CCM Made Easy Chap3 Quality and Outcomes Evaluations and Measures Questions with Verified Answers
Six quality indicators - CORRECT ANSWER
... [Show More] Clinical
Financial
Productivity
Utilization
Quality
Client experience
In this quality improvement method a process is identified that has yielded less than ideal outcomes, with measurement of key performance attributes with a subsequent devisement of a new approach and a finalIntegration of a re-designed approach. - CORRECT ANSWER Plan do study act approach (PDSA)
This healthcare quality improvement technique uses a five step approach to process improvement known by the acronym DMAIC - CORRECT ANSWER Six sigma
DMAIC - CORRECT ANSWER Define
Measure
Analyze
Improve
Control
This quality improvement technique emphasizes reducing waste to increase value - CORRECT ANSWER Lean approach
URAC
Joint commission
Commission on accreditation of rehabilitation facilities (CARF)
National committee for quality assurance (NCQA)
National quality forum (NQF)
Agency for healthcare research and quality (AHRQ) - CORRECT ANSWER Accrediting bodies
Commission on accreditation of rehabilitation facilities (CARF) - CORRECT ANSWER An independent, nonprofit accreditor of health and human services.
CARF Provides accreditation in the following areas - CORRECT ANSWER Medical rehabilitation
Durable medical equipment, prosthetics, orthotics, and supplies
Aging services
Behavioral health, including opioid treatment programs
URAC - CORRECT ANSWER Utilization review accreditation commission
National Committee for Quality Assurance (NCQA) - CORRECT ANSWER Accreditation for healthcare organizations and managed care organization's
National Quality Forum (NQF) - CORRECT ANSWER Not for profit, non-partisan, membership-based organization whose mission is to improve the quality of healthcare
The centers for Medicare and Medicaid services - CORRECT ANSWER A federal agency within the US Department of health and human services
Mission of the QIO - CORRECT ANSWER Improve the effectiveness, efficiency, economy, and quality of services deliver to Medicare beneficiaries
Core measures - CORRECT ANSWER "Core Measures are evidence-based criteria that indicate efficient and effective care for specific conditions by outlining key actions that have contributed to successful outcomes for these conditions:
•Acute Myocardial Infarction (AMI)
•Heart Failure (HF)
•Pneumonia (PN)
•Surgical Care: The Surgical Care Improvement Project (SCIP)
•Children's Asthma Care (CAC)
•Venous Thromboembolism (VTE)
•Stroke (STK)"
inpatient quality indicators (IQI) - CORRECT ANSWER a set of measures that provide a perspective on hospital quality of care using hospital administrative data.
Patient safety indicators - CORRECT ANSWER a set of indicators providing information on potential in hospital complications and adverse events following surgeries, procedures, and childbirth.
Pediatric quality indicators - CORRECT ANSWER Reflect the quality of care for Neo Nate's and children younger than 17 inside the hospital and identify potential he avoidable hospitalizations among children
Cost-Benefit Analysis (CBA) - CORRECT ANSWER A technique or systematic process used to calculate and compare the benefits and costs of an action, intervention, service or treatment, and to determine how well, or how poorly, it will turn out. This analysis reveals whether the benefits outweigh the cost, and by how much so that the involved parties able to make appropriate decisions.
A cost benefit report formally documents monetary savings related to case management involvement - CORRECT ANSWER Cost benefit analysis
Hard cost savings - CORRECT ANSWER Savings directly related to the case managers actions
Soft cost savings - CORRECT ANSWER Potential savings, more difficult to measure
Health risk assessment (HRA) - CORRECT ANSWER An assessment of a client conducted to identify the presence of risk and determine how much risk may influence health seeking behaviors. This assessment may cover various aspects of a clients condition including but not limited to level of physical activity and exercise; nutritional status; general health, safety, social, and environmental wellness; emotional awareness; Mental, intellectual, and occupational wellness; and culture including values, spirituality, and beliefs
What are the three components to the HRA? - CORRECT ANSWER Questionnaire
Risk calculation
Feedback
Adjusted clinical groups (ACGs) - CORRECT ANSWER Clusters clients into homogenous groups based on a unique approach to measuring morbidity to ultimately improve accuracy and fairness in evaluating healthcare providers performance, identifying clients at high-risk, forecasting healthcare you lies Asian, and setting equitable payment structure and rates for the providers of care. [Show Less]