Question 1

Which organization attempts to develop and implement a case mix classification system that can provide a basis for Medicare and Medicaid payments as well as serve as a quality monitoring system?

Accepted Answer

The Multistate Nursing Home Case Mix and Quality Demonstration has developed quality indicators for long-term settings.

Question 2

Which organization developed standards for nursing practice that became the basis for quality assurance programs?

Accepted Answer

During the 1960s,the ANA started a division of nursing practice to develop standards for nursing practice,which became the basis for quality assurance programs.The ANA also developed a process to evaluate the quality of patient care.

Question 3

Extraneous variables can confound the effects of the experimental variable and are therefore sources of internal invalidity.If subjects are lost from the comparison groups,the source of internal invalidity is said to be:

Accepted Answer

Experimental mortality is the differential loss of subjects from comparison groups.

Question 4

Which event during the 1940s helped the United States realize the need for a prepaid payment system that would relieve the burden on the sick person and ensure that the hospital and hospital expenses were paid?

Accepted Answer

Technological advances and the development of antibiotics during the 1940s increased the ability to improve health,but unfortunately the cost was prohibitive for most people in the United States.

Question 5

Several tools are available to analyze information once it is collected.Which tool is used to identify the root causes of a problem or outcome?

Accepted Answer

A cause-and-effect,or fishbone,diagram is used to identify the root causes of a problem or outcome.

Question 6

Which quality management philosopher believed in a system that creates quality by prevention of errors instead of appraisal?

Accepted Answer

Crosby,known for his zero defects concept,defined quality as conformance to requirements.He believed that the system for creating quality is prevention of errors instead of appraisal.

Question 7

Both leaders and managers have a responsibility for quality improvement.A manager's function is to:

Accepted Answer

Managers determine discrepancies between care provided and standards.

Question 8

Establishing the validity of the tools used to measure the extent of goal achievement is an important step in continuous quality improvement.Which type of validity is theory oriented?

Accepted Answer

Construct validity is theory oriented.Construct validity is particularly important when phenomena or concepts that are not directly observable,such as intellectual skills,human characteristics,and personal adjustment,are involved.

Question 9

Deming,who revitalized the Japanese industry with his focus on total quality management (TQM)and continuous quality improvement (CQI),introduced what concept to TQM?

Accepted Answer

The Deming chain (PDCA)reaction is as follows: (1)improve quality; (2)decrease costs with fewer mistakes,less rework,fewer delays,and better use of time and materials; (3)improve productivity; (4)capture the market with better quality at lower prices; (5)stay in business;and (6)provide jobs.

Question 10

The federal government began facilitating competition among health care services when:

Accepted Answer

The federal government began facilitating competition among health care services when it permitted HMOs to offer competitive medical plans.

Question 11

The evaluator should structure the evaluation using an appropriate research design.When utilizing an instrument to collect data,the evaluator may need to select the time and the individuals on whom observations will be made.For which research design is it best if the design is repeated by several researchers in separate situations?

Accepted Answer

In a time series design,a series of measurements are made over a period of time with an experimental variable introduced at some point in the sequence.It is best if the design is repeated by several researchers in separate situations.

Question 12

Which organization required audits of care,which later became part of a quality assurance program?

Accepted Answer

The JCAH required audits of care,called for by its initial quality assurance standards,and increased the number of multidisciplinary audits.The quality assurance program recommended by JCAH was a retrospective review of patient care through a closed-chart audit that focused on patient care outcomes.

Question 13

Continuous quality improvement (CQI)is a process carried out by a team that establishes criteria,identifies relevant information,collects and analyzes data,judges quality,takes corrective action,reevaluates,and does public reporting.Criteria are established by developing standards and setting benchmarks.Standards are structure,process,and outcomes.Which of the following is an outcome statement?

Accepted Answer

Structure standards typically relate to the physical environment,the structure,or the management.Process standards concern the delivery of care.Outcome standards relate to the results of the care or administration and should be stated in measurable terms.

Question 14

Several tools are used to collect data to facilitate continuous quality improvement.What kind of audits review critical pathways and standardized clinical guidelines?

Accepted Answer

Process audits examine aspects of care such as implementation of physicians' orders,observation of symptoms,implementation of nursing procedures,teaching,discharge planning,and charting practices.

Question 15

The health care risk management process includes all of the following except:

Accepted Answer

Health care risk management is a process that is designed to reduce or prevent practices or situations that pose a threat to the safety and well-being of a patient,visitor,or staff member.The risk management process includes risk identification,evaluation,and reduction strategies.

Question 16

During President Clinton's years of service,the Health Security Act was passed,which was another step in health care reform.Which principle of the Health Security Act called for every employee and every employer to contribute to the cost of health care?

Accepted Answer

The principle of responsibility holds that everyone is responsible for health care.Responsibility means that every employee and every employer must contribute to the cost of health care.

Question 17

As health care expanded,the federal government became involved.The federal government realized it could not meet the costs of unlimited health care coverage,so which of the following was initiated?

Accepted Answer

Cost containment policies such as utilization review,rate control,and control of capital expenditures were initiated by the federal government.In 1972,the Social Security Act was amended to create the PSRO.

Question 18

Which of the following is a valuable tool that is used for planning and judging the progress of the program evaluation?

Accepted Answer

One of the first things the evaluator should do is develop a calendar of events that depicts the tasks to be done,the schedule,and the organization of the project.This is a valuable tool for planning and judging the progress of the program evaluation.

Question 19

The Clinton administration instructed the President's Advisory Commission on Consumer Protection and Quality in the Health Care Industry to work with the Institute of Medicine Reports to develop the core competencies for health care professionals.What publication reported the core competencies for health care professionals?

Accepted Answer

Health Professions Education: A Bridge to Quality,published in 2003,indicated that the core areas in which health professionals should maintain competency are patient-centered care,interdisciplinary teams,evidence-based practice care,quality improvement,and informatics.

Question 20

Effective January 1,2007,the Joint Commission requires accredited hospitals to collect and submit performance data related to which of the following?

Accepted Answer

The Joint Commission requires accredited hospitals to collect and submit performance data related to three of the following four conditions: (1)acute myocardial infarction; (2)health failure; (3)pregnancy and related conditions;and (4)community-acquired pneumonia.

Quiz 15: Continuous Quality Improvement, Risk Management, and Program Evaluation