HSCC 440 Midterm Review

New policies create changes that are sometimes not apparently beneficial, so managers must learn to: a. Accept trade-offs b. Reject change c. Embrace siloed care d. Increase patient volume and raise prices e. Accept tight coupling

a. Accept trade-offs

Operational activities, business management functions, and clinical care are examples of: a. Conversion processes b. Inputs c. Core procedures d. Quality factors e. Management duties

a. Conversion processes

Which of the following is a principle of Total Quality Management? a. Customer focus b. Reduced error c. Better outcomes d. Aggressive process improvement e. Manage differently

a. Customer focus

As discussed in class, healthcare settings are sometimes inappropriate places for: a. Double-loop learning b. Double-loop strategizing c. Dynamic complexity d. Lean management e. Evaluative strategizing

a. Double-loop learning

Which of the following best describes quality assurance, as discussed in Module 1? a. Find and repair faulty processes causing defective outputs b. Understand and improve the system to achieve goals c. Manage differently using a customer focus d. Seek better ways to organize human actions and processes to eliminate waste e. Aggressive process improvement

a. Find and repair faulty processes causing defective outputs

An organization's purpose is described by: a. Its mission b. Donabedian's framework c. Its bylaws d. Its charter e. Its vision

a. Its mission

Select the term that best describes the status granted by a governmental body and confirming minimum standards: a. Licensure b. Accreditation c. Certification d. Confirmation e. Recognition

a. Licensure

Which of the following is not a management consideration related to systemic structure? a. Management theories are interdependent b. Systemic structure influences behavior c. Systemic structure is not readily visible d. Information is essential to identifying systemic structure e. Identifying systemic structure involves going 'below the water line'

a. Management theories are interdependent

Select the term that best describes the non-partisan organization that promotes quality patient care and transparency: a. National Quality Forum b. The Department of Health and Human Services c. The Centers for Disease Control and Prevention d. The U.S. Patient Care Consortium e. The Patient Care and Transparency Foundation

a. National Quality Forum

Which of the following is not part of the quality continuum as discussed in Module 1? a. Quality statistics b. Quality priorities c. Quality scope d. Quality transparency e. Performance measures

a. Quality statistics

Healthcare organizations tend to tightly coupled at the: a. Task level b. Unit level c. Community level d. Organization level e. Department level

a. Task level

Select the term that best describes the division of the Department of Health and Human Services that leads the National Quality Strategy: a. The Agency for Healthcare Research and Quality b. The Centers for Disease Control and Prevention c. The Office of the National Health Policy Strategy d. The Food and Drug Administration e. The National Health Service

a. The Agency for Healthcare Research and Quality

An organization at which point on the quality continuum features goals that are beginning to be defined? a. The early systemic approach b. The less-mature end c. The aligned approach d. The integrated approach e. The late systemic approach

a. The early systemic approach

An organization at which point on the quality continuum uses processes and measures that align with strategic and operational goals? a. The integrated approach b. The early systemic approach c. The aligned approach d. The less-mature end e. The late systemic approach

a. The integrated approach

Which of the four models discussed in chapter 5 states that patients are impacted by how each level of a health system interacts? a. The interconnected systems model b. The three core process model c. The Baldrige Performance Excellence Program framework d. The socioecological framework e. The continuous improvement model

a. The interconnected systems model

Effective goal-setting in complex systems involves all of the following except: a. Developing a provisional picture of partial goals b. Interfacing with outside teams as a function of boundary management c. Clarifying what needs to be done with partial goals d. Focusing on multiple elements of the issue e. Pursuing several goals at once

b. Interfacing with outside teams as a function of boundary management

In healthcare settings, quality efforts focus on: a. Managing outputs and conversion processes b. Managing inputs and conversion processes c. Managing conversion processes only d. Managing inputs only e. Managing outputs only

b. Managing inputs and conversion processes

Select the term that best describes the effect of an action being disproportionate to its cause: a. Dynamic complexity b. Nonlinearity c. Transactional synthesis d. Dynamism e. Allocative synthesis

b. Nonlinearity

An approach to solving problems that entails addressing the issues that the organization is familiar with rather than the ones that it needs to address is called: a. The Peter Principle b. Repair service behavior c. Misdirected problem-solving d. Organizational misalignment e. A convenience approach

b. Repair service behavior

The 'S' in SMART goals stands for: a. Superficial b. Specific c. Salacious d. Superfluous e. Spectacular

b. Specific

The interrelationships among key elements in a system and the influence of these interrelationships on a system's behavior over time is referred to as: a. Organizational structure b. Systemic structure c. Dynamic complexity d. Iceberg theory e. Industrial complexity

b. Systemic structure

Which of the following terms describes McLaughlin and Olsen's (2012) description of "a view of reality that emphasizes the relationships and interactions of each part of the system to all the other parts?" a. Nonlinearity b. Systems thinking c. Lean management d. Value-based care e. Tight coupling

b. Systems thinking

Challenging assumptions about the nature of a problem relates to: a. Donabedian's model b. The Purpose Principle c.The Peter Principle d. Cyclical change e. Crafting a vision statement

b. The Purpose Principle

As discussed in class, a deeply ingrained way of thinking that influences how a person sees the world and acts is referred to as: a. A learned behavior b. A systematic bias c. A mental model d. A psychological barrier e. A psychological model

c. A mental model

Which of the following describes "a patient safety event that affects a patient and results in death, permanent harm, or severe temporary harm and intervention required to sustain life" (Joint Commission 2016)? a. A decertification event b. An actionable offense c. A sentinel event d. A catastrophic event e. A forbidden event

c. A sentinel event

Select the term that best describes "a public recognition by a healthcare accreditation body of the achievement of accreditation standards by a healthcare organization, demonstrated through an independent external peer assessment of that organization's level of performance in relation to the standards" (Smits, Supachutikul, and Mate 2014, 66) a. Certification b. Commendation c. Accreditation d. Confirmation e. Licensure

c. Accreditation

Patient health is an example of: a. A conversion process b. An input c. An output d. A quality factor e. An administrative burden

c. An output

Clinical professionals who are promoted to management roles are examples of: a. Management experts b. Context experts c. Content experts d. Team players e. Modern leaders

c. Content experts

Organizational assumptions that guide how an organization defines itself refer to: a. Bylaws b. Culture c. Context d. Vision e. Dynamic complexity

c. Context

Beginning with outcomes and working backwards describes the best approach to: a. Dynamic complexity b. The Peter principle c. Designing interventions d. Managing adversity e. Quality-based care

c. Designing interventions

Considering the influence of interrelationships on a system's behavior over time is referred to as: a. Complex dynamism b. Interdependent management c. Going below the waterline d. Conducting a deep dive e. Searching for the waterline

c. Going below the waterline

Patients, personnel, supplies, equipment, and capital are examples of: a. Outputs b. Business expenses c. Inputs d. Conversion processes e. Core items

c. Inputs

An organization's ideal state is described by: a. Its leadership b. Its bylaws c. Its vision d. Its mission e. Its charter

c. Its vision

Select the term that best describes this definition: "the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge." a. Safety b. Efficiency c. Quality d. Best practice e. Value

c. Quality

As discussed in class, the mix of tight and loose coupling in a healthcare organization can result in: a. An efficient allocation of resources b. Continuous quality improvement c. Dynamic complexity d. Lean management e. A failure to anticipate errors

e. A failure to anticipate errors

Select the term that best describes a form of external quality review for health services professionals and organizations: a. Recognition b. Commendation c. Affirmation d. Licensure e. Certification

e. Certification

Which of the following accurately describes modern healthcare systems? a. Tightly coupled at the task and departmental levels b. Lacking in complexity c. Traditionally focused on value-based care d. Traditionally focused on maximizing effectiveness while minimizing costs e. Complex set of interdependent systems

e. Complex set of interdependent systems

Preparation for aspirational goals is achieved using: a. Mission-building b. Lean management c. Single-loop learning d. A convenience approach e. Intermediate goals

e. Intermediate goals

Which of the following is not a system boundary as described in chapter 6? a. Accountability b. Scope of the work c. Expectations d. Decision-making authority e. Mission statement

e. Mission statement

What kinds of history should a manager consider to understand systemic issues? a. Organizational, departmental, community, & individual b. Community, systemic, individual, & global c. Managerial, community, systemic, & global d. Organizational, managerial, community, & systemic e. Organizational, departmental, community, & systemic

e. Organizational, departmental, community, & systemic

Which of the following is not a key component of quality healthcare as discussed in Module 1? a. Safe b. Effective c. Equitable d. Patient-centered e. Patient-focused

e. Patient-focused

Which of the following best describes Lean/lean thinking, as discussed in Module 1? a. Fulfil process requirements b. Reduce deliberation time c. Understand and improve the system to achieve goals d. Manage differently using a customer focus e. Seek better ways to organize human actions and processes to eliminate waste

e. Seek better ways to organize human actions and processes to eliminate waste

Which of the following is a component of Donabedian's framework? a. Excellence b. Lean management c. Six Sigma d. Workflow e. Structure

e. Structure

Which of the following is not one of the four models describing systems thinking discussed in chapter 5? a. The interconnected systems model b. The three core process model c. The Baldrige Performance Excellence Program framework d. The socioecological framework e. The continuous improvement model

e. The continuous improvement model

Which of the four models discussed in chapter 5 includes a determinant, an intervention, an impact, and an outcome in its framework? a. The continuous improvement model b. The Baldrige Performance Excellence Program framework c. The three core process model d. The interconnected systems model e. The socioecological framework

e. The socioecological framework

The 'T' in SMART goals stands for: a. Time-bound b. Terminal c. Thorough d. Trivial e. Trite

a. Time-bound

Which of the following, as discussed in Module 1, describes the role of management in the shared responsibilities for quality? a. To enforce relevant labor laws b. To plan, control, and execute policies c. To reform the healthcare system d. To create and manage structured systems e. To develop efficient care processes

a. To enforce relevant labor laws

Select the term that best describes networks of shared responsibility for care coordination and service provision: a. MIPS b. Accountable Care Organizations c. Preferred Provider Organizations (PPOs) d. Accountable Health Networks e. Medicare Managed Care Networks

b. Accountable Care Organizations

Which of the following is a strategy used by managers to identify systemic issues below the waterline? a. Implementing novel incentives b. Being aware of mental models c. Changing communication styles d. Rewriting vision, mission, goals, and objectives e. Organizing team retreats

b. Being aware of mental models

Which of the following emphasizes team interactions, rather than individual ones? a. Dynamic management b. Boundary management c. Absolute management d. Upper-level management e. Lean management

b. Boundary management

Starting a change process by examining assumptions and identifying lessons is referred to as: a. Single-loop learning b. Double-loop learning c. Double-loop strategizing d. The single-loop fallacy e. Double-loop logic

b. Double-loop learning

A culture of history-dependency in the healthcare industry can complicate which one of the following? a. The transition to volume-based care b. The transition to value-based care c. The respect for tradition among providers d. Established hierarchies e. The licensure process

b. The transition to value-based care

Teams are often not positioned to effectively design interventions, as discussed in chapter 6, because: a. They aren't in alignment with management b. They aren't addressing the right issue c. They didn't read chapter 6 d. They haven't mastered the foundations of Lean/Six Sigma e. They haven't surveyed outside departments

b. They aren't addressing the right issue

Which if the four models discussed in chapter 5 discusses the importance of supporting employees in adapting to change? a. The socioecological framework b. The interconnected systems model c. The Baldrige Performance Excellence Program framework d. The continuous improvement model e. The three core process model

c. The Baldrige Performance Excellence Program framework

Select the term that best describes the project that guides efforts to improve healthcare quality with the goals of better health, better care, and more affordable care: a. The Affordable Care Act b. The Mission to Improve Health Outcomes c. The National Quality Strategy d. The National Healthcare Strategy e. The American Health Care Improvement Consortium

c. The National Quality Strategy

An organization at which point on the quality continuum addresses key strategies and organizational goals? a. The early systemic approach b. The late systemic approach c. The aligned approach d. The less-mature end e. The integrated approach

c. The aligned approach

Select the term that best describes the context in which changes to a system's parts have a prompt and major impact: a. Dynamic complexity b. Allocative synthesis c. Tight coupling d. Nonlinearity e. Dynamism

c. Tight coupling

Which of the following terms best describes the ratio of quality to cost? a. The quality-cost equation b. The new healthcare standard of excellence c. Value d. Access e. The Triple Aim

c. Value

Which of the following is one of the three core process categories of the three core process model? a. Continuous improvement b. Determinants c. Interventions d. Administrative e. Outcomes

d. Administrative

Which of the following best describes Six Sigma, as discussed in Module 1? a. Fulfil process requirements b. Understand and improve the system to achieve goals c. Seek better ways to organize human actions d. Aggressively improve processes and reduce variation to achieve zero defects e. Manage differently using a customer focus

d. Aggressively improve processes and reduce variation to achieve zero defects

An understanding of the continuum of patient care outside of one's department or organization is an example of: a. Continuous quality improvement b. Volume-based care c. Realizing the vision d. Boundary management e. Lean management

d. Boundary management

Which of the following is not an example of a quality management system in healthcare? a. Licensure b. Accreditation c. Research standards d. Data collection e. Performance appraisals

d. Data collection

Which of the following is not something that leads to ineffective goals as discussed in chapter 7? a. Inadequate preparation of or by the decision maker(s) b. Political pressure c. A flawed decision-making process d. Dynamic complexity e. Ignorance of legitimate alternatives

d. Dynamic complexity

Which of the following terms describes Senge's (2006) characterization of a context in which "cause and effect are subtle, and where the effects over time of interventions are not obvious?" a. Tight coupling b. Loose coupling c. Value-based care d. Dynamic complexity e. Nonlinearity

d. Dynamic complexity

Identifying issues above the waterline involves considering: a. Roles and events b. Roles and responsibilities c. Patterns and structures d. Events and patterns e. Events and structures

d. Events and patterns

Which term provides a likely reason, as discussed in class, for the resistance to change that is typical of healthcare organizations? a. Lean management b. Value-based care c. Loose coupling d. History dependency e. Irrational complexity

d. History dependency

The less-mature end of the quality continuum is characterized by which of the following? a. Dynamic complexity b. Systems thinking c. Weak mission statement d. Poorly defined goals e. Single-loop learning

d. Poorly defined goals

Select the term that best describes organizations that promote knowledge acquisition, transparency, & financial incentives: a. Licensure-granting bodies b. Accreditation firms c. State medical boards d. Quality oversight organizations e. Independent consulting bodies

d. Quality oversight organizations

Select the term that best describes this definition: "freedom from accidental or preventable injuries produced by medical care." a. Quality b. Assurance c. Accreditation d. Safety e. Excellence

d. Safety

Changing actions to get better outcomes without examining the assumptions that are driving the actions is referred to as: a. Double-loop learning b. Double-loop strategizing c. The single-loop fallacy d. Single-loop learning e. Triple-loop logic

d. Single-loop learning