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Frequently Asked Questions
Question # 1
In managed care, the most widely used performance measures are
A. Agency for Healthcare Research and Quality (AHRQ).
B. Healthcare Effectiveness Data and Information Set (HEDIS).
C. National Quality Forum (NQF).
D. Uniform Hospital Discharge Data Set (UHDDS).
Question # 2
Which of the following charts would most likely be used first in a root cause analysis?
A. Pareto
B. control
C. flow
D. Gantt
Question # 3
The perception of how an organization operates, including how employees relate to internal and external customers, is the organizational
A. mission.
B. vision.
C. structure.
D. culture.
Question # 4
The leader of a pain management performance improvement team has asked the Quality Council to disband the team. The most important factor for the Quality Council to assess is
A. the amount of data the team has collected.
B. the effectiveness of the team leader and facilitator.
C. how well the team met the intended outcome.
D. the length of time the team has been together.
Question # 5
When considering the use of an external subject matter expert (SME), which of the following characteristics is most critical?
A. references of the SME
B. cost of the SME's services
C. geographic location of the SME
D. leadership's personal preference
Question # 6
A consulting firm has been selected by a facility's quality professional to assess the quality improvement program. Before starting the assessment, the quality professional should
A. define expectations and outcomes.
B. develop potential action plans.
C. help the consulting firm to identify problem areas.
D. schedule the activities of the consulting firm.
Question # 7
Performing a root cause analysis of a sentinel/unexpected event provides all of the following EXCEPT
A. recommendation for actions to prevent or decrease recurrence.
B. measurement strategies for each factor affecting the outcome.
C. continuous monitoring to identify opportunities for improvement.
D. identification of why the variance occurred.
Question # 8
The best way to evaluate the effectiveness of performance improvement training is through
A. observed behavioral changes.
B. participants' feedback.
C. post-test results.
D. self-assessments.
Question # 9
When examining the relationship between staff and patient outcomes, which of the following would be most appropriate to assess?
A. occurrence reports and sentinel events
B. staff turnover and budget
C. overtime data and absenteeism rates
D. patient safety data and overtime data
Question # 10
A new quality director has reviewed the information related to the Quality Council minutes and notes the following: - The council meets quarterly. Meetings last approximately two hours. - The council roster includes all clinical department managers and the quality director. Attendance ranges from 45-60%. -The primary role of the council is to receive department quality reports, which are then forwarded to the organization's governing body. Based on the information above, which of the following actions is most appropriate
A. Redefine the council's role to coordinate and prioritize quality activities.
B. Require departments to forward reports for review prior to the meetings.
C. Eliminate the council and directly report quality data to the governing body.
D. Switch to a monthly meeting with a new agenda format
Question # 11
A patient safety program can best be enhanced by which of the following technologies?
A. online evidence-based medicine guidelines
B. computers on wheels at the patients' bedsides
C. digital medication reference materials
D. barcode system for medication administration
Question # 12
Which of the following actions would have the greatest impact in reducing harm?
A. increasing data collection frequency
B. forming a performance improvement team
C. improving interdisciplinary communication
D. revising the patient safety evaluation tool
Question # 13
Which of the following is the major responsibility of senior management regarding continuous quality improvement?
A. Communicate the organizational mission and values.
B. Develop organization-wide training sessions.
C. Participate in Quality Council activities.
D. Conduct periodic reviews of the program.
Question # 14
In the quality improvement process, performing a cost-benefit analysis would be most useful in
A. designing solutions and controls.
B. checking performance.
C. analyzing process problems.
D. implementing solutions and controls.
Question # 15
Which of the following is always true regarding a sentinel event?
A. The findings must be reported to a regulatory body.
B. The occurrence requires an immediate investigative response.
C. The cause is established as a deviation from standards.
D. The incident is a result of a medical error.
Question # 16
A. Suspend privileges for physician C.
B. Initiate peer review with physician C.
C. Initiate peer review with physician A.
D. Suspend privileges for physician A.
Question # 17
Which of the following is the most effective way to integrate performance improvement concepts throughout an organization?
A. quality teams
B. monthly lectures
C. continuous monitoring
D. quarterly newsletters
Question # 18
A clinical pathway on the management of hip fractures has been developed by a multidisciplinary team and implemented in a large teaching hospital. After monitoring for 6 months, the length of stay continues to exceed the guidelines. Which of the following should be the next step?
A. Correlate the pathway with staffing levels.
B. Re-educate the staff on the purpose of the pathway.
C. Evaluate compliance with the pathway.
D. Continue to monitor and collect additional data.
Question # 19
Results of physician practice pattern studies are most likely to promote behavior changes when disseminated to the
A. practitioners.
B. governing body.
C. quality committee.
D. administration.
Question # 20
Random screening of newborns by the neonatology department has confirmed a high incidence of glucose insufficiency (G6PD) in the local population. Management believes that the cost of testing all newborns would be too high. Which of the following should the healthcare quality professional suggest?
A. Review literature to determine best practices.
B. Continue to conduct random testing.
C. Conduct an analysis to confirm management's beliefs.
D. Test only newborns with a family history of G6PD.
Question # 21
Which of the following topics are discussed at a morbidity and mortality conference?
A. planned readmissions and newborn mortality rates
B. healthcare-acquired infections and perioperative mortality
C. inpatient mortality and admissions
D. Cesarean section rates and number of physicians
Question # 22
A healthcare quality professional is conducting a study to determine how many patients contractedinfluenza after receiving flu shots. This study is evaluating
A. prevalence.
B. efficacy.
C. process.
D. appropriateness.
Question # 23
Which of the following should be included in an annual performance improvement report to a governing body?
A. team achievements
B. meeting minutes
C. incident/occurrence reports
D. physician peer reviews
Question # 24
A. caring and most satisfied with cost.
B. cost and most satisfied with caring.
C. communication and most satisfied with comfort.
D. cost and most satisfied with communication.
Question # 25
A summary of antibiotic usage for the fourth quarter showed that an internal medicine department did not meet pre-established criteria in 82% of the patients reviewed. Following review, the pharmacy and therapeutics committee should recommend that the results be shared first with the
A. utilization committee.
B. Quality Council.
C. governing body.
D. chief of the department
Question # 26
Frequency distribution can best be displayed through use of
A. an interrelationship diagram.
B. a force field analysis.
C. a flow chart.
D. a histogram.
Question # 27
In lean thinking, a process step is defined as "value added" if the
A. customer recognizes the value.
B. process owner recognizes the value.
C. process owner changes the value of the product.
D. customer corrects a mistake to add value.
Question # 28
A physician who has a high inpatient mortality rate compared to others in a facility should first be
A. suspended in the interest of patient safety.
B. counseled by the department chairperson.
C. evaluated by the credentialing committee.
D. subjected to a more in-depth review of cases.
Question # 29
The phrase "reaching consensus" is often used in performance improvement. The term consensus refers to
A. unanimous agreement
B. everyone being totally satisfied.
C. a majority vote of those present
D. support by all members.
Question # 30
An operating room circulating nurse reported that the instrument count indicated a missing clamp. X-ray findings were negative, and the patient showed no adverse effects. This occurrence is an example of which of the following?
A. malpractice
B. potentially compensable event
C. clinical incompetency
D. claims management
Question # 31
Which of the following action plans is the first step in correcting inappropriate blood usage in an emergency department?
A. development of a new procurement procedure
B. improvements in documentation
C. elimination of wasted blood
D. in-service on blood usage for the physicians
Question # 32
A policy for "time-outs" in an operating room was initiated in the first quarter. The second quarter data has demonstrated only 40% compliance with all elements of the process. The first step the Quality Council should take is to
A. ask the nurses to identify non-compliant surgeons.
B. continue to audit to confirm that a problem exists.
C. create a letter for the chief executive officer to send to all surgeons.
D. examine if the policy is clear and user friendly.
Question # 33
When using cost-benefit analysis in decision making, it is important to remember that
A. qualitative and quantitative data should be used.
B. implementation costs are more important than return on investment.
C. return on investment should be at least 10 to 1.
D. consideration of the benefit is more important than cost.
Question # 34
When developing a strategic plan that integrates patient safety, which of the following factors is most critical?
A. cost-benefit of patient safety programs
B. culture of performance improvement
C. patient-to-staff ratio
D. resources for advanced technology
Question # 35
When a team evaluating the use of restraints starts to discuss a liability claim related to a patient, the facilitator should
A. consult the risk manager.
B. redirect the team.
C. review team ground rules.
D. request the medical record.
Question # 36
An annual evaluation of a laboratory's quality program identified no opportunities for improvement. Which of the following elements of the program should be reviewed?
A. frequency of data collection
B. performance indicators
C. format of data display
D. committee meeting attendance
Question # 37
Human factors engineering is defined as the study of humans and their interaction with
A. medical technology and the organizational systems.
B. adverse events and latent errors.
C. demographics and the organization.
D. the tools they use and the environment.
Question # 38
Deemed status refers to
A. surveyors who work for both an accrediting body and a healthcare organization.
B. physicians who have been reported to the National Practitioner Database.
C. accreditation equivalency with a Centers for Medicare & Medicaid Services (CMS)
survey.
D. a healthcare organization that passes a Centers for Medicare & Medicaid Services (CMS) survey.
Question # 39
Balanced scorecards are useful because they
A. concentrate on the performance of individual units.
B. focus on the most significant strategic initiative.
C. evaluate the pros and cons of the governing body's priorities.
D. put strategy and vision at the center of an organization's effort
Question # 40
Staff has been trained and oriented on a new electronic incident reporting system. In the past, staff could report anonymously. The new system requires staff to sign in with an individualized username and password. Three months after implementation, there is a sharp reduction in the number of reported incidents. Which of the following reasons for underreporting of incidents is of greatest concern?
A. staff fear of negative consequences of reporting
B. time required to complete an incident report
C. incomplete understanding about required reporting
D. lack of knowledge about how to use the system
Question # 41
A monitoring system is being designed in which data will be collected and compared to criteria. Which of the following will best enhance the validity and reliability of the data?
A. providing a practice-based definition and specific instructions for each element
B. establishing criteria that are based on the most recent changes in medical science and technology
C. using a computerized system to substitute data for missing responses
D. assigning one staff member to identify, collect, enter, and interpret all data
Question # 42
Medication reconciliation is a process intended to
A. improve efficiency of medication administration.
B. investigate formulary discrepancies.
C. identify and resolve discrepancies.
D. increase use of electronic medication administration
Question # 43
Which of the following is the best tool to begin an investigation into the causes of laboratory labeling errors?
A. histogram
B. flow chart
C. affinity diagram
D. prioritization matrix
Question # 44
Comparing healthcare organizations by using medical error rates
A. provides the best method for benchmarking patient safety.
B. must include a minimum of 10 different facilities.
C. may present bias due to differences in reporting practices.
D. cannot be performed by facilities with less than 100 beds.
Question # 45
A facility is becoming part of a healthcare network. Which of the following employee education programs is most important?
A. consumer expectations
B. organizational change
C. conflict resolution
D. quality teams
Question # 46
Medication reconciliation is a process intended to
A. improve efficiency of medication administration.
B. investigate formulary discrepancies.
C. identify and resolve discrepancies.
D. increase use of electronic medication administration.
Question # 47
The clinical competency of a physician is determined by
A. a committee of peers.
B. the hospital governing body.
C. a quality management committee.
D. the chief executive officer.
Question # 48
A performance improvement training program for supervisors should include
A. review of patient falls.
B. results of a failure mode and effects analysis (FMEA).
C. budget-variance reporting.
D. rapid-cycle process.
Question # 49
In the process of strategic planning, an organization makes decisions about the future. A basic component of the planning process is to
A. contract with a consulting firm to assist with the planning process.
B. determine organizational profitability during the most recent fiscal year.
C. examine both internal and external environments.
D. develop contractual relationships to enhance market share.
Question # 50
Which of the following elements must be present in order to evaluate the effectiveness of a healthcare organization's quality improvement program?
A. integrated data collection
B. quantifiable objectives
C. support from the medical staff
D. well-defined organizational structure
Question # 51
The target for performance improvement should be
A. policies and procedures.
B. employees.
C. systems.
D. standards and regulations.
Question # 52
Which of the following is most appropriate in preparation for an external survey of a healthcare facility?
A. Set up teams to make a good showing for the survey.
B. Assign key staff to answer all questions.
C. Ask department heads to prepare a presentation for the survey team.
D. Educate staff about the types of questions they may be asked.
Question # 53
A culture of patient safety in an organization will have been successfully created when
A. staff members serve as safety advocates.
B. near miss reporting of safety issues declines.
C. a root cause analysis is performed regularly.
D. personal accountability is removed from the organization.
Question # 54
Minimizing the chances of an adverse event reoccurring includes determining the primary contributing factor by using
A. root cause analysis.
B. clinical pathways.
C. failure mode and effects analysis (FMEA).
D. force field analysis.
Question # 55
A healthcare quality professional has been asked to assess a facility's patient safety culture. Which of the following should be targeted in a validated survey?
A. a random sample of leaders and staff
B. a stratified sample of physicians and nurses
C. all staff and physicians
D. all patients and their families
Question # 56
The utilization management committee is reviewing length-of-stay data for a particular procedure. In comparing data by physician, which of the following statistics would be most useful?
A. range
B. correlation
C. mean
D. standard deviation
Question # 57
Facility A is investigating its medication administration time for a specific diagnosis. Evidence-based guidelines indicate that administration of a particular drug within 30 minutes significantly improves patient outcomes. The national average is 32 minutes. The average for Facility B is 28 minutes. If the average for Facility A is 35 minutes, Facility A should
A. identify the average time of its competitors.
B. determine whether its rate is within one standard deviation of the national average.
C. contact Facility B to determine its practices.
D. decrease its rate to meet the national average.
Question # 58
A healthcare network has implemented an electronic medical record system allowing data to betransmitted, on demand, from one facility to another. Which of the following will best promote bothcost effectiveness and patient satisfaction?
A. eliminating the need for patients to hand-carry records
B. decreasing repeat tests when a patient is seen in more than one facility
C. increasing the security of confidential patient information
D. improving the accuracy of medication reconciliation
Question # 59
Which of the following team members is responsible for keeping meetings focused?
A. time keeper
B. recorder
C. leader
D. facilitator
Question # 60
In profiling length-of-stay data for benchmarking, it is important that data be
A. raw numbers.
B. severity adjusted.
C. equal numbers.
D. reported monthly.
Question # 61
Based on the principles from the Institute for Healthcare Improvement (IHI), who has the ultimate responsibility for the effectiveness of quality improvement and patient safety within an organization?
A. chief executive officer
B. quality improvement director
C. medical director
D. governing body
Question # 62
A serious event has occurred related to the timely notification of critical test results. The root cause was traced to nursing difficulty with following the organizational policy. To prevent a similar event from reoccurring, which of the following should be done next?
A. Continue to collect data as one event is insufficient to take action.
B. Refer the involved nurse to nursing peer review.
C. Review the policy with nursing representatives to identify ambiguities.
D. Educate nursing staff on the importance of timely notification of critical test results.
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