ABQAURP (HCQM) Certification final Exam Questions and Answers
how is quality defined? - no errors, degree of excellence, do the right thing and do it well. Meeting
customers expectations, exceed expectations.
What is quality mgmt.? - examine the process to delivery of care, the outcomes measured
plan-do-check-act - Walter Shewhart
Edward Deming - introduced statistical process to improve quality
He recognized importance of having accurate and meaningful infor to improve quality
Demings 7 deadly diseases - lack of consistency, emphasis on short term profits, eval of
performanmce,job hopping, excessive medical cost, excessive liability
Joseph Juran - introduced Total Quality Control
Philip Crosby - He added financial consequences to quality performance
Savings are generated by "doing things right the first time"
Quality Mangt. QM - approaches to imporving quality
emphasis on preventing errors, empowerment of employees, improve performance, focus on
supplier relationships
Quality Assurance - addresses negative outcomes ( sentinel events). Hx punishment of peers
Quality Improvement - improving on outcomes that are consider satisfactory, get better.
Typically focus on process and systems, no individuals
Continuous Quality Improvement - uses a systematic process, enhance performance. Looks at
processes, not individual. ( ex laparoscopy, less hospt stay)
, Total quality management - uses QA, QI, CQM and focuses on customer desire
Sentinel Event - unexpected death, unrelated loss of function, IP suicide, infant abduction,
transfusion rxn, wrong site surgery
Root Cause Analysis - Analyzing a sentinel event, must assess the culture.
Credentialing - Key part of QM.Make sure the right person , right knowledge in the right position
Risk Mgt. - Focus on monetary loss by eliminating negative outcomes. Includes insurance, pt
satisfaction and legal issues.. Improve documentation. Medical records analysis is very helpful
Ultimate responsibility is the governing body of the hospital.
UR - formal review of the consumption of all resources in the delivery of care., Can be
prospective, concurrent or retrospective .Reduce resources to achieve the same result.
Infection Control - Focus on Outcomes, looks at transmission of illness to providers, staff and
visitors. Reduce risk of future infection
Outcome studies - important to analyze effectiveness. Computer generated outcomes best. self
report survey are vulnerable to inaccuracy, single review least reliable.
Peer review - An individual c similar training and the one being reviewed.
1-chart rev
2-patterns
3- peer intervention
PRO- peer review organization - 1972-82 was physician controlled, nonprofit org that looked at
Medicare IP, Utilization and quality. Changed to PSRO in 1982 via the Tax Equity and Fiscal
Responsibility act
QARI- quality assurance reform initiative - 1993- to assist states develop QI systems, focus on
clinical studies
QISMC- quality improvement for system of Managed Care - 1996-Federal govt formed as a guide
for quality mgt, esp for Medicare and Medicaid
-Designed to strengthen the efforts to protect and improve health and satisfaction to Medicare
and Medicaid enrollees
-clarifies responsibility in promoting quality
-promotes partnership
-develop coordinated quality oversight
-looks for new developments
BBA-balanced budget Act - 1997-comprehensive revision of federal statutes governing Medicaid
Revised 1999. Uses QISMC to set quality assurance provisions.
how is quality defined? - no errors, degree of excellence, do the right thing and do it well. Meeting
customers expectations, exceed expectations.
What is quality mgmt.? - examine the process to delivery of care, the outcomes measured
plan-do-check-act - Walter Shewhart
Edward Deming - introduced statistical process to improve quality
He recognized importance of having accurate and meaningful infor to improve quality
Demings 7 deadly diseases - lack of consistency, emphasis on short term profits, eval of
performanmce,job hopping, excessive medical cost, excessive liability
Joseph Juran - introduced Total Quality Control
Philip Crosby - He added financial consequences to quality performance
Savings are generated by "doing things right the first time"
Quality Mangt. QM - approaches to imporving quality
emphasis on preventing errors, empowerment of employees, improve performance, focus on
supplier relationships
Quality Assurance - addresses negative outcomes ( sentinel events). Hx punishment of peers
Quality Improvement - improving on outcomes that are consider satisfactory, get better.
Typically focus on process and systems, no individuals
Continuous Quality Improvement - uses a systematic process, enhance performance. Looks at
processes, not individual. ( ex laparoscopy, less hospt stay)
, Total quality management - uses QA, QI, CQM and focuses on customer desire
Sentinel Event - unexpected death, unrelated loss of function, IP suicide, infant abduction,
transfusion rxn, wrong site surgery
Root Cause Analysis - Analyzing a sentinel event, must assess the culture.
Credentialing - Key part of QM.Make sure the right person , right knowledge in the right position
Risk Mgt. - Focus on monetary loss by eliminating negative outcomes. Includes insurance, pt
satisfaction and legal issues.. Improve documentation. Medical records analysis is very helpful
Ultimate responsibility is the governing body of the hospital.
UR - formal review of the consumption of all resources in the delivery of care., Can be
prospective, concurrent or retrospective .Reduce resources to achieve the same result.
Infection Control - Focus on Outcomes, looks at transmission of illness to providers, staff and
visitors. Reduce risk of future infection
Outcome studies - important to analyze effectiveness. Computer generated outcomes best. self
report survey are vulnerable to inaccuracy, single review least reliable.
Peer review - An individual c similar training and the one being reviewed.
1-chart rev
2-patterns
3- peer intervention
PRO- peer review organization - 1972-82 was physician controlled, nonprofit org that looked at
Medicare IP, Utilization and quality. Changed to PSRO in 1982 via the Tax Equity and Fiscal
Responsibility act
QARI- quality assurance reform initiative - 1993- to assist states develop QI systems, focus on
clinical studies
QISMC- quality improvement for system of Managed Care - 1996-Federal govt formed as a guide
for quality mgt, esp for Medicare and Medicaid
-Designed to strengthen the efforts to protect and improve health and satisfaction to Medicare
and Medicaid enrollees
-clarifies responsibility in promoting quality
-promotes partnership
-develop coordinated quality oversight
-looks for new developments
BBA-balanced budget Act - 1997-comprehensive revision of federal statutes governing Medicaid
Revised 1999. Uses QISMC to set quality assurance provisions.
