CCM CCM Quality Improvement & Outcomes Management 1

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

The Model for Improvement, developed by the Institute for Healthcare Improvement (IHI), uses PDSA cycles to iteratively test and scale improvements.

Question 2

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

Accepted Answer

Healthcare Effectiveness Data and Information Set

Answer

HEDIS (Healthcare Effectiveness Data and Information Set) is a widely used set of performance measures used by health plans to assess quality of care.

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

A fishbone diagram helps teams visually map and categorize potential causes of a problem to identify root causes systematically.

Question 4

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

Accepted Answer

NCQA

Answer

The National Committee for Quality Assurance (NCQA) offers Case Management Accreditation, assessing programs against standardized quality and performance criteria.

Question 5

What does a process measure in quality improvement assess?

Accepted Answer

Whether recommended care steps were actually performed

Answer

Process measures evaluate whether specific evidence-based steps in care delivery were completed, such as whether a diabetic patient received an annual HbA1c test.

(CCM) Certified Care Manager Practice Test

(CCM) Certified Care Manager Practice Test

CCM CCM Quality Improvement & Outcomes Management 1