Quality Assurance & Standards Flashcards

Which organization publishes the HEDIS measures used to evaluate health plan performance?

Answer: NCQA

NCQA (National Committee for Quality Assurance) develops and maintains HEDIS measures used to compare health plan quality.

In a healthcare quality improvement project, a 'fishbone diagram' is primarily used to:

Answer: Identify root causes of a problem

A fishbone (Ishikawa) diagram is a cause-and-effect tool that identifies potential root causes of a quality problem.

The Donabedian model evaluates healthcare quality using which three dimensions?

Answer: Structure, Process, Outcome

Donabedian's framework assesses quality through structure (resources), process (care delivery), and outcomes (patient results).

A control chart's 'upper control limit' (UCL) is typically set at how many standard deviations above the mean?

Answer: 3

UCL and LCL in a control chart are set at three standard deviations from the mean to distinguish common from special cause variation.

Which quality standard framework is specifically designed for patient safety and medical device risk management?

Answer: ISO 13485

ISO 13485 is the quality management standard specifically for medical devices and related services.

Under CMS's Value-Based Purchasing (VBP) program, hospital payments are adjusted based on:

Answer: Patient satisfaction and clinical quality scores

VBP ties a portion of Medicare payments to hospitals' performance on quality measures including clinical care and patient experience.

A healthcare analyst notices a sudden spike in medication errors after a new EHR module was deployed. This type of variation is called:

Answer: Special cause variation

Special cause variation arises from identifiable, non-random factors — in this case, the EHR deployment — and requires investigation.