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Applying Quality Management in
Healthcare A Systems Approach, 5e
Patrice L. Spath (Test Bank Latest Edition
2023 - 24, Grade A+, 100% Verified)
To determine internal priorities for performance improvement, a health care organization must consider the: - ANSWER>>>Needs and expectations of all the stakeholders A component of the organization's quality management activities that is often documented in the performance improvement plan: - ANSWER>>>performance improvement model used by the organization The lead Federal agency in health care quality research. - ANSWER>>>Agency for Healthcare Research & Quality !!! The 3 components of health care quality management - ANSWER>>>measurement, assessment and improvement Which of the following dimensions of health care was NOT identified by the Institute of Medicine in 2001 as needing improvement? - ANSWER>>>Convenience Group that sponsors the HEDIS performance measurement system for managed care organizations. - ANSWER>>>National Committee for Quality Assurance The reporting structure for quality management activities in a hospital is commonly documented in the organization's: - ANSWER>>>performance improvement plan
"Championing Quality" throughout the organization is the job of: - ANSWER>>>Senior Management A basic responsibility of the quality management department in a healthcare organization. - ANSWER>>>Help other departments identify potential quality problems Group ultimately responsible for the quality of health care in a healthcare organization. - ANSWER>>>governing board A way of doing business which continuously improves products and services to achieve ever better levels of performance. - ANSWER>>>Quality management To determine compliance with departmental standards, the manager of the hospital registration department is collecting data on the accuracy of patient demographic information that has been into the computer system by registration clerks. This activity is an example of:
- ANSWER>>>Measuring performance Performance measurement data are collect primarily for the purpose of: - ANSWER>>>identifying opportunities for improvement !!! For performance measure, "Percentage of surgery patients who develop a wound infection," what number is used for the denominator? - ANSWER>>>Number of surgery patients !!! A PROCESS measure used to evaluate care provided to patients in the emergency department. - ANSWER>>>Percent of records that include name of patient's next of kin. Examples of Outcomes measures - ANSWER>>>1. Rate of uninsured patients
- Percent of patients that develop wound infections
- Rate of readmission to the emergency department within 24 hours
Example of an objective performance goal - ANSWER>>>Dictated reports shall be transcribed within 24 hours One of the recommendations of the Joint Commission is: Improve the accuracy of patient identification. Which of the following performance measures would a hospital use to evaluate success at achieving this goal? A Percent of time the patient's name is verified prior to drawing blood for a lab test. B Number of medication errors per 1000 medication doses administered C Average time from patient arrival at the hospital until the admission process is complete D Percent of patients designated as non-English speaking - ANSWER>>>A. Percent of time the patient's name is verified prior to drawing blood for a lab test. Surveys developed by the Agency for Healthcare Research and Quality to be used to evaluate patient satisfaction in healthcare organizations. - ANSWER>>>Consumer Assessment of Healthcare Providers and Systems A criterion considered by the National Quality Forum in its endorsement of performance measures. - ANSWER>>>Useability Which of the following data collection methods would be BEST for gathering reliable information about physician compliance with a hospital's hand washing procedures? - ANSWER>>>Direct observation What is an advantage to using billing data as a source of information for evaluating the quality of patient care? - ANSWER>>>Billing data are readily available Instrument used to gather performance measurement data. - ANSWER>>>Check sheet
When the quality coordinator reviews the record of every tenth clinic patient to determine whether it contains up-to-date medication information, what sampling method is being used? - ANSWER>>>Systematic Which of the following performance measurement data sources is the most costly to use in terms of manpower required to gather information? - ANSWER>>>Paper-based patient records What data collection instrument is commonly used to gather information on patient's satisfaction with healthcare services? - ANSWER>>>Questionnaire A tool used to standardize the processes necessary for capturing data performance measures. - ANSWER>>>Data collection plan Data for the e-measures used by a hospital to monitor its performance are found in - ANSWER>>>Automated sources Continuous quality improvement in healthcare organizations require - ANSWER>>>A planned and systematic approach Six key dimensions of healthcare performance that need improving. - ANSWER>>>1. Safe
- Effective
- Patient-Centered
- Timely
- Efficient
- Equitable Public evaluations on healthcare quality on the Web in the form of: - ANSWER>>>Report cards Provider profiles Consumer reports
Percent of patients w/ stage III colon cancer who receive chemotherapy Percent of operative reports dictated immediately following surgery. Percent of patient records containing patient demographic errors. Percent pf patients who are discharged on antiplatelet therapy. Outcome measure examples - ANSWER>>>Rate:Number of patient falls per 1000 days Percent of patients w/ the principal diagnosis code of stroke that expire in the hospital. Average admitting times for inpatients, emergency, and outpatients. Percent of patients who reported being "very Satisfied" w/ admission process Six key dimensions by IOM: - ANSWER>>>1. Effectiveness-based on scientific knowledge, service provided to all who can benefit, service should not be provided to those not to benefit
- Efficiency-Avoidance of waste-equipment, supplies, time, energy, and ideas
- Equity- Quality doesn't change cause of patient's personal characteristics, gender, ethnicity, geographic location, and social status
- Patient-centeredness-Care is provided respectfully of and responsive to patient preferences, needs, and values
- Safety-Unintended patient injuries should be avoided
- Timeliness-No unnecessary waits and delays for those receiving care Developing Measures - ANSWER>>>1. Select process to be evaluated a. accreditation & regulatory requirements b. topics of national importance c. strategic quality goals d. customer needs & expectations
- Determine what you want to know
- Translate "What you want to know"(the critical activities/the process as a whole) into a performance measure.
- Establish performance goals. a. regulation & accreditation standards b. organizational quality goals c. guideline accommodations d.performance in other organizations. Customers: 3 stakeholders groups - ANSWER>>>1. Providers
- Purchasers
- Consumers Quality Management- AKA - ANSWER>>>Performance improvement Continuous quality improvement Total quality management Performance management When using comparative data to asses performance, what is the first step that should be taken to ensure a worthwhile assessment? - ANSWER>>>Verify data accuracy "Benchmarking" is a measure of - ANSWER>>>Current performance compared to an exemplary organization Purpose of risk adjusting patient outcome data - ANSWER>>>To enable fair statistical comparisons between different groups of patients Which parameters on a control chart represent an estimate of the standard deviation for the data plotted on the chart? - ANSWER>>>Control limits What graphic data display is used for analyzing performance trends? - ANSWER>>>Line graph Example of significant performance trend in the HIM department: - ANSWER>>>For 8 weeks in a row the number of coding errors has decreased.
FDA - ANSWER>>>Food and Drug Administration. The agency that is responsible for determining if a food or drug is safe and effective enough to be sold to the public. NIH - ANSWER>>>National Institutes of Health, improve nation's health by conducting & supporting research into causes, diagnosis, prevention, and cure of human diseases. QIO - ANSWER>>>Quality improvement organizations: external agencies that review the quality or care and use of insurance benefits by individual physicians and patients for Medicare and other insurers. AAAHC - ANSWER>>>Accreditation Association for Ambulatory Healthcare - a professional organization that offers accreditation programs for ambulatory and outpatient organizations such as single and multispecialty group practices, ambulatory surgery centers, college/university health services, and community health centers. ACHC - ANSWER>>>Accreditation Commission for Health Care - A private nonprofit accreditation organization offering accreditation services for home health, hospice, and alternate site healthcare such as infusion nursing, and home/durable medical equipment supplies. CARF - ANSWER>>>Commission on the Accreditation of Rehabilitation Facilities, provides accreditation for organizations offering behavioral health physical and occupational rehabilitation services as well as assisted living continuing care community services employment services and others. CoC - ANSWER>>>Commission on Cancer of the American College of Surgeons-Approves cancer programs NIAHO - ANSWER>>>National Integrated Accreditation for Healthcare Organization
NCQA - ANSWER>>>National Committee on Quality Assurance. A not-for-profit organization that performs quality oriented accreditation reviews on HMOs and similar types of managed care plans. JC - ANSWER>>>Joint Commission for Accreditation of Healthcare Organizations, - sets standards and accredits most general, long-term, psychiatric hospitals, substance abuse programs, outpatient surgery centers, urgent care clinics, group practices, community health centers, hospices and HH agencies, lab IOM - ANSWER>>>Institute of Medicine of the National Academies; a nonprofit organization created to provide unbiased, evidence based and authoritative information and advice concerning health and science policy,-- care should be safe, effective, patient centered, efficient and equitable NAHQ - ANSWER>>>National Association for Healthcare Quality NQF - ANSWER>>>national quality forum, for healthcare quality measurement and reporting, not for profit, (National Quality Forum) is a not for profit membership organization created to develop and implement a national strategy for health care quality measurement and reporting. Governing board - ANSWER>>>aka-Board of Trustees--Has ultimate responsibility for the quality of patient care and services provided. Responsibility of the support in the organization's mission& strategic priorities. Senior Leaders - ANSWER>>>President, COO(chief operating officer) vice presidents, medical director--Responsible for ensuring continuous quality improvement and for establishing and cultivating a culture of safety. Second tier groups - ANSWER>>>Quality management oversight committees or councils.
What group acts on the behalf of consumers to keep healthcare costs down? - ANSWER>>>Insurance industry Which of the following is one aspect of the definition of healthcare quality? - ANSWER>>>Consistent with current professional knowledge What organization published Crossing the Quality Chasm: A New Health System for the 21st Century? - ANSWER>>>Institute of Medicine Which of the following healthcare dimensions was NOT mentioned by the Committee on Quality of Health Care in America as an area that needed improvement? - ANSWER>>>Convenience When desired results are achieved with minimal expenditure of resources, the healthcare services are most accurately described as what? - ANSWER>>>Cost-effective Which of the following best describes a reliable healthcare service? - ANSWER>>>One that consistently performs as intended Which of the following is one of the three broad aims of the National Quality Strategy? - ANSWER>>>Affordable care The healthcare quality Triple Aim framework was developed by the National Academy of Medicine. - ANSWER>>>False Doctors often practice defensive medicine for the purpose of avoiding malpractice liability. - ANSWER>>>True Healthcare quality can never be achieved without reliability. - ANSWER>>>True What are the three primary quality management activities? - ANSWER>>>Measurement, assessment, and improvement
What is the denominator for the performance measure "percentage of home health patients admitted to the hospital"? - ANSWER>>>Total number of home health patients Which of the following is a process measure of performance in a hospital intensive care unit? - ANSWER>>>Percentage of staff using hand cleaner when entering patient room What type of healthcare organization uses measures found in the Healthcare Effectiveness Data and Information Set (HEDIS)? - ANSWER>>>Health insurance plan Which of the following is a data-gathering tool used to collect performance measurement data? - ANSWER>>>Check sheet What activity-level measure is related to the system-level measure "percentage of hospital patients who are very satisfied with the overall quality of care"? - ANSWER>>>Percentage of patients reporting that nurses treated them with respect What situation puts data accuracy at risk when more than two people are independently gathering data for the same performance measure?
- ANSWER>>>Poor interrater reliability What is a process measure of staff performance in a nursing home? - ANSWER>>>Number of records lacking documentation of resident's allergies What is the first step in constructing a performance measurement? - ANSWER>>>Identify topic of interest What framework is used by an organization to categorize system-level performance measures? - ANSWER>>>Balanced scorecard Which of the following is a trend in modern health care across industrialized nations? - ANSWER>>>Providers are becoming more specialized.
In regard to health disparities around the world, which of the following statements is most true? - ANSWER>>>The root causes of health disparities are complex. Which of the following countries has implemented cost-effectiveness requirements for drug approvals? - ANSWER>>>All of the above Among developed nations which of the following statements is true? - ANSWER>>>During the past 15 years, countries around the world have used different approaches to improve health care quality and access. Which of the following statements is a reason for improving the US health care system? - ANSWER>>>A and B Why was it important for the Institute of Medicine (IOM) to develop its six aims for health care? - ANSWER>>>So that health care organizations would have a better idea of what they needed to improve Which of the IOM aims has this hospital FAILED to meet? - ANSWER>>>Timely The hospital where Michael is recovering reviews its patient satisfaction survey results in order to improve its care and patient outcomes. Leaders poring over the data note that 90 to 100 percent of patients rate staff as "excellent" in the following categories: listening, answering questions, being friendly and courteous, and giving good advice based on specific needs and preferences. Which aim is the hospital generally achieving? - ANSWER>>>Patient-centered Which of the following improvement efforts is the best example of increasing the effectiveness of care? - ANSWER>>>Improving the percent of clinic patients achieving their goal blood pressure by instituting a series of reminders for providers about evidence-based processes
c. Computerized flow sheets that enable documentation required by regulatory standards d. Centralized appointment scheduling system that decreases patient wait time - ANSWER>>>a. Use of computerized decision support to facilitate evidence-based practice
- Patients and families are more likely to view quality as a. the application of evidence-based professional knowledge b. adherence to standards c. how well the provider communicates d. use of preventive services - ANSWER>>>c. how well the provider communicates
- An example of a structure used to evaluate quality of health care information technology is a. A policy describing the prescriber's role and responsibilities with respect to provider order entry. b. Data on medication errors noted in the on-line event reporting system c. Data on how well physicians and nurses document problems on the electronic problem list. d. Patient satisfaction with the electronic portal. - ANSWER>>>a. A policy describing the prescriber's role and responsibilities with respect to provider order entry.
- According to the Institute of Medicine Crossing the Quality Chasm, which of the following is NOT a quality improvement aim? a. Efficiency b. Patient Centeredness c. Effectiveness d. Innovation - ANSWER>>>d. Innovation
- What quality improvement measures must eligible providers report in 2011 to quality for meaningful use incentive payments? a. Must report on blood pressure, tobacco status, and adult weight screening as well as three additional measures from a list of metrics.
b. Must report on a single quality improvement measure of their own choosing c. Must report on substance abuse, exercise tolerance, and nutritional status. d. Must report on advance directives in patients aged 65 and older. - ANSWER>>>a. Must report on blood pressure, tobacco status, and adult weight screening as well as three additional measures from a list of metrics
- One example of how HIT can enhance patient-centeredness is: a. Reduce drug errors through computerized provider order entry b. Increase efficiency through automated vital sign capture c. Tailor care plan to individual needs through clinical decision support d. Remind providers of best practices through prompts and flags e. All the above - ANSWER>>>e. All the above
- An example of a workaround that can result in unintended consequences is a. Reporting patient fall via an on-line event reporting system b. Having nurses enter prescriber orders because the prescriber is too busy. c. Use of a patient locator board to track patients d. Use of paper-based report sheets to communicate changes in patient condition - ANSWER>>>b. Having nurses enter prescriber orders because the prescriber is too busy.
- Man-made tools that aid or enhance the user's thinking abilities are called: a. Structures b. Objects c. Artifacts d. Work-arounds - ANSWER>>>c. Artifacts
- The following is a basic principle of the science of safety a. The system is perfectly designed to deliver the results it gets. b. Workers are largely to blame when mistakes happen. c. The principles of safe design only refer to technical work.
