AHIMA Quality Improvement 2 — Questions and Answers
Question 1: What is the primary purpose of a fishbone (Ishikawa) diagram in quality improvement?
- To track patient outcomes over time
- To identify potential root causes of a problem (Correct answer)
- To measure process cycle efficiency
- To document standard workflow steps
Correct answer: To identify potential root causes of a problem
The fishbone diagram is a cause-and-effect tool used to visually identify and categorize the potential root causes contributing to a specific problem.
Question 2: In the Plan-Do-Study-Act (PDSA) cycle, what occurs during the 'Study' phase?
- A change is implemented at full organizational scale
- Objectives and predictions are established for the test
- Data is analyzed and compared to predictions (Correct answer)
- The change is formally adopted or abandoned
Correct answer: Data is analyzed and compared to predictions
The Study phase involves analyzing the data collected during the Do phase and comparing actual results to predicted outcomes to determine what was learned.
Question 3: Which quality improvement tool displays process variation over time and distinguishes between common-cause and special-cause variation?
- Pareto chart
- Histogram
- Control chart (Correct answer)
- Scatter diagram
Correct answer: Control chart
A control chart plots data points over time with upper and lower control limits, helping identify whether variation is inherent to the process or caused by an unusual event.
Question 4: A Pareto chart is MOST useful for:
- Displaying the frequency distribution of a single variable
- Identifying the vital few causes that account for most problems (Correct answer)
- Showing the correlation between two variables
- Tracking performance trends across multiple time periods
Correct answer: Identifying the vital few causes that account for most problems
Based on the 80/20 rule, a Pareto chart ranks causes by frequency so teams can focus on the few factors responsible for the majority of problems.
Question 5: The Institute for Healthcare Improvement's 'Triple Aim' framework focuses on simultaneously improving which three dimensions?
- Cost, quality, and patient safety
- Population health, patient experience, and per capita cost (Correct answer)
- Access, efficiency, and staff satisfaction
- Clinical outcomes, documentation accuracy, and coding quality
Correct answer: Population health, patient experience, and per capita cost
The Triple Aim targets better health for populations, better care experiences for individuals, and lower per capita costs for healthcare systems.
Question 6: The healthcare quality measurement framework of 'structure, process, and outcome' was developed by which pioneer?
- W. Edwards Deming
- Joseph Juran
- Avedis Donabedian (Correct answer)
- Philip Crosby
Correct answer: Avedis Donabedian
Avedis Donabedian proposed this three-part framework for evaluating healthcare quality, where structure enables process and process influences outcomes.
Question 7: The primary goal of a sentinel event review under Joint Commission standards is to:
- Assign individual accountability for adverse outcomes
- Identify systemic contributing factors and prevent recurrence (Correct answer)
- Document the event for malpractice defense purposes
- Report findings to state licensing boards
Correct answer: Identify systemic contributing factors and prevent recurrence
A sentinel event root cause analysis (RCA) aims to uncover the underlying system failures that allowed the event to occur and implement corrective actions.
AHIMA Quality Improvement 2
What is the primary purpose of a fishbone (Ishikawa) diagram in quality improvement?