CHL Healthcare Quality Management 5 — Questions and Answers
Question 1: Which national patient safety initiative uses evidence-based 'bundles'—small sets of interventions applied together—to prevent ICU complications such as ventilator-associated events?
- The Leapfrog Group safety standards
- IHI 100,000 Lives Campaign bundle approach (Correct answer)
- CMS Hospital Compare reporting
- The Joint Commission Speak Up program
Correct answer: IHI 100,000 Lives Campaign bundle approach
The IHI popularized the care bundle concept, demonstrating that consistently applying a small group of evidence-based practices together dramatically reduces complications.
Question 2: A healthcare quality leader is reviewing HCAHPS results showing low scores in the 'communication about medicines' domain. Which improvement strategy is most directly aligned?
- Increase nursing staff on evening shifts
- Implement structured teach-back during medication education with patients (Correct answer)
- Redesign the pharmacy dispensing workflow
- Add pharmacy kiosks to patient floors
Correct answer: Implement structured teach-back during medication education with patients
Teach-back is an evidence-based communication strategy proven to improve patients' understanding of their medications.
Question 3: Which term describes the comprehensive review of a patient's complete medication regimen at each transition of care to avoid errors such as omissions, duplications, and interactions?
- Formulary management
- Medication reconciliation (Correct answer)
- Pharmacy benefit management
- Adverse drug event reporting
Correct answer: Medication reconciliation
Medication reconciliation is a formal process of comparing a patient's current medication orders against all medications the patient has been taking at every care transition.
Question 4: A quality improvement team discovers that a new sepsis screening protocol reduced mortality but increased ICU length of stay. How should they interpret this finding?
- The project has failed and the protocol should be abandoned
- The outcome measure improved, but a balancing measure revealed an unintended consequence requiring further study (Correct answer)
- The data is invalid and should be recollected
- The improvement is complete since mortality is the primary outcome
Correct answer: The outcome measure improved, but a balancing measure revealed an unintended consequence requiring further study
When a primary outcome improves but a balancing measure worsens, the team must investigate trade-offs before spreading the change.
Question 5: Which accreditation body assesses health plans using the Healthcare Effectiveness Data and Information Set (HEDIS) measures to evaluate quality of care and service?
- The Joint Commission (TJC)
- National Committee for Quality Assurance (NCQA) (Correct answer)
- Det Norske Veritas (DNV)
- Utilization Review Accreditation Commission (URAC)
Correct answer: National Committee for Quality Assurance (NCQA)
NCQA developed and manages HEDIS, which is used to measure health plan performance on over 90 measures of care and service.
Question 6: Which type of benchmarking compares an organization's performance against the best-performing organizations regardless of industry to identify breakthrough improvements?
- Internal benchmarking
- Competitive benchmarking
- Functional or generic benchmarking (Correct answer)
- Collaborative benchmarking
Correct answer: Functional or generic benchmarking
Generic benchmarking looks outside one's industry to adopt best practices from any sector that excels in a particular function.
Question 7: A CHL candidate is designing a quality scorecard for a hospital. Which framework specifically organizes performance measures into four perspectives: financial, customer, internal processes, and learning and growth?
- Baldrige Performance Excellence Framework
- Balanced Scorecard (BSC) (Correct answer)
- ISO 9001 Quality Management System
- Donabedian structure-process-outcome model
Correct answer: Balanced Scorecard (BSC)
The Balanced Scorecard, developed by Kaplan and Norton, organizes strategic measures across four linked perspectives.
CHL Healthcare Quality Management 5
Which national patient safety initiative uses evidence-based 'bundles'—small sets of interventions applied together—to prevent ICU complications such as ventilator-associated events?