Deck 12: Performance Management and Patient Safety

Question 1

The concept underlying lean thinking is

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

Answer 1

Value.

Question 2

Indirect measures of performance are referred to as

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

Answer 2

Indicators.

Question 3

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

Answer 3

A collaboration of large employers

Question 4

Benchmarking is a performance improvement technique based on

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

Question 5

Clinical practice guidelines are

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

Question 6

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

A) Six sigma
B) Brainstorming
C) Flowcharting
D) Prioritization

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

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 9

Which type of organization is not accredited by the National Committee for Quality Assurance (NCQA)?

A) Managed behavioral health care organization
B) Health maintenance organization
C) Ambulatory health care organization
D) Accountable care organization

Question 10

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 11

The purpose of using thresholds when applying performance measures is to

A) Identify "best" outcomes.
B) Trigger focused reviews.
C) Establish provider accountability.
D) Evaluate relevance of the measure.

Question 12

The six sigma approach was introduced by

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

Question 13

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

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

Question 14

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

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

Question 15

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 16

Performance assessment should occur

A) Before a Joint Commission survey.
B) When yearly strategic planning occurs.
C) At periodic intervals defined by the facility.
D) When service volume is higher than usual.

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) Palliative care

Question 18

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

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

Question 19

What does pay for performance mean?

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 20

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

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

Question 21

Structure measures of quality are dynamic indicators of organizational performance.

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

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

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

Question 24

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

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

Question 25

The National Practitioner Data Bank contains information about a physician's

A) Current health status.
B) Liability insurance coverage.
C) Incidents of adverse quality of care.
D) Education and training.

Question 26

Most problem-solving models begin with

A) Data collection.
B) Risk assessment.
C) Team formation.
D) An expected outcome.

Question 27

Which of the following is a primary data source for patient safety reports?

A) Utilization review documents
B) Master patient index
C) Credentials files
D) Incident reports

Question 28

In what Joint Commission requirement would you find accuracy of patient identification?

A) Infection prevention
B) Patient advocacy
C) Patient safety
D) Leadership

Question 29

Failure mode and effects analysis is a useful tool for

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

Question 30

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

A) Data capture is more efficient.
B) Random errors can be eliminated.
C) Bias is more easily detected.
D) Patterns of events or occurrences can be identified.

Question 31

Which of the following is a technique used to investigate an adverse event to understand why it happened?

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

Question 32

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

Question 33

The Baldrige National Quality Award was established by

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

Question 34

Rapid cycle improvement often involves

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

Question 35

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

Question 36

What is the denominator for the performance measure, "percentage of surgery patients who received prophylactic antibiotics within one hour of the surgery start time"?

A) Number of surgery patients who receive prophylactic antibiotics within 1 hour of the surgery start time
B) Number of surgery patients who did not receive prophylactic antibiotics within 1 hour of the surgery start time
C) Number of surgery patients for whom preoperative antibiotics were ordered
D) Number of surgery patients

Question 37

To achieve lasting performance improvements, managers should focus on

A) Training people in performance management skills.
B) Testing redesigned processes.
C) Keeping abreast on changing regulations and incentives having to do with performance improvement.
D) All of the above.

Question 38

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 39

Correlation is a statistical measure of

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

Question 40

A decision matrix is a useful tool for

A) Generating support for ideas.
B) Collecting data.
C) Setting priorities.
D) Quickly seeing data relationships.

Question 41

Utilization review can only be conducted by health plan employees.

Question 42

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

Question 43

A structure measure is direct measure of quality.

Question 44

When a physician reviews the health records of another physician, this is often called peer review.

Question 45

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

Question 46

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

Question 47

The role of HIM professionals in performance management and patient safety improvement is crucial to collect and analyze performance data.

Question 48

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

Question 49

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

Question 50

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