Labor and Delivery Services:You are the new manager of the Social Services Department of a small, 18-bed rural hospital within the Bright Road Health Care System. As a member of the ethics committee for the hospital, you have been asked by the CEO and CFO to contribute to an initial discussion about whether or not to continue having labor and delivery in the hospital. You will speak with Board members and hospital staff members to uncover the hospital, patient, and community impact of such a decision. You will submit their recommendation, along with their rationale, to the committee.Equipment Purchase:You are the CFO of small rural women’s health center within Bright Road Health Care System. The center’s physicians have approached you about purchasing a mammography 3D machine. The equipment is state-of-the-art and excellent for early diagnosis, but the women’s health center has limited funds and currently does not have a large incidence of breast cancer diagnosis. In addition to thinking about the impact of the machine on early diagnosis and increasing revenue, you are keenly aware of the importance of keeping the young physicians happy, in order to retain staff. On the other hand, the Board of Directors has indicated they want to keep a tight control over frivolous spending, as they are uncertain how new regulations like the ACA will impact the solvency of the corporation. You will need to balance financial concerns, the authority of the Board of Directors, public relations/marketing, the wishes of medical staff, and future implications when making a decision.Two recommendations. which is two seperate email bodys.  Note key points and back up with the facts from the notes
Labor and Delivery Services:You are the new manager of the Social Services Department of a small, 18-bed rural hospital within the Bright Road Health Care System. As a member of the ethics committee f
Health Care Ethics Navigate 2 Scenario : Continuing Obstetric Care at Bright Road December 21 , 2017 Continuing Obstetric Care at Bright Road Introduction: You are the new manager of the Social Services Department of a small, 18 -bed rural hospital within the Bright Road Health Care System. As a member of the ethics committee for the hospital, you have been asked by th e CEO and CFO to contribute to an initial discussion about whether or not to continue having labor and delivery in the hospital. You will speak wi th Board members and hospital staff members to uncover th e hospital, patient, and community impact of such a decision. You will submit your recommendation, along with your rationale, to the committee. Characters: 1. Jeff Passmore, General Counsel for Bright Roads Health Care System 2. Blake Hines , CEO of Bright Road’s Health Care System 3. Kimberly O’Neill , CFO of Bright Road’s Health Care System 4. Ken Bloom, Chief Nursing Officer 5. Sofia Lozano, Concerned citizen Locations: 1. Manager of Social Services’ Office 2. Women’s H ealth Center Conference Room 3. Hospital Corridor 4. General Counsel’s Office 5. CEO’s Office Health Care Ethics Navigate 2 Scenario : Continuing Obstetric Care at Bright Road December 21 , 2017 Scene 1: Meeting Request In this scene, the Social Services Manager is sitting at their desk, checking their calendar and reading email. Location Manager of Social Services’ Office Scene setup The student is looking at the computer On -screen characters None Off -screen characters N/A On -screen text: Let’s see what is on your calendar and then it’s time to check email. Note: A calendar button flashes on screen for student to click. CALENDAR FOR THURSDAY THE 10 TH 1:00 PM: Lunch with Ken Bloom Note: An email button flashes on screen for student to click. EMAIL FROM BLAKE HINES Good morning, As part of the ethics committee, you may know that the administration has been discussing whether or not Bright Road should continue providing labor and delivery services. This is a highly contentious issue due to competing interests, namely the willingne ss and ability of the hospital to continue providing these services in a cost -effective manner weighed against the overwhelming demand by the community. As you know, we are the only hospital in the county to provide these services. If you have time this morning, Kimberly O’Neill and I will be discussing this issue and we’d love to get your input. Are you available at 11 AM? We will be onsite in the large conference room. Best, Blake Blake Hines, Bright Road Health Care System CEO Health Care Ethics Navigate 2 Scenario : Continuing Obstetric Care at Bright Road December 21 , 2017 On -screen text: You’d better respond quickly and go! Note: Email response button flashes on screen for student to click. EMAIL RESPONSE OPTION 1 (CORRECT) Good Morning Blake, Thank you for including me. I will be there. Best, Social Services Manager EMAIL RESPONSE OPTION 2 (INCORRECT) Good Morning Blake, I just read your email and I don’t really have time to come discuss this issue today. But perhaps we should stop providing the service; I don’t think it will have much impact. Talk to you later, Social Services Manager Note: Student choosing option 1 allows student to continue. Selection of Option 2 will trigger response 2 and kick student back to options. On -screen text (RESPONSE 1): Great, you’d better get your things together and don’t forget to take notes at your me eting! On -screen text (RESPONSE 2): That’s not really a productive or constructive way to respond to the CEO’s request. You’d better try again. END OF SCENE 1 Health Care Ethics Navigate 2 Scenario : Continuing Obstetric Care at Bright Road December 21 , 2017 Scene 2: Outlining the Issue In this scene, the student meets with the CEO and CFO to hear th e details of the ethics committee discussion on whether or not Bright Road should continue providing labor and delivery at the rural hospital. Location Women’s Health Center Conference Room Scene setup Blake Hines and Kimberly O’Neill are sitting at the conference room table. On -screen characters Blake Hines, Kimberly O’Neill Off -screen characters N/A On -screen text: You meet with Blake and Kimberly. Be sure you take good notes! Note: Blake and Kimberly are sitting across the table in Bright Road’s Conference Room. BLAKE HINES Thank you for meeting on such short notice. We were just starting to talk about the issue. I know you’re new to our team. Have you met Kimberly O’Neill? STUDENT OPTION 1 Yes. You are Bright Road’s Chief Financial Offi cer, right? KIMBERLY O’NEILL RESPONSE 1 Yes! It’s good to see you. STUDENT OPTION 2 No, I don’t believe so. KIMBERLY O’NEILL RESPONSE 2 I’m KimberlyO’Neill, Bright Road’s Chief Financial Officer. It’s nice to meet you. BLAKE HINES RESPONSE 2 Kim and I were just talking about what kinds of services we currently provide. This hospital has one Ob/Gyn on staff, Dr. Linda Miller who provides labor and delivery services. On -screen text: It’s time to get more information about the hospital’s Ob/Gyn s ervices… Note: Student must choose both options in order to proceed. STUDENT OPTION 1 Do we have a backup Ob/Gyn who can help Dr. Miller out? BLAKE HINES RESPONSE 1 No, we don’t. We have staff that can generally help out in an emergency until Dr. Miller arrives, but none that have her qualifications. Health Care Ethics Navigate 2 Scenario : Continuing Obstetric Care at Bright Road December 21 , 2017 STUDENT OPTION 2 I know that we’re the only hospital in the county. Is there any other Ob/Gyn that provides these services to our community? BLAKE HINES RESPONSE 2 No, unfortunately. We are in a h istorically underserved area and it’s difficult to recruit Ob/Gyn specialists to come out here to practice. Note: Students must choose all options in order to proceed. STUDENT Where’s the next closest hospital that provides labor and delivery services? BLAKE HINES We’re the only hospital in the county. The closest hospital to provide labor and delivery services is about 80 miles away, which is a pretty long drive for someone who’s in labor. Student can choose either option to proceed. STUDENT OPTION 1 It sounds like the community relies on the service. Why are we thinking of discontinuing it? ** STUDENT OPTION 2 So, why would we discontinue the service, when it seems so necessary? KIMBERLY O’NEILL Well, cost quite frankly. Dr. Miller’s malpractice i nsurance increases every year and it’s becoming difficult to keep her here due to her not having backup coverage. BLAKE HINES And women often wait until late in the second trimester or even in the third trimester to start their prenatal care, which can make things more complicated for their doctors. On -screen text: Now, it’s time to talk about alternatives… Note: The student must choose all options in order to proceed. STUDENT OPTION 1 Would Bright Road be willing to hire another Ob/Gyn? KIMBERLY O’NEILL RESPONSE 1 I don’t know how that would be financially possible. As a rural hospital, we tend to run pretty close to cost and don’t have a lot of room in our budget. I suppose the next time we hire, we could look for a physician willing to be the backup for Dr. Miller. Health Care Ethics Navigate 2 Scenario : Continuing Obstetric Care at Bright Road December 21 , 2017 STUDENT OPTION 2 Would our family practitioner be willing to act as the backup for Dr. Miller? KIMBERLY O’NEILL RESPONSE 2 Unfortunately, no. We floated that idea to him but he was reluctant for the same reasons a lot of physici ans don’t go into obstetrics. He doesn’t like unpredictable hours, and doesn’t want to carry the additional insurance. STUDENT Does the community understand the difficulty of finding and keeping an Ob/Gyn on staff? BLAKE HINES Yes, I think that the c ommunity understands and appreciates that we are the only health care provider in the area willing to provide this service. If we stop providing this service, the community will likely be upset. Student can choose either option to proceed. STUDENT OPTION 1 How do you think this decision will affect our relationship with the community? ** STUDENT OPTION 2 Do you think we’ll lose patients? KIMBERLY O’NEILL I don’t think that they’ll start going anywhere else for care because we don’t have any local c ompetition. But it’s tough to predict what people will do. BLAKE HINES Can you talk to Ken Bloom to try and get a read on how he thinks the community would be affected? Student can choose either option to proceed. STUDENT OPTION 1 Yes, of course. ** STUDENT OPTION 2 I’m actually meeting Ken for lunch today. I’ll be sure to bring it up. BLAKE HINES Thanks. Let us know how it goes. END OF SCENE 2 Health Care Ethics Navigate 2 Scenario : Continuing Obstetric Care at Bright Road December 21 , 2017 Scene 3: Impact on Community and Services In this scene, the student talks to K en Bloom in order to assess what the community’s perceptions will be if Bright Road stops providing labor and delivery services, as well as to see if Ken has any suggestions on how to improve these services at the hospital and provide better outcomes. Lo cation Hospital Corridor Scene setup Ken Bloom walks in from the right side of the screen. On -screen characters Ken Bloom Off -screen characters N/A On -screen text: You run into Ken Bloom before your lunch meeting… Note: Start with Hospital Corridor, have Ken walk in from the right side of the screen. KEN BLOOM Hi there, how’s it going. It’s not lunch time yet, is it? Student can choose either option to proceed. STUDENT OPTION 1 Not yet. But while I have your attention, do you have a minute to talk? ** STUDENT OPTION 2 It’s still early. But I do have something I want to discuss. Got a minute? KEN BLOOM Yes, I just finished my rounds and was going to work on some reports. What’s up? Student can choose either option to hear a resp onse, but must choose correct option to proceed. STUDENT OPTION 1 (INCORRECT) The hospital’s ethics committee is trying to assess if it makes sense to Bright Road to continue to provide labor and delivery services. KEN BLOOM RESPONSE 1 Interesting. How can I help? STUDENT OPTION 2 (CORRECT) Bright Road’s ethics committee is trying to assess whether to continue providing labor and delivery services. What are your thoughts? Health Care Ethics Navigate 2 Scenario : Continuing Obstetric Care at Bright Road December 21 , 2017 KEN BLOOM RESPONSE 2 It makes sense to continue providing these services. If we stopped, these patients would have to drive for an hour and a half to get to the nearest hospital! STUDENT Right, I understand that. You work with Dr. Miller occasionally, don’t you? KEN BLOOM I have a few nurses who help with obstetrics. I really d on’t think we can stop providing labor and delivery services. There is no other alternative and our community will not tolerate this service being discontinued. Student can choose either option to proceed. STUDENT OPTION 1 What impression do you get from your nurses about the overall labor and delivery services that we provide? ** STUDENT OPTION 2 What do the nurses think about the labor and delivery services that we provide? KEN BLOOM My nurses are generally happy to be providing a much -needed service to the community. They are also aware that Dr. Miller bears the burden of this service mostly on her own. On -screen text: Now, it’s time to ask about some challenges… Student must choose both options to proceed. STUDENT OPTION 1 What do you think is Dr. Miller’s biggest concern? KEN BLOOM RESPONSE 1 I think one of the biggest concerns is the cost of malpractice insurance for obstetricians. Compared to all other types of malpractice insurance, obstetricians usually have to pay the highest premiums. But I don’t want to speak for Dr. Miller. You’d have to ask her what her main concerns are. STUDENT OPTION 2 What are the most difficult issues with obstetric care? KEN BLOOM RESPONSE 2 When my nurses complain about working in obstetrics, it’s usually about the patients. These patients are very reluctant to get prenatal care before the end of their second trimester for some reason. Without proper prenatal care, complications are more likely to occur. Health Care Ethics Navigate 2 Scenario : Continuing Obstetric Care at Bright Road December 21 , 2017 STUDENT How does prenatal care affect hospital operations? KEN BLOOM That’s a good question. Pati ents who get regular checkups during the first trimester learn a lot about how to prepare for pregnancy, labor, and delivery. If a patient is able to take better care of herself during pregnancy, she is likely to experience fewer complications in labor and delivery. Fewer complications mean lower costs for the hospital and that benefits the community. STUDENT Do you know if we have had many malpractice suits brought against our doctors? KEN BLOOM I don’t think we have. In general, our community isn’t too litigious. But Jeff Passmore, the hospital’s general counsel, is a better person to talk to about that. STUDENT That’s a good idea, I think that I’ll do that. Meet you back here for lunch at 1? KEN BLOOM Sure. See you then! END OF SCENE 3 Health Care Ethics Navigate 2 Scenario : Continuing Obstetric Care at Bright Road December 21 , 2017 Scene 4: Legal Advice After speaking to Ken Bloom, the student decides to talk to Jeff Passmore about the legal implications of continuing to provide delivery and labor services to the community and the community’s history of being reluctant to sue the hospital du e to being grateful that the hospital provides these services. Location General Counsel’s Office Scene setup Jeff Passmore is sitting at his desk On -screen characters Jeff Passmore Off -screen characters N/A On -screen text: You schedule a meeting with Jeff Passmore to get more information about malpractice suits at the hospital … STUDENT OPTION 1 Hi Jeff, thank you for taking the time to meet with me. JEFF PASSMORE Well, how can I help bring you up to speed about malpractice? Student can choose either option to get a response, but must choose the correct option to proceed. STUDENT OPTION 1 (INCORRECT) I’m sitting on the hospital’s ethics committee and we’ve been talking about labor and delivery services here at the hospital. JEFF PASSMO RE RESPONSE 1 Well, I’m not exactly tied too closely to obstetrics… STUDENT OPTION 2 (CORRECT) I was talking to Ken Bloom about labor and delivery services and he said we have a low occurre nce of malpractice suits. Is that right? JEFF PASSMORE RESPONSE 2 Yes. Compared with other hospitals, we fortunately have a low litigation rate. Student can choose either option to get a response, but must choose the correct option to proceed. STUDENT OPTION 1 (INCORRECT) Is it because our patients are too scared to sue us? Health Care Ethics Navigate 2 Scenario : Continuing Obstetric Care at Bright Road December 21 , 2017 JEFF PASSMORE RESPSONSE 1 No, I don’t think that’s the reason. STUDENT OPTION 2 (CORRECT) Is it because our patients value the service we provide to them? JEFF PASSMORE RESPONSE 2 That might be true. It’s difficult to say why different groups would be more likely to sue than others. But the fact that they don’t have an alternative might cause them to be more forgiving on smaller issues. Student can choose either option to get a response, but must choose the correct option to proceed. STUDENT OPTION 1 (CORRECT) Do you think that litigation rates will be affected if we discontinue providing labor and delivery services? JEFF PASSMORE RESPONSE 1 It’s possible. The community probably won’t be happy about Bright Road discontinuing a service like this, but I’m not sure that they’ll take it out on us through increased lawsuits. STUDENT OPTION 2 (INCORRECT) What can we do to keep our patients from suing us? Can we threaten to withdraw from the market to decrease our lit igation rate? JEFF PASSMORE RESPONSE 2 That’s a very unethical action to even suggest, and I used to work in the tobacco industry! STUDENT What does a malpractice case generally cost the hospital? JEFF PASSMORE It depends on where the hospital is and what the state’s regulations are regarding malpractice lawsuits. Some states have passed tort reform legislation to cap the amount of damages that a judge can require a hospital or obstetrician to pay to a patient for pain and suffering. The most common cap is $250,000. In these states, malpractice insurance premiums are much lower than in states where there is no cap. Student can choose either option to proceed. STUDENT OPTION 1 And our state laws don’t have a cap, right? ** STUDENT OPTION 2 If I recall correctly, our state doesn’t have a cap. Health Care Ethics Navigate 2 Scenario : Continuing Obstetric Care at Bright Road December 21 , 2017 JEFF PASSMORE That’s correct, which is why our premiums are so high. They could be as much as 18 times lower if there were a cap in place. Court -awarded payouts could also be a lot higher than $250,000. Student can choose either option to proceed. STUDENT OPTION 1 Wow. That’s pretty high. ** STUDENT OPTION 2 That’s quite a payout! JEFF PASSMORE Definitely. But we might be able to do a few things to lower the risk and decrease our premiums. The easi est thing to do would be to hire an additional Ob/Gyn. Having more than one will reduce Dr. Miller’s workload. If her workload is reduced, the insurance company might reduce her rates because she’s less likely to make a costly mistake. Student can choose either option to proceed. STUDENT OPTION 1 That’s a good point. ** STUDENT OPTION 2 That sounds like a viable solution. JEFF PASSMORE Well, overall, if you’re able to decrease the risk at the hospital in general, then there will be fewer mistakes and fewer malpractice cases brought against the hospital and our staff. Student can choose either option to proceed. STUDENT OPTION 1 That puts it into a new perspective. Thank you for taking some time out of your day to talk to me, this has been ver y informative. ** STUDENT OPTION 2 Thank you for taking some time out of your day to talk to me. I appreciate your point of view. JEFF PASSMORE Any time. Let me know if you need any more help with this issue. END OF SCENE 4 Health Care Ethics Navigate 2 Scenario : Continuing Obstetric Care at Bright Road December 21 , 2017 Scene 5: Touching Base In this scene, the student goes back to their office to check email and to receive an unexpected phone call from Sofia Lozano, a concerned community member. The student also receives an email from Blake Hines requesting a brief meeting in her office. Locatio n Manager of Social Services’ office Scene setup Student is sitting at the computer On -screen characters None Off -screen characters Sofia Lozano On -screen text: It’s time to process what Jeff, Ken, Blake and Kimberly have told you about labor and delivery services at Bright Road… Note: Make the phone button flash for student to click on. On -screen text: Looks like you’re getting a phone call… STUDENT Hello, Brig ht Road Social Services. MS. LOZANO Hello, my name is Sofia Lozano. I heard from a friend of mine who works at your hospital that the hospital is going to stop delivering babies soon. Is this true? Student can choose either option to proceed. STUDENT OP TION 1 Uh… no, not exactly, do you live here in the community? ** STUDENT OPTION 2 Ms. Lozano, are you a member of the community that Bright Road s ervices? MS. LOZANO Well, I am pregnant, but I do n’t have insurance. And I know other women in my situation that don’t have the right paperwork to qualify for government programs. STUDENT May I ask, where were you planning to have your baby? MS. LOZANO I don’t really know. There is a clinic where women like me go, because they don’t charge as much and they don’t ask too many questions. STUDENT I see. And you know for a fact that many women use this clinic? Health Care Ethics Navigate 2 Scenario : Continuing Obstetric Care at Bright Road December 21 , 2017 MS. LOZANO Yes, I personally know many families that have their babies at this clinic. We’d prefer to have them at your hospital, but we just don’t feel like that’s an option . STUDENT There are some non -profit health clinics close by that you might not be aware of. Would you be able to come in to the hospital, so that we can talk further? MS. LOZANO I guess, if you promise that you ‘ll keep our conversation confidential . STUDENT Yes, I promise. Please come in and we’ll see what we can do for you. I really beli eve we can help you. MS. LOZANO Fine. I’ll come in tomorrow. STUDENT If it’s okay with you, I’d also like to talk to you more about the other women you say are in your same predicament. MS. LOZANO Sure. If there’s a better option for women in my situ ation, then I’d like to share it. STUDENT Great. I’ll see you tomorrow. Take care. MS. LOZANO Goodbye. Note: Make phone end -call button flash for student to click. On -screen text: Well, that was unexpected! Try and think about how this part of the community can be served by Bright Road as you continue to work on the issue of whether or not to continue these services. Oh, looks like you’ve received an email… Note: Make email button flash for student to click on. EMAIL FROM BLAKE HINES Hello, Thanks for meeting with Kimberly and me this morning, I hope that you’ve been giving this issue your direct attention. Can you come by my office to give me an update? Thanks! Blake On -screen text: When Blake wants an issue resolved, she wants the results fast! Looks like you’ll be paying her a visit soon! END OF SCENE 5 Health Care Ethics Navigate 2 Scenario : Continuing Obstetric Care at Bright Road December 21 , 2017 Scene 6: Reviewing the Issues In this scene, the student returns to Blake Hine’s office to discuss the student’s initial thoughts. The student is trying to find a solution that is acceptable fo r all parties concerned and realizes that this will require all parties to compromise. Location CEO’s Office Scene setup Blake Hines sitting at her desk. On -screen characters Blake Hines Off -screen characters N/A We can’t keep our community from suing us, but we can do things to reduce litigation by reducing errors and improving communication about the relationship between health care costs for us and health care costs for them. BLAKE HINES Hello again. Thanks for getting right to work on this iss ue. Student can choose either option to continue. STUDENT OPTION 1 Of course. I’ve received a lot of good information ** STUDENT OPTION 2 Of course. I can bring you up to speed. BLAKE HINES Great! Well, I’ll leave it to you to quickly summarize and walk me through your findings. Where would you like to start? On -screen text: Select who you’d like to talk about first. Note: Student must select all branches. Within each branch, the student must choose the correct response in order to proceed. BRANCH 1 STUDENT My discussion with Jeff Passmore. BLAKE RESPONSE How did that go? STUDENT OPTION 1 (INCORRECT) We discussed the number of malpractice suits the hospital has right now. Health Care Ethics Navigate 2 Scenario : Continuing Obstetric Care at Bright Road December 21 , 2017 BLAKE HINES RESPONSE 1 That’s interesting, but I’m not sure how that helps drive your recommendation. STUDENT OPTION 2 (CORRECT) We discussed cost drivers of malpractice insurance premiums and how we could potentially keep these costs down. BLAKE HINES RESPONSE 2 That’s helpful information. Jeff has a pretty interesting work history and really brings a wide range of experience to the table. He’s usually dead -on with his perception of situations, at least in terms of the legal ramifications of making decisions. BRANCH 2 STUDENT Ken Bloom’s input. BLAKE R ESPONSE I’m sure Ken had good insight. What did he say? STUDENT OPTION 1 (CORRECT) He focused a lot on providing additional help to Dr. Miller in the form of a backup Ob/Gyn to help her. BLAKE HINES RESPONSE 1 I see his point, but it’s going to be difficult to convince our family practitioner to get on board with this. I’m looking forward to hearing your suggestions for reducing costs and attracting another Ob/Gyn specialist. Anything else? STUDENT He also mentioned the high cost of malpractice ins urance and the inherent problem with women delaying the start of their prenatal care. BLAKE HINES RESPONSE That’s definitely an important factor in the equation. STUDENT OPTION 2 (INCORRECT) He focused on how to avoid malpractice suits. BLAKE RESPONS E 2 Really? I thought he would focus on operations. BRANCH 3 STUDENT The impact on the community. BLAKE HINES RESPONSE The community? Do they even know about this? STUDENT OPTION 1 (INCORRECT) Yes. The information leaked. Health Care Ethics Navigate 2 Scenario : Continuing Obstetric Care at Bright Road December 21 , 2017 BLAKE HINES RESPONSE 1 It usually does. So what are they saying? STUDENT OPTION 2 (CORRECT) I got a call from a community member. She’s not a legal citizen and is worried about traveling to a metropolitan hospital. BLAKE HINES RESPONSE 2 I’m excited to hear the details about y our conversation, but I’m also a bit concerned about how we’re going to negotiate our own legal requirements in this situation. I’m not against it, I think that we should be able to treat everyone in our community. This is just a difficult population to se rve and we’ll need to think about this some more. Student can choose either option to proceed. STUDENT OPTION 1 What have you and Kimberly discussed? ** STUDENT OPTION 2 What do you and Kimberly think? BLAKE HINES We both value your opinion, and are looking for your recommendation. You have my word that your input will be considered very seriously. Student can choose either option to proceed. STUDENT Ok, I’m going to need some time to gather my thoughts and organize a response. ** STUDENT Can I h ave a little bit of time before I get this to you? BLAKE HINES Yes, of course. I don’t expect you to provide an answer on the spot. But don’t take too long; this is an important issue! I look forward to your recommendation. END OF SCENE 6 Health Care Ethics Navigate 2 Scenario : Continuing Obstetric Care at Bright Road December 21 , 2017 Assessment If all previous scenes have been completed, a 10 -question assessment is presented to the student. Answer the following 10 questions to show what you know about health care ethics for labor and delivery. Good luck! The student answers the ques tions and then sees the assessment results. Assessment Results Here are your results. Click Continue if you are satisfied with the result. Or you can click Try Again if you want to try and improve your score. NOTE: The student can retry the assessment by clicking the Try Again button, or can continue to final scene by clicking the Continue button. Health Care Ethics Navigate 2 Scenario : Continuing Obstetric Care at Bright Road December 21 , 2017 Scene 7: Making Your Recommendation In this scene, the student will craft an email to Blake Hines, Kimberly O’Neill and Jeff Passmore at Bright Road, with a re commendation. The recommendation will consider both sides of the issue based on information gathered from the staff and community members. Location Social Services Manager’s Office Scene setup Student is sitting in front of the computer On -screen charac ters None Off -screen characters None On -screen text: After gathering information from key team members, it’s time to make a decision. NOTE: The scene is a close up of the student’s computer screen with the email application open. The “To:” section is filled with email addresses of Blake Hines, Jeff Passmore, and Kimberly O’Neill and the subject is already filled in: “CONFIDENTIAL: Labor and Delivery Services at Bright Road.” On -screen text: Type your recommendation in the body of the email below. Don’t forget, you can use the notes you’ve taken throughout your interviews. Be sure to back up your decision with the analysis of the information gained from the team members, and input from the community member. Click Send when you are ready to submit your re commendation. NOTE: The student will be given an option to “ Send” (s ubmit ) the email after writing it. On -screen text: Congratulations! Your recommendation has been sent! FADE OUT NOTE: The student will be given an option View/Save their recommendation bef ore closing the scenario . THE END
Labor and Delivery Services:You are the new manager of the Social Services Department of a small, 18-bed rural hospital within the Bright Road Health Care System. As a member of the ethics committee f
Health Care Ethics Navigate 2 Scenario : Equipment Purchase January 2, 201 8 1 Equipment Purchase Introduction: You are the C hief Financial Officer (CFO) of a small rural women’s health center within the Bright Road Health Care System. As CFO, you will review a proposal to purchase a 3D mammography machine for the women’s health center and will discuss the issue with a physician, the chairman of the Board of Directors and the Director of Nursing to understand all costs and benefits of this purchase . You need to consider finance, authority of the Board of Directors, public relations/marketing, wishes of medical staff, needs of the community, and future implications when making your decision whether to purchase the equipment. After gathering the info rmation, y ou will submit your decision , along with your rationale, to the Board of Directors . Characters: 1. Thomas Jenkins , Physician at the Women’s Health Center 2. Maria Vasquez , Director of Nursing at the Women’s Health Center (case management) 3. Quinn Smith , Chairman of the Board of Bright Road Health Care System Locations: 1. CFO’s Office 2. Hospital Corridor 3. Conference Room (Women’s Health Care Facility) 4. Chairman of the Health Care Board’s Office Health Care Ethics Navigate 2 Scenario : Equipment Purchase January 2, 201 8 2 Scene 1: Planning Your Day In this scene, the student /CFO begins their day in their office. The CFO begins by looking at the day’s appointments and checking email to establish the case, namely that the CFO will need to determine whether to recommend purchasing mammography imaging equipment. Location CFO’s office Scene setup The student is looking at their computer On -screen characters None Off -screen characters N/A On -screen text: Good morning and welcome to the office! Take a look at your calendar to see what meetings you have lined up for the day. Note: A compu ter hotspot flashes on screen for student to click. On -screen text: You’ve got a busy day lined up! You’d better check your email now, before things get too hectic. Note: A computer hotspot flashes on screen for student to click. EMAIL FROM HEALTHYTECH CORPORATION Dear Chief Financial Officer, Thank you for contacting us about our range of health care equipment solutions. Here is the quote of the equipment that you have requested. HealthyTech 3D Digital Mammography Imager: $500,000 Our Mamm ography Imager is the most advanced and current imaging technology available. By purchasing the Imager, you would allow the Bright Road Health Care System to offer a valuable service to your community and would improve your community’s chances in the figh t against breast cancer. We have several financing options available if cost is a concern; please feel free to contact me with any questions. Health Care Ethics Navigate 2 Scenario : Equipment Purchase January 2, 201 8 3 Regards, Steven Archibald HealthyTech Sales Manager On -screen text: $500,000 is a large investment, especially when the future of health care funding is so unpredictable. It looks like you’ve got another unread email. Note: An email button flashes on screen for student to click. EMAIL FROM QUINN SMITH Good morning, I’ve spoken to the Board about the possibility of making new capital purchases and the Board is very reluctant to make large purchases in medical technology, especially if the services are available at another facility. Overall, the Board is worried about both state and federal health care legislation a nd how that will impact Bright Road’s bottom line. We can talk more about this at our meeting this afternoon. If you’re recommending a large equipment purchase, the Board needs to understand why this is absolutely necessary and how Bright Road is going to benefit. Quinn Quinn Smith Chairman Board of Directors, Bright Road Health Care System On -screen text: Looks like you’ll need to do some more research on this. A good place to start would be talking to Thomas Jenkins, the physician who suggested this purchase in the first place. Note: Add cell phone button on screen On -screen text: Send a text message to Thomas Jenkins to see if he’s available to talk about why he wants the health center to buy this equipment. Note: Make cell phone button flash for student to click on, make student click screen after each text message is read . Health Care Ethics Navigate 2 Scenario : Equipment Purchase January 2, 201 8 4 CELL PHONE SCREEN STUDENT OPTION Good morning Thomas, do you have time today to discuss the mammography imager? THOMAS JENKINS TEXT RESPONSE Yes, I have a few minutes right now before my appointments start. I’ll meet you on the way. STUDENT TEXT RESPONSE Great, see you in a minute. THOMAS JENKINS TEXT RESPONSE Sounds good. END OF SCENE 1 Health Care Ethics Navigate 2 Scenario : Equipment Purchase January 2, 201 8 5 Scene 2: Discussion with Thomas Jenkins , M.D. In this scene, the student talks to Thomas Jenkins in order to assess why the medical staff is requesting the purchase of a mammography imager. Location Hospital Corridor Scene setup The corridor is empty, Thomas Jenkins walks in from right side of scre en On -screen characters Thomas Jenkins Off -screen characters N/A On -screen text: Thomas should be here any moment. Taking notes about your conversation will help when making your recommendations later! Note: Thomas walks on screen from the right side of screen THOMAS Hi, thanks for texting me. How are you? STUDENT I’m doing well . Busy, huh ? THOMAS Very busy today, I’m sorry that I only have a few minutes to talk but it’s important for Bright Road to get this upgrade. State of the art technology like this made a positive impact at the hospital where I previously worked . STUDENT That’s why I’m glad you had a minute to talk. I’ve been researching this equipment but I don’t understand why it’s absolutely necessary to make this purchase now. THO MAS Well, a t the hospital I worked at before Bright Road, we had a 3D imager and we were able to detect breast cancer much earlier than we had been able to before. Student may choose either option to proceed. STUDENT OPTION 1 How does that affect treatment? ** STUDENT OPTION 2 Why is early detection so important? THOMAS RESPONSE When you detect breast cancer earlier, it’s easier to treat and there’s a better chance of a positive outcome. Health Care Ethics Navigate 2 Scenario : Equipment Purchase January 2, 201 8 6 Student m ust choose correct option to proceed. STUDENT OPTION 1 (INCORRECT) Why does the medical staff want to have a 3D imager here? STUDENT OPTION 2 (CORRECT) Why can’t we refer our patients to medical care facilities that have this technology already? THOMAS RESPONSE 1 I think that it’s obvious that our staff wants our patients here to have the best possible care, and that includes preventive care like this. THOMAS RESPONSE 2 Our mission as a women’s care facility is to provide the best possible care to women in our area. If we don’t provide 3D imaging to our patients and refer them to other facilities, it’s a slippery slope for Bright Road to walk down. Would we recommend our patients go to another facility if our x -ray machine went out? I know it’s kind of an absurd example, but one that we n eed to think about when we consider our responsibility to the community. Student must choose all options to move to the next question . STUDENT OPTION 1 Did your previous employer’s contract with the vendor include upgrades to the technology? STUDENT OPTION 2 Do insurance companies provide increased reimbursements for 3D imaging? STUDENT OPTION 3 What is the error rate for 3D imaging? THOMAS RESPONSE 1 I’m not sure. You might want to contact a few vendors to find out. THOMAS RESPONSE 2 No, as far as I know, the insurance companies have just been providing the same reimbursement rate as with traditional 2D imaging. At the AMA convention last year, I had heard from some colleagues that some of their hospitals were charging an additional $50 for 3D imaging. Health Care Ethics Navigate 2 Scenario : Equipment Purchase January 2, 201 8 7 THOMAS RESPONSE 3 There’s a 7% improvement in cancer detection when you use both 2D and 3D image s together. When using the traditional 2D imaging, you have a 10% false positive rate. STUDENT Wait, so you use both the 2D that we currently have and a 3D imager together? THOMAS Yes, at my previous hospital we were using both together. The FDA has only approved 3D as an add -on, not a replacement for 2D imaging, probably because the technology is so new. ( Thomas looks at his watch) Listen, I h ave to run, I have an appointment that I’m late for, but let me know if you want to talk about this more. I’ll see you later. STUDENT Thanks for talking to me about this. END OF SCENE 2 Health Care Ethics Navigate 2 Scenario : Equipment Purchase January 2, 201 8 8 Scene 3: Equipment Purchase After speaking to Thomas Jenkins about the purchase of the mammography equipment, the student realizes that they need more information from the vendor. In this scene, the student will select questions to send in an email to the vendor to get better inform ation about the equipment. Location CFO’s office Scene setup The student is looking at the computer On -screen characters None. Off -screen characters N/A On -screen text: Well, it looks like you’ll need more information from the vendor. Reply to the HealthyTech Sales Manager and ask more questions about the 3D Mammography Imager. Note: An email button flashes on screen for student to click. EMAIL TO HEALTHYTECH CORPORATI ON Dear Steven Archibald, Thanks for sending the quote for the HealthyTech 3D Digital Mammography Imager. I have a few more questions about this technology. On -screen text: Select questions from the following list to include in your email to Steven Archibald. Think about your conversation with Thomas Jenkins and address the questions that arose. Click “No more questions” when you have finished asking all of your questions . Note: Student must select at least Options 1, 2 and 3. If student does not select 1, 2 and 3, student will be kicked back to select more options before proceeding when clicking the “ No more questions” button. STUDENT OPTION 1 Is the 3D imager intended to be a replacement of our current 2D mammography machine? STUDENT OPTION 2 What is the reimbursement rate from insurance companies when billing for this service? Do any of your clients charge their patients a premium for 3D imaging? STUDENT OPTION 3 Wh at happens if there is a major advance in this technology next year? If we bought a 3D imager from HealthyTech, is there a guarantee that you will provide technology upgrades or is that provided at an additional cost? Health Care Ethics Navigate 2 Scenario : Equipment Purchase January 2, 201 8 9 STUDENT OPTION 4 What kind of financ ing is available? Can we lease the imager? STUDENT OPTION 5 What is the error rate for 3D imaging? If options 1, 2 and 3 selected, an email Send button flashes on screen after click of “No more questions” button. ON -SCREEN TEXT FOR INCOMPLETE I don’t think that you’ve asked enough questions yet. Remember, you’re trying to get information about the equipment so you can determine whether it’s a good investment. Better select one or two more. ON -SCREEN TEXT FOR COMPLETE Great! This information will be very helpful as we keep going. On -screen text: Looks like you’re getting a text message! Better answer it. Note: Make cell phone button flash for student to click on, make student click screen after each text message is read CELL PHONE SCREEN: MARIA VASQUEZ TEXT Hi, it’s Maria, are we still on for this afternoon? STUDENT TEXT RESPONSE Absolutely! 1:00, right? MARIA VASQUEZ TEXT RESPONSE Yes, 1:00. See you then. STUDENT TEXT RESPONSE Great, thanks Maria! Note: Make cell phone OFF button flash for student to click on to close phone graphic Note: An email button flashes on screen for student to click. Email includes responses to questions clicked on by student in the email sent previous to text message. EM AIL FROM HEALTHYTECH CORPORATION Hello, Thanks for writing, I’m happy to answer your questions. (RESPONSE 1) While we believe that the 3D mammography imager is capable of providing an accurate diagnosis, the FDA has not yet approved its use without a Health Care Ethics Navigate 2 Scenario : Equipment Purchase January 2, 201 8 10 concurrent 2D mammography. (RESPONSE 2) Regarding reimbursement rates, we recommend contacting insurance companies that you currently work with to answer that question. Unfortunately, we can’t provide you with information about specific clients, but yes , some do offer to provide 3D mammography imaging for an additional fee. (RESPONSE 3) You’re right, the 3D mammography imaging technology is moving very quickly . Our engineers plan for that as best they can, so that if you buy a 3D imager from us, we’ll p rovide software updates and a warranty, but you will still have to pay for regular maintenance, much like when you purchase a car. (RESPONSE 4) As far as financing goes, we do have several banks that we work with to provide financing . I can set up a mee ting with our preferred lenders, although I’m sure that Bright Road has its own banking preferences and relationships built. We are unable at this time to offer our 3D imagers for lease. (RESPONSE 5) The error rate for 3D imaging is very low, as low as 5 .2% for technologists who have a lot of training and experience. This translates into fewer requests for retesting and much lower stress for your patients. If you need anything else, please don’t hesitate to ask, we want you to be happy with your decisio n. Regards, Steven Steven Archibald HealthyTech Sales Manager Health Care Ethics Navigate 2 Scenario : Equipment Purchase January 2, 201 8 11 Note: An email close button flashes on screen for student to click. On -screen text: Wow that was a fast response! Looks like Thomas has his facts straight. You’d better get moving, you don’t want to keep Maria Vasquez waiting. END OF SCENE 3 Health Care Ethics Navigate 2 Scenario : Equipment Purchase January 2, 201 8 12 Scene 4: Meeting with Maria Vasquez , R.N. In this scene, the student speaks with Maria Vasquez, the Director of Nursing at the Women’s Health Center to assess the needs of the community, future implications and possible public relations and marketing strategies centered around offering 3D mammography services at the Center. Location Conference Room (Wome n’s Health Care Facility) Scene setup Conference Room has Maria Vasquez sitting at the table On -screen characters Maria Vasquez Off -screen characters N/A MARIA Hi! How’s your day going? STUDENT Oh, very busy! I’m trying to get all of the information I can about the 3D mammography imager, and everyone’s input on what this will mean for us here at Bright Road. MARIA Well, I am supportive of us getting this 3D technology here. You spoke to Dr. Jenkins about this already, right? He used to work at a hospital that had an imager and he said that it really was helpful in catching breast cancer early. STUDENT Yes, I just spoke with him earlier today. He mentioned that there was a lower error rate with this kind of technology. MARIA I can’t begin to tell you how much that means to a cancer survivor like me. When I was diagnosed, my mammogram wasn’t conclusive and I had to go back for two additional mammograms before running tests. Just not knowing whether or not you have breast cancer and c ontinuing for weeks with these tests is incredibly stressful and really takes its toll. If this 3D technology can eliminate that stress for our patients who aren’t cancerous but would have to return for more tests, it would be worth it. Student must choo se both options to move to the next question. STUDENT OPTION 1 I’m sure that’s true. I’ve heard that other hospitals are charging a premium to offer 3D mammography imaging to patients. Do you think that our patients will pay an additional fee for this service? STUDENT OPTION 2 Good point. So, h ow are we going to tell our patients and the community that we’re offering 3D mammography imaging? Health Care Ethics Navigate 2 Scenario : Equipment Purchase January 2, 201 8 13 MARIA RESPONSE 1 I’m really against charging a high additional fee for 3D imaging. It puts up a barrier between the highest quality care and the patient. We have a responsibility to provide the best care to all of our patients. I think that a lot of our patients will pay for this additional service, as long as it’s not too high a fee. I’d really prefer to have our patients not have to make receiving the best possible health care a financial decision if we can help it. MARIA RESPONSE 2 If the Center decides to buy this equipment, I’ll be sure to begin telling my women’s health groups ab out it and all of my patients. We have a database of all our current and former patients and I can draft an email announcing when we’ll be offering the service. Our database is really great too; we can target patients in different age groups as well as t hose patients who are due to come in for a mammogram. Student must choose all options to move to the next question. STUDENT OPTION 1 Would it be feasible to recommend that our patients drive to the city to get this procedure done? STUDENT OPTION 2 How would we market this to our patients? STUDENT OPTION 3 Can the 3D save costs? MARIA RESPONSE 1 A lot of our patients aren’t able to go to the city for medical procedures. The city’s over an hour’s drive away, and if you don’t have a car, it takes nearl y the whole day to get there and back by bus. We really owe it to our community to provide the best possible care to them within reason. Buying a 3D imager is within reason for a modern health care facility. MARIA RESPONSE 2 There are a number of different ways that we can market this. Of course, we can use our website and our presence on social media to make sure that all of our friends and followers on the internet know that we’re providing the best possible service. We could take out a few pri nt ads as well and suggest to Bright Road’s corporate office that they could use our Center’s acquisition of a 3D mammography imager in a national ad campaign to show how Bright Road is addressing the needs of the communit y. Just off the top of my head, i f we absolutely have to charge a fee for this service, we could run a discount during Breast Cancer Awareness Month. Health Care Ethics Navigate 2 Scenario : Equipment Purchase January 2, 201 8 14 MARIA RESPONSE 3 When you catch breast cancer early, available treatments are much less invasive. Generally, the more invasive the trea tment, the more expensive it is for both the patient and the health care provider. I don’t know how many patients will be able to avoid more expensive procedures, but there will be savings. STUDENT I understand that 3D imaging isn’t allowed by the FDA t o be used as a standalone procedure. Why can’t we wait to buy one until the FDA approves use as a replacement for the 2D machines that we already have? MARIA: You could make that argument for buying any tech equipment. Why buy a new computer to replace the one you have now when you know that next year, there will be a better one? The bottom line is that we should be providing the best health care possible and a 3D mammography imager falls into that category. Student can choose either option to continue. STUDENT OPTION 1 Maria, I’m not sure I know where you stand on this issue. Should we take more time to think about this? ** STUDENT OPTION 2 You make a great point. Well, I think that I have a pretty good sense of how you feel about this! MARIA (laughs) Yes, I’m sorry, I don’t mean to be pushy, I just really believe that buying this 3D imager would be great for us and would benefit the community. Just the fact that we’re offering a service that’s currently only available in more affluent an d urban areas of our state will be positive for the Center as a whole, both for the bottom line and for patient outcomes. It’s definitely worth the cost. STUDENT Tha nks so much for taking the time to speak with me, this has been really informative. I ha ve to run to go talk to the Chairman of the Board, is there anything else that you’d like me to know about? MARIA Just one more thing. I think we need to consider the physicians. We have two new doctors on our staff, coming from residency programs where they had the 3D Imager. If they do not feel their requests are being heard and they do not get equipment that they think is crucial to their job, they might just leave. After all, they have been here less than two years and do not have deep ties to the community. Health Care Ethics Navigate 2 Scenario : Equipment Purchase January 2, 201 8 15 Student can choose either option to continue. STUDENT OPTION 1 Thanks Maria, I’ll talk to you later. STUDENT OPTION 2 Maria, I don’t know that I agree that the physicians should have a big say in the purchase, but I really appreciate you taking the time to talk to me. MARIA Anytime, I’m happy to help out wherever I can! END OF SCENE 4 Health Care Ethics Navigate 2 Scenario : Equipment Purchase January 2, 201 8 16 Scene 5: Discussing Capital Ex penditures In this scene, the student talks to Quinn Smith, the Chairman of the Board at Bright Road. The student will ask about the Board’s position on major capital purchases, the financial impact of buying a 3D imager, and how the return on investment factors into the Board’s decisions. Location Chairman of the Health Care Board’s Office Scene setup Chairman’s office has Quinn Smith standing On -screen characters Quinn Smith Off -screen characters N/A On -screen text: Lastly, you’re meeting with Quinn Smith, the Chairman of the Health Care Board’s Office. Be sure to take good notes! QUINN Good to see you . Ho w is everything in the Finance department? STUDENT We’re doing well, keeping busy for sure. How was the last Board meeting? QUINN Well, it’s always interesting, I’ll give you that. Between trying to predict what the Feds are going to do next year with health care reform and trying to plan for the future of all of the healthcare centers we operate, it’s a miracle we’re able to keep members on the Board trying to handle everything. STUDENT Wow, it sounds like you’ve got a lot on your plate. QUINN You co uld say that. In addition to all that, we have to see that our shareholders are turning a profit , while simultaneously ensuring that we’re making people better. STUDENT Well, that’s why I wanted to speak with you this afternoon. The physicians and nurse s at the Women’s Health Center are pushing for us to buy a 3D mammography imager. QUINN That sounds expensive. I think that I read about these in the New England Journal of Medicine. They’re supposed to complement the ones we have, right? Health Care Ethics Navigate 2 Scenario : Equipment Purchase January 2, 201 8 17 Student must select correct option to continue. STUDENT OPTION 1 (INCORRECT) I think that it’s a standalone device . STUDENT OPTION 2 (CORRECT) You’re right, it is used with the current 2D mammography machine. QUINN RESPONSE 1 Yes, it is, I remember it because they were comparing the new machine to the same make and model of the one we have here at the Women’s Health Center. Response 1 kicks student back to options. QUINN RESPONSE 2 So, if it has to be used with what we already have, why do we need to buy it? Response 2 allows student to continue. Student must select correct option to continue. STUDENT OPTION 1 (CORRECT) Using a 3D mammography imager along with a traditional 2D machine increases the accuracy and allows u s to detect breast cancer at an earlier stage. STUDENT OPTION 2 (INCORRECT) It decreases the number of false positive readings from 10% to 5%. QUINN RESPONSE 1 Well, that’s a better outcome, I’ll give you that. Response 1 allows student to continue. QUINN RESPONSE 2 So, we reduce the number of overall tests a little bit? I don’t mean to sound callous, but this isn’t really an argument that will hold water by itself with the Board. Response 2 kicks student back to options. QUINN How much does it cost? STUDENT $500,000. Health Care Ethics Navigate 2 Scenario : Equipment Purchase January 2, 201 8 18 QUINN The Board will never approve it. At the last Board meeting, they voted down spending $275,000 on renovations for the canteen in the annex of the Center. Why do you think they’ll approve such a large capital expenditure o n such new technology? STUDENT I don’t really know if the plan has legs yet, I’m still trying to assess the situation. On -screen text: Ask Quinn a few questions about capital investments. Student must select all options before moving on. All Quinn Re sponses will kick back to the options until all are selected. STUDENT OPTION 1 How does the Board decide whether or not to make purchases like this one? STUDENT OPTION 2 What problems would you foresee with buying a 3D mammography machine? STUDENT OPTION 3 What questions do you want answered? STUDENT OPTION 4 I have to present ROI to the board. Any advice about how to get their attention ? QUINN RESPONSE 1 We bring in the CFO, in this case you, to explain to us why we need to buy something, why w e can’t do without it, and how much it’s going to cost us. Then, we decide if we agree with you. QUINN RESPONSE 2 The problem with any technology upgrades is that they become obsolete so quickly. What guarantees do we have that this technology won’t be history before we have the debt repaid? QUINN RESPONSE 3 The main question is this , if we buy the 3D machine, will we be required by new federal health care mandates to provide this service to everyone, or can we keep it as a premium service to pay down the cost of the machine? QUINN RESPONSE 4 They’re going to want to know how many patients we expect to use it each year and how much we’ll get from insurance reimbursements . Keep in mind that the board members aren’t all CFOs like you. So, m ake it clear how the income will exceed the cost . You probably won’t see any ROI in the first year, so I’d show an ROI analysis over the next five years. But don’t tell the Board that I’m helping you get us into debt. Health Care Ethics Navigate 2 Scenario : Equipment Purchase January 2, 201 8 19 STUDENT This is all very helpful, I’ll be sure to have a recommendation to you soon. QUINN Don’t thank me just yet, you haven’t gotten anything approved. Be sure to look at how much financing the project would cost in the long run and do a few different debt scenarios, ones that might make your ar gument easier to swallow. END SCENE 5 Health Care Ethics Navigate 2 Scenario : Equipment Purchase January 2, 201 8 20 Assessment If all previous scenes have been completed, a 10 -question assessment is presented to the student. Answer the following 10 questions to show what you know about health care ethics for equipment purchasing. Good luck! The student answers the questions and then sees the assessment results. Assessment Results Here are your results. Click Continue if you are satisfied with the result. Or you can click Try Again if you want to try and improve your score. NOTE: The student can retry the assessment by clicking the Try Again button, or can continue to final scene by clicking the Continue button. Health Care Ethics Navigate 2 Scenario : Equipment Purchase January 2, 201 8 21 Scene 6: Making Your Recommendation In this scene, the student will craft an email to the Board of Direct ors, with a recommendation. The recommendation will include each aspect of the analysis, as gathered from the staff. Location Chief Financial Officer’s Office Scene setup CFO is sitting at their desk. On -screen characters None Off -screen characters None On -screen text: After gathering information from key team members, it’s time to write your recommendation to the Board. On -screen text: Type your recommendation in the body of the email. Don’t forget, you can use the notes you’ve taken throughout yo ur interviews. Be sure to back up your recommendation with the analysis of the information gained from the team members. Also, don’t forget to briefly outline the key points of a change management plan corresponding to your recommendation. NOTE: An email a pplication open s. The “To:” section is filled with an email group description “Bright Road Board” and the subject is already filled in: “ CONFIDENTIAL: 3D MAMMOGRAPHY CAPITAL INVESTMENT.” NOTE: The student will be given an option to submit the email after writing it by clicking the “Send” button . After the student submits the email, the computer screen fades to the previous view of the student’s office. On -screen text: Congratulations! Your recommendation to the Board has been sent! FADE OUT THE END




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