Deck 23: Quality Management

Question 1

The formal recognition of a person as a professional with technical competence or of an agency that has met minimum standards of a performance is called:

A) Certification
B) Accreditation
C) Registration
D) Credentialing

Answer 1

Credentialing

Question 2

Doing an assessment of the necessity of care before giving service is:

A) Concurrent audit
B) Retrospective audit
C) Prospective utilization review
D) Retrospective utilization review

Answer 2

Prospective utilization review

Question 3

There are two approaches to quality improvement, general and specific. The specific approach includes methods used to:

A) Evaluate an agency's ability to meet criteria or standards
B) Manage a health care delivery system
C) Provide care to individual citizens
D) Using criteria set forth by regulatory agencies

Answer 3

Manage a health care delivery system

Question 4

Public health cannot ensure services that improve health if those services lack quality. Public health must:

A) Provide the same service to all citizens
B) Maintain quality in its workforce and continually evaluate service effectiveness
C) Rid itself of low-quality services
D) Depend on outside agencies to evaluate effectiveness

Question 5

The application of quality improvement strategies comprises six areas of performance. They include:

A) Providing appropriate and effective care if possible
B) Elevating access barriers
C) Reducing unjustified geographic variation in care
D) Application of managed care to all citizens

Question 6

According to the Institute of Medicine, quality health care is:

A) Licensed-all health care workers must have a license
B) Safe- avoiding injuries to patients from the care intended to help them
C) Timely-no waiting or delay for health care
D) Innovative-new innovations must be used when they become available

Question 7

The purpose of Total Quality Management is to:

A) Ensure that the client is getting quality care at top value for money spent
B) Provide cost-efficient care across all age groups
C) Provide necessary care to clients in a cost-effective system
D) Provide efficient systems of primary care

Question 8

The general approach to protecting the public includes ensuring a level of competency among health care professionals. Licensure is a:

A) Formal recognition of a person as a professional with competence
B) Voluntary approach to quality control
C) Contract between the profession and the state
D) Mechanism by which a state government agency grants corporate status to institutions

Question 9

An elderly female client was receiving home care after hospitalization for a cerebrovascular accident. After several weeks of physical and speech therapy, the client showed few signs of progress. The utilization review committee considered the client's condition to be stable and declined reimbursement for further home care. This client may reverse the decision through a process called:

A) Development of explicit criteria
B) Appeal mechanism
C) Concurrent utilization review
D) Medicare reversal process

Question 10

Which of the following is an area of public health nursing interventions for quality-oriented health care?

A) Health teaching
B) Debating
C) Disease eradication
D) Policy reversal

Question 11

The team approach to solving problems and locating opportunities for system improvement involves five steps. The first step is to discover what could be the most important accomplishments of the team and what changes are desirable. The best method of accomplishing step one is to:

A) Compare job descriptions.
B) Analyze mission and goals.
C) Brainstorm.
D) Develop charts and diagrams.

Question 12

The National Health Quality Report (NHQR) is a collaborative effort among agencies of the Department of Health and Human Services. The purpose of the NHQR is:

A) Reporting on the Agency for Healthcare Research and Quality's goal for the year
B) To describe the yearly activities of the agency
C) To ensure national quality of services
D) Providing documentation of whether health care quality is stable, improving, or declining over time

Question 13

Which of the following statements about the quality assurance process is accurate?

A) Quality is defined, and processes are implemented to maintain quality.
B) Needs are assessed, and programs are developed to meet needs.
C) Quality is concerned with the accountability of the provider.
D) Standards for care are established and evaluated, and when care does not meet standards, action is taken to bring about change.

Question 14

From the Total Quality Management (Continuous Quality Improvement) focus on delivering quality health care, quality is defined as:

A) Risk reduction
B) Customer satisfaction
C) Increased efficiency
D) Improved functional status

Question 15

Staff review committees are the most common specific approach to quality assurance. The audit, the major tool used to evaluate quality of care, consists of six steps. A quality assurance manager does an audit and six months later returns to see if a problem has been eliminated. This step is:

A) The step that involves selecting explicit criteria for quality care
B) The step where records are reviewed
C) The step that includes a peer review of all cases that do not meet criteria
D) The last step in the audit process

Question 16

One of the first nursing tools to measure quality assurance was:

A) American Nurses Association Standards of Practice
B) Joint Commission of Accreditation of Hospitals Nursing Audit Criteria
C) Community Health Nursing Practice Standards
D) Phaneuf Nursing Audit

Question 17

Which of the following monitors implementation of the prospective reimbursement system for Medicare clients?

A) Professional Review Organizations (PROs)
B) Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
C) National Health Quality Improvement Act
D) Diagnostic Related Groups (DRGs)

Question 18

An example of a voluntary approach to quality control used primarily for institutions is

A) Accreditation
B) Licensure
C) Certification
D) Credentialing

Question 19

According to the Agency for Healthcare Research (AHRQ), problems of quality care are divided into five groups. The "overuse of service" refers to:

A) Conservative treatment practices
B) Patient safety issues and how disability and mortality can be reduced
C) Disparities of quality
D) The ordering of unnecessary tests, surgeries, and treatments

Question 20

One reason for using a concurrent audit rather than a retrospective audit is that it:

A) Is less costly than a retrospective audit
B) Represents the total picture of care that the client receives
C) Provides more accurate data for planning corrective action
D) Identifies problems at the time that care is given

Question 21

A staff development program to teach nurses and other providers how to reduce risk by properly documenting intervention provided is an example of which of the following levels of prevention as applied to quality management?

A) Primary prevention
B) Secondary prevention
C) Tertiary prevention
D) Quality care

Question 22

The number of clients seen daily, the immunizations given, home visits made daily, and transportation and mileage are examples of information found in which of the following?

A) Clinical record
B) Provider service record
C) Financial record
D) Central index system

Question 23

Records are an important part of the communication structure of the health care organization. Which of the following is true about records? Select all that apply.

A) Records provide complete information about the client.
B) Records resolve legal issues in malpractice suites.
C) Records provide information for education and research.
D) Records allow anyone interested in a patient's progress to view a chart.

Question 24

Both consumers and providers have a vested interest in the quality of the health care system. Which of the following are reasons for health care providers to be concerned about health care quality? Select all that apply.

A) The principle of nonmaleficience, a basic ethical principle
B) The principle of beneficence, a basic principle of professionalism
C) A strong social work ethic
D) The need for advanced training to meet quality standards

Question 25

A major objective of a Professional Review Organization (PRO) is to reduce:

A) The liability of the agency by reviewing patterns of risk
B) Inappropriate admissions and unnecessary procedures
C) The use of alternative care options such as home care
D) The practice of professionals without appropriate credentials