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Read and complete "Stakeholder Scenario" resource.
While APA format is not required for the body of this assignment, solid academic writing is
expected, and documentation of sources should be presented using APA formatting guidelines,
which can be found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to
become familiar with the expectations for successful completion. Stakeholder Scenario
Goal: To convince a group of people to use a specific, new type of antibiotic for patients preoperatively 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.
Grading Rubric as a guide for this assignment
Stakeholder Scenario
1
2
Unsatisfactor Less Than
y
Satisfactory
0.00%
65.00% 3
Satisfactory
75.00% 4
Good
85.00% 70.0 %Content
Failure to
Demonstrates Demonstrates
Demonstrates
40.0 %
ability to write a
Development of demonstrate only minimal basic ability to
the ability to ability to write write a proposal proposal for a
an
a proposal for for a major
major change
Implementation write a
proposal for a a major
change, but has project.
Plan Based on
slight
Addresses the
the Assignment major change change
project.
project. Only misunderstanding points required
Scenario. The
minimally
of addressing the in the
Administrator's Failure to
addresses the points required in assignment.
Initial Statement address the
points
the assignment. Develops a
of What is Being points
required in the required in
Develops an
logical
Implemented
assignment
the
incomplete
implementation
and Why; the
assignment
communications plan for the
Writer's Option directions.
directions.
plan and creation project,
Choice; How
of a design and
including a
Communication
implementation communications
to the
team by roles.
plan and
Stakeholders will
creation of a
be Effected;
design and
Evaluation
implementation
Criteria; Time
team by roles.
Frames for
Implementation;
and Other Items
to Include in the
Plan Should be
Included
Failure to use Provides some Supports main
Supports main
30.0 %
references,
supporting
points with
points with
Integration of
examples, or examples, but examples and
references,
Information
explanations. minimal
explanations, but explanations,
from Outside 5
Excellent
100.00%
Describes clearly
the ability to
write a complete
proposal for a
major change
project. Fully
develops an
implementation
plan for the
project, including
a
communications
plan and creation
of a design and
implementation
team by roles.
Shows evidence
of independent
thinking and
ability to plan
ahead for
problems. Supports main
points with
references,
examples, and explanations
and no
published
references
included. Resources into
the Body of
Paper 20.0
%Organization
and
Effectiveness
7.0 %
Assignment
Development
and Purpose Paper lacks
any
discernible
overall
purpose or
organizing
claim. fails to include
published
references to
support claims
and ideas. Thesis and/or Thesis and/or
main claim are main claim are
insufficiently apparent and
developed
appropriate to
and/or vague; purpose.
purpose is not
clear. and examples.
Analysis and
description is
direct,
competent, and
appropriate of
the criteria. full explanations
of how they
apply.
Thoughtfully
analyzes,
evaluates, and
describes major
points of the
criteria. Thesis and/or
Thesis and/or
main claim are main claim are
clear and
comprehensive.
forecast the
The essence of
development of the paper is
the paper. It is contained within
descriptive and the thesis. Thesis
reflective of the statement makes
arguments and the purpose of
appropriate to the paper clear.
the purpose.
Argument is
Argument shows Clear and
8.0 % Argument Statement of Sufficient
purpose is not justification of orderly, but may logical
convincing
Logic and
justified by the claims is
have a few
progression.
argument
Construction
conclusion.
lacking.
inconsistencies. Techniques of
presents a
The conclusion Argument
The argument
argumentation persuasive claim
does not
lacks
presents minimal are evident.
in a distinctive
support the
consistent
justification of
There is a
and compelling
claim made.
unity. There
claims. Argument smooth
manner. All
Argument is are obvious
logically, but not progression of sources are
incoherent and flaws in the
thoroughly,
claims from
authoritative.
uses
logic. Some
supports the
introduction to
noncredible
sources have purpose. Sources conclusion. Most
sources.
questionable used are credible. sources are
credibility.
Introduction and authoritative.
conclusion
bracket the
thesis.
5.0 % Mechanics Surface errors Frequent and Some mechanical Prose is largely Writer is clearly
are pervasive repetitive
errors or typos
free of
in command of
of Writing
enough that
mechanical
are present, but mechanical
standard,
(includes
they impede errors distract are not overly
errors, although written,
spelling,
communicatio the reader.
distracting to the a few may be
academic
punctuation,
n of meaning. Inconsistencie reader. Correct present. A
English.
grammar,
Inappropriate s in language sentence
variety of
language use)
word choice
choice
structure and
sentence
and/or
(register),
audiencestructures and
sentence
sentence
appropriate
effective figures
construction structure,
language are
of speech are
are used.
and/or word used.
used.
choice are
present.
10.0 %Format
Template is
Appropriate Appropriate
Appropriate
All format
5.0 % Paper
template is
template is used. template is fully elements are
Format (Use of not used
Formatting is
used. There are correct.
appropriate style appropriately, used, but
or
some elementscorrect, although virtually no
for the major
errors in
and assignment) documentation are missing or some minor format is
mistaken. A
errors may be
formatting style.
rarely followed lack of control present.
correctly.
with
formatting is
apparent.
Reference page is Reference page In-text citations
5.0 % Research No reference Reference
page is
included and lists is present and and a reference
Citations (In-text page is
included. No present.
sources used in fully inclusive of page are
citations for
citations are Citations are the paper.
all cited sources. complete and
paraphrasing
used.
inconsistently Sources are
Documentation correct. The
and direct
used.
appropriately
is appropriate
documentation of
quotes, and
documented,
and citation
cited sources is
reference page
although some
style is usually free of error.
listing and
errors may be
correct.
formatting, as
present
appropriate to
assignment and
style)
100 % Total
Weightage
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