Domain III, Topic E, Quality Management and Improvement

Question 1

A ____/_______ analysis

1) Determines whether the goal of the intervention is worthwhile in terms of cost
2) The value of the benefits derived from the intervention must outweigh the costs
3) State objectives clearly and quantifiably

Answer 1

Cost Benefit

Question 2

______ Benefits include

• Change in diet or food habits as a result of counseling
• Change in functioning of body due to altered diet intake (weight change, reduced constipation due to high fiber diet, reduction of hypertension due to weight loss)
• Value is determined by measuring the cost of treatment alternatives needed due to absence of improved food habits

Answer 2

Direct

Question 3

________ Benefits

a) Saving of physician’s time and other resources due to the prevention or reduction in severity of a disease (decrease in admissions or length of stay)
b) Calculate total costs of program
c) Calculate benefit / cost ratio

Answer 3

Indirect

Question 4

A ____/_____________ analysis

1) Assumes that the goal of the project is worthwhile
2) Question to resolve is which method of intervention is the most effective (in terms of value) in achieving the goal
3) Compares costs of alternative strategies
4) Analysis uses outcomes research

Answer 4

Cost effectiveness

Question 5

An _____ is a formal study that retrospectively monitors performance
1) Way to document appropriate care patterns and for identifying areas needing improvement

Answer 5

Audit

Question 6

The _____ _______ __________ (TQM) approach is a philosophy where processes are refined with goal of improving performance in response to customer needs and expectation.
- Involves continuous improvement of organizational processes, resulting in high quality products and services

Answer 6

Total Quality Management

Question 7

The three elements of the TQM approach are

1) __________ / _______ - True judges of quality
2) _______ - Environment created that establishes quality as a top priority
3) ________ - Measurement of what constitutes a high quality service or product and what needs improvement

Answer 7

Customers / Clients, Culture, Counting

Question 8

The PDCA (\_\_\_\_, \_\_, \_\_\_\_\_, \_\_\_) or PDSA (\_\_\_\_, \_\_, \_\_\_\_\_, \_\_\_) cycles of the TQM approach are
- Problem solving techniques for coordinating process improvement

Answer 8

Plan, do, check, act, Plan, do, study, act

Question 9

The acronym FOCUS outlines the process to use in the TQM approach

F\_\_\_ a process to improve
O\_\_\_\_\_\_\_ a team that knows the process
C\_\_\_\_\_\_ current knowledge of the process
U\_\_\_\_\_\_\_\_\_ causes of process variation
S\_\_\_\_\_ the process improvement

Answer 9

Find, Organize, Clarify, Understand, Select

Question 10

The PDSA cycle of the TQMm approach means to
P___ to improve (How changes will be made)
D_ the changes (Implement the intervention
S____ the results (Determine the impact
A__ to maintain and continue

Answer 10

Plan, Do, Study, Act

Question 11

__________ _______ ___________ (CQI) is an integreal part of the TQM

a) Emphasizes organization and systems rather than idividuals
b) ideal tat systems and performance can always improve
c) uses outcome assessment

Answer 11

Continuous Quality Improvement

Question 12

Improvement processes use three criteria to describe desirable health care processes or outcomes

a) _________ - environmental and personnel factors, policies, budget
b) _______ - procedures used, sequence of activities (assessment, documentation in medical record, distribution of food)
c) Outcome (end result) - Measurable result of your intervention; measures success or failure of process of care provided; includes time frame
1) Anthropometric, biochemical data
2) “Based on survey results, customers are satisfied with meals”

Answer 12

Structure, Process, Outcome

Question 13

Characteristics of process improvement criteria (RUMBA)
R\_\_\_\_\_\_\_
U\_\_\_\_\_\_\_\_\_\_\_\_\_
M\_\_\_\_\_\_\_\_\_
B\_\_\_\_\_\_\_\_\_
A\_\_\_\_\_\_\_\_\_

Answer 13

Relevant, understandable, measurable, behavioral, achievable

Question 14

__________ are measurement tools that monitor and evaluate important aspects of patient care and management functions.

a) Serve as flags to direct attention to specific issues. Not intended to be direct measures of quality, but desirable events, complications or outcomes
b) Thresholds for evaluation (% numbers): level at which a stimulus is strong enough to signal need to respond; then begin process to determine why threshold was crossed

Answer 14

Indicators

Question 15

____ _____ indicator (comparative rate indicator)

1) what will happen with the BEST care, thresholds between 1% and 99%
2) 95% high - risk patients are assessed within 24 hours
3) 95% of trays are delivered intp patient’s room within 10 minutes of arrival on floor

Answer 15

Rate based

Question 16

________ _____ indicator

• Serious event that requires further investigation each time it occurs; undesirable but avoidable events
  1) Threshold of either 0% or 100% (never or always)
  2) 0% food poisoning; dish machine area floor is dry 100%
  3) 100% oncology patient are fed within 5 days

Answer 16

Sentinel Event

Question 17

_______ management systems evaluate effectiveness and efficiency

Answer 17

Outcome

Question 18

_____________ refers to the degree to which an exchange helps to achieve your objectives (Doing the right thing)

Answer 18

Effectiveness

Question 19

__________ refers to the minimization of resources you must spend to achieve that desired level of exchange (Doing things right)

Answer 19

Efficiency

Question 20

___ ____ is a data driven approach for improving quality by removing defects and their causes.

_____ is a statistical unit of measurement used to define standard deviation

Achieving ___ _____ (6 standard deviation from the mean) means there is very little variation in a process.

Helps organizations focus on developing and delivering near perfect products and services

Answer 20

Six Sigma, Sigma, six sigma

Question 21

Six Sigma uses the DIMAC approach
D\_\_\_\_\_
M\_\_\_\_\_\_
A\_\_\_\_\_\_
I\_\_\_\_\_\_
C\_\_\_\_\_\_

Answer 21

Define, Measure, Analyze, Improve, Control

Question 22

In the ______ philosophy, “good change” suggests making continuous small incremental improvements in process on a daily basis, rather than large revolutionary changes.

• It focuses on teamwork, discipline, improved morale, quality circles, and suggestions for improvements

Answer 22

Kaizen

Question 23

The ____ method uses less human effort, less space, less capital, and less time to make products exactly as the customer wants with few defects.
- Use videotaping and stopwatches to capture work being done.

• Reorganize workflow, duties and practices.
• Reduce food costs, increase efficiency and customer satisfaction

Answer 23

Lean