Quality Control & Process Improvement Flashcards
7 cards from real CCM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Quality Control & Process Improvement flashcards as text
Which data collection method is most appropriate for capturing patient-reported experience with care management services?
Answer: Validated patient satisfaction survey
Validated surveys capture the patient's subjective experience and perception of care, which claims or clinical data cannot measure.
Failure Mode and Effects Analysis (FMEA) is best used to:
Answer: Proactively identify potential process failures before they happen
FMEA is a proactive risk assessment tool that identifies potential failure points and their consequences before an error occurs.
A care management organization tracks its 30-day readmission rate monthly using a run chart. The chart shows seven consecutive data points all above the median. This is called:
Answer: A signal or run rule violation indicating a shift
Seven or more consecutive points on one side of the median is a run rule that signals a non-random shift in the process.
Which of the following is a leading indicator in care management quality measurement?
Answer: Percentage of diabetic members with HbA1c tested in the past year
A leading indicator measures a process or activity predictive of future outcomes, such as testing completion rates.
The Plan-Do-Study-Act (PDSA) cycle differs from Six Sigma DMAIC primarily in that PDSA:
Answer: Is a rapid, iterative small-scale testing cycle
PDSA cycles are designed for rapid, small-scale testing and learning, making them practical for frontline care improvement efforts.
When reporting quality metrics to stakeholders, which measure would best demonstrate the VALUE of a care management program?
Answer: Return on investment (ROI) based on avoided hospitalizations
ROI calculations linking care management activities to avoided high-cost events demonstrate the financial and clinical value of the program.
In quality improvement, 'special cause variation' is best described as:
Answer: Variation caused by identifiable, non-random factors that can be eliminated
Special cause variation arises from specific, assignable causes outside the normal process and requires investigation and correction.