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Healthcare Organization (HCO) |
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A formal legal entity that reaches across the panorama of medicine, other clinical disciplines, and business to identify and deliver care to its community. |
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Individuals or groups who have a distinct interest in the organization. |
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Patients and others who use the services of the organization and generally compensate the organization for those services; also, by extension, other units within the HCO that rely on a particular unit for service. |
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Institutional and personal caregivers such as physicians, hospitals, and nurses. |
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A payment agent for healthcare insurance (e.g. Medicare intermediaries that pay providers as agents for CMS). |
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The state agency handling claims and payments for Medicaid. |
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Government regulatory agencies |
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Agencies with established authority over healthcare activities. |
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Certificate of Need (CON) |
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Certificates or approvals for new services and construction or renovation of hospitals or related facilities; issued by many states |
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Quality Improvement Organizations (QIOs) |
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External agencies that review the quality of care and us of insurance benefits by individual physicians and patients for Medicare and other insurers. |
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Health Insurance Portability and Accountability Act (HIPPA) |
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A 1996 Federal act that establishes standards of privacy for patient information. |
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Primary care practitioners |
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Initial contact providers, including physicians in family practice, general internal medicine, pediatrics, obstetrics, and psychiatry; nurse practitioners; and midwives. |
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Referral specialists physicians |
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Doctors who care for patients referred by primary care practitioners on a limited or transient basis; likely to manage episodes of inpatient care. |
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Physicians who manage broad categories of hospitalized patients. |
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Equal employment opportunity agency |
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Government agencies that monitor the rights of associate groups; these are among those entitled to access to the HCO and its records. |
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Formal, long-term collaborative contracts usually involving equity investment. |
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A model of care giving that assists with physical, emotional, spiritual, psychological, social, financial, and legal needs of the dying patient and his family; the service may be provided in the patient's home or an HCO |
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Customers whose opinions of the organization are so positive that they will return for further interaction and will recommend or refer the organization to others. |
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A short-stay general or specialty (e.g. women's, children's, orthopedic) hospital, excluding those owned by the fed). |
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Healthcare organizations that operate multiple service units under a single ownership. |
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The affiliation of organizations that provide different kinds of service, such as hospital care, ambulatory care, long-term care, and social services. |
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Integration of organizations that provide the same kind of service, such as two hospitals and two clinics. |
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A statement of purpose--the good or benefit the HCO intends to contribute-- couched in terms of an identified community, a set of services and a specific level or cost or finance. |
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An expansion of the mission that expresses intentions, philosophy, and organizational self-image. |
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An expansion of the mission that expresses basic rules or acceptable conduct, such as respect for human dignity or acceptance of equality. |
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The ability of an associate to control his or her work situation in ways consistent with the mission. |
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The notion that the organization can rely on an individual or team to fulfill a specific, prearranged expectation. |
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Associates anticipate and meet or exceed customer needs and expectations on the basis of the mission and values. |
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Evidence-based management |
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Relies heavily on formal process specification and performance management. |
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Patient care protocols or guidelines |
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Formally established expectations that define the normal steps or processes in the care of a clinically related group of patients at a specific institution. |
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These determine how functional elements of care are carried out. |
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Operations measures or operation scorecards |
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Six dimensions of measurement that include three measurements of inputs or resources and three measurements of outputs or results. |
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Strategic measures or strategic scorecard |
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Four dimensions of measurement (finance, operations, customer relations, and learning/hr) appropriate for service lines or the HCO as a whole. |
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A reporting and communication system that links each operating unit to the governing board, usually grouped by similar centers together under middle management. |
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The best-known value for a specific measure, from any source. |
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Opportunities For Improvement (OFIs) |
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Result of comparing actual outcomes against goals and goals against benchmarks; also arise from qualitative assessments, including listening. |
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Process Improvement Team (PIT) |
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A group that analyzes processes and translates OFIs to actual performance improvement. |
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The underlying factors that must be changed to yield consistently better outcomes. |
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Performance Improvement Council (PIC) |
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A formal coordinating structure composed of representatives from all major activities or activity groups; the PIC's first job is to prioritize the OFIs. |
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A systematic response to a specific stakeholder need. |
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The set of decisions about missions, ownership, scope of activity, location, and partners that defines the organization and relates it to stakeholders needs. |
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Safeguards the assets of the organization. |
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Associates and teams who work inside the HCO. |
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The leader's obligation to be sensitive and responsive to the associate's needs. |
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Having requisite or adequate ability or quality that results in effective action and/or superior performance in a job. |
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360-degree or multi-rater review |
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Formal evaluation of performance by subordinates, superiors, and peers of the individual or unit. |
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Leadership succession plan |
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A written plan for replacing people who depart from management positions. |
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A standing multidisciplinary committee that is concerned with biomedical ethical issues and decision making processes, formulation of policies, and review and consultation of medical ethical issues. |
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In a business setting, rounding involves leaders' taking an hour a day to touch base with their employees, make a personal connection, find out what's going well, and determine what improvements can be made. Quite simply, it's a way to gather info you need to do your job and do it well-- in a timely and efficient manner. |
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The basic physical and organizational structures needed for the operation of an enterprise. |
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Epidemiological planning model |
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A process to rigorously define, measure, and forecast the community served and its needs. |
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Members of the governing board of non-for-profit HCOs who volunteer their time to the organization; their only compensation is the satisfaction they achieve from their work. The title reflects their acceptance of the assets in trust for the community; also called directors. |
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Alternative approaches to improving the profile of opportunities reflected in the environment assessment. |
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Opportunities that involve quantum shifts in service capabilities or market share, usually by interaction with competitors, large-scale capital investments, and revisions to several line activities. |
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A model of a specific strategy or function that guides design, operations, and goal setting. |
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Long range financial plan (LRFP) |
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An ongoing projection of financial position showing earnings, debt, and capitalization for at least the next seven years. |
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Any review of professional performance by members of the same profession. |
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Medical staff organization |
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The organization of a HCOs staff members that provides a structure to carry out policies, expectations for quality of clinical care, and communication from physicians to the governing body. |
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A formal document of the governance of procedures for physicians and other who provide care in the organization; approved by the governing body. |
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A certified public accounting firm that attests that the accounting practices followed by the organization are sound and that the financials fairly represent the state of business. |
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Comments of external auditors to the governing board that accompany their audited financial report. |
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Programs designed to meet statutory and regulatory requirements; may be based on legislation or voluntary efforts such as accreditation. |
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A permanent committee established in the bylaws of the corporation. |
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A committee formed to address a specific purpose, for a specified time period. |
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A corporate document that specifies quorum riles of order, duties of standing committees and officers, and other procedures for the conduct of business. |
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Decisions permanently vested in the central corporation of a multi-corporate system. |
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A group of agenda items passed without discussion, unless a member requests a review; used to focus attention on priority matters. |
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Systematically employing a trial-and-error mechanism that recognizes uncertainty and proceeds cyclically as more information is gathered. |
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Key to manage uncertainty in medicine, framework for selecting diagnostic testing and treatment. |
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Patient Management Protocols |
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Formally established expectations that define the normal steps or processes in the care of a clinically related group of patients at a specific institution. |
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Procedures and sets of activities to carry out elements of care. |
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Clinical Practice Guidelines |
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Systematically developed statements to assist practitioner and patient decisions about appropriate healthcare for specific clinical circumstances. |
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Treatment to manage and reduce pain, discomfort, and other uncomfortable symptoms of life-limiting diseases or conditions with no cure; services are provided in a holistic manner to include the patient and their family. |
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The process of validating a professional's eligibility for medical staff membership and/or privileges to be granted on the basis of academic preparation, licensing, training, certifications, and performance. |
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Expectations for the care of individual patients based on assessment of individual needs. |
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Interdisciplinary Plan of Care (IPOC) |
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A process that includes the patient, the family, and all clinical disciplines involved in planning and providing care to patients, from system point of entry, through out the entire acute care episode and to the next level of care. |
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Takes place before the disease emerges to eliminate or reduce its occurrence. (Immunizations, seat belts, sewage treatment). |
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Reduces the consequences of disease of by early detection and treatment. (Self-examinations, dental inspections). |
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Is the avoidance of complications or sequelae (early physical therapy.) |
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National Quality Measures Clearinghouse |
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A database measure sets for practitioners, health delivery systems, and healthcare providers, with standardized abstracts and ordering details. |
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Written report of an untoward event that raises the possibility of liability of the organization. |
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Pay for performance is an emerging movement in health insurance. Providers under this arrangement are rewarded for meeting pre-established targets for delivery of healthcare services This is a fundamental change for fee-for-service payment. |
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Physicians who have the privilege of using the hospital for patient care and who are designated as the physician of record for particular patients. |
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A concept or model of care delivery that includes an ongoing relationship between a provider and patient, around the clock access to medical consultations, respect for a patient's cultural and religious beliefs, and a comprehensive approach to care and coordination of care through providers and community services. |
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Licensed physicians who pursue postgraduate education; residents who pursue advanced study are also called fellows; residents and fellows are also called house officers. |
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A state of equilibrium with one's environment. |
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A system of assessing patients, diagnosing individual nursing care needs, planning care, implementing plans, and evaluating care. |
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A standardized statement about the health of a client for the purpose of providing nursing care; identified for the purpose of providing nursing; identified from a master list of nursing diagnosis terminology. |
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North American Nursing Diagnosis Association (NANDA) |
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Mission: To facilitate the development, refinement, dissemination and use of standardized nursing diagnostic terminology. Vision: NANDA international will be a global force for the development and use of nursing's standardized terminology to ensure patient safety through evidence-based care, thereby improving the health care of all people. |
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Caregivers with training in critical care management and emergency treatment protocols; deployed when a patient's condition suddenly deteriorates. |
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Healthcare professional responsible for providing patient care through nursing process- assess, plan, implement, and evaluate nursing care of the sick and injured. |
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Licensed Practice Nurse LPN |
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1-year JUCO program, nurses who provide care under supervision of physicians or RNs. |
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Full-time equivalent (FTE) |
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Group of nurses whose time adds up equal to that of one's full time hours. |
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Specialized department to provide critical care in a hospital. |
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Organizational structure wherein various councils develop and oversee the major dimensions of nursing and interdisciplinary practice. |
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Advanced Practice Nurse APN |
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A master's prepared nurse with specialization and licensure to practice as a nurse practitioner, nurse anesthetist, nurse midwife, clinical nurse specialist, clinical nurse leader, or other advanced specialist role. |
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A registered nurse who has advanced education and certification to carry out expanded healthcare evaluation and decision making regarding patient care boundaries of independent practice are set by state laws. |
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Nurse with special training who practice uncomplicated obstetrics. |
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Nurse with special training who administers anesthesia without direct physician supervision. |
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A health professional who advocates for the patient to receive the most appropriate treatment with acceptable quality in the most effective manner and appropriate setting at the best prices. |
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Clinical Nurse Leader CNL |
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Assumes accountability for healthcare outcomes for a specific group of clients within a unit or setting through the assimilation and application of research-based information to design, implement and evaluate client plan of care. Serves as a lateral integrator for the healthcare team and facilitates, coordinates, and oversees the care provided by the healthcare team. |
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Doctor of Nursing Practice DPN |
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Emphasizes the preparations of leaders for clinical practice, health policy, administration, and clinical research. Work at the highest level of clinical practice with nurse researchers to provide leadership in nursing in a variety of settings, with complementary roles between the DNP and the more research-oriented PhD degree in nursing. |
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Chief Nursing Officer CNO |
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Principle strategic and operation executive for the nursing organization; nurse executive with an organization to ensure credentialing, manage nurse training and development, recruit and retain a competent and proficient nursing workforce, implement nursing practice standards and functional protocols, and maintain consistent performance or nursing activities. |
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Magnet Recognition Program |
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1) Professional autonomy over practice; 2) Nursing control over the practice environment; 3) Effective Communication among nurses, physicians and administrators. |
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Proposals for new or replacement capital equipment or major revisions of service. |
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Clinical Support Services (CSS) |
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Specialized professionals providing important clinical information (diagnostic services) or specific interventions (treatment services). |
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A focus on sustaining all members of the community at their highest possible level of functioning for their individual happiness and their collective benefit. |
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A process for identifying and quantifying opportunities for improvement. |
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Federally Qualified Health Centers |
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A community clinic which serves primarily disadvantaged ("medically disenfranchised") patients, regardless of their ability to pay. (Primary care, preventive care, health, oral, mental/substance abuse). |
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Center for Medicare and Medicaid Services (CMS) |
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A branch of the U.S. Department of Health and Human Services. CMS is the federal agency that administers the Medicare program and monitors the Medicaid programs offered by each state. |
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The systematic use of the existing market place to expand the total use of appropriate services. |
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