HLT540 week 8 Stakeholder Scenario Assignment
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Details:
1) Read and complete
“Stakeholder Scenario.”
2) Prepare this
assignment according to the APA guidelines found in the APA Style Guide,
located in the Student Success Center. An abstract is not required.
Stakeholder Scenario
Goal: To convince a group of people to use a specific, new type
of antibiotic for patients pre-operatively in order to decrease surgical wound
infections.
Scenario:You are a healthcare administrator that is trying to introduce a
change in practice to a group of stakeholders. Your goal is to help them
understand the rationale and need for the change, and to get a sense of the
areas of resistance to the change. The change under discussion is to implement
a new antibiotic to be given one hour before surgery starts as a way of
reducing post-op wound infections. The Centers for Medicare and Medicaid
Studies (CMS) have indicated that timely pre-op application of specific
antibiotics is becoming a requirement and will be a publicly reported indicator
on the CMS Web site for your hospital. Thus, institution of this new procedure
is something you really need to pull off.
As the administrator
in this scenario, you will hear the initial responses of each of the stakeholders.
You will then be presented with several options for your response. Select the
option you think is most effective.
Review the
stakeholders’ responses to the option you selected. According to their own
perspectives and prerogatives, the stakeholders will respond in different ways
to each choice. Your goal is to achieve some level of buy-in to the change.
Issues:
·
The antibiotic is new
and people aren’t familiar with it.
·
Requires
administration within one hour of the actual surgery start time.
·
Requires
administration by IV.
·
Adds a step to the
busy pre-op nurse’s work load.
·
Saves the hospital
$28,000 per year.
·
Research shows wound
infections down 47% with this new antibiotic if it is administered in a timely
fashion.
Players:
·
Pharmacist: He’s learned about the new antibiotic through his research
studies, and is excited about using it.
·
Pre-op Nurse: She is worried about having one more thing added to the
pre-op activities list she must complete before the patient goes to surgery,
but she’s very interested in doing the right thing for her patients.
·
Surgeon: He hates government mandates, doesn’t like to be told what
to do, generally has a pretty good track record for his patients’ outcomes
after surgery, but has no idea what his actual rates of wound infection are.
·
Finance Analyst: It’s all about the money. Don’t make it harder by
concentrating on anything other than the dollars.
Stakeholders’
Background Thinking
Pharmacist: I really like this idea, because this antibiotic is better
and cheaper too. If we can standardize to this antibiotic, I can save money by
stocking only one antibiotic for surgery. It will save my staff time in
preparation also. This is a great idea for me and my department.
Pre-op Nurse: I am just worn out trying to keep up with all the changes
they keep hitting us with. It’s hard enough to do my job and remember to do
things differently and use different items. Why can’t they give me a break? Now
I’ll have to start an IV as well as give a drug, and they are already
pressuring me to get the patient ready for the OR faster. Sometimes I just want
to go home!! But I got into nursing to help people, and if this really makes a
difference, I guess I can suck it up.
Physician: The government makes me crazy! Those bureaucrats think
they know how to practice medicine better than I do. The last thing I need is
some ivory tower academic telling me what antibiotics to give! I’ve been doing
this for 30 years, and I know what works and what doesn’t. The stupid hospital
better shut up and let me do what I know is right and stop telling me how to be
a doctor. My patients like me and that is what counts. I’m sure voting
Libertarian in the next election!
Financial Analyst: I have been tasked to save this hospital hundreds of
thousands of dollars this year, and this one change will save us a bundle. Why
are they all arguing? This change could save their jobs! Don’t they get that
it’s all about the money? I wish they’d just shut up and approve the change so
we could go get lunch.
First Responses of
Stakeholders
·
Pharmacist: “This is really important. All the research on this new
antibiotic shows that it makes a big difference in reducing wound infections.
We could get our rate from 13% presently down to 2%. We need to do this.”
·
Pre-op Nurse: “This is going to take much more time. We’ve always been
able to give our patients pill antibiotics, and now you want me to have to
start an IV and administer the drug that way? What happens if I give it and the
surgery is delayed? There is already so much I have to do to get the patient to
the OR.”
·
Surgeon: “What a bunch of horse hockey! I’ve been using the same
antibiotic for 25 years and its fine. No need to make silly changes just to
keep the government happy. What do they know about medicine anyway? All they
want to do is make us follow some stupid ‘cookbook’ and it’s ridiculous. They
should just leave all that up to the doctor.”
·
Finance Analyst: “It saves money. Just do it.”
Administrator’s
Response Options
Select one:
1) “Well, we have to
do this because it’s a government requirement.”
2) “You all raise
valid points of concern. The evidence shows a significant benefit to our
patient care.”
3) “What could be done
in the implementation that would relieve some of your worries?”
Responses to Option 1
Pharmacist: “We can make this switch as soon as you are ready.”
Pre-Op Nurse: “We’ll have to tell the patient to come in four hours
before the surgery to do this. What a pain.”
Surgeon: “The heck with this. You can’t make me do it.”
Finance Analyst: “It saves money. Just do it.”
Responses to Option 2
Pharmacist: “There is a real benefit. Surgical site infections drop
like crazy. It’s the right thing to do.”
Pre-op Nurse: “I want to do the right thing. If Pharmacy can get the
drugs up to the unit in the morning, maybe I can start the IVs faster.”
Surgeon: “I’m all about patient care, but why can’t I use what I’ve
always used?”
Financial Analyst: “It saves money. Just do it.”
Responses to Option 3
Pharmacist: “It would help me to know how many drug doses to stock in
the OR each morning so I can make sure they have what they need on hand.”
Pre-op Nurse: “That would sure help me. We can begin by having the IVs
pre-prepared so we just have to put the needle in the patient.”
Surgeon: “Can I see the data about wound infections? How do I stack
up against other surgeons?”
Financial Analyst: “Great, you all see it. It saves money. Let’s do it.”
Assignment
As is usually the
case, it is possible to achieve some measures of acceptance of changes. The way
you respond will affect your ability to do this. However, in real life, it
rarely happens this quickly.
When involved in
negotiations, key elements to remember include:
·
Pay close attention to
the reasons people give for their resistance. You will gain a better insight
into their thought processes and can tailor your responses to their
perspectives.
·
You may have to ask
questions several times to dig into the real reasons why people may oppose
something. The opposition sometimes can be driven by fears and anxieties, but
those are not usually expressed initially. However, if you keep asking
questions and listening carefully, they will begin to emerge.
·
Once you have a sense
of the perspectives of the various stakeholders about the change, you can begin
to address them and use them to overcome any objections to the change.
·
Sometimes the best you
can get in the initial conversations is a willingness to move away from “I’m
not gonna.” to “Let me see the data.” That’s a big step toward willingness.
Based on this initial
scenario, develop an implementation plan. It should include:
·
The administrator’s
initial statement of what is being implemented and why.
·
(Review the
stakeholder’s background thinking and first responses.) The administrator’s
(your) response option choice.
·
How to communicate
with the stakeholders (especially if they need further convincing).
·
What evaluation
criteria are needed?
·
Time frames.
·
Other items you think
would be valuable to include.
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