Introduction to Radiologic Technology Module 1 PDF

Introduction to Radiologic Technology Module 1 The Health Care Environment Dr. Chona DL. Cabatay The Health Care Environment Learning Objectives: At the end of the lesson, students will be able to: 1. Discuss the health care environment 2. Identify various set...

Introduction to Radiologic Technology Module 1 The Health Care Environment Dr. Chona DL. Cabatay The Health Care Environment Learning Objectives: At the end of the lesson, students will be able to: 1. Discuss the health care environment 2. Identify various settings involved in the delivery of health care. 3. Identify the type of health care facilities 4. Outline the features of each health care facilities. 5. Understand the different services provided by each health care facilities The Health Care Environment A healthcare facility, is often thought as a hospital or clinic but even a brief look at the healthcare industry will show there’s a lot of options out there that might not be on the top-of-mind. More people seek accurate, holistic and cost-effective care, the healthcare industry is opening new options and expanding its reach. Specialized clinics and outpatient centers have appeared to help ease the burden on hospitals, and more long-term care facilities are rising up to accommodate patients who need months or years of assisted healing. 1. Ambulatory surgical centers Ambulatory Surgery Centers—known as ASCs—are modern health care facilities focused on providing same-day surgical care, including diagnostic and preventive procedures. ASCs have transformed the outpatient experience for millions of Americans by providing them with a more convenient alternative to hospital-based outpatient procedures—and done so with a strong track record of quality care and positive patient outcomes.  Ambulatory surgical centers, also called outpatient surgical facilities, allow patients to receive certain surgical procedures outside a hospital environment. These environments often offer surgeries at a lower cost than hospitals while also reducing the risk of exposure to infection— since patients are there for surgery, not to recover from sickness and disease. Ambulatory surgical centers don’t provide diagnostic services or clinic hours. Instead, they take patients who have been referred for surgery by a hospital or physician—they’re designed to be “all business” when it comes to surgical care.  What ASCs Are Not ASCs are not rural health clinics, urgent care centers or ambulatory care centers that provide diagnostic or primary health care services. ASCs treat only patients who have already seen a health care provider and selected surgery as the appropriate treatment for their condition. ASCs are not physicians' offices either. All ASCs must have at least one dedicated operating room and the equipment needed to perform surgery safely and ensure quality patient care.  Nine types of ASCs that it presently accredits: cosmetic and facial surgery centers endoscopy centers ophthalmology practices laser eye surgery centers centers for oral and maxillofacial surgery orthopedic surgery centers plastic surgery centers podiatry clinics multi-specialty surgery centers Advantages of ASCs Surgeons as well as patients tend to prefer ambulatory surgery centers for outpatient procedures for several reasons: Cost. In many cases, an outpatient procedure done in an ASC costs between one- half and one-third as much as the same procedure done in a hospital. It is important, however, for patients to compare costs carefully, because some ASC procedures may cost as much as or even more than hospital-based procedures. Convenience. There is much less administrative paperwork and “red tape” at an ambulatory surgical center compared to the admissions process at most hospitals. Patients also like the fact that they can leave an ASC relatively quickly after their surgery, which translates into less time lost from work. Presence of family and friends. Whereas most hospitals keep patients recovering from a surgical procedure in separate rooms, in an ASC the patient can usually spend the recovery period after surgery with their loved ones.  Greater efficiency. This advantage is particularly important to surgeons. It takes much less time to prepare an operating room in a specialized ASC for the next patient than in a standard hospital. Improved efficiency allows the surgeon to treat more patients in the same amount of time than he or she would be able to do in a hospital; some surgeons maintain that they can do three times the number of procedures in an ASC as they could in a hospital setting. Greater control over procedures and standards. Many doctors prefer working in an ASC because they can set the standards for staffing, safety precauions, postoperative care, etc., rather than having these things decided for them by a hospital manager. 2. Birth centers The birth center is a health care facility for childbirth where care is provided in the midwifery and wellness model. The birth center is freestanding and not a hospital. Birth centers are an integrated part of the health care system and are guided by principles of prevention, sensitivity, safety, appropriate medical intervention and cost-effectiveness. While the practice of midwifery and the support of physiologic birth and newborn transition may occur in other settings, this is the exclusive model of care in a birth center.  The birth center respects and facilitates a woman’s right to make informed choices about her health care and her baby’s health care based on her values and beliefs. The woman’s family, as she defines it, is welcome to participate in the pregnancy, birth, and the postpartum period. A birth center is a healthcare facility for childbirth that focuses on the midwifery model, according to the American Association of Birth Centers. They aim to create a birth environment that feels more comfortable to the mother and allows for a cost- effective, family-inclusive birth. Birth centers are not typically equipped with the same contingency equipment and staff as a hospital, such as surgeons in case of a C-section or a neonatal intensive care unit. As a result, birth centers accommodate only healthy pregnancies without any known risk or complication factors. These facilities are guided by principles of prevention, sensitivity, safety, cost- effectiveness and appropriate medical intervention when needed. The birth center can be described with 5 Ps: PEOPLE Healthy women anticipating a low-risk pregnancy and birth Licensed, qualified staff with full comprehension of limits of midwifery practice and insured for professional liability Qualified obstetric/pediatric consultants  PLACE Home-like - a maximized home rather than a mini-hospital Meets all construction, fire and safety, and health codes Equipped to provide routine care and initiate emergency procedures Freestanding facility - separate from acute obstetric/newborn care with autonomy in formulation of policy and management of operation Located so that there is reasonable cesarean section capability  PROGRAM Orientation and informed consent Antepartum care including continuous screening by history, physical exam, routine laboratory tests and health counseling Plan for participation of family members as defined by woman receiving care Educational program that includes component of self-care/self-help Plan for payment of services Twenty-four hour telephone access to care provider Intrapartum care with a midwife or physician in constant attendance during active labor Postpartum/newborn care supervised by licensed nurse or midwife Required newborn laboratory screening tests Plan for newborn health supervision at center or by referral Home-office visits for postpartum newborn follow-up Provision for support in parenting and breastfeeding PRACTICE OF MIDWIFERY Midwifery is Primary Care that emphasizes: o Support for pregnancy and birth as a natural physiological process - “normal until proven otherwise;” o Prevention of disease/promotion of health; o Individual responsibility and self-sufficiency through education; A systems approach to the delivery of health services; That midwifery may be practiced by any qualified, licensed provider willing to embrace the philosophy of midwifery and obtain the knowledge and skills needed for midwifery practice.  Midwifery Primary Care is a first-level entry into a health- oriented system, triaging when the process of pregnancy and birth departs from its normal course. It is dependent upon: o Laboratory services; o Availability of specialist services; o Access to acute care services; Separation of primary care from acute care in pregnancy and childbirth is the most important principle of the birth center concept. The interdependent relationship between the birth center and acute care services: PART OF THE SYSTEM Has written policies and procedures that reflect standard quality assurance Relationship with other community health agencies for complementary services Arrangement for referral and transfer to other levels of care Access to an acute care obstetrical/newborn unit 3. Blood banks Blood banks allow donors to donate blood and platelets while also storing and sorting blood into components that can be used most effectively by patients. “Red blood cells carry oxygen, platelets help the blood clot and plasma has specific proteins that allows proper regulation of coagulation and healing,” writes the American Society of Hematology. Sometimes, a single car accident victim could require as many as 100 pints of blood. 4. Clinics and medical offices The definition of a clinic is “a facility for diagnosis and treatment of outpatients.” There are many healthcare facilities that fit that definition across a wide variety of treatment specialties. Many people go to a clinic for routine doctor’s appointments and checkups. These healthcare facilities can be a physician’s private practice, a group practice setting or a corporately owned clinic that may be connected to a larger healthcare system or hospital. 5. Diabetes education centers Patients with diabetes need to manage the disease and typically make lifestyle adjustments to keep it from becoming life-threatening. Since diabetes is so widespread, diabetes education centers rose up to help patients manage their disease and to help people at risk for diabetes to avoid it, if possible. Diabetes education centers typically offer classes, education, support groups and a variety of resources to help patients manage their diabetes and live as complication-free as possible.  6. Dialysis Centers Patients with kidney disease often need regular treatments of dialysis. Dialysis is a process that filters and cleans the blood artificially—the work functioning kidneys normally take on. About 14 percent of Americans have chronic kidney disease. When kidneys aren’t able to filter the blood the way they are supposed to, patients might need dialysis as often as three times a week to avoid serious complications. With such high demand, dialysis facilities rose up to meet patient needs and avoid undue strain on hospitals. 7. Hospice homes Hospice can be a particularly confusing title. It represents a package of insurance benefits that deals with an end-of-life trajectory. It also represents a philosophy of care provision for dying patients as well as official networks that offer hospice care. Hospice is also a designation for specific healthcare facilities that specialize in end-of-life care.  Hospice care is a model that provides not only medical support, but also emotional and even spiritual support for patients and their families. According to the National Hospice and Palliative Care organization, a patient with hospice care has a team of care providers made up of the patient's personal physician, a hospice physician, nurses, home health aides, social workers, clergy or other counselors and physical or occupational therapists, if needed. Though patients can receive hospice care at home, if their medical needs are significant, they might live in a nursing home with hospice care, or a specified hospice home. 8. Hospitals Hospitals are the ultimate “catch-all” healthcare facility. Their services can vary greatly depending on their size and location, but a hospital’s goal is to save lives. Hospitals typically have a wide range of units that can be loosely broken into intensive care and non- intensive care units. Intensive care units deal with emergencies and the most serious illnesses and injuries. Patients with imminently life-threatening problems go here.  Non-intensive care units include things like childbirth, surgeries, rehabilitation, step-down units for patients who have just been treated in intensive care and many others. Typically, most hospital beds could be classified as non-intensive care. Hospitals may be compared and classified in various ways: by ownership and control, by type of service rendered, by length of stay, by size, or by facilities and administration provided. Examples include the general hospital, the specialized hospital, the short-stay hospital, and the long- term-care facility. Bed number and length of stay Hospitals may be compared by the number of beds they contain. Modern hospitals tend to rarely exceed 800 beds, and though some integrated health facilities may have more beds, they often comprise multiple geographic locations, each with several hundred beds. In the early 21st century, it was thought that a facility of 800 beds was the largest unit that could be governed Ownership and control The issues of hospital ownership and control underwent significant analysis and change in the late 20th and early 21st centuries. Such transformation was prevalent in developed countries, particularly those in which fiscal sustainability was problematic. In many countries nearly all hospitals are owned and operated by the government. In Great Britain, except for a small number run by religious orders or serving special groups, most hospitals are within the National Health Service. The local hospital management committee answers directly to the regional hospital board and ultimately to the Department of Health and Social Security. In the United States most hospitals are neither owned nor operated by governmental agencies. In some instances hospitals that are part of a regional health authority are governed by the board of the regional authority, and hence these hospitals no longer have their own boards. Financing Because hospitals may serve specific populations and because they may be not-for-profit or for-profit, there exist a variety of mechanisms for hospital financing. Almost universally, hospital- construction costs are met at least in some part by governmental contributions. Operating costs, however, are taken care of in different ways. Private health insurance corporations or agencies exist in many countries. These entities may offer different or more services relative to national health insurance, although generally at additional cost as well. Private insurance funds offer an alternative mechanism of hospital financing. The General Hospital General hospitals may be academic health facilities or community-based entities. They are general in the sense that they admit all types of medical and surgical cases, and they concentrate on patients with acute illnesses needing relatively short-term care. Community general hospitals vary in their bed numbers. Each general hospital, however, has an organized medical staff, a professional staff of other health providers (such as nurses, technicians, dietitians, and physiotherapists), and basic diagnostic equipment. In addition to the essential services relating to patient care, and depending on size and location, a community general hospital may also have a pharmacy, a laboratory, sophisticated diagnostic services (such as radiology and angiography), physical therapy departments, an obstetrical unit (a nursery and a delivery room), operating rooms, recovery rooms, an outpatient department, and an emergency department. Smaller hospitals may diagnose and stabilize patients prior to transfer to facilities with specialty services.  In larger hospitals there may be additional facilities: dental services, a nursery for premature infants, an organ bank for use in transplantation, a department of renal dialysis (removal of wastes from the blood by passing it through semipermeable membranes, as in the artificial kidney), equipment for inhalation therapy, an intensive care unit, a volunteer-services department, and, possibly, a home-care program or access to home-care placement services. The complexity of the general hospital is in large part a reflection of advances in diagnostic and treatment technologies. Such advances range from the 20th-century introduction of antibiotics and laboratory procedures to the continued emergence of new surgical techniques, new materials and equipment for complex therapies (e.g., nuclear medicine and radiation therapy), and new approaches to and equipment for physical therapy and rehabilitation.  The legally constituted governing body of the hospital, with full responsibility for the conduct and efficient management of the hospital, is usually a hospital board. The board establishes policy and, on the advice of a medical advisory board, appoints a medical staff and an administrator. It exercises control over expenditures and has the responsibility for maintaining professional standards. The administrator is the chief executive officer of the hospital and is responsible to the board. In a large hospital there are many separate departments, each of which is controlled by a department head. The largest department in any hospital is nursing, followed by the dietary department and housekeeping. Examples of other departments that are important to the functioning of the hospital include laundry, engineering, stores, purchasing, accounting, pharmacy, physical and occupational therapy, social service, pathology, X-ray, and medical records.  The medical staff is also organized into departments, such as surgery, medicine, obstetrics, and pediatrics. The degree of departmentalization of the medical staff depends on the specialization of its members and not primarily on the size of the hospital, although there is usually some correlation between the two. The chiefs of the medical-staff departments, along with the chiefs of radiology and pathology, make up the medical advisory board, which usually holds regular meetings on medical-administrative matters. The professional work of the individual staff members is reviewed by medical-staff committees. In a large hospital the committees may report to the medical advisory board; in a smaller hospital, to the medical staff directly, at regular staff meetings. General hospitals often also have a formal or an informal role as teaching institutions. When formally designed as such, teaching hospitals are affiliated with undergraduate and postgraduate education of health professionals at a university, and they provide up-to-date and often specialized therapeutic measures and facilities unavailable elsewhere in the region. As teaching hospitals have become more specialized, general hospitals have become more involved in providing general clinical training to students in a variety of health professions. Specialized health and medical care facilities Hospitals that specialize in one type of illness or one type of patient can generally be found in the developed world. In large university centres where postgraduate teaching is carried out on a large scale, such specialized health services often are a department of the general hospital or a satellite operation of the hospital. Changing conditions or modes of treatment have lessened the need or reduced the number of some types of specialized institutions; this may be seen in the cases of tuberculosis, leprosy, and mental hospitals. On the other hand, specialized surgical centres and cancer centres have increased in number. 9. Imaging and radiology centers These facilities, much like their hospital counterparts, offer diagnostic imaging services to patients. Diagnostic imaging includes CT scans, ultrasounds, X-rays, MRIs and more. While hospitals and even clinics have imaging centers, outpatient facilities help keep costs lower and allow more convenient scheduling for patients. Hospital facilities will likely handle imaging for urgent cases, such as an MRI for a brain injury. But any imaging that can be scheduled in advance, such as ultrasounds to monitor a pregnancy, could take place at an imaging center. Imaging and Radiology Radiology is a branch of medicine that uses imaging technology to diagnose and treat disease. Radiology may be divided into two different areas, diagnostic radiology and interventional radiology. Doctors who specialize in radiology are called radiologists. DIAGNOSTIC RADIOLOGY Diagnostic radiology helps health care providers see structures inside your body. Doctors that specialize in the interpretation of these images are called diagnostic radiologists. Using the diagnostic images, the radiologist or other physicians can often: Diagnose the cause of your symptoms Monitor how well your body is responding to a treatment you are receiving for your disease or condition Screen for different illnesses, such as breast cancer, colon cancer, or heart disease The most common types of diagnostic radiology exams include: Computed tomography (CT), also known as a computerized axial tomography (CAT) scan, including CT angiography Fluoroscopy, including upper GI and barium enema Magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) Mammography Nuclear medicine, which includes such tests as a bone scan, thyroid scan, and thallium cardiac stress test Plain x-rays, which includes chest x-ray Positron emission tomography, also called PET imaging, PET scan, or PET-CT when it is combined with CT Ultrasound INTERVENTIONAL RADIOLOGY Interventional radiologists are doctors that use imaging such as CT, ultrasound, MRI, and fluoroscopy to help guide procedures. The imaging is helpful to the doctor when inserting catheters, wires, and other small instruments and tools into your body. This typically allows for smaller incisions (cuts). Doctors can use this technology to detect or treat conditions in almost any part of the body instead of directly looking inside of your body through a scope (camera) or with open surgery. Interventional radiologists often are involved in treating cancers or tumors, blockages in the arteries and veins, fibroids in the uterus, back pain, liver problems, and kidney problems. The doctor will make no incision or only a very small one. You rarely need to stay in the hospital after the procedure. Most people need only moderate sedation (medicines to help you relax).  Examples of interventional radiology procedures include: Angiography or angioplasty and stent placement Embolization to control bleeding Cancer treatments including tumor embolization using chemoembolization or Y-90 radioembolization Tumor ablation with radiofrequency ablation, cryoablation, or microwave ablation Vertebroplasty and kyphoplasty Needle biopsies of different organs, such as the lungs and thyroid gland Breast biopsy, guided either by stereotactic or ultrasound techniques Uterine artery embolization Feeding tube placement Venous access catheter placement, such as ports and PICCs 10. Mental health and addiction treatment centers This type of healthcare facility is a grouping for many different types of facilities. Specialty treatment centers exist all across America for specified mental health issues and addictions. Mental health treatment facilities sometimes exist as a general institution for any mental health issue and are sometimes specialized. 11. Nursing homes Nursing homes offer a living situation for patients whose medical needs aren’t severe enough for hospitalization, but are too serious to manage at home. Some nursing homes offer services for heavier medical needs, such as speech and occupational therapy. Other nursing homes try to create a homier atmosphere, and might operate like an apartment complex with medical staff on hand. 12. Orthopedic and other rehabilitation centers Orthopedic medicine deals with muscles and bones. Physical therapists are typically the practitioner patients see for problems in these areas of the body. If you are experiencing chronic lower back pain, for example, you might see a physical therapist at an orthopedic center or clinic to get a diagnosis and a plan of treatment. Orthopedic centers deal in everything from athletic injuries to therapy for patients with disabilities. They typically offer evaluation and diagnosis of the problem, as well as prevention, treatment and rehabilitation work involving bone, tendon, ligament, muscle and joint conditions. 13. Urgent care Urgent care (UR) facilities exist for on-demand healthcare needs that aren’t severe enough for the emergency room, but are too severe or concerning to wait for a scheduled appointment at the doctor’s office. Urgent care is a common choice when children get sick, for example, and need an immediate diagnosis or relief from symptoms. Providers in the UR are experts in acute care. They can set broken bones and treat limb fractures; diagnose a viral illness; run strep tests, blood tests and urine labs and provide treatment for injuries. If a problem is too severe, then urgent care practitioners will call an ambulance or refer patients to a hospital or specialist. 14. Telehealth Telehealth refers to the use of electronic communication technology to facilitate long-distance health care and health education, according to the federal Health Resources and Services Administration (HRSA). Many people lack easy access to physicians and specialty clinics. Whether through their physical location, physical ability, living situation or transportation choices, many patients have a hard time getting to a medical practitioner face to face. Those patient limitations, the push to lower costs in healthcare, and new technological capabilities have all come together to motivate telehealth applications. This might look like live video conferencing between patient and physician. Or a patient with an illness might wear a device to allow remote monitoring from their medical team.  References: https://www.rasmussen.edu/degrees/health- sciences/blog/types-of-healthcare-facilities/ https://www.encyclopedia.com/medicine/encyclopedias- almanacs-transcripts-and-maps/ambulatory-surgery-centers-0 https://www.birthcenters.org/page/bce_what_is_a_bc https://www.britannica.com/science/hospital/The-general- hospital https://medlineplus.gov/ency/article/007451.htm