2021 Management & Leadership Flashcards
What is the difference between goals and objectives?
Both goals and objectives describe what outcomes we are trying to achieve, however goals focus on longer term or distal outcomes that are broader in nature while objectives focus on short-term or intermediate outcomes that are more concrete in nature.
What is a logic model and list 3 benefit of having a logic model in analyzing a policy?
Logic model is a visual representation of the connection between various elements of a program including inputs, outputs and activities. Benefits of logic models in analyzing a policy: -Defining clearly the policy being studied -Assess the plausibility of the chain of expected effects -Guiding data collection and indicator selection for evaluation -Communicate the logic of the intervention and also the causal relationships
List 4 functions of a governing board, and for each function, identify an example of how a CEO would optimally support the board.
1) Supervise CEO/MOH e.g. regular updates of duties/responsibilities in reports, oral presentation or meetings 2) Approve strategic goals & direction manage public health resources e.g. Bring issues critical to operation to the attention to BOH 3) Establish a framework for MONITORING public health program/service delivery and performance (effectiveness and quality) e.g. Regularly assess organizational performance and summarize findings in reports to BOH 4) Policy development e.g. Provide education/training/other resources necessary to support BOH in this role 5) exercise Legal authority e.g. Provide education/training/other resources necessary to support BOH in this role 6) Oversee ENGAGEMENT of other partners/oversee stakeholder relationships e.g. Provide education/training in how best to engage partners 7) Oversee the organization’s risk management e.g. Provide information about risk facing health unit and training needed to manage risk 8) 9)Manage the board’s own governance
List 4 leadership types
Bureaucratic - by the book (think CRA) Authoritarian (aka Autocratic) - demands compliance (think military) Laissez-faire - hands-off Democratic (aka Participative) - achieving consensus through participation Pacetter / Trasactional - similarly expects high performance and self direction from employees (think pharmaceutical company sales rep) Servant/ Coaching /Transformational - similarly relationship focused Visionary (think Steve Jobs or Obama)
In situational leadership, what types of leadership styles should you use for the following: -low competence and high commitment -low to medium competence and low commitment -medium to high competence and variable commitment -high competence and high commitment
“Enthusiastic beginner” →Directing (highly structured, incremental, frequent instructions) “Disillusioned learner” → Coaching (motivating, explaining, two-way dialogue) “Capable but cautious performer”; employee is capable but still wants you to check their work → Supporting (encouraging, empowering) “Self-reliant achiever” → Delegating (passive)
List 5 components of emotional intelligence?
MESSS Motivation - internal motivation comes from a sense of: autonomy, mastery, purpose, belonging Empathy Self awareness Self regulation Social skills
What is the difference between a leader and a manager?
Leader articulates a vision and develops/executes a plan to achieve it Manager focuses on the operational aspect of the plan by allocating resources, overseeing the work of others and ensuring tasks are completed.
List 3 cognitive bias a leader or manager may be prone to.
Anchoring: to first impressions even when there is new evidence Confirming evidence: seeking evidence that supports a preferred option Overconfidence: assuming you understand all the possible options Framing: asking questions a certain way to get a certain response (ie. leading Qs) Sunk cost: pursuing an option bc it has already been paid for Status quo: failing to consider options other than the current one Prudence: being overly cautious Recallability: assuming current situation is the same at the last worst case scenario
List the 5 components of the LEADS framework for leadership
Lead self Engage others Achieve results Develop coalitions/partnerships Systems transformation
What is public health governance?
The overall processes and structures used to direct and manage an organization’s operations and activities with the ultimate goals of effectiveness, credibility and viability of the organization
List 2 reasons for strategic planning and list 5 key steps of strategic planning process.
- Clearly DEFINE organizational purposes via mission and clarify future directions via vision.
- Establish REALISTIC strategic directions, goals, objectives consistent with mission.
- Ensure effective resource use by focusing on organizational key priorities
- Provide baseline data to measure progres
- Improved communication of goals and objectives to stakeholders.
- Develop a sense of ownership for the plan and thus greater commitment and retention among employees.
- Promote strategic thinking, acting and learning.
- Improved decision making.
- Solve major organizational problems
- Enhance organizational effectiveness, responsiveness, and resilience.
- Improve public sector organizational legitimacy
5 Steps of strategic planning process:
- Screening - assessing organizational readiness for strategic planning including structure in place and capacity for this process
- Start off by determing Vision, Mission, Values, Strategic Directions Goals
- Perform stakeholder consultation and analysis, PESTLE analysis, and SWOT analysis to identify key strategic areas to address critical issues,
- Set organizational strategic prorities by prioritizing key strategic areas and aligning emerging themes of these strategic areas with other government directives, and validate these organizational priorities with key stakeholders.
- Build into the strategic plan performance indicators to create an evaluation framework.
Pick a change management framework and list the steps
Kotter’s 8 step change model
- Create a sense of urgency - Help others see the need for change and the importance of acting immediately.
- Build a powerful coalition to guide the change
- Create a vision for change and initiatives linked to the vision.
- Communicate the vision and gain buy-in
- Enable people to act by removing barriers such as inefficient processes and hierarchies
- Generate short-term wins - recognized and communicate positive results – early and often – to track progress and energize people to persist.
- Build on the change - continue to build on the momentum you’ve achieved.
- Institute change - make the change stick. articulate the connections between the new behaviors and organizational success, making sure they continue until they become strong enough to replace old habits.
What is quality improvement ? List the 4 steps in PDSA cycle.
Quality improvement = Activities to continually monitor and improve all processes within a system.
PDSA cycle = Plan-Do-Study-Act Cycle is a model used for improving the process of implementing change.
- Plan: Form your team, define your objectives, current context and process, and the problem,. Develope alternatives to current process.
- Do: Implement one of the alternatives on a very small scale; collect data on outcomes
- Study: Evaluate the outcomes of the implementation
- Act: Based on the evaluation, decide whether or not the alternative should be implemented in a more widespread way; if so, standardize the improvement and implement it more broadly
List the 4 components of a SWOT analysis and identify their critical questions
- Strengths: What factors internal to the organization help it fulfill its mission?
- Weaknesses: What factors internal to the organization prevent it from fulfilling its mission?
- Opportunities: What factors external to the organization help or could help it fulfill its mission?
- Threats: What factors external to the organization prevent or could prevent it from fulfilling its mission?
What are three components of an operational plan?
- Annual goals/objectives: The program activities that will be completed and outputs that will be generated within the year; should be SMART:
- Specific
- Measureable
- Attainable
- Realistic
- Time-bound
- Actions: The activities that will be undertaken to achieve the goals outlined in the strategic plan
* Each action should be associated with a timeframe, resources and responsibility - Performance indicators
List three components of a Fishbone / Ishikawa diagram
- Backbone: The problem you would like to address
- Ribs: The major inputs into the process that contribute to the problem (e.g., staff, computer programs, budget)
- Branches: The “causes of causes”; the reasons the “ribs” contribute to the problem
List five criteria you would use to assess the continued funding of a program
- Size of problem
- Seriousness of problem
- Availability of current interventions
- Economic or social impact
- Public health concern
- Political will to address issue
- Availability of resources , Disease of international interest
- Equity
Prioritizing Public Health Problems. Atlanta, GA: Centers for Disease Control and Prevention (CDC), 2013. Slide Set available at: https://www.cdc.gov/globalhealth/healthprotection/fetp/training_modules/4/prioritize-problems_ppt_final_09132013.pdf Facilitator’s guide available at: https://www.cdc.gov/globalhealth/healthprotection/fetp/training_modules/4/prioritize-problems_fg_final_09262013.pdf
List three aspects of a gantt chart
A GANNT chart shows
- the activities and/or resources of a project on the vertical access
- time on the horizontal access
- Relationships between the activities can then be used to identify a critical path showing which activities must precede which.
You are a newly-hired Associate Medical Officer of Health/Medical Health Officer in a local public health organization.
- You become aware that 12 of the nurses have been providing psychological counselling to students. When asked, they identify significant needs for this service and a high level of demand from teachers. Your organization does not have a mandate to deliver these services to individual students. What will you do next?
- Risk Management – does your organization have the appropriate training in place for staff employed by your organization to do this work? What if any record keeping system is in place for the resultant personal health information of those students receiving counselling? What policies and procedures are in place regarding disclosure or referral if students receiving counselling disclose suicidal ideation?
- Relationship Management – providing this service responds to a need (unclear who identified this need) and meets demand from teachers; is this demand from teachers and school/board leadership or is this ‘front line’ support to teachers to relieve them of this work? Both may be legitimate goals but they have different implications for the relationship between the school board and the public health department
- Staff Engagement & Morale – clinically trained staff, such as nurses or physicians, will have differing levels of personal interest in one-on-one client or patient interactions; does this significant use of your organization’s resources (i.e. 60% of available nursing staff in the school health program) imperil mandated program delivery? What will be the reaction if you unilaterally order this work to stop – telling clinically trained people to stop taking home office supplies is different from telling them to stop responding to children in apparent need…
List four steps in succession planning
- Assess: Identify critical roles within your organization
- Plan: Identify key competencies required to perform the critical roles and choose
workforce development strategies that will develop these key competencies
- Implement: Implement the planned workforce development strategies
- Evaluate: Monitor, evaluate, and adjust the succession plan
List three components of a business case
- Assess: Assess strengths and limitations of the project across six elements, Project design (logic model), Resources and budget, Work plan and Stakeholder roles and expectations
- Analyze: Based on the strengths identified in the previous step, list the potential benefits of the project. Based on the limitations identified in the previous step, list the potential risks of the project. Identify the areas that will be impacted by these benefits and risks (e.g., population health, access to services). Describe how likely and how significant each risk and benefit is. Consider strategies that will maximize benefits and minimize risks.
- Advise: Examine the overall patterns of strengths, limitations, risks and benefits in the context of your minimization and maximization strategies. Draw conclusions about the overall project.
List 5 types of budgets
- Master
- Operating
- Cash Flow
- Financial
- Static
What is the Lean process and list 4 types of waste
Lean is a systematic approach to increase efficiency of process by identifying and eliminating waste in the process.
- Unnecessary inventory - e.g. overestimating emergency support materials
- Waiting - e.g. Paperwork waiting for mx signature
- Duplication -e.g. re-entering data of a case
- Intellect - e.g. hiring physician to do nursing type job
- Defects - e.g. wrong vaccine name on the vaccination consent form
- Overprocessing
- Transportation/handling - AV equipment stored in single room, requiring frequent movement through high-traffic areas
- Unnecessary motion - Testing equipment stored far from work
Conflict management
List 5 steps of conflict management of two of your employees
- Acknowledge that a difficult situation exists and let individuals express their feelings.
- Define the problem by getting facts from the two employees separately
- Determine underlying needs and find common areas of agreement
- Find solutions to satisfy needs of both and ensure all parties buy into actions
- Develop a follow up plan to minitor the situation.
List 4 steps in progressive discipline
- Provide a verbal warning
- Provide a written warning
- Escalating number of days suspended without pay
- Proceed with termination
List 6 steps to take in managing an underforming employee
- Meet with employee and superviser to get facts about performance
- Clearly communicate performance expectations to employee
- Counsel employee about performance expections ((gap between expectations and reality) and ascertain employee’s understanding about performance
- Ascertain whether there are any issues contributing to the poor performance that are not immediately obvious to the supervisor.
- Identify any specific learning/coaching needs or personal issues that are contributing to the poor performance.
- Address identified issues if possible e.g. training, employee assistance program.
- Set specific performance improvement objectives with specific time frames.
- Meet regularly with the employee/supervisor to monitor performance.
List 8 types of waste in the Lean method of quality improvement
IOU-MTW-DE
- Inventory: Inventory or information that is being stored or not being processed likely due to line imbalance or overproduction
- Overproduction: Producing more product than what is required to meet current demand
- Unrecognized talent: Failure to effectively engage employees in the process and fully utilize their knowledge and skills
- Motion: Unnecessary motion of personnel, equipment or information due to inadequate workspace layout, missing parts or tools and ergonomic issues
- Transportation: Transporting items or information that is not required to perform the process from one location to another
- Waiting: Time waiting for parts, tools, supplies or the previous process step
- Defects: Non-conforming products or services requiring resources to correct
- Extra processing: Activity that is not adding value or required to produce a functioning part, product or service
A) List 4 categories of perspectives that are included in the general BSC
B) List 4 uses of the Balanced Scorecard
C) List 4 possible categories of a BSC for public health authority
A) 4 perspectives of BSC
- Financial (or stewardship) perspective
- Customer & stakeholder perspective
- Internal process perspective
- Learning & growth (or Organisational capacity)
B) 4 uses of BSC: CAMP
- Communicate what they are trying to accomplish
- Align the day-to-day work that everyone is doing with strategy
- Measure and monitor progress towards strategic targets
- Prioritize projects, products, and services
C) Healthcare BSC example
- Health determinants and health status
- Community engagement
- Resources and services
- Integration and responsiveness within the healthcare system
List the 8 step’s in Kotter’s change management mondel
UCVC-EWSI
- Create a sense of urgency
- Build a guiding coalition
- Form a strategic vision and initiatives
- Communicate the Vision
- Enable change by removing barriers
6 .Generate short-term wins
- Sustain acceleration
- Institutionalise change in organisational culture
List 6 elements you would include in a job description
- Job Title, location, FTE
- Brief description of the opportunity
- Responsibilities
- Qualifications
- Benefits and remuneration
- Instructions on how to apply
Identify SIX key steps in developing and executing a career succession plan
- Identifying key positions for which a succession plan is necessary
- Identifying potential successor or successors
- Inform potential successors
- Identifying job requirements and any gaps that need to be filled by potential successors
- Provide professional development opportunities
- Trial potential successors to act in position when opportunities available
- Monitor and evaluate progress of potential successors in relation to developing skills and experience required
List 5 key elements of providing constructive/effective feedback
- Specific
* Feedback must be concrete and relate to a specific, measurable performance goal - Positive
* Feedback should be presented in a positive, tactful and non-threatening manner - Accurate
* The feedback should be based on accurate information - Recurring
* Feedback should be recurring. Schedule performance reviews each month and ensure that managers deliver informal feedback daily - Timely
* Employees must receive the feedback as close to the event as possible
List 5 key elements/considerations when providing negative feedback
- Do not provide negative feedback in front of team members
- Focus on the observed behavior, not the person
- Be specific
- Be timely
- Remain calm
- Keep emotions under control
- Invite other party to engage
- Define and agree on a mutually acceptable action plan
- Set a time to follow-up
List 5 key elements of a terms of reference for a committee/working group/advisory committee
- Purpose of the committee/group etc.
- Membership and structure
- Roles and responsibilities
- Meeting frequency
- Accountability and reporting relationships
- Decision making processes (voting, concensus, define a quora)
List 5 employee retention strategies
- Provide training and development opportunities
- Provide flexible working arrangements
- Ensure regular constructive and positive feedback is being provided to employees
- Monitor and maintain appropriate employee workloads
- Offer competitive salary and compensation
- Provide additional wellness benefits
- Review and improve recruitment strategies and processes
- Provide opportunities for growth and development through new challenges and opportunities
A) What is a root cause analysis
B) List 7 key questions to ask when conducting a root cause analysis
C) List 6 categories of factors that potentially are involved in a patient safety incident
A)
RCA is a defined process that seeks to explore all of the possible factors associated with an incident by asking what happened, why it happened and what can be done to prevent it from happening again.
B)
- What happened?
- Who was involved?
- When did it happen?
- Where did it happen?
- How severe was the actual or potential harm?
- What is the likelihood of recurrence?
- What were the consequences?
C) CC-EE-RF
- Communication:
- Was the patient correctly identified?
- Was information from patient assessments shared by members of the treatment team in a timely way?
- Environment:
- Was the work environment designed for its function?
- Had there been an environmental risk assessment
- Equipment:
- Was the equipment designed for its intended purpose?
- Had a documented safety review been performed on the equipment?
- Controls:
- What barriers and controls were involved in this incident?
- Were they designed to protect patients, staff, equipment or environment?
- Rules, policies and procedures:
- Was there an overall management plan for addressing risk and assigning responsibility for risk?
- Had a previous audit been done for a similar event?
- If so, were the causes identified and were effective interventions developed and implemented on a timely basis?
- Fatigue/scheduling:
- Were the levels of vibration, noise and other environmental conditions appropriate?
- Did personnel have adequate sleep?
Identify 6 key steps in conflict resolution
- Define the source of the conflict
- Identify any issues beyond a specific incident that might be contributing to the conflict
- Request solutions from both parties
- Identify solutions both parties can support
- Obtain agreement from both parties on solution
- Monitor and follow-up effectiveness of solutions
A) List 5 examples of conflict resolution strategies
B) List 2 elements of how the strategies in A be classified
A)
- Accomodating
- Avoidance
- Competing
- Collaborative
- Compromising
B)
- Assertiveness
- Cooperativeness
List 5 key elements of emotional intelligence
MESSS
- Motivation.
- Empathy
- Self-awareness.
- Self-regulation.
- Social skills.
List 2 advantages and 2 disadvantages of fee for service vs capitation for physician (primary care) remuneration
Fee for service
Advantages
- Allows for patient freedom to choose physician
- Allows for care to more easily be provided to mobile populations
- Can provide incentives for completeness of care
Disadvantages
- Gives physicians financial incentives to over treat
- Gives physicians incentives to see patients quickly
- Can result in less continuity of clinical care if patients are moving between physicians
Capitation
Advantages
- Encourages physicians to provide preventive education and care to patients
- Encourages physicians to establish long-term relationships with patients
- Provides better fiscal predictability to fundings sources
Disadvantages
- May incentivise clinicians to enroll a large number of patients on their roster
- Provides patients with less flexibility in choosing a physician as must use one physician/physician group
- May result in physicians tailoring practice to less complex patients
List 6 elements of the WHO communication continuum for behaviour change campaigns
ARA-CC-Da
- Awareness - build awareness of existing or emerging health threats or benefits
- Relevence - increase personal relevance of the issue and support an appropriate understanding of the risk
- Awareness of solutions - promote awareness of solutions Promote knowledge of solutions
- Capacity to change - instil the confidence to act and capacity to change
- Cost-benefit analysis - help the target audience see the benefits of protective health actions and lower the barriers for their uptake by influencing social norms
- Decision to take action and follow-through
https://www.who.int/about/communications/actionable/communications-continuum
