Ragava International Statistical Institute - Global Healthcare Training

1.) When comparing averaged immunization data from two pediatric medical groups, it is appropriate to use

Standard deviation

A t-test

A chi-square

Variance

2.) The frequency of errors in a particular process would best be displayed in an .....

Matric diagram

Pareto chart

Affinity diagram

Histogram

3.) When assessing an emergency room, the best strategy for data collection is..

Cluster sampling

Continuous sampling

Matched random sampling

Accidental sampling

4.) In data collection, Qualitative data are to Quantitative data as

Opinion are to facts

Fabrications are to designs

Attitudes are to deeds

Actions are to outcomes

5.) After aggregating data, it is important to summarize the information with data-displays so that it is

Visually appealing and compelling

Meaningful to those analyzing the outcomes

Understandable to all organization employees

Publishable to the general public and in compliance with HIPPA standards

6.) Which one of the following is not the description of an analysis tool?

Pareto chart: illustrates common causes or sources of problems

Run chart: Provides a running record of a process over time

Control chart: Similar to the Run chart, but includes a median data line

Scatter diagram: graphically displays the relationship between two variables

7.) The CPHQ uses a run chart or control chart to find trends within a process. A trend is determined by

Seven or more consecutive ascending or descending data points with 21 or more total points

Seven or fewer consecutive ascending or descending data points with 21 or more total points

Seven or more consecutive data points all above or all below the median or mean.

Unrelated points indicating a special-cause variation

8.) The CPHQ measures averages to locate the center point in a data group. Which statement is false?

Mean calculates the frequency a number occurs and gives the most valid picture.

Median calculates the average number

Variance measures the distance between the extreme numbers.

Standard deviation is the square root of the variance

9.) Random Variation is to Special cause of variation as

An expected outcome is to an adverse outcome

Geriatrics is to primary care medicine

Tonsillectomy is to appendectomy

a sterile filed is to an operating room

10.) Secular variation of a time series is represented graphically by

Cyclic movements

Sporadic motions

A trend line

Staying within control limits

11.) Which of the following statements about capability analysis of a process is TRUE?

Capability analysis requires the presence of a special cause of variation

Capability analysis requires that the process is in Statistical control

Capability analysis is used to identify the limits of the current process

The degree to which the average temperature in refrigerators in a hospital falls outside specification on any given day may be displayed in a

12.) The degree to which the average temperature in refrigerators in a hospital falls outside specification on any given day may be displayed in a

bar chart

Pareto chart

Control chart

Histogram

13.) The upper limit of a control chart should be

2 standard deviations above the center line

3 standard deviations above the center line

4 standard deviations above the center line

None of the above

14.) From a study of a sample of patient records for the prior 20 months, the medication error rate was found to be 1 per 1000, with a 90% confidence interval between zero and 3.4 error per 1000.What is the chance that the true value is not covered by the interval?

0

0.034

0.1

0.9

15.) The upper and lower control limits of a process control chart are three standard deviations from the mean. A data point that falls outside these limits

Will be found 5% of the time even if the process is in statistical control

Will be found 5% of the time even if the process is out of statistical control

Indicates the presence of a sentinel event

Is a signal for further investigation

16.) In which of the following scenarios is rule-based sampling most appropriate?

Obtaining customer feedback

Assessing compliance to the time-out procedure

Measuring patient falls

Functional testing of laboratory machines.

17.) What is the most likely effect of tampering when dealing with control charts?

Reducing variation when the process is table

Increasing variation when the process is stable

Failing to recognize special cause variation when it is present

Falsely identifying special cause variation when none exists

18.) A frequency plot may be used to examine

The shape of data

The spread of data

The center of data

All of the above

19.) A data inventory and a data dictionary will

Increase the need for new data elements

Increase the efficiency of the data collection process

Increase the cost of the data collection process

Result in all of the above

20.) An acute care facility recently revised its clinical protocol for the prevention of ventilator-associated pneumonia. It has since experienced greater variation in monthly staff performance. The number of ventilated patients per month has remained approximately the same, when sampling medical records for the monthly review, how shold the organization adjust the sample size?

Reduce the sample size

Increase the sample size

Keep the sample size the same

Review the medical record of each ventilated patient until variation is reduced.

21.) What is the maximum time interval between data points on a run chart?

One week

One Month

One quarter

None of the above

22.) What is the minimum number of cases in each data point on a run chart?

1

10

25

None of the above

23.) A 700-bed acute care facility receives 40% of its admissions from the emergency department (ED). Quality problems, especially wait time, were expressed by patients, family members, and physicians. Which tool should the ED team use first in the investigational phase of the improvement process?

Histogram

Control chart

Flow chart

Pareto chart

24.) In comparing the percentage of falls with injuries in calendar year 2012 between facilities that use restraints and those that do not, which chart should be used?

Line chart

Bar chart

Pie chart

Scatter plot

25.) Which of the following display formats is best used to evaluate the number of ear infections, urinary tract infections, and conjunctivitis experienced by individuals served in a group home?

Line graph

Bar chart

Histogram

Control chart

26.) A line graph may be transformed into a run chart by

Determining the range of the data

Drawing in the median measurement

Changing the vertical scale

Modifying the time scale

27.) The monthly rate of resident falls in the past 12 months was plotted on a control chart. All data points are within the control limits but the last data point falls exactly on the upper control limit. The improvement team should conclude that

The process is in statistical control

The process is out of statistical control

More data points are needed to determine whether the process is in statistical control

Other statistical techniques should be used to determine whether the process is in statistical control

28.) The first step in collecting meaningful data is

Establishing the goals of data collection

Developing operational definitions

Planning for data consistency

Evaluating the resources available

29.) As an external consultant, you have completed a gap analysis of an acute care facility that is preparing for TJC accreditation. Which of the following charts will you use to summarize your findings in six of the chapters of standards for the Hospital Accreditation Program?

Line chart

Radar chart

Bar chart

Pareto chart

30.) An emergency department tracks wait times from patient arrival to physician assessment. Data are reported using a run chart. Which of the following demonstrates a true statistical increase in treatment delays?

6 consecutive ascending data points

7 consecutive descending data points

A zigzag pattern of 10 data points

Data points close to the mean line

31.) Which of the following sampling technique involves selecting the medical record of every fifth patient undergoing cardiovascular bypass?

Convenience

Systematic

Stratified

Simple random

32.) Which of the following tools be used to record patient and practitioner specific data?

Flowchart

Graphs

Histogram

Spreadsheet

33.) When a case manager wants to demonstrate length of stay data that depicts both common cause and special cause variation, which of the following should be used?

Pareto chart

Scatter plot

Shewhart chart

Frequency plot

34.) Which of the following is a typical size for a customer focus group?

1 to 3

3 to 5

8 to 12

15 to 20

35.) The success of a customer focus group rests principally on the:

Group size

Length of meeting

Opinions of the group

Skill of the moderator

36.) Managing data and assisting with mathematical calculations is the best description of:

Database

Graphics

Spreadsheet

Word processor

37.) Which of the following is an example of nominal data?

Pre-op, Post-op

AS, BS, MS, PhD.

Temperature

Mass

38.) Which of the following is an example of ordinal data?

Pre-op, Post-op

AS, BS, MS, PhD.

Temperature

Mass

39.) Which of the following is an example of ratio data?

Pre-op, Post-op

AS, BS, MS, PhD.

Temperature

Mass

40.) Which of the following is an example of Interval data?

Pre-op, Post-op

AS, BS, MS, PhD.

Temperature

Mass

41.) Which one of the following is a synonym for count data?

Analog.

Continuous.

Discrete.

Variable.

42.) The sampling of 5% or 30 cases, whichever is greater, is an example of sampling

Convenience

Expert

Purposive

Quota

43.) The test used to analyze the difference between 2 means is the:

Chi-square.

Multiple regression analysis.

Regression analysis.

T-test.

44.) If you want to predict IV site infiltration based on osmolarity of the IV solution and the addition of potassium to the IV, you should use:

Chi-square

Multiple regression analysis

Regression analysis

T-test.

45.) Which test is often used by quality managers when data is counted, not measured?

Chi-square.

Multiple regression analysis

Regression analysis

T-test

46.) Which of the following is the best confidence interval?

0.99

0.95

0.9

0.85

47.) Which of the following is the best confidence interval?

0.01

0.02

0.05

0.1

48.) Historically, when the level of significance has been belowresearchers have rejected the null and declared their results statistically significant.

0.01

0.02

0.05

0.1

49.) A freeform generation of ideas best describes:

Brainstorming

Delphi technique

Motivating.

Nominal group technique.

50.) The appropriateness of care is

Primary a focus of utilization management

A key dimension of quality care

Equivalent to case management

The degree to which healthcare services are coherent & unbroken

51.) A medication is ordered for a diabetic patient. Its capacity to improve health status, as a dimension of quality or performance, is its

Effectiveness

Potential

Appropriateness

Efficacy

52.) If, in the continuous quality improvement process, we increase our emphasis on customer satisfaction and outcomes of care, which two dimensions of quality /performance must be incorporated into all quality management activities?

Availability and respect/caring

Respect/caring and competency

Effectiveness and respect/caring

Continuity and competency

53.) The quality professional can best facilitate the development of a quality culture in an organization by

Assessing the organizations readiness to commit to change

Designing a long range plane for cultural transformation

Encouraging leaders to commit to a culture of excellence

Leading the cultural transformation redesign team

54.) The task of setting up an ambulatory care setting QM/QI program that focuses on outcomes as a measure of treatment effectiveness is difficult because

The patient remains in control of treatment

Patient care outcomes are determined by the payer

There are no required medical records

Expected outcomes for ambulatory conditions are too obvious

55.) In developing a program to evaluate the effectiveness of physician care, a primary care clinic would select which one the following indicators?

The patients will express overall satisfaction with clinic facilities

The contract lab will provide results within 24 hours of sample delivery

The staff complies with all infection control policies and procedures

Newly diagnosed hypertensive patients are controlled within 6 months

56.) The perception of quality by a patient receiving care in an ambulatory healthcare center is influenced most by

The physical environment

Caring staff and physician

New technology

The physicians technical competence

57.) Total quality management philosophy assumes that

Most problems with service delivery result from systems difficulties

Frequent inspection is necessary to improve quality

Most problems with service delivery result from difficulties with individuals

Top management leadership in quality activities disenfranchises employees

58.) A potential conflict between the philosophy of total quality management and quality improvement in healthcare is the challenge in Demings Principles to

Eliminate numerical goals for management

Cease dependence on inspection

Constantly improve every process

Break down barriers between staff areas /departments

59.) What is the most important relationship between structure, process and outcome as types of indicator of quality?

Interdependent: Structure directly affects both process and outcome

Causal: Structure leads to process and process leads to outcome

Relational: useful for comparisons, but not causal

There is no relationship; they are categorized used to group indicators.

60.) Which of the following best describes the successful outcome of the quality improvement process?

Customer satisfaction

Enhanced communication

Employee empowerment

Improved Statistical data

61.) Monitoring the specific organization and content requirements of a medical record system is a review of which focus?

Outcome of care

Process of care

Structure of care

Administration of care

62.) The major difference between traditional quality assurance activities and the expanded quality improvement /performance improvement activities is the QI/PI focus on

People and competency

Analysis of data

Performance measures

System and processes

63.) The centerpiece of outcomes management in healthcare is

The measurement of the patients functionality and quality of life

Morbidity and mortality

Data reliability

Finance impact

64.) Common causes of problems in processes refer to

One-time situations

Temporary situations

Acute situations

Chronic situations

65.) Review of the timeliness of high risk screening for diabetes addresses which focus?

Outcome of care

Process of care

Structure of care

Administrative procedure

66.) Under the quality improvement paradigm, which statement is incorrect?

The focus is on the competency of individual practitioners

The focus on the efficacy and effectiveness of processes

The focus is on the patient

The focus is on organization performance

67.) Within the context of total quality management philosophy, communication of quality is

The responsibility of top management leaders

Delegated to the Quality Management Department

An internal organizational, not community, issue

Independent of process budgets or costs.

68.) The team working on a improvement plan using Rapid Cycle. After they pilot the program, analyzed data and determined that the action is effective. What is the next step?

Spread the change among staff

Set goals

Change the aim of the project

Implement QIP

69.) For CQI to be successful, who must be included in staff:

Department supervisor

Administrator

Facilitator

Staff

70.) For CQI to be successful who must be included in staff:

Administrator

Person performing process

Quality management representative

Department supervisor

71.) Who is responsible for providing CQI direction

Facilitator

Quality council

Leader

Team

72.) Who is responsible for quality improvement with organization

Quality manager

Frontline staff

Everyone within organization

Chief executive officer

73.) Who is responsible for creating and monitoring the implementation of improvement project work plan and time line?

Sponsor

Team leader

Team facilitator

Quality council

74.) Who is ultimately responsible for the effective implementation of the quality program:

Governing body

CEO

All staff

The CFO

75.) Most effective way to integrate performance improvement through the organization:

Continuous monitoring

Quality teams

Employees

Champions

76.) In an integrated delivery system, the success of the quality strategy is most dependent on the effectiveness of the

Information system

QI team process

Case management process

Patient care management system

77.) Which of the following element must be present in order to evaluate effectiveness of healthcare organization quality improvement program?

Integrated data collection

Quantified objective

Well defined organization culture

Well educated medical staff

78.) In health care organization, the quality department developed an indicator to measure the commitment of the staff to myocardial infarction guidelines. This indicator measure:

Process

Structure

Culture

Outcome

79.) The phrase intensive analysis as used in quality /performance improvement

Applies only to peer review

Is an automatic indication of a problem

Means the trigger is never set at 0%

Includes all defined sentinel events

80.) Which of the following is not a requirement for an organization wide QM program?

Quality management activities include the use of performance measures inn peer review activities

Peer review problems are resolved and opportunities for improvement are taken

Reports to the governing body include the findings from peer review activities

The effectiveness of the program, including peer review, is evaluated.

81.) When the surgeons at sunrise ambulatory surgery center determine that action must be taken to resolve scheduling problems in the operating room, the first task should be to:

Write a letter to each surgeon involved

Form a team of interested surgeons

Refer the issue to administration

Refer the issue to an interdisciplinary QI team

82.) action by the quality professional is an example of data

Collection

Analysis

Tabulation

Reporting

83.) For quality improvement team to deal effectively with conflict, it is important to appoint which of the following to its membership?

Risk manager

Human resources representative

Facilitator

Senior leader

84.) Meaningful quality process measures must be

Relevant and valid

Publicly reported and explainable

Relevant and explainable

Valid and publicly reported

85.) A quality council has started a performance improvement team to reduce medication errors. The team has been meeting for several months and progress has been very low. Which of the following is the most important factor for the quality council to assess with the team leader?

Composition of the team

Number of medication errors since team was started

Team members ability to interpret graphs

Length of team meetings

86.) To reduce the incidence of ventilator associated pneumonia (VAP) in a critical care unit, who should be included on a quality improvement team?

Intensivist, ICU nurse, and respiratory therapist

Primary care physician, infection control nurse, and surgeon

ICU manager, respiratory therapist, and pharmacist

Pharmacist, intensivist, and infection control nurse

87.) Implementation quality management approach

All staff

Quality manager

Leader

Front line staff

88.) One major difference between traditional quality assurance and quality improvement is that quality improvement:

Stresses peer review, while QA focuses on the customer

Focuses on the individual while QA focuses on the process

Stress management by objective while QA stresses team management

Focuses on the process while QA focuses on individual performance

89.) The physical difference between quality assurance and continuous quality improvement is a shift focus from:

Retrospective review to concurrent screening

Individual faults to focus on customer satisfaction

Identify poor performance to good performance

Short term gain to long term one

Practice Question / HDA_Part 3

1.) When comparing averaged immunization data from two pediatric medical groups, it is appropriate to use

2.) The frequency of errors in a particular process would best be displayed in an .....

3.) When assessing an emergency room, the best strategy for data collection is..

4.) In data collection, Qualitative data are to Quantitative data as

5.) After aggregating data, it is important to summarize the information with data-displays so that it is

6.) Which one of the following is not the description of an analysis tool?

7.) The CPHQ uses a run chart or control chart to find trends within a process. A trend is determined by

8.) The CPHQ measures averages to locate the center point in a data group. Which statement is false?

9.) Random Variation is to Special cause of variation as

10.) Secular variation of a time series is represented graphically by

11.) Which of the following statements about capability analysis of a process is TRUE?

12.) The degree to which the average temperature in refrigerators in a hospital falls outside specification on any given day may be displayed in a

13.) The upper limit of a control chart should be

14.) From a study of a sample of patient records for the prior 20 months, the medication error rate was found to be 1 per 1000, with a 90% confidence interval between zero and 3.4 error per 1000.What is the chance that the true value is not covered by the interval?

15.) The upper and lower control limits of a process control chart are three standard deviations from the mean. A data point that falls outside these limits

16.) In which of the following scenarios is rule-based sampling most appropriate?

17.) What is the most likely effect of tampering when dealing with control charts?

18.) A frequency plot may be used to examine

19.) A data inventory and a data dictionary will

21.) What is the maximum time interval between data points on a run chart?

22.) What is the minimum number of cases in each data point on a run chart?

23.) A 700-bed acute care facility receives 40% of its admissions from the emergency department (ED). Quality problems, especially wait time, were expressed by patients, family members, and physicians. Which tool should the ED team use first in the investigational phase of the improvement process?

24.) In comparing the percentage of falls with injuries in calendar year 2012 between facilities that use restraints and those that do not, which chart should be used?

25.) Which of the following display formats is best used to evaluate the number of ear infections, urinary tract infections, and conjunctivitis experienced by individuals served in a group home?

26.) A line graph may be transformed into a run chart by

27.) The monthly rate of resident falls in the past 12 months was plotted on a control chart. All data points are within the control limits but the last data point falls exactly on the upper control limit. The improvement team should conclude that

28.) The first step in collecting meaningful data is

29.) As an external consultant, you have completed a gap analysis of an acute care facility that is preparing for TJC accreditation. Which of the following charts will you use to summarize your findings in six of the chapters of standards for the Hospital Accreditation Program?

30.) An emergency department tracks wait times from patient arrival to physician assessment. Data are reported using a run chart. Which of the following demonstrates a true statistical increase in treatment delays?

31.) Which of the following sampling technique involves selecting the medical record of every fifth patient undergoing cardiovascular bypass?

32.) Which of the following tools be used to record patient and practitioner specific data?

33.) When a case manager wants to demonstrate length of stay data that depicts both common cause and special cause variation, which of the following should be used?

34.) Which of the following is a typical size for a customer focus group?

35.) The success of a customer focus group rests principally on the:

36.) Managing data and assisting with mathematical calculations is the best description of:

37.) Which of the following is an example of nominal data?

38.) Which of the following is an example of ordinal data?

39.) Which of the following is an example of ratio data?

40.) Which of the following is an example of Interval data?

41.) Which one of the following is a synonym for count data?

42.) The sampling of 5% or 30 cases, whichever is greater, is an example of sampling

43.) The test used to analyze the difference between 2 means is the:

44.) If you want to predict IV site infiltration based on osmolarity of the IV solution and the addition of potassium to the IV, you should use:

45.) Which test is often used by quality managers when data is counted, not measured?

46.) Which of the following is the best confidence interval?

47.) Which of the following is the best confidence interval?

48.) Historically, when the level of significance has been belowresearchers have rejected the null and declared their results statistically significant.

49.) A freeform generation of ideas best describes:

50.) The appropriateness of care is

51.) A medication is ordered for a diabetic patient. Its capacity to improve health status, as a dimension of quality or performance, is its

52.) If, in the continuous quality improvement process, we increase our emphasis on customer satisfaction and outcomes of care, which two dimensions of quality /performance must be incorporated into all quality management activities?

53.) The quality professional can best facilitate the development of a quality culture in an organization by

54.) The task of setting up an ambulatory care setting QM/QI program that focuses on outcomes as a measure of treatment effectiveness is difficult because

55.) In developing a program to evaluate the effectiveness of physician care, a primary care clinic would select which one the following indicators?

56.) The perception of quality by a patient receiving care in an ambulatory healthcare center is influenced most by

57.) Total quality management philosophy assumes that

58.) A potential conflict between the philosophy of total quality management and quality improvement in healthcare is the challenge in Demings Principles to

59.) What is the most important relationship between structure, process and outcome as types of indicator of quality?

60.) Which of the following best describes the successful outcome of the quality improvement process?

61.) Monitoring the specific organization and content requirements of a medical record system is a review of which focus?

62.) The major difference between traditional quality assurance activities and the expanded quality improvement /performance improvement activities is the QI/PI focus on

63.) The centerpiece of outcomes management in healthcare is

64.) Common causes of problems in processes refer to

65.) Review of the timeliness of high risk screening for diabetes addresses which focus?

66.) Under the quality improvement paradigm, which statement is incorrect?

67.) Within the context of total quality management philosophy, communication of quality is

68.) The team working on a improvement plan using Rapid Cycle. After they pilot the program, analyzed data and determined that the action is effective. What is the next step?

69.) For CQI to be successful, who must be included in staff:

70.) For CQI to be successful who must be included in staff:

71.) Who is responsible for providing CQI direction

72.) Who is responsible for quality improvement with organization

73.) Who is responsible for creating and monitoring the implementation of improvement project work plan and time line?

74.) Who is ultimately responsible for the effective implementation of the quality program:

75.) Most effective way to integrate performance improvement through the organization:

76.) In an integrated delivery system, the success of the quality strategy is most dependent on the effectiveness of the

77.) Which of the following element must be present in order to evaluate effectiveness of healthcare organization quality improvement program?

78.) In health care organization, the quality department developed an indicator to measure the commitment of the staff to myocardial infarction guidelines. This indicator measure:

79.) The phrase intensive analysis as used in quality /performance improvement

80.) Which of the following is not a requirement for an organization wide QM program?