CCM CCM Quality Improvement & Outcomes Management

Question 1

Which quality improvement model uses Plan-Do-Study-Act (PDSA) cycles to test and implement changes in care delivery?

Accepted Answer

The Model for Improvement

Answer

Six Sigma

Answer

LEAN methodology

Answer

Root Cause Analysis

Question 2

In quality management, what does the acronym HEDIS stand for?

Accepted Answer

Healthcare Effectiveness Data and Information Set

Answer

Health Evaluation and Data Integration System

Answer

Health Equity and Disparity Improvement Standards

Answer

Hospital Efficiency and Diagnostic Indicator Summary

Question 3

A care manager wants to reduce hospital readmission rates for heart failure patients. Which tool best helps identify the root cause of readmissions?

Accepted Answer

Fishbone (Ishikawa) diagram

Answer

Gantt chart

Answer

Control chart

Answer

Scatter plot

Question 4

Which accreditation body specifically evaluates care management programs and awards NCQA Case Management Accreditation?

Accepted Answer

NCQA

Answer

The Joint Commission (TJC)

Answer

URAC

Answer

CARF International

Question 5

What does a process measure in quality improvement assess?

Accepted Answer

Whether recommended care steps were actually performed

Answer

Patient clinical outcomes such as mortality rates

Answer

Financial costs of interventions

Answer

Patient satisfaction scores

Question 6

In the context of outcomes management, which statistical tool displays variation in a process over time to distinguish normal from special cause variation?

Accepted Answer

Control chart

Answer

Pareto chart

Answer

Histogram

Answer

Pie chart