CPHQ QUIZE 2 CHAPTER 3 CASES

As a performance measurement system, the key value of the "balanced scorecard" concept is its ability to

• serve as a comparative "report card" with like organizations.

• focus the organization on financial measures of survival and success.

• encompass all the organization's clinical and non-clinical measures.

• align measurement with the vision and strategy of the organization

According to QI process theory and quality/performance improvement standards, it is best to select a quality improvement project that

• is the chief executive officer's ongoing quality or cost concern.

• is limited in scope and time to provide quick feedback.

• has the greatest potential to improve patient outcome.

• has the greatest potential to save the organization money

Who usually makes the final decision regarding credentialing in a managed care organization?

• Governing body

• Credentialing committee

• Quality improvement committee

• Chief medical officer

Who makes the final decision regarding reappointment to the medical/ professional staff in a hospital?

• Governing body

• Medical staff executive committee

• Credentialing committee

• Medical staff as a whole

50-Clinical performance measures in disease management programs are based on

• standards of practice.

• clinical privilege criteria.

• clinical pathways.

• practice guidelines

The following term is synonymous with clinical practice guidelines except:

• Standards of care

• Standards of Practice

• Clinical Algorithms

• Practice parameters

The most important patient safety issue to a utilization reviewer is

• timeliness of treatment.

• medical necessity for treatment.

• correct assignment of diagnosis or procedure code.

• appropriateness of healthcare setting

The managed care organization’s use of a 24-hour nurse-staffed telephone hotline to inform

member/patient callers of care options and provide self-management education is a type of:

• preauthorization

• case management.

• disease management.

• demand management

72-The primary purpose of generic screening is to

• identify adverse occurrences as early as possible.

• provide data for practitioner reappraisal.

• identify common-cause variation.

• trend occurrence data over time.

Failure mode and effects analysis (FMEA) is what type of review or improvement tool?

• Concurrent

• Focused

• Prospective

• Retrospective