Exam 1 Part 1

Question 1

The degree or grade of excellence of goods or services, including, in healthcare, meeting expectations for outcomes of care.

Answer 1

Quality

Question 2

The continuous adaptation of a healthcare organizations functions and process to increase the likelihood of achieving the desired outcomes.

Answer 2

Performance Improvement

Question 3

The first hospital in America, which became a model for the development of hospitals in other communities, was ___________ Hospital.

Answer 3

Pennsylvania

Question 4

___________ General Hospital was the first hospital to practice the reporting of patient outcomes to the Hospital Board of Trustees. This hospital also set limitations on clinical practice in the first granting of clinical privileges.

Answer 4

Massachusetts

Question 5

__________ was the first state to pass the nurse registration bill in the US.

Answer 5

North Carolina

Question 6

In 1917, the American College of Surgeons (ACS) established the Hospital Standardization program, which marked the beginning of the accreditation process for healthcare organizations. The name of this program was ‘___________.’

Answer 6

The Minimum Standard.

Question 7

In 1946, the __________ established funding to build new hospitals.

Answer 7

Hill-Burton Act

Question 8

Conducted Chart audits and provided recommendations for improvement.

Answer 8

Peer Review Organizations (PRO)

Question 9

Quality of Care and Improvement of Care

Answer 9

Quality assurance

Question 10

Fee for Service

Answer 10

Retrospective Payment Systems

Question 11

Fixed payment based on DRG

Answer 11

Prospective Payment Systems

Question 12

Facility Resource Allocation Review

Answer 12

Utilization Review (UR)

Question 13

Link Quality to Reimbursement

Also known as “Pay for Performance”

Answer 13

Value-based Purchasing

Question 14

In the 1990s JCAH becomes _______ and Deming’s TQM philosophy begins to spread in US healthcare. _______ integrates quality improvement into the accreditation process.

Answer 14

JCAHO

Question 15

In 2002, the Health Care Finance Administration (HCFA) becomes the ______________________

Answer 15

Center of Medicare and Medicaid Services (CMS)

Question 16

In 2003, JCAHO implemented the ___________________ in the attempt to improve the quality of healthcare in the US.

Answer 16

National Patient Safety Goals (NPSG)

Question 17

In 2009, ________ Legislation was passed which provided funding to health care providers to move towards technological integrations.

Answer 17

HITECH

Question 18

In 2010, the ____________ Act passed which ensures equitable insurance coverage to all. (addressed issues such as pre-existing conditions, etc.)

Answer 18

Affordable Care Act

Question 19

Changes in healthcare impacted providers which led to development of __________, a type of health insurance. Contract with health care providers and medical facilities to provide care for members at reduced costs.

Examples of health plans: PPO, HMO, and POS

Answer 19

Managed Care Plans

Question 20

HMO stands for ________.

Answer 20

Health Maintenance Plan

Question 21

PPO stands for _________.

Answer 21

Preferred Provider Plan

Question 22

POS stands for __________.

This may include a hybrid of HMO and PPO

Answer 22

Point of Service

Question 23

__________ were established by the Affordable Care Act of 2010 to assist Medicare beneficiaries for a period of at least 3 years. An ACO is a network of doctors and hospitals that share responsibility for providing care to patients. There are responsibilities to CMS that come along with this agreement.

Answer 23

Affordable Care Organizations (ACOs)

Question 24

The evolution of Quality in Healthcare was sparked by ___________.

Answer 24

Edward Deming

Question 25

The concept of _____________ engages the individuals directly involved in the work and they are the ones who make recommendations on improvement. TQM Concept: “Problematic processes NOT people cause inferior products and outcomes”

Answer 25

Total Quality Management (TQM)

Question 26

In the 1990’s, quality improvement in healthcare was renamed _____________.

Answer 26

Performance improvement or PI

Question 27

In 1999, the Institute of Medicine (IOM) published a landmark report titled __________. This report Raised the awareness of healthcare quality and patient safety in the US.

Answer 27

To Err is Human

Question 28

In 2001, the IOM released a another new report titled _________.

Answer 28

Crossing the Quality Chasm

Question 29

Crossing the Quality Chasm paper identified ___ core foundations that should be found in patient care. Additionally, this paper also included 10 rules to redesign healthcare

Answer 29

6

Question 30

``` Safe Effective Patient-centered Timely Efficient Equitable ```

Answer 30

6 core foundations that should be found in patient care

Question 31

In 2002, Peer Review Organizations (PROs) were renamed ____________.

Answer 31

Quality Improvement Organizations (QIOs)

Question 32

In 2014, the Improving __________________ Act was passed, which required reporting for LTACs, SNF, Rehab and Home Health agencies.

Answer 32

Medicare Post-Acute Care Transformation (IMPACT)

Question 33

In 2015, the ________________ (MACRA) created the Quality Payment Program. Healthcare providers will no longer be paid for medical errors, complications and readmissions that resulted from lack of quality care.

Answer 33

Medicare Access and CHIP Reauthorization Act (MACRA)

Question 34

Avedis Donabedian applied the concepts of TQM to healthcare by assessing four perspectives:

Answer 34

Structure Process Outcome Cost