Using the CPHQ Dumps (V10.03) is the Greatest Way to Pass the NAHQ Certified Professional in Healthcare Quality (CPHQ) Exam Successfully

1. “Underuse is evidence by the fact that many scientifically sound practices are not used as often they should be, For example, biannual mammography screening in woman ages 40 to 69 has been proven beneficial and yet is performed less than 75 percent of the time.” This is the categorization of:

2. __________ is a term applied when the proper clinical car process is not executed appropriately, such as giving the wrong drug to a patient or incorrectly administering the correct drug.

3. Crossing the Quality Chasm provided a blueprint for the future that classified and unified the components of quality through six aims for improvement, chain of effects, and simple rules for redesign of healthcare. The six aims for improvement, viewed also six dimensions of quality.

Which of the following is NOT out of those dimensions?

4. ______________ can be measured by how well evidence-based practices are followed, such as the percentage of time diabetic patients receive all recommended care at each doctor visit, the percentage of hospital-acquired infections, or the percentage of patients who develop pressure ulcers (bed sores) while in the nursing home.

5. Today’s patients’ perception of the quality of our healthcare system is not favourable. In healthcare, qualityis household word that evokes great emotion, including:

6. There is a story of an intensive care unit (ICU) at Dominican Hospital in Santa Cruz Country, California. Dominican, a 379-bed community hospital, is part of the 41-hospital Catholic Healthcare West system. “We used to replace ventilator circuit for incubated patients daily because we thought this helped to prevent pneumonia,” explained Lee Vanderpool, vice president. “”But the evidence shows that the more you interfere with that device, the more often you risk introducing infection. It turns out it is often better to leave it alone until it begins to become cloudy, or ‘gunky,’ as the no clinicians say.”

The hospital staff learned an important lesson from this experience that:

7. A number of attributes can characterize the quality of healthcare services. As, there are different groups involved in healthcare, such as physicians, patients and health insurers, tend to attach different levels of importance to particular attributes and as a result define quality care differently.

Which of the following is/are NOT out of those attributes?

8. Quality and technical performance refers to how well current scientific medical knowledge and technology are applied in a given situation.

It is usually assessed in terms of:

9. The quality of amenities of care refers to the characteristics of the setting in which the encounter between patient and clinician takes place, such as:

10. Amenities may cover areas as mentioned below EXCEPT:

11. _________________ refers to the “degree to which individuals and groups are able to obtain needed services.”

12. In earlier formulations, responsiveness to patients’ preferences was just one of the factors seen as determining the quality of patient clinician interpersonal relationship. But, now it is translated into many factors.

Which of the following is out of such factors?

13. Efficiency refers how well resources are used in achieving a given result. Efficiency whenever the resources used to produce a given output are _____________.

14. In general, as the amounts spent on providing services for a particular condition grow, diminishing returns set in meaning that each unit of expenditure yield ever-smaller benefits until a point where ________________.

15. “Quality is the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.”

This is the definition of Quality care often quoted by:

16. “Likelihood of desired health outcomes” corresponds to clinicians’ view that, with respect to outcomes, there are only probabilities, not certainties, owing to factors-such as patients’ genetically determined physiological reliance-that influence:

17. In fact, because patients’ satisfaction is so influenced by __________________ rather than to the more indiscernible technical ones-health maintenance organizations, hospitals and other health care delivery organizations have come to view the quality of nontechnical aspects of care as crucial to attractions and retaining patients.

18. Payers are more likely to embrace the optimization definition of care which can put them at odds with:

19. The manager’s perspective on quality differs markedly from that of clinicians and patients on:

20. Strong disagreement do arise, among the five parties’ definitions (i.e. the clinician’s, the patient’s the payers, the manager’s and the society’s), even outside the realm of cost effectiveness.

Conflicts typically arise when:

21. All the evaluations of quality of care can be classified in terms of one three aspects of care giving they measure.

Which of the following is/are NOT out of these measures?

22. When quality is measured in terms of structure the focus is on the relatively static characteristics of the individuals who provide care and of the settings where the care is delivered. These characteristics include ____________ of professionals who provide care and the adequacy of the facility’s equipment, and overall organization.

23. Licensing and accrediting bodies have relied heavily on structural measures of quality not only because the measures are relatively stable and thus easier to capture but:

24. Ordering the correct diagnostic procedure for a patient is a measure of _________. When evaluating the process of care, however, appropriateness is only half the story. The other half is in how well and how promptly (i.e. skill-fully) the procedure was carried out.

25. Because of the goals of care can be defined broadly, outcome measures have come to include the costs of care as well as patients’ satisfaction with care.

In formulations that stress the technical aspects of care, however outcome typically refers to:

26. 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.

27. Universities often evaluate applicants for admission on the basis of, among other things, the applicants’ scores on standardized tests. The scores are thus one of the criteria by which program judge the Quality of their applicants. However, although two programs may use the same criterion C scores on a specific standardized examination-to evaluate applicants, the programs may differ markedly on standards: One program may consider applicants acceptable if they have scores above the 50th percentile, whereas the score above the 90th percentile may be the standard of acceptability for the other program.

This example clearly defines the difference between:

28. For cheing the outcomes our focus of attention is blood pressure of patients with diabetes.

Its criteria and standard can be respectively:

29. When formulating medical standards, a critical decision that must be made is the _____ at which the standard should be set.

30. _________________ standards denote level of quality that can be reached under the best conditions, typically conditions similar to those under which efficacy is determined. These standards are especially useful as a reference points being evaluated should set as a benchmark.

31. ___________________ is a difference between an observed event and a standard or norm. Without this standard, or, best practice, measurement of variation offers little beyond a description of the observations.

32. Measurement of variation in health care and its application to quality improvement must begin with the identification and articulation of:

33. __________________ 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.

34. He used his understanding of statistics to design tools to respond to variation. Following his arrival at Western Electric Co. in 1924, Shewhart introduced the concepts of common cause, special cause variation and statistical control. He designed these concepts to assist Bell Telephone of repairs within its transmission systems.

Who is he?

35. 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?

36. Joseph juran defined quality as consisting of two different but related concepts. The first form of quality is income oriented and includes features of t he product t hat meet customer needs and thereby produce income (i.e., higher quality costs more).

The second form of quality is cost oriented and emphasizes:

37. Juran Trilogy includes all the following sub-points under the major heading of quality planning EXCEPT:

38. Overproduction

Inventory

Repairs/rejects

Motion

Processing

Waiting

Transport

These are the types of _____________ identified by Taiichiohno.

39. TQC is excellence driven rather than defect driven-a system that integrates:

40. Crossby’s quality improvement process is based on the Absolutes of Quality Management.

Which of the following is/are out of those absolutes?

41. Quality improvement approaches are derivatives and models of the ideas and theories developed by thought leaders and include all of the following EXCEPT:

42. The following diagram shows:

43. The Baldrige criteria were originally developed and applied to business; however, in 1997, healthcare-specific criteria were created to help healthcare organizations address challenges such as focusing on core competencies, introducing new technologies, reducing costs, communicating and sharing information electronically new alliance with healthcare providers, and maintaining market advantage. The Baldrige healthcare criteria are built on the set of interrelated core values and concepts.

Which of the following is NOT out of those values and concepts?

44. Baldrige’s scoring system is based on a __________point scale. Each of seven criteria is assigned maximum value ranging from 85 to 450 maximum points.

45. The weight of scoring system is based on an emphasis Baldrige places on ___________ and an organization’s ability to demonstrate performance and improvement in the following areas:

Product and service outcomes

Customer-focused outcomes

Financial and market outcomes

Workforce-focused outcomes

Process effectiveness outcomes

Leadership outcomes

46. The focus of Lean methodology is a “ba to basics” approach that places the needs of customer first through five steps.

Which of the following is NOT out of those steps?

47. Although Lean thinking focuses on removing waste and improving flow, it also has some secondary effects such as:

48. Six sigma (3.4 defects per million) is a system for improvement developed over time by Hewlett-Paard, Motorola, General Electric, and others in the 1980s and 1990s.

The aim of six sigma is:

49. By using a set of statistical tools to understand the fluctuation of a process, management can predict the expected outcome of that process. If the outcome is not satisfactory, management can use associated tools to further understand the elements influencing that process. Six sigma includes process steps which are commonly known as ____________.

50. One of the difficult things about quality is explaining how _________ is different from a process or system.

51. The American Society for Quality has formed six categories of quality tools.

Which of the following is NOT out of those categories?

52. A Japanese tool called 5S (each step starts with letter “S”) is a systematic program that helps workers take control of their workspace so that it actually works for them (and their customers) instead of being a neutral or, as is quite common, competing factor.

Which of the following is/are NOT out of these five 5S?

53. Within any unit, organization, or system, there will be barriers to spread and adoption (e.g., organizational culture, communication, leadership support).

However, failure to transfer knowledge effectively may result in:

54. 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:

55. Organizational size affects the ability to disseminate best practices

56. A social service department regularly monitors the number of inappropriate referrals, the timeliness of discharge planning, and the number of days of discharge delays.

What additional monitor should be added to evaluate the appropriateness of social service interventions?

57. The primary purpose of a management information system is to:

58. One major difference between traditional quality assurance (QA) and quality improvement (QI) is that QI:

59. Which of the following processes is most cost-effective in preventing unnecessary resource consumption in the hospital?

60. The primary benefit of adopting a countrywide or global uniform set of discharge data is to:

61. Which of the following process can be judged as having highest quality of care?

62. The concept of cost-effectiveness in Healthcare delivery means:

63. Interpersonal relationships are the fundamental part of a management system. They basically coordinate activities of different departments in a unit.

What is the role of Interpersonal relationships in Healthcare delivery systems?

64. IHI has designed a model to support its breakthrough collaborative series.

A key component of the collaborative model is the ability of participants to work with other organizations to discuss:

65. Employees involved in quality circles are encouraged to develop ideas for improvement or request management efforts to propose solutions for adoption.

The aims of the quality circle activities are all of the following EXCEPT:

66. During improvement in healthcare system, because of a combination of technical complexity, system fragmentation, a tradition of autonomy, and hierarchical authority structures, overcoming the “daunting barrier to creating the habits and beliefs of common purpose, teamwork and individual accountability” necessary for spread and sustainability will require:

67. The increased focus on and mandate for healthcare data place healthcare providers in a different situation than they have known in the past. Providers document such things and, unfortunately, many providers struggle to address the measurement mandate proactively, which leads organizations to assume a defensive posture when external organizations release the data.

Which of the following ways show/s the responses of provider in such cases?

68. A more proactive posture would be to develop an organization-wide approach to quality measurement that meets both internal and external demands.

This approach is:

69. This example shows the relationship between:

70. In healthcare, many terms call for more precise operational definitions that how do an organization define the terms such as:

71. Stratification is the separation and classification of data into reasonably homogenous categories. It allows understanding of differences in the data caused by all of the following EXCEPT:

72. “A quality improvement team is interested in determining the percentage of medication orders that are delivered to nurses’ stations within one hour of the order’s receipt in the pharmacy. Before collecting data on this question, the team should determine whether it believes that this percentage could differ by floor, time of day, day of week, type of medication ordered, pharmacist on duty, or volume of orders received. If the team believes that one or more of these factors will influence the outcome, it should take steps to ensure that it collects the data relevant to these factors each time the pharmacy receives an order.”

This example explains:

73. 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:

74. _______________ is based on a simple principle-statistical probability. In other words, within a known population of size n, there will be a fixed probability of selecting any single element.

75. If you decided to interview ten patients in your emergency room on a given day and drew conclusions about your emergency services from these people. You have taken limited data and made a huge jump in logic.

This jump is known as:

76. Quality circles are groups of five to ten employees, with management support, who meet to solve problems and implement new procedures.

The aim/s of quality circle activities is/are:

77. Basically an operational definition is a description in quantifiable terms, of what to measure and the specific steps needed to measure it constantly.

A good operational definition:

78. Using the same operational definition becomes even more critical if you are trying to compare several hospitals or clinics in a system. When national hospitals are made, the operational definition challenge becomes extremely complex. All good measurements begin and end with_____________.

79. The problem with using readily available, convenient data is that the data usually do a poor job of answering the questions necessary to access performance. Ten years ago this “good enough” approach to data collection might have been acceptable. Today, however, because of the increasing demand to demonstrate effectiveness of care and efficiency of healthcare processes, this mind set is not acceptable. Performance quality and excellence do not occur because organizations do what they have always done or what is convenient.

Most healthcare observers agree that:

80. The data collection phase of the journey consists of two parts: (1) Planning for data collection and (2) The actual data gathering. A well designed data collection strategy should address different analytical questions.

Which of the following is/are the part of planning section for data collection?

81. Once you have resolved these issues, the data collection should go smoothly. Unfortunately, many quality improvement teams do not spend sufficient time discussing their data collection plans. They want to move immediately to data collection step.

This haste usually guarantees that the team will:

82. Two key data collection skills satisfaction and sampling enhance any data collection effort. These skills are based more on___________ and _____________ then on statistics, yet many healthcare professionals have received limited training in both concepts.

83. Stratification is the separation and classification of data into reasonably homogenous categories, within the data, that are mutually exclusive and facilitate:

84. For example, if you are using a survey to gather patient satisfaction feedback by email, you would not send a survey t o ever y patient. You would start by sending surveys t o roughly 50 percent of the patients an see how many are returned. This limited survey allows you to determine the response rate. Assume that 25 percent of these patients return the surveys. The next task is to determine how representative of the total population these respondents are. To test this question, you need to develop a profile of the total population. Typically, this profile is based on standard demographics such as gender, age, type of visit, payer class, and whether the respondent is a new or returning patient. If the distribution of these characteristics in the sample is similar (within 5 percent) to that found in the total population, you can be comfort able t hat your sample is reasonably representative of the population. If the characteristics of the sample and the population show considerable variation, however, you should adjust your sampling plan. This example clarifies that:

85. All of the following are characteristics of probability sampling EXCEPT:

86. Systematic sampling is achieved by numbering or ordering each element in the population (e.g., time order, alphabetical order, and medical order) and then selecting every kth element.

The key point that most people ignore when doing a systematic sample is that:

87. A random sampling also can be drawn by placing equally sized pieces of paper with a range of numbers on them (e.g., 1 to 100) in a bowl and picking a predetermined number to be the sample.

The problem with simple random samples is that:

88. Convenience sampling produces a biased sample that is basically a collection of anecdotes that cannot be applied generally to larger populations.

Convenience sampling is also known as:

89. Quota sampling was developed in the late 1930s and used extensively by the Gallup organization. Babbie (1979) describes the steps involved in developing a quota sample.

All of the following are out of those steps EXCEPT:

90. Statistical analysis conducted with control charts is different from what some consider “traditional research” (e.g. hypothesis testing, development of p-values, design of randomized clinic trials). Traditional research is designed to compare the results at time one (e.g. the cholesterol levels of a group of middle-aged men) with the results at time two (typically months after the initial measure). Research conducted in this manner is referred to as___________________.

91. When groups are asked to evaluate how effective they are with respect to will, ideas and execution, they consistently provide bothersome answers. Self-assessment to hundreds of healthcare professional is administered in United States and abroad.

Most respondents mark:

92. Which of the following is NOT out of Quality measurement categories or domains?

93. Generally, medical record review and prospective data collection are considered the most time-intensive and expensive ways to collect information.

Many reserve these methods for highly specialized improvement projects or use them to answer questions that have:

94. A data analyst, using a clinical decision support system (administrative database), discovered a higher-than-expected incidence of renal failure (a serious complication) following coronary artery bypass surgery. The rat e was well above 10 percent for the most recent 12 months increased over the last six quarters. However, the clinical decision support system did not contain enough detail to explain whether this complication resulted from the coronary artery bypass graft procedures or was a chronic condition present on admission.

To find the answer, the data analyst use different steps.

This example illustrates:

95. The syndrome of stockpiling is proven to be ineffective and inefficient. It also creates quality issues. This approach provides little value to the data collection effort and is one of the biggest mistake quality improvement teams make.

Rather than provide a rich source of information, this approach unnecessarily derives up:

96. The distinction between inpatient and outpatient data is an important consideration in planning the data collection process because:

97. What approach should be followed by the healthcare improvement team for the best outcomes?

98. To identify outpatient data sources, the team should consider the following questions EXCEPT:

99. Which of following objectives is/are NOT essential for successful quality improvement project and data collection initiative?

100. Some database projects rely on medical record review because many of the data are not available in administrative database, e.g.