test one Pre health professional.pdf

Interdisciplinary Team – Lecture 1: 8/21/24 Silos: straight isolated structure, can reflect how US professional schools are set up (by professions: PT, PA, MED) Varies from our experience in healthcare studies as we get to interact with other people pursu...

Interdisciplinary Team – Lecture 1: 8/21/24 Silos: straight isolated structure, can reflect how US professional schools are set up (by professions: PT, PA, MED) Varies from our experience in healthcare studies as we get to interact with other people pursuing various fields the different professions within healthcare are not always familiar with how to work with other professions as their training is specifically with other classmates who are training for the same profession When they are in the real-world workplace, it can be difficult to adjust to working with a whole team of different professionals The US are behind in this sector as other countries have set up their training to be more interdisciplinary Students from each medical professional program will rotate with instructors from varying healthcare professionals from all types of medical sectors Referrals (understands other professionals, correct referrals), Cohesiveness and seamless care This type of training: Interdisciplinary Education and Training (IEAT) Research from other countries have shown that this training is extremely beneficial when students are entering the professional sector Students are able to better understand their scope of practice (responsibilities of each health profession) Efficient referrals allow the healthcare system to flow as patients are able to access care (specialized, rehab) Students are used to working and communicating with other professionals when they are working This type of training: breaks down barriers Greater respect of other professionals Emphasizes the common goal of all healthcare teams: taking care of the patient, removes any superiority/hierarchy Efficient Workplace Barriers within the healthcare system can be broken down Ex of barriers: one professional might not want to call/talk to another professional as they do not want to feel dumb/silly if they do not know the correct terminology If barriers are broken down, processes of trial and error will not need to happen, and patients are able to get clear information efficiently Communication One major issue is also that certain professionals will not talk to other professionals and instead go to administration (they might hold prejudices or have personal problems) Various conflicts surrounding communication could even happen in front of the patients and their families  Many professionals lose sight of the importance of communication/common goal IEAT: Advantages for Patients Increased coordination of care (no years in between inappropriate care) Reduces duplication of diagnostics/prescriptions (duplicates of diagnostics can lead to higher costs for patients) Reduced costs for patients overall Increased efficiency of care for patients Patient safety issues uncovered as a result of lack of communication ▪ you treat a patient with a wrong method/harmful effect to another treatment performed by another professional bc you did not know that they were treated before UNT Health Science Center has incorporated the IEAT method into all their programs (Ask in interviews: Do you have an interdisciplinary health team program (IEAT) incorporated in your program?) Professional School, The Program Set-Up – Lecture #2: 8/28/24 Entrance/First Years of School Didactic portion of training People can only apply during the annual application process (once a year) Cohort: the group of people that are accepted to that specific school on the same year Each cohort is given specific schedule/classes to take each year, so they can ensure that all of them have the same level of knowledge/progressing at the same rate Important to retain information as classes just keep going/building on top of each other each semester Clinical portion of training Everyone in the cohort that is allowed to start have been deemed to be prepared to move onto the clinical training program Every program is structured like this in order to regulate/ensure students are ready Socialization Process Interwoven into your training Each health professional school has their own set of beliefs, values, attitudes/behaviors, and approaches to all things that are taught to their students Ex: dental school might say that teeth is the most important part of the body Even in CE conferences those same values are emphasized especially when people of all one profession gather Decision Making Process Each profession has its own adaptations decision making process for all the patients that they see Assessment of the patients and their symptoms differ between all professionals  As a team member: make sure that you are listening and really taking in what other professionals are saying in context of the patient ▪ They might have other insights/perspectives from their training ▪ They might point out specific things that could impact their treatment plan ▪ There is a broader range of information for that patient ▪ Patients don't tell everybody the same exact things ▪ Must review all the information taken in as a team and use each perspective to determine a possible solution ▪ Important to make a team treatment decision Characteristics of Interdisciplinary Team in the Workplace (that works well) Team members support each other (not ignoring/tearing each other down) ▪ Turfism: not invading somebody's space/area of expertise, "I know the best about this…., you don't know what you're talking about when talking about drugs - a pharmacist", makes somebody seem more important than other people Remember common goal: Treating the Patient, know that we are working in a patient centered manner Contributions of all team members valued: making sure that all members of a team even (CNA, PCTs) are regarded and listened to Appropriate processes in place for communication: regular meetings between various healthcare professionals regarding a patient/patients (clinical staffing, group huddle), everyone gets to hear the same information at the same time (not Dr tells nurse only ) and knows/can prepare for the information that they need to share in the meeting from their week of treatment ▪ Can also be for information regarding the business side of things (new hires, positions open), also a time to ask questions ▪ Important to ask a facility (in interview) regarding if they have this kind of meeting regularly, shows that they are really paying attention to the facility and staff as a whole ▪ Many tough conversations can even be brought up in these meetings, especially when there is conflict within the team Team members utilize feedback from fellow professionals: if patient tells OT something PT did in treatment, they can let the PT know what the patient said Team members share info to make decisions: "when are we going to discharge the patient", the whole team makes these kinds of decisions Team staffing process in place: really important to workplace environment, "what is our procedure for interviewing applicants", it is common that a new applicant might be interviewed (part 2) by a whole team of professionals from different areas of the facility ▪ Consider: are they team orientated, not egotistic/self-centered, can't just say "I like working in a team :)"  Facility promotes team approach in hiring: each facility attempts to ensure that there is an equal number of various professionals on their teams, won't be working with 10 pharmacists to 1 PT or OT Respect for knowledge: really respect the other members and the knowledge/training that they bring into the team Facility promotes professional development/continuing education: means that they promote/have time built in for their professionals to take time off from work to really focus on their continuing education (separate from vacation time) ▪ Another question to ask facility when interviewing about continuing education Benefits of Interdisciplinary Team in Facility The care provided makes for a more efficient workplace When all these characteristics are met: there is a less turnover amongst the professionals Improved communication amongst healthcare professionals AND healthcare management staff Open discussions, no hesitation regarding certain questions (equipment, materials, budget) ▪ People usually must submit proposals of what they want and don't usually get a response, no feedback More efficient daily operations, everything that is set out to be done is done on that day Impact on Students: When you get to the clinical part of your training: the program will decide where you will go, most communication is with the PTs at that specific location (focus is on how that PT will work with their specific patients, treatments) They really only receive evaluations on how they treat patients based on the standards established by that school, not in the standards from other professional schools Clinical instructors are not told to diversify their training programs Why does US not of IEnT? The faculties of schools around the country think it's too much trouble to implement these programs into their programs UNT and UTSA (new) have incorporated IEnT Case Management – Lecture #3: 9/4/24 This system of case management includes: patients, families, and healthcare professionals Impacts every single patient from the time they enter for care until they do not need certain healthcare services anymore Process takes place in every sector of healthcare, all healthcare professionals must participate Case managers are in charge of this process/field Employed by a variety of the different payers of the healthcare system They are given a certain number of cases that represent each of the patients they are overseeing  Group of people in healthcare that are in charge of reading all your documentation, monitor all patients they in charge of at that time If the documentation is incomplete (for referrals, other procedures), case managers must call that professional that wrote the healthcare professional to clarify the information As a professional: Respond to calls from case management politely and timely to ensure that information can be completed, must answer all their questions The calls are documented, and all the information is noted by the case managers If the call is not answered in time, the care for the patient is stopped because the payers will not pay out without the information complete Trying to cover up small mistakes can also be caught by case managers Do not try to suck up to case managers or be overly friendly, keep a good and professional relationship Role of Case Managers pt.2 when the information is complete, the case managers are in charge to approve the plan and the care can continue Case managers are often assigned geographically, so it is important to know them as professionals will encounter them numerous times as long as they stay at the same region They are a part of the team that are advocates for patients Working to prevent: double/triple payments for misdiagnosis, incomplete information Advocate for medical necessity: prescriptions, procedures (in or outpatient), makes sure that the documentation follow every single thing that has been or is planned to be done to treat a patient ▪ Also, can see if anything in the treatment plan is out of place or too extreme/invasive form of treatment They are reviewing and monitoring Who are Case Managers: There are many people employed as case managers as our payer system is extremely fragmented Often have a background of healthcare training, has worked as a nurse, PT, or OT for several years and want to change their role in healthcare Also people who have a bachelor's degree in healthcare studies LOL Caseloads are distributed evenly, they have autonomy in most cases as they handle the patient cases that are assigned to them Many employers require a certification of CCM (certified case manager), initiated internally from the employer (often after a few years of working for that company) ▪ The CCM designation that signifies not only experience/knowledge but also intention to stay in the field and move up  ▪ As they move up in positions: directors of case managements - $400,000, supervisors - $125,000 to $150,000 ▪ Director: hiring, training, any conflict with healthcare facilities/providers ▪ Supervisors: manages a team, answers their questions They have their own professional organization: Case Management Society of America ▪ They oversee creating the certification exam, the scoring process ▪ Applying for the certification: proof of employment/years of experience, along with application ▪ Topics: medical related knowledge (terms), processes of the workplace, career specific questions ▪ Employer would likely pay the fee, allow for time to prepare for the test, can be expensive Utilization Management They monitor the all patient documentation from healthcare professionals to analyze the different areas of healthcare that are being utilized in the time the patient is being treated Duplication of prescriptions, duplication of procedures, excessive/out of standard treatment plans Out of place or misuse of healthcare resources cause case managers to alert and touch base with healthcare professionals They would not want to pay for "overuse" of healthcare resources What do Case Managers manage? They do not look over regular checkups, routine visits due to seasonal diseases (flu) or seasonal allergies (severe) ▪ They don't look at each specific patient that comes through for those types of appointments Patients with multiple chronic illnesses, that have varying and multiple contacts with different healthcare professionals or healthcare facilities are the patients whose cases that are managed by a case managers, they follow them row by row ▪ Patients that are in and out of healthcare facilities or need multiple medical treatments over the years are the types that are followed by a case manager year after year Case Managers that work in Hospitals Employer is the hospital: they only work in that one hospital, every hospital has their own department of case management (size varies based on size of the hospital) They stay with the patients that they are assigned too until their stay at the hospital has ended They are overseeing the patients stay from the time they arrive to their treatment to the time they are discharged  ▪ Case managers collate all the documents needed for the patients whole stay and also communicate to the long term healthcare facilities/rehab facilities a patient might need to go to after their hospital stay Life Care Planning Most serious/complex + involved case managements Only works with example: 26 y/o male motorcycle accident, head and spinal cord injury, broken leg/arms/hand, internal organ injuries, ribs broken Focused on patients that have experienced extremely traumatic injuries (vehicle, water skiing, skiing, rock climbing, workplace) ▪ Patients are often unable to make decisions for themselves after the accident There are often other parties involved in this accident so there is also a lawsuit ongoing These case managers work in law firms that work with these kinds of cases, often big enough law offices will employ 1 or 2 case managers They might not have many patients everyday as these events don't happen as often, but they follow their patient cases for life ▪ Patients in this case cannot really gain their independence back, might have to receive treatments/surgeries often ▪ Life Care Planners must monitor their various moves to different facilities and other treatments they must receive The law firm manages the settlement from the other party to make sure that the patients care can be taken care of They can go in-person to facilities to monitor the progress of the patient's treatment processes, monitor if the treatment is helpful and if the patient needs other types of treatment Qualifications: ▪ Same as other case managers in terms of education, medical experience (depending) ▪ Certifications are different as they must know specific legal jargon, same as other case managers with internal referrals from employers ▪ There are 6 courses that they must take, varying in lengths (a few weeks), they must pass ▪ Exam consists of material from their medical/healthcare system knowledge and information from those 6 courses Advancing in position: due to the fact that there are not as many life care planners, there is not really positions and many people work as equals ▪ Years of experience can lead to higher pay, salary can vary depending on size of law firm Questions: Prior Authorizations Patients in hospice have case managers (in most cases) Sometimes hospital case manager and payer case managers may work together HIPAA – Lecture #4: 9/11/24 Health Insurance Portability and Accountability Act We are required to protect patient information/health information New employers are also not allowed to view past information about even an interviewee/new employee regarding their health information Awareness There are more people aware of this act and law, which causes professionals and facilities to be more careful about their actions in fear of somebody suing them (people can lose their jobs) This can even happen in the waiting room if the admin accidently mentions private information about a patient coming in Hospitals used to have whiteboards listing each of the floors with patient rooms + names, giant HIPAA violation Healthcare professionals talking to each other about patients has a risk of being listened on by passersby, waiting room people ▪ Important to go into a place where others cannot hear you to pass off important information (like PT to OT) Cannot get away with as many things as before (all the rules under HIPAA) Privacy Rule Need to have in writing from patient to release information Information must be concealed, need to even protect the forms that they sign Stay with patient as they sign these types of forms, make sure they have completed/you saw them sign the forms Covers how facilities transmit patient information electronically - important to protect through security software Take every effort to protect information being entered into the screen/shown ▪ Direct family members, visitors away from the screen, adjust the screen so they are not able to see Documentation has extremely important and private information: diagnosis, treatment plans, prescriptions, patient notes, also any information beyond the patients discharge Can't have just one single form, must have a form for every single type of information to release it In the case of an office owned by a group of doctors: all aspects of HIPAA applies to them - not only the healthcare professional role They must be equipped with a security software that helps all information that passes through their office They also must have privacy screens on every computer  Transactions of Information: assumed that any information passed on to a case manager to is protected, they are a covered entity, make sure to check in and make sure that they are who they say they are when needed Security Rule: Covering any information that is sent through electronic methods, also fax and scanning documents Risk management: healthcare facilities are required to have risk management procedures established in relation to the security rule ▪ They must prove they/all staff knows what to do if information goes missing Employees cannot take their work home, need specific internet/program on a computer/device to access, not (normal) internet based Administrative safeguards: each facility has their own procedures for this section Main HIPAA Loophole Retail Pharmacy Locations: pharm techs and pharmacists are shouting out information: name, address, prescription ▪ Especially at the drive thru as all information is broadcasted ▪ Each pharmacy has its own rules/guidelines for the prescription pick-ups (can range from simple name, or written slip, some only need address) ▪ Controlled substances can have even more specific rules Emergency Rooms: HIPAA doesn't have specific enough rules to cover people who are semi or unconscious Only in the ED: a person can verbally approve another person to come into the room In other areas: there is a process of written confirmation for even people waiting in the waiting room (esp for pre/post-op) Healthcare Professional Associations Overview Every healthcare provider has their own association specific to their profession This is at the national level (all clustered in the DC area), exist to represent the profession as a whole There is also an association at the state level (every state has one, state association offices are located in the capital of the state Some associations have chapters as well, chapters are not offices, they are designated groups of professionals that meet at a certain place/time, covers a greater area or metroplex Staff of Professional Associations all levels of an association (national/state) have a full-time staff that run the organization for the professionals Handle all types of roles, all communication is specific to the professionals apart with the association  You do not to have to be a PT, dentist, etc. to work for these association, just must be knowledgeable about the healthcare field such as med term/clinical processes (retired nurse might work for the PT association) Positions (same for national and state) Executive Director: going to represent that association, talks to media and community surrounding, supervises/manages staff apart of the board Assistant Director: similar to executive, takes up tasks when executive is out, hiring/interviewing at times Membership Director: answers questions from members regarding to their membership/organization overall *Goal of university level organizations is to emulate this type of program/staffing Director of Continuing Education Advocacy Staff: depending on size this position could have 2 to 3 people in this position Publications Staff: number also depends on organization size *People can move up overall, due to experience/seniority Staff hears information in relation to the profession from the professionals themselves, not the other way around (professionals must share what they are experiencing, what is currently important for the professionals in the field) Membership Categories Professional: only pertains to fully licensed, practicing professionals Retired Student: most associations have this, many moving towards this overall, for students in health professional school ▪ Many schools have made this a requirement to join at least the state healthcare professional associations ▪ This is especially as these associations oversee releasing the journal articles that might be needed to read in class, every student has access to the same thing ▪ Instructors might have their students present to other students at state conferences :O Dues: Professional has the highest, Retired is a little lower, Student is the lowest rate in your life Important to use your voice through the association, this is really the best way to express your opinion in this broad sector of healthcare Must apply for most associations, pay dues - most associations will check applicants license number, other information Committees All associations have permanent committees, put in their input to help drive the direction of the organization as a whole Types of Committees ▪ Public Policy: working in the areas of advocacy  ▪Research: receive all the proposed journal articles submitted for publication, peer review ▪ Ethics: review information regarding negative actions of people under the profession that the association is overseeing, address known transgression of members, might be writing journal articles regarding the ethical areas of their profession Every association has a code of ethics, established for a long time, this committee can add to this ▪ Clinician Issues: discussion of current treatments/new treatments/adjustments to certain procedures Tracking of the decision process of these treatment proposals is made public to professionals Committees are staffed with members who are at the professional level (fully licensed) and in good standing, generally all committees have around 4 to 5 people on them (can change as size adjusts) Many professionals may want to be a part of these committee as they can have a direct impact on current issues, share their voice ▪ Employers may approach their professionals (that are good at what they do) to ask if they want to join committees, they believe that you can represent your profession well, also shows that their company has many credible and respected professionals (show that their staff is involved and informed) Applying to committees often only come out once every year, applications are also reviewed by directors, committee itself also has a say in who is in the positions, there is a leader giving direction within each committee Serving on a committee is an awesome thing to have on your resume, conveys to employers that you are knowledgeable/exposed to more information Lecture #5: 9/18/24 Health Care Structure: Board o President o Vice President o Secretary o Treasurer ▪ Members have to choose to run for a position ▪ Application process Submit resume, answer questions Once prospective applicants are reviewed by current board, they’re chosen and put on ballot New board members are voted in, usually through email  Board members usually serve one year term Board, staff and committee work together to run a professional’s organization o If a healthcare professional has issues, they need to let the President know so that problem can be resolved by board members When problem is resolved or in process of being resolved, people are informed through articles, newsletters, etc that are initiated by board members What organization provides a dues-paying member: o Advocacy ▪ Full time staff engaged in advocacy for profession: hire those with a political science/government background, don’t need to hire someone with a healthcare background Monitor pending legislation Attend hearings/meetings in relation to legislators(who only meet once in 2 years in Texas) Making sure the health profession they represent are included in legislation, bills, etc. ▪ This is important because surprisingly, there are many entities that want to restrict licensure for health professionals- when legislators take on issues as part of their platform, they may try to restrict or impose on licensure as a result Send letters to health professionals when issues with bills are noticed with pre-written letters to legislators notifying them you oppose the bill and for what reasons- health professional just has to sign and mail out o Notifies healthcare providers of problem o Saves them time and effort of writing a letter o Makes the result (many letters from health professionals to legislators) more effective Example: Optometrists in Texas have been under siege by ophthalmologists in Texas o More money for ophthalmology Number of bills that cite healthcare licensure is extremely high o About 25% of pending bills in Texas is related to a health profession Advocates set up Capitol Day: scheduled day for a specific health profession to go to Capitol to talk to legislators about bills, issues, etc. o Legal Care ▪ Situations where a healthcare professional is being sued, attacked legally, etc Usually you call 1800 number, are connected to healthcare attorney after self-verification, explain the situation at hand, and then are given legal counsel on next steps to take  Phone calls are at no cost to provider, all calls are confidential, and they are unlimited- can also refer you to an attorney in your area if more action is necessary o Journals ▪ Journals are peer-reviewed and current ▪ Other forms of information including papers, newsletters, etc are continually published and made available o Career Center (or job bank) ▪ Allows access to jobs that are just part of one specific healthcare profession o Continuing Education ▪ Needed by professionals to maintain and renew license ▪ All professional healthcare associations put on an annual conference, usually 3-4 days long, that have continuing education sessions throughout the day ▪ Units of continuing education are c.e.u.- continuing education units- like credit hours for college classes ▪ Reviewing agenda gives professionals the opportunity to pick and choose which sessions to attend, based on interests and specializations in career Not every session is same length, so not the same number of c.e.u’s each Can be 1.5 c.e.u.’s or 3 c.e.u.’s- c.e.u. amount does not depend on length of session Must rotate location of where session is nationally to make the conference fair for all healthcare professionals in the state o Must evaluate hotels to check for enough space for sessions, taste food to make sure it’s ok o Meet with hotel management to negotiate room rate prices for health professionals o Board members and staff must review submissions to present at the sessions, select and send information back to continuing education staff ▪ If submitted information isn’t new, organization will give it fewer c.e.u.’s ▪ More new, complex information will be awarded more c.e.u..’s ▪ Health professional schools might ask their students to present, employers might ask “star” members of their staff to present to show that their company is filled with awesome healthcare professionals (advertisement) o Opportunity for healthcare professions to learn more about the c.e.u.’s , can earn more in a shorter amount of time (withing 3-4 days)  Networking: people next to you at the conference can be amazing connections for job positions opening and opportunities within the field o At all levels of the conferences: there will be all types of vendors related to the profession will be in the ballroom, this can bring in lots of money for the professional association as they charge vendors for table space o Vendors can be bringing in new products, medical equipment, facilities related to the professional and could be used by their patients/clinic, professionals can try things in-person and can even meet recruiters Motivating professionally: all the people that are there do the same exact thing so they can relate to challenges/happy moments as well National conferences will be more expensive overall, even have ones on cruises (you can earn CEUs still!) - Certifications o Training may be provided by healthcare professional associations can be very e xpensive ($4000 - $5000) includes fees to take the certification exam o Most of the time, the certifications are already included within the healthcare professional’s licensure – many people take it out of the thought that they do not know/it is not in their scope of practice o Certifications are required especially when there are new technologies or new treatment processes that have been approved nationally and is applicable to the patients and diseases that professional works with/focused on o Healthcare professional associations organize the scheduling of the classes, exams, and determine the location + costs o Certifications may come with their own specific CEUs that are required, along with the CEUs that are already required for their profession, may overlap but still adds onto costs/time that will have to be spent on CEUs o Many professionals believe that they will be paid more, but most employers are focused on the licensure that the provider holds Professionalism: Professional School o Differences with University: school with only people studying to be in the same profession, same classes with the same cohort, increased workload, o More overlap in classes and connections between information ▪ In the past, it was thought that just observing instructors in a clinical setting would allow students to absorb information ▪ Now know that the assumption is wrong- reason for specific professionalism classes  ▪ Most likely will have a class that has “professionalism” in the name, with actual curriculum on how to be professional. This sets a specific standard on how to be professional within certain healthcare fields ▪ Benefits of having specific curriculum: Uniformity/standards Reduced liability issues o Socialization Process: o Helps to establish the standards for what is acceptable for each specific health profession ▪ Ex: female dentists don’t wear black nail polish o Student handbook for program: which equipment, supplies, scrubs you need ▪ Code of conduct: required of all students Sign and date on expectations on day of orientation Expectations include: no hitting students, no bad language, no shouting, even things like no biting or kicking Other expectations: o wearing student ID- will not misrepresent oneself as a fully trained health professional o no referencing titles you don’t have yet(doctor) o don’t misrepresent self to family members of patients o no taking pictures of anyone at healthcare facility- specifically taking pictures of patients’ body parts o do not disparage health professional school program while in rotations, etc., don’t disparage other health facilities you rotate at or any healthcare professionals there, don’t disparage patients or use abusive language, no negative comments to patients Code of conduct states that infringement from any requirements will lead to termination from program Lecture #6 – 9/25/24 (IRENE DAY!!) Board Committees - Meet 4 times a year, proves to membership that they are working on/thinking about the current concerns of the members - To meet 4 times, associations will pay for the fees associated with travel for the board members that must travel to the location (ex: Austin) o The goal is to ensure that the board members (voluntary) don’t have to pay even more for the duties that they are volunteering for o No extra cost for the professionals serving on these boards Professionalism in Healthcare - Shift towards continuing education shifts this title to Professional Ethics - Fraudulent/criminal activities are increasing amongst healthcare professionals out there o Cameras: important, caught professionals stealing computers/drugs - as a result there must be more precautionary measures put in place o Criminal background checks across the facilities: starting from professional school after you finish the didactic year (entering facilities, encountering real patients) , every new position as well o Drug tests also accompany ^ as well o Fraudulent bills: adding onto the patient’s bill with extra treatments/procedures that might have never been performed - Core Attributes of Healthcare Professionals: o Accountability: taking responsibility for your actions ▪ Honoring and upholding ethics of your professions (specific to each health professional school) o Provide patient-centered care ▪ Centered around patient’s needs and not our own o Quality improvement ▪ Reason why all health professionals have continuing education ▪ Want to continue building on professional knowledge o Respect for others ▪ Includes patients, family members, colleagues o Communication ▪ Awareness that we must communicate efficiently with patients, family members, colleagues, case managers, ▪ Extends to speaking, written communication, documentation, referrals o System based practice ▪ Have knowledge of all existing healthcare facilities and services so that efficient and appropriate referrals can be made ▪ Lack of awareness results in not referring patients, which hurts them o Resilience: newest addition to list, hasn’t been acknowledged until recently ▪ Ability to not transfer emotions and feelings at the time to patients – disagreeing in a professional manner, sharing what you have observed kindly ▪ How you overcome challenges and obstacles ▪ Important to not bring emotions from home to the workplace, not fair to the patients if their care is impacted by these types of negative emotions ▪ Professionals are human too they have challenges as well, important to acknowledge and work on, find what makes you feel refreshed (taking breaks, healthcare is a very heavy in person-to-person interactions) JCAHO – The Joint Commission for the Accreditation of Hospitals and Healthcare Organizations - Only organization in country that has this function - Licenses hospitals to operate, and if it’s not licensed then hospital cannot be opened - JCAHO licenses all types of hospitals o Psychiatric hospitals, facilities labeled as hospitals etc. o Long term care facilities, free standing labs (quest labs) - All hospitals in country must follow JCAHO standard, guidelines, deadlines - Every year, JCAHO surveys each hospital and facility - Only employs healthcare professionals with many years of healthcare experience (25+ years) - they apply for a JCAHO position o Headquarters in Chicago suburb - When it is time to survey hospitals, JCAHO divides the country into NW, SW, NE, SE o They will send out teams of healthcare professionals (Survey Team) that have never worked in the specific region to survey the hospitals there, limits bias (not running into people that they have worked with before) o JCAHO surveys are unannounced, prevents facilities from preparing for them to come, hospitals should be practicing/meeting standards at any point of time o When they walk in: people can probably recognize them (wearing suits/briefcases), Survey Team size varies on the size of the hospital ▪ Med City Plano would probably have 3 to 4, Texas Presby would probably have 5 to 6 o JCAHO people have a lot of power, must bring anything/everything that they need/want (conference rooms, donuts, coffee), they split up the hospital, review can spread across multiple days o They note EVERYTHING, not just patient care, also everything about the facility (carpets lifting, red speck on the wall), checks medical records as well – seeing history of patients (doesn’t violate HIPPA, another org that reads your documentation) o When information documented doesn’t look right or match up, JCAHO makes a note and then goes to HR to find provider’s information ▪ Deal with licensed healthcare professional individually – JCAHO tells them about their deficiencies, individual fines o JCAHO can stop anyone in a patient room, hallway, etc. to ask question about patient care, facility (volunteers are told not to come) o Exit/Ending interview ▪ JCAHO issues final report- usually very long and must be completed within a short period of time ▪ Report lists written form of all deficiencies – anything lacking, missing, or something with issues ▪ Hospital must respond to report in written form and explain how all deficiencies will be corrected within the next 30 days – another team will be brought in from JCAHO to review the changes  ▪ Deficiencies also come with fines; fines are high – high fines show that the hospital is unsanitary, unsafe in certain ways (fines are not publicly available) o Patients can file complaints with JCAHO that they can investigate next time they come to the facility o JCAHO is the entity that has developed approved medical abbreviations that we’re allowed to use in medical documents, practice, etc. in hospitals and long-term facilities ▪ Avoid using JCAHO abbreviations outside of hospital and facilities because of issues with case managers ▪ Copy of approved JCAHO abbreviations is printed and given to providers at hospitals and facilities o JCAHO has trademarked certain protocols for hospitals ▪ Ex. Developed procedure for preventing wrong site, wrong procedure, wrong person surgery Give patient a marker to mark the appendage they’re having the procedure/surgery done on ▪ Have also developed the term “sentinel event” which means healthcare issue that should never happen (again) Includes leaving things inside a patient during surgery, deaths, permanent harm to a patient (not just accidents, anyway patient is harmed) Will use the term sentinel event in the deficiencies report From a numbers report from JCAHO, there are hundreds of thousands of sentinel event that takes place ▪ Standardized forms for procedures – everything is in position, all tools ready to be used, is everything accounted for ▪ There is another form for post procedure as well, to ensure that nothing is left behind, everything is accounted for Lecture #7 – 10/1/24