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Health Services Management

Recalled by Mr. Da Roux Barrett (MBBS 2k14) August 22, 2011 1:00 p.m.

Questions 1-6 are based on the following scenario St. Barnabas is a 15 year old type IV health centre situated on one of the arterial roots of an urban center. In its first 5 years it enjoyed a solid reputation for clinical care, provided for a small user fee. Dr. Thompson an experienced public health specialist was its first manager. He knew alll the staff members whether they were professional technical or auxilliary and had a reputation of being firm but fair. He retired after running the facility for its first 5 years. Towards the end of his tenure it was noted that the clinic was beginning to attract a larger number of patients than before. This was presumed to be due to its excellent reputation. In the past 10 years several events have occurred. Three successive administrators have been appointed. One a physician, the two others trained health administrators. In the last year the new government has abolished user fees. The last administrator had done a situational analysis which was so impressive he had been invited to apply for the post. He however resigned after six months stating that he had been given basket to carry water. Over the last few years there has been an exodus of all categories of staff. Many nurses have migrated and an equal number retired. So that the nursing establishment was at 60% capacity. The pharmacists (three) were very short, there place being taken by technicians. More recently there have been flair-ups between staff and patients which have made their way into the newspapers. Doctor Goodheart is now the Physician in charge. Relating to an administrator who in turn reports to the regional health authority. The day after Dr. goodheat takes over he calls a general staff meeting and aks for ideas to tackle the clinic problems. One of the original staff members becomes aggitated and says what we need is someone with the style of Dr. Thompson. There was order when he was here. Yes says another he could command and control. Based on the St. Barnabas scenario 1. Dr. Goodheart in his analysis determines that hygiene factors are not being met for the workers at St. Barnabas. Which of the following best matches with his analysis? a. b. c. d. The institution needs repair The workers need more pay He needs to attend to their security He needs an urgent appointment with the regional health authority

Hygiene factors are similar in some respects to Maslow's lower orders. These are the factors which when operating properly produce satisfaction, their absence dissatisfaction. Generally they relate to the physical and emotional work environment. Motivational factors The motivational factors relate to the quality of the job and how it is carried out. The factors found to be important to workers are: 1. Recognition 3. The work itself 5. Advancement 2. Achievement 4. Responsibility Motivation requires that both factors be attended to. It is the motivational factors that mainly enhance performance, even if some of the hygiene factors are not fully met. Essentially, the theory is grounded in the assumption that most people want to do a good job and achieve goals, stated or unstated.

Health Services Management


Recalled by Mr. Da Roux Barrett (MBBS 2k14) August 22, 2011 1:00 p.m. The achievement of goals becomes a motivation in its own right. This sense of motivation is further enhanced when there is team or public recognition of the achievement. Sometimes there is conflict between individual and organizational goals. For example, seeing patients thoroughly, versus seeing them quickly might create conflict in physicians. Some relevant issues. 1. These conflicts are more evident now that health care services are operated more using business and management principles. 2. Professionals often want to work with state of the art equipment and medications, both for personal satisfaction and better patient care. The organization may not be able to provide 'cutting edge' technology or medication. 3. Limitations, in respect of senior positions in the organization are also frequent sources of frustration. Let us now look at some of the ways that frustration manifests itself in individuals at the work place. Frustration leads to stress, conflict, anxiety, and burnout. The most mature response to frustration is to engage in:

problem solving, individually or collectively.

Problem solving should begin with a diagnosis of the situation. This will include those factors coming from 'problems within the system'. These might be related to how work is organized, and who does what, some members of the team may be overburdened, while others may be underutilized. Alternatively or additionally, there may be an attitudinal problem preventing the individual or organization from attaining the goal. To effect a solution, though the diagnosis and possible solution have to be shared with those having the power to effect change, the problems and the solutions have to be aired at the correct forum and at a point when individuals are felt to be ready to listen. Other responses to frustration may be:

Resignation to the status quo 'what can I do, nothing is going to change, I can't change anything'..'I'm simply trying to survive'. Individuals in this mode function on autopilot and resist change which they see as doomed to fail. The status quo is tacitly defended as 'the devil that you know'. Avoidance behaviour frequent absences, many minor illnesses etc. Retreat, including requests for transfers to other institutions, or moving from the public to the private environment.

2. Which of the following was the institution St. Barnabas a victim? a. b. c. d. Goals displacement Shortage of staff Neglect of infrastructure Poor leadership

3. Dr. Goodheart should in his situation recognise the need for all except? a. Team building b. A public relations campaign

Health Services Management


Recalled by Mr. Da Roux Barrett (MBBS 2k14) August 22, 2011 1:00 p.m.

c. Involving the community in the running of the health facility d. Enforcing discipline in the clinic with a dress code

4. Which of the following should Dr. Goodheart now undertake? a. b. c. d. Weed out those forces that are now keeping back progress at St. Barnabas Learn as much as he can about the facility and do his own analysis Implement changes at once since there is a crisis Seek a meeting with the health authority

5. A staff member says to him, I cant deal with the chaos, You have to stop it. How should Dr. Goodheart best respond? a. b. c. d. Assure her that the organisation will settle down again Point out that chaos was generally part of change Ask her what she was doing to stop the choas Ask her to identify the sources of chaos

6. What in your view would be the most important role of the team members in the stabilization or reorganisation of St. Barnabas? a. b. c. d. Perform other technical functions well Make sure that contributions in their disciplines is acknowledged and protected Be open to working for change with their new leader Work and watch, there is a great possibility of burn out

7. Your friend is now ready to change some of the operations of the clinic. What would be her most useful activity a. Post Clear and concise notice on the clinic advising the staff and patients of the changes b. Discuss the proposed changes with the staff explaining how she thinks they will help to make things better c. Ask the parish manager to ratify the changes and issue the relevant notices under her signature d. Explain only to those persons whose job will be affected by the changes 8. Dr. Jones is a consultant surgeon who has taken up the post of hospital manager at a major metropolitan hospital. Which class of skills is she least likely to use in her new Job? a. Budgeting b. Human

Health Services Management


Recalled by Mr. Da Roux Barrett (MBBS 2k14) August 22, 2011 1:00 p.m.

c. Conceptual d. Clinical

9. Which of the following best refers to Fayols Esprit De Corps states in his general principles of management. a. b. c. d. Unity of command - There is only one don!" One person who is superior. Unity of direction - One head and one plan for a group of activities with the same objective. Initiative - All levels of staff should be encouraged to show initiative Teamwork

Espirit de Corps - Harmony is a strength to an a organization and teamwork must be encouraged. Management Principle Division of work Authority Discipline Unity of command Unity of direction Subordination of individual interests to the general interest Remuneration Centralization Scalar chain Order Equity Stability of tenure of personnel Initiative Espirit de corps Relevance Reduces the span of attention or effort for any one person or group. Develops practice and familiarity. The right to give orders. Should not be considered without reference to responsibility. Outward marks of respect in accordance with formal or informal agreements between a firm and its employees. "There is only one don!" One person who is superior. One head and one plan for a group of activities with the same objective. The interests of one individual or one group should not take precedence over the general good. Pay should be fair to both the employee and the firm Is always present to a greater or lesser extent. The line of authority from top to bottom of the organization A place for everything and everything in its place Kindliness and justice to employees Employees need time to settle into their jobs All levels of staff should be encouraged to show initiative Harmony is a strength to an a organization and teamwork must be encouraged.

10. In carrying out the controlling function, a Manager will be expected to do all of the following except? a. b. c. d. Establishing standards Measure performance Training leaders of the workforce Correct deviations from standard

Controlling 1. Regulating activities in accordance with the requirements of plans 2. Linked to planning function

Health Services Management


Recalled by Mr. Da Roux Barrett (MBBS 2k14) August 22, 2011 1:00 p.m.

A manager "controls" many things: money, performance, quality of care for example. The principles are the same in this function of controlling: 1. 2. 3. 4. Establish standards Measure performance Compare results with standards Correct deviation from standards

1. Planning

Primary management function Lays foundations for other functions Decides in advance what is to be done (sets objectives) Offsets uncertainty and chance Fosters economical operation Facilitates control

2. Organizing Having set objectives - develop an organizational framework or context for carrying them out. Organizational Framework: - relating people and things to each other in such a way that they are combined into a unit capable of being directed toward organization objectives. As we get organized we start forming WORK UNITS or groups of individuals with particular tasks and responsibilities. A process of vertical and horizontal differentiation takes place in the organization producing a formal organization structure held together by responsibility and authority. Responsibility: - obligation to execute functions of work - emerges out of authority Authority: - legitimized power related to role or position in organization - legal right to act Authority and responsibility must be commensurate. That is one should not be given responsibility without commensurate authority.

3. Directing Once plans are made and organization set up the work effort of the organization need to be stimulated and organized. The task or directing function is involved here as follows:

Ordering (order giving)

Health Services Management


Recalled by Mr. Da Roux Barrett (MBBS 2k14)

August 22, 2011 1:00 p.m.

Supervising Leading Motivating Communicating

Supervision: - training and disciplining of the workforce Leadership: - ability to inspire and influence others to contribute to the attainment of the objective Motivating: - achieving goal-directed behaviour

4. Co-ordinating This is the act of synchronizing people and activities so that they function smoothly in the attainment of objective. Another way of seeing coordinating is that of preventing and managing conflict at all levels. Coordinating is therefore: Synchronizing people and activities so that they function smoothly Preventing and managing conflict at all levels As organizations become more complex and there is differentiation of activities and specialization of labour, then the coordinating function becomes even more important.

11. When we says that those who need get what they need we are describing a concept related to which of the following terms? a. b. c. d. Access Earning Capacity Equity Eficiency

12. Which of the following is least likely to suggest a decline in team morale? a. b. c. d. Conflict between staff Frequent resignations High Absenteeism Low productivity

13. Defective change leadership is characterised by which of the following?

Health Services Management


Recalled by Mr. Da Roux Barrett (MBBS 2k14) August 22, 2011 1:00 p.m.

a. b. c. d.

Questioning and suspicion of the organisations motives A demand by the leader for total loyalty to the organisation A willingness of the leader to communicate constantly A Jockeying for power among staff in the new organisation

14. In paying for healthcare health insurance is characterised by all of the following except? a. b. c. d. The certainty of a small loss to the risk of a much greater loss Risk rating of individuals based on their age and health satus Prepaying doctors a fixed amount to cover a group of patients Combining the individual risk in what is called risk pooling

15. In preparing a news release to provide information via the media to community members about suspected but unconfirmed cases of leptospirosis in your parish. Which of the following things is most important for the manager to know? a. b. c. d. When test results on suspected cases will be available The communication policies of your organisation Which media house the community uses most How many suspected cases there were and where exactly they occurred

16. You cannot exercise leadership in the health team effectively if? a. b. c. d. You are not in the position of authority You are the only doctor on the team You are the most junior member of the team Your communication skills are poor

17. If you were advising a colleague on how best to improve teamwork in staff members who are demotivated. Which of the following group of strategies you would think would be most effective? a. Emphasize the importance of each specific job function to team success; Include staff in planning and keep the communication lines open b. Promote one person as an incentive and have an open door policy c. Acknowledge good work, listen to their grievance and promise to explore the possibility of salary increases d. Be assertive when stating your expected deliverables, remind team members about job security and use the media to promote your team. 18. Which of the following is an accepted characteristic of authority? a. Be commensurate with responsibility

Health Services Management


Recalled by Mr. Da Roux Barrett (MBBS 2k14) August 22, 2011 1:00 p.m.

b. It is legitimised power based on position with the organisation c. It is necessary to achieve motivation in the team d. It should be commensurate with years of experience Responsibility: e. - obligation to execute functions of work f. - emerges out of authority Authority: g. - legitimized power related to role or position in organization h. - legal right to act i. Authority and responsibility must be commensurate. That is one should not be given responsibility without commensurate authority. 19. In paying for health care services which of the following relates to the fee for a service arrangement? a. b. c. d. It involves a health insurance provider It involved a pre-paid scheme It is a bi-lateral model It is a tri-lateral model

20. Academic or cognitive intelligence on its own is inadequate preparation for the emotional challenges inevitable in a medical career. Based on the principle of emotional intelligence, which of the following competences are vital for the emotionally intelligent leader? a. b. c. d. Self-control, Conflict management, personal awareness and authority Social awareness handling relationships managing emotions and self awareness Anger management, Inter-personal skills manipulation and charm Perceiving reasoning managing and directing emotions

21. Which of the following features was most notable in the delivery of health services as proposed in the health unit system by Stock Daley in 1947? a. b. c. d. Hierarchy efficiency Independence of sectors Limited community involvement Involve only public health nurses

22. Which of the following is an acceptable goal of health sector reform? a. b. c. d. Increased equity and benefits Maintained efficiency in management Reduced cost effectiveness in satisfying health needs Change in political directorates

Health Services Management


Recalled by Mr. Da Roux Barrett (MBBS 2k14) August 22, 2011 1:00 p.m.

23. The most important reason to learn about leadership is? a. b. c. d. To allow you to take your place as the head of the team To help you understand why things often go wrong To examine your leadership style and areas you wish to strengthen To decide whether youll seek leadership positions later in your career

24. Which does not belong among the usually discussed management continuum? a. b. c. d. Offer functions Plan visioning Co-ordinating Directing and planning

25. A member of a health team is worried about a sick child needs to be? a. b. c. d. Told to leave the problems at home Given extra leave, we all have problems Encouraged and helped to find appropriate solutions for care Reassured that the child will be fine

26. Communication and change should concern itself with which of the following? a. b. c. d. Only what the leader thinks people need to know Addressing mostly the positive benefits related to change Receiving as well as conveying the feelings and information Only those aspects that directly affectet the workers job

27. Staff meeting an be useful to achieve all the following except? a. b. c. d. Build morale Point out problems on the team Monitor attendance Propose solutions and give feedback

28. Which of the following does not relate to Maslows hierarchy of needs?

Health Services Management


Recalled by Mr. Da Roux Barrett (MBBS 2k14) August 22, 2011 1:00 p.m.

a. b. c. d.

It is a theoretcial framework which can hardly explain human motivation Has 5 levels of needs Individuals understand their personities Places self-esteem needs at the summit

29. Theory X and Theory Y relates to which of the following statements? a. b. c. d. The way in which women and men handle authority Theories related to different leadership styles The link between leadership and productivity Assumptions underlying why people work

30. Which of the following statements best describes Theory Z? a. b. c. d. It focuses on technology issues as important for productivity It is based on an American approach to management It concentrates on coordinating people to improve productivity Was devoloped by Henri Fayol as a classic management principle

31. In operatin a new business, the point at which the revenue generated matches the expenses is called? a. b. c. d. Balance sheet point Break open point Net profit point Break even point

Break even':usually a business takes time before it can stand on its own feet.This means the point at which its expenses are covered by the revenue being generated.? When you are going in to practice medicine as a business you will be thinking: " how many patients do I need to see per day in order to pay all my business expenses"So projecting the volume of operation is an important factor in looking at business viability over time.Afetr breaking even you will then be making profits.Before the break even point you will need to have some "working capital" to keep up with your expenses.This is money that you or an invetsor will be putting into the business.Hopefully your business will survive!

32. Dr. Smith was advised to conduct a SWOT analysis of the organisation on taking up his job as the new health manager. T his meant that he should examine? a. Strengths, Weaknesses, Outcomes and Time b. Strenght, Weaknesses, Opportunities and Threats c. Strenght, Weaknesses, Opportunities and Time

Health Services Management


Recalled by Mr. Da Roux Barrett (MBBS 2k14) August 22, 2011 1:00 p.m.

d. Strengths, Weaknesses, Outcomes and Threats

33. Planning as a primary management function? a. b. c. d. Puts individuals into work units organizing Offsets uncertainty and chance Has little to do with economical operation planning fosters economical operation Creates linkages between staff

Planning

Primary management function Lays foundations for other functions Decides in advance what is to be done (sets objectives) Offsets uncertainty and chance Fosters economical operation Facilitates control

Organizing

Having set objectives - develop an organizational framework or context for carrying them out. Organizational Framework: - relating people and things to each other in such a way that they are combined into a unit capable of being directed toward organization objectives. As we get organized we start forming WORK UNITS or groups of individuals with particular tasks and responsibilities. A process of vertical and horizontal differentiation takes place in the organization producing a formal organization structure held together by responsibility and authority.

34. A manager who is carrying out a co-ordinating function is? a. b. c. d. Stimulating oraganisational conflicts Synchronising people and activities Training and disciplining individuals Comparing results and standards

Co-ordinating-This is the act of synchronizing people and activities so that they function smoothly in the attainment of objective. Another way of seeing coordinating is that of preventing and managing conflict at all levels. Coordinating is therefore: Synchronizing people and activities so that they function smoothly Preventing and managing conflict at all levels

Health Services Management


Recalled by Mr. Da Roux Barrett (MBBS 2k14) August 22, 2011 1:00 p.m.

35. Leadership is best defined as? a. b. c. d. The abiity to tell or advise other people what to do The proper use of authority in a workplace setting Knowing what to do and telling others how to do it The process of influencing others to perform better

36. Some barriers to effective communication among team members are all of the following except? a. b. c. d. Building team spirit Poor listening skills Making assumptions Misuse of power and authority

37. With respect to financial statements? a. b. c. d. Balance sheets balance out only for companies that are doing well Business revenue less expenses is a measure of the net income Assets are the personal belongings of the directors including cash Owners equity is the profit reaped at the end of the financial year

38. All of the factors below are responsible for an increase in the cost of providing health care except? a. b. c. d. Increase in supply of generic drugs Increased technological output Increased demand for health services Increasing burden of chronic diseases

39. which represents a decisional role of the manager? a. b. c. d. Allocator Figure head Liason Spokesman

1. Interpersonal roles:

2. Informational roles:

3. Decisional:

figurehead leader liaison

monitor disseminator spokesman

entrepreneur disturbance handler resource allocator negotiator

Health Services Management


Recalled by Mr. Da Roux Barrett (MBBS 2k14) August 22, 2011 1:00 p.m.

40. Shock and denial are most peoples reaction to sudden change; From a leadership point of view which of the following is most appropriate to address these negative reactions? a. b. c. d. Isolate those that seem to be negative Plan meetings to discuss the change Ignore it as it will pass away soon Slow down the process if he or she can

41. Which of the following is classified as an inter-personal role of the manager? a. b. c. d. Entrepeneur decisional Disturbance handler decisional Liason Resource allocator decisional

42. Reasons for improving morale in the work environment include all except? a. b. c. d. Patients like facilities where the staff seems happy Good morale boosts workplace productivity Good morale makes the environment less stressful Staff can be paid less when morale is high

43. Free reign or Laissez faire leadership works best with? a. b. c. d. People who are difficult to control People who are highly motivated People who are senior to the leader People who are older than the leader

44. In financial management? a. b. c. d. Assets are what the business owns Assets are intangibly defined Assets are only cash reserves Assets are what a business owes

45. According to Henri Fayol, managers of organisations need to consider a. b. c. d. Authority with responsibility Resoponsibility by itself The unity of demand Authority by itslef

Health Services Management


Recalled by Mr. Da Roux Barrett (MBBS 2k14) August 22, 2011 1:00 p.m.

1 Marks: 1 Some barriers to effective communication among team members are all of the following except Choose one answer. a. building team spirit b. Poor listening skills c. Misuse of power and authority d. Making assumptions 2 Marks: 1 In paying for health care, health insurance is characterized by all of the following except: Choose one answer. a. c. risk rating of individuals based on their age and health status b. the certainty of a small loss to the risk of a much greater loss c. a. pre-paying doctors a fixed amount to cover a group of patients d. b. combining individual risk in what is called risk pooling 3 Marks: 1 A manager who is carrying out a coordinating function is Choose one answer. a. comparing results and standards b. synchronizing people and activities c. training and disciplining individuals d. developing organizational policy 4 Marks: 1 With respect to financial statements:

Choose one answer. a. business revenue less expenses is a measure of the net income b. balance sheets balance out only for companies that are doing well c. owners equity is the profit reaped at the end of the financial year d. assets are the personal belongings of the directors including cash

Health Services Management


Recalled by Mr. Da Roux Barrett (MBBS 2k14) August 22, 2011 1:00 p.m.

5 Marks: 1 Regarding follower-ship Choose one answer. a. one must never challenge the leaders point of view b. good leaders often come from a pool of good followers c. following and leading are not mutually exclusive d. good followers generally do not make good leaders

To a large extent the composition of a group determines who will emerge as leader. Followers have their own needs and expectations to be satisfied. A leader is likely to be chosen or to emerge as a reflection of those needs: i.e. the followers will allow the leader who best fits their needs to emerge. Leadership then is often a dynamic relationship between leaders and followers.

Marks: 1 The directing function in management includes all of the following except: Choose one answer. a. setting goals b. budgeting c. supervising d. leading 7 Marks: 1 Shock and denial describe most peoples initial reaction to sudden change. - a leader should Choose one answer. a. slow down the process if he/she can b. isolate those that seem to be negative c. ignore it, as it will pass away soon d. plan meetings to discuss the change 8 Marks: 1 Planning as a primary management function Choose one answer. a. puts individuals into work units b. has little to do with economical operation c. offsets uncertainty and chance d. creates linkages between staff

Health Services Management


Recalled by Mr. Da Roux Barrett (MBBS 2k14) August 22, 2011 1:00 p.m.

9 Marks: 1 Free rein or laissez faire leadership works best with: Choose one answer. a. People who are senior to the leader b. People who are older than the leader c. People who are difficult to control d. People who are highly motivated 10 Marks: 1 All of the factors below are responsible for an increase in the cost of providing health care except:

Choose one answer. a. increased technological output b. increase in supply of generic drugs c. increasing burden of chronic diseases d. increasing demand for health services 11 Marks: 1 Effective change leadership is characterized by Choose one answer. a. questioning and suspicion of the organizations motives b. a jockeying for power among staff in the new organization c. a demand by the leader for total loyalty to the organization d. a willingness of the leader to communicate constantly 12 Marks: 1 Dr Smith was advised to conduct a SWOT analysis of the organization on taking up his job as the new health manager. This meant he should examine: Choose one answer. a. strengths, weaknesses opportunities and threats b. strengths, weaknesses, opportunities and time c. strengths, weaknesses, outcomes and threats d. strengths, weaknesses, outcomes and time 13 Marks: 1

Health Services Management


Recalled by Mr. Da Roux Barrett (MBBS 2k14) August 22, 2011 1:00 p.m.

The main focus of health sector reform includes all except: Choose one answer. a. improving the efficiency of health services b. improving efficiency in management c. improving health promotion programmes d. improving consumer satisfaction 14 Marks: 1 With respect to the entity concept in financial management, Choose one answer. a. accounts are kept for the business only b. a. accounts are kept for personal expenses only c. c. accounts are kept for both personal and business d. accounts are kept for creditors only 15 Marks: 1 In a comparison of two medical centers delivering the same kind of service in similar neighbourhoods, Center A saw 650 patients for the month of March and made a net income of $90,000. Center B however saw 1,150 patients for the same month and made a net income of $43,000. Which of the following is true in comparing Centre A and B? Choose one answer. a. Center A is more profitable than Center B b. Both Centers A and B are profitable c. Both Centers generated revenue d. Center B is more profitable than Center A 16 Marks: 1 Leadership is best defined as Choose one answer. a. The proper use of authority in a workplace setting b. The ability to tell or advise other people what to do c. Knowing what to do and telling others how to do it d. The process of influencing others to perform better 17 Marks: 1 You cannot exercise leadership in the health team effectively if: Choose one answer. a. You are the most junior member of the team

Health Services Management


Recalled by Mr. Da Roux Barrett (MBBS 2k14) August 22, 2011 1:00 p.m.

b. Your communication skills are poor c. You are the only doctor on the team d. You are not in a position of authority 18 Marks: 1 Factors driving health sector reform in the Caribbean include all of the following except: Choose one answer. a. the epidemiological transition b. demographic issues c. weaknesses in the health sector d. patient lobby groups 19 Marks: 1 An information interview aims to do which of the following Choose one answer. a. To stimulate action among managers b. To make important information public c. Give leaders a chance to manage better d. Improve relationship with the media 20 Marks: 1 The term "liabilities" in financial management refers to: Choose one answer. a. c. claims of debtors against the business assets b. b. using an approach for which you can be sued c. d. claims of creditors against the business assets d. a. an employee who is not performing adequately 3. Assets - the economic resources of an entity what the business owns. 4. Equities - claims of various parties against assets. 5. Liabilities - claims of creditors against assets. 6. Owners equity - claims of owners of business against asset also called capital.

21 Marks: 1 All of the following would be appropriate rationale for introducing health services management in the medical curriculum except:

Health Services Management


Recalled by Mr. Da Roux Barrett (MBBS 2k14) August 22, 2011 1:00 p.m.

Choose one answer. a. to improve the efficiency and effectiveness of health services b. to stimulate doctors to think about organizational issues c. to make the curriculum more broad-based d. to increase the earning output of future physicians 22 Marks: 1 Which of the following does not relate to Maslows hierarchy of needs?

Choose one answer. a. Is applicable in the Caribbean environment b. Helps one to understand his/her personality c. Has five levels of hierarchical needs d. Places self esteem needs at the summit 23 Marks: 1 The need for power is Choose one answer. a. one of the observed characteristics of a good leader b. to be discouraged until individuals are ready for promotion c. a product of family dynamics d. not to be encouraged in females 24 Marks: 1 Dr. Reganam said he would organize the blood transfusions for patients on the ward. According to health management theory this meant: Choose one answer. a. he would arrange the transfusions in order of priority b. he would assign responsibility and authority to various individuals c. he would order the blood from the blood bank d. he would group and cross match all the patients and collect the blood 25 Marks: 1 The following are true of a health budget except: Choose one answer. a. it cannot be revised during the year

Health Services Management


Recalled by Mr. Da Roux Barrett (MBBS 2k14) August 22, 2011 1:00 p.m.

b. it can be used to assess performance c. it can help to motivate and control d. it is a plan in quantitative terms 26 Marks: 1 Theory X and Theory Y relate to: Choose one answer. a. Theories related to different leadership styles b. The link between leadership and productivity c. Assumptions underlying why people work d. The way women and men handle authority 27 Marks: 1 Theory Z Choose one answer. a. concentrates on coordinating people to improve productivity b. focuses on technology issues as important for productivity c. was developed by Henri Fayol as a classic principle d. is based on an American approach to management 28 Marks: 1 Communication and change should concern itself with Choose one answer. a. only what the leader thinks people need to know b. receiving as well as conveying feelings and information c. addressing mostly the positive benefits related to the change d. only those aspects that directly affect the workers job 29 Marks: 1 Which represents a decisional role of the manager? Choose one answer. a. liaison b. resource allocator c. spokesman d. figurehead 30 Marks: 1

Health Services Management


Recalled by Mr. Da Roux Barrett (MBBS 2k14) August 22, 2011 1:00 p.m.

When we speak of hygiene factors we are describing: Choose one answer. a. factors whose absence cause dissatisfaction b. factors which are not motivational c. d.factors related to the physical and emotional work environment d. a workplace which is clean and tidy 31 Marks: 1 The job of a manager in dealing with a worker showing evidence of frustration is essentially to: Choose one answer. a. offer them a less stressful position b. clarify and investigate their problems c. refer them for counseling before they get worse d. remind them of organizational goals 32 Marks: 1 Emotional safety in a job speaks to all of the following except: Choose one answer. a. policies applied fairly b. clear job descriptions c. latitude to express ones self freely d. having job security 33 Marks: 1 When we say that those who need get what they need we are describing a concept related to: Choose one answer. a. advocacy b. equity c. access d. efficiency 34 Marks: 1 The following have been found to be qualities of a leader except: Choose one answer. a. Sharing information in an effective manner b. Having a clear vision for the organization

Health Services Management


Recalled by Mr. Da Roux Barrett (MBBS 2k14) August 22, 2011 1:00 p.m.

c. Seldom making mistakes in the workplace d. Directing staff and subordinates with coaching 35 Marks: 1 Which does not belong among the usually discussed management continuum of functions? Choose one answer. a. planning b. directing c. visioning d. coordinating 36 Marks: 1 A decline in team morale can often be inferred from all of these factors except:

Choose one answer. a. low productivity b. frequent resignations c. conflict between staff d. high absenteeism Measuring declines in morale 1. 2. 3. 4. High turnover of staff Frequent absenteeism Poor teamwork A general low energy atmosphere

37 Marks: 1 Reasons for improving morale in the work environment include all except: Choose one answer. a. Good morale boosts workplace productivity b. Good morale makes the environment less stressful c. Patients like facilities where the staff seem happy d. Staff can be paid less when morale is high 38 Marks: 1 In operating a new business, the point at which the revenue generated matches the expenses is called the

Health Services Management


Recalled by Mr. Da Roux Barrett (MBBS 2k14) August 22, 2011 1:00 p.m.

Choose one answer. a. near profit point b. balance sheet point c. break even point d. break open point 39 Marks: 1 In financial management Choose one answer. a. assets are what the business owes b. assets are only cash reserves c. assets are intangibly defined d. assets are what the business owns 40 Marks: 1 According to Henri Fayol managers of organizations need to consider: Choose one answer. a. responsibility by itself b. authority with responsibility c. authority by itself d. the unity of demand

1 Marks: 1 With respect to financial statements:

Choose one answer. a. owners equity is the profit reaped at the end of the financial year b. balance sheets balance out only for companies that are doing well c. assets are the personal belongings of the directors including cash d. business revenue less expenses is a measure of the net income

Health Services Management


Recalled by Mr. Da Roux Barrett (MBBS 2k14) August 22, 2011 1:00 p.m.

3. Assets - the economic resources of an entity what the business owns. 4. Equities - claims of various parties against assets. 5. Liabilities - claims of creditors against assets. 6. Owners equity - claims of owners of business against asset also called capital.

2 Marks: 1 Which of the following does not relate to Maslows hierarchy of needs?

Choose one answer. a. Has five levels of hierarchical needs b. Places self esteem needs at the summit c. Is applicable in the Caribbean environment d. Helps one to understand his/her personality

Mnemonic for Maslows hierarchy of needs: Please Stop Breaking Every China-plate Around Susie! (physiological, safety, belongness and love, emotional, cognitive, aesthetic and self-actualisation) At the base and most basic are physiological needs. At the apex is self-actualisation

3 Marks: 1 All of the factors below are responsible for an increase in the cost of providing health care except:

Choose one answer. a. increasing burden of chronic diseases

Health Services Management


Recalled by Mr. Da Roux Barrett (MBBS 2k14) August 22, 2011 1:00 p.m.

b. increased technological output c. increasing demand for health services d. increase in supply of generic drugs

4 Marks: 1 The main focus of health sector reform includes all except: Choose one answer. a. improving consumer satisfaction b. improving health promotion programmes c. improving efficiency in management d. improving the efficiency of health services

5 Marks: 1 You cannot exercise leadership in the health team effectively if: Choose one answer. a. You are the most junior member of the team b. You are not in a position of authority c. You are the only doctor on the team d. Your communication skills are poor

6 Marks: 1

Health Services Management


Recalled by Mr. Da Roux Barrett (MBBS 2k14) August 22, 2011 1:00 p.m.

In operating a new business, the point at which the revenue generated matches the expenses is called the Choose one answer. a. break open point b. break even point c. balance sheet point d. near profit point

7 Marks: 1 The directing function in management includes all of the following except: Choose one answer. a. supervising b. leading c. budgeting d. setting goals

8 Marks: 1 Reasons for improving morale in the work environment include all except: Choose one answer. a. Good morale makes the environment less stressful b. Staff can be paid less when morale is high c. Good morale boosts workplace productivity d. Patients like facilities where the staff seem happy

Health Services Management


Recalled by Mr. Da Roux Barrett (MBBS 2k14) August 22, 2011 1:00 p.m.

9 Marks: 1 Free rein or laissez faire leadership works best with: Choose one answer. a. People who are older than the leader b. People who are difficult to control c. People who are senior to the leader d. People who are highly motivated

10 Marks: 1 Dr. Reganam said he would organize the blood transfusions for patients on the ward. According to health management theory this meant: Choose one answer. a. he would arrange the transfusions in order of priority b. he would assign responsibility and authority to various individuals c. he would group and cross match all the patients and collect the blood d. he would order the blood from the blood bank

11 Marks: 1 Dr Smith was advised to conduct a SWOT analysis of the organization on taking up his job as the new health manager. This meant he should examine: Choose one answer.

Health Services Management


Recalled by Mr. Da Roux Barrett (MBBS 2k14) August 22, 2011 1:00 p.m.

a. strengths, weaknesses, outcomes and threats b. strengths, weaknesses opportunities and threats c. strengths, weaknesses, outcomes and time d. strengths, weaknesses, opportunities and time

12 Marks: 1 Emotional safety in a job speaks to all of the following except: Choose one answer. a. latitude to express ones self freely b. clear job descriptions c. having job security d. policies applied fairly

13 Marks: 1 With respect to the entity concept in financial management, Choose one answer. a. accounts are kept for the business only b. a. accounts are kept for personal expenses only c. accounts are kept for creditors only d. c. accounts are kept for both personal and business

14

Health Services Management


Recalled by Mr. Da Roux Barrett (MBBS 2k14) August 22, 2011 1:00 p.m.

Marks: 1 A decline in team morale can often be inferred from all of these factors except:

Choose one answer. a. conflict between staff b. frequent resignations c. low productivity d. high absenteeism

15 Marks: 1 Effective change leadership is characterized by Choose one answer. a. a demand by the leader for total loyalty to the organization b. questioning and suspicion of the organizations motives c. a jockeying for power among staff in the new organization d. a willingness of the leader to communicate constantly

16 Marks: 1 Planning as a primary management function Choose one answer. a. puts individuals into work units b. offsets uncertainty and chance

Health Services Management


Recalled by Mr. Da Roux Barrett (MBBS 2k14) August 22, 2011 1:00 p.m.

c. has little to do with economical operation d. creates linkages between staff

17 Marks: 1 The following are true of a health budget except: Choose one answer. a. it cannot be revised during the year b. it can help to motivate and control c. it is a plan in quantitative terms d. it can be used to assess performance

18 Marks: 1 When we say that those who need get what they need we are describing a concept related to: Choose one answer. a. equity b. access c. efficiency d. advocacy

19 Marks: 1 Theory Z Choose one answer.

Health Services Management


Recalled by Mr. Da Roux Barrett (MBBS 2k14) August 22, 2011 1:00 p.m.

a. concentrates on coordinating people to improve productivity b. is based on an American approach to management c. focuses on technology issues as important for productivity d. was developed by Henri Fayol as a classic principle

20 Marks: 1 All of the following would be appropriate rationale for introducing health services management in the medical curriculum except: Choose one answer. a. to increase the earning output of future physicians b. to stimulate doctors to think about organizational issues c. to make the curriculum more broad-based d. to improve the efficiency and effectiveness of health services

21 Marks: 1 In financial management Choose one answer. a. assets are only cash reserves b. assets are what the business owes c. assets are what the business owns d. assets are intangibly defined

22

Health Services Management


Recalled by Mr. Da Roux Barrett (MBBS 2k14) August 22, 2011 1:00 p.m.

Marks: 1 In a comparison of two medical centers delivering the same kind of service in similar neighbourhoods, Center A saw 650 patients for the month of March and made a net income of $90,000. Center B however saw 1,150 patients for the same month and made a net income of $43,000. Which of the following is true in comparing Centre A and B? Choose one answer. a. Center B is more profitable than Center A b. Both Centers A and B are profitable c. Center A is more profitable than Center B d. Both Centers generated revenue

23 Marks: 1 Some barriers to effective communication among team members are all of the following except Choose one answer. a. building team spirit b. Making assumptions c. Poor listening skills d. Misuse of power and authority

24 Marks: 1 An information interview aims to do which of the following Choose one answer. a. To make important information public

Health Services Management


Recalled by Mr. Da Roux Barrett (MBBS 2k14) August 22, 2011 1:00 p.m.

b. Improve relationship with the media c. To stimulate action among managers d. Give leaders a chance to manage better

25 Marks: 1 Regarding follower-ship Choose one answer. a. following and leading are not mutually exclusive b. good followers generally do not make good leaders c. good leaders often come from a pool of good followers d. one must never challenge the leaders point of view

26 Marks: 1 Leadership is best defined as Choose one answer. a. The ability to tell or advise other people what to do b. The proper use of authority in a workplace setting c. Knowing what to do and telling others how to do it d. The process of influencing others to perform better

27 Marks: 1

Health Services Management


Recalled by Mr. Da Roux Barrett (MBBS 2k14) August 22, 2011 1:00 p.m.

According to Henri Fayol managers of organizations need to consider: Choose one answer. a. authority by itself b. the unity of demand c. responsibility by itself d. authority with responsibility

28 Marks: 1 Factors driving health sector reform in the Caribbean include all of the following except: Choose one answer. a. patient lobby groups b. weaknesses in the health sector c. demographic issues d. the epidemiological transition

29 Marks: 1 The job of a manager in dealing with a worker showing evidence of frustration is essentially to: Choose one answer. a. refer them for counseling before they get worse b. offer them a less stressful position c. clarify and investigate their problems d. remind them of organizational goals

Health Services Management


Recalled by Mr. Da Roux Barrett (MBBS 2k14) August 22, 2011 1:00 p.m.

30 Marks: 1 Shock and denial describe most peoples initial reaction to sudden change. - a leader should Choose one answer. a. slow down the process if he/she can b. isolate those that seem to be negative c. plan meetings to discuss the change d. ignore it, as it will pass away soon

31 Marks: 1 A manager who is carrying out a coordinating function is Choose one answer. a. developing organizational policy b. comparing results and standards c. training and disciplining individuals d. synchronizing people and activities

32 Marks: 1 In paying for health care, health insurance is characterized by all of the following except: Choose one answer.

Health Services Management


Recalled by Mr. Da Roux Barrett (MBBS 2k14) August 22, 2011 1:00 p.m.

a. a. pre-paying doctors a fixed amount to cover a group of patients b. c. risk rating of individuals based on their age and health status c. the certainty of a small loss to the risk of a much greater loss d. b. combining individual risk in what is called risk pooling

33 Marks: 1 The need for power is Choose one answer. a. to be discouraged until individuals are ready for promotion b. not to be encouraged in females c. one of the observed characteristics of a good leader d. a product of family dynamics

34 Marks: 1 Theory X and Theory Y relate to: Choose one answer. a. The way women and men handle authority b. Assumptions underlying why people work c. The link between leadership and productivity d. Theories related to different leadership styles

Autocratic Style In this style there is:

Health Services Management


Recalled by Mr. Da Roux Barrett (MBBS 2k14)

August 22, 2011 1:00 p.m.

Autocratic leadership "my way or the highway" Close control Little input from subordinates

This was described by Douglas McGregor as operating on the principle of theory X. The underlying assumptions of this theory are:

The average person dislikes work and will avoid it to the extent that he/she can Most people have to be forced or threatened by punishment to achieve organizational goals The average individual is passive and therefore prefers to be directed rather than take any risk or responsibility. Above all, he/she prefers security.

Democratic leadership (theory Y) This manager uses greater decentralization of autonomy, democratic techniques, consultation with subordinates, little reliance on coercion and control. The underlying assumptions of this theory are:

Work is natural to people and therefore is not avoided If the individual is committed to organizational goals there is self motivation. Coercion therefore is not the only form of influence to be used to motivate. Commitment is a crucial factor in motivation and arises from the inherent rewards coming from it. The average individual learns to ACCEPT AND SEEK responsibility given the proper environment. Creative and innovative solutions of organizational problems are widely not narrowly distributed. In modern organizations the intellectual potentials of employees are only partially utilized.

35 Marks: 1 The term "liabilities" in financial management refers to: Choose one answer. a. d. claims of creditors against the business assets b. c. claims of debtors against the business assets c. b. using an approach for which you can be sued d. a. an employee who is not performing adequately

36

Health Services Management


Recalled by Mr. Da Roux Barrett (MBBS 2k14) August 22, 2011 1:00 p.m.

Marks: 1 Which does not belong among the usually discussed management continuum of functions? Choose one answer. a. coordinating b. directing c. planning d. visioning

37 Marks: 1 Which represents a decisional role of the manager? Choose one answer. a. liaison b. spokesman c. figurehead d. resource allocator

38 Marks: 1 Communication and change should concern itself with Choose one answer. a. addressing mostly the positive benefits related to the change b. only those aspects that directly affect the workers job c. receiving as well as conveying feelings and information

Health Services Management


Recalled by Mr. Da Roux Barrett (MBBS 2k14) August 22, 2011 1:00 p.m.

d. only what the leader thinks people need to know

39 Marks: 1 The following have been found to be qualities of a leader except:

Choose one answer. a. Directing staff and subordinates with coaching b. Sharing information in an effective manner c. Having a clear vision for the organization d. Seldom making mistakes in the workplace

qualities of an effective leader.


Think explicitly about their leadership role Develop awareness and self belief Focus externally-listen support, provide feedback and coach Display integrity in decision taking and take decisions Share information Be confident enough to make mistakes, admit mistakes and learn from mistakes Direct with coaching Delegate authority as well as responsibility