2021 Management & Leadership

Question 1

What is the difference between goals and objectives?

Answer 1

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.

Question 2

What is a logic model and list 3 benefit of having a logic model in analyzing a policy?

Answer 2

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

Question 3

List 4 functions of a governing board, and for each function, identify an example of how a CEO would optimally support the board.

Answer 3

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

Question 4

List 4 leadership types

Answer 4

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)

Question 5

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

Answer 5

“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)

Question 6

List 5 components of emotional intelligence?

Answer 6

MESSS Motivation - internal motivation comes from a sense of: autonomy, mastery, purpose, belonging Empathy Self awareness Self regulation Social skills

Question 7

What is the difference between a leader and a manager?

Answer 7

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.

Question 8

List 3 cognitive bias a leader or manager may be prone to.

Answer 8

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

Question 9

List the 5 components of the LEADS framework for leadership

Answer 9

Lead self Engage others Achieve results Develop coalitions/partnerships Systems transformation

Question 10

What is public health governance?

Answer 10

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

Question 11

List 2 reasons for strategic planning and list 5 key steps of strategic planning process.

Answer 11

1. Clearly DEFINE organizational purposes via mission and clarify future directions via vision.
2. Establish REALISTIC strategic directions, goals, objectives consistent with mission.
3. Ensure effective resource use by focusing on organizational key priorities
4. Provide baseline data to measure progres
5. Improved communication of goals and objectives to stakeholders.
6. Develop a sense of ownership for the plan and thus greater commitment and retention among employees.
7. Promote strategic thinking, acting and learning.
8. Improved decision making.
9. Solve major organizational problems
10. Enhance organizational effectiveness, responsiveness, and resilience.
11. Improve public sector organizational legitimacy

5 Steps of strategic planning process:

1. Screening - assessing organizational readiness for strategic planning including structure in place and capacity for this process
2. Start off by determing Vision, Mission, Values, Strategic Directions Goals
3. Perform stakeholder consultation and analysis, PESTLE analysis, and SWOT analysis to identify key strategic areas to address critical issues,
4. 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.
5. Build into the strategic plan performance indicators to create an evaluation framework.

Question 12

Pick a change management framework and list the steps

Answer 12

Kotter’s 8 step change model

1. Create a sense of urgency - Help others see the need for change and the importance of acting immediately.
2. Build a powerful coalition to guide the change
3. Create a vision for change and initiatives linked to the vision.
4. Communicate the vision and gain buy-in
5. Enable people to act by removing barriers such as inefficient processes and hierarchies
6. Generate short-term wins - recognized and communicate positive results – early and often – to track progress and energize people to persist.
7. Build on the change - continue to build on the momentum you’ve achieved.
8. 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.

Question 13

What is quality improvement ? List the 4 steps in PDSA cycle.

Answer 13

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

Question 14

List the 4 components of a SWOT analysis and identify their critical questions

Answer 14

• 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?

Question 15

What are three components of an operational plan?

Answer 15

1. 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

2. 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
3. Performance indicators

Question 16

List three components of a Fishbone / Ishikawa diagram

Answer 16

1. Backbone: The problem you would like to address
2. Ribs: The major inputs into the process that contribute to the problem (e.g., staff, computer programs, budget)
3. Branches: The “causes of causes”; the reasons the “ribs” contribute to the problem

Question 17

List five criteria you would use to assess the continued funding of a program

Answer 17

1. Size of problem
2. Seriousness of problem
3. Availability of current interventions
4. Economic or social impact
5. Public health concern
6. Political will to address issue
7. Availability of resources , Disease of international interest
8. 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

Question 18

List three aspects of a gantt chart

Answer 18

A GANNT chart shows

1. the activities and/or resources of a project on the vertical access
2. time on the horizontal access
3. Relationships between the activities can then be used to identify a critical path showing which activities must precede which.

Question 19

You are a newly-hired Associate Medical Officer of Health/Medical Health Officer in a local public health organization.

1. 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?

Answer 19

1. 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?
2. 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
3. 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…

Question 20

List four steps in succession planning

Answer 20

1. Assess: Identify critical roles within your organization
2. Plan: Identify key competencies required to perform the critical roles and choose

workforce development strategies that will develop these key competencies

3. Implement: Implement the planned workforce development strategies
4. Evaluate: Monitor, evaluate, and adjust the succession plan

Question 21

List three components of a business case

Answer 21

1. 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
2. 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.
3. 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.

Question 22

List 5 types of budgets

Answer 22

1. Master
2. Operating
3. Cash Flow
4. Financial
5. Static

Question 23

What is the Lean process and list 4 types of waste

Answer 23

Lean is a systematic approach to increase efficiency of process by identifying and eliminating waste in the process.

1. Unnecessary inventory - e.g. overestimating emergency support materials
2. Waiting - e.g. Paperwork waiting for mx signature
3. Duplication -e.g. re-entering data of a case
4. Intellect - e.g. hiring physician to do nursing type job
5. Defects - e.g. wrong vaccine name on the vaccination consent form
6. Overprocessing
7. Transportation/handling - AV equipment stored in single room, requiring frequent movement through high-traffic areas
8. Unnecessary motion - Testing equipment stored far from work

Question 24

Conflict management

List 5 steps of conflict management of two of your employees

Answer 24

1. Acknowledge that a difficult situation exists and let individuals express their feelings.
2. Define the problem by getting facts from the two employees separately
3. Determine underlying needs and find common areas of agreement
4. Find solutions to satisfy needs of both and ensure all parties buy into actions
5. Develop a follow up plan to minitor the situation.

Question 25

List 4 steps in progressive discipline

Answer 25

1. Provide a verbal warning
2. Provide a written warning
3. Escalating number of days suspended without pay
4. Proceed with termination

Question 26

List 6 steps to take in managing an underforming employee

Answer 26

1. Meet with employee and superviser to get facts about performance
2. Clearly communicate performance expectations to employee
3. Counsel employee about performance expections ((gap between expectations and reality) and ascertain employee’s understanding about performance
4. Ascertain whether there are any issues contributing to the poor performance that are not immediately obvious to the supervisor.
5. Identify any specific learning/coaching needs or personal issues that are contributing to the poor performance.
6. Address identified issues if possible e.g. training, employee assistance program.
7. Set specific performance improvement objectives with specific time frames.
8. Meet regularly with the employee/supervisor to monitor performance.

Question 27

List 8 types of waste in the Lean method of quality improvement

Answer 27

IOU-MTW-DE

1. Inventory: Inventory or information that is being stored or not being processed likely due to line imbalance or overproduction
2. Overproduction: Producing more product than what is required to meet current demand
3. Unrecognized talent: Failure to effectively engage employees in the process and fully utilize their knowledge and skills
4. Motion: Unnecessary motion of personnel, equipment or information due to inadequate workspace layout, missing parts or tools and ergonomic issues
5. Transportation: Transporting items or information that is not required to perform the process from one location to another
6. Waiting: Time waiting for parts, tools, supplies or the previous process step
7. Defects: Non-conforming products or services requiring resources to correct
8. Extra processing: Activity that is not adding value or required to produce a functioning part, product or service

Question 28

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

Answer 28

A) 4 perspectives of BSC

1. Financial (or stewardship) perspective
2. Customer & stakeholder perspective
3. Internal process perspective
4. Learning & growth (or Organisational capacity)

B) 4 uses of BSC: CAMP

1. Communicate what they are trying to accomplish
2. Align the day-to-day work that everyone is doing with strategy
3. Measure and monitor progress towards strategic targets
4. Prioritize projects, products, and services

C) Healthcare BSC example

1. Health determinants and health status
2. Community engagement
3. Resources and services
4. Integration and responsiveness within the healthcare system

https://balancedscorecard.org/bsc-basics-overview/

Question 29

List the 8 step’s in Kotter’s change management mondel

Answer 29

UCVC-EWSI

1. Create a sense of urgency
2. Build a guiding coalition
3. Form a strategic vision and initiatives
4. Communicate the Vision
5. Enable change by removing barriers

6 .Generate short-term wins

7. Sustain acceleration
8. Institutionalise change in organisational culture

Question 30

List 6 elements you would include in a job description

Answer 30

1. Job Title, location, FTE
2. Brief description of the opportunity
3. Responsibilities
4. Qualifications
5. Benefits and remuneration
6. Instructions on how to apply

Question 31

Identify SIX key steps in developing and executing a career succession plan

Answer 31

1. Identifying key positions for which a succession plan is necessary
2. Identifying potential successor or successors
3. Inform potential successors
4. Identifying job requirements and any gaps that need to be filled by potential successors
5. Provide professional development opportunities
6. Trial potential successors to act in position when opportunities available
7. Monitor and evaluate progress of potential successors in relation to developing skills and experience required

Question 32

List 5 key elements of providing constructive/effective feedback

Answer 32

1. Specific
   * Feedback must be concrete and relate to a specific, measurable performance goal
2. Positive
   * Feedback should be presented in a positive, tactful and non-threatening manner
3. Accurate
   * The feedback should be based on accurate information
4. Recurring
   * Feedback should be recurring. Schedule performance reviews each month and ensure that managers deliver informal feedback daily
5. Timely
   * Employees must receive the feedback as close to the event as possible

Question 33

List 5 key elements/considerations when providing negative feedback

Answer 33

1. Do not provide negative feedback in front of team members
2. Focus on the observed behavior, not the person
3. Be specific
4. Be timely
5. Remain calm
6. Keep emotions under control
7. Invite other party to engage
8. Define and agree on a mutually acceptable action plan
9. Set a time to follow-up

Question 34

List 5 key elements of a terms of reference for a committee/working group/advisory committee

Answer 34

1. Purpose of the committee/group etc.
2. Membership and structure
3. Roles and responsibilities
4. Meeting frequency
5. Accountability and reporting relationships
6. Decision making processes (voting, concensus, define a quora)

Question 35

List 5 employee retention strategies

Answer 35

1. Provide training and development opportunities
2. Provide flexible working arrangements
3. Ensure regular constructive and positive feedback is being provided to employees
4. Monitor and maintain appropriate employee workloads
5. Offer competitive salary and compensation
6. Provide additional wellness benefits
7. Review and improve recruitment strategies and processes
8. Provide opportunities for growth and development through new challenges and opportunities

Question 36

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

Answer 36

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)

1. What happened?
2. Who was involved?
3. When did it happen?
4. Where did it happen?
5. How severe was the actual or potential harm?
6. What is the likelihood of recurrence?
7. What were the consequences?

C) CC-EE-RF

1. Communication:

• Was the patient correctly identified?
• Was information from patient assessments shared by members of the treatment team in a timely way?

2. Environment:

• Was the work environment designed for its function?
• Had there been an environmental risk assessment

3. Equipment:

• Was the equipment designed for its intended purpose?
• Had a documented safety review been performed on the equipment?

4. Controls:

• What barriers and controls were involved in this incident?
• Were they designed to protect patients, staff, equipment or environment?

5. 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?

6. Fatigue/scheduling:

• Were the levels of vibration, noise and other environmental conditions appropriate?
• Did personnel have adequate sleep?

Question 37

Identify 6 key steps in conflict resolution

Answer 37

1. Define the source of the conflict
2. Identify any issues beyond a specific incident that might be contributing to the conflict
3. Request solutions from both parties
4. Identify solutions both parties can support
5. Obtain agreement from both parties on solution
6. Monitor and follow-up effectiveness of solutions

Question 38

A) List 5 examples of conflict resolution strategies

B) List 2 elements of how the strategies in A be classified

Answer 38

A)

1. Accomodating
2. Avoidance
3. Competing
4. Collaborative
5. Compromising

B)

1. Assertiveness
2. Cooperativeness

Question 39

List 5 key elements of emotional intelligence

Answer 39

MESSS

1. Motivation.
2. Empathy
3. Self-awareness.
4. Self-regulation.
5. Social skills.

Question 40

List 2 advantages and 2 disadvantages of fee for service vs capitation for physician (primary care) remuneration

Answer 40

Fee for service

Advantages

1. Allows for patient freedom to choose physician
2. Allows for care to more easily be provided to mobile populations
3. Can provide incentives for completeness of care

Disadvantages

1. Gives physicians financial incentives to over treat
2. Gives physicians incentives to see patients quickly
3. Can result in less continuity of clinical care if patients are moving between physicians

Capitation

Advantages

1. Encourages physicians to provide preventive education and care to patients
2. Encourages physicians to establish long-term relationships with patients
3. Provides better fiscal predictability to fundings sources

Disadvantages

1. May incentivise clinicians to enroll a large number of patients on their roster
2. Provides patients with less flexibility in choosing a physician as must use one physician/physician group
3. May result in physicians tailoring practice to less complex patients

Question 41

List 2 advantages and 2 disadvantages to regionalisation of public health

Answer 41

Advantages

1. Opportunity to better integrate public health services within existing clinical services e.g. vaccination, cancer screening
2. Better opportunity to influence and reorient local health services towards preventive care

Disadvantages

1. Risk of public health becoming less visible and losing small public health budget to clinical care services
2. Increased risk of inconsistency of public health delivery across P/T and abilitiy to identify issues that span health authority boundaries

Question 42

List elements of a SWOT analysis matrix and whether each item is internal external and provide 4 general examples of elements for each quadrant that could apply to public health

Answer 42

Strengths (Internal) [Staff, facilities, training, ability to adapt, Services, leadership support]

1. A primary focus on quality improvement ($ saved from quality projects)
2. Internal teams dedicated to relevant aspect of PH (# personnel in relevant team e.g. vaccination, breastfeeding)
3. High-quality public health personnel (# of staff with external recognition)
4. Modern public health IT systems for surveillance and CD control, vaccination etc
5. Team has demonstrated previous ability to adapt to changing circumstances, government

Weaknesses (internal) [Tech, turnover, training, lack of leadership support]

1. Outdated healthcare facilities and technology
2. Insufficient management training
3. Lack of funding and resources to support public health programs
4. Poor location of public health services that are not easily accessible for staff and patients
5. High staff turnover

Opportunities (external) [collaborate, efficiency, new initiatives, integrate]

1. Collaborate with different healthcare organizations to knowledge share and provide programs
2. Develop new healthcare programs and initiatives to drive more community outreach and engagement
3. Opportunity to review priorities and improve efficiencies of various programs
4. Opportunity to better integrate with clinical services

Threats (external) [Funding, competition, expectations, lack of external support]

1. Economic or political insecurity of funding sources
2. Policy and legislation changes that result in budget deficits
3. Pressure to reduce costs while meeting expectations to continue to meet existing goals/targets
4. Increased competition for funding from clinical services

Question 43

List 6 criteria by which to prioritise funding of public health programs

Answer 43

1. Overall disease burden related to the issue
2. Total cost and cost-effectiveness of the program
3. Political mandates/commitments to certain programs
4. Legislative requirements to carry out certain public health activities
5. Urgency of addressing the issue
6. Cost and consequences of not funding the program
7. Existence of alternative methods that the services is being provided e.g. vaccination in primary care

Question 44

List 5 types of risks faced by PH organisations

Answer 44

1. Funding risks
2. Reputational risks
3. Legal/compliance risks - legislative obligations
4. Operational risks to business continuity (can be due to internal or external factors)
5. Competition - clinical services taking over certain PH roles e.g. vaccination
6. Security risks - hold lots of personal and health information that must be protected

Question 45

You are put in charge of a new team in Provincial Health Office. List 5 key steps you would initially take in forming and developing your team.

Answer 45

1. Introduction of team members to each other
2. Identify relevent skills of all team members
3. Assigning roles and responsibilities to team members and ensuring these are understood
4. Establish reporting processes and hierarchies within the team and ensure they are understood
5. Establish goals and essential tasks of the whole team/unit and ensure these are shared and understood
6. Regular team meetings to identify and clarify and issues with understanding of team structure and function

Question 46

A) List 4 general procurement methods and whether they can be used to procure goods or services or both

B) List 4 situations where direct contracting is generally used

Answer 46

A)

A)

1. Request for quote (Goods only)
2. Invitation to bids (Goods and Services)
3. Request for proposal (Services)
4. Direct contracting (Goods and services)

B)

1. Emergency situations
2. Time critical activities
3. No availability in local/regional market
   https: //www.who.int/about/accountability/procurement/methods-and-workflows

Question 47

List 5 core functions of public health in Canada

Answer 47

H³ -PHA - DIP

1. Population health assessment
2. Health surveillance
3. Health promotion
4. Health protection
5. Disease and injury prevention

Question 48

List 4 advantages and 4 disadvantages of using targets as a tool for improvement in health services

Answer 48

Advantages

1. Can provide a clear focus on outcomes
2. Provide a common agenda with shared objectives for professional and managerial endeavours
3. Provide a means of accountability for governments (national, local, other) and are a prominent part of national strategies
4. Enable audit against the targets at both individual and service level to enable identification of areas for service improvement

Disadvantages

1. Focus clinicians and organisations on the ‘measurable’ (e.g. vaccinations) and the masking of other public health priorities (e.g. prevention of disease)
2. Aspects of care which are important but difficult to measure may not appear as targets
3. a target may oversimplify and mask complexity making valid comparisons difficult (e.g. vaccine coverage in remote populations or those with communities of vaccine refusers)
4. Monitoring targets add extra administrative and personnel costs

Question 49

List 4 strengths and limitations of vaccination coverage as a public health indicator for performance of regional health authorities

Answer 49

Advantages

1. It is a clear, relatively unambiguous indicator
2. It can be clearly understood by the public and policy makers
3. It is a measure of an important public health intervention

4.

Disadvantages

1. Difficult to use for comparisons across regions due to population differences
2. Not all vaccinations are delivered by primary care therefore PH authorities may feel it is not under their control
3. May be problems to correctly measuring due to record keeping and data transfers involved in measuring vaccination coverage
4. May encourage PHA to put more efforts into vaccinating ‘easier’ populations than those more remote

Question 50

List 4 responsibilities of a health authority

Answer 50

1. identifying population health needs;
2. planning appropriate programs and services;
3. ensuring programs and services are properly funded and managed; and
4. meeting performance objectives.

Question 51

A) List 3 mechanisms by which the public can be involved in health service planning and monitoring and give THREE specific examples

B) List 5 constraints/limitations to public involvement in health service planning and monitoring

Answer 51

A)

Mechanisms

1. Groups
2. Processes
3. Engagement

Examples

1. As members of boards of health
2. As patient advocacy groups
3. As members of patient participation groups
4. As complainants
5. By providing feedback through public consulstation documents/processes
6. As participants in focus groups related to patient experiences

B) Constraints

1. Lack of time/financial availability
2. Lack of knowledge
3. Lack of organisational commitment to patient/public involvement in planning
4. Professional resistance to patient involvement due to autonomy/power concepts

Question 52

A) What is a functional, project and matrix organisational structure?

B) List 2 advantages and 2 disadvantages for each

Answer 52

A)

Functional

• grouping of professionals according to functions they perform e.g. Commissioning, Human Resources, Finance, Information, Public Health

Project

• In the Project structure, different specialists work together in project teams towards a common aim

Matrix

• Superimposes project and functional structures creating a dual line of authority

B)

Functional

Advantages

• Teams of professionals can fill in for each other during absences.
• Clear lines of accountability and responsibility

Disadvantages

• Many problems are complex, and not easily bounded in a single function.
• Tendency to inhibit horizontal communication and coordination

Project

Advantages

• Clear lines of accountability and responsibility
• Multi-disciplinary - a broader generalist perspective

Disadvantages

• Projects are time limited, and there is a risk of loss of expertise as the end-date approaches
• Project managers may have to compete with established functions, as well as other projects, to gain resources from the organisational management.

Matrix

Advantages

• Flexible team resources
• Particularly suitable for complex organisations where communication across disciplines is vital
• Can be used to run partnerships across different organisations

Disadvantages

• Role & authority ambiguity and confusion
• Potential conflict in reporting to two or more manager

Question 53

List four functions of a regional health authority board

Answer 53

1. Ensure that the organization complies with applicable legislation, regulations, provincial policies and Ministerial directives
2. A strategic role in setting direction for the health authority
3. A fiduciary role in policy formulation, decision-making, and oversight
4. Ensuring accountability by interacting and communicating with the public, stakeholders and partners

Question 54

List 6 common roles of a BOH

Answer 54

1. Establish a framework for performance oversight (approve strategic goals and direction, along with a performance oversight framework)
2. Oversee program effectiveness and quality (monitoring, reporting, evaluation)
3. Oversee financial condition and resources (fiscal oversight; approving operating and capital budgets)
4. Oversee enterprise risk management (e.g., information integrity, procurement, insurance, pensions)
5. Supervise leadership (MOH assessment, CEO succession planning)
6. Oversee stakeholder relationships (relationship building with other organizations)
7. Manage the board’s own governance (board self-assessment)

Question 55

A decision is made to consider safety measures at a local bridge in your area for the prevention of suicide by jumping as there have been an above average number of suicides in your area recently that have used this bridge.

A) Who would you invite to join a working group to discuss this?

B) List 5 pieces of information you prepare ahead of the meeting to present to the working group

Answer 55

A)

B)

1. Write a short briefing paper outlining the context and the key findings from recent local suicide report for the meeting.
2. Evidence summary on effectivness of safety measures on bridges to prevent suicide including examples of where this has been done elsewhere
3. Give the results of any local audits including suicides from other causes.
4. Draft a set of terms of reference for the group.
5. Decide on the suggested timescale for the work of the group.

Question 56

You are an MOHt in a public health team in a town with high levels of deprivation and a relatively low-skilled workforce.

A physician with an interest in diabetes at your local hospital sends you a copy of a recent paper and wishes to know if the findings can be used to target health promotion activity in the area, specifically aimed at people of lower socio-economic status.

A decision is made to develop a health promotion programme with the aim of reducing the incidence of type 2 diabetes in your health area.

A) List FIVE key agenda items for the first meeting of the group.

Answer 56

1. Membership
2. Welcome and introductions
3. Briefing paper outlining the context and giving the key findings from the recent published paper.
4. Terms of reference for the group
5. Identifying population needs and key areas to target
6. Resources available and additional resources required
7. Suggested timescale for the work of the group
8. Communications strategy
9. Summary of action points
10. Future meetings and working arrangements

Question 57

A) List 5 aspects of the job characteristics theory/core characteristics model

B) List 3 psychological states that are meant to be a result of the aspects listed in (A)

C) List 5 outcomes for workers/in the workplace as a result of satisfying the aspects in (A)

Answer 57

A) Job Characteristics Theory: S-TiTs-AF

1. Skill variety
2. Task identity
3. Task significance
4. Autonomy
5. Feedback

B) Psychological states

1. Experienced meaningfulness
2. Experienced responsibility
3. Knowledge of results

C) Work outcomes

1. Increased job satisfaction
2. Decreased absenteeism
3. Increased work motivation
4. Decrease staff turnover
5. Improved job and organisational performance

https://courses.lumenlearning.com/boundless-management/chapter/job-design-and-motivation/

Question 58

List 6 steps of the Kara Sax job model for social marketing and communications

Answer 58

(Adapted somewhat to make sense)

1. Map out the strategy from start to finish.
2. Create engaging stories to effectively communicate with consumers through a variety of media channels and platforms.
3. Activate short-term and long-term goals
4. Partner with clients and other stakeholders
5. Use a balanced strategy of technology and creativity
6. Execute strategic plan by maintaining a simple strategy and well-communicated roles and responsibilities

Question 59

Identify 5 key elements of the Six sigma approach

Answer 59

DMAIC

1. Define the problem and objectives
2. Measure what is needed to improve
3. Analyse the process and identify factors of influence
4. Improve - identify and implement improvements
5. Control and ensure improvements are sustained

Question 60

List 7 key elements of a Project charter (part of define phase of 6 sigma)

Answer 60

BC-PS-GS-PS-TP-TR-EPB

1. Business Case: helps to understand how the project is linked to the overall business objectives.
2. Problem Statement: describes the problem or issue, this project is intended for.
3. Goal Statement: defines the project goal by considering all elements of SMART
4. Project Scope: considers in and out for the project & defines the project boundary.
5. Team & their broad responsibilities: Project team description along with their responsibilities and roles
6. Time plan: i.e. milestones to ensure to keep a track on project progress as scheduled.
7. Estimated project benefits: Project benefits need to be estimated as a deliverable. Cost-benefit analysis is conducted & benefits, both tangible & intangible are speculated. Gives a direction to top management re: project approval

Question 61

List 7 types of basic quality tools (six sigma)

Answer 61

Faculty Public Health Sucks Cock, Cunts, Cum

1. Flow Chart
2. Pareto Chart
3. Histogram
4. Scatter Plot
5. Check Sheet
6. Cause and effect diagram (Ishikawa diagram)
7. Control Chart

Question 62

A) List FOUR different methods of developing a budget

B) List FOUR different types of budgets within a business or organisation

Answer 62

A) Budgeting methods

1. Incremental
2. Activity based
3. Value propositiion
4. Zero based
5. Performance based

B) Budget types

1. Master budget
2. Operating budget
3. Cash flow budget
4. Personnel budget
5. Financial budget
6. Static budget

https://corporatefinanceinstitute.com/resources/knowledge/accounting/types-of-budgets-budgeting-methods/

https://www.marketing91.com/10-types-of-budget/

Question 63

List the TWO primary methods of accounting and provide ONE advantage and ONE disadvantage for each method

Answer 63

Accrual accounting

• Used to record transactions when they happen instead of when money exchanges hands

Advantage

• Provides an accurate picture of overall cash flow for the organisation
• Preferred method by Generally Accepted Accounting Principles

Disadvantage

• More complex and requires more staff
• Pay taxes on funds not yet received
• Montly reporting

Cash based accounting

• Record income when you physically receive it and expenses when you physically pay it

Advantage

• Simple to perform
• Provides a picture of how much cash you currently have on hand

Disadvantage

• Not as good for planning of long-term finances
• Can be difficult to switch methods
• Not acceptable method for all types of businesses

Question 64

Identify FIVE functions of a budget for a public health organisation

Answer 64

1. Planning delivery of programs and services within the operational plans
2. Maintain fiscal responsibility
3. Mechanism to evaluate the performance of individual activities within an organization
4. Communication and coordination of operational plans within organisation
5. Allocation of financial resources within an organisation

http://www.publichealthfinance.org/media/file/PHFM_Finance_Tutorial_III.pdf

Question 65

Identify FIVE key steps in a budget variance analysis

Answer 65

1. Gather data into a centralized database and create a variance report with differences in what was spent and budgeted to spend
2. Evaluate and identify variances for further investigation

• Check accuracy of data
• Percentage variance
• Magnitude of variance

3. Investigate and identify reasons for variances
4. Compile an explanation of the variances and recommendations for senior management
5. Develop and implement plan to address/remedy variances and incorporate into future budget planning

Question 66

List 6 elements of the WHO communication continuum for behaviour change campaigns

Answer 66

ARA-CC-Da

1. Awareness - build awareness of existing or emerging health threats or benefits
2. Relevence - increase personal relevance of the issue and support an appropriate understanding of the risk
3. Awareness of solutions - promote awareness of solutions Promote knowledge of solutions
4. Capacity to change - instil the confidence to act and capacity to change
5. 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
6. Decision to take action and follow-through

https://www.who.int/about/communications/actionable/communications-continuum

Question 68

List 5 key elements of the communication process

Answer 68

1. Sender
2. Receiver
3. Message
4. Medium
5. Feedback

https://www.thoughtco.com/what-is-communication-process-1689767

Question 69

List 6 principles for effective communications in health campaigns

Answer 69

U-CARAT

1. Understandable
2. Credible
3. Accessible
4. Relevant
5. Actionable
6. Timely

https://www.who.int/about/communications/actionable/communications-continuum

Question 70

List 7 principles of organisational funding

Answer 70

1. Stewardship
2. Accountability
3. Transparency
4. Integrity
5. Viability
6. Accounting standards
7. Consistency

https://www.humentum.org/free-resources/guide/seven-principles

Question 71

List 6 functions of public health governance

Answer 71

1. Policy development - Lead and contribute to the development of policies that protect, promote, and improve public health
2. Resource stewardship - assure the availability of adequate resources (legal, financial, human, technological, and material) to perform essential public health services
3. Continuous quality improvement - routinely evaluate, monitor, and set measurable outcomes for improving community health status
4. Partner engagement - build and strengthen community partnerships through education and engagement to ensure the collaboration of all relevant stakeholders
5. Legal authority - exercise legal authority as applicable by law and understand the roles, responsibilities, obligations, and functions of the governing body, health officer, and agency staff
6. Oversight & responsibility for public health performance in the community by providing necessary leadership and guidance to support the public health agency in achieving measurable outcomes

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4355716/

Question 72

List the THREE types of medically necessary services that all provincial and territorial health insurance plans must insure

Answer 72

1. Provided by physicians
2. Provided by hospitals
3. Provided by dentists when the service must be performed in a hospital

Question 73

List 6 groups that the federal government provides direct healthcare services to

Answer 73

1. First Nations people living on reserves
2. Inuit
3. serving members of the Canadian Forces
4. eligible veterans
5. inmates in federal penitentiaries
6. some groups of refugee claimants

https://www.canada.ca/en/health-canada/services/canada-health-care-system.html

Question 74

List 6 roles of the federal government of Canada related to health/public health

Answer 74

SFDRRP²MP

1. Setting and administering national standards for the health care system through the Canada Health Act
2. Provides health care funding to the provinces and territories through the Canada Health Transfer
3. Provide certain direct health care services to some population groups
4. Responsible for the regulation of certain products e.g. food, pharmaceuticals, chemicals, pesticides, medical devices
5. Supports health research
6. Supports health promotion and protection
7. Supports disease monitoring and prevention

https://www.canada.ca/en/health-canada/services/canada-health-care-system.html

Question 75

List 5 types of health-relatd products regulated by the Federal Government of Canada

Answer 75

FM-PP-CCR

1. food
2. medical devices
3. pharmaceuticals
4. pesticides
5. cosmetics
6. chemicals
7. radiation-emitting devices like cellphones

https://www.canada.ca/en/health-canada/services/canada-health-care-system.html

Question 76

A) List 3 groups of people that P/T health insurance plans generally provide supplemental coverage for

B) List 5 types of health services that are generally not covered under P/T health insurance plans

Answer 76

A) Supplemental coverage groups

1. Seniors

2, Social assistance recipients

3. Children

B) Generally not covered

1. Prescription drugs
2. Ambulance services
3. Vision care
4. Independent living (home care)
5. Dental care

https://www.canada.ca/en/health-canada/services/canada-health-care-system.html

Question 77

List 6 types of leadership styles

Answer 77

1. Authoritarian Leadership
2. Participative Leadership
3. Delegative Leadership
4. Transactional Leadership
5. Transformational Leadership
6. Charismatic leadership

Question 78

In situational leadership

A) List 4 factors related to the type of leadership

B) List 4 leadership styles described by situational leadership theory

Answer 78

A) Factors

1. Level of competence of the individual
2. Level of committment of the individual
3. Level of directive behaviour
4. Level of supportive behaviour

B) Styles

1. Directing (aka telling)
2. Coaching (aka selling)
3. Participating
4. Delegating

https://johnkwhitehead.ca/situational-leadership/

Question 79

List 5 potential reasons for a budget variance

Answer 79

1. The actual cost of an activity/service is more/less than what was budgeted for
2. Planned activity did not occur when it was expected to occur
3. Change in activity (unplanned activity occurs or planned activity does not occur)
4. Data error/miscoding
5. Fraud

Question 80

List 5 roles of PT governments in health care

Answer 80

1, administration of their health insurance plans;

2. planning and funding of care in hospitals and other health facilities;
3. services provided by doctors and other health professionals;
4. planning and implementation of health promotion and public health initiatives; and
5. negotiation of fee schedules with health professionals.

Health Canada - health care system

Question 81

A) List 5 steps in the job hiring process

B) List 4 potential sources of information about a potential new employee

Answer 81

A) Job hiring steps

1. Determine need for the position and create a role description and recruitment plan
2. Advertise job availability with application process and timeline
3. Screen applicants to determine short-list for interviews
4. Interview candidates and perform reference checks
5. Make final selection and negotiate details/contract with preferred candidate

B) Sources of information

1. Direct from the applicant during/outside of interview
2. From references
3. From the applicant’s CV & cover letter
4. From the internet - research biography, professional social media sites
5. Informally from colleagues
6. From the hiring manager

Question 82

You are conducting performance reviews for your employees

A) List 4 things that you would do in preparation for a performance review meeting with an employee

B) List 4 things that should occur in a performance review meeting with an employee

Answer 82

A) Preparation for a performance review meeting

1. Gather and document accurate information about employee’s performance from your own observations, managers, and colleague’s
2. Review existing performance goals and objectives against performance outcomes
3. Review the results of any previous performance reviews including defined goals

B) During performance review meeting

1. Provide specific feedback to employee about their performance
2. Provide the employee with an opportunity to offer their own self-appraisal of their performance
3. Together with the employee, review actual performance with existing performance goals and objectives, including identifying those that were met, unmet, or exceeded
4. Set a new set of goals and objectives for the next performance review cycle, including any necessary training or coaching to assist in meeting goals

Question 83

A) List 6 reasons for rising healthcare costs

B) List the top 4 costs of healthcare system in Canada

Question 85

List 5 types and give an example of each of poor performance problems.

Answer 85

1. Knowledge or skills gap e.g lacking public health knowledge.
2. Workplace contranstraints e.g. lack of necessary IT equpiment to complete job
3. Interpersonal/behaviour issues e.g. low emotional intelligence
4. Personal challenges e.g. have to take care of ill family members
5. Serious issue. e.g. fraud