AHIC Quality Improvement 2 — Questions and Answers
Question 1: Which QI methodology uses a structured problem-solving approach with eight specific steps including defining the problem, analyzing root causes, and verifying solutions?
- Six Sigma DMAIC
- Eight Disciplines (8D) (Correct answer)
- Lean Value Stream Mapping
- FOCUS-PDCA
Correct answer: Eight Disciplines (8D)
The 8D (Eight Disciplines) methodology provides a structured eight-step team-based problem-solving approach commonly used in healthcare quality improvement.
Question 2: A hospital wants to reduce catheter-associated urinary tract infections (CAUTIs). Which tool would BEST help the QI team identify and visualize all potential contributing factors?
- Pareto chart
- Run chart
- Fishbone diagram (Correct answer)
- Control chart
Correct answer: Fishbone diagram
A fishbone (Ishikawa) diagram is used to systematically identify and organize potential root causes of a problem across categories such as people, process, equipment, and environment.
Question 3: In statistical process control, a process is considered 'in control' when:
- All data points fall within three standard deviations of the mean with no non-random patterns (Correct answer)
- The mean equals the median
- No defects occur in 30 consecutive observations
- The process Cpk index exceeds 2.0
Correct answer: All data points fall within three standard deviations of the mean with no non-random patterns
A process is in statistical control when all variation is due to common cause variation, evidenced by data points within control limits and no non-random patterns (runs, trends, etc.).
Question 4: The IHI Triple Aim framework focuses on three simultaneous goals. Which combination correctly represents these goals?
- Cost reduction, staff satisfaction, and patient safety
- Population health, patient experience, and per capita cost (Correct answer)
- Efficiency, effectiveness, and equity
- Access, quality, and outcomes
Correct answer: Population health, patient experience, and per capita cost
The IHI Triple Aim addresses improving the health of populations, enhancing the patient experience of care, and reducing the per capita cost of healthcare.
Question 5: Which statistical test is most appropriate for analyzing whether a QI intervention significantly changed a continuous outcome variable measured before and after in the same patient group?
- Chi-square test
- Paired t-test (Correct answer)
- ANOVA
- Mann-Whitney U test
Correct answer: Paired t-test
A paired t-test compares means from the same group measured at two time points, making it appropriate for pre-post intervention studies with continuous normally distributed data.
Question 6: What is the primary purpose of a 'failure mode and effects analysis' (FMEA) in healthcare quality improvement?
- Retrospectively investigate adverse events that already occurred
- Proactively identify potential process failures before they cause harm (Correct answer)
- Measure current baseline performance against benchmarks
- Document and report near-miss events to regulatory agencies
Correct answer: Proactively identify potential process failures before they cause harm
FMEA is a prospective risk assessment tool used to proactively identify potential failure modes in a process, evaluate their likelihood and impact, and prioritize prevention efforts.
Question 7: A QI team calculates a Risk Priority Number (RPN) during an FMEA. Which three factors are multiplied to calculate the RPN?
- Frequency, duration, and cost
- Severity, occurrence, and detectability (Correct answer)
- Impact, likelihood, and controllability
- Harm, probability, and preventability
Correct answer: Severity, occurrence, and detectability
In FMEA, the Risk Priority Number is calculated by multiplying Severity (impact of the failure), Occurrence (likelihood of the failure), and Detectability (ability to detect the failure before it reaches the patient).
AHIC Quality Improvement 2
Which QI methodology uses a structured problem-solving approach with eight specific steps including defining the problem, analyzing root causes, and verifying solutions?