Quiz 14: Measuring the performance of health services and programmes

Please choose the one, most correct answer to each question or statement.

1. Which of these is an example of a structure standard?
   • All soap dispensers are filled with soap
   • Staff members wash their hands after seeing a patient
   • There are low levels of wound infections
   • Antibiotics are prescribed appropriately
2. Which of these is an example of a process standard?
   • Hand spray is available at the bedside
   • Staff members wash their hands after seeing a patient
   • There are low levels of skin infections
   • Fire exits are clearly marked
3. What does “accreditation” of a clinic or hospital mean?
   • There are positive reports in the media about the facility
   • The facility scored highly on a survey among members of the public
   • The facility has met standards set and tested by an outside organisation
   • All staff are members of professional organisations
4. When measuring performance in healthcare, what is an “indicator”?
   • An indicator is a mark of approval for a clinic or hospital
   • An indicator is a marker that is chosen to measure activities or outcomes
   • An indicator is the “next best thing” if you cannot measure something important
   • An indicator is a direction marking that helps patients find their way around a hospital
5. What is an “adverse event” in healthcare?
   • A part of the healthcare process has gone wrong but no harm has come to the patient
   • Some harm has come to a patient but there was no problem with the healthcare process
   • There is a complaint in the newspaper
   • A part of the healthcare process has gone wrong and some harm has come to a patient
6. Why is it important that the healthcare team recognises adverse events?
   • The person responsible must be identified and disciplined at the M and M meeting
   • Managers must be prepared to deal with enquiries from the media
   • The underlying reasons for mistakes and misunderstandings can be identified by the whole team and avoided in the future
   • It is a legal requirement from the National Department of Health
7. What is a “near miss” in healthcare?
   • A part of the healthcare process has gone wrong but no harm has come to the patient
   • Some harm has come to a patient but there was no problem with the healthcare process
   • There is a complaint in the newspaper
   • A part of the healthcare process has gone wrong and some harm has come to a patient
8. Why is the “5 whys” method a useful tool when trying to understand the underlying reasons for a mistake?
   • Trying to think of 5 different reasons why something might have happened
   • Asking “why?” for each explanation until you can drill down to the underlying problem. This usually means asking “why” 5 times for each explanation
   • Researching the literature to find the 5 most common reasons something happened
   • Discussing things in detail after they have happened 5 times
9. In healthcare management, “patient safety” means:
   • Designing and using systems that catch mistakes before they happen
   • Making sure that patients have transport home after dark
   • Injury prevention laws, such as the wearing of seatbelts
   • Making sure there are enough security personnel on duty
10. What should be included when costing a six monthly blood test for glycosylated haemoglobin (HbA1C) in diabetics?
    • The lab charges only
    • The lab charges and the overhead costs of running the clinic
    • Costs of time off work and transport to the clinic for the patient
    • It depends on the “perspective” that is chosen
11. A cost analysis of screening for HIV that reports the cost per new case diagnosed would be called;
    • A cost benefit analysis
    • A cost utility analysis
    • A cost effectiveness analysis
    • A simple costing
12. A cost analysis of screening for HIV that reports the estimated years of life gained would be called:
    • A cost benefit analysis
    • A cost utility analysis
    • A cost effectiveness analysis
    • A simple costing
13. Programme monitoring means:
    • Seeing whether programme activities are being carried out as planned
    • Making sure staff turn up on time
    • Whether the expected results have been achieved
    • The use of computer programmes to record project details
14. Programme evaluation means:
    • Seeing whether programme activities are being carried out as planned
    • Making sure staff are in uniform
    • Whether the expected results have been achieved
    • The use of tablets to record project details
15. In order to determine whether the activities of a programme or project are working as expected, it is necessary first to:
    • Research the literature to see how well other programmes have worked
    • Ensure that adequate funds will be available
    • Ensure that you have the basic computer skills to run a programme
    • Decide how you expect the programme activities to achieve your aims by producing a “theory of change”
16. What are impacts?
    • The overall goal of a project
    • Obstacles to be tackled
    • Equipment needed to complete the project
    • Activities needed for the project
17. When the links between programme activities and the expected results have been thought about and written down, it is necessary to choose markers that can show the quality and quantity of activities and results. These markers are called:
    • Indicators
    • Inventories
    • Audit cycles
    • Inspectors
18. A team wishes to reduce the number of infants and young children with TB. It is decided that community care workers will visit homes of adult patients with TB, and refer contacts who are under 5 years old to the clinic. A good example of an evaluation indicator would be:
    • Numbers of homes visited per week
    • Severity of TB in children
    • Numbers of malnourished children with TB
    • Number of new cases of TB in children under 5 per month
19. A table that shows the links between programme activities and the expected outcomes, together with the indicators, where the information will come from, and the assumptions and threats to each stage is called:
    • An action framework
    • A rational framework
    • A logical framework
    • A valid framework
20. When explaining how programme activities are expected to work, why is it important to list the assumptions that have been made, and the possible threats to success?
    • If there are too many assumptions and threats, it may be necessary to choose a different programme
    • The assumptions and threats may need to be investigated and dealt with before the programme starts
    • There should be roughly equal numbers of assumptions and threats
    • Some assumptions and threats may be embarrassing