HIT Review Quiz 4

The cause-and-effect diagram, also known as the fishbone diagram, is a visual tool used to identify and analyze the root causes of a problem or an effect. It gets its name from its shape, which resembles the skeleton of a fish. The diagram helps to categorize and organize potential causes into major categories such as people, process, equipment, materials, and environment. By visually representing the causes and their relationships, the fishbone diagram allows for a systematic approach to problem-solving and helps teams to understand the underlying factors contributing to an issue.

Modems are not used to physically connect computers together in a network. Modems are used to connect computers to the internet or to other remote networks using telephone lines or other communication channels. On the other hand, twisted pair wiring, fiber optic cabling, and telephone wiring are all physical mediums that can be used to connect computers together in a network.

Record linkage refers to the process of connecting records on the same individual that have been generated at different times and in different places. This process helps to identify and link together related records, allowing for a more comprehensive and accurate understanding of an individual's information. By linking these records, patterns and relationships can be identified, enabling researchers, organizations, and policymakers to make informed decisions and gain valuable insights from the data.

Computer-based repositories of knowledge are called text-based systems because they primarily store and organize information in the form of text. These systems are designed to manage large amounts of textual data, such as articles, books, reports, and other written materials. Text-based systems allow users to search, retrieve, and manipulate text-based information efficiently. They are commonly used in libraries, research institutions, and digital archives where textual content is the primary focus. Unlike expert systems, which are designed to simulate human expertise and decision-making, text-based systems primarily serve as storage and retrieval tools for textual information.

Premature discharge refers to the practice of releasing a patient from the hospital before they are medically stable or ready to leave. This can lead to negative outcomes such as readmissions or worsening of the patient's condition. Overutilization, on the other hand, refers to the excessive use of healthcare services or resources, which may include unnecessary tests, procedures, or hospitalizations. Premature discharge is not an example of overutilization because it involves a lack of appropriate utilization of healthcare services, rather than excessive use.

Variance is a statistical measure that quantifies the spread or dispersion of a set of data points around the mean. It provides insight into how much the individual data points deviate from the average. A higher variance indicates a wider range of values, suggesting a greater degree of scatter or variability in the data. Therefore, variance is the appropriate measure to describe the degree to which scores scatter around the mean. Median, t-score, and z-score are not measures of dispersion and do not capture the spread of data points.

A run chart is the most appropriate choice to show how a process changes and fluctuates over a certain period of time. A run chart displays data points in chronological order, allowing for easy identification of trends, patterns, and shifts in the process. It helps to visualize the process performance over time and identify any variations or outliers that may occur. Unlike a bar graph or pie chart, a run chart focuses on the time dimension and is specifically designed for tracking process performance over time. A pareto chart, on the other hand, is used to prioritize problems or causes based on their frequency or impact.

The health information management director is responsible for managing and organizing medical records within a healthcare facility. They would most likely be able to provide information on the number of medical records on file, the number of locations the records might be used in, and the duration of time records may spend in one location. However, the costs of various components of the system would not typically fall under their purview. This information is more likely to be provided by the finance or procurement department.

The correct answer is "network and communication." HIPAA data security provisions include administrative provisions, physical safeguards, technical safeguards, and network and communication. This section focuses on the security measures and protocols related to the network infrastructure and communication channels used to transmit and store sensitive health information. It ensures that proper encryption, authentication, and access controls are in place to protect the confidentiality, integrity, and availability of the data during transmission and while it is at rest.

A histogram is a graphical representation that organizes data into intervals or bins and displays the frequency of occurrences within each bin. In this case, an HIM department can use a histogram to chart trends in response time to physicians' record requests. The x-axis of the histogram would represent the response time intervals, while the y-axis would represent the frequency or number of record requests within each interval. This would allow the department to visually analyze the distribution of response times and identify any patterns or trends over time.

Under PL 92-603, the UR/UM committee is responsible for reviewing and evaluating certain admissions. This includes Medicaid admissions, Medicare admissions, and Maternal and Child Health Program admissions. However, Blue Cross admissions are not necessary to review by the UR/UM committee.

Client-server technology is comprised of a host computer and several workstations. In client-server architecture, the host computer, also known as the server, provides services and resources to the workstations, also known as clients. The host computer handles tasks such as data storage, processing, and managing network connections, while the workstations access and utilize these resources. This architecture allows for a centralized and efficient distribution of tasks and resources, enabling multiple users to connect and interact with the host computer simultaneously.

Groupware refers to software that allows multiple users to collaborate and share information in a virtual environment. In this scenario, the physician needs to access various types of documents related to the patient's status, laboratory results, medications, and history. Groupware enables the convergence of these different types of documents, allowing the physician to access and review them all in one place, streamlining the process of checking on the patient's condition.

Computer networks rely on protocols that use the same language to communicate. Protocols are a set of rules and guidelines that govern the communication between devices in a network. They define how data is transmitted, received, and interpreted, ensuring that devices can understand and interact with each other effectively. Without protocols, devices would not be able to communicate with each other, resulting in a breakdown of the network. Therefore, protocols are essential for the proper functioning of computer networks.

The average output per FTE (Full-Time Equivalent) can be calculated by dividing the total lines per day by the number of transcriptionists. In this case, there are 6 transcriptionists, 2 of whom work half time. Therefore, the number of FTE transcriptionists is 6 - (2/2) = 5. The total lines per day is given as 5,150. Dividing 5,150 by 5 gives an average output per FTE of 1,030 lines per day.

To calculate the number of FTE transcriptionists needed to staff the unit, we divide the total number of lines of dictation (200,000) by the minimum productivity standard (1,000 lines per day). This gives us the number of days required to transcribe all the dictation, which is 200 days. Since there are 5 working days in a week, we divide 200 by 5 to get 40 weeks. Therefore, 40 FTE transcriptionists are needed to staff the unit. The correct answer is 40.0.

PL 92-603 refers to Public Law 92-603, which was an amendment to the Social Security Act. The Social Security Act is a federal law that established various social welfare programs in the United States. This amendment likely made changes or additions to the existing provisions of the Social Security Act, possibly expanding or modifying the programs it covers. Without further information, it is not possible to determine the specific details of the amendment, but it can be inferred that PL 92-603 was related to the Social Security Act in some way.

Comparative and correlational research designs are two types of casual research designs. Comparative research design involves comparing two or more groups or variables to determine the differences or similarities between them. Correlational research design examines the relationship between two or more variables to determine if there is a correlation or association between them. These research designs are used to study cause-and-effect relationships and to understand the relationship between variables.

Reliability refers to the consistency and stability of a measurement instrument. In this context, when a data collection instrument is given twice under the same circumstances and produces identical data, it demonstrates reliability. This means that the instrument is reliable in measuring the intended construct consistently. Validity, on the other hand, refers to the accuracy and truthfulness of the measurement instrument in measuring what it is intended to measure. Sensitivity and appropriateness are not directly related to the consistency of a measurement instrument.

An ordinal scale is a type of measurement scale that orders data into ranks. In this scale, the data is categorized based on their relative position or rank, without any specific numerical value or measurement. Unlike a nominal scale, which only categorizes data into distinct groups, an ordinal scale allows for the ranking of data points. It is important to note that the ordinal scale does not provide information about the magnitude of the differences between the ranks.

The ORYX initiative was designed in 1997 to incorporate outcomes measurement and monitoring into the accreditation process for hospitals, long-term care organizations, and health care networks. This initiative aimed to improve the quality of care provided by these organizations by focusing on measurable outcomes and using data to drive improvement efforts. It provided a framework for collecting and reporting data on key performance measures, allowing organizations to benchmark their performance and identify areas for improvement. The ORYX initiative was an important step in promoting accountability and quality improvement in the healthcare industry.

W. Edwards Deming is the correct answer because he was a pioneer in the field of quality improvement and is known for his 14 points for companies to follow for a successful quality improvement program. Deming's principles emphasize the importance of continuous improvement, customer focus, and employee involvement in order to achieve higher quality and productivity. He played a significant role in the development of Total Quality Management (TQM) and his teachings have had a lasting impact on the field of quality management.

Information is described as being "more complex than data" because data refers to raw facts or figures that have not been processed or organized, while information is the result of processing and organizing data to create meaning and context. Information often involves interpretation, analysis, and synthesis of data, which adds complexity to it. Therefore, information is considered to be more complex than data.

Charge capture refers to the process of entering every medication provided, diagnostic test performed, meal served, and other patient services into a system. This allows for accurate and efficient tracking of the services provided to patients, which is essential for billing and reimbursement purposes. It helps healthcare organizations capture charges for the services rendered and ensures that they are appropriately reimbursed for their services.

A hospital's utilization management plan should outline the organization of the committee, the administrative support for the utilization management program, and the relationship of the utilization management program to other quality management activities. However, it should not specifically outline the qualifications of the utilization management coordinator.

Risk management programs are designed to control liability for human errors and equipment failures. These programs focus on identifying potential risks, assessing their impact, and implementing strategies to mitigate or prevent them. By implementing risk management programs, organizations can minimize the negative consequences of errors and failures, protect their assets, and ensure the safety of their employees and customers. These programs involve various processes such as risk assessment, risk analysis, risk mitigation, and risk monitoring. They are an essential component of effective organizational management and help in maintaining a safe and secure environment.

Safety review is not considered a medical staff function included in the quality management program. While blood usage review, medical record review, and surgical case review are all directly related to medical staff functions and quality management, safety review is more focused on overall safety protocols and measures within the healthcare facility, which may involve non-medical staff members as well.

A stringent test of the quality of professional research is its ability to be duplicated with the same results. This means that if another researcher follows the same procedures and methods as the original study, they should be able to obtain the same results. This is important because it demonstrates the reliability and validity of the research findings. If the results cannot be replicated, it raises questions about the accuracy and credibility of the original study.

Time-sharing refers to the concept of multiple users being able to access and use a computer system simultaneously. It allows multiple users to share the resources of a single computer, such as the CPU, memory, and peripherals, by dividing the available time into small time slices or intervals. Each user is given a fair share of time to execute their tasks, and the system switches between users rapidly to give the illusion of parallel execution. This concept allows for efficient utilization of computer resources and enables multiple users to work on the same computer system concurrently.

A computerized Registration-Admissions, Discharge and Transfers (R-ADT) system would be used by several departments, including the health information management department. This means that the system is not limited to just one department but is utilized by multiple departments within the organization. The health information management department is specifically mentioned as one of the departments that would use the system, indicating its importance in managing patient information and records.

Under PL 92-603, hospitals were required to have a UR (UM) plan. This plan refers to a utilization review (UR) or utilization management (UM) plan. Utilization review is a process used by hospitals to evaluate the necessity, appropriateness, and efficiency of medical services provided to patients. It helps ensure that patients receive the most appropriate and cost-effective care. Therefore, it is essential for hospitals to have a UR (UM) plan in place to comply with the requirements of PL 92-603.

The transcription unit supervisor set a standard of 2% or less error rate. However, upon proofreading a sample of work, it was found that there are 156 lines with errors out of 2,586 lines of dictation. To calculate the error rate, we divide the number of lines with errors (156) by the total number of lines (2,586) and multiply by 100. The result is approximately 6.03%. Since the actual error rate is higher than the acceptable standard of 2%, it can be concluded that the unit has done worse than its standard.

JCAHO launched a major new quality project in 1986 to shift its focus from reviewing the structure and process to reviewing outcomes. This means that instead of solely evaluating the systems and procedures in place, JCAHO started to prioritize the actual results and impact of these processes. By emphasizing outcome review, JCAHO aimed to ensure that the quality of care provided by healthcare organizations was measured by the effectiveness of their treatments and interventions, ultimately improving patient outcomes.

Infection control is an example of hospitalwide quality assessment because it involves monitoring and preventing the spread of infections within the entire hospital. This includes implementing protocols and procedures to minimize the risk of infections, conducting regular audits and inspections to ensure compliance with infection control practices, and analyzing data to identify trends and areas for improvement. By focusing on infection control, hospitals can enhance patient safety, reduce healthcare-associated infections, and improve overall quality of care.

Optical character readers are not output devices but input devices. They are used to scan and convert printed text into digital format for processing by a computer. Output devices, on the other hand, are used to display or present information from a computer to the user, such as printers, monitors, speakers, etc.

To develop a comprehensive understanding of a research topic, it is important for a researcher to review literature in their own discipline as well as in other disciplines. This allows them to gain insights from different perspectives and identify any existing theories or facts related to the topic. Consulting with colleagues and experts further enhances their understanding by providing additional input and expertise. However, ignoring the lack of literature in one's own discipline can be detrimental as it may result in overlooking important information or gaps in knowledge that could impact the research findings.

A type I error occurs when a researcher rejects the null hypothesis, which states that there is no relationship or difference between variables, when it is actually true. This means that the researcher concludes that there is a significant relationship or difference between variables when there is not. Type I errors are considered false positives and can lead to incorrect conclusions and wasted resources.

Machine language is considered a high-level computer language because it is a programming language that is directly understood and executed by the computer's hardware. It uses binary code and specific instructions that are designed to be easily executed by the computer's central processing unit (CPU). Unlike low-level languages like assembly language, machine language does not require any translation or interpretation by a compiler or interpreter. It allows programmers to write programs at a higher level of abstraction, making it easier to understand and write complex programs.

Computer-generated information regarding patient accounts not yet paid can assist the health information management department in determining which health records are not yet received from the nursing units, determining which health records are not yet coded, and determining which health records have not yet had abstracted data entered into the computer system that provides information for billing purposes. However, it cannot assist in determining which health records are not yet filed in the permanent file because this task requires physical organization and filing of the records, which cannot be done through computer-generated information alone.

Computer systems can aid nursing management in automating practice guidelines, providing counseling to nursing personnel, and scheduling nursing personnel. However, determining patient acuity levels is not a function that computer systems can assist with. Acuity levels are typically determined by healthcare professionals based on their assessment of the patient's condition and needs.

Clinical decision support systems are not examples of administrative information systems that support the daily management of healthcare facilities. Instead, they are designed to provide healthcare professionals with evidence-based information and recommendations to assist in clinical decision-making. These systems analyze patient data and provide alerts, reminders, and suggestions for diagnosis, treatment, and monitoring. While they play a crucial role in improving patient care and outcomes, they are not directly involved in the administrative functions of healthcare facilities such as patient registration, financial management, and human resource management.

The project manager is at the design phase of the systems development life cycle. This is because they are creating the request for proposal, which is a crucial step in designing the computer-based system. During the design phase, the project manager determines how the system will be structured, what functionalities it will have, and how it will meet the requirements of the healthcare facility. This phase focuses on creating a detailed blueprint for the system before moving on to the implementation phase.

A second literature review at this point is more selective than the first review because by this stage, the researcher has already identified the problem and formulated research questions. Therefore, the focus of the second review would be to selectively search for and analyze relevant literature that directly addresses these research questions, rather than conducting a comprehensive review of all available literature on the topic. This selective approach helps the researcher to gather specific and targeted information that will be most useful for designing and conducting the research study.

In order to ensure the quality of medical staff, relevant findings from quality management activities should be taken into consideration during the reappointment process. This means that when deciding whether to renew the contracts of medical staff members, their performance and adherence to quality standards should be evaluated based on the findings from quality management activities. This helps to ensure that only competent and qualified medical staff members are retained, ultimately contributing to the overall quality of healthcare provided by the hospital.

When the need for admission cannot be determined, the case is first referred to a physician reviewer. A physician reviewer is a medical professional who reviews the patient's medical records and evaluates the necessity of admission. They have the expertise to assess the patient's condition and determine if hospitalization is required. This step ensures that the decision regarding admission is made by a qualified healthcare professional, helping to maintain the quality and appropriateness of care provided to the patient.

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A scatter diagram would help determine if there is a relationship between age and weight in female patients over age 30. This type of diagram plots the age on one axis and the weight on the other axis, and each data point represents a female patient. By observing the pattern of the data points, such as whether they form a linear or non-linear pattern, one can determine if there is a relationship between age and weight. If the data points show a clear trend or correlation, it suggests that there is a relationship between age and weight in the female patients.

QIOs, or Quality Improvement Organizations, are responsible for a variety of tasks related to improving the quality of healthcare. They review and assess the quality of services provided, ensuring that they meet professionally recognized standards of healthcare. They also evaluate whether the services provided were medically necessary and whether the care was provided in the most economical setting consistent with the patient's needs. However, determining whether a healthcare facility has met accreditation and licensing standards is not a specific responsibility of QIOs. This task is typically carried out by separate entities such as government agencies or accreditation organizations.

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Walter Shewhart is the correct answer because he is credited with developing the PDCA (Plan, Do, Check, Act) method in the 1920s. This method is a systematic approach to problem-solving and continuous improvement, widely used in quality management. Shewhart's work laid the foundation for later quality management gurus like W. Edwards Deming and Joseph Juran.

Pareto charts are used to display categories of data in descending order. This means that the chart arranges the categories from highest to lowest based on their frequency or impact. This helps in identifying the most significant categories and prioritizing actions accordingly. By visually representing the data in this manner, Pareto charts provide a clear understanding of the distribution and importance of different categories, making it easier to focus on the most critical areas for improvement.

The Nominal Group Technique (NGT) is a QI tool that is used when generating ideas on a particular subject and incorporating a rating system for prioritizing those ideas. NGT involves a structured group discussion where participants generate ideas individually, share them with the group, and then collectively rate and prioritize the ideas. This technique ensures equal participation from all group members and allows for a systematic approach to idea generation and prioritization.

Discrete storage media in a centralized dictation system using a telephone network include plastic belts or disks, microcassettes, and magnetic belts. However, endless loop magnetic tape is not a discrete storage media used in this system.

Brian Joiner is the correct answer because he is the QI pioneer who developed the three-faceted approach to quality or quality triangle. This approach includes the elements of quality, all-one-team, and a scientific approach. W. Edward Deming, Joseph Juran, and Philip Crosby are also well-known quality improvement pioneers, but they did not specifically develop the three-faceted approach mentioned in the question.

When a patient care service defines its important aspects of care, several things occur. Indicators are developed, which are measures used to assess the quality of care provided. Thresholds are defined, which are specific levels or values that indicate whether the care provided meets the desired standards. Indicators are evaluated to determine if the care provided meets the established thresholds. However, the definition of the service's major functions does not occur as a result of defining the important aspects of care. The major functions of the service are typically already established and known.

The UR/UM process involves reviewing and evaluating medical services to ensure they are appropriate and necessary. Concurrent review, retrospective review, and preadmission review are all types of reviews that are performed in the UR/UM process. However, "applied review" is not a recognized type of review in this process.

A tank can be considered as a self-contained dictation media because it is a large armored vehicle that is equipped with various communication systems, including radio and intercom systems, which allow for communication and dictation within the vehicle. It is designed to be self-sufficient and capable of operating independently, making it a suitable example of self-contained dictation media.

Systematic sampling is the correct answer because it refers to a sampling technique where every nth member of the population is selected after the first member is chosen randomly. In this case, every 10th member of the population is chosen, indicating a systematic sampling approach. This method ensures that the sample is representative of the population and provides an equal chance for each member to be selected.

Philip Crosby believed that the standard for quality should be "zero defects." He emphasized the importance of preventing defects rather than relying on inspection and correction. Crosby advocated for a proactive approach to quality management, focusing on prevention, continuous improvement, and the establishment of a quality culture within an organization. He coined the term "zero defects" to emphasize the goal of eliminating errors and defects in products and processes. Crosby's philosophy had a significant impact on the field of quality management and his ideas continue to be influential today.

A quality indicator is a measurement that targets events or patterns of events suggestive of a problematic process or behavior. It helps identify potential issues or areas that need improvement by highlighting specific indicators of quality. This measurement allows organizations or individuals to monitor and assess the quality of a process or behavior, enabling them to take corrective actions if necessary.

A bar graph would provide an assessment of the raw data for a month-to-month comparison of the number of coding errors by the coding staff. A bar graph is a visual representation that uses rectangular bars to compare data between different categories or groups. In this case, each month can be represented by a separate bar, and the height of each bar can indicate the number of coding errors for that month. This allows for easy comparison and identification of any trends or patterns in the data over time.

The industry standard for the average business word is five characters plus a space. A kilobyte of memory can store 1024 characters. To find the number of words that can be stored, we divide the total number of characters (1024) by the average number of characters per word (6). This gives us 170 words that can be stored in a kilobyte of memory.

Clinical pathways are a tool used in healthcare to achieve simultaneous goals of optimal care and appropriate resource utilization. They are multidisciplinary plans that outline the recommended care for patients with a specific condition or undergoing a specific procedure. Clinical pathways help healthcare providers standardize and coordinate care, ensuring that patients receive evidence-based treatments and interventions. By following clinical pathways, healthcare teams can improve patient outcomes, reduce variations in care, and optimize resource allocation, leading to more efficient and effective healthcare delivery.

The correct answer is test entry/outcome reporting because it accurately describes the process of a physician entering a request for a laboratory test and then being able to review the outcome. This term encompasses both the initial entry of the test request and the subsequent reporting of the results, allowing the physician to have a comprehensive view of the entire process.

Facilities management systems are not a subcategory of the management support system that provides reporting information. Facilities management systems are designed to manage and optimize physical assets and resources within an organization, such as buildings, equipment, and maintenance. On the other hand, management information systems, strategic decision support systems, and executive information systems are all subcategories of the management support system that provide reporting information to aid in decision-making and planning processes.

A hazard surveillance report is a tool used to identify potential risks before an incident occurs. This report involves monitoring and analyzing data related to hazards and potential dangers in order to assess the level of risk. By identifying these risks in advance, organizations can take proactive measures to prevent incidents and minimize their impact. This report helps in implementing effective risk management strategies and ensuring the safety of individuals and assets. It is different from other reports mentioned as it specifically focuses on surveillance and identification of hazards.

Controls in a computerized health information system are designed to assist in error detection, error location, and error correction to ensure the accuracy and integrity of data. Error manipulation, however, is not a valid function of these controls. Manipulating errors would imply altering data inappropriately, which would undermine the system's reliability. The goal is to identify, locate, and correct errors, not to manipulate or change data in a way that introduces inaccuracies.

PL 92-603 refers to Public Law 92-603, which was a legislation passed in the United States. This law provided for the establishment of PSROs, which stands for Professional Standards Review Organizations. PSROs were designed to review and evaluate the medical necessity, appropriateness, and quality of healthcare services provided to Medicare and Medicaid patients. They aimed to ensure that healthcare providers were delivering efficient and effective care to patients. Therefore, the correct answer is PSROs.

To calculate the storage needed for one page, we need to consider the number of words and the number of characters per word. Given that one page holds 250 words and one word equals six characters, we can calculate the total number of characters on the page by multiplying 250 by 6, which equals 1500 characters. Since each character takes up one byte of storage, the storage needed for one page would be 1500 bytes. To convert this to kilobytes, we divide 1500 by 1024, resulting in approximately 1.46 kilobytes.

The correct answer is "program" because it refers to the set of instructions that tells the computer what tasks to perform, including storing, manipulating, and retrieving data. The program is responsible for controlling the overall operation of the computer system and coordinating the activities of the other components, such as the control unit, storage unit, and arithmetic/logic unit. Without a program, the computer would not know how to execute tasks or process data effectively.

A check sheet would be helpful in gathering the number of delinquent records coming into the HIM department for the month of November. A check sheet is a simple and effective quality improvement tool that allows for the systematic collection and organization of data. It can be used to track and record the number of delinquent records on a daily basis, providing a clear picture of the volume and frequency of delinquent records. This information can then be used to identify trends, patterns, and areas for improvement in the department's processes and workflows.

A radar chart would effectively display the before-and-after data and the progress made by the chart analysis clerks. A radar chart is a graphical representation that displays multiple variables on different axes, allowing for easy comparison between different data points. By plotting the performance of the clerks before and after the inservice on the radar chart, it would be possible to visually assess the progress made by each employee and identify any areas of improvement.

Continuous quality improvement focuses on monitoring whether the appropriate things are being done correctly, with an emphasis on individual performance. It places attention on the processes and causes, rather than solely focusing on outliers, bad apples, and clinical outcomes. This approach recognizes that improving processes and addressing underlying causes will lead to better overall quality.

Occurrence screening is a mechanism that helps identify risk from physician-related activities. This screening process involves systematically reviewing and analyzing occurrences or incidents that have taken place in healthcare settings. It aims to identify patterns, trends, and potential risks associated with physician activities, such as medical errors, adverse events, or near misses. By analyzing these occurrences, healthcare organizations can identify areas for improvement, develop strategies to mitigate risks, and enhance patient safety.