1. The following represents an essential element to an effective quality council: A.consultation of the legal advisor.
   B.direction from the organization’s quality department.
   C.participation of the strategic planning committee.
   D.involvement of leadership.
2. For a community hospital, patient satisfaction scores demonstrate multiple areas needed for improvement including a need to improve attractiveness of the facility, responsiveness to patient needs, and physician and nursing communication. Based on these results, which of the following would the healthcare quality professional also will be expected to find?
   A.departments are operating independently with little communication between units.
   B.administration is prioritizing and leading units to achieve organizational goals. C.departments managers are openly discuss patient satisfaction scores.
   D.employee satisfaction scores in the 90th percentile compared to other peer organizations.
3. Dental department’s monthly case review revealed 240 records meeting criteria and 150 records did not meet the criteria. In calculating the incidence rate, the denominator is:
   A.90 B.390 C.240 D.150
4. Research, Quality Assessment and Quality Improvement: A.use scientific methods to test hypothesis and statistical methods to analyza data.
   B.are considered protocols rather than projects.
   C.do not share the aspect of systematic investigation.
   D.do not require documentation of IRB approval before publication.
5. Failure Mode and Effects Analysis (FMEA) is performed:
   A.as a preventative measure before an incident occurs.
   B.to immediately investigate an incident that occurred. C.if the severity of an incident led to a patient death. D.when there is a chance of an incident reoccurring.
6. The relationship between patient satisfaction and hours per patient day on a GOB unit was found to be (r=0.70,p < 0.05). What is the correlation between these two values?
   A.0.05 B.0.7 C.14 D.0.49
7. When a case manager wants to demonstrate length of stay data that depicts both common cause and special cause variation, which of the following should be used?
   A.Pareto chart. B.Scatter plot. C.Shewhart chart. D.Frequency plot.
8. In accordance with FDA Categorization for Medications Safety in Pregnancy, which statement is true?
   A.Category A drugs; no evidence of risk reported in humans so far.
   B.Category B drugs; evidence of risk is only in later trimesters in humans. C.Category C drugs; no risk to the fetus in the first trimester in humans. D.Category X drugs; risk is documented in animals but not in humans.
9. The leader of a quality improvement team needs to deal effectively with a conflict between two units, it is best to appoint which of the following to its membership?
   A.a human resources representative.
   B.a facilitator.
   C.a risk manager.
   D.a senior safety officer.
10. Which one piece of information is the most usefull to describe the age of population that is served in an anticoagulation monitoring service clinic?
    A.t-test.
    B.mean.
    C.standard error of the mean (SEM). D.chi square test.
11. The primary goal of risk management is to:
    A.minimize financial loss associated with legal actions.
    B.perform Failure Mode and Effects Analyses (FMEA). C.maintain an effective and timely incident reporting system.

D.identify the high risk areas of the organization.

12. A 67 years old diabetic patient being taught how to self-administer insulin. Which of the following is the best method to assess this patient’s understanding of the teaching?
    A.patient satisfaction survey.
    B.return demonstration.
    C.family’s ability to verbalize instructions. D.written pre- and post test.
13. All of the following are key aspects of quality EXCEPT: A.It depends upon customer perceptions.
    B.It does not change with time.
    C.It considers customers needs.
    D.It promotes high levels of precision.
14. Regarding Meta-analysis, all the following statements are True EXCEPT:
    A.It is a statistical procedure that integrates the results of several independent studies that considered to be combinable.
    B.It doesn’t allow a more objective appraisal of the evidence than traditional narrative reviews.
    C.It provides a more precise estimate of a treatment effect.
    D.It may be biased due to exclusion of relevant studies or inclusion of inadequate studies.
15. The following are reasonable description of variation in process capability EXCEPT: A.Extent to which process conforms to the norm.
    B.Distance from perfection.

C.Degree of distribution about the mean.
D.Antithesis of quality.

16. Published articles information in scientific lournals is set in the following sequence:
    A.Title, Author(s), Journal, Year, Volume, Issue, Page(s).
    B.Journal, Year, Volume, Issue, Page(s), Year, Title. C.Author(s), Title, Journal, Year, Volume, Issue, Page(s). D.Author(s), Journal, Title, Year, Volume, Issue, Page(s).
17. Your community hospital has coordinated with local municipality authority to convert a busy intersection to a roundabout (i.e., traffic circle) to alleviate long standing condestion, but after completion it was realized that large fire trucks cannot fit through the new configuration. This is an example of:
    A.Quality assurance.
    B.Unintended consequences.
    C.Continuous quality improvement. D.System re-engineering.
18. All of the following statement are true EXCEPT:
    B.The Institute for Healthcare Improvement is an independent, non-profit organization promoting patient safety initiatives.
    C.The National Quality Forum reviews and endorses voluntary consensus standards.
    D.The Hospital Quality Alliance develops and promotes the utilization of quality measures, such as those addressing surgical wound infections.
    A.Accreditation by the Joint Commission is mandatory for hospitals that bill Medicare for
    services.
19. A team approach to assist in problem solving is most useful when:
    A.diverse areas of expertise are required.
    B.the organization’s goals are unclear. C.communication challenges exist.
    D.there are adequate resources within the organization.
20. All of the following statement about variation in quality management methods are true EXCEPT:
    A.Special cause variation is best addressed at the specific source.
    B.Special cause variation is typically random in nature.
    C.Common cause variation is also known as (internal variation). D.Common cause variation is inherent to any given process.
21. Of a quality improvement perspective, the most desirable state is when: A.Best practices have been identified.
    B.Consensus has been achieved and articulated.
    C.Clinical studies identify effective therapies.
    D.Multiple treatment options are being studied.
22. What sampling technique involves selecting the medical record of every fifth patient undergoing Percutaneous Coronary Intervention (PCI) ?
    A.Convenience. B.Stratified. C.Simple. D.Systematic.
23. All of the following are presently components of National Quality Measures for Acute Myocardial Infarction (AMI) EXCEPT:
    A.Aspirin at arrival.
    B.Beta blocker prescribed at discharge.
    C.ACEI (Angiotensin Converting Enzyme Inhibitors) or ARB (Angiotensin Receptor Blockers) for left ventricular systolic dysfunction.
    D.Long-term lipid-lowering therapy adherence.
24. A utilization management department of a community hospital has collcted data on the length of stay and readmission rates. When compared to benchmarks, the length of stay rates are found to be higher and readmission rates are lower. Which of the following is the next step?
    A.Conduct a cost-benefit analysis.
    B.Display readmission rates with a run chart. C.Investigate the length of stay rates.
    D.Identify additional benchmarks to compare the data. 25. Meaningful quality process measures must be: A.feasible and explainable.
    B.relevant and explainable.
    C.valid and identifiable.
    D.relevant and valid.
25. What is “iatrogenic illness” ? A.Illness of the eye.
    B.Illness caused by iatro-genetic factors.

C.Illness caused by not enough iron in the blood supply.
D.Illness caused by doctors.

27. All of the following are essential to the implementation of an effictive quality improvement project EXCEPT:
    A.The hospital CEO and CFO.
    B.Support and resources from the senior administration.
    C.A clear charge and purpose for the group.
    D.A timeline for work completion and pre-determined reporting structure.
28. When evaluating the components of an existing medication utilization system, priority attention should be given to those steps that:
    A.occur within the pharmacy department. B.are the least prone to variation.
    C.cannot be easily observed “down stream”. D.have highly functional checks and balances.
29. Which one piece of information is the most useful to describe the age of the population that is served in a vaccination clinic?
    A.Pie chart.
    B.Radar chart. C.Gantt chart. D.Scatter plot.
30. Which of the following is the most practical and mandatory element of the process of developing quality measures for use in the healthcare setting?

A.Clinical trials.
B.Evidence-based guidelines. C.Hospital/physician quality measures. D.Pay for performance.

31. What are “psychic” externalities?
    A.External costs and benefits to society from having clairvoyants around.
    B.External costs and benefits associated with caring about other people.
    C.External costs and benefits from being at risk of catching diseases from other people. D.External costs and benefits from curing other people.
32. In evaluating “long waiting times,” a healthcare quality professional best demonstrates components related to staffing, methods, measures, materials, and equipment utilizing a
    A.run chart. B.histogram.
    C.pie chart. D.Ishikawa diagram.
33. Fall prevention programs should include all of the following EXCEPT: A.Assessment/reassessment criteria.
    B.An evidence-based risk assessment tool.
    C.Reimbursement criteria.
    D.Postfall assessment criteria.
34. Two hospitals A&B has recently been merged. After 8 months it has been noted that Hospital A has successfully transitioned their staff to new organization values, while Hospital B is still struggling. Hospital A’ success can be best attributed to
    A.ensuring adoption of new values by all staff. B.support of both hospitals’ mission statements. C.acceptance of the new mission and vision statements. D.integration of technology and databases.
35. An emergency department tracks patient’s mean waiting time from arrival to physician assessment. Data is plotted using a run chart. Which of the following shows a true statistical increase in treatment delays?
    A. 7 consecutive descending data points.
    B. 8 consecutive ascending data points.
    C. data points are close to the mean line. D. a zigzag pattern of 10 data points.
36. The two major responsibilities of the FDA for both drugs and devices are A.quality and affordability.
    B.safety and affectiveness.
    C.availability and durability.
    D.efficacy and reliability.
37. If you were comparing two treatments for which it is easy to arrive at evaluations of both their costs and consequences in monetary terms. Which method of economic evaluation would be best for comparing them?
    A.Cost-minimisation analysis. B.Cost-effectiveness analysis.
    C.Cost-utility analysis. D.Cost-benefit.
38. The operations management transformation process in a hospital is primarily which of the following?
    A.locational. B.exchange. C.physiological. D.storage.
39. This individual developed “bar chart” techniques for activity schedualing A.Elton Mayo.
    B.Adam Smith.
    C.Walter Shewhart.
    D.Henry Gantt.
40. More complex waiting line problems can almost always be handled by:
    A.computer simulation.
    B.mathematical models. C.queuing models. D.linear programming.
41. Which of the following is NOT associated with the Baldrige Award?

A.Primary focus is customer satisfaction and quality. B.For US firms only.
C.First awarded in 1989.
D.It serves as an inexpensive consulting service.

42. The sequential and continual nature of the continuous improvement process is illustrated by the PDCA cycle. PDCA stands for:
    A.plan-do-check-act.
    B.produce-design-catalogue-assess. C.plan-development-check-align. D.produce-deliver-check-assure.
43. A time sequences chart displaying plotted values of a statistic, including a center line and statistically determined control limits is a :
    A.process flow chart. B.scatter diagram. C.run chart. D.control chart.
44. A Quality Council has created a Patient Safety Council. The council is concerned that staff may see this as another program that has been added to their busy scheduales that will eventually go away. The best way for the organization to establish patient safety as an ongoing part of the organization’s culture is to
    A.identify the patient safety goals and how they will be monitored. B.display the number of incident reports monthly with lessons learned. C.make patient safety a part of the emloyees’ job descriptions.

D.include a presentation on patient safety in employee orientation.

45. The following is non-modifiable risk factors for coronary heart disease: A.Obesity.
    B.Smoking.
    C.Hypertension.
    D.Age.
46. The best way to facilitate change within a healthcare organization is to A.communicate through group meetings.
    B.arrange presentations by senior leaders.
    C.communicate through group e-mail.
    D.involve the individuals directly affected by the change.
47. Replacing retrospective review with concurrent review is an example of A.a process improvement.
    B.a paradigm shift.
    C.an impowerment process.
    D.productivity enhancement.
48. Who is responsible for notifying Clinical Engineering of any incoming medical equipment (including loaner, demo and rental) in order to complete an acceptance inspection prior to initial use on a patient?
    A.Technical staff of Clinical Engineering. B.Purchasing Department. C.Each department receiving the equipment.
    D.Nursing Department.
49. Four kinds of cost behaviors in cost accounting are: A.Incremental, fixed, variable, and semi-variable. B.Discretionary, fixed, variable, and semi-variable. C.Direct, indirect, fixed, and variable.
    D.Fixed, variable, semi-variable, and semi-fixed.
50. The overall coordinator responsible for the strategic planning process is
    A.The Board of Directors.
    B.Chief Executive Officer. C.Chief Financial Officer. D.The Medical Staff.

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