Health Delivery System

• Health care delivery system


  How a national, regional, or local health care system is organized, administered, provided, and paid for
• Health care delivery system is complex and constantly changing
• Broad variety of health care services are available from different disciplines
• Access to health care services

  • Difficult due to high health care costs, limited financial resources, and 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 and emotionally healthy clients, with the aim of health promotion
• Primary prevention


  1. Requires collaboration among health professionals, health care leaders, and community members

  2. Includes primary care, health education, proper nutrition, maternal-child care, family planning, immunization, and disease control

  3. Provided in settings like schools, physician's offices, occupational health clinics, and community health centers
• Health promotion programs


  Lower the overall costs of health care by reducing the incidence of disease, minimizing complications, and reducing the need for more expensive health care resources
• Secondary prevention


  Focuses on clients experiencing health problems and illness, and at risk for developing complications
• Secondary prevention


  1. Provided in settings like hospital emergency departments, urgent care centers, critical care units, and inpatient medical-surgical units

  2. The focus in hospitals is to provide the highest quality of care possible so patients are discharged early but safely

  3. Discharge planning begins the moment a patient is admitted
• Tertiary prevention


  Occurs when defect or disability is permanent or irreversible, with the aim of minimizing the effect of long-term disease or disability
• Restorative care


  Patients recovering from an acute or chronic illness or disability often require additional services to return to their previous or a new level of function
• Rehabilitation


  Restores a person to the fullest physical, mental, social, vocational, and economic potential possible, for patients recovering from physical or mental illness, injury, or chemical addiction
• 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, with a focus on palliative care rather than curative treatment
• Palliative care


  A level of care designed to relieve or reduce the intensity of uncomfortable symptoms, but not to produce a cure, using comfort measures and alternative therapies
• Nursing care delivery models

  • Managed care
  • Case management
  • Patient-focused care
  • Differentiated practice
  • Functional method
  • Team nursing
  • Primary nursing
• 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
• Case management


  Involves multidisciplinary teams that assume collaborative responsibility for planning, assessing needs, coordinating, implementing, and evaluating care for groups of clients from preadmission to discharge or transfer and recuperation
• Differentiated practice


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


  A task-oriented approach where personnel with less preparation than the professional nurse perform less complex care requirements, based on a production and efficiency model
• Team nursing


  Delivery of nursing care to individual clients by a group of providers led by a professional nurse, consisting of RNs, LPNs, and unlicensed assistive personnel (UAP)
• Primary nursing


  A system where 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 they do not deliver all the care personally
• Information technology


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

  A group of systems used within a health care organization to support and enhance health care, including clinical informative systems (CIS) and administrative information systems
• 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 nurses function and work by providing flexibility to view data, 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
• Health


  A state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity
• Each person has a personal concept of health, personality, and lifestyle, and individuals' view of health vary among different age-groups, race, 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 a higher level of functioning, achieving an optimum balance between internal and external environment
• Illness


  An abnormal process in which any aspect of a person's functioning is diminished or impaired compared with their previous condition
• Health promotion


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