Esr Certification Assessment - Esr Process & Program Tools

1. Which of the following best describes a Project Charter?

Documentation of program goals, scope, team member responsibilities, business case, and milestone plan

Documentation of clinical workflow including interactions, decisions, handoffs, and triggers

Documentation of appropriate messaging, target audience, and timing for program communications

[ESR Playbook - Align]

Explanation

[ESR Playbook - Align]

2. Introperative hemodynamic optimization has demonstrated the most impact in medium to high-risk surgeries. Surgical risk is related to both procedural and patient risk, and patient risk can be assessed using ASA score. Which level of ASA score does the ESR playbook suggest considering for PGDT?

All ASA scores

ASA 1b-2b + 1 comorbidity

ASA 2b + 1 comorbidity or higher

ASA 3-5

[ESR Playbook - Assess]

Explanation

[ESR Playbook - Assess]

3. During the "Assess" phase, it is important for the hospital to define program goals for PGDT outcomes based on estimated benefits and expected compliance. The ESR Playbook provides tips for defining program goals. Which one of the following is not included in these tips?

Set measurable program goals at the start of the project

Establish achievable targets using documented baseline data and published study results

Set different goals for each department

Align program goals with organizational priorities

Build stakeholder alignment with program goals

Measure progress to goals periodically

[ESR Playbook - Assess]

Explanation

[ESR Playbook - Assess]

4. The first step in the "Align" phase is to build a core team. The Project Charter Template provides a short list of potential team members to include in this core team. Which of the following roles are included in this list?

Executive Sponsor

Clinical Champion

Project Coordinator

Surgeons

Anesthesia Providers

Quality

All of the above

[ESR Playbook - Align]

Explanation

[ESR Playbook - Align]

5. Fill in the blank. Select the phrase that best completes the "Why" statement for the Enhanced Surgical Recovery program. "Based on clinical evidence, we believe the lack of a standardized approach leads to variations in the care and outcomes of surgical patients. This process inconsistency contributes to ______________."

Enhanced practice efficiency and improved profit margins

High operating costs and patient readmissions

Increased post-surgical complications and enhanced recovery

Preventable complications and avoidable costs

Standardized care and improved outcomes

[ESR Playbook - Intro]

Explanation

[ESR Playbook - Intro]

6. In the ESR "Assess" phase, which of the following tools could be leveraged during the "Select Surgical Procedure(s)" step to identify surgical procedures to target?

Applicable Procedures List

Hospital Data Form

PGDT Benefit Estimator

PGDT Protocol Summary

Sample Checklist

[ESR Playbook - Assess]

Explanation

[ESR Playbook - Assess]

7. The Applicable Procedures List contains surgical procedures and ICD-9 codes which are part of randomized controlled trials demonstrating the clinical and economic benefit of hemodynamic optimization through PGDT. All but one of the following procedures is listed. Which of the following is not included on the Applicable Procedures List.

Abdominal Aortic Aneurysm

Aorto-iliac and Peripheral Bypass

Colectomy

Coronary Artery Bypass

Femur and Hip Fracture Repair

Gastrectomy

Partial Hepatectomy

Resection of Rectum

Hip Replacement

[Applicable Procedures List]

Explanation

[Applicable Procedures List]

8. Which of the following tools can be used to help identify potential PGDT triggers within the procedure workflow?

Communication Plan Template

PGDT Protocol Summary

Procedure Flowchart Example (Sample Workflow Map)

Project Charter Template

[ESR Playbook - Align]

Explanation

[ESR Playbook - Align]

9. In the "Assess" phase, the hospital compares its own data to benchmarks. Which of the following describes the purpose for this comparison?

To estimate the clinical and economic benefit of PGDT

To identify specific opportunities for improvement

To publicly report regional rankings

[ESR Playbook]

Explanation

[ESR Playbook]

10. Select the option which accurately reflects the order of the ESR Implementation Process

Sell, Align, Apply, Measure

Assess, Align, Apply, Measure

Sell, Apply, Align, Assess

Align, Assess, Apply, Measure

[ESR Implementation Process Map]

Explanation

[ESR Implementation Process Map]

11. As part of the ESR implementation process, it is important to establish PGDT "triggers". What is the purpose of a "trigger"?

To kick-start the implementation process with a core team of stakeholders

To identify appropriate candidates for hemodynamic optimization using PGDT

To automate the PGDT protocol so all patients receive the same amount of fluid

To eliminate the clinicians who do not believe in the benefits of PGDT

[ESR Playbook - Align]

Explanation

[ESR Playbook - Align]

12. The ESR implementation process and tools are designed to help our customers implement an ESR Program at their hospital. Which of the following best describes the type of support Edwards can provide during an ESR Program implementation?

Any consulting or education, including meeting scheduling, protocol selection, and team alignment

Education on safe and effective use of Edwards products only

Education on PGDT and the benefits of using a protocol for fluid management only

[Legal and compliance guidance. Consulting services must be accompanied by a fair exchange of value as determined by a signed service agreement. Please note the disclaimer on the ESR Process Map for standard language.]

Explanation

[Legal and compliance guidance. Consulting services must be accompanied by a fair exchange of value as determined by a signed service agreement. Please note the disclaimer on the ESR Process Map for standard language.]

13. During the "Assess" implementation phase, what hospital stakeholder will typically be able to obtain relevant data on key metrics such as morbidity, length of stay, etc?

Anesthesiologist

CRNA

Colorectal surgeon

Quality officer

[ESR Playbook - Assess]

Explanation

[ESR Playbook - Assess]

14. True or False. The PGDT Benefit Estimator can be used to calculate potential reduction in morbidity, reduction in LOS, average cost avoidance per case, and the number of cases needed to justify the investment.

True

False

[PGDT Benefit Estimator]

Explanation

[PGDT Benefit Estimator]

15. In the "Align" phase, the final step is to choose a hemodynamic monitoring platform. Beyond simply selecting a supplier, which of the following best describes the purpose of this process step?

To determine which surgical procedures will be targeted to apply PGDT

To designate the monitoring platform(s) across the target population based on risk profile

To identify which anesthesia providers will be included in the ESR Program

To understand the unique value proposition of the ccNexfin technology

[ESR Playbook - Align]

Explanation

[ESR Playbook - Align]

16. In the "Assess" implementation phase, the hospital should develop a business case for an ESR Program, including the estimated costs and benefits of the program. When estimating the cost required to implement PGDT via an ESR Program, which of the following should be considered?

Advanced hemodynamic monitoring capital

Advanced hemodynamic monitoring disposables

Team member time

Other resources (e.g. trigger build in IT systems, etc)

All of the above

[ESR Playbook - Assess]

Explanation

[ESR Playbook - Assess]

17. During the "Align" implementation phase, it is important to establish PGDT triggers to maximize candidate identification and to alert key stakeholders to prepare accordingly (surgeon, anesthesiologist, CRNA, anesthesia tech, OR staff, scheduling, etc). According to the ESR Playbook, at which workflow steps could you consider including a PGDT trigger? Select all that apply.

Scheduling

Pre-screen

Registration / Admission

Pre-Op

Intra-Op

[ESR Playbook - Align]

Explanation

[ESR Playbook - Align]

Submit

18. Which sales tool provides information on the range of Edwards' hemodynamic monitoring portfolio?

Enhanced Surgical Recovery Program Brochure

FloTrac High Risk Surgery Brochure

PGDT Protocol Summary

Right Patient Right Device handout

[ESR Playbook - Align]

Explanation

[ESR Playbook - Align]

19. Which ESR implementation process steps are part of the "Assess" phase? Select all that apply.

Build Core Team

Choose a Hemodynamic Monitoring Platform

Assess Current Morbidity Rate and/or LOS

Train and Develop Competencies

Estimate Potential Clinical and Economic Benefits of PGDT

Select Surgical Procedures

[ESR Implementation Process Map]

Explanation

[ESR Implementation Process Map]

Submit

20. During the "Assess" implementation phase, it is important to understand current hospital metrics in order to make a comparison to post-implementation metrics. According to the ESR Playbook, which three of the following are key metrics that should be tracked as part of the ESR program? Select three.

30-day readmissions

Length of stay

Morbidity

Reimbursement per case

Variable cost per case

[ESR Playbook - Assess]

Explanation

[ESR Playbook - Assess]

Submit

21. Which ESR implementation process steps are part of the "Align" phase? Select all that apply.

Select Surgical Procedures

Build Core Team

Choose PGDT Treatment Protocol

Choose a Hemodynamic Monitoring Platform

Train and Develop Competencies

Quantify and Track Compliance

[ESR Implementation Process Map]

Explanation

[ESR Implementation Process Map]

Submit

22. According to the ESR Sales Process Map, the ESR implementation process overlaps with which three phases of the sales process?

Plan, Prospect, Investigate

Investigate, Evaluate, Implement

Evaluate, Implement, Support

None of these, the two processes are completely separate

[ESR Sales Process Map]

Explanation

[ESR Sales Process Map]

23. On a scale of 1 to 5 (1=not at all; 3=moderately; 5=extremely), please rate how comfortable you are with this content? [Note: This question will not be scored.]

1

2

3

4

5

The respondent rated their comfort level with the content as a 5, which indicates that they are extremely comfortable with it.

Explanation

The respondent rated their comfort level with the content as a 5, which indicates that they are extremely comfortable with it.