RHIT Performance Improvement and Quality Management 3

Question 1

Which organization is responsible for the Healthcare Effectiveness Data and Information Set (HEDIS), used to measure health plan performance?

Accepted Answer

NCQA

Answer

CMS

Answer

AHRQ

Answer

The Joint Commission

Question 2

In performance improvement, what does a 'tracer methodology' involve?

Accepted Answer

Following a patient's care experience across departments to evaluate systems

Answer

Tracking financial transactions through the revenue cycle

Answer

Mapping data flows through health information systems

Answer

Auditing coding accuracy across the facility

Question 3

A HIM department notices that the average discharge record completion time increased from 14 days to 22 days over six months. The FIRST step in a formal performance improvement process would be to:

Accepted Answer

Define and measure the problem clearly

Answer

Implement corrective action immediately

Answer

Benchmark against national standards

Answer

Report the issue to administration

Question 4

Which quality measure is used to evaluate the proportion of patients who develop a complication that was not present on admission?

Accepted Answer

Hospital-acquired condition (HAC) rate

Answer

Present on Admission (POA) indicator

Answer

Case mix index

Answer

Discharge disposition rate

Question 5

The goal of a 'case mix index' (CMI) in a quality and performance context is to:

Accepted Answer

Reflect the relative complexity and resource intensity of patients treated

Answer

Measure patient satisfaction scores

Answer

Calculate average length of stay

Answer

Track employee productivity rates

Question 6

A hospital's quality department is reviewing patient falls data by unit, shift, and patient age group. This process of breaking down data to identify patterns is called:

Accepted Answer

Stratification

Answer

Normalization

Answer

Triangulation

Answer

Aggregation

Question 7

Under CMS Conditions of Participation (CoPs), hospitals are required to have a functioning Quality Assessment and Performance Improvement (QAPI) program. This requirement ensures:

Accepted Answer

Ongoing systematic monitoring and improvement of patient care quality and safety

Answer

All inpatient claims are reviewed before payment

Answer

Annual accreditation surveys are conducted

Answer

Physicians maintain current licensure