Study guide topics Flashcards
PFCC
Patient & Family Centered Care
PFE
Patient Family Engagement: the practice of collaborating with patients, their families, and caregivers to participate in care planning, policy development, and related decision-making.
SDM
Shared Decision Making
4 Ps of Hourly Rounding
Pain, Positioning, Potty, Proximity of Personal Items
E patients
Patients who are equipped, enabled, empowered, and experts in their health
Transformational leadership
Idealized influence, intellectual stimulation, inspirational motivation, individualized consideration
S&C letter (S&C-05-42)
Survey and Certification Letter issued by CMS to provide clarifications and valuable information regarding the grievance and complaint process within healthcare facilities.
HEART
Service Recovery strategy
QAPI
A hospital’s Quality Assessment & Performance Improvement program covers a few key elements:
Design and Scope
Governance and Leadership
Feedback, Data Systems, and Monitoring
Performance Improvement Projects (PIPs)
Systematic Analysis and Systemic Action
QIO
Quality Improvement Organizations
REALM
Rapid Estimate of Adult Literacy in Medicine - health literature should be in the 4th-6th grade level
SBAR
Communications between physicians and nursing
AIDET
Framework to facilitate communication with patients and their families, reduce concerns and anxiety, and enhancinge transparency.
Acknowledge - Introduce - Duration - Explanation - Thank You
MSPB
Medicare Spending Per Beneficiary
PFA
Patient Family Advisors
VSM
Value Stream Mapping
DESK model
Strategy for navigating difficult conversations.
D: Describe the problem behavior you have seen.
E: Evaluate/explain how the problem behavior affects outcomes and performance.
S: Show exactly what steps the person needs to take to improve.
K: Know the consequences.
EBDM
Evidence Based Decision Making
Gemba
Place where work is done
HINN
Hospital Issued Notice of Noncoverage
SHARE approach
Five step process for making that can help patients and healthcare providers work together to make the best treatment decisions.
LEARN
Improve cross cultural communication in healthcare settings
PEARLS
Communication with patients in challenging situations
Muri
Overburdening equipment - lean
Muda
Wasteful activities that do not contribute to the end product or service
Mura
Unevenness or inconsistency in operations
BLAST
A method for resolving complaints effectively in patient care
CDS
Clinical Decision Support (CDS): Timely information at the point of care to aid in the decision making regarding a patient’s care
HUSH
Creates more restful environment for patients during the night
EMTALA
ERs have to treat anyone that comes in, even if they can’t pay
CLAS
Culturally and linguistically appropriate services
RATER
Customer service assessment tool that breaks service quality into 5 key dimensions that customers value
PDCA/PDSA
A four step cycle designed to facilitate change, address problems, and perpetually enhance processes.
Plan-Do-Study-Act
VBP
Value-Based Purchasing: rewards acute care hospitals with incentive payments for the quality of care provided in the inpatient hospital setting
Triple Aim
Healthcare framework that aims to improve patient experience, population health, and reduce per capita healthcare costs.
Patient Rights / Bill of Right
Includes admission, examination and treatment, participation and care decision, informed consent, refuse treatment, pain management, and quality care.
The goal of the Patients Bill of Rights is to help patients feel more confident in the US healthcare system, to stress the importance of a strong relationship between patients and their healthcare providers, and to stress the key role patients play and help them stay healthy by laying out rights and responsibilities for all patients and healthcare providers.
Affinity Chart
Organizes a large number of ideas into their natural relationships
Root Cause / 5 whys
Problem solving technique where you ask “Why” five times to progressively peel back the layers of a program and identify its underlying root cause
Run chart
Graphs of data over time - help assess how effective a change is
Control chart
Graphs detailing how a process changes over time, with a data line and upper and lower control lines.
HCAHPS
Hospital Consumer Assessment of Healthcare Providers and Systems (HCAPS) has 29 questions and 3 goals (but does NOT include anything regarding patient engagement):
- Produce data about patients’ perspectives of care that allow objective and meaningful comparisons among hospitals on topics important to consumers.
- Create incentives for hospitals to improve their quality of care by publicly reporting survey results.
- Enhance accountability in healthcare by increasing transparency of the quality of hospital care provided in return for public investment.
Service recovery gift limits
$50 in a calendar year
PFAC
Patient and Family Advisory Councils (PFACs): structured forums where health care institutions and practices collaborate closely with patients and families to receive feedback and insights on how to enhance the patient and family experience.
Empirical rule of standard deviation aka three-sigma rule
68% of data falls within one SD of the mean.
95% of data falls within 2 SDs of the mean.
99.7% of data falls within 3 SDs of the mean.
CARE Act
Legislation designed to support caregivers during a patient’s transition from hospital to home.
Caregiver Advise, Record, Enable
I CARE concept / Houston Methodist Experience
Integrity, Compassion, Accountability, Respect, and Excellence
Managing up
Positioning health care professionals as elevated in the eyes of patients
HCAHPS survey timeline
Issued to a random selection of adult patients across a variety of medical conditions between 48 hrs and 6 weeks post discharge.
“Top Box” score
Primary benchmark for numerous healthcare institutions, measured by dividing the quantity of top-tier ratings by the total number of respondents to a specific question.
ie. If the question has a four point rating scale, “Always” would be the Top Box score.
8-Step Change Model
- Create a sense of urgency
- Form a guiding coalition
- Develop a vision
- Communicate the vision
- Remove obstacles
- Generate short-term wins
- Consolidate gains
- anchorage changes in the culture
Rounding frequency
Nurse - hourly
Administrative - Daily
Ethnography
Qualitative research method used to study cultures and communities from the perspective of the study subjects involves researchers immersing themselves in the subject’s environment to understand their goals, cultures, challenges, motivations, and themes from the subject’s point of view
LEP
Limited English Proficiency
How to speak during service recovery
Softly to defuse tension and signal a willingness to listen and understand
Deescalate by being empathetic, avoiding overreacting, and respecting personal space
Focus Groups in health care
Considered especially relevant because many health conditions are both influenced by and arise within social contexts
When is a complaint considered resolved?
When the patient is satisfied with the actions executed on their behalf
When to make post-discharge follow up calls
Within 72 hours of service with 3 attempts made before being removed from the list
What is the best way to protect and maintain the culture a company hopes to establish?
Hire slow, fire fast
What is the appropriate timeframe for providing a response to a grievance?
On average, seven days
What is the most effective strategy for preserving organizational culture within a healthcare setting?
Selecting staff members who align with the organizational culture and investing in their development.
4 principles of PFCC
Dignity and Respect, Information Sharing, Participation, Collaboration
What is the BEST indicator of employee engagement in healthcare settings?
Staff understanding how their role contributes to the organization’s overall goals.
What distinguishes Type One Muda from Type Two Muda in the lean process?
Type One Muda includes activities that cannot be eliminated immediately, while Type Two Muda comprises activities that can be quickly eliminated through kaizen.
CLAS
Culturally and linguistically appropriate services
Nurse manager rounding frequency
Daily
Level 1 complaint
A concern that is addressed directly and immediately by the staff member who initially receives the complaint; typically less complex issues that can be resolved without having to escalate to higher levels of management.
Level 2 might be more complex and require the involvement of management or specialized staff to resolve.
HVBP
Hospital Value-Based Purchasing, tied to CAHSP scores. Beginning at 1% in fiscal year 2013, rising incrementally to 2% by fiscal year 2017.
What is an organization’s PRIMARY gaol when sharing patient experience survey results with staff?
A To instill competition between units and departments
B To recognize high-performing units and departments
C To drive change and improve outcomes
D To compare the results to other organizations
C To drive change and improve outcomes
Which of the following is a short meeting that can be called to quickly address sudden or unexpected issues impacting patient care?
A Briefing
B Review
C Forum
D Huddle
D Huddle
Which is the BEST tactic to drive executive-level visibility and identify issues impacting the organization?
A Attending departmental meetings
B Leadership rounding
C Weekly conference calls
D Quarterly town hall meetings
B Leadership rounding - best to ensure visibility and create direct opportunities for interaction and communication
Which is the key factor in overcoming resistance once change is instituted?
A Providing executive incentives for change success
B Reinforcing expected behaviors to achieve outcomes
C Communicating a clear vision and strategy
D Developing human resources policies focused on accountability
C Communicating a clear vision and strategy - vision is the only one that can create long term change. Incentives have short term gains, behavior does not always tie back to larger changes, and HR policies are more to control.
Which of the following measures is MOST sensitive to extreme scores?
A Mean
B Median
C Mode
D Medium
A Mean
In an organization with a healthy ethical environment and culture, virtually everyone:
A Sees ethics as a personal matter only
B Recognizes and discusses ethical concerns
C Participates on a local ethics committee
D Participates in setting ethics guidelines
B Recognizes and discusses ethical concerns
When is a complaint considered to be resolved?
A A written response is sent to the patient.
B An apology has been made to the patient, and a small token has been given if appropriate.
C The staff member who was involved provides written confirmation that it is resolved.
D The patient is satisfied with the actions taken on his or her behalf.
D The patient is satisfied with the actions taken on his or her behalf.
A patient experience officer is aware that their organization has not yet achieved its goals. What would make a clear statement to the leaders and staff that will help drive the organization forward?
A The CEO should identify those not meeting the mark and call them out in a meeting.
B The board should insist that quality, safety and patient experience be tied together on all initiatives.
C You should develop another round of educational sessions for the staff.
D The directors should hold a focus group of past patients and publicize your findings to the employees.
B The board should insist that quality, safety and patient experience be tied together on all initiatives. - having the board speak to the integration of these 3 key topics elevates the importance of these issues as the organization moves forward.
Which type of communication is MOST useful in generating buy-in at an organization undergoing significant change?
A Transparent communication repeated frequently using multiple formats
B Complex group presentations with detailed data displays
C Internal newsletter articles and frequently asked questions
D Formal written communications that focus on factual information
A Transparent communication repeated frequently using multiple formats
Which strategy is characteristic of health teams that have a relationship-based care (RBC) culture?
A They create the energy and interdependence required for well-coordinated, high-quality patient care delivery and quality outcomes.
B They encourage staff to single-handedly control situations and keep ideas confidential to create an independent leadership presence.
C They review survey scores daily and constantly adjust goals and best practices to meet the needs of the patient.
D They work in a static environment, provide information on a “need-to-know” basis, and use independent resources to carry out tasks rather than working with others.
A They create the energy and interdependence required for well-coordinated, high-quality patient care delivery and quality outcomes.
What is one way to deliver on a patient’s “unrecognized needs”?
A Provide the patient with high-quality clinical care
B Make the patient feel like the hospital is his/her “home away from home”
C Respond to the patient’s needs and requests promptly
D Thank the patient for choosing your facility
B Make the patient feel like the hospital is his/her “home away from home”
Which is the MOST appropriate reward for an intrinsically motivated individual?
A A thank-you note
B A gift card to a local coffee house
C An additional vacation day
D An increase in pay rate
A A thank-you note
Which of the following is NOT a documented benefit of using interactive patient care technology to enhance the patient experience?
A Increases patient satisfaction
B Improves clinical outcomes
C Generates new revenue opportunities
D Decreases face to face communication
D Decreases face to face communication - Decreasing communication overall is not a benefit in any scenario
What are the elements of skillful, effective apologies during communication with patients and families in service recovery situations?
A Well researched and documented in a log
B Sincere, personal, specific, and immediate
C Empathetic with assistance from another staff member
D Scripted with multiple references to pertinent policies
B Sincere, personal, specific, and immediate
Which graph is MOST appropriate to display a trend in emergency department waiting times and the impact on overall satisfaction?
A Bar chart plotting waiting time on the y-axis and overall satisfaction on the x-axis
B Frequency histograph displaying peak waiting times and overall satisfaction by shift
C Line graph plotting overall satisfaction score on the y-axis and waiting time on the x-axis
D Pie charts displaying the percentage of patients by wait time and satisfaction score
C Line graph plotting overall satisfaction score on the y-axis and waiting time on the x-axis
What are the MOST important pair of attributes when considering new interactive technology to enhance patient experience?
A Flexibility and simplicity
B Minimal cost and the ability to increase revenue
C No interface requirements and no additional personnel requirements
D No training requirements and guaranteed improvement in survey scores
A Flexibility and simplicity
Once patient experience survey data is collected, which is the BEST example of data analysis?
A Placing the data on a monthly dashboard organized by department
B Placing the data on an organizational website for public review
C Placing the data in context to identify trends and patterns
D Placing the data in an annual report for the organization’s CEO
C Placing the data in context to identify trends and patterns
What are four leadership competencies identified as important to creating cultures of inclusion in health care?
A Engagement, enablement, recruitment, and education
B Involvement, cultural awareness, recruitment, and education
C Engagement, enablement, empowerment, and recognizing/developing talent
D Involvement, cultural awareness, empowerment, and recognizing/developing talent
C Engagement, enablement, empowerment, and recognizing/developing talent
Which outcome is MOST likely when using a standard communication model to engage with patients and families?
A Increase in staff teamwork
B Increase in staff responsiveness
C Increase in patient’s medical understanding
D Increase in patient’s perception of caring
D Increase in patient’s perception of caring - using the standard communication model to engage with patients and families across the continuum of care increases the patient and family perception of caring because it ensures consistency in the care relationships.
Which is the BEST method for reviewing patient experience survey results and identifying the appropriate indicators for targeted improvement work?
A Identify the lowest scoring survey items as focus areas for improvement.
B Intervene with survey items that are ranked the lowest in relation to the peer group.
C Use correlation analysis to identify opportunities for intervention.
D Work with managers to determine which indicators to work on.
C Use correlation analysis to identify opportunities for intervention
Which category of basic customer expectations has the MOST effect on customer satisfaction?
A Empathy
B Reliability
C Timeliness
D Cleanliness
B Reliability
The unit practice councils (UPCs) in a patient experience professional’s organization have determined that the current patient education handouts need restructuring to aid in presenting the information in a streamlined fashion. Which action should the patient experience professional take for the presentation at the shared governance committee for leadership engagement and support?
A Let the committee know that the UPC members think this is the best step to take to help patients and their families.
B Insist that this new way of presenting education information will make it easier for the nurses to finish their work on time, thus preventing overtime costs.
C Provide survey data from the patient and family advisory council meetings and the results from patient and family interviews on the topic.
D Describe in detail to the committee how a patient’s family expressed that changing the method for providing education would result in increased compliance.
C Provide survey data from the patient and family advisory council meetings and the results from patient and family interviews on the topic.
In addition to involving patients and families in the design of care, what is another effective use of a patient and family advisory council?
A As a mechanism for fundraising among grateful patients
B As a support group if at least two members are dealing with grief or a loss
C As a means for patients and families to bring their personal grievances about their hospital/clinic experiences that need resolution
D As a way to bring patients, families, and staff together to share experiences and expertise that can enhance service delivery and improve quality
D As a way to bring patients, families, and staff together to share experiences and expertise that can enhance service delivery and improve quality
Which is the BEST approach when addressing a physician about improvement in communication?
A Have the senior medical leader reinforce the rules.
B Discuss the unique role of the physician in health care and the patient relationship.
C Explain the positive effects of good communication on the hospital’s market share and volume.
D Reinforce the hospital behavioral standards and why they should be followed.
B Discuss the unique role of the physician in health care and the patient relationship. - the best approach is to ultimately connect to WHY the physician engages in this work.
Which of the following is an identified barrier to care for those in marginalized populations?
A Insufficient insurance coverage
B Fear of stigma
C Poor communication
D Lack of community partnerships
B Fear of stigma - while all are true, the fear of stigma is unique to marginalized communities who are seeking out care from predominantly heteronormalized healthcare providers.
Which of the following is a central component of the experience-based co-design process?
A Surveying
B Storytelling
C Market research
D Rounding
B Storytelling - EBCD is grounded in the capacity to understand and share stories as a primary form of data.
A postpartum unit is undergoing construction. Which approach by the patient experience professional would BEST ensure renovations meet the needs of patients and care partners?
A Survey senior leaders.
B Involve the interdisciplinary team.
C Create co-design working groups.
D Review previous patient comments.
C Create co-design working groups.
Which of the following is true about the patient’s experience when a physician expresses empathy?
A An empathetic physician will feel the patients feelings.
B Empathetic physicians could create a negative experience for the patient.
C Physicians expressing empathy is strongly associated with patient satisfaction and trust
D Patients of empathetic physicians will have reduced patient compliance for many illnesses.
C Physicians expressing empathy is strongly associated with patient satisfaction and trust
Which of the following is generally the LEAST important quality/skill when identifying patient and family advisors?
A See beyond their own personal experiences
B Ability to listen well
C Show concern for more than one issue or agenda
D More than one type of care experience
D More than one type of care experience
Which is the MOST important element in coaching an individual?
A Providing a list of expectations to the individual
B Using general feedback and outlining the mistakes that the individual has made
C Asking the individual to review his or her actions so that infractions will not be repeated
D Giving specific feedback in a manner that is supportive and clearly communicated
D Giving specific feedback in a manner that is supportive and clearly communicated
Allowing stakeholders a voice in key decisions that affect them is BEST defined as an:
A Informational action.
B Argumentative action.
C Empowering action.
D Authoritative action.
C Empowering action.
To effectively communicate with patients when providing care and treatment, staff should always consider which of these FIRST when discussing their healthcare?
A Patient’s preferred language
B Patient’s need for personal devices such as hearing aides or glasses
C Patient’s preference for written or verbal information
D Patient’s health literacy
A Patient’s preferred language - while all are true, research shows that patients with limited English proficiency are more likely to experience adverse events.
Which action would be MOST beneficial for a clinician who wants to become more culturally competent?
A Attending patients’ family events
B Overcoming language barriers
C Taking ballroom dance lessons
D Completing licensure requirements
B Overcoming language barriers
A patient is concerned about an inability to afford the medications and appointments that will be recommended at discharge. Which is the BEST response?
A Give the patient the option of purchasing the medicines now or waiting until a free clinic opens nearby.
B Politely explain that the hospital cannot be liable if the patient does not follow the discharge instructions.
C Educate the patient by showing a video that demonstrates the consequences of not taking the recommended medications.
D Call the physician to request less expensive medications and call a social worker to seek referral for assistance.
D Call the physician to request less expensive medications and call a social worker to seek referral for assistance.
In a meeting with emergency department staff, a patient experience professional is asked how the staff should communicate with a patient who is angry about a delay. Which is the BEST response?
A Ask them to be patient and call for the patient advocate.
B Explain that the physician was delayed but is almost caught up.
C Explain to the patient that others are more critical and must be seen first.
D Acknowledge the patient’s frustration and apologize for the wait.
D Acknowledge the patient’s frustration and apologize for the wait.
Which group is the MOST important stakeholder in effectively implementing hourly rounding in patient care areas?
A Nursing staff
B Volunteers
C Human resources staff
D Support services staff
A Nursing staff
Which statement BEST describes the appropriate level of patient and family involvement in care?
A Patients should be the sole partner with the healthcare team involved in their own care.
B Patients and their designee should be involved in the level of care and decision making they choose.
C It is imperative that the family participate in all aspects of caring for the patient while in the hospital.
D Family must leave the room during bedside shift report and other aspects of care.
B Patients and their designee should be involved in the level of care and decision making they choose - patients and their designees should be able to choose their level of involvement in their care and decision making according to PFCC
Which of the following is a formal step in the PDSA improvement model?
A Prioritize
B Discuss
C Study
D Acknowledge
C Study
Which of the following domains of measurement is MOST correlated to the overall inpatient hospital rating (i.e. rating on a scale of 1 to 10)?
A Staff responsiveness
B Nurse communication
C Provider communication
D Facility quietness
B Nurse communication
41 In what phase of the PDSA cycle would a patient experience professional identify the measure or goal the team hopes to achieve?
A Plan
B Do
C Study
D Act
A Plan
Why are patient and family advisors important?
A They can offer innovative ideas that are usually evidence-based.
B They can offer insights based on needs rather than hospital staff assumptions.
C They help offset costs incurred from lawsuits by dissatisfied patients.
D They help provide free advertising for the hospital in the community.
B They can offer insights based on needs rather than hospital staff assumptions. - PFAs are usually individuals who received care at your organization and can help share insights on how to navigate that organization based on their lived experience
Which method of data analysis should be used to guide the development of interventions intended to improve health equity?
A Manually code qualitative data.
B Disaggregate data by race and ethnicity.
C Monitor trends in mean scores by acuity.
D Segment quantitative data by care path.
B Disaggregate data by race and ethnicity.
Which of the following is the BEST example of a roadblock to success in effectively addressing patient experience in a health system?
A Clinical teams not using a consistent framework to communicate with patients
B Clinical teams not using evidence-based medicine
C Organizations not listening and acting on the needs of physicians.
D Organizations not listening and acting on the needs of patients.
D Organizations not listening and acting on the needs of patients.
Which of the following is a benefit of experience mapping in relation to the patient experience?
A Understanding directions around the campus
B Learning about staff personalities
C Examining moments of truth that shape patients’ thoughts and feelings
D Finding solutions to language barriers
C Examining moments of truth that shape patients’ thoughts and feelings
Which statement most accurately reflects palliative care services?
A Palliative care is an inpatient approach that mirrors the experience of hospice care.
B Palliative care is focused solely on psychosocial symptoms and family caregiver well-being.
C Palliative care is focused on providing patients’ relief from the symptoms of pain and stress of a serious illness.
D Palliative care meets the needs of patients and families with complex and chronic illnesses.
C Palliative care is focused on providing patients’ relief from the symptoms of pain and stress of a serious illness.
Which behavior shows empathy to a patient?
A Listening only to the patient
B Connecting with the patient as a person
C Informing the patient of the plan of care
D Standing the entire time while interacting with the patient
B Connecting with the patient as a person
Which is a key consideration in recognizing an individual?
A Provide recognition as soon as the desired behavior occurs.
B Provide recognition once each quarter to increase the impact.
C Provide recognition only to individuals who exceed expectations.
D Provide recognition only to individuals observed directly.
A Provide recognition as soon as the desired behavior occurs.
How can leaders BEST use storytelling as a tool in their organization to promote employee engagement?
A Share stories that are simple and concise.
B Share stories that highlight lessons learned.
C Share stories that are humorous and entertaining.
D Share stories that demonstrate ideal behaviors.
D Share stories that demonstrate ideal behaviors.
What is the most important difference between patient experience and patient satisfaction?
A The Memorable Story
B The Memorable Event
C The Memorable Encounter
D The Memorable Care
A The Memorable Story - PFCC is all about the lasting story that people have and then share.
Process measure
How well a specific step or activity was executed
Outcome measures
The effect of evidence based care on the patient’s health
Average reading level of US adults
8-9 grade
Who ultimately owns the patient experience in a healthcare organization?
Chief Executive Officer
DMAIC (Define Measure Analyze Approve Control)
Six Sigma process
Servant leadership
A leadership style that prioritizes serving others over the leader’s own needs or the organization’s goals
Transformational leadership vs. servant leadership
Transformation leadership is focused on causing change in individuals and industries by inspiring team members to achieve higher performance levels; servant leadership is more focused on developing individuals to make sure they are thriving professionally and personally
