CMAS Quality Control & Process Improvement 2 — Questions and Answers
Question 1: Which quality improvement model uses the steps Define, Measure, Analyze, Improve, and Control?
- PDCA
- Six Sigma DMAIC (Correct answer)
- Lean TPS
- ISO 9001
Correct answer: Six Sigma DMAIC
Six Sigma uses the DMAIC framework to reduce defects and process variation in healthcare settings.
Question 2: 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?
- Gantt chart
- Fishbone (Ishikawa) diagram (Correct answer)
- Run chart
- Control chart
Correct answer: Fishbone (Ishikawa) diagram
A fishbone diagram visually maps potential root causes across categories such as people, process, and equipment.
Question 3: In a medical practice, 'benchmarking' refers to:
- Setting internal performance targets based on last year's data
- Comparing practice performance to industry best practices or peers (Correct answer)
- Measuring patient wait times daily
- Tracking individual employee productivity
Correct 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.
Question 4: Which type of data is collected when tracking the number of no-show appointments per week?
- Qualitative data
- Discrete (attribute) data (Correct answer)
- Continuous data
- Anecdotal data
Correct answer: Discrete (attribute) data
Discrete data consists of countable whole numbers, such as the count of no-show appointments.
Question 5: A practice administrator wants to reduce patient check-in time. Which Lean tool identifies steps that add no value to the patient experience?
- FMEA
- Value stream mapping (Correct answer)
- Control chart
- Pareto analysis
Correct answer: Value stream mapping
Value stream mapping visualizes each step in a process and distinguishes value-added from non-value-added activities.
Question 6: The primary goal of a sentinel event review in a medical office is to:
- Determine which staff member is at fault
- Identify system failures to prevent recurrence (Correct answer)
- Satisfy malpractice insurance requirements
- Document the event for billing purposes
Correct answer: Identify system failures to prevent recurrence
Sentinel event reviews use root cause analysis to uncover systemic issues rather than assign individual blame.
Question 7: Which performance indicator measures the percentage of claims paid on the first submission without denial?
- Days in accounts receivable
- First-pass resolution rate
- Net collection rate
- Clean claim rate (Correct answer)
Correct answer: Clean claim rate
The clean claim rate reflects the proportion of claims accepted and paid without requiring correction or resubmission.
CMAS Quality Control & Process Improvement 2
Which quality improvement model uses the steps Define, Measure, Analyze, Improve, and Control?