Quality Improvement in Healthcare (D512)

Correct Answer

A. Benchmarking

Explanation

Benchmarking is the best approach for determining how many patient records coders should be completing per hour. By examining industry standards or the performance of similar organizations, you can set a realistic and data-driven target. Benchmarking helps ensure that expectations are grounded in best practices, rather than arbitrary numbers or assumptions, leading to more efficient and reasonable productivity goals for coders.

Why other options are wrong

B. Making up a number – Making up a number without data or research would not provide an effective or realistic target. This approach could result in setting unattainable or unfair expectations for coders.

C. Asking each coder what they think – While it is valuable to involve coders in the process, relying solely on their opinions may not provide an accurate or objective benchmark. Coders may have varying perceptions, and their input might not reflect the overall performance standards in the industry.

D. Looking on the Internet – While online resources might provide some insight, using unverified or generic information from the Internet may not offer the most reliable or tailored benchmark for your specific organization’s needs.

Correct Answer

B. TJC will conduct an audit of the hospital every five years

Explanation

The Joint Commission (TJC) does not conduct audits of hospitals on a fixed five-year schedule. The frequency of surveys can vary, depending on the hospital's accreditation status and other factors. While hospitals are typically surveyed at least once every three years, the exact timing of the survey may differ, and it is not necessarily every five years.

Why other options are wrong

A. Accreditation by TJC is a requirement of participation in the Medicare program

This statement is true. Hospitals that wish to participate in Medicare must be accredited by The Joint Commission or another organization recognized by the Centers for Medicare and Medicaid Services (CMS).

C. TJC can audit without advance notice

This statement is true. TJC has the authority to conduct unannounced surveys, meaning that hospitals cannot always anticipate when the audit will occur.

D. TJC requires hospitals to have facility-wide disaster plans

This statement is true. The Joint Commission requires healthcare facilities to have disaster plans in place to ensure the safety and preparedness of the facility during emergencies, as part of their accreditation standards.

Correct Answer

C. Examining a group of deliverables to figure out why they all had the same defect

Explanation

Quality assurance (QA) focuses on ensuring that processes and procedures are being followed to prevent defects and deliver products that meet established standards. Option C refers more to quality control (QC), which focuses on identifying and correcting defects after they have occurred. QA is proactive, whereas QC is reactive. Identifying defects is part of QC, not QA.

Why other options are wrong

A. Examining the way deliverables are produced to see if processes are being followed – This is a fundamental aspect of quality assurance. It ensures that the correct processes are in place and being followed to prevent defects from occurring in the first place.

B. Examining deliverables to see if they meet requirements – This is part of quality assurance, as it ensures that the deliverables adhere to predefined requirements and standards.

D. Examining the company's documentation on how processes are to be performed – Reviewing documentation is part of quality assurance to ensure that processes are clearly defined and are followed properly during production.

Correct Answer

B. meaningful use

Explanation

The CMS (Centers for Medicare & Medicaid Services) offered an incentive program called "Meaningful Use" to healthcare professionals and hospitals. This program aimed to encourage the adoption and meaningful use of Electronic Health Records (EHRs). One example of a meaningful use requirement was to have a certain percentage of patients, like 5%, use technology to access their medical records online. The program was designed to improve healthcare quality, safety, and efficiency through the use of EHRs.

Why other options are wrong

A. interoperability – Interoperability refers to the ability of different EHR systems to work together and exchange data, but it is not the term used for the specific CMS incentive program for EHR adoption.

C. data exchange – While data exchange is important for EHR systems to share patient information, the CMS incentive program is specifically focused on meaningful use, not just data exchange.

D. quantified self – The term "quantified self" refers to individuals using technology to track personal data about their health and lifestyle. It is not related to the CMS incentive program for EHR adoption.

Correct Answer

C. An agenda for the meeting

Explanation

For the initial meeting, it is essential to have an agenda ready. The agenda will provide structure and ensure that all critical topics are covered during the meeting. This will help the analyst guide the conversation effectively, set clear expectations, and allocate time for discussion. The agenda also helps keep the meeting on track and ensures that practice leadership and staff are prepared for the discussion.

Why other options are wrong

A. A list of EMRs that have recently been selected by similar practices

While useful later in the process, this list is not essential for the initial meeting. The focus should be on understanding the practice’s needs and discussing objectives, not on EMR selection.

B. A facilitation plan for process redesign

A facilitation plan for process redesign may be needed later, but for the initial meeting, the focus should be on understanding the practice’s current situation, needs, and goals. This plan would be more useful in subsequent sessions after gathering input.

D. A set of slides to train the staff on practice management system functionality

Training slides would be premature at the initial meeting. The goal of the first meeting is to discuss goals, needs, and existing workflows, not to provide training.

Correct Answer

B. To document unexpected events and the responses to those events

Explanation

The primary purpose of an incident report is to document any unexpected events that occur within a healthcare setting. These events could range from patient safety concerns to deviations from standard procedures. The report includes details about the event, what caused it, and how the situation was addressed or managed. Incident reports are used to evaluate what happened, identify areas for improvement, and prevent future occurrences. They are not meant to evaluate staff performance or serve as part of the patient's medical record.

Why other options are wrong

A. To provide a detailed account of patient treatment plans – This is the function of medical records, not incident reports. Incident reports focus on unexpected events, not treatment planning.

C. To serve as a part of the patient's healthcare record – Incident reports are separate from the healthcare record. They document events that occur but are not directly part of the patient's medical documentation.

D. To evaluate the performance of healthcare staff – While an incident report may indirectly reflect on staff actions, it is not primarily used to evaluate staff performance. Its main purpose is to document the event and improve safety protocols.

Correct Answer

A. Faulty systems, processes and conditions that lead people to make errors

Explanation

In "To Err is Human", the primary cause of medical errors is attributed to faulty systems, processes, and conditions that create an environment where people are more likely to make errors. The report emphasizes that errors are often a result of systemic issues rather than individual negligence, suggesting that improving healthcare systems and processes can significantly reduce the occurrence of errors.

Why other options are wrong

B. Reckless actions by healthcare workers making mistakes

While healthcare workers can make mistakes, the report stresses that medical errors are not primarily caused by individual recklessness. The focus is on improving the systems and conditions that lead to errors rather than blaming individuals.

C. Malfunctioning equipment

Malfunctioning equipment can contribute to errors, but it is not identified as the primary cause in "To Err is Human." The focus is more on systemic issues, such as miscommunication and poor workflow, that contribute to errors.

D. Inadequate supplies and lack of staffing to care for patients

Inadequate supplies and staffing issues are important factors that can contribute to errors, but they are not identified as the primary cause. The report focuses more broadly on system-wide issues.

Correct Answer

B. A patient who lives in another state gets in a major car accident while on vacation is able to receive adequate care at a local hospital since they have easy access to his entire electronic medical record.

Explanation

Interoperability refers to the ability of different healthcare systems and technologies to exchange and use patient information seamlessly. In this case, the patient's electronic medical record is accessible by healthcare providers in a different state, demonstrating how interoperability enables efficient and timely care across different systems.

Why other options are wrong

A. Working with other healthcare disciplines (respiratory therapy, PT/OT, nutrition) to provide best patient care – While interprofessional collaboration is important for patient care, it is not an example of interoperability, which specifically involves data exchange between different systems.

C. After two failed attempts inserting an IV in a patient, the nurse asks another person to try – This is a collaborative healthcare activity but does not involve the exchange of patient information across systems.

D. The computer reminds the nurse when medications are due and alerts them when new labs or orders are in – This describes an automated system or alert function within a single healthcare setting, but it does not involve exchanging data across different systems or entities, which is the key characteristic of interoperability.

Correct Answer

D. HITECH

Explanation

The HITECH Act (Health Information Technology for Economic and Clinical Health Act) is a component of the American Recovery and Reinvestment Act (ARRA). It provides financial incentives to healthcare practitioners and facilities for adopting Electronic Health Records (EHR). These incentives are designed to encourage the use of health information technology and improve healthcare quality. Payments are made over a five-year period to those who meet the meaningful use criteria for EHR adoption.

Why other options are wrong

A. MIPPA – MIPPA (Medicare Improvements for Patients and Providers Act) is a different piece of legislation and does not provide incentives specifically for the adoption of EHRs.

B. HIPAA – HIPAA (Health Insurance Portability and Accountability Act) is focused on protecting the privacy and security of patient health information but does not provide financial incentives for EHR adoption.

C. HIE – HIE (Health Information Exchange) refers to the sharing of health information electronically across different healthcare systems, but it is not directly related to the financial incentives for adopting EHRs provided by the HITECH Act.