Chapter 5

Question 1

Glaser describes three realms of social activity

Answer 1

individual, institutional, and societal—each having an impact on the health professional’s effectiveness and sense of well-being.
Institutions sit at the interface between the individual and the larger society

Question 2

External Factors
that Influence
Health Care
Institutions

Answer 2

• Health policy
• Federal/state/local regulations
  governing practice
• Accrediting agency standards
• Healthcare financing systems
  that document care and serve as
  sources of quality monitoring
  and reporting

Question 3

Institutional Culture

Answer 3

basic assumptions about
the world and the values that
guide the life in organizations

Question 4

Institutional Climate

Answer 4

shared perceptions of and meaning attached to the policies, practices & procedures
employees experience and behaviors being rewarded, supported & expected

Question 5

Public-sector relationships

Answer 5

within institutions of public life

Question 6

Public-sector relationships

Answer 6

characterized by abrupt changes from
extreme remoteness to extreme nearness with the expectation that
the relationship will be temporary

Question 7

private-sector relationships

Answer 7

are reserved for the world of family, friends, and other intimates.

Question 8

administration’s role

Answer 8

safeguard the interests of the
institution and all its component
members including patients, families,
staff at all levels and lead the effort to
establish a positive workplace culture.

Question 9

Effective administrators

Answer 9

include the participation of key component
members in the design and review of policies and practices.

Question 10

Laws and
Regulations
Affecting
Professional
Caregivers

Answer 10

• Major categories include:
• To ensure professional
  competence
• To prevent discrimination
• Others

Question 11

HIPAA – 1996 Ted Kennedy.

Answer 11

• Protect people from losing their health insurance if they change jobs or have pre-existing conditions
• Create standard electronic formats for many administrative transactions.
• Protect privacy and security of personal health information

Question 12

MEDICARE

Answer 12

• Part A: hospital insurance - inpatient hospital care, skilled nursing facility, hospice, lab tests, surgery, home health care. - skilled care has time limit.
• Part B: - Doctor and outpatient care as well as durable medical equipment.
• Part C or Medicare Advantage: - replaces part A and B with a private plan and may cover more things in some instances and less in others. May have higher deductible and co-pay.
• Medicare Part D – prescription drugs.

Question 13

Patient bill of rights

Answer 13

• Information Disclosure – right to accurate easily understood information.
• Choice of Providers and Plans
• Access to Emergency Services -
• Participation in Treatment Decisions. –
• Respect and Nondiscrimination
• Confidentiality of Health Information
• Complaints and Appeals - Fair and efficient process for resolving differences including a rigorous system of internal review and an independent system of external review.
• Consumer Responsibilities. – Consumers take reasonable responsibilities.

Question 14

PTA patient care and supervision

Answer 14

• PT services are provided directly by the PT.
• PTA only individual who assists PT
• Responsibility is the PT
  o Referrals
  o Examination and reexamination
  o Plan of care
  o Deciding when to render service and when to use PTA
  o Revision of plan of care
  o Conclusion of episode of care
  o Responsibility for hand off communication
  o Oversite of all documentation of services.
  o Consultation

Question 15

• Considerations for how much collaboration with the PTA

Answer 15

o Education, training, experience, and skill level
o Patient or client critically, acuitly, stability, and complexity
o Predictability of consequences
o Setting in which care is being delivered
o Federal and state statutes, and rules or regulations
o Liability and risk management
o Mission of physical therapist services for the setting
o Needed frequency of reexamination.

Question 16

Supervision of PTA

Answer 16

• Physical therapist assistant should at least be in general supervision of PT. Must at least be available for telecommunication.
• Ability of the PTA shall be assessed on an ongoing basis by the supervising PT.

Question 17

Physical therapy State Practice Act

Answer 17

statute defining the scope and practice of physical therapy within the jurisdiction

“licensed physical therapist assistant is required to function under the direction
and supervision of a licensed physical therapist to perform physical therapy procedures delegated and supervised by the licensed physical therapist in a manner consistent with the rules adopted by the board.” - Iowa

Question 18

• Offsite supervising of PTA

Answer 18

o PT available for telecommunication
o Regularly scheduled collaboration with PT.
o PTA can request a supervisory visit by PT
 In case of need for reexamination
 Shall be made at least once a month
 Shall include
* Onsite reexamination
* Review of plan of care
* Evaluation of need and recommendation for utilization of outside resources.

Question 19

Title VII of Civil Rights Act (1964) and Equal Opportunities Act (1972

Answer 19

employment can’t be discriminated against on race, color, sex, religion, or national origin. (I think Transgender and sexual orientation have been added to this on the Bostock V. Clayton County supreme court case in 2020)

Question 20

Equal Pay act (1963)

Answer 20

Requires men and women to receive equal pay for equal work. There’s still a substantial gender pay gap however. If the pay gap continues to shrink at the rate it has equality wont exist until 2052. Longer for women of color.

Question 21

Age Discrimination and Employment Act (1967)

Answer 21

40 to 70 antidiscrimination in employment.

Question 22

Rehabilitation Act (1973) and Americans with Disabilities Act (1990) – ADA

Answer 22

Can’t discriminate against disabled for employment, and must have a reasonable accessible workplace.

Question 23

Universal (1985) and Standard Precautions (1996)

Answer 23

PPE provided by employer to protect employees and patients.

Question 24

Patient’s rights documents
that include the right to:

Answer 24

• considerate and respectful care
• accurate and complete information
• participation in health care decisions
• privacy and confidentiality (within
  constraints of the law)
• information about the institution
  itself
• continuity of care.

Question 25

Patient’s responsibility documents that include the responsibility to:

Answer 25

* Provide as complete a medical history as they can * Follow facility rules and regulations * Show respect and thoughtfulness * Meet financial commitments * Cooperate with agreed-on treatment plans

Question 26

Quadruple aim of institutions.

Answer 26

Patient Experience -> Population Health -> Reducing Costs -> Care Team well-being All four goals are necessary to achieve quality health care.