Quality

Question 1

5 objectives of a QA program

Answer 1

-reduce pt exposure
-improve quality of images
-reduce costs to department
-improve pt care
-records maintained to help future problems

Question 2

What is quality

Answer 2

The standard of something is measured against other things of a similar kind

Question 3

Three of the levels of quality

Answer 3

Expected quality, perceived, actual

Question 4

What is expected quality

Answer 4

Expected by the patient as an influence by outside factors like gossip, technologists have the least amount of impact on this because it presents before the patient shows up to the imaging department

Question 5

What is perceived quality

Answer 5

The patient’s perception of quality, how long the wait was, treatment, competency of staff
This is often what brings the patient back to the department and can be more important than the actual quality

Question 6

What is actual quality

Answer 6

Statistical data used to measure outcomes and consider all factors that influence the final outcome and compares the actual quality of the product with the competition

Question 7

What is Total Quality Management

Answer 7

The development, deployment, and maintenance of organizational systems required for business processes

A strategic approach used to maintain existing quality standards and make incremental improvements

Question 8

Who is W Edward Deming

Answer 8

Post World War II Japanese manufacturer that organized activities that happen is planned without errors in order to increase the cost of production and created the Deming cycle

Question 9

What is the Deming cycle

Answer 9

Plan, do, study, Act

Identify problem, develop solutions, evaluate desired goal, Implement solution

Question 10

What is the cost of quality or bad quality

Answer 10

Lost business, injury, bad revenue, bad reputation

Question 11

Examples of breaches and quality and what it is

Answer 11

A breach in quality is putting a patient in danger based on structural treatment or other hazards.

This is like putting an MRI scanner room right next to the reception room but the patients have no idea

Question 12

What is a quality indicator or metric

Answer 12

Used to describe data and measure quality and safety, trends, or make comparisons to other facilities

Question 13

What is a fishbone diagram

Answer 13

A structured brainstorming tool using categories to explore root causes for an undesirable effect.

The head of the fish is the problem and each bone is different variables for key characteristics and discusses area for improvement

Question 14

What is a flow chart

Answer 14

Visual representation of individual steps to the process

Question 15

What is a control chart

Answer 15

Modified Trend chart for the central line indicating the accepted normal usually on an X and Y axis with plotted points

Question 16

On a histogram where is the most frequent occurrence

Answer 16

In the middle

Question 17

What is a Pareto chart or a bar graph

Answer 17

A variation of a histogram also uses points and x and y axis to display the relative importance or priority of differences between groups of data

Question 18

Where are the most frequent problems located on a Pareto or bar graph

Answer 18

On the far left with problems decreasing going to the right

Question 19

What is a scatter plot or traditional XY access with no line through the dots

Answer 19

A traditional scatter plot with an X and Y axis that plots lots of little points of data to show an average of process

Question 20

What is a trend chart

Answer 20

Align with no dots where why is the variable and X is the time measures quality factors over time

Question 21

What does quality control do with data

Answer 21

Established acceptable ranges for specific measures or data points

Question 22

What is quality assurance

Answer 22

I’m more comprehensive systematic collection and evaluation of data; it usually encompasses quality control programs

Question 23

What is quality improvement

Answer 23

A proactive process that aims to improve and enhance the quality of care

Question 24

What is continuous quality improvement

Answer 24

Every activity in the Imaging facility is identified and clear standards are set and measured and we are always looking to improve

Question 25

What are the goals of continuous quality improvement

Answer 25

Satisfaction of the customer internally and externally, focusing on the needs and expectations of customers and continuous Improvement

Question 26

What is the 8515 rule versus the 8520 rule

Answer 26

8515 means that the process is the cause of the problem 85% of the time and people or Personnel are the cause of the problem 15% of the time The 80/20 rule is 80% of the problems are the result of 20% of the causes

Question 27

While using the Deming cycle a process of trial and error is used, is this more or less efficient than getting it right the first time?

Answer 27

More, trial and error equals trial and learn

Question 28

What is the lean management technique

Answer 28

Developed by Toyota and it uses tools to eliminate or reduce waste, we focus on getting the right things to the right place at the right time and in the right quantity

Question 29

What do lean management tools focus on (7 how to LEAN build muscle)

Answer 29

Overproduction, waiting, transport, movements, process, stocks, flaws

Question 30

What are the five s's of lean management

Answer 30

Sorting, setting an order, systematic cleaning, standardization, sustaining

Question 31

What is stream mapping

Answer 31

Drawing a map of the process

Question 32

What is production leveling

Answer 32

Making smaller batches than bulk

Question 33

What is pull systems

Answer 33

Ordering only the parts needed

Question 34

What is root cause and Analysis

Answer 34

Identifying and solving the root causes and problems or instances

Question 35

What is an important part of leadership culture

Answer 35

Start feeling comfortable disclosing errors including their own

Question 36

What is an adverse event reporting system

Answer 36

The reporting system for employees to anonymously report Adverse Events including near misses

Question 37

How do you audit

Answer 37

Direct observation, review patient charts, review policy and procedures

Question 38

What is a kpi

Answer 38

Key performance indicator

Question 39

What is a balanced scorecard

Answer 39

A key management tool that provides a framework for translating organizational Vision into strategies that incorporate all quantitative and Abstract measures that are true importance to the organization

Question 40

What does continuous quality improvement rely on?

Answer 40

The process of CQI relies on the ability to either define a specific parameter best state (using either published benchmarks or an internally derived goal) or identify a specific problem in the operations/ procedures that need to be overcome.

Question 41

Obstacles to CQI (continuous quality improvement)

Answer 41

Lack of training/education/experience ◦Ever-present distractions Culture Insufficient/Lack of resources Culture of independence Lack of obvious rewards Head in the Sand Lack of empowerment

Question 42

Four steps that must be of continuous process philosophy

Answer 42

1. Starts with leadership enforcement and valuing quality 2. Frequent communication to individuals involved in projects 3. Keep workflow going to keep initiative up 4. Accumulative data continually and make it part of the workflow

Question 43

RCA Root Cause Analysis

Answer 43

‣Structured process that focuses on events that have already surfaced. ‣Determine what happened how it happened, and why. ‣Done to know how to eliminate future occurrences.

Question 44

Joint commision requires a RCA to be done for every....

Answer 44

Sentinel event

Question 45

What is a sentinel event

Answer 45

Unexpected occurence resulting in death, injury, or risk.

Question 46

11 steps of RCA according to Joint Commision

Answer 46

1. Oraganize a team 2. Define the event 3. Identify and define the process(es) related to the event. 4. Identify proximate causes 5. Design and implement any "quick fix" interim changes. 6. Identify root causes 7. Identify potential risk reduction strategies. 8. Formulate and evaluate proposed improvement actions; identify measures of success. 9. Develop and implement an improvement action plan. 10. Evaluate and fine-tune improvement efforts. 11. Communicate results.

Question 47

Limits of RCA

Answer 47

-Hindsight Bias -Frequency of problems and when they come up is unpredictable -Root causes of problem can be from something specific to that day -aothers??

Question 48

Healthcare Failure mode and Effect Analysis

Answer 48

HFMEA focuses on the system and uses a multidisciplinary team to evaluate processes within it.

Question 49

What is Failure Mode

Answer 49

Failure modes are different ways in which certain process fails to achieve its intended purpose.

Question 50

Steps to performing a HFMEA

Answer 50

1. Define the topic - could be a sentinel event. 2. Assemble the team - leaders, quality improvement experts, and people closest to the failed process. 3. Graphically describe the process - identify process and sub processes 4. Conduct a hazard analysis - identify failure modes and determine severity of each mode 5. Identify Actions and Outcome Measurements Solutions and actions for each failure mode.

Question 51

HFMEA & RCA SIMILARITIES

Answer 51

*Interdisciplinary team * Develop flow diagram & Systems focus * Actions & Outcome measures * Scoring matrix (severity/probability) * Triage questions, cause & effect diag., brainstorming

Question 52

HFMEA and RCA Differences

Answer 52

* Preventive v. reactive * Analysis of Process v. chronological case * Choose topic v. case * Prospective (whatif analysis R2 * Detectability & Criticality in evaluation * Emphasis on testing intervention

Question 53

Cycle of Change Phases (5)

Answer 53

1. Uniformed optimism 2. Informed Pessimism 3. Valley of Despair 4. Informed Optimism 5. Fullfillment (Ex. Starting xray wide-eyed engenue, informed and bleh, burnout, informed optimism/change, then success from continually choise and such)