DHCA Doctor Exam key terms

The framework of accountability through which health care organizations assure and improve the quality and safety of care, covering standards, risk management, performance monitoring, and clear lines of responsibility.

The legal and ethical obligation of governing board members to act in the organization's best interest, exercising the duties of care, loyalty, and obedience when overseeing strategy, finances, and quality.

A situation in which a person's private, financial, or professional interests could improperly influence decisions made in their official role, managed through disclosure, recusal, or divestment.

The number of subordinates who report directly to a single manager; wide spans flatten hierarchies but require more delegation, while narrow spans permit closer supervision.

The formal arrangement of roles, reporting lines, and coordination mechanisms that determines how authority and work flow through an organization, such as functional, divisional, or matrix designs.

The process by which a manager assigns specific tasks and the corresponding authority to a subordinate while retaining accountability for the outcome.

A disciplined process of assessing the environment, defining mission and goals, and selecting long-term initiatives and resource allocations that position the organization for future success.

A structured planning tool that inventories an organization's internal strengths and weaknesses alongside external opportunities and threats to inform strategy formulation.

A quantifiable measure selected to track progress toward a specific strategic or operational objective, ideally few in number, clearly defined, and tied to accountable owners.

A performance management framework that tracks measures across financial, customer, internal process, and learning perspectives to prevent overemphasis on any single dimension.

A systematic, data-driven approach to continuously enhance care processes and outcomes, typically using iterative cycles of planning, testing, measuring, and adopting changes.

A structured improvement method in which a team plans a change, tests it on a small scale, studies the results, and acts to adopt, adapt, or abandon it before the next cycle.

A retrospective, team-based investigation that maps the sequence of events behind an adverse outcome and identifies underlying system failures rather than individual blame.

A prospective risk-assessment technique that identifies the ways a process could fail, estimates the severity and likelihood of each failure, and prioritizes preventive actions.

An unexpected occurrence involving death, serious physical or psychological harm, or the risk of such harm, which triggers immediate investigation and reporting obligations.

A serious, largely preventable patient safety incident, such as wrong-site surgery or transfusion with the wrong blood type, that should not occur if safeguards are followed.

An organizational climate that encourages reporting of errors and near misses by distinguishing honest mistakes and system failures from reckless or intentionally harmful behavior.

Comparing an organization's performance metrics against internal targets, peer organizations, or recognized best practices to identify gaps and prioritize improvement efforts.

Clinical and managerial decision-making that integrates the best available research evidence, professional expertise, and patient values and preferences.

The process of obtaining a patient's voluntary agreement to treatment after disclosing the diagnosis, proposed intervention, material risks and benefits, and reasonable alternatives, including the option of refusal.

The ethical and legal principle that competent patients have the right to make their own health care decisions, including the right to refuse recommended treatment.

A patient's clinical ability to understand relevant information and appreciate the consequences of a decision about their own care, assessed for a specific decision at a specific time.

A legal claim requiring proof that a professional owed a duty of care, breached the applicable standard of care, and thereby caused actual harm to the patient.

The ongoing process of identifying, evaluating, and reducing exposures that could cause harm to patients, staff, or the organization, including liability, financial, and operational risks.

U.S. federal law that sets national standards for protecting individually identifiable health information and for the privacy and security of electronic health records.

Individually identifiable health information held or transmitted by a covered entity or business associate, in any form, that is subject to privacy and security safeguards.

The HIPAA principle that uses and disclosures of protected health information should be limited to the least amount needed to accomplish the intended purpose.

The ability of different health information systems to exchange data and allow that data to be used meaningfully across settings, typically enabled by shared standards and terminologies.

An arrangement that allows clinical data to be shared electronically among providers, laboratories, pharmacies, and other stakeholders to support coordinated, safer care.

A reimbursement method in which a provider is paid a predetermined fixed amount per discharge, episode, or service, shifting financial risk for cost overruns to the provider.

A classification system that groups inpatient stays into categories based on diagnoses, procedures, and patient characteristics, used to determine fixed hospital payment amounts.

A measure of the average relative resource intensity or severity of the patients a facility treats, calculated from assigned diagnosis groupings and used to adjust payment and staffing expectations.

A payment model in which a provider receives a fixed amount per enrolled patient per period, regardless of the volume of services that patient uses.

Payment arrangements that link a portion of reimbursement to measured quality, safety, patient experience, and cost performance rather than volume alone.

Health services provided without expectation of payment to patients who cannot afford to pay, often tracked to demonstrate community benefit for tax-exempt status.

Programs and services a nonprofit health organization provides that improve community health and meet identified needs, documented to support tax-exempt status.

A data-driven approach to improving the health outcomes of a defined group by stratifying risk, coordinating care, and targeting preventive and chronic care interventions.

The conditions of birth, growth, living, working, and aging, such as income, housing, education, and food access, that shape health outcomes and utilization patterns.

A systematic process of collecting and analyzing data on a community's health status, resources, and priorities to guide planning and satisfy regulatory obligations.

The decisions, plans, and actions undertaken by governments and other actors to achieve specific health goals, shaping access, cost, quality, and delivery of services.