Deck 15: Continuous Quality Improvement, Risk Management, and Program Evaluation

Question 1

Which organization attempts to develop and implement a case mix classification system that can provide a basis for Medicare and Medicaid payments as well as serve as a quality monitoring system?

A)The Joint Commission
B)The Institute of Medicine
C)The Multistate Nursing Home Case Mix and Quality Demonstration
D)The National Committee for Quality Assurance

Answer 1

The Multistate Nursing Home Case Mix and Quality Demonstration

Question 2

Which organization developed standards for nursing practice that became the basis for quality assurance programs?

A)The Joint Commission on Accreditation of Hospitals (JCAH)
B)The American Nurses Association (ANA)
C)The Hospitals Association
D)Centers for Medicare & Medicaid Services

Answer 2

The American Nurses Association (ANA)

Question 3

Extraneous variables can confound the effects of the experimental variable and are therefore sources of internal invalidity.If subjects are lost from the comparison groups,the source of internal invalidity is said to be:

A)History
B)Instrumentation
C)Selection
D)Experimental mortality

Answer 3

Experimental mortality

Question 4

Which event during the 1940s helped the United States realize the need for a prepaid payment system that would relieve the burden on the sick person and ensure that the hospital and hospital expenses were paid?

A)Development of durable medical suppliers
B)Creation of disability insurance
C)Development of antibiotics
D)Formation of the American Medical Association

Question 5

Several tools are available to analyze information once it is collected.Which tool is used to identify the root causes of a problem or outcome?

A)Bar graph
B)Fishbone diagram
C)Benchmarking
D)Check sheet

Question 6

Which quality management philosopher believed in a system that creates quality by prevention of errors instead of appraisal?

A)Deming
B)Juran
C)Donabedian
D)Crosby

Question 7

Both leaders and managers have a responsibility for quality improvement.A manager's function is to:

A)Build a culture of disparity
B)Determine discrepancies between care provided and standards
C)Be proactive rather than reactive
D)Encourage the use of electronic systems

Question 8

Establishing the validity of the tools used to measure the extent of goal achievement is an important step in continuous quality improvement.Which type of validity is theory oriented?

A)Content validity
B)Construct validity
C)Concurrent validity
D)Face validity

Question 9

Deming,who revitalized the Japanese industry with his focus on total quality management (TQM)and continuous quality improvement (CQI),introduced what concept to TQM?

A)Trilogy concept
B)Zero defects concept
C)Plan-do-check-act cycle (PDCA)
D)Quality as conformance concept

Question 10

The federal government began facilitating competition among health care services when:

A)It mandated a decrease in the number of hospitals
B)It experienced increased costs due to increasing use of technology
C)It permitted health maintenance organizations (HMOs)to offer competitive medical plans
D)It initiated physician review of Medicare patients' charts to control health care utilization and costs

Question 11

The evaluator should structure the evaluation using an appropriate research design.When utilizing an instrument to collect data,the evaluator may need to select the time and the individuals on whom observations will be made.For which research design is it best if the design is repeated by several researchers in separate situations?

A)Time series
B)Factorial design
C)Counterbalanced design
D)Pretest-posttest control design

Question 12

Which organization required audits of care,which later became part of a quality assurance program?

A)The Joint Commission on Accreditation of Hospitals (JCAH)
B)The American Nurses Association (ANA)
C)The National League for Nursing
D)The American Hospital Association

Question 13

Continuous quality improvement (CQI)is a process carried out by a team that establishes criteria,identifies relevant information,collects and analyzes data,judges quality,takes corrective action,reevaluates,and does public reporting.Criteria are established by developing standards and setting benchmarks.Standards are structure,process,and outcomes.Which of the following is an outcome statement?

A)All nurse managers will have a master's degree in nursing.
B)All beds on the unit will be occupied by the end of the year.
C)Every patient will have a discharge plan before being discharged.
D)No more than 20% of patients with congestive heart failure will be readmitted within 2 months of discharge.

Question 14

Several tools are used to collect data to facilitate continuous quality improvement.What kind of audits review critical pathways and standardized clinical guidelines?

A)Nursing audits
B)Structure audits
C)Process audits
D)Outcome audits

Question 15

The health care risk management process includes all of the following except:

A)Risk identification
B)Analysis
C)Evaluation
D)Reduction strategies

Question 16

During President Clinton's years of service,the Health Security Act was passed,which was another step in health care reform.Which principle of the Health Security Act called for every employee and every employer to contribute to the cost of health care?

A)Security
B)Quality
C)Choice
D)Responsibility

Question 17

As health care expanded,the federal government became involved.The federal government realized it could not meet the costs of unlimited health care coverage,so which of the following was initiated?

A)The Hill-Burton Act
B)The Medicare and Medicaid programs
C)The Professional Standards Review Organization (PSRO)
D)Health maintenance organizations

Question 18

Which of the following is a valuable tool that is used for planning and judging the progress of the program evaluation?

A)Conceptual framework
B)Review of the literature
C)Instrument development
D)Calendar of events

Question 19

The Clinton administration instructed the President's Advisory Commission on Consumer Protection and Quality in the Health Care Industry to work with the Institute of Medicine Reports to develop the core competencies for health care professionals.What publication reported the core competencies for health care professionals?

A)To Err Is Human
B)Envisioning the National Health Care Quality Report
C)Crossing the Quality Chasm
D)Health Professions Education

Question 20

Effective January 1,2007,the Joint Commission requires accredited hospitals to collect and submit performance data related to which of the following?

A)Acute myocardial infarction
B)Acquired immunodeficiency syndrome
C)Total hip replacement
D)Diabetes mellitus

Question 21

Accredited organizations are expected to identify and respond to all sentinel events occurring in the organization.Errors are preventable events.Which of the following types of error is not the result of an individual's actions but is the predictable outcome of a series of actions that comprise a diagnostic or treatment process?

A)Medical error
B)System error
C)Medication error
D)Organizational error

Question 22

The first step in risk management is identifying potential or actual risks for accidents,injuries,or financial loss.The occurrence of an injury that is caused by medical management and results in a measurable disability is termed:

A)An error
B)An adverse event
C)An unpreventable adverse event
D)A near miss

Question 23

When a nurse is called to be an expert witness in a malpractice court case,the nurse draws on many standards of care.All of the following may be used to establish standards for court cases except:

A)Nurse practice acts
B)American Nurses Association (ANA)standards
C)Medical practice acts
D)Institutional policies and procedures

Question 24

The purpose of the Occupational Safety and Health Act of 1970 was to ensure safe and healthful working conditions.Workplace inspections are usually conducted without prior notice.What type of workplace condition is the top priority for an inspection?

A)Imminent dangers
B)Catastrophic accidents
C)Fatal accidents
D)Employee complaints

Question 25

The most common law affecting nursing practice is:

A)Public law
B)Private law
C)Tort law
D)Civic law