Quality and Outcomes Measurement 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 and Outcomes Measurement flashcards as text
A case manager is using a Likert scale questionnaire to assess patient functional status. This instrument measures which type of outcome?
Answer: Patient-reported outcome
Likert scale questionnaires completed by patients to assess functional status are patient-reported outcome measures (PROMs) that capture self-perceived health.
Which quality improvement method uses 'rapid-cycle' tests of change in small samples before spreading system-wide?
Answer: Model for Improvement (IHI)
The IHI Model for Improvement employs rapid Plan-Do-Study-Act (PDSA) cycles to test changes quickly and learn before broader implementation.
A health plan's case management program demonstrates a reduction in average hospital days per 1,000 members. This is an example of:
Answer: A utilization outcome metric
Hospital days per 1,000 members is a utilization outcome metric that quantifies inpatient resource use across a population.
When reporting quality outcomes, 'risk adjustment' is performed in order to:
Answer: Account for differences in patient populations when comparing providers or programs
Risk adjustment controls for differences in patient acuity and demographics so that outcome comparisons between programs or providers are fair and valid.
A case manager is reviewing a run chart for asthma action plan completion rates over 12 months. The PRIMARY purpose of this tool is to:
Answer: Detect trends and patterns in performance over time
Run charts display data over time and are used in quality improvement to detect trends, shifts, and patterns that indicate whether a process is improving.
Which scenario BEST illustrates 'sentinel event' reporting in a case management context?
Answer: A patient dies unexpectedly due to a medication error during a care transition
A sentinel event is an unexpected occurrence involving death or serious physical or psychological harm, such as a fatal medication error, requiring immediate investigation.
In population health management, 'stratification' of a patient population is used to:
Answer: Categorize patients by risk level to prioritize case management resources
Risk stratification categorizes patients from low to high risk so that intensive case management resources are directed to those with the greatest need.