MSRA Quality Assurance and Improvement 2 — Questions and Answers
Question 1: A hospital notices a spike in central line-associated bloodstream infections (CLABSIs). Which quality improvement methodology is most appropriate for identifying and eliminating the root cause?
- Failure Mode and Effects Analysis (FMEA)
- Root Cause Analysis (RCA) (Correct answer)
- Plan-Do-Study-Act (PDSA)
- Balanced Scorecard
Correct answer: Root Cause Analysis (RCA)
RCA is a reactive method specifically designed to identify the underlying cause of adverse events like CLABSIs after they occur.
Question 2: In the context of clinical audits, what does 'closing the loop' mean?
- Completing data collection
- Re-auditing after implementing changes to assess improvement (Correct answer)
- Submitting the audit report to management
- Recruiting a new audit team
Correct answer: Re-auditing after implementing changes to assess improvement
Closing the loop means re-auditing against the same standards after changes have been implemented to verify whether the desired improvement was achieved.
Question 3: A medication error occurs when a nurse administers a drug to the wrong patient. This is best classified as which type of error?
- Near miss
- Sentinel event
- Adverse event (Correct answer)
- No-harm incident
Correct answer: Adverse event
An adverse event is unintended patient harm resulting from medical care, and administering medication to the wrong patient constitutes such harm.
Question 4: Which statistical tool is used in Six Sigma to display the frequency distribution of defects or errors in a process?
- Control chart
- Histogram
- Pareto chart (Correct answer)
- Scatter diagram
Correct answer: Pareto chart
A Pareto chart ranks defects by frequency to identify the 'vital few' causes responsible for the majority of problems, supporting the 80/20 principle.
Question 5: What is the primary aim of the WHO Surgical Safety Checklist?
- To reduce operating room costs
- To improve communication and reduce preventable surgical complications (Correct answer)
- To speed up surgical throughput
- To document surgical procedures for legal purposes
Correct answer: To improve communication and reduce preventable surgical complications
The WHO Surgical Safety Checklist was designed to improve teamwork and communication among surgical teams to reduce deaths and complications.
Question 6: A 'never event' in healthcare refers to:
- An event that has never been reported before
- A serious, largely preventable patient safety incident that should not occur if guidelines are followed (Correct answer)
- Any adverse event occurring in an intensive care unit
- An event that never reaches the patient
Correct answer: A serious, largely preventable patient safety incident that should not occur if guidelines are followed
Never events are serious incidents that are considered wholly preventable when established safety measures are correctly implemented.
Question 7: In quality improvement, a 'driver diagram' is used to:
- Map the patient journey through a department
- Link the aim of an improvement project to the primary and secondary drivers that influence outcomes (Correct answer)
- Display staffing levels over time
- Plot adverse event frequency against patient volume
Correct answer: Link the aim of an improvement project to the primary and secondary drivers that influence outcomes
A driver diagram visually articulates the theory of change by connecting the project aim to the key primary and secondary drivers that need to be addressed.
MSRA Quality Assurance and Improvement 2
A hospital notices a spike in central line-associated bloodstream infections (CLABSIs).
Which quality improvement methodology is most appropriate for identifying and eliminating the root cause?