Domain II - Health Statistics and Research Support (11 %)

1. Domain II-Health Statistics and Research Support (11%) RHIA Prep Workshop 2014

2. Domain Content 1.Identify and/or respond to the information needs of internal and external healthcare customers 2.Filter and/or interpret information for the end customer 3.Analyze and present information for organizational management (for example, quality, utilization, risk) 4.Use data mining techniques to query and report from databases

3. Hot Topics • Dimensions of Data quality • Performance measurement • Disease prevalence • Data collection tools • Data display • Bar graph • Histogram • Pie Chart • Line Chart • (Next Slide)

4. Data Display

5. Hot Topics • Data mining • Do Not Use abbreviations- Joint Commission • Clinical Quality Improvement (CQI)- data capture and analysis • Risk Management • Data collection and reporting • Incident Reporting • Occurrence Screening • Joint Commission Sentinel event reviews • EHR functionality- clinical data repository • Data capture technology • Data retrieval technology • System communication and networks • Clinical research

6. Practice Question #1 A patient’s name is typically stored in a database as three data elements- last name, first name and middle name- and not as a single data element. Which dimension of data quality is being applied when this occurs? Accuracy Granularity Precision Currency

7. Utilization Management • Purpose: • ensuring the appropriate and efficient use of a facility’s or health plan’s resources. • Utilization Review • Formal review of patient resource use • Data collected helps determine the appropriateness of services provided. • Evidence Based Guidelines • Processes • Preadmission review • Admission review • Continued-stay review • Discharge planning • Retrospective review • Ancillary services review • Medicare review • External agency review • Medicaid review • Managed Care review

8. Practice Question #2 This function of the utilization management program determines medical necessity and appropriateness of admission. Admission review Concurrent review Discharge planning Preadmission planning

9. Decision Support • Data warehousing • Data mining • Transactional systems • Electronic data processing and storage • Database management • Graphical user interface (GUI) • Data-based DSS • Model-based DSS • Knowledge-based DSS • Graphics-based DSS

10. Data Warehousing

11. Standards • Qualitative • Service standards in the context of setting expectations for how well or how soon work or a service will be performed. • Quantitative • Measures of productivity in the context of setting expectations for how efficiently or effectively work will be performed.

12. Practice question #3 The following performance standard, “Complete five birth certificates per hour” is an example of: Quality standard Quantity standard Joint Commission Standard Compliance standard

13. Performance Measurement • Process of comparing outcomes of an organization, work unit, or employee to pre-established performance plans and standards. • Performance controls • Flexibility • Simplicity • Economy • Timeliness • Focus on exceptions

14. Performance Measurement • Assessment of Employee performance: • Monitor and measure outcomes • Turnaround times • Compare performance to established goals and standards • Productivity, trends • Evaluating variance and developing action plans • Collect data to show variances

15. Performance Improvement • Principles: • Input • Process • Output • Controls/standards • Feedback • External environment • Open systems • Cybernetic systems • Closed systems

16. Practice Question #4 The final results of care, treatment, and services in terms of the patient’s expectations, needs, and quality of life, which may be positive and appropriate or negative and diminishing, are included in what area of performance measurement? Outcomes Processes Systems Benchmarks

17. Statistics • Ratios • Proportions • Rates • Census data • Bed occupancy rates • Length of stay data • Mortality • Case-Mix Index (CMI) • National/Regional health statistics • Public health records • Centers for Disease control (CDC)

18. Practice Question This type of data are also called categorical data and includes values assigned to name specific categories. Nominal Data Ordinal Data Discrete Date Continuous Data

19. PRACTICE QUESTIONS

20. Health Hospital reports 1,652 discharges for March. The infection control report documents 21 nosocomial infections and 27 community-acquired infections for the same month. What is the community-acquired infection rate? 1.3 1.4 1.6 2.9

21. All of the following items mean the same thing, EXCEPT Inpatient service day Daily inpatient census Daily census Inpatient census

22. A patient was admitted to the hospital on March 24 and discharged on April 9. The LOS is ___. 14 days 15 days 16 days 17 days

23. Jason John was pronounced dead on arrival at the hospital. The hospital pathologist performed an autopsy on Mr. John’s body. This statistical even would be counted in the Net death rate Gross death rate Net autopsy rate Hospital autopsy rate

24. The best form/graph for demonstrating trends over time would be Frequency polygon Line graph Pie chart Histogram

25. You want to graph the number of patients admitted to three different medical staff services on each day of last month. Because you have a large number of observations (one for each day of the month) and you want to be able to compare the observations for each of the three services on one data display, your best choice is a Table Bar chart Line graph Histogram