cphq exam practice questions

CPHQ EXAM PRACTICE QUESTIONS RUBY MED PLUS TRAINING INSTITUTE CPHQ EXAM PRACTICE QUESTIONS DR. Shoeb AHMED BS, BDS, MS, PGDHM, EMSRHS, MHRM, MS (PSY), M.PHIL(HHSM), MS, PGDMLE, PGDHA, FHTA, Cert. Patient Safety, Cert. In Health Economics 3/5/2017

DR. Shoeb AHMED BS, BDS, MS, PGDHM, EMSRHS, MHRM, MS (PSY), M.PHIL(HHSM), MS, PGDMLE, PGDHA, FHTA, Cert. Patient Safety, Cert. In Health Economics Ruby Med Plus Health Care Consultants

1. What is the best explanation for the relatively slow introduction of lean practices into

medical laboratories?

A. The variability and complexity of the samples in a laboratory is much higher than in a

manufacturing environment

B. Scientists are less receptive to the core principles of lean

C. Medical laboratories function differently than factories

D. Medical research is mostly funded by the government

1. A: The best explanation for the relatively slow introduction of lean practices into

medical laboratories is that the variability and complexity of the samples in the

laboratory is much higher than in a manufacturing environment. In laboratories, it is

common for a huge number of slightly different samples to be processed. A simple

assembly line approach to laboratory processes is rarely successful. However, there

are striking analogies between manufacturing and laboratory work, and laboratories

can drastically improve efficiency by adopting lean practices. Contrary to the beliefs

of some, lean practices do not discourage innovation. Instead, they enable laboratories

to handle greater volume and diversity without sacrificing quality.

2. A delay in discharging patients is likely to cause recurrent bottlenecks in...

A. Admissions from the emergency room

B. The filling of prescriptions

C. Admissions from surgical wards

D. All of the above 2. D: A delay in discharging patients is likely to cause recurrent bottlenecks in admissions from the

emergency room and surgical wards and in the filling of prescriptions. Indeed, the negative

consequences of discharge delays may include the creation of other bottlenecks. It is important to

recognize that inefficiencies in one area of service provision can cause inefficiencies in many other

areas. A bottleneck occurs when there are not enough resources available to perform all of the

functions necessary at a given time. Discharge delays waste time, money, and resources.

3. Which of the following conditions should a quality assessment program NOT examine?

A. A condition that is thought to be treatable

B. A condition for which the treatment is susceptible to significant influence by health care

providers

C. A condition that has cost-effective treatments

D. A rare condition that has a small effect on mortality or morbidity 3. D: A quality assessment program should not include rare conditions that have a small effect on

mortality or morbidity. Such conditions have a limited bearing on the overall success of care. There is

a general agreement as to which conditions are appropriate for inclusion in a quality assessment

program. A condition should meet five criteria. First, it should either be common or have a

significant effect on morbidity or mortality. Second, there should be scientific evidence that there

are treatments effective at preventing or mitigating the effects of the condition. Third, it should be

established that improvement in the quality of treatment for the condition will improve overall

health. Fourth, the condition should have cost-effective interventions. Finally, the interventions for

the condition should be susceptible to significant influence by health care providers.


4. A doctor fails to administer an indicated test, and the patient's condition deteriorates to the

point that he must be admitted to an inpatient facility. This is an example of...

A. Preventive error

B. Treatment error

C. Diagnostic error

D. Communication error 4. C: When a doctor fails to administer an indicated test and the patient has an adverse result, the

doctor has committed a diagnostic error. A diagnostic error is committed whenever a condition is

misidentified or an indicated test is not performed. A diagnostic error can result in even more errors in

the future. A preventive error is a mistaken approach to avoiding a condition, while a treatment error

is a mistake related to the resolution of a condition. A communication error may occur between two

service providers or between a service provider and a patient.

5. When is the best time for chairing during a meeting?

One hour beforehand

At the beginning

In the middle

At the end

5. B: The best time for chairing is at the beginning of a meeting. In most cases, the facilitator and the

chairperson of the meeting are two different people. The chairperson is responsible for reviewing the

minutes from the previous meeting and eliciting feedback from team members. A facilitator may be

charged with organizing and moderating discussion, but the introduction to the meeting is typically

conducted by the chairperson. In many situations, it is appropriate to rotate the chairing duties.

6Q. The manager's perspective on quality differs markedly from that of clinicians and patients on:

A Efficiency, effectiveness and access

B Efficiency, cost effectiveness and equity

C Equity, access and technical performance

D Responsiveness to patient preferences

7Q. There is a story of an intensive care unit (ICU) at Dominican Hospital in Santa Cruz Country,

California. Dominican, a 379-bed community hospital, is part of the 41-hospital Catholic Healthcare

West system. "We used to replace ventilator circuit for incubated patients daily because we thought

this helped to prevent pneumonia," explained Lee Vanderpool, vice president. ""But the evidence

shows that the more you interfere with that device, the more often you risk introducing infection. It

turns out it is often better to leave it alone until it begins to become cloudy, or `gunky,' as the

nonclinicians say." The hospital staff learned an important lesson from this experience that:

A Introduction f a new protocol, or any new idea, involves education

B Intuition is more powerful than evidence


C Evidence is more powerful than intuition

D Efforts improve mortality rate

Q8. Payers are more likely to embrace the optimization definition of care which can put them at

odds with:

A Physicians

B Clinicians

C Health administrators

D Physicians and Health administrations

Q9. Crossing the Quality Chasm provided a blueprint for the future that classified and unified the

components of quality through six aims for improvement, chain of effects, and simple rules for

redesign of healthcare. The six aims for improvement, viewed also six dimensions of quality. Which

of the following is NOT out of those dimensions?

A Care centered

B Efficient

C Safe

D Effective

Q10. Efficiency refers how well resources are used in achieving a given result. Efficiency whenever

the resources used to produce a given output are__________.

A It is truly situation dependent

B Increases, increased

C Reduces, reduced

D Improves, reduced

Q11. Today's patients' perception of the quality of our health care system is not favorable. In

healthcare, quality is household word that evokes great emotion, including:

A Patient centered measures

B Anxiety over the ever-increasing costs and complexities of care

C Timely care that may be experienced in terms of performance of services

D Frustration and despair, exhibited by patients who experience health care services firsthand or

family members who observe the care of their loved ones and anxiety over the ever-increasing costs

and complexities of care.


Q12. In fact, because patients' satisfaction is so influenced by _________ rather than to the

moreindiscernible technical ones-health maintenance organizations, hospitals and other health care

delivery organizations have come to view the quality of non-technical aspects of care as crucial to

attractions and retaining patients.

A Their reactions to interpersonal and amenity aspect of care

B Patients recognize that they do not possess the wherewithal to evaluate all technical elements of

care

C Their likelihood of desires outcomes

D Every patient has definite preference in every clinical situation

Q13. "Likelihood of desired health outcomes" corresponds to clinicians' view that, with respect to

outcomes, there are only probabilities, not certainties, owing to factors-such as patients' genetically

determined physiological reliance-that influence:

A Outcomes of care and yet are beyond clinicians' control

B High cost interventions

C The primary concerns of patients

D Outcomes of care and now are within clinicians' control

Q14. In general, as the amounts spent on providing services for a particular condition grow,

diminishing returns set in meaning that each unit of expenditure yield ever-smaller benefits until a

point where________.

A No additional benefits accrue from adding more care

B Additional benefits are too small to justify the added costs

C There is displacement of more useful care

D Perfection is within the reach of all individuals

Q15. Strong disagreement does arise, among the five parties' definitions (i.e. the clinician's, the

patient's the payers, the manager's and the society's), even outside the realm of cost effectiveness.

Conflicts typically arise when:

A One party holds that a particular practitioner or clinic is a high quality provider by virtue of having

high ratings on single aspect of care

B The facility receives top marks from a team of expert clinicians whose primary focus is on technical

performance

C Each group emphasizes a particular aspect of care

D Practitioners who are highly skilled in trauma and other emergency care


Q16. The quality of amenities of care refers to the characteristics of the setting in which the

encounter between patient and clinician takes place, such as:

A Responsive to patient preferences

B Comfort

C Comfort, care and access

D Comfort, convenience and privacy

Q17. In earlier formulations, responsiveness to patients' preferences was just one of the factors seen

as determining the quality of patient clinician interpersonal relationship. But, now it is translated

into many factors. Which of the following is out of such factors?

A Respect for Respect for patient's convenience

B Respect for patients' expressed needs

C Respect for patients' preferences

D Respect for patients' values, preferences and expressed needs.

E Respect for patients' values

Q18. _____ can be measured by how well evidence-based practices are followed, such as the

percentage of time diabetic patients receive all recommended care at each doctor visit, the

percentage of hospital-acquired infections, or the percentage of patients who develop pressure

ulcers (bed sores) while in the nursing home.

A Safe care

B Effective care

C Equitable care

D Timely care

Q19. "Quality is the degree to which health services for individuals and populations increase the

likelihood of desired health outcomes and are consistent with current professional knowledge." This

is the definition of Quality care often quoted by:

A IHI

B IOM

C HQCB

D OCHP

Q20. Quality and technical performance refers to how well current scientific, medical knowledge

and technology are applied in a given situation. It is usually assessed in terms of:


A The quality of interpersonal relationships

B Appropriateness of therapy and other medical interventions are performed

C Timeliness and accuracy of the diagnosis and appropriateness of therapy and other medical

interventions are performed.

D Timeliness and accuracy of the diagnosis

Q21. Amenities may cover areas as mentioned below EXCEPT:

A Comfortable waiting rooms

B Ample and convenient parking

C Vast and facilitated food providing area

D Good directional signs

Q22. A number of attributes can characterize the quality of health care services. As, there are

different groups involved in healthcare, such as physicians, patients and health insurers, tend to

attach different levels of importance to particular attributes and as a result define quality care

differently. Which of the following is/are NOT out of those attributes?

A Technical performance

B Amenities

C Responsiveness to patient preferences

D Excess staff

Q23. _____ refers to the "degree to which individuals and groups are able to obtain needed

services."

A Responsiveness to patient preferences

B Equity

C Access

D Amenities

Q24. ____is a term applied when the proper clinical care process is not executed appropriately, such

as giving the wrong drug to a patient or incorrectly administering the correct drug.

A Illegal use

B Misuse

C Underuse

D Overuse


Q25. "Underuse is evidence by the fact that many scientifically sound practices are not used as

often they should be, For example, biannual mammography screening in woman ages 40 to 69 has

been proven beneficial and yet is performed less than 75 percent of the time." This is the

categorization of:

A Lack of professionalism in Medical field

B Healthcare practice

C Lack of care

D Defects

. Q26. To cut down on costs, a clinic has been hiring outside consultants to perform many of its tasks, but there are concerns that the performance of many of these consultants does not meet the state’s standards for the clinic’s operation. What is the CPHQ’s role in this?

A Supply the consultants with the information about state standards and ensure full compliance

B Create simulated activities to test the consultants and see if they are meeting the standards

C Develop educational programs to assist the consultants and ensure that the standards are met

D Review the activities of the consultants and report the results to the clinic administration

Feedback

The CPHQ is not responsible for overseeing consultants in general, but in the case of a failure in consultant activities, he or she is expected to review the activities of consultants and report on results. Answer choices A, C, and D all contain details that might be part of the review process for the CPHQ, but they lack the larger role of reviewing and reporting.

Q27. A hospital has found that the performance of one of its departments is consistently below the

expected standards. The hospital administration wants to locate the source of the problems and see

improvement in the department within six months. What is the CPHQ’s role in this?

A Research the problems and develop a program that applies current standards to the department

B Advise that a performance improvement team be assembled to review and address the failings

C Recommend that the hospital replace the current administration of the individual department

D Review the expected standards and submit these to the department for immediate application

Feedback

The primary role of the CPHQ is this particular situation is to advise the assemblage of a

performance improvement team that can review and address the failings. The CPHQ might be

involved in researching the problems, but the development of a program that applies the standards

to the department would exceed his responsibilities. He would certainly not be expected to advise

the hospital to replace the current administration of the department; this would be the role of a

larger group (such as a performance improvement team) that takes the time to review the situation.


Also, he would need to do far more than simply submit the expected standards to the department

for application. Obviously, the department is already failing to apply the standards, so something

more needs to be done.

Q28. A hospital’s administrative board is interested in applying a national excellence model to its

activities. What is the CPHQ’s role in this?

A Research the available national excellence models and recommend the one to utilize

B Review various national excellence models and evaluate their applicability to the hospital

C Assemble a review team to consider the different national excellence models for the hospital

D Survey department activities to consider in conjunction with various national excellence models

Feedback

In terms of national excellence models, the CPHQ should review the different models and evaluate

their applicability. He does not necessarily have the authority to recommend one in particular; the

goal is more one of providing the facility with the information it needs to make a decision, and the

decision itself is likely to come from a group of people. The CPHQ does not need to assemble a

review team; he should already be somewhat familiar with the different models and should be able

to generate an evaluation without the assistance of a review team. Finally, he does not need to

survey department activities, as it is likely that these are already familiar.

Q29. All of the following represent federally-mandated patient rights in the United States EXCEPT:

A Rights to obtain a copy of medical records

B Right to maintain the privacy of medical records

C Right to receive healthcare services

D Right to informed consent for medical treatment

Feedback

There is no federally mandated right to healthcare services for people in the United States. There are

other statutes – such as the law that forbids emergency rooms from turning away people without

insurance – but the federal government does not guarantee to people that they have the right to

receive healthcare services. The other rights listed (right to informed consent, right to privacy, right

to a copy of medical records) are all protected at the federal level.

Q30. Which of the following types of charts is best for determining cause and effect?

A Run

B Control

C Fishbone

D Pareto


Feedback

A fishbone chart is most useful for helping to determine cause and effect. A control chart is useful

for seeing the changes in a process; this would include effects but not necessarily causes. A run chart

is most useful for viewing data over a time sequence. A Pareto chart uses two types of charting

techniques to determine statistical information, but it is not necessarily useful for determining cause

and effect.

Q31. The administration of a hospital has discovered that a lack of communication among different

hospital departments has led to overspending and unnecessary errors in patient care. The

administration has asked the CPHQ to assemble a team that can improve department

communication and address the problems. What type of team would be most useful for this task?

A Work group

B Self-directed

C Cross functional

D Quality circle

Feedback

The key here is the need for a team that can find ways to improve communication among the

different departments. This type of team would need to be cross functional, because it would be

composed of people from the different departments who would then be delegated to communicate

with one another and pass on the communication to others in their respective departments. The

other types of teams – work group, quality circle, and self-directed – all have their place in

professional improvement, but a cross-functional team would be best in this situation.

Q32. A hospital has recently conducted extensive updates on its website and wants to make sure

that the new site is ready to be made available to the public. What is the CPHQ’s role in this?

A Evaluate the changes that have been made in the website and recommend improvements

B Review the website to ensure that the reported information is accurate and complete

C Compare the website to other hospital sites to ensure that the new site compares favorably

D Compile a list of required information for the website and report this to the hospital

Feedback

In terms of public reporting, such as websites, the CPHQ’s role is primarily one of ensuring that the

information presented to the public is accurate and complete. He might evaluate the changes and

recommend improvements, but this falls under the larger role of making sure the information is

accurate and complete. Similarly, the other answer choices – comparing the new site to other

hospital sites and compiling a list of required information – would fall under this larger category of

ensuring accuracy and completeness in the information.


Q33. All of the following are roles of the CPHQ in terms of performance improvement teams

EXCEPT:

A Taking part as a member of performance improvement teams

B Guiding the expectations of performance improvement teams

C Removing members from performance improvement teams

D Directing the activities of performance improvement teams

Feedback

The CPHQ is not necessarily responsible for removing members from the performance improvement

teams. He might recommend removal, but the decision is likely to come from a higher source. The

CPHQ is, however, expected to direct the activities, guide the expectations, and take part as a

member of performance improvement teams.

Q34. A healthcare facility has decided to establish a performance improvement team to see where

the facility can make positive changes. Before assembling the team, what is the primary role of the

CPHQ in assisting the healthcare facility?

A Aid in developing a list of performance standards for the performance improvement team to

follow

B Provide the healthcare facility with reports about performance improvement team results from

other facilities to offer a comparison

C Research past performance improvement team results to see what changes can be made for the

new team’s activities

D Suggest appropriate members for the performance improvement team to ensure team unity and

the completion of goals

Feedback

Before the team is assembled, the primary role of the CPHQ is to aid the facility in developing a list

of performance standards for the team to follow. After all, the team cannot accomplish much if it

does not know what the goals are. The other answer choices represent activities that might be part

of the process, but the primary step is certainly to identify the standards.

Q35. After a performance improvement team has completed its activities, what is the primary role

of the CPHQ?

A Disband the group and discontinue current activities of the performance improvement team but

maintain a core group of members for ongoing review

B Compose and present a report to the administration about the results of a performance

improvement team


C Disseminate the results of the performance improvement team to all employees within the health

facility

D Report the performance improvement results to the public to ensure organizational transparency

Feedback

After a performance improvement team has completed its activities, the CPHQ is expected to

compose a report and present the results to the healthcare facility’s administration. The CPHQ does

not necessarily have the authority either to disband the team or to maintain a core group for

ongoing review. He is also unlikely to disseminate the results to other employees; the purpose of the

performance improvement team is generally intended for administrative review. Also, unless the

public has been made aware of the performance improvement team, there is no need to report the

results to those outside the facility.

Q36. A CPHQ has all of the following responsibilities toward improving patient safety EXCEPT:

A Appointing a supervisor for a patient safety program

B Incorporating new technology into a patient safety program

C Helping to develop a patient safety program

D Setting and reviewing goals for a patient safety program

Feedback

In terms of improving patient safety, the CPHQ’s responsibilities include the following: helping to

develop a patient safety program, incorporating new technology into a patient safety program, and

setting and reviewing goals for a patient safety program. The CPHQ’s responsibilities do not

necessarily include the responsibility of appointing a supervisor for a patient safety program. That

particular task will likely fall to others within hospital administration.

Q37. A review of supplies determined that a clinic is running low on several items essential for

operation. With recent budget cuts, the clinic has to review costs carefully to find the best price for

each item. What is the CPHQ’s role in this?

A Oversee the purchase of each item to ensure cost management

B Determine which items need to be purchased from which supplier

C Assist in developing a list of suppliers, by cost, for each item

D Delegate the purchasing of each item to the appropriate department

Feedback

Among the answer choices provided, the CPHQ is responsible only for assisting in the process of

developing a list of suppliers. The responsibilities do not include overseeing the actual purchase (as

this is the responsibility of the purchasing department), determining the specific items (as this falls

to individual departments), or delegating the purchasing of each item to the appropriate


department (as most large purchases would be grouped under the responsibility of the purchasing

department).

Q38. Which of the following performance improvement models would be the best recommendation

for a clinic that wants to discover the source of problems in patient care, eliminate these problems,

and achieve consistently high quality results in patient care?

A FOCUS

B Six Sigma

C LEAN

D PDCA

Feedback

Six Sigma is recommended as a performance improvement model that enables an organization to

reduce problems and, more importantly, achieve consistency in results. The other performance

improvement models – FOCUS, PDCA, and LEAN – offer variations of problem identification and

reduction, but only Six Sigma specifically focuses on generating consistently good results.

Q39. One of the largest departments within a hospital has been running over budget for some time.

The increasing expenditure has become problematic, and therefore the department has been asked

to maintain a budget. What is the CPHQ’s role in this?

A Provide the department with the software tools to enable it to set a manageable budget

B Assist the department in developing a manageable budget and reviewing it for compliance

C Follow the hospital administration’s guidelines in setting a budget for the department

D Appoint a financial advisor to support the department in developing a compliant budget

Feedback

The CPHQ is responsible for assisting the department in developing a manageable budget and

reviewing it for compliance. He or she is not necessarily responsible for setting the budget; that

would require the assistance of the department. Providing software tools to help with developing a

budget would be part of the process, but the process is not limited to this. Additionally, the CPHQ

might appoint a financial advisor, but this again is part of the process but not the only part.

Q40. A clinic is looking into adding a new computer software program to update an outdated

program. The new computer system will keep better track of patient records and will enable the

clinic to streamline the care that patients receive. What is the CPHQ’s role in this?

A Advise the clinic to implement the software because of its value in improving patient care

B Create a simulation for the software to allow the clinic to see how it operates day to day

C Research the history of the software to see how it has impacted other clinics


D Assist the clinic in evaluating the pros and cons of the software

Feedback

In this situation, the CPHQ’s role is limited primarily to assisting the clinic in evaluating the pros and

cons of the software. Advising the clinic to adopt the software would come after the necessary

evaluation process, while researching the software and creating a simulation would be part of the

evaluation process, but each item is limited in itself. The larger goal for the CPHQ is one of

evaluation to assist the facility in making the best decision.

Q41. Which of the following is the primary role of the CPHQ in terms of committee meetings?

A Disseminate information from the committee meeting to different departments

B Review the topics to be discussed in the committee meeting

C Lead the committee meeting as an objective participant

D Organize and maintain the information from the committee meeting

Feedback

For committee meetings, the CPHQ should be involved in organizing and maintaining the

information from the meetings; this information might include the minutes from the meetings or

any reports presented at the meetings. The CPHQ does not need to lead the meetings or

disseminate information from meetings to the departments. It should also be noted that the activity

of reviewing topics from the meeting is likely to fall under the larger role of organizing and

maintaining meeting information.

Q42. A hospital has implemented a quality program to improve the overall quality of patient care. It

is discovered, however, that the program is running over budget, so the hospital administrative

board conducts a review of the program to see if it should continue. What is the CPHQ’s role in this?

A Evaluate the financial benefits of the program and demonstrate these to the board

B Prove to the administrative board that the quality program should continue in the hospital

C Create a committee to review the quality program and develop a list of reasons to keep it

D Assist the administrative board in making a final decision about the quality program

Feedback

The role of the CPHQ is to evaluate the financial benefits of the quality program and to present these

to the board. The CPHQ is not obligated to prove to the board that the quality program should

continue; indeed, unless asked specifically to do so, this would be overstepping the boundaries of

professionalism. He also is unlikely to assist the board in making a final decision or creating a

committee to review the program. Again, unless the CPHQ is asked to perform any of these tasks,

the role is limited to one of evaluating the financial benefits and demonstrating them as objectively

as possible.


Q43. A hospital needs to decide whether or not to incorporate a new feature into its current

services, and as a result has commissioned qualitative research that will provide detailed feedback.

Specifically, the hospital would like to collect opinions from patients and other hospital customers

with a wide range of experience and backgrounds. Which of the following types of assessments is

most likely to be of use to the hospital?

A Team analysis

B Case study

C Survey

D Focus group

Feedback

The focus group will be most useful in providing the hospital with a broad range of opinions, as well

as detailed feedback. The survey would limit answers to those available among the answer choice

options, so this would not necessarily guarantee detailed feedback. The team analysis would largely

remove patient and customer opinion from the decision. The case study would isolate findings to a

single scenario and would fail to offer broad findings and detailed feedback.

Q44. A disagreement has arisen between the hospital administration and the members of one of its

departments. The disagreement is in connection with the authority of the different parties involved

and whether or not the administration can require the department to perform a certain task. What

is the CPHQ’s role in this?

A Consider the statements from both sides and participate in finding a solution that meets the

expectations of both parties

B Advise the department to respect the authority of the hospital administration and to follow its

expectations for department performance

C Review the rules establishing authority and inform the parties about how these rules apply to the

department and the administration

D Create a review board to act as a mediator between the hospital administration and the

department to find an agreeable solution

Feedback

In terms of a dispute, the CPHQ’s role is only to understand how the lines of authority are drawn and

to present this information to the parties involved. He should not take sides in any way, making

answer choice B incorrect. Additionally, he is not responsible for mediating or even finding a solution

(unless asked specifically to do so). The role in this case is largely one of providing the information

and allowing the parties to consider it.

Q45. The process of risk management for the CPHQ includes all of the following EXCEPT:

A Prevention of risk


B Reporting of incidents

C Identification of risk

D Analysis of effects

Feedback

The CPHQ is responsible for the following, in terms of risk management: identifying the risk,

analyzing the effects of the risk, and preventing the risk. These responsibilities do not necessarily

include the responsibility of reporting an incident of risk; that may or may not apply, depending on

the source of the risk. (It should be noted, however, that the CPHQ is responsible for reviewing the

incident report about the risk; of course, this is not the same as actually reporting an incident of

risk.)

Q46. A surgery department's monthly case review revealed twenty-six records meeting the criteria.

Six records did not meet the criteria. When calculating the incidence risk, the denominator is

6

20

26

32

Answer: D

The total number of records was 32, i.e. 26 + 6. As explained in our article on Measures of

Occurrence (members-only content), the incidence risk r is the proportion of new cases that occur in

a population initially free of the condition during a specified period of time:

Risk Formula

Content Category: Information Management

Cognitive level required for a response: Application

Tasks on the CPHQ exam content outline to which the question is linked: Participate in development

of data definitions, goals, triggers, and thresholds

Q47. As the Director of Quality at Hospital X, you have been appointed to lead a team to improve

patient flow through the hospital system.

At your first team meeting, some people expressed their excitement over the new project while

others were unsure of their rôles and responsibilities. After several meetings, team members

disagreed on various issues, sometimes leading to heated debates. Cliques began to form within the


group, and some members resisted taking on more tasks. Collective decisions were difficult to make.

Over the next few weeks, the team gradually began to respect your authority as the team leader. As

team members knew one another better, they began to work more closely and socialize together. It

is evident that the team has developed a stronger commitment to the team goal. Meaningful

progress is finally being made but your participation is still required.

What is the term commonly used to describe the current stage of team development?

Norming

Performing

Forming

Storming

Question 1 Explanation:

Answer: A

In 1965, psychologist Bruce Tuckman described five stages of team development and behaviour:

Forming, Storming, Norming, and Performing. In 1977, he added a fifth stage to his Forming-

Storming-Norming-Performing team-development model: Adjourning.

Content Category: Performance Measurement and Process Improvement

Cognitive level required for a response: Application

Tasks on the CPHQ exam content outline to which the question is linked: Evaluate team

effectiveness (e.g., dynamics, outcomes)

Q48. “Underuse is evidence by the fact that many scientifically sound practices are not used as often

they should be, For example, biannual mammography screening in woman ages 40 to 69 has been

proven beneficial and yet is performed less than 75 percent of the time.” This is the categorization

of:

A. Defects

B. La of professionalism in Medical field

C. La of care

D. Healthcare practice

Q49. __________ is a term applied when the proper clinical car process is not executed

appropriately, such as giving the wrong drug to a patient or incorrectly administering the correct

drug.

A. Underuse

B. Overuse

C. Misuse

D. Illegal use


Q50. Crossing the Quality Chasm provided a blueprint for the future that classified and unified the

components of quality through six aims for improvement, chain of effects, and simple rules for

redesign of healthcare. The six aims for improvement, viewed also six dimensions of quality. Which

of the following is NOT out of those dimensions?

A. Safe

B. Care centered

C. Efficient

D. Effective

Q51. ______________ can be measured by how well evidence-based practices are followed, such as

the percentage of time diabetic patients receive all recommended care at each doctor visit, the

percentage of hospital-acquired infections, or the percentage of patients who develop pressure

ulcers (bed sores) while in the nursing home.

A. Safe care

B. Equitable care

C. Effective care

D. Timely care

Q52. Today’s patients’ perception of the quality of our healthcare system is not favorable. In

healthcare, quality is household word that evokes great emotion, including:

A. Frustration and despair, exhibited by patients who experience healthcare services firsthand or

family members who observe the care of their loved ones

B. Anxiety over the ever-increasing costs and complexities of care

C. Patient centered measures

D. Timely care that may be experienced in terms of performance of services

Answer: A, B

Q53. There is a story of an intensive care unit (ICU) at Dominican Hospital in Santa Cruz Country,

California. Dominican, a 379-bed community hospital, is part of the 41-hospital Catholic Healthcare

West system. “We used to replace ventilator circuit for incubated patients daily because we thought

this helped to prevent pneumonia,” explained Lee Vanderpool, vice president. “”But the evidence

shows that the more you interfere with that device, the more often you risk introducing infection. It

turns out it is often better to leave it alone until it begins to become cloudy, or ‘gunky,’ as the

nonclinicians say.” The hospital staff learned an important lesson from this experience that:

A. Evidence is more powerful than intuition

B. Intuition is more powerful than evidence

C. Efforts improve mortality rate

D. Introduction f a new protocol, or any new idea, involves education

Q54. A number of attributes can characterize the quality of healthcare services. As, there are

different groups involved in healthcare, such as physicians, patients and health insurers, tend to

attach different levels of importance to particular attributes and as a result define quality care

differently. Which of the following is/are NOT out of those attributes?

A. Technical performance


B. Responsiveness to patient preferences

C. Excess staff

D. Amenities

Q55. Quality and technical performance refers to how well current scientific medical knowledge and

technology are applied in a given situation. It is usually assessed in terms of:

A. Timeliness and accuracy of the diagnosis

B. Appropriateness of therapy and other medical interventions are performed

C. The quality of interpersonal relationships

D. Both A & B

Q56. The quality of amenities of care refers to the characteristics of the setting in which the

encounter between patient and clinician takes place, such as:

A.Comfort

B. Comfort, care and access

C. Comfort, convenience and privacy

D. Responsive to patient preferences

Q57. In earlier formulations, responsiveness to patients’ preferences was just one of the factors seen

as determining the quality of patient clinician interpersonal relationship. But, now it is translated

into many factors. Which of the following is out of such factors?

A. Respect for patients’ values

B. Respect for patients’ preferences

C. Respect for patients’ expressed needs

D. Respect for Respect for patient’s convenience

Q58. Which of the following groups is least likely to report errors?

a. Primary care physicians

b. Support staff

c. Independent contractors

d. Nurses

C: Independent contractors are the group least likely to report errors. In part, this is because

they have the least personal interest in the success of the health care facility. Also, an

independent contractor is more likely to view his employment as tenuous, and is therefore

more nervous about admitting mistakes. A system that explicitly avoids punishing those who

report will improve the incidence of error reporting among independent contractors.

Q59. Which of the following is vastly different from the others?

SIPOC

DMAIC

PDCA

PDSA


A: SIPOC (suppliers, inputs, process, outputs, customers) is different from the other three

acronyms, which are sequential programs for quality improvement. SIPOC, on the other

hand, is a form of diagram that enables Six Sigma practitioners to identify the important

components of process improvement. DMAIC (define, measure, analyze, improve, control) is

a general structure for eliminating defects. Similarly, PDCA (plan, do, check, act) and PDSA

(plan, do, study, act) are structures for the improvement of processes.

Q60. A presentation on the basic structures and processes of clinical governance would be

most useful...

For small teams of employees

For the organization as a whole

For the directorate

For individual employees

B: A presentation on the basic structures and processes of clinical governance would be most useful

for the organization as a whole. Such a general presentation would really only be effective as an

introduction for the entire organization. Other presentations, such as those delivered to small

teams, the directorate, or individual employees, will need to be more targeted and specific. It is a

good idea to introduce the basic concepts of clinical governance to the entire organization because

the transition to this method of management often entails drastic change.

Q61. What are the three dimensions of quality in the most common framework for quality

assessment?

Service, process, and mortality

Structure, process, and outcomes

Population, structure, and satisfaction

Function, outcomes, and clinical status

B: In the most common framework for quality assessment, the three dimensions of quality are

structure, process, and outcomes. The structure of care is the basic elements of the population and

the health care provider. Care can only succeed to the extent that the structure allows. Elements of

structure include the characteristics of the community, healthcare organization, population, and

healthcare provider. Process is the dynamic act of care provision. It includes both technical and

interpersonal excellence, because quality care requires not only competence but responsiveness to

the emotional needs of patients. Finally, outcomes are the full range of results from care. Clinical

status and mortality are outcomes, but so is patient satisfaction.

Q62. A top-level administrator is asked by a lower-level manager to lead a meeting of new

employees. What should the administrator do first?

Review the notes from previous meetings

Discuss the meeting participants with the manager

Organize preliminary notes

Compose an introductory statement


B: The administrator’s first step should be to discuss the meeting participants with the manager. This

discussion will inform and organize preparation for the meeting. It is likely that the manager will

have valuable insight into the existing knowledge base and special characteristics of the new

employees. It may be useful for the administrator to review the notes from previous meetings or

organize his notes, but these steps should take place after talking with the manager.

Question 63) Administrative databases are an excellent source of data for reporting on clinical

quality, financial performance, and certain patient outcomes. Use of administrative database is

advantageous for the following reason EXCEPT:

A. They are less expensive source of data than other alternatives such as chart review or prospective

data collection

B. The incorporate transaction system already used in the daily business operations of a healthcare

organization (frequently referred to as legacy system)

C. The volume of available indicators is 1000 times greater than that available through other data

collection techniques

D. data reporting tools are available as part of the purchased system or through third-party add-on

or services.

Question 64) Patient registries are a powerful source of quality improvement data because of their

detail and straightforward design. Registries usually are specialty or procedure specific, such as:

A. Acute myocardial infraction

B. Total joint replacement

C. Patient’s bile test

D. Enrollment in disease management program

Question 65) Healthcare purchasers and payers are demanding that providers demonstrate their

ability to provide high quality patient care at fair prices. Specifically, they are seeking:

A. Objective evidence that hospitals and other healthcare organizations manage their costs well

B. Current performance

C. Baseline information

D. Objective evidence that hospitals and other healthcare organizations satisfy their customers and

have desirable outcomes

Question 66) An organization may develop performance measure internally or adopt them from a

multitude of external resources. However, regardless of the source of performance measure each

measure should be evaluated against certain characteristics to ensure a credible and beneficial

measurement effort. Which of the following characteristics is/are critical to performance measures?

A. Reliability

B. Validity

C. Cost-effectiveness

D. Interpret-ability

Question 67) _______ are similar to proportion measures in that both are based on count (or

attributes) data but differ in that the numerator and the denominator address different attributes.


A. Ratio measures

B. Continuous variable measures

C. Predicted rate

D. Outcome measures

Question 68) "Likelihood of desired health outcomes" corresponds to clinicians' view that, with

respect to outcomes, there are only probabilities and not certainties owing to factors such as

patients' genetically determined physiological reliance that influence:

A. Outcomes of care and yet are beyond clinicians' control

B. Outcomes of care and now are within clinicians' control

C. The primary concenrs of patients

D. High cost interventions

The Certified Professional in Healthcare Quality (CPHQ) examination.

Question 69) If you decided to interview ten patients in your emergency room on a given day and

drew conclusions about your emergency services from these people. You have taken limited data

and made a huge jump in logic. This jump is known as:

A. Stereotyping

B. Over-generalization

C. Ecological fallacy

D. Quota sampling

Question 70) Stratification is the separation and classification of data into reasonably homogenous

categories, within the data, that are mutually exclusive and facilitate:

A. Data collection efforts

B. Discovery of patterns that would not be observed id data were aggregated

C. Skills that are based more experience than knowledge

D. frustrated measurement process

Question71) Which of following objectives is/are NOT essential for successful quality improvement

project and data collection initiative?

A. Identify the purpose of the data measurement activity (for monitoring at regular

intervals, investigation over a limited period, or one time study).

B. Identify the most appropriate data sources

C. Identify the most important measures for collection (the critical few).

D. Commonsense all the data collected that will provide the actual information

Question 72) The theory behind SPC (Statistical Process Control) is straightforward. It requires a

change in thinking from error detection to error prevention. The use of SPC in healthcare has a

number of benefits excluding:

A. Increased quality awareness on the part of healthcare organizations and practitioners

B. Increased focus on patients

C. The ability to base decisions on database

D. Moderation is processes that result in lengthening the outcomes having better quality care


Question 73) A surgeon’s wound infection rate is 32%. Further examination of which of the following

data will provide the most useful information in determining the cause of this surgeon’s

infection rate?

A. Mortality rate

B. Facility infection rate

C. Use of prophylactic antibiotics

D. Type of anesthesia used

Question 74) Which of the following describes the incorrect administration of a drug to a patient?

A. Overuse

B. Underuse

C. Misuse

D. Illegal use

Question 75) Crossing the Quality Chasm provided a blueprint for the future that classified and

unified the components of quality through six aims for improvement, chain of effects, and simple

rules for redesign of healthcare. The six aims for improvement, viewed also six dimensions of quality.

Which of the following is NOT out of those dimensions?

A. Safe

B. Efficient

C. Effective

D. Care centered

Question 76) Which of the following can be measured by how well evidence-based practices are

followed, such as the percentage of time diabetic patients receive all recommended care at each

doctor visit, the percentage of hospital-acquired infections, or the percentage of patients who

develop pressure ulcers (bed sores) while in the nursing home?

A. Safe care

B. Equitable care

C. Effective care

D. Timely care

Q77) Which of the following types of budgets itemizes the major equipment to be purchased in the

next year?

A. capital

B. variable

C. operating

D. zero-based

Q78) The separate services of Pharmacy and Nursing are having difficulty developing an action plan

for medication errors. Pharmacy Services states that Nursing Services causes the majority of the

problems related to errors, while Nursing Services states the opposite. The quality professional’s role

in resolving this problem is to:

A. provide them with directives on how to solve the problem.


B. facilitate discussion between the groups to enable them to assume ownership of their portions of

the problem.

C. assign the task to an uninvolved manager.

D. refer the problem to the facility-wide quality council.

Q79) The following represents two samples of five hospitals’ hysterectomy rates per

1,000 women aged 40-60 years of age:

Rates Mean Standard Deviation

Sample A 3, 5, 7, 8, 5 5.6 1.8

Sample B 4, 5, 6, 7, 5 5.4 1.1

In analyzing this information, it can be concluded that:

A. Sample A has more variability than Sample B.

B. Sample A’s performance is superior to

Sample B’s.

C. there are more cases in Sample B.

D. there is a data collection error in Sample B.

Q 80) A clinic is reviewing the option of adding a new program to its available treatments but

needs to be sure the program is worth the cost. What is the first step that the healthcare quality

management professional should take in this?

A. Create a cost-analysis plan that enables the clinic to add the program within budget

B. Revise the clinic’s budget to ensure that the treatment program can be added

C. Contact other facilities to generate feedback and see if the program should be added

D. Research the program and submit information indicating the feasibility of adding it

Q 81) A practitioner decision has generated controversy within a healthcare facility. What is one

important role of the healthcare quality management professional in this situation?

A. Contact the regulatory body to determine the correct procedure for practitioner

activities

B. Interview staff members to determine whether or not a risk management review is

needed

C. Develop a performance improvement activity to ensure that facility procedure is

followed

D. Evaluate the evidence from the practitioner and compare it to current practice

guidelines

Q 82) Which of the following represents an electronic entry process for physicians or

practitioners to create patient treatment instructions?

A. EMR

B. BCMA

C. CPOE


D. JCI

Q 83) A healthcare quality management professional is reviewing patient information during an

officially approved experimental treatment. Which of the following reflects qualitative data among

the patient details?

A. Blood pressure readings

B. Changes in weight

C. Mood during treatment

D. Cholesterol levels

Q 84) Which of the following types of team structures is best for combining employees with

different skill sets and areas of experience to complete a task?

A. Cross-functional

B. Work group

C. Quality circle

D. Self-directed

Q 85) What is the primary purpose of the Consumer Assessment of Health Providers and

Systems (CAHPS)?

A. To relieve data collection efforts by administrators

B. To offer patients an anonymous outlet for healthcare complaints

C. To capture patient satisfaction data in a universal manner

D. To provide a forum for more effective communication between patients and providers

Q86) As a manager, you see a need to strengthen patient safety within your organization. What

is the most effective way to introduce new patient safety measures into your organizational

culture?

A. As a manager, you see a need to strengthen patient safety within your organization.

What is the most effective way to introduce new patient safety measures into your

organizational culture?

B. Provide extensive mandatory training on patient safety

C. Assemble managers and require them to roll policies down to employees

D. Create a new set of organizational goals solely based on patient safety

Q 87) When does the credentialing process generally take place?

A. Prior to employment

B. Prior to termination

C. Every year of employment

D. Every five years of employment

Q88) What type of chart is most effective in demonstrating cause and effect?

A. Flowchart

B. Run chart


C. Fishbone diagram

D. Pareto chart


“Desire is the key to motivation, but it’s determination and commitment to an unrelenting pursuit of

your goal - a commitment to excellence - that will enable you to attain the success you seek.” Mario

Andretti

“If you wait, all that happens is you get older.” Mario Andretti


1- The role of IHI (Institute for Healthcare Improvement) and the NQF (National Quality Forum):

- IHI model of improvement

- IHI Global trigger tool

- IHI two ways to improve process reliability CH 1

- NQF role in developing standards and measures for public reporting and patient safety.

2- Utilization management is coming back, transitional planning (discharge planning) and may be

case management.

3- CH 8:

- OSHA (Federal Occupational Safety and Health Act)

- HIpaa (Health Insurance Portability and Accountability Act): focus on the sum of roles and

regulations to protect the confidentiality of patient and practitioner information. It includes

regulations for non-disclosure of some peer review and quality information in the court of law. In

addition to some other regulations about health coverage, fraud and abuse.

4- Diagnosis and procedures coding: MS-DRGs, ICD9, ICD 10

5- CH 7: Magnet recognition, Baldrige award, deemed status. Education and training for

accreditation surveys. (Plus what already studying in CH7)

6- The last part of CH 1: Focus on what is managed care as a concept, prospective payment system,

capitation (concept, benifits, fears), pay for performance (pay organizations for reporting their

measures as a proof of improvement in care coordination, cost and safety.It is a CMS initiative).

7- External reporting of patient safety measures and events: HEDIS (NCQA) and ORYX and core

measures (TJC)

8- Human Factors engineering in CH 3 section 9.5.4

9- Consider the latest updates of TJC national patient safety goals. Effective January 1, 2015.

Download the NPSGs Chapter using the link below :

http://www.jointcommission.org/assets/1/6/2015_NPSG_HAP.pdf


10- Consider these updates in the AHRQ list of sentinel/never events (don't answer merely based on

the severity remember (or the risk thereof) in the definition of the sentinel event. These types of

events are included in the following list with the events that cause disability and death):

http://psnet.ahrq.gov/primer.aspx?primerID=3

CPHQ Exam Topics:

• Types of Leaders

• Code of Ethics

• National Committee for Quality Assurance

• Barriers to System Change

• Tracer Methodology

• Cross-functional Teams

• Activity-based Costing

• ANCC Magnet Status

• Health Insurance Portability and Accountability Act

• Goals and Objectives

• Plan-Do-Check-Act

• Information Management Design

• Internal and External Sources of Data

• Ddata Collection Methodology

• National and International Quality Models

• Computer Hardware and Software

• Measures of Distribution

• Accreditation and Licensure

• Ishikawa Fishbone Diagram

• Pareto Chart

• Xerox 10-step Benchmarking Model

• Six Sigma Performance Improvement Model

• Scattergram Control Chart


• Emergency Medical Treatment and Active Labor Act

• Root Cause Analysis (RCA)

• Five Whys

• Tracer Methodology

• Healthcare Quality Improvement Act

• Performance Measurement and Improvement Planning

• Gantt Chart

• Juran quality planning process

• Delphi Technique

• Baldrige Award criteria

• Malcolm Baldrige National Quality Award

• Implementation

• Eight Disciplines of Problem Solving

• Credentialing and Privileging

• National Nosocomial Infections Surveillance

• Process variance monitoring

• Healthcare Quality Improvement Act

• Cost-utility Analysis

• Radiology Reviews

• Ethical and Clinical Conflicts

• Case Management

• Models of Integration

• Utilization Management

• Communication

• Patient Safety Strategy

• Organization's Patient Safety Culture

• Four Types of Data


• Joint Commission's National Patient Safety Goals

• IHI 5 Million Lives Campaign

• Negligence

• Education and Training

• Approaches to Teaching

• Practitioner Profiling

My Experience with CPHRM Exam

Sep 19, 2015805 views32 Likes19 CommentsShare on LinkedInShare on FacebookShare on Twitter

Dear readers I am writing this post to share with you my experience with the exam preparation and

my opinion about it. My goals are to help those who plan to take exam and to recruiters, managers

who will see the CPHRM credential on candidates CV.

I will start by explaining what is CPHRM, how I prepared for it, and my opinion about it.

According to AHA (American Hospitals Association) ''The Healthcare Risk Management

Professional’s primary duties include the prevention, reduction, and control of loss to the healthcare

organization, its patients, visitors, volunteers, physicians, other healthcare professionals and

employees' CPHRM hand book.

CPHRM (Certified Professional in Healthcare Risk Management) is governed by '' The American

Hospital Association Certification Center (AHA-CC) is a division of the AHA. Its mission is to create,

facilitate and administer the healthcare industry’s premier certification programs'' CPHRM hand

book. To my knowledge this the only specialized certification for healthcare sector.

The exam is administered by AMP (Applied measurement professional). This means the exam is

taken at recognized and monitored testing centers worldwide. CPHRM is not a self-study online

exam taken at home or where the candidate wants.

The exam content: (100 questions scored)

Clinical/Patient Safety (35 Questions)


Risk Financing (10 Questions)

Legal and Regulatory (24 Questions)

Healthcare Operations (20 Questions)

Claims and Litigation (5 Questions)

Passing score 72 correct answers

How I prepared for the exam:

References:

Ref 1: ASHRM’s CPHRM Exam Preparation Guide is updated and organized according to the most

current Certification Exam Content Outline.

Ref 2: Risk Management Handbook for Health Care Organizations, Student Edition.

Ref 3: CPHRM Flashcards.

Ref 4: CPHRM Practice Questions.

Ref 5: CPHRM Online Course by ASHRM

I didn’t use the 3 volumes books for handbook of risk management (the essentials, Clinical, business

risk). They are very detailed for exam preparation. However, the student edition (second reference

above) covers all the main domains for the exam.


They are good (3 volumes book) if you want to refer to specific things during the exam preparation.

For me they represent less than 5% of the exam preparation. Therefore, I recommend sticking with

the reference I used.

Also, I found that Ref 5 (the online course) content is very similar to Ref 1 (the prep guide).

Therefore, you can stick with the first four references (Ref 1 to Ref 4).

How to start your preparation:

First of all, keep in your mind that you can pass the exam and you are not less smart that those who

passed the exam.

Second, organize the flash cards into domains such risk financing, and claims. Keep them in your bag

and use them in your free time (in the coffee shop, while waiting in the bank or clinic), read each

group of cards three times. However, you need to do that on separate times i.e. you scheduled your

exam after three months, keep the cards reading ongoing during these three months don’t do it all

in the first week or first month, because by the third month you will start forgetting what read in the

first week.

Third, start your reading concurrently, for example start by the risk financing chapter ref 2 (the

handbook) then review the chapter in ref 1 (the preparation guide), make sure you understand don’t

just skim the chapter. I recommend reading each chapter twice.

Fourth, after finishing your concurrent reading of ref1 and 2, which should be finished by the second

month. Focus your reading on ref 1 for the last 4 weeks before the exam.

Tips and Tools:

- Don’t solve the questions in ref 1 in the book, have a note book outside and write your answers

there, because you need to redo the questions several times.


- Highlight the questions you answered wrongly, and review them frequently the last week before

the exam on a daily basis.

- Use the mind maps, especially in sections that requires memory (claims, insurance, laws and

regulations.

My opinion about CPHRM:

Well, CPHRM has some positives and negatives in terms of application and benefits. Taking the exam

is a good professional achievement, because of its specialization. It gave me a framework of looking

and analysing risk management problems, and understanding the structure and relation of domains

such as ethics to risk management. However, for those not working in USA, they will not have the

opportunity to implement USA related regulations and systems covered in the exam such as

reporting to health practitioner data bank and management of law suit. However, I still recommend

it for practitioners in the field and I recommend that AHA develop exam content that is applicable

for international exam takers.

Thank you