DMAIC (Define, Measure, Analyze, Improve, Control) is a Six Sigma methodology for process improvement, with each phase serving a specific purpose.
Option A (Measure): The Measure phase collects baseline data to understand current performance, not sustain improvements.
Option B (Analyze): The Analyze phase identifies root causes, not focused on sustaining new processes.
Option C (Improve): The Improve phase implements solutions, but does not ensure long-term sustainability.
Option D (Control): This is the correct answer. The NAHQ CPHQ study guide states, "The Control phase of DMAIC establishes monitoring systems and standardizes processes to sustain improvements over time" (Domain 4). Tools like control charts and standard operating procedures ensure performance is maintained.
CPHQ Objective Reference: Domain 4: Performance and Process Improvement, Objective 4.3, "Use structured improvement methodologies," includes DMAIC's Control phase for sustainability. The NAHQ study guide notes, "Control ensures improvements are sustained through ongoing monitoring and standardization" (Domain 4).
Rationale: The Control phase is designed to maintain process performance, aligning with CPHQ's focus on sustainable improvement.
Reference: NAHQ CPHQ Study Guide, Domain 4: Performance and Process Improvement, Objective 4.3.

Using patient storytelling is the most effective approach to motivate stakeholders across the care continuum to take action. Stories about real patients help to humanize the data, making the need for improvement more tangible and emotionally compelling. This approach can resonate deeply with stakeholders by illustrating the direct impact of quality initiatives on patient lives, thereby driving a stronger commitment to improvement efforts.
* Release national benchmarks (A): While important, benchmarks alone may not motivate action as effectively as personalized, emotional stories.
* Develop interactive dashboards (B): Dashboards are useful for tracking performance but may not evoke the same emotional response as storytelling.
* Publish unblinded outcome reports (C): This can promote transparency but may not engage stakeholders emotionally or inspire action as effectively as storytelling.
References
* NAHQ Body of Knowledge: Stakeholder Engagement and Motivation Techniques
* NAHQ CPHQ Exam Preparation Materials: Using Storytelling in Quality Improvement
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To decrease the length of stay for inpatients on a surgical unit, measuring delays between steps in the patient care process is crucial. These delays often represent non-value-added time that can be reduced or eliminated to streamline patient flow and reduce overall length of stay. Identifying and addressing these inefficiencies can lead to more timely care and quicker discharges.
* Number of services provided (A): This measures volume, not process efficiency.
* Turnaround time for diagnostic test results (B): This is important but only one component of potential delays.
* Nursing productivity (D): While important, it does not directly address process inefficiencies related to length of stay.
References
* NAHQ Body of Knowledge: Lean Principles and Process Optimization
* NAHQ CPHQ Exam Preparation Materials: Reducing Length of Stay through Process Improvement
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Detailed Explanation:
High-reliability organizations emphasize learning from failures by gathering insights from those involved in incidents to prevent recurrence.
Option C: Meet with staff involved in the errors to gain additional insight This option aligns with high-reliability principles by fostering an open learning culture and understanding factors contributing to errors.
References:
The high-reliability framework promotes analyzing errors collaboratively to enhance safety and prevent recurrence, as covered in CPHQ resources.

Hot-spotting (Answer B) is a population health management technique used to identify patients or geographic areas that generate a disproportionately high number of emergency room visits or healthcare costs. By focusing on these "hot spots," healthcare providers can develop targeted interventions to address the underlying issues that lead to frequent ER visits, such as chronic disease management, social support needs, or access to primary care. The aim is to improve patient outcomes and reduce healthcare utilization in these high-need areas.
The other options refer to different public health or surveillance methods:
* Public health surveillance (A) is the continuous, systematic collection and analysis of health data for the planning, implementation, and evaluation of public health practice.
* Syndromic surveillance (C) involves the real-time collection of data on symptoms or syndromes to detect potential outbreaks of disease before diagnoses are confirmed.
* Cold-spotting (D) typically refers to identifying areas or populations with low healthcare utilization or unmet needs, which is the opposite focus of hot-spotting.
References:
* National Association for Healthcare Quality (NAHQ) - Certified Professional in Healthcare Quality (CPHQ) Study Materials.
* Population Health Management Techniques, NAHQ Documentation.
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