Q&A Hero

Q: The process of developing a data dictionary involves which of the following? a. It is a consensus among individuals to share information in a specified way so that all participants derive the same meaning from the content. b. Accumulating a list of data elements over time so that new elements are captured as the electronic health record evolves c. Performance indicators are constantly evolving, and it facilitates sharing of information. d. It is an information repository that gives participants several meanings on the basis of the content of the electronic health record.

Q: Use of aggregate data from various payers is limited because of a. Differing providers and coding systems from provider data. b. Lack of legal right to data for encounter information. c. Differing diagnostic code requirements for reimbursement. d. Lack of data sharing agreements and differing data elements for the longitudinal records.

Q: Which organization plays an active role in trauma registries? a. American College of Surgeons b. American Heart Association c. American Medical Association d. None of the above

Q: The reference date for a cancer registry is defined as the date the a. Registry is implemented. b. Data collection begins. c. Cancer committee is formed. d. Cancer program is approved.

Q: One of the reasons that aggregate data analysis from varying payers is limited in accuracy is a. Differing providers and coding systems from provider data. b. Lack of legal right to data for encounter information. c. Differing coding requirement and reimbursement rules. d. Lack of data sharing agreements and differing data elements for the longitudinal records.

Q: A physician is able to evaluate her use of antibiotics compared with the use of antibiotics by other physicians in similar patients within the same organization. This is an example of a. Lack of a Health Plan Employer Data and Information Set (HEDIS) format in a format usable by physicians who need it. b. A warehouse format that is usable by quality improvement and health care professionals. c. Lack of core measures in a format that is usable by those who need it. d. A data warehouse format that is not usable by those who need it.

Q: Insurers often have access to longitudinal performance data through a. Claims information such as coded and administrative data. b. A more comprehensive clinical picture but limited sample size. c. Data developed by standards development organizations but no external comparison. d. A more limited clinical picture with added local data.

Q: A hospital would like to evaluate readmission rates of total hip replacements. What data should be used to identify the cases in the organization? a. Health Plan Employer Data and Information Set (HEDIS) b. Core measures c. Pay for performance d. Claims data

Q: Information regarding the treatment of community-acquired pneumonia is collected by the Joint Commission and subsequently provided through its Web site to the public. This is an example of what is most commonly known as a. Pay for performance. b. Process management. c. Core measures. d. Provider expertise.

Q: The outcomes data warehouse should be structured around a. An individual person whose data are stored in the warehouse. b. The health care industry€s data. c. The population of people served or to be served by the warehouse. d. Billed data captured from coded data.

Q: A structure measure is direct measure of quality.

Q: When a physician reviews the health records of another physician, this is often called peer review.

Q: The role of HIM professionals in performance management and patient safety improvement is crucial to collect and analyze performance data.

Q: The "best" process solutions often are the quickest fixes, those that can be implemented in a short time period.

Q: The purpose of credentialing is to assign physicians to a unit of the medical staff organization.

Q: Utilization review can only be conducted by health plan employees.

Q: Failure mode and effects analysis (FMEA) is a relatively inexpensive approach to problem solving.

Q: Lean thinking is more about cost containment than about customer focus.

Q: A highly reliable measure will yield a large number of random errors.

Q: The mortality rate has been determined to be the most reliable clinical outcome measure.

Q: Structure measures of quality are dynamic indicators of organizational performance.

Q: Accreditation refers to the credentialing process for an individual health professional.

Q: An adverse patient event is synonymous with a potentially compensable event.

Q: To achieve lasting performance improvements, managers should focus on a. Training people in performance management skills. b. Testing redesigned processes. c. Keeping abreast on changing regulations and incentives having to do with performance improvement. d. All of the above.

Q: The National Practitioner Data Bank contains information about a physician€s a. Current health status. b. Liability insurance coverage. c. Incidents of adverse quality of care. d. Education and training.

Q: Most problem-solving models begin with a. Data collection. b. Risk assessment. c. Team formation. d. An expected outcome.

Q: Which of the following is a primary data source for patient safety reports? a. Utilization review documents b. Master patient index c. Credentials files d. Incident reports

Q: Correlation is a statistical measure of a. Relationship significance. b. Causal relationship. c. Variable importance. d. Relationship uniqueness.

Q: A second y axis is useful on a Pareto chart to plot a. Cumulative frequency. b. Categories of events. c. Relative rank of categories. d. Reverse occurrence order.

Q: A decision matrix is a useful tool for a. Generating support for ideas. b. Collecting data. c. Setting priorities. d. Quickly seeing data relationships.

Q: Rapid cycle improvement often involves a. Incremental implementation rollout. b. Pilot testing. c. Redundant testing. d. Large process changes.

Q: Which of the following is a primary benefit of analyzing aggregate data? a. Data capture is more efficient. b. Random errors can be eliminated. c. Bias is more easily detected. d. Patterns of events or occurrences can be identified.

Q: What is the denominator for the performance measure, "percentage of surgery patients who received prophylactic antibiotics within one hour of the surgery start time"? a. Number of surgery patients who receive prophylactic antibiotics within 1 hour of the surgery start time b. Number of surgery patients who did not receive prophylactic antibiotics within 1 hour of the surgery start time c. Number of surgery patients for whom preoperative antibiotics were ordered d. Number of surgery patients

Q: The Baldrige National Quality Award was established by a. The Joint Commission. b. National Committee for Quality Assurance. c. Congress. d. Deming.

Q: Identifying potentially compensable events is one step in a. Establishing clinical practice guidelines. b. Financial planning to meet legal obligations. c. Managing patient length of stay. d. Negotiating managed care contracts.

Q: Failure mode and effects analysis is a useful tool for a. Cost analysis. b. Clinical practice management. c. Risk analysis. d. Lean thinking.

Q: Which of the following is a technique used to investigate an adverse event to understand why it happened? a. Root cause analysis b. Force field analysis c. Rapid cycle analysis d. Pareto analysis

Q: Which hospital department often is responsible for monitoring patient incident data? a. Social services b. Patient accounting c. Infection control d. Risk management

Q: In what Joint Commission requirement would you find accuracy of patient identification? a. Infection prevention b. Patient advocacy c. Patient safety d. Leadership

Q: Two improvement tools that connect performance variables to outcomes are a cause-and-effect diagram and a a. Force field analysis. b. Brainstorming. c. Control chart. d. Pareto chart.

Q: What technique is used to maximize the number of ideas for problem analysis and resolution? a. Six sigma b. Brainstorming c. Flowcharting d. Prioritization

Q: The concept underlying lean thinking is a. Cost savings. b. Improved quality. c. Decreased errors. d. Value.

Q: The six sigma approach was introduced by a. Honda. b. Motorola. c. Xerox. d. Leapfrog Group.

Q: Which of the following is based on the Plan-Do-Check-Act (PDCA) model? a. Six sigma b. Affinity modeling c. Rapid cycle improvement d. Nominal group technique

Q: The Plan-Do-Check-Act (PDCA) improvement model was created by a. Juran. b. Motorola. c. Ishikawa. d. Shewhart.

Q: Benchmarking is a performance improvement technique based on a. Comparison with other high performers. b. Identification of key indicators. c. Tracking of sentinel events. d. Continuous incremental improvement.

Q: Performance assessment should occur a. Before a Joint Commission survey. b. When yearly strategic planning occurs. c. At periodic intervals defined by the facility. d. When service volume is higher than usual.

Q: A stable measure that shows consistent results over time is said to be a. Efficient. b. Sensitive. c. Reliable. d. Specific.

Q: The purpose of using thresholds when applying performance measures is to a. Identify "best" outcomes. b. Trigger focused reviews. c. Establish provider accountability. d. Evaluate relevance of the measure.

Q: Indirect measures of performance are referred to as a. Guidelines. b. End results. c. Advocacy. d. Indicators.

Q: Clinical practice guidelines are a. Statements of the "right" things to do for patients with a particular diagnosis. b. Standards for accountable care organizations. c. Billing regulations for Medicare and Medicaid services. d. Recommendations for providers negotiating third-party contracts.

Q: Efforts to ensure that current research is applied in medical decision-making are termed a. Performance measuring. b. Evidence-based medicine. c. Pay for performance. d. Patient advocacy.

Q: Organizations such as the National Quality Forum were established to a. Promote collaborative efforts to improve health care quality. b. Decrease the cost of health care. c. Provide oversight of health care facilities and individual providers. d. Create a forum for health care consumers to interact with lawmakers.

Q: What does pay for performance mean? a. Denial of payment when undesirable clinical outcomes occur b. Negotiated payment for large-scale providers c. Sliding scale payment based on severity of illness in the target population d. Financial rewards for providers who achieve specific quality goals

Q: Which of the following best describes the Leapfrog Group? a. A federal agency b. A collaboration of large employers c. A regulatory body d. An accrediting body

Q: The Baldrige Award criteria a. Are similar to the Joint Commission criteria. b. Must be met to qualify for Medicare funding. c. Are based on categories of management disciplines. d. Are applicable only to nonprofit entities.

Q: Which group sponsors the Healthcare Effectiveness Data and Information Set (HEDIS)? a. National Commission for Quality Assurance b. The Joint Commission c. Centers for Medicare and Medicaid Services d. National Institutes of Health

Q: Which type of organization is not accredited by the National Committee for Quality Assurance (NCQA)? a. Managed behavioral health care organization b. Health maintenance organization c. Ambulatory health care organization d. Accountable care organization

Q: Which of the following is not one of the core measure areas for the Joint Commission? a. Acute myocardial infarction b. Heart failure c. Community-acquired pneumonia d. Palliative care

Q: Which key dimension of health care quality refers to ensuring the services provided are based on scientific knowledge? a. Effectiveness b. Safety c. Patient-centered d. Efficiency

Q: When designing a case-control study, you must always match cases with controls on age, sex, and race.

Q: Outcomes research focuses on measures of mortality.

Q: Life-table analysis is most appropriate for prospective or experimental studies.

Q: The odds ratio is an estimate of a confidence interval.

Q: The three major types of epidemiologic research study designs are (1) descriptive studies, (2) analytical studies, and (3) experimental studies.

Q: Sensitivity is the percentage of all true cases correctly identified.

Q: Reliability assesses relevance, completeness, accuracy, and correctness.

Q: The significance section of the research proposal conveys why the research is needed or important, and it is stated succinctly and clearly.

Q: Specific aims should include a step-by-step process of what is done in the research study and why this process is necessary to test the hypothesis properly.

Q: The bibliography within a research article may contain many more articles and books than are cited in the article itself.

Q: "Peer reviewed" means that peers within the specific research area have not reviewed the research article before publication.

Q: In a causal relationship, the cause is the independent variable, and the effect is the dependent variable.

Q: The hypothesis is an opinion or value judgment.

Q: Healthy People 2020 is an action agenda for the twenty-first century and includes priorities and research needs relevant to health information management.

Q: Research enables individuals to learn something new and valuable about their professions.

Q: Epidemiology is the study of disease and the determinants of disease in individual cases.

Q: The independent variable is the disease under study, and the dependent variable is the risk factor or characteristic under study.

Q: When conducting a case-control or retrospective study, a researcher should match cases on variables known to be associated with the disease or the exposure under study.

Q: A case-control study should find controls similar to the characteristics of the cases (such as age and sex), but without the disease, and obtain histories on them.

Q: A major advantage of a prospective study is that its results can be measured after a very short time.