Operations in Healthcare Final Exam

You are considering adding two nurses around the clock to staff a new skilled nursing facility. How many FTEs are needed to staff these positions? Round number to tenths.

8.4

Calculate the average daily census for January 2017 using the following data: Patient days in January 2017= 310

A) 100 B) 10 C) 10.5 D) 100.5 ANSWER: (B) 10

Calculate days of working capital from the information below: Gross patient revenue- 1,300,000 Net patient revenue- 999,000 Current assets- 900,000 Current liabilities- 300,000 Operating expense per day- 50,000

A) 26 days B) 12 days C) 60 days D) 6.02 days ANSWER: (B) 12 days

Your clinic nurses put in a total of 13,000 hours last year. Net margins for the clinic is over $250,000 per years. Clinic expenses are up 15%. How many nursing FTEs staffed the clinic last year

A) 62.5 B) 6.25 C) none, they are all contract nurses D) .625 ANSWER: (B) 6.25

HIPPA was passed into law in 1996. Much of its focus was on protecting what?

A) A patient's right to deny treatment B) A patients right to be informed about conflicts of interest C) A patient's right to have their private health information kept confidential D) A patient's right to die ANSWER: (C) A patient's right to have their private health information kept confidential

Which of the following are common methods to build sophistication into planning projecrs

A) APD and FTE B) bell curve charts C) PowerPoint and excel D) CPM and PERT ANSWER: (D) CPM and PERT

Sometimes when collecting data about wait times there are obvious errors in the data, like the electronic record showing that doctors discharged patients from their care before actually being seen by the doctor. If you are going to use this data for forecasting, what will need to be done to the data prior to using it?

A) Abstract the data B) review the data C) cleanse or scrub the data D) use data as is ANSWER: (C) Cleanse or scrub the data

Any hospital where on average patients stays are greater than 30 days is best referred to as a...

A) Acute Care B) Rehabilitation C) Specialty D) Long Term Care E) Convalescent home ANSWER: (D) Long term care

In many small ERs, regulations require a minimum level of staff. This hospital department can flex its labor hours up in times of high demand but must always maintain a _______ level regardless of ER patient volumes

A) Base Staffing B) Fixed Staffing C) Regulatory Impacts D) Productive Advantage ANSWER: (A) Base Staffing

What commonly used quality management tool, adapted from the airline industry, is used in emergency rooms to prevent doctors from leaving items inside the patient after surgery

A) Bonefish diagram B) Pareto chart C) Statistics D) Check List ANSWER: (D) Check List

What type of health insurance payment model incentivizes providers to keep patients healthy by placing a upper limit on what is paid to the providers per covered life by insurance group.

A) Bundled Payments B) DRGs C) Population Health D) Episode of Care ANSWER: (C) Population Health

The ______ ______ is a tool used to visualize measurements for key performance indicators for an organization relative to time, and targets

A) Check List B) Pareto Chart C) Performance Scorecard D) Sensitivity Analysis ANSWER (C) Performance Scorecard

You are leading a performance improvement team and are working to improve the length of time it takes the business office to collect on patient bills. What resources might you use to tell how well your current billing is doing with their efforts

A) Compare your numbers to those of other industries B) Net collections numbers C) National bench marking data D) Opinion of your business office manager ANSWER: (C) national bench marking data

Select from the list below which answers does NOT contribute to the increasing cost of healthcare

A) Consumers living longer B) Pharmaceutical cost reductions due to improved product development C) Cost changes in Medical Technology D) Cost of Labor Answer: (B) Pharmaceutical cost reductions due to improved product development

All healthcare operations work diligently to provide high-quality care at the lowest costs. The balancing of costs and quality is referred to in the text as...

A) Cost-quality continuum B) Cost-quality trade off C) Quality control D) Performance improvement ANSWER: (A) Cost-Quality Continuum

Operations management is a set of processes and decisions that address what aspects of healthcare operations? Select all that apply:

A) Costs B) Process C) Technology D) Productivity E) All of the above ANSWER: (E) All of the above

Select for the list below a common way hospitals adjust their financial calculations to account for differing patient mix

A) DRGs B) Case mix index C) TEFRA D) Capitation ANSWER: (B) Case mix index

Common issues in productivity measurement for hospitals include:

A) Data too detailed B) Quality of data C) Simplicity of defining outputs D) Steady rates of demand ANSWER: (B) Quality of Data

What tool is used to by quality improvement managers to quickly determine what problem might need to be addressed next using the 80/20 rule

A) Fishbone Diagram B) Pareto Chart C) Root cause analysis ANSWER: (B) Pareto Chart

This chart shows data over time relative to both the mean and control limits

A) Fishbone chart B) quality control C) root cause analysis D) control chart ANSWER: (D) Control chart

Which of the following is NOT a major classification of Hospitals according to the American Hospital Association?

A) General B) Specialty C) Rehabilitation D) Psychological ANSWER: (D) Psychological

Hospital A has 2015 labor costs of $10,364,341. That year is has 18,450 patient discharges Hospital B has 2015 labor costs of $6,456,400. That year it had 15,555 patient discharges. Which hospital was the most efficient as it relates to labor costs per discharge?

A) Hospital A B) Hospital B C) Can't tell from the information provided ANSWER: (B) Hospital B

Business planning and performance improvement in hospitals include areas such as:

A) Infrastructure Support B) Organizational development and training C) Performance Benchmarking D) Telecommunication Optimization ANSWER: (C) Performance Benchmarking

Which of the following is NOT an input to the production of healthcare services?

A) Labor B) Supplies C)Healing sick patients D) Equipment ANSWER: (C) Healing Sick Patients

This type of government insurance program covers most people over the age of 65

A) Medicaid B) Medicare C) Massachusetts Health D) Blue Cross Blue Shield ANSWER: (B) Medicare

Working capital is represented by

A) Net patient receivables B) Current Assets minus Current Liabilities C) Fixed Assets, net of depreciation D) Net assets minus long term liabilities ANSWER: (B) Current Assets minus Current Liabilities

Common problems with time and motion studies include:

A) Non-bias effect B) Waiting line queue effect C) Hawthorne effect D) non of the Above ANSWER: (C) Hawthorne effect

The search for cost savings of key resources and supplies and for better management of goods and services in the physical supply chain is responsible for creating job opportunities for analysts and professionals interested in a wide number of fields, including:

A) Nursing B) Logistics C) Food Services D) Health Policy Development ANSWER: (B) Logistics

Which of the following is a characteristic of a community hospital?

A) Only organized as a for-profit operation B) Teaching focus with larger size C) Operated to serve federal health beneficiaries such as the Veterans Administration D) Focused on short-term stays for a specific episode of care ANSWER: (D) Focused on short-term stays for a specific episode of care

Project managers have many tools at their disposal to help them visualize the resources and time allocations for key tasks.

A) Pareto Chart B) Gantt Chart C) Affinity diagram D) fishbone chart ANSWER: (B) Gantt chart

In hospital settings which group of employees take the largest percentage of the payroll.

A) Radiology Techs B) Nurses C) Human Resource Staff D) Physicians E) Administration ANSWER: (B) Nurses

Select from the list below the best response to the location of the bottleneck in this scenario: Registration time: 8 minutes Nursing Assessment: 5 minutes Physician Assessment and Treatment: 10 minutes

A) Registration time B) nursing Assessment C) physician Assessment and treatment ANSWER: (C) Physician Assessment and treatment

Hospitals can learn about operations management effectiveness from which of these industries?

A) Retail B) Airline C) Electronics D) All of these are industries that can inform hospital operations managers ANSWER: (D) All of these are industries that can inform hospital operation managers

Which of the following describes the accounting equation?

A) Revenues-Expense=Income B) Assets+Income=Fund Balance C) Assets=Liabilities+Equity D) Net Assets=Income-Expenses ANSWER: (C) Assets=Liabilities+Equity

Teaching hospitals differ from other hospitals in a number of ways. Select all the answers from the listing below that describe aspects of teaching hospitals that are not true of other hospitals

A) Smaller and more specialized B) Are for-profit organizations C) Engage in significant amounts of research D) Don't provide services to the general public ANSWER: (C) Engage in significant amounts of research

_____ is the comparison of key performance indicators relative to other similar organizations

A) Standard deviation B) benchmarking C) multi variant D) regression analysis ANSWER: (B) Benhmarking

Typical tracking mechanisms include which of the following?

A) Stopwatches and clipboards B) Video Surveillance C) Bar codes D) Computer MAC addresses ANSWER: (C) Bar Codes

As a leader of the quality team, you have developed a process chart that accurately describes how patients move through the ER. Your team decides the process needs changing to reduce cycle time and creates a new process chart. What is that type of chart called?

A) To-be process chart B) scatter diagram C) fishbone chart D) Pareto chart ANSWER: (A) To-be process chart

What term below best describes the process of managing the collection of patient and insurance claims

A) accounts receivable trend analysis B) accounts payable management C) collection agency referrals D) Revenue cycle management ANSWER: (D) Revenue cycle management

Adjusted patient days is used for what?

A) an index of a hospitals total output including outpatient revenue B) an index to define relative value units C) corrected for patients that leave the hospital before midnight D) is the same as adjusted daily census ANSWER: (A) an index of a hospitals total output including outpatient revenue

Which of the following are considered a benefit of RFID tracking?

A) automated vital signs recording B) monitoring of inventories C) faster employee error-checking D) increased prices per unit sold ANSWER: (B) monitoring of inventories

Common challenges for project management in hospitals include:

A) available project management tasks B) opportunities for projects to improve hospital performance C) project management tools D) power struggles between physicians and managers ANSWER: (D) power struggles between physicians and managers

Measurement systems in productivity management must be

A) consistent, recordable, manageable, qualitative, and inexpensive B) flexible, manageable, safe, qualitative, and comparable C) trended, inexpensive, automated, documentable, and comprehensive D) consistent, reliable, measurable, quantitative, and comprehensive ANSWER: (D) Consistent, reliable, measurable, quantitative, and comprehensive

On the balance sheet, those items listed as non-patient related income might include:

A) contractual adjustment B) Fundraising and donations C) Depreciation D) Employee Benefits ANSWER: (B) Fundraising and Donations

Major opportunities to improve processes include which of the following?

A) decreasing use of statistical analyses that divert resources from patient care B) adding steps in a process to validate data gathered at earlier steps and increase accuracy C) increasing variability in performance over time D) increasing throughput or capacity with little or no change in inputs ANSWER: (D) increasing throughput or capacity with little or no change in inputs

Examples of projects for healthcare operations management projects include all of the following EXCEPT?

A) deployment of a pharmaceutical ordering and inventory system B) upgrading an archiving and communication system C) design/ construction of a new facility or building D) decision on which political party to support ANSWER: (D) Decision on which political party to support

Your hospital has just bought an MRI. The manufacturer states that the machine can operate 24 hours a day, 7 days a week. Is the salesman describing the design capacity or the effective capacity?

A) design B) effective ANSWER: (A) Design Capacity

Which of the following best defines the goal of Lean?

A) elimination of defects B) reduction of process variability C) determine conformance with customer requirements D) remove non-valued added activities ANSWER: (D) remove non-valued added activities

Every hospital has a charge description master. What information is contained in the master list?

A) every item the hospital can order from suppliers B) a list of everything in central supply C) Every item the hospital charges for and the amount they charge for it D) a list of all procedures done at that hospital ANSWER: (C) every item the hospital charges for and the amount they charge for it

Which of the following describes the amount that a healthcare provider will actually collect when they bill for a service?

A) gross patient revenues B) charge description master fees C) contractual adjustments D) hospital charges less contractual adjustments ANSWER: (D) Hospital charges less contractual adjustments

Common productivity metrics in hospitals include which of the following?

A) hospital man-hours per discharge B) department man-hours per supply used C) severity of illness per labor hour D) wage rate per bed ANSWER: (A) hospital man-hours per discharge

The adjusted occupied bed AOB metric is calculated as:

A) impatient days / inpatient discharges B) outpatient days / available beds C) (outpatient visits + inpatient days) / days in the period D) adjusted patient days / days in the period ANSWER: (D) adjusted patient days / days in the period

Which of the following is not a financial statement used in management of healthcare organizations?

A) income statement B) EBIT C) balance sheet D) Cash flow statement ANSWER: (B) EBIT

Common sources of operational data in hospitals include:

A) income statements B) Medicare cost reports C) payroll journals D) all of the above are sources of operational data ANSWER: (D) All of the above are sources of operational data

The goal for operational managers in a hospital include:

A) increasing variability B) Reducing Costs C) Increasing space used for inventories D) All of these are goals for hospital operations management ANSWER: (B) Reducing Costs

Which of the following factors causes projects to fail?

A) inexperienced employees B) excessive implementation times C) lack of financial resources D) poor communication E) All of the above ANSWER: (E) All of the above

As a manager, you have to consider purchasing automated equipment that will result in a reduction in your workforce. This process is sometimes called Capital Versus _______.

A) labor substitution B) capital depreciation C) capital regression D) asset shifting ANSWER: (A) labor substitution

When planning to solve a problem that continues to plague a process, one tool a manager might use is a ______ to examine whether the problem is with people, equipment or policy.

A) lean B) Quality Control C) Root Cause analysis D) Fish Bone chart ANSWER: (D) Fish bone chart

Hospitals charge insurance companies for products and services rendered to patients. Hospital charges are based on the fees listed in its charge master description. Insurance companies never pay the full charge master rate because they have negotiated contracts with hospitals to pay amounts that are lower than those listed in the chargemaster. From the list below, select the accounting term that is commonly used to refer to the amount of the discount provided to the insurance company

A) loss leader B) contractual adjustment C) gross revenue D) days in accounts receivable ANSWER: (B) contractual adjustment

Wait times in health care result in:

A) opportunities for staff to rest and improve care B) decreased patient satisfaction C) quality checking prior transactions D) smoother staging of demand ANSWER: (B) decreased patient satisfaction

You work in a psychiatric hospital. The hospitals average length of stay is average 4 days shorter than the national benchmark for similar hospitals. What might this information tell you about you patients length of stay?

A) other hospitals are keeping their patients too long B) insurance companies don't pay for long stays C) you might be discharging your patients too soon D) the numbers are so close they don't tell you anything ANSWER: (C) you might be discharging your patients too soon

Productivity dan improve in which of the following ways?

A) output expands with an increase in inputs B) inputs are reduced with a decrease in outputs C) output increases with a decrease in inputs D) new technology increase the labor hours per output ANSWER: (C) output increases with a decrease in inputs

Which of the following is not a common measure of hospital output?

A) patient says B) patient discharges C) adjusted patient roster D) average daily census ANSWER: (C) adjusted patient roster

The amount of net revenue that is created on average by each employee is referred to as what?

A) procedures per employee B) FTE/AOB C) Net Revenue / FTE D) AADC ANSWER: (C) Net Revenue / FTE

Which of the following is a key to success in a hospitals project?

A) project sponsor with ability to provide resources and clear obstacles B) patients interested in learning about the project C) multiple deliverables with flexible definitions D) all of the above are keys to success ANSWER: (A) project sponsor with ability to provide resources and clear obstacles

This is a method of reimbursement that pays providers a fixed-dollar amount per patient over a given time period.

A) prospective B) Retrospective C) Capitation D) ICD 10 ANSWER: (C) Capitation

When wait times for patient registration exceed management expectations, which of the following can be used to improve performance?

A) reduce the number of steps in the registration process B) increase the number of appointments available to maximize available demand C) Decrease the number of employees working on that process to reduce overlap D) all of the above can improve wait time performance ANSWER: (A) Reduce the number of steps in the registration process

Productive hours exclude which of the following?

A) regular paid hours B) sick time C) overload pay premiums D) contract labor ANSWER: (B) Sick Time

To obtain approval to conduct a project in a hospital what two key elements do you need

A) resource and actuarial B) opportunities and deliverables C) adequate funding D) a clear understanding of potential risks and potential rewards ANSWER: (D) a clear understanding of potential risks and potential rewards

Which of the following should be considered in the adoption of operational metrics in a hospital

A) the number of metrics should be maximized B) reporting frequency should be convenient C) resources need not used to compile data D) operational metrics should be aligned with strategic objectives ANSWER: (D) operational metrics should be aligned with strategic objectives

Benchmarking a process includes all of the following EXCEPT:

A) using sources of data from other industries B) collect and analyze data for comparison C) identify differences in performance and determine sources of those differences D) incorporate benchmarks into performance scorecards ANSWER: (A) Using sources of data from other industries

Timelines define the beginning and end point of the project. They also contain dates by which major project's deliverables should be achieved. The date when an interm deliverable is set to be achieved is often referred to as a _________

A) way point B) milestone C) resource investment D) scope ANSWER: (B) Milestone

True of False: Dealing with insurers is a minor concern to healthcare provider organizations, since the patient is ultimately responsible for paying the bill

False

True or False: Academic medical centers are generally the same as other community hospitals in terms of size and number of service lines

False

True or False: Benchmarking hospital financial performance using audited financial statements is fairly easy since all hospitals operate under the same financial disclosure rules

False

True or False: Continuous improvement in the context of a hospital organization entails maintaining profitability, even if some quality measures have to be traded off

False

True or False: Dealing with insurers is a minor concern to healthcare provider organizations, since the patient is ultimately responsible for the bill.

False

True or False: Labor inputs are of little consequence in operations management since they account for a small proportion of operating expenses in a hospital

False

True or False: Organizations should track at least 50 measures in order to optimize control over operational performance, since "things measured are things managed"

False

True or False: There is one best tool for identifying opportunities to improve health care quality

False

True or False: Vertical integration in healthcare involves alliances among several competitive hospitals

False

True or False: increasing capital investments in a process should have little impact in a production function.

False

Which of the following is a consideration for operations management in assessment of workflow process?

How many manual processes exist?

______ is the rate or velocity at which services are performed or goods delivered

Throughput

True or False: About one-third of hospitals in the United States have a negative operating margin

True

True or False: Documenting the current process in a hospital helps to find opportunities for reducing steps, interactions, decisions, and length of a process

True

True or False: Fear of change is a common obstacle to change in a healthcare organization

True

True or False: Finding waste, improving, utilization, and generally stabilizing and reducing the overall cost of delivering high quality services are essential functions for healthcare manager

True

True or False: Healthcare operations is about management of interconnected process, or systems

True

True or False: Measurement of productivity in hospitals is not common as in other industries

True

True or False: Operations management seeks to minimize the volume of inputs for a given level of outputs

True

True or False: Operations managers can have a large proportion of their work consumed in projects

True

True or False: Project deliverables are tangible produts

True

True or False: The income statement and the balance sheet are two of the most common financial statements used in healthcare organizations.

True

True or False: The main focus of HITECH was to develop a national health information technology infrastructure

True

True or False: There is no such thing as an optimal solution to eliminate wait times

True

True or False: generally, an input can be measured base on the cost of resources devoted to the production of the output

True

True or False: some of the central elements of the lean process are reducing the supplies used in a process and reducing steps in a process

True

True or False: timelines are extremely important for projects as they define expectations for occurrence of events or consumption of resources

True