Chapter 18
Question 1
According to Peters (2002), which of the following are considered stages of policy
development?
1. Recognition of a problem or issue
2. Agenda setting
3. Policy formation
4. Brainstorming
5. Budgeting
Correct Answer: 1, 2, 3
Rationale 1:
Recognition of a problem or issue is the first step in policy development as it involves
identifying and acknowledging that a particular problem exists and requires attention from
policymakers.
Rationale 2:
Agenda setting follows the recognition of a problem or issue. It involves deciding which
issues will receive attention from policymakers and be placed on the political agenda for
consideration and action.
Rationale 3:
Policy formation is the stage where potential solutions to the identified problem are
developed and evaluated. This stage involves the drafting and shaping of policy proposals to
address the problem or issue at hand.
Rationale 4:
Brainstorming may be a part of the policy development process, but it is not universally
considered a distinct stage. It often occurs during the policy formation stage as a method for
generating ideas and potential solutions.
Rationale 5:
Budgeting is an important aspect of policy implementation rather than policy development.
While financial considerations are relevant throughout the policy process, budgeting typically
occurs after policies have been formulated and adopted, during the implementation phase.
Question 2
Health policy may at times contribute to negative trends. Certain aspects of U.S. health policy
have been blamed for creating or contributing to some of the health problems. Which of the
following are associated with wayward policies?
1. Lack of clinical and administrative standardization
2. Fragmented care
3. Unequal access to care
4. Turning health problems into marketing opportunities
5. Failure to curtail costs for services
Correct Answer: 1, 2, 3, 4, 5
Rationale 1:
Lack of clinical and administrative standardization can result from fragmented policies and
regulations, leading to inefficiencies, errors, and inconsistencies in healthcare delivery.
Without standardized practices, it becomes challenging to ensure quality, safety, and
interoperability across healthcare settings.
Rationale 2:
Fragmented care often arises from disjointed policies and reimbursement structures that
incentivize volume over value, leading to fragmented care delivery, care coordination
challenges, and gaps in continuity of care. Fragmentation can result in suboptimal health
outcomes, increased healthcare costs, and patient dissatisfaction.
Rationale 3:
Unequal access to care can stem from policies that fail to address socioeconomic disparities,
insurance coverage gaps, geographic barriers, and systemic biases. Such policies perpetuate
inequities in healthcare access and outcomes, exacerbating health disparities among
vulnerable populations.
Rationale 4:
Policies that prioritize profit motives over public health interests may contribute to turning
health problems into marketing opportunities, such as the promotion of unnecessary
medications, medical procedures, or lifestyle products. This can lead to overmedicalization,
inappropriate healthcare utilization, and increased healthcare spending without commensurate
improvements in health outcomes.
Rationale 5:
Failure to curtail costs for services can result from policies that lack effective costcontainment measures, such as fee-for-service reimbursement models, lack of price
transparency, and limited competition in healthcare markets. Without addressing cost drivers,
healthcare spending continues to escalate, straining budgets, limiting access to care, and
undermining the sustainability of healthcare systems.
Question 3
The need for health care reform has been obvious for some time but the implications of the
broken U.S. health care delivery system were largely brought to the attention of the public
through which famous report?
1. Learning What Works: Infrastructure Required for Comparative Research - Workshop
Summary
2. From Public Health: Revitalizing Law and Policies to Meet New Challenges
3. To Err is Human: Building A Safer Health System
4. Leading Health Indicators for Healthy People 2020
Correct Answer: 3
Rationale 1:
The Institute of Medicine published the classic report To Err is Human: Building A Safer
Health System. The data described in the report highlighted the need for immediate action to
minimize errors in the health care setting.
Rationale 2:
The Institute of Medicine published the classic report To Err is Human: Building A Safer
Health System. The data described in the report highlighted the need for immediate action to
minimize errors in the health care setting.
Rationale 3:
The Institute of Medicine published the classic report To Err is Human: Building A Safer
Health System. The data described in the report highlighted the need for immediate action to
minimize errors in the health care setting.
Rationale 4:
The Institute of Medicine published the classic report To Err is Human: Building A Safer
Health System. The data described in the report highlighted the need for immediate action to
minimize errors in the health care setting.
Question 4
Health information technology can be seen as a tool to aid the health care reform process
through which of the following?
1. Limited engagement
2. Sharing information with interested parties
3. Recognition of its potential to improve the safety and efficiency of health care delivery
4. Denying care to individuals who cannot pay
Correct Answer: 3
Rationale 1:
Limited engagement is not a way in which health information technology aids the health care
reform process. In fact, effective health information technology implementation often
requires widespread engagement from various stakeholders to ensure successful adoption and
integration into healthcare systems.
Rationale 2:
Sharing information with interested parties is a potential benefit of health information
technology, but it alone does not represent how it aids the health care reform process. Health
information technology facilitates the secure exchange of health information among
healthcare providers, patients, and other authorized parties, which can contribute to improved
care coordination and communication, but this does not directly address healthcare reform.
Rationale 3:
Recognition of its potential to improve the safety and efficiency of health care delivery is a
key way in which health information technology aids the health care reform process. By
leveraging health IT solutions such as electronic health records (EHRs), telemedicine, and
health data analytics, healthcare systems can enhance patient safety, reduce medical errors,
streamline workflows, and improve overall quality and efficiency of care delivery, aligning
with the goals of healthcare reform.
Rationale 4:
Denying care to individuals who cannot pay is not a function or purpose of health
information technology. In fact, one of the aims of healthcare reform is to increase access to
care and reduce disparities, and health information technology is often utilized to support
these efforts by improving care coordination, expanding telehealth services, and enhancing
population health management.
Question 5
President George W. Bush signed a law that mandated the development of an EHR for every
American by which year?
1. 2013
2. 2014
3. 2015
4. 2020
Correct Answer: 2
Rationale 1:
President George W. Bush signed the law promoting the adoption of electronic health records
(EHRs), known as the Health Information Technology for Economic and Clinical Health
(HITECH) Act, in 2009. However, it did not specify the development of an EHR for every
American by 2013.
Rationale 2:
The correct answer. The HITECH Act, signed into law by President George W. Bush in 2009,
mandated the development of an EHR for every American by 2014. This legislation aimed to
accelerate the adoption and meaningful use of electronic health records to improve healthcare
quality, safety, and efficiency.
Rationale 3:
While 2015 is a significant year in the timeline of EHR adoption and meaningful use
requirements, it is not specifically tied to the law signed by President George W. Bush
mandating the development of an EHR for every American.
Rationale 4:
While 2020 represents a more recent timeframe in the evolution of healthcare and health
information technology, it is not associated with the law signed by President George W. Bush
mandating the development of an EHR for every American. The requirement was set for
completion by 2014, as mandated by the HITECH Act.
Question 6
Widespread adoption of HIT (Health Information Technology) requires _______________
and policies that make quality improvement and cost reduction essential to providers in order
to accomplish their financial and professional goals.
Correct Answer: economic incentives
Rationale:
Ultimately widespread adoption of HIT requires economic incentives and policies that make
quality improvement and cost reduction essential to providers in order to accomplish their
financial and professional goals.
Question 7
Healthcare technology has multiple benefits and can be instrumental in continuing the
healthcare reform process. Which of the following would be considered a benefit?
1. Immediate electronic access to all records
2. The development of best practice models
3. A larger portion of the operating budget used to purchase and maintain electronic
equipment
4. Improves the safety and efficiency of health care delivery
5. Facilitates the sharing of information needed to improve the quality of care
Correct Answer: 1, 2, 4, 5
Rationale 1:
Immediate electronic access to all records is a significant benefit of healthcare technology. It
allows healthcare providers to access patient records quickly and efficiently, leading to betterinformed decision-making, improved care coordination, and enhanced patient safety.
Rationale 2:
The development of best practice models is facilitated by healthcare technology. Electronic
health records (EHRs) and data analytics enable healthcare organizations to identify and
disseminate best practices, standardize care protocols, and implement evidence-based
interventions to improve patient outcomes and quality of care.
Rationale 3:
A larger portion of the operating budget used to purchase and maintain electronic equipment
is not necessarily a benefit of healthcare technology. While investment in technology is
essential, the goal is to achieve cost-effective solutions that improve healthcare delivery,
rather than increasing spending on equipment alone.
Rationale 4:
Improving the safety and efficiency of healthcare delivery is a key benefit of healthcare
technology. Electronic health records, clinical decision support systems, telemedicine, and
other technological innovations help reduce medical errors, streamline workflows, and
optimize resource utilization, ultimately enhancing patient safety and care quality.
Rationale 5:
Facilitating the sharing of information needed to improve the quality of care is another
significant benefit of healthcare technology. Interoperable systems, health information
exchanges, and data-sharing platforms enable healthcare providers to exchange relevant
clinical information, coordinate care across settings, and collaborate on care plans, leading to
improved care coordination and better health outcomes for patients.
Question 8
The Health Information Technology (HIT) Committee was created under the auspices of the
Federal Advisory Committee Act (FACA). The committee is composed of several
workgroups designated by the National Coordinator for Health IT. Which of the following
individual working groups are associated with the HIT Committee?
1. Governance
2. Privacy and Security Tiger Team
3. Strategic Plan Privacy and Security Policy
4. National Health Information Network (NHIN)
5. Meaningful Use Certification/Adoption Information Exchange
Correct Answer: 1, 2, 3, 4, 5
Rationale 1:
The Governance workgroup focuses on establishing policies, procedures, and guidelines for
the effective governance of health information technology initiatives and infrastructure,
ensuring alignment with organizational objectives and regulatory requirements.
Rationale 2:
The Privacy and Security Tiger Team workgroup is tasked with addressing privacy and
security issues related to health information technology, including the development of
policies, standards, and best practices to safeguard patient information and mitigate security
risks.
Rationale 3:
The Strategic Plan Privacy and Security Policy workgroup is responsible for developing
strategic plans and policies to address privacy and security concerns in health information
technology, ensuring compliance with relevant laws and regulations while promoting
interoperability and data sharing.
Rationale 4:
The National Health Information Network (NHIN) workgroup focuses on advancing the
development and implementation of a nationwide health information exchange network,
facilitating secure and interoperable exchange of health information among healthcare
providers, organizations, and stakeholders.
Rationale 5:
The Meaningful Use Certification/Adoption Information Exchange workgroup is dedicated to
promoting the adoption and meaningful use of health information technology, including the
development of certification criteria and standards to support interoperability, usability, and
quality improvement in healthcare delivery.
Question 9
Which of the following serve as a guide in the development of the policies and technologies
used to support quality reporting and other uses of health data?
1. Budget
2. Regulations
3. Issues
4. Values
Correct Answer: 4
Rationale 1:
Budget considerations may influence the implementation of policies and technologies, but
they do not directly guide the development of policies and technologies related to quality
reporting and health data usage.
Rationale 2:
Regulations, such as laws and guidelines set forth by government agencies, provide the legal
framework for quality reporting and the use of health data. While regulations are important
for compliance and governance, they are not inherently guiding principles in the development
process.
Rationale 3:
Issues related to healthcare, data management, and quality improvement may inform the
development of policies and technologies, but they do not serve as a guide in themselves.
Rather, addressing these issues may be a goal of policy and technology development.
Rationale 4:
Values, including ethical principles, patient-centeredness, transparency, and accountability,
serve as guiding principles in the development of policies and technologies used to support
quality reporting and health data usage. These values inform decision-making, shape
priorities, and ensure that policies and technologies align with ethical standards and
stakeholder interests.
Question 10
The development of HIT policy advisory boards should reflect the needs of all citizens. To
gather data needed to create appropriate policies, special interest groups become part of the
assessment and planning process. To that end, which of the following groups support or
impact health care policy?
1. Agency for Healthcare Research and Policy
2. Alliance for Health Reform
3. American Federation of Labor and Congress of Industrial Organizations
4. American Hospital Association
5. Henry J. Kaiser Family Foundation
Correct Answer: 1,2,3,4,5
Rationale 1:
Agency for Healthcare Research and Policy is a government agency whose research provides
evidence-based information on health care outcomes, quality, cost, use, and access.
Rationale 2:
Alliance for Health Reform is a bipartisan, nonprofit that conducts health policy briefings on
Capitol Hill for congressional staff and media, publishes resource books on health policy
topics, aids journalists to develop articles and broadcasts on health issues, and maintains a list
of hundreds of health care experts.
Rationale 3:
American Federation of Labor and Congress of Industrial Organizations is a political voice
for workers and represents employees in policy reforms, including health care and employee
benefits.
Rationale 4:
American Hospital Association is a national organization representing hospitals, health care
networks, patients, and communities in national health policy development, legislative and
regulatory debates, and judicial matters.
Rationale 5:
Henry J. Kaiser Family Foundation is a nonprofit, private operating foundation that focuses
on major health care issues. It is an independent voice and source of facts and analysis for
policymakers, media, health care professionals, and the public.
Question 11
With the increased use of HIT in health care settings, nurses are asked to participate in the
development of national, state, and local policy. How can nurses gain practical experience in
policy shaping and development?
1. Internships
2. Continuing education programs
3. Online legal courses
4. Volunteer in a homeless shelter
Correct Answer: 1
Rationale 1:
Nurses can gain the training and expertise in policy development in a number of ways. There
are internships provided by a number of agencies that offer nurses the opportunity to learn
about policy initiatives from a front line perspective. Health care professionals interested in
health policy beyond the course content offered in formal nursing programs should explore
educational opportunities offered through the Institute of Medicine the Health Policy
Educational Programs and Fellowships (HPEPF) office.
Rationale 2:
Nurses can gain the training and expertise in policy development in a number of ways. There
are internships provided by a number of agencies that offer nurses the opportunity to learn
about policy initiatives from a front line perspective. Health care professionals interested in
health policy beyond the course content offered in formal nursing programs should explore
educational opportunities offered through the Institute of Medicine the Health Policy
Educational Programs and Fellowships (HPEPF) office.
Rationale 3:
Nurses can gain the training and expertise in policy development in a number of ways. There
are internships provided by a number of agencies that offer nurses the opportunity to learn
about policy initiatives from a front line perspective. Health care professionals interested in
health policy beyond the course content offered in formal nursing programs should explore
educational opportunities offered through the Institute of Medicine the Health Policy
Educational Programs and Fellowships (HPEPF) office.
Rationale 4:
Nurses can gain the training and expertise in policy development in a number of ways. There
are internships provided by a number of agencies that offer nurses the opportunity to learn
about policy initiatives from a front line perspective. Health care professionals interested in
health policy beyond the course content offered in formal nursing programs should explore
educational opportunities offered through the Institute of Medicine the Health Policy
Educational Programs and Fellowships (HPEPF) office.
Question 12
TIGER Leadership Collaborative Report has called for transformation of the health care
delivery system through the development of a national health information infrastructure that
requires nurse leaders “understand, promote, own, and measure the success of health IT.” To
do so, which of the following strategies cannot be incorporated?
1. Education programs for nurse executives and faculty that stress the value of information
technology and empower them to use HIT appropriately
2. The expansion/integration of informatics competencies into nursing leadership
development programs
3. Exchange best practice models with physician groups
4. Sharing of best practices using HIT effectively to improve the delivery of nursing care
Correct Answer: 3
Rationale 1:
Education programs for nurse executives and faculty are essential for promoting
understanding and appropriate use of health information technology (HIT) among nursing
leaders. Empowering nurse leaders with knowledge and skills in HIT ensures they can
effectively champion HIT initiatives and drive organizational change.
Rationale 2:
The expansion and integration of informatics competencies into nursing leadership
development programs are crucial for preparing nurse leaders to effectively leverage HIT in
healthcare delivery. Integrating informatics into leadership development ensures that nurse
leaders possess the necessary skills and knowledge to lead HIT initiatives and drive
transformation.
Rationale 3:
While exchanging best practice models with physician groups may be beneficial for
improving healthcare delivery and fostering interdisciplinary collaboration, it is not a strategy
specifically focused on enhancing nurse leaders' understanding, promotion, ownership, and
measurement of health IT success. Therefore, it cannot be directly incorporated as a strategy
to achieve the goals outlined in the TIGER Leadership Collaborative Report.
Rationale 4:
Sharing best practices using HIT effectively to improve the delivery of nursing care is a key
strategy for nurse leaders to promote the successful implementation and use of HIT in nursing
practice. By sharing experiences and lessons learned, nurse leaders can facilitate the adoption
of HIT solutions that enhance patient care outcomes, workflow efficiency, and nursing
practice quality.
Question 13
Nurse executives are asked to play important roles in the shaping of HIT policy. Which of the
following apply to ways in which they can be actively involved?
1. Overcome financial and cultural barriers related to HIT
2. Support and provide leadership development on HIT-related topics
3. Incrementally decrease the information technology budget line for support services
4. Contribute to research that substantiates the business case for nursing
5. Improve patient safety through the use of decision-support tools at the point of care
Correct Answer: 1,2,4,5
Rationale 1:
Nurses have been encouraged to play an active and supporting role in the development and
implementation of HIT within their organizations. To do so, they can assist in overcoming
barriers, promote and be part of the change process, educate themselves and others on the
overall benefits of HIT, and work in tandem with special interests groups to identify and
promote policy.
Rationale 2:
Nurses have been encouraged to play an active and supporting role in the development and
implementation of HIT within their organizations. To do so, they can assist in overcoming
barriers, promote and be part of the change process, educate themselves and others on the
overall benefits of HIT, and work in tandem with special interests groups to identify and
promote policy.
Rationale 3:
Nurses have been encouraged to play an active and supporting role in the development and
implementation of HIT within their organizations. To do so, they can assist in overcoming
barriers, promote and be part of the change process, educate themselves and others on the
overall benefits of HIT, and work in tandem with special interests groups to identify and
promote policy.
Rationale 4:
Nurses have been encouraged to play an active and supporting role in the development and
implementation of HIT within their organizations. To do so, they can assist in overcoming
barriers, promote and be part of the change process, educate themselves and others on the
overall benefits of HIT, and work in tandem with special interests groups to identify and
promote policy.
Rationale 5:
Nurses have been encouraged to play an active and supporting role in the development and
implementation of HIT within their organizations. To do so, they can assist in overcoming
barriers, promote and be part of the change process, educate themselves and others on the
overall benefits of HIT, and work in tandem with special interests groups to identify and
promote policy.
Question 14
Nurses can be leaders in the development and implementation of HITs by which of the
following?
1. Guiding the process
2. Attending graduate school
3. Resisting change and innovation
4. Researching best practice models
Correct Answer: 1
Rationale 1:
As health care professionals, especially nurses collect and synthesize data that supports the
efficiency of HIT, individuals initially opposed to the advancement of HIT may consider
being part of the process of change.
Rationale 2:
Nurses have the opportunity to promote change within the system by demonstrating
leadership and enthusiasm for change.
Rationale 3:
Resisting change does not advance the achievement of the HIT goals.
Rationale 4:
Researching best practice models is useful but does not demonstrate leadership in the
development and implementation of HITs.
Question 15
What are some of the HIT benefits that can be actualized in the health care setting?
1. Decreased point of care contact
2. Increased revenue
3. Personalized health care
4. Increased need to upgrade technology
Correct Answer: 3
Rationale 1:
Decreased point of care contact is not typically considered a benefit of health information
technology (HIT). In fact, HIT often facilitates more efficient and effective point-of-care
interactions by providing healthcare providers with access to comprehensive patient
information and decision support tools.
Rationale 2:
Increased revenue may be a potential outcome of HIT implementation in some cases, such as
through improved billing and coding accuracy, streamlined administrative processes, and
enhanced patient engagement leading to increased utilization of services. However, increased
revenue is not a universal benefit of HIT and may depend on various factors such as
organizational goals, payer models, and reimbursement structures.
Rationale 3:
Personalized healthcare is a significant benefit of health information technology. HIT enables
the collection, analysis, and utilization of patient data to tailor healthcare interventions,
treatment plans, and preventive strategies to individual patient needs, preferences, and risk
factors. Personalized healthcare can lead to better health outcomes, improved patient
satisfaction, and more efficient resource allocation.
Rationale 4:
Increased need to upgrade technology may be a consequence of HIT implementation rather
than a direct benefit. While technological advancements and upgrades are necessary to ensure
the continued effectiveness and security of HIT systems, the need for upgrades does not
necessarily constitute a benefit of HIT itself.
Question 16
The future of HIT in the healthcare system is reliant on a number of individuals dedicated to
the creation and success of the initiative. Which of the following are some of the key figures
in the positive launch of a system?
1. Nurse informaticians
2. Information technologists
3. Physicians
4. Vice presidents
5. Staff nurses
Correct Answer: 1, 2, 3, 4, 5
Rationale 1:
Nurse informaticians play a crucial role in the successful implementation and optimization of
health information technology (HIT) systems within healthcare organizations. They possess
expertise in both nursing practice and information technology, enabling them to bridge the
gap between clinical needs and technological solutions, train and support nursing staff in HIT
utilization, and advocate for nursing informatics initiatives.
Rationale 2:
Information technologists, including IT professionals and HIT specialists, are essential for the
design, development, implementation, and maintenance of HIT systems. They possess the
technical expertise and skills required to configure, customize, and troubleshoot HIT
solutions, ensure interoperability and data security, and provide technical support to users
across healthcare settings.
Rationale 3:
Physicians, including clinicians and healthcare providers, are key stakeholders in the
adoption and utilization of HIT systems. They rely on HIT solutions to access patient
information, support clinical decision-making, streamline workflows, and improve patient
care outcomes. Physician engagement and buy-in are critical for the successful integration of
HIT into clinical practice.
Rationale 4:
Vice presidents, such as vice presidents of information technology, nursing informatics, or
clinical operations, often play leadership roles in driving the strategic planning, funding, and
governance of HIT initiatives within healthcare organizations. Their support and advocacy
are essential for securing resources, aligning HIT investments with organizational goals, and
promoting a culture of innovation and continuous improvement.
Rationale 5:
Staff nurses are frontline users of HIT systems and have a direct impact on the adoption and
effectiveness of HIT in clinical practice. They rely on HIT solutions to document patient care,
access clinical information, communicate with interdisciplinary teams, and monitor patient
outcomes. Staff nurses' engagement, training, and feedback are essential for optimizing HIT
usability, workflow integration, and patient safety.
Question 17
What do the TIGER initiative and nursing have in common?
1. One of the top goals of the TIGER Initiative is to have more nurses play an active role in
the development of a national health care information technology infrastructure.
2. One of the top goals of the TIGER Initiative is to have more nurses create standards of
approval.
3. One of the top goals of the TIGER Initiative is to move toward medical informatics.
4. One of the top TIGER initiative goals is to add supportive personnel at the bedside.
Correct Answer: 1
Rationale 1:
The TIGER Initiative (Technology Informatics Guiding Education Reform) aims to engage
nurses and nursing faculty in the advancement of health information technology (HIT) and
informatics competencies. One of its top goals is to empower nurses to play an active role in
the development, implementation, and adoption of HIT solutions to improve healthcare
delivery and patient outcomes. This aligns with nursing's role as frontline caregivers and
advocates for patient-centered care, making it the common ground between the TIGER
Initiative and nursing.
Rationale 2:
While nurses may contribute to the development of standards and guidelines related to HIT
and informatics, creating standards of approval is not a specific goal of the TIGER Initiative.
The focus of the TIGER Initiative is more on enhancing nursing education, practice, and
leadership in HIT and informatics rather than standard-setting.
Rationale 3:
While the TIGER Initiative aims to advance nursing informatics competencies and the use of
HIT in nursing practice, its goal is not specifically to move toward medical informatics,
which encompasses a broader range of healthcare professionals and disciplines beyond
nursing.
Rationale 4:
The goal of adding supportive personnel at the bedside is not specifically associated with the
TIGER Initiative. While improving staffing and support for bedside care may be important
for enhancing patient care delivery, it is not a primary focus of the TIGER Initiative, which is
primarily concerned with nursing education, leadership, and practice in HIT and informatics.
Test Bank for Handbook of Informatics for Nurses and Healthcare Professionals
Toni Lee Hebda, Patricia Czar, Theresa Calderone
9780132574952, 9780132959544, 9780134711010, 9780131512627, 9780130311023, 9780805373264, 9780135205433, 9780135043943
