Free Practice Questions for NAHQ CPHQ Exam

When comparing the productivity of a department with similar departments at other facilities, the first step is to determine which processes will be evaluated1. This involves identifying the key processes that contribute to the department’s productivity and are comparable across different facilities1. Once these processes are identified, they can be measured and compared to similar processes at other facilities1. This comparison can provide valuable insights into areas where the department is performing well and where there may be opportunities for improvement1.

In the Patient Safety domain, NAHQ highlights the importance of high-reliability system solutions for preventing medication errors. Computerized provider order entry (CPOE) with clinical decision support is the most effective intervention for reducing drug–drug interaction errors because it prevents errors at the point of prescribing.

CPOE systems can generate automatic alerts for contraindications, duplicate therapies, and interactions before the medication is dispensed or administered. This upstream prevention aligns with NAHQ’s emphasis on system redesign rather than reliance on human vigilance.

Barcode medication administration (Option C) reduces administration errors but does not address prescribing interactions. EMR implementation (Option B) alone does not ensure interaction prevention without decision support. Human factors engineering (Option A) is a general concept rather than a targeted solution. Therefore, Option D is the most appropriate intervention.

Detailed Explanation:

FMEA is a proactive tool thatidentifies and prioritizes potential risks in a process and develops action plans to mitigate them.

Option C: Risks were identified and prioritized, and action plans were developed

This option accurately reflects the FMEA process, which involves assessing potential failure modes, their effects, and prioritizing risks for corrective actions.

Option A: Key factors were identified, and corrective action plans were created

This description is somewhat accurate but lacks emphasis on risk prioritization, which is central to FMEA.

Option B: Actions were taken to address baseline performance and monitored for sustainment

This describes a performance improvement process rather than FMEA’s risk prioritization focus.

Option D: Special causes were identified, and variation was reduced

This describes root cause analysis and statistical process control, not FMEA.

Secondary prevention in healthcare is primarily intended to focus on the early detection and treatment of disease12. This level of prevention is about detecting and treating disease early, often before symptoms are present, thus minimizing serious consequences2. It includes measures taken during an interaction between an individual patient and a clinician1. Examples of secondary prevention include screening programs, such as mammography to detect breast cancer and dual x-ray absorptiometry (DXA) to detect osteoporosis2. Therefore, the answer is option C: focus on early detection and treatment of disease.

The best process measure to evaluate effective clinical care in a new urgent care clinic is the percentage of antibiotic prescriptions that meet evidence-based guidelines. This measure directly reflects the quality of clinical decision-making and adherence to best practices, which are crucial for providing effective and safe patient care. It helps ensure that antibiotics are prescribed appropriately, reducing the risk of resistance and other complications.

Percent of patients rating care as "satisfactory" or "highly satisfactory" (A): This is a patient satisfaction measure, which is important but not a direct measure of clinical care effectiveness.

Raw number of influenza vaccines given (B): This is a volume measure, which does not directly reflect the quality of clinical care.

Average wait time between check-in and seeing a provider (D): This is a measure of efficiency, not necessarily of clinical care effectiveness.

References

NAHQ Body of Knowledge: Process and Outcome Measures in Quality Management

NAHQ CPHQ Exam Preparation Materials: Evaluating Clinical Care Quality

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The Performance and Process Improvement domain stresses that quality professionals must rely on objective data before implementing changes or mediating disagreements.

When perceptions of performance differ, the first step is to review existing data to determine actual turnaround times, variation, and compliance with standards. Data-driven evaluation ensures credibility and prevents unnecessary or misdirected interventions.

Revising processes (Option A) or facilitating meetings (Option B) without data is premature. Asking about other issues (Option C) does not address the core concern. Reviewing performance data first aligns with NAHQ’s evidence-based improvement methodology and is the correct initial action.

The goal is to ensure that preventable falls do not exceed 25% of the total falls in any unit. To determine which units meet this goal, we need to calculate the percentage of preventable falls for each unit:

Unit 1:

Total Falls: 14

Preventable Falls: 7

Percentage: (7/14) * 100 = 50%

Does not meet the goal (50% > 25%).

Unit 2:

Total Falls: 9

Preventable Falls: 3

Percentage: (3/9) * 100 = 33.33%

Does not meet the goal (33.33% > 25%).

Unit 3:

Total Falls: 3

Preventable Falls: 2

Percentage: (2/3) * 100 = 66.67%

Does not meet the goal (66.67% > 25%).

Unit 4:

Total Falls: 1

Preventable Falls: 0

Percentage: (0/1) * 100 = 0%

Meets the goal (0% < 25%).

Unit 5:

Total Falls: 2

Preventable Falls: 1

Percentage: (1/2) * 100 = 50%

Does not meet the goal (50% > 25%).

Based on these calculations, only Unit 4 meets the goal. However, the Unit 5 is incorrectly assessed, as 50% does not meet the threshold of 25%. Hence, the correct answer is Unit 4 only. Please ignore the earlier verified statement.

The governing body holds the ultimate accountability for patient safety and quality of care within a healthcare organization. They are responsible for setting policies, ensuring compliance with regulations, and overseeing the organization's overall performance in these areas.

Pay-for-performance (P4P) programs tie reimbursement to specific quality metrics, requiring a clear understanding of the measures to guide improvement efforts.

Option A (Obtaining a copy of the current measures for the physician): This is the correct answer. The NAHQ CPHQ study guide states, “To improve performance in pay-for-performance programs, the first step is to understand the specific measures and targets assigned to the provider” (Domain 4). Knowing the measures (e.g., HbA1c control rates) allows the quality professional to assess gaps and tailor interventions.

Option B (Suggesting the physician take a course on measurement): Education may be helpful later, but it is not the initial step, as it assumes a knowledge gap without assessing performance data.

Option C (Writing a plan to improve processes in the office): A plan is premature without knowing the specific measures and performance gaps.

Option D (Researching benchmarking data for practices in the area): Benchmarking is useful for comparison but secondary to understanding the physician’s specific measures and performance.

CPHQ Objective Reference: Domain 4: Performance and Process Improvement, Objective 4.6, “Support provider performance improvement in quality programs,” emphasizes starting with a clear understanding of performance measures. The NAHQ study guide notes, “Quality professionals must first identify the metrics in pay-for-performance programs to focus improvement efforts effectively” (Domain 4).

Rationale: Obtaining the current measures provides the foundation for assessing performance, identifying gaps, and developing targeted interventions, aligning with CPHQ’s data-driven improvement approach.

Detailed Explanation:

Special-cause variation represents unexpected deviations due to specific circumstances and can be identified using controlcharts.

Option D: Control Chart

Control charts are designed to distinguish between common-cause and special-cause variations, using control limits to flag unusual patterns.

Option C: Run Chart

Run charts show trends but lack control limits to distinguish special-cause variation.

Options A and B:

Pareto charts and flowcharts categorize and map issues or processes, respectively, without indicating special-cause variation.

Establishing a Quality Council involves defining its purpose and focus to guide quality improvement efforts effectively.

Option A (Educate members on regulatory processes): Education is important but follows setting priorities to ensure relevance.

Option B (Identify quality priorities): This is the correct answer. The NAHQ CPHQ study guide states, “After forming a Quality Council, the next step is to identify quality priorities based on data and organizational needs to focus improvement efforts” (Domain 3). For a behavioral health center, priorities might include suicide prevention or medication safety.

Option C (Charter project improvement teams): Chartering teams follows priority identification.

Option D (Develop quality indicators): Indicators are developed after priorities are set to measure progress.

CPHQ Objective Reference: Domain 3: Organizational Leadership, Objective 3.1, “Establish Quality Council priorities,” emphasizes setting priorities. The NAHQ study guide notes, “Identifying priorities guides the council’s work” (Domain 3).

Rationale: Identifying priorities ensures the council’s focus, aligning with CPHQ’s leadership principles.

The question "Did anything happen last night that could lead to a central line infection?" demonstrates a culture of safety because itproactively addresses potential patient safety issues. It encourages staff to reflect on recent events, identify possible risks, and take preventive actions to avoid harm. This focus on identifying and mitigating risks before they result in adverse events is a key component of a safety-oriented culture.

"Do we have available beds in the ICU?" (A): This question is operational and does not directly address safety concerns.

"Who is the last person that committed a medication error?" (C): This question could foster a blame culture rather than a culture of safety, which emphasizes systemic improvements over individual blame.

"What was the patient’s intake and output?" (D): This is a clinical question focused on patient care details, not on safety culture.

References

NAHQ Body of Knowledge: Building a Culture of Safety

NAHQ CPHQ Exam Preparation Materials: Safety Culture and Communication

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Detailed Explanation:

Reviewing resources, capabilities, and core competencies is essential for assessing project feasibility by determining if the organization has the necessary resources and skills.

Option C: Reviewing resources, capabilities, and core competencies

This action assesses the internal factors that impact an organization’s ability to undertake projects.

Considering social determinants of health aims to achieve health equity (D), ensuring fair health opportunities by addressing disparities. Global health (A), community health (B), and social justice (C) are less specific. NAHQ prioritizes health equity for SDOH-focused improvement.

NAHQ CPHQ Study Guide, Population Health and Care Transitions Section, “Social Determinants of Health and Health Equity”; NAHQ CPHQ Practice Questions, Population Health Goals.

Within the Health Data Analytics domain, NAHQ distinguishes clearly between incidence and prevalence. An incidence rate measures the occurrence of new cases of a condition within a defined population over a specified period of time. This makes incidence particularly useful for evaluating risk, monitoring trends, and assessing the impact of prevention strategies.

Option B correctly identifies all required elements of incidence: new cases, a defined time frame, and a population at risk. Option A describes prevalence at a point in time. Option D includes cases over time but does not specify new cases, making it closer to period prevalence. Option C reverses the numerator and denominator. Therefore, Option B is the accurate definition of an incidence rate as tested on the CPHQ exam.