RHIT Performance Improvement and Quality Management 2 — Questions and Answers
Question 1: A fishbone (Ishikawa) diagram is primarily used to:
- Track performance trends over time
- Identify possible causes of a problem (Correct answer)
- Display frequency distributions
- Compare data from two variables
Correct answer: Identify possible causes of a problem
A fishbone diagram visually maps potential root causes of a problem across categories such as people, process, equipment, and environment.
Question 2: An unexpected event involving patient death or serious injury that is not related to the natural course of illness is classified as a:
- Near miss
- Adverse event
- Sentinel event (Correct answer)
- Variance
Correct answer: Sentinel event
A sentinel event is an unexpected occurrence resulting in death or serious physical or psychological harm, requiring immediate investigation and response per Joint Commission standards.
Question 3: Which of the following BEST describes a 'near miss' in a healthcare quality context?
- An event that results in temporary patient harm
- An error that is caught before reaching the patient (Correct answer)
- A patient complaint about care quality
- An event requiring root cause analysis
Correct answer: An error that is caught before reaching the patient
A near miss is an event or situation that could have resulted in patient harm but was intercepted before reaching the patient, providing an opportunity to prevent future errors.
Question 4: The measure 'hospital readmission rate within 30 days' is an example of which type of quality indicator?
- Structure indicator
- Process indicator
- Outcome indicator (Correct answer)
- Compliance indicator
Correct answer: Outcome indicator
An outcome indicator measures the end result of care delivery for patients, such as readmission rates, mortality, or complication rates.
Question 5: In healthcare quality management, 'utilization review' primarily focuses on:
- Ensuring accurate medical coding
- Evaluating the medical necessity and appropriateness of services (Correct answer)
- Monitoring employee performance
- Auditing financial records
Correct answer: Evaluating the medical necessity and appropriateness of services
Utilization review evaluates whether healthcare services provided are medically necessary, appropriate, and delivered in the right care setting, helping to control costs and ensure quality.
Question 6: A hospital conducts a Failure Mode and Effects Analysis (FMEA) before implementing a new medication administration process. This is an example of:
- Retrospective quality review
- Proactive risk assessment (Correct answer)
- Concurrent utilization review
- Retrospective auditing
Correct answer: Proactive risk assessment
FMEA is a proactive tool used to identify potential failure points and their consequences before a process is implemented, allowing teams to prevent problems before they occur.
Question 7: Which statistical tool is BEST used to monitor whether a process is in statistical control over time?
- Histogram
- Scatter diagram
- Control chart (Correct answer)
- Pareto chart
Correct answer: Control chart
A control chart plots data points over time with upper and lower control limits, allowing quality teams to distinguish between common cause variation and special cause variation.
RHIT Performance Improvement and Quality Management 2
A fishbone (Ishikawa) diagram is primarily used to: