NFHS Quality Assurance & Improvement 3 â Questions and Answers
Question 1: A school athletic director wants to assess whether coaches are following the concussion removal-from-play policy. The most direct assessment method is:
- Reviewing game film to observe coach behavior when athletes show concussion signs (Correct answer)
- Surveying parents about their perception of coach responsiveness
- Counting the number of first aid kits available on the sideline
- Reviewing athletes' academic performance after injuries
Correct answer: Reviewing game film to observe coach behavior when athletes show concussion signs
Game film review provides direct observational evidence of coach behavior during potential concussion situations.
Question 2: Stakeholder feedback in concussion quality assurance typically includes input from all of the following EXCEPT:
- Athletes who have experienced concussions
- Parents and guardians of student athletes
- Opposing team coaches (Correct answer)
- School physicians and athletic trainers
Correct answer: Opposing team coaches
Opposing coaches are generally not internal stakeholders in a school's own concussion quality assurance process.
Question 3: Which principle underlies the rationale for documenting every suspected concussion, even those that do not result in removal from play?
- Documentation creates liability protection for athletes in future lawsuits
- Complete records enable pattern analysis and identify underreporting trends (Correct answer)
- All suspected concussions must be reported to the NCAA by federal law
- Documentation is required to bill athlete health insurance for treatment
Correct answer: Complete records enable pattern analysis and identify underreporting trends
Comprehensive documentationâincluding suspected but not confirmed casesâhelps quality teams detect underreporting and adjust education efforts.
Question 4: A quality improvement team finds that athletes from one sport have a significantly higher concussion rate than others. The recommended next step is:
- Immediately suspend that sport for the remainder of the season
- Conduct a sport-specific analysis to identify risk factors unique to that activity (Correct answer)
- Mandate that all athletes in that sport wear additional protective gear immediately
- Report the finding to state officials and await their instructions
Correct answer: Conduct a sport-specific analysis to identify risk factors unique to that activity
Sport-specific analysis identifies unique risk factorsâsuch as contact rules, equipment, or training methodsâthat can be addressed with targeted interventions.
Question 5: Which type of goal is most appropriate for a school concussion quality improvement plan?
- Reduce athlete concussion rates to zero within one season
- Increase the percentage of athletes completing baseline cognitive testing by 15% in 12 months (Correct answer)
- Eliminate all contact in practice drills by the start of the next season
- Require all parents to sign a new concussion waiver form annually
Correct answer: Increase the percentage of athletes completing baseline cognitive testing by 15% in 12 months
Effective QI goals are specific, measurable, achievable, relevant, and time-bound (SMART), such as increasing baseline testing completion by a defined percentage.
Question 6: When a concussion protocol change is implemented, the most important follow-up step in the quality cycle is:
- Immediately revising the protocol again based on anticipated future needs
- Measuring outcomes after the change to determine whether the protocol achieved its goal (Correct answer)
- Announcing the change to parents via a newsletter and considering the task complete
- Waiting three full seasons before evaluating whether the change was effective
Correct answer: Measuring outcomes after the change to determine whether the protocol achieved its goal
Measuring outcomes after implementation is essential to determine whether the protocol change produced the intended improvement.
Question 7: Which scenario best illustrates an organizational culture that supports concussion quality improvement?
- Coaches are penalized for reporting any concussion that causes a player to miss a game
- Athletes are encouraged to self-report symptoms without fear of losing playing time (Correct answer)
- Only the athletic trainer is authorized to discuss concussion policy with staff
- Concussion incidents are kept confidential from all school administrators
Correct answer: Athletes are encouraged to self-report symptoms without fear of losing playing time
A culture that removes barriers to self-reporting produces more accurate data and earlier identification of concussions, which is foundational to QI.
NFHS Quality Assurance & Improvement 3
A school athletic director wants to assess whether coaches are following the concussion removal-from-play policy.
The most direct assessment method is: