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1 / 30 CPXP Exam Study Guide Complete Solutions 2026 Updates
1. How did the report of quality measures to CMS begin?: Hospitals could voluntarily report quality measures starting in 2001-
adapting to current state from there
2. What is HCAHPS: Hospital Consumer Assessment of Healthcare Providers and System
3. What are some metrics for outcome of care?: mortality, readmission, complications, hospital associated infections
4. Describe "Pay for performance": provide financial incentives to hospitals, physicians, and other providers to carry out improvement
and achieve optimal outcomes for patients
5. What are some reasons patients may not voice their complaints?: Don't know where to complain, afraid of
retribution, not worth the trouble
6. What are the IOM six aims of for quality (established in 2001): Safe, time, ettective, eflcient, equitable, patient-centered
(STEEEP)
7. What is the IHI triple aim?: improve patient experience, improve health of populations, reduce per capita cost
8. Describe health literacy: capacity to obtain, process and understand basic health information needed to make appropriate health decisions
9. What percentage of adults are estimated to have a proficient health literacy-
10. Which year was the American Society for Hospital Risk Management formed?: 1980
11. What was the original name for the CMS: Health Care Financing Administration
12. What is the definition of Culture (Irwin Press): Culture exists when its members share values and behaviors that they take
for granted
13. What is empathy: the ability to understand and share the feelings of another
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14. What percentage of CMS reimbursement is dependent on patient satisfac- tion scores: 1%
15. What are the 4 basic needs that should be met to create an ideal patient experience:
confidence, integrity, pride, passion
16. In which year did hospitals establish patient advocates and representatives?-
17. In which year did the American hospital association develop patients bill of rights: 1973
18. What is the RATER scale and when was it developed: Reliability, Assurance, Tangibles, Empathy,
Responsiveness (early 80s)
19. What are some of the key concepts of the Planetree model: Importance of social support, patient/resident
education, healing environment (design- iron curtain)
20. In which year were Diagnostic Related Groups (DRG) introduced?: 1983
21. What is the Emergency Medical Treatment and Labor Act (EMTALA) and when was it established:
requires hospitals to stabilize any patient who shows up in the ER regardless of ability to pay (1986)
22. When was the Health Insurance Portability and Patient Protection Act (HIP- PA) created?:
23. In which year did the IOM publish the report "To Err is Human" regarding the significance of
medical errors: 1999
24. What is the IPFCC: Institute for patient family-centered care
25. What are some of the limitations to the Press Ganey surveys: low return rate, minorities
underrepresented
26. What is a "Likert" scale: Ex: Very poor, poor, fair, good, very good
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39. Which year did AHA develop and adopts patients bill of rights?: 1973
40. What was the Karen Quinian case?: Young women slipped into coma after drug interaction with alcohol (ethics of euthanasia)
41. What is cultural competence: being sensitive to others cultures and beliefs
42. According to the Beryl Institute article, what are the three areas that inte- grate to create
patient experience: quality, safety, and service
43. According to the Beryl Institute article, which method of patient survey is the most effective?: phone
surveys. Tend to give more positive responses than paper survey.
44. What other surveys are in use or under development?: Clinical and group consumer assessment of
healthcare providers (CGCAHPS) and systems and EDCAHPS (Emergency department)
45. What is the relationship to HCAHPS and Value based purchasing?: Hospital that fail to publicly report the
required quality measure, may receive an annual payment update that is reduced by 2%
46. What is value based purchasing?: payment method that rewards quality of care through payment incentives and transparency.
47. What are some key differences between HCAHPS and Rush Press Ganey surveys?: PG otters a
neutral answer, while HCAHPS does not. PG does not ettect reimbursement. HCAHPS publicly reported on Medicare website
48. Describe service recovery: apology to patient if service wasn't satisfactory
49. What do the initials in the HEART model for handling complaints stand for: H-hear the
patient E-empathize A- apologize R-respond T- Thank
50. Picker Institute Eight Characteristics of patient centered care: Access to care,
5 / 30 respect for patient values-preferences-needs, coordination/integration of care, information-communication-education, transition and continuity of care, involving family and friends, emotional support reducing fear/anxiety, physical comfort
51. What is the name of the rules that give rise to a patient's right to file a
grievance against a hospital: Patient rights and responsibilities
52. What is the primary reason for patient lawsuits against physicians: Lack of communication
53. Value Based Purchasing
started as and then went to : Pay for reporting-- Pay for Performance
54. Name one significant person in the evolution of the field of patient experi- ence and his/her
contribution: Angelica Theriot who developed the Planetree model
55. Describe three reasons used by CMS/ARHQ to justify the development of the HCAHPS survey: incentive to
improve quality of care, create a standardization survey for hospital comparison, creates accountability
56. What is a complaint: expresses displeasure that is addressed when it occurs
57. What is a grievance: more formal complaint that is filed with the hospital and can address bigger issues such as abuse
58. What is the main difference between a complaint and a grievance: a grievance requires a written
response
59. The FY 2014 Hospital Value Based Purchasing (Hospital VBP) links a portion of IPPS
(Inpatient Prospective Pricing System) hospital payment from CMS to performance on a set of quality measures. The HCAHPS survey is the basis of the Patient Experience of Care Domain and accounts for this percent of the hospital's Total Performance Score.: 25%
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71. Which year was the Institute of Patient Family Centered Care (IPFCC) creat- ed: 1992
72. What is the AHRQ and in which year did they begin to develop the HCAHPS survey: Agency for
healthcare research and quality- 2002
73. Which year did the Cleveland Clinic hire the first MD as a CXO?: Bridget Dutty 2006
74. What is BART: Behavior action response team
75. What does the communication model include? (4 E's): engaging empathizing
educating enlisting
76. Which Rush locations have the largest amount of grievances filed?: RUMG (Rush
university medical group) & IP
77. What is the Rush patient promise (3 components): safe care, high quality care, patient satisfaction
78. Which year was the Institute of Healthcare Improvement (IHI) triple aim created?: 2007
79. What are core concepts of patient centered care (4 components): -respect & dignity
-information sharing
- participation
- collaboration
80. What is AIDET: Acknowledge
Introduce Duration Explanation
8 / 30 Thank
81. What is the JCAHO (2010): Joint commission on accreditation of health care (set patient centered
communication standards)
82. Culturally Competent Model of Care: 1. Cultural awareness - self-reflection of one's own biases
2. cultural knowledge - obtaining information about ditterent cultures
3. cultural skill - conducting an assessment of cultural data of the patient
4. cultural encounters - personal experiences with patient of ditterent backgrounds
5. cultural desire - process of anting to be culturally competent.
83. Impact of cultural competency and diversity in health care: 1. more successful resident/patient
education
2. increases in health care-seeking behavior
3. more appropriate testing and screening
4. fewer diagnosis errors
5. avoidance of drug complications
6. greater adherence to medical advice
7. expanded choices and access o high-quality clinicians
84. CLAS, Office of Minority Health: CLAS is a tool that promotes cultural and linguistic competence. CLAS standards are
primarily directed at health care organizations.
10 / 30 Respect - Consciously respect the persons religious tradition Resources - known who to call, handbook, webpages, etc.
95. Examples of cultural and religious situations that affect patient care.: 1. Spanish word for bladder and
gallbladder may only be known by a Spanish speaking healthcare and not a non-healthcare worker.
2. body language and tone say more to patients than what is verbally expressed.
3. Are schedules reviewed to make accommodations for patients prayer traditions? Is there private space for patients
and family members to use for prayer? Is the healthcare worker responding appropriately and doing what is necessary to answer these questions?
96. Experience and Perception: Other people's experience of the interaction is built on their receptions
rather than intentions.
97. The act which address that federal funds must provide effective commu- nication services to
their limited English proficient, Deaf and hard of hearing patients: Civil Rights Act of 1964, revised in 2000 commonly known as "Title VI"
98. Language Proficiency: the ability to convey the appropriate tense, syntax and other components of language structure as well as
comprehension of the non-native speaker, such as localized accents
99. Other skills for a medical interpreter: 1. Completeness
2. accuracy
3. transparency
4. positioning
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5. ethical decision-making
6. medical terminology and vocabulary
7. anatomy
100. Reasons for not using minors to communicate with LEP: 1. Limited emotional maturity
- Vocabulary to communicate complex medical terminology
101. Using family and friends to communicate with LEP: Friends and family members regardless of age, are not
appropriate to use as interpreters for medical conversations. They often present as support to the patient and adding the role of interpreting changes this dynamic. Family and friends often inadvertently and sometimes intentionally leave out information that might attect the com- pleteness or ettectiveness of the communication
102. National Council for Interpreting in Healthcare: resource in the interpreting field and has
work to professionalize the field of interpreting through activities such as developing standards of practice in the medical interpreter code of ethics.
103. Communicating with the deaf or hard of hearing: 1. Hearing aids
2. lip reading
3. sign language
4. TTY devices
5. Communication signs
6. whiteboards
7. assisted listening devices
104. Who assures the patient's rights and responsibilities: American Hospital Association, The Joint Commission,
13 / 30 -Assure appropriate behavior of both patients and visitors -Avoid self-administration of medication -Adhere to agreed-upon treatment plan -Provide accurate insurance information and responsible payment of medical bills -Keep appointments -Comply with hospital policy -Show respect for other patients and health workers as they expect for themselves -Understand medical science has limitations -Ask questions
109. Patient Visitation Rights: •To have written policies and procedures about patient's visitation rights
• Inform patients or an attending friend or family member of the patient's rights to visitors of his or her choosing
• to have a policy which prohibits discrimination against a visitor based on race, ethnicity, religion, sex, gender identity, sexual orientation or disability
• to designate a supportive visitor and to be present through the procedure of his or her hospital stay
110. Goals of the Patient Bill of Rights: 1. To help patients feel more confident in the US healthcare system
2. to stress the importance of a strong relationship between patients and their healthcare providers
3. to stress the key role patients play and staying healthy by laying out rights and responsibilities for all patients and healthcare providers
111. Patient Bill of Rights: known as the consumer bill of rights and responsibilities that was adopted by the
14 / 30 US advisory commission on consumer protection and quality in the healthcare industry in 1998.
112. Patient Right: Admission: Admission - although persons who are not within the statutory classes have no right of admission, hospitals
and their employees owe a duty to extend reasonable care for those who present himself for assistance and need immediate attention. With respect to such person's governmental hospitals are subject to the same rules that apply to private hospitals.
113. Patient Right: Examination and Treatment: patients have the right to expect their physician
will conduct an appropriate history and physical examination based on the patients presenting complaints.
114. Patient Right: Participate in Care Decisions: patients have the right to choose the medical care they wish to receive.
They have the rights and other treatment options and to accept or refuse care. Although the patients have a right to make their own care and treatment decisions, they often faced conflicting religious and moral values in their decision-making process.
115. Patient Right: Informed Consent: patient have the right to receive all the information necessary
to make an informed decision prior to consenting to a proposed procedure or treatment. This information should include the possible risks and benefits of the procedure or treatment the right to receive information from the physician
16 / 30 and neighborhoods
5. converse intelligently with the residents about community issues, personalities and geography
6. speak convincingly with media about the community
7. share information with other organizations or coalitions that work in the community
8. providing background and justification for proposals
9. knowing the context of the community so that you can tailor interventions and programs to its norms and culture and increase chances of success
123. Factors that can impact the relationship between patients and health
providers: •Communication and interpersonal relationship styles including word choice, voice tone and volume, eye contact, and proper titles
• gender issues and consideration of appropriate male/female interaction
• age, respect, and seniority
• individualism and equality
• clothing, hairstyles, and body adornment
• informal and social interactions
• language spoken/use of interpreters or family members
124. Negative impacts of cultural competency and diversity in healthcare: •Disrupt- ing the relationship between
patients and providers
• Creating mistrusting miscommunication
• diminished care experience
• legal consequences
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• Financial impact
125. Common reasons regarding do you like of awareness in cultural compe- tence: 1. Lack of
knowledge resulting in an inability to recognize ditterences
2. Self protection and denial leading to an attitude that these ditterences are not significant or that are common humanity transcends our ditterences
3. fear of the unknown or the new because it is challenging and perhaps intimidating to understand something new that does not fit into one's worldview
4. feeling of pressure and due to time constraints, which can lead to feeling rushed and unable to look in depth at an individual patient's needs
126. Steps in Building Cultural Competence: 1. Starts with Awareness-this includes addressing
simple concept of ditterence and understanding the importance
2. Grows with Knowledge-identifying key knowledge staff must focus on
3. Enhanced by Skill-develop core skills such as effective cross cultural communication and conflict resolution
4. Polished through Interactions-Application of these ideas in a day to day interactions that one is both tested and behaviors are refined
127. Paraverbal Communication: How we say the words we say, for example do we seem happy, sad,
angry, determined, or forceful.
128. Received Communication Breakdown: 7% Verbal
55% Nonverbal 38% Paraverbal
129. When faced with a difficult or violent patient, the most important things remember are:: 1.
safety
2. judge a level of what is happening before jumping in with both feet
3. stay in control and demonstrate this control with a strong voice and body language
19 / 30 heart disease diabetes and cancer
134. Plain Language: a strategy for making written and oral information easier to understand.
135. Statistics of those who may lack the skills needed to manage their health and prevent disease.:
9 out of 10 adults lack the skills. 14% of adults have Below Basic health literacy (42% are poor and 28% lack health insurance)
136. Health Literacy: who is at risk?: Older adults, racial and ethnic minorities, people with less than a HS diploma or GED, low
income, non-native speakers of English and people with compromised health status.
137. Health Literacy and PX: Average 6% more hospital admission More
frequent ED visits 2 days longer for hospitalization Earlier mortality Cost $106 billion to $238 billion annually
138. Ask Me 3: An educational program that encourages patient and families to ask three specific questions of their providers to better
understand their health conditions and what they need to do to stay healthy
139. Ask Me 3: the questions: 1. What is my main problem?
2. What do I need to do?
3. Why is it important for me to do this?
140. Dangers of ALL CAPS on location signs: ALL CAPS changes the shape of the word. By creating a rectangle, those with
learning disabilities can no longer recognize words. Those with learning disabilities may requires the hook of a lower-case "g" to understand the word.
141. Teach Back: Do and Dont's: DON'T: "do you understand?"
20 / 30 DO: "what are you going to tell your wife about the food she buys"
142. What is a Grievance?: •All written letters, emails, faxes and social media from patients or the represen- tative, including any written
attachment to a patient satisfaction survey
• All complaints alleging abuse, neglect, patient harm, or noncompliance with any CMS requirement
• Any instance where the patient or the representative requests a complaint to be handled as a grievance
• All complaints not resolved by "statt present"
143. Staff Present: "Statt present" is further defined to all and any involved statt to resolve the issue that moment for that day
