Quality and Process Improvement
For a large PI project, Joe would like to diagram all of the required important steps in the process, their dependency, interaction, and schedule requirements. What would you recommend Joe use to do this?
Gantt chart
A patient was taken into surgery at a local hospital for treatment of colon cancer. A large section of the colon was removed during surgery and the patient was taken to the medical floor after surgery. Within the first 24 hours post-op, the patient developed fever, chills, and abdominal pain. A abdominal CT scan revealed the presence of a foreign body. This situation describes a:
Sentinel Event
The principal process by which organizations optimize the continuum of care for their patients is ______?
Case Management
The totality of healthcare services provided to a patient and their family in all settings, from the least to most extensive, is called
Continuum of Care
A movement in healthcare reimbursement where providers are rewarded for meeting pre-established targets for delivery of healthcare services that improve quality and efficiency is called:
Pay for Performance
A performance measure that enables healthcare organizations to monitor a process to determine whether it is meeting process requirements is called a/an
Indicator
Which of the following would be an example of a reviewable sentinel event?
Incidence of hospital acquired infection
Incidence of an unruly patient
Incidence of infant abduction
Incidence of blood transfusion reaction
Incidence of infant abduction
Upon receiving a call from Kathy's physician to schedule a hysterectomy, the case manager contacts Kathy's insurance company to get their approval for the procedure. This is an example of which step in the case management process?
Preadmission Care Planning
The established criteria against which the decisions and actions of healthcare practitioners and other representatives of healthcare organizations are assessed in accordance with nationally accepted standards of care called
Clinical practice standards
A patient presents to the emergency room acutely dehydrated and is admitted to the hospital for IV therapy to rehydrate the patient. Which admission criteria would be used to justify admitting this patient as an inpatient?
Intensity of Service
PDCA stands for...
Plan, Do, Check, Act
True or False: Surveyors are instructed not to search for or investigate sentinel events during an accreditation survey or to inquire about sentinel events that have been reported to The Joint Commission.
True
Dorothy was admitted to the hospital after she fell and fractured her right hip. She will need rehabilitation services after she leaves the hospital. Dorothy is assisted by the case manager in the hospital with her placement at Sunnyville Rehab Center. Which case management step is being performed to plan Dorothy's continued care after her healthcare facility services end?
Discharge planning
A graphic tool used to communicate established standards of patient care for specific diagnoses is called:
clinical care pathways
If a patient comes into the emergency room with left-sided hemiparesis that started within the last three hours, which admission criterion would be used to justify admitting this patient as an inpatient?
Severity of illness
Quality Family Healthcare HMO sent a survey out to their members about what services they would like added to their pediatric and adolescent healthcare sector. The idea for the enhancement of these services for pediatric and adolescent healthcare came from a recent evaluation of the area population shift. Quality Forum Healthcare HMO is trying to address the specific needs of their members through a/an:
Quality Needs Assessment
Analysis of a sentinel event from all aspects to identify how each contributed to the occurrence of the event and to develop new systems that will prevent recurrence is called:
Root Cause Analysis
Follow-up on a patient after discharge to ensure that the transition has gone smoothly and that the patient is receiving all of the services required is considered this case management step:
Caitlin’s physician suspects that she has cholecystitis and has ordered a gallbladder ultrasound to be performed. The staff at the physician office contacts Caitlin’s third party payer to determine benefits and coverage for this procedure prior to scheduling the cholecystectomy. What is this process called?
Preauthorization
How often are healthcare facilities required to practice their emergency preparedness plan each year?
two times
What are the 5 steps in a performance model?
Identify performance measure, Measure performance, Analyze and compare internal/external data, Identify improvement opportunity, and Perform ongoing monitoring.
What are the four goals of the sentinel event policy?
1. To positively impact care, treatment, and services by helping health care organizations identify opportunities to change their culture, systems, and processes to prevent unintended harm
2. To help health care organizations that have experienced a sentinel event determine and understand contributing factors (including causes, latent conditions, and active failures) and develop strategies to prevent or reduce such events in the future
3. To increase the health care organization's resilience by becoming a learning organization
4. To maintain the confidence of the public, clinicians, and health care organizations in the priority of patient safety in Joint Commission-accredited health care organizations
What is an integral component of case management that helps to improve patient outcomes and lower healthcare spending while still providing appropriate care to patients at the appropriate time?
Utilization Review
List three examples of workplace violence that must be addressed in the facility's management plan.
threatening behavior, verbal or written threats, harassment, verbal abuse, physical attacks, employee-to-employee harassment, domestic violence, and stranger violence.
In a healthcare organization’s emergency operations plan (EOP), the six critical areas that need to be addressed are:
Communication
Resources and Assets
Safety and Security
Staff Responsibilities
Utilities management
Patient and clinical support activities