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Q:
CMS attempts to make the Medicare beneficiary a better informed public consumer of health care for inpatient services by providing which of the following?
a. Health Grades
b. Hospital Compare
c. Texas Medical Foundation Health Quality Institute
d. Agency for Health Care Research & Quality
Q:
Health care organizations and providers are required to report data on specific core measures. This is an example of which use of health care data reporting?
a. Benchmarking
b. Clinical decision support
c. Consumer education
d. Performance management
Q:
The AIS scores would be found in which of the following registries?
a. Trauma registry
b. Cancer registry
c. Birth registry
d. Diabetes registry
Q:
Which one of the following is NOT a step in building a data dictionary?
a. Perform an inventory of the current system.
b. Identify new data content needs of the current system.
c. Mandate the adoption of your preferred definitions of data elements.
d. Develop a consensus between all users of the system.
Q:
Which of the following cancer data may be released without patient authorization?
a. Aggregate
b. Patient
c. Physician
d. Facility
Q:
Which of the following cancer registry files is considered a working file?
a. Accession register
b. Follow-up
c. Patient index
d. Primary site
Q:
Cancer registries have been established to
a. Investigate the cause(s) of cancer as a disease.
b. Eradicate cancer as a disease.
c. Assess cancer incidence, treatment, and end results.
d. Monitor physician performance in treating cancer patients.
Q:
Which organ-specific registry is associated with the National Organ Procurement Transplantation Network?
a. Kidney
b. Heart/lung
c. Pancreas
d. All of the above
Q:
What is the required follow-up rate for approved hospital cancer programs?
a. 60%
b. 75%
c. 80%
d. 90%
Q:
Certified Tumor Registrar is
a. A credential based on education.
b. A credential based on an examination.
c. A credential that is honorary.
d. None of the above.
Q:
Immunization registries store data electronically on all National Vaccine Advisory Committee€approved core data elements. Knowledge of vaccination rates helps to determine
a. The potential need for rapid immunization in the event of bioterrorist attack.
b. Whether public health goals are being met.
c. Whether public health interventions are needed to increase immunization rates.
d. All of the above.
Q:
A study is conducted that evaluates the impact on the use of coronary artery bypass grafts in patients with myocardial infarctions in the populations of two states. Which of the following is the most likely way to adjust for risk in the two populations?
a. Coding Classification Sets
b. Elixhauser Comorbidity Measurement
c. Weiner Data Complexes
d. Charleson Index
Q:
All the following are included in the International Classification of Diseases for Oncology, 3rd edition (ICD-O-3) coding scheme except
a. Differentiation.
b. Etiology.
c. Grading.
d. Morphology.
Q:
In Best Health General Hospital, the cancer registrar associated with the cancer program undertakes a systematic sampling of 5% to 10% of cases in the registry. The main goal of the evaluation is to
a. Compare the results of the two studies with each other.
b. Optimize care for patients with cancer.
c. Evaluate the quality of the coded data.
d. Contribute to public health cancer-control goals.
Q:
A physician at Best Health General Hospital questions the quality of the data in the computerized cancer registry. The quality control process would be specified in the Cancer Registry Manual under
a. Coding and abstracting policies and procedures.
b. Computerized database policies and procedures.
c. Confidentiality policies and procedures.
d. Quality control policies and procedures.
Q:
A cancer registrar identifies applicable data elements and includes them in the registry data. This is an example of what kind of process required by the American College of Surgeons?
a. Abstracting
b. Posting
c. Quality control
d. Accessioning
Q:
Compared with claims data, the value of registry data is of
a. Higher quality.
b. Lower quality.
c. Higher consistency.
d. Lower consistency.
Q:
If a patient meets the clinical definition of a reportable disease, the case is
a. Identified as the index case.
b. Reported on the basis of the epidemiologic definition.
c. Aggregated for batch reporting.
d. Evaluated for treatment of the disease.
Q:
A registry established by the state to capture all patients with reportable cases is a
a. Population-based registry.
b. Specialty registry.
c. Cancer-control registry.
d. Hospital-based registry.
Q:
The information contained in the databases developed from the patient record is considered to be
a. Primary data.
b. Secondary data.
c. Tertiary data.
d. None of the above.
Q:
Government agencies and third-party payers require that appropriate codes be used to represent the reason for the encounter. The aggregate data from these health encounters may be used to populate special databases for
a. Patient treatment.
b. Physician decision-making.
c. Research.
d. Interoperability analysis.
Q:
Which of the following cases is ineligible for inclusion in the hospital-based cancer registry?
a. Patient admitted to hospice care
b. Patient receiving planned therapy
c. Patient who was diagnosed elsewhere and is receiving part of therapy elsewhere
d. Both a and c
Q:
Cancer screening and smoking cessation programs are a function of which type of population-based registries?
a. Incidence
b. Cancer control
c. Research
d. All of the above
Q:
In the physician office, codes for reimbursement may be assigned by those who have not been trained in established coding rules. Because of this,
a. The resulting codes may be more accurate than inpatient codes.
b. The resulting codes will be of equal quality to those generated in the inpatient coding process.
c. The resulting codes will be of lower quality than those generated in the inpatient coding process.
d. The resulting codes will be exactly the same.
Q:
Coded and administrative data are used by public health agencies for
a. Reimbursing health services provided.
b. Planning related to health care services.
c. Tracking and preventing disability and disease.
d. Pay for performance.
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