Information Management PDF

CPHQ QUESTIONS 2 Which of the following may be considered examples of discrete variables? a. Height and weight b. Community-acquired and nosocomial infection rates c. Surgical or emergency department response time d. Patient visits in the months of May and June Discrete = Integer Janet - CH 5...

CPHQ QUESTIONS 2 Which of the following may be considered examples of discrete variables? a. Height and weight b. Community-acquired and nosocomial infection rates c. Surgical or emergency department response time d. Patient visits in the months of May and June Discrete = Integer Janet - CH 5 – Information Management The method of ordering data by listing all possible values, and all individuals receiving each value, is called a. the range. b. the standard deviation. c. a simple frequency distribution. d. a grouped frequency distribution Janet - CH 5 – Information Management What percentage of the total # of units typed and cross-matched for January was wasted? a. 6.5% b. 5.5% c. 21% d. 4.5% Janet - CH 5 – Information Management What percentage of cross-matched units were infused in March? a. 91% b. 89% c. 99% d. 92% Janet - CH 5 – Information Management What percentage of total units infused in March were whole blood? a. 2% b. 3% c. 4% d. 5% Janet - CH 5 – Information Management What is the ratio of units wasted to total units typed and cross-matched in February? a. 21:381 b. 13:300 c. 13:287 d. 13:38 Janet - CH 5 – Information Management Based on accuracy review of the data, which aspect of blood utilization would you recommend first for further investigation? a. Typing and cross-matching b. Units wasted c. Single-unit transfusions d. Use of whole blood Janet - CH 5 – Information Management When data has a range of values between the lowest and highest that is wide, but you want to rank-order them, it is best to use a a. line graph b. simple frequency distribution c. grouped frequency distribution d. cumulative frequency distribution Janet - CH 5 – Information Management The average between the highest and lowest measures is the a. median b. mean c. mode d. dispersion Janet - CH 5 – Information Management What is the total "N"? a. 11 b. 8 c. 19 d. 15 Janet - CH 5 – Information Management What is the range of values? a. 11 b. 8 c. 19 d. 15 Janet - CH 5 – Information Management What is the arithmetic mean? a. 11 b. 10 c. 9 d. 8 Janet - CH 5 – Information Management What is the mode? a. 11 b. 10 c. 9 d. 8 Janet - CH 5 – Information Management What is the median? a. 11 b. 10 c. 9 d. 8 Janet - CH 5 – Information Management The most accurate measure describing the amount of variability in a distribution is the a. variance. b. range. c. standard deviation. d. dispersion. Janet - CH 5 – Information Management The rate of increase or decrease in total medication errors over a six-month period could best be displayed by the use of a a. frequency polygon. b. line graph. c. bar graph. d. cumulative frequency curve. Janet - CH 5 – Information Management Measurement and assessment activities by the local Ambulatory Surgery Center indicate that monthly surgical site postoperative infection rates have increased over the past year. A comparison of the local Center's aggregated rate to the other surgery centers in the same region, for like procedures, is best displayed by the use of a a. bar graph. b. pie graph. c. grouped frequency distribution. d. line graph. Janet - CH 5 – Information Management You are setting up the data collection methodology for a study of certain inpatient cardiac procedures. Of the following, where might you look for the most concise basic information? a. Master patient index b. Disease index c. Surgical index d. Surgical log Janet - CH 5 – Information Management Your medical center QM department is asked to prepare quarterly summaries comparing cause of death as listed in the medical record with final autopsy findings. How could you set up the initial screening process to minimize effort? a. Use the master patient index. b. Use the death register. c. Contact the pathologist on a regularly scheduled basis. d. Rereview all death charts after 90 days. Janet - CH 5 – Information Management Management information systems are designed to be a. separate data sources. b. primarily manual. c. used in decision making. d. used primarily for long-term data storage. Janet - CH 5 – Information Management In a large community health center, with only the billing system currently automated, the best computerized QM system might be a. none. b. a stand-alone PC with network capabilities. c. a terminal tied in to the mainframe. d. a network system with medical records and finance Janet - CH 5 – Information Management In selecting software for quality improvement activities, it is essential to a. involve all potential users in determining specifications. b. have information systems staff make the final decision. c. have administration make the final decision. d. trust potential vendors to draft specifications Janet - CH 5 – Information Management A focused review of every other case seen in the Emergency Department on June 2, is an example of which type of sampling? a. Nonprobability quota b. Stratified random c. Systematic random d. Nonprobability purposive Janet - CH 5 – Information Management In order to have the most direct access to data regarding patients in your organization, along with analysis and report capability, your computer system must be at least a. a personal computer with a network link and your own database software. b. a terminal networked to the mainframe. c. a personal computer with statistical, graphic, and report-generating software. d. a notebook computer that can go where you go Janet - CH 5 – Information Management According to epidemiological theory, the rate of new cases of transfusion reaction since the previous year would be termed a. a numerator. b. a denominator. c. a prevalence rate. d. an incidence rate. Janet - CH 5 – Information Management When comparing averaged immunization data from two pediatric medical groups, it is appropriate to use a. standard deviation. b. a t-test. c. a chi-square test. d. variance Janet - CH 5 – Information Management The use of regression analysis to help determine relationships between groups of numbers is most closely associated with which graphic display technique? a. Frequency distribution b. Scatter diagram c. Line graph d. Histogram Janet - CH 5 – Information Management The ability of a data measurement tool to produce the same results over a period of time is known as a. sensitivity. b. specificity. c. validity. d. reliability Janet - CH 5 – Information Management You are the quality professional for a large provider organization. You have two sets of monthly utilization data—total costs and total reimbursements from payers—for the last two years. Use this information to answer questions To best display the data for the full two years, which of the following types of graphic displays should you use? a. Pie charts b. Bar charts c. Run charts d. Pareto charts Janet - CH 5 – Information Management You are the quality professional for a large provider organization. You have two sets of monthly utilization data—total costs and total reimbursements from payers—for the last two years. Use this information to answer questions If the reimbursement data is broken out by payer for the last year, which statistical calculation and chart would probably be more informative? a. Pie chart and means b. Bar chart and means c. Run chart and standard deviations d. Pareto chart and percentages Janet - CH 5 – Information Management Which is the best graphic display to show proportion? a. Pie chart b. Bar chart c. Run chart d. Pareto chart Janet - CH 5 – Information Management Which display is best to help the ambulatory clinic team decide which of 10 reasons for patient dissatisfaction to address this year? a. Pie chart b. Bar chart c. Run chart d. Pareto chart Janet - CH 5 – Information Management The distance from the lowest to the highest value in a frequency distribution of wait times in the Emergency Department is the a. standard deviation. b. range minus 1. c. range. d. variance. Janet - CH 5 – Information Management The primary care clinic tracks callers’ telephone wait times as a recurring performance measure twice a year. In the last two months, wait times have been increasing. On the latest run chart, 8 consecutive data points all in ascending order, with 21 total data points, represents a/an a. common cause variation. b. special cause variation. c. cyclical variation. d. astronomical value Janet - CH 5 – Information Management As quality management director at Sunshine Community Medical Center, you are conducting comparative analysis of the surgical wound infection rate data between two surgical units. The "p-value" of the chi-square test you run will help you draw what conclusion about the relationship between the two sets of data? a. Ratio of the two rates b. Standard deviation of the difference from the mean c. Proportion of the relationship d. Significance of the relationship Janet - CH 5 – Information Management Your medical group has recently merged with two other medical groups and three hospitals covering 20,000 square miles. You have been asked to participate on a team to purchase software to link as many clinical activities as possible for coordination of care, integrated billing, and performance and outcome measurement. What is the most important requirement you must specify? a. Ability to integrate separate existing databases in real time b. Stand alone PCs to assure confidentiality and security c. A completely automated patient record to get all the data d. Ad hoc reporting at all levels in each organization Janet - CH 5 – Information Management The Pareto rule is which of the following? a. 80% of QM activities are wasted. b. 80% of the problems have 20% of the impact. c. 20% of the problems have 80% of the impact. d. 20% of the costs reap 80% of the benefit Janet - CH 5 – Information Management In the community health clinic, at least four complaints have been received per month for the past four months, compared to an average of one per month for the six prior months. The average number of patients seen per month is 2000. The trigger is >0.2%. What is the appropriate response? a. Select a more useful indicator. b. Perform intensive analysis now. c. Trend for at least three more months. d. Reward the entire staff Janet - CH 5 – Information Management Sometimes, when developing indicators to measure performance, specific criteria must be written to fully define the measure. This type of criteria facilitates which step? a. Intensive analysis b. Initial analysis c. Data aggregation d. Data collection Janet - CH 5 – Information Management Brainstorming is best used to a. identify or refine cause and effect relationships. b. perform intensive analysis or peer review. c. subdivide or organize a large number of ideas. d. identify, analyze, or plan solutions to problems Janet - CH 5 – Information Management An affinity diagram is best used when a. information is clearly connected to one issue. b. there is inadequate information. c. the volume of information is very large. d. brainstorming is not an option. Janet - CH 5 – Information Management PROJECT: IMPROVE PATIENT ACCESS TO CLINIC The Prioritization Matrix survey above deals with decisions about how to improve patient access to a rural ambulatory primary care center. The choices include adding a toll free telephone number to encourage calls, expanding hours to accommodate employed patients, and marketing use of the physicians’ on-call numbers after hours so patients can discuss problems with physicians by telephone. The QI team feels that impact on safety, patient outcome (functionality and quality of life), patient satisfaction (perceived), and cost ($ figures available to all participants) are the key criteria to evaluate in deciding which option should be implemented first. Participants (all staff) are to score the three options on each criterion. Use the matrix and this information to answer questions What criterion may have been overlooked in evaluating the potential impact of the proposed options? a. Documentation b. Staff satisfaction c. Medical necessity d. None—only those listed on the matrix are important to consider Janet - CH 5 – Information Management PROJECT: IMPROVE PATIENT ACCESS TO CLINIC The Prioritization Matrix survey above deals with decisions about how to improve patient access to a rural ambulatory primary care center. The choices include adding a toll free telephone number to encourage calls, expanding hours to accommodate employed patients, and marketing use of the physicians’ on-call numbers after hours so patients can discuss problems with physicians by telephone. The QI team feels that impact on safety, patient outcome (functionality and quality of life), patient satisfaction (perceived), and cost ($ figures available to all participants) are the key criteria to evaluate in deciding which option should be implemented first. Participants (all staff) are to score the three options on each criterion. Use the matrix and this information to answer questions In order to be objective in their evaluation, the team needs to establish a relative weight for each criterion, unless all carry the same value, and a. provide current utilization data to survey participants before they complete the matrix. b. provide for independent external review of the survey calculations and results. c. determine a maximum score for each option to guarantee implementation. d. determine a minimum score for each option to remain under consideration Janet - CH 5 – Information Management PROJECT: IMPROVE PATIENT ACCESS TO CLINIC The Prioritization Matrix survey above deals with decisions about how to improve patient access to a rural ambulatory primary care center. The choices include adding a toll free telephone number to encourage calls, expanding hours to accommodate employed patients, and marketing use of the physicians’ on-call numbers after hours so patients can discuss problems with physicians by telephone. The QI team feels that impact on safety, patient outcome (functionality and quality of life), patient satisfaction (perceived), and cost ($ figures available to all participants) are the key criteria to evaluate in deciding which option should be implemented first. Participants (all staff) are to score the three options on each criterion. Use the matrix and this information to answer questions What would be the most likely reason for not implementing all three options? a. Cost b. Staff dissatisfaction c. Too few patients d. Patient dissatisfaction Janet - CH 5 – Information Management Of the following, which quality improvement tool best demonstrates cause and effect? a. Fishbone diagram b. Flowchart c. Pareto chart d. Affinity diagram Janet - CH 5 – Information Management Sunbelt Healthplan started receiving a rash of complaints from parents of pediatric patients at Sunrise Pediatric Medical Group concerning long wait times and crowded waiting rooms. A oneday time study revealed an average wait time of 55 minutes, with 25% waiting >75 minutes. A QI team was formed to reduce wait time for seeing a physician or nurse practitioner. The team is comprised of a receptionist, physician, nurse practitioner, nurse, medical records specialist, and a facilitator from the Healthplan. Use this information to answer questions: Of the following, which quality improvement tool is probably most appropriate to help determine current process? a. Brainstorming b. Flowchart c. Cause and Effect Diagram d. Affinity Diagram Janet - CH 5 – Information Management Sunbelt Healthplan started receiving a rash of complaints from parents of pediatric patients at Sunrise Pediatric Medical Group concerning long wait times and crowded waiting rooms. A oneday time study revealed an average wait time of 55 minutes, with 25% waiting >75 minutes. A QI team was formed to reduce wait time for seeing a physician or nurse practitioner. The team is comprised of a receptionist, physician, nurse practitioner, nurse, medical records specialist, and a facilitator from the Healthplan. Use this information to answer questions: Once the current process (from the time the patient is signed in to the time actually seen by the MD or NP) is understood, what is the next logical step for the team, which now seeks to learn why delays are occurring? a. Collect more data b. Flowcharting c. Prioritization Matrix d. Brainstorming Janet - CH 5 – Information Management Sunbelt Healthplan started receiving a rash of complaints from parents of pediatric patients at Sunrise Pediatric Medical Group concerning long wait times and crowded waiting rooms. A oneday time study revealed an average wait time of 55 minutes, with 25% waiting >75 minutes. A QI team was formed to reduce wait time for seeing a physician or nurse practitioner. The team is comprised of a receptionist, physician, nurse practitioner, nurse, medical records specialist, and a facilitator from the Healthplan. Use this information to answer questions: By the third team meeting, over 60 possible causes of delay had been listed by the members. During this meeting they will categorize and then prioritize their ideas. What is the best tool to use? a. Affinity diagram b. Cause and effect diagram c. Force field analysis d. Flowcharting Janet - CH 5 – Information Management Sunbelt Healthplan started receiving a rash of complaints from parents of pediatric patients at Sunrise Pediatric Medical Group concerning long wait times and crowded waiting rooms. A oneday time study revealed an average wait time of 55 minutes, with 25% waiting >75 minutes. A QI team was formed to reduce wait time for seeing a physician or nurse practitioner. The team is comprised of a receptionist, physician, nurse practitioner, nurse, medical records specialist, and a facilitator from the Healthplan. Use this information to answer questions: The team now understands that delay can occur anywhere along the process. Data is inadequate at this point to identify a particular time of day, day of week, type of patient, and/or step in the process that is largely responsible for the delays. Further data collection is necessary. What should the team "product" be for the next meeting? a. A prioritization matrix b. A data collection tool and instruction sheet c. Questions to be answered and a data collection tool d. An events and causal factors chart Janet - CH 5 – Information Management It is generally understood that the patient owns the information in his or her medical record. The physical record is the property of the a. patient. b. physician. c. healthcare organization. d. third party payer. Janet - CH 5 – Information Management The QI team is responsible for determining whether the data demonstrates special or common cause variation. Of the following, what is the best display option to use? a. Run chart b. Pareto chart c. Scatter diagram d. Control chart Janet - CH 5 – Information Management Requiring peer reviewers to sign a confidentiality agreement helps protect review information from legal discovery and a. is necessary for releasing the medical record for peer review. b. is necessary for proper informed consent. c. enhances the privacy of medical record information. d. releases the organization from liability for the quality of medical care Janet - CH 5 – Information Management The number of designated women receiving breast cancer screening (mammograms) in the reporting year measures a. process. b. clinical outcome. c. process outcome. d. process and clinical outcome Janet - CH 5 – Information Management Confidentiality of information is best accomplished by a. limiting access. b. obtaining proper consent to release. c. having all staff sign a confidentiality agreement. d. removing all patient and practitioner identifiers from documents. Janet - CH 5 – Information Management The part of documentation for medical staff peer review that is most often missing is a. findings/conclusion. b. recommendations. c. actions taken. d. follow-up/evaluation of action effectiveness. Janet - CH 5 – Information Management Which of the following descriptors correctly correlate with continuous data? a. Variables, counted, categorized, percentages, means, t test b. Counted, categorized, measured, variables, means, t test c. Discrete, counted, categorized, percentages, chi-square, whole numbers d. Attributes, counted, measured, discrete, chi-square, means Janet - CH 5 – Information Management The most important time to collect and use data is a. before the QI project begins, to prove a problem exists. b. during the QI project, to answer questions about cause. c. during the QI project, to help prioritize the implementation of improvements. d. after the implementation of the improvement, to maintain the gain Janet - CH 5 – Information Management Inpatient length of stay (LOS) is the number of days, including the day of admission and excluding the day of discharge. What data elements are essential in order to calculate the average length of stay for simple pneumonia patients for 1st quarter, this year? a. Number of discharges and number of patient days b. Each pneumonia patient's LOS c. Number of pneumonia patients and number of discharges d. Total LOS for pneumonia patients Janet - CH 5 – Information Management A performance measure that records the number of well-child visits within the first fifteen months of life in the reporting year is a measure of a. structure. b. process. c. outcome. d. process and outcome. Janet - CH 5 – Information Management Providing the patient or representative with enough information to permit a knowledgeable decision regarding submission to an upcoming surgical procedure is the responsibility of the a. attending physician. b. anesthesiologist. c. surgeon. d. organization. Janet - CH 5 – Information Management Providing the patient or representative with enough information to permit a knowledgeable decision regarding submission to an upcoming surgical procedure is the responsibility of the The process described above is called a. consent for treatment. b. informed consent. c. release of information. d preauthorization Janet - CH 5 – Information Management When interpreting a run chart or control chart, a "cyclical" pattern of data points indicates that a. there is normal common cause variation. b. something systematic is affecting the process. c. there is a need to change the process. d. the process is in statistical control. Janet - CH 5 – Information Management The performance indicator, “Total unscheduled inpatient admissions following ambulatory procedure (within 48 hours)” is a measure of a. structure. b. process. c. outcome. d. process and outcome. Janet - CH 5 – Information Management A "report card," or a report that helps consumers evaluate the quality of care and services of health plans or providers, A. is required to receive accreditation. B. shows comparative performance in specific areas. C. is based on the organization's unique performance measures. D. aggregates data showing how quickly patients return to health Janet - CH 5 – Information Management The Quality Council has received a recommendation from a QI Team to completely redesign the appointment process, telephone system, and Website to address the expectations of patients for timely, easy access to the integrated delivery system clinical sites. Which of the following should the Council validate before approving the project? a. The accuracy of the data b. The team's analysis process c. The team's interpretation of the analyzed data d. The team's charter Janet - CH 5 – Information Management Data collection is part of which performance improvement process? a. Design b. Monitoring c. Analysis d. Improvement Janet - CH 5 – Information Management If planning data collection for antibiotic use in urinary tract infection (UTI), what should you do first? a. Define UTI. b. Define the population. c. Determine which antibiotics to include. d. Determine which sampling method to use Janet - CH 5 – Information Management To display the best reimbursement/cost ratios for procedures performed in three ambulatory surgery centers in the last calendar year, use a ## Which display is best to help the ambulatory clinic team decide which 10 reasons for patient dissatisfaction to address this year a. scatter diagram. b. pie chart. c. control chart. d. Pareto chart Janet - CH 5 – Information Management Comparison data is best displayed by a. flowchart, cause and effect diagram, scatter diagram. b. run chart, table, scatter diagram. c. pie chart, control chart, Pareto chart. d. flowchart, cause and effect diagram, affinity diagram. Janet - CH 5 – Information Management Relationships are best displayed by a a. flowchart, cause and effect diagram, or scatter diagram. b. run chart, table, or scatter diagram. c. pie chart, prioritization matrix, or Pareto chart. d. flowchart, cause and effect diagram, or check sheet. Janet - CH 5 – Information Management Your quality department has secure computer access to patient information, along with other departments doing case management and risk management. You all have personal computers. Your system is a a. wide area network. b. mainframe. c. legacy network. d. local area network. Janet - CH 5 – Information Management In a proportion, the difference between the two ratios 50:1000 and 375:5000 is a. 125 b. 250 c. 325 d. 4000 Janet - CH 5 – Information Management At the We Care Urgent Care Center, wait times from registration to physician contact are calculated and averaged daily. The data is tracked monthly, using a run chart. Which of the following would indicate a true statistical increase in treatment delays? a. 6 consecutive ascending data points b. p =.0515 c. 8 consecutive ascending data points d. 7 consecutive descending data points Janet - CH 5 – Information Management Based on cost-benefit analysis, Comprehensive Health integrated delivery system IDS) added a home health agency, with investments in a building, staff, marketing, computer system, and other equipment and materials. You are tracking revenue and expenses. Of the following, what type of graph will tell you when you reach the break even point? a. Control chart b. Run chart c. Pareto chart d. Scatter diagram Janet - CH 5 – Information Management In response to the occurrence of a sentinel event, Sunshine Medical Center's designated QI Team developed and implemented a clinical patient safety process called Clinical Team Management (CTM). To determine the impact of the process on medical error reporting patterns, the team compared the number of event reports/total admissions for one year before implementation and one year after full implementation: P = < 0.0001. Comparison of event severity for near misses and adverse events with minimal effect: P = 0.059. Use this information to answer questions It is likely that the team selected which of the following analysis tools: a. Regression analysis b. Standard deviation c. Chi-square d. t Test Janet - CH 5 – Information Management In response to the occurrence of a sentinel event, Sunshine Medical Center's designated QI Team developed and implemented a clinical patient safety process called Clinical Team Management (CTM). To determine the impact of the process on medical error reporting patterns, the team compared the number of event reports/total admissions for one year before implementation and one year after full implementation: P = < 0.0001. Comparison of event severity for near misses and adverse events with minimal effect: P = 0.059. Use this information to answer questions Based on the analysis, what conclusion did the team report? Implementation of CTM a. eliminated sentinel events. b. significantly decreased event severity. c. only slightly improved event reporting. d. significantly improved event reporting. Janet - CH 5 – Information Management Focus groups provide patient/customer input or feedback. What type of information do they offer? a. Qualitative b. Quantitative c. Measured d. Opinionated Janet - CH 5 – Information Management Of the following possibilities, what does the control chart below tell you (CL = Center Line— either mean or median, depending on type of data; LCL = 0)? a. Three sentinel events occurred since mid-2006 with effective intervention. b. Special cause variation occurred with effective intervention in mid-2007. c. Falls are within control limits since mid-2006. d. Falls are out of control since mid-2007. Janet - CH 5 – Information Management Sunshine Medical Center implemented a Clinical Pathway for CVA, with the goal to transition from acute care to the next level of care after five days acute length of stay (LOS). Review the histogram below and use the information to answer questions The histogram represents a. standard of practice. b. standard deviation from the mean. c. a cumulative frequency. d. a frequency distribution Janet - CH 5 – Information Management Sunshine Medical Center implemented a Clinical Pathway for CVA, with the goal to transition from acute care to the next level of care after five days acute length of stay (LOS). Review the histogram below and use the information to answer questions The histogram tells the clinical path team that a. they are meeting the LOS goal. b. average LOS is two days longer than the goal. c. average LOS is one day longer than the goal. d. LOS is within the control limits Janet - CH 5 – Information Management