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Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...
The Healthcare Common Procedure Coding System (HCPCS, often pronounced by its acronym as "hick picks") is a set of health care procedure codes based on the American Medical Association's Current Procedural Terminology (CPT).
A medical procedure is a course of action intended to achieve a result in the delivery of healthcare. A medical procedure with the intention of determining, measuring, or diagnosing a patient condition or parameter is also called a medical test .
The anticipate, recognize, evaluate, control, and confirm (ARECC) decision-making framework began as recognize, evaluate, and control.In 1994 then-president of the American Industrial Hygiene Association (AIHA) Harry Ettinger added the anticipate step to formally convey the duty and opportunity of the worker protection community to proactively apply its growing body of knowledge and experience ...
The COSO definition relates to the aggregate control system of the organization, which is composed of many individual control procedures. Discrete control procedures, or controls are defined by the SEC as: "...a specific set of policies, procedures, and activities designed to meet an objective. A control may exist within a designated function ...
Administrative controls are training, procedure, policy, or shift designs that lessen the threat of a hazard to an individual. [1] Administrative controls typically change the behavior of people (e.g., factory workers) rather than removing the actual hazard or providing personal protective equipment (PPE).
Infection prevention and control is the discipline concerned with preventing healthcare-associated infections; a practical rather than academic sub-discipline of epidemiology. In Northern Europe , infection prevention and control is expanded from healthcare into a component in public health , known as "infection protection" ( smittevern ...
The Donabedian model is a conceptual model that provides a framework for examining health services and evaluating quality of health care. [1] According to the model, information about quality of care can be drawn from three categories: "structure", "process", and "outcomes". [2]