HCQM UPDATED EXAMS REVIEW QUESTIONS
AND ANSWERS SURE A+
✔✔Lean - ✔✔Approach to Quality Improvement originating in Japan with a focus on
production systems (grounded in analysis of the actual processes that produce the
outcome). Data based and is continuous. Improvements achieved by improving process
flow and eliminating unnecessary steps or steps that do not "add value". Findings and
improvements target process improvements that can be integrated into daily work.
✔✔Six Sigma - ✔✔Quality approach using data-driven information to eliminate defects
in order to achieve a theoretical six standard deviations between the mean and the
nearest specification limit. To achieve a six sigma performance, a process must not
produce more 3.4 defects per million opportunities. Customer driven like total quality
management. Aims to both improve process flow as well as reduce process variation.
Expands the focus beyond lean process flow to include process management.
✔✔Six Sigma Defect - ✔✔Not meeting the customer specifications.
✔✔Lean Six Sigma 5 Phases - ✔✔1. Define 2. Measure 3. Analyze 4. Improve 5.
Control (follow-up) AKA DMAIC (pronounced duh-may-ik)
✔✔Credentialing - ✔✔Assures that the correct individual with the correct skills, correct
knowledge, and the correct performance is put in the correct position.
✔✔Quality Assurance and Peer Review are less important in the quality process when
this is a cornerstone. - ✔✔Credentialling
✔✔Credentialing allows for variances in outcomes to be investigated with the primary
focus on these. - ✔✔The environment and the systems within which qualified people
work.
, ✔✔When credentialing is performed, the quality approach has more latitude to be -
✔✔Supportive rather than punitive if the personnel are competent.
✔✔System approach seeks to introduce these to avoid lapses of judgment by qualified
individuals from having negative results. - ✔✔Safeguards.
✔✔Risk Management - ✔✔Relates to the quality process as it focuses on preventing
monetary loss by eliminating negative outcomes. Includes insurance, patient
satisfaction, and legal issues.
✔✔Analyzes areas in which an organization or provider may lose money in order to
identify opportunities for improvement. - ✔✔Risk Mangement
✔✔Focuses on improving the documentation of care as a means to protect the
providers if a question arises regarding services provided. - ✔✔Risk Management
✔✔Uses quality processes to determine what can be done proactively to prevent a
reoccurrence of situations that produce risks. - ✔✔Risk Mangement
✔✔These two tools help with risk management processes. - ✔✔Common database of
information and use of medical record analysis.
✔✔Deals with loss prevention on a day-to-day basis. - ✔✔Risk Management
✔✔Proactive approaches are used to avoid negative situations. Positive outcomes,
satisfied patients, and adherence to regulations all decrease loss potential. - ✔✔Risk
Management
✔✔Utilization Review - ✔✔Formal review of the consumption of all resources used in
delivering care to a patient. Traditionally focuses on length of stay or the
appropriateness of performing a procedure.
✔✔Includes analyses of specific resources used for a patient and may be prospective,
concurrent, or retrospective. - ✔✔Utilization Review
✔✔Focuses on improving already successful care by reducing the resources used to
achieve the same results. - ✔✔Utilization Review
✔✔Medical Records - ✔✔Used as a primary source of information in the quality
process. Type of record must be validated prior to interpretation; this is best done by
contacting the individual responsible for creating the record in order to clarify its status.
AND ANSWERS SURE A+
✔✔Lean - ✔✔Approach to Quality Improvement originating in Japan with a focus on
production systems (grounded in analysis of the actual processes that produce the
outcome). Data based and is continuous. Improvements achieved by improving process
flow and eliminating unnecessary steps or steps that do not "add value". Findings and
improvements target process improvements that can be integrated into daily work.
✔✔Six Sigma - ✔✔Quality approach using data-driven information to eliminate defects
in order to achieve a theoretical six standard deviations between the mean and the
nearest specification limit. To achieve a six sigma performance, a process must not
produce more 3.4 defects per million opportunities. Customer driven like total quality
management. Aims to both improve process flow as well as reduce process variation.
Expands the focus beyond lean process flow to include process management.
✔✔Six Sigma Defect - ✔✔Not meeting the customer specifications.
✔✔Lean Six Sigma 5 Phases - ✔✔1. Define 2. Measure 3. Analyze 4. Improve 5.
Control (follow-up) AKA DMAIC (pronounced duh-may-ik)
✔✔Credentialing - ✔✔Assures that the correct individual with the correct skills, correct
knowledge, and the correct performance is put in the correct position.
✔✔Quality Assurance and Peer Review are less important in the quality process when
this is a cornerstone. - ✔✔Credentialling
✔✔Credentialing allows for variances in outcomes to be investigated with the primary
focus on these. - ✔✔The environment and the systems within which qualified people
work.
, ✔✔When credentialing is performed, the quality approach has more latitude to be -
✔✔Supportive rather than punitive if the personnel are competent.
✔✔System approach seeks to introduce these to avoid lapses of judgment by qualified
individuals from having negative results. - ✔✔Safeguards.
✔✔Risk Management - ✔✔Relates to the quality process as it focuses on preventing
monetary loss by eliminating negative outcomes. Includes insurance, patient
satisfaction, and legal issues.
✔✔Analyzes areas in which an organization or provider may lose money in order to
identify opportunities for improvement. - ✔✔Risk Mangement
✔✔Focuses on improving the documentation of care as a means to protect the
providers if a question arises regarding services provided. - ✔✔Risk Management
✔✔Uses quality processes to determine what can be done proactively to prevent a
reoccurrence of situations that produce risks. - ✔✔Risk Mangement
✔✔These two tools help with risk management processes. - ✔✔Common database of
information and use of medical record analysis.
✔✔Deals with loss prevention on a day-to-day basis. - ✔✔Risk Management
✔✔Proactive approaches are used to avoid negative situations. Positive outcomes,
satisfied patients, and adherence to regulations all decrease loss potential. - ✔✔Risk
Management
✔✔Utilization Review - ✔✔Formal review of the consumption of all resources used in
delivering care to a patient. Traditionally focuses on length of stay or the
appropriateness of performing a procedure.
✔✔Includes analyses of specific resources used for a patient and may be prospective,
concurrent, or retrospective. - ✔✔Utilization Review
✔✔Focuses on improving already successful care by reducing the resources used to
achieve the same results. - ✔✔Utilization Review
✔✔Medical Records - ✔✔Used as a primary source of information in the quality
process. Type of record must be validated prior to interpretation; this is best done by
contacting the individual responsible for creating the record in order to clarify its status.
