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Quality Man Final

HIT 216

QuestionAnswer
The process of comparing the outcomes of HImi abstracting functins at your facility with those of comparable departments of superior performance ni other health care facilities to help improve accuracy on quality is referred to as Benchmarking
You are helping Nursing write indicators to determine the appropriate formulas for rations and to determine data collection time frames. Nursing would like to assess its documentation of education on colostomy care for patients with new colostomies. Concurrently
Which department will most likely be responsible for taking corrective action regarding the following quality indicator? Medical Staff Office
The following "sentinel events" must be available for JCAHO review EXCEPT Petechiae due to adverse drug reaction
The primary advantage of concurrent quality data collection is that Practitioners receive immediate feedback about patient processes and outcomes
An indicator about the institution's death rate would be which type? Outcome
This group has the ultimate responsibility for maintaining the quality and safety of patient care provided by its healthcare organization. Board of Directors
The act of granting a healthcare organization or an individual healthcare practitioner permission to provide services of a defined scope in a limited geographical area is called: Licensure
What process assists a health care facility in continuously looking at the ways that problems develop and seeking ways to prevent problems from happening in the future? Performance improvement
The responsibility for performing quality monitoring and evaluation activities in a departmentalized hospital is delegated to Clinical chairpersons of medical staff committees or ancillary department directors
What feature distinguishes the NGT from brainstorming? NGT determines the importance of responses through a rating system
What feature is a trademark of an effective PI program? A continuous cycle of improvement projects over time
Patient mortality, infection and complication rates, adherence to living will requirements, adequate pain control and other documentation that describe end results of care or a measurable change in the patient's health are examples of Outcome measures
In quality review activities, departments are directed to focus on clinical processes that are All of the above
What action(s) would assist the manager of a medical record department in improving customer perception of the quality of services provided by the department? identify specific customer needs in order to design value-added services
Which of the following processes is mandatory for health care facilities? Licensure
Continuous quality improvement is best described by the following statements, EXCEPT Corrective action targets clinicians more so than processes
An indicator about the placement and number of fire extinguishers would be which type? Structure
Several factors must be addressed when assessing data quality including: Data accuracy, consistency, completeness and timeliness
Which state passed the first nurse registration bill in the U.S. in 1903? North Carolina
Which organization(s) decided to join the ACS to develop the Joint Commission on Accreditation of Hospitals? All of the above
Performance improvement (PI) is the key to: All of the above
Which is not a Data Quality issue? Data Abstracting
What are the differences between a mission and vision statement? A vision is where the organization or individual wants to be. The mission is the instructions or steps it takes to get there.
Please list the steps in the organization-wide PI process. identify the problem Collect data to analyze positive or negative outcomes Plan an appropriate course of action Reengineer the process Monitor the process to ensure compliance
Performance monitoring is data driven. True
Quality improvement models are cyclical in nature. True
Several factors must be addressed when assessing data quality including: Data accuracy, consistency, completeness and timeliness
how are minutes and agendas used in meetings: The help keep the meeting on track by allowing people to be prepared, allowing a clear direction for the meetings topics and setting the amount of time the topic will be discussed
A blitz team does not spend a lot of time gathering data and reengineering processes. True
This type of data display tool is a platted chart of data that shows the progress of a process over time: Line charts
This type of chart is used to focus attention on any variation in the process and helps the team to determine whether that variation is normal or a result of special circumstances: Control chart
This data collection tool is used when one needs to gather data on sample observations in order to detect patterns: check sheet
This type of data is also called categorical data and includes values assigned to name-specific categories: Nominal data
This type of data is also called ranked data and expresses the comparative evaluation of various characteristics or entities and relative assignment of each to a class according to a set of criteria: Ordinal data
This type of data are numerical values that represent whole numbers: Discrete data
A research instrument that is used to gather data and information from respondents in a uniform manner through the administration of a predefined and structured set of questions and possible responses is called a/an Survey
In this type of interview the sequence of questions is not planned in advance and it is conducted in a friendly, conversational manner: Unstructured interview
In this type of interview, a predetermined list of questions is used: Structured interview
This type of data assumes an infinite number of possible values in measurements that have decimal values as possibilities: Continuous data
This type of data display tool is used to display discrete categories: Bar graphs
This type of data display tool is used to display data proportionally. They are used to identify problems or changes in a system or process: Histogram
This type of data display tool is used to show the relationship of each part to the whole: Pie charts
The customer is the receiver of a product or service as a result of an organizational process. True
Internal customers are individuals from outside the organization who receive products or services from within the organization. False
A graphic display tool used to communicate the details of performance improvement activities is called: Storyboard
What issues may the survey designer expect with the responses of open ended questions? It's hard to pick out a pattern with open-ended questions because answers can be so varied making it difficult to collect data.
A patient's family asked the attending physician to keep the patient in the hospital for a few days more until they could make arrangements for the patient's home care. The patient no longer meets to criteria for continued stay. If the physician complies It would be an inappropriate use of hospital resources
Review of a planned admission to determine whether the services are medically necessary and whether the patient qualifies for inaptient benefits. Preadmission review
Assessment of a patient's readiness to leave the hospital. Discharge Utilization Review
Periodic review during a current admission to determine whether the patient still needs acute care services. Continued Stay Review
Review of the patient's need for care and of the care provided at the time services are rendered. concurrent Utiliztion Review
Review of the appropriateness of the care setting and resources used to treat a patient. Utilization Management
Review of records some time following the patient's discharge to determine any of several issues, including quality or appropriateness of the care provided. Retrospective Utilization Review
Standards that, if met, allow a hospital to receive reimbursement for care provided to Medicare beneficiaries. Condition of Participation
Severity-of-illness or intensity-of-service standards used to determine whether the planned services are medically necessary and require treatment in an acute care setting. Screening Criteria
Review at that time of admission to determine medical necessity and appropriateness of care in an acute care setting. Admission Utilization Review
Which of the following is NOT one of the basic functions of the UR process? Claims Management
What is the role of a case manager? Coordinate medical care and ensure the necessity of the services provided to the patients
Which is NOT a type of utilization review? Documentation UR
Discharge planning begins: On admission
The main purpose of Utilization Management is to review charts, evaluate effectiveness of services, evaluate appropriateness of services. True
A performance measure that enables healthcare organizations to monitor a process to determine whether it is meeting process requirements is called: Indicator
A project management tool used to schedule important activities is called a: Gantt chart
The cause of every transfusion reaction must be investigated. True
Criteria that has been developed by many of the same agencies for use across the continuum of care and in various regions of the country is referred to as: Generic
The totality of healthcare services provided to a patient and their family in all settings, from the least extensive to the most extensive is called: Continuum of care
The principle process by which organizations optimize the continuum of care for their patients is Case Management
A performance measure that enables healthcare organizations to monitor a process to determine whether it is meeting process requirments is called a/an Indicator
Monitoring the patient throughout the entire episode of care is considered this case management step: Review the progress of care
in risk management terminology, an exposure to the chance of injury or financial loss and their associated liability is: Risk
Analysis of a sentinel event from all aspects to identify how each contributed to the occurrence of the event and to develop new systems that will prevent recurrence is called Root-cause analysis
The investigational technique that facilitates the identification of the various factors that contribute to a problem known as a fishbone diagram is also called a/an Cause-and-effect diagram
Events that occur in a healthcare organization that do not necessarily affect an outcome, but if were to recur, carry significant change of being a serious adverse event are called Near-misses
The risk manager's principal tool for capturing the facts about potentially compensable events is the Occurrence report
Risk management only involves the process of working through a malpractice suit. False
Occurrences involving liability for injury or property loss are called Potentially compensable events
What IS/SI criteria? These are the criteria used to determine if a patient should be admitted, how long they should stay and when they should be discharged. They track the patient throughout their course of stay in the hospital.
Occurrences involving liability for injury or property Potentially Compensable Events
the Risk Managers principal tool for capturing the facts about PCE's Occurrence Report
Events that occur in a healthcare organization that do not necessarily affect an outcome but if were to recur, carry significant chances of being an adverse event Near miss
The investigational technique that facilitates the identification of the various factors that contribute to a problem Cause and Effect Diagram
Analysis of a sentinel event from all aspects to identify how each contributed to the occurrence of the event and to develop new systems that will prevent recurrence is called Root Cause Analysis
Know the proactive component/step in risk management activities Risk Identification
To control the threat of future liability risks, lessions learned from the past are used to redesign the process Risk control
The work of performance improvement is accomplished through Process Analysis
This group has the ultimate responsibility for maintaining the quality and safety of patient care provided by its healthcare organization. Board of Directors
This person is responsible for implementing board directives and for action as board representative in managing the operations of the organization. Chief Executive Officer
Governance of a healthcare organization is comprised of the board of directors and the Medical Staff Leaders
The document in which the leadership of a healthcare organization identifies the organization's overall mission, vision, and goals to help set the long-term direction of the organization as a business entity is called: Strategic plan
This sytem allows medical professionals to candidly critique and criticize the work of their colleaues without fear of reprisal. Peer Review
The act of granting approval to a healthcare organization based on whether the organization has met a set of voluntary standards is called: Accreditation
The act of granting a healthcare organization or an individual healthcare practitioner permission to provide services of a defined scope in a limited geographical area is called: Licensure
The act of granting approval for a healthcare organization to provide services to a specific group of beneficiaries is called: Certification
This organization has been responsible for accrediting healthcare organizations since the middle 1950s and determines whether the organization is continually monitoring and improving the quality of care they provide Joint Commission on Accreditation of Healthcare Organizations
This private, not-for-profit organization is committed to developing and maintaining practical, customer-focused standards to help organzations measure and improve the quality, value, and outcomes of behavioral health and medical rehability programs. commission on Accreditation of Rehabilitation Facilities
This organization accredits managed care organizations, managed behavioral health organizations, and credentials verification for physician organizations. National committee for Quality Assurance
Every organization that provides services to Medicare and Medicaid beneficiaries must demonstrate its compliance with this set of standards: Condition of Participation
A large database that stores every data element collected within a healthcare organization and is used for PI activities is called: PI database
This technology allows organizations to store reports, presentations, profiles, and graphics interpreted and developed from stores of data for reuse in subsequent organizations activities. Information warehouse
The responsibility for performing quality monitoring and evaluation activities in a departmentalized hospital is delegated to: clinical chairpersons of medical staff committees or ancillary department directors
Physicians who are members of the Surgery Committee meet to review surgical cases referred for quality issues and deviations from standard care norms. This type of review in which a physician's record is reviewed by his/her professional colleagues is know Peer review
As based in case law decisions and the JCAHO standards, who is ultimately responsible to assure quality and appropriateness of patient care in a health care facility? Governing body/board of trustees
Which of the following processes is mandatory for healthcare facilities? Licensure
This type of healthcare organization review is performed to fulfill legal or licensure requirements: Compulsory review
This type of healthcare organization review is conducted at the request of the healthcare facility seeking accreditation. Voluntary review
A large database that stores every data element collected within a healthcare organization and is used for PI activities is called: Data repository
When healthcare organizations evaluate their JCAHO core measure data with similar organizations, they are using this. Comparative performance data
The organization that coordinates the collection of performance data for managed care plans is the NCQA
Members of healthcare boards of directors are appointed from the community and frequently do not have any specific knowledge of healthcare operations or organizations. True
Collection and analysis of data about patient incidents that occur in a hospital is a job responsibility of the Risk Manager
What is data mining? The process of analyzing data from different perspectives and summarizing it into useful information.
Created by: adale3171