How does managed care affect the economics of health care delivery? - ANSDecreases duplicate processes and redundant facilities rationale: The corporatization of health care amalgamates the smaller health care operations into the larger organizations to decrease duplicate and redundant health care provisions. For example, one hospital would provide a high level of cardiac care, while another hospital would focus on oncology. What is meant by the term integrated health care delivery system (IHS)? - ANS-A large health care system that can provide all needed services under one corporate umbrella rationale: As part of the corporatization of health care, the individual health care organizations are merging into systems to provide all needed services under one corporate umbrella. These are known as integrated health care delivery systems. Characteristics of clinical pathways include all of the following except: - ANS-Being a nurse-centered orientation rationale: Clinical pathways help reduce expensive variations in care. Clinical pathways are interdisciplinary plans of care that outline the optimal sequencing and timing of interventions for clients with a particular diagnosis, procedure, or symptom. Patient-focused care is a recently developed term to describe: - ANS-A nursing care delivery system rationale: Patient-focused care is another type of delivery system. The level of productivity is increased through centralization of functions (phlebotomy, diet instruction, respiratory therapy) on the unit under the direction of the RN and cross-training ancillary workers to do more than one function. The patient comes into contact with fewer people under this organizational framework. What are two tools that support case management? - ANS-Clinical pathways and disease management rationale: Both of these tools support case management by coordination and delivery of highquality care. Clinical pathways are interdisciplinary plans of care that outline the optimal sequencing and timing of interventions for clients with a particular diagnosis, procedure, or symptom. A delivery of nursing care organized around tasks is known as: - ANS-Functional nursing rationale: Aides and vocational nurses/licensed practical nurses are allowed to perform functions such as administration of medication and treatments. This functional kind of nursing results in a fragmented, impersonal kind of care. A system in which a nurse plans and directs the care of clients over a 24-hour period is known as: - ANS-Primary nursing rationale: In primary nursing the fragmentation between shifts and nurses is eliminated because one nurse is accountable for planning the care of the client around the clock. Which statement is true about the case management model of nursing care? - ANSIt is based on previously defined client outcomes. rationale: Clinical pathways are a tool used to support case management and to define client outcomes.. These are interdisciplinary plans of care that outline the optimal sequencing and timing of interventions for clients with a particular diagnosis, procedure, or symptom to achieve a defined client outcome. What is the primary work environment of nurses who are case managers? - ANS-All types of health care organizations, as well as organizations with health-related functions, hire case managers. rationale: The case managers work in all types of health care institutions. They may also work for insurance or utilization review companies or in health-related areas of various types of large businesses. Which statement is true about client classification systems? - ANS-They provide historical data of the usage of nursing time, which is helpful when developing the department budget. rationale: A client classification or acuity system is used in many acute care hospitals to estimate the intensity of nursing care required to meet client needs. Which of the following best describes the concept of evidence-based practice? - ANS-It provides for the use of recent research in current nursing practice. rationale: The IOM reported that it took 17 years for research to be reflected into daily practice. Evidence based practice is the use of the current best evidence to provide care and make decisions regarding client care.