Chapter 18: Effective Quality and Productivity ManagementMultiple Choice Questions
1. Which of the following statements is correct?
a. Quality suffers when greater efficiency is required.
b. Improved efficiency means doing more with fewer resources.
c. Improved efficiency requires associates to work harder.
d. Quality and productivity can be improved simultaneously.
2. Why is the improvement of productivity particularly challenging in patient care delivery?
e. Caregivers are poorly trained.
f. Low morale is rampant among caregivers.
g. Patient care is labor intensive.
h. Patient care costs are mostly fixed costs.
3. How can productivity be enhanced?
i. Produce desirable quality at the least cost.
j. Have lower staff to patient ratios.
k. Lower the skill mix.
l. Maximize quality and the resource inputs.
4. A nursing facility achieves reliability in delivering quality when
m. the facility takes a holistic approach to the delivery of services.
n. quality remains uncompromised when no one is watching.
o. desirable outcomes are produced.
p. improvements in quality continue over time.
5. Which of the following is an indicator of improved quality?
q. An increase in positive outcomes
r. An increase in the staff skill mix
s. Delivery of care that is holistic
t. A reduction in the cost of delivering care
6. If the incidence of pressure ulcers acquired in the facility increases, it indicates an issue with
u. uniformity of care.
v. holistic care.
w. quality outcomes.
x. regularity of care.
7. The use of evidence-based practices can improve quality because
y. they apply to specific clinical situations
z. they benefit all patients regardless of race or pay type
aa. they are the best practices
bb. standardized work processes decrease variability in care delivery
8. Which of the following organizations does not develop clinical practice guidelines?
cc. American Medical Directors Association.
dd. Institute of Medicine.
ee. Agency for Healthcare Research and Quality.
ff. American Geriatric Society.
9. What is essential for the implementation of evidence-based protocols?
gg. Expert consultation.
hh. Ongoing research.
ii. Patient and family empowerment.
jj. Staff training.
10. Technical quality is mainly associated with
kk. repairs, upkeep, and sanitation.
ll. increased productivity while maintaining the level of quality.
mm. clinical care.
nn. observations and experiences of consumers.
11. In the framework of quality, structures represent
oo. resource inputs.
pp. delivery of services.
qq. customer satisfaction.
rr. clinical quality.
12. In the framework of quality, staffing levels are an example of
vv. technical quality.
13. In the framework of quality, use of clinical protocols is an example of
zz. technical quality.
14. Having in place all the necessary structural elements of quality only ensures that
aaa. the facility will use the correct processes.
bbb. not all outcomes will be produced.
ccc. the facility will deliver quality of life, but not quality of care.
ddd. the facility has the capabilities to deliver adequate care.
15. Clinical outcomes are evaluated against ____ to determine whether preestablished treatment and intervention goals have been met for each patient.
eee. clinical practice guidelines
fff. a facility's common practices
ggg. a facility's individualized services
hhh. the plan of care
16. What role do certification standards play in quality improvement?
iii. They improve quality by requiring the use of evidence-based practices.
jjj. They establish minimum standards of quality.
kkk. They produce uniform outcomes across the states.
lll. They do not play a role in quality improvement.
17. Under the Affordable Care Act, the Quality Assurance Performance Improvement program will place increased emphasis on
mmm. certain quality outcomes
nnn. clinical practice guidelines
ooo. research on quality improvement
ppp. use of the PDSA cycle
18. Measurement of quality requires
19. Which of the following defines whether quality goals are being met?
uuu. Structural measures
vvv. Process measures
www. Outcome measures
xxx. Attributes of quality
20. How can a facility measure customer satisfaction?
yyy. By taking a show of hands at the family council meeting.
zzz. By having a researcher talk to family members who visit the facility.
aaaa. By evaluating the results of the annual certification survey.
bbbb. By using an appropriately designed survey instrument.
21. Using a survey instrument, a nursing home scored an 8 on customer satisfaction in 2008. The same facility scored a 10 in 2009. Improvement in customer satisfaction can be inferred only if
cccc. the survey instrument gives reliable results.
dddd. in previous years, the score was less than 8.
eeee. the survey instrument is designed by a researcher.
ffff. the second result is more than 10.
22. A nursing home is trying to assess customer satisfaction with the services the facility delivers, but the survey instrument it is using contains mainly items pertaining to the facility's location, geographic access, and ability to pay. The survey instrument in this case does not have
23. After quality has been measured, evaluation requires the ____ of results.
24. Which of the following is regarded as external customers?
oooo. Governing board
qqqq. Non-long-term-care providers
rrrr. Potential customers in the target market
25. Which of the following is regarded as internal customers?
ssss. The facility's personnel who receive information, services, and support from fellow employees
tttt. The facility's residents and family members
uuuu. Residents, family members, and visitors
vvvv. Providers within the long-term care industry
26. In a continuous quality improvement program, process improvement is best undertaken by
wwww. quality consultants
xxxx. department managers
yyyy. associates responsible for the process
zzzz. interdisciplinary work teams
27. In the four-stage PDSA cycle, uncovering quality problems is associated with
28. In the four-stage PDSA cycle, actual data gathering is associated with
29. The following is associated with the "study" stage in the PDSA cycle:
iiiii. Implementing a change on a small-scale trial basis.
jjjjj. Selecting an appropriate benchmark.
kkkkk. Learning the PDSA system.
lllll. Evaluation of the changes that have been made.
30. A well-developed CQI program results in ____ learning.
ooooo. as needed
31. Value is added when
qqqqq. management does not cut costs.
rrrrr. a reduction in quality is less than the extent of cost-cutting.
sssss. both quality and costs increase proportionally.
ttttt. quality is improved to a greater extent than costs are increased.
32. According to Deming, what should inspections be used for?
uuuuu. They should be used as the principal tool for quality control.
vvvvv. They should be used for identifying employees who need further training.
wwwww. They should be used as an information gathering tool.
xxxxx. They should be used for identifying processes that need improvement.
33. According to Deming, CQI should be used to find ____ problems.