HEALTHCARE QUALITY
MANAGEMENT Exam #3 ACTUAL
QUESTIONS AND CORRECT ANSWERS
Steps to reach 95 Percent or Better Process Reliability - Correct answers✔✔1. Agree on a
measure for assessing reliability.
2. Measure how often accuracy is achieved according to the agreed-on measure.
3. Establish reliability goals for the measure.
4. Make stepwise improvements and measure success
Strategies to improve the reliability of healthcare processes that address the needs of staff and the
work to be done include: - Correct answers✔✔1. Limit or discourage people from working when
physically ill or mentally ill
2. Be sure people are physically and mentally fit for the tasks.
3. Provide adequate breaks.
Strategies to improve the reliability of healthcare processes that address the needs of staff and the
work to be done: part 2 - Correct answers✔✔4. Add technologies that reduce reliance on
memory
5. Rotate tasks to prevent complacency
6. Monitor people for excessive fatigue.
7. Place limitations on overtime
How are process reliability is measure and managed - Correct answers✔✔1. process failures
must be closely monitored.
2. targeted interventions must be designed and tested until the desired level of reliability is
achieved and maintained.
, 3. once sustained reliability is achieved, performance must be regularly reviewed and feedback
provided to the people doing the work
The purpose of utilization management - Correct answers✔✔ensure that patients receive
necessary medical services at the least cost
How are clinical practice guidelines are used for utilization management purposes - Correct
answers✔✔the basis for creating evidence-based performance measures and as a means of
standardizing clinical decision making. They are used specifically to reduce the provision of
unnecessary services
What are the roles of physician and nonphysicians in managing the sue of healthcare resources -
Correct answers✔✔Concurrent review by a physician advisor creates an opportunity for peer-to-
peer discussion about the best use of resources for a patient.
What is the importance of reliability in the delivery of health care services - Correct
answers✔✔Reliability ratings are important for healthcare quality improvement purposes.
Reliability science has demonstrated that certain process improvements are more likely to create
consistent quality.
How can Utilization trends be reviewed before a patient receives services - Correct
answers✔✔prospective review, during the delivery of services through concurrent review, or
after the patient receives services through retrospective review.
How is the effectiveness of improvement actions is measured and how are gains sustained -
Correct answers✔✔1. Clearly documented goals help frame the improvement initiative.
2. Once action plans have been implemented, evaluate whether goals have been achieved.
What are utilization management measurement, assessment, and improvement activities -
Correct answers✔✔Examines the appropriateness of healthcare services, to ensure services are
MANAGEMENT Exam #3 ACTUAL
QUESTIONS AND CORRECT ANSWERS
Steps to reach 95 Percent or Better Process Reliability - Correct answers✔✔1. Agree on a
measure for assessing reliability.
2. Measure how often accuracy is achieved according to the agreed-on measure.
3. Establish reliability goals for the measure.
4. Make stepwise improvements and measure success
Strategies to improve the reliability of healthcare processes that address the needs of staff and the
work to be done include: - Correct answers✔✔1. Limit or discourage people from working when
physically ill or mentally ill
2. Be sure people are physically and mentally fit for the tasks.
3. Provide adequate breaks.
Strategies to improve the reliability of healthcare processes that address the needs of staff and the
work to be done: part 2 - Correct answers✔✔4. Add technologies that reduce reliance on
memory
5. Rotate tasks to prevent complacency
6. Monitor people for excessive fatigue.
7. Place limitations on overtime
How are process reliability is measure and managed - Correct answers✔✔1. process failures
must be closely monitored.
2. targeted interventions must be designed and tested until the desired level of reliability is
achieved and maintained.
, 3. once sustained reliability is achieved, performance must be regularly reviewed and feedback
provided to the people doing the work
The purpose of utilization management - Correct answers✔✔ensure that patients receive
necessary medical services at the least cost
How are clinical practice guidelines are used for utilization management purposes - Correct
answers✔✔the basis for creating evidence-based performance measures and as a means of
standardizing clinical decision making. They are used specifically to reduce the provision of
unnecessary services
What are the roles of physician and nonphysicians in managing the sue of healthcare resources -
Correct answers✔✔Concurrent review by a physician advisor creates an opportunity for peer-to-
peer discussion about the best use of resources for a patient.
What is the importance of reliability in the delivery of health care services - Correct
answers✔✔Reliability ratings are important for healthcare quality improvement purposes.
Reliability science has demonstrated that certain process improvements are more likely to create
consistent quality.
How can Utilization trends be reviewed before a patient receives services - Correct
answers✔✔prospective review, during the delivery of services through concurrent review, or
after the patient receives services through retrospective review.
How is the effectiveness of improvement actions is measured and how are gains sustained -
Correct answers✔✔1. Clearly documented goals help frame the improvement initiative.
2. Once action plans have been implemented, evaluate whether goals have been achieved.
What are utilization management measurement, assessment, and improvement activities -
Correct answers✔✔Examines the appropriateness of healthcare services, to ensure services are
