CSC Quality Control & Assurance 2 — Questions and Answers
Question 1: Which statistical process control chart is most appropriate for monitoring the proportion of defective echocardiographic studies requiring repeat acquisition?
- X-bar chart
- p-chart (Correct answer)
- CUSUM chart
- R-chart
Correct answer: p-chart
The p-chart monitors the proportion (or percentage) of nonconforming units in a sample, making it ideal for tracking defective study rates.
Question 2: In a cardiac catheterization laboratory, the PDSA cycle stands for:
- Plan-Do-Study-Act (Correct answer)
- Prepare-Deploy-Sustain-Audit
- Prioritize-Define-Solve-Assess
- Process-Design-Standardize-Analyze
Correct answer: Plan-Do-Study-Act
PDSA (Plan-Do-Study-Act) is a foundational quality improvement framework used to test and implement changes iteratively.
Question 3: A hospital's door-to-balloon time for STEMI exceeds the 90-minute benchmark. Which tool best identifies the root cause of the delay?
- Run chart
- Fishbone (Ishikawa) diagram (Correct answer)
- Pareto chart
- Control chart
Correct answer: Fishbone (Ishikawa) diagram
A fishbone (Ishikawa) diagram systematically categorizes potential causes of a problem across multiple domains (people, process, equipment, etc.).
Question 4: The concept of 'failure mode and effects analysis' (FMEA) in cardiac care primarily serves to:
- Track adverse event rates after they occur
- Prospectively identify and prioritize potential process failures before they cause harm (Correct answer)
- Establish benchmarks for peer institutions
- Audit billing accuracy in cardiac procedures
Correct answer: Prospectively identify and prioritize potential process failures before they cause harm
FMEA is a proactive risk assessment tool that identifies potential failures and their impacts before an adverse event occurs.
Question 5: Which of the following is a key principle of the Lean methodology as applied to a cardiac imaging department?
- Increasing the number of staff per procedure
- Eliminating waste and non-value-added steps in workflow (Correct answer)
- Maximizing equipment purchase to reduce downtime
- Standardizing quality metrics across all U.S. hospitals
Correct answer: Eliminating waste and non-value-added steps in workflow
Lean methodology focuses on identifying and eliminating waste (muda) to improve efficiency and value delivery to the patient.
Question 6: In echocardiography QA, interobserver variability is best assessed by:
- Comparing two readers' measurements of the same study using intraclass correlation coefficient (ICC) (Correct answer)
- Reviewing only the most discrepant cases in a peer review session
- Having a single expert re-read all borderline studies
- Calculating the mean ejection fraction across all readers
Correct answer: Comparing two readers' measurements of the same study using intraclass correlation coefficient (ICC)
The intraclass correlation coefficient (ICC) quantifies agreement between two or more raters measuring the same continuous variable on the same subjects.
Question 7: Which of the following best defines a 'sentinel event' in the context of cardiac quality assurance?
- Any procedure performed outside normal business hours
- An unexpected occurrence involving death or serious physical harm requiring immediate investigation (Correct answer)
- A patient complaint about wait times in the cardiac clinic
- A laboratory value flagged as critical by the automated system
Correct answer: An unexpected occurrence involving death or serious physical harm requiring immediate investigation
A sentinel event is an unexpected occurrence resulting in death, serious physical or psychological injury, or the risk thereof, triggering a root cause analysis.
CSC Quality Control & Assurance 2
Which statistical process control chart is most appropriate for monitoring the proportion of defective echocardiographic studies requiring repeat acquisition?