SECTION A

(MULTIPLE CHOICE QUESTIONS)

A.1
A member of the community has asked you what your professional opinion is about legislation removing nutritional counselling for diabetes from being covered by your provincial health plan. Your best response would be:

1. Governments have to make tough decisions in order to reduce deficits.
2. Public policies such as these are good examples of how money and resources flow through society and can negatively impact the health of the population.
3. If more money is spent of recreation and leisure programs in the schools, less money would be needed to counsel obese populations who are prone to diabetes
4. People need to learn how to live a healthy lifestyle in order to ensure resources aren't spent unnecessarily.

a. 1 & 2
b. 2
c. 3
d. 4

A.2
A vision gives an organization:

a. focus of direction
b. mission
c. values
d. all of the above

A.3
In many hospitals, several of the existing programs are being identified for possible transfer to other institutions for a number of reasons.

As the CEO of Southeast Hospital you have been informed by a staff physician in your institution that Westland Hospital, a nearby facility, is interested in transferring a program with some funds to your hospital. He suggests that you should quickly seize the opportunity and have this program transferred to your hospital.

What would you do in this situation?

a. Convene a meeting of key medical and senior management staff of your hospital with the staff physician concerned to discuss the issue.
b. Request that the physician approach the medical staff at Westland Hospital to obtain additional information on the program.
c. Ascertain whether the medical director of the program to be transferred is interested in moving to your hospital.
d. Find out from the CEO of Westland General Hospital, whether the program in question has been identified as a likely candidate to transfer.

A.4
Assigning blame and punishing those responsible are common responses to error. Authors consistently describe a "culture of blame" within the health care system as a deterrent to reporting of adverse events. Which of the following individually and/or collectively perpetuate this culture of blame?

1. Patients and/or their families
2. Health professionals
3. Medico-legal system
4. Provincial Regulatory Bodies

a. 1 and 2
b. 3 and 4
c. 2, 3 and 4
d. All of the above

A.5
What is the first step in conducting a performance review?

a. Comparing the employee's skills against the job description.
b. Reviewing the performance objectives or expectations for the job.
c. Checking the progress of the employee's work.
d. Consulting the previous year's performance results.

A.6
As a new CEO, you have become aware of poor morale among staff and an attitude of indifference toward the patients.

Which of the following actions would you initiate immediately?

a. Arrange general staff sessions to hear their concerns and provide them with your management philosophy.
b. Hire a consultant to assess staff morale.
c. Have the staff development department offer sessions to all staff on how to communicate with the clients and their families.
d. Meet with senior staff to hear their ideas about the reasons for the morale and attitude problem.

A.7
Mr. Strong is an 88-year-old resident in the long-term care unit of your hospital. He is frail, confused and cries out constantly for his family. One son visits him once a month, only long enough to pick up the monthly dividend cheques. No lawyer or accountant seems to be involved, but there is always adequate money in his account to cover extra monthly costs for semi-private accommodation.

The nursing staff are annoyed with the family’s lack of concern and are exhausted by the constant demands of the patient. The rehabilitation staff feel he would respond to therapy if motivated. The social worker has given up on the family and wants him transferred to a private nursing home. The physician expresses no viewpoint and provides routine care.

To preserve the quality of life of the resident, what action would you take first?

a. Obtain family support.
b. Arrange for a volunteer to visit the resident on a regular basis.
c. Arrange a case conference.
d. Urge the physician to take greater responsibility for the case.

A.8
As the CEO of a 200-bed hospital, you have recently received independent verbal complaints from several members of your medical and nursing staff regarding medical competency and personality issues with a particular physician. The nurses feel that the physician cannot adequately manage emergency patients and they recommend that his privileges be immediately suspended. The medical staff members have informally discussed this physician for some time, but have taken no definitive action. You review the physician’s file and all relevant committee minutes and you find nothing in writing concerning the verbally reported difficulties. You request that the appropriate medical staff committee review a sufficient number of the physician’s past emergency records and ask the committee to make a recommendation on the basis of these records.

What is the best action you can take to identify similar problems in the future?

a. develop a database system and use it to review the care provided by each physician
b. have a representative sample of this physician’s cases reviewed on a regular basis
c. summarize the problems that occur with each physician at the time of reappointment
d. have all of this physician’s emergency cases reviewed for the next six months

A.9
The Canada Labour Code:

a. applies only to employment under federal jurisdictions
b. applies to approximately 10% of the Canadian workforce
c. is related to all the provincial codes
d. a & b

A.10
The new AIM (Achieving Improved Measurement) accreditation survey process involves:

1. surveyors meeting with individual department managers
2. tours of the diagnostic areas, where applicable
3. review of client charts/files
4. focus group meetings

a. all of the above
b. 2, 3 & 4
c. 1, 2 & 3
d. 1

A.11
A situation has occurred in your organization that may be cause for legal action. No legal action has been taken to date, but there is a concern that action might be taken soon.

What is the CEO’s first responsibility?

a. apprise the organization’s legal adviser of the situation
b. ensure documentation is complete and secured
c. call in the client’s family and ensure them that the situation is under control
d. call in the coroner and/or police

SECTION B

(SHORT ANSWER QUESTIONS)

Following are short answer questions. Please list your answers in point form.

B.1
You have been asked to formalize your organization’s strategy for managing client relationships. Identify and briefly discuss the strategy’s key elements.

B.2
Why is an environmental analysis important for an organization?

B.3
You have just received your transfer payment from the provincial ministry. Your appropriation has decreased by 10% for the upcoming fiscal year.

List two approaches with the community that could assist your organization to achieve its target.

B.4
You are asked by your board chair to clarify the direct cost of membership in the accreditation program. What information would you provide?