Read the following extract and answer the questions below:

Each year, the government of the Coastal Region publishes league tables ranking the performance of hospitals

in the region. All hospitals in the Coastal Region are publicly funded and are ultimately accountable to the

government's Health Department.

The Health Department argues that the league tables help identify those hospitals whose performance is

significantly better or worse than expected and highlight variations in performance among hospitals. However,

they also emphasize the importance of identifying and addressing the reasons behind large and unexplained

performance variations, particularly in hospitals that have underperformed.

Critics have argued that the league tables only focus on specific aspects of hospital performance, and the

indicators used have been selected based on data availability rather than what matters most to patients and

healthcare professionals. Another criticism is that these league tables can have a negative impact on public trust

in the healthcare system and the morale of healthcare workers.

An extract from the most recent hospital league table $($based on patient outcomes$)$ showed the following:

Rank Hospital Survival Rate $\%$ Patient Satisfaction

Score out of $100$

$1$ Coastal Regional $9285$

$52$ Harmony Medical Centre $7872$

$103$ Seaview General $6889$

Harmony Medical Centre and Seaview General are neighbouring hospitals. In the past three years, Seaview

General has consistently had high patient satisfaction scores, while Harmony Medical Centre has experienced

a decline in patient satisfaction despite having excess capacity.

The three hospitals $($Coastal Regional, Harmony Medical Centre, and Seaview General$)$ have recently

undergone routine inspections by Health Department evaluators. Coastal Regional received a rating of

'Outstanding.$\text{'}$ Harmony Medical Centre received a rating of 'Satisfactory,$\text{'}$ while Seaview General received a

rating of 'Excellent.$\text{'}$

Here are some excerpts from the Health Department evaluators' reports:

$[$Coastal Regional$]$: "Coastal Regional Hospital has demonstrated exceptional patient care practices, resulting

in a high survival rate. The hospital's commitment to patient satisfaction is evident, with a strong focus on holistic

healthcare."

$[$Seaview General$]$: "Seaview General Hospital has fostered a culture of patient$-$centric care. The hospital's

numerous patient engagement initiatives, such as support groups and community outreach programs, contribute

to its outstanding patient satisfaction scores.$$

Required

$1)$ Evaluate the appropriateness of the league table for monitoring hospitals' performance

in the Coastal Region. $(8$ marks$)$

$2)$ Recommend, with reasons, TWO additional indicators $($apart from those included in

the league tables$)$ which hospitals in the Coastal Region could use for evaluating their

performance. $(6$ marks$)$

$3)$ Briefly discuss THREE factors which will influence the effectiveness of any

performance standards selected for the hospital$$s new performance measurement

system. $(6$ marks$)$