SECTION 2.1 HEALTH CARE PROVIDERS. OBJECTIVES Match key terms with their correct meanings Research a volunteer agency Define managed care Define.

SECTION 2.1

HEALTH CARE PROVIDERS

OBJECTIVESMatch key terms with their correct meaningsResearch a volunteer agencyDefine managed careDefine ambulatory careEvaluate how managed care and ambulatory care meet the needs of the

changing health are systemUnderstand the role of government agencies in providing health careList six types of outpatient care and the type of treatment givenDefine wellness and preventive care Contrast the current trends with health care in the twentieth centuryBe able to use or read an organizational chart Give two reasons why the organization of heath care facilities is

importantExplain a chain of commandList and define the major services in health care Identify two departments in each major service

BACKGROUND

• It is the responsibility of every health care worker to help patients/ clients solve their health problems.• Health care industry has many delivery systems

TYPES OF FACILITIES

• There are several facilities and agencies that provide medical care. • General hospitals- where patients are hospitalized

for a short time. Days- weeks • Do not specialize in any one type of medical treatment• Wide range of diagnostic, medical, surgical, and

emergency care • Physicians, surgeons, nurses, and support staff for

inpatient and outpatient care.

TYPES CONTINUED

• Specialty hospital- provide inpatient continuity of care for clients with persistent, recurring diseases or complex medical conditions which require long-term (often over a month) care• Chronic diseases, pulmonary or physical rehabilitation,

wound care, and psychiatric problems.

TYPES CONTINUED

• Convalescent care- generally geriatric care- nursing services and assistance with ADL, and PC. • Nursing homes/ long-term care facilites • Care for physically ill or injured (all ages) that required

extended convalescence for recovery. • Rehabilitation, optimizing functional status• Nurses, nursing assistants, OT, PT, and ST, recreational

assistants, and social workers

CONVALESCENT CARE

• Nursing home- residents require constant nursing care and significant problems• Extended Care Facilities- residents need life long

care with ADL’s or medical care (moderate Alzheimer’s) • Independent /assisted living facilities- bridge the

gap between independent living and extended care or nursing homes. Residents are independent but need some assistance with ADL’s

TYPES OF FACILITIES

• Ambulatory care/ Clinics – physician with different specialties combine their practices• allows the patient/ client to have immediate care for

different illnesses• Physicians office, area of hospital, urgent care centers.• Outpatient services

TYPES CONTINUED

• Physician and dental facilities- promotes wellness and diagnosis of illness. • Simple surgery, bone setting, counseling, and

administration of drugs • Diagnostic services (lab, x-ray) • May choose ambulatory care setting

TYPES

• Rehabilitation centers- outpatient care for clients who require physical or occupational therapy, recreational therapy, hydrotherapy, or speech, hearing. • May receive prosthetics or learn how to use adaptive

devices.• From community and return to the community after

session

TYPES

• Industrial Health Care Centers- located in large companies and industrial facilities. • They provide health care for the staff and employees of

the business• Basic examinations and emergency or urgent care• May teach accident prevention and safety

TYPES

• School Health Services- found in educational institutions (schools)• Provide emergency care in case of accidents or sudden

illnesses.• Provide medication dosing, and monitor children with

chronic childhood diseases and problems (diabetes, asthma, and cognitive impairment)

TYPES

• Health Maintenance Organizations (HMOs)- a types of managed care organization.• Stress wellness (preventive health care). • Helps avoid unnecessary hospitalization and other

unnecessary major medical expenses. • Provide health services that include hospitalization, basic

medical services, immunizations, basic checkups and education.

TYPES

• Home Health Care- provide care in the home for patients/ clients who need health services but not hospitalization. • Services include nursing, PT, PC (bathing, dressing) and

homemaking (housecleaning, food shopping, and cooking)

• Care is provided for all ages, from infant to elderly.

TYPES

• Senior day Care- care for the elderly people who are able to live at home with their families but need care when the family is away. • A place where the elderly can be cared for during the

day.• Provide activities, rehabilitation, and contact with others.• Medications, and aid in mobility.

TYPES

• The World Health Organization (WHO) – special agency, funded by the UN founded in 1948 • Concerned with world health problems and publishes

health information, compiles statistics, and investigates serious health problems worldwide

TYPES

• Hospice- are important in our health care system• Provide end-of life care with 6 month or less to live • CA is the #1 diagnosis for hospice Pt• Professionals and volunteers provide medical services

and psychological and spiritual support to both Pt. and families

• Covered by Medicare, Medicaid, and insurance. If no insurance offers a sliding scale based on ability to pay

• Goal to make Pt as comfortable as possible.

GOVERNMENT AGENCIES

• Federal, state and local governments provide health services• These services are funded by taxes• Responsible for:• giving direct health care• safeguarding our food and water supplies• promoting health education

• Veterans Administration hospitals- (VA) Federally supported and provide care for veterans who served in the armed forces

• U.S. Public Health Department –federal agency that has six major responsibilities: • Performing research on diseases that kill, handicap, or

cripple• Preventing and treating alcohol and drug abuse• Preventing and controlling diseases that are transmitted

by insects, animals, air, water and people.• Checking the safety of food and drugs that consumers

purchase• Planning more effective ways to deliver health services• Making quality care available and affordable by

encouraging health personnel to work in underserved areas.

• State Psychiatric Hospitals- serve the mentally ill • State University Medical centers- provide training

for health workers, give medical care, and conduct medical research.• State Public Health Services- provide health

education materials. They are responsible for water and food purity, communicable disease control, alcohol and drug abuse control, maternal health , and licensing of various health agencies.

• The U.S. Department of Health and Human Services (USDHHS)- protects the health of all Americans by providing vital human services, especially to those least able to help themselves. • The National Institute of Health (NIH)- the worlds

leading agency for conducting and supporting medical research

• The Centers for Disease Control (CDC)- monitors and prevents disease outbreaks, including bioterrorism. The CDC implements disease prevention strategies and maintains national health statistics. • The food and Drug administration (FDA) assures

the safety of foods, cosmetics, pharmaceuticals, biological products, and medial devices

• The Occupational Safety and Health Administration (OSHA)- imposes safety and health legislation to prevent injury, illness, and death in the workplace. • The Agency for Health Care Policy and Research

(AHCPR) - works to improve the quality, safety, efficiency, and effectiveness of health care for all Americans by using research and technology to promote the delivery of the best possible care.

• County hospitals- provide care for the ill and injured, especially those patients/ clients who require financial help in order to receive care. • Laboratory- a facility that provides controlled

conditions in which scientific research, experiments, and measurements can be performed. • Hospitals, dental offices, schools, universities, industry,

government, and military facilities • https://www.youtube.com/watch?v=UvSG2-U15Jk

• Local Public Health Departments- provide services to local communities focusing on the reporting of communicable diseases, public health nursing, health education, environmental sanitation, maternal and child health services, and public health clinics. • Senior Centers- have clinics that provide special

services for geriatric Pt. (podiatry, hypertension, general medical care)

VOLUNTEER AGENCIES• Receive support from donations, gifts,

membership fees, fund-raisers, and endowments. • Not supported by the government, and many who

work for them are not paid. • They raise funds for medical research and for

public education about various health problems.• Many focus on a particular disease or medical

condition: *American Cancer Society *March of Dimes

*American Diabetes Association *American Red Cross

*National Association of Mental health *American Heart Association

*American Respiratory Disease Association

*HOSA

MANAGED CARE:QUALITY CARE & MANAGED COSTS

• Managed care provider's goals are to provide quality care at reasonable costs.• Certain policies help ensure quality care at

minimal cost.

PREVENTIVE CARE

• Routine physicals, well-baby care, immunizations, and wellness education to keep Pt. healthy• Wellness education stresses the importance of

good nutrition, wt control, exercise, and healthy living practices• Health education programs, wellness centers, wt-

control programs, fitness centers, health food distributors, and health care organizations promote wellness and preventive care.• Being healthy helps prevent serious illness and lowers

medical costs

PRIMARY CARE PROVIDERS

• Family and general practice physicians, internists, nurse practitioners, and physicians assistants. • Usually the first contact a Pt has for an

undiagnosed condition (family doctor) • Primary providers care for all routine medical

problems• Refer pt./ clients to specialists.

SPECIALTY CARE

• Care given by a provider who is trained in one special area• Specialists usually limit their practice to treating

one type of problem• Have a broad knowledge of the specialty area• Surgery• Podiatry• Audiology• Orthopedics• Chiropractic• Urology

EMERGENCY CARE/ URGENT CARE

• Emergency care is for life-threatening conditions that require hospitalization. • Ambulance services, rescue squads and helicopter or

airplane rescue vehicles

• Urgent care is for non-emergencies that require prompt treatment. • Emergencies requiring hospital care are expensive. • Excellent care is available in urgent care settings and

costs are lower.

PREADMISSION AUTHORIZATION FOR HOSPITALIZATION

• Allows necessary hospitalization and prevents unnecessary hospitalization.• Good quality outpatient care is encouraged when

possible• Outpatient care is less expensive and patients/

clients often prefer being in their own homes

AMBULATORY CARE• The current trend is to develop large managed

care organizations that provide good quality, cost-effective health care.• providers follow managed care concepts• One change keeps patients/ clients at home for their care

whenever possible• Most patients like to be at home • Reduces health care costs• Only very ill and severely injured are hospitalized

• Facilities • Rehabilitation centers, Outpatient surgery, Outpatient

medical centers/ clinics, Physicians offices, day care

• In ambulatory care:• Opportunities for health care workers to use their

multidisciplinary skills (EKG, phlebotomy, and/ or limited radiology certificate)

ORGANIZATION

• To give efficient health care the facility must be well organized• Organizational chart shows how departments fits

into the system and identifies the line of authority• Tells:• who your immediate supervisor is • The areas of responsibility for all the employees• Establishes the chain of command

CHAIN OF COMMAND

• Tells you whom you take questions, reports, and problems too• This is your immediate supervisor• If your immediate supervisor is unable to find a

solution they take the problem to their supervisor• This provides an efficient problem-solving

structure• Bypassing links in the chain causes

misunderstanding and is unprofessional

MAJOR SERVICES IN HEALTH CARE

• Therapeutic services• Care over time

• Diagnostic services • Used to identify a particular condition or disease such as

x-rays or blood tests

• Informational services• Document and process information

• Environmental services• Create a relaxing, healing, and supportive environment

for patients