Freddie the tutor

TOPIC 1:

  The outcome model of quality is a way of measuring quality using three aspects of care according to Dr. Avedis Donabedian. These three aspects are structure, process, and outcomes. These three aspects allow an individual to really look at key components of care and be able to dig deep to really assess the quality of care given. In addition, “Donabedian broadened the definition of quality to include not just the technical management of the patient but also the management of interpersonal relationships, as well as access to care and continuity of care” (Sollecito and Johnson, 2011). In my own interpretation this model of quality allowed gave individuals a model to use to guide them in assessing quality of care and creating a way to really acknowledge areas of improvement within processes and not just by looking at things at the surface.

TOPIC 2:

Good evening professor and classmates, a false claim is an offense that is committed with actual knowledge and intent to defraud or deceive. Also having actual knowledge that a claim is false or acting with “reckless disregard” as to whether a claim is false.

According to the False Claims Act it does not cover mistakes, errors or negligence. The OIG has stated that it is mindful of the difference between errors and abuse. I personally don't think a mistake or an error are fraudulent behavior, they are often innocent mistakes not intended to defraud the Medicare system.  

The purpose of a compliance program is to prevent or detect violations of law or company policy. They also help physicians and small group practices design voluntary compliance programs that best fit the needs of their practices.

The step I feel is most important to the process is, to designate a compliance officer to monitor compliance efforts and enforce practice standards. Because a compliance officer helps prevent future overpayments by schedule to audit charts and monitor billing. They screen and train employees and providers, perform background checks, maintain an open line of communication and enforce discipline.

TOPIC 3:

A false claim is where someone over charges for a product, service, or failing to perform a service to cheat the Federal Government out of money. Mistakes and errors on a claim is not considered fraudulent behavior, unless the person has intentionally decepted or misrepresented a claim. If mistakes or errors are unknown this could cause the medical office to experience financial difficulties, because of the claims being denied or delayed payments, and costly fines and loss of revenue. The compliance program is used to prevent and /or detect violations of law or company policy. I think that requiring employees to participate in training programs is the most important, because the employee will not know what is expected when they do have a major error this will preventing the employee from saying they have not had that training  

TOPIC 4:

1. Convert the ingredients in your recipe from its original imperial units into metric units. Post both the original and converted recipe in the same post so that your classmates and instructor can look at the differences. There is no need to post the preparation or cooking instructions—only the ingredients.

King Ranch Chicken

Imperial Measurements                                                                                                 Metric Measurements 2 cups Chopped cooked chicken                                                                                   473.149 milliliters Chopped cooked chicken 1 bag (12 oz) frozen onions, celery, bell pepper and parsley seasoning blend             354.88 milliliters frozen onions, celery, bell pepper and parsley seasoning blend 1 can (10 ¾ oz) condensed cream of chicken soup                                                       317.9154 milliliters condensed cream of chicken soup 1 can (10 ¾ oz) condensed cream of mushroom soup                                                  317.9154 milliliters condensed cream of mushroom soup 1 can (10 oz) diced tomatoes with green chiles, undrained                                           295.7353 milliliters diced tomatoes with green chiles, undrained 1 teaspoon chili powder                                                                                                 4.928922 milliliters chili powder ½ teaspoon garlic salt                                                                                                    2.464461 milliliters garlic powder 12 soft corn tortillas (6 inch), torn into 1-inch pieces                                                     12 soft corn tortillas (15.24 cm), torn into 2.54 cm pieces 2 cups shredded Cheddar cheese (8 oz) (Betty Crocker, 2015)                                   473.149 milliliters shredded Cheddar Cheese (236.5882 milliliters)

2. Was it difficult to make the conversion from one system of units to the other? Why, or why not?

It was difficult to make the conversions with the online apps but, my computer calculator does this for me and it made it easier.  But math is not my strong suit!

3. Time to shift your focus to another system of measurements. Now, use an online mapping program to find out how far you will have to travel to get to one of Kaplan’s graduation ceremonies (in Chicago, IL or Miami, FL) from your hometown. Approximately how far in miles and in kilometers will you have to travel?

From Conroe Texas to the Kaplan graduation ceremony in Miami, FL it takes 1,190.18 miles which is equivalent to 1,915.409 kilometers that I would have to travel.

4. What if you wanted to know what the distance would be in smaller units? In the imperial system you could convert miles into yards and feet. Using SI units you could convert kilometers into meters and centimeters. 

a. Convert the data from question 3 into the number of feet and meters you will have to travel.

I would travel 5,280 feet to reach Miami, FL from Conroe, or 1,915,409 meters.

b. Which system (Imperial or SI) did you find easier to calculate the smaller distances in? Why?

I found it easier to calculate the smaller distance in the Imperial system, only because I have a calculator and know this system better.  But after doing the calculations it may have been easier to switch from kilometers to meters.  

5. Humans have used different systems of measurement throughout history. Do some research on your own, and find a unit of measurement that you did not know about before and give a brief description of its history. Explain how to convert it into a unit of measurement that people would be familiar with today.

After during some research I found in England before 1824 they used English units.  The English units were a combination of the Anglo-Saxon and Roman systems.  Some examples of measurements include digit, or finger.  A digit is an ancient measurement of length.  A digit is equivalent to ¾ inch.  A finger is equivalent to 7/8 inch. (Pedia View, 2015)

Topic 5:

The outcome model of quality or the Donabedian Model consists of three different categories, structure, process and outcomes.  In 1980, Dr. Avedis Donabedian announced his thoughts on ways that quality could be measured within the healthcare system (Sollecito and Johnson, 2011). Structure consists of resources that can provide necessary healthcare.  This may include staff trainings, facilities and equipment (Sollecito and Johnson, 2011). The process includes the activities of giving and receiving care for the patient and the physician.  The outcome is the end result of treatment and includes how the patient feels about the care they received.  These processes may be used to exchange information such as an interface for an EHR or look at better ways of scheduling patient to improve the flow of the workday.  The outcome model of quality can also be used to help treat certain diseases such as systemic lupus erythematosus (SLE).  This is valuable because it helps with research and intervention to improve the quality of care in SLE patients.