Health Care Quality

Question 1

Scope of quality: a continuum of quality consistency

Answer 1

Patient centered;
Patient care outcomes;
Patient satisfaction;
Safety;
Evidence-based;
Resource efficient

Question 2

Safe health care

Answer 2

Knowledge based, 
sound decision making, 
avoidance of injuries, 
scope of practice honored, 
practice within standards of care

Question 3

Effective health care

Answer 3

Offers services that are most important;
Addresses needs of populations served, including the vulnerable;
Curative and preventive services;
Attains high population coverage

Question 4

Efficient health care

Answer 4

Transitions are respectful, coordinated, and efficient;
Routinely uses information for decision making;
Monitors costs;
Minimizes length of stay;
Work done well with fewer resources

Question 5

Errors of execution

Answer 5

Failure of a planned intervention;
Failure to complete an action as intended;
Variations form the standard of care

Question 6

Errors in planning

Answer 6

Wrong diagnosis;
Wrong treatment plan;
Wrong delivery of care

Question 7

Human error

Answer 7

Caused by people

Question 8

System error

Answer 8

Failure in the system identifying a mistake that could potentially cause a harmful or unintended outcome

Question 9

Near miss event

Answer 9

Mild variation in care;
Caused by system or human;
Does not reach the pt;
Does not cause harm;
Use FMEA to analyze

Question 10

Sentinel event

Answer 10

Severe variation in care;
Caused by system or human;
Reaches the pt;
Death or major harm occurs;
Use RCA to analyze

Question 11

Adverse event

Answer 11

Moderate variation in care;
Caused by system or human;
Reaches the pt;
Minimal or no harm;
Use FEMA to analyze

Question 12

Health care quality

Answer 12

The degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge

Question 13

Complex adaptive systems

Answer 13

Humans are fallible;
Systems are flawed;
Negligence or criminality are rarely the cause of error

Question 14

Root cause analysis (RCA)

Answer 14

Formal process:
Define the problem,
Identify the risks and protective factors,
Develop and test prevention strategies,
Implement and adopt strategies

Question 15

Failure mode effective analysis

Answer 15

Process to prevent the occurrence of errors or system failures:
Define the critical problem,
Analyze causes,
Identify solutions,
Evaluate the results

Question 16

Quality and safety education for nurses (QSEN)

Answer 16

Patient centered care;
Teamwork/collaboration;
Evidence-based practice;
Quality improvement;
Safety; 
Informatics

Question 17

Process of quality

Answer 17

Services offered;
Technical quality of the services;
Quality of the interpersonal relations;
Adequacy of pt education, access, safety, and promotion of continuity of care

Question 18

Outcomes of quality

Answer 18

The impact of structure and process on the pts satisfaction:
Perceptions of quality,
Knowledge,
Attitudes,
Behavior,
Health outcomes

Question 19

Culture of safety

Answer 19

Acknowledgment of high risk, error prone nature;
Blame free environment;
Expectation of collaboration;
Willingness to direct resources toward safety

Question 20

Health information technology

Answer 20

Enables the use of data to track performance against benchmarks;
Coordinates the care and multi-disciplinary teams;
Translates new evidence into practice

Question 21

Structure of quality

Answer 21

Adequacy of facilities, equipment,supplies, staff training, provider knowledge and attitudes, and supervision

Question 22

Centers for Medicare and Medicaid services (CMS)

Answer 22

Regulates organizations;
Has quality oversight for Medicare/Medicaid reimbursement;
Includes focus on measuring nursing quality

Question 23

The joint commission (TJC)

Answer 23

Only accrediting organization with the capability and experience to evaluate health care organizations across the continuum of care;
National pt safety goals established to address specific areas of concern in regards to pt safety

Question 25

Institute of medicine (IOM)

Answer 25

Conducts studies and provides unbiased and authoritative advice to improve the nations health

Question 26

The national quality forum (NQF)

Answer 26

Multi stakeholder organization that advances efforts to improve quality through performance measurement and public reporting

Question 27

The national database for nursing quality indicators (NDNQI)

Answer 27

Aids the RN in pt safety and quality improvement by providing research-based national comparative data on nursing care and its relationship to pt outcomes

Question 28

Health care quality interrelated concepts

Answer 28

Health policy;
Health care economics;
Health care organizations;
Safety;
Technology and informatics

Question 29

PDSA

Answer 29

Develop a plan to test the change;
Try out the plan;
Analyze what happened from the change;
Determine what was learned, refine the plan, repeat the cycle

Question 30

Leap frog group

Answer 30

Works with medical experts throughout the U.S. To identify and propose solutions designed to reduce medical errors

Question 35

Regulatory agencies

Answer 35

Oversight bodies in place to ensure health care quality and public safety:
Centers for Medicare and Medicaid services;
The joint commission;
OSHA;
FDA;
DEA

Question 38

Advisory bodies

Answer 38

The institute of medicine (IOM);
Quality and safety education for nurses (QSEN);
National quality forum (NQF);
National database for nursing quality indicators (NDNQI)