Question 1
Which quality pioneer developed the tripartite model classifying healthcare quality measurement into Structure, Process, and Outcome?
Show answer & explanation
Correct answer: B - Avedis Donabedian
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These 10 free CHCQM questions are organized by exam domain, so you can see how each part of the Certified in Health Care Quality and Management blueprint is tested. Reveal the answer and explanation under each question.
Which quality pioneer developed the tripartite model classifying healthcare quality measurement into Structure, Process, and Outcome?
Correct answer: B - Avedis Donabedian
A nurse routinely bypasses the barcode medication administration (BCMA) scanning step because she believes it slows down her workflow during high-census shifts. No patient harm has occurred. According to Just Culture principles, the most appropriate management response is to:
Correct answer: B - Coach the nurse and remove incentives for the workaround
During a complex surgical procedure, a circulating nurse identifies a discrepancy in the sponge count and halts the procedure despite the attending surgeon's initial objection. The surgical team defers to the nurse's assessment, and an additional sponge is located. This scenario best illustrates which High Reliability Organization (HRO) principle?
Correct answer: B - Deference to expertise
A 72-year-old Medicare beneficiary presents to the emergency department with chest pain. After evaluation, the attending physician determines the patient requires cardiac monitoring and serial troponins but expects the total hospital stay to be approximately 18 hours. Under CMS's Two-Midnight Rule, the most appropriate patient status designation is:
Correct answer: B - Observation services under Medicare Part B
A 68-year-old Medicare patient was admitted as an inpatient for pneumonia with an expected stay of three days. On hospital day two, the patient's condition improves significantly and the clinical team determines the patient no longer meets inpatient medical necessity criteria but still requires monitoring for an additional 12 hours. The utilization review nurse contacts the Physician Advisor. The most appropriate action is to:
Correct answer: B - Have the Physician Advisor review the case and apply Condition Code 44 to change the patient's status to observation
A discharge nurse asks a heart failure patient to explain in his own words how to weigh himself daily and when to call the physician about weight gain. This technique aligns with which category of the NTOCC Care Transitions Bundle?
Correct answer: C - Patient and Family Engagement/Education
A hospital contracts with a cloud-based health information technology vendor to store patient records. The hospital's compliance officer needs to ensure this business associate is directly subject to HIPAA security and breach notification requirements. Which federal legislation extended HIPAA's obligations directly to business associates?
Correct answer: B - The HITECH Act of 2009
A hospital's Ongoing Professional Practice Evaluation (OPPE) data reveals that a surgeon's complication rate for a specific procedure has exceeded the institutional benchmark for two consecutive review periods. The most appropriate next step by the medical staff is to:
Correct answer: B - Initiate a Focused Professional Practice Evaluation (FPPE)
In a managed care arrangement, a primary care physician receives a fixed dollar amount per enrolled member per month regardless of the volume of services provided. This reimbursement model is known as:
Correct answer: B - Capitation
In workers' compensation, Maximum Medical Improvement (MMI) is best defined as the point at which:
Correct answer: B - Further functional recovery from the work-related condition is not expected
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