EMT Practice Test

1. Question Content...

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Question1: Licensing and accrediting bodies have relied heavily on structural measures of quality not only because the measures are relatively stable and thus easier to capture but:

Question2: The components which support successful implementation of performance improvement programs and attainment of
project goals and objective include/s:

Question3: Efficiency refers how well resources are used in achieving a given result. Efficiency whenever the resources used to
produce a given output are _____________.

Question4: Through ___________ the data collection staff can spot patient trends as they develop rather than receive the information after the patient have been discharged.
For instance, the incidence of ventilator-associated pneumonia sooner, or it may spot an increase in the rate of aspiration in stroke patients as it occurs.

Question5: 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?

Question6: Experts on delivering superior customer service suggest that healthcare organizations adopt the following set
principles EXCEPT:

Question7: Typically, patients receive questionnaires from two weeks to four months after discharge from the hospitals. This delay raises concern about the reliability of the patient's memory.
Memory studies have shown that:

Question8: Which of the following is most likely to be a benefit of concurrent ambulatory surgical case review?

Question9: Measurement of variation in health care and its application to quality improvement must begin with the identification
and articulation of:

Question10: Case-mix adjustment accounts for the different types of patients in institutions. Adjustment should be considered
when hospital survey results are being released to the public. The characteristics commonly associated with the
patient reports on quality of care are all of the following EXCEPT:

Question11: The manager's perspective on quality differs markedly from that of clinicians and patients on:

Question12: The percentage of patients with congestive heart failure who are receiving an ACE inhibitor is an example of retrospective measure. The use of ACE inhibitors in the population is indicated for all patients with an ejection fraction of less than 40 percent. The ejection fraction is not part of the typical administrative database.
Sometimes the information is contained:

Question13: When continuing unique events, one uses a p-chart. The number plotted on a chart would be either a proportion or a percentage. When counting total events (e.g., the number of falls per patient day each month), one plots a ratio on a u-chart.
Examples of attributes data plotted as percentage on p-charts include figures such as (Choose two):

Question14: Statistical analysis conducted with control charts is different from what some consider "traditional research" (e.g. hypothesis testing, development of p-values, design of randomized clinic trials). Traditional research is designed to compare the results at time one (e.g. the cholesterol levels of a group of middle-aged men) with the results at time two (typically months after the initial measure).
Research conducted in this manner is referred to as ___________________.

Question15: Face validity is based on the logical relationship among variables (or questions) and refers to the extent to which a
scale measures the structure, or theoretical framework, it is designed to measure (e.g., satisfaction).

Question16: Which of the following are hardware components that would be included in a computerized management information
system?

Question17: Face validity is based on the logical relationship among variables (or questions) and refers to the extent to which a scale measures the structure, or theoretical framework, it is designed to measure (e.g., satisfaction).

Question18: All of the following are characteristics of probability sampling EXCEPT:

Question19: 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:

Question20: Amenities may cover areas as mentioned below EXCEPT:

Question21: Using the same operational definition becomes even more critical if you are trying to compare several hospitals or clinics in a system. When national hospitals are made, the operational definition challenge becomes extremely complex.
All good measurements begin and end with _____________.

Question22: Some argue that administrative data are less reliable than data gathered by chart review. However, administrative data can be just as reliable as data from chart review when they are properly cleaned and validated, the indicator definitions are clear and concise, and measures from the CR system were validated using approach/es:

Question23: 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:

Question24: IHI has designed a model to support its breakthrough collaborative series. A key component of the collaborative
model is the ability of participants to work with other organizations to discuss:

Question25: The CAHPS (Consumer Assessment of Healthcare Providers and Systems) program is a multiyear public- private initiative to develop standardized surveys of patients' experiences with ambulatory and facility-level care.
Healthcare organizations, public and private purchasers, consumers, and researchers use CAHPS results to:

Question26: Which of the following processes is most cost-effective in preventing unnecessary resource consumption in the hospital?

Question27: Many organizations establish condition-specific patient registries for their more sophisticated quality improvement projects because they do not have a reliable source of clinical information.
The use of patient registries is advantageous for the following reasons EXCEPT:

Question28: Which of the following monitors provides patient outcome information?

Question29: Once listing posts system is in place, root-cause analyses can be performed to identify particular problems, such as a staff member or medical group that contributes to problems, or problems that are systemic to the delivery of care, such as an antiquated manual appointment system.
Listing post strategies include (Choose two):

Question30: Attribute data are discrete whole numbers and not continuous. Examples of attribute data plotted as ratio data on u-
charts include figures such as:

Question31: - Health care provider accountability
- Decision making public reporting
- Organizational evaluation
- National performance improvement goals and activities
These are the performance measures identified by health organizations in order to meet:

Question32: Generally, medical record review and prospective data collection are considered the most time-intensive and expensive ways to collect information.
Many reserve these methods for highly specialized improvement projects or use them to answer questions that have:

Question33: Quality circles are groups of five to ten employees, with management support, who meet to solve problems and
implement new procedures. The aim/s of quality circle activities is/are:

Question34: ________________ is the degree to difference between survey results when the scales are applied in different settings. Survey scores should reflect differences institutions, where care is presumably different.

Question35: Best- practice standards in healthcare continue to evolve in response to new medicines and treatment option. The
following list details a number of concerns in the creation of physician profiles EXCEPT:

Question36: Universities often evaluate applicants for admission on the basis of, among other things, the applicants' scores on
standardized tests. The scores are thus one of the criteria by which program judge the Quality of their applicants.
However, although two programs may use the same criterion - scores on a specific standardized examination-to
evaluate applicants, the programs may differ markedly on standards: One program may consider applicants
acceptable if they have scores above the 50th percentile, whereas the score above the 90th percentile may be the
standard of acceptability for the other program. This example clearly defines the difference between:

Question37: __________ 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.

Question38: Studies comparing self-reports with proxy reports do not consistently support the hypothesis that self- reports are more accurate than proxy reports.
However, conclusions drawn from studies in which responses were verified using hospital and physician records show that, on average (Choose two):

Question39: The term __________ brings in mind that indicator panel on an automobile, which is most useful when the car is moving as a way for the driver to monitor key performance metrics such as speed, fuel level, engine performance, temperature and direction from digital display units.

Question40: Prospective data collection also relies on medical record review, but it is completed during a patient's hospitalization or visits rather than retrospectively.
Obviously this method of data collection is expensive but:

Question41: Through ___________ the data collection staff can spot patient trends as they develop rather than receive the
information after the patient have been discharged. For instance, the incidence of ventilator-associated pneumonia
sooner, or it may spot an increase in the rate of aspiration in stroke patients as it occurs.

Question42: For example, if you are using a survey to gather patient satisfaction feedback by email, you would not send a survey t
o ever y patient. You would start by sending surveys t o roughly 50 percent of the patients an see how many are
returned. This limited survey allows you to determine the response rate. Assume that 25 percent of these patients
return the surveys. The next task is to determine how representative of the total population these respondents are. To
test this question, you need to develop a profile of the total population. Typically, this profile is based on standard
demographics such as gender, age, type of visit, payer class, and whether the respondent is a new or returning
patient. If the distribution of these characteristics in the sample is similar (within 5 percent) to that found in the total
population, you can be comfort able t hat your sample is reasonably representative of the population. If the
characteristics of the sample and the population show considerable variation, however, you should adjust your
sampling plan. This example clarifies that:

Question43: Convenience sampling produces a biased sample that is basically a collection of anecdotes that cannot be applied generally to larger populations.
Convenience sampling is also known as:

Question44: Depending upon the direction of a measure's improvement, outlier interpretations can be:

Question45: An alternative to a walk-through is a similar technique called ___________. A staff member asks permission to accompany a patient through the visit and take notes on patients' experience.

Question46: 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:

Question47: IHI has designed a model to support its breakthrough collaborative series.
A key component of the collaborative model is the ability of participants to work with other organizations to discuss:

Question48: The CAHPS (Consumer Assessment of Healthcare Providers and Systems) program is a multiyear public-private
initiative to develop standardized surveys of patients' experiences with ambulatory and facility-level care. Healthcare
organizations, public and private purchasers, consumers, and researchers use CAHPS results to:

Question49: 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 no clinicians say." The hospital staff learned an important lesson from this experience that:

Question50: Which of the following process can be judged as having highest quality of care?

Question51: The ability to report survey results at an actionable level is critical; in most cases, actionable level means:

Question52: TQC is excellence driven rather than defect driven-a system that integrates:

Question53: The comparison chart interpretation will result in one of the following scenarios, regardless of the type of measure EXCEPT:

Question54: Some database projects rely on medical record review because many of the data are not available in administrative database, e.g.

Question55: Statistical analysis conducted with control charts is different from what some consider "traditional research" (e.g.
hypothesis testing, development of p-values, design of randomized clinic trials). Traditional research is designed to
compare the results at time one (e.g. the cholesterol levels of a group of middle-aged men) with the results at time
two (typically months after the initial measure). Research conducted in this manner is referred to
as___________________.

Question56: Because of the goals of care can be defined broadly, outcome measures have come to include the costs of care as well
as patients' satisfaction with care. In formulations that stress the technical aspects of care, however outcome typically
refers to:

Question57: When groups are asked to evaluate how effective they are with respect to will, ideas and execution, they consistently provide bothersome answers. Self-assessment to hundreds of healthcare professional is administered in United States and abroad.
Most respondents mark:

Question58: The downside of _____________ is cost. It is very costly and time consuming, and it often requires several full time
data analysts.

Question59: There are many different control charts. However, it its initial efforts, the average facility can manage with only four.
Which of the following is/are NOT out of those?

Question60: Convenience sampling produces a biased sample that is basically a collection of anecdotes that cannot be applied
generally to larger populations. Convenience sampling is also known as:

Question61: Stratification is the separation and classification of data into reasonably homogenous categories, within the data, that are mutually exclusive and facilitate:

Question62: The weight of scoring system is based on an emphasis Baldrige places on ___________ and an organization's ability to demonstrate performance and improvement in the following areas:
Product and service outcomes

Customer-focused outcomes

Financial and market outcomes

Workforce-focused outcomes

Process effectiveness outcomes

Leadership outcomes

Question63: __________ 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.

Question64: The downside of _____________ is cost. It is very costly and time consuming, and it often requires several full time data analysts.

Question65: Basically an operational definition is a description in quantifiable terms, of what to measure and the specific steps needed to measure it constantly.
A good operational definition (Choose two):

Question66: The percentage of patients with congestive heart failure who are receiving an ACE inhibitor is an example of
retrospective measure. The use of ACE inhibitors in the population is indicated for all patients with an ejection
fraction of less than 40 percent. The ejection fraction is not part of the typical administrative database. Sometimes the
information is contained:

Question67: Organizational size affects the ability to disseminate best practices

Question68: The comparison chart interpretation will result in one of the following scenarios, regardless of the type of measure
EXCEPT:

Question69: Quality improvement approaches are derivatives and models of the ideas and theories developed by thought leaders
and include all of the following EXCEPT:

Question70: The creation of an information technology infrastructure to analyze the performance of all physicians in a healthcare system can be useful in:

Question71:

Question72: Collecting patient __________ data also is becoming a standard evaluation measure in the education and certification of medical, nursing, and allied health students.

Question73: The distinction between inpatient and outpatient data is an important consideration in planning the data collection
process because:

Question74: The focus of Lean methodology is a "ba to basics" approach that places the needs of customer first through five steps.
Which of the following is NOT out of those steps?

Question75: 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:

Question76: Weighting of scores is frequently recommended if members of a (patients) population have unequal probabilities of being selected for the sample. If necessary, weights are assigned to the different observations to provide a representation picture of the total population.
Weighting should be considered when

Question77: A social service department regularly monitors the number of inappropriate referrals, the timeliness of discharge
planning, and the number of days of discharge delays. What additional monitor should be added to evaluate the
appropriateness of social service interventions?

Question78: The increased focus on and mandate for healthcare data place healthcare providers in a different situation than they
have known in the past. Providers document such things and, unfortunately, many providers struggle to address the
measurement mandate proactively, which leads organizations to assume a defensive posture when external
organizations release the data. Which of the following ways show/s the responses of provider in such cases?

Question79: For cheing the outcomes our focus of attention is blood pressure of patients with diabetes.
Its criteria and standard can be respectively:

Question80: Crossby's quality improvement process is based on the Absolutes of Quality Management.
Which of the following is/are out of those absolutes?

Question81: The Baldrige criteria were originally developed and applied to business; however, in 1997, healthcare-specific criteria
were created to help healthcare organizations address challenges such as focusing on core competencies, introducing
new technologies, reducing costs, communicating and sharing information electronically new alliance with healthcare
providers , and maintaining market advantage. The Baldrige healthcare criteria are built on the set of interrelated core
values and concepts. Which of the following is NOT out of those values and concepts?

Question82: When quality is measured in terms of structure the focus is on the relatively static characteristics of the individuals
who provide care and of the settings where the care is delivered. These characteristics include ____________ of
professionals who provide care and the adequacy of the facility's equipment, and overall organization.

Question83: Generally, effective performance measurement benefits organizations in the following way/s EXCEPT:

Question84: In healthcare, many terms call for more precise operational definitions that how do an organization define the terms such as (Choose two):

Question85: Rapid cycle testing is designed to reduce the cycle time of new process implementation from months to days.
To prevent unnecessary delays in testing or implementation, teams or units using rapid cycle testing must remain focused on the testing of solutions and avoid:

Question86: One major difference between traditional quality assurance (QA) and quality improvement (QI) is that QI:

Question87: Six sigma (3.4 defects per million) is a system for improvement developed over time by Hewlett-Packard, Motorola, General Electric, and others in the 1980s and 1990s.
The aim of six sigma is:

Question88: The performance improvement methodology is a carefully chosen, strategically driven, value based, systematic, organization-wide approach to the achievement of specific, meaningful, high-priority organizational improvements.
The plan should include:

Question89: Within any unit, organization, or system, there will be barriers to spread and adoption (e.g., organizational culture,
communication, leadership support). However, failure to transfer knowledge effectively may result in:

Question90: Health care provider accountability
Decision making public reporting
Organizational evaluation
National performance improvement goals and activities
These are the performance measures identified by health organizations in order to meet:

Question91: Which of the following types of budgets itemizes the major equipment to be purchased in the next year?

Question92: Physicians' actions have been noted be a major contributor to unexplained clinical variation in healthcare.
Unexplained clinical variation leads to increased healthcare costs, medical errors, patient frustration, and poor clinical
outcomes. The increase in information being collected on physician practice patterns has begun to expose widespread
variations in practice. In healthcare, variation exists among providers by:

Question93: Which of the following are hardware components that would be included in a computerized management information system?

Question94: _________________ standards denote level of quality that can be reached under the best conditions, typically conditions similar to those under which efficacy is determined. These standards are especially useful as a reference points being evaluated should set as a benchmark.

Question95: The concept of cost-effectiveness in Healthcare delivery means:

Question96: The American Society for Quality has formed six categories of quality tools. Which of the following is NOT out of those
categories?

Question97: Systematic sampling is achieved by numbering or ordering each element in the population (e.g., time order, alphabetical order, and medical order) and then selecting every kth element.
The key point that most people ignore when doing a systematic sample is that:

Question98: The primary benefit of adopting a countrywide or global uniform set of discharge data is to:

Question99: Organizational size affects the ability to disseminate best practices

Question100: Stratification is the separation and classification of data into reasonably homogenous categories.
It allows understanding of differences in the data caused by all of the following EXCEPT:

Question101: In fact, because patients' satisfaction is so influenced by __________________ rather than to the more indiscernible technical ones-health maintenance organizations, hospitals and other health care delivery organizations have come to view the quality of nontechnical aspects of care as crucial to attractions and retaining patients.

Question102: Which of following objectives is/are NOT essential for successful quality improvement project and data collection initiative?

Question103: 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 no clinicians say." The hospital staff learned an important lesson from this experience that:

Question104: There is an art to constructing patient satisfaction surveys that produce valid, reliable, and relevant information.
Likewise, survey validation itself is a time-consuming and complex undertaking. A quality improvement team can:

Question105: There is an art to constructing patient satisfaction surveys that produce valid, reliable, and relevant information. Likewise, survey validation itself is a time-consuming and complex undertaking.
A quality improvement team can:

Question106: The creation of an information technology infrastructure to analyze the performance of all physicians in a healthcare
system can be useful in:

Question107: A social service department regularly monitors the number of inappropriate referrals, the timeliness of discharge planning, and the number of days of discharge delays.
What additional monitor should be added to evaluate the appropriateness of social service interventions?

Question108: Benchmarking is goal directed and promotes performance improvement by all of the following ways EXCEPT:

Question109: Joseph juran defined quality as consisting of two different but related concepts. The first form of quality is income
oriented and includes features of t he product t hat meet customer needs and thereby produce income (i.e., higher
quality costs more). The second form of quality is cost oriented and emphasizes:

Question110: The test-retest reliability coefficient is a method to measure instrument reliability. This method measures the degree
of correspondence between:

Question111: Measures of central tendency describe the:

Question112: A data analyst, using a clinical decision support system (administrative database), discovered a higher- than-expected incidence of renal failure (a serious complication) following coronary artery bypass surgery.
The rat e was well above 10 percent for the most recent 12 months increased over the last six quarters.
However, the clinical decision support system did not contain enough detail to explain whether this complication resulted from the coronary artery bypass graft procedures or was a chronic condition present on admission.
To find the answer, the data analyst uses different steps. This example illustrates:

Question113: Which part of a job description should be used in a criteria-based performance evaluation?

Question114: Some database projects rely on medical record review because many of the data are not available in administrative
database, e.g.

Question115: The weight of scoring system is based on an emphasis Baldrige places on ___________ and an organization's ability to
demonstrate performance and improvement in the following areas:
Product and service outcomes
Customer-focused outcomes
Financial and market outcomes
Workforce-focused outcomes
Process effectiveness outcomes
Leadership outcomes

Question116: Which of the following is the relationship between clinical outcomes and patient satisfaction?
Besides measuring morbidity and mortality, this management takes into account the quality of healthcare received from the patient's perspective.

Question117: Knowledge about _______ is crucial to making valid judgments about quality of care using either process or outcome
measures. If we know that a given clinical intervention was undertaken in circumstances that match those, under
which the intervention has been shown to be efficacious, we can be confident, that the care was appropriate and, to
the extent of good quality.

Question118: _______________ is based on a simple principle-statistical probability. In other words, within a known population of
size n, there will be a fixed probability of selecting any single element.

Question119: The problem with using readily available, convenient data is that the data usually do a poor job of answering the questions necessary to access performance. Ten years ago this "good enough" approach to data collection might have been acceptable. Today, however, because of the increasing demand to demonstrate effectiveness of care and efficiency of healthcare processes, this mind set is not acceptable.
Performance quality and excellence do not occur because organizations do what they have always done or what is convenient.
Most healthcare observers agree that:

Question120: 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?

Question121: The test-retest reliability coefficient is a method to measure instrument reliability.
This method measures the degree of correspondence between:

Question122: "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: