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質問 # 71
Although Lean thinking focuses on removing waste and improving flow, it also has some secondary effects such as:
- A. All of these
- B. Simplification of processes results in less time in process
- C. Quality is improved
- D. Reduces the chances of damage
正解：A
質問 # 72
Quota sampling was developed in the late 1930s and used extensively by the Gallup organization. Babbie (1979)
describes the steps involved in developing a quota sample. All of the following are out of those steps EXCEPT:
- A. Once the matrix has been created and a relative proportion assigned to each cell in the matrix, data are collected
from persons having all the characteristics of a given cell - B. Develop a matrix describing the characteristics of the target population. This may entail knowing the proportion of
male and female; various age, racial and ethnic proportions; as well as the education and income levels of the
population - C. All persons in a given cell are then assigned a weight
appropriate to their proportion of the total - D. When all the sample elements are so weighted, the overall data should provide a reasonable representation of the
majority of the samples
正解：D
質問 # 73
The downside of _____________ is cost. It is very costly and time consuming, and it often requires several full time data analysts.
- A. Prospective data collection approach
- B. Flow charts
- C. Retrospective approach
- D. Scanners
正解：A
質問 # 74
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___________________.
- A. None of these
- B. Static group comparison
- C. SPC
- D. Continuous distribution
正解：B
質問 # 75
Honest criticism is hard to take, particularly from a relative, a friend, an acquaintance, or a stranger. Resistance to
lower-than-expected results is common and reasonable. It is not necessarily a sign of complacency or lack of
commitment to high-quality, patient entered care. Most of the resistance comes in any two forms:
- A. People resistance
- B. Arguments about patients
- C. None of these
- D. Data resistance
正解：A
質問 # 76
He used his understanding of statistics to design tools to respond to variation. Following his arrival at Western Electric Co. in 1924, Shewhart introduced the concepts of common cause, special cause variation and statistical control. He designed these concepts to assist Bell Telephone of repairs within its transmission systems.
Who is he?
- A. Walter Shewhart
- B. Armand Shewhart
- C. W Edwards Deming
- D. Joseph M Juran
正解：A
質問 # 77
A random sampling also can be drawn by placing equally sized pieces of paper with a range of numbers on them (e.g., 1 to 100) in a bowl and picking a predetermined number to be the sample.
The problem with simple random samples is that:
- A. They may under represent segments of population
- B. They may over or under-represent segments of population
- C. They may over represent segments of population
- D. They cannot truly depict the samples
正解：B
質問 # 78
Which of the following are the three primary quality management activities?
- A. assessment, improvement, and strategic planning
- B. define goals, assessment, and review results
- C. review trends, assessment, and stakeholder accountability
- D. measurement, assessment, and Improvement of outcomes
正解：D
解説：
Quality management is a critical aspect of healthcare, and it involves various activities to ensure that healthcare services meet the desired standards. The three primary quality management activities are:
* Measurement: This is the first step in quality management. It involves defining and collecting data on various aspects of healthcare service delivery. This could include patient outcomes, process efficiency, or other relevant metrics. The goal is to establish a baseline for understanding the current state of quality.
* Assessment: Once data has been collected, it needs to be analyzed to assess the quality of healthcare services. This could involve comparing actual outcomes against desired outcomes, identifying gaps in service delivery, or looking for trends and patterns in the data.
* Improvement of outcomes: Based on the assessment, targeted interventions are designed and implemented to improve outcomes. This could involve changes to processes, training for staff, or other interventions. The effectiveness of these interventions is then measured and assessed, creating a continuous cycle of quality improvement.
References: The information is based on standard quality management principles and practices, which are widely recognized and utilized in the healthcare industry123.
質問 # 79
The term __________ brings in mind that indicator panel on an automobile, which is most useful when t he car is
moving as a way for t he driver t o monitor key performance metrics such as speed, fuel level, engine performance,
temperature and direction from digital display units.
- A. Charts
- B. Scoreboard
- C. Dashboard
- D. Scanners
正解：C
質問 # 80
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:
- A. Patient satisfaction
- B. Discharge service (e.g., childbirth patients evaluate their experiences more favourably
than do medical or surgical patients; medical patients report the most problems with care) - C. Patient age (i.e., older patients tend to report fewer problems with care)
- D. Number of visits to the hospitals
正解：A
質問 # 81
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:
- A. Day of the week
- B. Type of order
- C. Area of facility
- D. Time of the day
正解：C
質問 # 82
The American Society for Quality has formed six categories of quality tools. Which of the following is NOT out of those
categories?
- A. Evaluation and decision making
- B. Cause Analysis
- C. Idea adoption
- D. Process analysis
正解：C
質問 # 83
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:
- A. Purchase an existing survey
- B. Any one of these can be the case
- C. Design the survey itself
- D. Design with the help of outside experts to design the survey
正解：B
質問 # 84
A quality Improvement team has Identified specific changes to Implement for a quality Improvement Initiative. As the next step, the team would like to establish a concrete timeline for implementation. Which of the following is the best tool to use for this step?
- A. bar graph
- B. Ishikawa diagram
- C. process map
- D. Gantt chart
正解：D
解説：
* A process map is a tool that shows the sequence of steps or activities involved in a process, and identifies the inputs, outputs, and decision points. It can help to identify waste, variation, and inefficiencies in a process, and to design or redesign a process for improvement. However, it does not show the time required or allocated for each step or activity, nor the dependencies or interrelationships among them. Therefore, it is not the best tool to use for establishing a timeline for implementation.
* A Gantt chart is a tool that shows the tasks or phases of a project, the duration and order of each task or phase, the milestones or deliverables, and the progress or status of each task or phase. It can help to plan and schedule a project, to monitor and communicate its progress, to identify critical tasks or phases, and to allocate resources and responsibilities. Therefore, it is the best tool to use for establishing a timeline for implementation.
* An Ishikawa diagram (also known as a fishbone diagram or a cause-and-effect diagram) is a tool that shows the possible causes of a problem or an effect, andorganizes them into categories or branches. It can help to identify the root causes of a problem, to brainstorm potential solutions, and to prioritize areas for improvement. However, it does not show the time or sequence of the causes or solutions, nor the tasks or phases of a project. Therefore, it is not the best tool to use for establishing a timeline for implementation.
* A bar graph (also known as a histogram or a column chart) is a tool that shows the frequency or distribution of data in different categories or groups, using vertical or horizontal bars. It can help to compare data across categories or groups, to identify patterns or trends, and to display numerical information visually. However, it does not show the time or sequence of the data, nor the tasks or phases of a project. Therefore, it is not the best tool to use for establishing a timeline for implementation.
References:
* Gantt Chart | Digital Healthcare Research
* Gantt Chart | Turas | Learn
* Chart Template - Gantt Chart - Health Quality Council
* Project Planning - Institute for Healthcare Quality Improvement
* Best examples of timelines, Gantt charts, and roadmaps for the healthcare sector
* [HQ Principles | NAHQ]
質問 # 85
Honest criticism is hard to take, particularly from a relative, a friend, an acquaintance, or a stranger.
Resistance to lower-than-expected results is common and reasonable. It is not necessarily a sign of complacency or lack of commitment to high-quality, patient entered care.
Most of the resistance comes in any two forms (Choose two):
- A. People resistance
- B. None of these
- C. Arguments about patients
- D. Data resistance
正解：A、C
質問 # 86
Strong disagreement do 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. Practitioners who are highly skilled in trauma and other emergency care
- C. The facility receives top marks from a team of expert clinicians whose primary focus is on technical performance
- D. Each group emphasizes a particular aspect of care
正解：A
質問 # 87
What approach should be followed by the healthcare improvement team for the best outcomes?
- A. Collection of a balanced amount of data in order to full-fill the current demands
- B. Data collection should be thorough. The team may need the data down the road
- C. Collecting the critical few rather than collecting for a rainy day
- D. Stockpiling of data "just in case"
正解：C
質問 # 88
Continuous variable measures and rate-based measures are the further categories of:
- A. Process measures
- B. All of these
- C. Outcome measures
- D. Structure measures
正解：B
質問 # 89
A healthcare organization has Introduced an Initiative to Increase lung cancer screenings for Its patient population with a history of smoking. This screening would fall into which of the following types of prevention?
- A. secondary
- B. tertiary
- C. quaternary
- D. primary
正解：A
解説：
The initiative to increase lung cancer screenings for a patient population with a history of smoking falls under secondary prevention123. Secondary prevention aims to reduce the impact of a disease or injury that has already occurred2. This is done by detecting and treating disease or injury as soon as possible to halt or slow its progress2. In the context of healthcare, screenings are a common form of secondary prevention123. They allow for early detection of diseases like lung cancer, especially in high-risk groups such as smokers123. Early detection can lead to more effective treatment and better health outcomes123.
References: 1
https://www.iwh.on.ca/what-researchers-mean-by/primary-secondary-and-tertiary-prevention
質問 # 90
Ordering the correct diagnostic procedure for a patient is a measure of _________. When evaluating the process of care, however, appropriateness is only half the story. The other half is in how well and how promptly (i.e. skill-fully) the procedure was carried out.
- A. Appropriateness
- B. Consciousness
- C. Care assessment
- D. Equity
正解：A
質問 # 91
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