Ragava International Statistical Institute - Global Healthcare Training

1.) In any quality management approach, how can you best evaluate the effectiveness of action taken?

Use the same performance measures to re-monitor the process

Formulate a new special study to monitor the action.

Interview the staff involved in implementing the action plan.

Do nothing. Effectiveness is expected with well-planned action.

2.) A continuous quality improvement team has proposed a major change in the billing process for home health service. Staff acceptance of the change is best facilitated by:

Immediate implementation

Medical staff education

Long-range planning

A pilot project

3.) Responsibility of quality improvement teams include all of the following except:

Defining the roles and duties of the members

Communicating results

Setting goals and timetable for the steps of the process

Establishing the need for the team

4.) Which of the following could be used as an outcome measure during indicator development?

Staff adherence to a standard of practice

Compliance rate for specific surgical procedure

Required diagnostic testing performed before medication was prescribed

Laboratory compliance with policy and procedure for drawing peak and though levels

5.) A performance improvement program for supervisors should include

Rapid cycle process

Results of FMEA

Budget variance reporting

Review of patient falls

6.) An ambulatory outpatient care facility identifies an opportunity to improve the turnaround time for reports of X-rays performed at a local hospital. Which of the following groups should be involved in the team to improve the process?

Primary care physician, clinic nurse and clinic administrator

Radiologist, primary care physician, and clinical medical record

Clerical, clinical, and administrative staff from both facilities

Administrative representation from both facilities

7.) Which of the following statements best defines a quality problem?

The gap between what is and what is expected by the customer.

The gap between what is and what is desired by the organization.

The gap between what is and what is the benchmark

The gap between what is and what is expected by accreditation bodies.

8.) A small rural hospital wishes to evaluate customer satisfaction using a survey; the organization has four patient care units, emergency department and Ambulatory unit. Which of the following survey methods provides the most reliable information?

A random sample of 5% of all annual discharge/visits

A random sample of 20% of annual discharges /visits per unit

All discharges /visits of customers with a last name beginning with the letters A-E

All discharges /visits in January and July

9.) A healthcare organizations strategic plan includes, as one of its objective, a customer satisfaction rating of at least 85% in each unit. The overall customer satisfaction rating for the past quarter in 3 units are shown below. Unit A----------88%Unit B..80%Unit C..62%Which of the following should the quality professional recommend?

Provide incentives to the staff of Unit B and Unit C

Share Unit As practice with the other units

Review the performance of the manager of Unit C

Change the target for customer satisfaction rating to 90%

10.) The following information about falls is obtained from a facility with units that have similar average daily census: Unit A---6%, Unit B---4%, Unit C---9% and Unit D.8%. What additional information is most important to evaluate the cause of the falls?

Time of day

Compliance with fall protocol

Number of fall

Medication education

11.) A quality improvement manager received the results from the most recent customer survey. Sixty percent of the residents in the nursing home have rated the temperature of foods as poor. Which of the following actions should be taken first?

Call the dietitian and ask for an explanation

Set up a continuous monitor for review

Ignore the results and assess next quarter

Review previous results and assess trends

12.) The team approach in quality improvement activities is preferred when

Financial resources are scarce

The solution is evident

Data management is required

The process has many owner

13.) The medical record manager reports that authentication of verbal orders occurs 25% of the time, as compared to a reported 85% in situations, which of the following is the initial action for the manager to take?

Recommend continued measurement of the indicator

Share the data with the medical staff

Organize PI team

Recommend improvement strategies

14.) When a surveyor reached for regulatory visit, the first question that the quality professional will ask for is

Please let me see your identification

Let us sit to schedule for your visits

Which area of compliance would you like to review

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15.) One way to measure clinical outcomes is through

Aggregate data review

Pareto charts

Pre-admission review

The number of healthcare contracts

16.) Thedimension of quality/performance that is addressed by introducing a rapid response team in a hospital is

Continuity of care

Efficiency

Effectiveness

Prevention and early detection

17.) When. Developing department specific performance measures and indicators, the quality manager as a consultant should:

Prioritize the quality indicators for selection by the department leader

Ensure that the numerator and denominator are clearly defined

Review the mission statement and seek physician input

Conduct a literature search and select quality indicators

18.) Which of the following is the most appropriate question to ask when reviewing an organizations performance improvement plan?

Has the organization been successful in communicating the intent and message of the PI plan to employees?

Are there sufficient organizational resources to support the PI plan?

Does the PI plan include Statistical methods for monitoring change?

Is the PI plan consistent with the organizations mission and strategic priorities?

19.) Which of the following is example of outcome measure:

Mortality rate

Average LOS

Medication dispensing rate

Lab specimen

20.) One of the aims in the treatment of severe community-acquired pneumonia is to maintain an oxygen saturation of >94% (or 88-92%) in patients with chronic obstructive airway disease). Ensuring adequate oxygenation for this condition is

Process and outcome measure

Structure measure

Process measure

Outcome measure

21.) The first step in the design process of a QI plan is:

Determine the scope of the organization

Make a cost-benefit analysis

Establish performance objective

Establish the project goals

22.) A facility is providing a new service for patients with chronic pain. Which of the following is the primary role of the healthcare professional in evaluating this new service?

Comparing outcome to benchmark data

Evaluating cost benefit ratio

Assuring the staff is adequately trained

Developing performance monitoring criteria

23.) Quality improvement plan must be

Focused on organizational improvement

Consistent with business goals and objectives

Evolve the training plan of hospital

Ensure regular maintenance program

24.) A performance improvement team aims to reduce the rate of post-surgical infections rates in a small rural acute facility. Which of the following should the team use as a reference?

The post-surgical rates among individual surgeons

Post-operative antibiotic use among the surgeons

National benchmark post-surgical infection rates based on the most recent research

Post-surgical infection rates in similar facilities

25.) Which of the following concerns would be best solved by a QI team?

A system issue

A discipline problem

A customer complaint

A financial variance

26.) In developing a performance improvement action plan the first tool to use is

Control chart

Interrelationship diagram

Cause and effect diagram

Pareto chart

27.) The senior leaders of a hospital are prioritizing performance improvement initiatives for the coming year. Which of the following tools will be most useful for this purpose?

Pareto chart

Cause-and-effect diagram

Affinity diagram

Stratification

28.) After administration of the flu vaccine, the quality professional measures how many people caught influenza after administering the vaccine. In this case which dimension she measures:

Efficacy

Effectiveness

Availability

Appropriateness

29.) There were a large number of late visits for home care. The quality professional wants to talk to the home care nurse at this problem. What is the best approach?

Explain the cause of the problem and ask for solution

Describe the problem ask for feedback

Share his home care experience

Observing her visit process

30.) Which one should be included when reporting PI to GB:

Team achievements

Team minutes

Occurrence and incident reports

Trend of improvement

31.) If a hospital has a problem with multi-disciplinary teams performance during CPR, what is the best method to assess the problem?

Observe the process

Review the hospitals code policy

Survey the staff

Review medical record documents

32.) Infection rate in practitioner A is higher than B, the quality professional should make:

FPPE

OPPE

DO nothing

Privilege review

33.) The infection rate in practitioner A is found to be higher than that of practitioner B. The quality professional should make:

FPPE

OPPE

Do nothing

Refer the issue to peer review

34.) The primary goal of quality/performance improvement is to improve

Patient care process

Patient safety

Patient outcomes

Patient satisfaction

35.) A nursery home 60% of residents complained of food that was delivered cold as a quality professional you should do:

Call dietician and ask for explanation

Review previous results and trend data

Do nothing

Perform kitchen audit

36.) A performance improvement team has been created to examine infection rates following surgery. Which of the following is the best reference for the team to use?

Hospital infection rate following surgery among similar facilities

Number of surgeries performed among similar facilities

Individual infection control rate for each surgeon

Postoperative antibiotic use among surgeons

37.) A performance improvement team aims to reduce the rate of post-surgical infection rates in a small rural acute care facility. Which of the following should the team use as a reference?

The post-surgical infection rates among individual surgeons

Postoperative antibiotic use among the surgeons

National benchmark post-surgical infection rates based on the most recent research

Post-surgical infection rates in similar facilities.

38.) The best way to evaluate effectiveness of performance improvement training is through

Self-assessment

Participants feedback

Observed behavioral changes

Post-test results

39.) All of the following conditions contribute to system improvement except:

Measuring performance of process & their outcomes using valid statistics methods

Taking action to improve the way the processes are discharged and carried out

Studying & understanding the complex process that contribute to care

Identifying and responding to individual performance issues

40.) QP search on data of other facilities to improve providing of care, this assessment method called:

Statistical analysis

Benchmarking

Gap analysis

Outcome measurement

41.) Performance improvement team are used to:

Evaluate data

Root cause analysis

Identify problem

Data collection

42.) Quality improvement strategic plan

Shows future direction of quality in org.

Asses opportunities to improvements

Encourages team involvement

Promotes safety culture

43.) After PI team finish the program who will write the report or present the results

Team leader

Facilitator

Recorder

Team member

44.) After.education of continuous quality improvement program to evaluate effectiveness of the program:

Do pre & post education exam

Evidence that the staff begin continuous quality improvement activities

Monitoring the previous performance of the staff

Review the attendance rate of the staff

45.) Which of the following is not a function of the facilitator on a quality improvement team?

Keep the group focused on a central issue

Tactfully prevent anyone from dominating the discussion

Manage time

Keep minutes and records of the teams effort

46.) Who is responsible of quality improvement within the organization?

Quality manager

Frontline staff

Everyone within the organization

Chief Executive officer

47.) QI program start on reality when:

The staff believe it is desired

Staff be owners and start to participate

Budget allocated

Leadership is involved

48.) After-in-depth data analysis, there is evidence of over utilization of computerized tomography to diagnose acute appendicitis. A team has been formed to develop a performance improvement plan for emergency department physicians. Which of the following leadership style is most effective to implement best practice guidelines?

Laissez faire

Democratic

Participatory

Autocratic

49.) When describing continuous quality improvement (CQI) to a senior administrator in a healthcare organization, which of the following is not a component of CQI:

Analyzing clinical processes

Empowering all levels of employees to improve quality

Identifying individual practice patterns

Analyzing variation

50.) A facilitator in a team meeting:

Participate in the discussion of topics

Change the topic of the meeting

Modulate the meeting

Allocating budget

Practice Question / PI_Part 1