Reference no: EM132325800

Part 1

1. The science of innovation diffusion focuses on
a. the rate at which change spreads
b. how new technologies are evaluated
c. how policymakers influence change
d. how managers affect change

2. Theories of innovation diffusion center on three basic themes:
a. Financial incentives, policy incentives, moral imperatives
b. Complexity of the innovation, financial implications of the innovation, people who implement the innovation
c. How the innovation is perceived, the characteristics of the people who choose to adopt or not adopt the innovation, the context in which the innovation is introduced
d. How the innovation is messaged, how the innovation affects daily workflow, how the intervention affects senior leaders

3. Compatibility is
a. the perception of the difficulty of the innovation's application
b. the degree to which potential adopters perceive the innovation as being consistent with their past experiences, values, and needs
c. the ability to use the innovation on a trial basis before deciding to adopt it
d. the ease with which a potential adopter can view others trying the change first

4. The most important group of individuals to adopt an innovation is the
a. innovators
b. laggards
c. late majority
d. early adopters

5. The continuity model of change describes the phenomenon of
a. abrupt change in response to an immediate challenge
b. practitioners changing readily on the basis of a level of preparedness for a particular change
c. physicians responding to evidence-based medicine
d. a culture of continuous improvement

6. Which of the following is NOT a reason most practitioners are not using guidelines in everyday practice?
a. Qualities of the guidelines themselves (e.g., are they simple and practical, and do they increase staff workload?)
b. Characteristics of the practice setting
c. Inadequate incentives
d. Physicians who don't care about their patients

Part 2

7. The largest and most powerful payer in the United States is
a. Blue Cross Blue Shield
b. Centers for Medicare & Medicaid Services
c. United Healthcare
d. Individuals

8. The Leapfrog Group initially identified three practices that would create a "leap" in quality and patient safety. Those three practices are
a. hospitals having an electronic health record, implementation of evidence-based guidelines, moving more surgeries to outpatient settings
b. increased physician leadership in hospitals, medication reconciliation, surgical checklists
c. hospitals having anelectronic health record, chronic disease management programs, increased nurse ratios in intensive care units
d. hospitals having computerized provider order entry, evidence-based hospital referral, intensive care unit staffing by physicians experienced in critical care medicine

9. Which of the following are examples of "advocates" for quality improvement?
a. National Patient Safety Foundation
b. Quality improvement organizations
c. Robert Wood Johnson Foundation
d. Institute for Healthcare Improvement
e. A, C, and D
f. All of the above

10. The Healthcare Effectiveness Data Information Set (HEDIS) database is developed and maintained by the
a. National Committee for Quality Assurance (NCQA)
b. Centers for Medicare and Medicaid Services (CMS)
c. Agency for Healthcare Research and Quality (AHRQ)
d. Institute for Healthcare Improvement (IHI)

11. Which of the following is NOT one of the primary uses of quality measures?
a. Accreditation
b. Public reporting
c. Justification that no improvement efforts are necessary
d. Payment incentives to improve care
e. Internal quality reporting

12. A simple definition of value in healthcare is
a. high-quality healthcare at the lowest cost
b. affordable healthcare
c. evidence-based healthcare
d. ensuring everyone has access to healthcare through affordable insurance premiums

Part 3

13. The procedure and process by which one party provides a justification and is held responsible for its actions by another party who has an interest in the action is
a.responsibility
b.accountability
c. certification
d.accreditation

14. The process by which an entity external to the organization providing good or services evaluates the organization against a set of predetermined requirements or desirable attributes and publicly attests to the results is
a. certification
b. accountability
c. recognition
d. accreditation

15. In the accreditation process, measurement can involve which of the following methods?
a. On-site observation
b. Review of data from clinical records
c. Interviews with patients
d. All of the above
e. A and B only

16. Throughout the 1980s, HMO accountability grew in response to
a. robust regulatory requirements
b. market forces
c. patient horror stories
d. All of the above

17. One of the early pioneers of health plan accreditation has been the
a. Institute for Healthcare Improvement
b. National Business Group on Health
c. National Committee on Quality Assurance
d. Centers for Medicare and Medicaid Services

18. The Joint Commission was created specifically to provide accreditation to
a. health plans
b. hospitals
c. home health agencies
d. ambulatory surgery centers

Part 4

19. The concept of value-based purchasing was initially applied in healthcare based on the premise that
a. consumers would choose providers based on increased information on cost and quality measures available directly to consumers
b. employers would compete for employees by providing health plans with greater value
c. physician offices would compete for consumers by demonstrating greater effectiveness in caring for patients
d. plans would compete for employer/employee premium dollars by demonstrating greater effectiveness in caring for covered members and greater efficiency in paying for care services

20. The expansion of networks has led to a reduction in relative purchasing power. As a result, purchaser focus has shifted from
a. individual plan performance to individual provider performance
b. individual provider performance to individual plan performance
c. medical group performance to hospital performance
d. individual plan performance to employee health behaviors

21. "Demand management" uses
a. employee-based interventions
b. shareddecision making
c. growing provider networks
d. All of the above
e. A and B only

22. The poles of the spectrum of payment incentives are
a. fee-for-service and pay-for-performance
b. pay-for-performance and capitation
c. bundled payment and capitation
d. fee-for-service and capitation

23. Which of the following is NOT a lesson learned from the Bridges to Excellence program?
a. Create meaningful incentives
b. Measure what matters
c. Better quality always costs more
d. Avoid "tournament-style" programs

24. Early lessons learned about medical homes reveal that
a. it is relatively easy to transform a traditional physician practice into a medical home
b. the evidence of a positive financial impact is uniformly strong
c. the search for sustainable funding models continues
d. there is no evidence of positive financial impact

Part 5

25. The first curve and second curve in healthcare represent
a.volume-based care and value-based care
b.fee-for-service and capitation
c.physician-centered care and patient-centered care
d.free-market healthcare and socialist healthcare

26. The second curve of healthcare is characterized by
a. encouraged coordination
b. payment that rewards value
c. thriving stand-alone care systems
d. All of the above
e. A and B only

27. Which of the following is NOT one of the must-do strategies for all hospitals in the next few years?
a. Develop integrated information systems
b. Improve efficiency through productivity and financial management
c. Shift to an employment model for physicians
d. Use evidence-based practices to improve quality and patient safety
e. Align hospitals, physicians, and other providers across the continuum of care

28. The chapter identifies four emerging quality-of-care issues:
a. Population health management, implementation of the Affordable Care Act, reducing hospital-acquired infections, payment reform
b. Reducing readmissions and improving the continuum of care, transitioning to population health management, spreading improvement, innovative demonstrations and pilots
c. Patient-centered medical homes, bundled payments, accountable care organizations, population health management
d. Reducing readmissions, health insurance exchanges, physician alignment, spreading improvement

29. Which of the following contribute(s) to unplanned readmissions?
a. Inadequate discharge planning
b. Poorly coordinated care among multiple settings
c. Premature discharge from hospital
d. All of the above

30. One criticism of efforts to decrease readmissions is that
a. Readmissions are largely driven by patient and community factors outside of the hospital's control
b. Current risk-adjustment methodology is imperfect
c. Attributing the readmission to the appropriate hospital is difficult
d. All of the above
e. A and B only