CMSM CMSM Quality Improvement and Performance Metrics

Question 1

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

Accepted Answer

PDSA cycle

Answer

Six Sigma

Answer

Root cause analysis

Answer

Lean manufacturing

Question 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?

Accepted Answer

Hospital Readmissions Reduction Program (HRRP)

Answer

Hospital Value-Based Purchasing Program

Answer

Merit-Based Incentive Payment System (MIPS)

Answer

Bundled Payments for Care Improvement (BPCI)

Question 3

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

Accepted Answer

The Joint Commission (TJC)

Answer

NCQA

Answer

URAC

Answer

AAAHC

Question 4

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

Accepted Answer

An unexpected occurrence involving death or serious physical or psychological injury

Answer

A near-miss incident that did not cause patient harm

Answer

A patient complaint filed with administration

Answer

A medication dispensing error caught by the pharmacist

Question 5

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

Accepted Answer

Outcome measure

Answer

Structure measure

Answer

Process measure

Answer

Balancing measure

Question 6

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

Accepted Answer

Fishbone (Ishikawa) diagram

Answer

Control chart

Answer

Pareto chart

Answer

Run chart