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HLT 540 Health Care Research Methods, Analysis, and Utilization
HLT 540 Full Course
GC HLT540 week 1 dq 1 & dq 2
dq 1
Why do you think many
healthcare practitioners are often unwilling to change practice patterns, based
on research findings? Some practitioners criticize evidence-based practice as
“cookbook care.” Considering these perceptions, how would you utilize your
education and experiences in planning the implementation of a major change?
dq 2
Consider the question:
“Why do physicians and nurses kill more people than airline pilots?” Apply your
critical thinking skills to this argument and critique the statement. First, do
you think it’s true? If it is, what do you think about their rationale? How
would you address it if the question were posed to you in a forum?
GC HLT540 week 2 dq 1 & dq 2
dq 1
What kinds of
extraneous variables (not cited in the studies) do you think could have
affected the relationships between the independent variables and the dependent
variables in both the Messina et al. and Coyne et al. studies?
dq 2
How effectively do you
think the Coyne et al. study and the Messina et al. study both used their
review of literature to help the reader understand why the research question
was asked? How could they have done it more effectively?
GC HLT540 week 3 dq 1 & dq 2
dq 1
Given that there is a
documented advantage to the use of an experimental and control group design,
discuss why other designs are frequently used, and the situations that may
prompt the use of one.
dq 2
Discuss your understanding
of the concept of internal validity in a research study, and the impacts of
several errors or biases that can reduce the study’s validity.
GC HLT540 week 4 dq 1 & dq 2
dq 1
Why do you think so
many people have problems with using, interpreting, or applying statistics in
making business decisions?
dq 2
As you have learned to
evaluate different research studies, what elements seem the most important to
you for evaluation of the research’s quality? Why?
GC HLT540 week 5 dq 1 & dq 2
dq 1
Discuss the concept of
the normal distribution, why it is important, and what you think it means.
dq 2
When students talk
about “grading on the curve,” how does that apply to the normal distribution?
GC HLT540 week 6 dq 1 & dq 2
dq 1
Discuss the
differences between the concepts of correlation and causality, and why it is
critically important to make sure that the differences are understood?
dq 2
What are the
indicators for using a t-test? Create a research scenario in which it would be
correct to use a t-test, including the research question, sample size, and
dependent and independent variables.
GC HLT540 week 7 dq 1 & dq 2
dq 1
What are the
indicators for using an ANOVA? Create a research scenario in which it would be
correct to use an ANOVA, including the research question, sample size, and
dependent and independent variables.
dq 2
What are the
indicators for using a regression analysis? Create a research scenario in which
it would be correct to use a regression analysis, including the research
question, sample size, and dependent and independent variables?
GC HLT540 week 8 dq 1 & dq 2
dq 1
Re-visit the roadmap
that you began at the start of your program of study. Complete information
regarding this course. In the discussion, reflect on how this course meets your
career goals. What have you gleaned from the course that will help you in your
career path? Respond to at least two other classmates.
dq 2
Discuss your thoughts
about the ethics of using informed consent vs. blinding the subjects to the
expected outcomes of the intervention. Should they be told? How much should
they be told? How would the placebo effect be impacted if subjects are told
which intervention is being applied to them?
HLT540 week 2 Evidence-Based Research Interview Assignment
Details:
Identify, analyze, and
discuss the components that comprise a valid evidence-based research study.
Based on the
information compiled above, interview a health care leader about his/her
experiences related to using evidence-based research to drive changes in
practices in his/her facility.
Write a report
(1,000-1,250 words) of your findings. Include the following in your report:
1) The changes that
the health care leader has been involved in implementing.
2) How strong did the
leader feel the research on the topic was? Why?
3) Have they ever
rejected research findings? Why or why not?
4) Include any
concerns they have had or resistance they have experienced when implementing
changes based on research.
5) Analyze your
findings as they apply to the components of evidence-based research.
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.
This assignment uses a
grading rubric. Instructors will be using the rubric to grade the assignment;
therefore, students should review the rubric prior to beginning the assignment
to become familiar with the assignment criteria and expectations for successful
completion of the assignment.
HLT540 week 3 Assessing a Research Study Assignment
Details:
1) Choose a research
study article of interest to you.
2) Refer to the study
you choose and complete “Assessing a Research Study.”
3) Identify an article
that directly references your chosen study and compare it to your findings.
Does this article refute or confirm the study’s findings?
4) Write a paper
(750-1,000 words) that analyzes and summarizes your findings.
5) 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.
6) This assignment
uses a grading rubric. Instructors will be using the rubric to grade the
assignment; therefore, students should review the rubric prior to beginning the
assignment to become familiar with the assignment criteria and expectations for
successful completion of the assignment.
Assessing a Research Study
Review the study
components in the left-side column of the form below. Refer to the study you
chose, and complete the data in the right-side column with the key components
in that study.
Research
Question:
|
|
How
did the research question emerge from the review of literature in the
article?
|
|
Independent
Variables
Type:
|
|
Dependent
Variables
Type:
|
|
Identify
and Define the Study Design Elements:
1.
Quantitative vs. Qualitative:
2.
Sample Size
3.
Method of sample selection: Explanation.
4.
Identify and define the experimental and control groups?
5.
Reliable and valid data instruments? Explain.
|
|
Describe
analysis.
What
statistics were used?
|
|
Did
the researchers’ conclusions make sense, did they answer the research
question, and did they appear to flow from the review of the literature?
Did
they explore control of extraneous variables?
|
HLT540 week 3 Coyne and Messina Articles, Part 1 Analysis
Assignment
Details:
1) In a paper
(1,000-1,250 words), compare and contrast the major elements of the reports by
Coyne et al. and Messina et al., listed in the Module 2 Readings.
2) Complete the “Coyne
and Messina Articles Analysis.” Study the information in the right-side column
related to the Coyne, et al. study, which identifies the required elements as
found in the reading. Complete the information for the Messina et al. article
by identifying the required elements from the article.
3) 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.
4) This assignment
uses a grading rubric. Instructors will be using the rubric to grade the
assignment; therefore, students should review the rubric prior to beginning the
assignment to become familiar with the assignment criteria and expectations for
successful completion of the assignment.
Coyne and Messina Articles Analysis
As an example
guideline, review the study components in the left-side column of the table
below. Read the study by Messina et al., and build the data in the right-side
column with the key components in that study.
Research
Question:
|
Coyne:Do size and ownership type make a difference
in the efficiency and cost results of hospitals in Washington state?
(Highlight p.164, second column, starting 15 lines from bottom to seven lines
from bottom.)
Messina:
|
How
did the research question emerge from the review of literature in the
article?
|
Coyne:Built on an earlier study by Coyne on
performance differences between multi-facility systems and independent
hospitals using two cost measures. Cited studies that used a range of
variables to measure differences in hospital performance, and noted that
prior findings have been inconclusive in regard to hospital size, although
economies of scale were found.
Messina:
|
Independent
Variables
Type:
|
Coyne:Hospital size and hospital ownership
structure.
Categorical
Messina:
|
Dependent
Variables
Type:
|
Coyne:Efficiency measures – continuous variables.
Cost measures –
continuous variables.
Messina:
|
Design
Elements
1.
Quantitative vs. Qualitative
2.
Sample Size
3.
Method of sample selection
4.
Experimental vs. control group?
5.
Reliable and valid data instruments?
|
Coyne:
Quantitative
96
Picked all hospitals
in state, except investor owned hospitals.
No
Used data that are
commonly used to measure hospital efficiency and performance with high
degrees of accuracy (reliable), and data that are historically used and make
sense to other hospital users (valid).
Messina:
|
Describe
analysis.
What
statistics were used?
|
Coyne:Two-way Analysis of Variance (ANOVA)
Messina:
|
Did
the researchers’ conclusions make sense, did they answer the research
question, and did they appear to flow from the review of the literature?
Did
they explore control of extraneous variables?
|
Coyne:They concluded that size and ownership type
make a difference in reported levels of efficiency. Not for profits seem to
achieve higher performance levels, and medium and large not for profits
operate more efficiently than industry average. The same results were found
for cost levels, in that size and ownership type do make a difference, with
medium sized hospitals reporting lower costs than large or small hospitals.
Yes, when they
called for national studies that controlled for case mix, scope of services,
and payer mix, all of which could have affected the results in this study in
an unmeasured way.
Messina:
|
HLT540 week 4 Coyne and Messina Articles, Part 2 Statistical
Assessment Assignment
Details:
1) Write a paper of
1,000-1,250 words regarding the statistical significance of outcomes as
presented in Messina’s, et al. article “The Relationship between Patient
Satisfaction and Inpatient Admissions Across Teaching and Nonteaching
Hospitals.”
2) Assess the
appropriateness of the statistics used by referring to the chart presented in
the Module 4 lecture and the resource “Statistical Assessment.”
3) Discuss the value
of statistical significance vs. pragmatic usefulness.
4) 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.
5) This assignment
uses a grading rubric. Instructors will be using the rubric to grade the assignment;
therefore, students should review the rubric prior to beginning the assignment
to become familiar with the assignment criteria and expectations for successful
completion of the assignment.
Statistical Assessment
Use the chart in the
Module 4 lecture to complete the table below to assess the appropriateness of
the statistics used, and determine the statistical significance of outcomes in
Messina’s, et al., article “The Relationship Between Patient Satisfaction and
Inpatient Admissions Across Teaching and Nonteaching Hospitals” . Refer
specifically to the discussion on pages 189-90 of the article.
Messina, D., Scotti,
D., Ganey, R., Zipp, G., & Mathis, L. (2009). The Relationship Between
Patient Satisfaction and Inpatient Admissions Across Teaching and Nonteaching
Hospitals. Journal of Healthcare Management, 54(3), 177-89, discussion 189-90. Retrieved
from.gcu.edu:2048/login?url=http://proquest.umi.com.library.gcu.edu:2048/pqdweb?did=1752526601&sid=1&Fmt=4&clientId=48377&RQT=309&VName=PQD”>http://library.gcu.edu:2048/login?url=http://proquest.umi.com.library.gcu.edu:2048/pqdweb?did=1752526601&sid=1&Fmt=4&clientId=48377&RQT=309&VName=PQD
Statistic
|
Data
type
|
Sample
Size
|
Research
Question
|
Statistical Significance:
There were three errors in Table 4 on page 185. In your
identification of significant findings, can/did you find them?
The chart from the
Module 4 Readings:
Statistic
|
Data
Type
|
Sample
Size
|
Research
Question
|
Mean and Standard
Deviation
|
Interval or ratio
|
>2
|
What does the data
set look like?
|
Frequency
Distribution
|
Nominal-Ratio
|
>2
|
What does the data
set look like?
|
Chi-Square
|
Nominal-Ordinal
|
>4
|
Is the variance of
one variable equal to or different from another variable
|
Correlation
Coefficient
|
Interval-Ratio
|
>4
|
What is the relationship
between two variables?
|
t-Test
|
Interval-Ratio
|
<30
|
Is there a
significant difference between two groups? May be intrinsic or may be
experimental
|
ANOVA (Analysis of
Variance)
|
Interval-Ratio
|
>30
|
Is there a
significant difference between 2 or more groups?
|
Regression Analysis
|
Interval-Ratio
|
>30
|
How much of the
change in the dependent variable is predicted by the independent variable or
variables?
|
Refer to the Module 4 Readings for explanation of the chart.
HLT540 week 5 Broyles Textbook Practice Exercise Assignment
Details:
Complete “Practice
Exercise 11” (page 157) and “Practice Exercise 11” (page 180) in the textbook.
For the data set listed, use Excel to extract the mean and standard deviation
for the sample of lengths of stay for cardiac patients. Use the following Excel
steps:
1) Enter the data set
into Excel.
2) Click on the Data
tab at the top.
3) Highlight your data
set with your mouse.
4) Click on the Data
Analysis tab at the top right.
5) Click on
Descriptive Statistics in the analysis tool list.
6) Find the mean and
standard deviation of the data sets.
7) Send the results to
instructor via e-mail, along with your analysis of the description of the data
set.
APA format is not
required, but solid academic writing is expected.
This assignment uses a
grading rubric. Instructors will be using the rubric to grade the assignment;
therefore, students should review the rubric prior to beginning the assignment
to become familiar with the assignment criteria and expectations for successful
completion of the assignment.
HLT540 week 5 Coyne and Messina Articles, Part 3 Spearman
Coefficient Review Assignment
Details:
1) Write a paper
(750-1,000 words) regarding the use of the Spearman rank correlation
coefficient by Messina, et al. in “The Relationship between Patient
Satisfaction and Inpatient Admissions Across Teaching and Nonteaching
Hospitals,” listed in the module readings.
2) Comment on what
variables were used; whether it answered the research question; and whether the
Spearman rank correlation coefficient is appropriately used, given the
requirements of the Spearman rank correlation coefficient.
3) 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.
4) This assignment
uses a grading rubric. Instructors will be using the rubric to grade the
assignment; therefore, students should review the rubric prior to beginning the
assignment to become familiar with the assignment criteria and expectations for
successful completion of the assignment.
HLT540 week 6 Yeung Analysis Assignment
Details:
1) Refer to “The Use
of Electro-Acupuncture in Conjunction with Exercise for the Treatment of
Chronic Low-Back Pain” by Yeung, Leung, and Chow.
2) Complete “Yeung
Analysis Worksheet.”
3) Examine the
question the researchers were trying to answer and write an essay (500-750
words) that explains why you feel the t-test was chosen. Choose one of the
other tools studied so far in this course and explain why it would not provide
relevant findings.
4) 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.
5) This assignment
uses a grading rubric. Instructors will be using the rubric to grade the
assignment; therefore, students should review the rubric prior to beginning the
assignment to become familiar with the assignment criteria and expectations for
successful completion of the assignment.
Yeung Analysis Worksheet
Yeung, C., Leung, M.,
& Chow, D. H. K. (2003). The Use of Electro-Acupuncture in Conjunction with
Exercise for the Treatment of Chronic Low-Back Pain. Journal of Alternative and
Complementary Medicine, 9(4), 479-490. Retrieved from http://library.gcu.edu:2048/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=10555113&site=ehost-live&scope=site
What was the research
question?
What were the
independent variables?
What was the dependent
variable?
What was the sample
size and how was it chosen?
What was the
experimental design and use of control group?
Were the instruments
of measurement shown to be reliable and valid?
What data types were
included?
Describe the
statistics used, what they were used for, and the results.
What were the
researchers’ conclusions? How did they answer the research question(s)?
How was error
controlled?
Did you see any
concerns with the research study? If so, what?
HLT540 week 6 Correlation between Two Variables Assignment
Details:
Use Excel to do a correlation
between the following variables:
1) X – 2,5,5,6,6,7,8,9
2) Y – 1,2,2,3,4,4,5,5
This assignment uses a
grading rubric. Instructors will be using the rubric to grade the assignment;
therefore, students should review the rubric prior to beginning the assignment
to become familiar with the assignment criteria and expectations for successful
completion of the assignment.
HLT540 week 6 T-Test for Two Samples Assignment
Details:
A drug company is
measuring levels of oxygenation in patients after receiving a test medication.
As the researcher, you are interested in whether Group I, which received the
medication, has the same oxygenation levels as Group II, which did not.
1) Group 1:
2,3,3,4,4,7,8,9
2) Group 2:
1,2,2,3,4,4,5,5,6,8
Use Excel to run a
t-test for two samples, assuming equal variances, with an alpha value of 0.05.
Run the t-test and note:
1) Are you doing a
one-tailed test or a two-tailed test (Excel will give you both)?
2) What is the
probability that Group I is different from Group 2, using the p value? Is it
significant against the benchmark of p < .05?
APA format is not
required, but solid academic writing is expected.
This assignment uses a
grading rubric. Instructors will be using the rubric to grade the assignment;
therefore, students should review the rubric prior to beginning the assignment
to become familiar with the assignment criteria and expectations for successful
completion of the assignment.
HLT540 week 7 Broyles Textbook Exercise 7 Assignment
Details:
1) Use Excel to
complete “Exercise 7” on page 208 (ANOVA) in the textbook.
2) Answer the
questions at the end of the exercise.
3) APA format is not
required, but solid academic writing is expected.
4) This assignment
uses a grading rubric. Instructors will be using the rubric to grade the
assignment; therefore, students should review the rubric prior to beginning the
assignment to become familiar with the assignment criteria and expectations for
successful completion of the assignment.
HLT540 week 7 Roddy and Ganz Assessments Assignment
Details:
1) Use “Roddy and Ganz
Worksheets” to complete an assessment of the research studies: “Evidence-Based
Clinical Guidelines: A New System to Better Determine True Strength of
Recommendation” by Roddy et al., and “ICU Nurses’ Oral-Care Practices and the
Current Best Evidence” by Ganz et al.
2) In a paper
(1,000-1,250 words), analyze and support whether you believe that the changes
recommended are statistically valid and sound enough to make practice changes
in a hospital.
3) 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.
4) This assignment
uses a grading rubric. Instructors will be using the rubric to grade the
assignment; therefore, students should review the rubric prior to beginning the
assignment to become familiar with the assignment criteria and expectations for
successful completion of the assignment.
Roddy Analysis Worksheet
Using the worksheet
below, complete an assessment of the following article.
Roddy, E., Zhang, W.,
Doherty, M., Arden, N. K., Barlow, J., Birrell, F., et al. (2006).
Evidence-based clinical guidelines: A new system to better determine true
strength of recommendation. Journal of Evaluation in Clinical Practice, 12(3), 347-352. Retrieved
from.gcu.edu:2048/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=20870724&site=ehost-live&scope=site”>http://library.gcu.edu:2048/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=20870724&site=ehost-live&scope=site
What was the
research question?
|
|
What were the
independent variables?
What was the
dependent variable?
|
|
What was the sample
size and how was it chosen?
|
|
What was the
experimental design and use of control group?
|
|
Were the instruments
of measurement shown to be reliable and valid?
|
|
What data types were
included?
|
|
Describe the
statistics used, what they were used for, and the results.
|
|
What were the
researchers’ conclusions? How did they answer the research question(s)?
|
|
How was error
controlled?
|
|
Did you see any
concerns with the research study? If so, what?
|
Ganz Analysis Worksheet
Using the worksheet
below, complete an assessment of the following article.
Ganz, F., Fink, N.,
Raanan, O., Asher, M., Bruttin, M., Nun, M., et al. (2009). ICU nurses’
oral-care practices and the current best evidence. Journal of
Nursing Scholarship, 41(2),
132-138. Retrieved
from.gcu.edu:2048/login?url=http://proquest.umi.com.library.gcu.edu:2048/pqdweb?did=1780947491&sid=1&Fmt=3&clientId=48377&RQT=309&VName=PQD”>http://library.gcu.edu:2048/login?url=http://proquest.umi.com.library.gcu.edu:2048/pqdweb?did=1780947491&sid=1&Fmt=3&clientId=48377&RQT=309&VName=PQD
What was the
research question?
|
|
What were the
independent variables?
What was the
dependent variable?
|
|
What was the sample
size and how was it chosen?
|
|
What was the
experimental design and use of control group?
|
|
Were the instruments
of measurement shown to be reliable and valid?
|
|
What data types were
included?
|
|
Describe the
statistics used, what they were used for, and the results.
|
|
What were the
researchers’ conclusions? How did they answer the research question(s)?
|
|
How was error
controlled?
|
|
Did you see any
concerns with the research study? If so, what?
|
HLT540 week 7 Broyles Textbook Exercise 1 Assignment
Details:
1) Use Excel to
complete “Exercise 1” on page 247 (Regression Analysis) in the textbook.
2) Answer the
questions at the end of the exercise.
3) APA format is not required,
but solid academic writing is expected.
4) This assignment
uses a grading rubric. Instructors will be using the rubric to grade the
assignment; therefore, students should review the rubric prior to beginning the
assignment to become familiar with the assignment criteria and expectations for
successful completion of the assignment.
HLT540 week 8 Proposal Development Paper Assignment
Details:
Write a proposal paper
(1,250-1,500 words) for a major change project that you would like to lead.
Identify a health care
issue that interests you and explain why.
Develop a rationale
using evidence-based research, including:
1) The background.
2) Statistical
findings.
3) Probable
stakeholders.
4) Logical
conclusions.
Design an
implementation plan for the project, including:
1) A communications
plan.
2) Creation of a
design and implementation team by roles.
List the strategies
you would use to lead the team to success and identify potential obstacles that
may be faced, along with plans to deal with them.
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.
This assignment uses a
grading rubric. Instructors will be using the rubric to grade the assignment;
therefore, students should review the rubric prior to beginning the assignment
to become familiar with the assignment criteria and expectations for successful
completion of the assignment.
HLT540 week 8 Stakeholder Scenario Assignment
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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