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Hsmu 392:Qa/Qc In Halth Care Question Paper
Hsmu 392:Qa/Qc In Halth Care
Course:Public Health
Institution: Kenya Methodist University question papers
Exam Year:2013
KENYA METHODIST UNIVERSITY
END OF 1''ST ''TRIMESTER 2013 (EVENINGEXAMINATIONS
SCHOOL : MEDICINE & HEALTH SCIENCES
DEPARTMENT : HEALTH SYSTEMS AND MANAGEMENT
UNIT CODE : HSMU 392
UNIT TITLE : QA/QC IN HEALTHCARE
TIME : 2 HOURS
Instructions:
SECTION A: Respond to all question in this section.
SECTION A
Question One
Read the following statements and state one dimension of quality each best describes. (10mks)
A well maintained ambulance is available to transfer clients to other facilities for further care.
The health facility acquires more instruments so that the sterilizer can be run fewer times during the day
A HIV-positive woman enrolled in the PMTCT program is informed that her child is HIV-negative after the required 18 month period.
The health facility adopts a system of generating printed prescriptions to improve legibility of the prescriptions.
The health facility provides lockable lockers for clients to store their personal effects while admitted.
A client who has been undergoing treatment for TB fully recovers after the therapy.
The hospital has a nurse trained in sign language on duty at all times in the labour ward
The payroll system correctly submits the salaries to each health facility staff.
A woman in labour can choose to have her husband accompany her
The surgeon explains the surgical procedure to the client and responds to the client’s questions the day before the surgery.
Question Two
Read the following standard statements and state for each whether it can be classified as an input, process, or result standard. (10mks)
All new members of staff are oriented to the health facility, their job responsibilities and their specific assignments.
Before discharge from the maternity wards, each new mother can correctly attach her baby to her breast for breastfeeding.
The health facility has manual for orientation of all new staff.
The child of a HIV-positive woman who goes through the PMTCT program is HIV negative at 18 months.
The health facility has a an up-to-date list of medicines, reagents, and supplies available at the facility.
Health facility staff are given updates on blood safety and universal precautions to prevent HIV transmission at the workplace.
The health facility has a written protocol to guide decisions on antiretroviral therapy eligibility.
The health facility provides people living with HIV information on the care and services available to them.
HIV positive antenatal clients can correctly state three ways to prevent transmission of HIV to the infant.
The health facility staff obtains informed consent from clients before conducting HIV tests.
Question Three
Licensure, accreditation and certification are approaches of external quality evaluation. State the most appropriate approach to use in each of the situations represented by the statements below.
(5mks)
A hospital management team applies to have the hospital assessed to receive the company of the year award (COYA)
A security officer working at a health facility completes a First Aid course
A team of midwives wish to open and manage a nursing home.
A nurse has completed a course on advanced life support
A hospital applies to be assessed to join a network of hospitals that is part of the National Hospital Insurance Fund.
Respond to the following questions.
(5mks)
Name the components of Juran’s trilogy for quality management.
Name the technique of seeking out and studying the best processes in other divisions or units within the same organization with the intent of continuous improvement
Name the process of studying best practices of other organizations.
In relation to the shewhart cycle, name the element of the cycle being executed when a team tires out a procedure for reducing medication errors.
In relation to the Shewart cycle, NAME the element of the cycle being executed when a team decides to make a change in the standard operating procedure for medication administration.
Question Four
Classify the following statements into "prevention costs", "appraisal costs", "internal failure costs" or "External failure costs" based on the Cost of Quality model COQ). (10mks)
The accountant notices the pricing of certain services is incorrect and adjusts it before re-circulating the price list for use by the cashiers.
The nurse follows the sterilization protocol when processing used instruments.
The health facility receives a team that is assessing the facility’s readiness to be awarded the "Baby friendly hospital" title.
Clients seeking services at the outpatient department are kept waiting excessively due to a staff meeting that takes long
The hospital Public Health Officer collects samples from various parts of the hospital to assess the level of contamination with microbes that can transmit hospital acquired infections.
The ambulance driver misunderstands the patient transfer instructions and takes the patient to the wrong hospital.
The health facility management team ensures that staff are hired only when they meet the minimum required qualifications.
The quality improvement team regularly conducts maternal mortality audits.
The health facility cleaner notices some fluid on the floor of the treatment room and cleans it up before other staff and clients begin using the room.
The clinician requests for unnecessary diagnostic tests for clients who have health insurance policies.
SECTION B: Response to any TWO questions from this section.
Question One
The quality assurance committee of Mapato Hospital collected the following data on the cost of quality incurred by the hospital between September and December 2012.
Aspects Cost (US $)
Being sued by clients because of performing incorrect surgical procedures 26,335
Correcting patients adverse reactions to incorrect medication 17,735
Developing a sterilization protocol for use while processing used surgical equipment 495
Disposing expired medication from the stores 18,755
Getting assessed for purposes of being ISO certified 2,375
Monitoring adherence to standards developed 990
Sending heads of departments for training on leadership 4,985
Based on the above data, calculate the following, clearly showing your calculations.
(10mks)
Prevention costs
Appraisal costs
Total failure costs
Based on your responses from the above questions, discuss the course of action you would recommend to the Mapato hospital staff and management.
(20mks)
Question Two
A couple has had a childless marriage for five years and is considering getting professional assistance from a fertility expert. On investigation, they discover that they could seek help from a medical fertility clinic in the capital city about 200kms from where they live or from a traditional healer in a neighbouring village (about 3km away), or from a spiritual healer who lives about 30kms away. Discuss how their decision on where to seek assistance could be affected by any FIVE dimensions of quality. (30mks)
Question Three
Commotion at the VCT.
You are walking by the VCT of the hospital you manage when you notice that there is a commotion there. You get into the VCT and find a client who appears to be very agitated talking with one of your VCT counselors who looks scared. On enquiring, you are informed that this client had been counseled and tested for HIV about two weeks before at this VCT centre and been found to be HIV positive. Not believing these results he had visited three different VCT centres in different towns and been found to be HIV negative. He was angry that the HIV counselor had "lied" to him and made him think he was HIV positive "What if I had committed suicide? He asked " I will sue you!"
Citing specific instances from the case study above, identify two examples of Costs of Quality
(6mks)
Citing specific examples from the case study, identify any three dimensions of quality apparent from the story and determine whose perspective each dimension you identify represents.
Processes, like HIV testing, may not perform exactly right all the time because they are vulnerable to influence from many sources of variation. Briefly explain how any five sources of variation could have led to this apparently erroneous HIV test result.
(15mks
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