DHA Quality Improvement & Audits 4 — Questions and Answers
Question 1: In a clinical audit cycle, what is the correct sequence of steps?
- Collect data → Set standards → Implement change → Re-audit
- Set standards → Collect data → Compare results → Implement change → Re-audit (Correct answer)
- Implement change → Set standards → Collect data → Re-audit
- Compare results → Set standards → Collect data → Implement change
Correct answer: Set standards → Collect data → Compare results → Implement change → Re-audit
The audit cycle follows: set standards, collect data, compare against standards, implement changes, then re-audit to confirm improvement.
Question 2: Which statistical tool used in quality improvement displays data points over time to distinguish common cause from special cause variation?
- Pareto chart
- Ishikawa diagram
- Control chart (Correct answer)
- Scatter diagram
Correct answer: Control chart
Control charts (run charts with control limits) distinguish random common-cause variation from assignable special-cause variation over time.
Question 3: A DHA facility wants to reduce medication dispensing errors by 50% within 6 months. This goal is best described as:
- A process indicator
- A SMART objective (Correct answer)
- A sentinel event target
- A balanced scorecard metric
Correct answer: A SMART objective
The goal is Specific, Measurable, Achievable, Relevant, and Time-bound — meeting all SMART criteria.
Question 4: In the context of DHA accreditation, a 'tracer methodology' during survey means surveyors:
- Review only paper-based medical records
- Follow a patient's care experience across departments to evaluate system performance (Correct answer)
- Audit financial billing records for accuracy
- Interview only senior management about policies
Correct answer: Follow a patient's care experience across departments to evaluate system performance
Tracer methodology follows individual patients through their care journey to evaluate how systems and processes work together across the organization.
Question 5: Which quality improvement model uses iterative small tests of change through repeated Plan-Do-Study-Act cycles?
- Six Sigma DMAIC
- Lean Value Stream Mapping
- Model for Improvement (IHI) (Correct answer)
- ISO 9001 framework
Correct answer: Model for Improvement (IHI)
The IHI Model for Improvement pairs three fundamental questions with PDSA cycles to test, implement, and spread changes iteratively.
Question 6: A hospital's cesarean section rate exceeds the DHA benchmark. The FIRST step in a quality improvement response is to:
- Immediately mandate retraining for all obstetricians
- Conduct a root cause analysis to identify contributing factors (Correct answer)
- Report the finding to the Ministry of Health without internal review
- Suspend elective surgeries until the rate normalizes
Correct answer: Conduct a root cause analysis to identify contributing factors
Root cause analysis must precede any intervention to identify the actual drivers of the problem rather than applying a blanket solution.
Question 7: In healthcare quality, 'reliability' of a care process means:
- The process is fast and cost-effective
- The right care is delivered consistently every time it is needed (Correct answer)
- Staff satisfaction with clinical protocols is high
- Patient outcomes are above the national average
Correct answer: The right care is delivered consistently every time it is needed
Reliability in healthcare means delivering evidence-based care consistently and correctly every time, reducing variation and failure rates.
DHA Quality Improvement & Audits 4
In a clinical audit cycle, what is the correct sequence of steps?