Stakeholder and Resistance Analysis-Academic Medical Hospital Case

Stakeholder and Resistance Analysis-Academic Medical Hospital Case

1. Dr. George Calhoun, Chair of EM Dept.

• Motivations: achieving national EM program recognition and publications
• Has great influence over residents and attending
• Strategy: Peer advocacy through Dr Elbridge. Explaining to him that patient satisfaction may be recognized nationally.

1. Dr. Frank Boots (page 11), ED attending, and similar attending

• Was against 6-sigma data collection as this distracts the staff from patient care
• Dr James Wilson, the GB of the project and attending from surgery came to rescue Jane McCrea in explaining why the staff should collect the data: “Frank, wouldn’t you rather that the people who work here and know the system are the individuals conducting the study, as opposed to spending tons of funds to have some consulting firm come in here and tell us what to do?”
• Attending like Frank like 1-less funds to be spent on improvement projects, 2-people internally find the solutions. 3-see happier patients who have waited less. 4-spend less of their time on low-tech boring jobs. 5-get recognized for their contribution to improvements.
• Strategy: ask other physicians to approach them and advocate the project. Explain the benefits of the project to them personally. Make sure you avoid any suggestion that they do not understand improvement; attending like to be appreciated for their medical expertise as well as intelligence.

1. Dr. Terry Hamilton, Vice Chair of EM and Residency Program Director, Sponsor of the project

• Similar to Dr Frank Boots and very resistant to change.
• He cares about resident education and experience. Some residents work as physician in the ED.
• Motivations: less work for physicians, happier patients, and happy residents who learn the most.
• Strategy: His motivations are indeed in line with the outcomes of the project, so explain to him how the project meets his goals. Other CAP tools are recommended. For instance, approach from all organizational paths (top-down, bottom-up, and through peers). Dr James Wilson is his friend; James should talk to him. Dr. George Calhoun is his boss, get George on board and ask him to advocate. Residents are under his watch. Get residents on board and build a momentum to put pressure on him.

1. ED Nurses

• Interest: less work and happier patient
• A workshop to provide training and orientation. Explain how they benefit from the program. A fear this kind of people have is that such improvements may cut jobs. They must be trained that improvements like this can reassign their available time to more value-added activities leading to happier patient faces, smoother jobs, and financial benefit for the organization.