Decision-Making Case Study
October 22, 2012
Decision-Making Case Study
The current grave state of the economy has had a significant impact on health care across The United States. Massive budget cuts, reduced services, and limited access to care significantly have affected Medicaid patients. Hennepin County Clinic (HCC), a facility that provides health care to Medicaid patients, is dealing with an additional 15% budget cut that will force management to make decisions about which services must be changed or eliminated while still meeting the basic needs of the clients. Stemming from consumers’ increased demands for enhanced quality of care and greater accountability from health care organizations, leaders must engage in decision-making that incorporates evidence from well-conducted research whenever possible. The Informed Decisions Toolbox (IDT), a process of evidence-based decision-making, involves six steps in the decision-making process (Rundall, et. al, 2007). While every step is consequential, step two, the process of gathering evidenced-based sources of information, is the most important tool in decision-making. The IDT plays an important role in increasing organizational accountability, facilitating knowledge transfer within a facility, and contributing to a questioning organization. Step One
The first step in the IDT is formulating a question or questions behind the decision. This is done in such a way that will increase the likelihood of uncovering useful research studies. As a manager, one must discover what information is needed to make the best decision. When investigating the needs of Medicaid clients and deciding which clinical services to change or eliminate, it is vital to research information regarding the various services used by these patients. The manager must ask several questions. Do individuals enrolled in Medicaid have unique health needs that differ from the larger population? What are the services most utilized within HCC at any given time? In what ways will service cuts and elimination of resources affect the clients? What services can be outsourced to other facilities that accept Medicaid? Can the current physician staff be reduced, and the use of nurse practitioners and physician’s assistants be implemented? Step Two
After the questions are formulated, step two involves identifying credible sources of information to answer these questions. In an age of abundant technological resources, a large percentage of sources may be found on research-based websites, bibliographic databases, online academic and peer-reviewed journals, books or other publications, and government reports, to name a few (The Center for Health Research, 2011). It may also be helpful for the manager to locate internal information available within the clinic that will tailor to the unique needs of HCC. While the IDT mainly focuses on evidenced-based sources of information, the manager may also utilize supportive colloquial knowledge from and opinions of colleagues, employees, patients, and other health care professionals (Rundall, et. al, 2007). Steps Three, Four, and Five
Steps three through five take the collected research and evaluate its accuracy, applicability, and “actionability.” First, step three emphasizes the accuracy of the research presented. The manager must question if the research is of high-quality, originates from a credible source, presents complete and balanced viewpoints, and comprises reliable and valid measurements (The Center for Health Research, 2011). Step four highlights the applicability of the research. The manager must ask if the research is relevant to his or her question at hand and whether or not it applies specifically to HCC. Step five focuses on the “actionability” of the research. The manager needs to know how the research is going to be implemented and who exactly is going to do it. Step five also pertains to the implications and...
References: Buchen, I, & Rowley, L. (2000). The questioning culture: Perpetual state of the art. Performance
Improvement, (39)5, 26-30
Melynk, B., & Fineout-Overholt, E. (2005). Evidence based practice in nursing and healthcare.
Philadelphia, PA: Lippincott Williams & Wilkins.
Pentland, D., & Forsyth, K. (2011). Key characteristics of knowledge transfer and exchange in
healthcare: integrative literature review
Rundall, T., Martelli, P., Arroyo, L., McCurdy, R., Neuwirth, E., et al. (2007). The informed
toolbox: Tools for knowledge transfer and performance improvement
The Center for Health Research. (2011). The informed decisions toolbox. Retrieved from
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