CPXP EXAM REVIEW SOLUTION

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Grand Canyon University *

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152

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Health Science

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Nov 24, 2024

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6

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CPXP EXAM REVIEW SOLUTION HEART - Hear, empathize, apologize, respond, thank HEART - Hear, empathize, apologize, respond, thank LEARN - Listen, empathize, apologize, resolve, never leave them hanging. HCAHPS 8 Composites of Care - NDHPMHDO, Nurse communication, doctor communication, hospital staff responsiveness, pain management, medicine communication, hospital cleanliness and quietness, discharge information, overall hospital rating HCAHPS frequency scales - always, usually, sometimes, never HCAHPS VBP scoring - Achievement points and improvement points. Consistency score. Patient rights - Freedom from discrimination, medical information explained, know names of caregivers, right to refuse treatment, pain management, info about advance directives, accessibility to spiritual counseling, confidentiality, effective communication, confidential records, dignity, right to complain, access to medical record, right to info regarding associated agencies for care, accept or decline in research, discharge planning, estimated costs, patient visitation rights. Complaint - Concern voiced by a patient or patient's rep about service, care or treatment that can be resolved quickly by the staff present. Is resolved with the patient is satisfied with the actions taken on his/her behalf. Three Rs in religious diversity - Religion, respect, resources. What is the patient's religion? Respect: sacred texts, clothing, sacramental needs. Resources: chaplain, etc. Sympathy vs. empathy - Sympathy is feeling sorry for someone, empathy is walking in someone else's shoes. With empathy, an advocate can begin to understand the underlying emotions and pressures.
Managing difficult behavior - Maintain adequate space, keep hands out of pockets, avoid threatening gestures, avoid rapid movements, avoid laughing, be calm, lower volume of voice, speak firmly, use short simple sentences, position by a safe exit, convey expectation that the patient can control behavior, stay in front but to the side of the patient, demonstrate listening behaviors, let patient vent, be honest AIDET - Acknowledge (Mr. Smith), introduce (with experience), duration (length of test), explanation (explain the procedure), thank patient. Five pillars of excellence - people service quality finance and growth DESK model - Describe the behavior you have seen, evaluate how you feel, show what you want to see instead, know the consequences. "I have noticed you leave your work space in an inappopriate manner. I'm disappointed in this and want you to fix it. Let me show you how the space should look when you leave for the day. This is a verbal warning, if it happens again...then .... " Heart Head Heart Model - Start with a caring message. "I'm sorry to see you in pain." Use a Head message next, sharing or gathering information. "Tell me more about the pain." End with an emotional message. "I want to help." Ask Tell Ask model - Find out what the patient already knows by asking him/her to tell you. Provide an explanation to meet the person's needs. Verify understanding by asking a question (teach back). Hard Conversations Model - State our positive intent, tell the truth fast, listen and understand, find common ground, identify options and the action plan, express appreciation The Caring Broken Record - To address repeated resistance, use this method: State your clear bottom line message, add lots of caring messages, continually repeat. For as long as the person resists, keep combining your bottom line message with a caring statement. Complaint - Concern voiced by a patient or patient's rep about service, care or treatment that can be resolved quickly by the staff present. A complain is
resolved with the patient is satisfied with the actions taken on his/her behalf. Grievance - written or verbal complaint by a patient, or patient rep, about the patient's care. When a verbal complain by the patient is not resolved at the time of the complain by staff present. A written note attached to a patient survey.. An issue of abuse, neglect, patient harm or hospital compliance. Kotter's 8 stage Process for Organizational Transformation - Establish a sense of urgency, Create the guiding coalition, develop a vision and strategy, communicate the change vision, empower employees for broad based action, generate short term wins, consolidate gains and produce more change, anchor new approaches in the culture Communication - Correlates to: quality, safety and patient loyalty. Effective healthcare communication leads to increased satisfaction, increased trust with the clinician, improved overall health status and functional and psychological well being. Patients of physicians with high empathy scores, measured by a validated sale, were significantly more likely to have good control of diabetes and cholesterol. Physicians typically redirect patients within 18 - 23 seconds of listening to them speak Communication skills that work - Create a shared agenda, show empathy, use understandable explanations Beginning of the conversation - Establish rapport, ask for list of all concerns, negotiate shared agenda. Building Trust - Ask open ended questions and listen actively, elicit the patient's ideas and expectations, respond with empathy, transition to further data gathering. PEARLS - Partnership, emotion, apology, respect, legitimization, support. (Communication RX p, 43) P = "Let;s work together. E = I imagine this is frustrating for you. A = I am sorry to keep you waiting R = you have worked really hard to get through this. L: most people in your position would feel this way S: I'm going to stick with you through this
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Delivering Diagnosis with ART - Ask the patient for his or her perspective about the diagnosis or symptoms, Respond to them with active listening and empathy, Tell your perspective (Communication RX, p. 50) Three Talk Model (Shared Decision Making) - Team Talk: emphasize supporting patient as you signal choices and elicit goals. Option talk: compare alternatives using risk communication principles. Decision talk: elicit preferences and integrate into next steps (Communication RX: p. 97) Accountabilities drive structure and structure drives - culture (If Disney ran your hospital, p. 41). Culture eats strategy for breakfast. Improve efficiency by... - Placing courtesy and service fist, before efficiency. Next External focus, responsiveness and sharing resources (IF Disney ran your hospital, p. 42) Cultivate patient loyalty - Patient satisfaction does not guarantee loyalty. Satisfied customers do not have stories to tell. Build customer loyalty through compassion and emotion. Spontaneity was described as the ability of frontline employees to solve problems spontaneously on the spot (If Disney ran your hospital, p. 106) How to improve the patient experience - Create a memorable experience, engage patients on an emotional, physical, intellectual and spiritual level. (IF Disney ran your hospital, p. 111) Staging an experience, not delivering service. Four levels of motivation - Compliance, will power, imagination, habit (If Disney ran your hosp, p. 134) Target imagination for motivation. Imagine how the patient feels, tell patient stories, visualize when you have lost the weight, etc. Six high level disciplines of customer experience - strategy, customer understanding, design, measurement, governance, culture (Manning & Bodine, p. 62) Nominal scale - A naming scale, where variables are simply "named" or labeled, with no specific order. Democrat vs. republican, type of computer.
Ordinal scale - Has all its variables in a specific order, beyond just naming them. Depict non-mathematical ideas such as frequency, satisfaction, happiness, a degree of pain.The distance between variables can't be calculated. Grades, satisfaction, happiness. Interval scale - Offers labels, order, as well as, a specific interval between each of its variable options. Defined as a numerical scale where the order of the variables is known as well as the difference between these variables.Celsius and Farhenheit, family income. The only drawback of this scale is that there no pre-decided starting point or a true zero value. Ratio scale - Bears all the characteristics of an interval scale, in addition to that, it can also accommodate the value of "zero" on any of its variables. Defined as a variable measurement scale that not only produces the order of variables but also makes the difference between variables known along with information on the value of true zero. With the option of true zero, varied inferential and descriptive analysis techniques can be applied to the variables. Height. Weight. Nominal scale is measured using - percentages or mode. Interval scale can be measured by... - Mean, median or mode Ratio scale can be measured by - Mean, median, mode & varied inferential and descriptive analysis techniques can be applied to the variables. With a ratio scale, we can - Add, subtract, multiply and divide variables. With an interval scale, we can - Add and subtract variables You can calculate the mean with which scale types? - Interval and ratio Which scale type has an absolute 0? - Ratio Pareto charts - Are a graphical way of identifying the few critical items from the many less important ones. Length of bars represent frequency or cost (time or money) and are arranged with the longest bars on the left, and the shortest to the right.
Use Pareto Charts when... - When analyzing data about the frequency of problems or causes in a process, and when you want to focus on the most significant issues of many. Also, when analyzing broad causes by looking at frequency of components. Affinity diagram - A tool that gathers large amounts of language data (ideas, opinions, issues) and organizes them into groupings based on their natural relationships (Viewgraph 1). The Affinity process is often used to group ideas generated by Brainstorming. PDSA - Plan, Do, Study, Act DMAIC - Define, Measure, Analyze, Improve, Control A3 Report - One page reports used for documenting the necessary information needed for progress reporting and decision making. Some of the items that are usually present in an A3 Report are: Background, Current Situation and Problem, Objective, Root Cause Analysis. Action/Improvement Item, Validation of Improvement, Follow-up and Changes
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