Quality Control Exam Chapter 7-14

This predefined process icon (rectangle with two lines inside the rectangle) is used in flowcharting to indicate _________.

A formal procedure that participants are expected to carry out the same way every time

Identify which of the following is an example of a patient who contributes to their own health risk?

A patient who has been diagnosed with COPD and continues to smoke

This decision icon symbol (diamond) is used in flowcharting to indicate __________.

A point in the process at which participants must evaluate the status of the process

This manual input icon (skewed rectangle) is used in flowcharting to indicate __________.

A point in the process where the participants must record data in paper-based or computer-based formats

Inappropriate timing of dose, transcription errors, missed doses, and extra doses given are all examples of this type of medication error __________.

Administration

Which core process area is concern addressed for: social, spiritual, and cultural variables that influence the patient's and family members' perception of their lives?

Assessing the patient's needs

Match the patient care situation to the appropriate core process in the patient care process cycle. ____ Patient is assessed for issues related to legal or correctional status ____ Family or friends who will assist the patient at home following discharge ____ Patient's status continuously monitored for signed of stabilization ____ Written plan for treatment is developed a. Assessing the patient's needs b. Planning care, treatment and services c. Providing care, treatment, and services d. Coordinating care, treatment, and services

Assessing the patient's needs Coordinating care, treatment, and services Providing care, treatment, and services Planning care, treatment and services

James recently changed physicians because his previous physician retired. In the process of making his selection, James reviewed information from his health plan about the new physician and read reviews from other patients. James is confident that he has found an excellent physician to take over his care. What aspect of quality does this exemplify?

Assurance

Sacred Heart Nursing and Rehab Center has discovered that their satisfaction scores need improvement. Carol, the facility administrator, is looking for ways to improve these scores. What information must Carol understand in order to monitor and improve the satisfaction of her facility's residents?

Carol needs to specifically know what is not meeting customer satisfaction. She should do a survey amongst facility residents and family as to what could improve their performance and make people feel better about the Rehab Center.

The principal process by which organizations optimize the continuum of care for their patients is __________.

Case management

____________ attempt(s) to standardize the care of a single condition across the entire country.

Clinical guidelines

The established criteria against which the decisions and actions of healthcare practitioners and other representatives of healthcare organizations are assessed in accordance with nationally accepted standards of care called __________.

Clinical practice standards

Community Hospital is reviewing their job descriptions and notices that some their job descriptions for clinical positions include a reference to the potential risks of exposure to blood-borne pathogens and others do not. The human resource manager insists that all job descriptions include this language. Why is this important to include?

Community Hospital needs to define the level of risk for infection from blood borne pathogens for their employees.

An infection that was present in the patient before he or she was admitted to the facility is called __________.

Community-acquired infection

If the patient presents to the hospital with symptoms of cough, fever, and chills and is later diagnosed with pneumonia the incidence of this infection would be determined as _________.

Community-acquired infection

The symbol in flowcharting that is used to mark the point in the process where the analysis skips to another common point of the process is called __________.

Connector icon

How can continuity and coordination of care increase patient safety?

Continuity and coordination of care increase patient safety because it ensures that the patient is always receiving the proper treatment to highest level of care and when the services rendered are completed, the coordination ensures that even after discharge, the patient is sent home with the proper instructions.

The totality of healthcare services provided to a patient and his family in all settings, from the least to most extensive, is called __________.

Continuum of care

The outcome of which flow of care is an improvement in the patient's condition that allows discharge to the patient's home or to a different care setting?

Coordinating care, treatment and services

Healthcare facilities are at a higher risk for the occurrence of errors simply due to the complex nature of healthcare. Because of this fact, healthcare organizations must:

Create an environment that acknowledges untended human error and learns from it

A multidisciplinary outline of anticipated care within an appropriate period to aid a patient in moving progressively through a clinical experience that ends in a positive outcome is called a __________.

Critical pathway

The health information professional relies on the patient registrar to accurately identify the patient in the EHR this is an example of a(n) __________.

Customer expectation

A staff member is assigned to sit in the waiting room of the physician's office to collect data on patient waiting times. The staff member records the time the patient comes in the door and when the patient is called back to the examining room. Of what type of data collection is this an example?

Direct observation

Follow-up on a patient after discharge to ensure that the transition has gone smoothly and that the patient is receiving all of the services required is considered this case management step:

Discharge planning

The removal of medication from its usual stream of preparation, dispensing, and administration by personnel involved in those steps in order to use or sell the medication in non-healthcare settings is called __________.

Diversion

Dr. Hansen saw a patient in his office with measles. He directed his office staff to call the local department of health to report this case of measles. The office manager called right away and completed the report as instructed. Did Dr. Hansen's office follow appropriate infectious disease reporting requirements?

Dr. Hansen's office followed protocol and reported this case of measles correctly.

The list of medications maintained in the healthcare organization which includes medications used for commonly occurring conditions or diagnoses treated in the organization and selected by members of the healthcare team is called ____________.

Drug formulary

The chain of custody of a drug as it moves through the supply chain from manufacturer to pharmacy is called __________.

Drug pedigree

A Joint Commission-accredited organization must review their formulary annually to ensure a medication's continued __________.

Efficacy and safety

Healthcare customers expect that staff and providers will understand their emotional reactions to their illness and will help them cope with their circumstances. This is an example of __________.

Empathy

Care processes or interventions that developed from research performed on large population-based studies in order to achieve the best patient care outcomes are called __________.

Evidence-based medicine

This component of a healthcare organization's infection surveillance program is responsible for documentation and tracking of follow-up procedures related to staff exposure to blood-borne pathogens:

Facility infection surveillance

Publicly reported data and information about nursing home quality of care is located on the nursing home compare website. This data is generated from the nursing home's __________.

Facility quality-indicator profile

This technique promotes systems thinking and includes the use of flow charts to define high-risk processes.

Failure mode and effect analysis

Internal customers are individuals from outside the organization who receive products or services from within the organization.

False

Occurrence reports are generally open to view by the plaintiff's attorney in a malpractice suit.

False

Western States Medical Center has been recognized for its exceptional cancer treatment, which has resulted in an increase in patients seeking cancer treatment at the facility. To address this increased need for cancer care, Western States Medical Center is adding a specialty hospital for cancer treatment to its services. In this scenario, Western States Medical Center is fulfilling which aspect of quality for its patients and community?

Features

Which of the following techniques, used in unstructured interviews, helps the interviewer establish trust with the respondent and address the pertinent quality issues by moving questions from a broad theme to a narrow theme?

Funneling

Criteria that have been developed by many of the same agencies for use across the continuum of care and in various regions of the country are referred to as __________.

Generic

Which of the following represents a list of potential blood-borne pathogens?

HIV and hepatitis B

Which of the following includes the management of toxic materials and wastes through the identification of chemicals and materials that need special handling and disposal?

Hazardous materials and waste management plan

Proper handwashing has been identified by the CDC as one of the single most important methods for preventing the spread of infection. Describe how healthcare organizations continue to educate staff to make hand washing a critical patient safety issue.

Healthcare organizations place posters or stickers in restrooms and around the facility to remind staff and visitors to wash their hands. Hand sanitizer is placed all around the facility so that it is available whenever an employee might need it. They also have mandatory continuous education or standard precaution meetings for employees before starting a shift.

Discuss why healthcare organization find it difficult to define what quality of care or services means to individuals and their community.

I think these terms are hard to define because every individual has their own idea as to what they mean and you cannot make people think otherwise. Every community and individual has their own way to interpret and think, to want everyone to refer to things in a nice bubble doesn't always work and how a healthcare organization defines something will always find someone who disagrees.

Explain how the implementation of the National Patient Safety Goals has improved healthcare.

In spite of the tremendous amount of data collection that has occurred in healthcare. The NPSGs have provided a widespread, national focus on safety. Some of the seemingly simple requirements of the NPSGs, such as identifying patients correctly, have had a significant impact on safety. This is just one example of the many improvements that have occurred with the implementation of the NPSGs.

A family member of a patient is walking through the hall in the hospital and slips and falls on a recently mopped floor. A nurse on the floor observes the fall and helps the family member. This nurse should report this event to the risk manager using which of the following?

Incident report

In the example below, which survey design problem is represented? How satisfied are you with your care? _________ How would you rate the cleanliness of your room? (circle your answer) Great Good Poor

Inconsistent format

When a hospital patient is diagnosed with one of the diseases from the health department's communicable disease list, who is responsible for notifying the health department?

Infection prevention and control team

A patient presents to the emergency room acutely dehydrated and is admitted to the hospital for IV therapy to rehydrate the patient. Which admission criteria would be used to justify admitting this patient as an inpatient?

Intensity of service

CLIA and the CDC have established protocols for _____.

Laboratory departments

Which of the following is a plan based on the appropriate design and construction of the building, detection, alarm and extinguishing systems, and training to provide appropriate training for all occupants?

Life safety (fire prevention) management plan

Bacteria of any kind that has become resistant to many different antibiotics is called __________.

MDROs

This section of a cause and effect diagram examines influences of major pieces of equipment on the situation.

Machinery

This section of a cause and effect diagram examines influences of the human worker on the situation:

Manpower

This section of a cause and effect diagram examines influences of the products, supplies, or substances used in the patient care event:

Material

This program provides safe and reliable equipment to patients, trains care providers in the safe and effective use of the equipment, and ensures that the equipment is maintained by qualified individuals:

Medical equipment management

This record is used in the healthcare organization to document each dose of medication that is given to the patient during their hospitalization.

Medication administration record

A mistake that involves an accidental drug overdose, administration of an incorrect substance, accidental consumption of a drug, or misuse of a drug or biological during a medical or surgical procedure is called a __________.

Medication error

A patient is transferred from the critical access hospital (CAH) to the university medical center. The CAH sent a list of her current medications with the transfer documents. This list is then compared to the physician's admitting orders at the university hospital for consistency in order to provide continuity of care. This process is called __________.

Medication reconciliation

Discuss the two CMS Quality Payment Program options providers may choose from based on their practice size, specialty, location, or patient population.

Merit Based Incentive Payment System and Alternative Payment method. In MIPS, you may earn performance-based payment adjustments for the services you provide to Medicare patients. An APM is a customized payment approach developed by CMS, often designed to provide incentives to clinicians who are providing high-quality, high value care.

This section of a cause and effect diagram examines influences of the procedures and processes used in the patient care event:

Methods

Elsie was admitted to Rosehill Nursing Facility for rehabilitation following her hip fracture. Upon admission to Rosehill, the nursing staff assessed Elsie in multiple areas, some of which are cognitive loss, mood, vision function, pain, and the medications she is taking. This information will be recorded in her health record for the __________.

Minimum data set to plan her care

Which of the following agencies provides organizations guidance on the required components of a fire prevention program?

NFPA

Which of the following is a system that provides guidelines for common functions and terminology to support clear communication and effective collaboration in emergency situations?

NIMS

Illustrate how healthcare organizations have benefitted from the National Patient Safety Goals (NPSGs) to develop for proactive risk-reduction activities.

NPSGs were developed to address specific areas of concern in relation to the safety of patients. Goals get re-evaluated continuously and either updated or are still worked on. To be accredited an organization must adopt the six goals and recommendations that go along with them. Sentinel events from other organizations are looked at and learned from.

Explain why organizations should treat near misses in the same way that they treat sentinel events, using error-reduction tools such as root-cause analysis or failure mode and effects analysis in an effort to prevent future occurrences.

Near misses should be treated the same way as sentinel events because just because they did not occur is does not make them any less important. Near misses can show an organization what could be lacking and what needs improvement. This will help prevent future occurrences.

An important strategy in survey design involves the use of terms, phrases, and words that are known to both the PI team and respondents. This clarity of terminology is called __________.

Operational definition

Which of the following acronyms is used to train healthcare staff on the proper steps to use a fire extinguisher?

PASS

Respect for patients' values, preferences, and expressed needs is one aspect of __________.

Patient-centered care

Which committee has a leadership role in the organization's medication safety efforts and consists of pharmacists, physicians, nurses, hospital administrators, and other healthcare professionals?

Pharmacy and therapeutics (P and T) Committee

Which of the following is a core process step that consists of the establishment of an interactive treatment plan that is specific, individualized, and based on a thorough assessment of the patient's physical, emotional, social, cognitive, and cultural needs?

Planning care, treatment, and services

Occurrences involving liability for injury or property loss are called __________.

Potentially compensable events

In this case management step, the case manager confirms that the patient meets criteria for the care setting and that the services can be provided at the facility:

Preadmission care planning

Match the following adverse drug events to the type of error. ____ Inappropriate dose ____ Incomplete dispensing instructions ____ Missed doses ____ Medication errors related to transfer ____ Transcription errors ____ Inappropriate dose recommendations a. Prescribing errors b. Administration errors c. Pharmacy errors

Prescribing errors Pharmacy errors Administration errors Prescribing errors Administration errors Pharmacy errors

According to the Joint Commission a well-planned, well implemented medication management system supports patient safety and improves the quality of care by doing what?

Reducing variation, errors, and misuse; using evidence-based practices to develop medication management processes; managing critical processes to promote safe medication management throughout the [healthcare organization]; monitoring medication management processes regarding efficiency, quality, and safety; standardizing equipment and handling processes, including those for sample medications, across the [healthcare organization] to improve the medication management system.

Stacy is the nursing manager for the cardiology services at a local hospital. The hospital has recently emphasized a policy requiring all managers to track and report their employees' absences from work. Stacy feels that this requirement is time consuming and unnecessary. Why would the hospital require their managers to complete this process?

Reports of absences are tabulated and examined for a possible HAI connection

When the customer (a patient) has judged that a healthcare worker is continuously monitoring both the customer's condition and his or her satisfaction with services, what aspect of quality of care or meeting the customer requirement is being met?

Responsiveness

During a hospitalization, the case manager is concerned that Sam's intensity of service is not meeting the criteria for continued hospitalization. The case manager speaks to Sam's physician, who updates the patient's care plan to reflect the high-level care being provided to the patient. Which part of the case management process is being performed?

Review the progress of care

Monitoring the patient throughout the entire episode of care is considered this case management step:

Review the progress of care

Paul is a registered nurse in a skilled nursing facility. He is administering a medication to one of the residents. Prior to administering the medication, Paul checks to make sure that the medication is prescribed to be taken by mouth. Which of the five rights of medication administration is Paul conducting?

Right route

In risk management terminology, an exposure to the chance of injury or financial loss and their associated liability is __________.

Risk

Analysis of a sentinel event from all aspects to identify how each contributed to the occurrence of the event and to develop new systems that will prevent recurrence is called __________.

Root-cause analysis

Match the following examples of hospital value-based purchasing program measures to their domain in the Medicare VBP program. ____ Catheter-associated UTI ____ HCAHPS Survey Results ____ Medicare spending per beneficiary ____ Heart failure 30-day mortality rate ____ Surgical site infection a. Safety b. Clinical care c. Efficiency and cost reduction d. Person and community engagement

Safety Person and community engagement Clinical care Efficiency and cost reduction Safety

Which of the following gives detailed information about a material, including any hazards associated with the material?

Safety data sheets

Which of the following plans demonstrates the master planning and outlines the design of the safety functions for the organization?

Safety management plan

Healthcare organizations often use color coded systems (such as Code Green) to alert employees about potential problems in and around the healthcare facility. Some examples of these potential problems are suspicious vehicles, disruptive visitors, and issuing of trespass notices. Which emergency management program would generate this alert?

Security management plan

Debbie is a risk manager at a local hospital. In order to reduce the risk of sentinel events occurring in her organization, she is using the lessons learned by other organizations regarding these events. To access details about sentinel events that have occurred at other facilities and recommended changes that may have prevented these events, Debbie utilizes which of the following?

Sentinel event alert

When developing a survey, the use of structured questions to limit the number of possible responses helps to:

Standardize the data collected

In this type of interview, a predetermined list of questions is used:

Structured interview

A telecommunications system that links healthcare organizations and patients from diverse geographic locations and transmits text and images for medical consultation and treatment is called __________.

Telehealth

Articulate the role and responsibilities of the infection prevention and control committee in a healthcare organization.

The IPC team needs to be able to move quickly and be able to manage their own authority so they can regulate care and employee resources if there is ever an infectious outbreak or influx of contagious patients. The team is usually lead by a doctor or epidemiologist. They have several agencies they must report to and their data is generally reviewed every quarter and annually by their governing board.

Jane has been having problems with redness and a rash on her face. She discussed her condition with a friend, who recommended her dermatologist to Jane. Jane called and made an appointment with the dermatologist and was seen the following week with great success. Upon receiving her explanation of benefits from in insurance provider, Jane was surprised to see that she owed more money than her normal copay for the dermatology visit. Identify the reason why Jane owes more for this visit.

The dermatologist is not a contracted physician with Jane' insurance provider

Cole's mother brought him to his pediatrician's office because he had a fever and runny nose. The pediatrician diagnosed Cole with an ear infection and prescribed an antibiotic for him to take. The prescription read, "200 mg/5ml Pen. oral suspension, take 1 teaspoon three times a day." What potential problem is there with this prescription?

The drug name should not be abbreviated

Describe the broad scope of the risk management function in healthcare organizations.

The purpose of risk management is to identify the situations that are categorized as high risk and to prevent them from occurring. When it is identified, the goal is to find ways to improve the process, to prevent injuries, and to stop accidents from happening that can cause bodily harm or even death.

Community Hospital has received a large number of claims denials for CT scans that were provided to patients. After review of the denied claims, the hospital has determined that clinical indications for the CT scan were not present. Which of the following reasons for claims denial does this scenario exemplify?

These scans did not meet medical necessity

An HMO must understand the community in which it operates and determine the community's healthcare needs. Describe the process that the HMO uses to complete this evaluation.

They use community needs assessments and the HMO members, community members and community leaders compile the assessments. They gather the information for these assessments by analyzing who lives in the community, what resources are available to them, and what needs are needed.

The customer is the receiver of a product or service as a result of an organizational process.

True

The five rights of medication administration include: right patient, right drug, right dose, right route, and right time.

True

How often are healthcare facilities required to practice their emergency preparedness plan each year?

Two times

Nurse Joan is working in the ICU at University Hospital. She is carrying out Dr. Jones' order for a medication prescribed to one of her patients. She has received the medication and is preparing to administer it to the patient. Upon entering the patient's room, she asks the patient his name and date of birth, and compares this information to the label on the medication. Joan then administers the medication to the patient. This scenario is an example of __________.

Using two patient identifiers to verify patient identity

Which of the following is an integral component of case management that helps to improve patient outcomes and lower healthcare spending while still providing appropriate care to patients at the appropriate time?

Utilization review