CPHQ Assessment 5 — Questions and Answers
Question 1: When assessing an organization's readiness for change, the ADKAR model evaluates which set of elements?
- Authority, Data, Knowledge, Action, Results
- Awareness, Desire, Knowledge, Ability, Reinforcement (Correct answer)
- Assessment, Design, Key performance, Action, Review
- Alignment, Deployment, Knowledge transfer, Adoption, Reliability
Correct answer: Awareness, Desire, Knowledge, Ability, Reinforcement
The ADKAR change readiness model assesses five building blocks: Awareness of need, Desire to participate, Knowledge of how to change, Ability to implement, and Reinforcement to sustain.
Question 2: A hospital uses CMS core measures to assess quality. These measures are BEST categorized as:
- Internally developed process measures
- Externally mandated standardized performance measures (Correct answer)
- Voluntary accreditation benchmarks
- Financial performance indicators
Correct answer: Externally mandated standardized performance measures
CMS core measures are externally mandated standardized measures required for hospital participation in Medicare and Medicaid reimbursement programs.
Question 3: During a qualitative assessment using focus groups, which technique BEST reduces moderator bias?
- Using closed-ended questions only
- Using a skilled neutral facilitator with a structured discussion guide (Correct answer)
- Recording answers before discussion begins
- Excluding outlier opinions from analysis
Correct answer: Using a skilled neutral facilitator with a structured discussion guide
A trained neutral facilitator using a pre-tested structured guide standardizes the focus group process and minimizes the moderator's influence on participant responses.
Question 4: An organization assesses its infection control program using incidence density rates. Incidence density is BEST defined as:
- Total infections divided by total patients
- Number of new infections per patient-days at risk (Correct answer)
- Percentage of patients with any infection
- Infections per 100 discharges
Correct answer: Number of new infections per patient-days at risk
Incidence density (rate) accounts for variable exposure time by expressing new infections per unit of patient-time at risk, such as infections per 1,000 patient-days.
Question 5: A quality team assesses whether a process is statistically stable over time. Which tool is MOST appropriate?
- Pareto chart
- Control chart (Shewhart chart) (Correct answer)
- Force field analysis
- Affinity diagram
Correct answer: Control chart (Shewhart chart)
Control charts use statistical control limits to determine whether process variation is due to common cause (stable) or special cause (unstable) variation over time.
Question 6: In a healthcare assessment, 'criterion-referenced' review means patient care is evaluated against:
- The average performance of peer institutions
- Pre-established explicit standards or evidence-based criteria (Correct answer)
- The judgment of individual physician reviewers
- Historical baseline performance of the same organization
Correct answer: Pre-established explicit standards or evidence-based criteria
Criterion-referenced review compares care against predetermined explicit criteria derived from evidence-based guidelines, eliminating subjectivity in the evaluation.
Question 7: A CPHQ professional is assessing the impact of a quality intervention using a pre-post design. The GREATEST threat to the validity of this assessment is:
- Small sample size only
- Regression to the mean and concurrent external changes (history effect) (Correct answer)
- Surveyor bias during data collection
- Insufficient follow-up period
Correct answer: Regression to the mean and concurrent external changes (history effect)
Pre-post designs without a control group are vulnerable to regression to the mean (extreme values naturally move toward average) and history effects (other concurrent changes).
CPHQ Assessment 5
When assessing an organization's readiness for change, the ADKAR model evaluates which set of elements?