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CPHQ Concepts Flashcards

(73 cards)

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1
Q

Duties Board of Directors

A

setting policy; quality of care; financial & strategic direction; goals & objectives

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2
Q

Pt Experience Mechanisms

A

HCAHPS Hospital Consumer Assessment of Healthcare Providers & Systems; CAHPS Consumer Assessment of Healthcare Providers & Systems; VoC Voice of the Customer; HHC CAHPS; ED CAHPS, HAHPS Home & Community Based Services; hospital CAHPS

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3
Q

Hoshin Planning

A

strategy implementation through department deployment; develops plan with targets & means with ongoing data0based review

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4
Q

Balanced Scorecard components

A

Financial; Customer; Business Process; Learning & Growth

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5
Q

Managed Care Reimbursement

A

3rd party payers manage cost of healthcare & episodes of care

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6
Q

DRG

A

Diagnosis-Related Group; developed in US in 1980s, set pricing for specific types/buckets of care

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7
Q

PPOs

A

Preferred Provider Organizations; don’t require PCP referral for additional care

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8
Q

HMOs

A

Health Maintenance Organization; usually require PCP, narrow network

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9
Q

2017 Quality Payment Program

A

Established MIPS Merit-Based Incentive Payment System

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10
Q

EPO

A

Exclusive Provider Organization; only the network is covered

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11
Q

Kirpatrick Model of Evaluation

A

Preferred by CMS; reaction (satisfaction w/ training); learning; behavior changes; results; return on investment

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12
Q

Magnet Recognition

A

Nursing designation for quality patient care/excellence in RN practice; 5 components: innovation/improvement, transformational leadership, structural empowerment, exemplary professional practice, empirical quality results

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13
Q

Baldridge

A

Presidential Award; organizational assessment tools, used for internal PI even if not applying; 7 categories: leadership, strategy, customers, measurement, analysis & improve of organizational performance, workforce, work processes, results

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14
Q

Patient-Centered Medical Home

A

Approach to improve quality, decrease cost for primary care; team-based & focused on care coordination

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15
Q

NCQA Pt-Centered Connected Care

A

Built from medical home model of care; encourages outpatient treatment to communicate with PCP

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16
Q

National Quality Award Program

A

Recognizes long-term care; bronze, silver, or gold

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17
Q

Voluntary Quality Ratings

A

National Quality Forum; National Association Healthcare Quality; Agency for Healthcare Research; Leapfrog; Institute for Healthcare Improvement; World Health Organization; Health & Medicine Division of Institute of Medicine

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18
Q

Regulatory Ratings

A

OSHA Occupational Safety & Health Admin (US Dept of Labor); HIPAA Health Insurance Portability & Accountability Act; SNF Quality Reporting Program (for short- and long-term care, measured by hospital readmissions)

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19
Q

ACOs

A

Accountable Care Organizations; care-coordination for Medicare members

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20
Q

Healthcare Waste

A

failure of care delivery; failure care coordination; overtreatment/low value care; pricing failure; fraud & abuse; administrative complexity

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21
Q

CMS Quality Goals

A

Safe, effective, efficient, patient-centered, equitable, timely

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22
Q

FPPE

A

Focused Professional Practice Evaluation; provider competency assessment for requested privileges/care delivery; reviews pt care, medical/clinical knowledge, practice-based learning & improvement, interpersonal & communications skills, professionalism, systems-based practice

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23
Q

OPPE

A

Ongoing Professional Practice Evaluation; peer-review; confidential

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24
Q

How to know which events are reportable?

A

Follow regulatory agency

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25
Sentinel Events
Patient safety even causing severe OR permanent harm; encouraged to report to the joint commission
26
MACRA Medicare Access & CHIP Reauthorization Act of 2015
Medicare physician reimbursement through MIPS or APMs
27
Accreditation Agencies with "deemed status" per CMS
The Joint Commission; Accreditation Commission for Health Care (ACHC) for hospitals; CIHQ Center for Improvement in Healthcare Quality (hospitals); NCQA National Committee for Quality Assurance (managed care, HEDIS); DNV GL Det Norske Veritas Germanischer Lloyd (international); Accreditation Association for Ambulatory Healthcare AAAHC; CARF International (for rehab)
28
Patient Safety Organizations
NPSGs National Patient Safety Goals; AHRQ Agency for Healthcare Research and Quality; not regulatory, not punitive
29
Human Factors Engineering
considers strengths & limitations; examines activity; focus on actual practice
30
Adverse Events
Due to medical care delivery, not outcome of patient condition or disease state; either preventable, ameliorable (unpreventable, but could have resulted in less harm with different care), or due to negligence
31
Sentinel Events
Adverse outcome; unanticipated patient safety event; JCI immediate investigation
32
Commission
Taking action in error
33
FMEA
Failure Mode & Effects Analysis; systemic, proactive approach used for new systems or system redesign; analysis completed for each failure point; prospective
34
RCA
Root Cause Analysis; reactive; may be regulatory requirement after sentinel event; finds basic cause and suggests corrective action after event has occurred
35
Corporate liability
Organization's duty to patients
36
Vicarious liability
(respondent superior); employer liability for employees
37
Ostensible agency
liability for independent contractor clinicians
38
res ipsa loquitur
patient can prove clear & obvious negligence w/out establishing standard of care
39
Value
(quality + outcomes)/cost
40
Prochaska's Stages in Changing Behavior
precontemplation; contemplation; preparation; action; maintenance; termination
41
Kotter's Heart of Change Model
Not allowing complacency; communicate powerful vision; create short-term winds; anchor the change within the culture
42
Kotter's 8-Stage Process for Major Change
create urgency; create guiding coalition; develop vision & strategy; communicate change vision; remove barriers to action; short-term winds; build on change; institute change
43
Force Field Analysis Change Model
Driving force (strengths) vs restraining force (barriers)
44
Diffusion of Innovation Model
knowledge, persuasion, decision, implementation, confirmation
45
SMART Goals
Specific, measurable, achievable, relevant, time-bound
46
Plan Do Check Act vs Plan Do Study Act
"study" component championed by Deming, more data-driven
47
The Model for Improvement
Set aims; establish measures; select changes; test via PDSA
48
LEAN & LEAN Sustain
system to eliminate waste and focus on customer-focused value stream through "kaizen" continuous improvement; make it mistake or error-proof "poke yoke;" safety, sort, set in order, shine, standardize, sustain
49
Sources of Healthcare Waste (LEAN)
TIM U WOOD Transportation, inventory excess, motion, unused creativity, waiting time, over-or incorrect processing, overproduction, defects or rework
50
Six Sigma
stats-based to eliminate variation; DeMAIC Define Measure Analyze Improve Control; also uses SIPOC Supplier Input Process Outputs Customer
51
Fishbone/Ishikawa
cause & effect brainstorming tool to ID root causes (manpower, methods, machines, materials) (people, procedure, place of work, provisions, patron)
52
Nominal Group Technique & multi-voting
For new groups or controversial decisions as anonymous; write ideas on card, give point value, and tally; multi-voting- doing this more and more times to find selection
53
RASCI Chart
Responsible, Accountable/approve (only 1!), Supportive, Consulted, Informed
54
Spaghetti Diagram
Layout diagram; shows flow of process in space to ID movement
55
Tree Diagram
paths/tasks process; multilayer with cause and effect across layers
56
Decision Support System
Data to guide medical management, performance evaluation, resource allocation, strategic planning & marketing
57
Probability Sample & Non-Probability Sample
probability sampling CAN generalize findings; non-probability sample can NOT
58
Snowball Sampling
Uses (participants') network
59
Purposive of judgement sampling
Cohort sample
60
Ratio vs Interval Data
Ratio data has true 0 and no negative values; interval data is continuous and does not have true zero
61
Run Chart
Charts a process over time; has median line in center; 4rules to identify changes: shift rule (6+ consecutive points above or below median & don't count value on median), trend rule (5 consecutive points going up or down; if 2 points are the same, count as single point) and runs rule (count # times line crosses median and add 1, compare to table) and astronomical point (outlier); up to 12 data points
62
Shewart Control Chart
To determine if process is stable; to determine special or common cause variation; has mean as central line and 3 SD upper & lower control limits; need 12+ data points and can recalculate upper & lower limits after 20-30 data points
63
Pareto chart
bar chart; 20%/80%
64
Histogram
Frequency bar plot; need 50 data points; check central location, spread, and shape ("skewed to the tail side")
65
Scatter Diagram
Shows relationship between two variables
66
Common cause variateion
indicates stable process; variation due to system/process design
67
special cause variation
variation in process due to special causes that are not part of process; not stable process; ID via 1. single point outside limits; 2. shift above/below center line of 8+ points; 3. trend 6 or more points all heading up or down; 4. 2 of 3 consecutive points in outer 3rd of limits or beyond; 5. 15+ points within center line and first SD
68
Reliability by equivalence
0.70 okay, but 0.80 better
69
T-test
tests if 2 groups are different
70
Regression analysis
Tests if variables are correlated (-1,0 (no correlation, 1)
71
Chi Square
most common in healthcare lit; tests categorial or count data to see if related; p less than 0.05 means statistically significant
72
Confidence interval
How closely the population is related to the sample
73
Patient Centered Medical Home
Centered around primary care

CPHQ (2 decks)

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