HCQM - Quality Improvement,
Management, & Assurance. Exam Study
Guide.
Basic common threads of Quality Management. - answer✔Examine the processes leading to the
delivery of care, the outcomes expected from the care, and the degree to which the expected
outcomes are reached.
Abraham Flexner - answer✔Quality should be measured.
E.A. Codman, MD - answer✔Boston surgeon from the early 1900's was a public health pioneer
studying hospital outcomes to determine how they could be improved.
Founded by E.A. Codman - answer✔American College of Surgeons and its Hospital
Standardization Program
The American College of Surgeons eventually became this organization - answer✔The Joint
Commission
E.A. Codman Award - answer✔Given out by the Joint Commission for the use of outcomes
measures to advance the quality and safety of patient care.
In 1918 the American College of Surgeons began to address the fact that patients did not feel
comfortable with this concept. - answer✔The operation was a success but the patient died.
John Williamson, MD - answer✔Recipient of the EA Codman Award in 2000 and is a leader in
the field of health care outcomes research and its implementation.
Outcomes Measures - answer✔Help identify (prioritize) areas for which measuring and
analyzing the process are likely to lead to improved outcomes.
When outcomes do not meet expectations it is appropriate to do this. - answer✔Measure the
process producing the outcomes to improve possibly substandard performance.
Avendis Donabedian, MD - answer✔Brought modern quality assurance techniques to modern
medicine by emphasizing structure, process, and outcome.
Walter Shewhart - answer✔American physicist, engineer, and statistician working in quality
control. Developed the Shewhart cycle.
Renamed the Shewhart Cycle the PDCA Cycle. - answer✔W. Edwards Deming, MD
Shewhart Cycle consists of the following four phases. - answer✔Plan, Do, Check, Act
PDCA approach is heavily emphasized in medicine because it embodies the principles of this
method. - answer✔Scientific method.
W. Edwards Deming - answer✔Introduced statistical processes to the industrial quality process
because he recognized the importance of having accurate and meaningful information.
Deming's 14 Points for Management - answer✔1. Create consistency of purpose toward
improvement of product and service, with the aim to become competitive, stay in business and
provide jobs. 2. Adopt the new philosophy. Management must take on leadership for change. 3.
Cease dependence on inspection to achieve quality. Build quality into the product in the first
place. 4. Move toward a single supplier for any one item, creating a long-term relationship of
loyalty and trust. 5. Improve constantly and forever the system of production and service. 6.
Institute training on the job. 7. Institute leadership. Supervision should aim to help people do a
better job. 8. Drive out fear so that everyone may work effectively. 9. Break down barriers
between departments. 10. Eliminate slogans, exhortations, and targets for the workforce. 11.
Recognize that the cause of low quality and low productivity belongs to the system, and thus
lies beyond the power of the work force - eliminate quotas and substitute leadership/ eliminate
management by objective and substitute leadership. 12. Remove barriers to pride of
workmanship. 13. Institute a vigorous program of education and self-improvement. 14. Put
everyone to work to accomplish the transformation.
Deming's Seven Deadly Diseases that interfere with achievement of continuous improvement. -
answer✔1. Lack of constancy of purpose. 2. Emphasis on short term profits. 3. Evaluation of
performance, merit rating or annual review. 4. Mobility of management - job hopping. 5.
Management by use of "visible figures" with no consideration of unknowns or unknowables. 6.
Excessive medical costs. 7. Excessive liability costs.
Deming believed this had more impact on quality than the individuals operating within this. -
answer✔The system.
Major proponent of statistical quality control. - answer✔W. Edwards Deming
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