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CCM Quality Improvement & Outcomes Management Flashcards

6 cards from real CCM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 6 CCM Quality Improvement & Outcomes Management flashcards as text

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

    Answer: The Model for Improvement

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

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

    Answer: Healthcare Effectiveness Data and Information Set

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

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

    Answer: Fishbone (Ishikawa) diagram

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

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

    Answer: NCQA

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

  5. What does a process measure in quality improvement assess?

    Answer: Whether recommended care steps were actually performed

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

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

    Answer: Control chart

    Control charts plot data over time with control limits to identify whether variation is due to common causes or special causes requiring intervention.