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CMSM Quality Improvement and Performance Metrics Flashcards

6 cards from real CMSM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 6 CMSM Quality Improvement and Performance Metrics flashcards as text

  1. Which quality improvement methodology uses a structured four-step cycle of Plan, Do, Study, Act to drive continuous improvement in healthcare?

    Answer: PDSA cycle

    The PDSA (Plan-Do-Study-Act) cycle is a widely used quality improvement framework in healthcare that promotes iterative, evidence-based change.

  2. A CMSM reviewing performance data notices the hospital's readmission rate for heart failure patients exceeds the national benchmark. Which CMS program financially penalizes hospitals for excess readmissions?

    Answer: Hospital Readmissions Reduction Program (HRRP)

    The HRRP reduces Medicare payments to hospitals with excess readmissions for specified conditions including heart failure, pneumonia, and hip/knee replacement.

  3. Which accrediting body issues the 'Gold Seal of Approval' for US hospitals and ambulatory care organizations based on compliance with national standards?

    Answer: The Joint Commission (TJC)

    The Joint Commission awards its Gold Seal of Approval to organizations that demonstrate compliance with its evidence-based performance standards during on-site surveys.

  4. In quality improvement, what does the term 'sentinel event' specifically refer to?

    Answer: An unexpected occurrence involving death or serious physical or psychological injury

    A sentinel event, as defined by The Joint Commission, is an unexpected occurrence involving death or serious harm to a patient that signals the need for immediate investigation and response.

  5. Which type of healthcare quality indicator measures the outcomes of care rather than the processes used to deliver it?

    Answer: Outcome measure

    Outcome measures assess the results of care for patients, such as mortality rates, infection rates, or functional health status, directly reflecting the impact of services provided.

  6. A CMSM wants to identify the root cause of recurring medication errors. Which quality tool is best suited for this investigation?

    Answer: Fishbone (Ishikawa) diagram

    A fishbone (Ishikawa) diagram visually maps potential causes of a problem across categories such as people, process, and environment to facilitate root cause analysis.

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