ABA Quality Assurance & Continuous Improvement 2 — Questions and Answers
Question 1: Which PDSA cycle step involves collecting data and comparing it to the predictions made during the Plan phase?
- Plan
- Do
- Study (Correct answer)
- Act
Correct answer: Study
The Study phase analyzes collected data to determine whether results match predictions and what was learned.
Question 2: A hospital notices a 15% rate of unplanned ICU admissions post-PACU. The FIRST step in a QI project to address this should be:
- Immediately implement a new monitoring protocol
- Perform a root cause analysis to identify contributing factors (Correct answer)
- Discipline staff involved in the cases
- Reduce the number of high-risk surgeries performed
Correct answer: Perform a root cause analysis to identify contributing factors
Root cause analysis identifies the underlying factors before implementing interventions, ensuring solutions target the actual problem.
Question 3: In the context of anesthesia quality metrics, 'failure to rescue' refers to:
- Failure to intubate on the first attempt
- Death following a complication that potentially could have been treated (Correct answer)
- Inability to reverse neuromuscular blockade
- Delayed emergence from anesthesia
Correct answer: Death following a complication that potentially could have been treated
Failure to rescue measures mortality after a serious complication, reflecting the system's ability to identify and respond to deterioration.
Question 4: A Pareto chart in anesthesia QA is most useful for:
- Tracking a single metric over time
- Identifying which few causes account for the majority of problems (Correct answer)
- Comparing outcomes between two patient populations
- Displaying normal distribution of data
Correct answer: Identifying which few causes account for the majority of problems
The Pareto principle (80/20 rule) helps QI teams prioritize by identifying the vital few causes that produce most defects.
Question 5: Which of the following best defines a 'sentinel event' as used by The Joint Commission?
- Any adverse event requiring additional treatment
- An unexpected event involving death or serious physical or psychological injury (Correct answer)
- A near-miss event that was caught before harming the patient
- Any medication error regardless of patient outcome
Correct answer: An unexpected event involving death or serious physical or psychological injury
The Joint Commission defines sentinel events as unexpected occurrences resulting in death or serious harm, requiring immediate investigation.
Question 6: In statistical process control (SPC) for anesthesia QA, a data point falling OUTSIDE the control limits indicates:
- Normal random variation in the process
- A special cause variation requiring investigation (Correct answer)
- The need to widen the control limits
- Acceptable performance within specification
Correct answer: A special cause variation requiring investigation
Points outside control limits suggest special cause variation—a non-random signal that warrants investigation to identify an assignable cause.
Question 7: The National Anesthesia Clinical Outcomes Registry (NACOR) primarily serves quality improvement by:
- Setting mandatory anesthesia staffing ratios
- Providing benchmarking data to compare practice outcomes nationally (Correct answer)
- Certifying anesthesia equipment manufacturers
- Establishing malpractice premium rates
Correct answer: Providing benchmarking data to compare practice outcomes nationally
NACOR aggregates anesthesia outcome data allowing practices to benchmark their performance against national standards.
ABA Quality Assurance & Continuous Improvement 2
Which PDSA cycle step involves collecting data and comparing it to the predictions made during the Plan phase?