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CERTIFICATION
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If a patient is asked where they would prefer to die the most common answer given is at home with hospice. - ANSWERS-True What is the definition of Operations Management? - ANSWERS-An area of management concerned with designing and controlling the process of production and redesigning business operations in the production of goods and services. What is at the heart of Operations Management in healthcare? - ANSWERS-Identification of barriers to care. What is the best way for NN to determine the current patient flow process across the continuum? - ANSWERS-Follow several patients through observation from one phase of care to the next. Without effective operations management, a patient may get overtreated, undertreated, and/or not receive quality of care. - ANSWERS-True
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Barriers may occur at various points in the cancer continuum, from prevention to end of life, and may overlap and repeat. - ANSWERS- True Components of NN role include assessment, shared decision-making and identifying resources. - ANSWERS-True Documented racial and ethnic inequalities also exist in women's cancer care across disease trajectories. - ANSWERS-True in 2015, how much higher was cervical cancer incidence in Hispanic women compared to white? - ANSWERS-50% Death rate for cervical cancer in black women was twice that of white, non-Hispanic women. - ANSWERS-True Patient navigation significantly shortened the time to diagnostic resolution compared with women who did not receive patient navigation. - ANSWERS-True
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What is a Phase III Clinical Trial? - ANSWERS-Testing of drugs on patients for efficacy. Assume every patient is compromised in their health literacy level. - ANSWERS-True What are some red flags to low cancer health literacy? - ANSWERS-No questions, decreased level of education, don't know their meds, they can provide no medical hx, lack of adherence to testing, no f/u with tests What is one method to ensure health literacy understanding? - ANSWERS-Teach-back method What year did the federal bill pass to ensure insurance coverage for breast reconstruction after breast cancer? - ANSWERS- 1998 What are Cancer Costs by 2020 - ANSWERS-$173 Billion When was Affordable Care Act Passed - ANSWERS- 2010
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What is the Affordable Care Act - ANSWERS-By 1/1/14 citizens must have health ins or pay penalty What is NCCN Distress Thermometer - ANSWERS-Tool to identify barriers and issues of distress What is Mullan's Seasons of Survival Model - ANSWERS- 3 stages of survival - Acute, Extended, Permanent What is Bidimensional Orientation of NN Role - ANSWERS-Patient- centered and healthcare system-centered What is the Freeman Model - ANSWERS-Navigation model using community members to help underserved and poor gain access to breast cancer screenings What is Major Purpose of Navigation - ANSWERS-Provide personal assistance in eliminating barriers to care
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What to Expect --> Physical Condition - ANSWERS-96% of patients say this is important What % of patients wish to die at home - ANSWERS- 50 - 90% How many patients die at home - ANSWERS- 10 - 35% How many patients die in hospitals - ANSWERS- 50 - 60% What is average length of time pt receives hospice - ANSWERS- 5 days What is % ICU deaths of metastatic patients - ANSWERS-21% What do patients think when they hear: "Hopeful your tumor will respond to this treatment" - ANSWERS- 30 - 81% patients think "cure" True/False: Being honest doesn't take away hope - ANSWERS-True
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What is #1 fear of entering hospice - ANSWERS-Fear of abandonment by their doctor What are 3 Phases of Hope? - ANSWERS-1) miracle, 2) long life w/quality of life, 3) accepting shortened life but still hope for quality of life What is the mean cost of cancer care in last 6 months of life? - ANSWERS-$74,000 (only 4% is hospice) True/False: Advanced Directives are just CPR - ANSWERS-False True/False: Poor communication is why pts don't get care they desire - ANSWERS-True What is Role of Navigation - ANSWERS-Improve patient's timely access to cancer-related care throughout the cancer continuum
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Why was first patient navigation program developed in Harlem? - ANSWERS-To reduce the stage of disease and mortality of black patients What does 20% coinsurance mean? - ANSWERS-Pay 100% of deductible and then 20% of any remaining healthcare costs for care received What does TNM refer to? - ANSWERS-System used to stage and grade cancer What is DRE? - ANSWERS-Digital Rectal Exam to evaluate prostate size/abnorm. What are some treatments for prostate cancer? - ANSWERS-Radiation, Prostatectomy, Orchiectomy What is role of non-licensed patient navigator? - ANSWERS-Coach patients to use their time effectively w/physician, help them find resources and advocate for patient rights
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Highest Breast Cancer Incidence in... - ANSWERS-White Women Highest Breast Cancer Mortality in... - ANSWERS-Black Women What did American College of Surgeons Commission on Cancer (CoC) mandate about navigation - ANSWERS-2012 announcement: must implement patient navigation by 1/1/15 for CoC accreditation What did IHI develop in 2008 - ANSWERS-Triple Aim What is Triple Aim - ANSWERS-1) improve pt exp, 2) improve pop. health, 3) decrease cost How many patients with cancer diagnosis in 2016 - ANSWERS-1. million How many patients with cancer diagnosis by 2030 - ANSWERS-2. million END OF PAGE
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What is FOCUS? - ANSWERS-Find, Organize, Clarify, Uncover, Select What is a Pareto Chart? - ANSWERS-80% comes from 20% of the problem What are SMART Goals? - ANSWERS-Specific, Measureable, Achievable, Relevant, Time Based What is FLOW - ANSWERS-Fund, Leadership, Ownership, Wisdom When did QI measures become public? - ANSWERS- 2004 What is Organizational Mgmt? - ANSWERS-Organize, plan, lead and control resources What is Effectiveness? - ANSWERS-Doing the right thing
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What is Efficiency? - ANSWERS-Comparison/doing it right (factor of productivity) What are Clinical Pathways? - ANSWERS-Systematic tool to improve care, standardized, can result in better outcomes What is an Oncology Pathway? - ANSWERS-Most effective, least toxic, least costly What are Guidelines? - ANSWERS-Recommended regimens per diagnosis What are Pathways? - ANSWERS-Based on clinical guidelines to factor in efficacy, toxicity, cost What is Health Utilization Management? - ANSWERS-Concurrent review, evaluate medical necessity, appropriateness, efficiency What is Health Utilization Review? - ANSWERS-Previous review
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What is a Values statement? - ANSWERS-What organizations believe and how it will behave (Moral Compass) What is goal of Community Outreach and Prevention? - ANSWERS- Decrease time from diagnosis to treatment, decrease barriers, facilitate access to quality of care According to Healthy People 2020, how many people do not have health insurance? - ANSWERS-1 in 5 According to Healthy People 2020, how many people do not have a PCP? - ANSWERS-1 in 4 What are the biggest barriers to quality healthcare? - ANSWERS-Lack of insurance, low socio-economic status How many people will use all of their savings due to cost of cancer? - ANSWERS-1 in 5
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True/False: Patients without insurance are less compliant with meds and treatment - ANSWERS-True How many people were uninsured in 2010 - ANSWERS- 50 million How many new cancers were diagnosed in 2015 - ANSWERS-1. million True/False: More men are diagnosed with cancer than women - ANSWERS-True True/False: More whites are diagnosed with cancer than blacks - ANSWERS-False How many cancer survivors are there? - ANSWERS-14.5 million What does the Quality of Life Model include? - ANSWERS-Physical, Psychosocial, Social Wellbeing, Spiritual END OF PAGE
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True/False: There is no difference in quality of life of patients managed by either PCP or oncologist - ANSWERS-True Where can you find more information on health insurance? - ANSWERS-National Coalition for Cancer Survivorship True/False: The NCI (National Cancer Institute) states that Americans can prevent 1/3 of cancers - ANSWERS-True How many employees does a company have to have to provide FMLA benefits? - ANSWERS-> What was cancer patient goal in 1970? - ANSWERS-To live What is the 6th Vital Sign? - ANSWERS-Distress What is the 5th Vital Sign? - ANSWERS-Pain
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What year did ACOS agreed with IOM that psychosocial had to be integrated into routine cancer care? - ANSWERS- 2012 What year did ACOS publish standards on psychosocial care that are necessary for accreditation? - ANSWERS- 2015 What is considered low distress? - ANSWERS-Less than or equal to 4 What is considered high distress? - ANSWERS-Greater than or equal to 5 What is the percentage of cancer patients experiencing distress? - ANSWERS- 29 - 43% What are the components of NCCN Standards of Care relating to patient distress (2014)? - ANSWERS-Recognized, Monitored, Documented, Treated Properly
