Quality, Technology, and Malpractice

Question 1

Underuse, overuse, misuse, and variation of services are all examples of what?

Answer 1

Healthcare quality failures

Question 2

What are the three parts of the Donabedian Triad which measures quality?

Answer 2

Structure, process, and outcome

Question 3

Which part of the Donabedian Triad deals with the perception?

Answer 3

Process

Question 4

The freedom of accidental or preventable injuries produced by medical care is called what?

Answer 4

Safety

Question 5

What is a harm that occurs because of medical care?

Answer 5

Adverse event

Question 6

What is a preventable adverse event, also known as a medical error?

Answer 6

Never events

Question 7

Match the top 10 leading causes of death and the numbers with them:
Accidents, diabetes, Alzheimer’s, chronic liver disease and cirrhosis, heart disease, COVID-19, cancer, nephritis/nephrotic syndrome/nephrosis, stroke, and chronic lower respiratory disease
702,880. 608,371. 277,039. 186,552. 165,393. 147,382. 120,172. 101,209. 57,937. 54,803.

Answer 7

1st: Heart Disease – 702,880
2nd: Cancer – 608,371
3rd: Accidents – 277,039
4th: COVID-19 – 186,552
5th: Stroke – 165,393
6th: Chronic lower respiratory disease – 147,382
7th: Alzheimer’s – 120,172
8th: Diabetes – 101,209
9th: Nephritis, nephrotic syndrome, and nephrosis – 57,937.
10th: Chronic liver disease and cirrhosis – 54,803.

Question 8

The 11th highest rated leading cause of death is what and if included, what would rank 3rd as the leading cause of death?

Answer 8

Suicide and medical errors

Question 9

What is an adverse drug event? A potential adverse drug event or potential AVE is what?

Answer 9

Any injuries that result from medication errors. A potential ADE is when harm could arise from a medication error but does not.

Question 9

Medication errors cost how many billion per year?

Answer 9

$40 billion

Question 10

While 66% of adults in the US take prescription drugs, how many get them from more than one provider?

Answer 10

53%

Question 11

While women take medication for about 60% of their lives, what percentage of their lives do men take it?

Answer 11

50%

Question 12

How many US adults are taking five or more prescriptions?

Answer 12

30%

Question 13

What is a handoff?

Answer 13

Transferring a patient from one person to another

Question 14

What is a disposition?

Answer 14

Transferring a patient from an inpatient setting to outpatient setting

Question 15

An average 5 day visit includes how many handoffs?

Answer 15

15 handoffs

Question 16

Why are issues with handoffs?

Answer 16

They are not standardized and take place quickly in an environment with a lot of noise which can disrupt the communication process

Question 17

What percent of patients have an adverse event within three weeks of a discharge?

Answer 17

20%

Question 18

What percentage of Medicare patients are readmitted to hospitals within 30 days of discharge?

Answer 18

20%

Question 19

What are the three steps taken in disposition?

Answer 19

Encoding, channeling, and decoding

Question 20

The Accreditation Council for Graduate Medical Education limited residency hours to how many per week? They also limited interns and 2nd year students to how many hours per shift?

Answer 20

Residency Hours – 80 hours per week
Interns – 16 hour shifts
2nd Year Students – 24 hour shifts

Question 21

In one study, the WHO Checklist resulted a drop of complications by what and deaths by what?

Answer 21

1/3 for complications, 1/2 for death

Question 22

The Keystone ICU Project in Michigan result in what percentage of a drop in deaths?

Answer 22

10%

Question 23

Are checklists considered to be a waste of time, illogical, or have problems with how they are introduced?

Answer 23

Yes

Question 24

Surgery on the wrong body part, wrong surgery on a patient, foreign object left in a patient after surgery, death/disability associated with with intravascular air embolism, incompatible blood, or hypoglycemia, stage 3 or 4 pressure ulcers after admission, and death/disability associated with electronic shock, a burn incurred within a facility, or a fall within a facility are all never events that are not what?

Answer 24

Protected by Medicare and Medicaid

Question 25

Kathy's Law establishes what for health care workers?

Answer 25

Ensuring that background checks are done

Question 26

The current ratio of what is ranging from 4.3 to 10.5?

Answer 26

Patient to nurse

Question 27

Illinois, New Jersey, Rhode Island, Vermont, and New York all require hospitals to post what?

Answer 27

Staffing ratios

Question 28

What state's mandated ratio varies by nursing speciality, such as 1:1 in the operating room, 1:2 in intensive care, and 1:4 in pediatrics?

Answer 28

California

Question 29

Which state doesn't have mandated ratios but hospitals are required to have nursing staff communities?

Answer 29

Connecticut

Question 30

Which state has their mandate as "an adequate number and type of staff is required to provide proper care to each resident"?

Answer 30

Missouri

Question 31

What improves efficiency and safety, shortens work process, easy access to instructions, groups common sets into orders, and can catch mistakes? This also has criticisms as there is inconsistent medication naming within and across systems, has poor medication search functions, is vulnerable to wrong-patient errors when multiple records are open, and has difficulty interpreting the displays?

Answer 31

Computerized physician order entry (CPOE)