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Candidate

Handbook
Effective January 2007

Certified Professional
in Healthcare Quality
Examination
Program Administered by the
HEALTHCARE QUALITY CERTIFICATION BOARD
of the National Association for Healthcare Quality

P. O. Box 19604
Lenexa, Kansas 66285-9604, USA
913-895-4609
Toll Free 800-346-4722
Facsimile 913-895-4652
E-mail: info@cphq.org
www.cphq.org

The CPHQ certification program is fully accredited by the National


Commission for Certifying Agencies (NCCA), the accrediting arm of the
National Organization for Competency Assurance (NOCA), Washington, D.C.
Table of Contents

Vision Statement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 General Information


Mission Statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Affiliation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Inclement Weather or Emergency . . . . . . . . . . . . . . . . . . . . . . 10
Accreditation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Special Arrangements for Candidates with Disabilities . . 10
Statement of Nondiscrimination. . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Scores Canceled by HQCB or AMP . . . . . . . . . . . . . . . . . . . . . . 10
Disciplinary Policy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
CPHQ Program Overview Pass/Fail Score Determination. . . . . . . . . . . . . . . . . . . . . . . . . . 11
Introduction to the CPHQ Program . . . . . . . . . . . . . . . . . . . . . 3 If You Pass the Examination . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Management and Examination Services . . . . . . . . . . . . . . . . 3 Continuing Education Credit . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Objectives of Certification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Verification of CPHQ Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Definition of the Quality Management Professional. . . . . 4 If You Do Not Pass the Examination . . . . . . . . . . . . . . . . . . . . 11
Certification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Appeals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Recertification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Duplicate Score Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Eligibility Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Name Change Notice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
About the Examination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Preparation for the CPHQ Certification Examination . . . . 12
The CPHQ Examination International Terminology Crosswalk . . . . . . . . . . . . . . . . . . . 13
Applying for the Examination . . . . . . . . . . . . . . . . . . . . . . . . . 6 Sample Examination Questions . . . . . . . . . . . . . . . . . . . . . . . . 14
Assessment Center Locations . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Answers to Sample Questions . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Appointment Changes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 CPHQ Examination Content Outline . . . . . . . . . . . . . . . . . . . . . 16
On the Day of Your Examination . . . . . . . . . . . . . . . . . . . . . . . 7
Required Candidate Identification. . . . . . . . . . . . . . . . . . . . . . 7 CPHQ Examination Blueprint Matrix . . . . . . . . . . . . . . . . . . . . . 18
Candidate Photograph. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Additional Sample Questions with Performance
Detail . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Rules for Computerized Testing
Assessment Center Security . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Instructions for Completing the CPHQ Examination
Examination Restrictions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Application Form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Misconduct . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Application Form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Copyrighted Examination Questions . . . . . . . . . . . . . . . . . . . 8
Practice Examination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Request for Special Examination Accommodations . . . . . 27
Timed Examination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Documentation of Disability-Related Needs . . . . . . . . . . . . . 28
Candidate Comments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Failing to Schedule and Report for an Examination . . . . . 9 Request for Duplicate CPHQ Examination Score
Following the Examination. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Request to Change Mailing or E-mail Address . . . . . . . . . . . 31
Board and Committee Member List . . . . . . . inside back cover

Copyright © 2007 by Healthcare Quality Certification Board; All Rights Reserved.


1/07

CPHQ EX AMINATION C ANDIDATE HANDBOOK


1
The Mark of Distinction in Healthcare Quality

IT IS YOUR RESPONSIBILITY TO READ AND UNDERSTAND


THE CONTENTS OF THIS HANDBOOK BEFORE APPLYING
Vision Statement
FOR THE EXAMINATION. The Healthcare Quality Certification Board is a globally
recognized leader dedicated to improving the quality of
This Handbook contains current information about the healthcare by providing a valid process for assessing the
certification examination developed by the Healthcare Quality competency of professionals in healthcare quality.
Certification Board (HQCB) as of January 1, 2007. It is essential
that you keep it readily available for reference until you are
notified of your performance on the examination. All previous Mission Statement
versions of this Handbook are null and void.
The mission of the Healthcare Quality Certification Board
Direct all correspondence, address changes, requests for a is to improve the quality of healthcare by advancing the
current Candidate Handbook, and for information about the theory, practice and professional growth of healthcare quality
development and administration of the CPHQ examination, professionals through a credible certification process.
certification program and recertification to:
HQCB Affiliation
P. O. Box 19604
Lenexa, Kansas 66285-9604, USA The Healthcare Quality Certification Board (HQCB) of the
913-895-4609 National Association for Healthcare Quality (NAHQ) was
Toll Free 800-346-4722 formed in 1976 to advance the profession of healthcare
Facsimile 913-895-4652 quality management through the development of a
E-mail: info@cphq.org certification program. The HQCB is the certifying arm of
www.cphq.org NAHQ, a not-for-profit organization. The HQCB establishes
policies, procedures and standards for certification and
Candidates taking the examination in the United States recertification in the field of international healthcare quality
can register for and schedule an examination online at management. The granting of Certified Professional in
www.goAMP.com. Healthcare Quality (CPHQ) status by the HQCB recognizes
professional and academic achievement through the
individual’s participation in this voluntary international
certification program.

Accreditation
The CPHQ certification program is fully accredited by the
National Commission for Certifying Agencies (NCCA), the
accrediting arm of the National Organization for Competency
Assurance (NOCA), Washington, D.C.

Statement of
Nondiscrimination
The certification examination is offered to all eligible
candidates, regardless of age, gender, race, religion, national
origin, marital status or disability. Neither the HQCB nor
AMP discriminates on the basis of age, gender, race, religion,
national origin, marital status or disability.

CPHQ EX AMINATION C ANDIDATE HANDBOOK


2
CPHQ Program Overview

Introduction to the Management and


CPHQ Program Examination Services
The purpose of certification in the international healthcare The HQCB contracts with Applied Measurement Professionals,
quality management field is to promote excellence and Inc. (AMP) to provide management and examination services.
professionalism. The program certifies individuals who AMP provides administrative support for the certification
demonstrate they have acquired a body of knowledge and process and Board operations. AMP maintains Board records,
expertise in this field by passing a written international handles finances, processes examination applications,
examination. The CPHQ designation provides the healthcare recertification materials, and requests for continuing
employer and the public with the assurance that certified education approvals. Contracting with a management services
individuals possess the necessary skills, knowledge and firm provides a stable base from which the voluntary HQCB
experience in healthcare quality management to perform operates and serves as a conduit of information between
competently. certified professionals, candidates, and the HQCB.

The high standards of the certification program are ensured AMP also provides examination services to assist HQCB. AMP
by the close working relationships among the National carefully adheres to industry standards for development
Association for Healthcare Quality (NAHQ), the Healthcare of practice-related, criterion-referenced examinations to
Quality Certification Board (HQCB), healthcare quality assess competency. AMP offers a full range of services,
management professionals, and testing experts. The including: practice analyses and development of examination
HQCB adheres to standards of the National Commission specifications, psychometric guidance to committees of
for Certifying Agencies (NCCA) in the development and content experts during examination question writing,
implementation of its certification program, as well as development of content-valid examination instruments,
guidelines issued by the Equal Employment Opportunity publishing, examination administration, scoring, and reporting
Commission (EEOC) and the Standards for Educational and examination results.
Psychological Testing (1999) prepared by the Joint Committee Applied Measurement Professionals, Inc. (AMP)
on the Standards for Educational and Psychological Testing 18000 W. 105th Street
of the American Educational Research Association (AERA), the Olathe, KS 66061-7543, USA
American Psychological Association (APA), and the National 913-895-4600
Council on Measurement in Education (NCME). Facsimile 913-895-4650
E-mail: info@goAMP.com
The certification program is not designed to determine
www.goAMP.com
who is qualified or who shall engage in healthcare quality
management activities. The goal is to promote excellence
and professionalism by documenting individual performance
as measured against a predetermined level of knowledge
Objectives of Certification
about quality management. A cooperative effort by the HQCB, The objectives of the certification program for quality
Applied Measurement Professionals, Inc. (AMP), and practicing management professionals are to:
healthcare quality management professionals has resulted 1. promote professional standards and improve the practice
in the definition of tasks significant to the practice of quality of international quality management;
management. It is these competencies that are included in
the certification examination. The examination materials are 2. give special recognition to those professionals who
developed by practicing quality management professionals demonstrate an acquired body of knowledge and
and the HQCB. expertise in the field through successful completion
of the examination process;
3. identify for employers, the public and members of allied
professions individuals with acceptable knowledge of the
principles and practice of healthcare quality management;
and
4. foster continuing competence and maintain the pro-
fessional standard in healthcare quality management
through the recertification program.

CPHQ EX AMINATION C ANDIDATE HANDBOOK


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CPHQ Program Overview

Definition of the Recertification


Quality Management Following successful completion of the certification
Professional examination, the CPHQ is required to maintain certification
by fulfilling continuing education (CE) requirements, which
The practice of quality management occurs in all healthcare are reviewed and established by the HQCB annually. The
settings, is performed by professionals with diverse clinical current requirements include obtaining and maintaining
and non-clinical educational and experience backgrounds, documentation of thirty (30) CE hours over the two-year
and involves the knowledge, skills and abilities needed recertification cycle and payment of a recertification fee. All
to perform the tasks significant to practice in the CPHQ continuing education must relate to areas covered in the most
examination content outline. (Refer to the Examination current examination content outline. Current employment
Content Outline found later in this Handbook.) in the quality management field is not required to maintain
active CPHQ status. The process for obtaining recertification
is described in the Recertification Handbook, which is provided
A Certified Professional in Healthcare Quality (CPHQ) is ... to each CPHQ upon initial certification and at the beginning of
an individual who has passed the HQCB’s accredited, inter- each subsequent recertification cycle.
national examination, demonstrating competent knowl-
edge, skill and understanding of program development
and management, quality improvement concepts, coordi-
Eligibility Requirements
nation of survey processes, communication and education In 2003, the Board of Directors of the Healthcare Quality
techniques, and departmental management. Certification Board (HQCB) voted to eliminate the minimum
education and experience criteria previously required to
apply for and take the CPHQ examination. The decision,
The examining board’s goal is to produce examinations effective 1 January 2004, removes all subjective barriers to
that test generic concepts that can be applied to any certification. With this change, all candidates have complete
healthcare setting globally. Candidates who pass the CPHQ access to the examination process. Those who aspire to excel
examination must also understand how all of these important and demonstrate their competency in the field of healthcare
elements of quality management, case/care/disease/ quality management will now have an equal chance to do so
utilization management and risk management, as well as and achieve certification.
data management and general management skills integrate
together to produce an effective and efficient system to After years of extensive experience in testing research and
monitor and improve care. development and after observing the extraordinarily diverse
backgrounds of exceptional candidates who have been
successful on the examination and as CPHQs, the Board
Certification is confident that the carefully crafted international CPHQ
To become certified, each quality management professional examination will differentiate between candidates who are
must pass the CPHQ examination. The examination is available able to demonstrate competence and those who are not. It is
in computer-based format at Assessment Centers in the with this confidence that the Board celebrates the elimination
United States and multiple international locations. Certified of barriers such as minimum education and/or experience
professionals are entitled to use the designation “CPHQ” after requirements that are not objectively linked to success on
their names. Certification in quality management is effective the examination and effectiveness as a healthcare quality
on the date you pass the examination. The credential is valid professional.
from that date through a two-year period which begins on the
However, with elimination of the previous minimum education
1st day of January of the year following the date you pass the
and experience requirements, each candidate must take time
examination. Candidates who do not achieve a passing score
to assess and judge his/her own readiness to apply to take
or whose cycle of eligibility has expired must submit a new
the CPHQ examination, particularly if you have not worked in
application and be determined eligible again for a subsequent
the field for at least two years. A careful review of all available
testing cycle.
information about the tasks covered in the CPHQ examination
Each successful candidate will receive a certificate that is content outline, the sample examination questions, reference
suitable for framing, identification card, CPHQ pin and list and any other available data is essential before you make
recertification information approximately 6-8 weeks after the decision to apply for the examination.
completing the examination.

CPHQ EX AMINATION C ANDIDATE HANDBOOK


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CPHQ Program Overview

The Examination Committee develops and writes the Pretest Questions on the Examination: In addition to the
examination to test the knowledge, skills and abilities of 125 scored questions, CPHQ examinations also include an
effective quality management professionals who have been additional 15 pretest questions. You will be asked to answer
performing a majority of the tasks on the examination these questions, however, they will not be included in the
outline for two years. The examination does not test at the scored examination result. Pretest questions will be disbursed
entry level and is not appropriate for entry-level candidates. within the examination, and you will not be able to determine
If you are new to healthcare quality management, have which of the questions are being pretested and which will
worked in the field less than two years or your experience as be included in your score. This is necessary to assure that
a quality manager was not specifically related to healthcare, candidates answer pretest questions in the same manner
the HQCB cautions that you may not be ready to attempt as they do scored questions. This allows the question to be
the examination. Refer to the content outline later in this validated as accurate and appropriate before it is included as a
Handbook for detailed content information and other tools to measure of candidate competency.
assess your readiness.
The examination content is based upon an international
practice analysis conducted to ensure the content is current,
About the Examination practice-related and representative of the responsibilities of
quality management professionals internationally. Participants
The international quality management certification in the international practice analysis survey must have
examination is the only fully accredited, standardized completed a minimum of one year working in healthcare
measurement of the knowledge, skills and abilities expected quality, case/care/disease/utilization and/or risk management
of competent quality management professionals. The for their responses to be included in the research.
examination is available in a computerized format on a daily
basis at AMP Assessment Centers.

The certification examination is an objective, multiple-


choice examination consisting of 140 questions. 125 of these
questions are used in computing the score, as discussed later
in this Handbook. The HQCB uses the following percentage
guidelines in selecting the three types of questions that
appear on each examination: 32% recall, 53% application, and
15% analysis. Recall questions test the candidate’s knowledge
of specific facts and concepts. Application questions require
the candidate to interpret or apply information to a situation.
Analysis questions test the candidate’s ability to evaluate,
problem solve or integrate a variety of information and/or
judgment into a meaningful whole.

CPHQ EX AMINATION C ANDIDATE HANDBOOK


5
The CPHQ Examination

4. The candidate must contact AMP to schedule an appoint-


Applying for the Examination ment and will be given the specific time to report to the
The CPHQ examination is administered via computer at Assessment Center. No admission letter will be issued;
over 130 AMP Assessment Centers geographically distributed therefore, the specified examination time should be noted.
throughout the United States. There are no application dead- Candidates who arrive at the Assessment Center later
lines. than 15 minutes from the scheduled appointment time
To apply for a computerized examination online, follow these will not be admitted. Unscheduled candidates (walk-
steps: ins) will not be admitted to the Assessment Center.

1. Go to www.goAMP.com and select “Candidates.” Select the Note: Examinations will not be offered on the following
examination program, submit a completed application and holidays.
receive confirmation of eligibility online.
New Year’s Day
2. If eligibility is confirmed, proceed to schedule an examina-
Martin Luther King Day
tion appointment. If eligibility is denied, submit requested
materials to AMP to confirm eligibility. Presidents’ Day
Good Friday
To apply for a computerized examination using the application Memorial Day
included in this handbook or downloaded from www.cphq.org:
Independence Day (July 4)
1. Complete the paper application and mail it with the Labor Day
appropriate fee to: AMP, 18000 W. 105th Street, Olathe, KS
Columbus Day
66061-7543.
Veterans’ Day
2. The application is processed, and a confirmation notice
Thanksgiving Day (and the following Friday)
of eligibility is sent to the candidate within approximately
10 business days. If a confirmation notice is not received Christmas Eve Day
within three weeks, contact the AMP Candidate Services Christmas Day
Department at 888-519-9901. A candidate’s eligibility and New Year’s Eve Day
acceptance of the application is valid for 90 days.
A candidate who fails to schedule an appointment for International Examination Services
examination within the 90-day eligibility period must
submit a complete application and examination fee to HQCB and AMP are making available international
reschedule an examination appointment. computerized examinations. For information regarding the
availability of international computerized Assessment Centers
3. The confirmation notice contains a web address and
please visit the AMP website at www.goAMP.com. AMP is
toll-free telephone number for the candidate to contact
continuing to expand its international locations and more
AMP. Appointments can be scheduled online 24 hours
locations are being added throughout the year. If you are an
a day, seven days a week at www.goAMP.com. The
international candidate you will need to submit a completed
toll-free line is answered from 7:00 a.m. to 9:00 p.m.
application form and the application fee. If you do not
(Central Time) Monday through Friday and 8:30 a.m. to
have a Social Security number or social insurance number,
5:30 p.m. on Saturday. The candidate must be prepared
a unique identifying number will be assigned to you when
to confirm a date and location for testing and to provide
her/his Social Security number as a unique identification your application is processed. All other rules and regulations
number. The examinations are administered by appoint- regarding the computerized examination apply to international
ment only Monday through Friday at 9:00 a.m. and examination candidates. All examinations will be given in
1:30 p.m. Individuals are scheduled on a first-come, computerized format only. International candidates will not
first-served basis. Refer to the following chart. receive instant score reports. Results will be sent within 3-
5 business days after completion of the examination to the
candidate’s address of record.
Depending on availability,
If AMP is called by 3:00 p.m. the examination may be
Central Time on... scheduled as early as...
Monday Wednesday
Tuesday Thursday
Wednesday Friday (Saturday if open)
Thursday Monday
Friday Tuesday

CPHQ EX AMINATION C ANDIDATE HANDBOOK


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The CPHQ Examination

Assessment Center Locations Required Candidate


AMP Assessment Centers are typically located in H&R Block Identification
offices. Detailed maps and directions are available on AMP’s To gain admission to the Assessment Center, you must present
website www.goAMP.com. two forms of identification, one of which must be a current,
Neither HQCB nor AMP is able to provide information about legal identification bearing your photograph and signature.
hotel accommodations. Candidates are advised to contact Acceptable forms of legal identification include a driver’s
the local Chamber of Commerce in the specific city for current license, government identity card, military identification card
information about local hotels. or passport. Credit cards, employment badges, student ID
cards or club membership cards are NOT acceptable for the
legal identification, although they may be used as the second
Appointment Changes form of identification. The second identification must be
current and must verify your signature and name. Any type
Each candidate is allowed to change his/her original of identification that verifies your signature and name may
examination appointment ONE time at no charge. This one be used as the second form of identification. Both forms of
opportunity to change a scheduled examination date is identification must be current. Temporary identification cards
provided to accommodate an unexpected occurrence or are NOT acceptable. You will also be required to sign a roster
demand on a candidate’s time. If rescheduling is needed, the for verification of identity.
candidate must call AMP at 888-519-9901 at least two business
days prior to the original scheduled examination session. Candidates are prohibited from misrepresenting their
(See table that follows.) identities or falsifying information to obtain admission to
the Assessment Center. (See “Disciplinary Policy” later in this
You must call AMP by 3:00 p.m. Handbook.)
If your examination Central Time to change your
is scheduled on... reservation by the previous... You must have proper identification to gain
Monday Wednesday admission to the Assessment Center.
Tuesday Thursday
After your identification has been confirmed, you will be
Wednesday Friday directed to a testing carrel. You will be instructed on the
Thursday Monday computer screen to enter your Social Security number.
Friday Tuesday Candidates without a U.S. Social Security number will be
assigned a unique test identification number by AMP.

On the Day of Your Candidate Photograph


Examination Prior to beginning the examination, you will capture your own
photograph using equipment at the computer terminal. The
On the day of your examination appointment, report to the photograph will remain on the computer screen throughout
Assessment Center no later than your scheduled testing time. your testing session. This photograph will also print on your
Once you enter the office, look for the sign indicating “AMP score report.
Assessment Center Check-In”. A candidate who arrives more
than 15 minutes after the scheduled testing time will not be
admitted.

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Rules for Computerized Testing

Assessment Center Security Misconduct


AMP maintains examination administration and security Individuals who engage in any of the following conduct may
standards that are designed to assure that all candidates are be dismissed from the examination, their scores will not be
provided the same opportunity to demonstrate their abilities. reported, and examination fees will not be refunded. Examples
The Assessment Center is continuously monitored by audio of misconduct are when a candidate:
and video surveillance equipment for security purposes. • creates a disturbance, is abusive, or otherwise
The following security procedures apply during the uncooperative;
examination: • displays or uses electronic communications equipment such
• Examinations are proprietary. No cameras, notes, tape as pagers, cellular phones, PDAs in the examination room;
recorders, personal digital assistants (PDAs), pagers or • gives or receives help or is suspected of doing so;
cellular phones are allowed in the examination room. • attempts to record examination questions or make notes;
• Calculators are not necessary as all calculations found on • attempts to take the examination for someone else; or
the examination can be performed without the aid of a
calculator. However, candidates who wish to do so are • is observed with notes, books or other aids.
permitted to bring a personal calculator and use it during
the examination. The only type of calculator permitted
is a simple battery-powered pocket calculator that does
Copyrighted Examination
not have an alphanumeric keypad, and does not have the Questions
capability to print or to store or retrieve data. You MUST
All examination questions are the copyrighted property of
present your calculator to the examination proctor for
HQCB. It is forbidden under federal copyright law to copy,
inspection PRIOR to the start of the examination. Using
reproduce, record, distribute or display these examination
a calculator during the examination that has NOT been
questions by any means, in whole or in part. Doing so may
inspected may result in dismissal from the examination.
subject the candidate to severe civil and criminal penalties.
• No guests, visitors or family members are allowed in the
testing room or reception areas. Practice Examination
• No personal items, valuables, or weapons should be brought
to the Assessment Center. Only keys and wallets may be Prior to attempting the timed examination, the candidate will
taken into the examination room. AMP is not responsible for be given the opportunity to practice taking an examination
items left in the reception area. on the computer. The time used for this practice examination
is NOT counted as part of the examination time or score.
When the candidate is comfortable with the computer testing
Examination Restrictions process, he/she may quit the practice session and begin the
• No personal belongings will be allowed in the Assessment timed examination.
Center. Pencils will be provided during check-in.
• The candidate will be provided with scratch paper to use Timed Examination
during the examination, which must be returned to the
supervisor at the completion of testing, or the candidate will Following the practice examination, the actual examination
not receive a score report. No documents or notes of any will begin. Before beginning, instructions for taking the
kind may be removed from the examination room. examination are provided on-screen.
• No questions concerning the content of the examination The computer monitors the time spent on the examination.
may be asked during the examination. The candidate will have three hours to complete the
• Eating, drinking or smoking will not be permitted in the examination. The examination will terminate if testing exceeds
Assessment Center. the time allowed. Click on the “Time” box in the lower right
• The candidate may take a break during the examination, but portion of the screen or select the Time key to monitor testing
will not be allowed additional time to make up for time lost time. A digital clock indicates the time remaining to complete
during breaks. the examination. The Time feature may be turned off during
the examination.

CPHQ EX AMINATION C ANDIDATE HANDBOOK


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Rules for Computerized Testing

Only one examination question is presented at a time. The Candidate Comments


question number appears in the lower right portion of the
screen. Choices of answers to the examination questions are During the examination, online comments may be provided
identified as A, B, C, or D. The candidate must indicate his/her for any question by clicking on the button displaying an
choice by either typing in the letter in the response box in exclamation point (!) to the left of the Time button. This
the lower left portion of the computer screen or clicking on opens a dialogue box where comments may be entered.
the option using the mouse. To change an answer, enter a Comments will be reviewed, but individual responses will not
different option by pressing the A, B, C, or D key or by clicking be provided.
on the option using the mouse. The candidate may change
his/her answer as many times as he/she wishes during the
examination time limit. Failing to Schedule and
Report for an Examination
A candidate who does not schedule an examination within
the 90-day eligibility period forfeits the application and all
fees paid to take the examination. Lack of availability of a
requested examination date and/or Assessment Center late
in the 90-day eligibility period is not an accepted justification
to waive the processing fee. A complete application and
examination fee are required to reapply for the examination.

Following the Examination


After you finish the examination, you are asked to complete
a short evaluation of your testing experience. Then, you are
instructed to report to the examination proctor to receive your
score report. Scores are reported in written form only, in
person or by U.S. mail. To assure confidentiality, no
candidate examination scores will be reported over the
To move to the next question, click on the forward arrow (>) telephone, by electronic mail or by facsimile. Neither the
in the lower right portion of the screen or select the NEXT HQCB nor the testing agency will release a copy of individual
key. This action will move the candidate forward through the score reports to employers, schools or other individuals or
examination question by question. To review any question, organizations without your written authorization.
click the backward arrow (<) or use the left arrow key to move
backward through the examination. The score report you receive as you leave the Assessment
Center will include your photograph, taken prior to the start
An examination question may be left unanswered for return of the examination. The score report will reflect either “pass”
later in the examination session. Questions may also be or “fail,” followed by a raw score indicating the number of
bookmarked for later review by using the mouse and clicking questions you answered correctly. Additional detail is provided
in the blank square to the right of the Time button. Click on in the form of raw scores by each of the four major content
the hand icon or select the NEXT key to advance to the next categories. This information is provided as feedback to help
unanswered or bookmarked question on the examination. you understand your performance within the major content
To identify all unanswered and bookmarked questions, categories. Your pass/fail status is determined by your overall
repeatedly click on the hand icon or press the NEXT key. When raw score for the entire examination. Even though the
the examination is completed, the number of examination examination consists of 140 questions, your score is based
questions answered is reported. If not all questions have on 125 scored questions. Fifteen of the questions on the
been answered and there is time remaining, return to the examination are “pretest” questions and are not included in
examination and answer those questions. Be sure to provide the final score.
an answer for each examination question before ending the
examination. There is no penalty for guessing. Failing candidates may reapply for subsequent examinations.
Candidates may test one time per 90-day period. There is no
limitation on the number of times the examination may be
taken.

CPHQ EX AMINATION C ANDIDATE HANDBOOK


9
General Information

If power to an Assessment Center is temporarily interrupted


Fees during an administration, your examination will restart where
Fees for the CPHQ examination are shown in the table that you left off and you may continue the examination.
follows.

CPHQ Examination Fees Special Arrangements for


Special NAHQ Candidates with Disabilities
Examination member or NAHQ AMP complies with the Americans with Disabilities Act and
Fee (In U.S. international society
strives to ensure that no individual with a disability is deprived
dollars) affiliate member fee
of the opportunity to take the examination solely by reason of
All Examinations: $440 $370 that disability. AMP will provide reasonable accommodations
for candidates with disabilities. Wheelchair access is available
The special member fee applies to current or new National at all established Assessment Centers. A candidate with
Association for Healthcare Quality (NAHQ) members or a disability may request special accommodations and
members of a non-U.S. national society NAHQ affiliate. The arrangements to take the examination on the regularly
special member fee does not apply to members of U.S. state scheduled examination date at established Assessment
NAHQ-affiliate associations unless they are also members Centers. Such requests must be made in writing to AMP at the
of NAHQ. Candidates who wish to join NAHQ must send the time of application. Verification of disability and statement of
separate membership application and dues directly to NAHQ, the specific assistance necessary must be included. Please use
not to the HQCB. Contact NAHQ at 800-966-9392 or visit the Request for Special Examination Accommodations and
www.nahq.org. Documentation of Disability-Related Needs forms included in
this handbook. Assessment Center personnel will be prepared
Fees may be paid by credit card, personal check, or money
to accommodate requested needs.
order for the total amount, payable to HQCB. Checks drawn
on non-United States banks must state “Payable in U.S.
Dollars”. Please write your name on the face of your check. Scores Canceled by
An additional $25 charge will be added for any returned
checks or rejected credit cards to cover additional handling HQCB or AMP
fees and service charges imposed by the bank or credit card HQCB and AMP are responsible for the integrity of the scores
company. Your canceled check or credit card receipt serve to they report. On occasion, occurrences, such as computer
document payment for the examination. malfunction or misconduct by a candidate, may cause a score
to be suspect. HQCB and AMP are committed to rectifying
such discrepancies as expeditiously as possible. HQCB may
Inclement Weather void examination results if, upon investigation, violation of its
or Emergency regulations is discovered.
In the event of inclement weather or unforeseen emergencies
on the day of an examination, HQCB and AMP will determine Disciplinary Policy
whether circumstances warrant the cancellation, and
subsequent rescheduling, of an examination. The examination The HQCB shall undertake sanctions against applicants,
will usually not be rescheduled if the proctor is able to open candidates or individuals already awarded the CPHQ
the Assessment Center. designation only in relation to failure to meet Board
requirements for initial certification or recertification. The
Candidates may contact AMP’s Weather Hotline at HQCB certification program is a voluntary process, not
800-380-5416 (24 hours/day) prior to the examination to required by law for employment in the field. Monitoring and
determine if AMP has been advised that any Assessment evaluating actual job performance is beyond the scope of the
Centers are closed. Every attempt is made to administer HQCB.
examinations as scheduled; however, should an examination
be canceled at an Assessment Center, all scheduled candidates
will receive notification following the examination regarding a
rescheduled examination date or reapplication procedures.

CPHQ EX AMINATION C ANDIDATE HANDBOOK


10
General Information

Applications may be refused, candidates may be barred from


future examinations, or candidates or individuals already
If You Pass the Examination
certified may be sanctioned, including revocation of the If you pass the HQCB examination, you are entitled to use the
CPHQ designation, for the following reasons: designation Certified Professional in Healthcare Quality and
1. attesting to false information on the application or on registered acronym “CPHQ”, with your name on letterheads,
recertification documents or during the random audit business cards, and all forms of address. Certification is for
procedure individuals only. The CPHQ designation may not be used to
imply that an organization, association, or private firm is
2. giving or receiving information to or from another certified.
candidate during the examination
HQCB mails a congratulatory letter and information packet
3. removing or attempting to remove examination materials
for each new CPHQ, which includes an identification card,
or information from the testing site
certificate and a CPHQ pin. You should expect to receive this
4. unauthorized possession and/or distribution of any official packet approximately one month following the end of the
testing or examination materials month within which you took and passed the examination.
5. representing oneself falsely as a designated CPHQ HQCB reserves the right to recognize publicly any candidate
who has successfully completed a CPHQ certification
Pass/Fail Score Determination examination, thereby earning the certification credential.

HQCB is not able to release or discuss individual questions with Replacement certificates can be purchased by sending
candidates following the examination. To do so would require a written request and the required $15 fee to the HQCB.
elimination of that question from the item bank of pretested Replacement or extra CPHQ pins are available for $7.
questions and deplete the number of pretested questions
required to develop future versions of the examination.
Continuing Education Credit
The methodology used to set the minimum passing score Some organizations accept successful completion of a
is the Angoff method, applied during the performance of certification examination for continuing education (CE) credit.
a Passing Point Study by a panel of experts in the field. Check with your licensure or registration board or association
The experts evaluated each question on the examination for acceptance and CE credits allowed.
to determine how many correct answers are necessary to
demonstrate the knowledge and skills required to pass this Refer to the “Recertification” section in this Handbook for
examination portion. Your ability to pass the examination details about CE requirements to maintain CPHQ status after
depends on the knowledge and skill you display, not on the passing the examination.
performance of other candidates.

Passing scores may vary slightly for each version of the Verification of CPHQ Status
examination. To ensure fairness to all candidates, a process Information on the current certification status of an individual
of statistical equating is used. This involves selecting an will be provided to the public upon request. Employers
appropriate mix of individual questions for each version of the who request verification of CPHQ status must provide the
examination that meet the content distribution requirements individual’s name and Social Security number to assure
of the examination content blueprint. Because each question correct identification in the CPHQ database. Annually, a listing
has been pretested, a difficulty level can be assigned. The of successful candidates will be published in the program
process then considers the difficulty level of each question newsletter and on the CPHQ website (www.cphq.org).
selected for each version of the examination, attempting
to match the difficulty level of each version as closely as
possible. To assure fairness, slight variations in difficulty level If You Do Not Pass
are addressed by adjusting the passing score up or down, the Examination
depending on the overall difficulty level statistics for the group
of scored questions that appear on a particular version of the If you do not pass the certification examination, you may
examination. reapply for subsequent examinations. Candidates may test one
time per 90-day period. There is no limitation on the number
of times the examination may be taken. Repeat candidates
must submit a new application and full examination fee.
Names of candidates who do not pass the examination are
confidential and are not revealed under any circumstances,
except by legal compulsory process.

CPHQ EX AMINATION C ANDIDATE HANDBOOK


11
General Information

Appeals Preparation for the CPHQ


Because the performance of each question on the Certification Examination
examination that is included in the final score has been The HQCB neither sponsors, endorses nor financially
pretested, there are no appeal procedures to challenge benefits from any review courses or published materials
individual for the CPHQ certification examination. Examination
examination questions, answers, or a failing score. questions are written from a wide variety of publications and
resources in the field. Some suggested preparation for the
Actions by the Board affecting eligibility of a candidate to
examination might include but should not be limited to the
take the examination may be appealed. Additionally, appeals
following resources:
may be considered for alleged inappropriate examination
administration procedures or environmental testing 1. CPHQ Practice Examination available at http://store.lxr.
conditions severe enough to cause a major disruption of the com.
examination process and which could have been avoided. 2. “A Dash through the Data! Using Data for Improvement”,
an educational DVD on the basics of using data for QI
All appeals must be submitted in writing. Equivalency by Sandra K. Murray, available through the National
eligibility appeals must be received within thirty (30) days Association for Healthcare Quality (NAHQ), 4700 W. Lake
of the initial HQCB action. Appeals for alleged inappropriate Avenue, Glenview, IL 60025-1485, 800-966-9392, interna-
administration procedures or severe adverse environmental tional 847-375-4720, FAX 847-375-6320, www.nahq.org.
testing conditions must be received within sixty (60) days of 3. Q Solutions is a valuable resource for any healthcare
the release of examination results. quality professional seeking certification as a Certified
The HQCB Chair will respond within thirty (30) days of receipt Professional in Healthcare Quality (CPHQ), particularly in
of the appeal. If this decision is adverse, the candidate may file conjunction with the Healthcare Quality Management:
a second-level appeal within thirty (30) days. A three-member Review and Study Session offered by NAHQ. To learn
panel of the HQCB will review the Chair’s decision and respond more about the product and to order online visit
with a final decision within forty-five (45) days of receipt. www.nahq.org.
4. Handbook for Improvement – 3rd Edition. 209 10th Avenue
South, Suite 154, Nashville, TN 37203.
Duplicate Score Report 5. The Healthcare Quality Handbook: A Professional
Candidates may purchase additional copies of their Resource and Study Guide, published by Janet A. Brown,
RN, CPHQ, JB Quality Solutions, Inc., 2309 Paloma Street,
score reports at a cost of $25 per copy. Requests must be
Pasadena, CA 91104, international 626-797-3074, FAX
submitted to AMP, in writing, within ninety (90) days after
626-797-3864, e-mail: jbrown@jbqualitysolutions.com,
the examination. The request must include the candidate’s
www.jbqualitysolutions.com. Workshop audio tapes or
name, Social Security number, mailing address, date of
CDs also available.
examination and authorization signature. Use the form in the
back of this Handbook to request a duplicate score report. 6. Hospital Peer Review published by American Health
Duplicate score reports will be mailed approximately two Consultants, Inc., 3525 Piedmont Road, Building Six,
weeks after receipt of the request. Suite 400, Atlanta, GA 30305, international 404-262-7436,
800-688-2421, FAX 404-262-7837, www.ahcpub.com.
7. Journal for Healthcare Quality published by the National
Name Change Notice Association for Healthcare Quality (NAHQ), 4700 W. Lake
Avenue, Glenview, IL 60025-1485, 800-966-9392, interna-
Prior to 1992, the HQCB was known as the Quality Assurance tional 847-375-4720, FAX 847-375-6320, www.nahq.org.
Certification Board (QACB). Candidates who successfully
passed the examination from 1984 through 1991 were granted 8. Managing Performance Measurement Data in Health
Care, published by Joint Commission Resources,
the designation and registered mark Certified Professional in
One Renaissance Blvd., Oakbrook Terrace, IL 60181,
Quality Assurance (CPQA®). Since 1992, all current and new
630-792-5800, Library of Congress Catalog Card
successful candidates are identified by the designation and
No. 00-110892, International Standard Book No.
registered mark Certified Professional in Healthcare Quality
0-86688-693-1, www.jcrinc.com.
(CPHQ®).
9. Statistics by Martin Sternstein, Ph.D., Barron’s EZ-101
Study Keys, published by Barron’s Educational Series,
Inc., 250 Wireless Blvd., Hauppauge, NY 11788, Library
of Congress Catalog Card No. 94-4069, International
Standard Book No. 0-8120-1869-9.

CPHQ EX AMINATION C ANDIDATE HANDBOOK


12
General Information

10. The Memory Jogger, a Pocket Guide of Tools for Terminology Crosswalk of Terms
Continuous Improvement, Second Edition, published
by GOAL/QPC, 2 Manor Parkway, Salem, NH 03079, • administrator = leader or facility (hospital) director
800-643-4316, international 603-893-1944, FAX • aggregate = summarize (usually referring to data)
603-870-9122, www.goalqpc.com. • ambulatory care unit = outpatient care unit
11. The Memory Jogger Plus+ by Michael Brassard, 1989, • appointment = initial acceptance for membership in a
First Edition, published by GOAL/QPC, 2 Manor Parkway, healthcare service, such as a medical staff or medical group
Salem, NH 03079, 800-643-4316, international • behavioral health = behavioral/mental health
603-893-1944, FAX 603-870-9122, www.goalqpc.com. • capitation = capitated = predetermined or pre-negotiated
12. The Team Handbook: How To Use Teams To Improve fee
Quality, Second Edition, by Peter R. Scholtes, published • case management = case/care/disease management
by Oriel Incorporated, 3800 Regent St., PO Box 5445, • case mix = patient groupings
Madison, WI 53705-0445, international 608-238-8134,
• CEO = chief executive officer (CEO)
www.goalqpc.com.
• charter = start = assign
13. The Team Memory Jogger, A Pocket Guide for Team
• clinical pathways = clinical/critical pathways/guidelines
Members, published by GOAL/QPC, 2 Manor Parkway,
Salem, NH 03079, 800-207-5813, international • compensable = payable
603-893-1944, FAX 603-870-9122, www.goalqpc.com. • CQI = continuous quality improvement (CQI)
14. a study of journal articles, textbooks or other publications • credentialing = initial evaluation of credentials or initial
related to the examination content outline. credentialing process
• credentials = qualifications (e.g., licenses, certifications,
15. continuing education programs related to the examina-
education, experience)
tion content outline.
• delinquency rate = non completion rate (usually referring
16. self-study interviews with current CPHQs and/or to medical records)
colleagues responsible for areas covered on the
• deploy = implement = start = initiate
examination which may not now be within the scope
of your work responsibilities. • DRG = the diagnosis related group (a method of
categorizing illnesses for purposes of payment or statistical
analysis)
International Terminology • ED = emergency department (ED)
Crosswalk • equipment = device = supplies
• FTE = full time equivalent = full time employee
Candidates are encouraged to review the terms listed on
pages 13-14 which could be found on a CPHQ examination. • generic screening = concurrent screening
This list includes healthcare quality terms and words that may • governing body = board of directors = board of trustees
have different meanings in different countries. For purposes • H&P = history and physical
of the CPHQ examination, they are considered to have the • healthcare organization = healthcare entity
same or equivalency meaning in the context of individual • HMO = health maintenance organization
examination questions. • legal standard = requirement of law
A translation of these terms from English to Arabic, Spanish • LOS = length of stay (LOS)
and Traditional Chinese can be viewed and printed from • managed care setting = a facility with managed care
the www.cphq.org website by clicking on “International.” contracts
The translation is provided as an aid to candidates for whom • “Meals on Wheels” = meals in home
English is not their primary language. These candidates may • member = patient, in the context of a managed care
find it helpful to familiarize themselves with the list and program
translation prior to taking the examination. • modality = type of service
The CPHQ Examination Committee uses this terminology • pathway = pathway/guideline
crosswalk as a reference when reviewing and approving • performance improvement = quality improvement
questions for the examination. They may decide to include • proctor = mentor = coach = supervise = observe
both or several words that have a similar meaning in the • providers/practitioners = physicians or other licensed
context of an individual question, separated by a “slash” mark, independent practitioners
to help candidates understand the question and/or answer • quality council = steering council = QM committee
choices.

CPHQ EX AMINATION C ANDIDATE HANDBOOK


13
General Information

• reappointment = renewal of membership in a healthcare 3. The primary purpose of a management information


service, such as a medical staff or medical group system is to
• reappraisal = re-evaluate competency = periodic A. provide data for quality assessment.
competency review B. computerize operations for greater effectiveness.
• recredentialing = periodic re-evaluation and renewing C. guarantee better coordination of organizational
of credentials change.
• senior management = directors = administrators D. provide information that facilitates management
• sentinel event = sentinel/unexpected event decisions.
• severity = mental or physical dependency = acuity
4. Which part of a job description should be used in a
• sues = takes legal action against criteria-based performance evaluation?
• third party payor = payer = insurance company
A. salary grade
• transcriptionist = secretary = typist
B. duties and responsibilities
• unit = unit/ward/floor C. working conditions
• workers compensation = injured workers D. qualifications
• “written off” = erased = waived (usually referring to a
financial obligation) 5. Which of the following are hardware components that
would be included in a computerized management
information system?
Sample Examination
A. binary and decimal coding
Questions B. flow chart and program
The following sample questions are illustrative of the type C. instructions and data
found on the CPHQ examination. The classification of each D. printer and random access memory
question, i.e., recall, application or analysis, is noted in the
answer key for information. (Refer to the “Additional Sample 6. Which of the following monitors provides patient
Questions” reproduced later in this Handbook for additional outcome information?
examples of CPHQ examination test questions.) A. nosocomial infection rate
B. degree of compliance with nursing care
1. Which of the following processes is most cost-effective documentation
in preventing unnecessary resource consumption in the C. degree of compliance with renewal of antibiotics
hospital? therapy
A. effective preadmission screening D. equipment malfunction rate
B. accurate DRG assignment at admission
C. second opinions for all surgeries 7. One major difference between traditional quality
D. preadmission insurance benefit denials assurance (QA) and quality improvement (QI) is that QI
A. stresses peer review, while QA focuses on the
2. A social service department regularly monitors the customer.
number of inappropriate referrals, the timeliness B. focuses on the individual, while QA focuses on the
of discharge planning, and the number of days of process.
discharge delays. What additional monitor should be C. stresses management by objective, while QA stresses
added to evaluate the appropriateness of social service team management.
interventions? D. focuses on the process, while QA focuses on
A. inadequacy of documentation in progress notes individual performance.
B. attainment of social service goals
C. timeliness of referrals to social services
D. number of social service referrals from nursing

CPHQ EX AMINATION C ANDIDATE HANDBOOK


14
General Information

8. Measures of central tendency describe the


A. typical or middle data point.
B. extent to which the data points are scattered.
C. type and number of classes for dividing the data.
D. average distance of any point in the data set from
the mean.

9. The following represents two samples of five hospitals’


hysterectomy rates per 1,000 women aged 40-60 years
of age:
Standard
Rates Mean Deviation
Sample A 3, 5, 7, 8, 5 5.6 1.8
Sample B 4, 5, 6, 7, 5 5.4 1.1
In analyzing this information, it can be concluded that
A. Sample A has more variability than Sample B.
B. Sample A’s performance is superior to
Sample B’s.
C. there are more cases in Sample B.
D. there is a data collection error in Sample B.

QUESTION
ANSWERS
_________ TYPE
_________
1. A application
2. B analysis
3. D recall
4. B application
5. D recall
6. A application
7. D recall
8. A recall
9. A analysis

Copyright 2007 by Healthcare Quality Certification Board;


All Rights Reserved.

CPHQ EX AMINATION C ANDIDATE HANDBOOK


15
CPHQ Examination Content Outline

The content validity of the CPHQ examination is based 6. Assist in developing objective performance
on an international practice analysis which surveyed QM measures/indicators
professionals on the tasks they perform. Each question on 7. Develop/revise a written plan for a risk management
the examination is linked directly to one of the tasks listed program
below. In other words, each question is designed to test if the 8. Design a risk management monitoring system
candidate possesses the knowledge necessary to perform the 9. Design a case/care/disease/utilization management
task and/or has the ability to apply it to a job situation. system
10. Develop quality management elements for contracts
Each of the tasks below was rated as significant to practice by 11. Coordinate the patient safety program
QM professionals who responded to the survey. One decision 12. Participate in other safety programs (e.g.,
rule used by the International Practice Analysis Committee environment, employee, equipment)
required that a task be significant to practice in the major 13. Coordinate survey processes (i.e., accreditation,
types and sizes of healthcare facilities, including those licensure, or equivalent)
employed in managed care. Thus the examination content 14. Participate in cost/benefit analyses
is valid for this segment of QM professionals as well as those
II. Information Management 36 questions or 29%
employed in hospital, clinic, home care, behavioral/mental
health or other care settings. A. Design and Data Collection
1. Maintain confidentiality of performance
The following list of tasks is those which form the content improvement activities, records and reports
outline of the CPHQ examination and to which the 2. Organize information for committee meetings (e.g.,
examination questions are linked: agendas, reports, minutes)
3. Assess customer needs/expectations using surveys
I. Management and Leadership 24 questions or 19% 4. Perform or coordinate data inventory listing
A. Strategic activities (i.e., what is available from which sources?)
1. Facilitate development of leadership values and 5. Perform or coordinate data definition activities
commitment 6. Assess customer needs/expectations using focus
2. Facilitate assessment of the organization’s culture groups
3. Participate in organization-wide strategic planning 7. Perform or coordinate data collection methodology
4. Identify internal customer/supplier relationships 8. Evaluate computerized systems for data collection
5. Identify external customer/supplier relationships 9. Implement computerized systems for data collection
6. Participate in developing an organizational vision 10. Use epidemiological theory in data collection and
statement analysis
7. Participate in developing an organizational mission 11. Collect qualitative data
statement 12. Collect quantitative data
8. Develop goals and objectives 13. Aggregate/summarize data for analysis
9. Develop and use balanced scorecards B. Analysis
10. Determine lines of authority/accountability 1. Use or coordinate the use of process analysis tools to
11. Evaluate the applicability of performance display data (e.g., fishbone, Pareto chart, run chart,
improvement models (e.g., FOCUS, PDCA, Six Sigma) scattergram, control chart)
12. Evaluate applicability of national/international 2. Use basic statistical techniques to describe data (e.g.,
excellence/quality models mean, standard deviation)
13. Facilitate evaluation and/or selection of appropriate 3. Use or coordinate the use of statistical process
voluntary accreditation process(es) control components (e.g., common and special
14. Develop a performance improvement plan cause variation, random variation)
15. Link strategic goals with performance improvement 4. Use the results of statistical techniques to evaluate
activities data (e.g., t-test, regression)
B. Operational 5. Perform or coordinate trend analysis
1. Facilitate establishment of performance C. Interpretation
improvement oversight group (e.g., Quality Council, 1. Use comparative data to measure or analyze
Steering Council, QM Committee) performance
2. Identify the need for a performance improvement 2. Interpret and use computer-generated information
team or teams 3. Interpret benchmarking data
3. Identify the appropriate team structure (e.g., cross 4. Interpret incident/occurrence reports
functional, self directed) 5. Interpret outcome data
4. Identify process owners and/or quality champions 6. Interpret data to support decision making
5. Monitor the activities of quality consultants

CPHQ EX AMINATION C ANDIDATE HANDBOOK


16
CPHQ Examination Content Outline

III. Education, Training, and Communication 6. Implement ongoing performance improvement


23 questions or 18% systems
A. Education and Training 7. Participate in the following:
1. Develop organizational performance improvement a. medication usage review
training b. operative/invasive/non-invasive procedure
2. Provide performance improvement training review
3. Evaluate the effectiveness of performance improve- c. medical record review
ment training d. infection control processes
4. Facilitate change within the organization e. incident report review
5. Develop/provide survey preparation training (e.g., f. sentinel/unexpected event review
accreditation, licensure, or equivalent) g. preventable adverse event review
B. Communication h. root cause analysis
1. Interact with clinical practitioners (e.g., medical staff) i. failure mode and effects analysis
and support personnel regarding individual patient j. mortality review
management issues k. peer review
2. Promote organizational values and commitment l. patient complaint/satisfaction review
among staff m. service-specific review (e.g., pathology, radiol-
3. Compile and write performance improvement ogy, pharmacy, nursing)
reports 8. Perform or coordinate case management with a
4. Integrate performance improvement concepts focus on patient advocacy (e.g., patient rights, eth-
within the organization ics)
5. Coordinate the dissemination of performance 9. Perform or coordinate risk management:
improvement information within the organization a. risk prevention
b. risk identification
IV. Performance Measurement and Improvement c. recommendations for quality improvement
42 questions or 34% projects
A. Planning C. Evaluation
1. Facilitate establishment of priorities for process 1. Evaluate team performance
improvement activities 2. Analyze/interpret performance/productivity reports
2. Facilitate development of performance improvement 3. Analyze patient/member/customer satisfaction
action plans
4. Conduct or coordinate physician profiling
3. Facilitate development or selection of process and
5. Perform or coordinate complaint analysis
outcome measures
D. Integration
4. Facilitate evaluation or selection of evidence-based
1. Integrate results of data analysis into the
practice guidelines (i.e., for standing orders or as
performance improvement process
guidelines for physician ordering practice)
2. Integrate outcome of risk management assessment
5. Participate in the development of clinical/critical into the performance improvement process
pathways or guidelines
3. Integrate outcome of utilization management
6. Aid in evaluating the feasibility to apply for external assessment into the performance improvement
quality awards process
B. Implementation 4. Integrate performance improvement findings into
1. Coordinate the performance improvement process governance and management activities (e.g., bylaws,
2. Lead performance improvement teams administrative policies and procedures)
3. Facilitate performance improvement teams
4. Participate on performance improvement teams TOTAL for 101 tasks 125 questions
5. Provide information for recredentialing 40 recall or 32%, 66 application or 53%, 19 analysis or 15%

CPHQ EX AMINATION C ANDIDATE HANDBOOK


17
CPHQ Examination Content Outline

CPHQ Examination Blueprint Matrix


# of questions in each of the three
cognitive levels on the exam
Content Category % of exam # of questions Recall Application Analysis
1. Management and Leadership 19.2% 24 5 15 4
2. Information Management 28.8% 36 10 19 7
3. Education, Training and Communication 18.4% 23 9 12 2
4. Performance Measurement and Improvement 33.6% 42 16 20 6
Total 100% 125 40 66 19
% of Total 100% 32% 53% 15%

CPHQ EX AMINATION C ANDIDATE HANDBOOK


18
Additional Sample Questions with Performance Detail

The following ten questions have been removed from active use from the Certified Professional for Healthcare Quality (CPHQ)
examination item pool that is established, maintained and owned by the Healthcare Quality Certification Board (HQCB) of the
National Association for Healthcare Quality (NAHQ). The purpose of releasing these questions is to provide information that could
assist prospective candidates to prepare for the examination and to further their understanding of the examination process.

In releasing these questions, the HQCB has attempted to provide examples that represent a range of content and difficulty that
would be typical of an actual examination. However, HQCB emphasizes that this small number of sample questions does not
provide a complete depiction of the overall diversity that candidates should expect to encounter on an actual examination form.

Following each question is the correct response (key), the cognitive level (Cog) required for a response, the linkage to the
current test content outline (TCO), and a description of other relevant question characteristics and notes about the history of
the question, where applicable. Additional information about the CPHQ examination and certification program is available from
a variety of other sources. These sources include but are not limited to: other sections in this Handbook, the HQCB worldwide
website (www.cphq.org), the HQCB-sponsored item writing workshop (“Secrets of Competency Testing: Writing Questions for the
CPHQ Examination”) presented at the annual NAHQ conference or in co-sponsorship with NAHQ-affiliated state associations, and
course work offered by NAHQ or other educational providers independently from and without endorsement by the HQCB.

Abbreviations used in the sample questions below are defined as


Key = the letter of the correct answer.
Cog = cognitive level required for a response (recall, application or analysis).
TCO = task on the test content outline to which the question is linked.

#1. The primary benefit of adopting a countrywide or global uniform set of discharge data is to
A. facilitate computerization of data.
B. validate data being collected from other sources.
C. facilitate collection of comparable health information.
D. assist medical records personnel in collecting internal data.
Key: C Cog: Application
TCO: II.A.7 – Perform or coordinate data collection methodology.
This question was used many years ago in a somewhat different form. When administered, the stem (question portion)
referred specifically to the Uniform Hospital Discharge Data Set (UHDDS), which is not currently considered to be
relevant content. When the question was used, approximately 78% of the candidates provided a correct response, with
approximately 7% choosing each of the distracters (or wrong answers A, B, and D).

#2. In order to perform a task for which one is held accountable, there must be an equal balance between responsibility and
A. authority.
B. education.
C. delegation.
D. specialization.
Key: A Cog: Application
TCO: I.A.9. – Determine lines of authority/accountability.
This question appeared on examination forms several years ago, but could still test relevant content. It was a fairly easy
question, in that approximately 85% of the candidates provided a correct response. Option B was chosen by approximately
10% of the candidates, and options C and D were selected less frequently.

CPHQ EX AMINATION C ANDIDATE HANDBOOK


19
Additional Sample Questions with Performance Detail

#3. A patient was in the operating room when a piece of a surgical instrument broke off and was left in the patient’s body. The
patient was readmitted for removal of the foreign object. Which of the following would most likely apply in this situation?
A. res ipsa loquitur
B. contributory negligence
C. contractual liability
D. tort liability
Key: A Cog: Application
TCO: IV.B.9b. – Perform or coordinate risk management (risk identification).
This question was considered to be of moderate difficulty, as approximately 75% of the candidates have responded
correctly. Among the distracters, option C has been the least attractive (2%); option B has been selected by about 13% and
option D has been selected by about 10%. The discrimination index (rpb, or point-biserial correlation) was quite acceptable,
i.e., the average raw score of candidates selecting the correct response was approximately seven points higher than the
average score of those selecting an incorrect response.

#4. Which of the following types of budgets itemizes the major equipment to be purchased in the next year?
A. capital
B. variable
C. operating
D. zero-based
Key: A Cog: Recall
TCO: I.B.10. – Participate in preparing and managing operating budgets.
This question has not been used on an examination form as it is shown here. The stem (question portion) of this version was
revised, but the previous version of this question performed quite effectively. It was about average in difficulty and had a
good discrimination index.

#5. A quality manager needs to assign a staff member to assist a medical director in the development of a quality program for a
newly established service. Which of the following staff members is most appropriate for this project?
A. a newly hired staff member who has demonstrated competence and has time to complete the task
B. a knowledgeable staff member who works best on defined tasks
C. a motivated staff member who is actively seeking promotion
D. a competent staff member who has good interpersonal skills
Key: D Cog: Analysis
TCO: I.A.11. – Develop a performance improvement plan.
This question was moderately difficult (68% correct) when it was administered several years ago. The most attractive
distracter was option B, and options A and C were selected by a small percentage of candidates.

#6. A surgeon’s wound infection rate is 32%. Further examination of which of the following data will provide the most useful
information in determining the cause of this surgeon’s infection rate?
A. mortality rate
B. facility infection rate
C. use of prophylactic antibiotics
D. type of anesthesia used
Key: C Cog: Application
TCO: IV.B.7g. – Participate in peer review.
This question has been used on several examination forms, with consistently good performance characteristics. On average,
approximately 70% of the candidates have responded correctly, with most of the incorrect responses on option B. The
average raw score of respondents selecting the correct answer has been consistently around six points higher than those
selecting an incorrect response, resulting in rpb values around .30.

CPHQ EX AMINATION C ANDIDATE HANDBOOK


20
Additional Sample Questions with Performance Detail

#7. The separate services of Pharmacy and Nursing are having difficulty developing an action plan for medication errors.
Pharmacy Services states that Nursing Services causes the majority of the problems related to errors, while Nursing Services
states the opposite. The quality professional’s role in resolving this problem is to
A. provide them with directives on how to solve the problem.
B. facilitate discussion between the groups to enable them to assume ownership of their portions of the problem.
C. assign the task to an uninvolved manager.
D. refer the problem to the facilitywide quality council.
Key: B Cog: Application
TCO: III.A.4. – Facilitate change within the organization.
An question very similar to the one shown above was last used on an examination form in 1991, when approximately 82% of
the candidates provided a correct response. The question was modified as shown, but has not been used in this format. One
reason the question is no longer active is that a flaw was noted in this version of the question that could provide an unfair
advantage to test wise candidates, namely, the length of the correct response. Questions with such flaws are not approved
for use on a current examination form.

#8. Which of the following is most likely to be a benefit of concurrent ambulatory surgical case review?
A. decreased medical record review at discharge
B. an increase in the number of cases failing screening criteria
C. an increase in reviewer competence
D. decreased employee turnover
Key: A Cog: Application
TCO: II.A.7. – Perform or coordinate data collection methodology.
This question has been used on several examination forms, as recently as 1996, with consistently good performance
characteristics. On average, approximately 75% of the candidates have responded correctly, with approximately 16% of
the incorrect responses on option B, 8% on C, and 1% on D. The average raw score of respondents selecting the correct
answer has been consistently around seven points higher than those selecting an incorrect response.

#9. The primary purpose of an emergency preparedness program is to


A. conduct evaluations of emergency training.
B. provide evaluations of semiannual evacuation drills.
C. prevent internal disasters that disrupt the facility’s ability to provide care and treatment.
D. manage the consequences of disasters that disrupt the facility’s ability to provide care.
Key: D Cog: Application
TCO: I.B.7. – Design a risk management system.
This question has been used in this form only once, in 1994, when 81% of the candidates responded correctly. Among the
distracters, option C drew 10% of the responses, option A drew 7%, and option B drew 2%. On the 1994 administration,
the rpb was .26, which represents an appropriate level of discrimination.

CPHQ EX AMINATION C ANDIDATE HANDBOOK


21
Additional Sample Questions with Performance Detail

#10. According to Joint Commission standards, the safety program must include all of the following EXCEPT
A. monthly safety committee meetings.
B. planned response to natural disasters.
C. orientation and continuing education on safety issues.
D. review of safety policies and procedures for all departments.
Key: A Cog: Recall
TCO: Questions that test a candidate’s knowledge of standards applicable to specific accrediting or licensing
bodies are no longer on the examination because they may not be applicable globally in all countries.
Because it assesses knowledge of standards specific to the Joint Commission on Accreditation of Healthcare Organizations
(JCAHO), this question is no longer applicable for the examination. The question has been selected to demonstrate an
appropriate use of a negatively-worded format. Most negatively-worded questions follow this format, using the word
“except” at the end of the stem, printed in all capital letters. The other general format of negatively-worded questions
could include a statement such as: “Which of the following is NOT . . . ?”. This question has been used on two different
examination forms, most recently in 1994. Approximately 86% of the candidates selected option A as the element that did
not need to be included in a safety program; option C was selected by only 1%, option B by 4%, and option D by 8% of the
candidates.

CPHQ EX AMINATION C ANDIDATE HANDBOOK


22
HQCB Handbook, page 23

Instructions for Completing the


CPHQ Examination Application Form

1. Last/Family Name – Print your last/family name in the Zip/Postal Code – Starting with the box on the left, print
boxes provided. This is the way your name will appear on your zip or postal code.
your certificate if you pass the examination. If you have Country – Print your country of residence (if United States,
a double last name, e.g. Smith Jones, leave a blank box print USA).
between the names. If you have a hyphenated last name,
E-mail – Clearly print your full e-mail address, including
put a hyphen (-) in the box between the two names.
the @ sign between your e-mail address and the Internet
First/Surname – Follow the directions above. If you use service provider (e.g., @aol.com, etc.) and include the
two first names, e.g. Mary Lou, leave a blank box between appropriate provider end designation (e.g., .com, .net, .org,
the names. .edu, etc.). Please be certain to write clearly.
Middle Initial – Print the first letter of your middle name; Telephone – Print the area or country code, city code
only one (1) letter is allowed in this field. (if applicable), and telephone number for work, home
2. Membership Status – Check the appropriate box to and facsimile, including extension numbers if applicable.
indicate whether you are a current or new member of 5. Gender – (optional) Check the appropriate box so that
the National Association for Healthcare Quality (NAHQ) we may send future correspondence to you using the
or of a non-U.S. organization that has formally affiliated appropriate form of address.
with NAHQ. Both categories are eligible to take advantage
of the special member fee for the examination. New 6. Primary Place of Employment – Select the category from
members must send a membership application and the the list which most closely matches the setting in which
current member dues payment directly to NAHQ or call you currently spend the majority of your work time;
800-966-9392 or visit www.nahq.org. enter that two-digit code in the boxes provided.

3. Social Security Number – Fill in your United States-issued 7. Educational Level – Select the highest academic level
Social Security number. This will be your confidential you have completed from the list provided; enter that
examination identification number. Your Social Security two-digit code in the boxes provided.
number is required for us to verify CPHQ status for
8. Years of Experience in Healthcare Quality Management
employers. HQCB will assign a confidential examination
– Select the category from the list provided to indicate
identification number for candidates who do not have a
the number of years of experience you have completed
Social Security number.
performing QM/CM/UM/RM activities, by the application
4. Preferred Mailing Address – Print one number or letter deadline for the examination.
of your street address in each box and leave a blank box
9. Previous Examination Date – If you have taken the
for each space between words or numbers. This is the
examination before, enter the month and year of the
address to which all examination information and post
examination taken most recently.
examination materials will be mailed, including certificates
and pins for passing candidates. HQCB recommends 10. Fees – Indicate the correct member or non-member
candidates use their home address (not a business fee, in the box(s) provided. Add the amounts you have
address) entered, if needed, and fill in the appropriate total amount
to assure mail is forwarded if your address changes. in the box.
City – Print the name of the city of your mailing address. 11. Licenses or Registrations – Check the appropriate box
State/Province – Print the two-letter initials for your state to indicate any license(s) or registration(s) you currently
or province for your mailing address. hold.

Apply online at www.goAMP.com or


mail the completed application and appropriate fee
(checks payable to HQCB) or credit card information to:
AMP
18000 W. 105th Street
Olathe, KS 66061-7543

If paying by credit card, applications may be sent by facsimile to 913-752-4960.

(Note: If sending by facsimile, do not mail the original as this may result in a duplicate entry and duplicate charge to your credit
card. If paying by check, you must mail your application and check; do NOT also send it by facsimile as this may result in a duplicate
entry.)
HQCB Handbook, page 24
HQCB Handbook, page 25

APPLICATION FORM
The Certified Professional in Healthcare Quality (CPHQ) Examination
HEALTHCARE QUALITY CERTIFICATION BOARD
1. PRINT Last/Family
Name USE BLACK INK ONLY
FULL
NAME First Name

Middle Initial

2. Are you a member of NAHQ or a non-U.S. national quality society NAHQ-affiliate? (State, regional, local or non-affiliated national association
membership does not equal NAHQ membership.)
… No (Non-member exam fee applies) … Yes; NAHQ or affiliate member ID # ___________________________ or
… Yes; new member; dues sent to NAHQ on _____________________ (date) (Member exam fee applies; call NAHQ at 800-966-9392 to join.)
3. SOCIAL – –
SECURITY NUMBER
Required to verify CPHQ status for U.S. employers) (AMP will assign ID number for candidates without SS #s)

4. PREFERRED Street
MAILING
ADDRESS City
Use of home State;
Province Zip/Postal Code –
address
recommended Country
Home
Work Phone – Phone –
Area/Country City Code Number Area/Country City Code Number
Code (If applicable) Code (If applicable)

Fax – – *E-mail

5. GENDER (optional)
Male Female

6. Primary place of employment: 8. Years of full-time and/or part time experience in healthcare quality,
(01) college or university (non-hospital case/care/disease/utilization and/or risk management activities:
(02) outpatient/specialty facility or clinic (01) fewer than two years
(03) consultant (02) two to five years
(03) more than five but not more than 10 years
(04) extended care facility
(04) more than 10 years
(05) hospital or medical center
(06) private review agency/third party payer/HMO/PPO/MMO/ 9. Have you previously taken the CPHQ examination?
insurance company … Yes … No If yes, most recent date:
(07) government agency (non-hospital) Month Year

(08) home health/hospice 10. FEES: Examination fee:


(09) corporate/regional or network headquarters Non-NAHQ member fee: . . . . . . . . . . . . . . . . . . . . . . $440 USD
(10) licensing or accrediting body NAHQ/affiliate member fee: . . . . . . . . . . . . . . . . . . . .$370 USD
(includes members of non-U.S. national society NAHQ-affiliates)
(11) behavioral/mental health
(12) other (specify)___________________________________________ Total amount paid/authorized: $ USD
METHOD OF PAYMENT
… Check #______________ … Money order
(If rebilling is necessary,
7. Educational Level:
(indicate the highest level) … MasterCard … VISA … American Express a $25 fee will be added.)
(01) Licensed practical nurse (LVN/LPN) ______________________________________________________________
Print Credit Card Holder Name Account Number
(02) Registered Health Info. Technician (RHIT)
______________________________________________________________
(03) Registered Health Info. Administrator (RHIA) Expires (mo/yr) Signature of Credit Card Holder
(04) Diploma in Nursing (Registered Nurse)
11. License(s) and/or Registration(s) (current or inactive):
(05) Associate Degree
(06) Bachelor’s/Final Degree … RN … RHIA … MD … DPM
(07) Master’s Degree … LVN/LPN … RHIT … DO … Other license (specify type)
(08) Doctoral Degree (other than medical doctor) _________________________
(09) Medical Doctor (MD, DO) 12. Where did you hear about the CPHQ Examination?
(10) Other (specify)___________________________________________ … IHI … ASHRM … AHIMA … Website
… Other _________________________
OVER
HQCB Handbook, page 26

13. DECLARATION
AGREEMENT OF AUTHORIZATION and CONFIDENTIALITY
I authorize the Healthcare Quality Certification Board (HQCB) to make whatever inquiries and investigations that it deems necessary to verify my credentials and
professional standing. Further, I understand that the HQCB will treat the contents of this application as well as all documents relating to certification as confidential,
except when required by legal compulsory process, with the following exception. If I successfully pass the examination and attain the CPHQ designation, I authorize
the HQCB to release my name and address to the National Association for Healthcare Quality and its affiliated organizations for the purpose of mailing me association
information. I also authorize HQCB to use information from my application and subsequent examination for the purpose of statistical analysis, provided my personal
identification with the information has been deleted. I understand that the initial certification period is two calendar years following successfully passing the
examination and agree to meet current requirements if I wish to maintain active certification status thereafter. I further understand that the governing body has the
authority to change requirements to attain and maintain certification from time to time.
I have read and understand the information provided in the Candidate Handbook or on the cphq.org website. Under penalties of perjury, I declare that the
foregoing statements are true.
I understand that false information may be cause for denial or loss of the credential. I understand that I can be disqualified from taking or continuing to sit for an
examination or from receiving examination scores if the HQCB determines through either proctor observation or statistical analysis that I engaged in collaborative,
disruptive, or other prohibited behavior during the administration of the examination.

______________________________________________________________ ___________________________________
Candidate signature (Required) Date

Payment must be by credit card, check or money order payable in U.S. dollars to the “Healthcare Quality Certification Board”.
Please write your name on the face of the check. (HQCB/NAHQ tax ID #95-3062349)
No telephone or e-mail applications will be accepted. Completed forms may be sent by facsimile ONLY if paying by credit card.
Complete and mail this application with a check or credit card information to:
AMP/Examination Services
18000 W. 105th Street
Olathe, KS 66061-7543
913-895-4600
FAX 913-895-4650

HQCB Handbook, page 27

Request for Special


Examination Accommodations

If you have a disability covered by the Americans with Disabilities Act, please complete this form and the Documentation of
Disability-Related Needs on the reverse side so your examination accommodations can be processed efficiently. The information
you provide and any documentation regarding your disability and your need for examination accommodations will be treated
with strict confidentiality.

Candidate Information
Social Security # __________ – _______ – ____________
__________________________________________________________________________________________________________
Name (Last, First, Middle Initial, Former Name)

__________________________________________________________________________________________________________
Mailing Address

__________________________________________________________________________________________________________

__________________________________________________________________________________________________________
City State Zip Code

__________________________________________________________________________________________________________
Daytime Telephone Number

Special Accommodations
I request special accommodations for the ___________________________________________________________ examination.

Please provide (check all that apply):


______ Special seating or other physical accommodation
______ Reader
______ Extended examination time (time and a half)
______ Distraction-free room
______ Other special accommodations (Please specify.)
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________

Comments: ________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________

Signed: _________________________________________________________________ Date: ____________________________

Return this form with your examination application and fee to: Examination Services Department, AMP, 18000 W. 105th Street,
Olathe, KS 66061-7543. If you have questions, call the Examination Services Department at 913-895-4600.
HQCB Handbook, page 28

HQCB Examination

Documentation of
Disability-Related Needs

Please have this section completed by an appropriate professional (education professional, physician, psychologist, psychiatrist)
to ensure that AMP is able to provide the required examination accommodations.

Professional Documentation
I have known ______________________________________________ since _____ / _____ / _____ in my capacity
Examination Candidate Date

__________________________________________________________.
Professional Title

The candidate discussed with me the nature of the examination to be administered. It is my opinion that, because of this
candidate’s disability described below, he/she should be accommodated by providing the special arrangements listed on the
reverse side.

Description of Disability: _____________________________________________________________________________________


__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________

Signed: _________________________________________________________________ Title: ____________________________

Printed Name:_____________________________________________________________________________________________

Address: __________________________________________________________________________________________________

__________________________________________________________________________________________________________

Telephone Number:________________________________________________________________________________________

Date: _____________________________________________ License # (if applicable): ________________________________

Return this form with your examination application and fee to: Examination Services Department, AMP, 18000 W. 105th Street,
Olathe, KS 66061-7543. If you have questions, call the Examination Services Department at 913-895-4600.
HQCB Handbook, page 29

Request for Duplicate CPHQ Examination Score Report

Directions: You may use this form to ask the testing agency, AMP, to send you a duplicate copy of your score report. This
request must be postmarked no later than 90 days after the examination administration. Proper fees and
information must be included with the request. Please print or type all information in the form below. Be sure to
provide all information and include the correct fee, or the request will be returned.

Fees: $25 US Dollars per copy. Please enclose a check or money order payable in US Dollars to AMP. Do not send cash.
Write your test identification number on the face of your payment.

Mail to: Examination Services Department Amount enclosed: $___________________


Applied Measurement Professionals, Inc.
18000 W.. 105th Street Examination Date: ____________________
Olathe, KS 66061-7543, USA

Print your current name and address:


Name________________________________________________ Candidate ID or Social Security Number __________________

Street____________________________________________________________________________________________________

City___________________________________ State/Prov. ___________________ Zip/Postal Code _______________________

Country __________________________________________________________________________________________________

Daytime Telephone (_______) _______________________________ Fax (_______) ___________________________________

E-mail ___________________________________________________________________________________________________

If the above information was different at the time you were tested, please write the original information below:
Name________________________________________________ Candidate ID or Social Security Number __________________

Street____________________________________________________________________________________________________

City___________________________________ State/Prov. ___________________ Zip/Postal Code _______________________

Country __________________________________________________________________________________________________

Daytime Telephone (_______) _______________________________ Fax (_______) ___________________________________

E-mail ___________________________________________________________________________________________________

Examination Date _____________________________________ Test Site ____________________________________________

I hereby request AMP to send a duplicate copy of my score report to the first address shown above.

Candidate’s Signature Date


HQCB Handbook, page 30
HQCB Handbook, page 31

Request to Change Mailing or E-mail Address


(All address and e-mail changes must be submitted in writing, either by mail or
facsimile, including an authorization signature and candidate ID number.)

You may use this form to request that HQCB enter a change of address, including e-mail address, into our database once you
have registered for the examination. To protect your confidential record and assure that no unauthorized person is able to alter
your record, we require that all address changes be submitted in writing and include your authorizing signature.

HQCB will forward your address change to the testing agency AMP. If you have questions, contact HQCB at 913-895-4609 or toll
free 800-346-4722 or e-mail: info@cphq.org.

Mail or fax your request to: Healthcare Quality Certification Board (HQCB)
P. O. Box 19604
Lenexa, KS 66285-9604, USA
Facsimile 913-895-4652

Print your NEW name and address (use of home address recommended):
Name________________________________________________ Candidate ID or Social Security Number __________________

Street____________________________________________________________________________________________________

City___________________________________ State/Prov. ___________________ Zip/Postal Code ______________________

Country __________________________________________________________________________________________________

Work Telephone (_______) _____________________________ Home Telephone (_______) ___________________________

E-mail ___________________________________________________________________________________________________

Print your OLD information as it appeared on your application form:

Name________________________________________________ (if different from above)

Street____________________________________________________________________________________________________

City___________________________________ State/Prov. ___________________ Zip/Postal Code ______________________

Country __________________________________________________________________________________________________

Daytime Telephone (_______) _______________________________ Fax (_______) ___________________________________

E-mail ___________________________________________________________________________________________________

Examination Date _____________________________________ Test Site ____________________________________________

I hereby authorize HQCB and AMP to change my address in the examination database as shown above.

Candidate signature Date


2007 Healthcare Quality Certification Board
and Examination Committee Members

2007 Board of Directors Anita Garrison, RN, MSN, CS, CPHQ, CMC
HQCB Director
Joan Boldrey, RN, M.ED., MS, CPHQ Memphis, TN
HQCB Chair Phone: 901- 523-8990 ext. 6546
West Des Moines, IA anita.garrison@med.va.gov
Phone: 515-987-0515
Fax: 515-987-3956 Suzanne M. Williams, BA, RN, CCM, FNAHQ, CPHQ
cphq@mchsi,com HQCB Immediate Past Chair
Walnut Creek, CA
David S. Loose, MSN, CNAA, RN, CPHQ Phone: 925-295-4837
HQCB Secretary/Treasurer Suzanne.Williams@kp.org
Blackrock, Co Dublin
Phone: 011-353-1-278-5893 Linda S. Breen, MPH, RN, CPHQ
dloosesan@aol.com HQCB Director
Chicago, IL
Moi Lin Ling, MBBS, Dip. Bact., FRCPA, FMAS, CPHQ Phone: 312-202-5842
HQCB Director lbreen@sts.org
Singapore
Phone: 011-65-6321-3891
ling.moi.lin@sgh.com.sg
Examination Committee Members
Jack Peterson, CPHQ
HQCB Director All members of the Board of Directors
El Paso, TX and the following:
Phone: 915-760-4846 Lynne M. Gagnon, BSN, MS, RN
jpeterson@personandassociatesllp.com HQCB Examination Committee
Dover-Foxcroft, ME
Diana L. Martin, RN,MS,BSW,CPHQ,QMRP Phone: 207-564-4252
HQCB Director lgagnon@mayohospital.com
Evanston, WY
Phone: 307-783-8230 Dan Degnan III, PharmD, MS, CPHQ
diana_martin@chs.net HQCB Examination Committee
Indianapolis, IN
Paula J. Pillen, BFA, MPA, CFRE, LNHA Phone: 317-621-5268
HQCB Public Member ddegnan@ecommunity.com
Urbandale, IA
Phone: 515-276-7765
P2consulting@aol.com