Questions and Answers
What is the primary focus of Case Management/Discharge Planning?
Appropriate resource and support allocation
What is the main goal of Risk Management in healthcare?
Reducing the effects of negative outcomes on patients and organizations
Which aspect of healthcare is focused on identifying and managing potential risks?
Risk Management
What is the primary objective of Utilization Management?
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Which healthcare aspect involves allocating resources and support to patients?
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What is the primary focus of Infection Control in healthcare?
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Which healthcare aspect is responsible for optimizing resource allocation and efficiency?
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What is the primary role of Practitioner Credentialing in healthcare?
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What is the primary goal of the HHS Measurement Policy Council?
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What is an essential component of success in delivering quality healthcare?
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Who are considered internal customers in a healthcare organization?
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What is one of the nine topics addressed by the HHS Measurement Policy Council?
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What is a key aspect of care coordination in healthcare?
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What is a key element of effective treatment practices in healthcare?
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What is a key focus of healthy living initiatives in healthcare?
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What is a key goal of affordable care models in healthcare?
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Which HCQAURP Exam Core Body of Knowledge (CBK) concept is related to ensuring continuity of care?
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What is the primary focus of the American Society for Quality (ASQ) Certification?
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How many years of on-the-job experience are required for the Certified Manager of Quality/Organizational Excellence (CMQ/OE) certification?
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What is the format of the Certified Manager of Quality/Organizational Excellence (CMQ/OE) exam?
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What is the minimum number of years of experience required in a decision-making position for the Certified Manager of Quality/Organizational Excellence (CMQ/OE) certification?
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Which HCQAURP Exam Core Body of Knowledge (CBK) concept is related to ensuring that healthcare providers meet certain standards?
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What is the purpose of the HCQAURP Exam Core Body of Knowledge (CBK) concepts?
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What is the benefit of waiving some of the required years of experience for the Certified Manager of Quality/Organizational Excellence (CMQ/OE) certification?
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Study Notes
Patient Outcomes and Care Delivery Process
- Measurement, analysis, interpretation, and reporting of patient outcomes and care delivery process are crucial.
- Utilization management (UM) reviews medical necessity and appropriateness, and ensures resource allocation is timely, efficient, and cost-effective.
- Case management/discharge planning (CM/DP) screens and assesses patients, allocates resources, and coordinates care and aftercare planning.
Risk Management
- Risk management (RM) identifies and mitigates clinical occurrences, claims, and environmental hazards.
- It aims to prevent negative outcomes and their effects on the organization and patient.
Infection Control
- Infection control (IC) involves surveillance, identification, isolation, and prevention of infections.
- It includes guidelines, policies, and procedures for infection control, as well as education and training.
Practitioner Credentialing
- Practitioner credentialing, privileging, and policy management involve verifying qualifications and competence of healthcare providers.
- Medical staff requirements vary depending on the setting.
Healthcare Quality Basics
- The HHS Measurement Policy Council (MPC) has established a core set of measure definitions for healthcare quality.
- The nine topics addressed by the MPC include hypertension control, patient safety, and smoking cessation.
- The MPC recommends adoption of these measures by healthcare organizations and quality programs.
Customer Satisfaction
- Customer satisfaction is essential for healthcare success and economic survival.
- Customers include patients, families, and external stakeholders who receive goods or services.
- Internal customers are employees who depend on others for work.
HCQAURP Exam Core Body of Knowledge
- The HCQAURP exam covers concepts such as patient safety, transitions of care, accreditation, insurance, and case management.
- It also includes quality improvement, quality management, quality assurance, risk management, and regulatory environment.
American Society for Quality (ASQ) Certification
- The ASQ Certified Manager of Quality/Organizational Excellence (CMQ/OE) requires 10 years of experience in quality management.
- The exam covers areas such as leadership, strategic planning, and customer focus.
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