HCM 491 Module 5 Stakeholder Short Paper Example

Who Has to Say Yes? A Stakeholder Analysis for Dental Bridge

[Student Name]

Southern New Hampshire University

HCM 491: Health Sciences Capstone

Module Five Short Paper

[Instructor Name]

[Date]

The organization, setting and figures below are a composite written as a model document. No real employer, client, colleague or patient is described.

Who Has to Say Yes? A Stakeholder Analysis for Dental Bridge

Dental Bridge depends on people in two organizations who have not yet agreed to anything. ED physicians must learn nerve blocks, nurses must hand out a new packet, a community health worker must be hired, Riverside's dentists must hold slots open and the hospital's finance office must fund it all. This paper identifies these stakeholders and others, analyzes their interests, influence and positions and plans how to engage each one before the final proposal goes to the board.

The Approach

Brugha and Varvasovszky (2000) reviewed stakeholder analysis in health policy and presented it as a structured look at what each affected party wants, how much power it has and whether it will likely back or block a proposed change, so that planners can anticipate support and resistance. They cautioned that the analysis reflects the analyst's perspective and should be checked with others. For this paper, stakeholders were identified with the ED nurse manager and Riverside's clinic director, and ratings were reviewed by both.

Who the Stakeholders Are

Eleven stakeholders were identified. Inside Marlow: ED physicians and advanced practice clinicians, ED nurses, patient access staff, the chief financial officer, the chief operating officer and the community benefit office. At Riverside: dentists and dental assistants and the executive director. Outside both: patients with dental problems, the Medicaid managed care plans that cover many of them and the state hospital association, which could carry advocacy forward.

ED Clinicians

ED physicians care about patient flow and pain control. Some welcome a place to send dental patients; others worry that nerve blocks take time in a crowded department and carry a small risk of complications. Their influence is high, since they decide how dental patients are treated. The ED medical director supports the idea but wants training delivered on shift, not on days off. ED nurses share the flow concern and want the discharge packet kept to one page.

Riverside's Dentists and Leaders

Riverside's dentists are committed to serving low-income patients, but their main fear is empty reserved slots. When hospital referrals do not show up, a dentist sits idle while the clinic's own waiting patients go unseen. Riverside's executive director also worries about uncompensated care, since many referred patients will pay little. Their influence is decisive: without their slots, the pathway fails.

Finance and Executive Leaders

The chief financial officer wants evidence that the roughly $140,000 annual cost will be offset by fewer unreimbursed ED visits and admissions. The chief operating officer cares about ED throughput and staffing. The community benefit office sees the program as a strong fit with the hospital's needs assessment, which lists oral health among the top local concerns, and can count its costs toward the nonprofit's community benefit reporting.

Patients

Patients want pain relief, affordable treatment and an appointment soon enough to matter. Sun et al. (2015) found in interviews with ED dental visitors that cost, lack of a regular dentist and difficulty getting appointments drove their ED use, concerns that match comments in Marlow's surveys. Patients have little formal power, but their participation determines whether booked appointments are kept, so their influence on results is high.

Payers and the State Association

Medicaid managed care plans pay for many ED dental visits and may be interested in a program that reduces them, possibly funding part of the navigator role. Their current awareness is low. The state hospital association has influence with legislators on Medicaid benefits and could use Marlow's data in advocacy, but it has many competing priorities.

The Influence and Interest Grid

Table 1 places each stakeholder by influence over the pathway's success and interest in it, with their current position. Stakeholders with high influence and high interest need close management; those with high influence but lower interest need to be kept satisfied.

Table 1. Stakeholder Influence, Interest and Position

Note. Ratings by the author, reviewed by the ED nurse manager and Riverside's clinic director.

Solving the Empty Slot Problem

Riverside's concern needed a concrete answer. The proposal now includes a release rule: any reserved slot not booked by Dental Bridge by noon the day before returns to Riverside's own waiting list. The hospital will pay Riverside a flat $35 for each reserved slot, whether filled by a referral or released, covering the cost of holding it. The navigator's 48-hour reminder calls, modeled on the follow-up support Jiang et al. (2022) found improved appointment adherence, should keep no-shows low. Riverside's director has agreed to test this arrangement for six months.

Engagement Strategies

ED physicians will receive nerve block training in 30-minute sessions during shifts, led by a Riverside dentist, and two respected physicians will serve as champions. Nurses will help design the discharge packet. The chief financial officer will receive a cost and savings model in Module Six. Patients will be represented by two former ED dental patients recruited through the hospital's patient advisory council. The community benefit office will co-sponsor the proposal. Medicaid plans will receive a briefing once first-quarter data exist.

Anticipated Resistance

Some physicians may see dental care as outside the ED's job. The response is to frame Dental Bridge as reducing return visits that crowd the department, and to keep nerve blocks optional but encouraged. Some finance leaders may view the program as charity rather than an investment; the response is a cost model counting avoided admissions. Staff may worry about added work, so the navigator, not nurses, handles scheduling.

Communication Schedule

Communication will be regular and specific to each audience. Table 2 summarizes it.

Table 2. Communication Plan

Note. Plan developed by the author with the ED nurse manager.

Conclusion

Stakeholder analysis revealed that Dental Bridge's success depends most on ED physicians and Riverside's team, whose support is conditional. By answering the empty slot concern with a release rule and slot fee, training physicians on shift and bringing patients into design, the proposal turns conditional support into commitment. Module Six will show the finance office the numbers it needs.

References

Brugha, R., & Varvasovszky, Z. (2000). Stakeholder analysis: A review. Health Policy and Planning, 15(3), 239-246. https://doi.org/10.1093/heapol/15.3.239

Jiang, L. G., Zhang, Y., Greca, E., Bodnar, D., Gogia, K., Wang, Y., Peretz, P., & Steel, P. A. (2022). Emergency department patient navigator program demonstrates reduction in emergency department return visits and increase in follow-up appointment adherence. The American Journal of Emergency Medicine, 53, 173-179. https://doi.org/10.1016/j.ajem.2022.01.009

Sun, B. C., Chi, D. L., Schwarz, E., Milgrom, P., Yagapen, A., Malveau, S., Chen, Z., Chan, B., Danner, S., Owen, E., Morton, V., & Lowe, R. A. (2015). Emergency department visits for nontraumatic dental problems: A mixed-methods study. American Journal of Public Health, 105(5), 947-955. https://doi.org/10.2105/AJPH.2014.302398