1000 Questions in CPHQ

2014 NOITSEUQ 1000 QHPC TSURT EW HALLA NI
2
3
CPHQ
5
ALL IN ONE
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1000
7
QUESTIONS
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2014
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10
11
12
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14
1 15 in order for a quality improvement team to deal
effectively
16 with conflict ,it is important to appoint which of the
following
17 to its membership
A. 18 facilitator
B. 19 human resources representative
C. 20 risk manger
D. 21 senior leader
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22
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23
2 24 The use of clinical path ways and guidelines in hospitals
should
25 do which of the following?
A. 26 minimize variation in patient care
B. 27 reduce length of stay
C. 28 improve patient satisfaction
D. 29 identify errors in patient care
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30
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31
3 32 A critically ill patient is admitted and requires a specialist
procedure
33 .however; the surgeon does not have the privilege at
the34facility .Which of the following documents will be most
helpful
35 identifying the course of actionThe hospital should
take?
36
A. 37 patient safety manual
B. 38 risk management plan
C. 39 medical staff bylaws
D. 40 surgical policies and procedure
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41
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42
4 43 Which of the following step is the first step in the
strategic
44 planning process?
A-setting
45 goals and objectives
B-defining
46 organizational structure
C-determining
47 productivity indicator
D-establishing
48 and controlling a budget
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49
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50
5 51 which of the following national patient safety goals is
applicable
52 to everyone in health care facility
A-communication
53
B-medication
54 safety
C-health
55 care related associated infection
d-reconcile
56 medication
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57
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58
6 59 The best evaluation of performance improvement plan is
a- 60 Process improvement
b- 61 measurable objectives
c- 62 applicable deliverables
d- 63 timeline
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64
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65
66
7 67 quality assurance focuses on
1 68 Performance of individuals
2 69 Plan Apprisal
3 70 System
4 71 Process
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72
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73
8 74 quality performance improvement focused on
1 75 Process
2 76 System
3 77 Individual
4 78 Steps
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79
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80
9 81 according to pare to principle, in the era of quality

management
82 80 of the problem present in
1 83 System
2 84 Performance
3 85 Individual
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86
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87
10 88 the function which describes the assessment of

educational
89 needs is
1 90 Quality improvement
2 91 Utilization management
3 92 Risk management
4 93 Process map
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94
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95
11 96 the most appropriate to evaluate case manager
1 97 lenght of stay
2 98 nurse setting referral
3 99 patient complaints
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100
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101
19 102 strategy of brain storming
A. 103 Discussion of issues

B. 104 Prioritization of issues
C. 105 Recording of issues
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106
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107
108
109
110
111
20 112 main function of clinical pathway is
A. 113 Convert medicine into mathematics

B. 114 Monitor variations
C. 115 Limit Dr intervention
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116
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117
21 118 a 75 year patient with right side hip replacement

climbed
119 upstairs and had been fallen, as a risk manager before
the120
bill writing what type of risk do you consider this event
A. 121 Risk resistance

B. 122 Loss reduction
C. 123 Potential compensable event
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124
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125
22 126 the tool that keeps the team on track to follow all tasks
A. 127 Business plan

B. 128 Gantt chart
C. 129 Flowchart
D. 130 Control chart
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131
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132
23 133 the best way to display LOS variation is
A. 134 Line graph

B. 135 Histogram
C. 136 Scatter diagram
D. 137 Pare to chart
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138
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139
24 140 the best way to communicate the reduction of falls results
A. 141 . Bar graph shows the best 2 units achieved the goal
B. 142 . Line graph shows the falls during last two years
C. 143 It's better to hide such data

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144
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145
25 146 SBAR is a tool for
A. 147 Calculate average LOS

B. 148 Statistics between absolute averages
C. 149 Improve communication between care givers
D. 150 Financial control
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151
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152
26 153 when 2 facilities have a network, what is the most cost

effective
154 issue increases the patient satisfaction of the services
A. 155 When the patient don't have to repeat investigations in

other
156 facility
B. 157 When his satisfaction survey results are collected from
both
158facilities on the fly
C. 159 When both facilities have equal staff competencies
D. 160 When the network allows doctors to communicate
through
161 the internet
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162
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163
27 164 first tool to use in Root cause analysis is
A. 165 why diagram

B. 166 Flow chart
C. 167 Gantt chart
D. 168 Cause and effect diagram
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169
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170
28 171 0-occurance 100 % analysis is
A. 172 Occupancy report

B. 173 Sentinel event
C. 174 Cause and effect analysis

D. 175 Cost benefit analysis
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176
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177
29 178 vision statement represents the organization
A. 179 Domain of action for a year

B. 180 Why does it exists
C. 181 Future
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182
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183
30 184 the most appropriate design for strategic management is
A. 185 Vision mission core values goals

B. 186 Masterplan, business plan and departmental objectives
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187
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188
31 189 The most appropriate sequence for strategic management

implementation
190 is
A.Strategic
191 goals mission vision?
B.Vision
192 mission values goals?
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193
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194
195
32 196 it's noticed that increase aggressive behaviour among

psychiatric
197 patients , what is the appropriate action
A.Trend
198 data over time
B.Focus
199 group with end user
C. 200
Review restrains policy
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201
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202
33 203 the team member that keeps team on track and clarify
issues
204
A.Leader
205
B.Member
206
C.Facilitator
207
D.Time
208 keeper
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209
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210
34 211 the member - group responsible for continuous

improvement
212 of organization
CEO213
Quality
214 council
Share
215 holders
Governance
216 board
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217
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218
35 219 the ultimate responsibility of implementation of quality

relays
220 on
CEO221
Quality
222 council
Share
223 holders
Governance
224 board
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225
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226
36 227 the quality professional reviews the surgical consents

and228found a lot of incompetent consents, who is the first
person
229 to communicate
CEO230
Information
231 management professional
Director
232 of nurses (DON)
Chief
233 surgeon
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234
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235
37 236 When comparing your performance against field top

leaders,
237 this is considered as?
Best
238practice
Benchmarking
239
Severity
240 adjustment
Setting
241 goals
38 242 to protect your organization against unannounced

surveys
243 the most important to keep in your organization
Continuous
244 readiness
All245
plans unannounced
Patient
246 medical records for 3 months only
Copy
247 of all incident reports
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248
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249
39 250 just culture means
A. 251 Culture of no abuse

B. 252 Blame free culture
C. 253 Quality culture
D. 254 A culture of timeliness
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255
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256
40 257 last step in FMEA methodology is
A. 258 Analysis of effects

B. 259 Measure results
C. 260 Keep monitoring
D. 261 Results reporting
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262
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263
41 264 first step in strategic management is

A. 265 External and internal analysis

B. 266 Vision
C. 267 Setting goals
D. 268 Setting measurable objectives
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269
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270
42 271 Hoshin planning most valuable step is
A. 272 Roll down of strategies to departmental level

B. 273 Annual reporting
C. 274 Use of PDCA
D. 275 Prioritization of goals
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276
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277
43 278 if your department has contract with another facility to

provide
279 a risky service this is considered as
a. 280 Risk shift
b. 281 Risk adjustment
c. 282 Claim against you from 3rd party
d. 283 Negligence
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284
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285
286
44 287 Hospital Acquired infections HAI are considered as
a. 288 Sentinel events
b. 289 Outcome measurement
c. 290 Process measurement
d. 291 Near misses
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292
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293
45 294 Z-Score represents:
a. 295 Standard Deviation
b. 296 Average
c. 297 Ultimate goal
d. 298 Regression value

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299
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300
47-When
301 a major processes redesign is needed, the most
appropriate
302 approach is
A. 303 Quality circle PDSA
B. 304 Total quality management
C. 305 Six sigma
D. 306 Continues quality improvement
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307
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308
48-the
309 information gathering technique known as focus group
include
310 all of the following except:
a- provision
311 of written survey information
b- identification
312 of customer requirements
c- solicitation
313 of perception in meeting requirements
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314
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315
49-Design
316 of piece of device make errors. This type of error is:
a-active
317
b-negligent
318
c-latent
319
d- organizational
320
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321
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322
51-A
323 healthcare organization wants to adopt concurrent
324 process instead of retrospective review .To facilitate this
review
changes
325 the first to be inspired are
A-Leaders
326
B-Mangers
327
C-Physician
328
D-Nurses
329
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330
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331
52-In
332 a hospital using quality improvementstrategies, the
number
333 of overall patients last quarter was 1000 patients,100
admissions
334 with average LOS (Length of stay) 5 days. The
interdisciplinary
335 improvement team goal is 20% decline in
LOS.
336 How many admissions will be gained by reaching this:
337
A.80
338
B.200
339
C.400
340
D. 341
300
LOS342= 5 days, reducing the LOS by 20 % to become 4 days (20
* 5343
/100 = 4 days)
100344admissions stay for 5 days
How345many admissions stay for 4 days?
100346* 4 / 5 = 80
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347
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348
349
53-When
350 a surveyor reached for regulatory visit, the first
question
351 that the quality professional will ask for is
A-Please
352 let me see your identification.
B-Let
353 us sit to schedule for your visits.
c-Which
354 area of compliance would you like to review.
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355
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356
54-When
357 hiring a specialist from a consulting firm to evaulate
performance
358 improvement program ,as a quality professional
what
359 you should do?
a. Schedule
360 the program for the consulting firm.
b. identify
361 areas with problems to the consulting firm.
c- identify
362 outcomes
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363
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364
55-you
365 are goining to make major changes in the billing
system
366 in the organization. To increase the acceptance of the
staff
367to change:
a.medical
368 staff education.
b.long
369 range plan.
c.pilot
370 project
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371
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372
56-.which
373 of the following is the most useful in mortality /morbidty
review:
374
a.LOS.
375
b.autopsy.
376
c.physician
377 profile.
conflict
378 between a and c
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379
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380
57-A
381 health organization is becoming a member in a health
plan.
382 The most important educative program to be delivered to
the383
staff is
a-organizational
384 change
b. conflict
385 of interest
c. consumer
386 needs
d. accreditation
387 needs
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388
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389
58-Which
390 of the following charts is used to institute quality
improvement
391 & monitor cost reduction on ongoing basis?
A. 392 Pie chart
B. 393 Control chart
C. 394 Pareto chart
D. 395 Fishbone diagram
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396
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397
59-398
Patient safety indicators are developed by AHRQ are
designed
399 to be useful in all of the following except
A. 400 Collect patient safety data
B. 401 Support root cause analysis
C. 402 Monitor change initiatives post implementation
D. 403 Monitoring of the staff performance
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404
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405
60-406
To encourage adoption of quality improvement concepts in
day407work you do all the following except
A. 408 Distribute quality newsletter
B. 409 Make quality lectures
C. 410 Distribute external quality papers within the organization
D. 411 Ask the physicians to make self study on quality
improvement
412
413
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414
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415
61-416
a large facility has fostered a culture of patient safety
through
417 staff education , support of process improvement
,department
418 levels of implementation of non-punitive
approach
419 to error reporting compliance with patient safety
goals
420 ranges from 75-100% in assessing culture of patient
safety
421 cphq should:
a-survey
422 of all employee &physician
b-survey
423 pt last 6 m
c-review
424 collected data through incident reporting
d-review
425 post surgical infection rate data
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426
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427
62 428
-Even when appropriate process are in place , error can
occur,
429 understanding this, leader coordinating any safety
program
430 should focus on:
a-pt431survey
b-time
432 constrain
c-policies
433
d-performance
434 feed back
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435
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436
63-437
When choosing an outside consultants to lead employee
focus
438 group, what priority areas of expertise should cphq look
for?
439
a-Team
440 Development & Management
b-organizational
441 assessment & change management
c-group
442 dynamics & facilitation
d-organizational
443 design & reengineering
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444
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445
65-A
446 psychiatric hospital is reporting a significant level of
patient
447 aggression as a quality professional the appropriate
action
448 to make is:
A. 449 Generate a policy of restraining all patients

B. 450 Switch from physical to chemical restrain
C. 451 Adopt restrain free policy
D. 452 Make a system of early identification of patient

characteristics
453 may be indicative of aggression
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454
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455
66-456
Benchmarking is based in identifying
A. 457 Best practice
B. 458 Competition
C. 459 Deficiencies
D. 460 Statistical control
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461
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462
67-463
Which of the following is most helpful in integrating data
collected
464 in the performance improvement process?
A. 465 Discussing performance improvement findings with
senior
466 management
B. 467 Developing a performance improvement prioritization
matrix
468
C. 469 Creating a scatter diagram using the data
D. 470 Integrating the data based on team consensus
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471
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472
68-473
According to quality assurance point of view, the main
focus
474 is on:
475
A. 476
System
B. 477
Individual
C. 478
Processes
D .479
Customer
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480
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481
69-482
the physical difference between traditional QA & QI that QI is:
a- focus
483 on process& systems while QA focus on individual
faults
484
b- stress
485 peer review while QA focus on customer
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486
--------------------------
487
70-.the
488 best tool to display length of stay variation over the last 5
years
489 :
a.pareto
490 chart.
b.control
491 chart.
c.regression
492 anaylsis.
d.bar
493 gragh
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494
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495
71-496
which of the following tool could be used to assess the
effeciency
497 of lab speceimen processing?
a. pareto
498 chart.
b. regression
499 analysis.
c. profit
500 and loss sheet.
d. productivity
501 index.
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502
--------------------
503
73-one
504 of the team members hesitates to share in team discussions.
as 505
a team leader what should you do?
a. offer
506 to help the member to prepare the data.
b. exclude
507 the member from the team.
c. tell
508 the member the excpectation to contribution to discussion.
d- ask
509 him in non decisive issues
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510
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511
74-CPHQ
512 try to improve care through accurate definition of
indicators
513 .which of the following indicators reflect performance of
surgeons:
514
515
a) No
516 of patients referrals to ICU after surgery / no of all surgeons.
b) No
517 of patients admitted to ICU /total no of surgeries.
c) NO
518 of patients referral to ICU after minor surgery / no of minor
surgery.
519
d) No
520 of patient admitted to ICU / no of major surgery.
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521
--------------------
522
75-appropriateness
523 of appendectomy
A. 524 preadmission test
B. 525 pathology test
C. 526 age
D. 527 clinical test
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528
--------------------------
529
76-critical
530 value determined by
a-the
531 regulations and laws
b-accrediting
532 body
c-organization
533
D- 534
Literature
Critical
535 values in the lab and xray department which are cases
that536need immediate intervention , It is indicated by standards
and537organization states the policies and define critical values
and538how to report it and what is the accepted time
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539
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540
77-Which
541 of the following are attributes to culture of safety?
A- 542
Transparency & increased patient acuity level
Error proof environment & empowered staff
B- 543
C- 544
Empowered staff & transparency
D- 545
Increased patient acuity level & error-proof environment
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546
--------------------------
547
78-In
548 order to facilitate development of strategic plan, what to
consider
549 first?
A-Cultural
550 assessment, planning, implementation &
evaluation
551
B-Risk
552 management, gap analysis, identification of
organization
553 wide functions
C-Mission,
554 vision, values , short & long term goals &
objectives
555
D-Creation
556 of master plan, identify customers, goals &
objectives
557
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558
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559
79-When
560 facility make development of clinical indicator
criteria,
561 Healthcare quality professional should:
A-Selecting
562 indicators that are approved by accrediting
organization
563
B- 564
Selecting indicators that are approved by Payers
C-develop
565 criteria that reflect processes &outcomes
D-develop
566 criteria that reflect department policies
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567
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568
569
80-An
570 organization leader has directed a Healthcare Quality
Professional
571 to measure the success of a corrective action plan
on 572
patient care planning. The organization leader wants to be
at least
573 95 % confident of the accuracy of results. The average
daily
574 census at the organization is 1000 patients. The most
accurate
575 & efficient sampling technique for this study would
be:576
A- 577
Review 100% of all active records on one day of past month
B-review
578 10% of all discharge records for the past quarter
C-estimate
579 the percentage of records to be reviewed using an
accepted
580 statistical formula appropriate for the population
D- 581
Identify 30% of all records that failed preliminary care
plan
582compliance review
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583
--------------------------
584
81-A
585 healthcare organization implementing ongoing
performance
586 improvement, which of the following would most
likely
587 benefit the PI goals of the organization?
A- 588
A system selected by middle & senior management resulting
from
589 proposals by consultants
B-Cross
590 functional processes evaluated by multidisciplinary
teams
591 with support of management
C-Discrete
592 systems relevant to & monitored by individual
department
593
D- 594
Comprehensive process developed, implemented &
monitored
595 by the QM department
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596
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597
82-Problem
598 solving, cross functional understanding, expanded
area
599of expertise, gain in status & power & increase span of
knowledge
600 are examples of
A- 601 The benefits of teams

B- 602 Resource requirements
C- 603 Customer expectation
D- 604 Strategic alliance
605
606
83-Comparison
607 of surgeon specific infection rate is example of
A- 608
Practitioner profiling
B- 609
Root cause analysis
C- 610
Practitioner credentialing
D- 611
Incident analysis
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612
--------------------------
613
84-All
614 of the following conditions contribute to system
improvement
615 except
A- 616 Measuring performance of processes & their outcomes

using
617 valid statistics methods
B- 618 Taking action to improve the way the processes are

designed
619 & carried out
C- 620 Studying & understanding the complex process that

contribute
621 to care
D- 622 Identifying & Responding to individual performance
issues
623
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624
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625
85-Healthcare
626 quality professional has written patient safety
plan
627that includes: purpose, goals, objectives (scope &
processes)
628
A review
629 of outcomes data has been completed, which of the
following
630 additional information should be in the plan :
A- 631
Disaster preparedness
B- 632
Steps to improve patient satisfaction
C- 633
Equipment management
D- 634
Efforts to reduce harm
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635
--------------------------
636
86-Analysis
637 of events, trends & customer needs is the
initial
638 phase of
A- 639 cost benefit analysis

B- 640 strategic planning
C- 641 forecasting
D- 642 resource allocation

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643
--------------------------
644
87-Comparing
645 Healthcare organizations by using medical
error
646 rates:
A- 647 may present bias due to difference in reporting practices

B- 648 provide best method for benchmarking patient safety
C- 649 can't be performed by facilities less than 100 beds
D- 650 must include minimum of 10 facilities
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651
--------------------------
652
88-The
653 best tool to begin investigate causes of laboratory
labeling
654 errors
A- 655 histogram
B- 656 flowchart
C- 657 affinity diagram
D- 658 prioritization matrix
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659
--------------------------
660
89-Organizational
661 continuing education needs are best
identified
662 through what type of activities
A- 663 UM
B- 664 QI
C- 665 Budgeting
D- 666 HR
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667
--------------------------
668
90-Clinical
669 pathway identifies all of the following except:
A- 670 Patient satisfaction

B- 671 Better & Best Practice
C- 672 Cost survey
D- 673 Outcome of processes
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674 91- 91)
Arrange
675 ;
1-Gathering
676 data
2-Evaluate
677 effectiveness & improvement
3-Make
678 commitment
4-Implementation
679
A- 680 2- 1- 3 -4
B- 681 3- 2- 1- 4
C- 682 1 2- 3 -4
D- 683 3 -1 -4 -2
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684
--------------------------
685
92-A
686 poster contain information will most effectively convey
outcome
687 information to internal customers?
A- 688
2 Bar graphs showing the 2 unites with fewest number of
falls
689over past year
B- 690
(Patient fall decreased over 4 years) printed above a line
graph
691 showing percentage of falls to patient days
C- 692
Patient fall indicate downward trend. Go for team!
D- 693
(Patient fall last year were 0.5% of patient days) printed to
photograph
694 of the organization staff
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695
--------------------------
696
93-The
697 annual evaluation of QI process must
A- 698 be accomplished by healthcare quality professional

B- 699 document all problems identified in care / service
C- 700 be based on organizational objectives
D- 701 survey all departments & teams
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702
--------------------------94-The
703 chief executive officer of
healthcare
704 organization has requested a recommendation for
the705
most effective method of assessing the organization's
readiness
706 to adopt CQI, which of the following methods
should
707 CPHQ recommend:
A- 708 review aggregate results of employee performance

appraisals
709
B- 710 Hire a consultant to conduct personal interview of staff

C- 711 Conduct leadership ''walk through'' of the organization
D- 712 Administer surveys to evaluate organization culture.

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713
--------------------------
714
95-The
715 medical record manager reports that authentication of
verbal
716 orders occurs 25% of the time , as compared to a
reported
717 85% in situations ,which of the following is the initial
action
718 for the manager to take ?
A- 719 Recommend continued measurement of the indicator.

B- 720 Share the data with the medical staff
C- 721 Organize a PI team
D- 722 Recommend improvement strategies
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723
--------------------------
724
96-An
725 effective risk management plan includes all of the
following
726 except:
A- 727 description of educational programs

B- 728 statement of purpose
C- 729 description of reporting mechanisms
D- 730 scope of the program
731
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732
733
97-Which
734 of the following is true regarding medical error
A- 735 prevented by review of evidence based practice

B- 736 caused by gaps between patient expectation & practice

C- 737 avoided by uniform practice
D- 738 associated with process failure
739
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740
98-Primary
741 purpose of integration of financial & quality
management
742
A-develop
743 physician profiles
B-Identify
744 potential cash flow problem
C- 745
Identify problem in resource management
D-Determine
746 medical necessity of treatment
99-Developing
747 educational training program in QI , What
component
748 should be included :
A- 749 quality definition & principles

B- 750 performance appraisal results
C- 751 discussion of incidents
D- 752 Individual focus of activities
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753
--------------------------
754
100-The
755 best way to evaluate effectiveness of performance
improvement
756 training is through
A- 757 self assessment

B- 758 participants' feedback
C-
759 observed behavioral changes
D- 760 post-test results

761
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762
--------------------------
763
101-In
764 evaluating length of stay & outcome data on cardiac
cathertization.
765 HealthCare quality professional identified
direct
766 relationship between Adverse outcomes & physician
practice
767 pattern. This integrated approach involves correlating
A- 768 case/care management & finance

B- 769 UM & QM
C- 770 Finance & UM
D-
771 Discharge planning & QI
772
773 -----------------------------------------------------------------------
774 ---------------------------
775
102-A
776 Performance improvement program for supervisors
should
777 include
A- 778
Rapid cycle process
B- 779
Results of FMEA
C- 780
Budget variance reporting
D- 781
Review of patient falls
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782
--------------------------
783
103-Conclusions
784 in a statistical study are generalized to the
a- Sample
785
b- Mean
786
c- Subject
787
d- Population
788
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789
--------------------------
790
105-When
791 choosing an outside consultant to lead employee
focus
792 groups, what priority areas of expertise should CPHQ
look
793for?
794
a- team
795 development & management
B-Organizational
796 assessment & change management
C-Group
797 dynamics & facilitation
D-Organizational
798 design & re-engineering
-----------------------------------------------------------------------------
799
--------------------------
800
106-In
801 reviewing medical records in 1st& 2nd quarters of
year
802
surgical time out performed 90 95

communication of critical results 91 95
pain score used 50 60

initial patient assessment 52 45
performed
Which
803 to be reviewed?
This
804q is wrong , but from data we cant suggest answer???D
as 805
there is decrease of that process
-----------------------------------------------------------------------------
806
--------------------------
807
107-Responsibility
808 of Patient safety:
A- 809 Entire staff

B- 810 Senior leader
C- 811 Patient safety officer
D- 812 Medical executive officer
-----------------------------------------------------------------------------
813
--------------------------
814
108-To
815 assess culture:
A- 816
Incident reports of all physicians & employees.
B- 817
Facilitator expectation & records of team efforts.
C- 818
Health insurance company contract.
-----------------------------------------------------------------------------
819
--------------------------
820
109-The
821 greatest fear from using electronic medical record
system
822
A-Data
823 sabotage
B-Process
824 reboot
-----------------------------------------------------------------------------
825
--------------------------
826
110-Organization
827 committed to improving patient safety,
Key
828areas to influence change are
A- 829 Staff willingness to change, policies& procedures,

redesign
830 the structure & improvement of morale.
B- 831 Structure, environment, equipment, process,
application,
832 leadership, culture.
C- 833 Medication delivery,structure,staff willingness to
change,
834 on-slip floors, improvement of wards , environment
D- 835 Leadership ,culture ,policies& procedures ,staff
incentives,
836 better lightening , evaluation of processes &
Electronic
837 medical records
-----------------------------------------------------------------------------
838
--------------------------
839
111-Successful
840 development of clinical practice guidelines:
A-Physician
841 involvement
B-Staff
842 education
C- 843
Quality improvement tools
D-Patient
844 education
845
114-Quality
846 improvement activities should be considered for
all 847
except:
A-Compatibility
848 with facilities mission
B-Ease
849 of development of data collection tool
C- 850
Processes that are high volume for the facility
D- 851
Findings from patient satisfaction surveys
-----------------------------------------------------------------------------
852
--------------------------
853
115-Deploying
854 a CQI team would be first approach in
addressing
855 which:
A-Several
856 patient complained their call lights not answered
during
857 night shifts
B-Several
858 physicians don't allocate enough time for
procedures
859 which booking surgical cases
C- 860
Finance billing outpatient procedures as ambulatory
surgery
861
D- 862
Results of preadmission testing for inpatient survey are
unavailable
863 35% of time causing delays.
-----------------------------------------------------------------------------
864
--------------------------
865
116-Choosing
866 software for physicians, what is the role of
healthcare
867 quality professional?
A- 868 assess use of technology

B- 869 Cost-benefit analysis
C- 870 Focus group with end users
-----------------------------------------------------------------------------
871
--------------------------
872
117-Generic
873 screening is a type of risk:
A- 874 Identification
B- 875 Evaluation
C- 876 Reduction
D- 877 Intervention
-----------------------------------------------------------------------------
878
--------------------------
879
880
118
881 - A surgeons wound infection rate is 32%.
882 Further examination of which of the following data
883 will provide the most useful information
884 in determining the cause of this surgeons infection
885 rate? :
886
A.mortality
887 rate
888
B.facility
889 infection rate
890
C. 891
use of prophylactic antibiotics
892
D. 893
type of anesthesia used
894
Explanation:
895
A. 896 Mortality may be a sequence of infection or any other

known
897 or unknown reason. It is not a definite or correlated
CAUSE.
898
B. 899 Facility infection rate is a global scheme that includes
all 900
inpatient rates and not specific only to post surgical
wound
901 infections.
C. 902 Use of prophylactic pre and post surgical antibiotics is
a an903accreditation prerequisite and patient files must be
reviewed
904 preliminary to ensure compliance with clinical
pathways
905 and ascertain surgeons competency.
D. 906 There is no correlation between postsurgical infection
rates
907 and type of used anesthetic.
908
909
119-
910 The Balanced Scorecard answers which
911 questions? :
912
a. "How
913 are we going to get there?" "Which way do we
go?"
914
b. "How
915 are we doing?" "Are we there yet?"
c. "Where
916 are we going?" "What are we doing?"
d. "Why
917 are we here?" "What is our purpose?"
-----------------------------------------------------------------------------
918
--------------------------
919
920
921
120-If
922 a sphygmomanometer was used to measure the blood
pressure
923 of one patient, the blood pressure at the first trial
was924110/70; one minute later, the blood pressure of the same
patient
925 was measured by the same nurse and the result was
180/120;
926 then this measurement tool can be described as:
927
a) 928 unreliable
b) 929 invalid
c) unreliable
930 and invalid
d) incorrect
931
Explanation:
932
A. 933
The first requisite for blood pressure determination is a
correctly
934 calibrated manometer. Reliability is the
consistency
935 of measurement, or the degree to which an
instrument
936 measures the same way each time it is used
under
937 the same condition with the same subjects. In short, it
is the
938 repeatability of measurement under same conditions.
939
B. 940
Validity is the relationship between treatment and
observed
941 outcome. It involves the degree to which you are
measuring
942 what you are supposed to. The more consistent is
the943
relationship the more degree of validity. A
Sphygnomanomer
944 is made to measure Blood Pressure and it
does
945so, this means that it is valid for the purpose. It doesnt
measure
946 temperature or process food. Its accuracy,
dependability
947 or consistency is an issue that can be handled
differently.
948
949
C. 950
See explanations in both A and B.
951
D. 952
Incorrect describes the reading not the device. By logic,
either
953 one or both readings are incorrect. So the answer is
partially
954 true but if remained with answer A, it will be
dropped
955 out since answer A is more robust. If I were to set
the956
question, I would prefer not to put this distractor but
rather
957 replace it with other terms such as unpleasant,
unsafe,
958 uncertain or flexible. In such kinds of question, my
advice
959 is just (go with the flow) and dont make much fuss.
Just
960pass the exam their way then after certification, act
your
961 better own one ( think global and act local).Equally
remember
962 that USA is a nation of immigrants and English is
very
963likely to be a second language and terms may not
interpreted
964 as precise as they should be.
965
-----------------------------------------------------------------------------
966
--------------------------
967
121-Reengineering
968 QI in a newly merged multi-specialty
medical
969 group practice represents which process in the
quality/performance
970 improvement function? :
971
a. 972 Planning/design
b. 973 Measurement/monitoring
c. 974 Assessment/analysis
d. Improvement/re-monitoring
975
-----------------------------------------------------------------------------
976
--------------------------
977
978
979
980
981
982
983
122-Under
984 the quality improvement paradigm, which
statement
985 is incorrect?
986
a. The
987 focus is on the competency of individual practitioners.
b. The
988 focus is on the efficacy and effectiveness of processes.
c. The
989 focus is on the patient.
d. The
990 focus is on organization performance.
991
-----------------------------------------------------------------------------
992
--------------------------
993
123-Choose
994 the best indicator(s) to use when determining
the995
effectiveness of services at the emergency department
(ED)
996 in your hospital:
997
a) The
998 number of unplanned returns to the ED
b) The
999 percentage of ED patients admitted as inpatients
c) The
1000 patient waiting time at the ED
d) a1001
and b
-----------------------------------------------------------------------------
1002
--------------------------
1003
124-An
1004 accurate sequence of team formation and growth
would
1005 begin with forming, then:
1006
a. norming,
1007 performing, storming.
b. performing,
1008 norming, storming.
c. storming,
1009 norming, performing.
d. storming,
1010 performing, norming.
-----------------------------------------------------------------------------
1011
--------------------------
1012
1013
125-That
1014 dimension of quality/ performance that is
dependent
1015 upon evaluation by the recipients and/or
observers
1016 of care is:
1017
a. 1018respect/caring.
b. 1019safety.
c. 1020continuity.
d. availability.
1021
1022
1023
1024The recipients of service evaluate its quality mostly by
level of respect and care they receive from care providers,
1025
that's
1026 what matters to them; they wouldn't be really able to
evaluate
1027 technical details, guidelines, competency or other
dimensions
1028 of quality.
1029
1030
1031
1032
1033
1034
126-Incorporating
1035 TQM key concepts,
compartmentalization
1036 of QM/QI activities by organizational
structure,
1037 i.e., by department or discipline, is:
1038
a.weakness
1039 in implementing quality improvement .
b. the
1040 most efficient structure.
c.consistent
1041 withTQM philosophy.
d. important
1042 for preservation of medical stuff autonomy.
-----------------------------------------------------------------------------
1043
--------------------------
1044
1045
127-Whenever
1046 a quality problem has multiple causes, just a
few1047
of those causes account for most of the incidents is an
expression
1048 of:
1049
A. 1050Deming's first principle
B. 1051
Deming's third precept
C. 1052
the Pareto principle
D. 1053
the quality improvement principle
-----------------------------------------------------------------------------
1054
--------------------------
1055
1056
128-The
1057 concept of "benchmarking" includes which of the
following
1058 actions? :
1059
A. 1060
Responding only as problems arise
B. 1061
Changing based on the values of service providers
C. 1062
Doing things the same way for a long time
D. 1063
Comparing products and processes to those of the best
competitor
1064
1065
1066
129-Which
1067 of the following is the BEST reason why the
graphic
1068 representation of data is usually superior to verbal
or 1069
written representations?
1070
A. 1071
Faster interpretation
B. 1072
Easier to perform
C. 1073
Most managers can't understand numbers
D. 1074
Easier on the eyes
-----------------------------------------------------------------------------
1075
--------------------------
1076
130-Which
1077 of the following is the BEST definition of
process?
1078 :
1079
A. 1080
The steps required to provide care
B. 1081
A series of steps that achieve a desired outcome
C. 1082
Patient care activities
D. 1083
Technical aspects of providing care
1084
1085
1086
131-Organizational
1087 culture is best defined as:
1088
A. 1089
assumptions about individuals and how work gets done
B. 1090
ethnic make-up of employees
C. 1091
provision of activities to employees such as National
Nurses
1092 Week
D. 1093
professional development of employees
1094
-----------------------------------------------------------------------------
1095
--------------------------
1096
1097
132-Responsibility
1098 of quality improvement within the
organization
1099 is to:
1100
A. 1101
Chief executive officer
B. 1102
Quality manger
C. 1103
Frontline staff
D. 1104
Everyone within the organization
-----------------------------------------------------------------------------
1105
--------------------------
1106
1107
133-The
1108 CEO has the following responsibility except:
1109
A- 1110
Implementing the policies of the governing body
B- 1111
Monitoring the productivity of the organization
C- 1112
Monitoring the quality improvement function
D- 1113
Approval of the reappointment
1114
Approval
1115 of reappointment of medical staff is the ultimate
responsbility
1116 of the Governing Board although the
recommendations
1117 are made by the CEO through chief of
staff affairs.
1118
1119
134-Before
1120 the end of the meeting the most important to do
is: 1121
1122
A. 1123
Putting the agenda for next meeting
B. 1124
Make summery for the meeting
C. 1125
Instruct the members to do their duties
D. 1126
Make summery to the leader
1127
1128
1129
135-One
1130 of the team members that keep members on
track&focus
1131 on the process is:
1132
A. 1133
Leader
B. 1134
Facilitator
C. 1135
Time keeper
D. 1136
Recorder
1137
-Facilitator
1138 is not one of the team member.
- Time
1139 keeper is part of team members and the one who
monitors
1140 the time spent in meetings and keeps people in
1141,so that times are well spent and dont exceed
track
scheduled
1142 times.
- Recorder
1143 is the secretary and part of team members is
responsible
1144 for keeping documents and creating reports or
documents
1145 as needed by the team.
- Team
1146 leader is the member of the team and is the one who
provide
1147 direction.
-The
1148answer is (A) the leader.
1149
136-The
1150 following is important in development of practice
guidelines
1151 except:
1152
A. 1153
Evidence based researches
B. 1154
Experience of peers
C. 1155
Patient expectation
D. 1156
Clinical knowledge of peer physician
1157
1158
1159
1160
137-In
1161 development of the practice guidelines, the following
is involved
1162 except:
1163
A. 1164
Physician
B. 1165
Quality manger
C. 1166
Evidence based research
D. 1167
Nurses
-----------------------------------------------------------------------------
1168
--------------------------
1169
1170
138-Nurse
1171 to patient ratio is an example of what type of
measures?
1172 :
1173
A-Structure
1174
B-Process
1175
C-Outcome
1176
D-Monitoring
1177
1178
1179
139-On
1180 presentation of graphed data to governing body,
which
1181 of the following you need to add to help interpretation
of data:
1182
1183
A. 1184
Methods of data collection
B. 1185
Compare with bench mark
C. 1186
Names of data collectors
D. 1187
Duration of data collection
1188
1189
140-When
1190 the team members start to interest in hearing
each other, being on focus on goals, this is the stage of
1191
1192
A. 1193
Performing
B. 1194
Storming
C. 1195
Norming
D. 1196
Forming
-----------------------------------------------------------------------------
1197
--------------------------
1198
1199
141-Validity
1200 of measures is defined as:
1201
A-Repeated
1202 measuring leads to the same results
B-Low
1203 in cost
C-Well
1204 understood
D-Measure
1205 what's intended to measure
-----------------------------------------------------------------------------
1206
--------------------------
1207
1208
142-Avoiding
1209 waste, in particular waste of equipment,
supplies,
1210 ideas, and time actualize which quality dimension:
1211
A-effectiveness
1212
B-efficiency
1213
C-appropriateness
1214
D-efficacy
1215
Efficiency
1216 is the maximum utilization of the available
resources,
1217 maximum unit production from unit of resources.
Efficacy:
1218 the capacity of the resources to deliver + results
proved
1219 by research
Effectiveness:
1220 the amount of the desired +ve results reached
when
1221we actually utilize the resources
Appropriateness:
1222 is that the service we deliver is related and
in accordance
1223 to the real need of the patient
1224
143-A
1225 team approach to problem solving is most useful
when:
1226
1. The
1227 organization goals are unclear
2. Diverse
1228 areas of expertise are required
3. Communication
1229 challenges exist
4. There
1230 are ample resources within the organization.
1231
144-After
1232 completing a surgery the nurse responsible for the
surgical
1233 instruments didnt find one surgical clamp, an
ultrasound
1234 was done to the patient and nothing was found in
her1235
abdomen ,in your opinion this case is:
1. Claim
1236 management
2. Res
1237 ipsa loquitor
3. Malpractice
1238 from the nurse.
4. Doesnt
1239 matter since nothing happen to the patient
The answer is 3. malpractice from the nurse because it cant
1240
be 1241
claim management or res ipsa loquitor because there is
evidence() about the negligence and if I didnt do
no 1242
nothing
1243 then this is not quality as of course something will
happen
1244 in the future, so I will consider malpractice from the
nurse
1245 and I will investigate to find the root causes for this
accident
1246 in order to prevent it in the future (risk
prevention).
1247
1248
1249
145-Who
1250 is responsible for developing vision for change:
1. CEO
1251
2. Quality
1252 Council.
3. Quality
1253 Leader.
4. Quality
1254 Manager.
Those
1255 who set the vision have to be leaders and there is no
single
1256 person responsible for setting the vision alone so the
perfect
1257 answer here would be QUALITY COUNCIL as it is
formed
1258 of group of quality leaders.
1259
146-To
1260 successfully achieve Quality Improvement, Leaders
should:
1261
1. power
1262 over others.
2. power
1263 through others.
3. power
1264 with others.
4. delegate
1265 power to others.
1266
-----------------------------------------------------------------------------
1267
--------------------------
1268
147-Which
1269 of the following statements and documents are
most
1270likely to reveal the organization's underlying or true
value
1271system? :
1272
a. Mission,
1273 ethics policy, strategic initiatives
b. Vision,
1274 ethics policy, corporate bylaws.
c. Values,
1275 QM/QI plan, utilization management plan.
d. Mission,
1276 Vision, Values.
1277
1278
The key words of this question are:
1279
UNDERLYING
1280 or TRUE VALUE SYSTEM, this means
that there are 2 types of value systems ,the one which is
1281
documented
1282 and planned for before the implementation and
the1283
one which really represents the value system in our
organizations
1284 during the implementation which is not
necessarily
1285 the same as the one documented. so we have to
seek in the answers for the answer which represent the value
1286
system
1287 which is documented and the one really implemented
( how
1288 the work really gets done).
Answers,
1289 B C and D, all represents written documents, the
right
1290answer is A and the key here is SRATEGIC
INTIATIVES
1291 which is a key word for the implementation of
all 1292
those written documents.
1293
1294
1295
1296
148-Theres
1297 multiple payment systems for healthcare
systems,
1298 the following system foster quality improvement by
the1299
healthcare organizations:
A-pay
1300 for service
B-prospective
1301 payment system
C-payment
1302 responsibility is held by the patient
D-retrospective
1303 payment system
-----------------------------------------------------------------------------
1304
--------------------------
1305
1306
149-the
1307 quality professional should master all of the
following
1308 skills but the most effective one is:
1. data
1309 analysis
2. financial
1310 management.
3. systems
1311 design.
4. written
1312 and verbal communication
1313
first of all u have to know how to answer theses kind of
1314
questions,
1315 the key word here is the most effective one: this
refers
1316 to that all the answers are skills that the quality
professional
1317 must own and master in order to perform
properly,
1318 he has to know how to analyze data and use these
data for decision making and prioterization, he has to to
1319
know
1320 how to design or share in the designing and planning
of different
1321 systems, he has to be aware about different
aspects
1322 of financial management in order to control and
evaluate
1323 the cost in order to add value to the process of care.
but1324
imagine with me that this quality specialist is a bad
communicator
1325 how could all his tasks be effective??????
how could he communicate the results of the analysis of
1326
data?
1327 how could he share in designing systems with people
he 1328
cant communicate with ?
and1329
the most important how could he lead?
how could he educate:
1330
how could he be a marketer for quality?
1331
how could he lead by example?
1332
how could he reach the buy in of the leaders and the detailed
1333
management?
1334
how could he reach the leadership and the organizationwide
1335
commitment?
1336
how could create a culture of quality?
1337
communication
1338 communication communication
u have
1339 to own this skill to make dreams come true.
1340
1341
1342
150-Leader
1343 that transfer values of the organization to the
employee
1344 to make
A .face
1345 to face communication
B.open,
1346 timely and 2-way communication
C .top-down
1347 instruction
D .paper-mediated,
1348 closed door communication
-----------------------------------------------------------------------------
1349
--------------------------
1350
1351
151-In
1352 behavioral health care setting CQI team working for
1353 to decrease the chemical& physical restraint .After
1 year
application
1354 of the program, the falls with subsequent
injuries
1355 increase for 1 standard deviation, the following
action
1356 is-2
Return
1357 to the physical restraint & increase monitoring-A
Continue
1358 the program & seek opportunities to decrease falls-B
Stop the program & reengineer the process-C
1359
Use1360
more chemical restraint & educate the physicians-D
-----------------------------------------------------------------------------
1361
--------------------------
1362
152-On
1363 presentation of the annual review to the governing
body,
1364 the following is important to include the presentation
1365 & tables -A

Graphs
Minutes
1366 -B
1367 achievement-C
Team
Complaints
1368 -D
-----------------------------------------------------------------------------
1369
--------------------------
1370
153-In
1371 the first meeting of quality improvement team the
following
1372 is done except
Introduce
1373 the members-A
Studying
1374 the process -B
Agreeing
1375 on ground rules-C
Organize
1376 the dates of the meetings D
1377
154-The
1378 drawback of raw data for interpretation is
Can't
1379 be graphed-A
Can be measured for adherence to standard only?-B

1380
reference points for interpretation?-C

No1381
Can't
1382 be averaged-D
-----------------------------------------------------------------------------
1383
--------------------------
1384
155-On
1385 presentation of graphed data to governing body,
which
1386 of the following you need to add to help interpretation
of data
1387
Methods
1388 of data collection-A
Compare
1389 with bench mark-B
Names
1390 of data collectors-C
Duration
1391 of data collection-D
-----------------------------------------------------------------------------
1392
--------------------------
1393
156-The
1394 upper & lower limits of control charts are
measured
1395 from
actual process measurement-A
The1396
Benchmark-B
1397
Community
1398 advised measures-C
Recommendation
1399 of accrediting body-D
-----------------------------------------------------------------------------
1400
--------------------------
1401
157-For
1402 variance interpretation, the most suitable statistical
tool1403
is
Flowchart-A
1404
1405 chart-B
Control
Bar1406
graph-C
Pie1407
charts-D
-----------------------------------------------------------------------------
1408
--------------------------
1409
158-After
1410 patient death due to medication interaction, the
following
1411 action is
Couse
1412 & effect diagram-A
1413cause analysis-B
Root
Failure
1414 mood & effect analysis-D
1415
159-A
1416 hospital found a high rate of vaginal delivery after
primary
1417 caesarian section, the appropriate action is
Recommended
1418 to increase rate of caesarian-A
Review
1419 competence of the obstetricians-B
1420 the diagnostic criteria leads to caesarian-C

Review
Try1421
to maintain this strategy-D
-----------------------------------------------------------------------------
1422
--------------------------
1423
160-The
1424 paradigm shift is
1425 the frame of thinking-A
Change
Improve
1426 the monitoring measures-B
Increase
1427 the standard-c
Use1428
the recent in medicine and technology-D
-----------------------------------------------------------------------------
1429
--------------------------
1430
161-The
1431 facilitator has knowledge of performance
improvement&
1432 can use tools properly & must not
a member of the team& invest interested in the process-A

Be1433
Quality
1434 professional-B
Skillful
1435 in team management-C
Be1436
working in the organization-D
-----------------------------------------------------------------------------
1437
--------------------------
1438
162-When
1439 the team members start to interest in hearing
each other's & being on focus on goals & to respect each
1440
other's,
1441 this is the stage of
Performing-A
1442
Storming-B
1443
Norming
1444 -C
Forming-D
1445
-----------------------------------------------------------------------------
1446
--------------------------
1447
1448
163-In
1449 a culture of patient safety, the most appropriate
surveillance
1450 to assess the infection rate is
Total
1451house surveillance?-A
Targeted,perioterized
1452 surveillance?-B
Community
1453 surveillance-C
None
1454of the above-D
-----------------------------------------------------------------------------
1455
--------------------------
1456
1457
164-An
1458 organization hires a quality professional to pass
1459 improvement concepts to the staff .The first thing
quality
the1460
quality professional should do
Deliver
1461 lectures to the staff-A
1462 the present knowledge of the staff-B

Assess
Review
1463 the previous performance of the staff-C
Make
1464 interview with the staff-D
-----------------------------------------------------------------------------
1465
--------------------------
1466
1467
165-The
1468 responsibility to pass quality improvement values to
the1469
organization is of the
1470 -A
Leader
Quality
1471 manger-B
External
1472 consultant-C
Nurse
1473 manger-D
-----------------------------------------------------------------------------
1474
--------------------------
1475
1476
166-A
1477 physician complain a nurse to quality manger that the
nurse
1478 doesnt do his orders ay time & ask him to tell the
nurse
1479 manger what should quality manger do first
Tell the nurse directly-A

1480
1481 the medical record-B

Review
Talk
1482to the nurse manger-C
Tell the CEO-D

1483
1484
-----------------------------------------------------------------------------
1485
--------------------------
1486
1487
168-The
1488 responsibility of implementation the quality
improvement
1489 approach within the organization is to
Medical
1490 staff-A
Quality
1491 manger-B
Leader-C
1492
1493 line staff-D

Front
-----------------------------------------------------------------------------
1494
--------------------------
1495
1496
169-Continuous
1497 quality improvement efforts find problems
in h hospital admission to provide breakthrough ideas in
1498
admission
1499 , the quality improvement team seek ideas from
Other
1500 hospital-A
Previous
1501 lectures-B
Automobile
1502 industry-C
1503resort industry-D
Hotel
-----------------------------------------------------------------------------
1504
--------------------------
1505
1506
170-All
1507 of the following is considered type of recognition to
the1508
team except
Putting
1509 their names in the storyboard-A
Allowing
1510 them to make presentation to the management-B
Makes
1511 an articles in hospital newspaper-C
Give
1512certificate signed by the leader-D
-----------------------------------------------------------------------------
1513
--------------------------
1514
1515
171-According
1516 to Deming one of his advises in quality
improvement
1517 is
Stop annual inspection for employee-A
1518
Make
1519 responsibility of quality for one person-B
Give
1520more lectures to the staff-C
Increase
1521 the hierarchy of the staff-D
-----------------------------------------------------------------------------
1522
--------------------------
1523
1524
172-Surveillance
1525 from 2 teams reach to opposite out
comes.as
1526 a quality manger the following action is
Make
1527 anew surveillance-A
Check
1528 the method of data collection-B
Make
1529 decision depends on the outcome of one surveillance-C
Nothing-D
1530
-----------------------------------------------------------------------------
1531
--------------------------
1532
173-In
1533 the business cycle, the negative cash flow present in
which
1534 of the following stages:
1535 stage- A
Growth
Harvest
1536 stage -B
Maintenance
1537 stage- C
None
1538of the above- D
-----------------------------------------------------------------------------
1539
--------------------------
1540
174-Medication
1541 error rates are considered an indicator of
which
1542 of the following parameters:
Finance-
1543 A
Patients-
1544 B
1545 process-C
Clinical
Learning
1546 D
-----------------------------------------------------------------------------
1547
--------------------------
1548
1549
175-Measurement
1550 of effectiveness of a seminar delivered to
the1551
staff on new methods for training asthmatic patients to
use1552
metered dose inhaler is best done by:
Satisfaction
1553 survey for the trainees- A
Tracking
1554 number of attendees -B
Incidence
1555 and survey for the patients -C
Satisfaction
1556 survey for the patientD
-----------------------------------------------------------------------------
1557
------------
1558
176-To
1559 gain the leadership commitment to performance
improvement
1560 projects, the quality professional should
capitalize
1561 on which of the following:
A-Importance
1562 of the project on employee satisfaction and
financial
1563 health of the org
Importance
1564 of the project on the accreditation status and the
1565 -B
clinical
Importance
1566 of the project on the financial health and
accreditation
1567 status of the org -C
Effect
1568 of the project on the community- D
-----------------------------------------------------------------------------
1569
------------
1570
177-The
1571 followings can enhance the spread of the change in
the1572
organization except:
Inclusion
1573 of the leaders in the planning process- A
Seeking
1574 input from the staff- B
-C-Make
1575 punishments on errors related to the
implementation
1576 of the change
Adopt
1577 open door policy- D
-----------------------------------------------------------------------------
1578
------------
1579
178-Measuring
1580 morbidity and mortality is considered:
Administrative
1581 data- A
Support
1582 data- B
Managerial
1583 data-c
Clinical
1584 data-D
-----------------------------------------------------------------------------
1585
------------
1586
1587
179-Information
1588 about customers can be obtained from all
of the
1589 followings except:
Complaint
1590 logs- A
Managerial
1591 observations- B
Satisfaction
1592 survey- C
Employee's
1593 opinions about customer's attitude-D
-----------------------------------------------------------------------------
1594
------------
1595
180-Data
1596 about the competitors may be obtained from all of
the1597
followings sources except:
National
1598 standards- A
Individual
1599 customers- B
News
1600media- C
Surveys
1601 performed by the local government- D
-----------------------------------------------------------------------------
1602
------------
1603
181-When
1604 there's uncertainty about the outcome of the
process
1605 with presence of guidelines and experienced staff,
the1606
process is considered as:
A-Complicated
1607
B-Complex
1608
C-Simple
1609
D-Flexible
1610
-----------------------------------------------------------------------------
1611
------------
1612
182-Bias
1613 of a measure occurs when the measure:
A-Produce
1614 different results on repetitive measuring
B-Measure
1615 what's intended to measure
C-Produce
1616 data errors consistently and systemically
D-Exclude
1617 the negative cases consistently
-----------------------------------------------------------------------------
1618
------------
1619
183-The
1620 percentage of early diagnosed breast cancer after
usage
1621 of new imaging technique is considered:
A-Structure
1622 measure
B-Process
1623 measure
C-Outcome
1624 measure
D-Continuous
1625 measure
-----------------------------------------------------------------------------
1626
------------
1627
184-Make
1628 it safe to make mistakes, Will:
A-Increase
1629 the learning state within organization
B-Increase
1630 the errors
C-Decrease
1631 the loyalty of the customers
D-Decrease
1632 the self-esteem of the staff
-----------------------------------------------------------------------------
1633
------------
1634
185-All
1635 of the following are considered criteria for review of
capital
1636 budget except
A-Feasibility
1637
B-project
1638 revenue
C-customer
1639 acceptance
D-actual
1640 costs
-----------------------------------------------------------------------------
1641
------------
1642
186-Cost
1643 benefit analysis is defined as
A-analysis
1644 of the capital expenditures for its effectiveness on
the1645
process
B-analysis
1646 of the capital expenditures for its viability and the
broader
1647 benefit
C-seeking
1648 for resources for the capital expenditures
D-a1649
process done by the quality manger and approved by
the1650
governing body
Answer:
1651 B
A is the Cost effectiveness, the rest are not cost analysis
1652
means
1653
1654
1655
1656
187-All
1657 of the following may be realized as financial return
on 1658
an investment except
A-learning
1659 of the staff
B-reduction
1660 in losses
C-profit
1661
D-avoided
1662 costs
-----------------------------------------------------------------------------
1663
------------
1664
188-To
1665 enhance coping of the desired behavior by the
employee,
1666 you should
A-punish
1667 the UN desired behavior maker
B-Make
1668 rewards on the desired behavior
C -make
1669 the desired behavior appear as normal
requirement
1670 and needs no recognition
D-blame
1671 and train the undesired behavior maker
-----------------------------------------------------------------------------
1672
------------
1673
189-Physician
1674 cooperation in quality improvement
initiatives
1675 is important and best gainedBy:
A-demonstrating
1676 the importance of the project on the
competitive
1677 status of the organization
B-clarifying
1678 the effect of the project on the effectiveness and
efficiency
1679 on the process
C-clarifying
1680 that TQM conflict with the way the physician
thinks
1681
D-demonstrating
1682 the importance of the project for the
accreditation
1683 process
-----------------------------------------------------------------------------
1684
------------
1685
190-Training
1686 should be delivered to all levels of the
organization,
1687 training should be
A-organizationwide
1688
B-just
1689 on time training
C-a1690
and b
D -None
1691 of the above
-----------------------------------------------------------------------------
1692
------------
1693
191-After
1694 providing training, the specialist evaluate the
increased
1695 skill within the trainees, this is considered what
level of evaluation
1696
A-reaction
1697 level
B-result
1698 level
C-behavior
1699 level
D-learning
1700 level
-----------------------------------------------------------------------------
1701
------------
1702
192-The
1703 important things for a particular group are:
A-culture
1704 of the group
B-norms
1705 of behavior
C-value
1706 of the group
D-language
1707 communicated by the group
-----------------------------------------------------------------------------
1708
------------
1709
193-Avoiding
1710 waste in particular waste of equipment,
supplies,
1711 ideas, and energy is:
A-effectiveness
1712
B-efficiency
1713
C-appropriateness
1714
D- 1715
patient-centeredness
-----------------------------------------------------------------------------
1716
------------
1717
194-In
1718 response to public concern the institute of medicine,
published
1719 the report "crossing the quality chasm" The
following
1720 are domains for health improvement identified in
the1721
report except
A-safety
1722
B- 1723
patient-centeredness
C-equity
1724
D-appropriateness
1725
-----------------------------------------------------------------------------
1726
------------
1727
195- Avoiding injuries to patient from care that's intended

1728
to help
1729 them is:
A --patient-centeredness
1730
B-equity
1731
C-safety
1732
D-timeliness
1733
-----------------------------------------------------------------------------
1734
------------
1735
196-Health
1736 care organization is complex system .In complex
system
1737 all of the following are right except:
A-the
1738 interrelationships between agents are most important
B-The
1739 outcome is predictable
C-dealing
1740 with complex system require understanding the
bid1741
picture
D-here's
1742 a high chance for variation that may be identified
as 1743
error or innovation
-----------------------------------------------------------------------------
1744
------------
1745
197-System
1746 thinking is seen wholes, as regarding to system
thinking
1747 all of the following are right except:
A-facilitate
1748 the identifying the major component
B-foster
1749 integration
C-allow
1750 for narrow scope variation
D-provide
1751 basis for integration
-----------------------------------------------------------------------------
1752
------------
1753
1754
1755
1756
198-In
1757 health care organization, the quality department
developed
1758 an indicator to measure the commitment of the
staff to myocardial infarction guidelines .This indicator
1759
measure:
1760
A-process
1761
B structure
1762
C-culture
1763
D-outcome
1764
-----------------------------------------------------------------------------
1765
------------
1766
1767
199-All
1768 of the following are considered as rules that adopted
health
1769 care organization in the new century except:
A-decision
1770 making is evidence based
B-safety
1771 is system priority
C-the
1772 system react to needs
D-the
1773 patient is the source of control
-----------------------------------------------------------------------------
1774
------------
1775
200-All
1776 of the following are goals for strategic management
except:
1777
A-Creating
1778 a fit between the organization and its external
environment
1779
B -Facilitate
1780 consistent decision making.
C-Foster
1781 anticipation, innovation and excellence
D-Make
1782 day to day work flow easy
1783
1784
1785
200-All
1786 of the following are goals for strategic management
except:
1787
A-Creating
1788 a fit between the organization and its external
environment
1789
B -Facilitate
1790 consistent decision making.
C-Foster
1791 anticipation, innovation and excellence
D-Make
1792 day to day work flow easy
1793

1794
201-Mission
1795 is defined as++++:
A-Statements
1796 of future goals of the organization
B-Organization's
1797 reason for existence
C-The
1798 plan developed by the organization in pursuit to its
goal and objectives
1799
D-The
1800 attitude and polices for employee
1801

1802
202-Goals
1803 and objectives are similar but could be
differentiated
1804 by:
A-Goals
1805 are non-measurable while objectives are
measurable
1806
B-Goals
1807 are time-limited while objective are not
C-Goals
1808 are broad & general statement whole objectives are
specific
1809 statements
D-goals
1810 are non-observable while objectives are observable
1811

1812
203-When
1813 writing objectives, the following are guidelines
except+++:
1814
A-Keep
1815 the statements short and simple
B-State
1816 the desired outcome
C-Prioritize
1817
D-Write
1818 the statement broadly
objectives
1819 must be written by following SMART criteria

1820

1821
204-The
1822 external environment affects the healthcare
organizations,
1823 so assessment of the environment is
important
1824 .The followings are examples for external forces
except:
1825
A-Economic
1826 forces
B-Societal
1827 values
C-Political
1828 issues
D-Other
1829 competitors
E-Equipment
1830 the organizations have
E-
1831Research

1832
205-Gap
1833 analysis may be used in:
A-Measuring
1834 the gap in performance between physicians
B-Measuring
1835 the economic gap between the individuals in
the1836
society
C-Measuring
1837 the gap in clinical status of patient
D-Evaluating
1838 the extent to which present strategy would
have
1839to be changed in order to meet the goals and objectives

1840
1841
206-Hoshin
1842 planning allows integration of quality
improvement
1843 with strategic planning the primary reason to
undertake
1844 hoshin planning is:
A-Allow
1845 long term planning
B-Align
1846 vision with day to day operations
C-Evaluate
1847 the extent to which strategy is accomplished
D-Demonstrate
1848 the gap between the organization and the
best performer
1849
1850

1851
207-Commitment
1852 of the governing body to quality
improvement
1853 is essential for the success of quality
improvement
1854 activities .Quality professional can enhance
the1855
board's commitment to quality by:
A-Assess
1856 knowledge and provide easily understood
information
1857
B-Ask
1858 them to make search on quality concepts
C-Provide
1859 them with materials to be studied on their own
D-Use
1860 of external educator
the1861
quality specialist must be an excellent educator and
communicator
1862 becoz he is the one who convince others by
his1863
skills so he must help others to understand, feel the
importance
1864 of quality and commit to it using these skills ,
communication
1865 and interaction is a must
1866

1867
208-The
1868 ultimate responsibility for setting policy for quality
of care
1869 provided by the organization is rested on
A-Staff
1870
B-Quality
1871 manger
C-board
1872 of trustees
D-Department
1873 director
1874

1875
209-The
1876 American hospital association outlined 6 broad
categories
1877 of responsibilities for the board .One of the
following
1878 is not included in the
A-Responsibility
1879 for ensuring access to education and
research
1880 program
B-Responsibility
1881 for maintaining productive external
relationship
1882 and for influencing -public policies related to
healthcare
1883
C- 1884
Responsibility for day-to-day activities
D- 1885
Responsibility for protection or human resources
1886

1887
210-Health
1888 care quality professional can best communicate
organizational
1889 values & committed through
A-Leading
1890 by example
B-Disseminate
1891 monthly newsletter
C-Establishing
1892 a multidisciplinary task force
D-Creating
1893 mission statement
1894

1895
211-To
1896 allow changes to be maintained, you should ensure
the1897
change in
A-The
1898 behavior of the staff
B-The
1899 hierarchy of the organization
C-The
1900 values within the organization
D-The
1901 reward system
1902

1903
212-All
1904 of the following leads to powerful culture for quality
improvement
1905 except
A-Consider
1906 sharing of the staff to quality activities at the
time of reappointment
1907
B-Align
1908 reword to behavior support activities
C-Face
1909 the resistance to quality by strict action
D-Integrate
1910 quality improvement into strategic planning
1911

1912
213-Administration
1913 of penicillin to patient with history of
allergy
1914 is
A-Potential
1915 drug event
B-Preventable
1916 adverse drug reaction
C-Non
1917 Preventable adverse drug reaction
D-Financial
1918 loss
1919

1920
214-All
1921 of the following are consider medical error except
A-Giving
1922 the patient drug of an in corrected type
B-Defibrillation
1923 by dead batteries
C-Misinterpretation
1924 of diagnostic test?
D-Rash
1925 caused by drug with negative history?
1926

1927
215-Which
1928 of the following is the primary goal of risk
management?
1929
A-Identify
1930 high risk areas of the organization
B-Maintain
1931 an effective reporting system
C-Perform
1932 failure mode & effect analysis
D-Reduce
1933 financial loss within the organization

1934

1935
216-The
1936 following are function of risk management except
A-Review
1937 for over usage of resources
B-Development
1938 risk management plan
C-Regulatory
1939 compliance
D-Claims
1940 management
1941

1942
217-The
1943 following are important aspect the risk manger
should
1944 be known except
A-Insurance
1945 industry
B-Aviation
1946 industry
C-Legislation
1947 and laws
D-Clinical
1948 area
1949

1950
218-Operative
1951 patient due to forgotten instrument inside the
patient
1952 is considered as
A-Common
1953 cause variation
B-Medication
1954 error
C-Sentinel
1955 event
D-Nurses
1956 fault
1957

1958
219-Root
1959 cause analysis is considered
A-Retrospective
1960 review
B-Concurrent
1961 review
C-Prospective
1962 review
D-Force
1963 field analysis
1964

1965
220-Which
1966 of the following is right order of steps in root
cause
1967 analysis?
A-Finding,
1968 develop action plan, redesign the process,
investigate
1969 event
B-Investigate
1970 event, develop action plan, report finding, and
redesign
1971 the process
C-Investigate
1972 event, develop action plan, redesign the
process
1973 and report finding
D-Investigate
1974 event. report finding, develop action plan,, and
redesign
1975 the process

1976

1977
221-When
1978 an incident to patient is occurring, the
appropriate
1979 action is
A-Distract
1980 the attention of the patient, discuss the incidence
with the staff and make action plan
1981
B-Discuss
1982 the incidence with the patient; make punishment
on 1983
responsible for the incidence
C-Discuss
1984 the incidence with the patient and the staff and
make
1985 an action plan
D-Make
1986 no action
1987

1988
222-Which
1989 aspect of confidentiality of patient , the medical
record
1990 may be used in all of the flowing except
A-Education
1991
B-Statistical
1992 evaluation
C-Research
1993
D-Announcement
1994 to the organization

1995

1996
223-The
1997 departments that have more concern on discharge
planning
1998 is
A-Quality
1999 management department
B-Utilization
C-Risk
D-Human
2002 resources department
2003

2004
224-All
2005 of the following are purpose of the utilization
management
2006 program except
A-Assure
2007 fair and consistent utilization management
decision
2008 making
B-Ongoing
2009 monitoring to effective and efficient utilization of
facilities
2010
C-Education
2011 of staff on appropriate use of health care
resources
2012
D-Collaboration
2013 with the financial office staff regarding
methods
2014 of risk financing

2015

2016
225-Claim
2017 review is an example of
A-Prospective
2018 review
B-Retrospective
2019 review
C-Concurrent
2020 review
D-None
2021 of the above
2022

2023
226-The
2024 review of appropriateness of care provided by
physician
2025 that's done by another physician is called
A-Initial
2026 clinical review
B-Clinical
2027 peer review
C-Appeals
2028 consideration
D-Reappointment
2029
2030

2031
227-Concurrent
2032 review that evaluate of each hospital case
against
2033 established criteria is
A-Preadmission
2034 test
B-Discharge
2035 planning
C-Review
2036 against criteria
D-Pattern
2037 review
2038

2039
228To
2040 change behavior within the organization the first step
is 2041
A-Create
2042 an urgency to change
B-Provide
2043 education bout the change
C-Anchor
2044 the improved behavior
D-Ask
2045 advice external consultant
2046

2047
229-Which
2048 of the following relate the cost of the process to
the2049
desired outcome
A-Cost-effectiveness
2050 ?analysis
B-Cost-benefit
2051 ?analysis
C-Operation
2052 budget
D-Capital
2053 budget
2054

2055
230-In
2056 the first meeting of continuous quality improvement
team
2057the following id done except
A-Introduce
2058 the members
B-Studying
2059 the process
C-Agreeing
2060 on ground rules
D-Organizing
2061 the dates meetings
2062

2063
231-Which
2064 from is the right order in development of teams
A-Forming,
2065 storming, performing, norming
B-Storming,
2066 forming, norming, performing
C-Forming,
2067 norming, storming, performing
D-Forming,
2068 storming, norming, performing
232-Conflict
2069 management is a function of leader to mange
team
2070in certain stage of its development, this stage is
A-Storming
2071
B-Norming
2072
C-Adjourning
2073
D-Forming
2074
2075

2076
233-Evaluation
2077 of team is an issue to assure the effectiveness
of the
2078 performance improvementTeams, the following may
be 2079
used in evaluation except
A-Satisfaction
2080 of team members
B-Individual
2081 growth
C-Satisfaction
2082 of the board
D-Productivity
2083

2084

2085
234-Provide
2086 training about quality improvement tools but
may be forgotten as it's not used after the training, the
2087
following
2088 may enhance the use of the tools except
A-Giving
2089 example
B-Provide
2090 on time training
C-Make
2091 mock situation
D-Ask
2092 trainees to make on line search

2093

2094
2095
235-Clinical
2096 decision support system can support medication
safety2097 by altering prescribers to:
A. patient 2098compliance and allergies
B. the need 2099 for dose adjustments and patient weight changes
C. drug2100 interaction and patient weight changes
D. allergies2101 and drug interactions

2102

2103
2104
236-The
2105 surgery department monthly case review revealed 10
records
2106 meeting criteria. six records did not meet the criteria
in calculating
2107 the incidence rate the dominator is
2108
A. 4 2109
B. 6 2110
C. 10 2111
D. 16 2112

2113

2114
2115
237-to
2116 be useful in preventing future error, a root cause
analysis(RCA)
2117 Should be performed
A. utilizing
2118 a multidisciplinary team
B. using2119
practitioners who not involved in the event
C. starting
2120 no earlier than 45 days after the event
D. documenting
2121 opinion as well as facts
2122

2123

2124
2125
238-A
2126 quality council has charted a performance improvement
team
2127to reduce medication errors, team has been meeting for
several
2128 months and progress has been very slow . Which of the
following
2129 is the most important factor for quality council to
assess
2130 with team leader ?
A. composition
2131 of the team
B. number
2132 of medication errors since the team was charted
C. team2133
member ability to interpret graphs
D. frequency
2134 of team meetings
2135

2136

2137
2138
239-A
2139 patient in acute psychiatric unit committed suicide by
hanging
2140 himself with his shoelaces to prevent this from
occurring
2141 again the most appropriate action is to institute
A. patient
2142checks every 15 minutes
B. a policy
2143 allowing only non laced shoes
C. a 24 hour
2144 video monitoring system
D. a buddy
2145 system for the patient
2146
Direct
2147 interference with the event by error proofing, prevent
the2148cause

2149

2150
2151
2152
240-physician
2153 profiles are reviewed at time of reappointment
to 2154
A. ensure practitioner competency
2155
B. compare
2156 practitioner to peers
C. review number of complaints
2157
D. facilitate
2158 reappointment approval
2159

2160

2161
2162
241-which
2163 of the following is the best way to determine if
quality
2164 improvement initiatives is successful ?
A. Compare
2165 outcomes with pre established goals
B. Conduct
2166 a survey of employees
C. Present
2167 findings to the quality council
D. Survey
2168 patient and customers
2169
244-management
2170 using quality improvement principles should
emphasize
2171 the importance of
A. Staff 2172 orientation
B. Customer
2173 expectations
C. Quarterly
2174 statistical reports
D. Team 2175 development

2176

2177
2178
245-what
2179 sampling technique involves selecting the medical
record
2180 of every fifth patient undergoing cardiovascular
bypass?
2181
A. Convenience
2182
B. Systematic
2183
C. Stratified
2184
D. Simple
2185 random

2186

2187
2188
246-the
2189 most effective tool to improve communication between
caregivers
2190 is known as
A. SOAP 2191
B. PDCA 2192
C. PDSA 2193
D. SBAR 2194

2195

2196
2197
247-quality
2198 improvement (team outcomes ) are best evaluated
by 2199
which of the following ?
A.
2200Team leader
B.
2201Senior leadership
C.
2202PDCA process
D.
2203Nominal group techniques
2204
2205
2206
248-which
2207 of the following best describes an organizational
vision
2208 statement
A. It is used as a marketing strategy
2209
B. It defines the structure of the institution
2210
C. Describes
2211 the organization strategic plan
D. It reflects the organization inspiration+++
2212
2213
2214
2215
249-Two
2216 surveys were completed in a healthcare facility that
showed
2217 conflicting results concerning patient satisfaction with
food services ,the two surveys were independently designed
2218
and2219
distributed by different departments within the facility, the
healthcare
2220 quality professional should first :
A.2221
Set up quality improvement team to improve food
services
2222
B.2223
Distribute the surveys to obtain a larger sample size
C.2224
Design,distribute,and analyze a new survey instruments
D.2225
Meet with the departments to review the survey
processes
2226
2227
250-Replacing
2228 retrospective review with concurrent review is
an 2229example of
A.2230A paradigm shift
B.2231A process improvement
C.2232An empowerment process
D.2233Productivity enhancement

2234

2235
2236
251-which
2237 of the following is essential component of
performance
2238 improvement report
A. Governing
2239 body approval
B. Data 2240 analysis and display
C. Individual
2241 performance review
D. team 2242composition and attendance

2243

2244
2245
253-A 2246 failure mode and effect analysis (FMEA) is performed
A. To2247 immediately investigate an incident occurred
B. As 2248a preventive measure before an incident occurs
C. If the2249severity of incident led to a patient death
D. When 2250 there is a chance of an incident reoccurring

2251

2252
254-A
2253 quality council has charted patient safety council the
council
2254 is concerned that staff may see this as another
program
2255 that has been added to their bust schedules that will
eventually
2256 go away ,the best way for the organization to
establish
2257 patient safety as an ongoing part of the
organization's
2258 culture is to
A.2259
Display the number of incident reports monthly with
lessons learned
2260
B.2261
Identify the patient safety goals and how they will be
monitored
2262
C.2263
Make patient safety a part of the employee's job
description
2264
D.2265
Include a presentation on patient safety in employee
orientation
2266
2267
2268

2269
2270
255-Standards
2271 of care based on the knowledge and research of
recognized
2272 experts are known as
A.
2273Benchmarking data
B.
2274Generic screens
C.
2275Pre established criteria
D.
2276Evidence based guidelines

2277

2278
2279
256-An
2280 utilization management department of a hospital; has
collected
2281 data on length of stay (LOS ) and readmission rates .
compared
2282 to benchmarking the (LOS) rates are higher and
readmission
2283 rates are lower which of the following is the next
step2284
A. Identify
2285 additional benchmarks to compare data
B. Conduct
2286 cost benefit analysis
C. Display
2287 readmission rates with run charts
D. Investigate
2288 the length of stay rates

2289

2290
2291
257-In2292 evaluating "long waiting times " a healthcare quality
professional
2293 best demonstrates components related to
staffing,methods,measure,materials
2294 and equipments utilizing
A. Run 2295chart
B. Histogram
2296
C. Pie 2297chart
D. Ishikawa
2298 diagram

2299

2300
2301
258- Hospital A has recently merged with hospital B after 6
2302
months
2303 it is noted that hospital A has successfully transmitted
their staff to new organizational values while hospital B still
2304
struggle
2305 .hospital A success can best be attributed to
A. Required
2306 adoption of new values by all staff
B. Support
2307 of both hospital's mission statements
C. Acceptance
2308 of new mission and vision statements
D. Integrating
2309 technology and database
2310

2311

2312
260- 2313 A healthcare quality professional is reviewing data with
wide 2314 range of values between highest &lowest points . the best
way2315 to rank order using
A.
2316Line graph
B.
2317Simple frequency distribution
C.
2318Ground frequency distribution
D.
2319Bar graph

2320
2321
2322
262-Analysis
2323 of post operative surgical infection rate over past
year 2324demonstrates an increase in infections. Which of the
following
2325 best provides display of aggregated data compared to
data 2326from a local facility?
A.
2327Bar graph
B.
2328Control chart
C.
2329Pareto chart
D.
2330Histogram

2331
2332
2333
2334
264-A 2335 healthcare quality professional hypothesize that a
sample2336 mean is different from population mean . the standard
deviation
2337 is not known . the estimate must be calculated from a
sample2338 . Which of the following statistical technique should be
used 2339 :
A.
2340Regulation analysis
B.
2341Chi square analysis
C.
2342T- test
D.
2343analysis of variance

2344
2345
2346
265-Which
2347 of the following are measures of central tendency?
A.
2348Mean ,mode ,median
B.
2349Standard deviation, variance, standard error
C.
2350Grouped data, bell curve & distribution
D.
2351Correlation, regression & T-test

2352
2353
2354
267-Quality
2355 improvement teams are beneficial because they:
A.
2356Maximize expertise & perspectives
B.
2357Promote competition & pride among members
C.
2358Improve management control
D.
2359Authorize solutions to problems

2360
2361
2362
2682363
-A computer report is generated to assess the type of
patient
2364 served show 72% of visits were for obestric service
which
2365 of the following codes should be reviewed for verify the
accuracy
2366 of percentage?
A.
2367Procedural
B.
2368Diagnostic
C.
2369Medication
D.
2370Attending physician

2371
2372
271-Data
2373 regarding the relationship between patient
satisfaction
2374 & hours per patient day on a medical unit were
reported
2375 to be [r=0.69,p>0.05] what's the correlation between
these 23762 values?
A.
23770.05
B.
23780.65
C.
23790.69
D.
23800.36

2381
2382
272-Surgery
2383 department's monthly case view revealed 10
records
2384 meeting criteria,6 records didn't meet, when
calculating
2385 the incidence rate the denominator is
A.
23864
B.
23876
C.
238810
D.
238916
2390
273-Quality
2391 improvement requires healthcare quality
professional
2392 to recognize that
2393 A. Quality improvement generates its own change
2394 B. The process is ongoing continuous & dynamic
2395 change
2396 C. Process require radical change in short period of
2397 time
2398 D. Quality improvement is managed by senior
2399 leaders

2400
2401
2402
274- 2403For which of the following the process capability best
used 2404
A.
2405Identify if process is having intended effect
B.
2406Focusing a team on the best thing to do
C.
2407Narrowing down options through systematic approach
2408of comparison
D.
2409Determining if a process meets established
2410specifications
2411 E. Fishbone diagram

2412
2413
2414
275- 2415When a case manager want to demonstrates length of
stay2416 data that depicts both common cause & special cause
variation
2417 which of the following should be used :
A.
2418Pareto chart
B.
2419Scatter plot
C.
2420Shewart chart
D.
2421Frequency plot

2422
2423
276- 2424The most effective way for healthcare quality
professional
2425 to communicate quality improvement activities
to the2426medical staff is by
2427 A. Developing professional relationships

2428 B. Inviting medical staff to an in service on quality
2429 tools
2430 C. Evaluating physician participation on quality
2431 teams
2432 D. Providing outcomes data at medical staff meeting

2433
2434
2435
277- 2436which of the following does an outcome indicator
measure?
2437
2438 A. What happens as result of a process
2439 B. The steps leading to process
2440 C. Individual performance of the process
2441 D. Priority area to improve the process

2442
2443
2444
278-physician
2445 profiling is reviewed at time of reappointment
to:2446
2447 A. Ensures practitioner competency
2448 B. Compare practitioner to peers
2449 C. Review number of complains
2450 D. Delay reappointment approval

2451
2452
279- The use of clinical pathways & guidelines in hospital
2453
should:
2454
2455 A. Minimize variation in patient care
2456 B. Reduce Length of stay
2457 C. Improve patient satisfaction
2458 D. Identify errors in patient care
2459
280- Utilization management department of hospital has
2460
collected
2461 data on length of stay & readmission errors
compared
2462 to benchmarks. The length of stay rates higher &
readmission
2463 rates are lower .which of the following is the next
step? 2464
2465 A. Identify additional benchmarks to compare
2466 B. Conduct cost benefit analysis
2467 C. Analyze readmission rates with run chart
2468 D. Continue to monitor length of stay rates

2469
2470
2471
281-Which
2472 of the following best describe vision statement?
2473 A. It is used as a marketing strategy
2474 B. It is define the structure of the institution
2475 C. It describe organization strategic plans
2476 D. It reflect the organization culture
2477
2478
282-A 2479 facility is providing a new service for patients with
chronic
2480 pain .which of the following is the primary role of the
healthcare
2481 quality professional on evaluating this new service
: 2482
2483 A. Comparing outcome to benchmark
2484 data+++++
2485 B. Evaluating cost benefit ratio
2486 C. Assuring the staff is adequately trained
2487 D. Developing performance monitoring criteria

2488
2489
2490
283- Surveys were completed in healthcare quality facility that
2491
showed
2492 conflicting results concerning patient satisfaction with
food service. The 2 surveys were independently designed &
2493
distributed
2494 by different departments within the facility. The
healthcare
2495 quality professional should:
2496 A. Setup a quality improvement team to improve
2497 food services
2498 B. Distribute the surveys to obtain a larger
2499 sample size
2500 C. Design, distribute, analyze a new survey

2501 instrument
2502 D. Meet with the department to review the
2503 survey process

2504
2505
2506
285- 2507Which of the following is the first step in strategic
planning
2508 process?
2509 A. Setting goals and objectives
2510 B. Define organizational structure
2511 C. Determine productivity indicators
2512 D. Establish & controlling of budget

2513
2514
2515
286-A 2516 health care organization was recently reviewed by an
outside
2517 agency the most effective way to communicate the
findings
2518 to senior leadership is
2519 A. Detailed report of finding
2520 B. An explanation of findings that include data tables
2521 C. An analysis of findings with graphs
2522 D. A memo highlighting the main findings+++++++

2523
2524
2525
287- 2526A patient is being taught to self administer insulin which
of the2527 following is the best method to assess the patient
understanding
2528 of the teaching
2529 A. Return demonstration
2530 B. Patient satisfaction survey
2531 C. Family ability to verbalize instructions
2532 D. Written pre& post test

2533
2534
2535
288- 2536 A reengineering effort occurred at a facility. Activities

particularly
2537 those regarding staff layoffs were carefully
planned,
2538 communicated & implemented according to the plan
,one 2539 year later the business is stable but staff morale is very
low2540 a healthcare quality professional has been asked to
consult
2541 in determining where the effort went wrong. Based on
the2542 concepts of change theory the cause is most likely:
2543 A. That reengineering decision was mistake
2544 B. A failure to address the needs of staff that were
2545 retained
2546 C. That leadership wasn't properly trained in the
2547 change management
2548 D. That a few disgruntled staff are instigating
2549 dissension in the ranks

2550

2551
2552
289- 2553A patient was admitted to a hospital with chest pain on
Friday2554 evening, a myocardial infarction was ruled out & the
patient
2555 discharged on Sunday the utilization management
coordinator
2556 reviewed the chart on Monday to determine
medical
2557 necessityfor admission. This type of review
2558 A. Avoidable
2559 B. Prospective
2560 C. Retrospectives
2561 D. Concurrent

2562
2563
290- 2564Which of the following tools should be used to collect
patient
2565 and practitioner special data
2566 A. Flow chart
2567 B. Graphs
2568 C. Histogram
2569 D. Spreadsheet

2570
2571
2572
291-The
2573 main purpose of conducting focus group is to
2574 A. Direct attention to identified problems
2575 B. Determine customer needs
2576 C. Track and trend occurrences
2577 D. Obtain a clear picture of recurring problem
2578
292- 2579Which of the followings are primary reasons for
developing
2580 drug formulas?
2581 A. Manage pharmacy cost & promote patient safety
2582 B. Reduce medication errors& educate physicians
2583 C. Encourage the appropriate use of medication&
2584 minimize inventory
2585 D. Decrease food and drugs interactions and improve
2586 patient satisfaction

2587
2588
2589
293- 2590An example of integrating the results of utilization
management
2591 assessment in the performance improvement
process
2592 is
2593 A. Educate case manager in discharge planning
2594 B. Hiring more nurses
2595 C. Reporting assessment result to executive staff
2596 D. Assessing results of patient satisfaction survey

2597
2598
2599
294-Priors
2600 to plotting a line graph, healthcare quality
professional
2601 should first
2602 A. Calculate the mean
2603 B. Define the axis measure
2604 C. Identify the parameters
2605 D. Develop a legend

2606
2607
2608
295-Which
2609 of the following does quality leadership start, in
contrast
2610 to management by results
2611 A. Profit & loss
2612 B. Return on investments
2613 C. Current procedures & services
2614 D. Customer needs and expectation

2615
2616
2617
296- 2618Barriers in implementing the evidence based guidelines
include
2619 all of the following except
2620 A. Lack of awareness that the guidelines are present
2621 B. Lack of ability to implement
2622 C. Lack of agreement by physicians
2623 D. Lack of information of the patient acceptance

2624
2625
2626
297-Comparing
2627 physicians performance will lead to all of the
following
2628 except
2629 A. Increase the quality of care
2630 B. Decrease costs
2631 C. Increase competitions
2632 D. Increase costs
2633
2634
2635
2636
2637
2638
2639
298- Concepts of error reduction include all of the following
2640
except
2641
2642 A. Respect limits on attention
2643 B. Encourage reporting of errors

2644 C. Increase punishments on errors
2645 D. Standardize

2646
2647
2648
299- 2649All of the followings related to patient safety except
2650 A. Inpatient suicide
2651 B. Wrong site injury
2652 C. Patient discrimination
2653 D. Infant abduction

2654
2655
2656
300- To enhance patient safety communication has an
2657
important
2658 role the type of communication should be
2659 A. Closed doors, one way communication
2660 B. Open door, two way communication
2661 C. Paper mediated communication
2662 D. Directive instructions

2663
2664
301-Sources
2665 of information that may enhance patient safety
include
2666 all of the following except
2667 A. Internal risk screening as adverse events reports
2668 B. Standards for the patient safety
2669 C. Recommendation following analysis of sentinel
2670 events
2671 D. Intuition of the leaders

2672
2673
2674
302-The
2675 following are domains included in the IOM report
"crossing
2676 the quality chasm" except
2677 A. Equity
2678 B. Appropriateness
2679 C. Safety
2680 D. Effectiveness

2681
2682
303- 2683All healthcare settings are required to adopt patient safety
goals,2684 the following setting has the highest priority
2685 A. Home care setting
2686 B. Acute health care
2687 C. Sub acute healthcare
2688 D. Chronic setting

2689
2690
2691
304-All
2692 of the following are methods to improve the accuracy
of patient
2693 identification at the blood transfusion except
2694 A. Use 2 patient identifiers
2695 B. Using bar codes
2696 C. Using radio frequency identification tags
2697 D. Asking the patient his name
2698

2699
2700
2701
2702
305-Low
2703 medication error rating in a health care organization
may be due to one of the following except
2704
2705 A. Highly developed culture of safety
2706 B. The systems has detect errors deficient
2707 C. The staff is reluctant reports due to fear of reprisal
2708 D. The organization adopt performance improvement
2709 approach lead to error reduction

2710
2711
2712
306- All of the following priorities safety issue to be improved
2713
except
2714
2715 A. Increase potential for harm
2716 B. Increased frequency of occurrence
2717 C. Decreased the likelihood that intervention

2718 could be implemented
2719 D. Increased costs and claims from this issue in
2720 other healthcare organization

2721

2722
2723
307- 2724 To reach a culture of patient safety, the following order
of steps
2725 is
A. Staff survey, plan & implement improvement, take in
2726
2727depth look, documents the results and resurvey the
2728staff
B. Staff survey, take in depth look, plan & implement
2729
2730improvement, documents the results and resurvey the
2731staff
C. Staff survey , plan & implement improvement,
2732
2733documents the results, take in depth look and resurvey
2734the staff
D. Staff survey. take in depth look, plan & implement
2735
2736improvement, resurvey the staff and document the
2737results
2738

2739
2740
308- 2741The approach of the six sigma
2742 A. Find a problem, organize team. Clarify problem,
2743 understand variation and specify solutions
2744 B. Design, collect data, aggregate and analyze data,
2745 improve and redesign
2746 C. Determine, measure, analyze, improve and
2747 continue
2748 D. Define , measure , analyze , improve & control

2749

2750
2751
307- 2752 Analysis of data what phase of PDCA cycle

2753 A. Plan
2754 B. Do
2755 C. Study
2756 D. Act
2757

2758
2759
308-The
2760 following criteria should be considered when
selecting
2761 a measurement except
A.2762Reliability & validity
B.2763Usability
C.2764Scientific acceptability
D.2765Approval by accreditation body

2766

2767
2768
309-Risk
2769 adjustment is a method to
2770 A. Collect data
2771 B. Make the results comparable
2772 C. Disseminate the results
2773 D. Report the results to insurers
2774

2775
310-If2776 the goal of data collection is to generate new knowledge
point 2777the need of performance improvement, it's considered as
2778 A. Recording
2779 B. Sophisticated quality improvement
2780 C. Benchmarks
2781 D. Research

2782

2783
2784
311- the incidence of catheter related nosocomial urinary tract
2785
infection
2786 is
2787 A. Structure measure
2788 B. Outcome measure
2789 C. Process measure

2790 D. Sentinel events indicator

2791

2792
2793
312- 2794 Patient specific indicators are not useful for
2795 A. Reappointments of practitioner
2796 B. Monitoring safety
2797 C. Reporting to a senior management team
2798 D. Comparing performance to external standards
2799

2800
2801
313-Why
2802 the use of evidence based medicine likely to improve
patient
2803 safety?
2804 A. It will help providers to avoid "cookbook
2805 "medicine practice
2806 B. It will be prevent the inappropriate use of
2807 certain procedures
2808 C. It will replace clinical decision making
2809 D. Patient will receive consistent care based on
2810 sound scientific research

2811

2812
2813
314-Clinical
2814 outcome of medication include decreased
2815 A. Hospital readmission, cost and medication
2816 errors
2817 B. Hospital readmission, cost and discharge
2818 medication orders
2819 C. Cost, confusion over medication and hospital
2820 staff satisfaction
2821 D. Patient satisfaction, confusion over
2822 medication and costs
2823
315- Determining what medication are to be taken at home is
2824
the2825
responsibility of the
2826 A. Patient
2827 B. Physician
2828 C. Patient family
2829 D. Beside nurse
2830

2831
2832
316- 2833 Implementation of the medication reconciliation process
require
2834 the interdisciplinary effort of
2835 A. Nurse, physicians, laboratory technicians and
2836 informatics
2837 B. Nurse, physicians, pharmacists and informatics
2838 C. Nurse, physicians, chaplains and informatics
2839 D. Nurse, physicians, pharmacists and medical
2840 therapists
2841

2842
2843
317-Medication
2844 reconciliation is-------????????
2845 A. The reconciliation of duplicated dosage, frequency
2846 and discrepancies
2847 B. The resolution of medication discrepancies in dose,
2848 frequency and therapeutic duplication at time of
2849 discharge
2850 C. The reconciliation of medication through the
2851 patient's hospital stay
2852 D. The clarification of patient's medication at time of
2853 discharge
2854

2855
318- 2856 The most cost effective opportunity to enhance patient
safety
2857 is to
2858 A. Discover new therapies
2859 B. Hire more competent staff
2860 C. Discover how to deliver therapies that are known
2861 to be effective
2862 D. Not accepting patients with known liability of

2863 complication
2864

2865

2866
319- 2867 To insure that medication administration more safe, the
steps2868of administration should be
2869 A. More complex
2870 B. More branched
2871 C. More simple
2872 D. More dependent on experience of staff
2873

2874
2875
320- 2876 What is not useful in making medication reconciliation
successful?
2877
2878 A. Staff education
2879 B. Collaboration between staff and patient
2880 C. Making reconciliation errors part of staff
2881 reappointment process
2882 D. Continues measurement by reliable measures
2883

2884
2885
321-All
2886 of the following are considered as barriers to safety
project
2887 except
A.
2888Poor coordination
B.
2889High collaboration
C.
2890Conflict of schedule
D.
2891Resistance to change
2892
2893
322-Prevention
2894 quality indicators are useful in
2895 A. Monitoring of mortality rate for medical and
2896 surgical patients
2897 B. Identifying avoidable intervention
2898 C. Identifying preventable complications and

2899 iatrogenic events for pediatric patients
2900 D. Identifying potentially avoidable complication

2901

2902
2903
323-Indicators
2904 designed to identify potentially avoidable
complications
2905
2906 A. Prevention quality indicators
2907 B. Inpatient quality indicators
2908 C. Patient safety indicators
2909 D. Pediatric quality indicators
2910

2911
2912
324- Patient safety incident is
2913
A.
2914Any unintentional event caused by healthcare that
2915either did or could have led to patient harm
B.
2916Tool designed to elicit information from patient
2917regarding certain activities and behaviors that can
2918influence health status
C.
2919Making the member an active participant in choosing
2920the course of care
D.
2921Examining claims for mistakes
2922

2923

2924
325- 2925Voluntary reporting system may under report incidents
due2926 to all of the following except
2927 A. Time constraints
2928 B. Fear of shame
2929 C. Developed safety culture
2930 D. Blame litigation

2931

2932
2933
326- The best strategy for preventing errors that cause harm is
2934
2935 A. Focus on who hold accountable to the harm

2936 B. Provide a system of care in which patients are well
2937 protected
2938 C. Refuse admission of patients prone to
2939 complications
2940 D. Make the family responsible for safety of patient

2941
2942
2943
327- As a quality professional to eliminate the misreading of
2944
prescriptions
2945 or orders the appropriate action is
2946 A. Make oral communications between the physicians
2947 and pharmacists
2948 B. Make prescriptions done by electronic means++++
2949 C. Giving training to physicians to improve the
2950 writing behavior
2951 D. Make penalties on both physicians and pharmacist
2952 when prescription error occurs
2953
328-When
2954 admission of patients prone to complications
occurred
2955 the appropriate action is
2956 A. Decrease the nursing ratio
2957 B. Increasing workers ratio
2958 C. Increase physicians ratio
2959 D. Increase the nursing ratio

2960
2961
329- 2962The most common source of errors in diabetes care are
2963 A. Physicians
2964 B. Nurses
2965 C. Pharmacists
2966 D. Patients
2967
Answer
2968 D; cause of lack of patient compliance on long term
care plans
2969
2970

2971

2972
330- 2973To be patient centered organization
2974 A. Focus on cost containment
2975 B. Focus on avoiding illogical waste
2976 C. Focus on who is to blame
2977 D. Offer more education allow the patients to
2978 demonstrate what they know

2979

2980
2981
331-All
2982 of the following should be incorporated in the solution
for2983
medical except
2984 A. Understanding the underlying cause of errors
2985 B. Learn from reported errors
2986 C. Eliminate conditions that contribute to preventable
2987 adverse events
2988 D. Focus on staff producing errors

2989
2990
2991
2992
2993
332- 2994 The least appropriate mean in training the staff to
perform
2995 tasks in a superior fashion with safer outcome is
2996 A. Give team materials to be studied at home
2997 B. Making workshops
2998 C. Using mannequin and human simulator model
2999 D. Web based education
3000

3001
333- 3002 Several types of information technology reduce the
frequency
3003 of medication errors which is not an example
information
3004 technology
3005 A. Computerized physician order entry
3006 B. Robots
3007 C. Computerized medication administration records
3008 D. Registers
3009 E. Automated pharmacy systems
3010 F. Smart intravenous devices
3011

3012
3013
334- The magnitude of benefit of information technology is
3014
greater
3015 in pediatrics than in adult medicine due to
3016 A. The pediatric are less competent
3017 B. The variability in children is more than in adults
3018 C. The liability for claims is more in pediatrics
3019 D. Need for weight based dosing
3020

3021

3022
335-An
3023 order written for an albuterol sulphate inhaler
without
3024 specifying a frequency is
3025 A. Adverse drug interaction
3026 B. Medication error
3027 C. Non preventable adverse drug event
3028 D. Potential adverse drug event
3029
Prescription
3030 must include 5 rights of medication; right
medication
3031 for the right patient by the right dose In the
right
3032time by the right route; otherwise it's a medication
error
3033in prescribing

3034

3035
3036
336- Development of cefazoline sodium rash in patients with
3037
known
3038 allergy to cefazoline
3039 A. Potential adverse drug event
3040 B. Preventable adverse drug event
3041 C. Nonpreventable adverse drug event
3042 D. Health risk appraisal
3043

3044
3045
337- System improvement by introducing information
3046
technology
3047 applications are considered
3048 A. Organizational change
3049 B. Process change
3050 C. Paradigm shift
3051 D. Outcome change
3052

3053

3054
3055
338-What
3056 is of the following enhance patient safety culture
3057 A. Openness about failure
3058 B. An environment of team work and information
3059 sharing
3060 C. An emphasis on learning
3061 D. Accountability
3062 E. All of the above

3063

3064
3065
3393066
-Hand washing is an important aspect in infection and
improvement
3067 of patient safety the following may reduce
infection
3068
3069 A. Use of alcohol based hand rubs
3070 B. Surgical hand antiseptics
3071 C. Elimination of the use of artificial nails
3072 D. Natural nail tips limited to 1/4 inch
3073 E. All of the above
3074
340-An
3075 outpatient clinic assess medication side effect for
children
3076 with the following ages (1111122345)
The3077
modal pattern of the children ages is
A- 3078
1 B- 2 C- 3 D- 4
The3079
median age is
A- 3080
1 B- 1.5C- 3 D- 3

3081
3082
341- 3083A healthcare organization is in a region with population
with 3084high affection with G6PD deficiency in their children. As
screening
3085 is expensive, the organization screen samples only
but3086 the organization found that treatment of undetected cases
is more
3087 costly than screening of whole population ,the
organization
3088 should
3089 A. Continue to screen samples
3090 B. Screen all the population
3091 C. Stop screening
3092 D. Increase the size of sample

3093
3094
3095
342-The
3096 sample include all available patients in the area is
3097 A. Quota
3098 B. Convenience
3099 C. Stratified random
3100 D. Purposive

3101
3102
3103
343- The stratified random sample is
3104
3105 A. Random sampling after dividing the population
3106 into groups
3107 B. Portions of the population
3108 C. Choosing subjects fulfill the criteria
3109 D. Sampling randomly

3110
3111
3112
344- The following are steps in the data collection except
3113
3114 A. Interviewing
3115 B. Monitoring
3116 C. Correlations
3117 D. Records reviewing

3118
3119
345-To
3120 identify the medication administration process which
tool3121
is used
3122 A. Control chart
3123 B. Cause and effect analysis
3124 C. Flow chart
3125 D. Bar graph

3126
3127
346- After education of continuous quality improvement
3128
program
3129 to evaluate effectiveness of the program
A.3130
Do pre & post education exam
B.3131
Evidence that the staff begin continuous quality
improvement activities
3132
C.3133
Monitoring the previous performance of the staff
D.3134
Review the attendance rate of the staff
3135
3473136 The primary purpose of the survey is to measure
3137 A. Patient expectations
3138 B. Capacity of the process
3139 C. Competence of the staff
3140 D. Utilization appropriateness

3141
3142
348- 3143 The process of monitoring newly privilege physician is
3144 A. Credentialing
3145 B. Proctoring
3146 C. Appointment
3147 D. Reappointment

3148
3149
3493150 An organization ask a quality professional to help in

preparedness
3151 to survey of accrediting body the quality
manager
3152
3153 A. Assign a team that makes presentation to the
3154 surveyors
3155 B. Make mock surveys
3156 C. Educate the staff types of questions that ay be
3157 asked
3158 D. Review adherence of the organization to quality
3159 standards

3160
3161
350-The
3162 standard deviation can help in
3163 A. Assess the variance of various points
3164 B. Compare the difference between points
3165 C. Correlate the points of each others
3166 D. Identifying out of control

3167
3168
351--
3169As a quality manager to evaluate the effectiveness of
dietary
3170 department you review
3171 A. The timeliness of diets delivered after physician
3172 orders
3173 B. The appropriateness of the nurses' request to diet
3174 C. The delivery of special diets ordered by physicians
3175 D. Complication of the whole parental diet

3176
3177
352- A healthcare organization negotiate a contracts with
3178
insurance
3179 company that required data about readmission of
patients,
3180 as a quality professional the first thing to take
concern
3181 about is
3182 A. Confidentiality of patients
3183 B. Methods of data collection
3184 C. Identify the exact data required by the company
3185 D. Data collectors

3186
3187
353-Epowerment
3188 mix the employee
3189 A. Makes money
3190 B. Solve problems
3191 C. Gain respect from others
3192 D. Upward mobility

3193
3194
354- 3195On discharge patient refuse billing because 2 out of 3
days 3196of his stay in the hospital is due to medication
anaphylaxis
3197 this occurrence is
3198 A. Billing error
3199 B. Potentially compensable event
3200 C. Nurse incompetence
3201 D. Admission error

3202
3203
355- 3204A nurse receives a verbal order for medication from
physician,
3205 the nurse should
3206 A. Ask the medication from pharmacists
3207 B. Neglect the order
3208 C. Read the order back
3209 D. Write and tell the order

3210
3211
356- 3212Practice guidelines can be useful in all of the following
except3213
3214 A. Identify best practice
3215 B. Cost saving
3216 C. Patient expectation
3217 D. Identify the process of care

3218
3219
357- The facilitator in patient focus group should do first
3220
A. Choose homogenous group
3221
B. Make ground rules
3222
C. Make
3223 rapport with group
D. Instruct orders
3224

3225

3226
358- 3227Nurse in the post operative found missed clamp, X-ray
has3228 done to the patient was negative & the patient has no
symptoms
3229 this occurrence is type of
3230 A. Claim management
3231 B. Potentially compensable event
3232 C. Error rating
3233 D. Incompetent surgeon

3234

3235
359-generic
3236 screening is an example of risk:
a. reduction.
3237
b. identification.
3238
c. prevention.
3239
d. handling.
3240
3241

3242
360-consensus
3243 means:
a. all
3244members support decision.
b. unanimous
3245 agreement.
c. all
3246the members are satisfied.
3247

3248
361- the most common cause of medication error is:

3249
a. communication
3250 breakdown.
b. computer
3251 system error.
c. incompetent
3252 nurse.
3253

3254
362-Continuous
3255 quality improvement efforts find problems
in hospital
3256 admissions to provide breakthrough ideas in
admission,
3257 the quality improvement team seek ideas from:
a-other
3258 hospital
B-previous
3259 lectures
C-automobile
3260 industry
C-hotel
3261 and resort industry

3262

3263
363- 3264On discharge woman refuse billing because 2 out of 3
days 3265of his stay in the hospital is due to medication
anaphylaxis
3266 ,pt complain from
3267 E. Billing error
3268 F. Medication error
3269 G. Admission error

3270

3271
364- Team cohesion is found in any stage of team development:

3272
a- storming
3273
b- performing
3274
c- norming
3275
d- forming
3276
3277

3278
365- Root Cause Analysis conducted e' analysis of aggregated

3279
data , is considered:
3280
a- prospective
3281
b- concurrent
3282
c- retrospective
3283
3284

3285
366- To display the stability of nosocomial infection rate

3286
overtime
3287 ,use which of the following tools:
a- pareto
3288 chart
b- 3289
control chart
c-flow
3290 chart
d-bar
3291 chart
3292

3293
367- To prioritize
3294
a- pareto
3295 chart
b- 3296
flow chart
c- run
3297 chart
3298

3299
368- The ultimate responsibility of setting policy for quality of

3300
care provided by organization is rested on:
3301
a- quality
3302 manager
b- staff
3303
c- governing
3304 body
3305

3306
369-There
3307 is increase in rate of medication errors in a unit , what
should
?3308 Quality Professional do
a- review
3309 technology medication
b- 3310
ask advice from other successful units
c- review
3311 the delivery process of medications in the unit
3312

3313
370- Journal publish new article include 3 new patient safety

3314
intiatives.
3315 ?as QP,what should you do first
a- enter
3316 the intiatives in policy of patient safty
b- 3317
review the organizition for applicability of intiatives
3318

3319
371- The least prefered outcome of QI:

3320
a- empowerment
3321
b- 3322
increased statistical data
c- increased
3323 communication bet. staff
e-
3324customer satisfaction
3325

3326
372- Staff education in organizational change include all of the

3327
following
3328 except:
a- negotiating
3329 process
b- 3330
project & time mangement
c- conflict
3331 resolution
d- 3332
budjeting techniques
3333

3334
373- The best tool to display relation bet. Reimbursement & cost
3335
is: 3336
a- scatter
3337 diagram
b- 3338
pareto diagram
c- flow
3339 chart
3340

3341
374- Benchmark is best describes as:

3342
a- progressive
3343 attainment
b- 3344
compare e' measures
3345

3346
375- Valid data collection tool incorporates:

3347
a- definition
3348 of data elements
b- 3349
reliable graphic presentation
3350

3351
376- ?CQI to be successful ,who must be included in the team

3352
a- Adminstrator
3353
b- 3354
Quality council
c- persons
3355 performing process
3356

3357
377- The 1st crucial task of patient safety council is:

3358
a- determine
3359 how patient safety goals will be monitored
b- 3360
make patient safety deparetment
c- make
3361 rapid response team
3362

3363
378- Integrating stratigic planning e' patient safety is considered:

3364
a- cost
3365 benefit of patient safety program
b- 3366
organizitional performance culture
3367

3368
379- ?What is important for technology to reduce harm

3369
a- feasible
3370 & usable
b- 3371
used e' clinical work-flow
3372

3373
380- The indicator is driven from:

3374
a- standards
3375 of accrediting body
b- 3376
community standards
c- important
3377 of care & service aspects

3378

3379
381- Best way to pass vision to all members of organization :

3380
a- put
3381 in employee handbook
b- 3382
discuss vision at regular schedules+++
c- put
3383 in organization intranet

3384

3385
382-
?3386Which of the following is essential to an effective CQI
a- consultation
3387 of legal advisor
b- 3388
support of leadership
c- direction
3389 from organization's quality department
3390

3391
383- Important reason for monitoring nearmiss record is to:

3392
a- identify
3393 incompetent staff
b- 3394
provide lesson to staff
c- prevent
3395 negative publicity

3396

3397
384- Who is responsible of providing theorganizational

3398
guidance
3399 ?for a facility's continous quality improvement
a- facilitator
3400
b- 3401
quality council
c- leader
3402
3403

3404
385-
3405gross cost 750.000$
net3406
benefit 250.000$
net3407
cost 250.000$
gross
3408benefit 500.000$
- for every dollar spent , there is revenue:
3409
a- 0.3
3410 $
b- 3411
1$
c- 1.5
3412$
d- 3413
3$
3414

3415
386- when you see physician profile , what is your

3416
?conclusion
3417
a- arthroscopy
3418 policy must be reviewed
b- 3419
number of cases seen by physician must be reviewed
c- clinical
3420 competency of physician is answerable

3421

3422
378- what should be added in physician profile to give

3423
complete
3424 ?idea about him
a- number
3425 of surgeries done by him
b- 3426
number of cases seen by physician per day
c- number
3427 of deaths related to physician
3428
379- all of the following are considered type of reward &

3429
recognition
3430 of team members except:
a- put
3431 their names in storyboard
b- 3432
makes article in hospital newspaper
c- acknowledging
3433 certificate during annual employee
meeting
3434
d- 3435
make team member present results to board of directors
3436

3437
380- which of following tools keeping team on the track to

3438
complete
3439 all tasks?
a- flow
3440 chart
b- 3441
gantt chart
c- pareto
3442 chart
3443

3444
381-The
3445 facilitator's main role is concerned with the team
A keep
3446 the team focused
Quality
3447 professional
Help
3448leader in assignment
3449

3450
382-If
3451 the gross cost of a quality improvement project is
750$,
3452the net cost is 250$, net profit is 250$ and the gross
profit
3453 is 500$. Then the return on investment (ROI) from
such a project is:
3454
a. 13455
b. 0.33
3456
c. 23457
3458
3833459--how to compare l.o.s of many patient-
by 3460
the physician
mean
3461
correlation
3462
s.d3463
range
3464
3465

3466
384-indicators
3467 should come from
-organization
3468 wide plan
-process
3469 of care
-standard
3470 indicators
-accreditation
3471 indicator
3472

3473
385-QI
3474 activities should be considered for all except
a- comptability
3475 and facilities mission
b-ease
3476 of development of data collection tool
c-process
3477 that are high volume for facility
d-finding
3478 from pt satisfaction survey
3479

3480
386-software
3481 for physician what is role of cphq?
a-assess
3482 use of technology
b-cost-benefit
3483 analysis
c-focus
3484 group with end users
3485

3486
387-Risk
3487 control imposes providing mechanisms
for3488
:
a. Elimination
3489 of hazards that lead to risk occurrence+++.
b. Prevention
3490 of recurrence of risk occurrences.
c. Minimizing
3491 the loss after risk occurrence.
d. Dealing
3492 with the legal aspect of risk liabilities
3493

3494
388-Tracking
3495 positive variance
A. 3496
tends to show the costlier procedures
tends to show clues to cost-effective care
B. 3497
C. 3498
shows best what doesn't work
helps to track standard practice patterns )showing the
D. 3499
best practiceon right side of bell shap)
3500

3501

3502
389-The
3503 role of a successful leader in problem solving is
all 3504
of the following,
but3505the most effecting is:

a. Identify the cause of the problem.
3506
b. Guide others to solve the problem.
3507
c. Bring order out of chaos caused by the

3508
problem.
3509
d. Reward supporting behaviors during the problem.
3510
3511

3512
390-All
3513 of the following are important roles of HQP
in 3514
QM, but his main duty is to:
Communicate Q. defects.
a. 3515
Report Q. defects.
b. 3516
Present possible solutions for Q. defects.
c. 3517
d. Document
3518 Q. defects.
3519

3 3520 91-To ensure implementation of the
required
3521 improvements, whose commitment must be sought
: 3522
To p ma na g e ment.
a . 3523
Lea ders
b . 3524
Org a niza tio n w ide
c . 3525
Deta iled ma na g e ment
d . 3526
3527

3528
392- In planning for a crises, a leader should:
3529
a. 3530Provide a sound infrastructure.
b. 3531Develop a plan to deal with the situation during the

crises.
3532
c. 3533Develop a plan to deal with the situation after the crises.
d. 3534Provide no preliminary plans and face the situation as

applicable.
3535
3536

3537
393-Linking
3538 physicians incentives with quality
performance
3539 runs the risk of:
a. Over-utilization
3540 of care.
b. Under-utilization
3541 of care.
c. Misutilization
3542 of care.
d. Negligence
3543 of care
394-healthcare
3544 q. professional has been asked to present
information
3545 to senior leadership about hospital publicity,
the3546
report should include:
a-clinical
3547 expert
b-computer
3548 training
c-comparison
3549 of data with benchmark
d-customer
3550 satisfaction
395-the
3551 chief q. officer has the responsibility of education &
implementation
3552 of CQI process, to affect cultural change
administration
3553 must:
a-believe
3554 the costs are justified by the benefits
b-be assigned as member of the team
3555
c-receive
3556 quarterly reports
396-for
3557 continuous q. improvement team to be successful
who must be included in the team:
3558
a-administrator
3559
b-department
3560 supervisor
c-staff
3561
d-facilitator
3562
397-the
3563 key for creating sustained value in the org. is to:
a-delegate
3564 policy-making &oversight to q.council
b-develop
3565 a strategy that derives from the vision,strategic
goals
3566&cost benefit analysis
c-adopt
3567 an organizational ethics policy &code linked to
mission,vision
3568 &values
d-act
3569on predictive performance measures aligned to
strategic
3570 goals & department objectives
398-in
3571 evaluating the current improvement program for
strengths
3572 &weaknesses, it's not necessary to assess:
a-strategic
3573 initiatives
b-managed
3574 care contracts
c-team
3575 minutes
d-alternative
3576 q.management software products project
399-Which
3577 of the following is the best approach when
implementing
3578 a National Patient Safety Goal related to
identifying
3579 potential errors in a patient's care, treatment,
and3580
services?
A. 3581
providing the patient and family an opportunity to ask
questions
3582
B. 3583
having the patient provide return demonstration of the
knowledge
3584 provided
C. 3585
showing a video to a patient and their family
D. 3586
giving both written and verbal instructions to a patient
and3587
family
400- Appropriateness" of care refers to:

3588
a. The
3589 degree to which the care is accessible and obtainable.
b. The
3590 degree to which needed care is provided to the
patient
3591 at the most beneficial time.
c. The
3592 degree to which care provided is relevant to the
patient's
3593 clinical needs.
d. The
3594 coordination of needed healthcare services for a
patient
3595 among all practitioner andacross various settings.
3596

3597
401-When
3598 a newly introduced drug is told to be able of
producing
3599 positive results for certain clinical conditions, then
this3600
drug should be considered:
a. Effective.
3601
b. Efficient.
3602
c. Efficacious.
3603
d. Appropriate.
3604
3605

3606
402-When
3607 an employer contracts with a health plan or directly
with a provider, this employer should be concerned about
3608
which
3609 of the following perspectives:
a. The
3610 cost of the care provided.
b. The
3611 quality of the care provided.
c. The
3612 outcomes of the care provided.
d.All
3613of the above.
3614

3615
403-Which
3616 of the following healthcare reformers developed
the3617
structure, process, and outcomes" model?
a. Ernest
3618 Codman.
b. Florence
3619 Nightingale.
c. Avedis
3620 Donabedian.
d. Donald
3621 Berwick.
3622

3623
404-Which
3624 of the following tools can be used to identify
(Customer
3625 Needs)?
a) Focus
3626 groups.
b) Brainstorming.
3627
c) Surveys
3628 and interviews.
d) a3629
and c only.
e) a, b and c.
3630
3631

3632
405-When
3633 the health care delivered should not vary in
Quality
3634 because of patient's personal characteristics such as
gender,
3635 ethnicity, geographic location, and socioeconomic
status;
3636 then this health care is
a) Safe.
3637
b) Efficient.
3638
c) Patient
3639 centered.
e) Equitable..
3640
3641

3642
406-The
3643 healthcare quality professional should
a) Practice
3644 the profession with honesty and integrity.
b) 3645
Have enough knowledge about relevant laws and
legislations.
3646
c) Promote
3647 the right of privacy for all patients.
d) all
3648of the above.
3649

3650
407-Which
3651 of the following situations best describes the
term 3652Misuse of Resources at healthcare facilities?
a) Patients
3653 receive appropriate medical services that are
provided
3654 poorly, exposing them to added risks of
preventable
3655 complications.
b) Patients
3656 undergo treatment or procedures from which
they do not benefit.
3657
c) Patients
3658 do not receive beneficial health services.
d) None
3659 of the above.
3660

3661
3662
3663
408-Which
3664 of the fol1owing items is not considered as
an 3665
"outcome"?
a) Mortality.
3666 .
b) Management
3667 of Complications
c) Patient/family
3668 satisfaction.
d) " 3669Activities of daily living" status.
3670

3671
409-All
3672 of the following actions would aid in adopting a
"Quality
3673 culture" inside any healthcare organization
.EXCEPT
3674
a) Delegation
3675 and empowerment of staff.
b) The
3676 (Quality professional) is assigned to lead such
cultural
3677 transformation.
c) Increased
3678 communication.
d) Top
3679 management commitment and involvement
3680

3681
410-All
3682 of the following are ways through which any
organization
3683 leadership can enhance the spread of "quality
culture"
3684 within the organization EXCEPT
a) Develop
3685 mission and vision statements.
b) Develop
3686 quality initiatives.
c) Adopt
3687 flexible management styles.
d) Assign
3688 quality professionals to lead the process of cultural
transformation.
3689
3690

3691
411-What
3692 is the right sequence for the elements of
Donabedian's
3693 model?
a) Process
3694 - Structure - Outcome
b) 3695
Outcome - Process - Structure
c) Structure
3696 - Process - Outcome
d) Process
3697 - Outcome - Structure
3698

3699
412-All
3700 of the following are key components that guide the
(Strategic
3701 Organizational Direction), except:
a) Mission.
3702
b) Vision.
3703
c) Procedures.
3704
d) Values.
3705
3706

3707
412-Which
3708 of the following is not correct about (Strategic
planning)?
3709
a) May3710 need annual development of operational plans.
b) Should
3711 be based on objective environmental assessment.
c) Neither
3712 long-term nor short-term objectives should be
developed
3713 until the organization completes the strategic
planning
3714 process.
d) Can3715 be prepared for a single department within the
organization.
3716

3717

3718
413-Which
3719 of the following statements is not correct
concerning
3720 (Goals and Objectives)?
a) Goals
3721 are more specific than Objectives.
b) A 3722 single Goal may have many Objectives.
c) Objective
3723 should be challenging yet achievable.
d) A 3724 Goal statement should mention the excepted time for
achieving
3725 the goal.
3726

3727
414-All
3728 of the following criteria are considered by the
hospital
3729 leaders when selecting a (Strategic Quality
Initiative),
3730 except:
a) Has3731 organization-wide impact
b) Is3732 linked to one or more strategic goals.

c) Should
3733 addresses clinical issues only.
d) Should
3734 focus on the improvement of systems and
processes.
3735
3736

3737
415-The
3738 CEO of hospital (X) sake an area for improvement,
he 3739
asked each member of the senior management group to
propose
3740 him a list of potential improvement opportunities in
the3741next meeting; what is the most reliable source from
which3742 the managers can get their ideas?
a} 3743
Assessment of internal and external customer needs.
b) Assessment
3744 of needs of external customers only.
c) Comparative
3745 information pertinent to competitors.
d) The
3746 work experience each manager has.
3747

3748
3749
416- 3750 All of the following about the using (Metrics) or

(Measurement
3751 methods) in an organization is correct,
except:
3752
a) They
3753 have no role in linking the organizational processes
to the
3754 achievement of the corporate plan.
b) They
3755 are the diagnostics which show progress in meeting
corporate
3756 goals and objectives.
c) They
3757 may take various forms according to the process to
be 3758
measured and the type of data to be collected.
d) Clear
3759 understanding of the organizational mission and
vision,
3760 would ultimately facilitate the development of the
appropriate
3761 metrics.
3762

3763
417-All
3764 of the following statements concerning the "Goals"
and3765 the "Objectives" are correct, except:
a) Objectives
3766 are more specific than goals.
b) A 3767 single goal may have many objectives.
c) Objectives
3768 can be measured with qualitative and
quantitative
3769 criteria
d) 3770
Objectives are developed before goals.
3771

3772
418-Risk
3773 management in an organization is most effective
when 3774it is:
a)
3775Responsible for sentinel event root cause analysis
b)
3776Incorporated into safety management
c)
3777Integrated with organizationalwide performance
3778Improvement
d)
3779The responsibility of the clinical performance
3780improvement teams.
3781

3782
419-One
3783 fundamental difference between monitoring
product
3784 quality and service quality is based upon the fact
that
3785
3786
3787 a. a service is easier to measure and verify in

3788 advance
3789 b. a service is not perishable
3790 c. a service is more heterogeneous than an object
3791 d. there are more service delays than product delays
3792

3793
420-The
3794 perception of quality by a patient receiving care in
an 3795
ambulatory healthcare center is influenced most by
3796
3797a. the physical environment.

3798b. caring staff and physician.
3799c. new technology.
3800d. the physician's technical competence.
3801
421-What
3802 is the most important relationship between
structure,
3803 process, and outcome as types of indicators of
quality?
3804
3805
3806a. Interdependent: Structure directly affects both

3807 process and outcome.

3808b. Causal: Structure leads to process and process
3809 leads to outcome.
3810c. Relational: Useful for comparisons, but not causal
3811d. There is no relationship; they are categories used
3812 to group indicators
3813

3814
422-Which
3815 of the following best describes the successful
outcome
3816 of the quality improvement process?
3817
3818a. Customer satisfaction

3819b. Enhanced communication
3820c. Employee empowerment
3821d. Improved statistical data
3822

3823
422-Monitoring
3824 phlebitis associated with IV insertions by
nurses
3825 in the Surgical Intensive Care Unit addresses which
focus?
3826
3827
3828a. Outcome of care

3829b. Process of care
3830c. Structure of care
3831d. Administrative procedure
3832

3833
423-Organizational
3834 "culture" most often refers to
3835
3836a. the ethnicity of the organization's employees and

3837 licensed independent practitioners
3838b. assumptions about people and how work gets
3839 done
3840c. the efforts to reach out to the diverse groups in
3841 the community.
3842d. the scheduled social and cultural events within the
3843 organization.
3844

3845
424-The
3846 leadership style that is said to motivate employees,
and3847
that optimizes the introduction of change, is
3848
3849a. autocratic.
3850b. consultative.
3851c. participatory.
3852d. democratic
3853

3854
425-In
3855 participative management the manager
3856
3857a. relinquishes decision-making responsibility to the

3858 staff.
3859b. retains the final decision-making responsibility.
3860c. presents a final decision to the staff
3861d. permits staff participation only with noncritical
3862 issues
3863

3864
426-Which
3865 of the following is most important to the
successful
3866 implementation of quality improvement
activities?
3867
3868
3869a. Financial commitment and written quality

3870 management plan
3871b. Leadership commitment and organizationwide
3872 collaboration
3873c. Leadership commitment and financial
3874 commitment
3875d. Information management system and department
3876 collaboration
3877

3878
427-The
3879 best way to facilitate leadership education about the
role of ethics in the organization is to understand that
3880
3881
a.
3882 each leader's personal value system drives decision
3883 making.
b.
3884 the organization's written Code of Ethics drives
3885 decision making.
c.
3886 the organization can have both good and bad ethics.
d.
3887 accountability for organizational ethics is primarily
3888 internal, not public.
3889

3890
428-In
3891 any quality management approach, how can you best
evaluate
3892 the effectiveness of action taken?
3893
3894a. Use the same performance measures to remonitor

3895 the process.
3896b. Formulate a new special study to monitor the
3897 action.
3898c. Interview the staff involved in implementing the
3899 action plan.
3900d. Do nothing. Effectiveness is expected with well-
3901 planned action
3902

3903
3904
429-According
3905 to QI process theory and
quality/performance
3906 improvement standards, it is best to
select
3907 a quality improvement project that
3908
3909a. is the chief executive officer's ongoing quality or

3910 cost concern.
3911b. is limited in scope and time to provide quick
3912 feedback.
3913c. has the greatest potential to improve patient
3914 outcome.
3915d. has the greatest potential to save the organization
3916 money
3917
430-All
3918 quality improvement approaches or models include
the3919
following mechanisms except
3920
3921a. developing strategic goals.

3922b. prioritizing problems/projects.
3923c. collecting and analyzing data
3924d. taking action to improve
3925

3926
431-The
3927 main goal of measurement in performance
improvement
3928 is to
3929
3930a. provide specifications for processes needing

3931 redesign.
3932b. keep track of process and practitioner variances.
3933c. collect accurate data reflecting actual
3934 performance
3935d. establish benchmarks for the improvement
3936 process
3937

3938
432-The
3939 integrated delivery system is undergoing a major
reengineering
3940 effort, with corporate goals to complete
projects
3941 timely and within budget. Of the following, the most
appropriate
3942 approach or model is
3943
3944a. Failure Mode and Effects Analysis (FM EA).

3945b. rapid cycle.
3946c. FOCUS-PDCA.
3947d. Balanced Scorecard
3948

3949
433-The
3950 primary goal of quality/performance improvement
is to improve
3951
3952
3953a. patient care processes.

3954b. patient safety.
3955c. patient outcomes.
3956d. patient satisfaction
3957

3958
434-Failure
3959 mode and effects analysis (FMEA) is what type
of review
3960 or improvement tool?
3961
3962a. Concurrent
3963b. Focused
3964c. Prospective
3965d. Retrospective
3966

3967
435-The
3968 basic philosophy of benchmarking is
3969
3970a. eliminating the competition

3971b. finding best practice and incorporating it.
3972c. getting all processes under statistical control
3973d. eliminating process deficiencies.
. 3974
3975
436-in
3976 developing a performance improvement plan you will
implement
3977 the following steps in which order:
1. collect
3978 basaline data.
2.evaluate
3979 the effectivness of action taken.
3.make
3980 the commitment.
4.implement
3981 the plan.
3982
a.1,2,3,4
3983
b.1,3,4,2
3984
c.3,1,4,2
3985
d.3,2,1,4
3986
3987
3988

3989
437-in
3990 postoperative assessment the nurse discovered that the
surgeon
3991 has replaced the wrong hip for a patient.this is
considered:
3992
a.sentinel
3993 event.
b.malpractice.
3994
3995

3996
3997
438-insurance
3998 company would require which of the following
data 3999 in renewing a contract with a hospital:
a. Hospital
4000 revenue,LOS, mortality rate.
b. Complication
4001 rate,readmission rate.
c. Custmer
4002 satisfaction,LOS
LOS is very generic and cannot judge the real
4003
performance
4004 of Hospitals. Revenue is confidential data
Complication
4005 and readmission both represent care provided
and4006 are the most annoying part between Hospitals and
insurance
4007 companies

4008

4009
438-FMEA
4010 is considered:
a.proactive.
4011
b.retrospective.
4012
c.concurrent.
4013

4014

4015
439-which
4016 of the following should be presented to GB in the
annual
4017 review of performance improvement plan?
a.team
4018 minutes.
b.team
4019 achievments.
c.occurance
4020 and inciedent reports.

4021

4022
440-when
4023 using mortality data in benchmarking ,it should be :
a.DRG
4024
b.severity
4025 adjusted.
c.LOS
4026 adjusted.
4027

4028
441-method
4029 of data collection allowing direct contact and
immediate
4030 ?feed back
a.focus
4031 group.
b.quesstionare.
4032
c.surveys.
4033
4034

4035
442-the
4036 best word explaining empowerment:
a.delgate
4037 tasks.
b.mutal
4038 trust.
c. open
4039 discussion but the leader perform all important tasks.
4040

4041
443-the
4042 team go through all of the following except:
a.norming.
4043
b.forming.
4044
c.storming.
4045
d.conforming.
4046
4047

4048
444-the
4049 best evidence of pateint safety culutre:
a.audits
4050 standards & medical record review.
b.anynomous
4051 reporting &audits standerds.
4052
445-to
4053 facilitate change in the organization:
a.publish
4054 newsletters.
b.involve
4055 people who are working in the process.
c- get
4056approval of governing body
4057

4058
446- when hiring a specialist from consulting firm to evaulate

4059
performance
4060 improvement program ,as a quality professional
what
4061u should do?
a.schedule
4062 the program for the cosultaing firm.
b.identify
4063 areas with problems to the consulting firm.
c- identify
4064 outcomes
EVALUATE=OUTCOME
4065
4066

4067
447-concentrated
4068 electrolytes should be removed from pt care
unit to :
4069
a.prevent
4070 medication errors.
b.improve
4071 resource utilization.
c.check
4072 expiration date.
4073

4074
448-which
4075 of the following is example of outecome measure:
a.mortality
4076 rate.
b.average
4077 LOS.
c.medication
4078 dispensing rate.
d.lab
4079speciemen.
4080 YES....actually we have 3 aspects of patient

4081 care that outcome indicators should
4082 monitor:1- clinical outcome (mortality,
4083 morbidity, readmission,adverse reactions....)
4084 2- patient functionality (long term health,
4085 ADL....) AND 3- Perceived outcome (pt
4086 satisfaction, peer acceptability....)So the only
4087 outcome measure in this question is A;
4088 Clinical outcome.
4089

4090
449-type
4091 and volume of pateints admitted in the hospital:
a.daily
4092 census.
b.case
4093 mix .
c.DRG
4094
d.acuity
4095 index.
4096

4097
450- all of the following is positive patient outecome except:

4098
a.decreased
4099 complication.
b.improved
4100 clinical &health status.
c.reduced
4101 infection rate.
d.decreased
4102 LOS
4103

4104
451-the
4105 ultimate authority and responsibilty for continous
quality
4106 improvement through out the organization are upon:
a.GB
4107
b.cheif
4108 executive officer.
c.cheif
4109 financial officer.
d.quality
4110 professional.
4111

4112
452-the
4113 purpose for reappointment of a physician:
a.ensure
4114 clinical comptencey .
b.ensure
4115 that every physician has malpractice insurance
coverage.
4116
c.used
4117 in peer review activities.
4118

4119
453-to
4120 increase the effectivness of reenginering program ,the
quality
4121 professional should :
a.review
4122 polices and procedures.
b.plan
4123 carefully,communicate widely and lead effectively.
c.make
4124 a lecture for employees to define reenginering.

4125

4126
454-in
4127 root cause analysis the first thing to do:
a.flow
4128 chart.
b.fishbone
4129 diagram.+++
c. 54130
Whys.

4131

4132
455-which
4133 of the following diseases is best for beginning of
implementation
4134 of clinical pathway?
Volume Rate of Physician LOS variation
complication champion
Heart failure 80 0.2 Yes Yes
Gastroenteritis 40 0.01 Yes No
Diabetes 50 0.05 No No
a.Diabetes.
4135
b.heart
4136 failure.
c.gastroenteritis.
4137

4138

4139
456-the
4140 main goal of performance improvement in patient safety
culture
4141 is to:
a.reduce
4142 harm.
b.form
4143 a just culture.
c.conduct
4144 gap analysis.
4145

4146
457-in
4147 a culture of patient safety error is considered:
a.normal.
4148
b.misconduct.
4149
c.purposality.
4150
error
4151is not normal, it said than to err is human, only to confess
that we may err but it's not accepted to deal with it as a normal
4152
practiceError
4153 is not a common cause to consider it normal
4154

4155
457-use
4156 the following data to answer the following 2 Q:
Number
4157 of discharges 142
Number
4158 of procedures 100
Orthroscopies
4159 20
Hip4160
replacement 40
Surgical
4161 wound infections 32
Incomplete
4162 medical records 40
4163

4164
457-A.the
4165 rate of overall surgical wound infections:
a.32%.
4166
b.23%.
4167
c.30%
4168
d.40%.
4169
457-B.the
4170 rate of overall delinquent medical record:
a.40%.
4171
b.28%.
4172
c.30%.
4173
d.20%.
4174
4175
4176
458-performance
4177 improvement focus on:
a.process
4178 and systems.
b. individuals.
4179
4180

4181
459-as
4182 a result of custmer surveys, a new service is suggested to
be 4183
delivered. It should be written in :
a.financial
4184 plan.
b.strategic
4185 plan.
c.quality
4186 management plan.
4187

4188
460-sharing
4189 in developing SBAR with quality professional:
a.nurse.
4190
b.medical
4191 record director.
c.financial
4192 officer.
4193

4194
461-multiple
4195 regression analysis means:
a.measure
4196 the relationship between 1 independent variable
&multiple
4197 dependent variables.
b.to4198
exclude the main causes of the problem .
4199

4200
462- to show the relationship between 2 process characterstics:

4201
a.pareto
4202 chart.
b.fishbone.
4203
c.regression
4204 analysis.
4205

4206
463-to
4207 evaluate the effectiveness of the pharmacy unit, you
should
4208 review:
a. timeliness
4209 of delivery of prescribed drugs.
b.length
4210 of Ab use.
c.the
4211effectiveness of the drug prescribed.
4212

4213
464- when you compare between the performance of your

4214
organization
4215 and the performance of industry leader,this is
called:
4216
a.best
4217 practice.
b.benchmarking.
4218
c.setting
4219 objectives.
4220

4221
465-After
4222 making a brainstorm session for a, the next tool to
be 4223
used is:
a. flow
4224 chart
b. multivoting
4225
c. Delphi
4226 technique
d. affinity
4227 diagram

4228

4229
4230
467- A Performance measure/indicator is:
4231
4232
4233
a.
4234A statement of expectation to perform as expected.
4235
b.
4236A set of specifications of care.
4237
c.
4238Used to assess an outcome or a process of care.
4239
d.
4240Describes appropriate and expected courses of action.
4241
4242

4243
4244
468-In
4245 six sigma model, the goal is
4246
4247a. elimination of defects
4248
4249b. Zero defects
4250
4251c. 0.34 defects per million
4252
4253d. 3.4 defects per million
4254

4255
4256
469- Six sigma strategy involves the following consecutive
4257
steps:
4258
4259
a.
4260Define, analyze, aggregate, control , improve and
4261replicate.
4262
b.
4263Define, measure, analyze , improve, control, and
4264replicate.
4265
c.
4266Define, organize, measure, analyze , control, improve
4267and replicate.
4268
d.
4269Define, measure, improve, analyze, control and
4270replicate.
4271
4272

4273
470-In
4274 the concept of performance improvement, its
definition
4275 is:
4276
4277a. Performance improvement is the degree of
4278 excellence.
4279
4280b. Performance improvement is simply the degree to
4281 which healthcare is efficacious.
4282
4283c. Performance improvement is what is done and how
4284 well it is done to provide healthcare.
4285
4286d. Performance improvement is doing the right things
4287 right.
4288
4289
4290
471- Healthcare organizations need to consider three issues
4291
in building
4292 the framework for P.I:
4293
a.
4294The state of the art professional knowledge, the
4295integrated, coordinated efforts, and competent
4296technical skills.
4297
b.
4298Measuring, assessing and improving important
4299functions and work processes.
4300
4301The leaders ability to anticipate, understand,
c.
4302proactively and flexibly
respond
4303 to healthcare changes
4304
d.
4305The organization's relationships to the external
4306environment, its internal characteristic and functions,
4307its methodology for systematically improving
4308important functions.
4309

4310
472- 4311 The function of performance improvement includes:
4312
a.
4313Three processes linked to the quality management
4314cycle.
4315
b.
4316Four processes linked to the quality management cycle.
4317
c.
4318Design, monitor and analyze processes not linked to
4319planning ,control and improvement cycle.
4320
d.
4321Planning, control and improvement cycle linked to
4322PDCA cycle.
4323

4324
473-The
4325 quantifiable process and outcome indicators used to
monitor
4326 performance are:
4327
a.
4328Process indicators.
4329
b.
4330Performance measures.
4331
c.
4332Monitors.
4333
d.
4334Threshold measures.
4335

4336
4337
474-Monitoring
4338 process includes:
4339
a.
4340Ongoing prioritization of measurement efforts based
4341on strategic goals, data collected and available
4342resources.
4343
b.
4344Validation that selected performance measures
4345actually measures what it is intended to measure.
4346
c.
4347Linkage to outcome objectives, reliability and validity
4348checks, timely collection of data, and use of acceptable
4349data bases.
4350
d.
4351All of the above

4352

4353
4354
475-Those
4355 who determine and prioritize data collection are:
4356
a.
4357CEO.
4358
b.
4359Leaders.
4360
c.
4361Process owners.
4362
d.
4363Medical staff.
4364

4365
476-Anytime
4366 the performance of an individual practitioner
becomes
4367 the focus:
4368
a.
4369The quality professional should assume responsibility
4370for analysis and action.
4371
b.
4372The CEO should assume responsibility for the analysis
4373and action.
4374
c.
4375The leader of the organization should assume
4376responsibility for the analysis and action.
4377
d.
4378The appropriate peer review body must assume
4379responsibility for the analysis and action.
4380

4381
477-Aggregation
4382 of data is:
4383
a.
4384The separation of substantial whole into its constituent
4385parts.
4386
b.
4387The translation of data collected during the monitoring
4388process into information.
4389
c.
4390Combining standardized data; gathering into a mass,
4391sum, or whole.
4392
d.
4393None of the previous.
4394

4395
478-The
4396 analysis process includes:
4397
a.
4398The separation of a substantial whole into its
4399constituent parts for individual study.
4400
b.
4401The comparison of aggregate level of actual
4402performance for each indicator with the designated
4403triggers.
4404
c.
4405The translation of data collected during the monitoring
4406process into information
4407
d.
4408All of the above.
479-What
4409 is a process?
A. 4410
It assures continuous improvement and employee
participation.
4411
B. 4412
It converts inputs into outputs.
C. 4413
Anything that satisfies customers.
D. 4414
Anything that causes change.
a. A only.
4415
b. B only.
4416
c. C and D.
4417
D .B and D.
4418

4419

4420
480-How
4421 do you know if a process is operating normally
(i.e., in statistical control)?
4422
a. Customers
4423 are satisfied.
b. Performance
4424 measures display variation consistent with a
Normal
4425 curve.
c. Performance
4426 exceeds standards.
e.
4427Performance measures are within the 3 sigma limits.
4428

4429
481-Characteristics
4430 of effective brainstorming include:
A. 4431
Generate lots of ideas quickly.
B. 4432
Understand the root cause of the problem.
C. 4433
People contribute without fear of ridicule.
D. 4434
Everyone agrees on the topic or issue.
a. A,
4435B, and C.
b. A,
4436B, and D
c. A, C, and D
4437
d. 4438
B, C, and D
4439

4440
482-A
4441 Pareto Chart is used to:
a. Document
4442 the steps and material used in a process.
b. Identify
4443 the most important items.
c. Determine
4444 which alternative is best.
d. Track
4445 performance over time.
4446

4447
483-A
4448 Histogram is used to:
a. Provide
4449 a picture of process variation.
b. Track
4450 performance over time.
c. Identify
4451 the most important cause of a problem.
d. Segment
4452 customers and customer needs.
4453

4454
484-To
4455 facilitate the identification, exploration, and
graphical
4456 display of the POSSIBLE causes of an effect you
would
4457 use a:
a. Force
4458 Field analysis.
b. Flowchart.
4459
c. Corrective
4460 Action process.
d. Fishbone
4461 diagram.

4462

4463
485-A
4464 process can be documented by using:
A. 4465
Flowcharts and Standard Operating Procedures.
B. 4466
Pictures and video.
C. 4467
Histograms and Cause-Effect diagrams.
D. 4468
Capability studies.
a. A and B only.
4469
b. A and D only.
4470
c. B4471
and C only.
d. C and D only.
4472
4473

4474
486-A
4475 team has identified a process for improvement ,
selected
4476 examples of best practice performers ,visited those
sites ,gathered all necessary data & compiled results. The
4477
most
4478effective next step for the team is to:
a)identify
4479 the next process for benchmark
b)implement
4480 change back at the team site
c)compare
4481 results to historical data
d)make
4482 the results public for others to use in benchmarking
4483

4484
487-In
4485 special cause variation, the source of variation is:
4486
A-Intermittent,
4487 unpredictable, chronic , extrinsic and
assignable.
4488
4489
B-Intermittent,
4490 unpredictable, unstable, extrinsic and
assignable.
4491
4492
C-Intermittent,
4493 inliers, unstable, extrinsic and assignable.
4494
D-Intermittent,
4495 unpredictable, unstable, and intrinsic and
assignable.
4496
4497
4498

4499
4500
489-Intensive
4501 analysis is mainly performed :
4502
a)
4503At specified time intervals.
4504
b)
4505To identify opportunities to improve.
4506
c)
4507When significant undesirable variation in performance
4508occurs.
4509
d)
4511
4512

4513
490-When
4514 no problems or opportunities to improve care are
found4515 after sufficient time:
4516
A-Do
4517nothing ,this is the ideal situation.
4518
B-.Wait
4519 for a few weeks and reevaluate.
4520
C-Wait
4521 for a sufficient time(6 months-1 year),then celebrate.
4522
D-Wait4523 for a sufficient time (6 months-1 year),then
reevaluate
4524 the indicators, data collection methods and
analysis
4525 processes.
4526

4527
491-A 4528 common cause variation is:
4529
4530a. An intrinsic, inliers, unpredictable, chronic
4531 variation.
4532
4533b. The responsibility of the process owners.
4534
4535c. Correctable by top management and the team.
4536
4537d. An intrinsic, outlier, unpredictable, acute variation.
4538

4539
492-Selecting
4540 improvement opportunities depend on:
4541
a.
4542 Deficient systems
4543
b.
4544 Insufficient knowledge
4545
c.
4546 Deficient individual performance or behavior.
4547
d.
4548 All of the above
4549

4550
4551
493-The
4552 most important value of pilot testing during the
improvement
4553 process is to:
4554
A.4555 Establish time frames ,sample size,and location most
4556 representative of the whole population.
4557
B.4558 Determine if the improvement is viable (will have the
4559 desired results).
4560
C.4561 Test alternative improvement action if pilot test is
4562 unsuccessful.
4563
D.4564 All of the above
4565

4566
494-Pareto
4567 rule means that:
4568
a.
456980% of the problems will have 20% of the impact.
4570
b.
457120% of the activities will bring 80% of the results.
4572
c.
4573Focus on high-volume, high-risk, and problem prone
4574issues.
4575
d.
4576Ignore problems with low potential for adverse impact.
4577

4578
4579
495- Based on most quality improvement standards, the
4580
quality
4581 council is all of the following except:
4582
A-
4583Delegated to plan strategically for all improvement
4584plans.
B-
4585Delegated by the governing body, administration , and
4586medical staff.
C-
4587Comprised of representatives from administration
4588,governing body, medical staff and key departments of

4589the organization.
D-
4590Delegated to prioritize, and coordinate all
4591organization-wide quality PI activities.
4592

4593
496-The
4594 following are some of the responsibilities of the
quality
4595 council:
4596
a.
4597Select, and charter teams for designated QI/PI
4598projects.
4599
b.
4600Develop, modify and approve the PI plan prior to
4601approval by the governing body.
4602
c.
4603Approve strategic quality initiatives based on strategic
4604plan goals.
4605
d.
4607
4608
4609

4610
497-The
4611 following are among the responsibilities of quality
council:
4612
4613
4614
a.
4615Reporting to the governing body and providing
4616summary reports.
4617
b.
4618Establishing and overseeing a confidential peer review
4619policy.
4620
c.
4621Meeting at least monthly or more on the call of the
4622chair.
4623
d.
4625

4626
498-All
4627 of the following is a true function of the quality
council
4628 except:
4629
a.
4630Determines and supports the education and training
4631needs of the organization related to quality/PI.
4632
b.
4633Replaces the peer review committees and handles
4634practitioner-specific issues.
4635
c.
4636Review aggregated data feedback from customer
4637satisfaction surveys.
4638
d.
4639Determine the budget needs and implications of
4640organization wide PI activities.
4641

4642
499-The
4643 only unique step in the 10-step benchmarking
model4644 is:
4645
a.
4646Identify what is to be benchmarked.
4647
b.
4648Identify comparative providers.
4649
c.
4650Communicate benchmark findings and gain
4651acceptance.
4652
d.
4653Project future performance levels.
4654

4655
4656
4657
500-In
4658 the Benchmarking process, future performance goals
answer
4659 which question:
4660
a. What
4661 is our current performance?
4662
b. What
4663 was our previous performance?
4664
c. Where
4665 do we want to be?
4666
d. Where
4667 will our competitors be?
4668

4669
4670
501-The
4671 sequence of events in the PDCA cycle is:
4672
a. Plan
4673 change, gather data, implement on small scale then
act.
4674
4675
b. Plan,
4676 implement plan on small scale, educate, gather data,
implement
4677 on full scale.
4678
c. Plan,
4679 implement change on small scale, then full scale,and
gather
4680 data to to evaluate results of change.
4681
d. Find
4682 process to improve, plan, implement on large scale,
study,act.
4683
4684

4685
502-Patient
4686 satisfaction scores for a community hospital
demonstrate
4687 multiple areas for improvement including a
need
4688to improve attractiveness of the facility responsiveness
to patient
4689 needs & physicians & nursing communication.
Which
4690 of the following should the healthcare quality
professional
4691 also expect to find?
A) 4692
administration prioritization & leading units to achieve
organizational
4693 goals
B) 4694
unit manager who openly discuss patient satisfaction
scores
4695
C)units
4696 operating independently with little communication
between
4697 units
D) 4698
employee satisfaction scores in the 80th percentile
compared
4699 to other peer organizations

4700
503- Outcomes as used as indicators of quality are defined as

4701
any4702
of the following except :
4703
a. Changes
4704 in health states
4705
b. Changes
4706 in knowledge or behavior pertinent to future
health
4707 states.
4708
c. Provide
4709 report of what is the organization is doing now.
4710
d. Satisfaction
4711 with healthcare.
4712

4713
504- 4714Outcomes measures enable us to measure and assess
which4715 of the following:
4716
a. 4717
What is the right thing to do(the quality of technology)
4718
b. 4719
Whether what is already known to be best practice is
being
4720 implemented.
4721
c. 4722
Whether what is being done is acceptable (the quality of
performance).
4723
4724
d. 4725All of the above

4726
506-Outcomes
4727 measurement include the following
4728
a. 4729Control of results of processes.
4730
b. 4731Patient perception of outcome.
4732
c. 4733Ability to function and impact on quality of life.
4734
d. 4735All of the above
4736
507- The following term is synonymous with clinical practice

4737
guidelines
4738 except:
4739
a. Standards
4740 of care
4741
b. Standards
4742 of Practice
4743
c. Clinical
4744 Algorithms
4745
d. 4746 Practice parameters

4747
508-Clinical
4748 pathways are developed as a way to:
4749
a. 4750Track significant variations case by case.
4751
b. 4752Predict preadmission / preprocedure visits in managed
care.
4753
4754
c. 4755Establish a clear mechanism focused on the patient.
4756
d. 4757All of the above.

4758
509- 4759 An emergency room tracks wait times from patient
arrival
4760 to physician assessment. Data are reported using run
chart4761which of the following demonstrate a true statistical
increase
4762 in treatment delays:
A)64763
consecutive ascending data points
B) 4764
7 consecutive descending data points
C) 4765
zigzag pattern of 10 data points
D) 4766
data points are close to the mean line

4767
510- standards of care based to the knowledge & experience

4768
of recognized
4769 experts & healthcare research are known as:
A) 4770
benchmark data
B) 4771
generic screen
C) 4772
pre-established criteria
D) 4773
evidence based guidelines
4774
511- which is the following is an essential component in

4775
performance
4776 improvement report:
A) 4777
governing body approval
B) 4778
data analysis & display
C) 4779
individual performance review
D) 4780
team composition and attendance
4781
512- the evaluation of quality & appropriateness of patient

4782
care in the radiology department is the responsibility of:
4783
A) 4784
medical director of radiology
B) 4785
chief medical officer
C) 4786
medical director of quality department
D) 4787
administrator of clinical service
4788
513- Meauring the time it takes a nurse to perform a

4789
procedure
4790 address which of the following:
A) 4791
monitoring
B) 4792
process
C) 4793
outcome
D) 4794
structure
the4795
TIMELINEES of any procedure is a PROCESS
INDICATOR
4796 :)
4797
514-The
4798 concept of organizational liability is important to
the4799
field of healthcare quality because it holds the
organization
4800 responsible for:
A) 4801
ensure confidentiality of all documents
B) 4802
requiring physician to carry adequate malpractice
insurance
4803
C)maintain
4804 a process to identify deficiencies in the provision
of care
4805
D) 4806
assure that peer review physicians have no interest in
cases
4807being review

4808
516- A healthcare quality professional is reviewing data with

4809
a wide
4810 range of values between the highest & the lowest
points.
4811 The best way to rank order using a:
A) 4812
line graph
B) 4813
simple frequency distribution
C) 4814
grouped frequency distribution
D) 4815
bar graph
(JB4816
.. keyword : wide range)

4817
4818
517-Which
4819 of the following tools should be used FIRST
when
4820developing a performance improvement action plan:
A) 4821
story board
B) 4822
cause & effect diagram
C) 4823
interrelationship diagram
D) 4824
statistical process control chart

4825
518- Analysis of post-operative surgical infection rates over

4826
the4827
past year demonstrate an increase in infections. Which
of the
4828 following BEST provides display of aggregated data
compared
4829 to data from a local facility?
A) 4830
bar graph
B) 4831
control chart
C) 4832
pareto chart
D) 4833
histogram
Comparison
4834 = bar graph

4835
519- Team performance is BEST evaluated by:

4836
A) 4837
the team leader
B) 4838
senior leadership
C) 4839
the PDCA process
D) 4840
the nominal group technique
Explanation:
4841
A. 4842
The team leader may be biased and is not the best source
for4843
team evaluations.
B. 4844
Senior leadership is not usually involved in evaluating a
team.
4845
C. 4846
The Plan, Do, Check, Act process is a comprehensive
methodology
4847 used to conduct performance improvement
activities,
4848 including the analysis of progress.
D. 4849
The nominal group technique is a group decision-making
process
4850 for generating a large number of ideas where each
member
4851 works individually. This technique would not be
helpful
4852 in evaluating team progress.

4853
520- Replacing retrospective review with concurrent review

4854
is an
4855example of:
A) 4856
a paradigm shift
B) 4857
a process improvement
C) 4858
an empowerment process
D) 4859
productivity enhancement

4860
521- Which of the following should be appointed to quality

4861
improvement
4862 council to deal effectively with conflict?
A) 4863
facilitator
B) 4864
chief operating officer
C) 4865
risk management
D) 4866
senior leader

4867
522- Meaningful quality process measures must be:

4868
A) 4869
relevant & valid
B) 4870
feasible & explainable
C) 4871
relevant& explainable
D) 4872
valid& identifiable

4873
523- The BEST way to facilitate change within a healthcare

4874
organization
4875 is to:
A) 4876
involve the individual directly affected by the change
B) 4877
communicate through group meeting
C) 4878
arrange presentation by senior leaders
D) 4879
communicate through group e-mail

4880
524-A
4881 healthcare quality professional hypothesizes that a
sample
4882 mean is different from population mean. The
standard
4883 deviation is not known. The estimate must be
calculated
4884 from a sample .which of the following statistical
technique
4885 should be used:
A) 4886
regression analysis
B) 4887
chi square test
C) 4888
t-test
D) 4889
analysis of variance
(comparison
4890 of means t-test )

4891
525- Which of the followings are measures of central

4892
tendency?
4893
A) 4894
mean, mode, median
B) 4895
standard deviation, variance, standard error
C) 4896
grouped data, bell curve & distribution
D) 4897
correlation, regression & t-test

4898
526-The
4899 following is the FIRST step in facilitating change in
an 4900
organization?
A) 4901
review customer satisfaction survey
B) 4902
get feedback from staff on problems to be addressed
C) 4903
identify key people in the organization that should be
involved
4904
D) 4905
develop a performance improvement plan
4906
527- Private insurer has contracts with 2 area hospitals.

4907
Hospital
4908 A is a 250 bed community facility & hospital B is a
900-bed
4909 tertiary care centre. Costs were less at the tertiary
care centre. From a financial stand points, the BEST option
4910
to private
4911 insurer is to:
A) 4912
maintain both contract with no further action
B) 4913
monitor the expenses of both institution for the next year
C) 4914
negotiate an exclusive arrangement with hospital B
D) 4915
recommend that hospital B acquire hospital A

4916
528- Which of the following is the BEST way for a

4917
healthcare
4918 quality professional to involve nursing staff in the
restructuring
4919 of a patient care unit :
A) 4920
present at a department meeting
B) 4921
ask the nurse leader for recommendation
C) 4922
conduct a focus group
D) 4923
survey the nursing staff

4924
530-A
4925 surgery department's monthly case review revealed
10 4926
records meeting criteria.6 records did not meet the
criteria.
4927 When calculating the incidence rate, the
denominator
4928 is:
A) 4929
4
B) 4930
6
C) 4931
10
D) 4932
16
(total
4933population)

4934
531- Quality improvement requires healthcare quality

4935
professional
4936 to recognize that :
A) 4937
quality improvement generates its own change
B) 4938
the process is an ongoing continuous & dynamic change
C) 4939
the process require radical change in a short period of
time
4940
D) 4941
quality improvement is managed by senior leaders

4942
532- For which of the following is process capability BEST

4943
used ?
4944
A) 4945
identifying if a process is having the intended effect
B) 4946
focusing a team on the best thing to do
C) 4947
narrowing down options through a systematic approach
of comparison
4948
D) 4949
determining if a process meets established specifications
A =4950
Validity
D=4951 Capability

4952
533- Which of the following is essential to an effective

4953
quality
4954 council?
A) 4955
involvement of leadership
B) 4956
consultation of the legal advisors
C) 4957
participation of the strategic planning committee
D) 4958
direction from the organization's quality department

4959
534- The most effective way for healthcare quality

4960
professional
4961 to communicate quality improvement activities
to the
4962 medical staff is by:
A)developing
4963 professional relationships
B)inviting
4964 medical staff to an in service on quality tools
C)evaluating
4965 physician participation on quality teams
D)providing
4966 outcome data at medical staff meeting

4967
535-An
4968 utilization management department of a hospital has
collected
4969 data on length of stay & readmission rates.
Compared
4970 to benchmarks. The length of stay rates are
higher
4971 & readmission rates are lower. Which if the following
is the
4972next step?
A) 4973
identify additional benchmarks to compare the data
B)conduct
4974 a cost-benefit analysis
C)analyze
4975 readmission rates with a run chart
D) 4976
continue to monitor length of stay rates
The 4977length of stay rates higher , it is a bad outcome need
further
4978 investigation to analyse the causes so Continue to
monitor
4979 length of stay rates

4980
534- Benchmarking is based on identifying:

4981
A) 4982
best practice
B) 4983
competition
C) 4984
deficiencies
D) 4985
statistical control

4986
535- Which of the following BEST describe an organization

4987
vision
4988 statement ?
A)it's
4989 used as a marketing strategy
B)it4990
define the structure of the institution
C)it describe the organization strategic plan

4991
D)it reflect the organization culture

4992
4993
536- In deciding to submit an application for an external

4994
quality
4995 award. The FIRST step is to determine if the award
criteria:
4996
A)are
4997 aligned with the organization strategic plan
B)are
4998 well written
C)demonstrate
4999 excellence in quality
D)are
5000 approved by the chief executive officer
5001
537- A reengineering effort occurred at a facility. Activities

5002
particularly
5003 those regarding staff layoffs ,were carefully
planned
5004 ,communicated & implemented according to the
plan.
5005One year later, the business is stable, but staff morale
is very
5006 low. A healthcare quality professional has been asked
to consult
5007 in determining where the effort went wrong.
Based
5008 on the concepts of change theory, the cause is most
likely:
5009
A) 5010
that the reengineering decision was a mistake
B)a5011
failure to address the need of the staff who were
retained
5012
C)that
5013 leadership was not probably trained in the change
process
5014
D) 5015
that a few disgruntled staff are instigating dissension in
the5016
ranks

5017
538- The master patient index is considered :

5018
1.
5019A permanent file of all patients seen in the organization
2.
5020A file of cases attended by individual physicians
3.
5021A file of principal diagnosis codes.
4.
5022A file of principal procedures.

5023
539-The
5024 physician index is considered :
a. A 5025permanent file of all patients seen in the organization
b. A 5026file of cases attended by individual physicians
c. A 5027file of principal diagnosis codes.
d. A 5028file of principal procedures.

5029
540-The
5030 disease index is considered :
a.A
5031 permanent file of all patients seen in the organization
b. A file of cases attended by individual physicians
5032
c. A file of principal diagnosis codes.
5033
d. A file of principal procedures.
5034

5035
541- The surgery index is considered :

5036
a.5037
A permanent file of all patients seen in the organization
b.5038
A file of cases attended by individual physicians
c.5039
A file of principal diagnosis codes.
d.5040
A file of principal procedures.

5041
542-Among
5042 registers which are permanent chronological
listings
5043 for maintaining certain statistics :
a.5044
Surgical log
b.5045
Surgery index
c.5046
A and B
d.5047
None of the above.
Registers:
5048 Are permanent chronological listings for
maintaining
5049 certain statistics.
Ex.5050
: surgical log, admission, inpatient, outpatient, and death
registers.
5051
5052
543- Regression analysis is a statistical technique that :

5053
a.5054
Compares two sets of like things using means.
b.5055
Compares ratios and rates using tally data.
c.5056
Compares distribution of observations of one variable
with
5057 the distribution of another.
d.5058
Evaluates kinds of data found in pareto charts.

5059
544-In
5060 comparing rates of nosocomial infection rates
between
5061 two hospitals the following test is commonly used:
a.5062
The t-test
b.5063
Linear regression analysis test.
c.5064
The Chi-square test.
d.5065
Standard deviation.
5066(comparing rates = Chi-square)
5067
545-The
5068 separate services of Pharmacy and Nursing are
having
5069 difficulty developing an action plan for medication
errors.
5070 Pharmacy Services states that Nursing Services
causes
5071 the majority of the problems related to errors, while
Nursing
5072 Services states the opposite. The quality
professionals
5073 role in resolving this problem is to?
A. 5074
Provide them with directives on how to solve the problem
B. 5075
Facilitate discussion between the groups to enable them to
assume
5076 ownership of their portions of the problem
C. 5077
Assign the task to an uninvolved manager
D. 5078
Refer the problem to the facility-wide quality council

5079
546- A quality manager needs to assign a staff member to

5080
assist
5081a medical director in the development of a quality
program
5082 for a newly established service. Which of the
following
5083 staff members is most appropriate for this
project?
5084
A. 5085A newly hired staff member who has demonstrated

competence
5086
and5087
time to complete the task
B. 5088
A knowledgeable staff member who works best on
defined
5089 tasks
C. 5090
A motivated staff member who is actively seeking
promotion
5091
D. 5092
A competent staff member who has good interpersonal
skills
5093
5094
547-A
5095 social service department regularly monitors
5096the number of inappropriate referrals,

5097the timeliness of discharge planning, and
5098the number of days of discharge delays.
What
5099 additional monitor should be added to evaluate the
appropriateness
5100 of social service interventions?
A. 5101
Inadequacy of documentation in progress notes
B. 5102
Attainment of social service goals
C. 5103
Timeliness of referrals to social services
D. 5104
Number of social service referrals from nursing
appropriateness=
5105 relevant to patient need = attainment of
goals
5106= B
effectiveness
5107 = how the care or service would achieve z
OUTCOMES
5108 not the Goals..
appropriateness
5109 = how z care or service would be RELEVANT
to z5110individual s NEEDS or in accordance wz z PURPOSE
WHICH5111 = ur GOALS from the start r they achieved ?!
5112
548-A
5113 patient was in the operating room when a piece of a
surgical
5114 instrument broke off and was left in the patients
body.
5115 The patient was readmitted for removal of the foreign
object.
5116 Which of the following would most likely apply in
this5117
situation?
A. 5118
Res ipsa loquitur
B. 5119
Contributory negligence
C. 5120
Contractual liability
D. 5121
Tort liability

5122
549- Which of the following is most likely to be a benefit of

5123
concurrent
5124 ambulatory surgical case review?
A. Decreased
5125 medical record review at discharge
B. An
5126 increase in the number of cases failing screening
criteria
5127
C. An
5128 increase in reviewer competence
D. Decreased
5129 employee turnover

5130
550- In order to perform a task for which one is held

5131
accountable,
5132 there must be an equal balance between
responsibility
5133 and
A. 5134
Authority
B. 5135
Education
C. 5136
Delegation
D. 5137
Specialization

5138
551-The
5139 primary purpose of an emergency preparedness
program
5140 is to
A. 5141
Conduct evaluations of emergency training
B. 5142
Provide evaluations of semi-annual evacuation drills
C. 5143
Prevent internal disasters that disrupt the facilitys
ability
5144 to provide care and treatment
D. 5145
Manage the consequences of disasters that disrupt the
facilitys
5146 ability to provide care

5147
5148 Underuse is evidence by the fact that many

552-
scientifically
5149 sound practices are not used as often they
should
5150 be, For example, biannual mammography screening
in woman
5151 ages 40 to 69 has been proven beneficial and yet is
performed
5152 less than 75 percent of the time. This is the
categorization
5153 of:
A. 5154
Defects
B. 5155
La of professionalism in Medical field
C. 5156
La of care
D. 5157
Healthcare practice

5158
553-__________
5159 is a term applied when the proper clinical
car5160
process is not executed appropriately, such as giving the
wrong
5161 drug to a patient or incorrectly administering the
correct
5162 drug.
A. 5163
Underuse
B. 5164
Overuse
C. 5165
Misuse
D. 5166
Illegal use
Sometimes
5167 come in the exams by (Medication Error)

5168
554-which
5169 of the following is example of outcome measure:
A. 5170
mortality rate.
B. 5171
average LOS.
C. 5172
medication dispensing rate.
D. 5173
labspeciemen.

5174
555- 5175 Which one of the following BEST describes
organizational
5176 culture and change?
5177
A. 5178
It is best to move quickly with change.
B. 5179
Professionals are relatively easy to convince of the need
for5180
change.
C. 5181
The factor most often misjudged in the change process is
magnitude of change required and the staff
the5182
response
5183 to change.
D. 5184
Ingrained mindsets are incapable of change; thus, they
should
5185 simply be eliminated from the change process.

5186
556- 5187 Which of the following is the MOST common reason
for5188failure of quality improvement initiatives?
5189
A. 5190
The expectation that managers will become part of the
change
5191 process
B. 5192
The expectation that staff will become part of the change
process
5193
C. 5194
Viewing quality improvement as a long-term process
D. 5195
Viewing quality improvement as a short-term fix

5196
557-The
5197 best view of outcomes is that they should be ____
focused,
5198
5199
A. 5200
patient B. physician
C. 5201
staff D. statistically
5202

5203
558-Which
5204 of the following is the MOST common mistake in
the5205use of consultants?
5206
A. 5207
Following their recommendations blindly
B. 5208
Not following their recommendations at all
C. 5209
Hiring based on cost
D. 5210
Not checking the references and track record of the
consultant
5211
5212

5213
559-From
5214 the standpoint of the hospital, which one of the
following
5215 best fits all three roles of customer, processor, and
supplier?
5216
5217
A. 5218
CEO
B. 5219
Employee
C. 5220
Patient
D. 5221
Physician
JB5222page No. VI-8 . part no. 3.3.2

5223
560-The
5224 capitation rate paid for a Medicare member is
____%5225 of the adjusted average per capita cost.
5226
A. 5227
100
B. 5228
95
C. 5229
75
D. 5230
66

5231
561-Which
5232 of the following are considered to be coordinated
care 5233 plans under Medicare Choice?
5234
I. Health
5235 Maintenance Organizations
II. 5236
Preferred Provider Organizations
III.5237
Provider Sponsored Organizations
5238
The CORRECT answer is:
5239
5240
A. 5241
I, II
B. 5242
I, III
C. 5243
II, III
D. 5244
I, II, III

5245
562-Which
5246 one of the following is NOT true regarding the
JCAHO's
5247 interpretation of environment of care?
5248
A. 5249
All employees must be determined competent before care
is rendered.
5250
B. 5251
Building evacuation is not required during quarterly fire
drills,
5252
C. 5253
Physicians are not included in this function.
D. 5254
Waste and utility systems management is a must know
item.
5255
5256

5257
563-Which
5258 of the following is NOT true regarding the
JCAHO's
5259 no smoking policy?
5260
A. 5261
Exceptions to the prohibitions are usually determined by
licensed,
5262 independent practitioners.
B. 5263
Social rehabilitation settings may not require a licensed
independent
5264 practitioners order.
C. 5265
Exceptions are allowed in hospital-sponsored ambulatory
care areas.
5266
D. 5267
Exceptions are not allowed in adolescent and child
patient
5268 care areas,
5269

5270
564-A5271 histogram with a twin peaks appearance is also called
(n)5272
___ distribution.
5273
A. 5274
bimodal
B. 5275
high variability
C. 5276
isolated peak
D. 5277
minimal variability

5278
565-Which
5279 of the following Is NOT a source of information
for5280the National Practitioner's Data Bank?
5281
A. 5282
American Medical Association
B. 5283
Healthcare entities
C. 5284
Insurance companies
D. 5285
Medical boards
insurance
5286 don't give information

5287
566-A5288 laboratory can receive a waiver from meeting
expanded
5289 proficiency testing standards under the Clinical
Laboratory
5290 Improvement Act of 19b8 provided
5291
A. 5292
all of its technologists and physicians are appropriately
licensed/certified
5293
B. 5294
the lab is in a state-recognized physician's office
C. 5295
the lab is hospital-based
D. 5296
the lab only performs simple tests

5297
567-Which
5298 one of the following best describes the intent of
OSHA 5299 regulations?
5300
A. 5301
The maintenance of hazardous materials
B. 5302
The maintenance of safe, healthful work conditions
C. 5303
The maintenance of medical devices
D. 5304
Conformance to federal labor law

5305
568-Which
5306 one of the following is not part of the Patient
Self-Determination
5307 Act?
5308
A. 5309
Informing requirements for hospitals
B. 5310
Informing requirements for physicians
C. 5311
Durable power of attorney
D. 5312
Living wills

5313
569- 5314 Which one of the following is NOT true regarding peer
review
5315 immunity under the Healthcare Quality
Improvement
5316 Act?
5317
A. 5318
Clinical psychologists are included as possible plaintiffs
B. 5319
It applies only to hospitals using formal peer review
processes.
5320
C. 5321
It does not prevent federal antitrust actions.
D. 5322
It is considered to be a conditional legislation.

5323
570- 5324 Rejecting the null hypothesis and concluding that
population
5325 means are not equal when they in fact are, is
5326
A. 5327
known as a Type I error
B, 5328
known as a Type II error
C. 5329
less likely if the alpha is set at .05 (as opposed to .01)
D. 5330
less likely if the alpha is set at .10 (as opposed to .05)

5331
571- The National Practitioner Databank was established by

5332
the5333
____ and became operational in ____.
5334
A. 5335
Health Care Quality Improvement Act of 1986; 1986
B. 5336
Health Care Quality Improvement Act of 1986; 1990
C. 5337
Joint Commission; 1986
D. 5338
Joint Commission; 1990
5339

5340
572-Which
5341 one of the following is NOT true regarding the
National
5342 Practitioner Databank?
5343
A. 5344
Health care practitioners may self-query at any time.
B. 5345
Hospitals must query when a practitioner applies for
privileges
5346 and. every two years on practitioners on the
medical
5347 staff or holding privileges.
C. 5348
Medical malpractice payers may query at any time.
D. 5349
State Licensing Boards may query at any time.
No5350Consensus

5351
573- 5352 Nurse Practice Acts are examples of____ law.
5353
A. 5354
administrative- B. common
C. 5355
public D. statutory

5356
5357
574-State
5358 Boards of Nursing are examples of ____ law.
5359
A. 5360
administrative B. common
C. 5361
public D. statutory
5362

5363
575- 5364 Informed consent is not needed when
5365
I. there
5366 is an emergency if there is an immediate threat to
life5367
01^ health
II. 5368
experts agree that it is an emergency
III.5369
the client is unable to consent and the ^legally
authorized
5370 person cannot be reached
5371
The CORRECT answer is:
5372
5373
A. 5374
I, II B. I, III C. II, III D. I, II, III
5375

5376
576-Which
5377 of the following would NOT satisfy the disclosure
element
5378 of informed consent?
5379
A. 5380
The patient has been informed of current course of
medical
5381 status and treatment
B. 5382
That the patient has been informed of the risks and
benefits
5383 of various treatment alternatives
C. 5384
The patient has been told that outcomes can be
guaranteed
5385
D. 5386
The patient has been given a professional opinion as to
the5387best alternative

5388
577- 5389Which of the following would constitute voluntary
standards
5390 used as a guideline for peer review?
5391
A. 5392
ANA Standards of Practice
B. 5393
Credentialing
C. 5394
Licensure
D. 5395
Nurse Practice Acts
Not5396 for CPHQ

5397
5398
578-A5399 person who____ would NOT be covered under the
Americans
5400 with Disabilities Act of 1990.
5401
A. 5402
has a communicable disease such as AIDS or HIV
B. 5403
has committed a felony
C. 5404
is recovering from drug or alcohol addiction
D. 5405
is regarded as disabled, whether or not he/she is in fact
disabled
5406
No5407consensus

5408
579-The
5409 error in reasoning made by American business
regarding.
5410 Japanese competition in the 1960s and 1970s was
tha.15411
5412
A. 5413
no one -will buy Japanese products
B. 5414
jobs will never be exported to Japan
C. 5415
Japanese competition is primarily. cost competition, not
quality
5416 competition
D. 5417
statistics are worthless in the business world
(Q-solution
5418 questions)

5419
580- 5420A manager who ____ best shows leadership in action.
5421
A. 5422
identifies several new markets for the company based on
strategic
5423 planning
B. 5424
advocates a one right way of doing things
C. 5425
is always pleasant with her employees
D. 5426
is well-viewed in the community

5427
581-To
5428 ____ customers is the best delineation of a goal, as it
is the
5429least subject to interpretation.
5430
A. 5431
identify
B. 5432
know
C. 5433
appreciate
D. 5434
understand

5435
582- 5436 In the hospital service delivery process, recent emphasis
has5437 been on
5438
A. 5439
admissions criteria
B. 5440
aftercare
C. 5441
continued stay criteria
D. 5442
preadmission processes

5443
583- 5444 The composition and qualifications of staff BEST
describes
5445 staff
5446
A. 5447
allocation
B. 5448
FTE
C. 5449
mix
D. 5450
roles and responsibilities
(No5451 consensus .. bet. C and D)

5452
584-Which
5453 of the following is the best description of the
JCAHO's
5454 view of model adoption for CQI?
5455
A. 5456
The ten-step process is a mandatory component.
B. 5457
Outdated models, such as Shewhart's PDCA cycle, should
be 5458
avoided,
C. 5459
Multiple models are preferred.
D. 5460
The institution must adopt whichever model best fits its
needs.
5461

5462
* 585-
5463 JoEllen Smith is determining how many clients still
became
5464 sick from influenza after receiving flu shots at her
facility.
5465 Under the JCAHO's Dimensions of Performance,
she5466is evaluating
5467
A. 5468
appropriateness
B. 5469
effectiveness
C. 5470
efficacy
D. 5471
safety
Many
5472 drs. Answer it B (Effectiveness) .. but I read it from
the5473
source of the question and it was C .. and why C ?
EFICACY=
5474 Acc. To JB is: 1- the power of a procedure or
treatment
5475 to improve health status ..
2- capability
5476 of the care to produce the desire effect or
outcome
5477 .
but effectiveness is the positive or negative result of the care
5478
. Here
5479 he ask about percentage (power-capability) of the ttt .
5480
* 586-When
5481 JoEllen evaluates how many people in her
facility's
5482 managed care plan were able to receive the flu shot.
She5483 is evaluating, under Dimensions of Performance
5484
A. 5485
appropriateness
B. 5486
availability
C. 5487
effectiveness
D. 5488
efficacy

5489
5490
* 587-When
5491 JoEllen evaluates how many people in her
facility's
5492 managed care plan were happy with the service
received
5493 while receiving the flu shot, she is evaluating, under
Dimensions
5494 of Performance,
5495
A. 5496
effectiveness
B. 5497
efficacy
C. 5498
respect and caring
D. 5499
safety
Many 5500 Drs. Answer it (C) but why we select A ?
Isn't5501 Happiness = Satisfaction = Outcome = Effectiveness
Respect
5502 and Caring acc. to JB : degree to which those
providing
5503 services do so with sensitivity for the individuals
needs5504 and expectations and individual differences or degree
to which
5505 the individual or a designee is involved in his/her
own 5506care and service decision . (not included in the question)

5507
588- 5508Robert Smith determines that the laboratory is the
cause5509 of the most waiting in his hospital, followed by
radiology,
5510 and admissions. When he decides to place most of
his5511
efforts to decrease wait times by starting with the lab, he
is 5512
5513
A. 5514
monitoring quality costs
B. 5515
Pareto planning
C. 5516
rank-ordering
D. 5517
stratifying data

5518
589- 5519 The fewest number of measures in performance
monitoring
5520 should be in the area of
5521
A. 5522
process
B. 5523
outcome
C. 5524
structure
D. 5525
utilization

5526
590-An
5527 integral part in the process of determining medical
necessity
5528 in the delivery of quality medical care including
weighing
5529 the potential for undesirable outcomes and side
effects
5530 against the potential for positive outcomes of a
treatment
5531 best describes
5532
A. 5533
cost-effective medical care
B. 5534
efficacious medical care
C. 5535
efficient medical care
D. 5536
risk-benefit analysis

5537
591- 5538____ is correlated to. the timeliness of delivered
medically
5539 necessary standard of care services and supplies
which5540 result in the least cost.
5541
A. 5542
Cost-effective medical care
B. 5543
Efficacious medical care
C. 5544
Efficient medical care
D. 5545
Risk-benefit analysis
Here
5546we seek (optimum time) & (low cost) .. We here seek
to Efficiency
5547
5548
both ( Time and Money) are resources .. and we here seek to
5549
save both of them ..
5550
In 5551
addition of (timeliness) not means ((Effectiveness)) .. and
cost-effectiveness
5552 assume that comparing between value of
effectiveness
5553 is it justify its cost or not .. but we here not
measure
5554 this ..

5555
592- 5556 The selection of the least expensive medically necessary
treatment
5557 from two or more that are equally efficacious in
achieving
5558 a desired health care outcome is termed
5559
A. 5560
cost-effective medical care
B. 5561
efficacious medical care
C. 5562
efficient medical care
D. 5563
risk-benefit analysis
JB5564ch3 p135 :
Cost-effectiveness
5565 analysis (CEA)
-The 5566least costly alternative may be selected as best if all
alternatives
5567 prove to be equally effective.
We5568 select the least expensive when equally efficacious in
achieving
5569 the desired outcome
(Thanks
5570 Dr. Eman Sultan)

5571
593- 5572 Quality improvement and risk management are ____ in
the5573long run, ____ risk translates into ____ quality.
5574
A. 5575
not related; reduced; no change
B. 5576
interrelated; higher; higher
C. 5577
interrelated; reduced; reduced
D. 5578
interrelated; reduced; higher

5579
5580
594- 5581____ risk is best described as the risk of doing business.
5582
A. 5583
Claims
B. 5584
Managed care
C. 5585
Marketing
D. 5586
Operational

5587
595-Health
5588 economic research that focuses on personal
satisfaction
5589 after retirement would best be described as ____
research
5590
5591
A. 5592
cost utilization
B. 5593
cost minimization
C. 5594
outcomes
D. 5595
quality of life
http://www.ahrq.gov/.../facts.../outcomes/outfact/index.html
5596
5597
No5598
consensus .. between C and D
5599

5600
596- 5601Which one of the following is NOT a typical means by
which5602 managed care organizations try to reduce costs?
5603
A. 5604
Denial of non-emergency ER visits
B. 5605
Denying all services
C. 5606
Increased use of PAs and NPs
D. 5607
Increased emphasis on prevention and self-care

5608
5609
597-The
5610 data shared between institutions to see how each
one5611 is doing is BEST defined as ____ data
5612
A. 5613
comparative
B. 5614
definitive
C. 5615
normative
D. 5616
relational

5617
598- 5618 If a study has 40 true positives and 10 false negatives,
then 5619 its sensitivity is____%.
5620
A. 5621
8
B. 5622
80
C. 5623
88
D. 5624
90
Sensitivity
5625 = (True / (True + false)) % = (True / (total)) % =
(40/5626
(40+10)) % = (40/50) % =4/5 % = 80% #
5627
..
50 5628
50 5629
----- 100
40 5630
----- X ? (40x100)/ 50 = 80

5631
5632
599- 5633Our Lady Hospital, finding that 80% of its patients are
poor 5634over 65 years of age, decides to develop programs
specifically
5635 for that group. This is called
5636
A. 5637
assessment
B. 5638
improvement
C. 5639
reiteration
D. 5640
statistical analysis
most 5641of drs. select A .. but I think the best answer is B ..
because
5642 there is a decision already taken .

5643
600-Nancy
5644 Smith designs a study to look at two individuals
working
5645 in the hospital; RNs and CNAs. This is an example
of a(n)
5646 ____ variable.
5647
A. 5648
acentric
B. 5649
causal
C. 5650
dichotomous
D. 5651
twin

5652
5653
601-The
5654 documentation of basic treatment or action
sequence
5655 in order to eliminate unnecessary variation best
describes
5656
A. 5657
benchmarking
B. 5658
critical path
C. 5659
flow charting
D. 5660
variation reduction

5661
5662
602-Under
5663 JCAHO's Cycle for Improving Performance,
historical
5664 patterns of performance in the organization is also
called
5665
A. 5666
baseline performance
B. 5667
benchmarking
C. 5668
designed performance limits
D. 5669
practice guidelines and parameters

5670
603-The
5671 steps involved in JCAHO's Cycle for improving
performance
5672 are
A. 5673
design, measure, assesses, and improves
B. 5674
find, organize, clarify, understand, and select
C. 5675
focus, adapts, develop, and evaluate
D. 5676
plan, do, check, and act

5677
604-Which
5678 of the following would be the BEST means of
charting
5679 continuous data?
A. 5680
Fishbone diagram
B. 5681
Flowchart
C. 5682
Histogram
D. 5683
Pie chart

5684
605-(1)
5685 Call patient by name; (2) Walk patient back to
radiographic
5686 room;(3)Perform x-ray exam; is an example of
5687
A. 5688
flowcharting
B. 5689
improvement cycle
C. 5690
planning
D. 5691
process

5692
606-Joe
5693 Smith wants to study patient satisfaction in his
institution
5694 but wants to get the largest group possible so he
conducts
5695 his study in the local mall. His study might be
criticized
5696 not only for reaching individuals who are not
patients,
5697 but also that it is
A. 5698
capitated
B. 5699
nonrandomized chapter 5
C. 5700
randomized
D. 5701
variated

5702
607-Your
5703 6 units receive patient satisfaction scores of 56, 66,
68,5704 70, 78, 89. What is the mean score for the group?
A. 5705
56
B. 5706
70
C. 5707
71
D, 5708
89

5709
5710
5711
608-Your
5712 6 units receive patient satisfaction scores of 56, 66,
68,5713
70. 78, 89. Which of the. following are accurate
representations
5714 of range?
I. 56-89
5715 II. 33 III. 71/33
The 5716CORRECT answer is:
A. 5717
I, II
B. 5718
I, III C. II, III
D. 5719
I, II, III

5720
5721
609-Death
5722 rate as an indicator for the quality of care
I. often
5723 ignores case mix
II. 5724
often ignores regional differences
III,5725is the best indicator of physician performance
A. 5727
I, II
B. 5728
I, III C. II, III
D. 5729
I, II, III

5730
610-Jane
5731 Smith develops a patient survey and tests it on a
number
5732 of patients, who can understand it. She receives
fairly
5733 identical comments and results. She can consider that
this5734survey meets standards of ____ and ____, but perhaps
not5735____,
5736
A. 5737
readability; reliability; validity
B. 5738
validity; readability; reliability
C. 5739
reliability; validity; readability
D. 5740
accuracy; validity? Readability

5741
611-The
5742 method of case management with the longest
history
5743 is ____ case management.
A. 5744
institution based
B. 5745
private based
C. 5746
reimbursement
D. 5747
social welfare

5748
612-The
5749 three displays of a scattergram show
A. 5750
large relation, small relation, narrow relation
B. 5751
normally distributed, left skewed, right skewed
C. 5752
positive relation, neutral relation, negative relation
D. 5753
skewed relation, normal relation, inter-related

5754
613-An
5755 affinity diagram groups
A. 5756
identical ideas
B. 5757
people by skill
C. 5758
people by job
D. 5759
related ideas

5760
614-The
5761 Process Decision Program Chart (PDPC) is a
combination
5762 of ____ and____ diagrams.
5763
A. 5764
Fishbone; flow
B. 5765
Fishbone; GANTT
C. 5766
Fishbone; tree
D. 5767
GANTT; affinity

5768
615-Whereas
5769 strategic planning focuses on ____, tactical
planning
5770 focuses on ____.
A. 5771
immediate; long range
B. 5772
long range; immediate
C. 5773
overview; the process
D. 5774
the process; overview

5775
616-If
5776 step one in a quality improvement program is to
clarify
5777 goals, then the next logical step is to
5778
A. 5779
analyze data
educate and build the team?
B. 5780
C. 5781
investigate the process?
D. 5782
take appropriate actions

5783
617-The
5784 best description of a specification is
5785
measurable aspects of a producer service that
A. 5786
match
5787 customer needs
B. 5788
specific aspects or attributes of a product or service
C. 5789
written documents
D. 5790
written protocol or policy for action
5791

5792
5793
618-The
5794 ideal flow of information in a business or
organization
5795 is from
A. 5796
customer to worker to manager
B. 5797
manager to supervisors to workers
C. 5798
manager to workers
D. 5799
vendor to manager to worker

5800
619-Which
5801 of the following would most likely NOT
represent
5802 a typical CQI team?
5803
A. 5804
Mammographic image quality: radiologist, technologist,
physicist
5805
B. 5806
Patient satisfaction: admissions clerk, staff RN, MD,
patient
5807 representative
C. 5808
Patient transport: transporter, radiology representative,
lab5809
representative, staff RN
D. 5810
Product supply: staff technologist, staff RN, medical
records
5811 clerk

5812
620-The
5813 most realistic outcome of Continuous Quality
Improvement
5814 is an
A. 5815
improvement may not work, but it is a useful learning
tool5816
B. 5817
improvement will always work if properly carried out
C. 5818
improvement will work most of the time but people
usually
5819 mess them up
D. 5820
outcome is a stepping stone to the next higher step
5821

5822
621-Symptomatic
5823 treatment is considered inadequate in
CQI 5824 and performance improvement; instead, the goal must
be 5825
to
5826
A. 5827
determine the root causes of a problem
B. 5828
find all problems
C. 5829
fix all problems
D. 5830
fix problems at the lowest cost
5831

5832
5833
622-GANTT
5834 charts define ____ and ____.
5835
A. 5836
internal processes; external processes
B. 5837
management responsibilities : employee responsibilities
C. 5838
problems; who fixes them
D. 5839
who does what; when

5840
623-In
5841 a systems approach, the most important step to avoid
frustration
5842 and keep working toward future excellence is
5843
A. 5844
converting customer needs to expectations
B. 5845
output or outcomes identification
C. 5846
selection of appropriate measures
D. 5847
the ability to go back to a prior step if a barrier occurs in
the5848 process

5849
5850
624-Critical
5851 pathways would most likely be developed first
for5852 diagnoses and procedures that are high
A. 5853
cost
B. 5854
risk
C. 5855
volume
D. 5856
all of the above

5857
625-When
5858 should patients be advised of their rights?
A. 5859
Prior to entry into a healthcare setting
B, 5860
At entry into a healthcare setting
C. 5861
Following entry into a healthcare setting
D. 5862
Patients must ask for explanations of their basic rights

5863
626-The
5864 Mammography Quality Standards Act requires
direct5865 reporting to patients in which form?
I. Oral
5866 II. Written III. In lay terms
A. 5868
I. II
B. 5869
I, III
C. 5870
II, III
D. 5871
I, II, III

5872
5873
627-In
5874 development performance improvement action plan,
this5875
of the following tools should be used first
A -control
5876 chart
B -cause
5877 and effect diagram
C -interrelation
5878 ship diagram
D-pareto
5879 chart

5880
628-quality
5881 improvement team are beneficial because they
a-maximize
5882 expertise and perspective
b- 5883
Promote competition and pride among members
d- 5884
Authorize solutions to problems

5885
629-The
5886 first step in the design process of a QI plan is
a. determine
5887 the scope of the organization. . . . . . . . . it is
not5888a strategic plan
b. make
5889 a cost-benefit analysis
c. establish
5890 performance objectives
d. establish
5891 the project goals

5892
630-The
5893 strategic plan is used to
A-Achieve
5894 the mission+++++
B-Achieve
5895 tactical objectives
jjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjBSGAFHDFHJBBbbasDHjjjjjjjjj
5896
jjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjSKLVH
5897
631- "Occurrence reporting" is a type of

5898
a. risk
5899 reduction
b. risk
5900 evaluation
c. risk
5901 identification
d. risk
5902 prevention=

5903
5904
632- 60 years female spend 2 more days in hospital due to

5905
medication
5906 reaction this is
A- 5907
Medication error
B-Unexpected
5908 adverse occurrence
5909
633- ?"which is the best tool used in "generic screening

5910
a. medical
5911 record
b. claims
5912 data
c. incident
5913 report
d. performance
5914 indicators

5915
634- Which of the following is NOT included in a utilization

5916
management
5917 plan
a. procedures
5918 for discharge
b. organization's
5919 reporting structure
c. confidentiality
5920 agreement
d. annual
5921 budget

5922
635-Morbidity
5923 rate for obstetric measured by
Septicaemias
5924 after delivery
Caesarean
5925 rate
Normal
5926 delivery rat

5927
636- 5928 A level of cohesion between team members is reached
in 5929
a. forming
5930 stage
b. norming
5931 stage
c. storming
5932 stage
d. performing
5933 stage
5934

5935
637-During
5936 performing a re-appointment for a physician,
which
5937 of the following can be
A. 5938
blood utilization review
B surgical
5939 case mix
c. Medical
5940 Record Completion Review
D. 5941
fall rate review

5942
638- In a behavioral healthcare facility, CQI team was

5943
working
5944 for one year to decrease chemical and physical
restraint.
5945 After applying the program, the falls with
subsequent
5946 injuries increased for one standard deviation.
The following action is:
5947
a.5948
return to the physical restraint and increase monitoring
b. continue the program and seek opportunities to
5949
decrease falls
5950
c. stop the program and re-engineer the process
5951
d. use more chemical restraint and educate physician
5952

5953
639- Stability Of Infection Control Rate Over Time

5954
Run 5955 chart

Control
5956 chart

5957
640-Successful
5958 development of guidelines
A-physician
5959 involvement
B-staff
5960 education
C-QI 5961tools
D- 5962
pt. education

5963
5964
641-organizational
5965 committed to improving patient safety
key5966
area to influence change are:
A-staff
5967 willingness to change, policies. Procedures,
equipment,
5968 technology, evaluate process; redesign the
structure,
5969 improving of morale
B-structure,
5970 environment, equipment, process, application,
leadership,
5971 culture
C-medication
5972 delivery, structure, staff willingness to change,
non-slip
5973 floor, improvement of wards environment
D-leadership,
5974 culture, policies &procedure, staff incentives,
better
5975 lightening, evaluate process &EMR
Explain:
5976 Donabedian model = structure (leadership, culture,
staff incentives, better lightening, EMR)... Process
5977
(Commitment
5978 to guidelines, policies &procedure)...
Outcome
5979 (safety)... Quality
5980
5981
642- Which is attributes to culture of safety
5982
A-transparency
5983 & increase pt. acuity level
B-error-proof
5984 environment of empowered staff
c-empower
5985 staff &transparency
D-increase
5986 pt. acuity level& error proof environment

5987
643-which
5988 best enhance patient safety program
A-online
5989 staff survey
B-bar
5990 code of supplies
C-video
5991 pt. monitoring
D-EMR
5992
Explain:
5993 d...EMR is the best tool for PS program as it
provides
5994 info. About patient with good eligibility and timely
intervention
5995 so remove any risk of error occurrence to
patient.
5996 But barcode offer only safety to right patient..
5997

5998
644-under
5999 conducting a sentinel event review a RCA is
a-provide
6000 judgment of staff behaviour
b-require
6001 team consensus
c-identify
6002 gap in pt. care behaviour
D-proactively
6003 identifies causes & effects

6004
645-One
6005 of the team members that keep team members on
track
6006& focus on the process is:
A. 6007
Leader
B. 6008
Facilitator
C. 6009
Time keeper
D. 6010
Recorder when implementing a breakthrough
improvement
6011 to an admission process, than a hospital

6012
646-When
6013 implementing a breakthrough improvement to an
admission
6014 process, the hospital can benchmark with the
practice
6015 of:
a. Other
6016 health care organizations
b. Evidence
6017 from literature
c. Hotels
6018 and resorts
d. Neighbour
6019 hospitals

6020
6021
647-aproprietness
6022 of appendectomy
1.6023
preadmission test
2.6024
pathology test
3.6025
age
4.6026
clinical test

6027
648-alarm
6028 on iv infusion was broken nurse evaluate the
patient
6029 she should
1-call
6030 physician
2-call
6031 to fix the alarm
3-
6032call the head nurse

6033
6034
649- 6035 The physical difference between traditional QA & QI
that 6036QI is:
a- focus
6037 on process& systems while QA focus on individual
faults6038
b- 6039
Stress peer review while QA focus on customer

6040
650-Managing
6041 data and assisting with mathematical
calculations
6042 is the best description of
A. 6043
database
B. 6044
graphics
C. 6045
spreadsheet
D. 6046
word processor
6047
651-Which
6048 individual can be seen as serving as an internal
consultant
6049 for the organization in an accreditation survey?
A. 6050
B. 6051
Chief financial officers
C. 6052
Chief operating officer
D. 6053
Quality manager

6054
652-The
6055 least preferred outcome of QI:
a- empowerment
6056
b- increased
6057 statistical data
c- increased
6058 communication between staff
d- customer
6059 satisfaction
6060
653-A
6061 Team has been tasked with developing a program to
prevent
6062 patient falls which of the following data elements from
an 6063
incident\ occurrence report would provide the most useful
information
6064 for the team in evaluating the program success?
A-patient
6065 demographic
B-record
6066 of the time of the fall
C-nursing
6067 assessment
D-staffing
6068 ratio at the time of the fall
6069
654-Physician
6070 asks the nurse to cancel EKG for a patient
The 6071nurse forget to record this cancelling Action & then the
6072 die .the physician should
patient
Do6073nothing since the cancellation is the cause of death-A-
-Ask 6074the nurse to write cancellation in the medical record-B
C-Add6075 an addendum to the record that the EKG had been
cancelled-
6076
The 6077physician add the cancelled order to the record---D

6078
6079
655-External
6080 benchmarking can be
A. 6081
useful because all institutions are different.
B. 6082
misleading because all institutions are different.
C. 6083
meaningful when different populations are sampled
internally.
6084
D. misinterpreted because the data are so vast.
6085

B. 6086
misleading because all institutions are different.
External
6087 benchmarking involves analyzing data from
outside
6088 an institution, such as monitoring national rates of
nosocomial
6089 (hospital-acquired) infection and comparing
them
6090to internal rates. To make this data meaningful, use
the6091
same definitions and the same populations for effective
risk stratification. Using national data is informative,
6092
6093
but6094
each institution is different, so relying on external
benchmarking
6095 to select indicators for Infection Control or
other
6096processes can be misleading. Benchmarking is a
compilation
6097 of data that may vary considerably if analyzed
Individually,
6098 and its anonymity makes comparisons difficult.
Internal
6099 trending involves comparing internal rates
of one
6100 area or population with another, such as infection
rates
6101in ICU and General Surgery. Trending can help to
pinpoint
6102 areas of concern within an institution, but making
comparisons
6103 is still problematical because of inherent
differences.
6104 Use a combination of external and internal data
to identify
6105 and select reliable indicators.
6106

6107
6108
656-which
6109 of the following is most commonly omitted from
the6110
Q. assessment & improving:
a-reporting
6111 results of studies in a timely manner
b-determining
6112 the effectiveness of actions taken
c-defining
6113 criteria
d-delegating data collection activities
6114

6115
657-a
6116 report that helps customers to evaluate Q. of care &
services
6117 of health plans or providers is required to:
a-show
6118 comparative performance in specific areas
b-identify areas for performance improvement
6119

6120
6121
658-Which
6122 one of the following is not a way to promote
organizational
6123 values and commitment among the staff?
A. 6124
Establish departmental goals as mandated by the
governing
6125 agencies.
B. 6126
Assist teams to develop good listening and collaborative
skills.
6127
C. 6128
Build upon the beliefs of the staff to establish a mindset
for6129
continuous improvement.
D. 6130
Encourage staff to create personal goals within the
organizational Mission and Vision.+++++dr hadia el shukri
6131

6132
659-comparison
6133 of surgical wound infection rate is an eg. of:
a-surgery
6134 profiling
b-practitioner credentialing
6135

6136
660-who
6137 is responsible for providing organizational
direction
6138 for a facility's CQI ?
a- facilitator
6139
b- 6140
Quality council
c- Leader
6141
d- Teams
6142

6143
6144
661-a
6145 facility decide to implement standard precautions
1year
6146 ago ,but compliance of the staff has been poor, to
assess
6147 the causes of poor compliance& improve it, the most
effective
6148 way of the organization is to:
a-initiate
6149 testing as a part of staff competency
b-show
6150 a videotape on standard precautions quarterly
c-review & revise policies & procedures
6151

6152
662-Healthcare
6153 associated infections / injuries is regarded
as:6154
.
a. Sentinel
6155 event
b. Incompliance
6156 with standards.
c. Mal-practice.
6157
d. Negligence
6158

663-The
6159 organizations strategic goals are best linked to its
performance
6160 improvement activities by management
A. 6161
offering many performance improvement models from
which
6162 each area can choose.
B. 6163
assigning improvement models to areas as deemed
appropriate
6164 by the key leaders.
C. 6165
obtaining organizational consensus for continuous
improvement
6166 activities.+++
D. 6167
analyzing the goals and improvement activities of other
similar
6168 organizations

6169
6170
664-design
6171 of piece of device makes error this type of error
is 6172
a. active
6173
b. negligence
6174
c. latent
6175
d. organizational
6176

6177
665-healthcare
6178 quality program had prepared a balanced
score6179card that displayed patient satisfaction was 98%,
financial
6180 target has been met , medication error had been
increased by 30% and heart surgery rate decreased 3% ,
6181
what
6182additional information the governing body may ask
for?
6183
a) Type
6184 of medication error.
b) 6185
Heart surgery case.
c) Patient
6186 satisfaction data.
d) Review patient compliant .
6187

6188
666-brainstorming
6189 is best used to:
a-subdivide
6190 or organize a large no. of ideas
b-identify,
6191 analyze ,or plan solutions to problems
c- identify cause & effect relationships
6192

6193
667-to
6194 display the best reimbursement/cost ratios for
procedures
6195 performed in 3 ambulatory surgery centers in
the6196
last calender year, use a:
a-scatter
6197 diagram
b-pie
6198chart
c-control
6199 chart
d-Pareto chart
6200

6201
668-to
6202 reduce incidence of ventilator associated pneumonia
in ICU,
6203 who should b included in QI team:
a-ICU
6204 nurse, respiratory therapist & internist
b-pharmacist,
6205 nurse manager ,infection control nurse
c-ICU
6206 manager ,respiratory therapist, pharmacist
d-1ry care physician, infection control nurse
6207

6208
669-The
6209 quality of service of care refers to characterisitcs of
the6210setting in which encounter between patient and
clinician
6211 takes place ,,such as :
a-comfort
6212
b-comfort,
6213 care and access
c-comfort ,convenience and privacy
6214
6215
670-Staff
6216 education in organizational change include all of
the6217
following except:
a- negotiating
6218 process
b- project
6219 & time management
c- conflict
6220 resolution
d- budgeting technique
6221
6222
671-when
6223 considering use of external consultant, which of
the6224
follow. Characteristics is important:
a-cost
6225 of consultant's service
b-references
6226 of the consultant
c-leadership's personal preferences
6227

6228
672-A
6229 seamless continuum of care is a:
a. System
6230 oriented process.
b. Client
6231 oriented process.
c. Practitioner
6232 oriented process
d. Managerial oriented process
6233

6234
673-the
6235 First Key to determine when u could evaluate the
current
6236 status of A Quality Improvement Program :
a-Climate
6237 for change in each department and service
b-Extent
6238 of the leadership Knowledge and Improvement in
Quality Activities.
6239
6240
674-The
6241
key goal of Re-engineering is to :
a-improve care process
6242
b-satisfy
6243
the customer
c-position
6244
to change
d-redesign the organization
6245

6246
675-a
6247 nursery home 60% of residents complained of food
that was delivered cold as a quality professional you should
6248
do:6249
a. Call
6250 dietarian and ask for explanation.
b. Review
6251 previous Results & trend data.
c. do
6252nothing

6253
6254
676-Which
6255 of the following information would be most
useful
6256 in performing SWOT analysis?
(A)6257
The experiences of cross-functional teams
(B)6258
Historical data on accounts receivable
(C)6259
A report on the turnover rates of competitors
(D)6260
Trends in market growth

6261
678-All
6262 of these are considered barriers for communication
except
6263 :
a-lack
6264 of interest
b-semantics
6265
c-assumption
6266
d-active
6267 listening

6268
6269
679-Evaluating
6270 medication administration to reduce medical
errors
6271 is an example of
A. 6272
risk management.
B. 6273
utilization management.
C. 6274
quality management.
D. 6275
financial managemen
6276
6277
680-Clinical
6278 performance measures in disease management
programs
6279 are based on
a. standards
6280 of practice.
b. clinical
6281 privilege criteria.
c. clinical
6282 pathways.
d. practice guideline
6283

6284
681-One
6285 standard element of organization-wide strategic
planning
6286 is
A. 6287
determining the future implications of the services
offered
6288 by other healthcare facilities.
B. 6289
analyzing internal services and community needs.
C. 6290
adopting the fiscal and ethical standards of the corporate
model.
6291
D. adopting the strategic plans of successful organizations.
6292
6293
682-In
6294
a managed care organization (MCO), an appeal
following
6295
a denial of care or benefits:
a-may
6296
be reviewed by an independent external review
process.
6297
b-is a formal grievance filed by a patient.
6298
c-is6299
limited to insurance coverage issues.
D-may be reviewed by a patient advocacy group process.
6300

6301
683-As
6302 quality management director at Sunshine
Community
6303 Medical Center, you are conducting
comparative
6304 analysis of the surgical wound infection rate
data between two surgical units. The "p-value" of the chi-
6305
square
6306 test you run will help you draw what conclusion
about
6307 the relationship between the two sets of data?
6308
a-Ratio
6309 of the two rates
b-Standard
6310 deviation of the difference from the mean
c- Proportion
6311 of the relationship
d-Significance of the relationship
6312

6313
684-The
6314 appraisal of individual practitioner performance in
health
6315 care, beyond minimum standards and criteria, is
known
6316 as
A. continuous quality improvement.
6317
B. 6318
intensive analysis.
C. 6319
perceptive quality.
D. peer review.
6320

6321
685- Measuring the time it takes a nurse to perform a

6322
procedure
6323 address which of the following:
A) 6324
Monitoring
B) 6325
Process
C) 6326
Outcome
D) 6327
Structure

6328
6329
686-In6330 any hospital, developing (Continuous Education
Programs)
6331 is usually a function of which of the following
departments?
6332
a) Human
6333 Resources department.
b) 6334
Quality Management department.
c) Risk
6335 Management department.
d) Nursing
6336 department

6337
6338
687- 6339 When hospital (X) is a provider in the network of
providers
6340 which has contracts with the Managed Care
Organization
6341 (Y) in order to provide clinical services for the
enrolees
6342 of the plans offered by this MCO. If the contract
between
6343 hospital (X) and the MCO (Y) will be renewed;
what 6344type of information will be of high importance to the
MCO 6345 to know before renewal of the contract?
a) Admission
6346 rate, charges, and resource utilization.
b) Admission
6347 rate, costs, and resource utilization.
c) Charges
6348 and revenues.
d) None
6349 of the above.

6350
6351
688-The
6352 middle manager should be involved in any CQI
program
6353 under direct supervision from:
a) Governing
6354 body.
b) CEO.
6355
c) Senior
6356 managers.
d) The6357 Quality Council.

6358
6359
6360
689-______________
6361 can be measured by how well evidence-
based
6362 practices are followed, such as the percentage of time
diabetic
6363 patients receive all recommended care at each
doctor
6364 visit, the percentage of hospital-acquired infections,
or 6365
the percentage of patients who develop pressure ulcers
(bed sores) while in the nursing home.
6366
A. 6367
Safe care
B. 6368
Equitable care
C. 6369
Effective care
D. 6370
Timely care

6371
6372
690-healthcare
6373 quality professional can best communicate
organizational
6374 value and commitment through
A-leading
6375 by example
b-Disseminating
6376 monthly newsletters
C-establishing
6377 multidisciplinary task force
D-creating
6378 mission statement

6379
691-Crossing
6380 the Quality Chasm provided a blueprint for
the6381
future that classified and unified the components of
quality
6382 through six aims for improvement, chain of effects,
and6383
simple rules for redesign of healthcare. The six aims for
improvement,
6384 viewed also six dimensions of quality. Which
of the
6385 following is NOT out of those dimensions?
A. 6386
Safe
B. 6387
Care cantered
C. 6388
Efficient
D. 6389
Effective
6390
6391
692-Todays
6392 patients perception of the quality of our
healthcare
6393 system is not favourable. In healthcare, quality is
household
6394 word that evokes great emotion, including:
A. 6395
Frustration and despair, exhibited by patients who
experience
6396 healthcare services first-hand or family members
who observe the care of their loved ones
6397
B. 6398
Anxiety over the ever-increasing costs and complexities of
care
6399
C. 6400
Patient centred measures
D. 6401
Timely care that may be experienced in terms of
performance
6402 of services
Answer:A
6403

6404
693-There
6405 is a story of an intensive care unit (ICU) at
Dominican
6406 Hospital in Santa Cruz Country, California.
Dominican,
6407 a 379-bed community hospital, is part of the 41-
hospital
6408 Catholic Healthcare West system. We used to
replace
6409 ventilator circuit for incubated patients daily
because
6410 we thought this helped to prevent pneumonia,
explained
6411 Lee Vanderpool, vice president. But the
evidence
6412 shows that the more you interfere with that device,
the6413
more often you risk introducing infection. It turns out it
is often
6414 better to leave it alone until it begins to become
cloudy,
6415 or gunky, as the no clinicians say. The hospital
staff learned an important lesson from this experience that:
6416
A. 6417
Evidence is more powerful than intuition
B. 6418
Intuition is more powerful than evidence
C. 6419
Efforts improve mortality rate
D. 6420
Introduction f a new protocol, or any new idea, involves
education
6421

6422
6423
694-A
6424 number of attributes can characterize the quality of
healthcare
6425 services. As, there are different groups involved
in healthcare,
6426 such as physicians, patients and health
insurers,
6427 tend to attach different levels of importance to
particular
6428 attributes and as a result define quality care
differently.
6429 Which of the following is/are NOT out of those
attributes?
6430
A. 6431
Technical performance
B. 6432
Responsiveness to patient preferences
C. 6433
Excess staff
D. 6434
Amenities
6435
6436
695-Quality
6437 and technical performance refers to how well
current
6438 scientific medical knowledge and technology are
applied
6439 in a given situation. It is usually assessed in terms of:
A. 6440
Timeliness and accuracy of the diagnosis
B. 6441
Appropriateness of therapy and other medical
interventions
6442 are performed
C. 6443
The quality of interpersonal relationships
D. 6444
Both A & B

6445
696-The
6446 quality of amenities of care refers to the
characteristics
6447 of the setting in which the encounter between
patient
6448 and clinician takes place, such as:
A. 6449
Comfort
B. 6450
Comfort, care and access
C. 6451
Comfort, convenience and privacy
D. 6452
Responsive to patient preferences
key6453
word is Amenities of care =
the6454
quality of being pleasing or agreeable in situation,
prospect
6455 or any feature that provides comfort, convenience,
or 6456
pleasure e.g. bathroom, ,parking areas. And so on,so (
sure privacy all b needed in bathroom ) and it should be

6457
convenient
6458 ,,,simply :
so 6459
he asked about the Quality of amenities Not Quality of
Care
6460here ,,this the difference between B and

6461
697-Amenities
6462 may cover areas as mentioned below
EXCEPT:
6463
Ample and convenient parking

A. 6464
B. 6465
Good directional signs
C. 6466
Comfortable waiting rooms
D. 6467
Vast and facilitated food providing area

6468
6469
698-as
6470 a result of customer surveys, a new service is
suggested
6471 to be delivered. It should be written in :
a. financial
6472 plan.
b. strategic
6473 plan.
c. quality
6474 management plan.
6475

6476
699-to
6477 increase the effectiveness of reengineering program ,the
quality
6478 professional should :
a. review
6479 policies and procedures.
b. plan
6480 carefully, communicate widely and lead effectively.
c. make
6481 a lecture for employees to define reengineering
6482

6483
700-The
6484 roles and responsibilities of a process improvement
team
6485should be established by which of the following
hospital's
6486 authorities?
(A)6487The board of directors...

(B)6488The human resources department
(C)6489The team members supervisors

(D)6490The quality steering committee

6491

6492
6493
6494
700-The
6495 roles and responsibilities of a process improvement
team
6496should be established by which of the following
hospital's
6497 authorities?
(A)
6498 The board of directors ..
(B)
6499 .(B) The human resources department
(C)
6500 (C) The team members supervisors
(D)
6501 quality steering committe
6502
6503
701- One of the most important follow-up activities for root
6504
cause
6505 analysis (RCA) is to review the database of previous
findings
6506 internally and compare with related external
databases,
6507 if available. The purpose is to also look for
a. common
6508 cause.+++++
b. special
6509 cause.
c. positive
6510 outcomes.
6511
6512
702-_________________
6513 refers to the degree to which
individuals
6514 and groups are able to obtain needed services.
A. 6515
B. 6516
Amenities
C. 6517
Equity
D. 6518
Access
6519
6520 earlier formulations, responsiveness to patients

703-In
preferences
6521 was just one of the fact or seen as determining
the6522
quality of patient clinician interpersonal relationship.
But, now it is translated into many factors. Which of the
6523
following
6524 is out of such factors?
A. 6525
Respect for patients values
B. 6526
Respect for patients preferences
C. 6527
Respect for patients expressed needs
D. 6528
Respect for Respect for patients convenience
6529
704-Efficiency
6530 refers how well resources are used in
achieving
6531 a given result. Efficiency whenever the resources
used to produce a given output are ______
6532
A. 6533
Reduces, reduced
B. 6534
Increases, increased
C. 6535
Improves, reduced
D. 6536
It is truly situation dependent
6537
705-In
6538 general, as the amounts spent on providing services
for6539
a particular condition grow, diminishing returns set in
meaning
6540 that each unit of expenditure yield ever-smaller
benefits
6541 until a point where _____
A. 6542
No additional benefits accrue from adding more care
B. 6543
Additional benefits are too small to justify the added costs
C. 6544
There is displacement of more useful care
D. 6545
perfection is within the reach of all individuals
6546
706-Quality
6547 is the degree to which health services for
individuals
6548 and populations increase the likelihood of
desired
6549 health outcomes and are consistent with current
professional
6550 knowledge. This is the definition of Quality
care often quoted by:
6551
A. 6552
IOM
B. 6553
IHI
C. 6554
HQCB
D. 6555
OCHP
6556
707-Likelihood
6557 of desired health outcomes corresponds to
clinicians
6558 view that, with respect to outcomes, there are
only probabilities, not certainties, owing to factors-such as
6559
patients
6560 genetically determined physiological reliance-that
influence:
6561
A. 6562
The primary concerns of patients
B. 6563
Outcomes of care and yet are beyond clinicians control
Outcomes of care and now are within clinicians control
C. 6564
D. 6565
High cost interventions
6566
708-In
6567 fact, because patients satisfaction is so influenced by
__________________
6568 rather than to the more indiscernible
technical
6569 ones-health maintenance organizations, hospitals
and6570 other health care delivery organizations have come to
view 6571the quality of non technical aspects of care as crucial to
attractions
6572 and retaining patients.
A. 6573
Their reactions to interpersonal and amenity aspect of
care
6574
B. 6575
Patients recognize that they do not possess the
wherewithal
6576 to evaluate all technical elements of care
C. 6577
Every patient has definite preference in every clinical
situation
6578
D. 6579
Their likelihood of desires outcomes
6580
709-Payers
6581 are more likely to embrace the optimization
definition
6582 of care which can put them at odds with:
A. 6583
Clinicians
B. 6584
Health administrators
C. 6585
Physicians
D. 6586
Both A & B
6587
710-The
6588 managers perspective on quality differs markedly
from
6589that of clinicians and patients on:
A. 6590
Efficiency, effectiveness and access
B. 6591
Efficiency, cost effectiveness and equity
C. 6592
D. 6593
Equity, access and technical performance
6594
711-Strong
6595 disagreement do arise, among the five parties
definitions
6596 (i.e. the clinicians, the patients the payers, the
managers
6597 and the societys), even outside the realm of cost
effectiveness.
6598 Conflicts typically arise when:
A. 6599
Practitioners who are highly skilled in trauma and other
emergency
6600 care
B. 6601
Each group emphasizes a particular aspect of care
C. 6602
One party holds that a particular practitioner or clinic is
a high
6603 quality provider by virtue of having high ratings on
single
6604 aspect of care
D. 6605
The facility receives top marks from a team of expert
clinicians
6606 whose primary focus is on technical performance
6607
6608
712-All
6609 the evaluations of quality of care can be classified in
terms
6610 of one three aspects ofcare giving they measure.
Which
6611 of the following is/are NOT out of these measures?
A. 6612
Structure
B. 6613
Process
C. 6614
Output
D. 6615
Cut bas
6616
713-When
6617 quality is measured in terms of structure the
focus
6618is on the relatively static characteristics of the
individuals
6619 who provide care and of the settings where the
care is delivered. These characteristics include
6620
____________
6621 of professionals who provide care and the
adequacy
6622 of the facilitys equipment, and overall
organization.
6623
A. 6624
Education
B. 6625
Training
C. 6626
Certification
D. 6627
A, B and C
6628
714-Licensing
6629 and accrediting bodies have relied heavily on
structural
6630 measures of quality notonly because the measures
are6631
relatively stable and thus easier to capture but:
A. 6632
They reliably indentify providers who are cheap
B. 6633
They reliably identify providers who demonstrably la
means
6634 to deliver high quality care
C. 6635
They can never la the means to deliver high quality care
D. 6636
They reliably identify physicians
6637
715-Ordering
6638 the correct diagnostic procedure for a patient
is a6639
measure of _________. When evaluating the process of
care,
6640however, appropriateness is only half the story. The
other
6641half is in how well and how promptly (i.e. skillfully)
the6642
procedure was carried out.
A. 6643
Consciousness
B. 6644
Appropriateness
C. 6645
Care assessment
D. 6646
Equity
6647
716-Because
6648 of the goals of care can be defined broadly,
outcome
6649 measures have come to include the costs of care as
well as patients satisfaction with care. In formulations that
6650
stress
6651 the technical aspects of care, however outcome
typically
6652 refers to:
A. 6653
Health status-related indicators such as whether the pain
subsided
6654
B. 6655
Desired results
C. 6656
Appropriate and potentially harmless care
D. 6657
Special set of clinical activities
6658
717-Knowledge
6659 about _______ is crucial to making valid
judgments
6660 about quality of care using either process or
outcome
6661 measures. If we know that a given clinical
intervention
6662 was undertaken in circumstances that match
those,
6663 under which the intervention has been shown to be
efficacious,
6664 we can be confident, that the care was
appropriate
6665 and, to the extent of good quality.
A. 6666
Outcomes
B. 6667
Structure
C. 6668
Efficacy
D. 6669
Processes
6670
718-Universities
6671 often evaluate applicants for admission on
the6672
basis of, among other things, the applicants scores on
standardized
6673 tests. The scores are thus one of the criteria by
which
6674 program judge the Quality of their applicants.
However,
6675 although two programs may use the same
criterion
6676 scores on a specific standardized examination-to
evaluate
6677 applicants, the programs may differ markedly on
standards:
6678 One program may consider applicants
acceptable
6679 if they have scores above the 50th percentile,
whereas
6680 the score above the 90th percentile may be the
standard
6681 of acceptability for the other program. This
example
6682 clearly defines the difference between:
A. 6683
Sources and structure
B. 6684
Criteria and standards
C. 6685
Processes and outcomes
D. 6686
Efficacy and equity
6687
719-For
6688 cheking the outcomes our focus of attention is blood
pressure
6689 of patients with diabetes. Its criteria and standard
can6690
be respectively:
A. 6691
Criterion: Percentage of post heart atta patients
prescribed
6692 beta-blokers on discharge and Standard: At least
96%6693of heart atta patients receive a beta-bloker prescription
ondischarge
6694
B. 6695
Criterion: Percentage of patients with diabetes whose
blood
6696 pressure is at or below130/85 and Standard: At least
50%
6697of patients with diabetes have blood pressure at or
below
6698 130/85
C. 6699
Criterion: Sugar level in blood on daily basis and
Standard:
6700 How many times sugarlevel rises and how many
times
6701it declines in a week
D. 6702
None of these
6703
720-When
6704 formulating medical standards, a critical decision
that must be made is the _____at which the standard should
6705
be 6706
set.
A. 6707
Depth
B. 6708
Clarity
C. 6709
Level
D. 6710
utility of measurement
6711
721-Which
6712 of the following is a value-added activity?
A.Inspection
6713
B.Just-In-Time
6714 Inventory
C.Defect
6715 Correction
D.Waiting
6716
6717
6718
722-For
6719 a normal distribution, two standard deviations on
each side of the mean would include what percentage of the
6720
total population?
6721
a. 47%
6722
b. 68%
6723
c. 95%
6724
d. 99%
6725
6726
723-The
6727 roles and responsibilities of a Champion include all
of the
6728 following EXCEPT:
A.A Champion selects the Team Leader.

6729
B.A Champion reviews team progress.

6730
C.A Champion coordinates team logistics.

6731
D.A Champion assures the use of Six Sigma methods and

6732
tools.
6733
6734
6735
724-The
6736 objective of the define phase of a six sigma project
is to define:
6737
A.The
6738 quality policy
B.The
6739 customer, core business process involved and CTQ
business
6740 issues
C.The
6741 statistics work instructions
D.The
6742 procedures manual for control charting
6743
725-What
6744 is the Goal of Lean Manufacturing?
6745
A.Reduction
6746 of defects
B.Elimination
6747 of waste
C.Increased
6748 profits
D.All
6749of the above
6750
6751
726-An
6752 early step in any project must be seeking the voice of
the6753
internal and external customers of a project. This
statement
6754 is:
A.False,
6755 because projects should only be concerned with
external
6756 customers.
B.True,
6757 because both internal and external customers can be
impacted
6758 by the project.
C.True,
6759 because a project team wants to maintain good will
with all customers.
6760
D.False,
6761 because internal projects only impact internal
customers.
6762
6763
727-What
6764 is the best way to select six sigma projects when
addressing
6765 customer satisfaction issues?
A.Problem
6766 Focus
B.Product
6767 Focus
C.Project
6768 Cost Savings Focus
D.Process
6769 Focus
6770
6771
728-The
6772 primary purpose of a project charter is to
(A)6773
subdivide the project into smaller, more manageable
components
6774
(B)6775
provide management with a tool for selecting a project
that addresses business needs
6776
(C)6777
provide management with a tool to ensure that project
deadlines
6778 are met
(D)6779
provide the project manager with authority to apply
organizational
6780 resources to project activities
In 6781
project management, a project charter or project
definition
6782 is a statement of the scope, objectives and
participants
6783 in a project. It provides a preliminary
delineation
6784 of roles and responsibilities, outlines the project
objectives,
6785 identifies the main stakeholders, and defines the
authority
6786 of the project manager. It serves as a "reference of
authority"
6787 for the future of the project. The terms of
reference
6788 is usually part of the project charter
6789
729-Which
6790 of the following is NOT a key element of the
define
6791 phase?
A.Measure
6792
B.Process
6793 mapping
C.Project
6794 charter
6795
6796
730-the
6797 key dimensions of quality that are related to
utilization
6798 management are:
1. appropriateness
6799
2. availability
6800
3. continuity
6801
4. effectiveness
6802
5. Timeliness
6803
6804
731-In
6805 the community health clinic, at least four complaints
have
6806been received per month for the past four months,
compared
6807 to an average of one per month for the six prior
months.
6808 The average number of patients seen per month is
2000.
6809The trigger is >0.2%. What is the appropriate
response?
6810
a. Select
6811 a more useful indicator.
b. Perform
6812 intensive analysis now.
c. Trend
6813 for at least three more months.
d. Reward
6814 the entire staff.
6815
6816
732-Who
6817 is ultimately responsible for the effective
implementation
6818 of the quality program:
a. Governing
6819 Body
b. CEO
6820
c. All
6821staff
d. The
6822 CFO
6823
733-Mission
6824 statement means:
1. what
6825 the organization strives to be?
2. what
6826 to do to be successful?
3. purpose
6827 of the organization
4. where
6828 are we going?
6829
734-Which
6830 part of a job description should be used in a
criteria-based
6831 performance evaluation?
A. 6832
salary grade
B. 6833
duties and responsibilities
C. 6834
working conditions
D. 6835
qualifications
6836
735-based
6837 on your knowledge of motivational theory , which
of the
6838 following would most attract a job candidate
a. job
6839 description ,salary ,benefits
b.job
6840description ,salary ,excellent working relationships
c.job
6841description ,salary ,opportunities to advance
d. salary
6842 ,benefits ,retirement plan
6843
736-teaching
6844 the use of QI ''process tools '' is more effective
when
6845
a.all possible tool options are covered

6846
b. statistical
6847 process control is covered first
c. the
6848team needing the tool is meeting together
d.watching
6849 a videotape
6850
737-in
6851 general accrediting organizations expect to see
conclusions
6852 drawn from quality improvement used in:
a-utilization
6853 review
b-risk
6854 management decisions
c-productivity
6855 management
d-recredentialing
6856 LIPs
6857
738-during
6858 the team meeting, the facilitator should do 1st:
a-choose
6859 homogenous group
b-make
6860 ground rules
c-make
6861 rapport to the group
d- 6862
instruct orders
6863
739-A
6864 medication is ordered for a diabetic patient. Its
capacity
6865 to improve health status, as a dimension of quality
of performance,
6866 is its:
A. 6867Effectiveness
B. 6868Potential
C. 6869Appropriateness
D. 6870Efficacy
6871
6872
740-If,
6873 in the continuous improvement process, we increase
our6874
emphasis on customer satisfaction and outcomes of care,
which
6875 two dimensions of quality/performance must be
incorporated
6876 into all quality management activities?
A. 6877Availability and respect/caring
B. 6878Respect/caring and competency
C. 6879Effectiveness and respect/caring
D. 6880Continuity and competency
6881

6882
741-Review
6883 of the timeliness of high risk screening for
diabetes
6884 addresses which focus?
A. 6885Outcome of care
B. 6886Processes of care
C. 6887Structure of care
D. 6888Administrative procedure
6889
742-The
6890 centerpiece is of outcomes management in
healthcare
6891 is:
A. 6892The measurement of the patient s functionality and

quality
6893 of life
B. 6894Morbidity and mortality

C. 6895Data reliability
D. 6896Financial impact
6897
743-Within
6898 the context of total quality management
philosophy,
6899 communication of quality is:
A. 6900The responsibility of top management leaders
B. 6901Delegated to the quality management department
C. 6902An internal organizational, not community, issue
D. 6903Independent of processes budgets or costs
6904
744-Which
6905 of the following key healthcare issues is more
problematic
6906 for ambulatory care than for inpatient care?
A. 6907Reimbursement of care
B. 6908Access to specialty care
C. 6909Appropriateness of treatment setting
D. 6910Quality of care provided
6911
745-One
6912 fundamental differences between monitoring
product
6913 quality and service quality is based upon the fact
that:
6914
A. 6915A service is easier to measure and verify in advance

B. 6916A service is not perishable

C. 6917A service is more heterogeneous than an object
D. 6918There are more service delays than product delays
6919
746-The
6920 task of setting up an ambulatory care setting
QM/PI
6921 program that focuses on outcomes as a measure of
treatment
6922 effectiveness is difficult because:
A. 6923The patient remains in control of treatment
B. 6924Patient care outcomes are determined by the payer
C. 6925There are no required medical records
D. 6926Expected outcomes for ambulatory conditions are too
obvious
6927
6928
6929
747-The
6930 function in the Juran Quality Management Cycle
that includes the initial analysis of data/information is:
6931
A. 6932Quality planning
B. 6933Quality initiative
C. 6934Quality control/measurement
D. 6935Quality improvement
6936
748-When
6937 common cause process variation is identified, the
goal of quality improvement is to:
6938
A. 6939Promote compliance with established procedure or

protocol
6940
B. 6941Eliminate the variation

C. 6942Improve practitioner competency
D. 6943Reduce variation sufficiently to produce stability
6944
749-Use
6945 the following list of values to answer questions 1- 5:
4 6946 8 12
5 6947 8 12
5 6948 9 15
6 6949 10 18
8 6950 11 19
6951
1. 6952What ?"is the total "N

6953
a. 695411
b. 69558
c. 695619
d. 695715
6958
2. 6959What ?is the range of values

a. 696011
b. 69618
c. 696219
d. 696315
6964
3. 6965What ?is the arithmetic mean

a. 696611
b. 696710
c. 69689
d. 69698
6970
4. 6971What ?is the mode

a. 697211
b. 697310
c. 69749
d. 69758
6976
5. 6977What ?is the median

a. 697811
b. 697910
c. 69809
d. 69818
6982
750-You
6983 are setting up the data collection methodology for a
study
6984 of certain inpatient cardiac procedures, of the
following,
6985 where might you look for the most concise
e. 6986Master patient index

f. 6987Disease index
g. 6988Surgical index
h. 6989Surgical log
6990
751-Management
6991 information systems are designed to be
a. 6992Separate data source
b. 6993Primarily manual
c. 6994Used in decision making
d. 6995Used primarily for long-term data storage
6996
6997
752-When
6998 comparing averaged immunization data from two
pediatric
6999 medical groups, it is appropriate to use
A.Standard
7000 deviation
B. 7001
A t-test
C.A chi-square test
7002
D.Variance
7003
7004
7005
752-The
7006 use of regression analysis to help determine
relationships
7007 between groups of numbers is most closely
associated
7008 with which graphic display technique?
a. Frequency
7009 distribution
d. Scatter
7010 diagram
c. Line
7011 graph
d. Histogram
7012
7013
753-The
7014 ability of a data measurement tool to produce the
same
7015results over a period of time is known as:
a. Sensitivity
7016
b. Specificity
7017
c. Validity
7018
d. Reliability
7019
7020
754-Every
7021 communication carries which two messages?
a. Surface
7022 and hidden
b. Truth
7023 and untruth
c. 7024
Mixed and contradictory
d. Content
7025 and relationship
7026
755- The strategy for conflict resolution that emphasize facts

7027
and7028
finding an appropriate alternative solution, is called
a. Smoothing
7029
b. Negation
7030
c. Forcing
7031
d. Discussion
7032
7033

7034
756-According
7035 to Total Management principles, mangers
must
7036
a. 7037Lead with autocratic decision making

b. 7038Lead with participative decision making
c. 7039Communicate successes or failures only to the boss
d. 7040Concentrate on short-term financial impact of quality
improvement
7041 techniques
7042
757-Which
7043 of the following concerns would be best solved by
a QI ?team
7044
a. A system issue
7045
b. A discipline problem
7046
c. A customer complaint
7047
d. A financial variance
7048
7049
758-What
7050 ?is the best way to deal with conflict in a group
a. A mandate
7051
b. Assertiveness
7052
c. Smoothing
7053
d. Negotiation
7054
7055
7056
759-Which
7057 of the following is a typical size for a customer
focus
?7058group
a. 70591 to 3
b. 70603 to 5
c. 70618 to 12
d. 706215 to 20
7063
7064
760-The
7065 success of a customer focus group rests principally
on 7066
the:
a. Group
7067 size.
b. Length
7068 of meeting.
c. Opinions
7069 of the group.
d. Skill
7070 of the moderator.
7071
761-Which
7072 ?of the following is an example of nominal data
A. 7073
Pre-op, post-op.
B. 7074
AS, BS. MS, PhD.
C. 7075
Temperature.
D. 7076
Mass.
7077
7627078
?.Which of the following is an example of ordinal data
e. 7079Pre-op, post-op.
f. 7080AS, BS. MS, PhD.

g. 7081Temperature.
h. 7082Mass.
7083
763- ?Which of the following is an example of ratio data

7084
a. 7085Pre-op, post-op.
b) 7086AS, BS. MS, PhD.
)c 7087Temperature.
d) 7088Mass.
7089
764-Which
7090 ?of the following is an example of interval data
a. 7091Pre-op, post-op.
b. 7092AS, BS. MS, PhD.
c. 7093temperature.
d. 7094Mass.
7095
765-Which
7096 ?one of the following is a synonym for count data
a) 7097Analog.
b) 7098Continuous.
)c 7099Discrete.
d) 7100Variable.
7101
7102
766- be the least powerful statistically?

7103
a) 7104Interval.
b) 7105Nominal.
c) 7106Ordinal.
d) 7107Ratio
7108
767-The
7109 sampling of 5% or 30 cases, whichever is greater, is
an 7110
example of ____ sampling.
a) 7111Convenience.
b) 7112Expert.
c) 7113Purposive.
d) 7114Quota.
7115
768-Comparing
7116 scores on one-half of a test with scores on
the7117
other half provide ____ reliability.
a) 7118Equivalence.
b) 7119Internal.
c) 7120Paired.
d) 7121Test-retest.
7122
769-The
7123 degree to which an instrument adequately measures
the7124
universe of content is ____ validity:
e) 7125Construct.
f) 7126Criterion.
g) 7127Critical.
h) 7128Face.
7129
770-Which
7130 type of validity uses the opinions of experts to
determine
7131 whether the instrument meets the standards
required?
7132
a) 7133Construct.
b) 7134Criterion.
c) 7135Critical.
d) 7136Face.
7137
7138
771-If
7139 the score on an instrument can be related to the
behavior
7140 that the instrument was supposed to predict then it
possesses
7141 ____ validity.
a) 7142Construct.
b) 7143Criterion.
c) 7144Critical.
d) 7145Face.
7146
772-The
7147 test used to analyze the difference between 2 means
is the:
7148
a) 7149Chi-square.
b) 7150Multiple regression analysis.

c) 7151Regression analysis.
d) 7152T-test.
7153
773-If
7154 you want to predict IV site infiltration based on
osmolarity
7155 of the IV solution and the addition of potassium
to the
7156 IV, you should use:
a) 7157Chi-square.
d) 7160T-test.
7161
774-Which
7162 test is often used by quality managers when data
is counted,
7163 not measured?
a) 7164Chi-square.
d) 7167T-test.
7168
775-Which
7169 of the following is the best confidence interval?
a) 717099%
b) 717195%
c) 717290%
d) 717385%
7174
7175
776-Which
7176 ?of the following is the best level of significance
a) 71770.01
b) 71780.02
)c 71790.05
d) 71800.10
7181
777-Historically,
7182 when the level of significance has been
below
7183 ____ researchers have rejected the null and declared
their
7184results statistically significant.
a) 71850.01
b) 71860.02
)c 71870.05
d) 71880.10
7189
7190
778-The
7191 Delphi technique is a form of ____ sampling:
a) 7192Convenience.
b) 7193Expert.
)c 7194Purposive.
d) 7195Quota.
7196
7197
779-A
7198 freeform generation of ideas best describes:
a) 7199Brainstorming.
b) 7200Delphi technique
c) 7201Motivating.
d) 7202Nominal group technique.
7203
780-An
7204 arrow-type diagram or PERT chart is a type of:
a) 7205Activity network diagram.

b) 7206Deployment chart.
c) 7207Pareto chart.
7208
781-Organizational
7209 profitability is the difference between:
a) 7210Reimbursement minus cost of service.
b) 7211Reimbursement minus charges.
c) 7212Fees minus cost.
d) 7213Cost minus reimbursement.
7214
782-To
7215 increase reliability of care process it is advisable to:
a.Design
7216 tasks around people 's professional skills
b. 7217
Design tasks to meet benchmarking. standards.
c. Design
7218 tasks to ensure a fair market share.
d. Design
7219 tasks to meet the organization goals.
7220
783-Prospective
7221 analysis approaches detect limitations in:
a) 7222Reporting process.
b) 7223Designing process.
c) 7224Implementing process.
d) 7225Monitoring process.
7226
784-Patient
7227 focused care deliver care services through:
a. 7228Unit-based teams.
b. 7229Specialized individuals.
c. 7230Departments.
d. 7231Independent practitioners.
7232
785-The
7233 goal of an integrated service approach is to:
a. 7234Reduce the cost of services
b. 7235Increase the organization financial return
c. 7236Involve top management, leaders, and department
managers
7237 in the process
d. 7238Involve all working personnel in the process
7239
786-Safety
7240 problems are regarded as:
a. 7241Managerial problems
b. 7242Clinical problems
c. 7243Quality problems
d. 7244Administrative problems
7245
787-It
7246 is difficult to predict outcomes of care in:
a. 7247Ambulatory care.
b. 7248Hospice care.
c. 7249Intensive care.
d. 7250Emergency care.
7251
788-Balance
7252 between cost, benefit and risk of under
investigation,
7253 constitutes a major problem in the
management
7254 of:
a. 7255Hospice care.
b. 7256Home care.
c. 7257Ambulatory care.
d. 7258Long-term care.
7259
7260
789-A
7261 patient was admitted to the chest out-patient clinic of
St.7262
Mark hospital suffering from chronic lung insufficiency,
to which
7263 level of care should the patient be referred to be
placed
7264 on a ventilator
a. 7265Emergency care.
b. 7266Intensive care.
c. 7267Sub-acute care.
d. 7268Long-term care.
7269
790-Choosing
7270 the practitioner whether from inside or
outside
7271 the contracted network, is a privilege provided to
customers
7272 of
a. 7273HMOs.
b. 7274PPOs.
c. 7275Point of service.
d. 7276Consumer directed health plan
7277
791-A
7278 patient filed a law suit against a healthcare org. for
removing
7279 his spleen without his consent. The court stated a
monetary
7280 compensation for the patient. This action is
considered:
7281
a. 7282Criminal liability.
b. 7283Expanded liability.
c. 7284Breach of duty.
d. 7285Tort liability.
7286
792-Pre-authorization
7287 is required for all of the following
except:
7288
a. 7289Inpatient acute care.

b. 7290Ambulatory care.+++++
c. 7291Rehabilitation.
d. 7292Psychiatric care.
7293
793-All
7294 of the following can be utilized as measures of
utilization
7295 performance except:
a. 7296Number of encounters in out-patient clinic.
b. 7297ALOS in acute inpatient care.
c. 7298Denials of service.
d. 7299LIPs' appraisal.
7300
7301
794-Case
7302 management is a comprehensive process that
involves:
7303
a. 7304Individual assessment.
b. 7305Assessment of cohorts of similar patient groups.
c. 7306Assessment of each DRG.
d. 7307Assessment of the entire community.
7308
795-A
7309 patient was admitted to the surgical department for
elective
7310 hip replacement, following surgery, the patient
suffered
7311 from diabetic coma, and stated that he is diabetic
since
73125 years. The investigation revealed that the surgeon
never
7313 ordered a blood analysis for the patient prior to
surgery,
7314 this is considered:
a. 7315Negligence.
b. 7316Breach of contract.
c. 7317Incompetence.
d. 7318Lack of professionalism.
7319
796-Compliance
7320 with policies and procedures can be a
useful
7321 tool for:
a. 7322Risk prediction.
b. 7323Risk prevention.
c. 7324Risk avoidance.
d. 7325Risk financing.
7326
797-Evaluation
7327 of financial performance is based on:
a. 7328Cost per unit of service.
b. 7329Direct cost of service.
c. 7330Indirect cost of service.
d. 7331Reimbursement rate.
7332
798-Patient
7333 safety is the responsibility of:
a. 7334Top management.
b. 7335Organization leaders.
c. 7336All working personnel.
d. 7337Patient safety officer / con bb b vvgfmmittee.
7338
7339
799-A
7340 safe environment can be best achieved by involving:
a. 7341Leaders and top management

b. 7342Delegating the responsibility to a cross-functional team
c. 7343Involving staff members organization wide in the
safety
7344 initiatives
d. 7345Establishing a specified committee to review safety

issues
7346 organization-wide

7347
7348
801-surgery
7349 department reported that the review of nursing
instrument
7350 sheet reveals the absence of clamp, an x-ray done
with negative results and the patient is asymptomatic this is
7351
considered
7352 as
a. 7353Potential compensable event
b. 7354near miss
c. 7355malpractice
d. 7356nurse incompetence

7357
7358
802-The
7359 three models for case management are
A.7360
Type of patient care, Focus of patient needs, and
Professional
7361 discipline
B.7362
Type of provider care, Focus of care, and Professional
discipline
7363
C.7364
Type of patient care, Focus of provider, and Professional
discipline
7365
D.7366
Type of provider care, Focus of patient needs, and
Professional
7367 discipline

7368
7369
803-An
7370 Incremental Cost-Effectiveness Ratio is
7371
A. 7372
the equivalent ratio of mandatory costs and projected
costs.
7373
B. 7374
the result of a cost-utility analysis, but stated in ratio
increments.
7375
C. 7376
the same as a cost-effective analysis, but stated in ratio
increments.
7377
D. 7378
the difference between a cost change and an outcome
change
7379

7380
804-Cost
7381 analysis involves cost allocation, in which costs are
determined
7382 as direct or indirect. Direct costs are to indirect
costs
7383as
A. 7384
departmental budget is to the organization.s mission
B. 7385
the organization.s mission is to departmental budget
C. 7386
out-patient costs are to in-patient costs
D. 7387
in-patient costs are to out-patient costs

7388
805-When
7389 developing a departmental budget, which one of
the7390
following need not be considered?
A. 7391
Employee Satisfaction
B. 7392
Strategic Mission and Vision
C. 7393
Controlling costs
D. 7394
Developing Quantitative Plan Records

7395
806-Data
7396 definition is necessary for performance
improvement.
7397 When measuring the frequency and type of
medication
7398 error, you must first
A. 7399
establish what is considered to be a medication error.
B. 7400
determine the need for measuring medication errors.
C. 7401
assemble a team familiar with those who make
medication
7402 errors.
D. 7403
request data regarding medication errors committed
recently.
7404
u need
7405 to know what u will do with data before start
defining
7406 and collecting it to avoid DRIP syndrome
7407
807-What
7408 are the four primary types of events related to
medical
7409 error?
A. 7410
Near-error, Unusual Activity, Sentinel, Adverse
B. 7411
Near-error, Unusual Activity, Sentinel, Anticipated
Outcome
7412
C. 7413
Near-error, Unsafe Activity, Sentinel, Adverse
D. 7414
Near-error, Unsafe Activity, Sentinel, Anticipated
Outcome
7415

7416
808-Risk
7417 Management assessment is a primary concern
during
7418
A. 7419
day-to-day patient care activities.
B. 7420
evaluation of practitioners for credentialing and
privileging.
7421
C. 7422
invasive procedures because of the high-risk equipment.
D. 7423
process evaluation and process improvement.
7424
809- To develop the organization.s patient safety culture, the

7425
CPHQ
7426 will not
A. 7427
establish a commitment for allocation of funds, personnel
and7428
resources.
B. 7429
develop strategic plans that promote patient safety.
C. 7430
evaluate patient safety scenarios based on data-stream
priorities.
7431
D. 7432
identify systemic processes that provide opportunities to
improve
7433 patient safety.

7434
810-Facilitating
7435 the development of a patient safety program
requires
7436 a CPHQ to
A. 7437
identify an interdisciplinary group to manage the safety
program.
7438
B. 7439
define the scope of the team and administrative oversight.
C. 7440
establish procedures for rapidly disseminating medical
errors
7441 reports.
D. 7442
outlining mechanisms to support the findings of sentinel
event
7443investigation.

7444
811-The
7445 most important components of a patient safety
program
7446 are
7447
A. 7448
links to external customers and suppliers based on
outward
7449 data-structures.
B. 7450
a functional infrastructure with a leader, safety officer,
teams
7451 and tracking mechanisms.
C. 7452
procedures for data collection that use data-streaming
and7453
vertical stratification.
D. 7454
reporting systems that allow for organizational
transparency
7455 with all events.
7456
812-In
7457 the past, the Surgery Department at Sunshine
Community
7458 Hospital received a quarterly report with year-
to-date
7459 information concerning the hospitalwide attack rate
of nosocomial
7460 infections, based on 100% surveillance data
from
7461concurrent chart review. Now 100% surveillance is no
longer
7462 performed; the Surgery Department wants to focus
on 7463
the surgical site infection CDC definitions and wants
targeted
7464 studies performed for four procedures that relate to
high-cost
7465 DRGs. The infection control practitioner has
similar
7466 requests from six other departments or section (e.g.,
focus
7467on pneumonia for Medicine and Family Practice
Departments,
7468 urinary tract infection for Urology Section,
etc.).
7469She cannot do everything and is frustrated at their
requests.
7470 In a QI environment, her best solution is to:
7471
a. argue
7472 for a return to 100% concurrent surveillance with
appropriate
7473 staffing.
b. request
7474 QI teams to perform all targeted studies and feed
the7475
data to the appropriate department.
c. requesta
7476 QI team to prioritize the surveillance process
and7477
assure accurate data collection.
d. send
7478 a memo to Utilization Management to do the studies
through
7479 concurrent review
7480
7481
813-At
7482 Sunshine Community Hospital, the quality
professional
7483 is asked to help the Respiratory Department
establish
7484 indicators to measure their performance in the
treatment
7485 of ventilator-dependent patients. This clinical
condition
7486 has been identified by organization leaders as a
Strategic
7487 Quality Initiative and representatives from all
appropriate
7488 departments are on the chartered QI team. The
Respiratory
7489 Department currently views this "study" as
added
7490 work and a "cost issue," not a part of their
departmental
7491 "quality management plan." Use this
information
7492 to answer Questions 2 through 5:
7493
7494
2- The
7495 quality professional, acting as facilitator, meets with
the7496
Respiratory Department QI Task-Team and identifies as
the7497
team's first clinical task:
7498
a. describing
7499 the scope of the problem and possible reasons.
b. identifying
7500 all current Respiratory Department indicators
and7501
criteria.
c. defining
7502 the Respiratory Department scopeof service and
ventilatorcare
7503 process.
d. reviewing
7504 all data collected in past monitoring of
ventilator-dependent
7505 patients.
7506
7507
3- Involving
7508 all appropriate departments/services in
organizationwide
7509 "Strategic Quality Initiatives" is
consistent
7510 with which aspect of the performance
improvement
7511 function?
7512
a. top-level
7513 involvement.
b. collaboration.
7514
c. prioritization.
7515
d. competency
7516 review.
7517
4- What
7518 can the quality professional do to best facilitate
"buy-in"
7519 on the part of the Respiratory Department?
7520
a. restate
7521 the mandate of the leaders to involve all
appropriate
7522 departments.
b. offer
7523 to do all the data collection and initial analysis.
c. providebackgrounddata/information
7524 concerning the
selection
7525 of theinitiative.
d. provide
7526 all available cost data on ventilator dependent
patients,
7527 with breakdown by department.
7528
7529
5- Once
7530 the Respiratory Department has gathered and
aggregated
7531 their data, the Department 01 Task-Team should
: 7532
7533
a. provide
7534 only summary findings; all data collected remains
confidential
7535 to the department.
b. provide
7536 information only to the Medicine Department of
the7537
medical staff, to whom the Respiratory Department
reports
7538 quarterly.
c. provide
7539 the ventilator data and all ongoing monitoring
activity
7540 data related to oxygen use.
d. provide
7541 the ventilator datand the QI team a and initial
findings
7542 to the quality professional.
814-A
7543 bundled payment, as described in the Accountable
Care
7544Act, for an inpatient hospitalization would include:
7545
A. 7546
All costs for hospital-based service
B. 7547
All costs for ancillary services while hospitalized
C. 7548
Costs incurred for 30 days after hospitalization
D. 7549
All of the above
7550
815-Which
7551 of the following is a likely process measure for a
patient
7552 with diabetes mellitus?
7553
A. 7554
Average value of HbA1C testing
B. 7555
hospitalization rates
C. 7556
percentage of patients developing foot ulcers
D. 7557
rates of foot examination?
7558
816-healthcare
7559 organization is in a region with population
that has a high population. The organization should:
7560
A) 7561
Continue to screen affection with G6PD deficiency in
their
7562children. As screening is expensive, the organization
screen
7563 samples only, but the organization found that the
treatment
7564 of undetected cases is more costly than screening
of whole
7565 samples
B) 7566
Screen all the population.
C) 7567
Stop screening
D) 7568
Increase the size of sample
7569
817-Attempts
7570 to align financial incentives of
purchasers,payers
7571 &providers with provider performance
on 7572
clinical process &outcome meadures encourages ......
7573
a.under
7574 utilization
b.community
7575 backlash
c.overutilization
7576
d.reengineering..
7577
818-the
7578 long-run objective of finanical management is to :
a. maximize
7579 the value of hospital common stock .
b. maximize
7580 market share.
c. maximize
7581 return on investement .
d. maximize
7582 earnings per share.
819-Comparing
7583 organization expenses with patient days is a
measure
7584 of:
a, Organization
7585 performance.
b. Staff
7586 accountability.
c. Compliance
7587 of the organization with benchmarking
standards.
7588
d. Productivity.
7589
820- Written structure, process and outcome criteria against

7590
which
7591 actual patient chart are screened to assess the
adequacy
7592 of intervention efforts is known as:
A. 7593
audit
B. 7594
critical pathways
C. 7595
diagnosis related groups
D. 7596
utilization review
7597
821-A
7598 primary purpose of an information management
system
7599 is to allow an organization to
7600
A .7601
save time .
B .7602
centralize demographics .
C .7603
reduce cost .
D .7604
evaluate data
822-Which
7605 of the following monitors provides patient
outcome
7606 information?
7607
A .7608
healthcare-acquired infection rate
B .7609
nursing care documentation compliance
C .7610
antibiotic therapy discontinuation compliance
D .7611
equipment malfunction rate
7612
7613
823-As
7614 the Director of Quality at Hospital X, you have been
appointed
7615 to lead a team to improve patient flow through
the7616
hospital system.
At 7617
your first team meeting, some people expressed their
excitement
7618 over the new project while others were unsure of
their
7619rles and responsibilities. After several meetings, team
members
7620 disagreed on various issues, sometimes leading to
heated
7621 debates. Cliques began to form within the group, and
some
7622members resisted taking on more tasks. Collective
decisions
7623 were difficult to make. Over the next few weeks,
the7624
team gradually began to respect your authority as the
team
7625leader. As team members knew one another better,
they began to work more closely and socialize together. It is
7626
evident
7627 that the team has developed a stronger commitment
to the
7628 team goal. Meaningful progress is finally being made
but7629
your participation is still required.
What
7630 is the term commonly used to describe the current
stage
7631of team development?
7632
a. Norming
7633
b. Performing
7634
c. Forming
7635
d. Storming
7636
7637
824-A
7638 quality professional needs to assign a staff member to
assist
7639a medical director in the development of a quality
program
7640 for a newly
established
7641 service . Which of the following staff members is
MOST
7642 appropriate for this project?
7643
A .7644
a newly hired staff member who has demonstrated
competence
7645 and has time to complete the task
B .7646
a knowledgeable staff member who works best on
defined
7647 tasks
C .7648
a motivated staff member who is actively seeking
promotion
7649
D .7650
a competent staff member who has good interpersonal
skill
7651
825-Discharge
7652 planners regularly monitor the number of
inappropriate
7653 referrals, the timeliness of discharge
planning,
7654 and the number
of days
7655 of discharge delays . What additional monitor should
be 7656
added to evaluate the appropriateness of discharge
planning
7657
interventions?
7658
7659
A .7660
adequacy of documentation in progress notes
B .7661
attainment of discharge planning goals
C .7662
timeliness of referrals to discharge planning
D .7663
number of discharge planning referrals from nursing
7664
826-A
7665 well-designed patient safety program should include
all 7666
of the following EXCEPT
7667
A .7668
an annual patient safety committee meeting .
B .7669
planned response to adverse events .
C .7670
orientation and continuing education on patient safety
issues
7671 .
D .7672
review of patient safety policies and procedures for all
departments
7673
827-A
7674 healthcare organization must have a Risk
Management
7675 plan to obtain liabilityinsurance. Which of the
following
7676 lists is best for a Risk Management plan?
7677
A. 7678
Statement of Purpose, Goals, Program Scope,
Procedures,
7679 Design Mechanisms
B. 7680
Statement of Purpose, Goals, Design Mechanisms,
Policies,
7681 Data Sources
C. 7682
Statement of Purpose, Goals, Program Scope, Policies,
Data
7683Sources and evaluation
D. 7684
Statement of Purpose, Goals, Team Member Evaluations,
Procedures,
7685 Data Sources
7686
828-When
7687 an expert consultant is hired to assist with the
Performance
7688 Improvement project , the CPHQ should
7689
A. 7690
allow the consultant to establish the necessary goals for
the7691
project.
B. 7692
ask theconsultant for an itemizedjob descriptionthat s/he
will7693
follow.
C. 7694
defer to the consultant regarding time frames and
deadlines.
7695
D. 7696
provide the consultant with an organizational chart
indicating
7697 lines of authority.
829-The
7698 champions of the Performance Improvement Team
7699
A. 7700
monitor of all of the teams day-to-day activities.
review the teams overall efforts and provide guidance
B. 7701
and7702
direction.
C. 7703
counsel, but are not accountable for the teams efforts.
D. 7704
support, but require the team to keep all interested
parties
7705 informed.
7706
830-To
7707 facilitate change within an organization, a CPHQ
should
7708
7709
A. 7710
obtain reference information from other organizations.
B. 7711
maintain every aspect of the plan as long as it is in place.
C. 7712
participatein developing andimproving a commonvision
of care.
7713
D. 7714
keep the plan for each department confidential from the
others.
7715
7716
831-Which
7717 one of the following is not an issue that must be
resolved
7718 when developing a Performance Improvement
Plan?
7719
7720
A. 7721
Assign key leaders at all levels of responsibility within the
organization
7722
B. 7723
Determine consistent terminology for documenting
planned
7724 activities
C. 7725
Allocate personnel to the Quality Council to oversee
activities
7726 required in the plan
D. 7727
Create an Oversight Group of the Governing Board to
supervise
7728 the Quality Council
7729
832-Your
7730 freestanding Radiology Center did 200 outpatient
CT7731
scans each of the last two years. The average
reimbursement
7732 rate has been decreased from 200$ to 100$.
The scanner and room need repairs estimated at 100.000$.
7733
there
7734are two other CT scanners in your immediate vicinity.
The most likely decision resulting from a cost-benefit

7735
analysis
7736 would be to:
.A.7737
Quit doing CT scans
B. 7738
Repair the scanner
C. 7739
Contract with a competitor for referral fees
D. 7740
Market heavily and postpone the repairs for 6 months

7741
833-managed
7742 competition in healthcare most often refers to:
7743
a.healthcare
7744 providers administered by competing
management
7745 companies.
b. healthcare
7746 providers competing by Diagnosis Related
Group
7747 (DRG).
c. Grouped
7748 healthcare providers competing within a
geographic
7749 region.
d. managed
7750 care organizations.

7751
7752
834-The
7753 Quality Management cycle, based on Juran's
Quality
7754 Trilogy (quality planning, quality control, quality
improvement)
7755
7756
a. excludes
7757 the lab's activities to monitor equipment.
b. requires
7758 a departmentalized approach to quality
management.
7759
c. encompasses
7760 only the nonclinical aspects of OM.
d. incorporates
7761 information from strategic planning.

7762
835-The
7763 most basic components of managed care include all
except
7764
a.
7765prepaid financing.
7766b. comprehensive services at multiple levels and
7767settings.
7768c. controlled access to services.
7769d. broad choice of providers.
7770
836-In
7771 managed care, the most common form of
mimbursement
7772 for primary care physicians is
a. straight
7773 salary.
b. capitation
7774 without withholds.
c. capitation
7775 with withholds.
d. discounted
7776 fee-for-service.
7777
837-A
7778 hospital utilization management plan generally
includes
7779 provision for:
A. 7780
Disaster planning
B. 7781
Transition planning
C. 7782
Quality planning
D. 7783
Financial planning
7784
838-It
7785 is important to identify customer-supplier
relationships
7786 to improve methods, to meet customers needs,
and7787
to increase internal awareness. Which of the following is
the7788
best example of a horizontal internal customer-supplier
relationship?
7789
7790
A. 7791
Administrators-Board of Directors
B. 7792
Administrators-Nursing Executives
C. 7793
Directors of Nursing-Charge Nurses
D. 7794
Charge Nurses-Registered Nurses with BSNs
7795
839-After
7796 defining "internal" and "external" customers,
your
7797organization is making a master list of each type of
customer
7798 before initiating a major change process. Of the
following,
7799 which is the best next question to ask of staff?
7800
a. Who
7801 do you receive services from?
b. Who
7802 in your work day do you serve?
c. Which
7803 patients receive your services?
d. How
7804 do you know a customer from a supplier?
7805

7806
840-Being
7807 immediately responsive and attentive to a familys
concerns
7808 following a patients fall in the subacute care
facility
7809 is:
A. 7810
Loss reduction activity
B. 7811
Loss prevention activity
C. 7812
Risk shifting activity
D. 7813
Risk avoidance activity

7814
841-In
7815 your organization, Quality management (QM) and
Risk
7816Management (RM) are separate departments. As QM
Director,
7817 you recognize the importance of linking with RM
to prevent
7818 or reduce risk and maximize patient safety. Use
this7819
information to answer questions 1 & 2
7820
7821
1- How
7822 can Quality Management link with Risk
Management
7823 on peer review cases
A. 7824
Provide information about peer review actions
B. 7825
Provide information about patient occurrences
C. 7826
Provide aggregate occurrence data
D. 7827
Meet with RM Director regularly in confidence
7828
2-Of the following, sharing which data supports risk

7829
prevention?
7830
A. 7831
Annual practitioner profiling
B. 7832
Monthly event/occurrence reporting
C. 7833
Root cause analysis
D. 7834
Failure mode and effects analysis

7835
842-even
7836 with good process,errors may occur,,knowing this
..leaders
7837 should depend on..:
a-strict
7838 policy
b-performance
7839 feedback
c-customer
7840 survey

7841
843-most
7842 appropriate educational programme during
merger:
7843
a-rapid
7844 cycle
b-organizational
7845 change

7846
844-In
7847 the transition from quality assurance to quality
management/quality
7848 improvement, which of the following
emphases
7849 has resulted in the most significant benefit?
7850
a. Focusing
7851 primarily on process rather than individual
performance
7852
b. Focusing
7853 on organizationwide rather than clinical
processes
7854
c. Organizing
7855 activities around patient flow rather than
department
7856 or discipline
d. Initiating
7857 more prospective rather than retrospective
improvement
7858 efforts

7859
845-strategic
7860 planning is:
a-mission,vision,values,goals,objectives
7861
b-master
7862 plan,customer,quality initiatives

7863
846-Reasons
7864 for using pre-certification as a prospective
review
7865 method include all of the following, except:
7866
A. 7867
It enables the UM staff at the MCO to perform a pre-
admission
7868 review on the case
B. 7869
It enables the MCO to divert the case to the provider with
the7870
lowest prices.
C. 7871
It enables the MCO to capture data for more accurate
estimation
7872 of financial accruals rather than waiting for
claims
7873 to come in.
D. 7874
The MCO uses the pre-certification process to verify the
member's
7875 eligibility for coverage
7876
BBB.....MCO
7877 concern with effectiveness & efficiency of the
care delivered......
7878
A...UM
7879 review..promote effeciency & medical necessity & this
is important
7880
C.... estimate financial accurals...promote risk management &
7881
this7882
is important
D...member
7883 eligibility to coverage ....also promote efficiency
while..BB...lowest
7884 price of provider ..not by itself a goal
So,7885
my answer is BBBB

7886
7887
847-standard
7888 of care is:
a-based
7889 on what an ordinary prudent person of like training
and7890
expertise would do for a specific condition
b-an expression of the ideal care that the pt needs and
7891
expects
7892 to receive for a specific condition
c-based
7893 on locale where the individual receives care
d-not
7894acceptable in a court of law for a malpractice case
7895

7896
7897
848- patients are key customer in PI..of the following what is
7898
the7899
most accurate way to measure patient perception of care
after
7900completion of treatment:
7901
a-log
7902and analyze expressed pt outcome
b-collect
7903 data on returns to emergency departement, revisits
to primary
7904 care and re admission to acute care
c-utilize
7905 pt satisfaction surveys, sampling each quarter
d-utilize
7906 pt health out come questionaires for specific
illnesses
7907

7908
7909
849-The
7910 Organizational Culture comprises the attitudes,
beliefs,
7911 and behaviors of thoseinvolved in the organization.
The four basic types of Organizational Cultures areStable-
7912
Learning,
7913 Group, Independent, and
A. 7914
Dependent.
B. 7915
Secure.
C. 7916
Insecure.
D. 7917
Environmental

7918
850-Timely
7919 intervention is MOST likely possible with a ____
review
7920 system.
A. 7921
concurrent
B. 7922
focused
C. 7923
prospective
D. 7924
retrospective

7925
851- 7926hoshin planning most valuable step is
A. 7927
Roll down ofstrategies to departmentallevel
B. 7928
Annual reporting
C. 7929
Use of PDCA
D. 7930
Prioritization of goals

7931
852-In
7932 the "language" of strategic planning, the "strategies"
of the
7933 organization can also be called
7934
a. objectives.
7935
b. critical
7936 success factors.
c. goals.
7937
d. the
7938 dashboard.

7939
853-The
7940 capability of the indicator to describe the feature of
interest,
7941 expresses its:
7942
a. Credibility.
7943
b. Reliability.
7944
c. Validity.
7945
d. Clarity.
7946

7947
854-An
7948 organization asks a Q professional to help in
preparedness
7949 to a survey of accreditation body,the Q
manager
7950 will first
a.assigna
7951 team for the project
b.arrange
7952 for a mock survey
c.educate
7953 the staff about the Q that they may be asked
d.review
7954 the adherernce of org to accreditation standards

7955
7956
855-of
7957 the following the most effective quality -based
management
7958 of human resources involves
7959
a.hiring,training,appraising,firing
7960
b.hiring,training,appraising,promoting
7961
c.hiring,training,appraising,employee
7962 relations
d.hiring
7963 ,retaining,promoting ,appraising

7964
856-healthcare
7965 quality programe has prepared a balanced
score
7966card that displayed pt satisfaction was 98%..financial
targets
7967 has been met,medication error increased by 30
%..and
7968 heart surgeries decreased by 3%..what addidtional
information
7969 should the GB ask for..:
a-type
7970 of medicationerror
b-heart
7971 surgery case
c-pt satisfaction data
7972
d-review
7973 pt complaints

7974
857- 7975in a health care organization ,CEO requested the most
effective
7976 recommendations to assess the organization
readiness,,which
7977 of the following methods should the
healthcare
7978 Q proffesional recommend first..:
a-administer
7979 survey to evaluate org culture
b-review
7980 of performance up result
c-contract
7981 a Q.consultant to conduct review
d-walk
7982 through the org

7983
7984
858-a
7985 descriptive measure derived from a population is
known
7986 as:
a-parameter
7987
b-statitsic
7988
c-data
7989
d-precision
7990

7991
859-provision
7992 of safty services must be consistent with :
a_patient
7993 perespective
b_practitioner
7994 credentialing
c_best
7995 practice
d_organization
7996 initiatives

7997
860-The
7998 hospital management asked you, as a social worker,
to conduct
7999 a survey that measure caregiver attitudes about
six8000
patient safety-related domains, to compare themselves
with 8001 other organizations, to promote interventions to
improve
8002 safety attitudes, and to measure the effectiveness of
these8003interventions. What these domain scales?
8004
A. 8005
Teamwork climate, job satisfaction, perceptions on risk
management,
8006 safety climate, optimal personal factors, and
stress
8007 recognition.
B. 8008
Safe, timely, effective, efficient, equitable, and patient-
centered.
8009
C. 8010
Leadership competencies, culture of work, shared
leadership,
8011 perceptions on management, policies, and
external
8012 partnerships.
D. 8013
Effective communication, creative people, high-alert
leaders,
8014 external partnerships, timely effective care, and
punitive
8015 reaction.

8016
861-In
8017 one of the first class high quality hospitals in
Newcastle,
8018 Ministry of Health yield a survey about what is
the8019impact of safe culture of work on the caregivers? As a
quality
8020 man, What is not expected to find in the final report
of the
8021 survey?
A. 8022
The staff did not worry that their mistakes will be
reported
8023 in their personnel file.
B. 8024
The staff belief that their weakness points will not be used
against
8025 them.
C. 8026
The highest percentage of staff reported that no
significant
8027 adverse events had occurred in their setting
during
8028 the past 12 months.
D. 8029
Low average composite score involved questions related
to nonpunitive
8030 response to error.

8031
862-In
8032 an integrated delivery system, the success of the
quality
8033 strategy is most dependent on the effectiveness of the
a. information
8034 system.
b. Ql
8035team process.
c. case
8036 management process.
d. patient
8037 care management system.

8038
863-Clinical
8039 decision support systems can support
medication
8040 safety by alerting prescribers to
8041
A. 8042
patient compliance and allergies.
B. 8043
the need for dose adjustments and patient weight
changes.
8044
C. 8045
drug interactions and patient weight changes.
D. 8046
allergies and drug interactions.

8047
8648048
- A key physician /licensed independent practitioner QM
function
8049 is
a. Researching
8050 criteria options for specialty- specific peer
review
8051
b. Determination
8052 of what constitutes a deviation from
accepted
8053 standard of care
c. Determination
8054 of data collection methodology for non-
physician
8055 clinical reviewers
d. Tabulation
8056 of peer review data for periodic committee
reporting
8057

8058
865-Which
8059 of the following is NOT requirement for an
organization
8060 wide QM program?
a. 8061
Quality management activities include the use of
performance measures in peer review activities.
8062
b. 8063
Peer review problems are resolved and opportunities for
improvement are taken
8064
c. 8065
Reports to the governing body include the findings from
peer review activities
8066
d. 8067
The effectiveness of the program, including peer review
is evaluated
8068

8069
866-The
8070 Wellness Medical and Healthcare Center uses a
multi-level
8071 medical record review system to monitor clinical
care 8072that cannot be evaluated through their electronic stat
systems.
8073 Nurses, other clinical staff, health information
management
8074 staff, and physicians participate. physicians
usually
8075 do all except:
a. 8076
Review /confirm variations in trend data
b. 8077
Review selected cases to confirm noncompliance with
criteria
8078
c. 8079
Provide oversight monitoring of non-physician clinical
reviewers
8080
d. 8081
Screen cases for peer review

8082
867-What
8083 of the following is the greatest benefit of
concurrent
8084 clinical review?
a. 8085
Ability to focus review on prioritized performance
measures
8086
b. 8087
Ability to review outcomes of care and process
c. 8088
Timely assessment at the onset of care for continuity
d. 8089
Timely intervention to reduce risk of adverse outcomes

8090
8091
868-In8092 conjunction with hospital credentialing, clinical

privileges
8093 are granted
a. 8094
Only to members of the medical/professional staff
b. 8095
To all employees performing clinical procedures
c. 8096
To all licensed independent practitioners
d. 8097
Only to active members of the medical/professional staff

8098
8099
869-In
8100 the large healthy Community Medical Group, one
general
8101 surgeon has an 8% rate for both superficial and
deep 8102incisional surgical site infections for cases performed
from 8103October through March , 60 % higher than the
average
8104 for the other general surgeons in the group . in
conjunction
8105 with the medical director, what should the
quality
8106 professional do next?
a. Compare
8107 with local and national average in infection rates
b. Determine
8108 the surgeon risk-adjusted case mix and practice
patterns
8109
c. Compare
8110 with the rates of general surgeons in other surgical
groups
8111
d. Take 8112cases to the peer review body

8113
870-Operative/
8114 other procedure review is the responsibility
of 8115
a. 8116
The medical staff
b. 8117
The organization leaders
c. 8118
The Quality council
d. 8119
Those providing the care and service

8120
871-Most
8121 commonly the primary purpose for
incident/occurrence
8122 reporting is to
a. 8123
Record infection rates
b. 8124
Identify medication errors
c. 8125
Identify adverse patient events
d. 8126
Identify patient grievances

8127
872-Failure
8128 mode and effects analyses (FMEA) is what type
of review
8129 of improvement tool?
a. 8130
Concurrent
b. 8131
Focused
c. 8132
Prospective
d. 8133
Retrospective

8134
873-Which
8135 of the following four types of processes listed that
are8136associated with review of medication use, blood/blood
product
8137 use, or operative and other procedures use (hospital
or 8138
ambulatory care), which would most likely fall under the
purview
8139 of utilization management?
a. 8140
Indications/appropriateness
b. 8141
Preparation/dispensing
c. 8142
Administration/ performance
d. 8143
Monitoring effects

8144
874-The
8145 appropriateness of care is:
a) 8146Primarily a focus of utilization management.
b) 8147A key dimension of quality care.
c) 8148Equivalent to case management.
d) 8149The degree to which healthcare services are coherent
and8150 unbroken.

8151
875-Total
8152 quality management philosophy assumes that:
a. 8153Most problems with services delivery result from
systems
8154 difficulties.
b. 8155Frequent inspection is necessary to improve quality.
c. 8156Most problems with services delivery result from
difficulties
8157 with individuals.
d. 8158Top management leadership in quality activities

disenfranchises
8159 employees.

8160
876-The
8161 major difference between traditional quality
assurance
8162 activities and the expanded quality
improvement/performance
8163 improvement activities is the
QI/PI8164 focus on:
e) 8165People and competency
f) 8166Analysis of data
g) 8167Performance measures
h) 8168Systems and processes

8169
877-Organizational
8170 culture most often refers to:
a. 8171The ethnicity of the organizations employees and
8172 licensed independent practitioners
b. 8173Assumptions about people and how work gets done
c. 8174The efforts to reach the diverse groups in the
8175 community
d. 8176The scheduled social and cultural events within the
8177 organization

8178
878-Applying
8179 the Pareto Principle in quality improvement
is: 8180
a. 8181Prioritizing process issues
b. 8182Tracking and measuring process effectiveness
c. 8183Providing meaningful data to support strategic
8184objectives
d. 8185Prioritizing patient outcome issues

8186
879-A8187 hospital generally has a unique structure comprised
of a8188triangle which three entities make up the triangle?
a. 8189Governing body, administration, finance
b. 8190Administration, department managers, medical staff
c. 8191Governing body, administration/management, medical
8192 staff
d. 8193Administration, medical staff, nursing

8194
880-The
8195 best evidence of the incorporation of quality
planning
8196 into the organization wide strategic planning
process
8197 might be:
a. 8198Successful quality initiatives
b. 8199The organization wide plan for provision of patient
8200 care
c. 8201The quality management/quality improvement plan
d. 8202The quality management/quality improvement budget

8203
881-Strategic
8204 planning is best described as:
a. 8205A long-term focus, projecting the present into the
8206 future
b. 8207A set of top-level performance measures
c. 8208A statement of mission, vision, and values
d. 8209An ongoing look into the future

8210
882-In
8211 an organization wide QI model, the person or group
usually
8212 accountable for continuously assessing and
improving
8213 performance at the department level is the
a.8214Cross-functional QI team
b.8215Quality council
c.8216Department director
d.8217Department team

8218
883-A8219 large emergency department (ED) reduced its average
length
8220 of stay for discharged patients from 130 minutes to 1
hour 8221with a goal to improve patient satisfaction. How best
might8222 ED know the changes were also effective financially,
as 8223
part of a cost-benefit analysis?
a.8224Decreased staffing and decreased costs
b.8225Increased staffing and increased net revenue
c.8226Increased patient volume and increased net revenue
d.8227Increased patient volume and increased staffing

8228
884-A8229 quality professional in a home health care agency is

charged
8230 to develop a quality management/quality
improvement
8231 strategy. Of the following steps, which should
be 8232
done first?
a. 8233
Develop strategic quality initiatives
b. 8234
Determine the roles of leaders in implementation
c. 8235
Draft the QM/QI plan for review by leaders
Review the organizations scope of care and service
d. 8236

8237
885-Which
8238 of the following is not relevant to include in both
utilization
8239 management and quality management plans?
a.8240 Confidentiality policy
b.8241 Process for appealing treatment denials
c.8242 Conflict of interest policy
d.8243 Provision for annual program evaluation

8244
886-An
8245 85-year-woman is admitted through the emergency
department
8246 with a fractured right hip. When should
discharge
8247 planning begin?
a.8248After surgery, once the physical therapist has done an
assessment
8249
b.8250When the physician writes a discharge planning order
c.8251At time of admission to the acute hospital
d.8252When the decision is made concerning the next level of
care
8253

8254
887-Negligence
8255 means a lack of proper care, in medical
malpractice
8256 proper care is determined by:
a.8257JCAHO standards
b.8258Jury of civilian peers
c.8259Tort law
d.8260Medical peers

8261
888-The
8262 utilization management committee for a large
medical
8263 group is concerned about underutilization. Which
data 8264 supports the concern?
a.8265Lab report delays
b.8266Reduced pediatric hospitalization rates
c.8267Increased incidence of C-Sections
d.8268Reduced pediatric immunizations rates

8269
889-The
8270 term performance as used in healthcare quality
improvement
8271 activities, refers to:
a.8272The effective execution of functions and processes
b.8273An interactive series of process steps
c.8274A statement of expectations
d.8275A demonstration during accreditation survey

8276
890- 8277 The most effective way to ensure patient safety as a

dimension
8278 of performance is to:
a) Sponsor
8279 a hotline for reporting problems
b) Focus
8280 on processes and minimize individual blame
c) Have
8281 leaders who commit to and foster a safe culture
d) Encourage
8282 patients and families to identify risks

8283
2. 891-
8284 The responsibility to reduce risks of endemic and
epidemic
8285 nosocomial infection is vested in:
a) 8286The organization
b) 8287An interdisciplinary committee
c) 8288A qualified infection control practitioner
d) 8289The attending physician

8290
8928291
In any quality management approach, how can best
evaluate
8292 the effectiveness of action taken?
a) Use the same performance measures to re-monitor
8293
8294 the process
b) Formulate a new special study to monitor the action
8295
c)
8296 Interview the staff involved in implementing the
8297 action plan
d) Do nothing. Effectiveness is expected with well-
8298
8299 planned action

8300
893- An orthopedic surgeon in a surgical group refuses to

8301
accept
8302 high postoperative site infection rate for joint cases
over the last year. What could the QM professional try next
8303
to convince
8304 him?
a) Present
8305 the data to all the orthopedic surgeons using
practitioner
8306 names
b) Do
8307nothing with the surgeon, continue to measure
8308 peers outside the group review all the surgeons
c) Have
cases
8309
d) With
8310 the medical director, show the surgeon the data
compared
8311 to peers
8312

8313
894-Root
8314 cause analysis is the most the most appropriate PI
process
8315 for:
a) Determining
8316 costs/benefits
b) Evaluating
8317 dental care
c) Analysis
8318 sentinel events
d) Performing
8319 peer review
8320

8321
895- The benefits of studying a process include all of the

8322
following
8323 EXCEPT
A. 8324arriving at a common understanding.

B. 8325eliminating errors.
C. 8326eliminating inconsistencies.
D. 8327highlighting obvious problems.
8328

8329
896-The
8330 second sponge count at the end of a hernia repair
operation
8331 on an obese patient was incorrect. This was
confirmed
8332 by repeat sponge counts, and the surgeon
eventually
8333 located and retrieved the missing sponge. The
patient's
8334 recovery was uneventful.
The healthcare professional should

8335
A. 8336conduct root cause analysis.

B. 8337perform failure mode and effects analysis.
C. 8338continue to monitor incident reports of inaccurate
sponge
8339 counts from the Operating Room.
D. 8340recommend retraining of Operating Room staff to
better
8341 track surgical instruments and sponges during
surgical
8342 procedures.
8343

8344
897- 8345 A point prevalence survey in 2010 showed that the
overall
8346 prevalence proportion of healthcare-associated
infections
8347 in a hospital system was 7.3%. In 1990, the
prevalence
8348 proportion was 8.1%. A hypothesis test for the
difference
8349 between the two prevalence proportions gave a P-
value8350of 0.029.
Which
8351 of the following is the most accurate interpretation of
the8352
results?
A. 8353The prevalence of healthcare-associated infections in

2010
8354is significantly lower than that in 1990.
B. 8355The prevalence of healthcare-associated infections in
2010
8356is lower than that in 1990, but there is a small chance
that,
8357in reality, there was no difference in the prevalences.
C. 8358The prevalence of healthcare-associated infections in
2010
8359is higher than that in 1990 but there is a moderate
chance
8360 that, in reality, there was no difference in the
prevalences.
8361
D. 8362The prevalence of healthcare-associated infections in
2010 8363is slightly lower than that in 199

8364
8365
898- Which of the following is most effective in
8366
communicating
8367 instructions to patients before their
discharge
8368 from hospital?
A. 8369In addition to clear verbal instructions, the caregiver

conveys
8370 all instructions in written form.
B. 8371The caregiver gives verbal instructions on more tha
than one occasion before the patient's discharge from
8372
hospital.
8373
C. 8374The caregiver communicates the same instructions to a
member
8375 of the patient's family.
D. 8376The caregiver communicates instructions to the patient
and8377
thenasks the patient to explain what he/she has just
been
8378informed to do.
8379
8380

8381
8382
8383
899- Among the following factors, competency assessment of
8384
staff is LEAST influenced by data related to
8385
A. 8386productivity.
B. 8387feedback from patients, families, and staff.
C. 8388performance improvement findings relative to
performance
8389 standards in the job description.
D. 8390knowledge of administrative policies and procedures.
Question
8391 was not answered.

8392
900-The
8393 senior leaders of a managed care organization have
consulted
8394 a healthcare quality professional on the purchase
of a8395
clinical data management software system to support
performance
8396 improvement.
Which
8397 of the following is the most important issue in
identifying
8398 the system requirements?
A. 8399Users' need for customized graphs and tables.

B. 8400The number of existing computer terminals.
C. 8401The organization's goals for the data management
system.
8402
D. 8403Integration with existing information systems.

8404
8405
901-A 8406 team in a healthcare facility is working on a project to
improve
8407 access to primary care. The average length of time
to the8408 "third next available" appointment was chosen as an
outcome
8409 measure. Which of the following is the most
appropriate
8410 balancing measure
A. 8411Number of new patient visits.

B. 8412Percentage of patients satisfied with phone access.
C. 8413Individual panel size.
D. 8414Office visit cycle time.
Question
8415 was not answered.

8416
998-The
8417 formal functions of management include all except:
A. 8418Planning
B. 8419Organizing
C. 8420Directing
D. 8421Inspecting

8422
999-The
8423 principle underlying the selection of an
organization-wide
8424 quality council is:
A. 8425One oversight body

B. 8426Leadership control
C. 8427One-cross functional team
D. 8428Elimination of department/service quality control
8429

8430
8431
1000-Why
8432 should a UM plan include a conflict of interest
statement
8433
A. 8434To provide for unbiased decisions
B. 8435To prevent economic credentialing
C. 8436To provide for security and integrity of information
D. 8437To provide immunity for physician reviewers

8438
1001-The
8439 key advantage of case management in Managed
care 8440is:
A. 8441Control of clinical risk
B. 8442Control of hospital use
C. 8443Coordination of care
D. 8444Prevention of illness

8445
1002-The
8446 written scope of care and service of a healthcare
organization
8447 is best described as:
A. 8448A plan describing the linkages between care processes
and8449 outcomes
B. 8450The delineated activities performed by governance,
management,
8451 clinical and support personnel
C. 8452A logical sequence of operations to be performed to
care 8453 for and serve delineated populations of patients
D. 8454An interactive series of steps, processes, functions, and
systems
8455

8456
1003-
8457 The key issue in integrating the functions of
utilization
8458 management, quality management, and clinical
risk
8459management resolves around:
A. 8460Consolidation of leadership
B. 8461Information management
C. 8462Control by the quality council
D. 8463Cross-training staff

8464
1004-According
8465 to total quality management principles,
managers
8466 should:
A. 8467Lead with autocratic decision making
B. 8468Communicate successes or failures only to the boss
C. 8469Lead with participative decision making
D. 8470Focus on short term financial impact of quality
improvement
8471 techniques

8472
1005-Medical
8473 center had begun performing angioplasty
procedures
8474 for cardiac patients in anticipation of providing
cardiovascular
8475 surgery services. The administration then
failed
8476 to negotiate a contract with the cardiac surgery team
of physicians.
8477 The hospital and its cardiologists then
negotiated
8478 an exclusive contract with another hospital in the
area 8479 to refer all cardiac patients needing angioplasty to that
facility.
8480 This action constitutes:
A. 8481Risk retention
B. 8482Risk avoidance
C. 8483Risk shifting
D. 8484Risk prevention

8485
1006-Your
8486 hospital case management program monitors
length
8487 of stay (LOS) by condition. LOS for four conditions
has8488
decreased slightly each of the last six quarters. To
evaluate
8489 cost and quality of care impact, you recommend
which
8490 measures?
A. 8491Denials, comparison with previous two years LOS,
readmissions.
8492
B. 8493Staff productivity changes, reimbursement, LOS at
next level of care
8494
C. 8495Reimbursement, comparison with conditions with

increasing
8496 LOS, denials
D. 8497Outcome of transition plan, reimbursement,
readmissions
8498

8499
1007-In
8500 revising the Utilization Management (UM) Plan,
which8501 of the following is most important to consider?
A. 8502External UM contract requirements
B. 8503Accreditation survey results impacting UM
C. 8504UM performance measures results+++
D. 8505Clinical pathway length of stay variances

8506
1007-
8507 75 years old women with right Hip replacement
surgery
8508 , fall from bed in hospital to floor and the other hip
was8509
fractured. Risk manager visit the patient family and
told them the hospital will be written off. This action is:
8510
8511
A. 8512
Risk loss.
8513
B. 8514
Risk shift.
8515
C. 8516
Risk identification.
8517
D. 8518
Potential compensated event.

8519
8520
8521
1008-
8522 Strategic management does not include:
8523
A. 8524
Creating a fit between the organization and its external
environment.
8525
8526
B. 8527
Facilitate consistent decision making.
8528
C. 8529
Foster anticipation, innovation and excellence.
8530
D. 8531
Make day to day work flow easy.

8532
1009-Health
8533 care quality program had prepared a balance
score8534card, that displayed: patient satisfaction was 98%,
financial
8535 target has been met , medication error had been
increased
8536 by 30%, and the heart surgery rate decrease 3%.
What 8537 additional information the governing body may ask
for? 8538
8539
A. 8540
Type of medication error.
8541
B. 8542
Heart surgery case.
8543
C. 8544
Patient satisfaction data.
8545
D. 8546
Review patients complaint.

8547
1010-Which
8548 of the following could best be solved by quality
improvement
8549 team?
8550
A. 8551
Customer complaints.
8552
B. 8553
Claim issue.
8554
C. 8555
Financial problem.
8556
D. 8557
Administration issue.

8558
1011-During
8559 the process of strategic planning, the
organization
8560 should look for the basic components, like:
8561
A. 8562
Internal and external environment.
8563
B. 8564
Human resources.
8565
C. 8566
Finance.
8567
D. 8568
Management.

8569
1012-To
8570 increase the impact of reengineering and to assure
the8571greatest opportunity for success, the quality leader
should
8572 first
8573
A. 8574
Select conduct review.
B. 8575
Plan carefully, communicate widely and lead effectively.
C. 8576
Define the concept of reengineering to employees.
D. 8577
Develop policies first.

8578
8579
1013-The
8580 most important initial step in preparation for
accreditation
8581 survey is
8582
A. 8583
Ensure clinical competency.
8584
B. 8585
Provide teaching tools.
8586
C. 8587
Standards education.
8588
D. 8589
Quality improvement activities.

8590
8591
1014-Health
8592 care quality professional has been asked to
present
8593 information to senior leadership about hospital
publicity.
8594 The report should include:
8595
A. 8596
Clinical expert.
8597
B. 8598
Computer training.
8599
C. 8600
Comparison of data with benchmark.
8601
D. 8602
Customer satisfaction.

8603
8604
1015-In
8605 a health care organization, chief executive officer
requested
8606 the most effective recommendations to assess the
organization
8607 readiness. Which of the following method
should
8608 health care quality professional recommend first?
8609
A. 8610
Administer survey to evaluate organization culture.
8611
B. 8612
Review of performance up result.
8613
C. 8614
Contact a quality consultant to conduct a review.
8615
D. 8616
Walk through organization.

8617
8618
1016-Which
8619 of the following is the least important in
developing
8620 a standard of practice?
8621
A. 8622
Clinical knowledge of peer.
8623
B. 8624
Search finding.
8625
C. 8626
Patient expectation.
8627
D. 8628
Clinical trials.

8629
1017-For
8630 continuous quality improvement team to be
successful,
8631 who must be included in the team?
8632
A. 8633
Administrator.
8634
B. 8635
Department supervisor.
8636
C. 8637
Staff.
8638
D. 8639Facilitator.

8640
8641
1018-The
8642 responsibility to pass quality improvement values
to the
8643 organization is of the:
8644
A. 8645
Leader.
8646
B. 8647
Quality professionals.
8648
C. 8649
Senior staff.
8650
D. 8651
Accreditation agency.

8652
1019-To
8653 gain the leadership commitment for performance
improvement
8654 projects, the quality professional should focus
first8655on which of the following:
8656
A. 8657
Importance of the project on employee satisfaction and
financial
8658 health of the organization.
8659
B. 8660
Importance of the project on the accreditation status and
the8661
clinical process.
8662
C. 8663
Importance of the project on the financial health and
accreditation
8664 status of the organization.
8665
D. 8666
Effect of the project on the community.

8667
1020-The
8668 important things for a particular team are:
8669
A. 8670
Culture of the group.
8671
B. 8672
Norms of behavior.
8673
C. 8674
Values of the group.
8675
D. 8676
Language communicated by the group.

8677
1021-After
8678 providing training, the trainer evaluated the
increased
8679 skill within the trainees; this is considered what
level of evaluation?
8680
8681
A. 8682
Reaction level.
8683
B. 8684
Results level.
8685
C. 8686
Behavior level.
8687
E.
8688Learning level.

8689
8690
1022-Training
8691 within an organization should be delivered to
which
8692 levels?
8693
A. 8694
Group by group training.
8695
B. 8696
Just on time training.
8697
C. 8698
On price tag training.
8699
D. 8700
Individualized training.

8701
8702
1023-To
8703 enhance coping of the desired behavior by the
employees,
8704 you should:
8705
A. 8706
Punish the undesired behavior makers.
8707
B. 8708
Make rewards on the desired behavior.
8709
C. 8710
Make the desired behavior appear as normal
requirement
8711 and needs no recognition.
8712
D. 8713
Blame and change the undesired behavior makers.
8714

8715
1024-One
8716 of the team members that keep members on track
and8717 focus on the process is:
8718
A. 8719
Leader.
8720
B. 8721
Facilitator.
8722
C. 8723
Quality manager.
8724
D. 8725
Minutes recorder.

8726
1025-An
8727 example of integrating results of a utilization
management
8728 assessment in the performance improvement
process
8729 is:
8730
A. 8731
Educate case manager in discharge planning.
8732
B. 8733
Hiring more nurses.
8734
C. 8735
Reporting assessment results to executive staff.
8736
D. 8737
Assessing results of patient satisfaction survey.
8738
8739

8740
8741
1026-Analysis
8742 of events, trends, and customer need is the
initial
8743 phase of:
8744
A. 8745
Resource management.
8746
B. 8747
Strategic planning.
8748
C. 8749
Forecasting.
8750
D. 8751
Cost/benefit analysis.
8752

8753
1027-The
8754 key to creating sustained value in the organization
is to
8755
8756
A.8757
Delegate policy-making and oversight to the quality
council
8758
B.8759
Develop s strategic that derives from the version,
strategic goals, and cost benefit analyses
8760
C.8761
Adopt an organizational ethics policy and code linked to
mission, vision, and values
8762
D.8763
Act on predictive performance measures aligned to
strategic goals and departmental objectives
8764

8765
1028-8766 The person/group legally responsible for maintaining

quality
8767 patient care is the
A.8768
Governing body
B.8769
Quality improvement council
C.8770
D.8771
Medical/ professional staff

8772
1029-8773 "Organization function" refer to

A.8774
Key governance, management, clinical, and support
activities
8775
B.8776
Functions of the governing body
C.8777
Cross-functional team activities
D.8778
Legal and fiduciary obligations to patients

8779
1030-Which
8780 of the following statements refers only to
strategic
8781 planning and not to the former traditional "master
planning
8782 "?
A.8783
Planning focuses primarily on producing new services
B.8784
Planning begins with the statement of mission
C.8785
Planning is an integral part of management
D.8786
Planning ignores the political environment of the
organization
8787

8788
1031-The
8789 mission statement of the organization describes
A.8790
Where the organization is going
B.8791
The purpose of the organization
C.8792
The strategic direction of the organization
D.8793
The long-term goals of the organization

8794
1032-A8795 team has been selected from all linked services in

several
8796 healthcare organizations in the WeCare Health plan
network
8797 to address information management . the best term
describes
8798 a team is
A. Departmental
8799
B. Service-line
8800
C. Interdepartmental
8801
D. Cross-function
8802 ional

8803
8804
1033-Strategic
8805 leadership is linked to success in meeting
A.8806
budget requirements
B.8807
Intended objectives
C.8808
Governing body policy
D.8809
Contract requirements
8810

8811
1034-In
8812 crises situation, when a manger must make a rapid
decision,
8813 the most effective leadership style is:
A.8814
Consultative
B.8815
Participatory
C.8816
Autocratic
D.8817
Democratic

8818
8819 the "Quality based strategic planning" model

1035-In
A.8820
Representatives from each active QI team from the
strategic planning team
8821
B.8822
The steering council leads strategic planning as an
ongoing activity
8823
C.8824
Licensed independent practitioners lead the strategic
planning effort and formulate the performance measures
8825
D.8826
Input from management and staff is the key assessment
activity
8827

8828
1036-As
8829 a performance measurement system, the key value
of the
8830 ""balanced scorecard" concept is its ability to
A.8831
Serve as a comparative "report card" with like
organizations
8832
B.8833
Focus the organization on financial measures of survival
and success
8834
C.8835
Encompass all the organization's clinical and non clinical
measures
8836
D.8837
Align measurement with the vision and strategy of the
organization
8838

8839
1037-Leadership
8840 during a lengthy period of crises in the
organization
8841 is
A.8842
Based on the leader's position in the organization
B.8843
A participative activity performed by anyone committed
to lead
8844
C.8845
Dependent on a set of personal characteristics
D.8846
An autocratic style with decision made solely by the
leader.
8847

8848
1038-Having
8849 management pay attention to workers'
activities
8850 results in
A.8851
Decreased anxiety
B.8852
Decreased productivity
C.8853
Increased anxiety
D.8854
Increase productivity

8855
1039-You
8856 have joined the newly merged preferred health, a
for-profit
8857 integrated delivery system (IDS), as Vice
President
8858 for quality. You are responsible for reengineering
or 8859
otherwise integrating the QM/QI function across the
provider
8860 network. Based on your understanding of systems,
corporate
8861 culture, ethics, quality , leadership's influence ,
and8862
strategic planning, answer the questions :
8863
1-Which
8864 of the following statements and document are most
likely
8865 to reveal the organization's underlying or true value
system?
8866
A.8867
Mission, ethics policy, strategic initiatives
B.8868
Vision, ethics policy, corporate bylaws
C.8869
Values, QM/QI plan, utilization management plan
D.8870
Mission , vision, values
8871
8872
8873
8874
2-The8875 measures most indicative of the IDS' ability to provide
value8876to its stakeholders are:
A.8877
Improvement in patient outcomes and reduced costs of
car
8878
B.8879
An annual report with a positive bottom line
C.8880
Improvements in patient outcomes and patient
satisfaction
8881
D.8882
Reduced costs of care and competitive pricing

8883
1040-
8884 Utilization review includes all of the following except:
A.
8885Readmissions.
B.
8886Post-hospital care.)to red. Readdmesion)
C.
8887Referrals.
D.
8888Peer review.
Answer:
8889 B
Post Hospital care = follow up service
8890
Referrals
8891 & readmissions measure premature discharge
"underutilization"
8892 and complication of care
Peer review, can judge Doctors level of utilization in
8893
comparison
8894 to peers

8895
1041-For
8896 effective UM, integration of data concerning all of
the8897following is mandatory except:
a. Risk
8898 management.
b. Case
8899 mix.
c. Professional
8900 liability.
d. Severity
8901 of illness.

8902
1042-Community
8903 case management program targets:
A. Acute
8904 cases.
B. Chronic
8905 cases.+++
C. Epidemic
8906 conditions.
D. Endemic
8907 conditions.
8908

8909
1043-Risk
8910 insurance coverage is a mechanism used by
healthcare
8911 - organizations as a means of:
A. 8912
Risk prevention.
B. 8913
Risk transfer.
C. 8914
Risk control.
D. Risk
8915 retention.

8916
1044-8917 Patient safety goals focus on:
A. 8918
Identifying problematic areas in healthcare.
B. 8919
Identifying means of patient satisfaction / dissatisfaction.
C. 8920
Describing critical / clinical pathways.+
D. 8921
Describing expected healthcare personnel roles and
responsibilities,
8922

8923
1045-The
8924 executive nurse of the ICU discovered that the
night8925shift nurse has prepared a unit dose of the medications
required
8926 for each patient in the unit, but she did not label
the8927bottles, she only wrote the patient names on the bottles.
The 8928best decision in such a situation is:
A. 8929Give each patient the medication labeled with his / her
name.8930
B. 8931Send the bottles to the pharmacist to identify and label
each.8932
C. 8933Discard all the bottles immediately.
D. 8934Bring another sample from each drug registered for
each 8935 patient

8936
8937
1046-All
8938 of the following are challenge facing the
implementation
8939 of the EMR, but the most challenging is:
A. 8940
Cost
B. 8941
Resistance of physicians to change
C. 8942
complexity
D. 8943
Maintaining the confidentiality of patient information

8944
1047-Incident
8945 reporting is a tool for:iq
A. 8946
Early warning
B. 8947 Establishing a penalty system.

C. 8948 Identification of organizational threats and
opportunities.
8949
D. 8950 Performance of gap analysis.

8951
1048-Incident
8952 reporting is indicated for all of the following
except:
8953
A. 8954 Death of a recipient of care.
B. 8955 Attempted suicide of a recipient of care.
C. 8956 Increase post-surgical infection rate.
D. 8957 Medication error.

8958
1049-A
8959 process variation that did not affect an outcome, but
its 8960
recurrence carries the risk of an adverse outcome is a /
an:8961
A. 8962
Near miss.
B. 8963
Adverse event.
C. 8964
Potential compensable event.
D. 8965
Negligence.
8966
8967
1050-pain
8968 management is one of the major component of
a. Home
8969 care
b. Hospice
8970 care
c. Emergency
8971 care
d. Ambulatry
8972 care
8973

8974
8975
1051-A
8976 company comprising 500 employees, negotiated the
delivery
8977 of comprehensive package of health services to its
employees
8978 during the coming year, to be paid as a fixed rate
on 8979
monthly basis. This is mechanism of payment is:
a. 8980 Case rate.
b. 8981 Per-diem charges.

c. 8982 Capped rate.
d. 8983 Capitation rate.

8984
8985
8986
1052-A
8987 patient was admitted to El-Salama hospital suffering
from 8988liver insufficiency which required treatment for an
average
8989 of one week. during his stay, the patient developed
broncho-pneumonia
8990 which prolonged his stay for 3 more
days.8991The insurance company denied responsibility for the
extra89923 days, this is justified under:
a. 8993 DRG system.
b. 8994 Capitation system.
c. 8995 Capped rate system.
d. 8996 Case rate system.

8997
8998
1053-The
8999 insurance mechanism which entails paying a fixed
rate 9000per visit by the insured, while the insurer covers the
rest9001of the required expenses according to the care provided
is: 9002
a. 9003 Capitation.
b. 9004 Co-payment.
c. 9005 Deductible.
d. 9006 Fee- for service.

9007
9008
1054-After
9009 3 days of an abdominal surgery, the patient
developed
9010 severe pain. The ultrasonography revealed the
presence
9011 of some surgical gauge in the patient's abdomen.
This 9012 state of negligence
refers
9013 to:
a. 9014 Expanded liability.
b. 9015 Corporate liability.
c. 9016 Res Ipsa Loquitur
d. 9017 Tort liability.

9018
1055-Discharge
9019 planning for elective procedures
differs
9020 from traditional discharge planning in being
conducted:
9021
a. 9022Directly after patient admission.

b. 9023Before patient discharge.
c. 9024Before patient admission.
d. 9025After patient discharge.

9026
1056-Disease
9027 management is a coordinated system of
healthcare
9028 interventions for populations with all of the
following
9029 characteristics, except:
a. 9030Significant potential for improvement.
b. 9031Treatment by both primary care and specialist
physicians.
9032
c. 9033High risk of sudden changes.

d. 9034No variation in practice patterns.-

9035
1057-Discovering
9036 the need for dealing with the problem of
"look
9037 alike drugs" due to repeated medication errors, the
QP9038
proposed the administration of unit-dose medications.
This approach is considered a means for:
9039
a. 9040Risk avoidance.
b. 9041Risk transfer.
c. 9042Risk prevention.
d. 9043Risk prediction.

9044
1058-An
9045 80 years old patient fell while being transferred
from
9046his room to the radiology department. The patient
developed
9047 fracture hip due to the fall. This event is
considered:
9048
a. 9049An act of mal-practice.

b. 9050A potentially compensable event.++++
c. 9051An adverse patient occurrence.
d. 9052Negligence of conduct.

9053
1059-A
9054 healthcare organization decided to adopt a new
culture
9055 to enhance patient safety, the top management
should
9056 concentrate on all of the following except:
a. 9057Changing individual behaviors.

b. 9058Changing the organization mission, vision and goals.
c. 9059Enhancing the organization infra-structure.
d. 9060Changing systems and processes.

9061
1060-to
9062 re-enforce a "Just" culture:
a. 9063Seek out and punish staff members involved in

reckless
9064 behaviors.
b. 9065Avoid the discussion of errors to avoid blame.
c. 9066Discuss errors on the level of leaders, top management
and9067
department managers.
d. 9068Support the organization wide discussion of errors

and9069
communicate lessons learned.

9070
1061-A
9071 chest x-ray was prescribed for an 80 years old
patient
9072 with renal insufficiency. on the way to the x-ray
department;
9073 the patient-being unattended- slipped and fell.
The 9074best decision in such a situation is:
A. 9075 Tell the patient's family the whole truth and offer them
an 9076
apology and appropriate compensation.
B. 9077 Ignore the issue, until addressed by the family.
C. 9078 Manipulate the circumstances to avoid organizational
blame.
9079
D. 9080 Seek the responsible and punish him /her to satisfy the
family.
9081

9082
1062-All
9083 of the following information is crucial for
enhancing
9084 safe medication except:
A. Drug
9085 standard dosages.
B. Drug
9086 means of storage.
C. Drug
9087 labels.
D. Drug
9088 chemical constituents.

9089
1063-
9090 Read-back process involves:
a. The
9091 donor of the information repeats the message twice.
b. The
9092 recipient of the message repeats the received order.
c. The
9093 donor of the message must first have it written down.
d. The
9094 recipient receives only written messages.
9095
9096
9097

9098
9099
1064-Apanel
9100 of care providers decided on a certain
treatment
9101 plan for a patient, the plan included some
indispensable
9102 drugs that may cause some adverse
reactions,
9103 the best choice in such a situation is:
A. 9104Avoid informing the patient about the possible
adverse
9105 reactions to ensure his compliance.
B. Inform
9106 the patient of the whole plan and discard it if he
disagree.+++++
9107
C. Apply
9108 the treatment plan and inform the patient if
any
9109 of the expected adverse reactions did occur.
D. Discard
9110 the whole plan without informing the
patient
9111 and shift to other medications even if it did
not
9112 produce the desired effect.

9113

9114
1065-Pre-operative
9115 verification process includes all
of the
9116 following, except:
A.
9117Correct person
B.
9118Correct procedure
C.
9119Correct diagnosis
D.
9120d.Correct site

9121
1066-Plan
9122 of patient care is based-on:
A. 9123
Patient needs and values.
B. 9124
Benchmarking standards.
C. 9125
Professional credentials,
D. 9126
Accreditation standards.

9127
1067-Prioritization
9128 of problems to be addressed is based on:
A. 9129
The potential for harm.
B. 9130
Organization mission, vision and code of ethics.
C. 9131
Professional credentials.
D. 9132
Level of care.

9133
1068-Among the most important contributing factors to

safety is:
A. Effective communication.
B. Patient's age.
C. Efficient reporting mechanisms
9134
D. Availability of patient safety committee.

9135
9136
1069-Patient
9137 safety goals must be consistent with all of the
following,
9138 except:
A. 9139Accreditation standards
B. 9140Organization mission
C. 9141Patient needs
D. 9142Staff credentials

9143
1070-The
9144 primary safety goal is to prevent:
A. 9145 Negligence.
B. 9146 Patient fraud.
C. 9147 Accidental injury.
D. 9148 Sentinel events.

9149
1071-In
9150 reducing medication errors, CPOE involves
alerting
9151 the Prescriber to all of the following except:
A.
9152Exceeding the upper ceiling of the drug.
B.
9153The in efficacy of the drug to patient condition.
C.
9154The patient being allergic to the drug.
D.
9155The interaction of the prescribed drugs with others
9156the patient is receiving.

9157
1072- 9158 BPOC serves to prevent medication errors in the:

A. 9159Administration phase
B. 9160Transcribing phase
C. 9161Prescribing phase
D. 9162Dispensing phase

9163
1073-Incident
9164 reporting is performed by:
A. 9165 CEO.
B. 9166 Top management.
C. 9167 Quality council.
D. 9168 Any employee.

9169
9170
1074-An
9171 event that entails zero % acceptability is regarded
as:9172
A. An adverse event.
9173
B. A
9174 sentinel event.
C. A
9175 near miss
D. A potential compensable event
9176
E. 1075-
9177 Read this story then answer questions 1 & 2
A
9178 24 years old woman delivered a full term female
infant in the maternity ward of a public hospital. The
9179
following day the mother and child were discharged.
9180
On reaching home the mother discovered that the
9181
hospital has given her a baby boy instead. On
9182
investigation it was discovered that this event has
9183
happened twice before.
9184
1-This
9185 event should be investigated as:
An
9186 act of negligence.
9187 An adverse event.

9188 A sentinel event.
9189 A potential compensable event.
2-The
9190 recommended way to deal with such event is to:
9191 Report and perform a root cause analysis.
9192 Compensate the family and conceal the occurrence.
9193 Find who is responsible and punish.
9194 Put control barriers to prevent recurrence of such
event.
9195

9196
9197
1076-A
9198 sentinel event is regarded as a:
a. Common cause
9199
variation.
9200
b. assignable variation.
9201
c.Noise.
9202
d.Random
9203 variation.

9204
1077-Removal
9205 of the left leg, when the right leg was the
diseased
9206 part that required removal, would be seen legally
as 9207
9208
A. 9209
non compis B. quid pro quo
C. 9210
res Judicata D. res ipsa loquitor

9211
9212
1078-Grouped
9213 healthcare providers competing in a given
geographic
9214 region would most likely be called
9215
A. 9216
case management B. managed care
C. 9217
managed competition D. prospective payment

9218
1079-A
9219 managed care plan is said to have undergone
favorable
9220 selection when it(s)
9221
A. 9222
members are sicker than the average person in the
capitated
9223 population
B. 9224
members are healthier than the average person in the
capitated
9225 population
C. 9226
makes less money than previous years
D. 9227
makes more money than previous years
Answer
9228 B
The most accepted answer is the cost effective but here no
9229
mix9230
of answers (Money +Health) so we will go for Health
9231
9232

9233
1080-Providers
9234 who traditionally serve large numbers of low
income
9235 and uninsured people are termed
9236
A. 9237
indemnity health plan
B. 9238
provider sponsored organization
C. 9239
point-of-service option
D. 9240
safety net providers
9241

9242
1081-Which
9243 of the following situations best describes the
term 9244Misuse of Resources at healthcare facilities?
a) Patients
9245 receive appropriate medical services that are
provided
9246 poorly, exposing them to added risks of
preventable
9247 complications.
b) 9248
Patients undergo treatment or procedures from which
they do not benefit.
9249
c) Patients
9250 do not receive beneficial health services.
d) None
9251 of the above
A is 9252misconduct or mal practice, C is under utilization

9253
1081-Mortality
9254 reviews are a critical element of Risk
Management
9255 and Quality Improvement, conducted to
determine
9256
A. 9257
if the practitioner(s) involved was/were appropriately
licensed
9258 and credentialed.
B. 9259
if treatments and patient care were adequate and
appropriate.
9260
C. 9261
who was responsible for the mortality and what
disciplinary
9262 actions need to be taken.
D. 9263
what the unit staff was doing at the time of the mortality.

9264
1082-The
9265 first assessment step the CPHQ makes to prevent
risks
9266to the patients, the staff, or the organization is to
A. 9267
evaluate the corrective actions.
B. 9268
identify potential risks.
C. 9269
analyze the risks.
D. 9270
create an evaluation team.

9271
9272
1083-An
9273 organization-wide early warning system should be
in place
9274 to screen patients and identify
A. 9275
departments that carry the highest risk.
B. 9276
high-risk incidents that occurred within the past 24
hours.
9277
C. 9278
assessments that should be conducted when a risk
incident
9279 occurs.
D. 9280
adverse patient occurrences and potentially compensable
events.
9281

9282
1084-Utilization
9283 management assessments measure
A. 9284
how practitioners utilize Performance Improvement data.
B. 9285
the use of services, procedures and facility resources.
C. 9286
how employees utilize outcomes and manage daily
responsibilities.
9287
D. 9288
the use of high-risk
9289
9290
9291
Thanks For Our Team

9292
( IN ALLAH WE TRUST )
9293
9294
-DR/AHMED
9295 ATA
9296 -DR/AMANI
9297 ALI
- DR/RASHA
9298 ABDELSALAM
DR/ALMOTAZ
9299 BELLAH MOHAMED
-DR/EMAN
9300 MOSTAFA
9301 -DR/SHIMAA
9302 DIAB
-DR/MOHAB
9303 MATER
9304
9305
9306
9307
9308 TOGETHER
9309 EVERY ONE
9310 ACHIEVE
9311 MORE
9312
9313
9314

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2014 NOITSEUQ 1000 QHPC TSURT EW HALLA NI

8 74 quality performance improvement focused on

9 81 according to pare to principle, in the era of quality

10 88 the function which describes the assessment of

11 96 the most appropriate to evaluate case manager

19 102 strategy of brain storming

A. 103 Discussion of issues

20 112 main function of clinical pathway is

A. 113 Convert medicine into mathematics

21 118 a 75 year patient with right side hip replacement

A. 121 Risk resistance

A. 127 Business plan

23 133 the best way to display LOS variation is

A. 134 Line graph

24 140 the best way to communicate the reduction of falls results

C. 143 It's better to hide such data

25 146 SBAR is a tool for

A. 147 Calculate average LOS

26 153 when 2 facilities have a network, what is the most cost

A. 155 When the patient don't have to repeat investigations in

27 164 first tool to use in Root cause analysis is

A. 165 why diagram

28 171 0-occurance 100 % analysis is

A. 172 Occupancy report

C. 174 Cause and effect analysis

29 178 vision statement represents the organization

A. 179 Domain of action for a year

30 184 the most appropriate design for strategic management is

A. 185 Vision mission core values goals

31 189 The most appropriate sequence for strategic management

32 196 it's noticed that increase aggressive behaviour among

34 211 the member - group responsible for continuous

35 219 the ultimate responsibility of implementation of quality

36 227 the quality professional reviews the surgical consents

37 236 When comparing your performance against field top

38 242 to protect your organization against unannounced

39 250 just culture means

A. 251 Culture of no abuse

40 257 last step in FMEA methodology is

A. 258 Analysis of effects

41 264 first step in strategic management is

A. 265 External and internal analysis

42 271 Hoshin planning most valuable step is

A. 272 Roll down of strategies to departmental level

43 278 if your department has contract with another facility to

d. 298 Regression value

A. 449 Generate a policy of restraining all patients

D. 452 Make a system of early identification of patient

A- 601 The benefits of teams

A- 616 Measuring performance of processes & their outcomes

B- 618 Taking action to improve the way the processes are

C- 620 Studying & understanding the complex process that

A- 639 cost benefit analysis

D- 642 resource allocation

A- 647 may present bias due to difference in reporting practices

A- 670 Patient satisfaction

A- 698 be accomplished by healthcare quality professional

A- 708 review aggregate results of employee performance

B- 710 Hire a consultant to conduct personal interview of staff

D- 712 Administer surveys to evaluate organization culture.

A- 719 Recommend continued measurement of the indicator.

A- 727 description of educational programs

A- 735 prevented by review of evidence based practice