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Chapter 19 Healthcare Improvement in the Community
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Chapter 19 Healthcare Improvement in the Community
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lOMoAR cP SD |12827 373Chapter 19: Healthcare Improvement in the Community
Stanhope: Foundations for Population Health in Community/Public Health Nursing,
MULTIPLE CHOICE
1. Which of the following best describes one of the main problems in ensuring quality for health care in t
a. Consumers believe American health care is of high quality and the best in the
world.
b. Every hospital and health care agency has its own approach to data collection and
documentation.
c. Finances are the basis of clinical decisions, not quality of care.
d. We all agree on what quality is but not on how best to measure it.
ANS: B
Very little is known about quality of care in this country because a variety of definitions of quality are
comparable data from health care providers and agencies. All consumers, including private citizens, in
industry, and the federal government, are concerned about achieving the highest quality outcomes at th
Consumers want more information about quality. Both consumers and providers have a vested interest
the health care system.
2. A wealthy factory owner says, “I don’t care about the poor. I just want the best care available for me a
care if other people don’t get health care?” Which of the following would be the most appropriate resp
a. “If your employees are ill, who will do the work in your factory?”
b. “You might catch a contagious disease from one of your employees.”
c. “You have a moral obligation to help those less fortunate.”
d. “Your personal insurance and tax costs will go up if your employees have to use
community resources when they’re ill.”
ANS: D
Because the speaker’s primary concern is apparently money, an appropriate response must show that t
money if he doesn’t support the health of others in the community. Everyone—consumers, providers,
health care bills—benefits if people stay healthy. The focus should be on the larger community and no
to be done at the factory.
3. Which of the following information can be gathered by reviewing a community health report card?
a. Utilization of health care services in the community
b. Demographic information of the community
c. Leading causes of morbidity in a community
d. Frequency of malpractice claims within a community
ANS: C
The term community health report card refers to different types of reports, community health profiles,
scorecards, quality of life indicators, health status reports, and progress reports. Community health rep
in efforts to help identify areas where change is needed, to set priorities for action, and to track change
time. The report card may be used for tracking leading causes of morbidity and mortality in a commun
over time to see if public health interventions have improved health care outcomes. Utilization of healt
information, and frequency of malpractice claims in the community is information that is not found on
card.
4. What event led to the development of the National Health Quality Improvement Act?
a. A very famous movie and television star died as a result of a medical error.
b. The number of malpractice claims had increased.
c. Media such as films highlighted the reality of current medical care.
d. Publicity about a few unfortunate cases caused consumers to become concerned.
ANS: B
In response to a growing number of malpractice claims in the United States, the National Health Quali
was established, which encouraged consumers to become informed about their practitioner’s practice r
clearinghouse of information on provider malpractice records. The media did not play a role in the crea
, lOMoAR cP SD |12827 373
6. An agency has not created a continuous quality improvement program. Which of the following actions
to help ensure quality care within the institution?
a. Ensure appropriate policies and procedures are followed.
b. Employ highly recommended and credentialed professionals to give care.
c. Use administrative action to ensure that quality care is given to clients.
d. Write quality care plans for the most typical problems of clients.
ANS: A
Quality assurance/quality improvement (QA/QI) programs remain the enforcers of standards of care fo
not elected to engage in a program of CQI. These activities are called assurance activities because they
policies and procedures are followed so that appropriate quality services are delivered. Without proper
difficult to ensure quality care is provided by the professionals employed by the agency. Administrativ
having policies in place to support such actions. Policies and procedures provide a broader scope of qu
plan.
7. A home-care nurse is encouraging the administration of the agency to increase their quality assurance
the following best describes a negative outcome from this activity?
a. An agency deficiency may become visible.
b. An individual may be found at fault and then become fearful of being involved.
c. Some agency processes may be questioned.
d. Employees at the agency will have to commit extra time to complete this process.
ANS: B
Quality assurance (QA) focuses on the care a client receives within the system and is concerned with t
provider. A major problem with quality assurance efforts, done by the quality assurance team, is that i
be at fault and hence may be fearful of reporting problems or errors. Total quality management and co
improvement are concepts that give direction for managing a system of care, whereas quality assuranc
client
receives within the system. Continuous quality improvement focuses on processes and possible deficie
a whole so that everyone is involved.
8. How does continuous quality improvement (CQI) differ from quality assurance?
a. Quality assurance focuses on client care, whereas CQI focuses on system issues.
b. Quality assurance focuses on system issues, whereas CQI focuses on individual
client care.
c. Quality assurance measures care at one point in time, whereas CQI is an ongoing
issue.
d. Quality assurance focuses on families, whereas CQI focuses on agency issues.
ANS: A
Total quality management and continuous quality improvement are concepts that give direction for ma
whereas quality assurance focuses on the care a client receives within the system. Total quality manag
quality improvement focus on system issues, and quality assurance focuses on individual client care. Q
care at multiple points of time. Quality assurance focuses on care of the client, not families, and CQI f
system of care.
9. Which of the following is accomplished through the use of traditional quality assurance?
a. Implementation of new techniques to improve outcomes
b. Implementation of appropriate interventions for diagnosed problems
c. Implementation of change when measured performance does not meet standards
d. Implementation of research findings to ensure appropriate clinical treatment
ANS: C
Traditional approaches to quality assurance are to focus on assessing or measuring performance, to ens
conforms to standards, and to take action to bring about change when care does not meet standards. CQ
data analysis to detect process failures. Thus, implementation of new techniques, interventions, and res
ongoing evaluation of data which is accomplished through CQI, not QA.
10. What is the primary goal of total quality management?
a. To confirm the high standards desired in patient care
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