Practice Test Geeks(CPCS) Certified Professional Credentialing Specialist Practice Test
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Peer Review & Performance Improvement Flashcards

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

Read the first 7 Peer Review & Performance Improvement flashcards as text

  1. Ongoing Professional Practice Evaluation (OPPE) data should be reviewed at minimum how frequently according to The Joint Commission standards?

    Answer: Every 6 months

    TJC requires OPPE data to be reviewed at least every six months as part of the reappointment cycle.

  2. Which of the six general competencies established by ACGME/ABMS is most directly measured by peer review of clinical decision-making?

    Answer: Patient Care

    Patient Care competency encompasses clinical decision-making, procedures, and treatment appropriateness—the core focus of most peer review.

  3. A performance improvement team uses a fishbone (Ishikawa) diagram. What is its primary function?

    Answer: Identify root causes of a problem by category

    A fishbone diagram organizes potential root causes into categories (people, process, equipment, etc.) to facilitate systematic problem analysis.

  4. What distinguishes a sentinel event from a near-miss in quality management?

    Answer: A sentinel event results in death or serious harm; a near-miss is caught before patient impact

    A sentinel event is an unexpected occurrence resulting in death or serious physical or psychological harm, while a near-miss is an event that could have caused harm but did not reach the patient.

  5. Which tool is best suited for identifying the most frequent causes of a quality problem to prioritize improvement efforts?

    Answer: Pareto chart

    A Pareto chart ranks causes by frequency or impact, reflecting the 80/20 rule to help teams focus on the vital few issues causing most problems.

  6. Under HCQIA, which action by a peer review body would DISQUALIFY it from receiving immunity protections?

    Answer: Failing to provide the physician with adequate notice of the hearing

    HCQIA immunity requires that practitioners receive adequate notice and hearing opportunity; failure to provide due process can strip immunity protection.

  7. A credentialing specialist is assembling the peer review file for a physician's reappointment. Which document is LEAST relevant to include?

    Answer: The physician's personal tax returns

    Personal tax returns have no bearing on clinical competence or professional performance and are not part of a credentialing or peer review file.