CHAPTER 14 Quality Management in Managed Care

1.Describe and discuss the three criteria Donabedian developed to assess quality and identify circumstances in which they can be applied.

2.   Discuss the key
components of a quality management program? What features distinguish a quality
management program from traditional quality assurance?

3.   Discuss
how the quality management model can be applied to the development of a new
program in preventions, such as one to reduce teen smoking.

4.   Describe the
strategies an MCO can use to involve physicians in managed care processes.

5.   Which Institute of
Medicine publications have had the most influence on the quality of our health
care system?  What are the six aims for
quality improvement?

6.   What are the key
functions of a managed care organization? How can the functions be evaluated?

7. The Institute of Medicine’s Committee on the Quality of
Health Care in America proposed six  

     aims for
improvement in our health care system. 
Name the six aims and provide examples of

     each:

8. Process measures of health care performance
focus on the context in which care and services

    are
provided.

  1. True
  2. False

9. Infection rates are a traditional outcome
measure of care.

a. True

b. False

10. Donabedian’s
criteria for assessing quality of care are no longer relevant.

a. True

b. False

  1. Practice guidelines that can be repeated over
    and over again with the same result are always considered to be valid.
  2. True
  3. False
  1. Report cards are used to assess patterns of
    individual provider’s care.
  2. True
  3. False
  1. Practice guidelines that can be applied across
    settings and providers are considered:

a.         reliable

b.         valid

c.         descriptive

d.         none
of the above

  1. The first step in developing a quality
    management program is to:

a.         develop
measures to screen diseases

b.         identify
process criteria

c.         understand
consumer need

d.         none
of the above

  1. A set of causes and conditions that come
    together in a series of steps to transfer inputs into outcomes is called:

a.         outcomes

b.         structure

c.         process

d.         none
of the above

  1. Describe the key steps in developing a modern
    quality management program.

Originally posted 2019-03-13 23:00:30.

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