MGMT 538

You analyze and adverse event and conclude that the HC provider knowingly violated a rule and made a dangerous choice. The decision appears to be made with little or no concern about risk. Which of the following statements is true?

BOTH A & C -The provider is clearly accountable and needs retraining -If three other providers with similar skills and knowledge would do the same in similar circumstances, the system supports reckless action, and the system leaders share in accountability

Which of the following is true of hindsight bias?

BOTH A & D -It is the tendency to believe, after learning an outcome, that one would or could have foreseen it -It threatens the accuracy and efficacy of efforts to investigate errors and improve safety

Because patients often lack sophisticated medical knowledge,_____________

BOTH B & D -They use proxies, such as their observations of communication among clinical staff and the relative tidiness of clinics, to assess the quality of their healthcare. -Providers and administrators must manage the clues that patients use to assess the quality of their healthcare.

Which of the following statements regarding CQI is NOT true?

CQI is an approach to improvement that follows four steps: Planning, Doing, Studying, and Acting.

What is defined as the deliberate organization of patient care activities between two or more participants, which can include the patient, involved in a patient's care to facilitate the appropriate delivery of health care services?

Care Coordination

Acute Illness

Conditions that are severe and sudden in onset

According to Latham's & Locke's Goal Setting Theory, managers can improve employee engagement by:

Setting specific, measurable, challenging goals AND providing feedback on progress

Which of the following is NOT a factor that shapes organizational climate?

Stories and Legends

Match the type of measurement from Donabedian's model with its example:

Structure- Number of board-certified surgeons on staff Process- % of female patients receiving mammograms Outcome- # of patients readmitted to the hospital within 30 days of discharge

Avedis Donabedian identified three ways to measure quality. Match the type of measurement with its definition:

Structure- Relatively stable characteristics of practitioners or organizations Process- What providers actually do Outcome- Changes or results attributable to care

T/F- An IDS aims to integrate organizational structures, clinical and administrative work processes, information systems, and culture across the continuum of care.

TRUE

T/F- There is increasing evidence, although its not fully universal, that patient reported experiences of care are associated with good clinical quality of care

TRUE

______ considers that HC is basically safe and lack of competence is the source of error:

The "Bad Apple" Theory

The tradition of separating the authorities of HC administrators and clinicians is known as:

The Dual Hierarchy

When investigating adverse events, if we consider how actions made sense in the moment as the right thing to do, we are applying:

The Local Rationality Principle

Integration is:

The degree to which seamless coordination among subunits is achieved

Comorbidities

The simultaneous presence of two chronic diseases or illness conditions in a patient

According to Alfie Kohn, which of the following is not a key point about extrinsic rewards?

They change attitudes

Why are averages potentially problematic for quality measurement purposes?

They mask variation that may provide important insights into quality for subsets of patients.

Cultural competence is the ability of providers and organizations___________

To effectively deliver healthcare services that meet the social, cultural, and linguistic needs of all patients.

T/F- A person is underinsured when he/she has some insurance coverage but not enough to afford the OOP costs

True

T/F- Mutual adjustment is probably the best approach to coordination when tasks are either very simple or very complex

True

T/F: Under SHRM, bundles of high-performance work practices are intended to be implemented in concert and not as stand-alone practices.

True

An adverse event is:

Unintended injury resulting from or contributed to by medical care that requires additional monitoring, treatment or hospitalization, or that results in death

Coordination among operating units that are at different stages in the process of delivering care, such as between primary, secondary, tertiary, and post-acute healthcare providers, is an example of:

Vertical Integration

Variation that can be explained in terms of patient preference, disease prevalence, or other patient-related factors is ________

Warranted

Which of the following is not a symptom or indicator of burnout?

Work Overload

Match the key elements of organizational design with their definitions:

Work Specialization Departmentalization Chain of Command Span of Control Centralization and Decentralization Formalization

When evaluating organizational performance data to determine what, if any, further action is needed, it is good to consider:

ALL OF THE ABOVE -How problems identified align with organizational goals, pose significant risks to patients or staff, might generate negative PR, the impact failing to improve might have on staff morale and trust in leadership

Which of the following is an appropriate source for setting performance expectations?

ALL OF THE ABOVE -Past performance -Performance of comparable peers -Evidence-Based guidelines -Exemplary performers in the industry

Programming approaches to coordination:

ALL OF THE ABOVE -Standardize processes -Specify the intermediate outcomes of work -articulate the training or skills required to perform work

Cultural competence matters because___________

ALL OF THE ABOVE -There are considerable disparities in access to needed care services, the quality of care, and health outcomes among historically marginalized groups. -US demographics are changing. -Effectively educating patients about their health, illnesses, treatments, etc is greatly complicated by language proficiency, cultural norms, identity concerns, among other factors. -It can make the organization more appealing to a larger patient population, thereby increasing market share.

Which of the following statements is TRUE (Feedback approaches):

ALL OF THE ABOVE -may use a supervisor to direct employees as they are carrying out their work -may involve two or more workers exchanging information about their work performances as they reengaging in that work -require more effort and allow for more flexibility than do programmed approaches to coordination

Which of the following benefits can be achieved through effective Executive Walkrounds?

ALL THE ABOVE: Morale Boosting, Relationship building, problem identification

According to the Job Characteristics Model, managers can improve employee engagement by:

ALL THE ABOVE: increasing employee autonomy, providing feedback, increasing the degree to which jobs incorporate different skills and talents

Which of the following is not known to be a consequence of burnout?

Absence of fairness

In Lean, "waste" is defined as an activity that consumes resources without:

Adding value to the customer

According to the High-Performance Work Practices Framework, organizations need to align their leaders by:

All of the above: -Providing training in crucial leadership skills, including communication. -Planning for leadership succession. -Rewarding leaders for achieving organizational goals.

According to the High-Performance Work Practices Framework, organizations can empower the frontline by:

All of the above: -Removing threats of retaliation if one speaks up about problems. -Reducing status distinctions, such as between nurses and physicians. -Giving staff autonomy to make more decisions about their own work.

Which of the following is NOT a way to improve the patient experience?

Always deliver care exactly the same way to all patients.

Which of the following is not known to lead to burnout?

Autonomy

What is the main difference between measures of patient satisfaction and measures of patient experience?

BOTH A & B -Measures of satisfaction focus on attitudes and perceptions while measures of experiences focus on specific concrete events and actions. -Measures of patient satisfaction are more subjective, while measures of patient experience are more objective.

Which of the following statements is true regarding the AHRQ Survey on Patient Safety?

BOTH A & C -It measures the relative safety of HC organization through questions about communication openness, feedback about error, staffing, and teamwork, among others. -It is an important source of information that can be used as a starting point for action planning to achieve changes in safety culture.

Match the coordination mechanism with its definition AND with the explanation of how it enables coordination:

Roles Plans & Rules Tools Routines Proximity

Match the 6 Aims for an improved HC system with their definitions:

Safe Effective Efficient Timely Patient Centered Equitable

According to the High-Performance Work Practices Framework, organizations can engage staff by all of the following, except:

Selective hiring

Match the term with its correct definition: -Value-Based Payment System -Population Health -Social Determinants -Capitation -Episodic Payments -Pay for Performance

-A payment mechanism that hold the HC delivery system accountable for both quality and cost of care -The health outcomes of a group of individuals, including the distribution of such outcomes within the group -The conditions in which people are born, live, work, grow, and age -A payment approach that provides a fixed amount of money per patient per unit of time paid in advance to the provider for the delivery of HC services -A payment approach based on the expected costs for a clinically defined health issue for a specified period of time -A payment approach that ties payment for HC services to objective performance measures

Chronic Illness

A long-developing, persisting syndrome

______ considers human error to be an indicator of problems with the structures and processes of the organization:

A systems perspective

Currently, there is a shortage of which type of health professional?

A&B only: -Primary Care Physicians -Nurses

Which of the following statements is true regarding strategic human resource management (SHRM)?

A&B only: -SHRM views HR as the most valuable organizational assets. -SHRM view the work of HR as vital and central to the strategic performance of the organization.

According to the High-Performance Work Practices Framework, organizations should aim to acquire and develop talent by which of the following means?

A&C only: -Rigorously recruiting candidates who are a good "fit" with the organization and culture. -Initial training as well as ongoing career development.

Differentiation is:

A, B, and D ONLY -The degree to which tasks are separated into subunits -The extent to which work is subdivided -The degree to which workers are separated into subunits

Which of the following statements regarding the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey is true?

ALL OF THE ABOVE -HCAHPS is the primary instrument used to measure patient experiences in the US. -HCAHPS results are publicly reported. -The Centers for Medicare and Medicaid (CMS) mandates that all hospitals who receive Medicare reimbursements conduct the HCAHPS survey on a regular basis.

Which of the following is not one of the 7 key practices for improving employee relations and increasing the strategic value of an organization's HR?

Emphasize status distinctions to incentivize employees

Which of the following is NOT a way to create psychological safety?

Enforce strong authoritarian hierarchies

___________ is the conscientious, explicit, and judicious use of current best research in making decisions about the care of individual patients:

Evidence-Based Medicine

T/F: To successful manage population health, few changes are needed in the mindset and practices of most HC delivery organizations-

FALSE

T/F- Highly motivated employees are always the most productive?

False

T/F- Programmed approaches to coordination (standardizations), are equally appropriate for tasks of all levels of complexity

False

T/F: In a systems perspective on human error, there is no room for individual accountability?

False

Most HC services in the US are paid for on what basis?

Fee-for-service

Match the organizational design with its example:

Functional- Memorial Hospital is divided into Divisions of Medicine and Surgery, which are subdivided into various departments, including Cardiology, Gastroenterology, General Surgery... Service Line- Top University Health System is organized around key programs, including a Cancer program, Heart Health program... Matrix- Mary Smith, like other nurses at Complexity Hospitals and Health Systems, reports to both a director of Nursing and a director of a program, in her case, the Cancer Program

Which of the following represents a way to improve the value of HC?

Reducing the costs of care while improving the outcomes of care

_______ provides a significant amount of care to patients with little or no means to pay for that care

Health care safety net providers

A merger of two hospitals is an example of:

Horizontal Integration

Which of the following make up the Triple Aim?

Improve the Experiences of Care, Reduce the Per Capita Cost of Care and Improve the Health of Populations

Which set of fundamental managerial skills are equally important at all levels of management?

Interpersonal

Consider the following scenario: While exploring opportunities to improve processes of care for a large physician practice, you find variability in cancer screening across the practice's physicians over time. Is this variation problematic?

It depends. The variation is not problematic if it can be explained in terms of differences in patient preference, disease prevalence, or other patient-related factors.

Which of the following statements is true regarding psychological safety?

It makes it possible to give tough feedback and have difficult conversations, which demands trust and respect, without the need to tiptoe around the truth

What is defined as "the degree to which an employee's physical, cognitive, and emotional energies are invested in his or her work"?

Job engagement

Which of the following is NOT an effective organizational tactic for improving the experience of underserved groups?

Making decisions for patients who do not speak English.

Match the phases of the QI cycle with the questions that capture the focus of each phase:

Measurement: How are we doing? Assessment: Are we meeting expectations? Improvement: How can we improve performance?

When someone misinterprets a situation and applies the wrong knowledge, that person's action would constitute as a:

Mistake

Which of the following statements is true?

Organizational culture is comprised of shared V, B, and A Organizational climate is a collective mood or morale of a group of people

Performing surgery on a patient when research would indicate the patient is likely to heal more effectively and more quickly with less invasive therapy is an example of:

Overuse

Which of the following is not a factor that contributes to fragmentation of HC?

Overutilization of primary care and preventive services

Which of the following is not a current trend in health professions?

Physicians are increasingly setting up independent, private practices.

Match the phases of the PDSA cycle with the action that is included as part of that phase:

Plan- Determine the needed changes and set targets Do- Execute improvement and gather data Study- Compare results with targets/goals Act- Depending on adequacy of results, either repeat cycle or implement on a wider scale

What are the four core functions of management?

Planning, Organizing, Leading, Controlling