Chapter 2 Fundamentals of Respiratory Care
The joint committee (TJC)
A private non government agency that established guidelines for the operation of hospitals and other health care facilities, conducts accreditation programs and surveys, and encourages the attainment of high standards of institution medical care in the United States. Formally Joint Commission on Accreditation of Health Care Organizations (JACHO)
Quality Assurance
An evaluation of services provided and the result achieved as compared with accepted standards
To monitor correctness of respiratory care plans, what should be used?
Care plan auditors and case study exercises
Essential element of a comprehensive protocol program:
Carefully structured assessment tool and care plan form
The Responsibilities of a respiratory care department manager include all of the following:
Check that the medical devices function at an appropriate and safe level, develop respiratory care protocols and procedures, maintain knowledge of changes in medications and delivery devices, evaluate new devices and methods for effectiveness commensurate with cost
The medical director of respiratory care is responsible for all the following:
Clinical function of the department and provides oversight of the clinical care that is delivered
Respiratory care education programs are reviewed by which committee to ensure quality?
Committee on Accreditation for Respiratory Care (CoARC)
Current Joint Commission standards for accreditation emphasize what?
Continuous Quality Improvement CQI
Hospital restructuring and redesign have involved all of the following:
Cross-training employees and using unlicensed assistive staff, downsizing and decentralizing high budget, labor-intensive departments , deploying respiratory care personnel to individual nursing units, training multi skilled assistive personnel to perform basic patient care
What is one advantage that has been shown of respiratory care protocols?
Decrease In the overloading of respiratory care providers
Responsibility for the technical director of a respiratory care department lies with whom?
Department Manager
What term is used in current healthcare that refers to an organized strategy of delivering care to a large group of individuals?
Disease management
What is the chief reason that respiratory care protocols were developed and are currently being used in hospitals throughout North America?
Enhance proper allocation of respiratory care services
What is the most essential aspect of providing quality respiratory care?
Ensure that the care being provided is indicated and that it is delivered competently and appropriately
Treatment based on careful review of available literature is known as?
Evidence- based medicine
The effectiveness of the patient-patient-focused care model has been limited by what?
Expense of relocating radiology, pharmacy and laboratory services to nursing units
Respiratory care plans may be monitored by:
Experienced case plan auditors, computerized case study exercises, patient scenarios, comparison of therapist's patient assessment with the department's "gold standard" assessment
What term is used to describe the process in which a government agency gives an individual permission to practice an occupation?
Licensure
What term is used to describe the work done by a researcher who reviews numerous studies on a single topic and gives more weight to the more rigorous ones before making recommendations?
Meta-analysis
What organization is responsible for credentialing respiratory therapists?
NBRC National Board for Respiratory Care
What agency is responsible for ensuring quality in respiratory care through voluntary certification and registration?
NBRC National Boards for Respiratory Care
National Board of Respiratory Care (NBRC)
National credentialing agency for respiratory care practitioners and pulmonary function technologists
patient-focused care
Non traditional organization of services that emphasizes a team approach to service delivery using cross- trained providers. as well as simplifications of processes required to proved patient care
Characteristics of a respiratory care professional:
Participates in continuing education activities, obtains professional credentials, adheres to a code of ethics, completes an accredited education program
What system has the federal government developed to evaluate the quality of care given to Medicare beneficiaries?
Peer review organizations (PROs)
Committee on Accreditation for Respiratory Care (CoARC)
This committee is sponsored by four organizations: AARC, ACCO, ASA, and ATS that is responsible for ensuring that respiratory therapy educational programs follow accrediting standard or essentials as endorsed by the AMA
Key element of a respiratory care protocol program:
Strong and committed medical direction, collaborative environment among healthcare providers, responsiveness to address and correct problems, capable therapists
What voluntary accrediting agency monitors quality in respiratory care departments?
TJC The Joint Commission
HIPPA was established in 1996 to set standards related to sharing confidential health history information about patients. What does the letter "P" stand for?
The "P" in HIPPA stands for portability
evidence-based medicine
an approach to determining best clinical management based on rigorous and systematic review of available evidence critical analysis of what management conclusions are most sound and applicable and a disciplined approach to incorporating the literature with personal practice experience
For the CRT credential, what does the "T" stand for?
The T stands for THERAPIST
How are competencies being used to monitor the quality of respiratory care?
They are used to check the skill and knowledge of respiratory through the use of clinical simulations
Continuous Quality Improvement (CQI)
management strategy designed to enhance organization performance
Who is professionally responsible for the clinical function of the respiratory care department?
medical director
Quality in the practice of respiratory care encompasses which of the following?
personnel who performs respiratory care. the equipment used and the method or manner in which care is provided
Misallocation
process of prescribing diagnostic or treatment services when not indicated, have overdosing and under-dosing services
Respiratory therapy consult service
program in which respiratory care services are determined by respiratory care practitioners based on prescribed guidelines or algorithms, otherwise known as a evaluate and-treat program
highest credential in the profession
registered respiratory therapist
Respiratory care protocols
specification of actions that allows respiratory care practitioners to independently initiate and adjust therapy, within guidelines previously established by medical staff, also called therapist-driven protocol
Disease Management
systematic population based approach to identify persons at risk, intervene with a specific program of care and measure clinical and other outcomes
Quality of Respiratory Care:
equipment, personnel, method in which care is provided
quality
A characteristic reflecting a high degree of excellence fitness or grade "Quality is never a accident. It is always the result of intelligent effort"
The word "credentialing" in general refers to what?
Recognition of individuals in particular occupations or professions
Algorithm
Predetermined groups of directions to solve a problem in a finite number of steps
Cross-training
Process of providing health care professionals with multiple skills in areas that span single disciplines, for example, training a respiratory care practitioner to take chest radiographs
Factors in determining the quality of care delivered by a respiratory therapist:
Training, education, experience and professionalism