watson Theory
1792 Words | 8 PagesNurses play an essential role in the healthcare industry. The nurse workforce is made up of licensed nurses: registered nurses (RNs), licensed vocational nurses (LVNs) and licensed practical nurses (LPNs), along with nurse aides. Registered nurses are responsible for assessments of patients’ needs, development of care plans, medication administration, and treatments, while licensed vocational nurses perform specific care under the delegation of the registered nurses and supervisions. Nursing aides perform activities of daily living (unskilled attention) to the patient. Adequate nursing staffing is essential to both patient care and outcomes, also to the retention of nurses while inadequate staffing creates problems for both the patients and
HEDIS In Healthcare
660 Words | 3 PagesHEDIS is list of health care process measures and intermediate outcome measures based on administrative data, claims and patient records and is utilized by insurance agencies and CMS (Martino, Weinick, Kanouse, Brown, Haviland, Goldstein &… Elliott, 2013). The HEDIS measures include coronary artery disease, diabetes (and its complications), congestive heart failure, stroke, hypertension, obesity, smoking, metabolic syndrome, medication adherence and derive the best quality outcomes from trials and preventive medicine (Eddy, Pawlson, Schaaf, Peskin, Shcheprov, Dziuba & …Eng (2008). In 2005, these HEDIS measures targeted a study of 3.3 million and improvement in performance to those imply prevention of 1.9 million myocardial infractions, 0.8 million strokes, and 0.1 million cases of end-stage renal disease, however if performance would have been 100 percent 1.4 million myocardial infractions could have been prevented because the control of blood pressure has the largest potential effect on quality at a national level (Eddy, Pawlson, Schaaf, Peskin, Schcheprov, Dziuba & …Eng, 2008). These measures follow the best practice guidelines for improving the health of the
Electronic Health Records: Annotated Bibliography
150 Words | 1 PagesThe healthcare facility will produce better outcomes in EHRs with the
Hospital Compare In Healthcare
898 Words | 4 PagesHospital compare helps citizens find information for hospitals all over the country. This information helps the patients and their families make the best choice for their monetary restrictions and their health choices. This helps them find out whether the quality of care is adequate for their needs between many hospitals in the patient's home area. Hospital compare helps the patient by making the decision process easier, and making hospitals improve their health care quality. Patients can find a variety of information about the hospitals quality; including general ratings of the hospital, general information, payment and value of care, timely and effective care, and much more information on this website.
Disadvantages Of Health Information Exchange
872 Words | 4 PagesAdding more parties to sharing data along with the time it takes to complete a cohesive DURSA agreement can be lengthy and costly. Another challenge of HIE is that HIEs can sometimes be viewed as providing duplicative information or solutions offering patient portals or patient related information directly to the consumer. Health information exchange has three key forms: directed exchange, query-based exchange, and consumer mediated exchange. Directed exchange is the “ability to send and receive secure information electronically between care providers to support coordinated care” Examples of patient information include ancillary test orders and results, patient care summaries, or consultation reports. The encrypted patient information is electronically sent securely between parties with an established relationship.
Clinical Audit Assignment
2077 Words | 9 PagesClinical Audit Assignment. Introduction. There are many benefits in carrying out a clinical audit. It allows nurses to evaluate the care they are giving, encourages them to keep better records, focuses on the care given rather than the care giver themselves and achieves a feasible quality of nursing care (Harmer and Collinson 2005).
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