Question 1

Refer to the table Summary of Selected Blood Product Review. What percent of the fresh frozen plasma units met indications?

Accepted Answer

According to the table, 191 out of 797 fresh frozen plasma units met indications, which is approximately 24%.

Question 2

A surgeon left a clamp in a patient, resulting in a return to the operating room. In an integrated organizational quality management model, all of the following entities would receive data about the investigation EXCEPT the

Accepted Answer

In an integrated organizational quality management model, all of the following entities would receive data about the investigation EXCEPT the Pharmacy and Therapeutics Committee. This committee is not involved in the investigation or management of medical errors or adverse events. Instead, its responsibilities include selecting and evaluating medications and making recommendations for formulary management. The Tissue Committee, Credentials Committee, and Risk Management Program, on the other hand, all play important roles in incident reporting, investigation, and quality improvement.

Question 3

The primary advantage of concurrent quality data collection is that

Accepted Answer

The answer of The primary advantage of concurrent quality data...

Question 4

Continuous quality improvement is best described by the following statements EXCEPT:

Accepted Answer

Continuous quality improvement is a process designed to improve processes, systems, and outcomes rather than solely targeting clinicians for corrective action. The other statements (B, C, and D) accurately describe continuous quality improvement.

Question 5

Case study #6 You are helping the Nursing Department to write indicators, to determine appropriate formulas ratios and to determine data collection time frames. One important aspect of care is documentation of education of patients. More specifically, the nursing department would like assess its documentation of education on colostomy care for patients with new colostomies. Referring to Case Study #6, what would be the most cost-effective and appropriate collection time frame?

Accepted Answer

Retrospective data collection is often more cost-effective as it involves reviewing existing records rather than collecting new data in real-time. This method allows for a comprehensive analysis of past documentation practices without the need for additional resources required for prospective or concurrent data collection.

Question 6

Case Study #5 Upon employment at your facility, all new employees read, demonstrate understanding, and sign Confidentiality Statements. Disclosure of confidential information is grounds for immediate dismissal. Each year, during the annual performance evaluation, every employee again reads, demonstrates understanding, and signs the Confidentiality Statement. You are the Director of the Quality Department. Your Department has found that the femoral-popliteal bypass failure rate of one of your vascular surgeons, Dr. Z., is twice that of the national average. Members of the surgery department have reviewed that vascular surgeon's performance both by reading the medical records and by watching videos of her surgery. The Surgery Department and the Executive Committee have decided to deny reappointment for this surgeon. Lucille X, the mother of one of your quality coordinators, has severe peripheral vascular disease. She was admitted to your facility and has an angiogram. The angiogram shows that she should have a femoral-popliteal bypass. She had told you that she would be in your facility and asked you to visit her. You are now fulfilling that promise and are also bringing her flowers. While pausing to knock on her door, you hear your employee, Mary G., vehemently state to her mother, "Mom, Dr. Z is z quack; half of her bypass surgeries fail. You must have Dr. DoGood!" Referring to Case Study #5, what do you do as Director of the Quality Department?

Accepted Answer

The answer of Case Study #5 Upon employment at your...

Question 7

An indicator about the placement and number of fire extinguishers would be which type?

Accepted Answer

The placement and number of fire extinguishers is a structural indicator, as it pertains to the physical aspects of the environment and resources available.

Question 8

Which of the following is a disadvantage of retrospective data collection?

Accepted Answer

Retrospective data collection relies on existing documentation, which may be incomplete or inaccurate, leading to deficiencies in documentation that can affect reimbursement. The other options are advantages of retrospective data collection.

Question 9

If administrators of a home health agency wanted to measure the outcomes of adult pati receiving their agency's services, which tool would they use?

Accepted Answer

OASIS (Outcome and Assessment Information Set) is a tool designed specifically for home health agencies to measure patient outcomes. It assesses many areas of a patient's health status, including their functional abilities, and is used to develop a personalized care plan. HEDIS (Healthcare Effectiveness Data and Information Set) is a tool used to measure the quality of care provided by health plans and is not specific to home health agencies. ORYX and QAI (Quality Assessment and Performance Improvement) are general quality improvement frameworks that can be used by any healthcare organization, but they do not provide specific measures for patient outcomes in home health settings.

Question 10

You are determining the sample size for a quality study. Which of the following factors should you consider first?

Accepted Answer

The size of the target population is the most important factor to consider when determining the sample size for a quality study. This will ensure that the sample is representative of the population and that conclusions drawn from the study can be generalized to the population as a whole. Cost, personnel, and confidentiality should also be considered, but they are secondary factors that can be adjusted based on the size of the target population.

Question 11

Refer to the table Summary of Selected Blood Product Review. Which blood component derivative had the most units reviewed?

Accepted Answer

The answer of Refer to the table Summary of Selected...

Question 12

Case Study #5 Upon employment at your facility, all new employees read, demonstrate understanding, and sign Confidentiality Statements. Disclosure of confidential information is grounds for immediate dismissal. Each year, during the annual performance evaluation, every employee again reads, demonstrates understanding, and signs the Confidentiality Statement. You are the Director of the Quality Department. Your Department has found that the femoral-popliteal bypass failure rate of one of your vascular surgeons, Dr. Z., is twice that of the national average. Members of the surgery department have reviewed that vascular surgeon's performance both by reading the medical records and by watching videos of her surgery. The Surgery Department and the Executive Committee have decided to deny reappointment for this surgeon. Lucille X, the mother of one of your quality coordinators, has severe peripheral vascular disease. She was admitted to your facility and has an angiogram. The angiogram shows that she should have a femoral-popliteal bypass. She had told you that she would be in your facility and asked you to visit her. You are now fulfilling that promise and are also bringing her flowers. While pausing to knock on her door, you hear your employee, Mary G., vehemently state to her mother, "Mom, Dr. Z is z quack; half of her bypass surgeries fail. You must have Dr. DoGood!" Referring to Case Study #5, are the meeting minutes about the decisions regarding Dr. Z of Department of Surgery and of the Executive Committee admissible in court?

Accepted Answer

State laws typically provide privilege and protect the confidentiality of medical review committee records, meaning they cannot be used as evidence in court.

Question 13

An indicator about the institution's death rate would be which type?

Accepted Answer

Death rate is an outcome measure, as it reflects the result or impact of the institution's services or care. It is not a process measure (A), which would measure the steps taken to provide care, nor a structure measure (C), which would measure the resources, staffing, or physical environment of the institution. It also not a regulation (D), which would refer to a legal requirement or guideline.

Question 14

Case study #6 You are helping the Nursing Department to write indicators, to determine appropriate formulas ratios and to determine data collection time frames. One important aspect of care is documentation of education of patients. More specifically, the nursing department would like assess its documentation of education on colostomy care for patients with new colostomies. Referring to Case Study #6, which of the following ratios would you recommend?

Accepted Answer

The best ratio would be the number of records with documentation of colostomy-care teaching divided by the total number of patients with new colostomies. This allows for a more specific measure of the nursing department's documentation of education on colostomy care for the appropriate patient population. Option A would not be specific to new colostomy patients, option B would not be specific to colostomy care teaching, and option D would not distinguish between new colostomy patients and other patients.

Question 15

Refer to the table Summary of Selected Blood Product Review. The table was first produced during which quality improvement function?

Accepted Answer

The table is titled "Summary of Selected Blood Product Review," indicating that it was produced as part of a review of blood usage, making D the best choice. The other options (pharmacy and therapeutics function, drug usage evaluation, medical record review) may also involve quality improvement functions, but they do not specifically pertain to blood product review as the table does.

Question 16

The Anesthesia Department is adding a new indicator to its plan. The Chief Anesthesiologist has come to you, the Director of Quality Management, to help her design a data collection methodology. The two of you are now considering who will be doing the data collection. All of the following are factors in your deliberations EXCEPT

Accepted Answer

Joint Commission standards and required characteristics are not directly related to who will be collecting the data, but rather to the standards of care and quality that need to be met. The other options are more directly related to the logistics and practicalities of data collection.

Question 17

Refer to the table Summary of Selected Blood Product Review. Based on the results reported in the table, which blood component or derivative should first be the topic of an in- depth study?

Accepted Answer

Fresh frozen plasma (FFP) has the highest reported rate of transfusion reactions (4.43 per 10,000 transfusions) and the second highest rate of pathogen transmission (1 per 2 million units transfused). Therefore, FFP should be the topic of an in-depth study to identify ways to improve its safety.

Question 18

The manager of the Quality Department is listing various sources of data. Which of the following data sources would be an example of an external source?

Accepted Answer

Quality improvement organization information is an external source of data because these organizations are outside entities that work with healthcare providers to monitor and improve quality of care. The other options given are all internal sources of data, as they are generated within the healthcare organization itself.

Question 19

The manager of the utilization review department wants to monitor and evaluate the preventia of inappropriate admissions. When would the manager need to collect data?

Accepted Answer

Prospective data collection involves gathering information before the admission occurs, allowing the manager to prevent inappropriate admissions by evaluating the necessity beforehand.

Question 20

According to current theory in the quality management field, should concurrent data collection or retrospective data collection be utilized?

Accepted Answer

According to current theory in the quality management field, both concurrent and retrospective data collection methods should be utilized in order to effect meaningful interventions and contain costs. Concurrent data collection allows for immediate feedback and intervention, while retrospective data collection allows for analysis of trends and identification of root causes of problems. Utilizing both methods can lead to a more comprehensive understanding of the quality of care being provided and allow for targeted interventions to improve outcomes.

Exam 1: Registered Health Information Administrator