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質問 # 18
Through ___________ the data collection staff can spot patient trends as they develop rather than receive the
information after the patient have been discharged. For instance, the incidence of ventilator-associated pneumonia
sooner, or it may spot an increase in the rate of aspiration in stroke patients as it occurs.
- A. Scanners
- B. Data collection forms
- C. Prospective chart review
- D. Medical record review (Retrospective)
正解：C
質問 # 19
A healthcare quality professional receives the following Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey results:
Which of the following should be the next action by the professional?
- A. Solicit Input from the member advocacy panel regarding barriers to service.
- B. Recommend a member education Initiative on access to care standards.
- C. Request a population demographic report on current membership diversity.
- D. Initiate a practitioner communication initiative on access to care standards.
正解：D
解説：
The Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey results provide insights into patients' experiences with healthcare services12. In this case, the survey results indicate that there may be issues with how well doctors communicate and the ease of getting necessary care. These are areas where practitioners can directly influence patient experience. Therefore, initiating a practitioner communication initiative on access to care standards (option B) would be an appropriate next step. This initiative could involve training or workshops to improve communication skills and strategies to enhance access to care3. It's also important to continuously monitor CAHPS survey results to track progress and identify new areas for improvement4.
The CAHPS survey results indicate that the health plan's score on how well doctors communicate is lower than the Quality Compass Mean. Since communication with healthcare providers is a key aspect of patient experience and can greatly affect patient satisfaction and outcomes, focusing on improving practitioners' communication skills is essential. A practitioner communication initiative could address the gap in communication scores by providing training and resources to enhance how doctors interact with patients. This initiative would likely involve coaching for practitioners on how to effectively listen, explain, and engage with patients to ensure they understand their health conditions and the care provided.
References:The National Association for Healthcare Quality (NAHQ) provides resources on improving communication as part of quality improvement in healthcare. Such initiatives are supported by evidence showing that effective communication can lead to better patient satisfaction, adherence to treatment plans, and overall health outcomes. This is also in line with the principles outlined in the NAHQ Healthcare Quality Competency Framework under the domain of Patient Safety and Person-Centered Care, which emphasizes the importance of communication in providing high-quality, safe, and patient-centered care.
質問 # 20
Payers are more likely to embrace the optimization definition of care which can put them at odds with:
- A. Physicians
- B. Clinicians
- C. Health administrators
- D. Both A & B
正解：A
質問 # 21
Which of the following process can be judged as having highest quality of care?
- A. Successful completion of a surgical operation
- B. Successful completion of a surgical operation, a good recovery and ascertaining that the operation was not
indicated - C. Successful completion of a surgical operation and a good recovery
- D. Successful completion of a surgical operation, a good recovery and ascertaining that the operation was indicated
正解：B
質問 # 22
Sampling is a key that healthcare professionals need to develop. If a process does not generate a lot of data, you
probably will analyze all the occurrences of an event and not need to consider sampling. Sampling usually is not
required when the measure is:
- A. A percentage
- B. A strata
- C. A step by step process
- D. A rate
正解：A、D
質問 # 23
Prospective data collection also relies on medical record review, but it is completed during a patient's hospitalization
or visits rather than retrospectively. Obviously this method of data collection is expensive but:
- A. If staff can maximize the time required for data entry it can focus on accurate collection and the analysis/reporting
function - B. If staff can moderate the time required for data entry it can focus on accurate collection and the analysis/reporting
function - C. If staff can maximize the reliability required for data entry it can focus on accurate collection and the
analysis/reporting function - D. If staff can minimize the time required for data entry it can focus on accurate collection and the analysis/reporting
function
正解：D
質問 # 24
Knowledge about _______ is crucial to making valid judgments about quality of care using either process or outcome
measures. If we know that a given clinical intervention was undertaken in circumstances that match those, under
which the intervention has been shown to be efficacious, we can be confident, that the care was appropriate and, to
the extent of good quality.
- A. Efficacy
- B. Structure
- C. Outcomes
- D. Processes
正解：A
質問 # 25
__________ accounts for the different types of patients in institutions. Adjustments should be considered when
hospital survey results are being released to the public.
- A. Recall base
- B. Bias or mode effects
- C. Proxy response
- D. Case-mixed adjustment
正解：D
質問 # 26
Which of the following represents a medically underserved population?
- A. high risk obstetric patients in the third trimester
- B. families with a household size greater than 7.2
- C. patients living within S miles of an urban area
- D. patients living below the Income poverty line
正解：D
解説：
A medically underserved population is a population of individuals with either a large elderly population, high infant mortality rate, high level of poverty or lack of providers1. This definition aligns with option D, which refers to patients living below the income poverty line. These individuals often lack access to primary care health services2, which is a key characteristic of medically underserved populations. Therefore, the answer is D: patients living below the Income poverty line.
質問 # 27
Once collected, performance measurement data require interpretation and analysis if they are to be used to improve the processes and outcomes of healthcare. Data can be used to compare:
- A. A, B and C
- B. An organization's performance against established benchmarks or guidelines
- C. The performance of one organization to the performance of a group of organizations collecting data on the same measures in the same way
- D. An organizations performance against itself over time
正解：A
質問 # 28
Many assume they understand how to fix the problem and do not probe beneath the surface of complaints and use survey responses. Organizations should not be surprised by negative reports. Complaints about unhelpful office staff could stem from many sources.
For instance:
- A. Employees put patients on hold in the middle of medical emergencies
- B. Patients were not able to get an appointment when they needed one
- C. All of these
- D. Employees did not provide clear directions to patients on how to get the practice
正解：C
質問 # 29
A nursing director for a unit in a cancer hospital Is reviewing and assessing outcomes datainthe following scatter diagram:
The relationship between the incidence of infection and the decrease in staffing targets is
- A. strong and positive.
- B. weak and positive.
- C. weak and negative.
- D. strong and negative.
正解：D
解説：
The scatter diagram shows that as the decrease in staffing targets becomes more significant (moving right on the horizontal axis), the incidence of infection goes up (moving up on the vertical axis). This indicates a negative relationship because as one variable increases, the other one decreases. The relationship appears to be strongbecause the points lie closely to an imaginary line that slopes upwards from left to right, which suggests a consistent trend across the data points.
References:In healthcare quality improvement, it is critical to use data to inform decision-making. Scatter diagrams are a common tool used for this purpose. The NAHQ Healthcare Quality Competency Framework emphasizes the importance of analyzing and utilizing data in decision-making, as indicated in the Performance and Process Improvement domain. A strong negative relationship in this context could indicate that decreased staffing levels are associated with higher infection rates, which is a significant finding for a nursing director assessing outcomes and considering quality improvement initiatives.
質問 # 30
Which of the following is NOT out of Quality measurement categories or domains?
- A. Financial performance
- B. Operational status
- C. Clinical quality (including both process and outcome measures)
- D. patient satisfaction
正解：B
質問 # 31
Administrative databases are an excellent source of data for reporting on clinical quality, financial performance, and
certain patient outcomes. Use of administrative database is advantageous for the following reason EXCEPT:
- A. data reporting tools are available as part of the purchased system or through third-party add-ons or services.
- B. The incorporate transaction system already used in the daily business operations of a healthcare organization
(frequently referred to as legacy system) - C. The volume of available indicators is 1000 times greater than that available through other data collection
techniques - D. They are less expensive source of data than other alternatives such as chart review or prospective data collection
正解：C
質問 # 32
Knowledge about _______ is crucial to making valid judgments about quality of care using either process or outcome measures. If we know that a given clinical intervention was undertaken in circumstances that match those, under which the intervention has been shown to be efficacious, we can be confident, that the care was appropriate and, to the extent of good quality.
- A. Efficacy
- B. Structure
- C. Outcomes
- D. Processes
正解：A
質問 # 33
Some database projects rely on medical record review because many of the data are not available in administrative database, e.g.
- A. Nursing record
- B. Measurement that require time stamp, such as administration of antibiotics within one hour before surgical incision
- C. Patient's entries and visits to the physician
- D. Patients of test and lab reports
正解：B
質問 # 34
Administrative data are information collected, processed and stored in automated information system. Which of the
following is NOT included in that data?
- A. Manage care encounters
- B. Claims information
- C. Timely administration of therapies
- D. Enrollment or eligibility information
正解：C
質問 # 35
In successful implementation of performance improvement programs, use of a single improvement methodology
across all improvement initiatives is critical to facilitating a cohesive and consistent approach to improvement within
the organization. An organization can develop improvement methodologies internally or can adopt them from
external sources. Which of the following components is related to this strategy?
- A. Establishment of partnership with key stakeholder
- B. Staff understanding
- C. Selection and use of a performance improvement methodology
- D. Establishment of a performance improvement oversight entity
正解：C
質問 # 36
Which of the following processes is most cost-effective in preventing unnecessary resource consumption in the hospital?
- A. Effective preadmission screening
- B. Accurate DRG assignment at admission
- C. Second opinions for all surgeries
- D. Preadmission insurance benefit denials
正解：A
質問 # 37
Organizational size affects the ability to disseminate best practices
- A. Difficult to decide
- B. It depends on situation
- C. True
- D. False
正解：C
質問 # 38
Which of the following are hardware components that would be included in a computerized management information
system?
- A. Flow chart and program
- B. Printer and random access memory
- C. Binary and decimal coding
- D. Instructions and data
正解：B
質問 # 39
Which of the following is the relationship between clinical outcomes and patient satisfaction?
Besides measuring morbidity and mortality, this management takes into account the quality of healthcare received from the patient's perspective.
- A. Clinical pathways
- B. Outcome measures
- C. Benchmarking
- D. Outcome management
正解：C
質問 # 40
Rapid cycle testing is designed to reduce the cycle time of new process implementation from months to days.
To prevent unnecessary delays in testing or implementation, teams or units using rapid cycle testing must remain focused on the testing of solutions and avoid:
- A. Focused testing
- B. Buy-in
- C. Over-analysis
- D. Multiple PDSA cycles
正解：C
質問 # 41
In the 1970s, Deming developed his 14 points for western Management in response to requests from U.S. managers
for the secret to the radical improvement that Japanese companies were achieving in a number of industries. As part
of his "system of profound knowledge," Deming promoted that "around 15% of poor quality was because of workers,
and the rest of 85% was due to bad management, improper systems and processes." The "system" is based on parts.
Which o the following is/are NOT out of those parts?
- A. Sociology
- B. Theory of knowledge
- C. Appreciation for a system
- D. Knowledge about variation
正解：A
質問 # 42
__________________ arises from a single or small set of causes that are not part of event or process and therefore can be traced, identified and implemented or eliminated. In general, researchers are interested in this variation because they can link-or-assign variation to a single specific cause and act accordingly.
- A. Assignable variation
- B. Process variation
- C. Random variation
- D. Performance variation
正解：A
質問 # 43
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