PCE Quality Assurance and Improvement 2 — Questions and Answers
Question 1: A physiotherapy clinic notices a rise in patient fall incidents during gait training. Which QI tool is BEST suited to identify root causes?
- Fishbone (Ishikawa) diagram (Correct answer)
- Gantt chart
- SOAP note audit
- Patient satisfaction survey
Correct answer: Fishbone (Ishikawa) diagram
A fishbone diagram systematically maps potential causes across categories (equipment, environment, staff, process) to identify root causes of adverse events.
Question 2: In quality improvement, a 'run chart' is primarily used to:
- Compare two patient groups statistically
- Display data over time to detect trends or shifts (Correct answer)
- Rank clinicians by patient outcomes
- Document adverse event narratives
Correct answer: Display data over time to detect trends or shifts
A run chart plots data points sequentially over time, allowing clinicians to identify trends, shifts, or cycles in a process.
Question 3: Which of the following BEST describes the purpose of a clinical audit in physiotherapy?
- Billing verification for insurance claims
- Systematic review of practice against defined standards (Correct answer)
- Performance appraisal of individual therapists
- Patient satisfaction measurement
Correct answer: Systematic review of practice against defined standards
A clinical audit compares current practice against evidence-based standards to identify gaps and drive improvement.
Question 4: A PT department wants to reduce average wait time for initial assessment. Using PDSA cycles, after implementing a new scheduling protocol (Do phase), what comes NEXT?
- Plan the next improvement idea
- Study the data to determine if the change worked (Correct answer)
- Act by making the change permanent
- Repeat the Do phase with more patients
Correct answer: Study the data to determine if the change worked
After implementing the change (Do), the Study phase involves analyzing collected data to assess whether the intervention achieved its goal.
Question 5: Which indicator is an example of a PROCESS measure in physiotherapy quality monitoring?
- 30-day hospital readmission rate
- Percentage of patients who received a falls risk screen at initial assessment (Correct answer)
- Patient-reported functional improvement at discharge
- Cost per episode of care
Correct answer: Percentage of patients who received a falls risk screen at initial assessment
Process measures evaluate whether specific clinical steps are performed, such as completing a falls risk screen, regardless of the outcome.
Question 6: A physiotherapist reviews outcomes data and finds that patients with lower back pain treated with manual therapy show better outcomes than those treated with exercise alone. This type of quality review is BEST characterized as:
- Prospective randomized trial
- Retrospective outcomes analysis (Correct answer)
- Concurrent chart review
- Sentinel event investigation
Correct answer: Retrospective outcomes analysis
Retrospective outcomes analysis reviews previously collected data to compare treatment effectiveness after care has been provided.
Question 7: In the context of quality improvement, 'benchmarking' refers to:
- Setting minimum passing scores on competency exams
- Comparing performance metrics against best-practice standards or top-performing organizations (Correct answer)
- Establishing salary ranges for physiotherapy staff
- Reviewing equipment maintenance schedules
Correct answer: Comparing performance metrics against best-practice standards or top-performing organizations
Benchmarking involves comparing a clinic's performance data against external standards or high-performing peers to identify improvement opportunities.
PCE Quality Assurance and Improvement 2
A physiotherapy clinic notices a rise in patient fall incidents during gait training.
Which QI tool is BEST suited to identify root causes?