Failing to meet a strategic goal like improving patient satisfaction requires identifying the underlying reasons for the shortfall to inform effective interventions.
Option A (Implement benchmarking): Benchmarking compares performance to peers, useful later but not the initial step to understand internal issues.
Option B (Review department-specific data): Data review is part of root cause analysis but is too narrow as an initial step, as it assumes departmental issues.
Option C (Perform a needs assessment): Needs assessments identify gaps in resources or training, but they follow understanding the cause of failure.
Option D (Conduct a root cause analysis): This is the correct answer. The NAHQ CPHQ study guide states,
"When a strategic goal like patient satisfaction is not met, the initial step is to conduct a root cause analysis to identify underlying causes, such as process or communication failures" (Domain 4). RCA uses tools like fishbone diagrams to pinpoint issues.
CPHQ Objective Reference: Domain 4: Performance and Process Improvement, Objective 4.5, "Identify causes of performance gaps," emphasizes RCA for unmet goals. The NAHQ study guide notes, "RCA is critical to understand why strategic objectives are not achieved" (Domain 4).
Rationale: RCA identifies the root causes of the satisfaction gap, aligning with CPHQ's improvement principles.
Reference: NAHQ CPHQ Study Guide, Domain 4: Performance and Process Improvement, Objective 4.5.

The initiative to increase lung cancer screenings for a patient population with a history of smoking falls under secondary prevention123. Secondary prevention aims to reduce the impact of a disease or injury that has already occurred2. This is done by detecting and treating disease or injury as soon as possible to halt or slow its progress2. In the context of healthcare, screenings are a common form of secondary prevention123. They allow for early detection of diseases like lung cancer, especially in high-risk groups such as smokers123. Early detection can lead to more effective treatment and better health outcomes123.
Reference: 1
https://www.iwh.on.ca/what-researchers-mean-by/primary-secondary-and-tertiary-prevention

Human factors engineering is a science that uses a systems approach to consider human psychological, social, physical, and biologic characteristics and applies the information to design equipment, processes, and environments to optimize human performance, health, and safety1. One of the applications of human factors engineering is forcing functions, which are design features that prevent users from making errors or performing unsafe actions2. For example, a forcing function can prevent a user from inserting a wrong key into a lock, or plugging a wrong device into a socket. In the case of the defibrillator pads, a forcing function could have prevented the delay by making the pads incompatible with the wrong defibrillator, or by alerting the user of the mismatch before attempting to use the device. This would have ensured that only the correct pads were used with the correct defibrillator, and avoided the potential harm to the patient.
The other options are not applications of human factors engineering, but rather methods or strategies that can be used to improve quality and safety in health care. Checklists are tools that help users remember and follow a series of steps or tasks3. Resiliency efforts are actions that help users cope with and recover from adverse events or situations. Usability testing is a process that evaluates how easy and effective a product or system is to use by the intended users.
Reference: 1: Human Factors in Healthcare | SpringerLink 2: Human Factors Engineering | PSNet 3:
Checklist Use in Healthcare: A Practical Guide to Improving Quality and Safety: Resilience in Healthcare:
A Systematic Review and Synthesis of the Literature: Usability Testing of Medical Devices