All work mus be original and plagiarism free. What you are doing is writing 50 words like you and the student had a face to face discussion about what they wrote as it pertains to the original question and also give your inputs and thoughts.
Student #1 Response
A rule of thumb, to me, is a very broad practice or principle that is brought about based on previous experience. It is a convenient tool to use for quick decision making. It is not specific, strict, or an accurate calculation, but rather a generalization.
Step 0: What is an important decision that needs to be made frequently?
a) The decision to be made:
Adequate staffing of the Materials Management Department at Mosaic Life Care Hospital
b) The analysis:
If time was not an issue and there were no constraints, the following components would come in to play when deciding how to accurately staff and schedule the Mat. Mgmt. department:
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How many areas and par levels need to be counted and/or filled on any given day? (Certain areas are counted and filled every day, while others are counted on Mondays, Wednesdays, and Fridays, or a simple Tuesday and Thursday rotation, etc.).
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What is the current hospital census? (total number of patients, considering outpatient and admits)
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How many surgeries are scheduled that will result in a multiple-day patient admission?
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How large was the supply order on the previous day? (The supply truck arrives each morning at 4 AM with the supplies ordered on the previous day – adequate staff is needed to unload the truck.)
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What percentage of productivity is Mat. Mgt. operating with? (HR has a calculation that is used to determine productivity. It considers census, how many tickets were picked, how many people were scheduled, and overall how much work was done).
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What skill sets are used for which job tasks? (This needs to be considered so our $17/hr. positions are not doing the tasks of a $10/hr. position).
Step 1: The decision analysis shortcut
The decision analysis shortcut (rule of thumb):
There are 3 main areas that are staffed in the department. These are OR Supply, Floor Supply, and Storeroom Supply. Right now, the rule of thumb for the OR Supply is 3 caregivers, 1 for each OR hallway. The Floor Supply is similar in the sense that we schedule 1 caregiver per floor, for a total of 3. Our system averages a total 300 supply requests, or tickets, per day. We staff 1 caregiver per 75 tickets for a total of 4 caregivers. There is currently no set standard or policy for how many caregivers is required to count and re-stock supplies for the main hospital campus. Therefore, our rules of thumb have been put into practice.
These decisions and “rules of thumb” have been developed and implemented based on years of experience. These practices generally provide enough coverage for all of the necessary tasks to be completed each day. Our rule of thumb provides sufficient on an average day. However, when a caregiver calls in sick, there is on-site training which takes time out of everyone’s day, or an unexpected disaster bringing in large volumes of patients; caregivers are required to stay late to complete all of the tasks which results in large amounts of overtime pay.
Step 2: Success example
Give an example of where this decision analysis shortcut comes close (or would come close, if the rule is new) to the correct decision.
Step 3: Failure example
Give an actual example of where it failed badly and explain why (or where it may fail badly, if you are suggesting a new rule).
On Friday, October 21, 2016, there was an explosion in Atchison, Kansas which is only approximately 30 miles away. This explosion took place MGP Ingredients, Inc. due to a bad mixture of chemical components. This resulted in thousands of people in the local community needing medical treatment for breathing in harmful gases. Hundreds of these individuals drove to our facility to seek treatment.
Per Mosaic protocol, if a situation occurs that will bring in a mass amount of patients, each department is required to send caregivers to the ER and temporary decontamination areas to assist. By pulling staff to help out in another department, normal daily tasks are put on the back-burner and there is not sufficient staff to continue working in Mat. Mgmt.
On this particular day, we had 6 caregivers that each worked at least 4 hours of overtime to get everything done.
Step 4: Improvements
We currently have no forgiveness or breathing room in our staffing plan. If one caregiver calls in sick or has something unexpected come up, it can potentially throw the day off for the entire department. A suggestion for improvement would be to create a PRN position for the department. Being PRN status, our cost center would not be responsible for providing medical benefits and would have the ability to keep the description minimal. This would allow us to keep the position pay range to the lower end of the scale. Since this position would be designed to go wherever there is a need, minimal training and experience would be required, as we would have experienced staff maintain the critical areas in the event of a shortage.
At Mosaic, PRN status is basically on-call. They work when we call and state that there is a need for help, and there is no guarantee of a certain number of hours per week. If we had the luxury of being able to schedule a PRN person each day if necessary, our problems would be alleviated. Also, the last round of applications that were submitted in my inbox proved that there was a lot of interest in non-full-time work. Many local college students and such are looking for part-time or PRN employment. They do not desire a wage that is unattainable and they are well-qualified to meet our department needs.
The analytics will help in avoiding failure because if we have the ability to be flexible with our scheduling and can call in our PRN person when census is up on the nursing units, or when the Security department needs to perform an on-site training for the new “Active Shooter” plan of action, we aren’t letting our end-users down. Also, this design benefits our staff as well because they can come in for their shift knowing what time they start and what time they get off. There would be no unexpected overtime hours or staying until the job gets done.
Step 5: Testing
Mosaic Life Care has an excellent working relationship with two different staffing and employment agencies here in town. IMKO is the agency used most frequently. If we can create a temporary job ticket with the agency and provide them with at least 24 hours of notice for a staffing need, we can bring in a temporary individual to help fill the gaps. Approximately 3 months of data should provide sufficient evidence to HR that there is a definite need for an additional person. At that point, we can initiate the FTE request process (a process Mosaic uses to create positions for departments that need them – it includes descriptions and cost savings and analysis).
Since we are not the only department with staffing issues, our model can be followed by other departments. I understand that many areas share the same frustrations with unnecessary overtime hours so this will be welcomed with open arms. This plan would uphold our current contracts with the staffing agencies, while also providing the work force that is needed.
Student #2 Response
Below is my Unit 4 Discussion.
Definition of Rule of Thumb: Decisions based on wisdom or experience instead of policies or procedures.
Step 0: What is an important decision that needs to be made frequently?
a. The decision to be made:
Physicians have to decide if antibiotics need to be prescribed for patients presenting with sore throats. While only a small percent of patients with sore throats who are seen are found on throat culture to have strep throat infection, antibiotics are prescribed 75% of the time for these patients. There are concerns about rising rates of antibiotic resistance and the role of physicians’ prescription practices.
b. The analysis:
Physicians are trained to use a scoring system and are shown to improve their estimates of the probability of strep throat infection. Physicians are supposed to link score-derived recommendations as a way of limiting the impact of non-clinical factors on prescribing decisions in sore throat presentations. Physicians are supposed to incorporate the probability from the score into the decision process.
Step 1: The decision analysis shortcut (rule of thumb)
A physician decided about the need for a patient to receive antibiotics of her sore throat based on his experience of caring for patients with sore throats being ranked as of low, moderate, and high probabilities of strep infection. He based his rule of thumb decision on an assumption that the patient’s sore throat could be related to strep throat since he had patients in the past that had strep throat related to sore throat symptoms. Even though a physician is taught to estimate the probability of strep infection more accurately using a clinical score, the relative ranking remains unchanged and so the antibiotic prescription patterns remain the same.
Step 2: Success example
A patient that was seen 1 week after being prescribed an antibiotic for sore throat indicated that she was feeling much better after taking the antibiotic as prescribed. Her social and psychological features and expectations for antibiotics were considered a successful decision by her physician.
Step 3: Failure example
A patient developed an infection from an antibiotic that was prescribed for his sore throat. The antibiotic did not combine favorably with medications already prescribed for his coronary artery disease.
Step 4: Improvements
Physicians need to demonstrate that their decision to prescribe antibiotics for patients presenting with sore throats fall within the expected standard of care and ensure that the antibiotics do not intervene with other medications that the patient may be taking for other medical conditions. Physicians who use analytics as an explicit decision-support tool for evaluating patients with sore throats can reduce their overall prescribing of antibiotics.
Step 5: Testing
A randomized trial needs to be conducted to show the effects on the prescription of antibiotics for patients with sore throats of an explicit decision-support tool that cues physicians during patient encounters to use a sore throat scoring system linked to specific management recommendations. Physicians should be trained in the use of the scoring system with an interactive computer program, provided with periodic disease prevalence reports, and given a lecture. Exposure to score-related information will give physicians the ability to suggest appropriate management steps to take at the time they assess a patient. Using a scoring system during clinical encounters may be an effective way to lower unnecessary antibiotic prescribing by physicians.
