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CPXP Exam Study Guide Questions
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
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
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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
27. What is the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS): first
national standardized publicly reported survey of patients perceptions of hospital experience
28. What are the main functions of the Office of Patient Relations: Provide a centralized mechanism for
addressing patient concerns, liaison between patients and medical providers
29. What are the main goals of the Office of Patient Relations at Rush: Understand service gaps through
increased complaint capture Improve complaint resolution time
30. What is a level 1 complaint: concern addressed immediately by employee
31. What is a level 2 complaint: addressed at employee or escalated to management with additional tools (coupons, parking, flowers)
32. What is a level 3 complaint: employee escalates to manager refers patient/family or concern to patient relations
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34. What are the characteristics of hospitals that did NOT do well with value based purchasing?:
bigger, teaching hospitals, poor patients, govt owned
35. What is the goal of Partnership for Patients: decrease preventable hospital-acquired condi- tions, decrease preventable
complications during care center transition
36. When did Medicare Physician Pay for Performance begin?: started in 2015 for some physicians and
physician groups- projected to be for all physicians by 2017
37. What does the RUSH way stand for?: systematic approach to process improvement (Ready, understand, solve, hold)
38. Time frame that AHA establishes membership group: National society for patient
representation and consumer affairs: early 70's
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
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61. It is estimated that nearly out of 10 adults may lack the
skills needed to manage their health and prevent disease.: 9
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62. Definition of patient centered care: When healthcare works together across the continuum of care to meet the needs of the
patient.
63. What are the 3 goals of complaint management: correct what went wrong, learn from patients/customers/others,
create a positive relationship and increase satisfaction
64. Name one difference between how the Press Ganey survey results and the HCAHPs survey
results are calculated and reported?: Press Ganey uses a Likert scale and is not publicly reported, while HCAHPS uses a "Top Box" calculation and is reported on a CMS web site.
65. What is the quadruple aim: 1. Better outcomes
2. Lower costs
3. Improved clinician experience
4. Improved patient experience
66. What is EMTALA: law that prohibits ED's from turning away patients, no matter their ability to pay
67. Which year were Medicaid and Medicare established: 1965
68. In which decade did malpractice lead to the development of risk manage- ment
departments: 1970s
69. Which year was the Health Maintenance Organization (HMO) act put into place: 1973
70. Which year was the institute for Healthcare Improvement (IHI) established-
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
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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 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 different cultures
3. cultural skill - conducting an assessment of cultural data of the patient
4. cultural encounters - personal experiences with patient of different 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
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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.
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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
14 / 31 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
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 affect the com- pleteness or effectiveness 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
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5. Communication signs
6. whiteboards
7. assisted listening devices
104. Who assures the patient's rights and responsibilities: American Hospital Association, The Joint Commission,
DNV (Det Norske Veritas) Healthcare, the Center for Medicare and Medicaid services (CMS), and through many state and federal regulatory agencies
105. Classifications of Patient Rights: Legal - those emanating from law
Human Statements of Desirable Ethical Principles - the right to be treated with dignity and respect
106. Most federal state and local programs specifically require, as a condition for receiving funds
under such programs, and affirmation statement on the part of the organization that it will not.....: Discriminate
107. Key rights provided to patients: 1. admission
2. examination and treatment
3. participation and care decision
4. informed consent
5. refuse treatment
6. pain management
7. Quality care
108. Patient Responsibilities: -Inform staff about past and present illnesses and current medications
-Communicate care preferences -Practice a healthy lifestyle -Inform staff about changes in condition -Accurately describe symptoms -Understand illness and treatment plan -Staying informed
17 / 31 -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
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.
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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
- 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 differences
2. Self protection and denial leading to an attitude that these differences are not significant or that are common humanity transcends our differences
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 difference and understanding the importance
2. Grows with Knowledge-identifying key knowledge staff must focus on
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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
