GC HLT540 week 8 Stakeholder Scenario Assignment
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.
