CMC Quality Assurance & Improvement 4

Question 1

A hospital's cardiac surgery program is a significant outlier on risk-adjusted mortality in the STS database. What is the most appropriate first step?

Accepted Answer

Conduct a detailed case review and internal audit to identify patterns contributing to excess mortality

Answer

When a significant outlier signal appears, the first step is a rigorous internal case review and audit to determine whether the variation reflects true quality gaps or data/coding issues.

Question 2

Which quality framework uses 'Aim, Measures, Changes' as its three foundational questions?

Accepted Answer

The Model for Improvement (Institute for Healthcare Improvement)

Answer

The IHI Model for Improvement asks: What are we trying to accomplish? How will we know a change is an improvement? What changes can we make that will result in improvement?

Question 3

In Six Sigma applied to cardiac care, what does a defect represent?

Accepted Answer

Any instance where a patient does not receive a specified evidence-based care element

Answer

In Six Sigma, a defect is defined as any failure to meet a customer (patient) requirement or specified standard of care, allowing mathematical quantification of process performance.

Question 4

A cardiac ICU implements a checklist for daily goal-setting during rounds. This intervention targets which domain of the IOM's six aims for quality health care?

Accepted Answer

Equitable and Patient-Centered

Answer

Daily goal checklists during ICU rounds improve team communication about the patient's care plan, addressing patient-centered care and effectiveness of care delivery.

Question 5

Which of the following is the primary purpose of a Failure Mode and Effects Analysis (FMEA) in cardiac quality management?

Accepted Answer

To prospectively identify potential process failures and their impact before they cause patient harm

Answer

FMEA is a proactive risk assessment tool that systematically identifies how a process might fail and prioritizes preventive actions based on severity, occurrence, and detectability.

CMC - Cardiac Medicine Certification Practice Test

CMC - Cardiac Medicine Certification Practice Test

CMC Quality Assurance & Improvement 4