Quality Control & Process Improvement Flashcards

Which quality improvement model uses the steps Define, Measure, Analyze, Improve, and Control?

Answer: Six Sigma DMAIC

Six Sigma uses the DMAIC framework to reduce defects and process variation in healthcare settings.

A medical office notices billing errors occurring at a rate of 8%. Which document is MOST useful for identifying the root causes of these errors?

Answer: Fishbone (Ishikawa) diagram

A fishbone diagram visually maps potential root causes across categories such as people, process, and equipment.

In a medical practice, 'benchmarking' refers to:

Answer: Comparing practice performance to industry best practices or peers

Benchmarking compares a practice's metrics against external standards or top-performing organizations to identify improvement opportunities.

Which type of data is collected when tracking the number of no-show appointments per week?

Answer: Discrete (attribute) data

Discrete data consists of countable whole numbers, such as the count of no-show appointments.

A practice administrator wants to reduce patient check-in time. Which Lean tool identifies steps that add no value to the patient experience?

Answer: Value stream mapping

Value stream mapping visualizes each step in a process and distinguishes value-added from non-value-added activities.

The primary goal of a sentinel event review in a medical office is to:

Answer: Identify system failures to prevent recurrence

Sentinel event reviews use root cause analysis to uncover systemic issues rather than assign individual blame.

Which performance indicator measures the percentage of claims paid on the first submission without denial?

Answer: Clean claim rate

The clean claim rate reflects the proportion of claims accepted and paid without requiring correction or resubmission.