What is the role of committees, task forces, and councils in the organization, and who is invited to join? Consider how this relates to formal and informal leadership.

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Organizational Structures and Leadership

 

To prepare:

 

  • Review the information presented in Chapter 12 of the course text. Focus on the information about formal versus informal structure as well as the types of organizational structures.
  • Consider the overall structure or hierarchy of your organization or one with which you are familiar. Which organizational structure best describes your organization—line (or bureaucratic), ad hoc, matrix, service line, or flat? Note: It is possible to have a combination of structures in one organization. Is decision making centralized or decentralized in this organization?
  • What is the role of committees, task forces, and councils in the organization, and who is invited to join? Consider how this relates to formal and informal leadership.
  • Reflect on how decisions are made within a specific department or unit. Which stakeholders provide input or influence the decision-making process? Assess this in terms of formal and informal leadership.
  • To support your analysis, consider your own experiences and investigate these matters by speaking with others at the organization and reviewing available documents. Be sure to consider how the concepts of formal and informal structure and leadership relate to one another and are demonstrated in the organization and in the particular department or unit.

 

On the Week 3 Discussion Board,

 

 Post 1 page paper on a depiction of your organization’s formal structure, indicating whether it is best described as line, ad hoc, matrix, service line, flat, or a combination. Describe how decisions are made within the organization and within one department or unit in particular, noting relevant attributes of centralized/decentralized decision making. Explain the influence of formal and informal leadership on decision making within

 

 

 

References

 

  • Marquis, B. L., & Huston, C. J. (2015). Leadership roles and management functions in nursing: Theory and application (8th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.
    • Chapter 2, “Classical Views of Leadership and Management”

      Chapter 3, “Twenty-First Century Thinking About Leadership and Management”

      Review Chapter 12, “Organizational Structure”

 

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13)  Buying a hip replacement surgery is different from the assumptions of a purchase in the perfectly competitive market because a)  the seller has an ethical duty to care for you. b)  all buyers are price makers.

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13)  Buying a hip replacement surgery is different from the assumptions of a purchase in the perfectly competitive market because

a)  the seller has an ethical duty to care for you.

b)  all buyers are price makers.

c)  product characteristics do not vary significantly across providers.

d)  information is freely available about surgeons specializing in hip replacements.

e)  obtaining Board Certification in Orthopedic Surgery is a relatively quick and uncomplicated procedure.

 

13)  Buying a hip replacement surgery is different from the assumptions of a purchase in the perfectly competitive market because

a)  the seller has an ethical duty to care for you.

b)  all buyers are price makers.

c)  product characteristics do not vary significantly across providers.

d)  information is freely available about surgeons specializing in hip replacements.

e)  obtaining Board Certification in Orthopedic Surgery is a relatively quick and uncomplicated procedure.

 

15) Which of the following statements is false? Significant increase in healthcare spending over the past seventy years can in part be explained by the

a)  increase in the cost of labor-intensive services.

b)  increase in the overall level of medical care prices.

c)  increase in intensity and quality of care.

d)  increase in the share of the healthcare costs spent on manufactured goods such as drugs.

e)  population growth.

 

 

 

17)  Scarcity means

a)  time and resources spent researching a cure for breast cancer are time and resources that could have been spent researching cures for lymphoma.

b)  25 year olds might be more willing to start a family than 35 year olds.

c)  government funding of federal programs equals the amount paid in taxes.

d)  all consumers are assumed to have limited financial resources.

e)  money flows in a circle.

 

 

 

19) Firms apply marginal analysis to maximize the following production goal:

a)  demand.

b)  profit.

c)  output.

d)  prices.

e)  total revenue.

 

 

21)  Investments in human capital include all the following except

a)  attending college.

b)  saving money for college.

c)  exercising.

d)  maintaining a healthy weight.

e)  immunizing children against diseases.

 

23)  Which of the following statements about the concept of “rationality” is false?

a)  Rationality means that people make choices to make themselves better off subject to resource constraints.

b)  Rationality means that organizations make choices to meet their objectives (maximize profits, minimize cost, get elected).

c)  People and organizations are always perfectly rational in their decisions.

d)  Purchasing life insurance to minimize the risk of financial problems for your family is an example of a rational decision.

e) Rationality is a concept that organizes and guides economic analysis, but may sometimes miss the human meaning of transactions in healthcare markets.

 

 

Chapter 2: Demand and Supply

 

True/False

 

1)  The demand for cosmetic surgery is more elastic than the demand for Botox treatments.

 

 

3)  The Water-Diamonds Paradox is illustrated when water, which is essential for life, trades at a higher price than diamonds, which are not essential for life.

 

 

Multiple Choice

 

5)  The market demand curve for aspirin

a)  is measured at a specific time and place.

b)  is comprised of all the individual demand curves.

c)  is a marginal benefit curve.

d)  slopes downward because the benefit from the tenth aspirin is much less than the benefit from the first aspirin.

e)  all of the above.

 

 

7)  Price elasticity measures the:

a)  change in quantity per unit change in price.

b)  change in price per unit change in quantity.

c)  percentage change in quantity for each 1% change in price.

d)  price sensitivity when quantity purchased changes.

e)  quantity divided by price.

 

 

9)  Health economists observe individuals’ willingness t
o pay by observing not only cash transactions, but also by observing patients’ time spent waiting and/or pain endured to obtain medical services.  Examples of observable, non-cash prices paid by patients include all of the following, except

a)  a caretaker waits nine months for a family member to receive nursing home care.

b)  a patient undergoes experimental cancer vaccine to arrest the growth of a tumor.

c)  a patient pays another patient $50 to trade places in the queue at the free clinic.

d)  an elderly patient waits eight hours to see a doctor for free at a famous eye clinic.

e)  a morbidly obese patient must undergo six months of nutrition counseling prior to undergoing surgery to induce weight loss.

 

 

11) Consider the following scenario. A pharmaceutical company has spent 230 million dollars developing and testing a new drug. The company projects the total revenue from sales to be about 850 million dollars over the course of three years after the drug approval by the FDA. The company is close to the completion of the research phase, when they learn that a competing drug has entered the market. Sales projections have been downgraded to 150 million dollars. An investment of an additional 9 million dollars would be required to complete the research and obtain the FDA approval, if the company decides to do so. The cost of producing actual pills, after the research phase is complete, will be close to zero and can be ignored for simplicity. The company should complete the research and launch production of this drug only if the required additional investment does not exceed

 

a)  3 million dollars.

b)  9 million dollars.

c)  150 million dollars.

d)  230 million dollars.

e)  850 million dollars.

 

 

 

13)  Scientific evidence suggests that nurse practitioners (NPs) and physician assistants (PAs) can be considered as substitutes in providing many types of medical care. When hospitals take hiring decisions, the “price” (i.e. salaries) they have to pay for a new NP versus a new PA is one of the deciding factors. If PAs’ salaries have grown substantially during the last 6 months, while there has been no change in the NPs’ salaries, what would happen in the market for nurse practitioners’ services?

a)  Supply of NPs to hospitals will increase.

b)  Supply of NPs to hospitals will decrease.

c)  Hospitals’ demand for NPs will increase.

d)  Hospitals’ demand for NPs will decrease.

e)  The increase in the salaries of PAs should have no effect on hospitals’ demand for or supply of nurse practitioners’ services.

 

 

 

15)  Listed below are possible ways to improve the nation’s health status, except

a)  increasing spending on medical care.

b)  relaxing the environmental pollution standards.

c)  paying for college education for children from low income families.

d)  incentivizing consumers to participate in wellness programs, such as weight-loss plans.

e)  provide government rebates to consumers for purchasing environmentally friendly vehicles.

 

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 In which of the following examples does the fundamental theorem of exchange not apply? a)  You pay your optometrist $500 for a new pair of eyeglasses. b)  You donate your old, used eyeglasses to the Lions Club, a charitable organization which recycles and distributes the glasses to needy people.

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Health Economic and financing

  • Health Economic and financing

dlyChapter 1 Choices: Money, Medicine, and Health

Odd

 

True/False

 

 

1)  Over the past 100 years, out of pocket expenditures for health care services by individuals have decreased from about 50% to less than 10%.

 

 

3)  Ranking everyone by the amount spent on medical care, 70 percent of the total (all expenditures for all people) is accounted for by the top 10 percent of patients. This phenomenon is called cost shifting.

 

.

5)  The Flow of Funds idea emphasizes that total dollars spent by individuals, government and other third party payers for health care must equal total income earned by health care providers, administrators and other health care workers.

 

 

7)  Socioeconomic differences in mortality found in the U.S. are most likely attributable to lack of universal health insurance coverage.

 

 

9)  A hospital system is rewarded with higher profits in the short term when it implements electronic health records which increase the timeliness of physician and patient communication.

 

Multiple Choice

 

11)  In which of the following examples does the fundamental theorem of exchange not apply?

a)  You pay your optometrist $500 for a new pair of eyeglasses.

b)  You donate your old, used eyeglasses to the Lions Club, a charitable organization which recycles and distributes the glasses to needy people.

c)   You pay a fertility specialist $10,000 to perform In Vitro Fertilization procedure which does not result in pregnancy.

d)   You pay a fertility specialist $10,000 to perform In Vitro Fertilization procedure which results in pregnancy.

e)   Unknown to you, your neighbor is tapping into your cable TV service and sharing your service.

 

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Prepare for this Application Assignment as follows: Select a particular functional area within a health care setting. This must be an area that makes use of the types of patient data found in EHRs. Examples include: a hospital’s admissions department, emergency room, pharmacy, or nursing unit; or the billing department or outpatient treatment department at a clinic or physicians’ office.

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Adoption of Electronic Health Records

  • Adoption of Electronic Health Records

Application: Adoption of Electronic Health Records

EHRs are an important focus of the HITECH Act. To comply with this legislation and to make the best use of their organization’s resources, health care managers should develop a clear understanding of the nature of EHRs and of factors that promote or mitigate against their adoption.

Prepare for this Application Assignment as follows:

  • Select a particular functional area within a health care setting. This must be an area that makes use of the types of patient data found in EHRs. Examples include: a hospital’s admissions department, emergency room, pharmacy, or nursing unit; or the billing department or outpatient treatment department at a clinic or physicians’ office.
  • Review this week’s Learning Resources and conduct a literature search to determine factors that promote and hinder adoption of an EHR system across this type of organization and within this area in particular. Look not only for technological, but also human factors that impact the adoption of EHRs.

Then write a 2- to 3-page paper that addresses the following:

  • What are key problems related to the adoption of EHRs in your selected functional area?
  • What factors promote the adoption of EHRs in this particular setting?
  • Describe solutions that have been found to promoting adoption of EHRs and to overcoming barriers. Include specific examples, and be sure to address technological as well as human factors.
  • What are specific steps management can take to facilitate the adoption of EHRs?
  • Operations Management homework help
 

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   What are some key things you have learned about this culture through reading the scholarly sources? (approximately 300 words)

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Cultural Immersion Project – Part 1

  • Cultural Immersion Project – Part 1

Cultural Immersion Project – Part 1 Instructions

Distant Encounter

This part involves scholarly resources and Internet/media resources related to the cultural group you will be exploring. This group may be a different ethnicity, religion, and/or culture or have other significantly different cultural features (e.g., the elderly in nursing homes, disabled children, disabled adults, the homeless, prisoners, etc.). You must select a group with whom you have little or no prior experience. For example, if you have interacted with many Cubans previously, you cannot base the project on the Cuban culture. This also applies to your own cultural background. For example, if you are a white student from an Irish background, you cannot base the project on the Irish culture. No reusing past experiences. The cultural group you select must be new for you. For the Cultural Immersion Project – Parts 2 and 3, be aware that you must both participate in cultural group activities as well as interview an individual or married couple from your selected cultural group (see the instructions documents for Parts 2 and 3 for information on those later assignments); therefore, choose a culture group with whom you will be able to interact.

 

You will read at least 3 scholarly sources on your cultural group of interest (the resources must published by 2005 or later). A pertinent, unassigned chapter from the McGoldrick et al. text may count as 1 of these resources; however, the Hays & Erford text chapters may not count as a source. You must also use the Internet or media to examine at least 3 significant media sources related to the culture. For example, on the Internet, you may find the following types of resources that are both culturally useful and prominent:

·         Online newspapers from the selected country,

·         Internet radio broadcasts,

·         Music from the country/group,

·         Movies or videos,

·         Culture-specific online magazines or websites, and/or

·         Organizations.

 

You will answer the questions listed below. First person may be used in your answers. This assignment may also be in outline form instead of formatted as a traditional paper; however, you must observe correct and current APA style. The paper must have a correct title page, and you must use a reference page if you cite resources (no abstract is needed). A word estimate is beside each question; however, the quality of your answer is more important than the word count. You may expand further, but you do not have to do so.

 

1.      What are some key things you have learned about this culture through reading the scholarly sources? (approximately 300 words)

 

2.      What are some key things you have learned about this culture through interacting with Internet/media resources related to this culture? (approximately 300 words)

 

3.      Are there any current surprises regarding what you are finding out about this culture? (approximately 100 words)

 

4.      How does your search through the literature and Internet/media impact your expectations as you plan your immersion activities? (approximately 200 words)

 

On the reference page, list the scholarly resources and Internet/media resources that you used for this part of the immersion project in current APA format.

 

Note that the research you do for Parts 1 and 2 is necessary for the completion of Part 3. Organize all the notes and resources you have gathered thus far to enable you to easily accomplish the final part of this project.

 

 

Cultural Immersion Project – Part 1 Grading Rubric

Criteria Points Possible

Points Earned
Organization of Answers 0 to 25 points

·   There is a clear, logical flow to answers.

·   Important themes from the scholarly sources/Internet/media exploration are well-identified.

·   Major points are stated clearly.

·   Major points are supported by scholarly sources, Internet sources, and/or media sources.

Content of Answers 0 to 35 points

·  Answers reflect thoughtful analysis and exploration of the important themes identified through the scholarly sources and Internet/media search.

·  The culture being explored is identified.

·  Good, scholarly sources are used and cited when appropriate.

·  A variety of Internet/media sources are used and cited when appropriate.

·  Clear identification of key things learned from reading the scholarly sources is included.

·  Clear identification of key things learned from exploring Internet/media sources is included.

·  Discussion of anything that was surprising is included.

·  Good exploration of how the information from the reading and Internet/media experience impacts expectations for the other parts of the Cultural Immersion Project is included.

·  Each answer is of good quality.

Readability and Current APA Format 0 to 10 points

·   Spelling and grammar are correct.

·   First person is acceptable.

·   Sentences are complete, clear, and concise.

·   Current APA format is followed per instructions.

·   Scholarly and Internet/media sources are appropriately listed in current APA format.

Total

  • Psychology homework help
 

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With these thoughts in mind, develop a list of questions about the patient flow process (covering input, throughput, and/or output phases) to ask your interviewee. Through these questions, you should find out about challenges they have encountered regarding patient flow, and ways they have addressed it. Phrase these questions in your own words. At minimum, your questions should encompass the following: What are crucial challenges this ED has faced in recent years related to patient flow?

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Application: Improving Patient Flow in Emergency Departments

  • Application: Improving Patient Flow in Emergency Departments

Application: Improving Patient Flow in Emergency DepartmentsAs you learned from Chapter 4 of Hospital-Based Emergency Care and from this week’s articles, emergency departments face serious challenges that impact, and are impacted by, conditions throughout the hospital. Experts emphasize the need to making patient flow more efficient. As noted in the IOM Committee’s report:

Patient flow, defined as the movement of patients through this system, is an important indicator of the timeliness, safety, and quality of the care received. Efficient patient flow ensures maximum throughput (the number of patients treated and discharged from the ED per day), minimizing delays at each point of the delivery process with no decrement in the quality of care. Impaired patient flow, on the other hand, results in bottlenecks that prolong delays for patients already in the system, as well as those awaiting entry (p. 133).

 

For this Application, you will interview at least one administrator or manager working in a local emergency department to learn how his or her ED has identified and addressed challenges involving patient flow. On the basis of this interview, you will select one of these challenges and do further research about best practices to address this problem.

1. Setting Up the Interview

  • Read through the entire Application to gain an overview of this assignment.
  • As soon as possible, contact the emergency department at a local hospital and ask to set up an interview with an administrator or manager in this ED. This must be someone who can discuss process improvement efforts in this ED related to patient flow.

    The interviewee should hold one of the following (or comparable) positions for this ED:

    • Administrative director of the ED (usually non-physician)
    • Chief of Emergency Services or Emergency Department (physician)
    • Nurse Manager for ED
    • Lab Manager or Imaging Manager responsible for supporting ED
  • When contacting the department, identify yourself as a student in the Walden University MHA program and briefly describe your objective in interviewing the administrator or manager. Let your interviewee know that you will keep all identifying details (such as his/her name and the name of the hospital) confidential, if desired.

2. Preparing for and Conducting the Interview

  • Review the “Input/throughput/output Model” of a patient flow through the ED, on page 134 in Hospital-Based Emergency Care (http://books.nap.edu/openbook.php?record_id=11621&page=134# ). Consider why this is the typical model, and what the pros and cons of this process flow are. Make sure you understand how it represents patient flow.
  • Make a list of various issues related to patient flow, as identified in Chapter 4 of Hospital-Based Emergency Care and your other Learning Resources. Note when and why bottlenecks typically occur, and identify other problems in efficient processing of ED patients. Also list strategies used to address these challenges.
  • With these thoughts in mind, develop a list of questions about the patient flow process (covering input, throughput, and/or output phases) to ask your interviewee. Through these questions, you should find out about challenges they have encountered regarding patient flow, and ways they have addressed it. Phrase these questions in your own words. At minimum, your questions should encompass the following:
    • What are crucial challenges this ED has faced in recent years related to patient flow?
    • On what basis were these challenges identified? Were quantitative data used to identify and confirm the existence of problems, and if so, which types of data?
    • Focusing on one of these challenges, what process improvement or reengineering efforts has this ED taken to address the challenge? Did the department follow Lean and/or Six Sigma or other comparable approaches in addressing this?
    • Did the ED use any internal or external best practices to make these changes? If so, which ones?
    • Did the organization or ED establish any metrics to determine if expected outcomes are being met? If so, what were the metrics?
    • Did the implemented changes achieve expected outcomes?
  • Conduct your interview with at least one of the administrators or managers of a local hospital’s Emergency Department (see list of possible interviewees by title above). Ideally, conduct this interview in person in the hospital. If this is not feasible, however, you may complete this interview by phone. If follow-up questions are needed, these may be conducted by phone and/or email.
  • If possible, arrange for a tour of your selected ED, so that you may observe firsthand the layout and other notable features of the ED that may impact patient flow.

3. Completing the Application

  • Do further research through Walden Library and/or the web to learn more about the patient flow challenge identified by your interviewee. According to your research, what are best practices for this process improvement issue?
  • Write a 3- to 4-page paper in which you address the following:
    • Identify the name and organization of your interviewee (unless that person has requested anonymity).
    • Summarize the responses from your interviewee to your questions.
    • Based on the interview and additional research you conducted, what is the industry best practice for this performance improvement issue?
    • Which key stakeholders are likely to be affected by the performance improvement effort, and how?
    • Provide with any further conclusions about the ED’s operations or layout, and best practices as they relate to the challenges facing this ED.

 

 

ADDITIONAL RESOURCES: YOU CAN GOOGLE THE BOOK. CONTACT ME FOR ACCESS TO WALDEN LIBRARY

 

 

Readings

  • Course Text:
  • Langabeer II, J. R., & Helton, J. (2016). Health care operations management: A systems perspective (2nd ed.). Burlington, MA: Jones and Bartlett.
  •  
    • Chapter 4, “Process and Quality Improvement”

      Tools and methodologie
      s of process improvement, such as process mapping and benchmarking, are explained in this chapter.

  • Course Text: Quantitative Methods in Health Care Management
    • Chapter 6, “Reengineeing”

      Key elements of reengineering in health care are outlined in this chapter, including methods for measuring and analyzing of time standards, work sampling, and work simplification.

  • Book Excerpt: Committee on the Future of Emergency Care in the United States (2007). Improving the efficiency of hospital-based emergency care. In Hospital-based emergency care: At the breaking point (pp. 129–164). Retrieved from http://books.nap.edu/openbook.php?record_id=11621&page=129

    Chapter 4 of this report describes strategies for improving the efficiency of hospital-based emergency care, with special focus on issues of patient flow.

  • White Paper: Institute for Healthcare Improvement. (2005). Going lean in health care. Cambridge, MA. [White paper]. Retrieved from http://www.entnet.org/Practice/upload/GoingLeaninHealthCareWhitePaper.pdf
  • Article: Finefrock, S. C. (2006). Designing and building a new emergency department: The experience of one chest pain, stroke, and trauma center in Columbus, Ohio. Journal of Emergency Nursing, 32(2), 144–148. Retrieved from Walden Library Databases.
  • Article: Asplin, B. R., Magid, D. J., Rhodes, K. V., Solberg, L. I., Lurie, N., & Camargo, C. A., Jr. (2003). A conceptual model of emergency department crowding. Annals of Emergency Medicine, 42(2), 173–180. Retrieved from Walden Library Databases.

Websites

  • American College of Emergency Physicians: The Role of Metrics in Managing Clinical Operations

    http://www.acep.org/practres.aspx?id=29960

    Please scroll to the very bottom of the webpage to locate the link for the PDF of the article.

Review these Web pages for the Institute of Healthcare Improvement’s perspective on need for improving patient flow in emergency and other departments in health care organizations:

  • IHI: How to Improve

    http://www.ihi.org/knowledge/Pages/HowtoImprove/default.aspx

  • IHI: Flow

    http://www.ihi.org/explore/Flow/Pages/default.aspx

  • IHI: Patient First: Efficient Patient Flow Management Impact on the ED

    http://www.ihi.org/knowledge/Pages/ImprovementStories/PatientFirstEfficientPatientFlowManagementED.aspx

Optional Resources

  • Article: Hoot, N. R., & Aronsky, D. (2008). Systematic review of emergency department crowding: Causes, effects, and solutions. Annals of Emergency Medicine, 52(2), 126–136. Retrieved from Walden Library Databases.
  • Article: Snyder, K. D., & McDermott, M. (2009). A rural hospital takes on Lean. Journal of Healthcare Quality, 31(3), 23–28.Retrieved from Walden Library Databases.
  • Article: Chassin R. (2008).The Six Sigma initiative at Mount Sinai Medical Center. Mount Sinai Journal of Medicine, 75(1), 45–52. Retrieved from Walden Library Databases.
  • Article: Marjamaa, R. A., Torkki, P. M., Hirvensalo, E. J., & Kirvelä, O. A. (2009). What is the best workflow for an operating room? A simulation study of five scenarios. Health Care Management Science, 12(2), 142–147. Retrieved from Walden Library Databases.

 

 

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In this assignment, you will be writing a 1,000-1,250-word essay describing the differing approaches of nursing leaders and managers to issues in practice. To complete this assignment, do the following: 1) Select an issue from the following list: nursing shortage and nurse turn-over, nurse staffing ratios, unit closures and restructuring, use of contract employees (i.e., registry and travel nurses), continuous quality improvement and patient satisfaction, and magnet designation.

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NRS-451V Week 2 Effective Approaches in Leadership and Management

  • NRS-451V Week 2 Effective Approaches in Leadership and Management

In this assignment, you will be writing a 1,000-1,250-word essay describing the differing approaches of nursing leaders and managers to issues in practice. To complete this assignment, do the following:

 

1) Select an issue from the following list: nursing shortage and nurse turn-over, nurse staffing ratios, unit closures and restructuring, use of contract employees (i.e., registry and travel nurses), continuous quality improvement and patient satisfaction, and magnet designation.

 

2) Compare and contrast how you would expect nursing leaders and managers to approach your selected issue. Support your rationale by using the theories, principles, skills, and roles of the leader versus manager described in your readings.

 

3) Identify the approach that best fits your personal and professional philosophy of nursing and explain why the approach is suited to your personal leadership style.

 

4) Use at least two references other than your text and those provided in the course.

 

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

 

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Prior to starting this assignment be sure to have read this module’s assigned reading. Choose the best answer to answer each of the following questions: Need Help? Click here for complete quiz instructions. 1. APCs affect all outpatient services under Medicare payment. A) True B) False 2. One of the critical areas of organizational systems involvement for APC success is validation of code selection and reimbursement data that affect APC groups. A) True B) False

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Chargemaster and APC Articles and Worksheet

  • Chargemaster and APC Articles and Worksheet

Need complete correct answer by 12 midnight 9/12/2015

 

Prior to starting this assignment be sure to have read this module’s assigned reading. Choose the best answer to answer each of the following questions:

Need Help? Click here for complete quiz instructions.

1.
APCs affect all outpatient services under Medicare payment.

A) True

B) False

2.
One of the critical areas of organizational systems involvement for APC success is validation of code selection and reimbursement data that affect APC groups.

A) True

B) False

3.
When selecting an APC Coordinator, it is important to select someone with knowledge and expertise of billing systems and clinical departments as well as the HIM department.

A) True

B) False

4.
One of the responsibilities for the APC coordinator would be to analyze information flows for the billing process.

A) True

B) False

5.
The APC team is best organized as a subcommittee of the facility’s medical record committee.

A) True

B) False

6.
In assessing the revenue cycle, it is important to map the information flow through the organization’s automated information systems to assure the timeliness of information transfer.

A) True

B) False

7.
It is important to perform an in-depth review of chargemaster detail because 100% of charges associated with ambulatory surgery are generated through the chargemaster.

A) True

B) False

8.
The APC Team should include representation from HIM, information systems, nursing in ambulatory surgery and ancillary areas, patient finance/patient accounts, registration, and administration among others.

A) True

B) False

9.
It is important to develop a system where HCPCS codes must be matched to the appropriate revenue codes because revenue codes drive the packaging in the APC system.

A) True

B) False

10.
The primary objective of the APC system is to control costs for Medicare beneficiaries.

A) True

B) False

11.
Placement of the APC grouper in the organization’s information system must be analyzed because unlike the DRG system, the APC system uses both chargemaster-assigned and coder-assigned procedures in the final grouping process.

A) True

B) False

12.
One of the steps in examining the documentation processes is to review the information systems that generate supporting documentation for charges included on the HCFA 1500.

A) True

B) False

13.
The charge master is also known as a master charge list or a charge description list.

A) True

B) False

14.
The various supplies listed on the charge master for the average facility drives reimbursement for approximately 50% of the UB-92 claims for outpatient services alone.

A) True

B) False

15.
An inaccurate charge master may result in overpayment, underpayment, undercharging, claims rejection, fines and/or penalties.

A) True

B) False

16.
Because the charge master is an automated process that results in billing numerous services for high volume patients, there is a risk that a single coding or mapping error could spawn many billing errors before it is identified and corrected.

A) True

B) False

17.
One of the key elements of the charge master is the “Procedure Description” which has a set format and vocabulary used by all facilities.

A) True

B) False

18.
One of the required fields in the charge master is the ICD-9 procedure code.

A) True

B) False

19.
The “Revenue Code” is a two-digit code number representing a specific accommodation, ancillary service, or billing calculation required for Medicare billing.

A) True

B) False

20.
The “Charge Dollar Amount” is the specific amount the facility will be reimbursed by a third-party payer.

A) True

B) False

21.
The charge master should be overseen by a committee composed of key facility representatives that will contribute to the accuracy and quality of both the document database and the charge master review process.

A) True

B) False

22.
All services and procedures listed on the charge master will have a CPT or HCPCS code.

A) True

B) False

23.
The charge master committee should include representatives from health information management, ancillary departments, the financial service/business office and information systems.

A) True

B) False

24.
One of the responsibilities of the charge master committee is to review CPT codes, procedure and service descriptions, and revenue codes for accuracy.

A) True

B) False

25.
Any application that involves one charge description number “exploding” into more than one CPT/HCPCS code should be reviewed to prevent inadvertent unbundling or unearned reimbursement.

A) True

B) False

 

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Analyze and critique a quantitative nursing research article from a nursing research journal published within the past 5 years.  You must include five scholarly references—the article, the text, and three outside sources.

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Qualitative Research Article Analysis

  • Qualitative Research Article Analysis

**Analyze and critique a quantitative nursing research article from a nursing research journal published within the past 5 years.  You must include five scholarly references—the article, the text, and three outside sources.

**Use the Guidelines for Qualitative Nursing Research Critique (below) to write a 1,350-wordpaper analyzing the chosen article. Make sure that your responses to each criterion are complete and concise.

**Attach a copy of the article and the certificate of originality.

**Format your paper consistent with APA guidelines.

**No more than 10% of the paper can be quoted. This is your analysis of what the authors said—not a restatement of the article.

Guidelines for Qualitative Nursing Research Critique

Your qualitative research report analysis requires an in-depth analysis of the following questions:

 

 

·       Is the problem clearly stated and is significant to nursing or health care?

·       Is the purpose clearly stated?

·       Is the research question stated broadly enough for a qualitative study?

·       Is the study design consistent with its qualitative approach?

·       Are the subjects obtained using a method consistent with the qualitative methodology?

·       Is the setting appropriate for the study?

·       Are the data collection methods consistent with the purpose of the qualitative approach?

·       Are the rights of human subjects protected?

·       Is evidence of data saturation provided?

·       Are the data analysis procedures appropriate for the type of data collected and the qualitative method?

·       Is there sufficient evidence of scientific rigor?

·       Are the conclusions and implications appropriate and clearly stated?

·       Are suggestions for future research included?

 

DUE DATE/TIME: 9/20/15; 2:00PM CALIFORNIA TIME

 

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