Stakeholder Scenario<\/b><\/p>\n
Goal:<\/b> 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.<\/p>\n
Scenario: <\/b>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.<\/p>\n
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.<\/p>\n
Review the stakeholders\u2019 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.<\/p>\n
Issues: <\/p>\n
\u00b7 The antibiotic is new and people aren\u2019t familiar with it.<\/p>\n
\u00b7 Requires administration within one hour of the actual surgery start time.<\/p>\n
\u00b7 Requires administration by IV.<\/p>\n
\u00b7 Adds a step to the busy pre-op nurse\u2019s work load.<\/p>\n
\u00b7 Saves the hospital $28,000 per year.<\/p>\n
\u00b7 Research shows wound infections down 47% with this new antibiotic if it is administered in a timely fashion.<\/p>\n
Players:<\/p>\n
\u00b7 Pharmacist:<\/b> He\u2019s learned about the new antibiotic through his research studies, and is excited about using it.<\/p>\n
\u00b7 Pre-op Nurse:<\/b> 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\u2019s very interested in doing the right thing for her patients.<\/p>\n
\u00b7 Surgeon:<\/b> He hates government mandates, doesn\u2019t like to be told what to do, generally has a pretty good track record for his patients\u2019 outcomes after surgery, but has no idea what his actual rates of wound infection are.<\/p>\n
\u00b7 Finance Analyst:<\/b> It\u2019s all about the money. Don\u2019t make it harder by concentrating on anything other than the dollars.<\/p>\n
Stakeholders\u2019 Background Thinking<\/p>\n
Pharmacist:<\/b> 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.<\/p>\n
Pre-op Nurse:<\/b> I am just worn out trying to keep up with all the changes they keep hitting us with. It\u2019s hard enough to do my job and remember to do things differently and use different items. Why can\u2019t they give me a break? Now I\u2019ll 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.<\/p>\n
Physician:<\/b> 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\u2019ve been doing this for 30 years, and I know what works and what doesn\u2019t. 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\u2019m sure voting Libertarian in the next election!<\/p>\n
Financial Analyst:<\/b> 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\u2019t they get that it\u2019s all about the money? I wish they\u2019d just shut up and approve the change so we could go get lunch.<\/p>\n
First Responses of Stakeholders<\/p>\n
\u00b7 Pharmacist:<\/b> \u201cThis 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.\u201d<\/p>\n
\u00b7 Pre-op Nurse:<\/b> \u201cThis is going to take much more time. We\u2019ve 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.\u201d<\/p>\n
\u00b7 Surgeon:<\/b> \u201cWhat a bunch of horse hockey! I\u2019ve 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 \u2018cookbook\u2019 and it\u2019s ridiculous. They should just leave all that up to the doctor.\u201d<\/p>\n
\u00b7 Finance Analyst:<\/b> \u201cIt saves money. Just do it.\u201d<\/p>\n
Administrator\u2019s Response Options <\/p>\n
Select one:<\/b><\/p>\n
1) \u201cWell, we have to do this because it\u2019s a government requirement.\u201d<\/p>\n
2) \u201cYou all raise valid points of concern. The evidence shows a significant benefit to our patient care.\u201d<\/p>\n
3) \u201cWhat could be done in the implementation that would relieve some of your worries?\u201d<\/p>\n
Responses to Option 1<\/p>\n
Pharmacist:<\/b> \u201cWe can make this switch as soon as you are ready.\u201d<\/p>\n
Pre-Op Nurse:<\/b> \u201cWe\u2019ll have to tell the patient to come in four hours before the surgery to do this. What a pain.\u201d<\/p>\n
Surgeon:<\/b> \u201cThe heck with this. You can\u2019t make me do it.\u201d<\/p>\n
Finance Analyst:<\/b> \u201cIt saves money. Just do it.\u201d<\/p>\n
Responses to Option 2<\/p>\n
Pharmacist:<\/b> \u201cThere is a real benefit. Surgical site infections drop like crazy. It\u2019s the right thing to do.\u201d<\/p>\n
Pre-op Nurse:<\/b> \u201cI 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.\u201d<\/p>\n
Surgeon:<\/b> \u201cI\u2019m all about patient care, but why can\u2019t I use what I\u2019ve always used?\u201d<\/p>\n
Financial Analyst:<\/b> \u201cIt saves money. Just do it.\u201d<\/p>\n
Responses to Option 3<\/p>\n
Pharmacist:<\/b> \u201cIt 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.\u201d<\/p>\n
Pre-op Nurse:<\/b> \u201cThat would sure help me. We can begin by having the IVs pre-prepared so we just have to put the needle in the patient.\u201d<\/p>\n
Surgeon:<\/b> \u201cCan I see the data about wound infections? How do I stack up against other surgeons?\u201d<\/p>\n
Financial Analyst:<\/b> \u201cGreat, you all see it. It saves money. Let\u2019s do it.\u201d<\/p>\n
Assignment<\/b><\/p>\n
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.<\/p>\n
When involved in negotiations, key elements to remember include:<\/p>\n
\u00b7 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.<\/p>\n
\u00b7 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.<\/p>\n
\u00b7 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.<\/p>\n
\u00b7 Sometimes the best you can get in the initial conversations is a willingness to move away from \u201cI\u2019m not gonna.\u201d to \u201cLet me see the data.\u201d That\u2019s a big step toward willingness.<\/p>\n
Based on this initial scenario, develop an implementation plan. It should include:<\/p>\n
\u00b7 The administrator\u2019s initial statement of what is being implemented and why.<\/p>\n
\u00b7 (Review the stakeholder\u2019s background thinking and first responses.) The administrator\u2019s (your) response option choice.<\/p>\n
\u00b7 How to communicate with the stakeholders (especially if they need further convincing).<\/p>\n
\u00b7 What evaluation criteria are needed?<\/p>\n
\u00b7 Time frames.<\/p>\n
\u00b7 Other items you think would be valuable to include.<\/p>\n","protected":false},"excerpt":{"rendered":"
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 Read More …<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[],"tags":[],"class_list":["post-52274","post","type-post","status-publish","format-standard","hentry"],"_links":{"self":[{"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/posts\/52274","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/comments?post=52274"}],"version-history":[{"count":0,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/posts\/52274\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/media?parent=52274"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/categories?post=52274"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/tags?post=52274"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}