Answer Happy

aises a new issue. As you continue to evaluate the data and discreetly talk to other clini. the local reporter who sometimes covers healthcare calls your ofhce and Amour Secretariat procedure. Your first reaction is to start listing names of As for the mortality rates of your cardiovascular surgery program, includ- emal people who may have leaked this to the press. Once you calm down, you call in your staff attorney to begin debating how to respond, and she According to her interpretation of the Health Insurance Portability and Accountability Act (HIPAA), even if you wanted to report mortality data the media, the numbers of cases per month for the Secretariat procedure of so small that you would violate HIPAA. She cites the Center for Health Satistics as well as several articles in health law journals on the topic. You are confused. You have been considering posting mortality and quality data on your hospital website. You have even seen physicians post their data on the Secretariat procedure on their websites. The pressure of negative media attention to the Secretariat procedure, the surgeon's career, and your hospital all begin to weigh on you. You even have a friend to whom you recommended the procedure who will definitely call once this story runs in the newspaper. Question 7. What do you think your ethical responsibility is to your patients when it comes to making public your mortality data? To your board of directors? To your staff? A simple decision tree, part of systems thinking, can often be useful in helping a leader determine the risks involved in making decisions (or in not making a decision. Plenty of public information is available about deci- sion trees, and for leaders they serve as an artificial tool to force one to think through the ramifications of decisions. Ultimately decision trees help leaders think about additional information they may want to access and comprehend before making a decision on emotion or gut instincts. Exhibit 0.2 provides an example of a decision tree. The simple deci- sion tree helps guide a leader or a team through the process of evaluating (1) whether to offer a new clinical service, (2) the process for approval to offer a new service, and (3) the output of the decision. This decision tree might help a team remember that as part of the approval path, certain licensure or certificate of need requirements must be thought through before launching the new service.
Offer a new clinical service Tree ring ical Evaluate patient demand ices Build new Approach partners Evaluate investment needed Project to expensive Propose approval path: Medical staff Board of directors Regulators Payers Propose approval path: Medical staff Board of directors Regulators Payers Evaluate program End program Continue program Questions 8. Draw a simple decision tree of your decision making as you solve the problem of how to respond to the media and the implications of your response. Start with “provide data" versus "protect data." 9. How do you propose to balance your responsibility to the community, the hospital, and HIPAA as you respond to the media? You meet with the chair of your hospital's board of directors. She one of the few people with whom you are able to discuss openly many topics and, of course, this issue tops both of your lists. You share that while som members of your medical staft express concern, other members of your staff are aggressively pushing you not to halt the program. They are telling you unequivocally that without this procedure available, you are at risk of quickly losing many of your top specialists. The board chair, a local banker, asks a simple question: "It doesn't seem that your surgeon is doing a tremendous number of these surgeries. What is the real market for this procedure
You interpret this in two ways. First, clearly you have not yet articulated the value of the program, and second, you have not yet calculated the possible patient population for your referral area. Questions 10. In articulating the value of your clinical program, how might you go about understanding the evidence around a new procedure? 11. You ask your financial analyst to meet with you about the program. How might the two of you go about understanding the size of the market opportunity? Elemento Ons agrees to builds You and your chief medical officer meet with the young surgeon, and he participate in an evaluation of his program. During the meeting he a case that he has much more experience with the Secretariat procedure aw and knows that his mortality rates will soon be in line. He dearly states that f his program is put on hold, he will start looking for another place to practice. Your senior management team then meets to discuss next steps with the Secretariat procedure. Your chief nursing officer (CNO) suggests putting wgether a review team to perform a needs assessment, including quality assess- ment, measurement, control, and improvement. Everyone agrees. Unsaid in the meeting is that the Secretariat procedure will continuc. 13 What types Questions 12. Think about all of the parts of the surgical process (registration, financial counseling, pre-operation, anesthesia, intensive care, post- operation, and so on). Who would you recommend participate in a review and feedback of the program. How can you ensure an appropriate feedback loop is developed based on the participants? of measures would you suggest tracking to help you better understand the progress of the program 14. As the leader of the hospital, develop talking points that defend keeping the Secretariat procedure active but under review. Develop three potential questions you should expect from staff or external audiences, and provide reasonable defenses to these questions anal, such as worrying about staffing needs and providing day-to-da As CEO you work your way back into the daily grind of running the Sagement of the clinical and nonclinical staff. After a report to the boar went that the crisis has passed. Your board chair has not pressed you strong financial bottom line for the last 12 months, you start to fe wp information, and everyone seems more than happy to leaved at the past.