Introduction (5–6 slides)

Explain the importance of evidence-based decision making in health care. Discuss

how this evidence applies to patient care outcomes, financial outcomes, competitive advantage, and organizational transparency. Your slides must include:

•A definition of evidence-based decision making.

•An explanation of the relevance of evidence-bas.;ed decision making in the health care industry.

•A clearly defined the problem you intend to solve through the use of evidence-based decision making.

•A description of the types of HIT systems that recommend to support decision making.

Recommendation & Rationale (8–11 slides)

Using the data provided, analyze the current and future state of the ICU. Consider three scenarios for the future state, one without additional beds and two with additional beds. Based on your research and analysis, determine two viable scenarios for bed count and present these scenarios. Use graphics, text, and charts as required.

The slides and presenter notes should include:

•An overview of three options for the ICU that you analyzed. The presenter notes should provide a 2- to 3-paragraph analysis of the three options, using academic resources to support your options.

•A description of how each option will address the issues in the ICU. The presenter should provide 2- to 3-paragraph detailed explanation of how each option will address the issues in the ICU.

•A final recommendation for one of the options and an explanation of why it will maximize the benefits to the hospital, patients, and community.

•A detailed rationale justifying your recommendation.

•A graphic comparison between the current state of the ICU vs. the remote monitoring ICU implementation in 5 years. The presenter notes should include a detailed explanation of the graphic.

•An explanation of the impact of your recommendation on staffing, productivity, competitiveness, and finances, using appropriate qualitative and quantitative data to support your explanation. The presenter notes should include an explanation regarding how the data supports your explanation.

Evidence Evaluation

Knowing that United General’s leadership team focuses on evidence-based decision making, address the following, in 3–4 slides:

•Summarize the evidence used in developing the opportunity statement and recommendation.

•Describe why each piece of evidence is relevant to patients, the community, and the hospital.

•Summarize the analysis used to create the recommendation.

•Evaluate the validity and reliability of the data.

•Recommend methods to improve the validity and reliability of the data.

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Case Study – United General Hospital ICU Expansion Case StudyOverviewUnited General Hospital is a 15-year-old, 220-bed hospital built to serve a suburban community of90,000 residents, 60 miles outside Des Moines, Iowa. Of the beds, 10 are in the intensive care unit (ICU).Over the last 15 years, the community has grown to over 190,000 residents, who are supported byUnited General and four urgent care faciliTes. With the urgent care faciliTes able to address many of thepopulaTon’s non-emergency issues, there is an increase in the raTo between the use of the hospital’snon-ICU faciliTes and its ICU faciliTes. In a typical week, the ICU operates at 120% capacity and 40% ofpaTents experience a six- to eight-hour delay transferring to the ICU. ±he paTents remain either in theemergency department, creaTng an overcrowded emergency department, or in post-op, causingovercrowding and delays in scheduled surgeries.±he hospital has just received $15 million in funding and is considering expanding the ICU; however, theCEO is not convinced that expanding the ICU department is the right soluTon for the hospital. ±heanalysis is to include opTons that combine expanding the ICU department with using remote ICUmonitoring.±he ICU senior staF brought you, Raul Hemply, in as a consultant to build a business case to support thedecision to expand the ICU and use remote ICU monitoring. You will work with the ICU’s senior staF tobuild a business case and present it to the CEO and board of directors for ²nal consideraTon. ±here willbe great emphasis placed on data and analyses that support your recommendaTon. Because of this, youneed to use data derived from informed or objecTve sources, or evidence-based data, to build therecommendaTon. ±he CEO will want to know the sources, validity, and reliability of the evidencepresented.As you create your business case, there are several opTons to consider:1.Subscribe to remote ICU monitoring services with a per usage model so that you only pay forservices as they are rendered.2.Expand the ICU with a combinaTon of ICU beds and regular beds managed by a combinaTon ofbedside and remote ICU monitoring.3.Expand the ICU with ICU rooms managed by bedside teams.4.Expand the ICU and subscribe to remote ICU monitoring for rooms that will serve paTents withmore serious condiTons.2014 Walden University OM008

View the Answer

Excerpts of a conversaTon with George Mallory, the senior staF representaTveGeorge:Hello, Raul; it is good to meet you. We are looking forward to working with you on this businesscase to expand the ICU. We have already completed some research on the right size of the ICU, and wewill share that with you over the course of your invesTgaTon.Raul:Hi George, I appreciate you taking the Tme for this interview. ±his will help me in my research ofhow much to expand the ICU; I am also considering the use of remote ICU monitoring service as acomplement to expanding the ICU.George:Remote ICU monitoring services is a topic that will cause a lot of consternaTon here at UnitedGeneral. We have a number of staF members that fear that a remote service will put them out of a job,so I would touch lightly on that subject.Raul:Has your group done any research on remote ICU monitoring services in the area?George:We started to but realized that it was so controversial that it was not really an opTon. If you dolook into a remote service, please make sure to take the staF into account in the analysis.Raul:What caused the controversy with the idea of remote ICU monitoring?George: Physicians were reluctant to cede authority to a remote operaTon, and nurses were concernedabout a loss of autonomy. During a staF meeTng, a couple of nurses voiced concerns because theircolleagues complained of a poorly executed implementaTon.Raul: ±hank you George, I will. Can you tell me who on your staF has the research on the remote ICUmonitoring services?George:±hat would be ²rank. ²rank looked at the services from the standpoint of paTent and staFbene³ts and cost savings, as well as how the services help the paTent. We suggested that he speak tostaF in hospitals that have implemented these services to get their reacTon to the change, but he neverwent through with that because the staF here was so set against it. It will be a hard sell to the staF.Raul:±hank you for the heads up. Was there any other research completed about expanding the ICUthat I may be able to use?George:I cannot think of anything else. You may want to check with other hospitals that use theseservices, as part of your study.Raul:±hank you, George; I think I have enough to get started. I will check back with you if I need anyhelp.2014 Walden University OM008

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