This paper will be presented from the perspective of an assistant director of a hospital. The paper will discuss a problem impacting the facility, the service line associated therewith, the focus of the research project designed to address the problem, the manner in which the research collected will assist in the resolution of the problem, detail the sources of data that would be used to gather information on the problem, and detail at least three research questions that would need to be answered to ensure the successful resolution of the problem.
As the assistant director of the cardiovascular service line at an 800-bed acute care hospital who has only been present on the job for a few weeks, imagine the surprise when the director comes up and indicates that the responsibility of completing a research project has been tasked to this office. The focus of the research project is both simple and incredibly complex at the same time. The director indicated that the integration of the “cardiovascular service line (was) probably the most disruptive innovation our organization has ever experienced” (Dunn, 2012, p. 1). The issue, he indicated, was not the cardiovascular service line itself, but rather the issues that were created from an administrative standpoint with the shift from a vertical delivery structure to a horizontal one, which, while overall beneficial for the hospital’s statistics, served to create issues of discontent and a lack of knowledge or awareness as to who was tasked with the completion of certain responsibilities, creating vacuums in some areas, resulting in tasks being left incomplete, and turf wars in others, wherein too many people tried to step in and address the same responsibilities (Dunn, 2012).
When implementing a service line model that employs clinical specialties, the primary reason for the same is the benefits that are afforded by the use thereof due to the integral design and the focus afforded on the delivery of healthcare (Rodak, 2012a). In spite of the benefits, if there are issues during the implementation process, such as a lack of attention to the management structure or a lack of alignment with the strategic plan set forth by the hospital, difficulties may ensue, creating the problem that has been identified as necessitating further research (Dunn, 2012; Rodak, 2012a). The shift to the service line model stems from the increasing pressures on “hospital-physician alignment and coordinated care,” allowing for the promotion of collaboration and integrated care, as opposed to segregation and segmentation between departments (Rodak, 2012b, p. 1). Research into this area of concern will allow for a shift from the top down approach to management, incorporating both horizontal and vertical responsibilities, reducing tensions, decreasing issues, and working to ensure that all areas are addressed and that no responsibilities are duplicated or over managed (Dunn, 2012).
When the service line model is implemented successfully, there is no issue present in terms of alignment or in terms of responsibility (Rodak, 2012a; 2012b). As there is no set means through which the model can be applied, however, issues such as the one occurring within this hospital are a distinct concern (Rodak, 2012a). Reduced communication between departments, a feature of the most common original hospital model prior to the implementation of the service line model, can work to further compound issues if effective communication plans are not implemented and if duties are not clearly spelled out. Administration may believe that such concerns will not be a problem, as individuals within the different service lines will simply know what needs to be done, but without a clear strategy, the change from one model to one of a highly different nature can result in problems not anticipated by those implementing the change. In situations such as this, it becomes necessary to work to address the problem with all due haste, working not only to correct the matter but also to ensure that the problem that was created due to a lack of knowledge regarding current practices and a lack of a viable change management plan will not cost lives or serve to create an environment of increasing hostility, the result of which can be still further errors and the potential for even greater catastrophe.
On order to research the identified problem, it is necessary to determine the type of data that will be collected. As this is as much a human problem as it is a problem with administration, a mixed methodology study has been determined as the most logical approach to the matter (Creswell, 2013). The collection of quantitative data will allow for an understanding of the statistics of the matter, allowing for the identification of the areas of administrative duties and concerns that are lacking, while the collection of qualitative data will allow for an understanding, from the human perspective, as to why no one is completing certain tasks or why too many people are completing certain tasks; the collection of perspectives on this matter will allow not only for the identification of the same but gain insight into the most effective means through which to tackle those areas.
Quantitative data will be collected through a review of budgets, statistics concerning productivity, and results. Qualitative data will be collected through the completion of interviews, focus groups, and open-ended questionnaires to ensure that all perceptions may be understood. Through an understanding of this information, the requisite information regarding the best means through which to address this problem may be found.
The following research questions have been identified as the questions whose answers must be sought to resolve the problem:
What are the perceptions of individuals within the service lines concerning the completion of duties?
How are parties determining who will complete certain duties when those duties are not clearly delineated in the service line model implemented?
What areas of concern are being over addressed?
What areas of concern are being under addressed?
By working to answer these questions within the context of duties completed in the service line model implemented by the hospital, it will become possible to work to resolve the problem currently being faced therein.
Regardless of the amount of time an individual is in a position, if he or she is tasked with the responsibility of working to investigate a given problem and identify the manner in which the problem may be resolved, it is vital that he or she has the knowledge and tools necessary to know how to effectively approach the problem. This matter holds doubly true within hospital administration, where failure to resolve a problem could result in lives lost, higher costs, and corners being cut. Through the application of basic research principles, research design, and research methodology, any member of hospital administration will be able to not only take an identified problem, but determine the manner in which he or she should work to identify the requisite information and complete the task assigned to him or her.
While identifying the manner in which it becomes necessary to work to research the problem is not the only thing that must be done by department administration, it is the first step in working to understand the problem and the manner in which it originated. By understanding how the problem originated, it then becomes possible to determine the solution. Once the potential solution has been determined, the necessary steps to implement a change management plan to resolve the issue may then be identified and implemented, and the cycle can continue. A hospital is, in many regards, a living, breathing organism, and like all organisms, issues can arise in the functioning of the same, necessitating diagnosis and treatment, much in the same way that the patients of the hospital experience issues that necessitate resolution toward the successful operation of the same.
- Creswell, J. (2013). Qualitative inquiry & research design (3rd ed.). Thousand Oaks: Sage Publications.
- Dunn, L. (2012). Developing a Cardiovascular Service Line: Shifting From a Vertical to Horizontal Mindset. Beckershospitalreview.com. Retrieved 6 February 2016, from http://www.beckershospitalreview.com/hospital-key-specialties/developing-a-cardiovascular-service-line-shifting-from-a-vertical-to-horizontal-mindset.html
- Rodak, S. (2012). From Silos to Service Lines: Integrating Care to Meet Hospital Goals. Beckershospitalreview.com. Retrieved 6 February 2016, from http://www.beckershospitalreview.com/hospital-key-specialties/from-silos-to-service-lines-integrating-care-to-meet-hospital-goals.html
- Rodak, S. (2012). Structuring Hospital Service Line Management for Success. Beckershospitalreview.com. Retrieved 6 February 2016, from http://www.beckershospitalreview.com/hospital-key-specialties/structuring-hospital-service-line-management-for-success.html