Module 2 - ASK Critical Questions Flashcards
(20 cards)
Read the following claim and identify the (hidden) underlying assumption(s). Select the best answer.
Since IBM, Boeing, Ford, and several other Fortune 500 companies introduced the Agile methodology, their annual revenues have increased by 10 to 15 percent. Therefore, if a company wants to increase its performance and annual revenue, it should seriously consider introducing the Agile methodology.
Agile methodology causes a company’s performance and annual revenue to increase.
Read the following claim and identify the underlying (hidden) assumption. Select the best answer.
Companies like Google have used the Agile methodology in the past but found it to be ineffective, so I don’t think we should introduce this methodology in our company.
Our company is comparable to companies like Google.
Read the following meeting minutes:
Minutes of the Delasota State Economic Development Council—May 1
The Chairman opens the meeting by welcoming all present.
The Chairman provides a summary of the worrisome economic developments in our state. The analyses from the Bureau of Economic Affairs indicates that labor market conditions continue to weaken, and the annual growth rate for Delasota’s economy is expected to drop to 0.2 percent. This means the economy is doing very poorly, especially when compared to our neighbor state, Minneware, whose economy is expected to grow to 5.7 percent.
The Chairman points out that last year, to stimulate its economy, Minneware’s State Bureau of Tourism started a very successful campaign to promote ecotourism. In fact, within six months after the start of the campaign, the number of foreigners arriving at Minneware’s airport doubled. In addition, economic analyses forecast that this year Minneware’s average income per capita will increase by more than 10 percent.
To stimulate Delasota’s economy and increase the income of our citizens, the Chairman therefore proposes to start a similar campaign to promote ecotourism in our state. To make sure that the campaign will be successful, it is proposed to hire the director of Minneware’s State Bureau of Tourism as an advisor.
In this scenario, what would you consider to be the two most critical assumption(s) that should be checked to see whether there is sufficient evidence to support them?
The director of Minneware’s State Bureau of Tourism is directly responsible for the success of the campaign to promote ecotourism.
The growth of Minneware’s economy is a direct result of the states campaign to promote ecotourism and the ensuing increase in the number of tourists.
Read the following scenario and determine the PICOC terms:
The organizational data of a German pharmaceutical company indicate that the firm’s overall productivity is below the average in the sector. The HR director suggests conducting an employee engagement survey, arguing that a company’s productivity is dependent on the collective performance of its employees. After all, according to Gallup—a global analytics and consulting firm—engagement is the most important driver of performance by employees. The outcome of the survey shows that the company’s engagement score is below Gallup’s Global Employee Engagement Benchmark. For this reason, structured interviews with employees are conducted to identify factors that negatively affect their engagement. Based on the outcome of the interviews, several techniques for improving employee engagement are presented to the board, and a corporate action plan is agreed upon.
What is the outcome of interest?
The company’s overall productivity
The organizational data of a German pharmaceutical company indicate that the firm’s overall productivity is below the average in the sector. The HR director suggests conducting an employee engagement survey, arguing that a company’s productivity is dependent on the collective performance of its employees. After all, according to Gallup—a global analytics and consulting firm—engagement is the most important driver of performance by employees. The outcome of the survey shows that the company’s engagement score is below Gallup’s Global Employee Engagement Benchmark. For this reason, structured interviews with employees are conducted to identify factors that negatively affect their engagement. Based on the outcome of the interviews, several techniques for improving employee engagement are presented to the board, and a corporate action plan is agreed upon.
what is the intervention of interest?
Increasing employee engagement
Read the following scenario and determine whether the problem is sufficiently clear:
The passage of the Affordable Care Act (ACA, also called Obamacare) in 2010 required that US hospitals report their performance on new metrics. These new metrics allow the federal government to reimburse hospitals for the costs of care based on their performance quality.
Riverview Healthcare, a large hospital located in the eastern United States, decided to take the challenge of implementing the new performance metrics one step further by also changing the financial compensation plan for its physicians to improve the quality of care. The new plan would compensate physicians with both a base salary and a variable bonus tied to their individual performance on the ACA metrics. According to Riverview’s executives, the new plan would give greater emphasis to quality over quantity of care and result in a more patient-centered view.
How clearly defined is the problem (what, who, when, where, why)?
Very unclear
Riverview Healthcare, a large hospital located in the eastern United States, decided to take the challenge of implementing the new performance metrics one step further by also changing the financial compensation plan for its physicians to improve the quality of care. The new plan would compensate physicians with both a base salary and a variable bonus tied to their individual performance on the ACA metrics. According to Riverview’s executives, the new plan would give greater emphasis to quality over quantity of care and result in a more patient-centered view.
is it clear what the organizational consequences of the problem(s) are?
Very unclear
Riverview Healthcare, a large hospital located in the eastern United States, decided to take the challenge of implementing the new performance metrics one step further by also changing the financial compensation plan for its physicians to improve the quality of care. The new plan would compensate physicians with both a base salary and a variable bonus tied to their individual performance on the ACA metrics. According to Riverview’s executives, the new plan would give greater emphasis to quality over quantity of care and result in a more patient-centered view.
is it clear what the most serious and urgent problem is?
Very unclear
Read the continuation of the scenario we used above (in question 6) and determine whether the assumed problem is sufficiently supported by evidence from multiple sources.
Riverview Healthcare’s executives agree on the following problem description and related assumptions: (1) The new metrics required by the federal government are intended to improve quality of care; it shifts reimbursement for patients from quantity (services provided) to quality (clinical outcomes, patient satisfaction, etc.). (2) Riverview’s physicians are focused on quantity rather than quality, and their treatment plans are not patient-centered. (3) As a result, Riverview will score poorly on the new metrics. (4) As a result, the federal government will pay Riverview a lower compensation for the care provided. (5) In the long term, this may lead to a serious loss of revenue and possible bankruptcy.
The executives decide to see whether there is evidence to support this problem description. They hold several focus groups with managers, team leaders, and nurses. All participants feel that many physicians at Riverview lack patient focus—often, their main concern is the number of treatments rather than the quality of care. For this reason, they expect the hospital to score poorly on the new performance metrics. However, they point out that this is partly due to the current compensation system: more treatments = more dollars earned.
When the executives consult the organizational evidence, they notice that in the past five years, both the number of medical procedures and the physicians’ average income have increased. In the same period, however, several quality indicators (some of which are included in the new performance metrics) show poor outcomes: the number of readmissions, hospital acquired infections, and preventable medical errors have all increased. Not surprisingly, patient satisfaction has dropped significantly, and the number of complaints has surged.
Finally, interviews with the most important stakeholders, the physicians, paint a similar picture. Riverview is a hospital that emphasizes productivity and high performance, so physicians with a patient-centered focus who invest time in the doctor–patient relationship prefer to work elsewhere. Although there are still excellent physicians at Riverview whose first concern is the patient’s well-being, the hospital’s current compensation system provides a strong incentive to prioritize quantity over quality. As a result, they too expect the hospital to score poorly on the new metrics.
Does the evidence from practitioners support the assumed problem?
To a great extent
In the scenario we used above (question 9), does the evidence from the organization support the assumed problem?
Riverview Healthcare’s executives agree on the following problem description and related assumptions: (1) The new metrics required by the federal government are intended to improve quality of care; it shifts reimbursement for patients from quantity (services provided) to quality (clinical outcomes, patient satisfaction, etc.). (2) Riverview’s physicians are focused on quantity rather than quality, and their treatment plans are not patient-centered. (3) As a result, Riverview will score poorly on the new metrics. (4) As a result, the federal government will pay Riverview a lower compensation for the care provided. (5) In the long term, this may lead to a serious loss of revenue and possible bankruptcy.
The executives decide to see whether there is evidence to support this problem description. They hold several focus groups with managers, team leaders, and nurses. All participants feel that many physicians at Riverview lack patient focus—often, their main concern is the number of treatments rather than the quality of care. For this reason, they expect the hospital to score poorly on the new performance metrics. However, they point out that this is partly due to the current compensation system: more treatments = more dollars earned.
When the executives consult the organizational evidence, they notice that in the past five years, both the number of medical procedures and the physicians’ average income have increased. In the same period, however, several quality indicators (some of which are included in the new performance metrics) show poor outcomes: the number of readmissions, hospital acquired infections, and preventable medical errors have all increased. Not surprisingly, patient satisfaction has dropped significantly, and the number of complaints has surged.
Finally, interviews with the most important stakeholders, the physicians, paint a similar picture. Riverview is a hospital that emphasizes productivity and high performance, so physicians with a patient-centered focus who invest time in the doctor–patient relationship prefer to work elsewhere. Although there are still excellent physicians at Riverview whose first concern is the patient’s well-being, the hospital’s current compensation system provides a strong incentive to prioritize quantity over quality. As a result, they too expect the hospital to score poorly on the new metrics.
To a great extent
In the scenario we used above (question 9), does the evidence from relevant stakeholders support the assumed problem?
Riverview Healthcare’s executives agree on the following problem description and related assumptions: (1) The new metrics required by the federal government are intended to improve quality of care; it shifts reimbursement for patients from quantity (services provided) to quality (clinical outcomes, patient satisfaction, etc.). (2) Riverview’s physicians are focused on quantity rather than quality, and their treatment plans are not patient-centered. (3) As a result, Riverview will score poorly on the new metrics. (4) As a result, the federal government will pay Riverview a lower compensation for the care provided. (5) In the long term, this may lead to a serious loss of revenue and possible bankruptcy.
The executives decide to see whether there is evidence to support this problem description. They hold several focus groups with managers, team leaders, and nurses. All participants feel that many physicians at Riverview lack patient focus—often, their main concern is the number of treatments rather than the quality of care. For this reason, they expect the hospital to score poorly on the new performance metrics. However, they point out that this is partly due to the current compensation system: more treatments = more dollars earned.
When the executives consult the organizational evidence, they notice that in the past five years, both the number of medical procedures and the physicians’ average income have increased. In the same period, however, several quality indicators (some of which are included in the new performance metrics) show poor outcomes: the number of readmissions, hospital acquired infections, and preventable medical errors have all increased. Not surprisingly, patient satisfaction has dropped significantly, and the number of complaints has surged.
Finally, interviews with the most important stakeholders, the physicians, paint a similar picture. Riverview is a hospital that emphasizes productivity and high performance, so physicians with a patient-centered focus who invest time in the doctor–patient relationship prefer to work elsewhere. Although there are still excellent physicians at Riverview whose first concern is the patient’s well-being, the hospital’s current compensation system provides a strong incentive to prioritize quantity over quality. As a result, they too expect the hospital to score poorly on the new metrics.
To a great extent
In the scenario we used above (question 9), does the evidence from the scientific literature support the assumed problem?
Riverview Healthcare’s executives agree on the following problem description and related assumptions: (1) The new metrics required by the federal government are intended to improve quality of care; it shifts reimbursement for patients from quantity (services provided) to quality (clinical outcomes, patient satisfaction, etc.). (2) Riverview’s physicians are focused on quantity rather than quality, and their treatment plans are not patient-centered. (3) As a result, Riverview will score poorly on the new metrics. (4) As a result, the federal government will pay Riverview a lower compensation for the care provided. (5) In the long term, this may lead to a serious loss of revenue and possible bankruptcy.
The executives decide to see whether there is evidence to support this problem description. They hold several focus groups with managers, team leaders, and nurses. All participants feel that many physicians at Riverview lack patient focus—often, their main concern is the number of treatments rather than the quality of care. For this reason, they expect the hospital to score poorly on the new performance metrics. However, they point out that this is partly due to the current compensation system: more treatments = more dollars earned.
When the executives consult the organizational evidence, they notice that in the past five years, both the number of medical procedures and the physicians’ average income have increased. In the same period, however, several quality indicators (some of which are included in the new performance metrics) show poor outcomes: the number of readmissions, hospital acquired infections, and preventable medical errors have all increased. Not surprisingly, patient satisfaction has dropped significantly, and the number of complaints has surged.
Finally, interviews with the most important stakeholders, the physicians, paint a similar picture. Riverview is a hospital that emphasizes productivity and high performance, so physicians with a patient-centered focus who invest time in the doctor–patient relationship prefer to work elsewhere. Although there are still excellent physicians at Riverview whose first concern is the patient’s well-being, the hospital’s current compensation system provides a strong incentive to prioritize quantity over quality. As a result, they too expect the hospital to score poorly on the new metrics.
Unclear
Read the continuation of the scenario we used above, and determine whether the preferred solution is sufficiently clear.
Riverview Healthcare’s executives conclude that the evidence supports their hypothesis: the hospital will score poorly on the new performance metrics because many of Riverview’s physicians lack a patient-centered focus, which is partly due to the current compensation system. For this reason, they propose a new compensation plan that provides a strong financial incentive to prioritize quality over quantity of care. The new plan would include a variable bonus tied to the physicians’ group performance on the new metrics. The executives expect that the new compensation plan will shift physicians’ mindset and priorities to be more in line with a patient-centered view of health care and thereby improve the hospital’s score on the new metrics. The costs for the new plan are expected to be budget-neutral, but a one-time investment of $4.5 million is needed to make changes in the hospital’s IT system. Given the alternative—loss of revenue and possible bankruptcy—this is considered a good investment.
Were multiple options considered?
No
In the scenario we used above (question 13), how clearly defined is the preferred solution?
Riverview Healthcare’s executives conclude that the evidence supports their hypothesis: the hospital will score poorly on the new performance metrics because many of Riverview’s physicians lack a patient-centered focus, which is partly due to the current compensation system. For this reason, they propose a new compensation plan that provides a strong financial incentive to prioritize quality over quantity of care. The new plan would include a variable bonus tied to the physicians’ group performance on the new metrics. The executives expect that the new compensation plan will shift physicians’ mindset and priorities to be more in line with a patient-centered view of health care and thereby improve the hospital’s score on the new metrics. The costs for the new plan are expected to be budget-neutral, but a one-time investment of $4.5 million is needed to make changes in the hospital’s IT system. Given the alternative—loss of revenue and possible bankruptcy—this is considered a good investment.
Somewhat unclear
In the scenario we used above (question 13), is the logic model clear for how the solution actually would solve the problem?
Riverview Healthcare’s executives conclude that the evidence supports their hypothesis: the hospital will score poorly on the new performance metrics because many of Riverview’s physicians lack a patient-centered focus, which is partly due to the current compensation system. For this reason, they propose a new compensation plan that provides a strong financial incentive to prioritize quality over quantity of care. The new plan would include a variable bonus tied to the physicians’ group performance on the new metrics. The executives expect that the new compensation plan will shift physicians’ mindset and priorities to be more in line with a patient-centered view of health care and thereby improve the hospital’s score on the new metrics. The costs for the new plan are expected to be budget-neutral, but a one-time investment of $4.5 million is needed to make changes in the hospital’s IT system. Given the alternative—loss of revenue and possible bankruptcy—this is considered a good investment.
Very clear
In the scenario we used above (question 13), is it clear what the solution’s costs and benefits are?
Riverview Healthcare’s executives conclude that the evidence supports their hypothesis: the hospital will score poorly on the new performance metrics because many of Riverview’s physicians lack a patient-centered focus, which is partly due to the current compensation system. For this reason, they propose a new compensation plan that provides a strong financial incentive to prioritize quality over quantity of care. The new plan would include a variable bonus tied to the physicians’ group performance on the new metrics. The executives expect that the new compensation plan will shift physicians’ mindset and priorities to be more in line with a patient-centered view of health care and thereby improve the hospital’s score on the new metrics. The costs for the new plan are expected to be budget-neutral, but a one-time investment of $4.5 million is needed to make changes in the hospital’s IT system. Given the alternative—loss of revenue and possible bankruptcy—this is considered a good investment.
very clear
Read the continuation of the scenario we used previously and determine whether the preferred solution is sufficiently supported by evidence from multiple sources.
Riverview Healthcare’s executives decide to see whether there is evidence to support the preferred solution: implementing a new compensation system that provides a strong financial incentive to prioritize quality over quantity of care and that includes a variable bonus tied to the physicians’ group performance on the new metrics. Again, they hold several focus groups with managers, team leaders, and nurses. Most participants state that their experience is that, in general, most physicians are sensitive to financial bonuses and are gladly willing to change their focus and behavior if it yields more money. They therefore expect the new compensation system to shift physicians’ mindset and priorities to be more patient-centered.
When the research literature is consulted, it becomes clear that overall financial incentives (such as bonuses) have a strong positive effect on performance. Although some early studies found that financial incentives may negatively effect people’s intrinsic motivation—which is a strong predictor for quality of performance—this finding was not observed in later, more rigorous studies.
Finally, interviews with the most important stakeholders, the physicians, suggest that most of them welcome the new compensation system. They feel that including a variable bonus tied to the physicians’ group performance will definitely improve the hospital’s score on the new metrics and eventually shift physicians’ mindset. In addition, they expect the new compensation system to attract young physicians with a patient-centered focus whose first concern is the patient’s well-being rather than making a lot of money.
Does the evidence from practitioners support the preferred solution?
to a great extent
In the scenario we used above (question 17), can the kind of organizational data currently gathered be used to monitor the future effectiveness of the preferred solution?
Riverview Healthcare’s executives decide to see whether there is evidence to support the preferred solution: implementing a new compensation system that provides a strong financial incentive to prioritize quality over quantity of care and that includes a variable bonus tied to the physicians’ group performance on the new metrics. Again, they hold several focus groups with managers, team leaders, and nurses. Most participants state that their experience is that, in general, most physicians are sensitive to financial bonuses and are gladly willing to change their focus and behavior if it yields more money. They therefore expect the new compensation system to shift physicians’ mindset and priorities to be more patient-centered.
When the research literature is consulted, it becomes clear that overall financial incentives (such as bonuses) have a strong positive effect on performance. Although some early studies found that financial incentives may negatively effect people’s intrinsic motivation—which is a strong predictor for quality of performance—this finding was not observed in later, more rigorous studies.
Finally, interviews with the most important stakeholders, the physicians, suggest that most of them welcome the new compensation system. They feel that including a variable bonus tied to the physicians’ group performance will definitely improve the hospital’s score on the new metrics and eventually shift physicians’ mindset. In addition, they expect the new compensation system to attract young physicians with a patient-centered focus whose first concern is the patient’s well-being rather than making a lot of money.
unclear
In the scenario we used above (question 17), does the evidence from the scientific literature support the preferred solution?
Riverview Healthcare’s executives decide to see whether there is evidence to support the preferred solution: implementing a new compensation system that provides a strong financial incentive to prioritize quality over quantity of care and that includes a variable bonus tied to the physicians’ group performance on the new metrics. Again, they hold several focus groups with managers, team leaders, and nurses. Most participants state that their experience is that, in general, most physicians are sensitive to financial bonuses and are gladly willing to change their focus and behavior if it yields more money. They therefore expect the new compensation system to shift physicians’ mindset and priorities to be more patient-centered.
When the research literature is consulted, it becomes clear that overall financial incentives (such as bonuses) have a strong positive effect on performance. Although some early studies found that financial incentives may negatively effect people’s intrinsic motivation—which is a strong predictor for quality of performance—this finding was not observed in later, more rigorous studies.
Finally, interviews with the most important stakeholders, the physicians, suggest that most of them welcome the new compensation system. They feel that including a variable bonus tied to the physicians’ group performance will definitely improve the hospital’s score on the new metrics and eventually shift physicians’ mindset. In addition, they expect the new compensation system to attract young physicians with a patient-centered focus whose first concern is the patient’s well-being rather than making a lot of money.
to a great extent
In the scenario we used above (question 17), does the evidence from relevant stakeholders support the preferred solution?
Riverview Healthcare’s executives decide to see whether there is evidence to support the preferred solution: implementing a new compensation system that provides a strong financial incentive to prioritize quality over quantity of care and that includes a variable bonus tied to the physicians’ group performance on the new metrics. Again, they hold several focus groups with managers, team leaders, and nurses. Most participants state that their experience is that, in general, most physicians are sensitive to financial bonuses and are gladly willing to change their focus and behavior if it yields more money. They therefore expect the new compensation system to shift physicians’ mindset and priorities to be more patient-centered.
When the research literature is consulted, it becomes clear that overall financial incentives (such as bonuses) have a strong positive effect on performance. Although some early studies found that financial incentives may negatively effect people’s intrinsic motivation—which is a strong predictor for quality of performance—this finding was not observed in later, more rigorous studies.
Finally, interviews with the most important stakeholders, the physicians, suggest that most of them welcome the new compensation system. They feel that including a variable bonus tied to the physicians’ group performance will definitely improve the hospital’s score on the new metrics and eventually shift physicians’ mindset. In addition, they expect the new compensation system to attract young physicians with a patient-centered focus whose first concern is the patient’s well-being rather than making a lot of money.
to a great extent
