CHC Quality Assurance & Performance Improvement 5 — Questions and Answers
Question 1: A healthcare constructor implementing a quality management system (QMS) based on ISO 9001 would FIRST need to:
- Purchase and install quality control software on all jobsite computers
- Define the scope, context, and processes of the QMS and obtain top management commitment (Correct answer)
- Hire a third-party auditor to certify all subcontractors
- Submit the QMS plan to the state health department for approval
Correct answer: Define the scope, context, and processes of the QMS and obtain top management commitment
ISO 9001 requires organizations to establish the QMS scope, understand context, and demonstrate leadership commitment before implementing quality processes.
Question 2: In the context of healthcare construction QA, 'special inspection' as defined by the IBC refers to:
- A surprise inspection conducted by state licensing authorities
- Inspection of specified critical work by a qualified inspector, separate from routine contractor self-inspection (Correct answer)
- An OSHA inspection triggered by a worker injury
- A final walkthrough performed by the facility's infection control nurse
Correct answer: Inspection of specified critical work by a qualified inspector, separate from routine contractor self-inspection
Special inspections are required by the IBC for critical structural and safety elements and must be performed by approved inspectors independent of the contractor.
Question 3: A performance improvement initiative identifies that construction noise consistently exceeds the permissible levels in adjacent patient rooms. The MOST effective corrective action would be to:
- Post noise warning signs outside the construction zone
- Implement a construction noise abatement plan with scheduled quiet hours and acoustic barrier installation (Correct answer)
- Inform patients verbally that noise is temporary
- Request that the owner relocate all patients to another wing for the duration
Correct answer: Implement a construction noise abatement plan with scheduled quiet hours and acoustic barrier installation
A noise abatement plan with both scheduling controls and physical acoustic barriers directly addresses the root cause and protects patient care quality.
Question 4: Which of the following BEST describes the purpose of a 'lessons learned' session in healthcare construction QA?
- To identify subcontractors eligible for future bid lists
- To systematically capture what worked well and what failed so future projects benefit from experience (Correct answer)
- To finalize the project's as-built drawings for the owner's records
- To formally close outstanding change orders before final payment
Correct answer: To systematically capture what worked well and what failed so future projects benefit from experience
Lessons learned sessions convert project experience into institutional knowledge, directly feeding continuous improvement for future healthcare construction projects.
Question 5: When a nonconformance report (NCR) is issued on a healthcare construction project, which step must occur BEFORE work on the affected area resumes?
- The project owner must sign a waiver of liability
- The NCR must be dispositioned (accepted, repaired, replaced, or rejected) and approved by the responsible authority (Correct answer)
- A new bid must be solicited from an alternate subcontractor
- The NCR must be reviewed by the state health department
Correct answer: The NCR must be dispositioned (accepted, repaired, replaced, or rejected) and approved by the responsible authority
Work cannot resume in a nonconforming area until the NCR disposition is formally approved, ensuring the deficiency is properly resolved.
Question 6: Under ASHE (American Society for Health Care Engineering) guidelines, a healthcare constructor's quality plan should be submitted to the owner:
- After substantial completion, for post-project review only
- Prior to the start of construction, as part of preconstruction planning (Correct answer)
- Only if the contract value exceeds $10 million
- At the same time as the final lien waiver
Correct answer: Prior to the start of construction, as part of preconstruction planning
ASHE recommends that the quality plan be developed and submitted during preconstruction so that quality expectations, processes, and responsibilities are established before work begins.
Question 7: A statistical process control (SPC) chart used in healthcare construction QA would MOST likely monitor:
- The number of change orders approved per month
- Dimensional tolerances of critical installed components over time to detect process drift (Correct answer)
- Subcontractor invoice submission dates
- The ratio of design drawings to RFIs issued
Correct answer: Dimensional tolerances of critical installed components over time to detect process drift
SPC charts track measurable quality characteristics over time, allowing early detection of process drift before defects occur.
CHC Quality Assurance & Performance Improvement 5
A healthcare constructor implementing a quality management system (QMS) based on ISO 9001 would FIRST need to: