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Question # 4

Reviewing organizational priorities, addressing regulatory requirements, and identifying goals for the next year are important components in the development of which of the following?

A.

annual competency checklist

B.

survey readiness teams

C.

incentive bonus plans

D.

quality improvement plan

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Question # 5

A healthcare quality professional Is facilitating the establishment of a Quality Council for an outpatient surgery center. The following positions have been selected for membership: medical director, CEO. and CFO. Which of the following Is the most appropriate Individual to add?

A.

human resources director

B.

medical records director

C.

environmental safety officer

D.

nursing director

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Question # 6

Evaluating data to determine high utilizers ofemergency departments and their related characteristics is a strategy that can best help with

A.

hospital throughput.

B.

culture of safety.

C.

population health management.

D.

high reliability.

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Question # 7

Which of the following is an example of improving primary prevention strategies?

A.

Providing free flu vaccinations at the local community center

B.

Reducing time from stroke diagnosis to inpatient admission

C.

Assessing rehabilitation utilization rates for total hip replacement patients

D.

Setting parameters for non-compliant diabetic patients needing nutrition referrals

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Question # 8

Toassess compliance with quality standards, a healthcare organization needs

A.

standardized data collection methods.

B.

approval by the governing body.

C.

a dedicated standards assessment team.

D.

an electronic data analysis program.

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Question # 9

Which of the following identifies project deliverables as well as periods with simultaneously occurring activities?

A.

Pareto

B.

Gantt

C.

PERT

D.

A3

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Question # 10

Organizational leadership asks the healthcare quality professional to review patient identification safety events and develop an action plan. Which of the following steps is most effective for defining the problem?

A.

Review relevant policies and procedures

B.

Trend data with a control chart

C.

Use a Pareto chart to identify key issues

D.

Create a value stream map

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Question # 11

Which of the following best describes the goal of the Healthy People Initiative?

A.

Support health promotion and disease prevention across the lifespan.

B.

Provide each state with individualized plans for improving vaccination rates.

C.

Reduce the spread of infectious disease and prevent pandemics.

D.

Allocate funding to prevent disparities related to social determinants of health.

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Question # 12

The facility’s compliance rate on pain assessment is shown below:

Compliance Rate on Pain Assessment

January

February

March

Physicians

40%

50%

20%

Nurses

80%

75%

83%

Physical Therapists

60%

55%

50%

To improve performance, what should be done next?

A.

Disseminate the results to nursing staff

B.

Hire a pain management specialist

C.

Continue monitoring for another quarter

D.

Create an action plan with the department leaders

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Question # 13

A quality professional was asked to assist with strategic planning. Which ofthe following should have the primary impact on the quality and performance improvement goals?

A.

results of gap analysis

B.

findings from a staff needs assessment

C.

financial statement of the organization

D.

report of major competitors' performance

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Question # 14

A hospitalized patient received a medication that was contraindicated based on their home medications. This should have been prevented by

A.

Reaching out to the patient's family to discuss medications

B.

Obtaining a list of the patient's current prescribed medications

C.

Using the teach-back method on medication education

D.

Performing a medication reconciliation upon hospital admission

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Question # 15

Which of the following would provide the best information to a Quality Council interested in evaluating the effectiveness of quality improvement teams that were chartered during the past year?

A.

participant feedback about the dynamics of their team, ability of each team to meet pre-determined project milestones, and results of the team’s work

B.

a comparative matrix of each team's goals, demonstrated proficiency with statistical process control, and participant feedback about team members

C.

team diversity as evidenced by professional credentials of members, meeting minutes for productivity assessment, and aggregate member satisfaction data

D.

a summary of each team’s charter, timeliness of tasks completed by each team, and validation of each team’s commitment to conflict prevention

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Question # 16

Which of the following is a healthcare quality professional’s key responsibility for supporting organizational quality governance?

A.

assessing the board’s understanding of quality topics

B.

updating board members on key performance indicators

C.

presenting regular financial updates to the organization’s leaders

D.

deciding which quality initiatives will be set as priorities

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Question # 17

A facility plans to provide a new specialty. Which of the following will best provide information on the effectiveness of the specialty?

A.

A fishbone diagram identifying potential barriers to success

B.

Service line specific measures of performance

C.

Customer interviews of those who experienced the service

D.

A process map of the department's current workflow

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Question # 18

Cold-spotting involves identifying populations that

A.

engage in high-risk behaviors.

B.

lack access to healthcare or other community support.

C.

receive care through state and federally funded programs.

D.

utilize healthcare services frequently.

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Question # 19

The office manager of a primary careoffice reviewed the performance of the providers and noted that one provider has not been completing depression screenings consistently for patients in the previous month. The manager's next action is to:

A.

Discuss the findings in the next staff meeting.

B.

Encourage the medical assistants to complete depression screenings.

C.

Talk to the doctor privately about the result.

D.

Review the previous three to four months' performance of the provider.

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Question # 20

Integration of a quality culture within an organization Is best demonstrated by

A.

reduced adverse outcomes, culture of patient safety, and expansion of services.

B.

mission and vision statements, high patient census, and governing body involvement

C.

physician competence, staff longevity, and high patient satisfaction scores.

D.

leadership rounds. Increased staff satisfaction, and positive patient outcomes.

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Question # 21

Which of the following actions will best promote organizational efficiency in managing quality improvement projects?

A.

Create a team whenever there is an improvement project

B.

Identify project managers for all improvement projects

C.

Assign some projects to individuals and others to teams

D.

Only approve projects that have a high return on investment

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Question # 22

Which action should be taken to support continuous survey readiness?

A.

Facilitate a failure mode and effects analysis (FMEA) on patient consent

B.

Conduct time studies for patient registration processes

C.

Map the value stream for elective surgery patients

D.

Perform tracers on patients in restraints

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Question # 23

A healthcare quality professional can conclude that clinical performance measures in disease specific certification programs are best supported by the

A.

practice guidelines.

B.

regulatory requirements.

C.

compliance committee.

D.

licensing requirements.

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Question # 24

The staff in the outpatient department complete the morning schedule at varied times. There are multiple factors in the variation such as number of patients, complexity of the cases, and the number of cancellations. To identify common-cause variation affecting the completion of the morning schedules, what type of chart should be utilized?

A.

pie chart

B.

bar chart

C.

line graph

D.

control chart

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Question # 25

A healthcare quality analyst compiles and analyzes data to facilitate performance improvement opportunities. The most suitable data review to proactively control cost would be which type of review process?

A.

Retrospective

B.

Prospective

C.

Administrative claims

D.

Clinical records

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Question # 26

Using clinical guidelines based on scientific evidence will most likely

A.

Improve practice patterns.

B.

promote regulatory compliance.

C.

Increase patient satisfaction.

D.

stimulate practice variation.

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Question # 27

The upper and lower limits of a control chart are

A.

calculated from actual process measurements.

B.

calculated by projecting future requirements.

C.

derived from special cause variation.

D.

derived from external regulatory standards.

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Question # 28

An organization conducts daily briefing sessions. Which of the following questions demonstrates a culture of safety?

A.

"Do we have available beds in the ICU?"

B.

"Did anything happen last night that could lead to a central line infection?"

C.

"Who is the last person that committed a medication error?"

D.

"What was the patient’s intake and output?"

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Question # 29

Latent conditions can be described as

A.

Specific unsafe acts that have adverse consequences

B.

Defects that may go undetected for long periods of time

C.

Unintentional mistakes made by an individual

D.

Errors having a direct and immediate effect on safety

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Question # 30

Prior to a regulatory or accreditation visit, a healthcare quality professional should:

A.

Hire a consultant.

B.

Evaluate employee performance.

C.

Perform time-outs.

D.

Complete a gapanalysis.

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Question # 31

The tool used to graphically rank causes from most significant to least significant by using a vertical bar graph is known as a

A.

Gantt chart.

B.

Pareto chart.

C.

run chart.

D.

histogram.

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Question # 32

A positive correlation Is seen in a scatter diagram when

A.

increases on the x-axisrelate to decreases on the y-axis.

B.

there is a scattering of points in a triangular pattern.

C.

there is a scattering of points in a circular pattern.

D.

increases on the x-axis relate to increases on the y-axis.

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Question # 33

A CEO has directed a quality improvement council to develop objectives to meet an identified goal. When developing objectives, the council must remember to

A.

keep the objectives specific to the short term.

B.

tie the objectives to theorganization’s financial performance.

C.

use the Plan-Do-Study-Act cycle of continuous improvement.

D.

state the end result or desired outcome.

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Question # 34

Which team role is responsible for maintaining improvements after the implementation of a quality initiative?

A.

Champion

B.

Process Owner

C.

Sponsor

D.

Facilitator

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Question # 35

A hospital collects patient satisfaction data by mailing surveys to patients discharged home and analyzes the responses they receive. What is the most significant limitation of this sampling methodology?

A.

Patients may notrespond to all questions in the survey.

B.

Responses will be time-consuming to convert from hard copy responses to soft copies for data storage.

C.

Hospital employees have no control over which patients respond to the survey.

D.

Patients who respond to the survey may not be representative of all discharged patients.

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Question # 36

Which of the following Is an example of active surveillance?

A.

analyzing laboratory data for disease testing utilization

B.

Identifying disease outbreaks through public healthcontact tracing

C.

analyzing Infectious diseases based on hospital discharge final coding

D.

reporting of Infectious diseases data quarterly to local health departments

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Question # 37

The purpose of sentinel event review of never events is to

A.

engage leadership in identifying barriers to effective communication.

B.

identify individual performance gaps that resulted in the sentinel event.

C.

monitor staff and leadership involvement in the systematic analysis.

D.

specify sustainable systems-based improvements.

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Question # 38

Which of the following elements of an audit for a primary care office provides information about patient safety?

A.

Hours of operation and after-hours access

B.

Emergency supplies and medications

C.

Medical record privacy policy

D.

Capacity to accept new patients

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Question # 39

A new urgent care clinic is setting up a quality management system. Which of the following is the bestchoice as a process measure to evaluate effective clinical care?

A.

percent of patients that rate care as "satisfactory" or "highly satisfactory"

B.

raw number of influenza vaccines given in the annual flu season

C.

percent of antibiotic prescriptions that meet evidence-based guidelines

D.

average wait time between check-in and seeing a provider

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Question # 40

Quality measures must be relevant, scientifically sound, and

A.

Confidential

B.

Inexpensive

C.

Feasible

D.

Flexible

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Question # 41

The quality improvement (QI) specialist recognizes that any documents related to medical peer review are:

A.

Classified as confidential documents.

B.

Used to determine privileges.

C.

Reviewed during accreditation surveys.

D.

Included in QI research.

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Question # 42

Which of the following is the phase of D-M-A-I-C that is most suitable for ensuring the new process performance is sustained?

A.

Measure

B.

Analyze

C.

Improve

D.

Control

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Question # 43

A quality improvement team has been trained on writing SMART aim statements. Below are the team’s aim statements:

Reduce adverse drug events in critical care by 10% within 12 months.

Reduce the time from 911 call to intervention for cardiac complaints by 15%.

Reduce30-day readmissions from 20% to 15%.Which of the following key elements in aim development appears to have been lost after the training?

A.

time-bound

B.

achievable

C.

measurable

D.

specific

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Question # 44

The main goal of a clinical pathway/guideline Is lo

A.

assist in documentation of care.

B.

document practitioner variances.

C.

guide the patient's care toward identified outcomes.

D.

ensure precise treatment plans are followed.

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Question # 45

Which of the following is most effective to sustain knowledge gained from performance improvement training?

A.

Integrating key improvement teachings into daily work

B.

Rewarding demonstrations of performance improvement

C.

Using simulations to illustrate complex concepts

D.

Requiring repeat training and reassessments

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Question # 46

A healthcare quality professional is charged with facilitating a team. The goal of the team is to develop criteria for levels of care in behavioral/mental health. Which of the following is the most important characteristic of the facilitator?

A.

ability to select team members

B.

knowledge of behavioral/mental health

C.

ability to moderate a work group

D.

knowledge of levels of care

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Question # 47

A healthcare quality professional has been informed of a significant medication error resulting in patient harm. A multidisciplinary team should be selected to conduct a

A.

Multiple regression analysis

B.

Variation analysis

C.

Root cause analysis

D.

Failure mode and effects analysis (FMEA)

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Question # 48

What Is the Initial step the quality professional should take when the organization's performance on a patient satisfaction strategic goal Is below the desired performance?

A.

Research Industry benchmarks.

B.

Review department-specific data.

C.

Form a quality improvement team.

D.

Initiate a needs assessment

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Question # 49

An ambulatory care practice has reviewed data to identify patients with multiple visits to the emergency room within the last six months. The population health management technique for this type of data review is called

A.

Cold-spotting

B.

Hot-spotting

C.

Syndromic surveillance

D.

Public health surveillance

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Question # 50

The control chart above indicates which of the following?

A.

Common cause variation

B.

Special causevariation

C.

Unique cause variation

D.

No variation

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Question # 51

The best means of reducing sentinel events In a care delivery system Is

A.

layering methods of mistake-proofing.

B.

removing the human variables.

C.

incorporating the perspectives of patients.

D.

using computerized decision-making tools.

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Question # 52

Establishing a culture of safety begins with having the right

A.

recruitment strategies.

B.

plan.

C.

leadership.

D.

educational programs.

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Question # 53

A healthcare quality professional has been hired to assist a quality improvement team with data analysis. In an attempt to enhance the team’s analysis of the data, the quality professional should

A.

Use visual, graphical methods to present the data

B.

Collect and present all the completed data collection tools

C.

Publish and disseminate raw data in tables

D.

Direct the team to collect as much data as possible

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Question # 54

A director at a large health system is tasked with building a new population health program. What is the director’s first step?

A.

Implement artificial intelligence programs to stratify patients into categories of risk.

B.

Identify strategies to incorporate social determinants of health screenings.

C.

Design a complex care management programfocused on chronic health conditions.

D.

Analyze the data infrastructure capabilities and sources of information.

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Question # 55

The collection, analysis, and Interpretation of data for planning, Implementing, and evaluating health programs is

A.

prevalence.

B.

surveillance.

C.

Incidence.

D.

sampling.

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Question # 56

Which of the following is most important to include in a project to reduce post-operative infections?

A.

evidence-based literature

B.

a multidisciplinary team

C.

staff education

D.

data collection tools

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Question # 57

The ability to safely manage complex tasks in the face of time pressures, quickly identify and contain errors, and bounce back after stressful situations relates to organizational:

A.

Lean capacity

B.

Resilience

C.

Disaster readiness

D.

Safety rules

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Question # 58

A healthcare quality professional, previously employed by a hospital, has been hired by an ambulatory surgery center to create a continuous readiness program. Both employers are Medicare certified and are accredited by the same accrediting organization. The healthcare quality professional should first

A.

Assess current organizational practices related to on-site survey and regulatory visits

B.

Conduct individual, systems, and focused tracers across the organization

C.

Develop an education program for leaders and staff about continuous readiness

D.

Review setting-specific regulatory and accreditation requirements

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Question # 59

A healthcare quality professional Is doing a study in the emergency room. Every other patient admitted to the department Is Included in the sample. This sampling technique Is best described as

A.

quota.

B.

systematic.

C.

cluster.

D.

stratified.

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Question # 60

An organization has Just experienced a wrong site surgery. A quality leader was asked to conduct a review to understand how the process failed. The best quality Improvement tool to use In developing a shared understanding of the current process Is which of the following?

A.

Ishlkawa diagram

B.

stratification chart

C.

matrix diagram

D.

flowchart

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Question # 61

The healthcare quality professional has been asked to participate in the organizations population health program related to cost and utilization.

Based on this Information, what Is the next action the quality professional should take?

A.

Request Information on the cost per patient for those discharged to skilled nursing facilities.

B.

Request Information on total number of patients discharged to each location for both quarters.

C.

Analyze the appropriateness of discharges to Inpatient rehabilitation centers.

D.

Analyze the cost differences between patients discharged to home and skilled nursing facilities.

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Question # 62

A researcher decides to look at every fourth patient admitted each day and record if the IV is properly labeled, starting with a randomly selected patient. This is known as which of the following types of random selection?

A.

Simple

B.

Convenience

C.

Systematic

D.

Stratified

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Question # 63

An organization's culture is best assessed by examining the

A.

behavioral alignment with the core values.

B.

collaboration of medical staff and administration.

C.

number of performance improvement activities.

D.

involvement of each patient care department in strategic planning.

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Question # 64

A multidisciplinary team has been convened to review delays in laboratory turnaround time between the medicine clinic and the laboratory. The team's first step in evaluating the issue is to

A.

create a flow chart to study the process.

B.

see If the surgery clinic Is also experiencing delays.

C.

conduct a failure mode and effects analysis.

D.

observe how the medical assistants prepare the specimens.

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Question # 65

Physician quality data reports for all credentialed physicians disseminated at regular Intervals, as generally mandated by accreditation standards, are called

A.

focused professional practice evaluation (FPPE).

B.

CMS star ratings.

C.

quality spot checks.

D.

ongoing professional practice evaluation (OPPE).

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Question # 66

Consider the following data set:

DRG | Reimbursement | Cost

079 | $4,500 | $15,000

089 | $6,800 | $23,500

127 | $3,500 | $25,000

468 | $8,200 | $12,500

475 | $12,000 | $40,000

Which of the following is the best way to illustrate the relationship between reimbursement and cost?

A.

Mean

B.

Standard deviation

C.

Pie chart

D.

Scatter diagram

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Question # 67

When reporting infection control indicators to a governing body, a healthcare quality professional should demonstrate improvement with which of the following tools?

A.

run chart

B.

frequency plot

C.

pie chart

D.

scatter plot

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Question # 68

Which of the following should be a part of an organization's program of continuous readiness for accreditation?

A.

Conduct quarterly training on accreditation standards.

B.

Schedule the accreditation survey when the organization's CEO Is available.

C.

Maintain detailed agendas for environment of care rounding.

D.

Perform periodic audits to ensure standards for accreditation are met.

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Question # 69

Which of the following tools is most useful for an organization to complete prior to implementation of a new device for administration of intravenous chemotherapy?

A.

Cause and effect diagram

B.

Failure mode and effects analysis (FMEA)

C.

Common cause analysis

D.

Root cause analysis (RCA)

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Question # 70

A healthcare quality professional has been asked to evaluate the integrity of the data used for physician scorecards. When the data abstractors are asked to review physician A's charts, they each report back conflicting information on the physician’s performance. The results are as follows:

Abstractor 1: Compliance = 85%

Abstractor 2: Compliance = 75%

Abstractor 3: Compliance = 100%

This most likely indicates a problem with

A.

Sampling selection

B.

Interrater reliability

C.

Review tool validity

D.

Data definition

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Question # 71

When an identified solution requires significant change, the best tool to increase the likelihood of success is a:

A.

Force field analysis

B.

Fishbone diagram

C.

Pareto chart

D.

Decision matrix

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Question # 72

Which of the following interventions has the greatest potential for positive impact due to its ability to address social determinants of health?

A.

public transportation system expansion

B.

access to clean syringes

C.

tobacco control interventions

D.

worksite obesity prevention program

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Question # 73

A quality professional is leading a rapid process improvement event to reduce central line infections. Which of the following actions should be taken?

A.

Design indicators for hospital-wide data collection plan

B.

Search the United States Preventive Services Taskforce for recommendations

C.

Review the Agency for Healthcare Research and Quality for relevant resources

D.

Conduct a systematic review of studies in intensive care units

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Question # 74

A healthcare quality professional works in a primary care setting and has been asked to develop a patient safety program. The first step in program development is to

A.

complete a literature search.

B.

survey patients.

C.

visit similar organizations.

D.

define the scope.

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Question # 75

A physician challenges the number of healthcare-acquired infections reported for orthopedic surgery. Which of the following will be most effective in demonstrating the validity of the information?

A.

antibiotic usage by the orthopedic department

B.

criteria used to classify infections

C.

start time of antibiotics for each patient

D.

infection control procedure manual

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Question # 76

The strategic plan for an organization calls for expansion of information technology. The following information is available:

If equal weight is given to each consideration, which of the following options should be the primary choice?

A.

Option A

B.

Option B

C.

Option C

D.

Option D

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Question # 77

An initial step to address health disparities within a population is to:

A.

Expand the collection and standardization of health equity data.

B.

Create dashboards to visualize gaps in health equity.

C.

Increase accessibility to healthcare services for all equally.

D.

Engage with community leaders and identify available resources.

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Question # 78

A quality professional's key role in a performance improvement team is to serve as a:

A.

Process owner

B.

Decision maker

C.

Group facilitator

D.

Clinical champion

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Question # 79

The benefits of performing a community health assessment include

A.

Increasing knowledge about public health within the community

B.

Targeting a neighborhood for a more manageable assessment

C.

Allocating resources to the top opportunities for improvement

D.

Improving core measure performance in the organization

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Question # 80

A healthcare organization wishes to develop an education plan for quality and patient safety. Based on adult learning principles, the plannededucation Is most likely to be effective when

A.

training is provided by a subject matter expert, attendees have opportunities to ask questions, and written materials are provided.

B.

the content Is designed to meet accreditation standards, the training Is highly encouraged, and learners are allowed to obtain on-demand training.

C.

the program Is designed for delivery at the department level, staff are recognized for attendance, and written competency tests are administered.

D.

there is opportunity for active participation, staff members recognize a need to learn, and the material is presented in a logical progression.

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Question # 81

The focus for performance Improvement should be

A.

employees.

B.

systems.

C.

standards and regulations.

D.

policies and procedures.

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Question # 82

Which tool Is used to Identify resources needed to complete a project?

A.

control chart

B.

cause-and-effect diagram

C.

SIPOC diagram

D.

value stream man

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Question # 83

An organization has identified an increase in safety events related to the treatment of patients who are unable to give consent. At the beginning of the improvement process, which of the following tools should the healthcare quality professional use to assist the team?

A.

flow chart

B.

stakeholder analysis

C.

PERT chart

D.

force field analysis

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Question # 84

A quality improvement team develops a new procedure for improving timeliness in reporting urgent lab results to inpatient units. Prior to implementing the new procedure, the team wants to identify any potential deviations from the desired procedure. Which of the following tools should the team use to identify potential deviations?

A.

run chart

B.

interrelationship diagram

C.

matrix diagram

D.

process decision program chart

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Question # 85

A newpediatric psychiatric unit will open in one year. The utilization coordinator is responsible for developing the utilization management program. The program's success will depend on which of the following factors?

A.

Involving the team members in the development of the program

B.

developing the program and presenting it to the appropriate staff members

C.

obtaining approval from the chief psychiatrist at each stage of development

D.

providing educational in-services to all team members involved

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Question # 86

A performance improvement team has been examining delays in getting admissions from the emergency department (ED) to the coronary care unit. The team has collected data and determined that a significant number of delays are occurring because cardiologists are not consulting on their patients in the ED in a timely manner. The best way to communicate this information to the cardiologists is to:

A.

Prepare a letter for the Chief Administrator's signature to all cardiologists, requesting their assistance.

B.

Attend the next cardiologists' meeting to solicit their input.

C.

Forward all delays from the ED to the cardiology peer review committee.

D.

Ask the team leader to e-mail all the cardiologists and describe the problem.

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Question # 87

A nursing unit has collected the following data:

50 medical records reviewed

Nurse A

Nurse B

Doctor A

Doctor B

Timely initial assessment

45

40

10

25

Incomplete documentation

0

12

26

20

Which of the following is the best method to display this data?

A.

Pareto chart

B.

Bar chart

C.

Run chart

D.

Gantt chart

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Question # 88

In a data set, the difference between the highest and lowest observed values is known as the

A.

percentile.

B.

standard deviation.

C.

range.

D.

quartile deviation.

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Question # 89

A nursing home has established a quality indicator to accomplish a 5% reduction in falls. A guideline has been developed and implemented. After six months, the goal has not been reached. The next action steps should include

A.

revising annual evaluations to include compliance with fall prevention guidelines.

B.

providing feedback on a weekly basis rather than displaying data over time.

C.

measuring employee competency on understanding and use of the guideline.

D.

continuing to measure outcomes monthly and re-evaluate every threemonths.

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Question # 90

Which of the following payment systems carries the most financial risk for a provider?

A.

fee for service

B.

capitation

C.

pay for performance

D.

upside-only bundles

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Question # 91

A nurse inadvertently hung an IV medication on the wrong patient’s IV pump, but discovered the error prior to initiating the infusion. Patient harm was averted, and the nurse disclosed the error to a healthcare quality professional. The quality professional should

A.

encourage the nurse to report the near-miss error through the adverse event reporting system.

B.

recommend that the nurse undergo additional medication safety training.

C.

perform no additional action since the error did not affect the patient, and the nurse disclosed the near-miss.

D.

report the nurse to the manager for not performing safety checks prior to medication administration.

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Question # 92

Which of the following would be the best methodology to reduce referral wait time?

A.

Lean

B.

Six Sigma

C.

Rapid cycle improvement

D.

Plan-Do-Study-Act

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Question # 93

A root cause analysis is required after what type of occurrence?

A.

Patient death

B.

Medication error

C.

Sentinel event

D.

Near miss

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Question # 94

An internal customer of the admission process in a skilled nursing facility is the

A.

nurse completing the Initial assessment.

B.

insurance company.

C.

patient's spouse and family.

D.

patient being admitted.

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Question # 95

A healthcare quality professional is preparing a presentation related to incomplete documentation. According to principles of adult learning, the first step in preparing is to

A.

Determine the audience's knowledge and expectations

B.

Develop an evaluation tool for the presentation

C.

Present an inservice for the staff

D.

Obtain administrative support for the presentation

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Question # 96

Which of the following best describes the goal of the Healthy People Initiative?

A.

Allocate funding to prevent disparities related to social determinants of health.

B.

Support health promotion and disease prevention across the lifespan.

C.

Provide each state with individualized plans for Improving vaccination rates.

D.

Reduce the spread of infectious disease and prevent pandemics.

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Question # 97

An organization recently completed an analysis of safety events from the last year. The majority of events were related to the following:

• provider order transcription errors (5%)

• wrong medication given to the patient (12%)

• adverse reaction related to medication allergies (7%)

• Inappropriate medication dose administered (10%)

• delayed antibiotic administration (10%)

Which of the following would be most helpful to enhance patient safety In this organization?

A.

automated dispensing machine

B.

verbal order read-back

C.

bar code medication administration

D.

computerized provider order entry

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Question # 98

Which of the following performance improvement models is at the core of the Institute for Healthcare Improvement (IHI) collaborative approach?

A.

DMAIC

B.

PDSA

C.

Lean

D.

Six Sigma

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Question # 99

Patient complaints have been received regarding appointment time delays. Which of the following should be completed first?

A.

Form a performance improvement team

B.

Perform a patient survey

C.

Obtain waiting time data

D.

Initiate a new patient registration process

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Question # 100

A stated purpose of the National Committee for Quality Assurance (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS) public reporting is that accountable health care should:

A.

Ensure data is collected and reported annually

B.

Provide valid and reliable data

C.

Require both measurement and transparency

D.

Validate patient experience and satisfaction with care

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Question # 101

The greatest motivator for organization leaders to use a balanced scorecard is that it

A.

Identifies potential risk liabilities

B.

Highlights accreditation standard gaps

C.

Displays financial performance outcomes

D.

Provides key performance information

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Question # 102

A strategy to address social determinants of health would be to

A.

launch a community campaign to promote influenza vaccines.

B.

identify high-risk patients with high-cost medications.

C.

create patient education materials that are culturally competent.

D.

implement a standard questionnaire for pediatric lead screening.

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Question # 103

An organization is adopting Lean Six Sigma as their new performance improvement model. The best approach for providing training on the model is to

A.

display educational materials throughout workspaces.

B.

invite leadership to provide education at department meetings.

C.

require the completion of online training modules.

D.

include application exercises in the training sessions.

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Question # 104

What is the first step in turning an organization’s long-term goals into an operational plan for improvement?

A.

Determine a framework for improvement.

B.

Decide what qualitative data to use.

C.

Select criteria to improve risk and cost.

D.

Align priorities with the strategic plan.

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Question # 105

A long-term care facility has experienced an Increase in occupational Injuries among nursing staff and increased patient harm as aresult of unsafe patient handling. Which of the following is the best example of a human factors design solution this facility could Implement?

A.

development of an organizational minimal lift policy

B.

new lift equipment accessible at the point of care

C.

a dally email with safe patient handling reminders

D.

an education module on safe patient handling

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Question # 106

A patient safety program can best be enhanced by which of the following technologies?

A.

barcode system for medication administration

B.

online evidence-based medicine guidelines

C.

computers on wheels at the patients' bedsides

D.

digital medication reference materials

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Question # 107

When prioritizing quality improvement initiatives, which of the following should take the highest priority?

A.

a high-performing patient experience metric with one month of decreased performance

B.

a process to comply with a new regulatory requirement beginning in the next quarter

C.

a high-risk, low-volume process with common cause variation in the past quarter

D.

an outcome measure outperforming the benchmark for the past 12 months

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Question # 108

The purpose of considering social determinants of health during quality improvement activities is to achieve

A.

global health.

B.

community health.

C.

social justice.

D.

health equity.

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Question # 109

A nursing unit has collected the following data:

Which of the following is the best method to display this data?

A.

Bar Chart

B.

Gantt Chart

C.

Pareto Chart

D.

Run Chart

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Question # 110

An organization has implemented a quality improvement project. The goal is a mean compliance rate of 90%. The results of observations are found in the table below:

Which focus area presents the greatest opportunity for the organization?

A.

patient flow

B.

environment of care

C.

pain management

D.

infection prevention

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Question # 111

Which of the following is the best tool to report process improvements to a quality committee?

A.

Histogram

B.

Flow Chart

C.

Scatterplot

D.

Control Chart

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Question # 112

Which of the following Is true of a clinical pathway?

A.

depicted using a value stream map

B.

limited to one patient care setting

C.

used to reduce variations in care

D.

required for accountable care organizations

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Question # 113

A thorough and credible review of a wrong site surgery must include

A.

Securing the involved equipment

B.

Notifying the rapid response team

C.

Re-training the involved individuals

D.

Analyzing the underlying processes

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Question # 114

To evaluate outcomes, an ambulatory/outpatient care unit should analyze:

A.

Canceled surgeries

B.

Time of surgeries

C.

Admissions to the hospital

D.

Delays in obtaining laboratory results

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Question # 115

Which of the following approaches best allows an agency to align Its activities with organizational goals?

A.

benchmarks

B.

force field analysis

C.

data outcomes management

D.

balanced scorecard

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Question # 116

Which of the following strategies promotes timely completion of a quality improvement project?

A.

allowing the project sponsor to direct the project team's work

B.

assigning the team leader to document overall project progress

C.

requiring team members to devote a majority of their time to project work

D.

focusing routine senior leader updates on project successes

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Question # 117

A managed care peer review committee should obtain which of the following first?

A.

statement of authenticity

B.

clinical practice guidelines

C.

copies of the medical licenses

D.

confidentiality statement

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Question # 118

During a risk assessment, It Is noted that a unit manager and start feel there Is a high risk of aggressive patient behavior toward unit start Which of the following steps should a healthcare quality professional take first?

A.

Organize a staff focus group to explore perceptions.

B.

Discuss with administration the need for increased staff.

C.

Continue to survey staff to assess perceptions of risk.

D.

Review the facility's restraint policy.

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Question # 119

An organization recently lost its deemed status due to non-compliance with grievance process regulations. Which of the following standards would thequality professional research to identify grievance process requirements to correct the cited opportunities for improvement?

A.

Federal Register

B.

Centers for Medicare and Medicaid Services

C.

The Joint Commission (TJC)

D.

DNV GL Healthcare

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Question # 120

Which of the following is the key responsibility of a healthcare quality professional in all types of facilities and organizations?

A.

Resolve the management problems of the organization.

B.

Coordinate Internal support for quality improvement activities.

C.

Identify safety issues of the facility.

D.

Correct clinical qualityproblems.

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Question # 121

An emergency department's quality improvement report for the first quarter showed the following data:

Which of the following additional information should be included in this report for each month?

A.

number of incomplete medical records

B.

turnaround time for laboratory results

C.

number of inappropriate admissions

D.

number of X-rays performed

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Question # 122

Which of the following is the best way to evaluate the success of a performance improvement team?

A.

Incorporation of team recommendations into policies

B.

Adherence to team deadlines

C.

Periodic measurement of outcomes

D.

Identification of improvement opportunities

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Question # 123

To best achieve a low rate of harm in spite of inherent risks in healthcare, an organization must:

A.

Meet at least 95% of accreditation standards.

B.

Employ effective physician leaders.

C.

Apply principles of high reliability.

D.

Adopt a zero-tolerance for defect policy.

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Question # 124

The quality professional has been asked to perform chart audits on a population to assess how often hypertension is being addressed by clinicians when hypertensive patients presented to theclinic in the last year. The clinic has over 8,000 patients diagnosed with hypertension. Which of the following would be most appropriate for the quality professional to consider when selecting a sampling methodology?

A.

Selection of patients who had a visit during the last month of the year

B.

Selection of 400 charts using a simple random sampling method

C.

Selection of 800 patients using a snowball sampling method

D.

Selection of the entire population as a sample to make sure the results are accurate

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Question # 125

A national health plan has recently acquired a local health plan. At the year anniversary of the merger, the -local health plan staff still struggles with the transition to the new organizational values. Which of the following Is the most likely explanation for the difficulty?

A.

Incomplete data integration.

B.

Staff transition program training Incomplete.

C.

Lack of buy-In of the new mission and vision.

D.

Continued support of both mission statements.

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Question # 126

For which incident would a process improvement manager be required to perform a root cause analysis (RCA)?

A.

Incorrect critical care patient transported to radiology.

B.

Admitting a visitor who fell on hospital grounds.

C.

Wrong prescription given to a discharged patient with diabetes.

D.

Procedure performed on the wrong knee.

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Question # 127

In statistics, the p-value provides the data user with

A.

An index of data reliability

B.

A level of significance

C.

A measure of central tendency

D.

A degree of deviation

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Question # 128

Which Is a source of data tor analyzing staff flu vaccination trends for an accountable care organization?

A.

electronic health records

B.

vaccine manufacturer statistics

C.

insurance claims data

D.

pharmacy procurement records

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Question # 129

Continued evaluation of a quality improvement initiative occurs within which of the following phases of the DMAIC process?

A.

Measure

B.

Analyze

C.

Improve

D.

Control

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Question # 130

In aligning an organization's performance Improvement plan with strategic goals, a healthcare quality professional should consider

A.

staff satisfaction data, risk management data, and utilization review data.

B.

customer expectations, occurrence reports, and utilization review data.

C.

staff satisfaction data, benchmarking data, and occurrence reports.

D.

customer expectations, benchmarking data, and patient outcome data.

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Question # 131

Multi-voting Is frequently used in which of the following steps of the quality Improvement process?

A.

identifying root causes

B.

speculating on problem causes

C.

prioritizing Improvement opportunities

D.

Implementing solutions and controls

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Question # 132

A goal of measurement is to collect valid and reliable data that reflects

A.

actualperformance.

B.

targeted performance.

C.

potential performance.

D.

desired performance.

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Question # 133

A criterion is considered valid if it

A.

consistently yields the same results.

B.

does not change with changes in technology.

C.

is applicable to many groups and settings.

D.

measures what it is intended to measure.

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Question # 134

Which of the following Is an example of a population health strategy?

A.

scheduling discharged Inpatients for follow up appointments

B.

reviewing outpatient prescribing patterns for pain management patients

C.

Implementing an employee wellness program

D.

auditingInpatient admission medications for duplicates

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Question # 135

Which of the following is the most effective data display tool to demonstrate changes in monthly patient fall rates for the past fiscal year?

A.

Run chart

B.

Scatter diagram

C.

Fishbone diagram

D.

Pareto chart

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Question # 136

A patient safety manager is asked to recommend the best action to reduce medication errors at a hospital. Which of the following is the most appropriate next step?

A.

Re-educate the nursing staff on correct medication administration procedures.

B.

Conduct research on implementation of a bar code medication administration system.

C.

Ask the unit managers to counsel staff following medication errors.

D.

Drill down onthe data to identify trends before making recommendations.

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Question # 137

Which of the following stages may cause continuous quality improvement teams to dissolve prematurely?

A.

Performing

B.

Storming

C.

Norming

D.

Forming

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Question # 138

A quality council reviewed the following results from a performance improvement project:

Diabetic retinal eye exams

Target

Q1

Q2

Q3

>80%

60%

58%

62%

Which of the following should happen next?

A.

Continue the pilot for another quarter

B.

Implement the change

C.

Review additional data

D.

Plan for the next change

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Question # 139

Leadership at an outpatient multi-specialty clinic is working toward becoming a high-reliability organization. In the past week, there have been three medication errors with high-risk medications in the procedure area. Which of thefollowing responses by leadership is consistent with high-reliability principles?

A.

Create an additional constraint on availability of high-risk medications.

B.

Require medications be double-checked before administration.

C.

Meet with staffinvolved in the errors to gain additional insight.

D.

Ensure risk management staff coordinate disclosure to the patients.

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Question # 140

Which performance improvement tool best evaluates care processes and transitions?

A.

brainstorming

B.

planning grid

C.

affinity diagram

D.

flow chart

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Question # 141

When implementing a new process or procedure, which of the following tools should be used to anticipate and prevent potential problems?

A.

Failure Mode and Effects Analysis

B.

Flow Chart

C.

Root Cause Analysis

D.

Cause and Effect Diagram

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Question # 142

Prior to the implementation of a new electronic health record (EHR), a facility charters a failure mode and effects analysis (FMEA) team. After mapping out the process for creating a new patient chart, the next step should be to:

A.

Examine each step for potential process failures.

B.

Determine the reasons for identified process failures.

C.

Calculate risk priority numbers for each process failure.

D.

Consider the consequences of each process failure.

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Question # 143

Senior leadership is evaluating an organization’s progress toward achieving patient safety goals and has a goal of 100% compliance. Hand hygiene compliance is currently at 80%, and "time-out" compliance is at 90%. A healthcare quality professional should recommend

A.

Projecting the number of preventable adverse events

B.

Prioritizing implementation of strategies

C.

Determining barriers to compliance

D.

Benchmarking with a similar facility

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Question # 144

Which tool is used to identify, explore, and display the possible causes of a specific problem or condition?

A.

Fishbone diagram

B.

Check sheet

C.

Pareto chart

D.

Flow chart

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Question # 145

Which of the following regulatory agencies overseedevelopment of electronic clinical quality measures (eCQMs)?

A.

Occupational Safety and Health Association (OSHA)

B.

The Joint Commission (TJC)

C.

Centers for Medicare and Medicaid Services (CMS)

D.

DNV GL Healthcare

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Question # 146

In preparation for a provider organization accreditation survey, the most effective method for identifying training needs for staff is

A.

conducting a gap analysis with an interdisciplinary team.

B.

benchmarking with other organizations.

C.

engaging a consultant to identify areas needing improvement.

D.

comparing competency requirements with other facilities.

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Question # 147

Leadership at an outpatient multi-specialty clinic Is working toward becoming a high-re I lability organization. In the past week, there have been three medication errors with high-risk medications in the procedure area. Which of the following responses by leadership Is consistent with high-reliability principles?

A.

Ensure risk management staff coordinate disclosure to the patients.

B.

Meet with staff Involved In the errors to gain additional Insight.

C.

Require medications be double-checked before administration

D.

Create anadditional constraint on availability of high-risk medications.

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Question # 148

Several leaders in a healthcare facility have differing opinions regarding the pursuit of alternative certifications and recognitions. The Chief Quality Officer (CQO) has opted to retain an external quality consultant to determine relevance, appropriateness, and readiness for an alternative certification. The most appropriate role for an external consultant is to

A.

evaluate the facility’s needs, goals, and stakeholder input.

B.

determine the final certification selection.

C.

uncover other opportunities for improvement within the facility.

D.

support the CQO’s choice for alternative certification.

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Question # 149

In order to make effective long-term changes, performance Improvement emphasizes the need to study and understand

A.

outcomes.

B.

statistics.

C.

standards.

D.

processes.

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Question # 150

A new pediatric psychiatric unit will open in one year. The utilization coordinator is responsible for developing the utilization management program. The program's success will depend on which of the following factors?

A.

obtaining approval from the chief psychiatrist at each stage of development

B.

developing the program and presenting it to the appropriate staff members

C.

involving the team members in the development of the program

D.

providing educational in-services to all team members involved

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Question # 151

A quality improvement coordinator is asked to develop a training session on team facilitation based onadult learning principles. Which of the following would be the best approach to include?

A.

Ask participants to practice facilitation with the group during class.

B.

Ask participants to study facilitation techniques after class.

C.

Teach all the concepts and test participants at the end of class.

D.

Teach the basic concepts and handout printed slides for participants to refer to after class.

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Question # 152

Recognition of the formal and informal structure of an organization is necessary when implementing a quality improvement program because

A.

teams need to be self-directing.

B.

informal leaders can be influential.

C.

quality improvement programs must consult all levels before recommending policies.

D.

organizational structure should have low variability.

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Question # 153

What is the initial step an organization should take when the strategic goal of improving patient satisfaction has not been met?

A.

Implement benchmarking

B.

Review department-specific data

C.

Perform a needs assessment

D.

Conduct a root cause analysis

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Question # 154

The quality director would like to prepare the team for the upcoming accreditation survey. Which of the following would ensure continuous team survey readiness?

A.

Routine internal evaluations

B.

Gap analysis of any new standards

C.

Annual mock survey

D.

Just-in-time assessments

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Question # 155

An outbreak of measles in a school district resulted in 58 cases over a period of 5 months. Which of the following data displays best illustrates the occurrence of student measles by month?

A.

Gantt chart

B.

Pie chart

C.

Cause-and-effect diagram

D.

Run chart

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Question # 156

When recommending a quality improvement project, the quality professional must first consider

A.

when and how the project outcomes will be measured.

B.

how the project aligns with the organization's strategic goals.

C.

who will provide the resources for the quality project.

D.

what departments and stakeholders need to be engaged.

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Question # 157

Which of the following tools aids decision-making through organizing tasks, issues, or actions based on agreed-upon criteria?

A.

Brainstorming

B.

Multi-voting

C.

Prioritization matrix

D.

Delphi method

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Question # 158

An organization has a three-year accreditation cycle. The highest priority for the first year of the cycle by the accreditation team is

A.

preparing policy documents for review.

B.

performing a standards compliance gap analysis.

C.

using just-in-time training to address standards compliance.

D.

developing new programs to improve patient care.

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Question # 159

Which of the following action plans contains all key components of a SMART goal to support a strategic plan initiative?

A.

Ninety-five percent of hospital staff will complete training on hospital values.

B.

Improve Leapfrog Safety Grade score by one letter grade within 2 calendar years.

C.

Improve overall hospital rating in Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) within 2 years.

D.

Ninety-five percent of survey tracers related to environment of care will be completed on time.

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Question # 160

Leadership at a facility reviewed andrevised business process activities following staff layoffs. The activities were carefully planned, communicated, and implemented according to the plan. One year later, the business is stable but staff morale is very low. Based on the concepts of change theory, this is most likely due to:

A.

Leadership who were not immersed in the change process

B.

The revision of business processes

C.

Late adopters who are resistant to change

D.

A failure to address the needs of the staff who were retained

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Question # 161

Which of the following leads to better population health management in older adults with chronic conditions?

A.

Better clinical research around chronic diseases

B.

Comprehensive assessment of patients' health conditions

C.

Improving relationships between providers and patients

D.

Teaching patients how to access their patient portal

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Question # 162

An organization with a focus on population health may use data to

A.

identify high-risk patients.

B.

determine the voice of the customer.

C.

identify high-risk low-volume processes.

D.

determine high-cost procedures.

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Question # 163

A health system in an underserved area seeks to improve medication adherence in patients with hypertension. One of the barriers identified is patients with limited English proficiency. Which of the following solutions will best improve medication adherence?

A.

Use clinicians with shared language as interpreters.

B.

Use a telephonic interpreter service to communicate instructions.

C.

Provide written medication instructions in patients' preferred language.

D.

Implement an automatic refill program for hypertension medications.

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Question # 164

A hospital quality team notices there is an increased number of falls in the inpatient stroke unit. Which of the following is the best method to analyze the issue?

A.

fishbone diagram

B.

failure mode and effects analysis (FMEA)

C.

brainstorming

D.

process map

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Question # 165

Clinical staff at a hospital inconsistently document the fall risk assessment upon admission. What approach should the quality improvement professional recommend as a priority?

A.

Incorporate a forcing function for the fall risk assessment documentation.

B.

Audit clinical staff for fall risk assessment documentation compliance.

C.

Ensure all staff complete training on how to complete the fall risk assessment.

D.

Educate providers on fall risk assessment documentation requirements.

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Question # 166

A facility’s performance on a clinical outcome measure has deteriorated. The healthcare quality professional’s initial action should be to

A.

Analyze related process measure performance

B.

Re-educate staff on appropriate clinical outcomes

C.

Review current best practices on areas of deterioration

D.

Assess data entry errors in areas of deficiency

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Question # 167

An organization implemented a revised medication reconciliation process 21 months ago. The results of compliance with the revised process were recorded

on a statistical process control chart:

(Use the scroll bar to the right to scroll down as needed.)

Which of the following should be concluded by a performance improvement coordinator after evaluation of the control chart?

A.

The data indicate compliance has decreased.

B.

The data are inconclusive, and additional monitoring is required.

C.

The number of compliant clinicians has increased.

D.

There is an increasing trend toward compliance in recent months.

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Question # 168

A healthcare quality professional identifies a statistically significant difference in uncontrolled hypertension between its African American and Caucasian populations. What is the next best step?

A.

Partner with local community leaders to develop a community garden to improve nutrition.

B.

Evaluate data for an additional quarter to determine if the disparity persists.

C.

Host a community health fair that provides free blood pressure monitors.

D.

Invite patients with uncontrolled blood pressure to attend a focus group to discuss barriers.

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Question # 169

A healthcare quality Improvement team is working on an action plan to address medication system defects. Based on the data from the chart below, what would be the next step?

A.

Begin working to address the "Administration" defects.

B.

Conduct further analysis on "Administration" defects.

C.

Conduct further analysis on "Other" defects.

D.

Begin working to address the "Other" defects.

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Question # 170

A behavioral health hospital implemented restraint audits in each of its nursing units. After two months of data collection, what should the healthcare quality professional do next?

A.

Discontinue data collection for units where audit criteria were met.

B.

Assign a learning module on restraint use for the clinical team.

C.

Recommend peer review of providers who frequently order restraints.

D.

Create an aggregate utilization summary to identify trends.

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Question # 171

To promote staff engagement In a new Initiative, educators should focus on staff

A.

perceptions of the benefits of change.

B.

attitudes of business as usual.

C.

who appear resistant to change.

D.

who want to advance In the organization.

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Question # 172

Benchmark is a term used to describe

A.

Internal organizational performance

B.

Progressive attainment of improvement

C.

Achievement of outcomes

D.

Measurement against others

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Question # 173

Which of the following is the best example of a non-value added step in the healthcare environment?

A.

medication double checks

B.

medication reconciliation at transfer

C.

medication verbal order read-back

D.

medication administration workaround

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Question # 174

A department manager wants to improve customer service. In order to gain employee support, the manager should first

A.

Include customer service in performance reviews

B.

Demonstrate the need for change

C.

Seek authorization of the governing body

D.

Empower the employees

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Question # 175

While auditing a medical chart for breast cancer screening compliance using HEDIS, a quality professional questioned whether a patient’s last screening fell within the lookback period. Where should the quality professional look to ensure compliance?

A.

American Medical Association (AMA) Guidelines for Preventive Care

B.

Organization’s policy on preventive care guidelines

C.

A chart note from the physician stating the patient was compliant

D.

The technical specifications for the measure

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Question # 176

Which of the following is the strongest intervention for preventing medication safety events?

A.

Adding colored warning labels to high-risk medications

B.

Educating providers on accurate medication reconciliation

C.

Limiting the number of medication warnings triggered in the electronic health record

D.

Creating a hard stop for allergy documentation prior to ordering medications

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Question # 177

Where in the process of ensuring correct surgery does a "time-out" take place?

A.

just before leaving the unit

B.

immediately before surgery

C.

just before entering the operating room

D.

immediately upon arrival in the recovery room

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Question # 178

An organization IsImplementing a new electronic medical record and has employed a project manager. At the first meeting, the project manager observes the following:

• The team estimates It Is one-fourth finished with Identifying benchmark organizations.

• Team members have not yet begun to identify the current state.

- They are halfway through collecting public data, which puts them slightly behind schedule for that task.

Which of the following tools should the quality Improvement project manager recommend?

A.

Model for Improvement

B.

Design of Experiments

C.

Gantt chart

D.

Ishlkawa diagram

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Question # 179

The culture of safety survey data below is collected from perioperative services. Which action should the healthcare quality professional recommend?

A.

Implement a leadership training series on Just Culture principles.

B.

Establish a process for executive walk-arounds in the perioperative departments.

C.

Develop a team-based communication training for perioperative staff.

D.

Educate perioperative staff on how to submit incident reports.

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Question # 180

Which of the following is an outcome indicator for a radiology unit?

A.

Utilization of CT scan for low back pain

B.

Contrast-induced complications

C.

Mammography result turnaround time

D.

"Time-out" performed for interventional cases

Full Access