Goal: To convince a group of people to use a specific, new type of antibiotic for patients pre-operatively in order to decrease surgical wound infections.

Scenario: You are a healthcare administrator that is trying to introduce a change in practice to a group of stakeholders. Your goal is to help them understand the rationale and need for the change, and to get a sense of the areas of resistance to the change. The change under discussion is to implement a new antibiotic to be given one hour before surgery starts as a way of reducing post-op wound infections. The Centers for Medicare and Medicaid Studies (CMS) have indicated that timely pre-op application of specific antibiotics is becoming a requirement and will be a publicly reported indicator on the CMS Web site for your hospital. Thus, institution of this new procedure is something you really need to pull off.

As the administrator in this scenario, you will hear the initial responses of each of the stakeholders. You will then be presented with several options for your response. Select the option you think is most effective.

Review the stakeholders' responses to the option you selected. According to their own perspectives and prerogatives, the stakeholders will respond in different ways to each choice. Your goal is to achieve some level of buy-in to the change.

Issues:

• The antibiotic is new and people aren't familiar with it.
• Requires administration within one hour of the actual surgery start time.
• Requires administration by IV.
• Adds a step to the busy pre-op nurse's work load.
• Saves the hospital $28,000 per year.
• Research shows wound infections down 47% with this new antibiotic if it is administered in a timely fashion.Players:

• Pharmacist: He's learned about the new antibiotic through his research studies, and is excited about using it.
• Pre-op Nurse: She is worried about having one more thing added to the pre-op activities list she must complete before the patient goes to surgery, but she's very interested in doing the right thing for her patients.
• Surgeon: He hates government mandates, doesn't like to be told what to do, generally has a pretty good track record for his patients' outcomes after surgery, but has no idea what his actual rates of wound infection are.
• Finance Analyst: It's all about the money. Don't make it harder by concentrating on anything other than the dollars.