MEDA 260 FINAL

A proactive strategy.

A plan to prevent or diminish the opportunity for harm is known as: A. A reactive strategy. B. Objective protection. C. A proactive strategy. D. A risk analysis.

Reactive strategy.

"If a patient slips on a wet floor, staff members are directed to immediately help the patient up, perform a physical exam to determine harm, send the patient for x-rays to ensure no fractures were caused, and complete and submit an incident report." From its content, you can tell this statement is a: A. Cost-benefit analysis. B. Proactive strategy. C. Risk assessment. D. Reactive strategy.

MGMA Surveys

A physician's office with 2 full-time nurse practitioners currently has two coders on staff to perform all of the coding for the practice. The coder's state they need additional help to stay current and the physician state they should be able to keep up with the current staff. Where would you look to find benchmark information on how many coders should be on staff? A. MGMA Surveys B. OSHA compliance manual C. OIG compliance Plan D. EMR Statistics

Reactive strategy

A plan that specifies what actions staff members should take after an adverse outcome has occurred is known as a: A. Mitigation strategy B. Reactive strategy C. Defensive strategy D. Proactive strategy

current or former employee

A Qui Tam lawsuit is filed by a/n________ against the accused institution on behalf of the government. A. current or former patient B. county prosecutor C. FBI agent D. current or former employee

American Board of Medical Specialties

A claim that a physician is board-certified should be confirmed with the: A. National Quality Measures Clearinghouse. B. American Board of Medical Specialties. C. American Medical Association. D. National Medical Specialists Association.

A cost-benefit analysis.

A mathematical process by which to evaluate whether something has a value equal to or greater than the amount paid is known as: A. A proactive strategy. B. Risk management. C. Mitigation. D. A cost-benefit analysis.

Partially excuses a wrong

A migrating circumstance is one that: A. Magnifies the consequences of a wrong. B. Partially excuses a wrong. C. Prevents wrong-doing. D. Is cause for immediate termination.

M.D.

A physician's credential may be: A. M.D. B. RN. C. PT. D. Ph.D.

Program Evaluation and Review Technique.

A project management chart may be helpful, such as the PERT, which stands for A. Program Effectiveness and Routine Tasks. B. Project Evaluation and Routine Timeline. C. Program Evaluation and Review Technique. D. Project Efficiency and Report Timeline.

With the intent to get someone fired.

A reporting system should permit individuals to bring violations to the attention of the administrator: A. With the intent to get someone fired. B. To avoid suspicion. C. Without fear of repercussion. D. To get on your good side.

Hotline phone number.

A reporting system to permit staff to report an alleged violation might include: A. Voluntary DNA tests. B. Hotline phone number. C. A "tattler" t-shirt. D. All of the above.

Identification of the harm that could be caused.

A risk assessment begins with the first step of: A. Increasing the facility's liability insurance. B. Evaluating the individual(s) proposing the project. C. Identification of the harm that could be caused. D. Determining the budget.

Denied.

A thorough analysis must also include data on the cost to the organization if the project is: A. Mistaken. B. Lost in committee. C. Denied. D. Set aside.

Patient safety practice

A type of process that reduces the probability of adverse events is known as: A. Evidence-informed care management. B. Evidenced-based quality. C. Patient safety practice. D. Do/Do Not Do/Don't Know

50%

High-risk is described by a probability of harm over: A. 70%. B. 30%. C. 15%. D. 50%.

Use only standard terminology.

According to the DHHS-published list of suggestions for developing risk management strategies, to avoid miscommunications, you should: A. Accept verbal consent for non-emergency procedures. B. Only summarize in chart documentation. C. Never document patient non-compliance. D. Use only standard terminology.

National Practitioner Data Bank (NPDB)

All applicant physicians should be checked on the ________ before hiring or granting privileges to treat patients in your facility. A. Physician Quality Reporting System (PQRS) B. American Medical Association website C. National Practitioner Data Bank (NPDB) D. medical school website

Patient's reason for the encounter.

All clinicians are required by law to accurately document the complete details of every patient encounter and patient-related encounter, including: A. Patient's education level. B. Patient's reason for the encounter. C. Patient's salary. D. Patient's complete health history.

consequences

All compliance plans should include a clear explanation of the ________ for failing to follow the policies of the organization. A. guidelines B. support available C. consequences D. benefits

Timely and effective care for patients with AMI

All of the following are measured for quality of care by Hospital Compare, except: A. Timely and effective care for patients with AMI. B. Use of surgical techniques. C. Number of Medicaid patients. D. Spending per hospital patient with Medicaid.

Only complete process once and then move on

All of the following are steps to initiate effective benchmarking EXCEPT: A. Identify what you want to measure and improve and how you will obtain measurements B. Decide what improvements can be made to improve your processes C. Only complete process once and then move on D. Repeat-determine if your goals are accomplished and identify continual opportunities for improvement.

Mitigation.

An action that will lessen the severity of harm is known as: A. Aversion. B. An alibi. C. Mitigation. D. Complication.

Any of the above.

An appropriate consequence for breaching a policy may be: A. Verbal warning. B. Written warning. C. Additional training/education. D. Any of the above.

10% to 50%

An element of 'medium risk' means there is a ________ probability of harm. A. 0% to 25% B. 50% to 85% C. 10% to 50% D. 25% to 70%

An adverse outcome

An unexpected reaction to a procedure or treatment is known as: A. An adverse outcome. B. An anomaly. C. A misadventure. D. An accident.

Both A and B

As an administrator, you will need to assess the: A. Cost of new technology. B. True need for new equipment. C. Both A and B D. Neither A or B

Hospital Compare

As part of the Hospital Quality Initiative, CMS created: A. Hospital Compare. B. A toll-free hotline. C. EMTALA. D. HIPAA.

respect

It is a sign of ________ to explain the foundations of the policies to your staff. A. contempt B. weakness C. submissiveness D. respect

MGMA Annual Survey

As the practice manager, you notice that charges are not being coded as quickly as you believe they should. When you speak to coders, they complain that there are too many doctors and not enough coders to code all the changes in the timeframe you have requested. What resource could you use to find benchmark information to indicate how many coders you should employ in your practice? A. MGMA Annual Survey B. Quality Improvement Organizations C. CMS website D. Ask the practice next door how many coders they have

Proven quality indicators (QI)

Better, more effective care to patients can be supported by: A. Providing more benefits to staff. B. Paying clinicians higher salaries. C. Having staff work only 4 days a week. D. Proven quality indicators (QI).

Total Quality Management (TQM)

CMS identifies one private organization in each state to review the provision of health care services and to respond to complaints. These organizations are called: A. Healthcare Quality Indicators (HQI). B. Total Quality Management (TQM). C. Quality Improvement Organizations (QIO). D. Healthy People 2020.

The total number of patients who died due to a specific condition

Case fatality percentage can be determined by dividing which of the following by the total number of patients who have been diagnosed with that same condition within a specific period of time? A. The total number of patients found to have a genetic potential for a specific condition B. The total number of patients who have a family history of a specific condition C. The total number of patients who were treated for a specific condition D. The total number of patients who died due to a specific condition

audits

Conducting regularly scheduled ________ will reveal any violations relating to billing and claims. A. interrogations B. searches of desks C. department meetings D. audits

Are initiated by a regulating authority.

External audits: A. Evaluate air quality control. B. Are initiated by a regulating authority. C. Investigate the physical environment around the facility. D. Are initiated by the facility administration.

70%

Federal sentencing Guidelines may reduce fines and penalties by as much as ________ when a compliance plan has been created and implemented using the seven elements guidance. A. 55% B. 10% C. 70% D. 25%

An overview of the entire project

Good project management skills begin with: A. Delegation of work tasks. B. Creation of a timeline. C. Establishing quality standards. D. An overview of the entire project.

prevent

Health care laws and ethical codes demand that you do everything possible to________ negligence. A. ignore B. abate C. prevent D. ensure

FDA website.

Important approvals, recalls, and communications regarding medical devices can be found on the: A. Manufacturer's Facebook page. B. FDA website. C. Amazon. D. None of the above

Quantify it.

In order to accurately assess the level of risk of a procedure or using new equipment, you will need to: A. Qualify it. B. Visit the manufacturer's factory. C. Quantify it. D. Interview previous users.

Emotion

In risk assessment, it is important to keep which of the following out of the decision-making process? A. Consensus B. Statistical facts C. Calculations D. Emotion

Consequences.

In those cases when an employee does not comply, policies should clearly state: A. Bonus schedule. B. Accolades. C. Consequences. D. That no one should ever mention it.

Same-day surgery center

Inpatient quality indicators from AHRQ can be used by all of the following except a/n: A. Long-term rehabilitation center. B. Acute care hospital. C. Same-day surgery center. D. Skilled nursing facility.

Providing feedback, including physician performance evaluations.

Internal audits can improve the quality of care provided in your facility by: A. Supporting implementation of salary reductions. B. They do not improve the quality of care at all. C. Finding reasons to fire employees. D. Providing feedback, including physician performance evaluations.

Internal audits.

Investigations initiated by the administration of the organization designed to identify quality as well as human error or wrong-doing are known as: A. External audits. B. Internal audits. C. Due diligence. D. Employee reviews.

An increase in the use of midlevel providers.

It is anticipated that expansion of Medicaid and mandated insurance coverage will add millions of newly insured Americans. In order to meet the demand of these patients, it is anticipated: A. Medical schools will be forced to lower the entrance requirements B. Telehealth services will be approved for all sites of service C. An increase in the use of midlevel providers. D. Training more physician specialists

alleged violations

It is important that the compliance plan includes a secure process for employees, vendors, and patients to report ________ without fear of repercussions. A. alleged violations B. technical glitches C. excellent service D. compliant activities

hospital-acquired conditions

Nosocomial conditions, also known as ________, are those illnesses and injuries that affect a patient as a direct result of the patient's stay in the hospital. A. hospital-acquired conditions B. staph infections C. genetic anomalies D. medical misadventures

buy-in

Obtaining ________ on the proposal prior to implementation will encourage a better working relationship within the facility. A. permits and licenses B. government approval C. buy-in D. corporate approval

Determine the cause of the breach.

Once a breach is identified, you will need to: A. Determine the cause of the breach. B. Ensure everyone is sworn to secrecy. C. Hide the documentation. D. Fire everyone on the spot.

Medical necessity.

One of the first determinations required to support performing a test or procedure on a patient is called: A. Cause and effect. B. Medical necessity. C. Catalyst. D. Probable cause.

Lost productivity during implementation.

One of the hidden costs of a project or program might be: A. High cost of purchase. B. Lost productivity during implementation. C. Cost of staff training. D. All of the above.

EMTALA

Only Medicare-participating hospitals must comply with the terms of: A. The federal false claims act. B. The HIPAA Privacy Rule. C. EMTALA. D. The HIPAA Security Rule.

Solid direction for compliance.

Organizational policies and procedures should provide your staff with: A. Nothing about compliance. B. Ways around compliance. C. Solid direction for compliance. D. Questions to ask about compliance.

A quality cycle and QI method that systematically impacts a process of a system.

Plan-Do-Check-Act is defined as: A. A quality plan to manage and promote quality improvement at all levels. B. A quality cycle and QI method that systematically impacts a process of a system. C. A quality cycle focused on developing methods to fix processes D. A quality cycle developed to ensure a system is functioning well at an enterprise level

All of these.

Projects that may pose risk include: A. New equipment. B. Expansion of population services. C. Telemedicine. D. All of these.

A system of technical activities that measures against a criteria or standard.

Quality control is defined as: A. An integrated system ensuring that a process is needed and expected. B. A system of technical activities that measures against a criteria or standard. C. A strategy of continuously refining processes D. A system measuring the performance of a process to optimize levels of quality.

Routine measurement of performance

Quality improvement focuses on: A. Individual clinicians or system users B. Routine measurement of performance C. Information technology issues D. Constant training

All of the above.

Quality improvement strategies, as listed by AHRQ, include: A. Physician reminder systems. B. Patient education services. C. Internal audits. D. All of the above.

b and c only.

Realistic objective monitoring devices might include: A. Cameras in every corner of the office. B. RFID chips in paper records. C. An EHR log of who opens patient records. D. b and c only.

Evidence-based medicine (EBM).

Research studies provide statistical evidence as to which services, procedures, treatments, and policies work best. This is known as: A. National Guideline Clearinghouse (NGC). B. Interventions and Practices Considered (IPC). C. Quality Practices and Procedures (QPP). D. Evidence-based medicine (EBM).

investigating the origin of the incident

Reviewing complete incident reports and ________ will support improvement efforts. A. investigating the origin of the incident B. phoning the police C. terminating all staff involved D. making the staff member pay restitution

I, II, IV and V

Several patients have presented to the office over the last three weeks complaining they have not received their lab work or received incorrect results. To improve this process, you use the Plan, Do, Check, Act method. Which options below are included in this method? I. Gather a team of the key players together to outline the plan and list steps to achieve the goal. II. Perform a small-scale testing to determine if the plan will work. III. Ask other practices if they have this same problem IV. Check to see if improvements have been made. V. Implement a plan outlined by key players pf a team. A. I, II, III, and IV B. I, II, III, and V C. I, II, IV and V D. II, III, IV and V

Public disclosure.

Since 2001, CMS has published quality initiatives with the intent of supporting quality health care through: A. Threat of imprisonment. B. Claims denial. C. Public disclosure. D. Ancillary incentives.

All applicants.

State and national criminal background checks should be performed on: A. All administrative applicants. B. All applicants. C. All physician applicants. D. All clinical applicants.

I, II, and III are correct

The Congressional Budget Office estimates health care reforms will cost an estimated $940 billion over the next 10 years, which will be paid for primarily through: I. New taxes II. New health industry fees III. Cuts in existing government health programs IV. Budgetary cuts for government staff V. Elimination of federal funding for Medicaid A. I, II, III and V are correct B. III and IV are correct C. III, IV and V are correct D. I, II, and III are correct

Federal Sentencing Guidelines.

The FSG include seven steps to ensure due diligence is done properly. In this context, FSG stands for: A. Federal Safety Guidelines. B. Financial Sentencing Governance. C. Financial Security Guidelines. D. Federal Sentencing Guidelines

Impermissible use of protected health information (PHI).

The HITECH Breach of Notification Rule requires covered entities to report: A. The results of every internal audit. B. Impermissible use of protected health information (PHI). C. All accusations of impermissible use of PHI. D. The names of security personnel.

30%

The Patient Experience of Care domain accounts for ________ of the total performance score (TPS). A. 50% B. 85% C. 65% D. 30%

Advance planning.

The key to managing a crisis effectively is: A. Advance planning. B. Never saying you're sorry. C. Immediate lock-down. D. Offering safe harbor.

Continuing education for clinicians.

The nine quality improvement strategies identified by AHRQ include: A. Continuing education for clinicians. B. Ignoring patient complaints. C. Mandating overtime to provide more patient hours. D. Financial penalties for poor performance.

Providers and hospitals to better coordinate care and improve efficiency

The objective of an ACO is to minimize incentives that promote quality of care by realigning incentives between: A. Providers and hospitals to better coordinate care and improve efficiency B. Providers and patients to better coordinate care and improve efficiency C. Providers and hospitals to decrease the number of tests required to determine a diagnosis. D. Patient and hospitals to better coordinate care and use less home health services.

Risk management.

The process by which an organization can reduce the opportunity for an adverse event to occur is known as: A. Crisis management. B. Financial management. C. Risk management. D. Strategic management.

Compliance.

The process of obeying rules, regulations, and laws is known as: A. Qui tam. B. Due diligence. C. Compliance. D. Obedience.

Stage IV pressure ulcer

The ten categories of HACs for which Medicare will not reimburse include: A. Diabetes mellitus. B. Non-catheter-associated UTI. C. Cerebrovascular accident (CVA). D. Stage IV pressure ulcer.

Readmissions.

The term used to identify those patients who must be returned to inpatient status in a hospital for the same reason as the previous admission is: A. Manifestations. B. Resubmissions. C. Readmissions. D. Secondary conditions.

Level of performance.

The terms of the Hospital Value-Based Purchasing program (HVBP) provide hospitals with incentive payments based on: A. Number of patients treated. B. Severity of illness treated. C. Level of performance. D. Credentials of physicians.

Risk assessments

To identify what bad things could happen, the administrator should perform: A. Exit interviews. B. Safety protocols. C. Industry-wide research studies. D. Risk assessments.

Practice profitability

Under MIPS, which of the following is NOT considered an improvement activity? A. Expanding practice exam B. Participation in an APM C. Patient Safety and Practice Assessment D. Practice profitability

I, II and III are correct

Value-based purchasing is a new reimbursement model that pays hospitals based on performance around the following: I. Patient satisfaction scores II. Quality of care III. Efficiency IV. Return on investment V. Number of physicians employed A. All options are correct B. A, II and V are correct C. I, III and IV are correct D. I, II and III are correct

Patient-centered care

What is providing care that is responsive to individual patient preferences, needs, and values and assuring that patient values guide all clinical decisions? A. Equitable care B. Patient-centered care C. Timely Care D. Preventive Care

Continuous Quality Improvement

What is the strategy of continuous refinement to improve quality? A. Continuous Quality Improvement B. Quality Outcome Measurements C. Quality Assurance D. Creation of policies and procedures.

Quality Control

What is the system to measure the performance of a process, item or service against a defined standard? A. Quality Assurance B. Quality Control C. Continuous Quality Improvement D. None of the above

excellence

When an attitude of ________ is proliferated throughout the organization, everyone benefits and patient care is improved. A. non-compliance B. taking shortcuts C. excellence D. individual directions

Potential benefits.

When conducting a risk assessment, the administrator should include an analysis of potential harm as well as: A. Potential benefits. B. Internal politics. C. News coverage. D. Competition.

All of these.

When performing a risk assessment, you should consider potential for: A. Physical harm. B. Psychological harm. C. Financial harm. D. All of these

Low-risk.

When the probability of any harm is low, and the harm that might occur would be minor, this is considered: A. Unsafe. B. High-risk. C. Medium-risk. D. Low-risk.

Suspension without pay.

When there is need for corrective action with an employee, but there is benefit to retaining this individual on the staff, one punishment may be: A. To ignore the event. B. To give the employee a second chance. C. Suspension without pay. D. Promotion to a different department.

a and b only

Where can important risk information be found regarding new equipment? A. User manual B. MSDS C. Online 'likes' D. a and b only

I, II and III are correct

Which of the following are benefits for initiating quality efforts in a practice? I. Reduce the risk of medical law suits II. Improve patient satisfaction III. Strengthen stability of the business IV. Makes it twice as easy to recruit staff and providers A. I is correct B. II is correct C. III and IV are correct D. I, II and III are correct

I, II, and IV are correct

Which of the following are eligible providers under PQRS? I. Cardiologist II. Physical Therapist III. Outpatient surgery centers IV. Chiropractors V. Independent laboratories A. I, II, and IV are correct B. I, II, and III are correct C. I and II are correct D. I, III and V are correct

II, III and IV

Which of the following are examples of quality control (QC) processes? I. Comparing the process to other providers in the area II. Calibrating the blood pressure machines III. Testing the fire extinguishers in the clinic IV. Verifying accurate temperatures for the refrigerators containing vaccines V. Turning up the temperature of the refrigerators at night to save cost A. I, II and V B. I, III, and V C. II, III and V D. II, III and IV

An internal audit of billing procedures to verify compliance with federal and state regulations.

Which of the following is an example of a practice monitoring quality assurance? A. An internal audit of billing procedures to verify compliance with federal and state regulations. B. Weekly inspection of the sterilization machine used for surgical instruments. C. Determine the time it takes a medical assistant to prepare for a physical. D. Develop a budget to make sure cash is available to purchase equipment.

Computerized order entry for radiology tests

Which of the following is an example of how IT can help reduce medical errors? A. Computerized order entry for radiology tests B. Call in a prescription to a pharmacy for a patient who is out of town C. Automated insurance verification and authorization approvals. D. Coordination of care with home health agencies.

Lab equipment calibration

Which of the following is the best example of quality control? A. Lab equipment calibration B. Front desk audits to verify demographic information is collected properly C. Verifying that policies are up to date and being adhered to D. IT assessment to verify three are enough computers

A 5% increase in reimbursement for mental health services starting in 2010

Which of the following preventative services has been improved with the new legislation? A. A 5% increase in reimbursement for mental health services starting in 2010 B. A rebate on patients' insurance premiums when they present for a yearly physical. C. A waive of the patient's deductible when they have tests for pancreatic cancer. D. Preventive services can be reimbursed for all provider types.

All of the above

Which of the following processes will make quality improvement meaningful and reduce medical errors? A. Using computerized provider order entry (CPOE) of medications (e-prescribing) B. Medication Reconciliation C. Using computerization to track, report and measure quality D. All of the above

Comparing measurements to other organizations or industries to improve performance

Which of the following statements correctly describe external quality benchmarking? A. Measuring data over time in the practice to make improvements. B. Comparing measurements to other organizations or industries to improve performance C. Hiring an outside consultant to manage your QI initiatives D. Reviewing data from lower performing organizations to identify what is being done well

There are 50 questions in the CMS survey.

Which of the following statements regarding the Patient Experience of Care survey is false? A. A facility may add questions to the original questions. B. Patients are asked about the cleanliness of the hospital. C. There are 50 questions in the CMS survey. D. The survey asks about communication with physicians.

Focuses on prevention of issues.

Which option is FALSE regarding Quality Assurance (QA)? A. It is an integrated system of management involving planning, training, quality control, assessment, data review, reporting, and quality improvement to ensure a process, item or service is of expected type and quality. B. Focuses on inspection C. Sets policy and controls to ensure the usability of the product. D. Focuses on prevention of issues.