Management-Research Question Hierarchy – Writer Bay

Management-Research Question Hierarchy

Akron Children’s Hospital is a well-establish, highly respected and capable children’s care facility in a highly competitive pediatric health-care market. Akron Children’s Hospital was established in the late 1800’s and has grown to be the “region’s largest pediatric care provider with 253 beds. It offers 30 practice areas of medicine and surgery, specialized for children” (Schindler, 2021). Even with the robust and substantiated reputation of being a leader in innovation, medical excellence and having the largest bed availability, Akron Children’s Hospital was experiencing “overshadowing” by two nationally recognized pediatric care facilities in the region. As a result, Akron Children’s Hospital sought out an outside research company, Marcus Thomas LLC, to devise a new communication strategy. Akron Children’s Hospital’s goal was to distinguish itself from their regional competitors and to communicate “its commitment to children…[and] to the highest-quality and most medically advanced care” (Schindler, 2021).

The management-research question hierarchy for Akron Children’s Hospital is to first identify the management dilemma. The management dilemma is how to attract more customers, or in this case patients, to their hospital care facility verses the regional competitors’ care facilities. The management question is to determine how to differentiate itself from its overshadowing competition. The research questions should focus on how Akron Children’s Hospital can distinguish itself from the competitors in the region by highlighting its strong commitment to children and families in serious- and terminally ill situations with highest-quality and medically innovative pediatric-focused care. Investigative questions include how parents decide on which children’s care facilities they choose for their child’s care and how can Akron Children’s Hospital communicate their robust care and facilities in order to attract more parents to make Akron Children’s Hospital their first choice. Measurement questions that are asked directly to the participants in which researchers observe and record the conversations include: how did the doctors convey to the patient, in this case the ill child, their prognosis, did you feel the doctor and staff were child-focused, did you feel encouraged to stay with your child for the entirety of their stay at the facility, do you agree with the philosophy that being able to stay with your child 24/7 helped with the healing process, did you feel Akron Children’s Hospital truly focused on kids being kids. Additionally, a Likert scale will reveal ordinal nature of the data (Allen & Seaman, 2007) when asking the parents and children to rate on a number scale (1 being strongly disagree and 5 being strongly agree) when assessing the facility, staff and food experiences.

Advantages/Disadvantages of Observation Study

In designing a measurement instrument for the Akron Children’s Hospital study, Marcus Thomas LLC used the communication-based research through covert and overt observation methodology (Slack & Rowley, 2001) to gain information and insight from study

participants. “Researchers listened to, watched, and recorded first-hand physical and emotional reactions and heart-wrenching conversations” (Schindler, 2021). Marcus Thomas LLC also covertly observed doctor interactions with the patients, in this case children, and their parents. The advantage in using observational methodology in the Akron Children’s Hospital case is that the researcher can record what they observe from the primary source. This provides accuracy and reliability of information. In the case of face-to-face interviews with participants, the interviewer can get more in-depth in the subject matter, gleaning more detailed information through follow-up questions as the participant becomes more comfortable and gains rapport with the interviewer. Additionally, observation with recording provides a permanent record of events and responses allowing further analyzation in the future. The disadvantage of using the observation methodology is the cost, including time and financials, of conducting the interviews and observations. Observation study is more time consuming than a self-administered survey; participants may be geographically further away creating cost of time and money to get interviewers to conduct a face-to-fac survey, and physical presence bias, consciously or subconsciously, may have an effect on the participant’s reaction.

What Brand Promise Reveals about Researcher’s Experience and Conclusion

Upon conclusion of the research, Marcus Thomas LLC believed that a compelling brand promise, very specific to Akron Children’s Hospital’s robust attributes could be used to attract more patients to Akron Children’s Hospital, solving the above stated managerial dilemma. The brand promise “Akron Children’s Hospital focuses ALL of the hospital’s resources (energy, creativity, state-of-the-art technology, compassion, technical skill, competence, etc.) toward the simple good of helping every child reach his or her full potential.” (Schindler, 2021) revealed that researchers repeatedly experienced observations of these listed attributes. Observations through overt methods revealed participants reporting that they positively experienced these various attributes of the hospital’s resources. The surveys the researchers used to rate the facility, staff, and food must have revealed data with positive results. Based on the recommended brand promise, researchers concluded that in order to attract more parents to decide which hospital to choose, they must trust the hospital’s reputation, or in this case “brand”. The brand promise facilitates understanding how the organization is to be perceived (Hytti et al, 2015) which influences parents when shaping their decision of which hospital they choose to care for their child.

Designing an Observation Study

If I were designing a similar observational study I would direct the researchers to “obtain valid data on attitudes, likes, dislikes, personal satisfaction, awareness of situation, use of [facilities]” (Dutka & Frankel, 1993). I would direct researchers to record verbal responses, facial reactions, and body language in face-to-face interviews and in covert observation situations. I would advise for researchers to look for locations and situations that they could observe and record hospital staff interaction with patients and parents without presenting possible physical presence bias. Researchers should listen for verbal ques, sometimes subtle in nature. Examples could be sighs, shaky voice, joyful tones, laughter, crying, etc. all verbal indicators of truthful, raw emotion and feelings at the time of an observed interaction.

Ethical Issues

“Researchers and participants all have the responsibility to behave ethically” (Schindler, 2021). Ethical issues that would surface in hospital studies in general and in this study would be privacy, quality, notice, choice, security, respect, and bias issues. Researchers, in this case Marcus Thomas LLC, have the greatest ethic responsibility because they are serving the needs of Akron Children’s Hospital and the participant. There are strict HIPPA laws to protect patients right to privacy. (Kilbridge, 2003). Legally, the researcher must obtain informed consent before beginning the study. In this study, there are minor children involved, so consent must be gained from their parent or guardian. The researcher also must ensure participant’s right to privacy, confidentiality, and safety. The researcher also has ethical and legal standards to maintain with their sponsor, in this case the hospital. The hospital has a right to quality research, protection of confidentiality, protecting research process information, findings and recommendations. Every member of the research process needs to be mindful and respectful of ethical behavior and legalities. We are reminded to surround ourselves with moral, ethically conscious people in 1 Corinthians 15:33, “Do not be misled: Bad company corrupts good character” (NIV, 2011).



The hospital has an excellent reputation, has earned awards, and is considered an exceptional place to receive care for ailments such as burn victims, Hemophilia B, brain tumors, and pediatrics. The hospital is one of two in the U.S. that offers palliative care to pediatric patients (Schindler, 2022). Despite these staggering statistics, the hospital still faces two major competitors in the local area, which are both smaller hospitals but are nationally recognized for their own merits. The hospital would like to be the leading competitor in the area to provide the best care for its patients. This includes being able to serve as many counties in the surrounding areas as possible. Another one of the measuring sticks for providing quality care is the number of patients the hospital is able to treat. Excellent treatment can allow patients to recover and return to their homes in a more timely manner, where they are more comfortable and happy, a better environment for healing. This allows the hospital to turn over beds and treat more patients. Patient perspective on this concept is incredibly important, for the patients must not feel rushed in their care and this is a delicate balance to strike when trying to treat, diagnose, and return them to their home environment as expeditiously as possible. This philosophy of care is going to start with management and trickle down through the staff in energy, attitude, and job satisfaction which the patients will feel the impact of when being treated in the facility.


This area of the U.S. is known for some of the highest quality healthcare available. The research company tried to narrow down the specific reasons for why any of the three above-mentioned facilities were being chosen by a patient or the parent/guardian of a patient. The first discovery unearthed was that the two competing facilities were both ranked higher as a choice for hospital stays lasting longer than three days. The research team collected overall high ratings on Akron’s facility, but another area in which the score was low was an emotional connection to patients during treatment. The research team was able to begin the task armed with this knowledge, and sympathize with the medical staff. Emphasizing their interest in using the study to improve conditions building rapport with the providers and putting them at ease during the overt study is an advantage of this type of study (Wilson, 2020). While conducting direct observations of doctor-patient visits, the research team observed parents and children directly interacting with the providers and staff in a variety of care settings such as lab tests, consults, emergency room visits, routine checkups, and surgical preparation. For this part of the study, a video recording was permitted, which allowed the team to watch and re-watch to analyze things like body language and tone of voice. This gave the study an advantage in observing the exchange of communication from both sides with intensity, and provide an extremely thorough report. Disadvantages are the obvious presence of the camera and outsiders will undoubtedly make providers and patients behave differently than normal, and the experience is less organic, despite providing the material that can be studied in such depth.

Brand Promise

“Akron Children’s Hospital focuses ALL the hospital’s resources (energy, creativity, state-of-the-art-technology, compassion, technical skill, competence, etc.) toward the simple goal of helping every child reach his or her full potential” (Schindler, 2022). The great thing about the research was that the outcome was able to demonstrate that the true intent of the hospital and its staff is in the best interest of children receiving excellent health care and being allowed to be children. The study shows that the hospital lives up to its reputation in utilizing the most up-to-date technology and resources whenever possible and always putting the patients first. The Doctors use every effort to explain things to children in ways that they can understand. The entire experience is true to the mission statement of the hospital and with slight tweaking and training, the emotional connection can be improved upon in order to bring the brand promise up to the level of success the hospital is looking to achieve. Studies now show that the emotional connection can be as, if not even more effective treatment than the care given by the provider in a patient care setting (DeAngelis, 2019).

Observation Study

If another study were to be conducted, it would be wise to include the methods already being used here, because the direct observations used are the best way to collect data for this type of setting. Using indirect observations would also be valuable, it would give the results more confidence to show that as many methods as possible had been exhausted, even creative or unorthodox ones if necessary. For example, a patient questionnaire could have been put into place to ask patients how they witnessed the staff being treated by superiors during their visits. Sometimes the unexpected vantage points can give the most surprising yet valuable results in uncovering why a system isn’t operating at its full potential. Other methods that were more covert, or in secret, would capture more authentic behavior. This is difficult to do in a healthcare setting due to privacy rules. Perhaps a quality improvement disclosure could be included in the patient intake forms, and audio-recordings could be taken, which can easily have names and personally identifiable information (PII) deleted and the conversations between patients and providers or providers and subordinates can be listened to at random to monitor behavior and treatment. Unfortunately, for the process to be considered truly covert and the subject to behave in the most natural manner possible, consent is not granted, (Threlfall, 2011), so this would almost be impossible in a healthcare setting.

Ethical Issues

As mentioned, privacy issues are the most difficult to overcome in a study such as this. Caregivers must follow the rules and regulations of the Health Insurance Profitability and Accountability Act of 1996 (HIPAA) with full disclosure to patients of the study being conducted during the visit. Following the research, the proper security or destruction of the material collected is equally as important, so as not to allow the patients protected identity or health information to become available to unauthorized personnel.


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