Exam 2 quiz questions
Financial penalties and rewards in the contemporary payment system are designed to
provide incentives for providers to improve quality.
The two-bin system is used to
signal a need to order when one bin is full.
Which of the following is the most important reason to create a process map?
It provides a visual representation of a process that can be used to identify opportunities to make improvements.
The relationship between the arrival rate to a system, the time a patient spends in the system, and the number of items in a system is known as what?
Little's law
Tiffany worked with the radiologists to develop a new system to improve equipment utilization. In this new system, the instruments needed for an interventional procedure are organized outside of the interventional suite and prior to the procedure. What Lean tool is Tiffany using?
SMED
Tom Stinson is the COO of Memorial Hospital. He is receiving complaints about waiting times in the emergency department. What services other than emergency should be a priority for analysis?
Scheduled surgery
Jose is checking his laboratory equipment using test control samples that are designed to give the same results and are used to calibrate the equipment. When he runs 100 samples ,he gets two results that are greater than 3 standard errors of the mean. These results are called what?
Special variation
Tiffany wants to continue to make improvements in the imaging department and organized a kaizen event. What will be her first step?
Specify value to the patient
Tiffany works with radiologists in her department to develop a protocol that will to be used to sterilize each instrument used in a procedure in exactly the same manner. What Lean tool is she using?
Standard work
Julie enters the storeroom to get a special syringe for her patients, but none of the syringes are there. This is an example of what?
Stock out
What is throughput time?
The average time a unit spends in the process
The ABC classification system is used in inventory management to
divide inventory into three categories based on cost and then focus management on the most costly group.
The most accurate way to determine current inventory is to
do a physical inventory count.
The demand for chest X-rays is 4 per hour. It takes 12 minutes to take a chest X-ray. What is the takt time?
15 minutes
What variables are measured in the measurement phase of a Six Sigma project?
Process input, process output, critical to quality
A system can be subdivided into what elements?
Processes, subprocesses, and tasks
John is forecasting daily demand for laundry in the emergency department. He has very limited historical data. What forecasting method should he use?
Exponential smoothing
Jose is measuring the time it takes a technician to do a new test. He expects the test to take no more than 5 minutes and no less than 3 minutes. After observing a number of tests, he calculates the standard deviation of the test as 0.3 minutes. What is the process capability of the test?
1.1
The Memorial Hospital emergency department averages 30 patients in their department at any one time, and 20 patients arrive per hour. What is the average throughput time for each patient?
1.5 hours
The term "Six Sigma" represents what goal?
3.4 defects per million opportunities
A patient enters the MRI scanning suite at 1:00 pm and leaves at 3:30 pm. The MRI test takes 50 minutes. What is the percentage of value-added time?
33 percent
For CT scanning, the check-in process takes 3 minutes, the patient waits for 15 minutes, the patient then moves to the scanner (2 minutes), the scan takes 9 minutes, the patient is moved to the waiting room (2 minutes), and the patient then waits 20 minutes to be picked up. What it the throughput time?
51 minutes
Tiffany decides she can improve operations in her department by sorting, labeling, and cleaning the storage area. What Lean tool is she using?
5S
Jose has a new test that has three steps. He calculates that in each step some of the sample must be discarded. Step 1 has a discard rate of 2 percent, step 2 has a discard rate of 5 percent, and step 3 has a discard rate of 1 percent. How much of the sample is available after step 3?
86.5 percent
Which of the following is a good approach to cost reduction?
A systemic analysis of costs followed by targeted improvements
What are the steps of the PDCA cycle?
Plan, do, check, act to hold the gains
When prioritizing activities for overhead cost reduction, one should consider which of the following?
Activity cost vs. its importance to operations
Tiffany institutes as new system that indicates the status of the CT scanning suite with a series of lights. Green means the suite is available, yellow means the suite will be available in 3 minutes, and red means the suite is in use. What Lean tool is Tiffany using?
Andon
Jose is the supervisor of the laboratory. One of his testing machines seems to be giving different results for the same sample. To make sure he is delivering correct results, Jose uses a second machine to check the results of the first. This action represents which cost of quality type?
Appraisal
Which of the following is true when using the EOQ model?
As holding costs increase, the optimal order quantity decreases.
Which of the following is not an important cost management approach for an organization taking full capitation risk? A) Shared decision making for surgery based on EBM finding B) High patient copays and deductibles C) Implementation of healthcare homes D) Systems to prevent readmissions of patients that use EBM and optimized processes
B) High patient copays and deductibles
Which of the following activities will not result in a significant increase in revenue? A) Providing real-time feedback to clinicians about the effect on reimbursement based on care choices (e.g., medication choice) B) Measuring revenue per billing employee and replacing the lowest performers every quarter C) Using exception-based workflow, in which processes are mapped and automated and only exceptions are handled by staff D) Providing real-time information to claims processors through data warehouses
B) Measuring revenue per billing employee and replacing the lowest performers every quarter
Which of the following is not a method of bundling payments? A) Payment per hospital discharge B) Payment for a clinical service (e.g., CT scan) C) Payment for an episode of care D) Per diem
B) Payment for a clinical service (e.g., CT scan)
Which of the following approaches is not an effective means to reduce the cost of overhead? A) Implementing process improvement on all routine overhead processes (e.g., hiring new employees) B) Reducing executive salaries C) Reducing staffing layers D) Consolidating activities (e.g., memberships)
B) Reducing executive salaries
Which of the following is not a current trend in vendor supply chain relationships?
Bidding strictly on cost
Which of the following is not a major factor in the increasing costs of healthcare in the United States? A) Increasing incidence of chronic disease and an aging population B) New diagnostic and treatment technologies C) Malpractice costs D) A provider payment system (fee-for-service) that encourages the use of healthcare services
C) Malpractice costs
Which assumption is not part of the basic EOQ model? A) Demand is known and constant. B) Lead time is known and constant. C) Demand for the item in question is independent. D) Back orders and stock outs are allowed
D) Back orders and stock outs are allowed
Which of the following is not an effective cost reduction tool for a cost reduction project? A) Supply chain management B) Schedule optimization C) Process improvement including Lean and Six Sigma D) Finding ineffective employees and reassigning them
D) Finding ineffective employees and reassigning them
Which of the following is not a true statement about Lean and Six Sigma? A) Lean's focus is on reducing waste; Six Sigma's is on reducing defects. B) Lean and Six Sigma tools can both be used in process improvement projects. C) Lean tools are currently more widely used in healthcare applications. D) Lean and Six Sigma projects require the use of special software.
D) Lean and Six Sigma projects require the use of special software.
What is the correct project cycle for a Six Sigma project?
Define, measure, analyze, improve, control
What is the theory that provides optimal levels of stock on hand, order levels, and order frequency?
Economic order quantity
What is the primary goal of Lean?
Eliminate waste
Which is the smallest level of cost that should be analyzed when beginning a cost reduction project?
Fee-for-service
Which tool is not part of the analyze phase of a Six Sigma project?
Gantt chart
The use of all the cost management tools contained in this book will have the largest financial impact for which type of payment?
Global budget
Which of the following goals is not part of inventory management?
Having a variety of clinical devices available for physicians
Radiology technologists in Tiffany's department have specialized their work to a specific class of procedures. To improve the flow of patients in the department, she has instituted a series of in-service educational classes to improve the ability of all of her staff to do all of the procedures. What Lean tool is she using?
Heijunka (load balancing)
What approach should you use to identify bundled payments that are a priority for cost management?
Identify bundles with high volume, high cost compared with benchmarks from other organizations, and high use in bundled payments where costs are highly variable.
Once a cost reduction project is chartered, what should be the first step?
Identify key cost drivers and collect cost data related to each fee for service.
Which of the following are included in the five steps of the activity-based costing process?
Identify relevant activities, determine cost drivers, calculate total cost of service
To improve the flow of a process, what two key strategies should be employed?
Increase the speed, and decrease the variability of the process.
What are the most important data to track for a shared savings (ACO) program?
Individual patient costs over time
Susan Collins is the director of Memorial Hospital's emergency department. She has redefined the triage nurses' role to expand the number of tasks they can perform so that they can assist other staff. Which of the following describes what Susan is doing?
Load balancing
Susan has increased staffing levels on some evenings (e.g., first of the month, paydays) to reduce patient waiting time. This is an example of what?
Matching capacity to demand
Which of the following is a metric to measure the accuracy of your forecast?
Mean absolute deviation
Tiffany is the day shift supervisor in the imaging department. She has redesigned the patient intake system so that patients are only asked their name and birthdate once. The old system asked the patient this information three times. What type of waste did Tiffany reduce?
Overprocessing
What is supply chain management?
The management of all activities and processes related to both upstream vendors and downstream customers in the value chain; Tracking and managing demand, inventory, and delivery; Procurement and vendor relationship management
What is the capacity of a process?
The maximum possible output (goods or services) that a process or resource can produce or transform
What is the purpose of MedPAC?
To advise Congress on payment rates and methods for Medicare
John is the emergency department manager, and he wants to order supplies for his growing department. He knows his ED patient demand is stronger in the summer than in any other season. What forecasting method(s) should he use?
Trend and seasonal
Which of the following is not a common theme found in successful Six Sigma programs?
Use of Taguchi methods
Tom is watching a football game he prerecorded, and he is fast-forwarding to only watch the plays. What is he doing?
Using only the value-added time
Jose, the lab manager, wants to improve the quality in his laboratory with a Six Sigma program. He wants Sandy, his chemistry supervisor, to attend a Six Sigma training program so that she can oversee all Six Sigma projects that will occur in the lab. Sandy will be trained as a ______________.
black belt
Material requirements planning and enterprise resources planning systems are used for
synchronizing materials and supply availability with forecasted demand.