Case Study Decision Making

Decision-Making Case Study

HCS/514

Decision-Making Case Study

The current state of the economy has had a significant impact on health care across the country. Recipients of Medicaid services have especially been hit hard in the health care arena with budget cuts and reduced services. The Maricopa County Clinic is not different when it comes to budget cuts. The department providing outpatient services to Medicaid clients has received a 15% budget cut. The current budget constraint is now going to force decisions to be made regarding what clinical services should be eliminated or what changes could best address the health care needs of Medicaid population.

To be able to determine the decisions that need to be made the Informed Decisions Toolbox will be utilized to assist the team. According to Rundall, et al. the Informed Decisions Toolbox facilitates the use of research evidence in decision making. The first step is framing the Question (2007). This would require looking at what information is needed in order to be able to make decisions regarding the services provided. Specific questions would be what services can be provided by another entity to these patient's? What resources are available to the Medicaid patients of the clinic? Look at the needs of the patients at the clinic and determine what patient's are likely seen for is it minor health issues such as sore throats, cold and flu symptoms, cuts or sprains? What are the specifics that impact the budget outside of patient care? What are the average times that patient's are visiting? Is it busier after hours, weekends, or during the day? As well as any specific questions that mightier be pertinent to the stakeholders at the clinic, for example question that are specific to overhead, such as laboratory work, staffing, even janitorial services.

After framing the question the next step according to Rundall, et al. step 2 is finding sources of information (2007). When it comes to the budget at the clinic and looking at sources of information this can be done in a variety of ways. Some examples include utilizing the internet, looking at reports and data, or looking at internal information available within the clinic. According to Rundall, et al. with the recent development of several trustworthy websites, decision makers now have relatively easy access to high-quality systematic reviews and meta-analyses of the available data on a given topic (2007).

The next 3 steps referred to by Rundall, et al. include step 3: assessing the accuracy of the evidence, step 4: assessing the applicability of the evidence, step 5: assessing the "actionability" of the evidence (2007). It is these steps for example, when looking at the needs of the clinic the decision makers could look at the specific needs of the patients that are seen. Additional information can be evaluated regarding the specific level of services that have been provided in the past, and seeing what options are available to continue these services in the future as well as looking at what could be outsourced in order to help the bottom line. According to Liebler & McConnell, outsourcing is simply the process of having certain services that could be provided internally performed by agencies or individuals external to the organization (p. 189).

The final step, step 6 in the IDT process according to Rundall, et al. is determining if the information is adequate given the organization's needs, values and context (2007). The decisions that are going to impact the final budget will be long term and as a result they will impact the recipients of services at the clinic. The decision makers in the clinic want to make certain that the decisions that are made are in line with accurate information and also

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