CPHQ Prep (NAHQ Material) Complete
Solution, Over 300 Questions And Answers
Leaders
Cope with change by developing vision and aligning subsytems
Managers
Cope with complexity through planning and budgeting
Quality Roles for the Board of Directors/Governing body
Setting policy, financial and strategic direction, quality of care, goals and objectives
What are the subsystems of the organization and the principles of leadership
Structure, People, Renewal, Reward, Resources, Culture
Mission
Organizations purpose or reason for existence; why are we here?
Vision
Organizations statement of its goals for the future
Core values
Define an organizations attitudes and help direct vision
Organizations direction is built on ________ and guided by ________
mission; vision
Definition/explanation of a goal
broad general statement specifying a purpose or desired outcome
Definition/explanation of an objective
specific statements that detail how goals will be achieved through specific and
measurable actions
SMART Acronym
Specific, measurable, attainable, relevant, time bound
The following is an example of what? Place 100% of veterans in permanent
housing, which includes moves to HUD-VASH program and moves from VA SSVF
into permanent housing by September 30th annually
Objective
Voice of the customer (VOC)
is a process conducted at the start of any new product, process or service design
initiative to understand better the customer wants and needs
Four aspects of the VOC
Customer needs, a hierarchical structure, priorities, customer perceptions of
performance (the product is a list of needs, wants and desires of the customer of a
process output)
How to construct VOC research
identify customers of a process output, develop a list of questions to ask customers
about the process, refine the list to use with the process review and improvement
Hoshin Planning
a Japanese term that means policy deployment - it is used to ensure that the vision
being set forth by top management is being translated into planning objectives and
actions
,Four perspectives of measurement for a balanced scorecard
Financial, Customer, Internal Business processes, Learning and Growth
Financial Scorecard term
How do we look to providers or financial resources
Customer scorecard term
How do our customers see us
Internal business processes scorecard term
at what must we excel
Learning and growth scorecard term
can we continue to improve and create value for our customers
Steps for creating reward systems in company culture
1. Determine priorities, values and behaviors
2. Identify criteria for recognition
3. establish a budget
4. determine accountability for recognition
5. obtain feedback through performance appraisal
6. modify program based on feedback
7. give rewards based on the program
Population Health definition
outcomes for a group of individuals
What does PHM involve
PHM involves gaining an understanding of clinical and other characteristics (e.g. SES,
geography) of population/subpopulation and associated risks
Transition of care definition/example
a care transition occurs when a patient moves from one healthcare provider or setting to
another.
According to the joint commission, 80% of serious medical errors involve
_______ during the __________
miscommunication; transition of care
Handoffs
defined as a transfer and acceptance of patient care responsibility achieved through
effective communication
What should handoffs include?
patient history, heart rhythm, infections, complications, needs for restraints etc
to achieve successful handoffs, organizations should
1. demonstrate leaderships commitment to successful handoffs
2. standardize critical content to be communicated to the sender during a handoff, both
verbally and in written form
3. cover everything needed to safely care for the patient in a timely fashion
recommendations for improving transitions of care
1. improve communication during transitions between providers patients and caregivers
2. implement EMRs that include standardized medication reconciliation elements
3. establish points of accountability for sending and receiving care, particularly for
hospitals and nursing home providers
4. expand the role of pharmacists in transitions of care
5. develop performance measures to encourage better transitions of care
, episodes of care
all care a patient receives in the courses of treatment for a specific illness, condition or
medical event
sharing vital signs and care with the care providers on the next shift is an
example of what
handoff
a cardiac specialist called in to provide a consultation on cardiac issues with a
surgical patient is an example of what
episode of care
a hospital sharing patient information on hospital stay with home health service
is an example of what
transition of care
provide patient information to a dietitian consulted about a patient who is losing
weight after a procedure is an example of what
episode of care
Fee for service reimbursements
providers receive payment for each service provided
managed healthcare
A system of healthcare delivery that tries to manage the cost, quality and access of
healthcare
traditional retrospective payment
pays providers after services have been provided
Managed Care Reimbursement
Third party payers mange cost of healthcare and episodes of care
Episode-of-care reimbursement
Providers receive one lump sum for all the services they provide related to a condition
or disease
Capitation
third party payer reimburses providers a fixed per capita amount for a period (PMPM or
Per Member Per Month)
prospective payment
payment rates established in advance for a specified time period; predetermined rates
based on average levels of resource use (DRG)
Pay for performance
provides bonus to healthcare providers if they meet or exceed agreed upon quality or
performance measures. This may also reward improvement in performance over time
Patient Protection and Affordable Care Act (PPCA)
1. requires virtually every citizen to obtain health insurance
2. establishes a five year Medicare voluntary pilot program for integrating care across
hospitals, physicians and post acute providers during an episode of care
Value-based purchasing
PPACA establishes value based purchasing program for Medicare to pay hospitals
based on performance compared to quality measures.
Accountable Care Organization (ACO)
Solution, Over 300 Questions And Answers
Leaders
Cope with change by developing vision and aligning subsytems
Managers
Cope with complexity through planning and budgeting
Quality Roles for the Board of Directors/Governing body
Setting policy, financial and strategic direction, quality of care, goals and objectives
What are the subsystems of the organization and the principles of leadership
Structure, People, Renewal, Reward, Resources, Culture
Mission
Organizations purpose or reason for existence; why are we here?
Vision
Organizations statement of its goals for the future
Core values
Define an organizations attitudes and help direct vision
Organizations direction is built on ________ and guided by ________
mission; vision
Definition/explanation of a goal
broad general statement specifying a purpose or desired outcome
Definition/explanation of an objective
specific statements that detail how goals will be achieved through specific and
measurable actions
SMART Acronym
Specific, measurable, attainable, relevant, time bound
The following is an example of what? Place 100% of veterans in permanent
housing, which includes moves to HUD-VASH program and moves from VA SSVF
into permanent housing by September 30th annually
Objective
Voice of the customer (VOC)
is a process conducted at the start of any new product, process or service design
initiative to understand better the customer wants and needs
Four aspects of the VOC
Customer needs, a hierarchical structure, priorities, customer perceptions of
performance (the product is a list of needs, wants and desires of the customer of a
process output)
How to construct VOC research
identify customers of a process output, develop a list of questions to ask customers
about the process, refine the list to use with the process review and improvement
Hoshin Planning
a Japanese term that means policy deployment - it is used to ensure that the vision
being set forth by top management is being translated into planning objectives and
actions
,Four perspectives of measurement for a balanced scorecard
Financial, Customer, Internal Business processes, Learning and Growth
Financial Scorecard term
How do we look to providers or financial resources
Customer scorecard term
How do our customers see us
Internal business processes scorecard term
at what must we excel
Learning and growth scorecard term
can we continue to improve and create value for our customers
Steps for creating reward systems in company culture
1. Determine priorities, values and behaviors
2. Identify criteria for recognition
3. establish a budget
4. determine accountability for recognition
5. obtain feedback through performance appraisal
6. modify program based on feedback
7. give rewards based on the program
Population Health definition
outcomes for a group of individuals
What does PHM involve
PHM involves gaining an understanding of clinical and other characteristics (e.g. SES,
geography) of population/subpopulation and associated risks
Transition of care definition/example
a care transition occurs when a patient moves from one healthcare provider or setting to
another.
According to the joint commission, 80% of serious medical errors involve
_______ during the __________
miscommunication; transition of care
Handoffs
defined as a transfer and acceptance of patient care responsibility achieved through
effective communication
What should handoffs include?
patient history, heart rhythm, infections, complications, needs for restraints etc
to achieve successful handoffs, organizations should
1. demonstrate leaderships commitment to successful handoffs
2. standardize critical content to be communicated to the sender during a handoff, both
verbally and in written form
3. cover everything needed to safely care for the patient in a timely fashion
recommendations for improving transitions of care
1. improve communication during transitions between providers patients and caregivers
2. implement EMRs that include standardized medication reconciliation elements
3. establish points of accountability for sending and receiving care, particularly for
hospitals and nursing home providers
4. expand the role of pharmacists in transitions of care
5. develop performance measures to encourage better transitions of care
, episodes of care
all care a patient receives in the courses of treatment for a specific illness, condition or
medical event
sharing vital signs and care with the care providers on the next shift is an
example of what
handoff
a cardiac specialist called in to provide a consultation on cardiac issues with a
surgical patient is an example of what
episode of care
a hospital sharing patient information on hospital stay with home health service
is an example of what
transition of care
provide patient information to a dietitian consulted about a patient who is losing
weight after a procedure is an example of what
episode of care
Fee for service reimbursements
providers receive payment for each service provided
managed healthcare
A system of healthcare delivery that tries to manage the cost, quality and access of
healthcare
traditional retrospective payment
pays providers after services have been provided
Managed Care Reimbursement
Third party payers mange cost of healthcare and episodes of care
Episode-of-care reimbursement
Providers receive one lump sum for all the services they provide related to a condition
or disease
Capitation
third party payer reimburses providers a fixed per capita amount for a period (PMPM or
Per Member Per Month)
prospective payment
payment rates established in advance for a specified time period; predetermined rates
based on average levels of resource use (DRG)
Pay for performance
provides bonus to healthcare providers if they meet or exceed agreed upon quality or
performance measures. This may also reward improvement in performance over time
Patient Protection and Affordable Care Act (PPCA)
1. requires virtually every citizen to obtain health insurance
2. establishes a five year Medicare voluntary pilot program for integrating care across
hospitals, physicians and post acute providers during an episode of care
Value-based purchasing
PPACA establishes value based purchasing program for Medicare to pay hospitals
based on performance compared to quality measures.
Accountable Care Organization (ACO)
