CSC Quality Control & Assurance 3 — Questions and Answers
Question 1: The American College of Cardiology's Appropriate Use Criteria (AUC) for cardiac imaging are intended to:
- Replace physician clinical judgment in all cases
- Reduce inappropriate testing by providing evidence-based guidance on imaging indications (Correct answer)
- Mandate specific imaging modalities for all chest pain presentations
- Establish reimbursement rates for cardiac procedures
Correct answer: Reduce inappropriate testing by providing evidence-based guidance on imaging indications
AUC provide evidence-based guidance to help clinicians select the most appropriate imaging study for a given clinical scenario, reducing overuse and underuse.
Question 2: In Six Sigma quality methodology, 'DMAIC' refers to:
- Define-Measure-Analyze-Improve-Control (Correct answer)
- Detect-Monitor-Audit-Implement-Check
- Design-Map-Assess-Integrate-Close
- Diagnose-Modify-Apply-Inspect-Confirm
Correct answer: Define-Measure-Analyze-Improve-Control
DMAIC (Define-Measure-Analyze-Improve-Control) is the structured problem-solving roadmap used in Six Sigma improvement projects.
Question 3: A cardiac care unit tracks its central line-associated bloodstream infection (CLABSI) rate. This metric is an example of a:
- Structure measure
- Process measure
- Outcome measure (Correct answer)
- Balancing measure
Correct answer: Outcome measure
Outcome measures reflect the impact of care on the health status of patients, such as infection rates, mortality, or readmission rates.
Question 4: Which accreditation body specifically reviews echocardiography laboratory quality standards in the United States?
- The Joint Commission (TJC)
- Intersocietal Accreditation Commission (IAC) (Correct answer)
- College of American Pathologists (CAP)
- American Board of Internal Medicine (ABIM)
Correct answer: Intersocietal Accreditation Commission (IAC)
The IAC (formerly ICAEL) accredits echocardiography laboratories based on adherence to established quality and performance standards.
Question 5: A run chart showing a cardiac surgery program's 30-day mortality rate reveals seven consecutive data points below the median. This pattern suggests:
- Random variation only; no action needed
- A non-random signal indicating a true improvement in performance (Correct answer)
- The median was incorrectly calculated
- Data collection errors that require re-auditing
Correct answer: A non-random signal indicating a true improvement in performance
Seven or more consecutive points on one side of the median (a 'run') is a non-random signal indicating a real shift in process performance per run chart rules.
Question 6: When designing a quality improvement study in cardiology, 'balancing measures' are used to:
- Ensure the primary outcome is statistically significant
- Monitor unintended consequences of an improvement intervention on other parts of the system (Correct answer)
- Calculate the cost-effectiveness of the new protocol
- Balance the number of patients in each study arm
Correct answer: Monitor unintended consequences of an improvement intervention on other parts of the system
Balancing measures assess whether changes made to improve one part of a system are causing harm elsewhere in the system.
Question 7: Radiation dose optimization in the cardiac catheterization lab is best monitored using which quality indicator?
- Total procedure time
- Air kerma at the reference point (Ka,r) and dose-area product (DAP) (Correct answer)
- Number of cine acquisitions per case
- Patient weight documented in the procedure note
Correct answer: Air kerma at the reference point (Ka,r) and dose-area product (DAP)
Air kerma (Ka,r) and dose-area product (DAP) are the standard metrics for monitoring and reporting patient radiation exposure in fluoroscopy-guided procedures.
CSC Quality Control & Assurance 3
The American College of Cardiology's Appropriate Use Criteria (AUC) for cardiac imaging are intended to: