Hospice Medical Director Practice Resource and Exam Prep
Assess your knowledge in hospice practice and prepare for the Hospice Medical Director Certification Board (HMDCB) examination with HMD PREP. This online practice test consists of 75 multiple-choice practice questions designed to assess your knowledge, identify topics for which additional study may be useful, and simulate the HMD certification examination.
How You Will Benefit
- Pinpoint topic areas where you can benefit from further study.
- Experience an online test first hand before sitting for the certification exam.
- Earn CME credits and MOC points.
You can access HMD PREP in two ways (once in each testing mode):
- Study mode provides the correct answer and explanations throughout the test
- Test mode simulates an examination, with results and explanations delivered after you have completed the practice test.
Content is based on the HMDCB Content Blueprint for the actual certification examination, and each question includes explanations for the correct and incorrect answers and references for further study.
As the hospice medical director, you are part of the leadership team responsible for the quality assurance and performance improvement (QAPI) program. Your hospice program is rolling out a performance improvement project (PIP) based on the National Quality Forum (NQF)–approved measure that patients treated with an opioid be given a bowel regimen.
What is the best way to initiate this PIP?
- In-service all clinical managers and implement the measures across the organization on a defined date to ensure everyone is on the same page.
- Have you, the hospice medical director, lead the roll out on your home-care team because your enthusiasm will increase the likelihood of success.
- Implement the PIP with your newest teams because your experienced hospice physicians and teams already know about giving bowel regimens to patients taking opioids.
- Plan a roll out with one team, implement the measure, review how the process and data are working, then refine the next steps in further implementation.
The correct answer is D, plan a roll out with one team, implement the measure, review how the process and data are working, then refine the next steps in further implementation. It uses the Institute for Healthcare Improvement’s Plan-Do-Study-Act (PDSA) cycle as a model to improve the quality of care through iterative testing. The pragmatic principles of PDSA cycles promote the use of a small-scale, iterative approach to test interventions because this method enables rapid assessment and provides the flexibility to adapt and change according to feedback to ensure fit-for-purpose solutions are developed. Using PDSA or another proven model to improve processes, systems, and care is imperative for success.
Option A, in-service all clinical managers and implement the measures across the organization on a defined date to ensure everyone is on the same page, is incorrect. A full-scale roll out of a PIP assumes, without initial small-scale testing, that the measures and processes will work. Starting on a smaller scale to test and refine the process prior to a full-scale roll out promotes a more effective performance improvement (PI) program that will improve practice. Option B, have you, the hospice medical director, lead the roll out on your home-care team because your enthusiasm will increase the likelihood of success, is not correct. Although having a champion on the team can influence buy-in by colleagues, it is not likely to be successful without a PDSA or other PI model for implementation. Option C, implement the PIP with your newest teams because your experienced hospice physicians and teams already know about giving bowel regimens to patients taking opioids, is incorrect. Both experienced and inexperienced physicians need to adapt to the new Medicare-required NQF measures as they are now reported, because noncompliance can impact reimbursement. A PIP will help implement best practices and minimize variability in care quality.
Hospice physicians should play a role in the implementation of hospice QAPI programs and should focus their efforts on Medicare-reported measures for PIPs to avoid penalties and maximize hospice reimbursement.
National Quality Forum. 1617. Patients Treated with an Opioid Who Are Given a Bowel Regimen. Washington, DC: National Quality Forum; 2012. http://www.qualityforum.org/QPS/MeasureDetails.aspx?standardID=1617&print=0&entityTypeID=1. Accessed April 8, 2014.
Centers for Medicare & Medicaid Services. User Guide for Hospice Quality Reporting Data Collection. Baltimore, MD: Centers for Medicare & Medicaid Services; 2013. http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Hospice-Quality-Reporting/Downloads/UserGuideforDataCollection-.pdf. Accessed April 8, 2014.
- Holly Yang, MD FAAHPM
- Jeremy Hirst, MD
- Cathy Deamant, MD
- Jane Loitman, MD MBA FAAHPM
- Wayne McCormick, MD MPH FACP
- Ruth Thomson, DO FACOI FAAHPM
- Janet Bull, MD FAAHPM
- Tara Friedman, MD FAAHPM
- Mahveen Hussain, MD
- Christopher Jones, MD
- Robert Killeen, Jr, MD
- Laurel Kilpatrick, MD
- Marcia Levetown, MD FAAHPM
- Jane Loitman, MD MBA FAAHPM
- Asif Merchant, MD FACP CMD
- Michael Parmer, DO
- James Powers, MD
- Earl Quijada, MD
- Colin Raitiere, MD
- Amy Swindell, DO
- Denise Waugh, MD FAAHPM
- Patrick White, MD
- Holly Yang, MD FAAHPM
- C. Porter Storey, MD FAAHPM
- Todd Cote, MD FAAFP FAAHPM