Review QP: ch 10,12,15,16,17,18

Occurrences involving liability for injury or property loss are called? (ch 10)
Potentially Compensate Events

Risk management only involves the process of working through a malpractice suit. (ch 10)
False

The risk manager’s principal tool for capturing the facts about potentially compensate events is the
Occurrence Report

Events that occur in a healthcare organization that do not necessarily affect an outcome, but if were to recur, carry significant change of being a serious adverse event are called? (ch 10)
Near-Misses

A person who represents the rights and interests of another individual as though they were the person’s own is referred to as a patient
Advocate

The investigation technique that facilitates the identification of the various factors that contribute to a problem known as a fish-bone diagram is also called a/an?
(ch 10)
Cause-and-effect diagram

The four components in a fish-bone diagram include:
(ch 10)
Men
Methods
Machines
Material

Analysis of a sentinel event from all aspects to identify how each contributed to the occurrence of the event and to develop new systems that will prevent recurrence is called?
(ch 10)
Root-Cause Analysis

In risk management terminology, an exposure to the chance of injury or financial loss and their associated liability is: (ch 10)
Risk

Identify the five essential steps in Robust Process Improvement as defined by the Joint Commission. (ch 10)
1. Specifying the improvement target that requires participants to narrow the issue to its core impacts on patient care and safety.
2. Measuring the size of the problem with current data, identifying the absolute frequency of occurrence over recent periods of time, and remembering that these issues are often so risk-intensive that even one occurrence is unacceptable.
3. Identifying the specific causes for the occurrence from all vantage points: leadership, personnel policy, standardized procedures, information systems, and technology, communication pathways, management and supervision philosophies and processes, teamwork and coordination, staffing patterns and levels, equipment, care environment, and individuals.
4. Targeting interventions to the most important, modifiable cause.
5. Embedding interventions into routine work processes.

This plan demonstrates the master planning and outlines the design of the safety functions for the organization:
(ch 12)
Safety Management Plan

This program is designed to manage the physical and personal safeguard of the patients served, staff, and individuals coming to the organization: (ch 12)
Security Management

These documents give detailed information about a material, including any hazards associated with the material: (ch 12)
Material Safety Data Sheets

This analysis helps a healthcare organization to determine the types of disasters that they may face: (ch 12)
Hazard Vulnerability

This acronym is used to train healthcare staff the proper methods for fire responses: (ch 12)
PASS

How often are healthcare facilities required to practice their emergency preparedness plan? (ch 12)
Twice

List three examples of workplace violence that must be addressed in the facility’s security management plan.
(ch 12)
Threathening behavior
Verbal or Written threats
Harassment
Verbal abuse
Physical attacks
Employee to employee
Domestic violence
Stranger violence

The act of granting approval to a healthcare organization based on whether the organization has met a set of voluntary standards is called. (ch 15)
Accreditation

The act of granting a healthcare organization or an individual healthcare practitioner permission to provide services of a defined scope in a limited geographical area is called? (ch 15)
Licensure

The act of granting approval for a healthcare organization to provide services to a specific group of beneficiaries is called? (ch 15)
Certification

This type of healthcare organization review is performed to fulfill legal or licensure requirements: (ch 15)
Compulsory Review

This type of healthcare organization review is conducted as the request of the healthcare facility seeking accreditation:(ch 15)
Voluntary Review

The Process of meeting a prescribed set of standards or regulations to maintain active accreditation, licensure, or certification status. (ch 15)
Compliance

(NCQA) National Committee on Quality Assurance
organization that provides the most complete view of managed care plan quality

NCQA has loose standards for managing utilization of healthcare resources but rigorous standards for managing quality & reimbursement. (ch 15)
False

NCQA uses ______ to Accomplish assessments of managed health care plans. (ch 15)
(HEDIS) Healthcare Effectiveness Data and Information Set

HEDIS gathers data in which of the following areas?
(ch 15)
Measures of Access (1 visit to provider w/3yrs)
Measures of Quality (cholesterol screening)
Measures of Financial Performance (cost per member)

Process used by Joint Commission to analyze organizations systems by following individual patients through the organizations healthcare process in sequence experienced by patient. (ch 15)
Tracer Methodology

The Medicare Conditions of Participation require all healthcare facilities to institute utilization management program. (ch 15
False

Every Organization that provides services to Medicare & Medicaid beneficiaries must demonstrate its compliance with this set of standards. (ch 15)
Conditions of Participation

Standards that, if met, allow a hospital to receive reimbursement for care provided to Medicare beneficiaries
Conditions of Participation

This organization has been responsible for accrediting healthcare organizations since the middle 1950’s and determines whether the organization is continually monitoring and improving the quality of care they provide:(15)
Joint Commission on Accreditation of Healthcare Organizations

This private, not-for-profit organization is committed to developing and maintaining practical, customer-focused standards to help organizations measure and improve the quality, value, and outcomes of behavioral health and medical rehabilitation programs: (15)
Commission on Accreditation of Rehabilitation Facilities

This organization accredits managed care organizations, managed behavioral health organizations, and credentials verification for physician organizations. (ch 15)
National Committee for Quality Assurance

Every organization that provides services to Medicare and Medicaid beneficiaries must demonstrate its compliance with this set of standards: (ch 15)
Conditions of Participation

List the 5 possible categories JCAHO uses to report its decisions on accreditation (ch 15)
Accredited
Accreditation with follow-up survey
Contingent accreditation
Preliminary denial of accreditation
Denial of accreditation

(QIO) Quality Improvement Organization (ch 16)
are contracted to federal government to use medical peer review, data analysis, and other tools to identify patterns of care and outcomes that need improvement and then to work cooperatively with facilities and individual physicians to improve care.

The HIM Department is asked to pull records for review by the quality improvement organization (QIO). to ensure that health care services are (ch 16)
* Rendered according to appropriate professional standards
* medically necessary
* preformed in the most efficient, effective & economical manner

the manager of Quality dept is listing various sources of data. which of the following data
quality improvement organization information

The change phase that is characterized by grief and letting go is called (ch 18)
Ending

The change phase that is characterized by confusion and creativity is called (ch 18)
Transition

The change phase that is characterized by acceptance and hope for the future is called (ch 18)
Beginning

Identify the steps in the process of change management: (18)
Identifying the losses
Acknowledging the losses
Providing information and asking for feedback
Marking the endings
Managing the transition
Clarifying and reinforcing the beginning
Celebrating the successes

This phase in the project life cycle begins with the determination that there is a gap between organization performance and expected outcomes: (ch 16&17)
Initiation

This phase in the project life cycle includes clear objectives, importance of the project and the expected outcome on the organization: (ch 16&17)
Planning

This phase in the project life cycle is where installation of equipment or construction begins, and any policy or procedure manuals should be prepared for distribution (16&17)
Execution

This phase in the project life cycle is where the project shifts to become an integrated part of organizational operations: (ch 16&17)
Closure

The forming stage of project team development in which team members tend to be very polite as they get to know one another is also called (ch 16&17)
Cautious affiliation

The stage of project team development in which conflicts emerge is called (ch 16&17)
Competitiveness

The stage of project team development in which team members learn to communicate and collaborate is called
Harmonious cohesiveness

The stage of project team development in which team members work together easily is called (ch 16&17)
Collaborative teamwork

An effective tool for planning and tracking the implementation of a project is the (ch 16&17)
Gnatt Chart

This planning technique provides a structure that requires the project team to identify the order and projected duration of activities needed to complete a project:
(ch 16&17)
PERT Chart

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