CPHQ Exam Dumps - Certified Professional in Healthcare Quality Examination

Addressing the increased incidence of type 2 diabetes through the lens of social determinants of health involves addressing broader factors that impact health. Collaborating with local farmers' markets to make fresh produce more widely available is a strategy that addresses the social determinants of health by improving access to healthy food options. This approach can help reduce the risk of diabetes by making it easier for community members to make healthy dietary choices, thereby addressing one of the root causes of the increased diabetes incidence.

Educate newly diagnosed patients on diabetes disease management (A): While important, this strategy focuses on managing diabetes after it occurs rather than addressing the social determinants that contribute to its onset.

Set up a community-based education program about blood glucose monitoring (B): This is also important for management but does not directly address the social determinants that lead to the higher incidence.

Review evidence-based diabetes management protocols with primary care providers (C): This improves care quality but does not address the social factors contributing to the disease.

References

NAHQ Body of Knowledge: Addressing Social Determinants of Health in Quality Improvement

NAHQ CPHQ Exam Preparation Materials: Strategies for Managing Social Determinants of Health

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A scatter diagram is a graphic representation of the relationship between two variables12. It is used to test a theory that the two variables are related and to assess the strength, trend, and shape of that relationship2.

A Pareto chart is a type of bar chart that shows the frequency or impact of different causes or problems in descending order, along with a line graph that shows the cumulative percentage of the total3. It is used to identify the most significant factors among a large number of potential causes or problems3.

A control chart is a type of line chart that shows how a process changes over time, with upper and lower limits that indicate the range of acceptable variation4. It is used to monitor and control a process and to detect special causes of variation that may indicate problems or improvement opportunities4.

A histogram is a type of bar chart that shows the frequency distribution of a single variable in a data set5. It is used to summarize and display the shape and spread of the data and to identify outliers or gaps5.

Based on these definitions, the best tool to use for the outpatient medical clinic’s purpose is a scatter diagram, as it can show whether there is a relationship between lack of available transportation and the number of times patients do not keep appointments, and how strong or weak that relationship is. The other tools are not suitable for this purpose, as they do not show the relationship between two variables. References: 1: Scatter Diagram | Digital Healthcare Research 2: Scatter Plot - Clinical Excellence Commission 3: Pareto Chart | Institute for Healthcare Improvement 4: Plotting basic control charts: tutorial notes for healthcare practitioners 5: Histogram | Institute for Healthcare Improvement

To decrease the length of stay for inpatients on a surgical unit, measuring delays between steps in the patient care process is crucial. These delays often represent non-value-added time that can be reduced or eliminated to streamline patient flow and reduce overall length of stay. Identifying and addressing these inefficiencies can lead to more timely care and quicker discharges.

Number of services provided (A): This measures volume, not process efficiency.

Turnaround time for diagnostic test results (B): This is important but only one component of potential delays.

Nursing productivity (D): While important, it does not directly address process inefficiencies related to length of stay.

References

NAHQ Body of Knowledge: Lean Principles and Process Optimization

NAHQ CPHQ Exam Preparation Materials: Reducing Length of Stay through Process Improvement

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When a cross-functional team is assigned the task of improving a process, such as laboratory reporting time in the emergency room, the first step after identifying the problem is usually to understand the root causes of the problem. A fishbone diagram, also known as a cause and effect diagram or Ishikawa diagram, is a visual tool used to systematically identify and present all possible causes of a certain outcome1234.

In this case, the significant delay in receiving laboratory results is the problem that needs to be addressed. The team would use a fishbone diagram to identify and categorize potential reasons for this delay, such as equipment issues, process inefficiencies, human errors, etc. This step is crucial before developing action plans (Option D) because it ensures that the team’s efforts are directed towards addressing the root causes of the problem, rather than just the symptoms1234.

Options A (Identify the responsible individual) and C (Plot a scatter diagram) are not the immediate next steps in this scenario. Identifying a responsible individual is more about accountability after the root causes have been identified and action plans have been developed. A scatter diagram is a graphical tool used to understand the relationship between two variables and is not typically the next step in process improvement after identifying the problem1234.

References: 

https://fellow.app/blog/management/cross-functional-collaboration-common-challenges-and-tips-to-make-it-work/\

The implementation of a diabetes center of excellence falls into tertiary prevention. Tertiary prevention aims to manage and improve the quality of life for patients with chronic or advanced conditions, such as advanced diabetes. This type of prevention focuses on reducing complications, preventing further deterioration, and helping patients manage their illness effectively.

Primary (A): This involves preventing the onset of disease, such as promoting healthy lifestyles to prevent diabetes.

Secondary (B): This involves early detection and treatment to halt or slow the progression of a disease.

Quaternary (C): This involves preventing overmedicalization and protecting patients from unnecessary interventions.

References

NAHQ Body of Knowledge: Levels of Prevention in Healthcare

NAHQ CPHQ Exam Preparation Materials: Understanding Prevention Strategies

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When dealing with a significant increase in the time it takes for insurance claims to be submitted, which results in the hospital not being paid in a timely manner, the best course of action for a healthcare quality professional is to assemble a work group and facilitate the development of a fishbone diagram12.

A fishbone diagram, also known as a cause-and-effect diagram or Ishikawa diagram, is a visual tool used to systematically identify and present all the possible causes of a particular problem in order to find its root causes1. This approach is particularly useful in this scenario because it allows the team to visualize the many potential factors contributing to the increase in submission time for insurance claims.

Here are the steps that the healthcare quality professional would take:

Assemble a Work Group: Gather a team of individuals who are familiar with the process and can contribute to identifying potential causes of the problem1.

Define the Problem: Clearly articulate the problem of increased time for insurance claims submission. This is typically written at the head or mouth of the fish in the fishbone diagram1.

Identify Major Cause Categories: Common categories include methods, machines (equipment), people (manpower), materials, measurement, and environment. These are drawn as the “bones” of the fish1.

Identify Possible Causes: Brainstorm all the possible causes of the problem that fall into each category. These are written on the smaller “bones” off of the major cause categories1.

Analyze and Prioritize Causes: Discuss and analyze the identified causes, and prioritize them based on their impact on the problem1.

Identify Solutions: For each high-priority cause, develop strategies or changes to address the cause1.

Implement and Monitor Solutions: Implement the identified solutions, monitor their effectiveness, and make adjustments as necessary1.

By following these steps, the healthcare quality professional can systematically address the problem of increased insurance claim submission time, ultimately improving the hospital’s revenue cycle2.

 Using clinical guidelines based on scientific evidence is most likely to improve practice patterns12345. Clinical Practice Guidelines (CPGs) are systematically developed statements aimed at helping people make clinical, policy-related, and system-level decisions1. They are perceived to present the best evidence for managing clinical matters, including conditions or symptoms, and are upheld as the gold standard of high-quality healthcare1.

CPGs are intended to improve the quality of care provided to patients while containing healthcare costs and reducing variability in clinical practice1. They offer a way of bridging the gap between what is known to be the best evidence, policy, and good practice standards in healthcare1. By using these guidelines, healthcare practitioners can critically assess research data, clinical guidelines, and other information resources to correctly identify the clinical problem, apply the most high-quality intervention, and re-evaluate the outcome for future improvement5.

Therefore, the answer is option A: Improve practice patterns. This is because the use of evidence-based clinical guidelines helps to standardize care, reduce variability, and improve the quality and consistency of patient care12345.

A performance improvement plan (PIP) is a set of focused activities designed to monitor, analyze, and improve the quality of processes and outcomes in a healthcare organization12.

A PIP should be aligned with the strategic goals of the organization, which are the long-term objectives that reflect the vision, mission, and values of the organization3.

To align a PIP with strategic goals, a healthcare quality professional should consider the following factors45:

Customer expectations: These are the needs, preferences, and perceptions of the patients, families, and other stakeholders who receive or are affected by the healthcare services. Customer expectations are a key driver of quality improvement, as they reflect the degree of satisfaction and loyalty of the customers. Customer expectations can be measured by surveys, feedback, complaints, and compliments6 .

Benchmarking data: These are the comparative data that show how the organization performs relative to other similar or best-in-class organizations in terms of quality, efficiency, and effectiveness. Benchmarking data can help identify gaps, opportunities, and best practices for improvement. Benchmarking data can be obtained from external sources, such as national databases, accreditation agencies, or professional associations, or from internal sources, such as historical data, peer groups, or departments .

Patient outcome data: These are the data that show the results or impacts of the healthcare services on the health status, quality of life, and satisfaction of the patients. Patient outcome data are the ultimate indicators of quality improvement, as they reflect the effectiveness and value of the healthcare services. Patient outcome data can be measured by clinical indicators, such as mortality, morbidity, complications, or readmissions, or by patient-reported indicators, such as functional status, symptom relief, or experience of care .

By considering these factors, a healthcare quality professional can align a PIP with strategic goals in the following ways45:

Identify the strategic goals and priorities of the organization and ensure that they are clear, specific, measurable, achievable, relevant, and time-bound (SMART).

Assess the current performance of the organization in relation to the strategic goals and priorities, using customer expectations, benchmarking data, and patient outcome data as sources of information and evidence.

Identify the gaps and opportunities for improvement based on the assessment of the current performance and the comparison with the strategic goals and priorities.

Develop and implement improvement actions that address the gaps and opportunities for improvement, using evidence-based methods and tools, such as the Plan-Do-Study-Act (PDSA) cycle, root cause analysis, or process mapping.

Monitor and evaluate the improvement actions and their effects on the performance of the organization, using customer expectations, benchmarking data, and patient outcome data as measures of success and feedback.

Communicate and disseminate the improvement results and the lessons learned to the relevant stakeholders, such as the leadership, staff, customers, and partners, and celebrate the achievements and recognize the contributions.

Review and revise the improvement actions and the PIP as needed, based on the monitoring and evaluation results and the changing needs and expectations of the customers and the organization.

References:

1: Health Care Quality Improvement (QI) Action Plan Template 2: Quality Improvement (QI) Toolkit with Templates, Instructions, and … 3: The Top 4 Examples of Quality Improvement in Healthcare 4: Model Quality & Performance Improvement Plan 5: 8 Examples Of Quality Improvement Initiatives In Healthcare 6: [Shaping the Future of the Healthcare Quality Profession] : [The Role of the Healthcare Quality Professional in Population Health Management] : [Healthcare Quality Solutions: Ready Your Workforce for Quality] : [HQ Principles] : [The Financial Case for Quality as a Business Strategy] : [Utilization of Improvement Methodologies by Healthcare Quality Professionals During the COVID-19 Pandemic]