CPXPExamStudyGuide(inprogress)

CPXP Exam Study Guide (in progress) CPXP Exam Study Guide (in progress) 1. How did the report of quality measures to CMS begin ?: Hospitals could voluntarily report quality measures starting in 2001 - adapting to current state from there 2. What is HCAHPS : Hospital Consumer Assessment of Healthcare Providers and System 3. What are some metrics for outcome of care?: mortality, readmission, compli - cations, hospital associated infections 4. Describe "Pay for performance ": provide financial incentives to hospitals, physi - cians, and other providers to carry out improvement and achieve optimal outcomes for patients 5. What are some reasons patients may not voice their complaints?: Don't know where to complain, afraid of retribution, not worth the trouble 6. What are the IOM six aims of for quality (established in 2001 ): Safe, time, effective, efficient, equitable, patient -centered (STEEEP) 7. What is the IHI triple aim?: improve patient experience, improve health of populations, reduce per capita cost 8. Describe health literacy : capacity to obtain, process and understand basic health information needed to make appropriate health decisions 9. What percentage of adults are estimated to have a proficient health litera - cy: 12 % 10. Which year was the American Society for Hospital Risk Management formed?: 1980 11. What was the original name for the CMS : Health Care Financing Administra - tion 12. What is the definition of Culture (Irwin Press): Culture exists when its mem - bers share values and behaviors that they take for granted 13. What is empathy: the ability to understand and share the feelings of another 14. What percentage of CMS reimbursement is dependent on patient satisfac - tion scores: 1% 15. What are the 4 basic needs that should be met to create an ideal patient experience: confidence, integrity, pride, passion 16. In which year did hospitals establish patient advocates and representa - tives?: 1965 17. In which year did the American hospital association develop patients bill of rights: 1973 18. What is the RATER scale and when was it developed: Reliability, Assurance, Tangibles, Empathy, Responsiveness (early 80s) CPXP Exam Study Guide (in progress) CPXP Exam Study Guide (in progress) 19. What are some of the key concepts of the Planetree model: Importance of social support, patient/resident education, healing environment (design - iron curtain) 20. In which year were Diagnostic Related Groups (DRG) introduced?: 1983 21. What is the Emergency Medical Treatment and Labor Act (EMTALA) and when was it established: requires hospitals to stabilize any patient who shows up in the ER regardless of ability to pay (1986) 22. When was the Health Insurance Portability and Patient Protection Act (HIPPA) created?: 1996 23. In which year did the IOM publish the report "To Err is Human" regarding the significance of medical errors: 1999 24. What is the IPFCC: Institute for patient family -centered care 25. What are some of the limitations to the Press Ganey surveys: low return rate, minorities underrepresented 26. What is a "Likert" scale: Ex: Very poor, poor, fair, good, very good 27. What is the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS): first national standardized publicly reported survey of patients perceptions of hospital experience 28. What are the main functions of the Office of Patient Relations: Provide a centralized mechanism for addressing patient concerns, liaison between patients and medical providers 29. What are the main goals of the Office of Patient Relations at Rush: Under - stand service gaps through increased complaint capture Improve complaint resolution time 30. What is a level 1 complaint: concern addressed immediately by employee 31. What is a level 2 complaint: addressed at employee or escalated to manage - ment with additional tools (coupons, parking, flowers) 32. What is a level 3 complaint: employee escalates to manager refers patient/fam - ily or concern to patient relations 33. What are the characteristics of hospitals that did well with value based purchasing?: smaller, didn't train residents, more affluent patient mix, for profit 34. What are the characteristics of hospitals that did NOT do well with value based purchasing?: bigger, teaching hospitals, poor patients, govt owned 35. What is the goal of Partnership for Patients: decrease preventable hos - pital-acquired conditions, decrease preventable complications during care center transition 36. When did Medicare Physician Pay for Performance begin?: started in 2015 for some physicians and physician groups - projected to be for all physicians by 2017 CPXP Exam Study Guide (in progress) CPXP Exam Study Guide (in progress) 37. What does the RUSH way stand for?: systematic approach to process im- provement (Ready, understand, solve, hold) 38. Time frame that AHA establishes membership group: National society for patient representation and consumer affairs: early 70's 39. Which year did AHA develop and adopts patients bill of rights?: 1973 40. What was the Karen Quinian case?: Young women slipped into coma after drug interaction with alcohol (ethics of euthanasia) 41. What is cultural competence: being sensitive to others cultures and beliefs 42. According to the Beryl Institute article, what are the three areas that integrate to create patient experience: quality, safety, and service 43. According to the Beryl Institute article, which method of patient survey is the most effective?: phone surveys. Tend to give more positive responses than paper survey. 44. What other surveys are in use or under development?: Clinical and group consumer assessment of healthcare providers (CGCAHPS) and systems and ED- CAHPS (Emergency department) 45. What is the relationship to HCAHPS and Value based purchasing?: Hospital that fail to publicly report the required quality measure, may receive an annual payment update that is reduced by 2% 46. What is value based purchasing?: payment method that rewards quality of care through payment incentives and transparency. 47. What are some key differences between HCAHPS and Rush Press Ganey surveys?: PG offers a neutral answer, while HCAHPS does not. PG does not effect reimbursement. HCAHPS publicly reported on Medicare website 48. Describe service recovery: apology to patient if service wasn't satisfactory 49. What do the initials in the HEART model for handling complaints stand for: H-hear the patient E-empathize A-apologize R-respond T-Thank 50. Picker Institute Eight Characteristics of patient centered care: Access to care, respect for patient values -preferences -needs, coordination/integration of care, information -communication -education, transition and continuity of care, involving family and friends, emotional support reducing fear/anxiety, physical comfort 51. What is the name of the rules that give rise to a patient's right to file a grievance against a hospital: Patient rights and responsibilities 52. What is the primary reason for patient lawsuits against physicians: Lack of communication