Decision-Making Case Study Health Care Management

Standard County Public Health Clinic is located on Highway 25, North of Bloomfield, Missouri. The clinic provides services to infant and child; young and middle aged adults; older adults; environmental services; and group/community services. When the 2009 budget cuts were distributed among the different departments, the manager of the Young and Middle Aged Adult Department noted a 15% budget cut.

This paper is a case study of how the Young and Middle Aged Adult Department Manager will decide what tools she will use to decide which clinical service should be eliminated or introduced to better serve the Medicaid population at while at the name time make a 15% cut in its budget.

Clans Services Available and Staffing services available for the Young and Middle Aged Adult Department includes: breast and cervical screening project, anemia screening, sexually transmitted diseases, pregnancy testing, immunization, nutrition education, W.

I. C, women's health screenings, high risk pregnancy counseling and case management for prenatal (Standard County, 2008). Staffing for the department includes: Department Manager; 2 full-time Lips to perform screenings, draw blood samples and administer Immunization; 1 full-time nutritionist for the nutrition education; and 1 RAN Case Manager to manage the women's health screenings, high risk pregnancy counseling.

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The clerical staff is shared among the entire clinic.

The Department Manager looked at the year-to-date information for each service provided under her department with the thought of possibly eliminating a service to make up for the 15% budget cut. Upon reviewing the all statistics concerning frequency of use and after surveying all staff members within the clinic, it was determined that each service was very important to the Medicaid recipients of Standard County.

One suggestion from a staff member was to convert one of the full- time LIP positions to a part-time position and starting a clinical volunteer program.

Another position that could be changed from full-time to part-time is the Nutritionist. Statistics have shown that her services are only needed 4 hours a day Instead of the full 8 hours. The volunteers would be clinically proficient and could conduct the screenings that are very popular within Standard County. In order for the decision to be made, the Department Manager will need to make a decision to use a decision making analysis tool. The Informed Decisions Toolboxes option for the department manager can use to make a decision on how to manage a 15% budget cut for her clinic, is to use The Informed Decisions Toolbox developed by Thomas G.

Randall, PhD and his associates (University Of Phoenix, 2008). The toolbox is divided Into six steps to help managers make an informed decision. The six steps include: Step 1: Framing the question behind the decision; Step 2: Finding sources of information; Step 3: Assessing the Assessing the accountability of information; Step 6: Determining if the information is adequate (University Of Phoenix, 2008). Step 1: Framing the Question Behind the Decommissioned making an informed decision, the manager must formulate a research question out of the management question.

In this case study the management question is "How will the Young and Middle Aged Adult Department operate with a 15% budget cut? " The research question is "What clinical services should be eliminated or added to allow for the 15% budget cut within the Young and Middle Aged Adult Department's and how will it affect the profitability and quality of care outcomes during the 2009 budget year within the Medicaid population? " (University Of Phoenix, 2008). Step 2: Finding Sources of Informational 2 of The Informed Decisions Toolbox discusses different avenues of researching the management question.

These avenues include, but are not limited to: healthcare organization libraries, webmasters intranet information and in-house support systems; and the Internet. Step 2 also describes search tips that were very useful (University Of Phoenix, 2008). Step 3: Assessing the Accuracy of Informational 3 guides the user to asking the following questions to help ascertain whether the information is accurate: "Is the information valid and reliable? Is the information comprehensive? Am I missing important perspectives or aspects of my decision? (University Of Phoenix, 2008). Step 4: Assessing the Applicability of Information's step guides the user to decide if all the information accessed was applicable to making a decision. Step 5: Assessing the Accountability of Informational 5 will guide the user to determine if the information collected will provide useful recommendations to be implemented, what the expected effects may be of the decision and what are the possible effects that were not expected (University Of Phoenix, 2008).

Step 6: Determining if the Information is Adequateness last step will guide the user in making the determination as to when there has been enough information gathered to make a decision (University Of Phoenix, 2008). After reviewing the information on The Informed Decisions Toolbox, the Department Manager decided this tool wasn't useful for the type of decision that needed to be made. There are four key strategies that have been recommended for use that affects an organization when the toolbox is used:l . Strategy One: Recognize and Respond to the Growing Demand for Accountability as a Strategic Issue" (University of Phoenix, 008). Transfer" (University of Phoenix, 2008). 3. "Strategy Three: Build a Questioning Organizational Culture" (University of Phoenix). 4. "Strategy Four: Build Organizational Research Capabilities" (University of Phoenix, By using these strategies, an organization will be able to ensure that have all the research information at hand to help them stay accountable for their actions. It is also a way for sharing of knowledge and always questioning so as to build a stronger organization.

Devil's Advocate Deceitfulness's Advocate is a technique that is used in gathering he positive and the negative aspects to a decision that needs to be made (Libber & McConnell, 2008, p. 159). In this case, the Department Manager assigned the 2 Lips and Case Manager the task of brainstorming and writing down the negative aspects of her proposal and all the positive aspects to the proposal. Negative Sportscaster were some strong negative aspects that the team was able to verbalize during the brainstorming session. Some of the stronger comments were:l .

A full-time staff member will be required to have a change of status from full-time to part-time. This could cause the staff member make the decision to resign and find a position elsewhere. This will cause the Department to incur the expense of recruiting and training a replacement. 2. Cost of recruiting and training volunteer staff to make up for the h FEET position lost. 3. Loss of expertise from taking already fully training long-time employee out of the full-time position and replacing them with an inexperienced volunteer. Positive Sportscaster were some strong positive aspects that came from the brainstorming as well.