RPSGT Quality Assurance & Improvement 2 — Questions and Answers
Question 1: A technologist notices that EEG electrode impedances are consistently elevated at the F7 and F8 sites for the past three patients. What is the BEST quality improvement action?
- Document the findings and continue testing
- Inspect and clean the electrode application equipment and technique (Correct answer)
- Switch to a different electrode type without further investigation
- Notify the scoring physician immediately
Correct answer: Inspect and clean the electrode application equipment and technique
Recurring high impedance at specific sites suggests a systematic issue with equipment or technique that should be identified and corrected.
Question 2: Which metric is MOST useful for tracking the percentage of studies that meet AASM minimum technical standards?
- Average lights-off time
- Study adequacy rate (Correct answer)
- Equipment downtime percentage
- Average technologist hours per study
Correct answer: Study adequacy rate
Study adequacy rate directly measures the proportion of studies meeting minimum technical criteria, making it the primary QA metric for technical quality.
Question 3: During a QA review, a lab finds that 20% of portable (OCST) studies have missing flow signal data. What should be the FIRST corrective step?
- Switch vendors immediately
- Conduct root-cause analysis to identify why flow signals are failing (Correct answer)
- Eliminate OCST studies from the lab's offerings
- Score the affected studies using oximetry alone
Correct answer: Conduct root-cause analysis to identify why flow signals are failing
Root-cause analysis identifies whether the failure stems from equipment, patient setup, patient behavior, or protocol gaps before implementing a fix.
Question 4: Which of the following BEST describes the purpose of inter-rater reliability testing in a sleep lab?
- To ensure patients receive consistent billing
- To measure agreement between technologists or scorers on the same study (Correct answer)
- To compare a lab's equipment to manufacturer specifications
- To track the number of patient complaints per quarter
Correct answer: To measure agreement between technologists or scorers on the same study
Inter-rater reliability testing quantifies how consistently different scorers apply AASM scoring rules to the same polysomnographic data.
Question 5: A sleep lab is implementing a CPAP adherence follow-up protocol. Which QA measure BEST evaluates the protocol's effectiveness?
- Number of CPAP devices dispensed per month
- Percentage of patients achieving ≥4 hours of nightly CPAP use at 90 days (Correct answer)
- Average AHI reduction from diagnostic study
- Technologist satisfaction scores with the new protocol
Correct answer: Percentage of patients achieving ≥4 hours of nightly CPAP use at 90 days
Measuring the percentage of patients achieving the standard adherence threshold at 90 days directly evaluates whether the follow-up protocol improves patient outcomes.
Question 6: A new scoring technologist is added to the team. What QA process BEST ensures their scoring meets lab standards?
- Assign them independent overnight studies immediately
- Perform calibration scoring on a set of known studies and review discrepancies (Correct answer)
- Have them shadow another technologist for one night
- Compare their reports to the referring physician's clinical notes
Correct answer: Perform calibration scoring on a set of known studies and review discrepancies
Calibration scoring on studies with known agreed-upon results provides objective feedback on whether the new scorer applies rules correctly.
Question 7: Which statement BEST reflects the role of a physician medical director in sleep lab quality assurance?
- The medical director only signs off on final reports and has no QA role
- The medical director provides clinical oversight, reviews QA data, and approves corrective action plans (Correct answer)
- The medical director is responsible solely for billing compliance
- The medical director's QA role is fulfilled by attending quarterly meetings only
Correct answer: The medical director provides clinical oversight, reviews QA data, and approves corrective action plans
AASM accreditation standards require the medical director to have an active clinical oversight role including reviewing QA metrics and approving improvement plans.
RPSGT Quality Assurance & Improvement 2
A technologist notices that EEG electrode impedances are consistently elevated at the F7 and F8 sites for the past three patients.
What is the BEST quality improvement action?