HCAD 325 Final Exam | Answered with complete solutions

HCAD 325 Final Exam | Answered with complete solutions Jose is the supervisor of the laboratory. One of his testing machines seems to be giving different results for the same sample. To make sure he is delivering correct results, Jose uses a second machine to check the results of the first. This action represents which cost of quality type? a. Prevention b. Internal failure c. Appraisal d. External failure Which of the following is not a common theme found in successful Six Sigma programs? a. Top management support b. Use of quantitative measures c. Use of Taguchi methods d. Team-based projects The term "Six Sigma" represents what goal? a. Six standard deviations from the median b. 3.4 defects per million opportunities c. Six defects per million opportunities d. Sigma level quality Jose, the lab manager, wants to improve the quality in his laboratory with a Six Sigma program. He wants Sandy, his chemistry supervisor, to attend a Six Sigma training program so that she can oversee all Six Sigma projects that will occur in the lab. Sandy will be trained as a ______________. a. master black belt b. yellow belt c. green belt d. black belt What is the correct project cycle for a Six Sigma project? a. Analyze, define, measure, improve, control b. Measure, define, analyze, improve, control c. Define, measure, analyze, improve, control d. Define, improve, analyze, control What variables are measured in the measurement phase of a Six Sigma project? a. Process duration, process variability, critical to quality b. Process input, process output, process duration c. Process input, process output, critical to quality d. Process error rate, process output, process duration Which tool is not part of the analyze phase of a Six Sigma project? a. Regression analysis b. Gantt chart c. Pie chart d. Bar graph Jose is checking his laboratory equipment using test control samples that are designed to give the same results and are used to calibrate the equipment. When he runs 100 samples, he gets two results that are greater than 3 standard errors of the mean. These results are called what? a. 2 sigma quality b. Special variation c. Error bars d. Common variation Jose is measuring the time it takes a technician to do a new test. He expects the test to take no more than 5 minutes and no less than 3 minutes. After observing a number of tests, he calculates the standard deviation of the test as 0.3 minutes. What is the process capability of the test? a. 0.0 b. 1.8 c. 1.1 d. 2.0 Jose has a new test that has three steps. He calculates that in each step some of the sample must be discarded. Step 1 has a discard rate of 2 percent, step 2 has a discard rate of 5 percent, and step 3 has a discard rate of 1 percent. How much of the sample is available after step 3? a. 82.0 percent b. 75.5 percent c. 86.5 percent d. 99.1 percent What is the primary goal of Lean? a. Eliminate defects b. Eliminate waste c. Improve financial performance d. Maximize employee productivity Tiffany is the day shift supervisor in the imaging department. She has redesigned the patient intake system so that patients are only asked their name and birthdate once. The old system asked the patient this information three times. What type of waste did Tiffany reduce? a. Waiting b. Motion c. Overproduction d. Overprocessing Tiffany wants to continue to make improvements in the imaging department and organized a kaizen event. What will be her first step? a. Map and improve the value stream b. Specify value to the patient c. Develop a pull system d. Interview patients and staff A patient enters the MRI scanning suite at 1:00 pm and leaves at 3:30 pm. The MRI test takes 50 minutes. What is the percentage of value-added time? a. 25 percent b. 33 percent c. 50 percent d. 100 percent The demand for chest X-rays is 4 per hour. It takes 12 minutes to take a chest X-ray. What is the takt time? a. 15 minutes b. 12 minutes c. 1.25 minutes d. 0.8 minutes For CT scanning, the check-in process takes 3 minutes, the patient waits for 15 minutes, the patient then moves to the scanner (2 minutes), the scan takes 9 minutes, the patient is moved to the waiting room (2 minutes), and the patient then waits 20 minutes to be picked up. What it the throughput time? a. 3 minutes b. 9 minutes c. 42 minutes d. 51 minutes Tiffany decides she can improve operations in her department by sorting, labeling, and cleaning the storage area. What Lean tool is she using? a. 5S b. Single-minute exchange of die (SMED) c. Flow d. Spaghetti diagram Tiffany works with radiologists in her department to develop a protocol that will to be used to sterilize each instrument used in a procedure in exactly the same manner. What Lean tool is she using? a. Kaizen event b. Standard work c. 5S d. Value stream map Tiffany institutes as new system that indicates the status of the CT scanning suite with a series of lights. Green means the suite is available, yellow means the suite will be available in 3 minutes, and red means the suite is in use. What Lean tool is Tiffany using? a. Jidoka b. Pareto c. Andon d. Flow Tiffany worked with the radiologists to develop a new system to improve equipment utilization. In this new system, the instruments needed for an interventional procedure are organized outside of the interventional suite and prior to the procedure. What Lean tool is Tiffany using? a. Jidoka b. SMED c. Spaghetti diagram d. Standard work Radiology technologists in Tiffany's department have specialized their work to a specific class of procedures. To improve the flow of patients in the department, she has instituted a series of in-service educational classes to improve the ability of all of her staff to do all of the procedures. What Lean tool is she using? a. Standard work b. Andon c. 5S d. Heijunka (load balancing) Which of the following is not a true statement about Lean and Six Sigma? a. Lean's focus is on reducing waste; Six Sigma's is on reducing defects. b. Lean and Six Sigma tools can both be used in process improvement projects. c. Lean tools are currently more widely used in healthcare applications. d. Lean and Six Sigma projects require the use of special software. A system can be subdivided into what elements? a. Processes, people, and machines b. Processes, decisions points, and connectors c. Attitude, skills, and engagement d. Processes, subprocesses, and tasks What are the steps of the PDCA cycle? a. Plan, develop, channel, act b. Please, don't, change, anything c. Process, develop, change, actuate d. Plan, do, check, act to hold the gains To improve the flow of a process, what two key strategies should be employed? a. Increase the speed and decrease the variability of the process. b. Automate where possible. c. Decrease the speed and decrease the variability of the process. d. Find and remove all bottlenecks. Tom Stinson is the COO of Memorial Hospital. He is receiving complaints about waiting times in the emergency department. What services other than emergency should be a priority for analysis? a. Housekeeping b. Scheduled surgery c. Lab services d. Imaging Which of the following is the most important reason to create a process map? a. If can fix accountability for errors. b. It provides a visual representation of a process that can be used to identify opportunities to make improvements. c. It can be used to communicate a process to upper-level management. d. It can be used for team building. What is the capacity of a process? a. The maximum possible output (goods or services) that a process or resource can produce or transform b. The number of units produced per hour c. The longest time a unit will take to travel through the process d. The number of workers used in the process What is throughput time? a. The average time a unit spends in the process b. The average of the waiting times for a unit in the process c. The time to process one unit d. The length of the queue as a unit enters a process Tom is watching a football game he prerecorded, and he is fast-forwarding to only watch the plays. What is he doing? a. Counting the number of defects b. Using only the value-added time c. Observing set up times d. Calculating idle or wait time The Memorial Hospital emergency department averages 30 patients in their department at any one time, and 20 patients arrive per hour. What is the average throughput time for each patient? a. 3 hours b. 1 hour c. .66 hours d. 1.5 hours Susan Collins is the director of Memorial Hospital's emergency department. She has redefined the triage nurses' role to expand the number of tasks they can perform so that they can assist other staff. Which of the following describes what Susan is doing? a. Load balancing b. Eliminating duplicate activities c. Processing in parallel d. Using alternative process flow Susan has increased staffing levels on some evenings (e.g., first of the month, paydays) to reduce patient waiting time. This is an example of what? a. Using information for real time control b. Ensuring quality at the source c. Matching capacity to demand d. Reducing bottlenecks The relationship between the arrival rate to a system, the time a patient spends in the system, and the number of items in a system is known as what? a. Discrete event simulation b. Queuing notation c. Little's law d. Queue discipline What is supply chain management? a. All of these answers are correct. b. Procurement and vendor relationship management c. The management of all activities and processes related to both upstream vendors and downstream customers in the value chain d. Tracking and managing demand, inventory, and delivery Which of the following goals is not part of inventory management? a. Meeting anticipated demand b. Taking advantage of quantity discounts c. Protecting against stock outs d. Having a variety of clinical devices available for physicians The ABC classification system is used in inventory management to a. score vendors on service and price. b. divide inventory into three categories based on physician preference. c. divide inventory into three categories based on cost and then focus management on the most costly group. d. determine the most efficient layouts for stock rooms. The most accurate way to determine current inventory is to a. track additions and removals using RFID. b. do a physical inventory count. c. track additions and removals with bar coding. d. track additions and removals via point-of-sale equipment. What it is the next number in this forecasting series: 3.7, 3.7, 3.7, 3.7, 3.7, 3.7, 3.7, 3.7? a. Not determinable b. 3.8 c. 3.7 d. 3.6 What is the next number in this forecasting series: 2.5, 4.5, 6.5, 8.5, 10.5, 12.5, 14.5, 16.5? a. 18.5 b. 9.92 c. 8.5 d. 14.5 John is the emergency department manager, and he wants to order supplies for his growing department. He knows his ED patient demand is stronger in the summer than in any other season. What forecasting method(s) should he use? a. Trend and seasonal b. Cyclical c. Trend d. Seasonal and random John is forecasting daily demand for laundry in the emergency department. He has very limited historical data. What forecasting method should he use? a. Simple moving average b. Linear regression c. Weighted moving average d. Exponential smoothing Which of the following is a metric to measure the accuracy of your forecast? a. Standard deviation b. Mean absolute deviation c. Absolute error d. Average of the errors What is the theory that provides optimal levels of stock on hand, order levels, and order frequency? a. Economic order quantity b. Stock level index c. Order quantity and date d. Safety stock system Julie enters the storeroom to get a special syringe for her patients, but none of the syringes are there. This is an example of what? a. Lead time procedure b. Stock out c. Back order d. Set-up procedure Which assumption is not part of the basic EOQ model? a. Lead time is known and constant. b. Demand is known and constant. c. Back orders and stock outs are allowed d. Demand for the item in question is independent Which of the following is true when using the EOQ model? a. As ordering costs increase, the optimal order quantity decreases. b. As order quantities increase, supplier discounts increase. c. As holding costs increase, the optimal order quantity decreases. d. As inventory increases, less storage space is required. The two-bin system is used to a. signal a need to order when one bin is full. b. color-code types of inventory. c. provide overflow storage for inventory. d. provide easy movement of stock from the storeroom to the work area. Material requirements planning and enterprise resources planning systems are used for a. assigning tasks to robots in automated inventory systems. b. synchronizing materials and supply availability with forecasted demand. c. planning optimal layouts for inventory storage. d. integrating all information technology systems into one database. Which of the following is not a current trend in vendor supply chain relationships? a. Vendor-managed inventory b. Value-based standardization c. Group purchasing organizations d. Bidding strictly on cost What is the purpose of MedPAC? a. To advise Congress on payment rates and methods for Medicare b. To lobby Congress and the FDA on the acceptance of new medicine and pharmaceuticals c. To publish reports to guide states in their administration and payment methods for Medicaid d. To advise the president on payment methods for Medicare Which of the following is not a major factor in the increasing costs of healthcare in the United States? a. New diagnostic and treatment technologies b. Malpractice costs c. Increasing incidence of chronic disease and an aging population d. A provider payment system (fee-for-service) that encourages the use of healthcare services Which of the following is an important measure of financial performance? a. Cash on hand b. Number of employees per occupied bed c. Number of physicians in a hospital d. Rankings on H Which of the following is a good approach to cost reduction? a. Elimination of overtime b. Across-the-board expense reductions c. Outsourcing of those activities found to be too expensive to vendors with the lowest bids d. A systemic analysis of costs followed by targeted improvements Which is the smallest level of cost that should be analyzed when beginning a cost reduction project? a. Full capitation b. Shared savings payments c. Bundled payments d. Fee-for-service Once a cost reduction project is chartered, what should be the first step? a. Convene a physician advisory board. b. Inform employees that some staffing reductions will be necessary. c. Identify the largest payer and meet with them. d. Identify key cost drivers and collect cost data related to each fee for service. Which of the following is not an effective cost reduction tool for a cost reduction project? a. Supply chain management b. Schedule optimization c. Finding ineffective employees and reassigning them d. Process improvement including Lean and Six Sigma Which of the following are included in the five steps of the activity-based costing process? a. Determine cost drivers, implement healthcare home, calculate total cost of service b. Identify relevant activities, determine cost drivers, alter staffing levels c. Determine cost drivers, implement evidence-based medicine, calculate total cost of service d. Identify relevant activities, determine cost drivers, calculate total cost of service Which of the following is not a method of bundling payments? a. Payment for an episode of care b. Payment per hospital discharge c. Payment for a clinical service (e.g., CT scan) d. Per diem What approach should you use to identify bundled payments that are a priority for cost management? a. Identify bundles with high volume, high cost compared with benchmarks from other organizations, and high use in bundled payments where costs are highly variable. b. Change the overhead allocations to the costs in all the bundles. c. Identify which doctors have the most expensive cost for all the bundles. d. Challenge suppliers of materials in all of the bundles to reduce their prices. What are the most important data to track for a shared savings (ACO) program? a. Frequency of the types of diagnosis for participants b. Number of patients per primary care doctor c. Salaries of all providers in the ACO d. Individual patient costs over time Which of the following is not an important cost management approach for an organization taking full capitation risk? a. Systems to prevent readmissions of patients that use EBM and optimized processes b. Shared decision making for surgery based on EBM finding c. High patient copays and deductibles d. Implementation of healthcare homes Financial penalties and rewards in the contemporary payment system are designed to a. provide incentives for providers to improve quality. b. improve the coding of bills. c. deter fraud. d. reduce total payments to providers. The use of all the cost management tools contained in this book will have the largest financial impact for which type of payment? a. Bundled payments b. Global budget c. Shared savings d. Fee-for-service Which of the following approaches is not an effective means to reduce the cost of overhead? a. Reducing executive salaries b. Reducing staffing layers c. Implementing process improvement on all routine overhead processes (e.g., hiring new employees) d. Consolidating activities (e.g., memberships) When prioritizing activities for overhead cost reduction, one should consider which of the following? a. Activity staffing levels vs. cost/FTE b. Activity visibility to the board of directors c. Activity cost vs. its importance to operations d. Activity relationship to strategic plan Which of the following activities will not result in a significant increase in revenue? a. Measuring revenue per billing employee and replacing the lowest performers every quarter b. Providing real-time information to claims processors through data warehouses c. Using exception-based workflow, in which processes are mapped and automated and only exceptions are handled by staff d. Providing real-time feedback to clinicians about the effect on reimbursement based on care choices (e.g., medication choice) Social media is defined as: a. An electronic tool that provides a platform for customer interaction with the organization and each other