HCM 450 Final

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reliability

measurable capability of a process procedure or health service to perform its intended function in the required time under commonly occurring conditions

value

relative measure that describes a product's or service's worth, usefulness, or importance

safe, effective, patient centered, timely, efficient, and equitable

what are the 6 healthcare quality dimensions?

better care, healthy people and communities, and affordable care

what are the aims of the National Quality Strategy?

dashboard

which of the following is a type of data display that uses symbols or colors to draw people's attention to performance concerns

National Quality Forum

Which of the following groups does not establish performance measurement requirements for healthcare organizations?

convenience

Which of the following healthcare dimensions was not mentioned by the Committee on Health Care in America as needing improvement?

Facilitator

Which of the following individuals helps the improvement project team leader manage discussions during team meetings?

Leader

Which of the following individuals is responsible for keeping the improvement project team focused on the improvement goal?

data collected over a certain time frame are plotted on a control chart

which of the following statements regarding control charts is true

quality story board

which of the following tools is used to summarize the steps of a performance improvement project?

quality storyboard

which of the following tools is used to summarize the steps of a performance improvement project?

Workflow diagram

A team in a hospital registration department is conducting a lean project to reduce wasteful steps in the process of pre-registering elective and missions. Which qualitative improvement tool could the team use to better understand the movement of pre-admission paperwork throughout the department?

workflow diagram

A team in a hospital registration department is conducting a lean project to reduce wasteful steps in the process of pre-registering elective and missions. Which qualitative improvement tool could the team use to better understand the movement of pre-admission paperwork throughout the department?

All staff are truly committed to quality

According to Dr. Avedis Donabedian, what is the most important prerequisite to ensuring a healthcare organization will be high performing?

human factors

According to the JC, what is a common cause of sentinel events in healthcare organizations:

A patient dies after a nurse administers an incorrect medication

According to the JC, which of the following situations is a sentinel event?

Population of fewer than 30 cases, sample 100% of available cases

According to the Joint Commission, if there are 20 cases what happens to the sample?

six sigma

Achieving near-perfect performance is the primary goal of which improvement model

WRITTEN Utilization Method (UM) plan

All health plans accredited by the National Committee for Quality Assurance must have a __________________

force field analysis

An improvement team in a home health agency wants to streamline the agencies process of discharging patients. The team identifies all factors that can hinder the success of the improvement plans as well as all factors that would increase the likelihood of their success. Which improvement tool is the team using?

lean

Eliminating wasteful inefficiencies in a process is the primary goal of which performance improvement model

Flowchart

Employees in an ambulatory surgery center want to streamline the patient and mission process. Which performance improvement tool will they use to better understand how patients are currently admitted?

Flowchart

Employees in an ambulatory surgery center want to streamline the patient and mission process. Which performance improvement tool would they use to better understand how patients are currently admitted?

operate under an agreed-upon set of ground rules

Improvement teams work most effectively when they:

sponsor

The written charter for an improvement project is created by the team:

personally committed to achieving improvement goals

To be effective as project team members, individuals must first and foremost be:

stakeholder analysis

To improve productivity in a hospital's operating room, a manager wants to start scheduling effective surgeries on Saturday. What tool can the manager use to identify strategies for gaining support from individuals who might resist the change?

affordable care

One aim of the National Quality Strategy is....

check sheet

Which of the following is used to gather performance measurement data?

quality

attribute of a product or service

functions and structure of UM

1. Measure overuse and underuse of health services. 2. Assess measurement data to identify improvement opportunities. 3. Use improvement techniques to reduce overuse and underuse of health services.

help other departments identify potential quality problems

A basic responsibility of the quality department in a healthcare organization is to:

pareto chart

A hospital has collected patient satisfaction data for more than one year. It is now time for strategic planning, and you've been asked to summarize the satisfaction data so that senior leaders can establish two or three strategic objectives related to improving patient satisfaction. They want to focus on the vital few issues that receive the lowest satisfaction ratings. What type of graph would you use to provide them with the information they need?

Multi-voting

A hospital respiratory therapy department is conducting a Six Sigma project for the purpose of reducing the incidence of missed treatments. The department's medical director asks staff members to identify process changes that would reduce the number of missed treatments. Which qualitative improvement tool could the director use during this brainstorming session to narrow potential solutions to those most likely to be successful?

Clinical path

A hospital utilization committee wants to ensure that patients undergoing knee replacement surgery receive appropriate services. Which job aid could be created to remind care providers of the key interventions that should occur on each day of a knee surgery patient's hospitalization?

is derived from nationally recognized practice guidelines

A performance measure is considered "evidence based" if it

consistently performs as intended

A reliable healthcare service is one that....

decision matrix

An improvement team in a nursing home has brainstormed several potential solutions to a problem of high staff turnover. Now the team wants to narrow the list of solutions to those most likely to be successful. Which tool would the team use for this purpose

cause and effect diagram

An improvement team in an emergency department brainstorms all factors that affect the length of time patients wait before seeing a physician. Which performance improvement tool would be useful for categorizing the factors identified through this brainstorming activity

current performance compared to an exemplary organizations performance

Benchmarking is a measure of

Storming

In which of the following stages are improvement project teams characterized by dissension, irritation over lack of progress, and general impatience:

Purpose of utilization management:

It's a component of an organization's quality management efforts. All healthcare organizations are involved in or affected by UM activities. UM applies the basic principles of performance measurement, assessment, and improvement to minimize costs and use healthcare resources effectively.

clinical practice guidelines

Measures of clinical decision making are often based on information found in....

TRUE

No universally accepted definition of quality exists (T or F)

Is consistent with current professional knowledge

One aspect of healthcare quality is the degree to which it.....

True

Patient Safety Organizations gather and analyze information about patient incidents from providers in all states.

Pear Model

People, Environment, Actions, Resources. P in Pear Model is People and Psychological is just like a subset of People

affinity diagram

Staff members in a physical therapy department are gathering information to determine why patient treatments do not start at their scheduled time. They want to group the reasons for late treatment starts into categories so that commonalities can be identified. Which performance improvement tool could they use to sort the reasons into categories

the insurance industry

Which of the following groups acts on consumers behalf to keep healthcare cost down?

Catastrophic Processes

Processes with a high likelihood of patient death or severe injury immediately or within hours of a failure. 99.5%

response rate is low

Satisfaction data gathered through the use of patient questionnaires can be unreliable when the

response rate is low

Satisfaction data gathered through the use of patient questionnaires can be unreliable when the....

Forming Storming Norming Performing

Stages of Team development: 1. a group of people come together to accomplish a shared purpose. 2. Disagreement about mission, vision, and approaches combined with the fact that team members are getting to know each other can cause strained relationships and conflict. 3. The team has consciously or unconsciously formed working relationships that are enabling progress on the team's objectives. 4. Relationships, team processes, and the team's effectiveness in working on its objectives are synching to bring about a successfully functioning team.

line graph

Statistical process control techniques can be applied to which type of graph

performance gap

The difference between actual and expected performance is called a

identify the topic of interest

The first step in constructing a performance measurement is to......

find out the prevailing core values and beliefs

The first step in transforming an organization's culture into one that supports quality and improvement is to

Ganett Chart

The hospital team charged with reducing the incidence of patient falls has selected four different patient care process changes that need to be implemented. Which tool will the team use to document the tests that need to be completed to make this process changes?

planning matrix

The hospital team charged with reducing the incidence of patient falls has selected four different patient care process changes that need to be implemented. Which tool will the team use to document the tests that need to be completed to make this process changes?

Failure Mode and Effects Analysis (FMEA)

The ideal number of members on an improvement project team is:→5-1040)What is a proactive risk assessment technique?

scatter diagram

The medical director of an outpatient family practice clinic has asked you to investigate variations in patient wait times. The medical director wants to know if there is a correlation between the number of minutes patients must wait to see a physician and the time of the patient's scheduled appointment. Which type of graph would you use to provide the medical director with the information needed to determine if such a relationship exists.

protect the organization from financial loss

The primary purpose of risk management activities in a healthcare organization is to:

adding safeguards

We encounter examples of mistake proofing every day, the process can be changed to make errors impossible by adding a process, the likelihood of causing patient harm can be greatly reduced by

1) protect people involved against disciplinary proceedings 2) allow confidential reporting or DE identify the reporter 3) separate the agency or department collecting and analyzing the reports from those that have the authority to institute disciplinary proceedings and impose sanctions 4) provide rapid, useful, accessible, and intelligent feedback to the reporting community 5) make reporting easy

What are the five practices of O'leary and chapel ?

special cause variation

When a data point on a control chart falls above the upper control limit, the process being measured is said to be exhibition

cost-effective

When desired results are achieved with minimal expenditure of resources, the healthcare services are considered to be....

80 to 90% - People cannot be vigilant 100% of the time and mistakes happen

When improvement actions rely mostly on people's vigilance and hard work to get things done correctly, the best level of reliability that can be achieved is

continue to monitor performance

When measurement data show that a department's performance is meeting expectations, what action should the department's manager take?

Performance improvement model used by the organization

Which component of an organization's quality management (QM) activities is often documented in its QM plan?

Health Information Technology for Economic and Clinical Health Act

Which federal act established incentives for hospitals and providers to adopt electronic health records?

Administration

Which group is responsible for allocating resources to quality management activities in an organization?

Board of trustees

Which group is ultimately responsible for the quality of patient care and services in a healthcare organization?

The Joint Commission

Which group requires disclosure of unanticipated outcomes of care to the patient or his/her representative?

committees

Which of the following is a component of an organization's quality management infrastructure?

histogram

Which of the following is a graph used to display the frequency distribution of measurement data

Number of disaster drills conducted annually

Which of the following is a measure used to evaluate hospital performance?

Five Whys

Which of the following is a qualitative tool used by an improvement team to undercover the root cause of a performance problem?

Infection control coordinator

Which of the following is a quality related support position in a hospital?

pareto chart

Which of the following is a quantitative improvement tool

pareto chart

Which of the following is a quantitative improvement tool?

percentage of patients reporting nurses always treated them with respect

Which of the following is an activity level measure related to the system-level measure "percentage of hospital patients who are very satisfied with the overall quality of care"?

Physician prescribes antibiotics for a patient with a viral cold

Which of the following is an example of overuse of healthcare resources?

Total numbers of home health patients

Which of the following is the denominator in the performance measure "percentage of home health patients admitted to the hospital"?

Patient safety organization

Which of the following organizations is a federally recognized group that maintains a database of adverse patient events?

Institute of Medicine

Which of the following organizations published "Crossing the Quality Chasm: A New Health System for the 21st Century"?

A great deal of feedback, limited agenda items, and a focus on success

Which of the following traits are common to improvement project teams in the norming stage?

ratio

Which statistic is used to report a measurement that compare two things (actual number of hospital deaths compared to the number of expected deaths)

Hospital

Which type of healthcare organization has an organized medical staff?

recognize the teams natural progression through the stages

With regard to team development the role of the leader of an improvement teams is to

cause and effect diagram

a fishbone diagram is also known as

Institution of Medicine

a private nonprofit organization created by the federal government to provide science based advice on matters of medicine and health

cost & quality

connection between ______ and ______ is value

healthcare quality

degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge

clinical paths

descriptions of key patient care interventions for a condition, including diagnostic tests, medications and consultations, if completed are expected to produce desired outcomes

quality assurance

evaluation activities aimed at ensuring compliance with minimum quality standards

providers

individuals and organizations licensed or trained to give healthcare

purchasers

individuals and organizations that pay for healthcare services either directly or indirectly


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