Health services exam 2 well answers
graded A+ latest update
PCMH - correct answer ✔✔Operational model for primary care service delivery
•Developed in response to Crossing the Quality Chasm
•Existing payment models were not standardized which deterred health care providers from
practicing in primary care
•Supported the transition from fee-for-service models (quantity) to payment for value (quality)
PCMH - Intellectual Roots - correct answer ✔✔•1967 - Origin is linked to American Academy of
Pediatrics (AAP) Standards of Child Health Care which highlighted the need of a medical home
for children
•1978 - Alma Ata Declaration: health care access, team centered approach, improve the health
of populations, healthier communities
•1992 - AAP published the first policy statement about the medical home and offered an
operational definition
•Early 2000's - development of chronic care model
•2007 - four national physician organizations issued the joint principles of the patient-centered
medical home
,PCMH - Joint Principles - correct answer ✔✔Personal physician: having a physician you can trust
Physician-directed medical practice: leads a team of care providers who take responsibility for
patient, the whole team is responsible for the patient
Whole-person orientation: not looking at the physical health, taking a look at the person
holistically, acute care needs, prevention, all stages of life, end of life care, end of life decisions
Care coordination: personal physician is responsible for care with multiple entities, example:
behavioral health, pharmacy, mental health, making sure care is integrated
Quality and safety: the most efficient and effective use of health care services
Enhanced access: flexibility to take off work, expanded office hours, telemedicine, in evenings or
on weekends
Payment reform: work with policy makers, insurance companies so payers recognize the value
5 Key Functions of patient centered medical home - correct answer ✔✔•Comprehensive Care:
Physical and mental health needs (team-based approach)
•Patient-Centered: Relationship-based health care (patients and families are core members)
•Coordinated Care: Coordinates care across all aspects of the larger health care system
•Accessible Services: making use of telemedicine, expanding hours, clinic hours on Saturday
mornings
,•Quality and Safety: making sure that you are providing medicine on latest research and
evidence
patient care team: pharmacist, paramedic, emergency physician, hospitalist, social worker,
nurse practitioner, command center nurse nagivagator, mobile nurse
What is the evidence showing? - correct answer ✔✔•A study commissioned by the Agency for
Healthcare Research and Quality (AHRQ) examined the evidence (2000-2010):
•Favorable effects on quality of care
•Evidence on cost and service use showed limited favorable effects
•Favorable effects on experience of care
•Inconclusive results on the professional experience
Implementation - correct answer ✔✔Eight change concepts were embedded in four stages to
guide specific, actionable steps in practice improvement
Stage 1 - Laying the Foundation
Engaged Leadership - need to allocate resources and make the case for transformation to staff
Quality Improvement Strategy - these strategies provide the framework and tools to plan,
organize, and monitor improvement
, Stage 2 - Building Relationships
Empanelment - assigning individual patients to individual primary care provided and care teams
Continuous and Team - Based Healing Relationships - recognizing others as partners in patient
care (nurse, pharmacist, social worker, health educator, physical therapist, etc.)
Stage 3 - Changing Care Delivery
Organized, Evidence-Based Care - using evidence-based guidelines that are embedded into daily
clinical workflows
Patient-Centered Interactions - patients should take ownership in their health care decision
making, behavior change, and self-management
Stage 4 - Reducing Barriers to Care
Enhanced Access - the commitment to providing patients 24/7 access to their health care team
Care Coordination (see video) - assuming accountability for the patients to reduce
fragmentation and duplication of services
Future Directions - correct answer ✔✔•The foundation organizational structure in primary care
•Contributes to improved quality, increased access, lower costs (referring back to the Iron
Triangle)
•Not limited to primary care, but organizational concept can be used among all providers
graded A+ latest update
PCMH - correct answer ✔✔Operational model for primary care service delivery
•Developed in response to Crossing the Quality Chasm
•Existing payment models were not standardized which deterred health care providers from
practicing in primary care
•Supported the transition from fee-for-service models (quantity) to payment for value (quality)
PCMH - Intellectual Roots - correct answer ✔✔•1967 - Origin is linked to American Academy of
Pediatrics (AAP) Standards of Child Health Care which highlighted the need of a medical home
for children
•1978 - Alma Ata Declaration: health care access, team centered approach, improve the health
of populations, healthier communities
•1992 - AAP published the first policy statement about the medical home and offered an
operational definition
•Early 2000's - development of chronic care model
•2007 - four national physician organizations issued the joint principles of the patient-centered
medical home
,PCMH - Joint Principles - correct answer ✔✔Personal physician: having a physician you can trust
Physician-directed medical practice: leads a team of care providers who take responsibility for
patient, the whole team is responsible for the patient
Whole-person orientation: not looking at the physical health, taking a look at the person
holistically, acute care needs, prevention, all stages of life, end of life care, end of life decisions
Care coordination: personal physician is responsible for care with multiple entities, example:
behavioral health, pharmacy, mental health, making sure care is integrated
Quality and safety: the most efficient and effective use of health care services
Enhanced access: flexibility to take off work, expanded office hours, telemedicine, in evenings or
on weekends
Payment reform: work with policy makers, insurance companies so payers recognize the value
5 Key Functions of patient centered medical home - correct answer ✔✔•Comprehensive Care:
Physical and mental health needs (team-based approach)
•Patient-Centered: Relationship-based health care (patients and families are core members)
•Coordinated Care: Coordinates care across all aspects of the larger health care system
•Accessible Services: making use of telemedicine, expanding hours, clinic hours on Saturday
mornings
,•Quality and Safety: making sure that you are providing medicine on latest research and
evidence
patient care team: pharmacist, paramedic, emergency physician, hospitalist, social worker,
nurse practitioner, command center nurse nagivagator, mobile nurse
What is the evidence showing? - correct answer ✔✔•A study commissioned by the Agency for
Healthcare Research and Quality (AHRQ) examined the evidence (2000-2010):
•Favorable effects on quality of care
•Evidence on cost and service use showed limited favorable effects
•Favorable effects on experience of care
•Inconclusive results on the professional experience
Implementation - correct answer ✔✔Eight change concepts were embedded in four stages to
guide specific, actionable steps in practice improvement
Stage 1 - Laying the Foundation
Engaged Leadership - need to allocate resources and make the case for transformation to staff
Quality Improvement Strategy - these strategies provide the framework and tools to plan,
organize, and monitor improvement
, Stage 2 - Building Relationships
Empanelment - assigning individual patients to individual primary care provided and care teams
Continuous and Team - Based Healing Relationships - recognizing others as partners in patient
care (nurse, pharmacist, social worker, health educator, physical therapist, etc.)
Stage 3 - Changing Care Delivery
Organized, Evidence-Based Care - using evidence-based guidelines that are embedded into daily
clinical workflows
Patient-Centered Interactions - patients should take ownership in their health care decision
making, behavior change, and self-management
Stage 4 - Reducing Barriers to Care
Enhanced Access - the commitment to providing patients 24/7 access to their health care team
Care Coordination (see video) - assuming accountability for the patients to reduce
fragmentation and duplication of services
Future Directions - correct answer ✔✔•The foundation organizational structure in primary care
•Contributes to improved quality, increased access, lower costs (referring back to the Iron
Triangle)
•Not limited to primary care, but organizational concept can be used among all providers
