NRG 106 HEALTH CARE DELIVER SYSTEM

• Health care delivery system


  How a national, regional, or local health care system is organized, administered, provided, and paid for, sometimes to a circumscribed system such as that under the guidance of a specific medical and hospital insurance carrier or health maintenance organization
• Health care delivery system


  • Complex & constantly changing
  • Broad variety of services are available from different disciplines of health prof
  • Access to the services is difficult - High health care cost, Limited financial resources, Limited/no health insurance
• Types of health care services


  • Primary Prevention: Health Promotion and Illness Prevention
  • Secondary Prevention: Diagnosis and Treatment
  • Tertiary Prevention: Rehabilitation, Health Restoration, and Palliative Care
• Primary prevention


  The "True prevention", Applied to physically & emotionally healthy clients, Aim: health promotion, Requires collaboration among health professionals, health care leaders, and community members
• Primary health care (health promotion & disease prevention)

  • Includes: Primary care & health education, Proper nutrition, Maternal-child care, Family planning, Immunizations, Control of diseases
  • Settings: Schools, Physician's offices/clinics, Occupational health clinics, Community health centers
• Health promotion programs lower the overall costs of health care by reducing the incidence of disease, minimizing complications, and thus reducing the need to use more expensive health care resources
• Secondary prevention


  Focuses on clients who are experiencing health problems & illnesses & are at risk for developing complications, The most common services in the HCDS
• Diagnosis & treatment of illnesses

  • Settings: Hospital emergency departments, urgent care centers, critical care units, and inpatient medical-surgical units provide secondary and tertiary levels of care
  • The focus in hospitals is to provide the highest quality of care possible so patients are discharged early but safely to home or another health care facility that will adequately manage remaining health care needs
  • Discharge planning begins the moment a patient is admitted to a health care facility for continuity of care, using critical thinking and nursing process
• Tertiary prevention


  Occurs when defect or disability is permanent or irreversible, Minimizing effects of long-term disease or disability
• Rehabilitation, health restoration, and palliative care

  • Restorative care: Patients recovering from an acute or chronic illness or disability often require additional services to return to their previous level of function or reach a new level of function limited by their illness or disability
  • Rehabilitation: Restores a person to the fullest physical, mental, social, vocational, and economic potential possible, Patients require rehabilitation after a physical or mental illness, injury, or chemical addiction, Includes physical, occupational, and speech therapy and social services
  • Hospice: A system of family-centered care that allows patients to live and remain at home with comfort, independence, and dignity while easing the pains of terminal illness, Focus is on palliative care, not curative treatment
  • Palliative care: Level of care that is designed to relieve or reduce intensity of uncomfortable symptoms but not to produce a cure, Relies on comfort measures and use of alternative therapies to help individuals become more at peace during end of life
• Nursing care delivery models/frameworks for care/modalities help nurses achieve desirable outcomes for their patients, either in the way work is organized or in the way a nurse's responsibilities are defined
• Managed care


  A health care system whose goals are to provide cost-effective, quality care that focuses on decreased costs and improved outcomes for groups of clients, Health care providers and agencies collaborate to render the most appropriate, fiscally responsible care possible
• Case management


  Involves multidisciplinary teams that assume collaborative responsibility for planning, assessing needs, and coordinating, implementing, and evaluating care for groups of clients from preadmission to discharge or transfer and recuperation, A case manager, may be a nurse, social worker, or other appropriate professional, Tracks patient's progress
• Differentiated practice


  A system in which the best possible use of nursing personnel is based on their educational preparation and skill sets, Consist of specific job descriptions for nurses according to their education or training
• Functional method


  A task-oriented approach, Personnel with less preparation than the professional nurse perform less complex care requirements, Focuses on the jobs to be completed (e.g., bed making, temperature Measurement)
• Team nursing


  Delivery of nursing care to individual clients by a group of providers led by a professional nurse, Consist of RNs, LPNs, and UAPs, Team is responsible for providing coordinated nursing care to a set of clients for a specific period of time, Delegates appropriate tasks to team members
• Primary nursing


  A system in which one nurse is responsible for overseeing the total care of a number of hospitalized clients 24 hours a day, 7 days a week, even if he or she does not deliver all of the care personally, A method of providing comprehensive, individualized, and consistent care
• Information technology


  Refers to the management and processing of information, generally with the assistance of computers, Medical records shift from paper-based to computer-base
• Health care information system


  A group of systems used within a health care organization to support and enhance health care, Includes clinical information systems (CIS) and administrative information systems, Operate to make the entry and communication of data and information more efficient
• Nursing informatics


  A specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, and knowledge in nursing practice
• Effective nursing information system

  • Supports the way that nurses function and work by providing them the flexibility to use the system to view data and collect information, provide patient care, and document a patient's condition and care provided
  • Supports and enhances nursing practice through improved access to information and clinical decision-making tools
• Electronic health record (EHR)


  Electronic record of patient health information generated whenever a patient accesses medical care in any health care delivery setting
• Electronic medical record (EMR)


  Contains patient data gathered in a health care setting at a specific time and place and is a part of the EHR, EHR provides access to a patient's health record information at the time and place that clinicians need it, A unique feature of an EHR is its ability to integrate all pertinent patient information into one record, regardless of the number of times a patient enters a health care system
• Health


  A multidimensional concept and is viewed from a broader perspective, A "state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity" (WHO, 1947), A dynamic state in which individuals adapt to their internal and external environments so there is a state of physical, emotional, intellectual, social and spiritual well-being
• Each person has a personal concept of health, personality, and lifestyle, Individuals' views of health vary among different age-groups, genders, races, and cultures
• Health belief


  Personal belief about levels of wellness that can motivate or impede participation in changing risk factors, participating in care and selecting care options
• Wellness


  A dynamic state of health in which an individual progresses towards higher level of functioning, achieving an optimum balance between internal and external environment
• Illness


  Abnormal process in which any aspect of a person's functioning is diminished or impaired compared with his/her previous condition
• Health promotion


  A process of helping people improve their health to reach optimal state of physical, mental and social well-being