ACM flashcards
ACM · Build recall with a focused review session.
32 cards. Read the term and the definition here. The deck at the top of this page is optional.
- Case management process steps
- Screening, assessment, care planning, implementation, monitoring and evaluation, outcomes measurement, and termination of the case management relationship.
- Care coordination definition
- The deliberate organization of patient care activities and sharing of information among participants to facilitate appropriate, high-quality care across the continuum.
- Transitional Care Model
- Naylor model in which advanced practice nurses provide early assessment, discharge planning, and post-discharge follow-up to reduce readmissions and improve outcomes for high-risk patients.
- Case management intensity tiers
- Risk stratification levels - universal, targeted, and intensive - that determine how frequently and deeply a case manager engages a patient.
- Katz Index of ADLs
- Standardized tool rating independence in six activities: bathing, dressing, toileting, transferring, continence, and feeding.
- Mini-Cog cognitive screen
- Three-item recall plus clock drawing, scored 0 to 5; a score of 2 or less suggests cognitive impairment and warrants further evaluation.
- SMART care plan goals
- Goals written to be Specific, Measurable, Achievable, Relevant, and Time-bound so that progress can be objectively evaluated.
- Medication reconciliation
- Structured process of obtaining a complete medication list, comparing it with current orders, and resolving discrepancies at each transition of care.
- Three-day SNF rule
- Traditional Medicare Part A requires a qualifying three-day inpatient hospital stay, and observation days do not count, before covering skilled nursing facility care.
- IRF admission criteria
- Requires need for intensive rehabilitation, tolerance of three hours of therapy daily, physician oversight, and the facility meeting the 60 percent rule.
- Discharge planning CoP
- CMS Conditions of Participation require discharge planning to begin early, rest on an assessment, and include the patient's choice among post-acute providers.
- Teach-back method
- Asking the patient to explain instructions in their own words so misunderstanding is detected and corrected before discharge.
- Two-midnight rule
- Inpatient admission is generally appropriate when the physician expects the patient to require hospital care spanning at least two midnights.
- Advance Beneficiary Notice
- A form given to Medicare Part B beneficiaries when a service may be denied as not medically necessary; if signed, financial liability shifts to the patient.
- MS-DRG payment
- Prospective bundled per-discharge payment to a hospital that varies by the assigned diagnosis-related group and includes most inpatient costs.
- Condition Code 44
- Used when utilization review determines after admission that inpatient criteria were not met, converting the stay to outpatient observation status.
- SBIRT screening model
- Screening, Brief Intervention, and Referral to Treatment: a public health approach for identifying and addressing risky alcohol and drug use.
- Stages of change
- Prochaska's stages - precontemplation, contemplation, preparation, action, maintenance, and relapse - with interventions matched to the patient's current stage.
- PHQ-9 scoring
- Nine-item depression measure; scores of 5, 10, 15, and 20 represent mild, moderate, moderately severe, and severe depression respectively.
- Mandatory reporting duty
- Legal obligation to report suspected child abuse, elder abuse, or neglect to designated authorities, often without the patient's consent.
- Informed consent elements
- Capacity, disclosure of risks and alternatives, comprehension, and voluntariness; all are required before non-emergency treatment or procedures.
- Tarasoff duty to warn
- Obligation to protect an identifiable third party when a patient poses a serious threat of violence, which may require warning the person or authorities.
- HIPAA minimum necessary
- Requirement to limit uses and disclosures of protected health information to the least amount reasonably needed for the purpose.
- POLST order
- Portable medical order signed by a clinician that documents a seriously ill patient's preferences for CPR, intubation, and other treatments across care settings.
- SBAR handoff
- Structured communication format of Situation, Background, Assessment, and Recommendation used to give concise, complete handoffs between team members.
- Two-challenge rule
- TeamSTEPPS tool requiring a team member to voice a safety concern at least twice before escalating when others do not respond.
- OARS skills
- Open-ended questions, affirmations, reflections, and summaries - motivational interviewing skills used to build rapport and explore ambivalence.
- Interpreter use standards
- Trained medical interpreters should be used for patients with limited English proficiency; family members, particularly children, should not interpret.
- Donabedian quality model
- Framework that evaluates quality through structure (resources), process (what is done), and outcomes (results achieved for patients).
- Root cause analysis
- Retrospective, system-focused method used after a sentinel event to identify underlying causes and prevent recurrence.
- HCAHPS survey
- Standardized, publicly reported patient experience survey covering communication with nurses and doctors, responsiveness, cleanliness, pain management, and discharge information.
- PDSA cycle
- Plan-Do-Study-Act: iterative improvement method for testing small changes, studying results, and spreading changes that prove effective.