Trivium Quality Improvement and Compliance 2 — Questions and Answers
Question 1: A root cause analysis (RCA) is BEST described as:
- A process to discipline staff after a sentinel event
- A systematic process to identify underlying causes of adverse events (Correct answer)
- A financial audit of patient care costs
- A method to rank employees by performance
Correct answer: A systematic process to identify underlying causes of adverse events
RCA is a structured method used to identify the fundamental causes of problems or adverse events in healthcare.
Question 2: Under HIPAA, a covered entity must provide patients with access to their health records within how many days of a request?
- 15 days
- 30 days (Correct answer)
- 60 days
- 90 days
Correct answer: 30 days
HIPAA requires covered entities to provide access to records within 30 days, with a possible one-time 30-day extension.
Question 3: Which quality improvement model uses Plan-Do-Study-Act cycles?
- Six Sigma
- Lean methodology
- PDSA/PDCA model (Correct answer)
- Balanced Scorecard
Correct answer: PDSA/PDCA model
The PDSA (Plan-Do-Study-Act) cycle is a continuous improvement framework widely used in healthcare quality initiatives.
Question 4: Which agency is responsible for enforcing OSHA regulations in healthcare workplaces?
- CMS (Centers for Medicare & Medicaid Services)
- The Joint Commission
- OSHA (Occupational Safety and Health Administration) (Correct answer)
- The CDC
Correct answer: OSHA (Occupational Safety and Health Administration)
OSHA is the federal agency that enforces workplace safety regulations, including those applicable to healthcare settings.
Question 5: A 'never event' in healthcare refers to:
- A routine procedure that is never covered by insurance
- A serious, largely preventable patient safety event that should never occur (Correct answer)
- A medication that is never to be administered without a physician order
- A type of infection that has never been documented in the US
Correct answer: A serious, largely preventable patient safety event that should never occur
Never events are serious, preventable adverse events whose occurrence signals a fundamental failure in patient safety.
Question 6: Which of the following is a primary goal of utilization management in healthcare?
- Maximizing hospital revenue by extending patient stays
- Ensuring services are medically necessary and provided at the appropriate level of care (Correct answer)
- Reducing nursing staff to lower operational costs
- Prioritizing elective procedures over emergency care
Correct answer: Ensuring services are medically necessary and provided at the appropriate level of care
Utilization management ensures that healthcare services are medically appropriate, necessary, and delivered in the most cost-effective setting.
Question 7: The Donabedian model for evaluating healthcare quality focuses on three components. Which answer correctly identifies all three?
- Input, Process, Output
- Structure, Process, Outcome (Correct answer)
- Plan, Implement, Evaluate
- Access, Quality, Cost
Correct answer: Structure, Process, Outcome
Avedis Donabedian's model evaluates quality through Structure (resources/environment), Process (care delivery), and Outcome (patient results).
Trivium Quality Improvement and Compliance 2
A root cause analysis (RCA) is BEST described as: