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Q18. _____ can be measured by how well evidence-based practices are followed, such as the percentage of time diabetic patients receive all recommended care at each doctor visit, the percentage of hospital-acquired infections, or the percentage of patients who develop pressure ulcers (bed sores) while in the nursing home. A Safe care B Effective care C Equitable care D Timely care

B

Q19. "Quality is the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge." This is the definition of Quality care often quoted by: A IHI B IOM C HQCB D OCHP

B

Q38. Which of the following performance improvement models would be the best recommendation for a clinic that wants to discover the source of problems in patient care, eliminate these problems, and achieve consistently high quality results in patient care? A FOCUS B Six Sigma C LEAN D PDCA

B Six Sigma is recommended as a performance improvement model that enables an organization to reduce problems and, more importantly, achieve consistency in results. The other performance improvement models - FOCUS, PDCA, and LEAN - offer variations of problem identification and reduction, but only Six Sigma specifically focuses on generating consistently good results.

Q13. "Likelihood of desired health outcomes" corresponds to clinicians' view that, with respect to outcomes, there are only probabilities, not certainties, owing to factors-such as patients' genetically determined physiological reliance-that influence: A Outcomes of care and yet are beyond clinicians' control B High cost interventions C The primary concerns of patients D Outcomes of care and now are within clinicians' control Q14.

A

Q47. As the Director of Quality at Hospital X, you have been appointed to lead a team to improve patient flow through the hospital system. At your first team meeting, some people expressed their excitement over the new project while others were unsure of their rôles and responsibilities. After several meetings, team members disagreed on various issues, sometimes leading to heated debates. Cliques began to form within the group, and some members resisted taking on more tasks. Collective decisions were difficult to make. Over the next few weeks, the team gradually began to respect your authority as the team leader. As team members knew one another better, they began to work more closely and socialize together. It is evident that the team has developed a stronger commitment to the team goal. Meaningful progress is finally being made but your participation is still required. What is the term commonly used to describe the current stage of team development? Norming Performing Forming Storming

A

Q35. After a performance improvement team has completed its activities, what is the primary role of the CPHQ? A Disband the group and discontinue current activities of the performance improvement team but maintain a core group of members for ongoing review B Compose and present a report to the administration about the results of a performance improvement team C Disseminate the results of the performance improvement team to all employees within the health facility D Report the performance improvement results to the public to ensure organizational transparency

B After a performance improvement team has completed its activities, the CPHQ is expected to compose a report and present the results to the healthcare facility's administration. The CPHQ does not necessarily have the authority either to disband the team or to maintain a core group for ongoing review. He is also unlikely to disseminate the results to other employees; the purpose of the performance improvement team is generally intended for administrative review. Also, unless the public has been made aware of the performance improvement team, there is no need to report the results to those outside the facility. Q36.

Q28. A hospital's administrative board is interested in applying a national excellence model to its activities. What is the CPHQ's role in this? A Research the available national excellence models and recommend the one to utilize B Review various national excellence models and evaluate their applicability to the hospital C Assemble a review team to consider the different national excellence models for the hospital D Survey department activities to consider in conjunction with various national excellence models

B In terms of national excellence models, the CPHQ should review the different models and evaluate their applicability. He does not necessarily have the authority to recommend one in particular; the goal is more one of providing the facility with the information it needs to make a decision, and the decision itself is likely to come from a group of people. The CPHQ does not need to assemble a review team; he should already be somewhat familiar with the different models and should be able to generate an evaluation without the assistance of a review team. Finally, he does not need to survey department activities, as it is likely that these are already familiar.

Q20. Quality and technical performance refers to how well current scientific, medical knowledge and technology are applied in a given situation. It is usually assessed in terms of: A The quality of interpersonal relationships B Appropriateness of therapy and other medical interventions are performed C Timeliness and accuracy of the diagnosis and appropriateness of therapy and other medical interventions are performed. D Timeliness and accuracy of the diagnosis

C

Q33. All of the following are roles of the CPHQ in terms of performance improvement teams EXCEPT: A Taking part as a member of performance improvement teams B Guiding the expectations of performance improvement teams C Removing members from performance improvement teams D Directing the activities of performance improvement teams

C The CPHQ is not necessarily responsible for removing members from the performance improvement teams. He might recommend removal, but the decision is likely to come from a higher source. The CPHQ is, however, expected to direct the activities, guide the expectations, and take part as a member of performance improvement teams.

Question 67) _______ are similar to proportion measures in that both are based on count (or attributes) data but differ in that the numerator and the denominator address different attributes. A. Ratio measures B. Continuous variable measures C. Predicted rate D. Outcome measures

?

Question 68) "Likelihood of desired health outcomes" corresponds to clinicians' view that, with respect to outcomes, there are only probabilities and not certainties owing to factors such as patients' genetically determined physiological reliance that influence: A. Outcomes of care and yet are beyond clinicians' control B. Outcomes of care and now are within clinicians' control C. The primary concenrs of patients D. High cost interventions

?

Question 69) If you decided to interview ten patients in your emergency room on a given day and drew conclusions about your emergency services from these people. You have taken limited data and made a huge jump in logic. This jump is known as: A. Stereotyping B. Over-generalization C. Ecological fallacy D. Quota sampling

?

Q 84) Which of the following types of team structures is best for combining employees with different skill sets and areas of experience to complete a task? A. Cross-functional B. Work group C. Quality circle D. Self-directed Q

A

Q 87) When does the credentialing process generally take place? A. Prior to employment B. Prior to termination C. Every year of employment D. Every five years of employment

A

Q12. In fact, because patients' satisfaction is so influenced by _________ rather than to the moreindiscernible technical ones-health maintenance organizations, hospitals and other health care delivery organizations have come to view the quality of non-technical aspects of care as crucial to attractions and retaining patients. A Their reactions to interpersonal and amenity aspect of care B Patients recognize that they do not possess the wherewithal to evaluate all technical elements of care C Their likelihood of desires outcomes D Every patient has definite preference in every clinical situation

A

Q9. Crossing the Quality Chasm provided a blueprint for the future that classified and unified the components of quality through six aims for improvement, chain of effects, and simple rules for redesign of healthcare. The six aims for improvement, viewed also six dimensions of quality. Which of the following is NOT out of those dimensions? A Care centered B Efficient C Safe D Effective

A

Q42. A hospital has implemented a quality program to improve the overall quality of patient care. It is discovered, however, that the program is running over budget, so the hospital administrative board conducts a review of the program to see if it should continue. What is the CPHQ's role in this? A Evaluate the financial benefits of the program and demonstrate these to the board B Prove to the administrative board that the quality program should continue in the hospital C Create a committee to review the quality program and develop a list of reasons to keep it D Assist the administrative board in making a final decision about the quality program

A The role of the CPHQ is to evaluate the financial benefits of the quality program and to present these to the board. The CPHQ is not obligated to prove to the board that the quality program should continue; indeed, unless asked specifically to do so, this would be overstepping the boundaries of professionalism. He also is unlikely to assist the board in making a final decision or creating a committee to review the program. Again, unless the CPHQ is asked to perform any of these tasks, the role is limited to one of evaluating the financial benefits and demonstrating them as objectively as possible.

Q59. Which of the following is vastly different from the others? SIPOC DMAIC PDCA PDSA

A: SIPOC (suppliers, inputs, process, outputs, customers) is different from the other three acronyms, which are sequential programs for quality improvement. SIPOC, on the other hand, is a form of diagram that enables Six Sigma practitioners to identify the important components of process improvement. DMAIC (define, measure, analyze, improve, control) is a general structure for eliminating defects. Similarly, PDCA (plan, do, check, act) and PDSA (plan, do, study, act) are structures for the improvement of processes.

Q39. One of the largest departments within a hospital has been running over budget for some time. The increasing expenditure has become problematic, and therefore the department has been asked to maintain a budget. What is the CPHQ's role in this? A Provide the department with the software tools to enable it to set a manageable budget B Assist the department in developing a manageable budget and reviewing it for compliance C Follow the hospital administration's guidelines in setting a budget for the department D Appoint a financial advisor to support the department in developing a compliant budget

B The CPHQ is responsible for assisting the department in developing a manageable budget and reviewing it for compliance. He or she is not necessarily responsible for setting the budget; that would require the assistance of the department. Providing software tools to help with developing a budget would be part of the process, but the process is not limited to this. Additionally, the CPHQ might appoint a financial advisor, but this again is part of the process but not the only part.

Q31. The administration of a hospital has discovered that a lack of communication among different hospital departments has led to overspending and unnecessary errors in patient care. The administration has asked the CPHQ to assemble a team that can improve department communication and address the problems. What type of team would be most useful for this task? A Work group B Self-directed C Cross functional D Quality circle Feedback

C The key here is the need for a team that can find ways to improve communication among the different departments. This type of team would need to be cross functional, because it would be composed of people from the different departments who would then be delegated to communicate with one another and pass on the communication to others in their respective departments. The other types of teams - work group, quality circle, and self-directed - all have their place in professional improvement, but a cross-functional team would be best in this situation.

Q29. All of the following represent federally-mandated patient rights in the United States EXCEPT: A Rights to obtain a copy of medical records B Right to maintain the privacy of medical records C Right to receive healthcare services D Right to informed consent for medical treatment

C There is no federally mandated right to healthcare services for people in the United States. There are other statutes - such as the law that forbids emergency rooms from turning away people without insurance - but the federal government does not guarantee to people that they have the right to receive healthcare services. The other rights listed (right to informed consent, right to privacy, right to a copy of medical records) are all protected at the federal level.

Q 80) A clinic is reviewing the option of adding a new program to its available treatments but needs to be sure the program is worth the cost. What is the first step that the healthcare quality management professional should take in this? A. Create a cost-analysis plan that enables the clinic to add the program within budget B. Revise the clinic's budget to ensure that the treatment program can be added C. Contact other facilities to generate feedback and see if the program should be added D. Research the program and submit information indicating the feasibility of adding it

D

Q11. Today's patients' perception of the quality of our health care system is not favorable. In healthcare, quality is household word that evokes great emotion, including: A Patient centered measures B Anxiety over the ever-increasing costs and complexities of care C Timely care that may be experienced in terms of performance of services D Frustration and despair, exhibited by patients who experience health care services firsthand or family members who observe the care of their loved ones and anxiety over the ever-increasing costs and complexities of care.

D

Q16. The quality of amenities of care refers to the characteristics of the setting in which the encounter between patient and clinician takes place, such as: A Responsive to patient preferences B Comfort C Comfort, care and access D Comfort, convenience and privacy

D

Q17. In earlier formulations, responsiveness to patients' preferences was just one of the factors seen as determining the quality of patient clinician interpersonal relationship. But, now it is translated into many factors. Which of the following is out of such factors? A Respect for Respect for patient's convenience B Respect for patients' expressed needs C Respect for patients' preferences D Respect for patients' values, preferences and expressed needs.

D

Q22. A number of attributes can characterize the quality of health care services. As, there are different groups involved in healthcare, such as physicians, patients and health insurers, tend to attach different levels of importance to particular attributes and as a result define quality care differently. Which of the following is/are NOT out of those attributes? A Technical performance B Amenities C Responsiveness to patient preferences D Excess staff

D

Q25. "Underuse is evidence by the fact that many scientifically sound practices are not used as often they should be, For example, biannual mammography screening in woman ages 40 to 69 has been proven beneficial and yet is performed less than 75 percent of the time." This is the categorization of: A Lack of professionalism in Medical field B Healthcare practice C Lack of care D Defects

D

Q8. Payers are more likely to embrace the optimization definition of care which can put them at odds with: A Physicians B Clinicians C Health administrators D Physicians and Health administrations

D

Q41. Which of the following is the primary role of the CPHQ in terms of committee meetings? A Disseminate information from the committee meeting to different departments B Review the topics to be discussed in the committee meeting C Lead the committee meeting as an objective participant D Organize and maintain the information from the committee meeting

D For committee meetings, the CPHQ should be involved in organizing and maintaining the information from the meetings; this information might include the minutes from the meetings or any reports presented at the meetings. The CPHQ does not need to lead the meetings or disseminate information from meetings to the departments. It should also be noted that the activity of reviewing topics from the meeting is likely to fall under the larger role of organizing and maintaining meeting information.

Q26. To cut down on costs, a clinic has been hiring outside consultants to perform many of its tasks, but there are concerns that the performance of many of these consultants does not meet the state's standards for the clinic's operation. What is the CPHQ's role in this? A Supply the consultants with the information about state standards and ensure full compliance B Create simulated activities to test the consultants and see if they are meeting the standards C Develop educational programs to assist the consultants and ensure that the standards are met D Review the activities of the consultants and report the results to the clinic administration

D The CPHQ is not responsible for overseeing consultants in general, but in the case of a failure in consultant activities, he or she is expected to review the activities of consultants and report on results. Answer choices A, C, and D all contain details that might be part of the review process for the CPHQ, but they lack the larger role of reviewing and reporting.

Q46. A surgery department's monthly case review revealed twenty-six records meeting the criteria. Six records did not meet the criteria. When calculating the incidence risk, the denominator is 6 20 26 32

D The total number of records was 32, i.e. 26 + 6. As explained in our article on Measures of Occurrence (members-only content), the incidence risk r is the proportion of new cases that occur in a population initially free of the condition during a specified period of time: Risk Formula Content

1. What is the best explanation for the relatively slow introduction of lean practices into medical laboratories? A. The variability and complexity of the samples in a laboratory is much higher than in a manufacturing environment B. Scientists are less receptive to the core principles of lean C. Medical laboratories function differently than factories D. Medical research is mostly funded by the government

1. A: The best explanation for the relatively slow introduction of lean practices into medical laboratories is that the variability and complexity of the samples in the laboratory is much higher than in a manufacturing environment. In laboratories, it is common for a huge number of slightly different samples to be processed. A simple assembly line approach to laboratory processes is rarely successful. However, there are striking analogies between manufacturing and laboratory work, and laboratories can drastically improve efficiency by adopting lean practices. Contrary to the beliefs of some, lean practices do not discourage innovation. Instead, they enable laboratories to handle greater volume and diversity without sacrificing quality.

2. A delay in discharging patients is likely to cause recurrent bottlenecks in... A. Admissions from the emergency room B. The filling of prescriptions C. Admissions from surgical wards D. All of the above

2. D: A delay in discharging patients is likely to cause recurrent bottlenecks in admissions from the emergency room and surgical wards and in the filling of prescriptions. Indeed, the negative consequences of discharge delays may include the creation of other bottlenecks. It is important to recognize that inefficiencies in one area of service provision can cause inefficiencies in many other areas. A bottleneck occurs when there are not enough resources available to perform all of the functions necessary at a given time. Discharge delays waste time, money, and resources.

3. Which of the following conditions should a quality assessment program NOT examine? A. A condition that is thought to be treatable B. A condition for which the treatment is susceptible to significant influence by health care providers C. A condition that has cost-effective treatments D. A rare condition that has a small effect on mortality or morbidity

3. D: A quality assessment program should not include rare conditions that have a small effect on mortality or morbidity. Such conditions have a limited bearing on the overall success of care. There is a general agreement as to which conditions are appropriate for inclusion in a quality assessment program. A condition should meet five criteria. First, it should either be common or have a significant effect on morbidity or mortality. Second, there should be scientific evidence that there are treatments effective at preventing or mitigating the effects of the condition. Third, it should be established that improvement in the quality of treatment for the condition will improve overall health. Fourth, the condition should have cost-effective interventions. Finally, the interventions for the condition should be susceptible to significant influence by health care providers.

4. 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... A. Preventive error B. Treatment error C. Diagnostic error D. Communication error

4. C: When a doctor fails to administer an indicated test and the patient has an adverse result, the doctor has committed a diagnostic error. A diagnostic error is committed whenever a condition is misidentified or an indicated test is not performed. A diagnostic error can result in even more errors in the future. A preventive error is a mistaken approach to avoiding a condition, while a treatment error is a mistake related to the resolution of a condition. A communication error may occur between two service providers or between a service provider and a patient.

5. When is the best time for chairing during a meeting? One hour beforehand At the beginning In the middle At the end

5. B: The best time for chairing is at the beginning of a meeting. In most cases, the facilitator and the chairperson of the meeting are two different people. The chairperson is responsible for reviewing the minutes from the previous meeting and eliciting feedback from team members. A facilitator may be charged with organizing and moderating discussion, but the introduction to the meeting is typically conducted by the chairperson. In many situations, it is appropriate to rotate the chairing duties.

Question 63) Administrative databases are an excellent source of data for reporting on clinical quality, financial performance, and certain patient outcomes. Use of administrative database is advantageous for the following reason EXCEPT: A. They are less expensive source of data than other alternatives such as chart review or prospective data collection B. The incorporate transaction system already used in the daily business operations of a healthcare organization (frequently referred to as legacy system) C. The volume of available indicators is 1000 times greater than that available through other data collection techniques D. data reporting tools are available as part of the purchased system or through third-party add-on or services.

?

Question 65) Healthcare purchasers and payers are demanding that providers demonstrate their ability to provide high quality patient care at fair prices. Specifically, they are seeking: A. Objective evidence that hospitals and other healthcare organizations manage their costs well B. Current performance C. Baseline information D. Objective evidence that hospitals and other healthcare organizations satisfy their customers and have desirable outcomes

?

Question 66) An organization may develop performance measure internally or adopt them from a multitude of external resources. However, regardless of the source of performance measure each measure should be evaluated against certain characteristics to ensure a credible and beneficial measurement effort. Which of the following characteristics is/are critical to performance measures? A. Reliability B. Validity C. Cost-effectiveness D. Interpret-ability

?

Question 70) Stratification is the separation and classification of data into reasonably homogenous categories, within the data, that are mutually exclusive and facilitate: A. Data collection efforts B. Discovery of patterns that would not be observed id data were aggregated C. Skills that are based more experience than knowledge D. frustrated measurement process

?

Question 72) The theory behind SPC (Statistical Process Control) is straightforward. It requires a change in thinking from error detection to error prevention. The use of SPC in healthcare has a number of benefits excluding: A. Increased quality awareness on the part of healthcare organizations and practitioners B. Increased focus on patients C. The ability to base decisions on database D. Moderation is processes that result in lengthening the outcomes having better quality care

?

Question 73) A surgeon's wound infection rate is 32%. Further examination of which of the following data will provide the most useful information in determining the cause of this surgeon's infection rate? A. Mortality rate B. Facility infection rate C. Use of prophylactic antibiotics D. Type of anesthesia used

?

Question 74) Which of the following describes the incorrect administration of a drug to a patient? A. Overuse B. Underuse C. Misuse D. Illegal use

?

Question 75) Crossing the Quality Chasm provided a blueprint for the future that classified and unified the components of quality through six aims for improvement, chain of effects, and simple rules for redesign of healthcare. The six aims for improvement, viewed also six dimensions of quality. Which of the following is NOT out of those dimensions? A. Safe B. Efficient C. Effective D. Care centered

?

Question 76) Which of the following can be measured by how well evidence-based practices are followed, such as the percentage of time diabetic patients receive all recommended care at each doctor visit, the percentage of hospital-acquired infections, or the percentage of patients who develop pressure ulcers (bed sores) while in the nursing home? A. Safe care B. Equitable care C. Effective care D. Timely care

?

Question71) Which of following objectives is/are NOT essential for successful quality improvement project and data collection initiative? A. Identify the purpose of the data measurement activity (for monitoring at regular intervals, investigation over a limited period, or one time study). B. Identify the most appropriate data sources C. Identify the most important measures for collection (the critical few). D. Commonsense all the data collected that will provide the actual information

?

Q14. In general, as the amounts spent on providing services for a particular condition grow, diminishing returns set in meaning that each unit of expenditure yield ever-smaller benefits until a point where________. A No additional benefits accrue from adding more care B Additional benefits are too small to justify the added costs C There is displacement of more useful care D Perfection is within the reach of all individuals

A

Q15. Strong disagreement does arise, among the five parties' definitions (i.e. the clinician's, the patient's the payers, the manager's and the society's), even outside the realm of cost effectiveness. Conflicts typically arise when: A One party holds that a particular practitioner or clinic is a high quality provider by virtue of having high ratings on single aspect of care B The facility receives top marks from a team of expert clinicians whose primary focus is on technical performance C Each group emphasizes a particular aspect of care D Practitioners who are highly skilled in trauma and other emergency care

A

Q48. "Underuse is evidence by the fact that many scientifically sound practices are not used as often they should be, For example, biannual mammography screening in woman ages 40 to 69 has been proven beneficial and yet is performed less than 75 percent of the time." This is the categorization of: A. Defects B. La of professionalism in Medical field C. La of care D. Healthcare practice

A

Q53. There is a story of an intensive care unit (ICU) at Dominican Hospital in Santa Cruz Country, California. Dominican, a 379-bed community hospital, is part of the 41-hospital Catholic Healthcare West system. "We used to replace ventilator circuit for incubated patients daily because we thought this helped to prevent pneumonia," explained Lee Vanderpool, vice president. ""But the evidence shows that the more you interfere with that device, the more often you risk introducing infection. It turns out it is often better to leave it alone until it begins to become cloudy, or 'gunky,' as the nonclinicians say." The hospital staff learned an important lesson from this experience that: A. Evidence is more powerful than intuition B. Intuition is more powerful than evidence C. Efforts improve mortality rate D. Introduction f a new protocol, or any new idea, involves education

A

Q77) Which of the following types of budgets itemizes the major equipment to be purchased in the next year? A. capital B. variable C. operating D. zero-based

A

Q79) The following represents two samples of five hospitals' hysterectomy rates per 1,000 women aged 40-60 years of age: Rates Mean Standard Deviation Sample A 3, 5, 7, 8, 5 5.6 1.8 Sample B 4, 5, 6, 7, 5 5.4 1.1 In analyzing this information, it can be concluded that: A. Sample A has more variability than Sample B. B. Sample A's performance is superior to Sample B's. C. there are more cases in Sample B. D. there is a data collection error in Sample B. Q

A

Q86) As a manager, you see a need to strengthen patient safety within your organization. What is the most effective way to introduce new patient safety measures into your organizational culture? A. As a manager, you see a need to strengthen patient safety within your organization. What is the most effective way to introduce new patient safety measures into your organizational culture? B. Provide extensive mandatory training on patient safety C. Assemble managers and require them to roll policies down to employees D. Create a new set of organizational goals solely based on patient safety

A

Q34. A healthcare facility has decided to establish a performance improvement team to see where the facility can make positive changes. Before assembling the team, what is the primary role of the CPHQ in assisting the healthcare facility? A Aid in developing a list of performance standards for the performance improvement team to follow B Provide the healthcare facility with reports about performance improvement team results from other facilities to offer a comparison C Research past performance improvement team results to see what changes can be made for the new team's activities D Suggest appropriate members for the performance improvement team to ensure team unity and the completion of goals

A Before the team is assembled, the primary role of the CPHQ is to aid the facility in developing a list of performance standards for the team to follow. After all, the team cannot accomplish much if it does not know what the goals are. The other answer choices represent activities that might be part of the process, but the primary step is certainly to identify the standards.

Q36. A CPHQ has all of the following responsibilities toward improving patient safety EXCEPT: A Appointing a supervisor for a patient safety program B Incorporating new technology into a patient safety program C Helping to develop a patient safety program D Setting and reviewing goals for a patient safety program

A In terms of improving patient safety, the CPHQ's responsibilities include the following: helping to develop a patient safety program, incorporating new technology into a patient safety program, and setting and reviewing goals for a patient safety program. The CPHQ's responsibilities do not necessarily include the responsibility of appointing a supervisor for a patient safety program. That particular task will likely fall to others within hospital administration.

Q52. Today's patients' perception of the quality of our healthcare system is not favorable. In healthcare, quality is household word that evokes great emotion, including: A. Frustration and despair, exhibited by patients who experience healthcare services firsthand or family members who observe the care of their loved ones B. Anxiety over the ever-increasing costs and complexities of care C. Patient centered measures D. Timely care that may be experienced in terms of performance of services

AB

Q57. In earlier formulations, responsiveness to patients' preferences was just one of the factors seen as determining the quality of patient clinician interpersonal relationship. But, now it is translated into many factors. Which of the following is out of such factors? A. Respect for patients' values B. Respect for patients' preferences C. Respect for patients' expressed needs D. Respect for Respect for patient's convenience

ABC

6Q. The manager's perspective on quality differs markedly from that of clinicians and patients on: A Efficiency, effectiveness and access B Efficiency, cost effectiveness and equity C Equity, access and technical performance D Responsiveness to patient preferences

B

Q24. ____is a term applied when the proper clinical care process is not executed appropriately, such as giving the wrong drug to a patient or incorrectly administering the correct drug. A Illegal use B Misuse C Underuse D Overuse

B

Q50. Crossing the Quality Chasm provided a blueprint for the future that classified and unified the components of quality through six aims for improvement, chain of effects, and simple rules for redesign of healthcare. The six aims for improvement, viewed also six dimensions of quality. Which of the following is NOT out of those dimensions? A. Safe B. Care centered C. Efficient D. Effective

B

Q78) The separate services of Pharmacy and Nursing are having difficulty developing an action plan for medication errors. Pharmacy Services states that Nursing Services causes the majority of the problems related to errors, while Nursing Services states the opposite. The quality professional's role in resolving this problem is to: A. provide them with directives on how to solve the problem. B. facilitate discussion between the groups to enable them to assume ownership of their portions of the problem. C. assign the task to an uninvolved manager. D. refer the problem to the facility-wide quality council. Q79)

B

Q32. A hospital has recently conducted extensive updates on its website and wants to make sure that the new site is ready to be made available to the public. What is the CPHQ's role in this? A Evaluate the changes that have been made in the website and recommend improvements B Review the website to ensure that the reported information is accurate and complete C Compare the website to other hospital sites to ensure that the new site compares favorably D Compile a list of required information for the website and report this to the hospital

B In terms of public reporting, such as websites, the CPHQ's role is primarily one of ensuring that the information presented to the public is accurate and complete. He might evaluate the changes and recommend improvements, but this falls under the larger role of making sure the information is accurate and complete. Similarly, the other answer choices - comparing the new site to other hospital sites and compiling a list of required information - would fall under this larger category of ensuring accuracy and completeness in the information.

Q45. The process of risk management for the CPHQ includes all of the following EXCEPT: A Prevention of risk B Reporting of incidents C Identification of risk D Analysis of effects

B The CPHQ is responsible for the following, in terms of risk management: identifying the risk, analyzing the effects of the risk, and preventing the risk. These responsibilities do not necessarily include the responsibility of reporting an incident of risk; that may or may not apply, depending on the source of the risk. (It should be noted, however, that the CPHQ is responsible for reviewing the incident report about the risk; of course, this is not the same as actually reporting an incident of risk.)

Q27. A hospital has found that the performance of one of its departments is consistently below the expected standards. The hospital administration wants to locate the source of the problems and see improvement in the department within six months. What is the CPHQ's role in this? A Research the problems and develop a program that applies current standards to the department B Advise that a performance improvement team be assembled to review and address the failings C Recommend that the hospital replace the current administration of the individual department D Review the expected standards and submit these to the department for immediate application

B The primary role of the CPHQ is this particular situation is to advise the assemblage of a performance improvement team that can review and address the failings. The CPHQ might be involved in researching the problems, but the development of a program that applies the standards to the department would exceed his responsibilities. He would certainly not be expected to advise the hospital to replace the current administration of the department; this would be the role of a larger group (such as a performance improvement team) that takes the time to review the situation. Also, he would need to do far more than simply submit the expected standards to the department for application. Obviously, the department is already failing to apply the standards, so something more needs to be done.

Q60. A presentation on the basic structures and processes of clinical governance would be most useful... For small teams of employees For the organization as a whole For the directorate For individual employees

B: A presentation on the basic structures and processes of clinical governance would be most useful for the organization as a whole. Such a general presentation would really only be effective as an introduction for the entire organization. Other presentations, such as those delivered to small teams, the directorate, or individual employees, will need to be more targeted and specific. It is a good idea to introduce the basic concepts of clinical governance to the entire organization because the transition to this method of management often entails drastic change.

Q61. What are the three dimensions of quality in the most common framework for quality assessment? Service, process, and mortality Structure, process, and outcomes Population, structure, and satisfaction Function, outcomes, and clinical status

B: In the most common framework for quality assessment, the three dimensions of quality are structure, process, and outcomes. The structure of care is the basic elements of the population and the health care provider. Care can only succeed to the extent that the structure allows. Elements of structure include the characteristics of the community, healthcare organization, population, and healthcare provider. Process is the dynamic act of care provision. It includes both technical and interpersonal excellence, because quality care requires not only competence but responsiveness to the emotional needs of patients. Finally, outcomes are the full range of results from care. Clinical status and mortality are outcomes, but so is patient satisfaction.

Q62. A top-level administrator is asked by a lower-level manager to lead a meeting of new employees. What should the administrator do first? Review the notes from previous meetings Discuss the meeting participants with the manager Organize preliminary notes Compose an introductory statement

B: The administrator's first step should be to discuss the meeting participants with the manager. This discussion will inform and organize preparation for the meeting. It is likely that the manager will have valuable insight into the existing knowledge base and special characteristics of the new employees. It may be useful for the administrator to review the notes from previous meetings or organize his notes, but these steps should take place after talking with the manager.

7Q. There is a story of an intensive care unit (ICU) at Dominican Hospital in Santa Cruz Country, California. Dominican, a 379-bed community hospital, is part of the 41-hospital Catholic Healthcare West system. "We used to replace ventilator circuit for incubated patients daily because we thought this helped to prevent pneumonia," explained Lee Vanderpool, vice president. ""But the evidence shows that the more you interfere with that device, the more often you risk introducing infection. It turns out it is often better to leave it alone until it begins to become cloudy, or `gunky,' as the nonclinicians say." The hospital staff learned an important lesson from this experience that: A Introduction f a new protocol, or any new idea, involves education B Intuition is more powerful than evidence C Evidence is more powerful than intuition D Efforts improve mortality rate

C

Q 82) Which of the following represents an electronic entry process for physicians or practitioners to create patient treatment instructions? A. EMR B. BCMA C. CPOE D. JCI

C

Q 83) A healthcare quality management professional is reviewing patient information during an officially approved experimental treatment. Which of the following reflects qualitative data among the patient details? A. Blood pressure readings B. Changes in weight C. Mood during treatment D. Cholesterol levels

C

Q 85) What is the primary purpose of the Consumer Assessment of Health Providers and Systems (CAHPS)? A. To relieve data collection efforts by administrators B. To offer patients an anonymous outlet for healthcare complaints C. To capture patient satisfaction data in a universal manner D. To provide a forum for more effective communication between patients and providers

C

Q21. Amenities may cover areas as mentioned below EXCEPT: A Comfortable waiting rooms B Ample and convenient parking C Vast and facilitated food providing area D Good directional signs

C

Q23. _____ refers to the "degree to which individuals and groups are able to obtain needed services." A Responsiveness to patient preferences B Equity C Access D Amenities

C

Q49. __________ is a term applied when the proper clinical car process is not executed appropriately, such as giving the wrong drug to a patient or incorrectly administering the correct drug. A. Underuse B. Overuse C. Misuse D. Illegal use

C

Q51. ______________ can be measured by how well evidence-based practices are followed, such as the percentage of time diabetic patients receive all recommended care at each doctor visit, the percentage of hospital-acquired infections, or the percentage of patients who develop pressure ulcers (bed sores) while in the nursing home. A. Safe care B. Equitable care C. Effective care D. Timely care

C

Q54. A number of attributes can characterize the quality of healthcare services. As, there are different groups involved in healthcare, such as physicians, patients and health insurers, tend to attach different levels of importance to particular attributes and as a result define quality care differently. Which of the following is/are NOT out of those attributes? A. Technical performance B. Responsiveness to patient preferences C. Excess staff D. Amenities

C

Q55. Quality and technical performance refers to how well current scientific medical knowledge and technology are applied in a given situation. It is usually assessed in terms of: A. Timeliness and accuracy of the diagnosis B. Appropriateness of therapy and other medical interventions are performed C. The quality of interpersonal relationships D. Both A & B

C

Q56. The quality of amenities of care refers to the characteristics of the setting in which the encounter between patient and clinician takes place, such as: A.Comfort B. Comfort, care and access C. Comfort, convenience and privacy D. Responsive to patient preferences

C

Q88) What type of chart is most effective in demonstrating cause and effect? A. Flowchart B. Run chart C. Fishbone diagram D. Pareto chart

C

Q30. Which of the following types of charts is best for determining cause and effect? A Run B Control C Fishbone D Pareto

C A fishbone chart is most useful for helping to determine cause and effect. A control chart is useful for seeing the changes in a process; this would include effects but not necessarily causes. A run chart is most useful for viewing data over a time sequence. A Pareto chart uses two types of charting techniques to determine statistical information, but it is not necessarily useful for determining cause and effect.

Q37. A review of supplies determined that a clinic is running low on several items essential for operation. With recent budget cuts, the clinic has to review costs carefully to find the best price for each item. What is the CPHQ's role in this? A Oversee the purchase of each item to ensure cost management B Determine which items need to be purchased from which supplier C Assist in developing a list of suppliers, by cost, for each item D Delegate the purchasing of each item to the appropriate department

C Among the answer choices provided, the CPHQ is responsible only for assisting in the process of developing a list of suppliers. The responsibilities do not include overseeing the actual purchase (as this is the responsibility of the purchasing department), determining the specific items (as this falls to individual departments), or delegating the purchasing of each item to the appropriate department (as most large purchases would be grouped under the responsibility of the purchasing department).

Q44. A disagreement has arisen between the hospital administration and the members of one of its departments. The disagreement is in connection with the authority of the different parties involved and whether or not the administration can require the department to perform a certain task. What is the CPHQ's role in this? A Consider the statements from both sides and participate in finding a solution that meets the expectations of both parties B Advise the department to respect the authority of the hospital administration and to follow its expectations for department performance C Review the rules establishing authority and inform the parties about how these rules apply to the department and the administration D Create a review board to act as a mediator between the hospital administration and the department to find an agreeable solution

C In terms of a dispute, the CPHQ's role is only to understand how the lines of authority are drawn and to present this information to the parties involved. He should not take sides in any way, making answer choice B incorrect. Additionally, he is not responsible for mediating or even finding a solution (unless asked specifically to do so). The role in this case is largely one of providing the information and allowing the parties to consider it.

Q58. Which of the following groups is least likely to report errors? a. Primary care physicians b. Support staff c. Independent contractors d. Nurses

C: Independent contractors are the group least likely to report errors. In part, this is because they have the least personal interest in the success of the health care facility. Also, an independent contractor is more likely to view his employment as tenuous, and is therefore more nervous about admitting mistakes. A system that explicitly avoids punishing those who report will improve the incidence of error reporting among independent contractors.

Q 81) A practitioner decision has generated controversy within a healthcare facility. What is one important role of the healthcare quality management professional in this situation? A. Contact the regulatory body to determine the correct procedure for practitioner activities B. Interview staff members to determine whether or not a risk management review is needed C. Develop a performance improvement activity to ensure that facility procedure is followed D. Evaluate the evidence from the practitioner and compare it to current practice guidelines

D

Q10. Efficiency refers how well resources are used in achieving a given result. Efficiency whenever the resources used to produce a given output are__________. A It is truly situation dependent B Increases, increased C Reduces, reduced D Improves, reduced

D

Q40. A clinic is looking into adding a new computer software program to update an outdated program. The new computer system will keep better track of patient records and will enable the clinic to streamline the care that patients receive. What is the CPHQ's role in this? A Advise the clinic to implement the software because of its value in improving patient care B Create a simulation for the software to allow the clinic to see how it operates day to day C Research the history of the software to see how it has impacted other clinics D Assist the clinic in evaluating the pros and cons of the software

D In this situation, the CPHQ's role is limited primarily to assisting the clinic in evaluating the pros and cons of the software. Advising the clinic to adopt the software would come after the necessary evaluation process, while researching the software and creating a simulation would be part of the evaluation process, but each item is limited in itself. The larger goal for the CPHQ is one of evaluation to assist the facility in making the best decision.

Q43. A hospital needs to decide whether or not to incorporate a new feature into its current services, and as a result has commissioned qualitative research that will provide detailed feedback. Specifically, the hospital would like to collect opinions from patients and other hospital customers with a wide range of experience and backgrounds. Which of the following types of assessments is most likely to be of use to the hospital? A Team analysis B Case study C Survey D Focus group

D The focus group will be most useful in providing the hospital with a broad range of opinions, as well as detailed feedback. The survey would limit answers to those available among the answer choice options, so this would not necessarily guarantee detailed feedback. The team analysis would largely remove patient and customer opinion from the decision. The case study would isolate findings to a single scenario and would fail to offer broad findings and detailed feedback.