Akron's Children's Hospital Replies

Akron Children’s Hospital

· What is the management-research question hierarchy for Akron Children’s Hospital?

The management-research question hierarch is a step process which produces several specific questions from an original question which gives management information to make a decision on correcting a problem. “The management-research hierarchy in a business institution is a decision aid which is extremely useful for multiple‐alternative decisions.” (Wolfe et al., 1986, p.15) It first starts out with a management dilemma, which in this case of Akron Children’s Hospital, is what do they need to do to get more patient’s to come to their hospital for treatment instead of their competitors in the region. The second step is the management questions which asks, how do they communicate and distinguish themselves above their competitors that show they are committed to children and to the highest-quality care with the most medically advanced care? The next step would be to research what to do to accomplish this task. In Akron Children’s Hospital, they needed to research how to get parents and children to want to come to their facility versus their competitors for treatment and care. They found out that patients gave high survey ratings to medical capabilities and care they received as high-quality. Both of these were all based on emotion. After the research, there comes the investigation portion. Akron hired Marcus Thomas LLC. To investigate and gather data on these emotions that drove the decisions on where to go. They decided to conduct an observation study where researchers would shadow physicians, patient and parents through the process of coming to the hospital. This would allow first hand data about the emotional rollercoaster that everyone goes through coming to the hospital. Once the data was collected, the measurement portion comes into play. The hospital needs to be able to measure how to correct any deficiencies to allow growth advancements. This is by compiling all the data that the observers noted about all the interactions that patients had with doctors, nurses and other staff members. The final step is the management decision on how to fix the dilemma. Akron decided to focus all of the hospital’s resources to helping every child reach their full potential. If a parent believed in their brand promise, then they would be able to trust Akron Children’s Hospital.

· What are the advantages/disadvantages of an observation study for this research?

Some of the advantages of observation studies for this research are that the researchers can get data fast and with little to no delay. This can occur because they become part of the medical staff that treat the children for their illness and can report back each day with this data so as the days and weeks progress, they can see trends and correlations occur as they happen. This is also the most simplest and inexpensive way to collect data. The researchers would only need limited training to collect data and so will reduce expenditures for conducting the research. “Despite methodological challenges, high-quality observational studies have an important role in comparative effectiveness research because they can address issues that are otherwise difficult or impossible to study.” (Dreyer et al., 2010, p.1820)

Some disadvantages of observation studies for this research would be the permission from the researchers to be able to watch and document information. A lot of patient’s parents would probably not want their child followed throughout the process because they are already in an uncomfortable situation and could possible cause an even more of an emotional strain on the whole family. This would cause researchers to not have the pool of applicants they would like to get in a timely manner. To get an accurate amount of patients to participate in this observation could be long and enduring. The researchers would also need to worry about protecting the patient’s HIPPA rights (Health Insurance Portability and Accountability Act). They must be aware that they cannot talk about the patient’s medical history or it would violate federal law about patient confidentiality.

· What does the brand promise recommendation reveal about what researchers experienced and concluded from their study?

What the brand promise recommendation revealed about what the researchers experienced while conducting the study was that during the entire process, emotions played a huge part of the process. This is particularly true because children who are sick is an emotional hardship that everyone is effected by. “Parental perspectives are important to consider when discussing serious illness care decisions for critically ill children.” (Wool et al., 2021, p.1) Children have not lived very long and have not experienced life and so when they get sick, the staff that are treating them, the parents as well as the children themselves all become emotionally attached. “Lo, children are an heritage of the LORD: and the fruit of the womb is his reward.” (Psalms 127:3) In my profession as a professional firefighter and EMT, I have experienced hardships with children on calls. It is the most difficult of calls and no matter how well everyone is prepared or work their hardest, it is an emotional journey that everyone wishes they did not have to experience. When Akron brand promise talks about the simple goal of helping every child reach their full potential is an emotional support statement for parents who are going through challenges and only want what’s best for their children. 

· If you were designing such an observation study, what would you direct researchers to record/look for/listen for?

If I were to design an observation study, I would still make it an observational study but implement certain restraints on the research. When it comes to observing, I would make sure to ask the parents if they are willing for us to observe the process and interactions that occur with their child. They would sign a consent form allowing us to observe only and not interact with them. I would also have rooms that would allow the observers not to be seen by the patients so that they are more comfortable during the process. This could be done by as simple as installing a video camera with audio or to have a two-way mirror where they can observe and hear without the patients seeing them. “Observation by the use of the video technique within healthcare settings has proven to be capable of providing a thorough insight into the complex clinical work practice and its context - including parts of the tacit practice.” (Hostgaard et al., 2012, p.1) This would also allow the data to be more accurate because it would not allow any type of interference or distraction to occur. Children are already scared at the hospitals or doctor’s office, the more comfortable we can make it the more accurate the data would be. During the observation, I would listen to how the interactions occur with the parents and with the children with all of the staff members. Patients need to be treated as people and not as a number or job that just needs to get completed. Having a personal bond with children, especially ones that are sick, is a great medical practice that some staff members are great at and some are not. This is called proper bedside manner. Laughter is also a great medicine, I have seen it work on numerous occasions on incidents and it will have a great physiological and psychological effect of the patients. All of this needs to be conveyed to the staff and what they need to instill during future trainings.

· What ethical issues would surface in hospital studies in general and this study in particular?

Some ethical issues that would surface in the hospital studies and in this study in particular would be the HIPPA laws. These laws are in place by the Federal Government to protect patients from outside entities that could release their medical information to people who are not authorized to see it. All medical information is confidential to anyone who is not responsible for the care of that patient or their loves ones. “The HIPAA Privacy Rule of 1996 was proposed as both a remedy to privacy concerns and as groundwork for a national health management registry.” (Benefield et al., 2006, p.274) Patients or patient’s parents need to be aware of their rights when it comes to allowing anyone to observe or witness medical procedures. Both the patient and the patient’s parents, as well as the observers, need to sign and be aware of all the HIPPA laws and that none will be broken during these observations.

References

Benefield, H. (June 2006), Communication and Records: HIPPA Issues When Working in Health Care Settings, Professional Psychology: Research and Practice, 37(3) 273-277.  https://web-s-ebscohost-com.ezproxy.liberty.edu/ehost/detail/detail?vid=1&sid=a2f8dab5-611c-4d1e-bb30-cbf9cd66bd75%40redis&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#AN=2006-07098-008&db=pdh

Dreyer, N. (October 2010), Why Observational Studies Should Be Among The Tools Used In Comparative Effectiveness Research, Health Affairs, 29(10) 1818-1825.  https://www.proquest.com/docview/759172304?pq-origsite=summon&accountid=12085

Hostgaard, A. (August 2012), BMC Medical Informatics and Decision Making, Video observation in HIT development: lessons learned on benefits and challenges, 12(91).  https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/1472-6947-12-91

New International Version Bible. (2000). Zondervan (Original Work Published 1973)

Wolfe, C. (October 1986), The Analytical Hierarch Process – An Aid To Decision Making, American Journal of Business, 1(2) 13-18.  https://www-emerald-com.ezproxy.liberty.edu/insight/content/doi/10.1108/19355181198600009/full/html

Wool, J. (February 2021), , Parental Decision-Making in the Pediatric Intensive Care Unit: An Integrative Review, Journal of Family Nursing, 27(2).  https://journals-sagepub-com.ezproxy.liberty.edu/doi/full/10.1177/1074840720975869?utm_source=summon&utm_medium=discovery-provider