CPHQ 2

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Which of the following steps should be taken before QA activities begin?

The scope of involvement should be identified

Which is the following does NOT contribute to evidence-based practice inhealthcare?

Tradition

A healthcare provider recently conducted a customer satisfaction survey that focused on the five key quality characteristics in the graph below. Be analyzing the information, the provider can identify that customers were most dissatisfied with

cost and most satisfied with caring

Because of a doctor's poor handwriting, a prescription must be reworked before it leaves the pharmacy. Which of the following is true

the prescription should not count towards the pharmacy's yield

The protocol for ordering a medication should be

the same every time

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

How well the team met the intended outcome

An adverse drug reaction can be best described as

harm that occurs as a result of the administration of a drug

When conducting a sentinel event review, a root cause analysis

identifies gaps in patient care processes

Medication reconciliation is a process intended to

identify and resolve discrepancies

The primary purpose of risk management trend analysis is to

identify opportunities for improvements

Which of the following action plans is the first step in correcting inappropriate blood usage in an emergency department?

improvements in documentation

Which of the following should be included in an annual performance improvement report to a governing body?

incident/occurence reports

Confronted by excessive WIP levels, many laboratories take the unhelpful step of

installing new technology

In the perfect lean enterprise, delivery to the customer is

instantaneous

One advantage of the kaizen approach to DMAIC implementation is that

it is accomplished in about a week

Because the hospital is busy, an anesthesiologist is given less time than usual to examine the infusion device that will be delivering medication to a patient during surgery. The machine malfunctions and the doctors on hand must work feverishly to save the patients life. This is example of

latent error

In a typical hospital, approximately what percentage of error is reported?

less than 5%

The practice of waiting for a certain number of samples before commencing a test run results in

longer lead times

A failure mode and effects analysis (FEMA) provides which of the following types of review?

Proactive

In the lean enterprise model, what is the first step toward improving quality

establishing performance metrics

In a traditional meeting, the timekeeper and the minute taker roles are

filled by different people every time

Which of the following charts would most likely be used first in a root cause analysis?

flow

A good meeting facilitator will

focus on the process rather than the content

A presentation on the basic structures and processes of clinical governance would be most useful

for the organization as a whole

Failure modes can be prioritized by calculating the critically index. Which of the following three categories are normally used to calculate a criticality index?

frequency, severity and ease of detection

A performance improvement training program for supervisors should include

rapid-cycle process

A hospital-wide set of professional standards is important because it

reduces the waste of time and resources

When considering the use of an external subject matter expert (SME), which of the following characteristics is most critical?

references of SME

A hospital manager notices that a significant proportion of medication errors in the facility involve the same two drugs. What is the most likely cause of this?

the drugs come in similar packaging

What is one disadvantage of the visioning strategy for setting goals

the group must have at least six members for it to be feasible

Human factors engineering is defined as the study of humans and their interaction with

the tools they use and the enviroment

What is the best explanation for the relatively slow introduction of lean practices into medical laboratories?

the variability and complexity of the samples in a laboratory are much higher than in a manufacturing enviroment

A hospital manager operates on the assumption that his employees will thrive when they are given responsibility and the opportunity to perform well. THe manager's beliefs are aligned with

theory y

Satisfaction Surverys, focus groups, and complaint tracking are tools used to

understand customers' expectations

The process chain in a laboratory is particularly subject to

variability

Which of the following is the source of the most medication errors?

verbal orders

A meeting of department managers is discussing the catering service and menu for a hospital-wide special occasion. This decision should be made by

voting

Which of the following groups is least likely to report errors?

Independent contrators

During a meeting, the facilitator notices that one of the participants is getting agitated. After the meeting, what would be the best question for the facilitator to ask the participant?

"Were you feeling irritated during the meeting?"

Which of the following is NOT one of the typical questions in a force-field analysis

"What do you hope to accomplish in the meeting?"

Frequency distribution can best be displayed through us of

A histogram

Which of the following conditions should a quality assessment program NOT examine?

A rare condition that has a small effect on mortality or morbidity

Which of the following is NOT one of the types of quality problems identified by the Institute of Medicine's National Roundtable on Health Care Quality

Abuse

Deemed status refers to

Accreditation equivalency with a Centers for Medicare & Medicaid (CMS) survey

Quality improvement teams go through stages of development. These team development stages include all of the following EXCEPT

Conforming

An outpatient clinic is attempting to measure the quality of a newly developed diabetes disease management program. To accomplish this, laboratory results will be measured overtime. The best way to display the data is to use a

Control chart

According to the Institute of medicine, which of the following is NOT one of the domains of quality care?

Customization

Which of the following is an example of information that should be included in an incident report, but should not be recorded in a patients medical record?

Details concerning a medication preparation error discovered and corrected prior to administration

Which of the following is most appropriate in preparation for an external survey of a healthcare facility?

Educate staff about the types of questions they may be asked

A clinical pathway on the management of a 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?

Evaluate the compliance with the pathway

The quality improvement director is responsible for coordination of accreditation survey activities. Responsibilities will most likely include

Facilitating self-assessments of compliance with standards, communicating new requirements to pertinent parties, and distributing the agenda for the survey

In managed care, the most widely used performance measures are

Healthcare Effectiveness Data and Information Set (HEDIS)

Timeliness and compliance of documentation were discussed at a multidisciplinary team meeting. To evaluate the effectiveness of the team's action plan, which of the following would provide the most useful information

Medical record review

For continuous quality improvement team to be successful, who must be included on the team?

Person performing the process

Data collected about surgical cases show significant delays. Further analysis shows the following chart: Which of the following should a healthcare quality professional do?

Provide the service chief with further analyses of surgeon-specific data

Comparing healthcare organizations by using medical error rates

Provides the best method for benchmarking patient safety

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?

Review the policy with nursing representatives to identify ambiguities

Which of the following is the first step in preparing for an initial accreditation or certification

Review the standards and determine readiness

Which of the following is vastly different from the others

SIPOC (suppliers, inputs, process, outputs, customers)

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 the underreporting of incidents is of greatest concern

Staff fear of negative consequences of reporting

Random screening of newborns by neonatology department has so firmed a high incident 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?

Test only newborns with a family history of G6PD

A 69-year old female admitted for hip replacement is taken to surgery. The patient is identified, surgical site is marked incorrectly, and the equipment/x-rays are present. A near miss was most likely identified as a result of

a surgical team "time-out"

Before conducting a safety audit in an emergency department, an administrator must first obtain

a written set of safety standards

A delay in discharging patients is likely to cause recurrent bottlenecks in

admissions from ER, the filling of scripts, and admissions from surgical wards

When establishing a clinical-governance training program for the directorate, it is useful to

align the subject matter with the specific tasks of the audience

A strategy used in brainstorming is that ideas are

all recorded

A physician complains to the healthcare quality professional that the nursing staff did not strictly follow orders for a patient. The physician requests that the healthcare quality professional speak with the nurse manager. To facilitate improved communication, the healthcare quality professional should

arrange a meeting with the physician and nurse manager

A simple but effective way for managers to obtain the support of team members is to

ask for it

When is the best time for chairing during a meeting

at the beginning

When is the best time to discuss the results of a meeting exit survey

at the beginning of the next meeting

A patient safety program can best be enhanced by which of the following technologies?

barcode system for medication

A whole systems approach to clinical governance is important because

changes must be applied at all levels of the organization

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

chief of the department

A medication error occurred resulting on a severe adverse outcome. In addition to informing the patient and/or family, a healthcare quality professional should

conduct a root cause analysis

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

contact facility B to determine its practices

To avoid misinterpreting variances, which of the following statistical tools should be used?

control chart

In lean thinking, a process step is defined as "value added" if the

customer recognizes the value

In behavioral health, the most important sentinel event for root cause analysis is

death

The definitive proof of the success of a regulation program is

decrease need for inspections

Time available divided by time available and time required is the Six Sigma ratio for

dependability

In the quality improvement process, performing a cost-benefit analysis would be most useful in

designing solutions and controls

A doctor fails to administer an indicated test, and the patient's condition deteriorates to the point that he must be admitted to an inpatient facility. This is an example of

diagnostic error

Whenever possible, medication orders should be by

dose

Research suggests that the largest proportion of adverse events attributable to negligence occur in the

emergency room

Which are the following are attributes of a culture of safety?

empowered staff and transparency

Which of the following should a Quality Council provide to best ensure success of performance improvement teams

empowerment and training

A monitoring system us 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?

establishing criteria that are based on the most recent changes in medical science and technology

Hospitals that implement computerized provider order entry (COPE) almost always see a decline in

medication errors

A hospital manager finds that he is unable to effectively supervise all of the employees who report directly to him. A reorganization of the hospital hierarchy should

minimize the manager's span of control

Team cohesion is established during which of the following stages of team growth?

norming

Which of the following obstetrical outcomes would result in a morbidity review?

post-delivery septicemia

It is easy to conduct a survey of medications-related errors because

prescription-drug use is common and well documented

In a successful lean healthcare facility, the largest costs related to quality will be incurred by

preventive errors

A quality improvement manager must decide how to present data that demonstrates the relationship between two process characteristics. Which of the following data display techniques is most appropriate?

scatter diagram

When prescriptions are being prepared, the labeling process begins at the same time as the medication is being packaged. However, the labeling does not take as long as the packaging. This difference in the time does not add to the overall duration of the prescription-filling process. This an example of

slack time

A culture of patient safety in an organization will have been successfully created when

staff members serve as advocates

A behavioral health specialist notices a particularly high number of restraint deaths at a facility. An analysis of root causes of these events is most likely to indicate problems with

staff orientation and training

A physician who has a high inpatient mortality rate compared to others in a facility should first be

subjected to a more in-depth review of cases

The phrase "reaching consensus" is often used in performance improvement. The term consensus refers to

supported by all members

The target for performance improvement should be

systems


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