Healthcare Delivery Systems Quiz

Health Care Delivery System

• A mechanism to meet health-related needs of individuals
• Health care providers seek cost-effective ways to deliver increasing services
• Consumers demand quality, affordable, and accessible health care

Types of Health Care Services

• Categorized into primary, secondary, and tertiary levels
• Primary: Health promotion and illness prevention
• Secondary: Diagnosis and treatment (often in acute treatment centers, like hospitals)
• Tertiary: Rehabilitation (restoring the individual to a pre-illness state)
• Tertiary care is holistic, addressing physical, psychological, social, and spiritual aspects

1- Primary: Health Promotion and Illness Prevention

• Aims to promote wellness and prevent illness/disability
• Activities are directed at individuals, families, or communities

1- Primary: Health Promotion and Illness Prevention (continued)

• The current health care system isn't focused on promotion, but on treating illnesses
• Ideally, prevention should occur in communities (homes, workplaces, schools)
• This emphasizes healthy lifestyles

2- Secondary: Diagnosis and Treatment

• Most secondary care occurs in acute treatment centers (e.g., hospitals)
• A growing trend is placing diagnostic and therapeutic services in more accessible locations

3- Tertiary: Rehabilitation

• Restores individuals to their pre-illness state by helping them reach optimal self-care.
• Addresses all aspects of the person (physical, psychological, social, spiritual).

Types of Health Care Services (summary)

Secondary and Tertiary Care Centers: Hospitals

• Hospital emergency departments, urgent care/critical units, and inpatient/medical surgical units are sites for secondary and tertiary care.
• Quality and safe care are important concerns of acute care organizations

Secondary and Tertiary Care Centers: Hospitals (continued)

• Patients require instruction on medications and equipment, food-drug interactions, nutrition, and rehabilitation for functional independence

Secondary and Tertiary Care Centers: Intensive Care Unit (ICU)

• Focuses on close monitoring and intensive medical care for patients.
• Uses advanced technologies like computerized cardiac monitors and mechanical ventilators.
• Specialized nursing/medical staff is crucial

Secondary and Tertiary Care Centers: Psychiatric Facilities/Mental Health Hospitals

• Provides counseling and treatment for patients with emotional/behavioral issues (depression, violence, eating disorders).
• Located in hospitals, independent outpatient clinics, or private mental health facilities

Secondary and Tertiary Care Centers: Home Health Care

• Services are provided in homes for health maintenance, education, disease diagnosis and treatment, palliation, and rehabilitation.
• Home nursing involves monitoring vital signs, administering medications/nutrition/IV therapy, and providing wound or respiratory care; assisting with patient recovery and stabilization of illness

Secondary and Tertiary Care Centers: Rehabilitation

• Restores individuals to their fullest physical, mental, social, and vocational potential.
• Specialized services can include cardiovascular, neurological, musculoskeletal, pulmonary, or mental health rehabilitation.
• Helps patients and families adjust to needed lifestyle changes and cope with limitations of an illness

Secondary and Tertiary Care Centers: Rehabilitation (continued)

• Rehabilitation services use physical, occupational, and speech therapy. It also includes social services
• Initial rehabilitation aims to prevent complications after illness or injury
• It takes place in different health care settings like agencies, outpatient settings, or homes

Health Care Team: Nurses

• Health care is provided by a multidisciplinary team, but nurses coordinate care from other personnel.
• Nurses fulfill various roles affected by changes in the health care environment.
• Roles include dependent, independent, and interdependent roles

Health Care Team: Other Professionals

• List of other health care professionals' functions/roles: includes Nurse, Physician, Physician Assistant, Pharmacist, Dentist, Dietitian, Social Worker— see specific notes for details

Factors Influencing Health Care Delivery: Cost

• The existence of the health care system depends on fiscal issues.
• Government expenditure on per-person health care is a crucial factor

Factors Influencing Health Care Delivery: Access

• Access to care is severely impacted by poverty, causing difficulties for individuals to access services.
• Limited transportation/funding for transit impedes access to care

Factors Influencing Health Care Delivery: Quality

• An estimated 30%-40% of diagnostic/medical procedures are unnecessary.
• Reducing registered nurses may endanger care quality.

Issues in Health Care Delivery: Nursing Shortage

• Turkey has about 200,000 nurses.
• Roles generally involve medical-surgical, primary, or preventative care.
• Aging population is expected to worsen the shortage

Issues in Health Care Delivery: Competency

• Health care professionals need to be competent in the 21st century.
• Institute of Medicine (IOM) identified five essential competencies: work in interdisciplinary teams, provide patient-centered care, use evidence-based practice, use informatics, and apply quality improvement.

Issues in Health Care Delivery: Evidence-Based Practice

• Evidence-based practice is a problem-solving approach involving the use of current best evidence, clinical expertise, and patient preferences/values.
• Nurses are challenged to stay aware of new info to provide high-quality patient care.

Issues in Health Care Delivery: Quality and Safety

• Nurses play a key role in quality and safety in health care.
• Includes measures like hygiene, teamwork, training, prevention of influenza, catheter-related urinary tract infections, fall prevention, and medication reconciliation.

Issues in Health Care Delivery: Magnet Recognition Program

• This program recognizes health care organizations that excel in nursing practice
• Organizations applying for Magnet status need to demonstrate quality patient care, nursing excellence, and innovations.

Issues in Health Care Delivery: Nursing Informatics and Technological Advancements

• Nursing informatics utilizes technology for communication, knowledge management, error mitigation, and decision making.
• Artificial intelligence (AI) is an example

Issues in Health Care Delivery: Globalization of Health Care

• Advances in communication (primarily the internet) allow global communication among nurses, patients, and providers on health issues.
• Globalization improves the availability of health care services, but communicable diseases like are more common .

Community-Based Nursing Practice: Introduction

• Community-based health care is collaborative and utilizes evidence-based models to address the needs of a given community.
• The focus is on health promotion, disease prevention, and restorative care.

Community-Based Nursing Practice: Introduction (continued)

• A healthy community includes elements that promote high quality of life and productivity.
• Nurses have a strategic role in delivering health care and improving community health.

Community-Based Nursing Practice: Components of Community Health

• Community health nursing and community-based nursing are components of a health care delivery system that improve general public health.
• Nurses are leaders in assessments, diagnoses, and evaluation of health services for the community.
• These services exist outside traditional health care settings like hospitals.
• Provision of necessary services to individuals and families.

Community-Based Nursing Practice: Vulnerable Populations

• Vulnerable populations are more likely to develop health problems due to limited access, increased health risks, or dependence on others for care.
• Examples include people in poverty, older adults, homeless individuals, immigrants, individuals in abusive relationships, substance users, or individuals with severe mental illness

Community-Based Nursing Practice: Vulnerable Populations (continued)

• Immigrant populations often have higher rates of hypertension, diabetes, infectious diseases, reduced outcomes of care, and shortened life expectancies.
• Some immigrant groups use non-traditional healing practices.

Community-Based Nursing Practice: Vulnerable Populations (continued)

• People in poverty face hazardous environments, high-risk jobs, poor nutrition, multiple stressors, and vulnerability to homelessness.
• Homeless patients have limited access to shelter and struggle with finding food and shelter.

Community-Based Nursing Practice: Vulnerable Populations (continued)

• Physical, emotional, and sexual abuse and neglect are significant public health concerns affecting various demographics.
• Risk factors include mental health problems, substance abuse, socioeconomic problems, and dysfunctional family relationships.

Community-Based Nursing Practice: Vulnerable Populations (continued)

• Substance use includes illegal drugs, alcohol, and/or prescribed medications (e.g., antianxiety agents or opioid analgesics).
• Patients with substance abuse problems have health and socioeconomic problems.

Community-Based Nursing Practice: Vulnerable Populations (continued)

• Many individuals with severe mental illnesses experience homelessness or poverty.
• Patients with severe mental illnesses (e.g., schizophrenia or bipolar disorder) encounter various health and socioeconomic challenges.
• Services are often offered within a community, rather than in institutions.

Community-Based Nursing Practice: Vulnerable Populations (continued)

• The growing older adult population necessitates an increase in health care services for them. Nursing thorough assessments and community-based interventions can improve lifestyle and quality of life for older adults

Competency in Community-Based Nursing: Caregiver

• Nurses play a crucial role as caregivers, applying the nursing process within a critical thinking approach to give individualized support to patients and their families.

Competency in Community-Based Nursing: Case Manager

• Case management involves establishing a comprehensive plan of care based on assessing patients and families, coordinating needed resources/services, and ensuring the overall well-being across a continuum of care.
• Effective case managers understand the challenges, limitations, and opportunities in a community to support patients' health care needs.

Competency in Community-Based Nursing: Change Agent

• Nurses are change agents, identifying community problems and empowering affected individuals/families to address them, such as improving community child care/elder day care/reducing violence.
• This often involves working within health care agencies.

Competency in Community-Based Nursing: Patient Advocate

• Patient advocacy is crucial in today's complex health care system.
• Nurses assist patients in navigating the healthcare system, including identifying where and how to seek services, understanding needed services, and following through on received information.

Competency in Community-Based Nursing: Collaborator

• Collaboration with other healthcare disciplines is vital in community-based care, like coordinating end-of-life care for terminally ill patients with hospice staff.

Competency in Community-Based Nursing: Counselor

• Counseling involves helping patients clarify health concerns and choose appropriate actions for their situations.
• Counseling doesn't involve decision making, but empowers patients to make their own decisions in response to their situations/concerns.

Competency in Community-Based Nursing: Epidemiologist

• Epidemiologists identify patterns, causes, and effects of health conditions.
• This includes infections like COVID-19, outbreaks, vaccinations, mortality, and communicable illnesses.

Community Assessment

• Community assessment involves systematic data collection and monitoring of the health status/needs of a population.
• The data informs the actions and plans/policies of the community/organization and is used to serve the population effectively
• The components to consider are: structure/locale, the people, and social systems.

Test your knowledge on the various levels of healthcare delivery systems, including acute, primary, secondary, and tertiary services. This quiz explores the services provided by hospitals, the roles of different healthcare facilities, and patient care instructions. Challenge yourself to understand the nuances of modern healthcare.