HIT 217 Final Exam

which of the following statements does (do) apply to inpatient length-of-stay data? a. length of stay is determined by subtracting the data of admission and discharge fall in the same month. b. length of stay is determined by subtracting at midnight on every day after the date of admission and before the date of discharge. c. length of stay is determined by subtracting the data of admission from the total number of days for the month in which the patient was admitted and then adding the total number of hospitalized days for the month in which the patient was discharged when the dates of admission and discharge fall in different months. d. the average length of stay for newborns and children is calculated together as part of the average length of stay for adults

d. the average length of stay for newborns and children is calculated together as part of the average length of stay for adults

A cause and effect diagram is a a. structure to explore the potential causes of a problem b. technique to document the major steps in a process c. technique for choosing among alternatives by limiting team member choices d. method for ranking alternatives where team members record their preferences for all choices

a. structure to explore the potential causes of a problem

Mr. Jones was admitted to the hospital on March 21 and discharged on April 1. What was the length of stay for Mr. Jones? a. 5 days b. 10 days c. 11 days d. 15 days

b. 10 days

An outcome is a. everything that enters a system from the external environment b. the process of how work is performed c. the goods or services produced d. the performance of the goods or services produced e. information on how a system is performing

d. the performance of the goods or services produced

Which element of a system is most difficult to monitor? a. inputs b. outcomes c. outputs d. throughputs e. feedback

d. throughputs

The bed count times the number of days in a period under consideration is called which of the following? a. inpatient service delay b. change in bed count c. turnover rate d. total bed count days

d. total bed count days

Which of the following impacts a customer's perception of quality? a. the product or service b. the manner in which the product or service is delivered c. the timeliness of the product or service delivery d. the environment in which the product or service is received e. all of the above

e. All of the Above

Community Hospital has 250 patients in the hospital at midnight on May 1. The hospital admitted 30 days on May 2. The hospital discharged 40 patients, including deaths, on May 2. Two patients were both admitted and discharged on May 2. What was the daily inpatient census at midnight on May 2? a. 240 b. 242 c. 280 d. 320

b. 242

The production process that produces unique, low cost and high quality products is a. Mass production b. Mass customization c. Cottage industry d. Process improvement

b. Mass customization

Sometimes data do not follow a normal distribution and are pulled toward the tails of the curve. When this occurs, it is referred to as having a skewed distribution. Because the mean is sensitive to extreme values or outliers, it gravitates in the direction of the extreme values thus making a long tail when a distribution is skewed. When the tail is pulled toward the right side, it is called a ________. a. Negatively skewed distribution b. Positively skewed distribution c. Bimodal distribution d. Normal distribution

b. Positively skewed distribution

Ernest Codman's End Result Hospital idea promoted various initiatives to improve quality, which of the following ideas was NOT promoted by Codman? a. Long term tracking of patient outcomes b. Rigorous hand washing when moving between patients c. Peer comparison of physician outcomes d. Public release of performance information

b. Rigorous hand washing when moving between patients

Slips and lapses are examples o a. Rule-based errors b. Skill-based errors c. Knowledge-based errors d. Technology-based errors

b. Skill-based errors

In Donabedian's Structure-Process-Outcome paradigm, how well an organization follows agreed upon ways of doing things is a. a structural variable b. a process variable c. an outcome variable d. a fourth and unpublicized variable within the paradigm

b. a process variable

An error that arises due to the inability to appropriately carry out a plan of action is a. a storage error b. an execution error c. a planning error d. a knowledge error

b. an execution error

What term is used for the number of inpatient present at any one time in a healthcare facility? a. average daily census b. census c. inpatient service day d. length of stay

b. census

Florence Nightingale is known for her work on a. Obstetric mortality rates b. Combat hospital mortality rates c. Anesthesia mortality rates d. Coronary Artery Bypass Graft mortality rates

b. combat hospital mortality rate

Statistical process control aims at a. reviewing outputs before they reached customers b. controlling production processes c. controlling all operations from design through post-sale service d. continuous quality improvement

b. controlling production processes

What term is used for the number of inpatients at the census-taking time each day, plus any inpatient who were both admitted and discharged after the census-taking time the previous day? a. average daily census b. daily census c. inpatient service day d. length of stay

b. daily census

The difference between the odds ratio and the relative risk is that the odds ratio is an ______ of the risk since the study from which it was taken is based on retrospective data. a extrapolation b. estimate c. example d. assessment

b. estimate

Flowcharting is a tool to a. identify defects b. identify relationships in complex systems c. prioritize improvement projects d. test corrective actions

b. identify relationships in complex systems

Organized data is called a. data b. information c. knowledge d. policy

b. infromation

The graph above is an example of which type of bar chart? a. two variable bar chart b. one-variable bar chart c. horizonal bar chart d. stacked bar graph

b. one variable bar chart

Information a. is numbers, text, symbols, images, and sounds b. provides insight into phenomena and answers questions c. the condition of knowing what to do in a particular situation d. all of the above

b. provides insight into phenomena and answers questions

Error that arise due to the inability of a worker to properly execute a desired plan of action is a a. violation b. skill-based error c. rule-based error d. knowledge-based error

b. skill-based error

Process improvement is known for introducing a. accountability, standardization, and authority into production processes b. systems to identify, eliminate, and avoid errors in production processes c. consumer choice directly into production processes d. rapid job completion into production processes

b. systems to identify, eliminate, and avoid errors in production processes

Structure in Donabedian's Structure-Process-Outcome paradigm emphasizes a. how well an organization follows agreed upon ways of doing things b. the attributes of the human and material resources of an organization c. providing information and tools to providers to make better decisions d. the effects of care

b. the attributes of the human and material resources of an organization

In Eddy's Medical Decision-Making Model, the impact of a physician's medical training is most clearly seen in a. the evidence brought to bear on the treatment choice b. the clinical judgment used to make the treatment choice c. the analysis of the evidence and patient preferences d. the patient preferences used to determine the treatment choice

b. the clinical judgment used to make the treatment choice

The Joint Commission requires root causes analyses conducted in response to a sentinel event to be acceptable, thorough, and credible, thoroughness requires a. a focus on systems versus individuals b. the identification of direct causes and recommended improvements c. a review of relevant literature and the support of upper management d. the elimination of the chance of future error

b. the identification of direct causes and recommended improvements

A rule-based error is a. the inability to follow pre-programmed instructions b. the misapplication of an appropriate course of action or the selection of an inappropriate course of action c. the inability to analyze a situation and devise a course of action d. the inability to select the appropriate technology for a desired end

b. the misapplication of an appropriate course of action or the selection of an inappropriate course of action

What information is subtracted out when calculating the net death rate for a period? a. the number of deaths for the period b. the number of deaths occurring within 48 hours of admission for the period c. the number of discharges for the period d. the number of deaths occurring withing 24 hours of admission for the period.

b. the number of deaths occurring within 48 hours of admission for the period

The investigative technique that attempts to identify all the potential causes of a problem is a. the five whys b. the why-why diagram c. the Is/Is Not matrix d. flowcharts

b. the why-why diagram

What are statistics called that refer to important events in our lives, such as births, deaths, and divorces? a. health statistics b. vital statistics c. human statistics d. popular statistics

b. vital statistics

Last month, Community Hospital had 145 obstetrical discharges and deaths. There was 1 direct obstetrical death. What was the maternal death rate for Community Hospital last month? a. 0.60% b. 0.68% c. 0.69% d. 0.70%

c. 0.69%

According to McGlynn et al. what percentage of Americans receives recommended levels of care? a. more than 90% b.70-80% c.50-60% d.30-40% e. less than 20%

c. 50-60%

What is the average daily inpatient census for adults and children? a. 83 b. 84 c. 85 d. 86

c. 85

The final output of Eddy's Medical Decision-Making Model is a. A set of treatment options b. Patient Preferences c. A treatment decision d. Analysis

c. A treatment decision

The production process with the highest cost and lowest quality was a. Mass production b. Mass customization c. Cottage industry d. Process improvement

c. Cottage Industry

Selectivity, over-confidence, biased reviewing, and complexity lead to a. Rule-based errors b. Skill-based errors c. Knowledge-based errors d. Technology-based errors

c. Knowledge-based errors

Incidence is the number of __________ cases of a disease. a. existing b. recurring c. new d. old

c. New

Discomfort, as one of the 5 D's of health care quality, assesses quality by measuring a. Mortality rates b. Morbidity c. Pain management d. Satisfaction

c. Pain Management

The best response to error is a. Denial b. Repair c. Reform d. Automation

c. Reform

The fundamental rethinking and modification of processes in response to error is a. Denial b. Repair c. Reform d. Automation

c. Reform

Which of the following innovations is Walter Shewhart responsible for? a. The seven deadly diseases that lead to poor quality b. Quality circles c. Statistical process control d. The cause and effect diagram

c. Statistical process control

An execution error occurs when a. an inappropriate means to achieve an end is selected b. a task is interrupted and a worker skips or repeats steps c. a worker is unable to appropriately carry out a plan of action d. organizations have low performance expectations

c. a worker is unable to appropriately carry out a plan of action

A flowchart is used to a. document the number of defects in a process b. record the causes of defects in a process c. document the major steps of a process d. monitor the impact of an implemented solution

c. document the major steps of a process

Which type of qualitative study's focus is on people, culture, and life? a. grounded theory b. quasi-experimental c. ethnography d. experimental

c. ethnography

The element of a system that is designed to control overall performance is a. inputs b. throughputs c. feedback d. outputs e. outcomes

c. feedback

What is the term for an acute-care facility's formal acceptance of a patient who is to be provided with room, board, and continuous nursing service in an area of the facility where patients generally stay at least overnight? a. hospital patient b. inpatient discharge c. inpatient admisson d. acute care patient

c. inpatient admission

Which of the following statements best describe the difference between a hospital inpatient and a hospital outpatient? a. outpatients are treated in the emergency department; inpatient receive services in the regular clinical departments of the hospital. b. inpatients always stay in the hospital overnight; outpatient never do c. inpatients receive room, board, and continuous nursing services in areas of the hospital where patients generally stay overnight; outpatients receive ambulatory diagnostic and therapeutic services. d. outpatients primarily receive diagnostic services; inpatients receive mostly therapeutic services.

c. inpatients receive room, board, and continuous nursing services in areas of the hospital where patients generally stay overnight; outpatients receive ambulatory diagnostic and therapeutic services.

Useful information is called a. data b. information c. knowledge d. policy

c. knowledge

Which of the following is NOT one of the 5 M's commonly used as major causes on a cause and effect diagram? a. manpower b. methods c. mathematics d. materials e. machinery

c. mathematics

Outcomes management, disease management, and physician profiles fall within which category of Nash's quality paradigm? a. quality management theory b. process variables c. medical practice tools d. outcome variables

c. medical practice tools

Kaoru Ishikawa is known for a. statistical process control and the cause and effect diagram b. the Plan-Do-Check-Act cycle and quality circles c. quality circles and the cause and effect diagram d. statistical process control and the Plan-Do-Check-Act cycle

c. quality circles and the cause and effect diagram

A defective item check sheet is used to a. record the potential causes of a problem b. record the variability of a process c. record the type of defects that are occurring d. record where defects are occurring

c. record the type of defects that are occurring

This type of data display are excellent ways to organize and categorize data and can be useful to examine the detail of a specific concept, category, or response. What is this type of data display called? a. bar graph b. pie chart c. tables d. pareto chart

c. tables

The investigative technique that attempts to identify the particular circumstances that were present when an error arose is a. the five whys b. the why-why diagram c. the Is/Is Not matrix d. flowcharts

c. the Is/Is Not matrix

The approach to quality management that emphasizes improving products to meet changing consumer expectations is a. inspection b. statistical process control c. total quality management and continuous quality improvement d. mass production

c. total quality management and continuous quality improvement

A sentinel event is an a. event that fails to meet generally accepted standards but fails to produce injury b. event that fails to meet generally accepted standards and results in injury or death c. unexpected occurrence involving death or serious injury d. action that could have produced injury or death that was caught before injury occurred

c. unexpected occurrence involving death or serious injury

An undesirable action that is knowingly undertaken is a a. lapse b. slip c. violation d. mistake

c. violation

An action that could have produced injury or death but was caught before injury occurred is called a. a sentinel event b. a no-harm event c. an adverse event d. a near miss

d. a near miss

Which of the following process analysis tools is best to monitor how a system correction is performing? a. a Pareto chart b. a check sheet c. a scatter diagram d. a run chart e. a cause and effect diagram

d. a run chart

Which studies are similar to descriptive studies except that they determine if a relationship may exist between variable? a. experimental studies b. retrospective studies c. historical-prospective studies d. correlational studies

d. correlational studies

Which of the following is NOT an input in Eddy's Medical Decision-Making Model? a. Medical evidence b. Clinical judgment c. Patient Preferences d. Cost

d. cost

Most HIM research falls under which IRB category of review? a. Full board approval b. Facility approval c. HIM professionals do not do IRB research d. exempt and expedited

d. exempt and expedited

In this type of qualitative research, the researcher codes the data as it is collected and make memos and observations simultaneously so that the end of this refining process, the research is used to develop a theory. This type of research is called___________. a. ethnography b. focus study c. experimental d. ground theory

d. grounded theory

Error that arise due to the inability of a worker to understand the situation and develop an effective plan of action is a a. violation b. skill-based error c. rule-based error d. knowledge based error

d. knowledge based error

Walter Shewhart is known for all of the below except: a. differentiating natural and assignable variation b. statistical process control c. the PDCA cycle d. quality circles

d. quality circles

Skill-based performance a. is performance governed by pre-programmed instructions b. requires the worker to select an appropriate course of action c. requires a worker to analyze a situation and devise a course of action d. requires a worker to select the appropriate technology for a desired end

a. is performance governed by pre-programmed instructions

An error arising from a process being interrupted would be classified as a a. lapse b. slip c. violation d. mistake

a. lapse

Data a. is numbers, text, symbols, images, and sounds b. provides insight into phenomena and answers questions c. the condition of knowing what to do in a particular situation d. all of the above

a. numbers, text, symbols, images, and sounds

Tools to identify problems and knowledge of statistics constitute what factor in Nash's quality paradigm? a. quality management theory b. process variables c. medical practice tools d. outcome variables

a. quality management tools

The purpose of a scatter (XY) diagram is to determine a. correlation b. the small number of causes that account for the majority of problems c. the cause of a problem d. if performance is acceptable

a. correlation

The new born discharge days for January at Community Hospital was 84 days. There were 32 newborn discharges in the same period. What is the average length of stay for newborns during this period. a. 2.6 days b. 2.7 days c. 2.0 days d. 2.8 days

2.7 days

W. Edwards Deming is known for a. emphasizing the need for continuous quality improvement, the seven deadly sins, and 14 principles for quality improvement b. emphasizing total quality management, quality circles, and cause and effect diagrams c. differentiating natural and assignable cause variation, PDCA cycles, and statistical process control d. emphasizing zero defects, communication, and teamwork

a. emphasizing the need for continuous quality improvement, the seven deadly sins, and 14 principles for quality improvement

Community Hospital discharged nine patients on April 1. The length of stay of each of the patients was as follows; for patient A, one day; for patient B, five days; for patient C, three days; for patient D, three days; for patient E, eight days; for patient F, eight days; for patient G, eight days; for patient H, nine days; patient I, nine days. What was the average length of stay for these nine patients? a. 5 days b. 6 days c. 8 days d. 9 days

6 days

T or F: When constructing a cause and effect diagram the creator should identify eight or more major causes.

False

True or False: If ordinal or ranked variables are collected, then the Pearson correlation coefficient should be used

False

The stage in the PDCA cycle where the quality improvement team implements a small scale test of a change is: a. Act b. Plan c. Do d. Check

D. Check

The scientific method involves each of the following elements except a. research of relevant literature b. observation of phenomena c. hypothesis and model building d. prediction e. testing of predictions

a. research of relevant literature

T or F: The Pareto rule states that 80% of effects arise form 20% of causes.

True

True or False: Correlation does not equal causation

True

True or False: The number of rule and skill-based errors exceed the number of knowledge-based errors.

True

T or F: Adding a trend line to a run chart clarifies whether the process is improving, deteriorating or stable.

True

A no-harm event is an a. event that fails to meet generally accepted standards but fails to produce injury b. event that fails to meet generally accepted standards and results in injury or death c. unexpected occurrence involving death or serious injury d. action that could have produced injury or death that was caught before injury occurred

a. event that fails to meet generally accepted standards but fails to produce injury

An input is a. everything that enters a system from the external environment b. the process of how work is performed c. the goods or services produced d. the performance of the goods or services produced e. information on how a system is performing

a. everything that enters a system from the external environment

In this experimental study, blood pressure is taken before and after an experimental medication is used as the intervention in a sample of participants that were previously unable to control their blood pressure with other medications. In this example, the independent variable is the _________ and the dependent variable is the ___________. a. experimental medication; blood pressure b. blood pressure; experimental medication c. blood pressure; heart disease d. experimental medication; heart disease

a. experimental medication; blood disease

The stage in the PDCA cycle where the quality improvement team implements change across an organization is: a. Act b. Plan c. Do d. Check

a. Act

Which of the following is NOT one of the 5 D's of health care quality? a. Delay b. Death c. Disability d. Dissatisfaction e. Disease

a. Delay

Which group protects human subjects as they involved in research activities? a. Institutional Review Board (IRB) b. The Joint Commission c. Centers for Medicare and Medicaid (CMS) d. Office of Civil Rights (OCR)

a. Institutional Review Board (IRB)

The production process built around the ideas of accountability, standardization and authority is a. Mass production b. Mass customization c. Cottage industry d. Process improvement

a. Mass production

Death, as one of the 5 D's of health care quality, assesses quality by measuring a. Mortality rates b. Morbidity c. Pain management d. Satisfaction

a. Mortality rates

Ignaz Semmelweis is known for his work on a. Obstetric mortality rates b. Combat hospital mortality rates c. Anesthesia mortality rates d. Coronary Artery Bypass Graft mortality rates

a. Obstetric mortality rates

When the data collected for research studies are collated numerically with descriptive, inferential, or predictive statistics it is normally referred to as a __________. a. quantitative study b. qualitative study c. ethnography d. quality improvement study

a. Quantitative Study

An error arising from the inability to analyze a situation and devise an effective plan of action is a. Rule-based performance b. Skill-based performance c. Knowledge-based performance d. Technical-based performance

a. Rule-based performance

Performance governed by the classification of a situation is a. Rule-based performance b. Skill-based performance c. Knowledge-based performance d. Technical-based performance

a. Rule-based performance

A Pareto chart is a. a column charts displaying the frequency of events in descending order b. a line chart displaying the number of events in a defined time period in chronological order c. a diagram that plots points in a two dimensional space d. a chart that divides things into categories to identify commonalities

a. a column charts displaying the frequency of events in descending order

The use of under-skilled workers or inferior supplies or equipment is primarily a. an input problem b. a throughput problem c. an output problem d. an outcome problem

a. an input problem

Which of the following is the best type of team to have for a research or analysis project? a. An interdisciplinary team b. a team of HIM professionals c. a team of administrators from the healthcare facility d. a team of statisticians and epidemiologists

a. an interdisciplinary team

Which of the following measures the total number of deaths among the diagnosed cases of a specific disease? a. case fatality rate b. gross death rate c. net death rate d. institutional death rate

a. case fatality rate

David Nash's quality paradigm includes Quality management theory, Medical Practice Tools and Outcomes, Outcomes includes a. clinical guidelines and standardization b. outcomes management, disease management and profiling c. reengineering and process improvement d. training and empowerment of employees

a. clinical guidelines and standardization