[2025年12月10日]CPHQテスト準備できるトレーニング練習テスト試験問題
試験問題解答ブレーン問題集でCPHQ試験問題集PDFを使おう
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質問 # 56
A hospital received 50 Incident reports describing falls that occurred within aone-monthperiod. Which of the following actions should be taken?
- A. Ensure that each Incident report is correctly linked to the appropriate patient health record.
- B. Compare details from the Incident reports against the current fall prevention procedures.
- C. Review the Incident reports to Identify contributing factors.
- D. Separate incident reports based on injury status.
正解：C
解説：
When a hospital receives incident reports describing falls, it is crucial to review these reports to identify contributing factors1. This process is part of 'Incident Reporting in Healthcare,' which aims to highlight an emerging problem in a non-blaming way to root out the cause of the error or the contributing factors1. By identifying these factors, the hospital can take appropriate measures to prevent future incidents and improve patient safety1.
While options A, B, and C are also important steps in managing incident reports, option D is the most immediate and crucial action. Comparing details from the incident reports against current fall prevention procedures (option A) and ensuring each report is correctly linked to the appropriate patient health record (option B) are steps that can be taken after the initial review. Separating incident reports based on injury status (option C) can be part of the analysis process after identifying contributing factors.
References:
https://www.quasrapp.com/blog/incident-reporting-in-healthcare/
質問 # 57
In successful implementation of performance improvement programs, use of a single improvement methodology across all improvement initiatives is critical to facilitating a cohesive and consistent approach to improvement within the organization. An organization can develop improvement methodologies internally or can adopt them from external sources.
Which of the following components is related to this strategy?
- A. Selection and use of a performance improvement methodology
- B. Establishment of partnership with key stakeholder
- C. Staff understanding
- D. Establishment of a performance improvement oversight entity
正解：A
質問 # 58
A healthcare quality professional has the following data on a hospital's surgical site infection rates:
Procedure
Hospital Infection Rate
95% Confidence Interval
State Mean Infection Rate
Total Hip Replacement
0.4%
0.2%-0.6%
0.9%
Total Knee Replacement
1.1%
0.8%-1.2%
1.0%
ACL Reconstruction
1.5%
1.4%-1.6%
1.5%
Total Shoulder Replacement
1.3%
1.0%-1.6%
0.9%
Which procedure is the best area for focused quality improvement?
- A. ACL Reconstruction
- B. Total Shoulder Replacement
- C. Total Hip Replacement
- D. Total Knee Replacement
正解：B
解説：
Detailed Explanation:
The best area for focused quality improvement is determined by comparing the hospital's infection rate to the state mean infection rate and the confidence interval:
Analysis of Each Procedure
Total Hip Replacement: Hospital infection rate is lower than the state mean (0.4% vs. 0.9%), suggesting a lower risk than average.
Total Knee Replacement: Infection rate is slightly above the state mean (1.1% vs. 1.0%), but within a narrow confidence interval (0.8%-1.2%).
ACL Reconstruction: Infection rate aligns with the state mean (1.5%) and has a narrow confidence interval (1.4%-1.6%), indicating less room for reduction.
Total Shoulder Replacement: Hospital rate (1.3%) is higher than the state mean (0.9%), with a broader confidence interval (1.0%-1.6%), suggesting potential variability and room for improvement.
Conclusion
Total Shoulder Replacement (D) has the greatest opportunity for improvement, as its infection rate is notably higher than the state mean, and the confidence interval suggests variability in infection rates.
References:
This approach is consistent with CPHQ guidelines for identifying performance improvement areas, where quality professionals focus on processes with higher-than-average rates and wider confidence intervals.
質問 # 59
Which of the following approaches best allows an agency to align Its activities with organizational goals?
- A. data outcomes management
- B. force field analysis
- C. balanced scorecard
- D. benchmarks
正解：C
解説：
The Balanced Scorecard is a strategic planning and management system that organizations use to align business activities with the vision and strategy of the organization, improve internal and external communications, and monitor organization performance against strategic goals12. It translates an organization's mission and strategy into a set of performance measures that provide the framework for a strategic measurement and management system1. The Balanced Scorecard approach provides a clear prescription as to what companies should measure in order to 'balance' the financial perspective2.
References: 1
https://asana.com/resources/strategic-planning-models
https://asana.com/resources/strategic-planning-models
質問 # 60
The control chart above indicates which of the following?
- A. Special causevariation
- B. Unique cause variation
- C. No variation
- D. Common cause variation
正解：A
解説：
* Understanding Control Charts and Variation TypesControl charts are used to monitor process stability over time by identifying different types of variation. Variations on a control chart can generally be categorized as:
* Common Cause Variation: Random variation that is inherent to the process, typically within control limits.
* Special Cause Variation: Variation that is unusual, not inherent to the process, and suggests an external factor or a change in the process.
* Unique Cause Variation: This term is not commonly used in statistical process control; it likely refers to a special or unusual cause.
* No Variation: Indicates a completely stable process with no changes over time, which is rarely the case in practice.
* Interpreting the Control ChartThe control chart shows the rate of restraint hours per 1000 patient hours over time. Key indicators of special cause variation include:
* Data points outside the control limits (Upper Control Limit and Lower Control Limit).
* Patterns, such as runs of data points above or below the mean, or sudden shifts and spikes in data.
In this chart, we see several spikes (particularly in July and September of 2013 and again in October 2014) that reach or exceed the upper control limit. This suggests that certain events or changes in these periods caused the restraint hours to increase significantly, which is not due to the inherent process variation.
* Conclusion for the Correct AnswerSince the chart displays data points that go outside the control limits and exhibit unusual patterns, it is indicative of Special Cause Variation. This suggests external factors or specific changes in the facility process during those periods that require further investigation to determine the cause of the spikes.
References:
NAHQ Documentation on Control Charts and Process Variation
"Using Statistical Process Control to Monitor Quality Improvement in Healthcare" (NAHQ, 2019)
質問 # 61
Based on this matrix, which of the following ideas should the team address first?
- A. 3 and 4
- B. 2 and 5
- C. 1 and 7
- D. 6 and 8
正解：B
解説：
Based on the matrix provided, ideas 2 and 5 should be addressed first because they are in the quadrant that represents both high impact and high feasibility. Prioritizing ideas that are both highly feasible and likely to have a significant impact ensures that the organization can quickly and effectively implement changes that will yield the most benefit.
* High Impact and High Feasibility: Ideas in this quadrant are typically the most promising because they are not only achievable (high feasibility) but also expected to produce meaningful improvements (high impact).
* Strategic Prioritization: Addressing these ideas first allows the team to generate quick wins, which can build momentum and support for further quality improvement efforts.
* Comparison to Other Options:
* A. 1 and 7: High impact but low feasibility-these ideas might be more challenging to implement and could require more resources or time.
* B. 3 and 4: Low impact and low feasibility-these ideas are neither easy to implement nor likely to have a significant effect, making them lower priorities.
* D. 6 and 8: High feasibility but low impact-while these ideas are easier to implement, their impact might be minimal, so they should not be the primary focus initially.
References: NAHQ materials on prioritization in quality improvement emphasize the importance of focusing on initiatives that combine high impact with high feasibility to optimize resource use and maximize outcomes.
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質問 # 62
Using the data below, which issue would be identified as a priority for further performance improvement?
Issue
High Risk
High Strategic Priority
Cost
Customer Satisfaction
Quality Concern
Pressure Injuries
4
4
1
4
5
Medication Errors
3
1
2
1
5
Transfer to Higher Level of Care Within One Hour of Admission
2
5
4
1
3
Miscommunication of Abnormal Findings
4
3
5
1
4
- A. Pressure Injuries
- B. Medication Errors
- C. Transfer to Higher Level of Care Within One Hour of Admission
- D. Miscommunication of Abnormal Findings
正解：A
解説：
Prioritizing performance improvement initiatives involves assessing multiple factors, such as risk, strategic alignment, cost, customer impact, and quality concerns. The data provided assigns scores (likely on a scale of
1-5, with 5 being the highest) across these dimensions. A high-priority issue would score highly in areas like risk, quality concern, and strategic priority, indicating significant impact on patient safety and organizational goals.
Option A (Pressure Injuries): Scores 4 (High Risk), 4 (High Strategic Priority), 1 (Cost), 4 (Customer Satisfaction), 5 (Quality Concern). This issue has high scores in risk, strategicpriority, customer satisfaction, and the highest quality concern (5), making it a strong candidate for prioritization due to its impact on patient safety, quality, and organizational goals.
Option B (Medication Errors): Scores 3 (High Risk), 1 (High Strategic Priority), 2 (Cost), 1 (Customer Satisfaction), 5 (Quality Concern). While it has a high quality concern (5), the low strategic priority (1) and moderate risk (3) reduce its overall priority compared to pressure injuries.
Option C (Transfer to Higher Level of Care Within One Hour of Admission): Scores 2 (High Risk), 5 (High Strategic Priority), 4 (Cost), 1 (Customer Satisfaction), 3 (Quality Concern). Despite a high strategic priority (5), the lower risk (2) and quality concern (3) suggest it is less critical for immediate patient safety.
Option D (Miscommunication of Abnormal Findings): Scores 4 (High Risk), 3 (High Strategic Priority), 5 (Cost), 1 (Customer Satisfaction), 4 (Quality Concern). High risk and quality concern are notable, but the lower strategic priority (3) and high cost (5) make it less urgent than pressure injuries, which align better with strategic and quality goals.
CPHQ Objective Reference: According to the NAHQ CPHQ Content Outline, Domain 4: Performance and Process Improvement, Objective 4.2 states, "Prioritize performance improvement activities based on risk, impact, and alignment with organizational goals." Pressure injuries are a high-risk, high-quality concern issue with strong strategic alignment, making them the priority. The NAHQ study guide emphasizes that issues like pressure injuries, which are preventable and impact patient outcomes, are often prioritized due to regulatory scrutiny (e.g., CMS Hospital-Acquired Conditions) and patient safety implications.
Rationale: Pressure injuries score highest in quality concern (5) and have strong scores in risk (4), strategic priority (4), and customer satisfaction (4). Their low cost score (1) suggests improvement may be resource- efficient, further supporting prioritization. This aligns with CPHQ principles of focusing on high-impact, preventable conditions that affect patient outcomes and organizational performance.
Reference: NAHQ CPHQ Study Guide, Domain 4: Performance and Process Improvement, Objective 4.2, and CMS Hospital-Acquired Conditions guidelines, which prioritize pressure injuries due to their preventability and impact.
質問 # 63
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. Both A and B
- D. Timeliness and accuracy of the diagnosis
正解：C
質問 # 64
For example, a bathroom scale that always reads 185 pounds is reliable. Although the scale may be reliable and
consistent, it is not valid if the person does not weigh 185 pounds. So in conventional use, the term validity refers to:
- A. The degree to which the measurement made by a interviews corresponds to some fair value
- B. The extent to which an empirical measure accurately reflects the meaning of the concept under consideration
- C. The degree to which the measurement made by a survey corresponds to some true or real value
- D. The degree to which the measurement made by a focus group corresponds to some true or real value
正解：B
質問 # 65
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:
- A. Over-analysis
- B. Multiple PDSA cycles
- C. Buy-in
- D. Focused testing
正解：A
質問 # 66
After discharge, most patients with a mental health diagnosis have not been compliant with follow-up visits.
Which of the following Is the best way to Improve patient compliance?
- A. Include handoutsinthe discharge documents on the Importance of keeping follow-up appointments.
- B. Communicate to noncompliant patients that appointments should be kept.
- C. Initiate a process where the discharge planners call patients prior to the follow-up visit
- D. Benchmark with other facilitiesinthe area to determine the rate of patient compliance.
正解：C
解説：
* According to the National Association for Healthcare Quality (NAHQ), one of the core competencies of healthcare quality professionals is patient safety, which includes ensuring effective transitions of care and reducing preventable readmissions12.
* One of the strategies to achieve this goal is to improve patient compliance with follow-up visits, which can help monitor patient outcomes, prevent complications, and provide continuity of care34.
* Among the four options given, the best way to improve patient compliance is to initiate a process where the discharge planners call patients prior to the follow-up visit. This is because:
* A phone call can serve as a reminder for the patient to keep the appointment, as well as an opportunity to address any barriers or concerns that the patient may have34.
* A phone call can also help establish rapport and trust between the patient and the discharge planner, which can increase patient satisfaction and adherence4.
* A phone call can also allow the discharge planner to confirm the patient's understanding of the discharge instructions, medication regimen, and follow-up plan, and to provide any additional education or support that the patient may need34.
* The other options are less effective because:
* Benchmarking with other facilities in the area to determine the rate of patient compliance may provide some insight into the current performance and best practices, but it does not directly address the specific needs and preferences of the individual patient5.
* Including handouts in the discharge documents on the importance of keeping follow-up appointments may increase the patient's awareness and knowledge, but it may not be sufficient to motivate the patient to act on the information, especially if the patient has low health literacy, cognitive impairment, or mental health issues.
* Communicating to noncompliant patients that appointments should be kept may sound authoritative and judgmental, which may alienate the patient and reduce their willingness to cooperate. Instead, a patient-centered and empathetic approach that acknowledges the patient's challenges and preferences may be more effective. References: 1: [NAHQ Code of Ethics] 2:
[NAHQ HQ Principles] 3: The Importance of Patient Follow-Up | MagMutual 4: The Importance of Patient Follow-Up and Service Recovery 5: [The Financial Case for Quality as a Business Strategy] : [Utilization of Improvement Methodologies by Healthcare Quality Professionals During the COVID-19 Pandemic] : [Understanding the Evolving Landscape of Healthcare Quality] : https://nahq.org/about-nahq/code-of-ethics/ : https://nahq.org/products/hq-principles/ :
https://nahq.org/resources/the-financial-case-for-quality-as-a-business-strategy-2/ :
https://nahq.org/resources/journal-for-healthcare-quality/utilization-of-improvement-methodologies-
1: https://nahq.org/news-media/news/understanding-the-evolving-landscape-of-healthcare-quality/
質問 # 67
__________________ arises from a single or small set of causes that are not part of event or process and therefore
can be traced, identified and implemented or eliminated. In general, researchers are interested in this variation
because they can link-or-assign variation to a single specific cause and act accordingly.
- A. Assignable variation
- B. Process variation
- C. Random variation
- D. Performance variation
正解：A
質問 # 68
Which of the following is the key responsibility of a healthcare quality professional in all types of facilities and organizations?
- A. Coordinate internal support for quality improvement activities.
- B. Resolve the management problems of the organization.
- C. Identify safety issues of the facility.
- D. Correct clinical quality problems.
正解：A
解説：
The key responsibility of a healthcare quality professional across all types of facilities and organizations is tocoordinate internal support for quality improvement activities. This role is central to their function in maintaining and enhancing healthcare quality. Here's why:
* Facilitating Quality Improvement Initiatives: Quality professionals are responsible for leading and coordinating quality improvement projects, ensuring that these initiatives are aligned with organizational goals and are effectively implemented.
* Engaging the Workforce: Coordinating internal support involves engaging with various departments and staff members to foster a culture of quality. This includes providing the necessary tools, training, and resources for quality improvement activities, as well as ensuring that there is a collaborative approach to solving quality-related issues.
* Sustaining Continuous Improvement: Quality professionals must ensure that quality improvement activities are ongoing and not just one-time efforts. By coordinating internal support, they help embed continuous improvement into the organization's operations, making quality a core aspect of the healthcare facility's culture.
* Linking Quality with Outcomes: By coordinating internal support, healthcare quality professionals ensure that quality improvement activities are directly linked to patient outcomes, regulatory compliance, and overall organizational performance.
References: (Based on Healthcare Quality NAHQ documents and resources)
NAHQ Code of Ethics and Standards of Practice, Section on Quality Improvement.
CPHQ Study Guide, Section on Roles andResponsibilities of Quality Professionals.
Quality Management in Health Care, Discussion on Leadership in Quality Improvement.
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質問 # 69
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? (Choose three.)
- A. We can move in a better way without doing competition with others
- B. The data are not stratified and do not represent appropriate comparisons.
- C. The data are old (typically one or two years) and do not reflect our current performance
- D. Our patients are siertan those at the other hospitals in our comparison group (i.e., no risk adjustments were made to the data).
正解：B、C、D
質問 # 70
__________ accounts for the different types of patients in institutions. Adjustments should be considered when
hospital survey results are being released to the public.
- A. Proxy response
- B. Recall base
- C. Bias or mode effects
- D. Case-mixed adjustment
正解：D
質問 # 71
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. Both A & B
正解：A
質問 # 72
Which of the following is the most effective means of communicating commitment to patient safety?
- A. CEO presenting most recent medication error rates to the governing body
- B. posters and bulletin boards on units displaying up-to-date patient falls data
- C. senior leaders having discussions on units with front-line staff
- D. articles by a CEO in the employee newsletter
正解：C
解説：
Effective communication in healthcare is paramount for patient safety. It is the accurate transfer of information between two or more providers1. Communication fails when it is incomplete, ineffective, or inappropriate, resulting in patient harm1. Good teamwork and effective communication rely on mutual respect, problem-solving, and sharing of ideas1.
Senior leaders having discussions on units with front-line staff is a direct and effective means of communication. It allows for immediate feedback, clarification of doubts, and a better understanding of the situation on the ground2. This direct interaction can foster a culture of safety, encourage the sharing of ideas, and promote problem-solving1.
In contrast, the other options (A, B, and C) are less direct and may not effectively communicate the commitment to patient safety. For example, presenting error rates or displaying data on bulletin boards (options A and C) are important but may not lead to immediate action or feedback. Similarly, articles in a newsletter (option B) may not reach all staff or may not be read thoroughly.
Reference: 1, 2
https://psnet.ahrq.gov/perspective/approach-improving-patient-safety-communication
質問 # 73
An organization has compiled the scatter plots below:
Based on these plots, which of the following conclusions can be made by the quality professional?
- A. Setting 2 has a significant correlation between complication rate and time to positive outcome.
- B. Setting 1 has a strong positive correlation between complication rate and time to positive outcome.
- C. Complication rates are not causing longer time to positive outcome at setting 2.
- D. Complication rates are causing longer time to positive outcome at settling 1.
正解：B
解説：
A scatter plot is a graphical tool that shows the relationship between two continuous variables by plotting data points at their corresponding values on the x-axis and y-axis1.
To interpret a scatter plot, we need to look at the direction, strength, and shape of the relationship between the variables2.
The direction of the relationship indicates whether the variables tend to increase or decrease together (positive correlation) or in opposite directions (negative correlation).
The strength of the relationship indicates how closely the data points cluster around a line or curve that best fits the data. A common measure of the strength of the linear relationship is the correlation coefficient , which ranges from -1 to 1. The closer the absolute value of R is to 1, the stronger the linear relationship2.
The shape of the relationship indicates whether the data points follow a straight line (linear relationship) or a curved pattern (nonlinear relationship).
Based on these criteria, we can analyze the scatter plots for Setting 1 and Setting 2 as follows: Setting 1:
The scatter plot shows a clear upward trend, indicating a positive correlation between complication rate and time to positive outcome. The data points are tightly clustered around a line, indicating a strong linear relationship. The R^2 value of 0.9533 on the plot is close to 1, which means that the linear model explains 95.33% of the variation in the complication rate. Therefore, we can conclude that Setting 1 has a strong positive correlation between complication rate and time to positive outcome.
Setting 2: The scatter plot shows a scattered pattern, indicating a weak or no correlation between complication rate and time to positive outcome. The data points are widely spread around a line, indicating a weak linear relationship. The R^2 value of 0.4923 on the plot is far from 1, which means that the linear model explains only 49.23% of the variation in the complication rate. Therefore, we cannot conclude that Setting 2 has a significant correlation between complication rate and time to positive outcome, or that complication rates are causing longer time to positive outcome at setting 2.
Reference: 1: 8.8 Scatter Plots, Correlation, and Regression Lines 2: Scatterplots: Using, Examples, and Interpreting
質問 # 74
The control chart above indicates which of the following?
- A. Unique cause variation
- B. Special cause variation
- C. No variation
- D. Common cause variation
正解：B
解説：
* Understanding Control Charts and Variation TypesControl charts are used to monitor process stability over time by identifying different types of variation. Variations on a control chart can generally be categorized as:
* Common Cause Variation: Random variation that is inherent to the process, typically within control limits.
* Special Cause Variation: Variation that is unusual, not inherent to the process, and suggests an external factor or a change in the process.
* Unique Cause Variation: This term is not commonly used in statistical process control; it likely refers to a special or unusual cause.
* No Variation: Indicates a completely stable process with no changes over time, which is rarely the case in practice.
* Interpreting the Control ChartThe control chart shows the rate of restraint hours per 1000 patient hours over time. Key indicators of special cause variation include:
* Data points outside the control limits (Upper Control Limit and Lower Control Limit).
* Patterns, such as runs of data points above or below the mean, or sudden shifts and spikes in data.
In this chart, we see several spikes (particularly in July and September of 2013 and again in October 2014) that reach or exceed the upper control limit. This suggests that certain events or changes in these periods caused the restraint hours to increase significantly, which is not due to the inherent process variation.
* Conclusion for the Correct AnswerSince the chart displays data points that go outside the control limits and exhibit unusual patterns, it is indicative of Special Cause Variation. This suggests external factors or specific changes in the facility process during those periods that require further investigation to determine the cause of the spikes.
References:
* NAHQ Documentation on Control Charts and Process Variation
* "Using Statistical Process Control to Monitor Quality Improvement in Healthcare" (NAHQ, 2019)
質問 # 75
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:
- A. Health events are underreported in both populations
- B. Health events are reported in both populations
- C. Self-reports tend to be more accurate than proxy reports
- D. Proxy reports tend to be more accurate than self-reports
正解：C
質問 # 76
A physician's profile shows a 4%readmissionrate following outpatient gallbladder surgery, which Is significantly higher than the rate for their peers.
What action should the quality professional take next?
- A. Review a sampleof recent individual cases of the physician's readmissions.
- B. Review the physician's privileges against the procedures performed.
- C. Compare the physician'sreadmissionrate with peer physicians.
- D. Report the surgeon to the medical board.
正解：A
解説：
When a physician's readmission rate is significantly higher than their peers, the next step for a quality professional should be to review a sample of recent individual cases of the physician's readmissions (Option D). This will help identify any patterns or issues that could be contributing to the higher readmission rate12.
Reporting the surgeon to the medical board (Option A) is a drastic step that should only be taken if there is evidence of serious misconduct or incompetence. Reviewing the physician's privileges against the procedures performed (Option B) could be useful, but it would not directly address the issue of the high readmission rate.
Comparing the physician's readmission rate with peerphysicians (Option C) has already been done, as stated in the question. Therefore, the most appropriate next step is to review individual cases to gain a deeper understanding of the reasons for the high readmission rate345.
質問 # 77
The most effective data collection tools follow the _____________ of patient care and medical record documentation,
whether the data are collected retrospectively or prospectively.
- A. Chart review
- B. Registration system
- C. Actual flow
- D. Data analysts
正解：C
質問 # 78
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