1. Excellence is defined as “safe, effective, patient-centered, timely,
efficient, and equitable.” A new associate asks you why “safe” is
first. You reply:
a. “Because it has a long tradition. Hippocrates said ‘First, do
no harm.’ 2,000 years ago. It’s also consistent with ‘Do unto
others.’”
b. “Because people come to healthcare with troubles and
limitations, and they trust us to help, not harm.”
c. “Because accrediting and regulatory stakeholders expect
safety.”
*d. All of the above
2. You are meeting a group of new associates joining your well-managed
HCO. You show them the mission on the HCO’s website and say, “Our
mission is very real to us. It’s...”
a. “...what we say we are to patients.”
*b. “...a public declaration of intentions—why we’re here.”
c. “...a summary of shared objectives among competing
stakeholders.”
d. “...a way to focus everybody’s best effort.”
3. Why is a values statement important? Like the mission, many
associates will assume that it’s window dressing. What does leadership
need to say? “We’re serious about our values, and they are important
because...”
a. “...they are a foundation for working together.”
b. “...they establish basic expectations about conduct.”
c. “...they create a more comfortable workplace.”
*d. All of the above
4. In your internship, one of the younger people on the senior
leadership team reflects, “You know that, when you’re a leader, any
associate or patient comment should get a constructive response. When I
started, I had a lot of trouble understanding what ‘constructive
response’ means. What do you think that term means?” You reply, “I
think it means...”
a. “...solving the problem raised if you can and promising to
work on it if you can’t.”
b. “...explaining how the HCO has many problems, so it can only
work on important ones.”
c. “...trying to make the asker happy.”
*d. “...solving the problem raised if you can and accepting it as
an OFI if you can’t.”
5. WMHO defines stakeholders as having “a direct interest in an
organization’s success.” A PIT studying a not-for-profit HCO’s mission
wants to know, “Are some stakeholders more important than others? Can
we give priority to the interests of some group of stakeholders at the
expense of others shown in exhibit 1.3?” You reply:
a. “Patients come first, but any unhappy stakeholder group will
hamper the ability to deliver SEPTEE care.”
b. “If we meet our existing contracts, we can give priority to
any stakeholder group.”
*c. “They all have equal rights. If their ‘direct interests’ are
not met, any stakeholder group can close us down.”
d. “Giving any group except patients a priority might be
illegal.”
6. At many excellent HCOs, the CEO reviews the mission with all new
hires. When you’re hired as a young manager, you attend with all the
other hires. At the coffee break, you hear one new hire say, “The boss
really put emphasis on the mission and stuff. I wonder if he really
means it.” What is your best comment?
a. “He probably wouldn’t take time to talk with us if he didn’t
think it was important.”
b. “Yeah. A lot places, it’s just window dressing.”
*c. “I’m pretty sure he does. You could ask coworkers on your
team.”
d. Say nothing. It’s not your concern.
7. You want to describe evidence-based management (EBM) to a group of
civic leaders. Which of the following would you start with?
a. “EBM has led us to formal process specification.”
b. “EBM relies heavily on performance measurement.”
*c. “EBM replaces authority and opinion with fact.”
d. “EBM is the cheapest way to get the job done.”
8. A curious associate asks, “Who owns our HCO?” It’s a nonreligious
not-for-profit that is a subsidiary of a larger system with many HCOs
(like Sharp, Henry Ford, or Sutter Health). You respond, “The
individual HCOs are owned by…”
*a. “…the communities they serve.”
b. “… our overall corporate system.”
c. “…the trustees of our overall corporate system.”
d. “…the trustees of each local HCO.”
9. You’re recruiting a physician to join your HCO. She says, “The story
you tell, of what you call empowerment and continuous improvement,
sounds good, and I contacted some people I know on your clinical staff.
They say very complimentary things, that your HCO delivers, and they
like practicing there. My concern is this: I’m making basically a
lifetime commitment. How do I know the HCO will continue to be cuttingedge?” You begin, “Well, nobody can foresee the future, but...” What’s
the best way to complete the sentence?
a. “...the HCO works hard to keep up with changing needs in our
marketplace. We have an annual review to make sure we’re on
track.”
*b. “...our record is our best argument. We’ve got growing market
share, delighted patients, and enthusiastic associates.”
c. “...all of us have a stake in keeping the HCO a leader. If we
work together, we can win.”
d. “...we do everything the textbook says to stay current.”
10. You’re part of the strategy team at a small NFP HCO with a strong
patient-care mission. The question of joining are large system comes
up. One of the senior managers asks you, “Just in general, why might we
do that?” You reply, “I think the most important reason might be…”
*a. “The system will help us do a better job of supporting
patient care.”
b. “The system will help us lower costs.”
c. “The system will allow us to get higher prices from insurance
companies.”
d. “Managers in the system earn bigger bonuses than we do.”