Quality Improvement Flashcards
7 cards from real AHIMA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Quality Improvement flashcards as text
The Joint Commission's ORYX initiative requires accredited hospitals to collect and report data on:
Answer: Core performance measures linked to accreditation standards
ORYX integrates performance measurement data into the accreditation process, requiring hospitals to report on standardized core measures such as sepsis care, VTE prophylaxis, and perinatal care.
Which CMS program adjusts hospital inpatient payments based on performance on quality, safety, and patient experience measures?
Answer: Hospital Value-Based Purchasing (VBP)
The Hospital VBP program withholds a percentage of base operating DRG payments and redistributes them based on hospital performance across clinical outcomes, safety, and patient experience domains.
How do Hospital-Acquired Conditions (HACs) affect Medicare reimbursement under current CMS policy?
Answer: They result in reduced or eliminated additional payment for the preventable complication
CMS does not pay the higher DRG rate for cases where a HAC was not present on admission and could reasonably have been prevented, incentivizing hospitals to reduce preventable complications.
In healthcare quality terminology, a 'never event' is defined as:
Answer: A serious, largely preventable patient safety incident that should never occur in a well-run system
Never events, as defined by the NQF, are serious reportable events that are clearly identifiable, measurable, largely preventable, and signal a need for immediate investigation.
Which federal program publicly reports hospital quality measure performance data online as a condition of participation in Medicare?
Answer: Hospital Compare / Care Compare
CMS's Care Compare (formerly Hospital Compare) website publicly reports hospital performance on quality measures, enabling consumers to compare hospitals and incentivizing transparency.
Failure Mode and Effects Analysis (FMEA) differs from root cause analysis (RCA) primarily because FMEA is:
Answer: A proactive tool that identifies potential failures before they cause harm
FMEA is a prospective risk assessment tool that systematically evaluates processes to identify where and how they might fail before an actual adverse event occurs.
The Joint Commission uses 'tracer methodology' during accreditation surveys primarily to:
Answer: Follow a patient's care experience across departments to evaluate system performance
Tracer methodology follows the care journey of selected patients through the organization to identify potential vulnerabilities in care processes, communication, and documentation.