C157 and C128 combined test with 70 Questions and Answers with Rationales

Analyze each question and choose the best response. Record your rationale for each choice. 1. Quality improvement assumes that: a. Most problems with service delivery result from process difficulties, not individuals. b. Frequent inspection is necessary to improve quality. c. Employees generally try to avoid work. d. Top management leads all quality improvement activities. Response A is correct. QI starts with the assumption that errors occur as a result of system failures, not individual errors. We should eliminate response C. In response B, frequent inspection might help ensure quality control over the process we have now, but will not help us exceed the capability of the existing process to improve quality. In response D, top management would be the CEO and senior management—there is not enough of them to go around to lead ‘all’ QI activities. 2. The term “quality” as used in quality improvement usually refers to: a. Characteristics of a product or service that bear on its ability to satisfy stated or implied needs. b. A product or service free of deficiencies. c. Having a high degree of excellence. d. All of the above. Although each of the definitions provided are different ways in which we think of attribute of “quality”, quality improvement focuses on delivering quality services or products as determined by the customer. Therefore, in QI, high “quality” rests on the ability to satisfy customer needs. A product or service that is free of deficiencies or has a high degree of excellence but does not meet the customer needs would not be considered a “quality” result (we would think of it as wasteful). Note also the IHI “Triple Aim”: ⦁ Improving the patient experience of care (including quality and satisfaction); ⦁ Improving the health of populations; and ⦁ Reducing the per capita cost of health care.