HIT 201 final Study Guide (184 terms) with Complete Solutions Latest 2023., Exams of Nursing

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During a recent Joint Commission survey, one of the survey team members asked a nurse in the ICU about her patient. The surveyor asked the nurse about the medications that the patient was on and also asked for the nurse to explain how those medications were ordered and received from the pharmacy. After the nurse explained this process, the surveyor then went to the pharmacy and asked the pharmacist to explain his role in the medication process for this specific patient. The surveyor is utilizing what process? - AnswerTracer methodology Match the following definition to its proper term: "grants the healthcare organization legal authority to provide healthcare services within a limited geographical area" - AnswerLicensure When a facility wants to bill Medicare/Medicaid for services rendered, in order to apply to CMS to receive this funding the healthcare organization has to have met which guideline? - AnswerCoP What is the decision called when all available appeal procedures have been exhausted? - AnswerDenial of accreditation These are performed to fulfill legal or licensure requirements - AnswerCompulsory reviews As part of the CARF accreditation process, reviewers examine policies and procedures, administrative rules and regulations, administrative records, human resource records, and the case records of patients. This process is called _____. - Answerdocument review Community Hospital of the West has recently been accredited by the Joint Commission for a full three year period. Based on its accreditation status, CMS assumes that the Community Hospital of the West meets the Conditions of Participation. The reason CMS makes this assumption is because the Joint Commission has been granted _____. - Answerdeemed status This type of healthcare organization review is conducted at the request of the healthcare facility seeking accreditation _____. - Answervoluntary review Which of the following is the process of meeting a prescribed set of standards or regulations to maintain active accreditation, licensure, or certification status? performance improvement

compliance document review deemed status - Answercompliance Western States University Hospital has a contractual relationship with a municipal managed care health plan in its region. Each year, health plan quality management officials come to University Hospital to review cases against selected screens for health maintenance. What criteria are these health screens based on? - AnswerHEDIS In the 1700-1800s, this hospital became a model for the development of hospitals in other communities.

• AnswerPennsylvania Hospital This association was established in 1840 to represent the interests of physician across the United States - AnswerAmerican Medical Association Which of the following individuals volunteered to perform the first review of medical college curriculum and education processes leading to more rigorous academic standards for medical schools? - AnswerHenry Pritchett In 1965, the United States Congress passed Public Law 89-97, an amendment to the Social Security Act of 1935. This law established: - AnswerMedicare and Medicaid Which of the following is NOT a type of managed care? - AnswerTQM This act established a quality reporting program for skilled nursing care in the United States. - AnswerIMPACT Organizations that pay close attention to weak signals of trouble to catch problems or errors in the earliest stage are applying the principles of _____. - AnswerHRO high reliability organizations

A quantitative tool that provides an indication of an organization's performance in relation to a specified process or outcome is a/an _____. - Answerperformance measure Which of the following terms does the textbook use to identify a variety of methods PI teams can use to accomplish their goals? - AnswerQI toolbox techniques Root-cause analysis is a key technique used in this quality improvement methodology? - AnswerLean A type of PI team that constructs relatively simply and quick "fixes" to improve work process without going through the complete PI cycle is called a - Answerblitz team When a PI team first meets and discusses participation expectations, communication methods, and plans for decision making techniques to be used, these are examples of team ___________. - Answerground rules Which of the following would be an example of a reviewable sentinel event? incidence of infant abduction incidence of hospital acquired infection incidence of unruly patient incidence of blood transfusion reaction - Answerincidence of infant abduction The number of incidences of violence in the workplace would be collected as a risk management measure. This is an example of _________ - Answeran outcome measure The foundation of care giving, which include buildings, equipment, professional staff, and appropriate policies are included in what area of performance measurement? - Answersystems

The final results of care, treatment, and services in terms of the patient's expectations, needs, and quality of life, which may be positive and appropriate or negative and diminishing, are included in what area of performance measurement? - Answeroutcomes A tool used to ensure that every team members knows which items will be discussed or worked on during a meeting is called a - Answeragenda A PI team role primarily responsible for ensuring that an effective performance improvement process occurs by serving as advisor and consultant to the PI team, remaining a neutral, nonvoting member, suggesting alternative PI methods and techniques to keep the team on target and moving forward, maintaining group dynamics, acting as coach and motivator for the team, assisting in consensus building when necessary, and recognizing team and individual achievements is the _____. - Answerteam facilitator This statement describes what the organization or PI initiative will look like in the future or may describe some milestone the PI team will reach in the future. - Answervision statement Which of the following is the group that oversees all PI activities within a healthcare organization? - Answerperformance improvement council Which section of the CRAF minutes should document the results of the discussion and any decisions the group makes? - Answerconclusions Which of the following is a common standing committee in most healthcare organizations responsible for coordinating and reporting PI and safety activities? - Answerpatient safety and PI Committee A staff member is assigned to sit in the waiting room of the physician's office to collect data on patient waiting times. The staff member records the time in which the patient comes in the door and when the patient is called back to the examining room. This is an example of what type of data collection? - Answerdirect observation When the customer (patient) has judged that the healthcare worker is continuously monitoring both the customer's condition and his or her satisfaction with services, what aspect of quality of care or meeting the customer requirement is being met? - Answerresponsiveness

The health information professional relies on the patient registrar to accurately identify the patient in the EHR this is an example of a _____. - Answercustomer expectation The level at which an organization can provide an offered product or service when requested and as advertised is called _____. - Answerreliability The organizations reputation for the quality of its services and consumer reaction to these services and products based on their experiences with the organization is called _____. - Answerperceived quality The health information professional is a customer of the admitting department. What type of customer is the health information professional? - Answerinternal customer Which of the following can be used by a healthcare organization to communicate performance information that emphasizes the organization's mission within the community and their efforts to provide the community with high quality care? annual report dashboard storyboard charts - Answerannual report This type of report is based on the documented meeting minutes and should include information about PI activities such as: summaries of data collection, conclusions, and recommendations. - Answerquarterly report Institute of Medicine (IOM) is now known as - AnswerHealth and Medicine Division (HMD)

A patient satisfaction survey conducted after discharge is a method of quality measurement through - Answeroutcomes indicator Providing or improving access to health care services for millions of US citizens, including new restrictions on the ability of payers to limit coverage on the basis of preexisting conditions, an end to lifetime limits on coverage , and a requirement for payers to spend premium dollars on health care costs and not administrative costs - AnswerAffordable Care Act (ACA) Established a quality reporting program for skilled nursing care - AnswerIMPACT (Improving Medicare Post-Acute Care Transformation Act of 2014) Organizations that have learned to manage the unexpected - AnswerHigh Reliability Organizations (HROs) Viewing an organization as an open system of interdependencies and connectedness rather than a collection of individual parts and professional enclaves is a critical component of - Answersystems thinking This data is also called categorical data and includes values assigned to name-specific categories - Answernominal data Process of moving questions from a broad theme to a narrow theme in an unstructured interview - Answerfunneling The foundation of care giving, which includes buildings, equipments, technology, professional staff and appropriate policies - Answerstructure Programs that promote ___________ and _____________ have become the way for providers to add value of the services they provide and ensure their financial viability. - Answerefficiency and effectiveness Storyboards are a method used in health care that - Answergraphically display a performance improvement project conducted

Dr. Smith is establishing a clinical trial research study for the patients with lung cancer wishing to participate in a chemotherapy clinical trial. As Assistant Director, you are responsible for clinical abstract of data and advise him to first seek approval of research involving human subjects through the - Answerinstitutional review board (IRB) Clarity of terminology in a survey design is called - Answeroperational definition A short description that communicates an organizations social and cultural belief system - Answervalues statement A document that explains the issues the team was implemented to improve, describe the goals and objectives and desired end state (vision), and lists the initial members of the team and their respective department is called _____________ - Answerteam charter This team constructs relatively simple fixes that improve work processes without going through the whole PI process and without the need to involve other departments. - Answerblitz team Physicians are an example of - Answerinternal customers What type of QI tool is this below? - Answerhistogram The HIM transcription supervisor has instituted a performance improvement program that includes the use of benchmarks. Benchmarks have been established for total lines per hour of production, and the program was instituted two weeks ago. What should the supervisor do to determine if the benchmark is being met? - AnswerCompare individual transcriptionist line production per hour to the benchmark A HIM department director collects data quarterly on the average number of delinquent health records for the hospital. The following figure provides a graph of these averages. From a performance improvement perspective what is the best way to analyze the data? Average Delinquent Records - AnswerCompare the data to an established benchmark

In order to identify where improvements can be made, performance should be monitored - Answercontinuously The hospital's Revenue Cycle Management (RCM) team compiles data each month on the value of discharged not final billed (DNFB) cases. Given the data on this chart, what action by the HIM department should be taken? DNFB - AnswerDetermine the cause of the DNFB case upward trend and initiate process improvements The following table compares the length of stay for pneumonia at Community Hospital (observed LOS) to the length of stay for pneumonia at similar hospitals (expected LOS). Given this data, which clinical specialty has the lowest mean LOS observed in comparison to the mean LOS expected and might be used for internal benchmarking by Community Hospital? LOS Summary for Pneumonia by Clinical Specialty Clinical Specialty Cases Mean LOS Observed Mean LOS Expected Savings Opportunity Cardiology 1 6

0

Family Practice 17

38 Internal Medicine 34

Endocrinology 1

-

Pediatrics 7

https://otc.instructure.com/courses/8964/assignments/118197/submissions/6744 - AnswerInternal medicine What process assists a health care facility in continuously looking at the ways that problems develop and seeking ways to prevent problems from happening in the future? - Answerperformance improvement The improvement process of comparing the collection of POA(present on admission) indicators at your facility with those of comparable department of superior performance of other health care facilities is referred to as - Answerbenchmarking With the passage of Medicare (Title XVIII of the Social Security Act) in 1965, which of the following functions became mandatory? - Answerutilization review What criterion is critical in selecting performance indicators for a health information management department? - AnswerThe indicators must include the most important aspects of performance

What feature distinguishes the Nominal Group Technique (NGT) from brainstorming? - AnswerNGT determines the importance of responses through a rating system What feature is a trademark of an effective PI program? - Answera continuous cycle of improvement projects over time Patient mortality, infection and complication rates, adherence to living will requirements, adequate pain control, and other documentation that describe end results of care or a measurable change in the patient's health are examples of - Answeroutcome measures In quality review activities, departments are directed to focus on clinical processes that are - Answerhigh risk As the new Transcription Manager, you met with the transcription staff to encourage feedback on ways to increase transcription accuracy to meet established benchmarks. The transcriptionists provided feedback through brainstorming that you compiled on flip charts and organized into categories. This is known as a(n) - Answeraffinity diagram You sit on the quality improvement team for the Nursing department that meets to generate ideas to address verbal order documentation problems about the "Read Back Verbal Order" policy. What QI tool would prove useful in sharing input and various recommendations for solving this problem? - Answerbrainstorming Which quality management theorist developed the total quality management (TQM) as an alternative to authoritarian, top-down management philosophies? - AnswerDeming As the HIM Department Director you are asked to chair a committee that will review, select, and implement a CPOE system. The information has been collected, and you bring your committee together to prioritize their suggestions. This method of working with information is known as - Answernominal group process A histogram is a valuable tool for representing - Answera frequency distribution with continuous-interval data

Continuous quality improvement is best described by the following statements EXCEPT: corrective action targets clinicians more so than processes standards are defined, measured, and systemically applied monitoring is ongoing with periodic feedback all personnel support quality improvement efforts, including top management and the governing body - Answercorrective action targets clinicians more so than processes An unexpected occurrence involving death or serious physical or psychological injury, or risk thereof is called - Answersentinel event The Anesthesia Department is adding a new indicator to its plan. The Chief Anesthesiologist has come to you, the Director of Quality Management, to help her design a data collection methodology. The two of you are now considering who will be doing the data collection. All of the following are factors in your deliberation EXCEPT quality management organizational model of the institution The Joint Commission (TJC) standards and required characteristics the location of data the expertise of the staff - AnswerThe Joint Commission (TJC) standards and required characteristics

The manager of the Quality Department is listing various sources of data. Which of the following data sources would be an external source - Answerquality improvement organization (QIO) information Refer to the Summary of Selected Blood Product Review table shown below. Which blood component or derivative had the most units reviewed? SUMMARY OF SELECTED BLOOD PRODUCT REVIEW Monitoring Element Packed Red Blood Cells Fresh Frozen Plasma Platelets (N=295) (N=256) (N=29) (N=10) Met N (%) Unmet N (%) Met N (%) Unmet N (%) Met N (%) Unmet N (%) Indications 232

(91%)

(9%)

(24%)

(76%)

(100%)

0

(0%)

https://otc.instructure.com/courses/8964/assignments/118197/submissions/6744 - Answerpacked red blood cells Refer to the Summary of Selected Blood Product Review below. What percentage was unmet in Fresh Frozen Plasma? SUMMARY OF SELECTED BLOOD PRODUCT REVIEW Monitoring Element Packed Red Blood Cells Fresh Frozen Plasma Platelets (N=295) (N=256) (N=29)

(N=10)

Met N (%) Unmet N (%) Met N (%) Unmet N (%) Met N (%) Unmet N (%) Indications 232 (91%) 24 (9%) 7 (24%) 22 (76%) 10 (100%) 0 (0%) 7% 24%

22%

76%

https://otc.instructure.com/courses/8964/assignments/118197/submissions/6744 - Answer76% Refer to the Summary of Selected Blood Product Review table below. Based on the results reported in the table, which blood component or derivative should first be the topic of an in-depth study? SUMMARY OF SELECTED BLOOD PRODUCT REVIEW Monitoring Element Packed Red Blood Cells Fresh Frozen Plasma Platelets (N=295) (N=256) (N=29) (N=10) Met N (%) Unmet N (%) Met N (%) Unmet N (%) Met N (%) Unmet N (%)

Indications 232 (91%) 24 (9%) 7 (24%) 22 (76%) 10 (100%) 0 (0%) packed red blood cells fresh frozen plasma platelets unable to determine from the table https://otc.instructure.com/courses/8964/assignments/118197/submissions/6744 - Answerfresh frozen plasma The health information reception desk is experiencing a huge influx of phone calls on Monday, Tuesday, and Wednesday mornings. This is creating a problem in getting requested patient information out within an acceptable time frame. The reception staff work group has agreed to start recording the reason for the phone calls for the next 4 weeks. They want to focus on solving the response time problem by reducing the turnaround time for the largest category of phone calls. Which QI tool best supports this goal? - AnswerPareto Chart The board of directors of a 400-bed women's hospital receives a report of key quality indicator results on a periodic basis. The report always includes the quarterly cesarean section rate. This reporting period,

they see a rise in the rate and want to know if it is a significant increase. What is the best QI tool for this purpose? - Answercontrol chart What is the best tool for differentiating between common cause variation and special cause variation? - Answercontrol chart Which of the following is INCORRECT about the use of control charts? control charts can be used to measure key processes over time the upper and lower control limits are always +/- 2 standard deviations the lower control limits are always +/- 2 standard deviations the upper control limit are always +/- 1.8 standard deviations - Answerthe upper control limit are always +/- 1.8 standard deviations The average percent of patients exceeding acceptable waiting times was 3.7%. See table below. The calculated UCL (upper control limit) is 9.4. When you plot the upper and lower limits, what would you suggest as the reason fro the June variation? Year 2015 Percent Patients with Unacceptable Waiting Time (%) January 5 February 4 March 3 April 5

May 3 June 10 July 5 August 2 September 1 October 2 November 1 December 3 common cause variation root cause variation special cause variation unable to determine with the data given https://otc.instructure.com/courses/8964/assignments/118197/submissions/6744 - Answerspecial cause variation This survey was developed and initiated to provide a consistent format and process for gathering patient satisfaction and perspectives on hospital care - AnswerHCAHPS 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? - Answerseverity of illness

Ann'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 is called? - Answerpreauthorization Which of the following is an integral component of case management that helps to improve patient outcomes, lower healthcare spending, while still providing appropriate care to patients at the appropriate time? - Answerutilization review Which of the following is one of the tools utilized to help HMOs address their specific members' needs? admission planning post-discharge assessment community needs assessment discharge planning - Answercommunity needs assessment Criteria that have been developed by many of the same agencies for use across the continuum of care and in various regions of the country are referred to as - Answergeneric 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? - Answerintensity of service A multidisciplinary outline of anticipated care within an appropriate time frame to aid a patient in moving progressively through a clinical experience that ends in a positive outcome is called a _____. - Answercritical pathway

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 - Answerpostdischarge planning The totality of healthcare services provided to a patient and his family in all settings, from the least extensive to the most extensive is called - Answercontinuum of care Principal process by which organizations optimize the continuum of care for their patients - Answercase management An infection that was present in the patient before he or she was admitted to the facility is called _____.

• Answercommunity-acquired infection The symbol in flowcharting that is used to mark the point in the process where the analysis skips to another common point of the process is called _____. - Answerconnector icon Which of the following represents a list of potential blood-borne pathogens? Correct! HIV and Hepatitis B Colorado Tick Fever & Pertussis Mumps & HIV Hepatitis B & Pertussis - AnswerHIV and Hepatitis B If the patient presents to the hospital with symptoms of cough, fever, and chills and is later diagnosed with pneumonia the incidence of this infection would be determined as ____. - Answercommunity- acquired infection

OTC Hospital discharged 200 patients this past July. During July, OTC Hospital had 15 patients that experienced a nosocomial infection. What is the infection rate for the month of July at OTC Hospital? - Answer7.5 % 15/200 = .075 x 100 = 7.5% The establishment of an interactive treatment plan that is specific, individualized, and based on a thorough assessment of the patient's physical, emotional, social, cognitive, and cultural needs is which core process step? - Answerplanning care, treatment, and services Signs, symptoms, or conditions suffered by a patient as the result of the administration of an incompatible blood products is called _____. - Answertransfusion reaction CLIA and the CDC have established protocols for _____. - Answerlaboratory departments All of the following are Joint Commission core measure criteria sets except _____. heart failure acute myocardial infarction pneumonia diabetes mellitus - Answerdiabetes mellitus Large population based studies are used to identify the care processes or interventions that achieve the best healthcare outcomes in different types of medical practice. This research concept is called _____. - Answerevidence based medicine The risk manager's principal tool for capturing the facts about potentially compensable events is the - Answeroccurrence report

Events that occur in a healthcare organization that do not necessarily affect an outcome but carry significant change of being a serious adverse event if they were to recur are called - Answernear misses A person who represents the rights and interests of another individual as though they were the person's own is referred to as a patient - Answeradvocate The investigational technique that facilitates the identification of the various factors that contribute to a problem known as a fishbone diagram is also called a/an - AnswerCause-and-Effect Diagram A patient injury resulting from a medication, either because of a pharmacological reaction to a normal dose or because of a preventable adverse reaction to a drug resulting from an error, is called - Answeradverse drug event The list of drugs approved for use in the healthcare organization is generally referred to as the - Answerformulary A patent for a new drug gives its manufacturer an exclusive right to market the drug for a specific period of time under what type of name? - Answerbrand Inappropriate dose, nonformulary agent, and medication errors to transfer are all examples of this type of medication error - Answerprescribing Includes and process variation for which an recurrence would carry a significant chance of a serious adverse outcome is called a; - Answersentinel event In a cause and effect diagram the fish bones delineate the causes of the situation in four categories. They are - Answermanpower, material, methods, machinery This group has ultimate responsibility for maintaining the quality and safety of patient care provided by its healthcare organization. - AnswerBoard of Directors

This person is responsible for implementing board directives and for action as board representative in managing the operations of the organization - Answerchief executive officer The document in which the leadership of a healthcare organization identifies the organization's overall mission, vision, and goals to help set the long-term direction of the organization as a business entity is called - Answerstrategic plan Which of the following organizations mobilizes employer purchasing power to promote healthcare safety, quality, and customer value and recognize improvements with rewards? Leapfrog Centers for Medicare and Medicaid Premier National Quality Forum - AnswerLeapfrog Which type of data collection pertains to the care services provided to each patient? - Answerpatient- specific Data found on sites such as Hospital Compare use aggregated data to describe the experiences of unique types of patients with one or more aspects of their care. What is this data collection called? - Answercomparative As part of ARRA, this Act requires that healthcare organizations and providers make significant investments in information systems to have a positive impact on the care that they provide: - AnswerHITTECH __________________facilitates the use of data by multiple individuals and multiple teams. - Answerstandardization _______________________ allow organizations to store reports, presentation, profiles, and graphics interpreted and developed from stores of data for reuse in subsequent organizational activities. - Answerinformation warehouses

In the late 1990's some healthcare organizations began to develop these to facilitate PI activities and long-range strategic planning. - Answerdata repository Patient-specific, aggregated, and comparative fall into this category. - Answerdata collection These standards address areas contribute to high-quality and improved patient care - AnswerInformation Management Standards Deploying this type of technology can be used to allow everyone in a healthcare organization to be informed of the current status of performance improvement projects: - Answerintranet-based communication This phase in the project life cycle includes clear objectives, importance of the project, and the expected outcome on the organization. - Answerplanning The stage of project team development in which team members work together easily is called - Answercollaborative teamwork The planning technique provides a structure that requires the project team to identify the order and projected duration of activities needed to complete a project - AnswerPERT chart According to Mrs. Yu's OB death we read about in this lesson, what was the proximate cause of her death? - Answerinability of the OB nurses to assist in an emergency surgical procedure In the fishbone diagram, what is documented on the "head" of the fishbone? - Answereffect, problem, or quality characteristic In the fishbone diagram, what is shown on the "bones" of the fishbone diagram? - Answercause(s) of the effect What is a fishbone diagram used for?