HIM 3380 Exam 2 Chapter 7-12 Q&A

Name four core processes involved in the care of, treatment of, and services to patients:

1 - Assessing the patient's needs 2 - Planning care, treatment, and services 3 - Providing care, treatment, and services 4 - Coordinating care, treatment, and services

Identify the 5 essential steps in Robust Process Improvement as defined by the Joint Commission

1. Specifying the improvement target that requires participants to narrow the issue to its core impacts on patient care and safety. 2. Measuring the size of the problem with current data, identifying the absolute frequency of occurrence over recent periods of time, and remembering that these issues are often so risk-intensive that even one occurrence is unacceptable. 3. Identifying the specific causes for the occurrence from all vantage points: leadership, personnel policy, standardized procedures, information systems, and technology, communication pathways, management and supervision philosophies and processes, teamwork and coordination, staffing patterns and levels, equipment, care environment, and individuals. 4. Targeting interventions to the most important, modifiable cause. 5. Embedding interventions into routine work processes.

A high-performing and organized system of care and financing that can provide the full continuum of care to a specific population over an event, episode, or a lifetime while assuming accountability for clinical and financial outcomes is called _____. A. ACO B. HMO C. PPO D. CAH

A. ACO

Which committee has a leadership role in the organization ?s medication safety efforts and consists of pharmacists, physicians, nurses, hospital administrators, and other healthcare professionals? A. P and T Committee B. Ethics Committee C. Risk Management Committee D. Procedure Review Committee

A. P and T committee

[[Quiz #5]] The core care process that determines the patient ?s appropriateness for admission to the facility and the level of care and service to be rendered is called _____. A. assessing the patient's needs B. planning care, treatment, and services C. providing care, treatment, and services D. coordinating care, treatment, and services

A. assessing the patient's needs

Which of the following techniques, used in unstructured interviews, helps the interviewer establish trust with the respondent and address the pertinent quality issues by moving questions from a broad theme to a narrow theme? A. funneling B. skewing C. nominal group D. brainstorming

A. funneling

When developing a survey the use of structured questions to limit the number of possible responses helps to: A. standardize the data collected B. generate more responses C. elicit more information D. maximize the number of write-in responses

A. standardize the data collected

True or false? Many organizations treat near misses in the same way that they treat sentinel events, using error-reduction tools such as root-cause analysis or failure mode and effects analysis in an effort to prevent future occurrences. A. True B. False

A. true

In this type of interview, a predetermined list of questions is used: A. structured interview B. unstructured interview C. planned interview D. unplanned interview

Answer Key: A Feedback: structured interview

The level at which an organization can provide an offered product or service when requested and as advertised is called _____. A. responsiveness B. reliability C. assurance D. empathy

Answer Key: B Feedback: reliability

The health information professional is a customer of the admitting department. What type of customer is the health information professional? A. external customer B. experienced customer C. internal customer D. investment customer

Answer Key: C Feedback: internal customer

[[Quiz#3]] Healthcare customers expect that staff and providers will understand their emotional reactions to their illness and will help them cope with their circumstances. This is an example of _____. A. responsiveness B. perceived quality C. empathy D. assurance

Answer Key: C Feedback: empathy

The organizations reputation for the quality of its services and consumer reaction to these services and products based on their experiences with the organization is called _____. A. reliability B. assurance C. features D. perceived quality

Answer Key: D Feedback: perceived quality

In this case management step, the case manager confirms that the patient meets criteria for the care setting and that the services can be provided at the facility: A. preadmission care planning B. care planning at the time of admission C. review the progress of care D. discharge planning

B. care planning at the time of admission

The chain of custody of a drug as it moves through the supply chain from manufacturer to pharmacy is called _____. A. diversion B. drug pedigree C. generic drug D. patent

B. drug pedigree

Large population based studies are used to identify the care processes or interventions that achieve the best healthcare outcomes in different types of medical practice. This research concept is called _____. A. clinical pathway B. evidence-based medicine C. patient centered care D. morbidity indicators

B. evidence-based medicine

A patient was taken into surgery at a local hospital for treatment of colon cancer. A large section of the colon was removed during surgery and the patient was taken to the medical floor after surgery. Within the first 24 hours post-op, the patient developed fever, chills, and abdominal pain. An abdominal CT scan revealed the presence of a foreign body. This situation describes a _____. A. near miss B. sentinel event C. security incident D. time out

B. sentinel event

A patient is transferred from the critical access hospital (CAH) to the university medical center. The CAH sent a list of her current medications with the transfer documents. This list is then compared to the physician ?s admitting orders at the university hospital for consistency in order to provide continuity of care. This process is called _____. A. drug formulary evaluation B. medication administration C. drug diversion D. medication reconciliation

D. medication reconciliation

When the customer (patient) has judged that the healthcare worker is continuously monitoring both the customer ?s condition and his or her satisfaction with services, what aspect of quality of care or meeting the customer's requirements is being met? A. assurance B. empathy C. reliability D. responsiveness

D. responsiveness

Signs, symptoms, or conditions suffered by a patient as the result of the administration of an incompatible blood products is called _____. A. blood verification B. core measure C. comorbidity D. transfusion reaction

D. transfusion reaction

Which of the following is an integral component of case management that helps to improve patient outcomes, lower healthcare spending, while still providing appropriate care to patients at the appropriate time? A. clinical practice standards B. continuum of care review C. value-based purchasing D. utilization review

D. utilization review

True or false? One of the key aspects of the federal government ?s initiatives to advance the use of health information technologies was to provide greater emphasis on patient-centered care. A. True B. False

True

True or false? Proper handwashing has been identified by the CDC as one of the single most important methods for preventing the spread of infection. A. True B. False

True

A person who represents the rights and interests of another individual as though they were the person's own is referred to as a patient a. Advocate b. Friend c. Advisor d. Manager

a. Advocate

Which of the following represents a list of potential blood-borne pathogens? A. HIV and hepatitis B B. Colorado tick fever and pertussis C. mumps and HIV D. Hepatitis B and pertussis

a. HIV and hepatitis B

This process icon symbol (a blank box) is used in flowingchart to indicate... a. A process when actions are being performed by humans b. a point in the process at which participants must evaluate the status of the process c. formal procedures that participants are expected to carry out the same way every time d. a point in the process where the participants must record data in paper-based or computer-based formats

a. a process when actions are being performed by humans

Inappropriate timing of dose, transcription errors, missed doses, and extra doses given are all examples of this type of medication error _____. A. administration B. pharmacy C. discharge D. prescribing

a. administration

A patient injury resulting from a medication, either because of a pharmacological reaction to a normal dose or because of a preventable adverse reaction to a drug resulting from an error, is called.... a. Adverse drug event b. Adverse pharmacological c. Drug error d. Medication error

a. adverse drug event

A patent for a new drug gives its manufacturer an exclusive right to market the drug for a specific period of time under what type of name? a. Brand b. Generic c. Specific d. Patent

a. brand

The established criteria against which the decisions and actions of healthcare practitioners and other representatives of healthcare organizations are assessed in accordance with state and federal laws, regulations, and guidelines are called _____. A. clinical practice standards B. clinical guidelines C. clinical pathways D. clinical standards

a. clinical practice

A multidisciplinary outline of anticipated care within an appropriate time frame to aid a patient in moving progressively through a clinical experience that ends in a positive outcome is called a _____. A. critical pathway B. care plan C. care assessment D. continuum of care pathway

a. critical pathways

This technique promotes systems thinking and includes the use of flowcharts to define high-risk processes. A. failure mode and effect analysis B. root cause analysis C. cause and effect diagram D. incident report.

a. failure mode and effect analysis

This survey was developed and initiated to provide a consistent format and process for gathering patient satisfaction and perspectives on hospital care: a. HCAHPS b. Compulsory reviews c. SWOT analysis d. Meaningful Use

a. hcahps

An infection defined as occurring in a patient in a hospital or healthcare setting in whom it was not present or incubating at the time of the admission is... a. Healthcare associated infection b. Hospital sickness c. Community-acquired infection d. Community sickness

a. healthcare associated infection

A performance measure that enables healthcare organization to monitor a process to determine whether it is meeting process requirements is called a/an: a. Indicator b. Data measure c. Indication d. System measure

a. indicator

[[Quiz #4]] A patient presents to the emergency room acutely dehydrated and is admitted to the hospital for IV therapy to rehydrate the patient. Which admission criteria would be used to justify admitting this patient as an inpatient? A. intensity of service B. indicator C. severity of illness D. standard of care

a. intensity of service

This section of a cause and effect diagram examines influences of the human worker on the situation: A. manpower B. material C. methods D. machinery

a. manpower

Occurrences involving liability for injury or property loss are called _____. A. potentially compensable events B. risk management C. risk occurrences D. potentially harmful occurrences

a. potentially compensable events

When the patient's physician contracts a healthcare organization to schedule an episode-of-care, the healthcare organization begins which step in the case management process? a. Pre-admission care planning b. Care planning at the time of admission c. Review the progress of care d. Discharged planning

a. pre-admission care planning

an established set of clinical decisions and actions taken by clinicians and other representatives of healthcare organizations in accordance with state and federal laws, regulations, and guidelines is called a. standards of care b. clinical practice standards c. clinical pathways d. standard guidelines

a. standards of care

a research instrument that is used to gather data and information from respondent students in a uniform manner through the administration of a predefined and structured set of questions and possible responses is called? a. survey b. interview c. process measure d. QI box

a. survey

True or false? A patient can bring their own and take their own medications to the hospital during a hospitalization. A. True B. False

a. true

True or false? The five rights of medication administration include: right patient, right drug, right dose, right route, and right time. A. True B. False

a. true

The investigation technique that facilitates the identification of the various factors that contribute to a problem known as a fishbone diagram is also called a/an... a. Pareto chart b. cause-and-effect diagram c. flowchart d. affinity diagram

b. cause-and-effect diagram

The descriptions of medical interventions for specific diagnoses in which treatment regimens and the patients' progress are evaluated on the basis of nationally accepted standards of care for each diagnosis is called... a. Clinical practical standards b. Clinical guidelines c. Clinical pathways d. Clinical standards

b. clinical guidelines

The totality of healthcare services provided to a patient and his family in all settings, from the least extensive to the most extensive, is called a. Episode of care b. Continuum of care c. Services of care d. Settings of care

b. continuum of care

The list of drugs approved for use in the healthcare organization is generally referred to as the... a. Drug list b. Formulary c. Med Sheet d. Brand list

b. formulary

Once a patent for a brand drug expires, other manufacturers may copy the drug and release it under its pharmaceutical or _____. A. specific name B. generic name C. patent name D. brand name

b. generic name

In this type of interview the sequence of questions is not planned in advance and it is conducted in a friendly, conversational manner. a. structured interview b. unstructured interview c. planned interview d. unplanned interview

b. unstructured interview

Bacterial of any kind that has become resistant to many different antibiotics is called _____. A. CLIA B. NPSGs C. MDROs D. SARS

c. MDROs

The risk manager's principal tool for capturing the facts about potentially compensable events is the... a. Accident report b. RM report c. Occurrence report d. Event report

c. Occurrence report

The principal process by which organizations optimize the continuum of care for their patients is _____. A. utilization management B. services management C. case management D. resource management

c. case management

A graphic tool used to communicate established standards of patient care for specific diagnoses is called... a. Clinical practical standards b. Clinical guidelines c. Clinical pathways d. Clinical standards

c. clinical pathways

An infection that was present in the patient before he or she was admitted to the facility is called _____. A. healthcare-acquired infection B. hospital sickness C. community-acquired infection D. community sickness

c. community-acquired infection

[[Quiz #7]] A Joint Commission accredited organization must review their formulary annually to ensure a medication's continued _____. A. safety and dose B. efficiency and efficacy C. efficacy and safety D. dose and efficienc

c. efficacy and safety

This QI Toolbox Technique allows a PI team to examine the process under investigation from all directions: a. Cause-and-effect diagram b. Affinity diagram c. Flow chart d. Critical pathway

c. flow chart

Which of following report-able diseases require telephone reporting as opposed to other methods of reporting? a. Chickenpox b. influenza c. Measles d. Pertussis

c. measles

This record is used in the healthcare organization to document each dose of medication that is given to the patient during their hospitalization. A. occurrence report B. incident report C. medication administration record D. drug formulary record

c. medication administation record

Follow-up on a patient after discharge to ensure that the transition has gone smoothly and that the patient is receiving all of the services required is considered this case management step: A. care planning at the time of admission B. review the progress of care C. postdischarge planning D. discharge planning

c. post-discharge planning

A hospital advertises that patients visiting its emergency department will receive care within 15 minutes. If the organization meets this goal at the time a patient shows up for emergency services, what aspect of quality of care or meeting the customer requirement is being met? a. Assurance b. Empathy c. Reliability d. Responsiveness

c. reliability

During a hospitalization the case manager is concerned that Sam ?s intensity of service is not meeting the criteria for continued hospitalization. The case manager speaks to Sam ?s physician who updates the patient ?s care plan to reflect the high level care being provided to the patient. Which part of the case management process is being performed? A. preadmission care planning B. care planning at the time of admission C. review the progress of care D. discharge planning

c. review the progress

Analysis of a sentinel event from all aspects to identify how each contributed to the occurrence of the event and to develop new systems that will prevent recurrence is called _____. A. flowcharting B. statistical analysis C. root-cause analysis D. nominal group technique

c. root-cause analysis

If a patient comes into the emergency room with left-sided hemiparesis that started within the last three hours, which admission criterion would be used to justify admitting this patient as an inpatient? A. intensity of service B. indicator C. severity of illness D. standard of care

c. severity of illness

The use of infection prevention and control measures to protect against possible exposure to infectious agents is called.... a. infectious deterrents b Standards measures c. Standards precautions d. infectious measures

c. standard precautions

In this case management step, the case management plans continued care after the healthcare facility services end: a. Preadmission care planning b. Care planning at the time of admission c. Review the progress of care d. Discharged planning

d. discharged planning

[[Quiz #6]] A family member of a patient is walking through the hall in the hospital and slips and falls on a recently mopped floor. A nurse on the floor observes the fall and helps the family member. This nurse should report this event to the risk manager using which of the following? A. failure mode and effect analysis B. root cause analysis C. cause and effect diagram D. incident report

d. incident report

CLIA and the CDC have established protocols for _____. A. core measures B. surgery protocols C. emergency departments D. laboratory departments

d. laboratory departments

This section of a cause and effect diagram examines influences of major pieces of equipment on the situation. A. manpower B. material C. methods D. machinery

d. machinery

Events that occur in a healthcare organization that do not necessarily affect an outcome but carry significant chance of being a serious adverse event if they were to recur are called... a. Time-out b. Serious event c. Sentinel evens d. Near misses

d. near misses

A movement in healthcare reimbursement where providers are rewarded for meeting pre-established targets for delivery of healthcare services that improved quality and efficiency is called... a. Meaningful use b. Core measures c. Clinical practice standards d. Pay for performance

d. pay for performance

Caitlin's physician suspects that she has cholecystitis and has ordered a gallbladder ultrasound to be performed. The staff at the physician office contacts Caitlin ?s third-party payer to determine benefits and coverage for this procedure prior to scheduling the cholecystectomy. What is this process is called? A. utilization management B. explanation of benefits C. payment adjudication D. preauthorization

d. pre-authorization

Inappropriate dose, nonformulary agent, and medication errors to transfer are all examples of this type of medication error. a. Administration b. Pharmacy c. Discharge d. Prescribing

d. prescribing

In risk management terminology, an exposure to the chance of injury or financial loss and their associated liability is _____. A. incident B. occurrence C. rights D. risk

d. risk

What organization was formed in the late 1980s to address the lack of uniform standards for utilization review services by promoting quality and accountability of healthcare organizations through accreditation, education, and measurement programs? a. The Joint Commission b. CMS c. NCQA d. URAC

d. urac

True or false? Internal customers are individuals from outside the organization who receive products or services from within the organization. A. True B. False

false

True or false? Occurrence reports are generally open to view by the plaintiff ?s attorney in a malpractice suit. A. True B. False

false

True or false? Organizational leadership does not use indicators to identify cases in which a patient did not receive the best care. Indicators are not helpful in monitoring care processes. A. True B. False

false

Dr. Jones is filling for board certification in gastroenterology and has requested a report of all of the endoscopic procedures she performed last year from the manager of the health information management (HIM) department Is Dr. Jones considered a customer of the HIM department? If so, is she an internal or external customer? Explain your reasoning.

internal customers - individuals within the organization who receive products or services from an organizational unit or department i.e. surgeons w/ pathology, emergency care physicians w/ supply services

True or false? The customer is the receiver of a product or service as a result of an organizational process. A. True B. False

true