Deck 12: Performance Management and Patient Safety

Question 1

Performance assessment should occur:

A) After a sentinel event.
B) When cost overruns are identified.
C) At periodic intervals.
D) When volume is high.

Answer 1

At periodic intervals.

Question 2

Which agency sponsors the Healthcare Effectiveness Data and Information Set (HEDIS)?

A) National Commission for Quality Assurance
B) The Joint Commission
C) Centers for Medicare and Medicare Services
D) National Institutes of Health

Answer 2

National Commission for Quality Assurance

Question 3

Indirect measures of performance are referred to as:

A) Guidelines.
B) End results.
C) Advocacy.
D) Indicators.

Answer 3

Indicators.

Question 4

The underlying concept of lean thinking is:

A) Cost savings.
B) Improved quality.
C) Decreased errors.
D) Value.

Question 5

What technique is used to maximize the number of ideas for problem analysis and resolution?

A) Affinity
B) Brainstorming
C) Flowcharting
D) Cause and effect

Question 6

Which of the following is based on the Plan-Do-Check-Act (PDCA) model?

A) Six sigma
B) Affinity modeling
C) Rapid cycle improvement
D) Nominal group technique

Question 7

Efforts to ensure that current research is applied in medical decision making are termed:

A) Performance measuring.
B) Evidence-based medicine.
C) Pay for performance.
D) Patient advocacy.

Question 8

A stable measure that shows consistent results over time is said to be:

A) Efficient.
B) Sensitive.
C) Reliable.
D) Specific.

Question 9

What is the purpose of using thresholds in applying performance measures?

A) To identify "best" outcomes
B) To trigger focused review
C) To establish provider accountability
D) To evaluate relevance of the measure

Question 10

Pay for performance means:

A) Denial of payment when undesirable clinical outcomes occur
B) Negotiated payment for large scale providers
C) Sliding scale payment based on severity of illness in the target population
D) Financial rewards for providers who achieve specific quality goals

Question 11

Clinical practice guidelines are:

A) Statements of the "right" things to do for patients with a particular diagnosis.
B) Standards for managed care organizations.
C) Billing regulations for Medicare and Medicaid services.
D) Recommendations for providers negotiating professional fees.

Question 12

Benchmarking is a performance improvement techniques based on:

A) Comparison with other high performers.
B) Identification of key indicators.
C) Tracking sentinel events.
D) Continuous incremental improvement.

Question 13

Which of the following terms best defines the National Committee for Quality Assurance (NCQA)?

A) Federally funded
B) Private, not for profit
C) Proprietary
D) Community based

Question 14

The Plan-Do-Check-Act (PDCA) improvement model was popularized by:

A) Juran.
B) Motorola.
C) Ishikawa.
D) Shewhart.

Question 15

The six sigma approach was introduced by:

A) Honda.
B) Motorola.
C) Xerox.
D) Leapfrog Group.

Question 16

Which of the following best describes the Leapfrog Group?

A) A federal agency
B) A collaboration of large employers
C) A regulatory body
D) An accrediting body

Question 17

Which of the following is not one of the core measure areas for the Joint Commission?

A) Acute myocardial infarction
B) Heart failure
C) Community-acquired pneumonia
D) Fractured hip

Question 18

Which of the follow key dimension of health care quality refers to ensuring that services provided are based on scientific knowledge?

A) Effectiveness
B) Safety
C) Patient centered
D) Efficiency

Question 19

Organizations such as the National Quality Forum were established to:

A) Promote collaborative efforts to improve health care quality.
B) Decrease the cost of health care.
C) Provide oversight of health care facilities and individual providers.
D) Create a forum for health care consumers to interact with lawmakers.

Question 20

The Baldrige Award criteria:

A) Are similar to the Joint Commission criteria.
B) Must be met to qualify for Medicare funding.
C) Are based on categories of management disciplines.
D) Are applicable only to nonprofit entities.

Question 21

Accreditation refers to the credentialing process for an individual health professional.

Question 22

A second y axis is useful on a Pareto chart to plot:

A) Cumulative frequency.
B) Categories of events.
C) Relative rank of categories.
D) Reverse occurrence order.

Question 23

Structure measures of quality are dynamic indicators of organizational performance.

Question 24

The National Practitioner Data Bank contains information about:

A) Current health status.
B) Liability insurance coverage.
C) Adverse quality of care information.
D) Physicians' education and training.

Question 25

Two improvement tools that connect performance variables to outcomes a cause-and-effect diagram and:

A) Force field analysis.
B) Brainstorming.
C) Control chart.
D) Pareto chart.

Question 26

The mortality rate has been determined to be the most reliable clinical outcome measure.

Question 27

Accuracy of patient identification is a Joint Commission goal under:

A) Infection prevention.
B) Patient advocacy.
C) Patient safety.
D) Administrative responsibility.

Question 28

The Baldrige National Quality Award was established by:

A) The Joint Commission.
B) National Committee for Quality Assurance.
C) Congress.
D) Deming.

Question 29

Correlation is a statistical measure of:

A) Relationship significance.
B) Causal relationship.
C) Variable importance.
D) Relationship uniqueness.

Question 30

Which of the following is used to investigate an adverse event to understand the causes of occurrence?

A) Root cause analysis
B) Force field analysis
C) Rapid cycle analysis
D) Pareto analysis

Question 31

Which hospital department often is responsible for monitoring patient incident data?

A) Social services
B) Patient accounting
C) Infection control
D) Risk management

Question 32

Failure mode and effects analysis is a useful tool for:

A) Cost analysis
B) Clinical practice management
C) Risk analysis
D) Lean thinking

Question 33

Which of the following is a primary benefit of analyzing aggregate data?

A) Efficient data capture
B) Elimination of random error
C) Sentinel events are easily identifiable.
D) Detection of patterns of events or occurrences

Question 34

Rapid cycle improvement often involves:

A) Incremental implementation rollout.
B) Pilot testing.
C) Redundant testing.
D) Large process changes.

Question 35

Which of the following could be a significant primary data source for patient safety reports?

A) Utilization review documents
B) Flow charts
C) Credentials files
D) Incident reports

Question 36

Identifying potentially compensable events is one step in:

A) Establishing clinical practice guidelines.
B) Financial planning to meet legal obligations.
C) Managing patient length of stay.
D) Negotiating managed care contracts.

Question 37

A matrix is a useful tool for:

A) Idea generation.
B) Data collection.
C) Data reduction.
D) Quick visualization of data relationships.

Question 38

Most problem-solving models begin with:

A) Data collection.
B) Root cause analysis.
C) A sentinel event.
D) An expected outcome.

Question 39

An adverse patient event is synonymous with a potentially compensable event.

Question 40

Which of the following is the best example of a performance measure?

A) Ninety-five percent of all cardiovascular surgery patients will receive prophylactic antibiotics within 1 hour before incision.
B) All surgery patients should receive prophylactic antibiotics within 24 hours.
C) Surgeons must order prophylactic antibiotics the day before surgery.
D) Prophylactic antibiotics must be maintained in the surgical waiting area for administration before surgery.

Question 41

Lean thinking is more about cost containment than about customer focus.

Question 42

Failure mode and effects analysis (FMEA) is a relatively inexpensive approach to problem solving.

Question 43

Utilization review can only be conducted by health plan employees.

Question 44

A highly reliable measure will identify a large number of random errors.

Question 45

The "best" process solutions often are the quickest fixes, those that can be implemented in a short time period.

Question 46

The purpose of credentialing is to assign physicians to a unit of the medical staff organization.