C429 Healthcare Operations Management WGU
Which of the following is NOT considered in determining the staffing ratio for an ambulatory setting? A. Square footage per FTE employee. B. Ability and skill level of staff. C. Volume of patients. D. Complexity of patients.
a
Which of the following is the LEAST important factor in an effective physician/administrator leadership team? A. The team's long-term relationship. B. Teamwork. C. Shared common goals. D. Strong communication skills.
a
Which of the following is the best indicator of corporate culture in a medical practice? A. The actions of medical providers and staff. B. Patient satisfaction surveys. C. The medical practice's mission statement. D. Commitment to quality patient care.
a
Which of the following is the most important when developing a continuous quality improvement program? A. Frequently re-evaluating options. B. Turning to outside sources for help. C. Involving management. D. Developing a strong customer focus.
a
Which of the following legal terms requires a provider to explain the risks, benefits and alternatives connected with a procedure? A. Informed consent. B. Breach of confidentiality. C. Standard of care. D. Imputed liability.
a
Which of the following personality styles best fits in a team player environment? A. Facilitating. B. Analytical. C. Expressive. D. Controlling.
a
Which of the following provides an example of how an administrative system can improve the quality of clinical outcomes? A. Reminding diabetic patients to schedule eye exams. B. Asking a nurse to call diabetic patients and ask about their health. C. Researching potential complications of diabetes on the Internet. D. Referring diabetic patients to an ophthalmologist.
a
Which of the following increases patient compliance with physicians' directives? A. Repetitive visits to check for compliance. B. Written and visual (if applicable) instruction to the patient. C. Verbal instructions from the nurse. D. Self-learning materials picked up by the patient from an information kiosk.
b
Racial and cultural sensitivity is important to healthcare recruitment due to: A) Affirmative action plans B) Population shifting to non-white majority C) The number of people entering the country of treatment D) None of the Above
B
Which is not a type of universal care utilized in Europe? A) National Health System B) National HMO C) National Health Insurance D) Socialized Health Insurance System
B
All Americans have the right to __________under the Affordable Healthcare Act. A) Basic Care B) Purchase Care C) Low Cost Medications D) None of the Above
B
Supply-side rationing is used by universal healthcare, HMO's and ACO's to cut down on A) Duplication of Effort B) Access to specialists C) Decrease provider communication D) Cost
C
An ACO (Accountable Care Organization) earns additional money by: A) Setting a flexible fee schedule B) Getting a share of money it saves Medicare C) Producing better patient results D) Both C & B
D
What is not a reason for physician resistance to Evidence Based Practices? A) Too simple B) Too Complex C) Bias D) Not cost effective
D
Which of the following statements is the most important consideration in developing an effective media relations program for a health service organization? a) identify clear objectives for a media relations program and ensure they are communicated to everyone concerned b) invite the media to an open house at your organization c) maintain regular communication with the media on topical issues d) advise members of the media regarding their role at the organization
a
Which of the following would be a potential business-to-business target market for a medical practice? A. Referring physicians. B. Pharmaceutical representatives. C. The local radio station. D. The local bank manager.
a
2) Evidence Based Care uses _________ to improve quality of care. A) Scientific research and proven peer reviewed results B) Theoretical Models C) Administrative Oversight D) None of the above
a
A health care leader who navigates socio-political environments does the following: 1. collaborates to address emerging issues; 2. forms partnerships to achieve positive outcomes for all stakeholders; 3. anticipates situations in which concensus is not attainable to resolve matters between conflicting parties; 4. rejects public-private partnerships in order to avoid conflict among stakeholders. a) 1, 2, 3; b) 2, 3, 4; c) 1, 3, 4; d) 1, 2, 4
a
As the CEO of a 200-bed hospital, you have recently received independent verbal complaints from several members of your medical and nursing staff regarding medical competency and personality issues with a particular physician. The nurses feel that the physician cannot adequately manage emergency patients and they recommend that his privileges be immediately suspended. The medical staff members have informally discussed this physician for some time, but have taken no definitive action. You review the physician's file and all relevant committee minutes and you find nothing in writing concerning the verbally reported difficulties. You request that the appropriate medical staff committee review a sufficient number of the physician's past emergency records and ask the committee to make a recommendation on the basis of these records. What is the best action you can take to identify similar problems in the future? a. Develop a database system and use it to review the care provided by each physician b. Have a representative sample of this physician's cases reviewed on a regular basis c. Summarize the problems that occur with each physician at the time of reappointment d. Have all of this physician's emergency cases reviewed for the next six months
a
Critical Pathways are used to plan: A) Medical interventions in a set time-line B) IV access points C) Care Access D) None of the Above
a
EBP is based on the premises of better outcomes and ____________. A) Increased value B) Maximum use of services C) Empowering physician autonomy D) Tailoring patient care to the individual
a
Gene therapy is on the rise, in the future we can expect: A) Greater treatment options B) Less treatment options C) Higher deductibles D) None of the above
a
If we exclude Medicare and Medicaid from how we obtain insurance, how do most Americans get healthcare coverage? A) Through their employer B) Through state programs C) Independent contracts D) None of the Above
a
Integrating and gatekeeping are the job of: A) Primary care B) Secondary C) Insurance companies D) All the above
a
MCOs are accredited by the: A) National Committee for Quality Assurance (NCQA). B) Centers for Disease Control (CDC) C) Department of Health and Human Resources (DHHS) D) None of the Above
a
Point of entry of care is best handled by a A) A PCP B) An ER C) A specialist D) None of the above
a
Senior administrators concern themselves with leadership and A) Strategic Planning B) Operational Planning C) Both A & B D) None of the Above
a
The Role of Gate Keeper is typically assigned to: A) Primary Care Physicians B) Regulatory Agencies C) Specialists D) Surgeons
a
What is marketing mix? A. Product/service, price, promotion and place. B. Television, radio, print and electronic media. C. Demographic population. D. Budget, plan, mission and vision.
a
What is not true of the healthcare profession? A) Most work in hospitals B) One of the most highly educated C) Largest U.S. Employer D) Need is expected to keep increasing
a
What is the primary goal of quality improvement in a medical practice? A. To reduce errors and improve patient care. B. To gain efficiency. C. To increase profitability. D. To reduce error and streamline business tasks.
a
What kind of Disease Classification is defined by a severe, short duration episodes though typically treatable: A) Acute B) Sub-Acute C) Chronic D) All the above
a
Which historic healthcare facility type kept the poor, children and homeless we kept as inmates? A) Alms houses- B) Dispensaries C) Pest Houses D) Asylums
a
Which of the following are key characteristics of mentoring within a medical practice? A. Relationship with a senior leader designed to impart culture, values and strategic priorities. B. Relationship with a senior leader who is practical and goal-focused. C. Discussion with a senior leader about your barriers to achievement. D. Discussion with a senior leader to inform you about job opportunities
a
You are the newly appointed CEO of a health care organization, In the first few weeks in your new position, you are concerned by the lack of consistent understanding of the organization's strategy on the part of your executives. Some have even commented that "it doesn't seem to make any difference anyway...people do what they've always done and feel they need to do." You have discovered that, while there is a strategic plan for your organization,, there is no formal planning process and the setting of the strategic directions was historically the pursue of the past CEO and the VP Finance. You would like to create a formal strategic planning process that is more inclusive, and is a meaningful guide to the actions of your executives and their staff. At what stage of the strategic planning process should you involve your executives? a) the strategy formation stage, where the initial ideas around what the strategy should be are developed b) after the point of receiving approval to develop your strategy further from your Board c) the strategy implementation stage, where you present your strategy and seek assistance in implementing it d) the strategy evaluation stage, where you formulate the strategy, put it in place, and call upon your executives six months later to comment on its effectiveness
a
Match the specialist to the definition __ Nephrologist A) Kidney Specialist __ Orthodontist B) Nerve and Brian Specialist __ Neurologist C) Straightening of teeth __ Cardiologist D) Heart Specialist __ Periodontist E) Dental Implant specialist __ Optometrist F) Eye Specialist
a,c,b,d,e,f,
What is the main purpose of a strategic plan? A. For external customers and suppliers. B. To develop long-term objectives and strategies. C. To identify short-term business needs and desires. D. To evaluate operating efficiency and effectiveness
b
Which historic healthcare facility type most closely resembles today's free clinics? A) Alms houses B) Dispensaries C) Pest Houses D) Asylums
b
A member of the community has asked your opinion about legislation removing nutritional counselling for diabetes from being covered by your provincial health plan. Your best response would be: 1. Governments have to make tough decisions in order to reduce deficits. 2. Public policies such as these are good examples of how money and resources flow through society and can negatively impact the health of the population. 3. If more money is spent of recreation and leisure programs in the schools, less money would be needed to counsel obese populations who are prone to diabetes 4. People need to learn how to live a healthy lifestyle in order to ensure resources aren't spent unnecessarily. a. 1 & 2 b. 2 c. 3 d. 4
b
A.5 Many program evaluation systems have focused on program outputs (goods and services), but there has been a definite shift towards recognizing the need to evaluate program outcomes (the impact of a service on clients). Which of the following are program outcomes? 1. to discharge 85 percent of patients after four days 2. to increase the number of patients seen weekly from 70 to 100 3. to increase patients' knowledge of how to minimize lower back pain 4. to increase exercise tolerance of cardiac patients a) 1,2 and 3 b) 3 & 4 c) 1 & 2 d) 2, 3, and 4
b
Adjusting the utilization of care while active treating the patient is what type of review? A) Prospective Utilization B) Concurrent Utilization C) Both A&B D) None of the Above
b
Allied Health Professional Technologist differ from technicians in there level of training and their ability to ________. A) Teach classes B) Evaluate the appropriateness of treatment C) Treat patients independently of Physician orders D) None of the above
b
An event has occurred in your organization that may be cause for legal action. No legal action has been taken to date, but there is a concern that action might be taken soon. What is the CEO's first responsibility? a. apprise the organization's legal adviser of the situation b. ensure documentation is complete and sound c. call the client's family to assure them that the situation is under control d. call in the coroner and/or police
b
Due to the rapid spread of diseases in our global economy the text supports the idea of: A) Isolationism B) International Cooperation C) Travel Health Screenings D) None of the above
b
Emotional self-awareness involves: 1. recognizing one's emotions and their impact on others; 2. assessing one's emotional strengths; 3. striving to understand one's emotional triggers; 4. leveraging negative feelings to drive motivation and action. a) 1 and 2; b) 1, 2, 3; c) 1, 3, 4; d) 1, 2, 4
b
HMO use _________ and PPO offer ___________. A) Discounts, Capitation B) Capitation, Discounts C) Vouchers, Installments D) Installments, Vouchers
b
Health care organizations play an important role in population health. Given the current directions in health service delivery, which of the following is the most important role for a health care organization to play? a) developing secondary prevention clinics in collaboration with community agencies and disease-related organizations b) developing primary prevention programs for the community in conjunction with community agencies c) facilitating the community development approach to managing the determinants of health for specific high risk populations in the community d) none of the above
b
Holistic Medicine strives to A) Lower Health Cost B) Treat the whole Person C) Use alternative medicine D) None of the above
b
In-house training is being conducted on OSHA standards for all staff. What is being accomplished with this training? A) Regulatory Renewal B) Accreditation Renewal C) Regulatory Compliance D) None of the Above
b
Insurance cost sharing is meant to dissuade frivolous use of benefits typically this is achieved by requiring? A) Pre-Authorization B) Co-Pay C) A referral D) All the Above
b
Lifetime Limits were common in health Insurance were common before the ACA. Why did the ACA make these illegal? A) Reduce Premiums B) Make insurance cover recurring conditions like cancer C) Align with Medicare D) None of the above
b
MCO's formed to take advantage of what stated reason: A) Tax Incentives B) Greater Buying Power C) Greater Political Power D) None of the Above
b
Medicare Covers those who are ________, and those who are __________? A) Impoverished, Disabled B) Disabled, 65 and Over C) 65 and over, Impoverished D) All the Above
b
Medicare part A covers? A) Physician Fees B) Hospital Fees C) Both A&B D) None of the above
b
The IHR (International Health Regulations) is a binding legal agreement to: A) Respect international borders B) Prevent and respond to acute international health risks C) Population Control D) All the Above
b
The U.S. Healthcare System is faced with a serious shortage of A) Specialists B) Primary Care Physicians C) Out Patient Surgical Centers D) All of the Above
b
Though the U.S. tends to surpass other countries in interventional medicine, much of our elective or banned surgeries/procedures can be lost to low cost competion that has similar quality. The term for this loss is _____________. A) Free Market B) Medical Tourism C) Monroe Doctrine D) None of the Above
b
To deter patients from utilizing Health Tourism the United States should: A) Not allow non-U.S. residents to train her in U.S. B) Cut costs and continue to lead in quality C) Not sell medical equipment oversees D) Do not publish medical findings
b
What does a mission statement define? A. The organization's future image. B. The organization's unique and distinctive purpose. C. The type of business the organization intends to pursue. D. The organization's beliefs and culture
b
What is the first step in conducting a performance review? a. Comparing the employee's skills against the job description. b. Reviewing the performance objectives or expectations for the job. c. Checking the progress of the employee's work. d. Consulting the previous year's performance results.
b
Which of the following is NOT a good way to educate patients about researching medical information on the Internet? A. Providing a list of preferred websites. B. Rejecting information obtained by the patient unless it comes from a source that the physician trusts. C. Counseling the patient about the potential risk of unsupervised chat room data. D. Listening to patient concerns and evaluating the value of information provided by unfamiliar or questionable sites.
b
Which of the following is a benefit of an effective training and development program? A. Monitoring processes becomes unnecessary. B. Employee retention increases. C. Organizational goals are redefined. D. Employees are not paid for training time.
b
Which regulation safeguards the patient's right to privacy? A) Sarbanes-Oxley Act B) HIPAA C) EHR D) All the Above
b
Who is a stakeholder in the medical practice? A. Only people who own stock in the medical practice. B. Anyone who is affected by the medical practice. C. Patients, employees and owners of the medical practice. D. Only an owner or employee of the medical practice.
b
3) An APN consists of A) LPN's B) RN's C) NP, CNS's or NNP's D) All the Above
c
A patient that stays overnight is an_____________, a patient that receives care but does not stay overnight is an ________________. A) Impatient, Dependent B) Outpatient, Dependent C) Inpatient, Outpatient D) None of the Above
c
Cost control requires all but A) Supply-Side Rationing B) Limit Reimbursement to Providers C) Greater Access to Specialist D) Management of Utilization
c
If Medicare expenditures totaled $523 billion in 2010; the program's income amounted to $486 billion in the same year what does this mean? A) Medicare is producing strong profits B) Medicare is saving Billions in cost savings C) Medicare has a financing shortfall D) Medicare is Bankrupt
c
In-house training is being conducted on OSHA standards for all staff. What is being accomplished with this training? A) Regulatory Renewal B) Accreditation Renewal C) Regulatory Compliance D) None of the Above
c
Inpatient care continues to decline because of all these reasons except: A) Outpatient Competition B) Expensive inpatient care C) Doctors wishes D) New less invasive procedures
c
Licensing guidelines for clinical personnel are governed by which of the following? A. Local government. B. Federal government. C. State government. D. Professional associations.
c
Market Justice holds that people are best served if the: A) Services are prepaid B) Services are Single payer based C) Patient Demand is primary D) Health Need is Primary
c
Mr. Strong is an 88-year-old resident in the long-term care unit of your hospital. He is frail, confused and cries out constantly for his family. One son visits him once a month, only long enough to pick up the monthly dividend cheques. No lawyer or accountant seems to be involved, but there is always adequate money in his account to cover extra monthly costs for semi-private accommodation. The nursing staff are annoyed with the family's lack of concern and are exhausted by the constant demands of the patient. The rehabilitation staff feel he would respond to therapy if motivated. The social worker has given up on the family and wants him transferred to a private nursing home. The physician expresses no viewpoint and provides routine care. To preserve the quality of life of the resident, what action would you take first? To preserve the quality of life of the resident, what action would you take first? a. Obtain family support. b. Arrange for a volunteer to visit the resident on a regular basis. c. Arrange for a case conference. d. Urge the physician to take greater responsibility for the case.
c
Primary care includes all but: A) Diagnostics B) Counseling C) Inpatient Care D) Minor Surgery
c
Rural areas tend to suffer from less governmental subsidies and less access to care this will not cause which of the following? A) Delays in testing B) Delays in treatment C) Longer Life spans D) Less services offered
c
The AMA drew power from setting standards in: A) Health Insurance B) Passing Health Laws C) Health Education D) Hospital Standards
c
The first insurance in the U.S. was: A) Blue Cross B) Medicare C) Workman's Comp D) Medicaid
c
There are several activities which are essential to effective strategic planning. They include: 1) CEO defined vision, mission and values 2) defined roles and responsibilities 3) adequate consultation, discussion, and feedback 4) indicators that will be measured and monitored a) 1, 2, and 3 b) 1, 2, and 4 c) 2, 3, and 4 d) all of the above
c
This organization leads the effort to improve the quality of healthcare, reduce costs and provide resourced for biomedical research and testing. A) WHO B) FDA C) AHRQ D) CDC
c
To avoid having to go to a nursing home after back surgery the patient has opted for __________ so that she can get help with Activities of Daily Living (ADL's) until she heals. A) Skilled nursing Facility B) Outpatient nursing facility C) Home Health D) Hospice
c
What is not a product of increased preventative care: A) Lower costs B) Longer Life Expectancies C) Better technology D) All the above
c
What is not one of the determinates of a population or personal health: A) Genetics B) Medical Practice C) Political Affiliation D) Individual Behaviors
c
What type of Billing Fraud is being used when the organization falsely reports the illness or injury as being more serious than it is? A) Price Fixing B) Conflict of interest C) Up-coding D) All the above
c
Which is not a future concern for healthcare? A) Inadequate wellness programs B) Primary Care Services C) Too few physician specialist D) Healthcare tourism
c
Which of the following competencies is necessary for effective physician leadership? A. Excellent clinical skills and an interest in administration. B. Desire to cut back on clinical duties. C. Empowering others to accomplish goals. D. Popularity with the medical group.
c
Which of the following would NOT be an appropriate role for a chief medical officer? A. Effectively communicate medical staff issues. B. Facilitate resolution of conflict between medical providers and administrative staff. C. Act as the practice's chief executive officer. D. Review medical outcome data and present it to the board.
c
Which organization was instrumental in beginning the Blue Cross Network: A) Centers of Disease Control (CDC) B) The Joint Commission/JCAHO (TJC) C) American Hospital Association (AHA) D) None of the Above
c
An employee physician is MOST strongly motivated to remain with a group when he or she feels: A. Gratitude toward the group. B. Obligated to the group. C. Fear of finding a comparable position. D. Invested in the group.
d
As a new CEO, you have become aware of poor morale among staff and an attitude of indifference toward the patients. Which of the following actions would you initiate immediately? a. Arrange general staff sessions to hear their concerns and provide them with your management philosophy. b. Hire a consultant to assess staff morale. c. Have the staff development department offer sessions to all staff on how to communicate with the clients and their families. d. Meet with senior staff to hear their ideas about the reasons for the morale and attitude problem.
d
Community healthcare typically: A) Overrides the needs of the individuals B) Seeks to protect the most vulnerable parts of the community C) Change health attitudes and practices with regulations D) All the above
d
Cost containment can be achieved by A) Price Controls B) Competitive Approaches C) Health Planning D) All of the Above
d
Countries with health systems oriented toward primary care: A) Achieve better health levels B) Higher satisfaction with health services C) Lower expenditures in the delivery of health D) All the Above
d
Employer based health insurance is not A) A job Perk B) Tax Free C) Open to union bargaining D) Open to all employees
d
In the future Primary Care should be: A) The usual Route of entry B) Provide integrated health services C) Partnering with patients and the community D) All the Above
d
On what would an outcomes management database primarily focus? A. Reduction of costs for all stakeholders. B. Effectiveness of clinical data collection and analysis. C. Accurate tracking of cost savings and their equitable distribution. D. Effectiveness of clinical practice and the consumption of resources.
d
Organizational integration gave rise to which of the following: A) Medical Systems B) Physician/Hospital Partnerships C) Integrated Delivery System D) All the Above
d
Rural healthcare is far less accessible than that of urban centers and it dramatically limits the life expectancy in those areas. The lack of physicians per capita leads to: A) Shorter wait times B) Lower deductibles C) Better coordination of Care D) Worse Coordination of care
d
The first insurance in the U.S. was: A) Blue Cross B) Medicare C) Workman's Comp D) Medicaid
d
The roles and responsibilities of the board of directors for a medical practice is delineated in which legal document? A. Articles of incorporation. B. Employment agreement. C. Executive committee minutes. D. Corporate bylaws.
d
The three main types of cost sharing are utilized in private health insurance includes all but: A) Premium cost sharing B) Deductibles C) Copayments D) Stipends
d
Vulnerability is not determined by a convergence of: A) Predisposing B) Enabling C) Need D) Socio-Economics
d
What are some of the major differences between a technologist/therapists and a technician/assistants: A) A technician requires the supervision of a technologist B) A technologist or therapist tend to have 2 or more years education C) Technologist and therapist have higher levels of training in advanced procedures D) All the above
d
What does a benchmarking tool help organizations identify? A. Performance issues requiring disciplinary actions. B. Areas of fraud and abuse. C. Data for research projects. D. Areas of performance variation.
d
What is the term used for a job duty that is important to your company's operations, is performed frequently and cannot be assigned or performed in another way? A. Critical. B. Marginal. C. Mandatory. D. Essential.
d
What organization is responsible for the safety of medical devices and medications? A) FEMA B) OSHA C) CDC D) FDA
d
Which is not a Utilization Review A) Prospective Utilization Review B) Concurrent Utilization Review C) Retrospective Utilization Review D) CMS Utilization Review
d
Which is not a requirement for Healthcare financing under the ACA? A) Mandate to be covered B) Employers with 50 or more employees must offer insurance, an incentive is set for less than 25 C) Individuals with Pre-existing conditions cannot be denied D) Medicaid decreases the number of people who qualify E) States mandated to create HC exchanges so people can buy insurance
d
Which is not associated with Primary care? A) Point of Entry B) Coordination of Care C) Essential care D) Specialty Care
d
Which of the following is NOT a component of a good patient satisfaction program? A. Displaying cooperation, professionalism and pride in the job. B. Soliciting periodic feedback from patients. C. Showing respect and courtesy in every encounter. D. Personally acting on every survey response.
d
Which of the strategies listed below are applicable to networking? A. Delegating tasks whenever possible. B. Subscribing to trade publications. C. Periodic self assessments. D. Attending local, regional or national conferences.
d
Which one is not true, Tertiary care is: A) Highly technical B) Interdisciplinary C) Not in teaching hospitals D) None of the Above
d
You are the CEO of a healthcare organization, and a staff physicain has informed you that a nearby hospital is interested in transferring a program with some funds to your organization. He suggests you quickly seize the opportunity. What should you do in this situation? a. Convene a meeting of key medical and senior management from your organization to discuss the issue b. Request that the physician approach the medical staff at the other hospital to obtain additional information on the program c. Ascertain whether the medical director of the program that may be transferred is interested in moving to your hospital d. Find out from the hospital CEO whether the program in question is a candidate for transfer
d
