Performance Improvement and Quality Flashcards
7 cards from real ANM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Performance Improvement and Quality flashcards as text
An ANM is implementing a new hand hygiene protocol. Which change management model emphasizes creating urgency, building a guiding coalition, and consolidating gains?
Answer: Kotter's 8-Step Change Model
Kotter's 8-Step Model explicitly includes creating urgency, forming a guiding coalition, and consolidating gains as sequential steps for leading change.
A hospital tracks its medication error rate using DPMO (Defects Per Million Opportunities). A Six Sigma process has a DPMO of approximately:
Answer: 3.4
Six Sigma quality level corresponds to no more than 3.4 defects per million opportunities, representing 99.99966% accuracy.
Which CMS Hospital Value-Based Purchasing (VBP) domain directly measures clinical outcomes such as mortality and complications?
Answer: Clinical Care – Outcomes
The Clinical Care – Outcomes domain of CMS VBP specifically measures mortality rates, complications, and other clinical outcome measures.
A root cause analysis (RCA) team identifies that inadequate nurse-to-patient ratios contributed to a fall with injury. This is an example of a:
Answer: Latent contributing factor
Inadequate staffing ratios are a latent (system-level) contributing factor that creates conditions for errors rather than directly causing them.
The HCAHPS survey is BEST described as:
Answer: A standardized patient experience survey publicly reported by CMS
HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) is a standardized, publicly reported patient satisfaction survey mandated by CMS.
An ANM observes that staff skip a required time-out step before procedures when the unit is busy. Using the Swiss Cheese Model, this represents:
Answer: A latent error aligning holes across defensive layers
The Swiss Cheese Model shows how latent holes (like skipped time-outs) across multiple safety layers can align to allow harm to occur.
Which PI approach focuses on eliminating waste through the categories of Transportation, Inventory, Motion, Waiting, Overproduction, Overprocessing, and Defects?
Answer: Lean's 7 Wastes (TIM WOOD)
Lean methodology categorizes waste into 7 types remembered by the acronym TIM WOOD, targeting each to maximize value in care delivery.