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Health Care Management > Questions > Flashcards

Questions Flashcards

1
Q

You are working in the casualty of a District Hospital. A patient comes to the hospital without a referral letter and is turned away by the nurse and told to go to her local clinic first

a) List 5 possible reasons for the patient going straight to the hospital. (5)

A
  1. No access to clinic-distance, transport, hours, clinic closed
  2. Desire to be seen by medical doctors
  3. No Medication
  4. Long queues
  5. No equipment, e.g X-ray, lab
  6. Stigma-attached to the clinic or the patient’s disease.
  7. Loss of confidence in the care given at the clinic
  8. Lack of education about the referral system
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2
Q

You are working in the casualty of a District Hospital. A patient comes to the hospital without a referral letter and is turned away by the nurse and told to go to her local clinic first

(b) Discuss the reasons for the hospital turning them away and telling them to go to the clinic
First. (4)

A
  1. First contact should be at local clinic
  2. Clinics are free
  3. Cost efficiency (hospitals more expensive per visit)
  4. Avoid duplication of services
  5. Continuity of care/follow up
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3
Q

You are working in the casualty of a District Hospital. A patient comes to the hospital without a referral letter and is turned away by the nurse and told to go to her local clinic first.

(c) Describe what should be done before a patient is turned away from a medical facility. (3)

A
  1. Triage:
    °History,
    °Vitals,
    °Patient education
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4
Q

Describe the 5 methods to decrease the number of patients with TB in a village:

A
  1. Educate community about TB- Spread, infectivity, precipitating factors, common features, ways of minimizing spread and guide to follow when a community member is suspected to have TB.
  2. Adequate treatment of identified people with TB- Isolation for the first 2 weeks of treatment when pt is most infective.
  3. Screen ALL people who are in close contact with infected person and treat appropriately. Screening should be done at least twice on close contacts.
  4. Make treatment for TB in closest clinic to the village available at all times and educate pts about the treatment, the number, side effects, desired effects of anti-TB drugs. Also educate about the length, complications of not/or taking drugs.
  5. Treat active cases.
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5
Q

Clinical associate graduates have difficulty in transferring patients from the district hospital to a higher level. Discuss how this situation could be addressed. (5)

A
  1. Educate about the scope of practice of CA
  2. CA assess patients
  3. Make a diagnosis
  4. Prescribe treatment
  5. Do minor surgery under supervision
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6
Q

Who has the responsibility to notify medical conditions? (3marks)

A

The first person to be in contact with the patient.

It can either be a community healthcare worker, a nurse, a clinical associate, a doctor, or a private practitioner.

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7
Q

Explain the:
a) CATEGORY A notifiable medical condition. (2marks)

b) CATEGORY B notifiable medical condition. (1 mark)

A

a) Requires to be reported immediately using the most rapid means upon clinical or laboratory diagnosis, followed by a written or electronic notification within 24 hours of diagnosis.
b) Requires to be reported through a written or electronic notification within 7 days of clinical or laboratory diagnosis but preferably as soon as possible.

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8
Q

List 10 examples of notifiable medical conditions using the following table. (10)

A

CATEGORY A notifiable medical conditions:

  1. Rabies, human
  2. Anthrax
  3. Meningococcal infections
  4. Cholera
  5. Plague
  6. Hemorrhagic fever (African)
  7. COVID-19
  8. Measles
  9. Pertussis
  10. typhoid fever

CATEGORY B notifiable medical conditions:

  1. Viral (acute) hepatitis A
  2. Viral (acute) hepatitis B
  3. Tetanus
  4. Pulmonary TB & extra
  5. Congenital syphilis
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9
Q

Describe the essential data to be included in comprehensive referral latter. (10 marks)

A
  1. Name of referring center(hospital, community health center/ clinic).
  2. Name & contact details of the referring personnel.
  3. Name, or institution and contact details of the person receiving the referral.
  4. Patient details (Name, surname, age, gender, etc).
  5. Date that the patient was seen in OPD or date of admission of the patient in referring center.
  6. Diagnosis of the patient or current problem along with investigations.
  7. Reason for referral
  8. Recommendations to the person receiving the patient on how manage the patient.
  9. Medication that the patient is discharged on from the referring hospital or clinic.
  10. Signature of the referring person.
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10
Q

Principles of Primary health care. (5marks)

A

All Idots Can Enjoy

  1. Appropriate technology
  2. Intersectoral cooperation
  3. Community participation
  4. Equitable ditribution
  5. Health promotion.
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11
Q

Outline 8 essential health services in primary health care (4 marks)

A
  1. Maternal services (antenatal, theatres, post-natal).
  2. Emergency curative services (casualty).
  3. Immunization services (PMTCT, child health services).
  4. Rehabilitation services (physiotherapy, dietitian).
  5. Diagnostic (Radiology, Blood & specimen laboratories).
  6. Preventative (Counselling HIV & other diseases).
  7. Sending and receiving referrals & CSSD services for sterilization of instrument to be used in procedures.
  8. Curative services (OPD, wards)
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12
Q

5 types of Cares/Pillors in primary health care

A
  1. Promotive
  2. Preventive
  3. Palliative/supportive care
  4. Rehabilitation
  5. Curative
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13
Q

The ultimate goal of primary health care is better health for all. List 5 elements to achieve this goal. (5 marks)

ENDEMICS

A
  1. E- Edemic diseases (Prevent & control)
  2. N- Nutrition
  3. D- essential Drugs
  4. E-Education
  5. M- Maternal & child care + promotes Mental health care
  6. I-Immunization
  7. C- Common diseases & Injuries
  8. S- Sanitation
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14
Q

List Patient’s Rights

A
  1. Healthy and safety
  2. Participation in decision making.
  3. Access to health care
  4. Knowledge of one’s health insurance/medical aid scheme.
  5. Choice of health services
  6. Treated by a named health care provider
  7. Confidentiality and privacy
  8. Informed consent
  9. Refusal to treatment
  10. A second opinion
  11. Continuity of care
  12. Complaints about health services.
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15
Q

What are the patient’s responsibilities

A
  1. To take care of his/her own health
  2. To care for and protect the environment
  3. To respect the rights of other patients and health care providers
  4. To utilize the health care system properly and not to abuse it
  5. To know his/her local health care services and what they provide
  6. To provide health care provider with relevant and accurate information for diagnostic, treatment, rehabilitation or counseling procedures
  7. To advice health care provider about his/her wishes with regards to his/her death.
  8. To comply with the prescribed treatment or rehabilitation procedures
  9. To enquire about the related costs of treatment and/ rehabilitation and to arrange for payment
  10. To take care of the health records in his/her possession.
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16
Q

Batho Pele principles

A
  1. Consultation
  2. Service standards
  3. Access
  4. Courtesy
  5. Information
  6. Opennes and transparency
  7. Redress
  8. Value for money
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17
Q

Why are vaccine important?

A
  1. Prevent motility and morbidity
  2. To achieve herd immunity and prevent ongoing transmission
  3. Lowers the possibility of a pathogen to circulate in the community, and protects those who can not be vaccinated (due to health conditions, e.g. Allergies or their age)
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18
Q

What are the types of referrals

A
  1. Internal referral.
  2. External referral
  3. Emergency referral
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19
Q

Clinical discipline that should be provided at a District Hospital

A
  1. Family medicine & Primary health care.
  2. Medicine.
  3. Obstetrics
  4. Psychiatry
  5. Eye care
  6. Rehabilitation
  7. Surgery
  8. Pediatric
  9. Geriatric
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20
Q

What are the core ethical values and standards required of a health care provider?

A
  1. Respect for persons.
  2. Best interest or well-being
  3. Best interest or well-being: Beneficence
  4. Human rights
  5. Autonomy (honor pts rights)
  6. Integrity
  7. Truthfulness
  8. Confidentiality
  9. Compassion
  10. Tolerance
  11. Justice
  12. Professional competence and self-improvement
  13. Community
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21
Q

How to implement Infection prevention and control measures with patients with suspected or confirmed Covid-19?

Instructions for patients

A
  1. Wearing of mask
  2. Direct the patient to a separate area (isolate)
  3. Keep a 1-2m distance from people.
  4. Instruct all patients to cover nose and mouth during coughing or sneezing with a tissue or flexed elbow
  5. Wash your hands and/ use 70% alcohol hand sanitizer
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22
Q

How to implement Infection prevention and control measures with patients with suspected or confirmed Covid-19?

  1. Apply standard precautions
A
  1. Hand hygiene
  2. Use of personal protective equipment (PPE)
  3. Appropriate patient placement
  4. Prevention of needle-stick or sharps injury
  5. Safe waste management
  6. Cleaning and disinfecting of equipment & environment
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23
Q

What are the Components of and ideal clinic?

A
  1. Administration
  2. Integrated clinical service management
  3. Medicines, supplies and laboratory services
  4. Human resources for health
  5. Support services
  6. Infrastructure
  7. Health information management
  8. Communication
  9. District health system support
  10. Implementing partners and stakeholders
24
Q

Component: Administration

A
  1. Signage and notices
  2. Staff identity and dress code
  3. Patient service organization
  4. Management of patient records
25
Q

Principles of District health care

A
  1. Equity
  2. Effectiveness
  3. Decentralization
  4. Improved access to services
  5. Provision of comprehensive services
26
Q

What is a District Health System (DHS)

A

WHO defines a DHS as a system-based Primary Health Care that is more or less a self-contained segment of the national health system. It comprises of a well-defined population, living within a clearly demarcated administrative and geographical area, whether urban or rural. It includes all institutions and individuals providing health care in the district, whether governmental, social security, non-governmental, private, or traditional.

27
Q

Roles or dristrict hospital

A
  1. Delivery of comprehensive and integrated services up to and including district hospital services.
  2. Decentralised management responsibility, authority, and accountability.
  3. The planning and management of services delivered at the district level.
  4. The need for effective referral mechanisms within and between districts and levels of care.
  5. The need to deliver care in the most efficient and effective manner possible.
28
Q

The range of district hospital

services/ Clinical disciplines

A

Family Medicine and Primary health care

  • Medicine
  • Obstetrics
  • Psychiatry
  • Eye care
  • Rehabilitation
  • Surgery
  • Paediatrics
  • Geriatrics
29
Q

Briefly explain the role of the District Health System (DHS) in the Primary Health Care (PHC) of South Africa? (3marks)

A
  1. The DHS plays an important role in implementing comprehensive Primary Health Care.
  2. The DHS ensures that there is the coordination of primary health care between different levels of care.
  3. It aims to give more support and supervision to clinics and health workers with regards to their needs.
30
Q

Services offered by the DHS

A
  1. Identification of health care needs and prioritization of health services.
  2. Provision of identified and prioritized healthcare packages in an integrated continuous and comprehensive manner.
  3. Encourage community-based care.
  4. Identification and involvement of all stakeholders.
  5. Development and implantation of action plans.
  6. Ensuring customer/client satisfaction
31
Q

Intergrated Governance

A
  1. Corporate Governance: Accountability system to direct and control probity
  2. Staff Governance: Accountability system for fair and effective staff management.
  3. Clinical governance: Accountability system for improving quality of patient care.
32
Q

PRIMARY HEALTH CARE CLINIC services

A
  1. Immunisations
  2. Family planning
  3. Antenatal care
  4. Treatment of common conditions
  5. Treatment and management tuberculosis
  6. HIV/AIDS counselling
33
Q

COMMUNITY HEALTH CENTRE, services

A
  • CHC is the second step in the provision of health care but can also be used for first contact care
  • It offers similar services to a primary health care clinic with the addition of:
  1. A 24 hours maternity services
  2. Emergency care and casualty
  3. Short-stayed ward
34
Q

ROLE OF THE DISTRICT HOSPITAL

A
  1. District hospital supports the primary health care and is a gateway to more specialist care.
  2. It provides generalist support to CHC
  3. The hospital has between 30 and 200 beds, a 24-hour emergency services and an operating theatre
  4. Generalists from a range of clinical disciplines provides the services.
  5. District hospital supports the primary health care and is a gateway to more specialist care
    It provides generalist support to CHC

The hospital has between 30 and 200 beds, a 24-hour emergency services and an operating theatre

Generalists from a range of clinical disciplines provides the services.

35
Q

Different levels of Health Care

A

LEVEL 1
• Primary Health Care Clinic
• Community Health Care Clinic
• District Hospital

LEVEL 2
• Regional Hospital

LEVEL 3
• Provincial Tertiary Hospital

LEVEL 4
• Central Hospitals

36
Q

What is the difference between “Generalist” and “Specialist” in the context of health care manager?

A
  1. Generalist:

2. Specialist:

37
Q

Define Referral System?

A

Referral system is advocated from the lowest level of primary health care to the highest level of care in Public Health Care facilities, except in emergency when patient can be taken to any facilities for immediate treatment.

38
Q

Types of Referral

A
  1. Institutional
  2. Self-referral
  3. Emergency referral
39
Q

A good referral system can help to ensure

A
  • Clients receive optimal care at the appropriate level and not unnecessarily costly
  • Hospital facilities are used optimally and cost-effectively
  • Clients who most need specialist services can accessing them in a timely way.
  • Primary health services are well utilized and their reputation is enhanced
40
Q

Identified several factors that might influence a referral system and its usage

A
  1. Accessibility,
  2. Acceptability,
  3. Efficiency and
  4. Effectiveness
41
Q

Consequences of a poor referral policy

A
  1. The tendency of patients to bypass primary health care clinics makes patients to spend long waiting hours in hospitals.
  2. This also distorts the core functions of the hospitals and is linked to overcrowded out-patient and casualty departments.
  3. The provision of primary health care by hospital is uneconomical; treatment cost per illness is much more expensive than in a primary health care centre.
42
Q

What should be done in order to improve the referral system of South Africa

A
  1. There should be regular visits by hospital doctors to PHC facilities.
  2. There should be flexible and longer operating hours of clinics.
  3. There should be functional CHCs.
  4. There should be regular supplies of medication.
43
Q

Pregnant women which is at high risk is referred prenatally or sent to emergency obstetric care, what essential services should be available?

A
  1. Surgical obstetrics,
  2. anaesthesia,
  3. Medical treatment,
  4. Blood replacement
  5. Annual procedures and
  6. Monitoring labour,
  7. Management of women at high risk,
  8. Family planning support
  9. Neonatal special care
44
Q

What is Health?

A

Health is a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity (WHO)

45
Q

What is a System?

A

A system is a group of interacting, interrelated, or interdependent elements forming a complex whole

46
Q

What is Health System?

A

A health system consists of all organizations, institutions, people and actions whose primary intent is to promote, restore or maintain health (WHO 2009).

47
Q

What is Health Care System?

A

Is a means of organised social response to the health conditions of the population, it is narrower than a health system and is often described in terms of the levels of healthcare and organisational structure of the Ministry responsible for health in most countries.

48
Q

What is Primary Health Care?

A

° Primary health care is essential healthcare based on practical, scientific and socially acceptable methods and technologies.

° Primary Health Care is essential health care made universally accessible to individuals and families in the community by means acceptable to them and at a cost that the community and country can afford.

49
Q

What is Primary Care

A

°Primary Care is “that level of a health service system that provides entry into the system for all new needs and problems, provides person-focused (not disease-oriented)care over time, provides care for all but very uncommon or unusual conditions, and coordinates or integrates care provided elsewhere by others.”

50
Q

Decentralization Model

A

°Decentralisation implies the shift of power, authority and functions away from the centre.

°Decentralisation can take one of the following forms:

(1) Deconcentration;
(2) Devolution;
(3) Delegation; and
(4) Privatisation.

51
Q

Types of Decentralisation

A
  1. Deconcentration
  2. Devolution
  3. Delegation
  4. Privatisation
52
Q

Deconcentration

A

Deconcentration: defined by as ‘shifting power from the central offices to peripheral offices of the same administrative structure’. In the South African case the establishment of provincial, regional and district offices for health is an example of deconcentration.

53
Q

Devolution

A

° Devolution: is the shifting of power and responsibility to separate administrative structures but that are still within the public sector. It often implies ‘the transfer of functions or decision-making authority to legally incorporated local government.

54
Q

Delegation

A

° Delegation: is the shifting of responsibility to semi-autonomous ‘agencies’ which may vary from parastatals, functional development authorities or special project implementation units.

55
Q

Privatisation

A

° Privatization: outsourcing and contractual.

Health Care Management (1 decks)

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