NAHQ CPHQ UPDATED COMPREHENSIVE
QUESTIONS AND ANSWERS SURE A+
✔✔When use Six Sigma approach? - ✔✔Resource utilization
Patient safety
Appropriate use of technology
Increasing market share
✔✔Six Sigma methodology - ✔✔DMAIC
Define, measure, analyze, improve, control
✔✔lean enterprise - ✔✔Reduce waste and focus on activities that add value for the
customer
Eliminate waste in 8 key areas: defects, overproduction, waiting, nonutilized talent,
transportation, inventory, motion and extra processing
A Total redesign
✔✔Organization Structural elements of Infrastructure for Quality and Safety -
✔✔Governing body structures - ultimate responsibility for quality of care, either full
responsibility or delegates
Operational structures - manage the coordination of quality and improvement efforts
Teams - work on 1 or more targeted improvement opportunities
HCQP role is to evaluate the effectiveness of various structures, paying close attention
to alignment, coordination and communication
✔✔Distinction of lean enterprise approach - ✔✔Emphasis on investigating new ways of
getting things done and making the changes in a short period of time
,✔✔True or False - ✔✔Organization's usually implement lean methods before
considering six Sigma bc waste should be eliminated prior to fine tuning the system to
deliver excellence
✔✔How translate strategic goals into quality outcomes? - ✔✔Aligning improvement
activities with strategic goals
Establishing goals beyond benchmarks
Developing and implementing dashboards and scorecards
Communicating the goals
Identifying and engaging key stakeholders
✔✔Balanced Scorecard (BSC) - ✔✔A performance measurement and management
methodology that helps translate an organization's financial, customer, internal process,
and learning and growth objectives and targets into a set of actionable initiatives
Norton and Kaplan
Comprehensive view and not dependent on a few choice indicators
Better links long term strategy with short term activities
✔✔How to have a successful transformation with Change Management - ✔✔Leadership
(70 to 90%): defines what the future should like like, aligns people with the vision and
inspires them to make it happen despite obstacles
Management (10 to 30%): involves a set of processes that can keep a complex system
of people and technology running smoothly
✔✔True or False - ✔✔All changes do not lead to improvement, but all improvement
requires change.
✔✔2 factors to assess change in organizations - ✔✔1. The limits of human performance
in being able to respond to change
2. The actual capacity of the systems to handle change
✔✔Lewin's Change Model - ✔✔unfreeze, change, refreeze
Motivation and readiness for change must occur before the change can take place
Force field of driving and restraining forces
Driving forces must be stronger than restraining forces. Reduce # of restraining rather
than add more driving forces to increase change of success
Adding powerful drivers does not necessarily make change happen faster.
, Tool: Force field analysis
✔✔Force Field Analysis - ✔✔A technique for determining which forces drive a proposed
change and which forces restrain it.
Diagram of 2 columns, Driving and Restraining Forces. Analyzes opposing forces
related to a specific change.
Shows # and significance of opposing forces by indicating relative weights with the size
of the arrows.
Brainstorming (verbal) and brain writing (written) formats
✔✔Palmer's Change Model - ✔✔7 key elements:
1. Leading change
2. Creating a shared need
3. Shaping a vision
4. Mobilizing commitment
5. Monitoring progress
6. Finishing the job
7. Anchoring the change in systems and structure
Key strategy is to first assess READINESS
< 50% likelihood of success for change is low
✔✔DeWeaver and Gillespie's Change Model - ✔✔Reductionist approach. HCPs
objectively measure the system inputs and outputs for each part.
Depends on an orderly system in which objects behave predictably and new information
can fit into existing structures.
5 stages: awareness, curiosity, visualization, learning, use
Not linear model, may not make it through all stages and can revert to previous stage
✔✔Galpin's Human Side of Change Model - ✔✔HUMANISTIC APPROACH TO
CHANGE
Most important aspect of change is COMMUNICATION
9 steps in which Change is a deliberate, planned process
1. Establish the need to change
2. Develop and disseminate a vision of change
3. Diagnose/analyze the current situation
4. Generate recommendations
QUESTIONS AND ANSWERS SURE A+
✔✔When use Six Sigma approach? - ✔✔Resource utilization
Patient safety
Appropriate use of technology
Increasing market share
✔✔Six Sigma methodology - ✔✔DMAIC
Define, measure, analyze, improve, control
✔✔lean enterprise - ✔✔Reduce waste and focus on activities that add value for the
customer
Eliminate waste in 8 key areas: defects, overproduction, waiting, nonutilized talent,
transportation, inventory, motion and extra processing
A Total redesign
✔✔Organization Structural elements of Infrastructure for Quality and Safety -
✔✔Governing body structures - ultimate responsibility for quality of care, either full
responsibility or delegates
Operational structures - manage the coordination of quality and improvement efforts
Teams - work on 1 or more targeted improvement opportunities
HCQP role is to evaluate the effectiveness of various structures, paying close attention
to alignment, coordination and communication
✔✔Distinction of lean enterprise approach - ✔✔Emphasis on investigating new ways of
getting things done and making the changes in a short period of time
,✔✔True or False - ✔✔Organization's usually implement lean methods before
considering six Sigma bc waste should be eliminated prior to fine tuning the system to
deliver excellence
✔✔How translate strategic goals into quality outcomes? - ✔✔Aligning improvement
activities with strategic goals
Establishing goals beyond benchmarks
Developing and implementing dashboards and scorecards
Communicating the goals
Identifying and engaging key stakeholders
✔✔Balanced Scorecard (BSC) - ✔✔A performance measurement and management
methodology that helps translate an organization's financial, customer, internal process,
and learning and growth objectives and targets into a set of actionable initiatives
Norton and Kaplan
Comprehensive view and not dependent on a few choice indicators
Better links long term strategy with short term activities
✔✔How to have a successful transformation with Change Management - ✔✔Leadership
(70 to 90%): defines what the future should like like, aligns people with the vision and
inspires them to make it happen despite obstacles
Management (10 to 30%): involves a set of processes that can keep a complex system
of people and technology running smoothly
✔✔True or False - ✔✔All changes do not lead to improvement, but all improvement
requires change.
✔✔2 factors to assess change in organizations - ✔✔1. The limits of human performance
in being able to respond to change
2. The actual capacity of the systems to handle change
✔✔Lewin's Change Model - ✔✔unfreeze, change, refreeze
Motivation and readiness for change must occur before the change can take place
Force field of driving and restraining forces
Driving forces must be stronger than restraining forces. Reduce # of restraining rather
than add more driving forces to increase change of success
Adding powerful drivers does not necessarily make change happen faster.
, Tool: Force field analysis
✔✔Force Field Analysis - ✔✔A technique for determining which forces drive a proposed
change and which forces restrain it.
Diagram of 2 columns, Driving and Restraining Forces. Analyzes opposing forces
related to a specific change.
Shows # and significance of opposing forces by indicating relative weights with the size
of the arrows.
Brainstorming (verbal) and brain writing (written) formats
✔✔Palmer's Change Model - ✔✔7 key elements:
1. Leading change
2. Creating a shared need
3. Shaping a vision
4. Mobilizing commitment
5. Monitoring progress
6. Finishing the job
7. Anchoring the change in systems and structure
Key strategy is to first assess READINESS
< 50% likelihood of success for change is low
✔✔DeWeaver and Gillespie's Change Model - ✔✔Reductionist approach. HCPs
objectively measure the system inputs and outputs for each part.
Depends on an orderly system in which objects behave predictably and new information
can fit into existing structures.
5 stages: awareness, curiosity, visualization, learning, use
Not linear model, may not make it through all stages and can revert to previous stage
✔✔Galpin's Human Side of Change Model - ✔✔HUMANISTIC APPROACH TO
CHANGE
Most important aspect of change is COMMUNICATION
9 steps in which Change is a deliberate, planned process
1. Establish the need to change
2. Develop and disseminate a vision of change
3. Diagnose/analyze the current situation
4. Generate recommendations
