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Hsmg 543:Tqm Health Care Question Paper
Hsmg 543:Tqm Health Care
Course:Masters Of Heath Management Systems
Institution: Kenya Methodist University question papers
Exam Year:2013
KENYA METHODIST UNIVERSITY
END OF 1''ST ''TRIMESTER 2013 (EVENING) EXAMINATIONS
SCHOOL : MEDICINE & HEALTH SCIENCES
DEPARTMENT : HEALTH SYSTEMS AND MANAGEMENT
UNIT CODE : HSMG 543
UNIT TITLE : TQM IN HEALTH CARE
TIME : 3 HOURS
Instructions:
SECTION A: Respond to all questions in this section
Question One
Read the following standard statements and state for each whether it can be classified as an input, process, or result standard. (10mks)
A health facility financial report is submitted in accordance with the stipulated requirements and cycles.
All expectant women counseled at the antenatal clinic can list the danger signs during pregnancy.
The health facility has employed trained and certified HIV counselors to offer VCT services.
All new members of staff are oriented to the health facility, their job responsibilities, and their specific assignments.
Health facility staff are provided post-exposure prophylaxis (PEP) for HIV whenever exposed to risk of HIV infection.
The health facility has a written HIV testing, counseling, and referral policy.
The health facility provides information and education on health promotion and disease prevention in schools, workplaces, and other settings within the community.
The health facility has a manual for orientation of all new staff.
The pharmacy dispenses drugs in a container clearly labeled with the client’s name, the name of the drug, and dosage instructions.
The child of a HIV positive woman who goes through the PMTCT programme is HIV negative at 18 months.
Question Two
The County Director for Health of Mapato country received a report from one of the Sub-county team leaders about a health worker who was "underperforming". The County Director for Health immediately recommended the termination of employment of this health worker. Justifying your response, critically analyse the County Director’s course of action. (10mks)
Question Three
For each of the following sentences, state one dimension of quality it best describes.
(5mks)
The religious sponsored health facility provides services to the entire population regardless of religious affiliation.
The Ministry of Health orders for commodities required by all the health facilities in the country centrally.
The County Health Management team announces a reduction in HIV incidence among married couples in the county after a five year HIV prevention program.
The county Health Management team introduces a system for printing prescriptions in all public health facilities to improve legibility of the prescriptions.
The County Health Management team introduces an electronic client record system that can be accessed by all authorized health providers taking care of a client both in private and public health facilities.
For each of the following sentences, state one principle of quality it best describes.
(5mks)
The health facility regularly conducts client satisfaction surveys to identify and meet client needs and expectations.
The county-level commodities management agency uses the data it receives from each facility to determine and respond to the facility commodity needs.
The health facility staff and management hold regular meetings to deliberate on opportunities and challenges in providing quality health services to the catchment area.
The manger patiently waits for an explanation from the employee and gives useful feedback
The County Health Management team decides to include health workers from private health facilities in the updates it regularly provides to the health workers from public health facilities.
Question Four
The Quality Improvement Committee of Manukato hospital collected the following data on the Costs of Quality incurred by the hospital between September and December 2012:
Item Cost (us$)
A Being sued by clients because of performing incorrect surgical procedures 27,395
B Conducting spot checks and reporting on compliance to hand hygiene standards. 550
C Developing and communicating standards for various departments 1,250
D Developing tools for monitoring adherence to standards 645
E Disposing expired medication from the stores 18,395
F Monitoring adherence to standard developed 895
G Reviewing patient files to determine compliance with clinical care guidelines and protocols 1,676
Based on the above data, calculate the following, clearly showing your calculation. (10mks)
Prevention costs
Appraisal costs
Total failure costs.
SECTION B : Respond to any two question in this section.
Question One
Based on your responses from section A question 4, discuss the course of action you would recommend to the management and staff of Manukato hospital, clearly indicating the quality management tools, techniques, and approaches they could apply. (30mks)
Question Two
Based on your responses from section A question 4, discuss how you would assist the management and staff of Manukato hospital to re-design the surgical services so that the number and cost of legal suits due to incorrect surgical procedures can be reduced. (30mks)
Question Three
Rozana and Tamana are chatting while setting up the medicine trolleys before administering medication to the patients admitted in their ward. Rozana is so engrossed in the story that she does not notice that she has prepared the wrong mediation for some of her patients. When they finished preparing the medicine trolleys, Rozana took her trolley and went to begin administering medication to the clients on her side of the ward. Rozana follows her usual procedure when administering medication to her clients; she draws the curtains around the patient’s bed, smiles, greets and gently prepares her for medication. Once she finishes administering, she opens the curtains and goes to wash her hands at the sink before proceeding to the next client. Just before administering medication to the fifth patient, Rozana suddenly notices that the medication does not seem to have the colour she expected it to have. She retracts before administering it and goes back to the drug cabinet to confirm if she had the right one. She realizes that she had picked the wrong medicine, quickly disposes it and prepares the right one grateful that she had noticed the mistake on time. On her way back to administer medication to the remaining clients, she notices one of the clients to whom she had already administered the medication was gasping, having difficulty breathing and trying to call out to her. She rushes over to her while calling out to Tamana for assistance. They soon realize that the patient seemed to be having an allergic reaction. Tamana grabs the patient’s file, scans through it and finds a note indicating that the patient is allergic to penicillin. They quickly attend to the patient and she recovers.
Citing specific examples form the case study, identify two types of costs of quality highlighted.
(4mks)
Citing specific examples from the case study identify and briefly explain four dimensions of quality highlighted in the story.
(8mks)
This incident is brought to your attention because you are the quality improvement team leader. Discuss how you would respond to it. (18mks)
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