HCS 321 Week 4 Reports, Requests for Proposals and Proposals Example

Who Answers the Phone at 2 A.M.? A Request for Proposals, an Evaluation Report and a Recommendation Proposal for a Medical Group's After-Hours Nurse Triage Service

[Student Name]

University of Phoenix

HCS/321: Business Communication for Health Care Managers

Week 4 Assignment

[Instructor Name]

[Date]

The medical group, the vendors and their figures are composites written for a model paper; research findings come from the sources listed.

Physicians in a composite medical group of 20 primary care practices take turns answering patients' after-hours calls. Each physician covers about one week in six, receives an average of 14 calls a night and still works the next day. In a staff survey, 71% of physicians named after-hours calls as a leading source of fatigue, and two recruits declined offers last year partly because of call burden. The operations director proposed contracting with a nurse triage service. This paper presents the three documents the decision required: a request for proposals, an evaluation report and a recommendation proposal.

Three Documents, Three Purposes

A request for proposals invites vendors to propose solutions to a defined need on the same terms, so responses can be compared. A report presents findings objectively to inform a decision. A proposal argues for a specific action and asks for approval. Writing all three well draws on the communication and business skills domains expected of health care managers (Stefl, 2008). Keeping the report objective and saving persuasion for the proposal protects the board's trust, because a report that already argues for one vendor gives the reader no reason to believe its findings.

The Request for Proposals

The request described the group, its after-hours call volume of about 1,400 calls a month and its patient mix. The scope required registered nurses using recognized triage protocols, answering 90% of calls within 60 seconds, callback within 30 minutes for non-urgent calls, documentation sent to the group's electronic health record by 7 a.m., escalation to the on-call physician for defined conditions and Spanish-language service. Vendors had to describe protocols, staffing, licensure across states, quality monitoring, data security, references and pricing. The request stated evaluation criteria and weights in advance, set a 30-day response window and named one contact for questions.

Evaluation Criteria and Weights

Clinical quality and protocols: 35%. Access and response times: 20%. Integration with the electronic health record: 15%. Cost: 20%. References and experience: 10%. Clinical quality carries the highest weight because triage decides whether a sick patient reaches care in time.

Why Clinical Quality Carries the Most Weight

Huibers et al. (2011) systematically reviewed research on nurse and physician telephone triage outside office hours and found that, while triage was often safe, studies using high-risk simulated patients found that urgency was underestimated in a meaningful share of cases, and they called for further improvement of safety. The report therefore asks how each vendor tests and monitors its nurses on high-risk calls.

The Evaluation Report: Summary

Three vendors responded. Vendor B scored highest overall, with strong quality monitoring and full record integration at a middle price. Vendor A was cheapest but lacked integration. Vendor C had the best response times but the highest cost and limited Spanish-language service.

Findings by Criterion

Clinical quality: Vendor B audits 5% of calls monthly, uses simulated high-risk calls quarterly and reports under-triage rates; Vendor A audits 2% with no simulation; Vendor C audits 3%. Access: all three met the 60-second target in references; Vendor C averaged 22 seconds. Integration: Vendor B sends structured notes to the group's record; Vendor A sends faxes. Cost per year: A, $252,000; B, $302,000; C, $365,000. References: all satisfactory.

Weighted Scores

On a 100-point scale, Vendor B scored 86, Vendor C 78 and Vendor A 69. The report lists each score by criterion in a table so the board can see how the totals were reached.

Limits of the Evaluation

References came from vendors' chosen clients, and quality figures were self-reported. The report recommends confirming Vendor B's audit data during contract negotiation.

How the Board Will Read It

Board members will read the summary and the scores table first and turn to the findings only if something surprises them. The report is therefore arranged so that its first page stands alone: the need, the three vendors, the scores and the one caution about self-reported quality data. Details sit behind that page for anyone who wants them, and an appendix holds each vendor's full pricing.

The Recommendation Proposal: Request

The operations director requests approval of a two-year contract with Vendor B at $302,000 a year, beginning July 1.

The Problem Restated

After-hours call duty contributes to physician fatigue and has cost the group recruits in a market where each primary care vacancy costs an estimated $500,000 in lost revenue per year.

The Proposed Solution

Vendor B's nurses will answer all after-hours calls, use standardized protocols, escalate defined urgent calls to the on-call physician and send notes to the record by morning. Physicians remain on call only for escalations, expected to be about two calls a night.

Benefits

Fewer overnight calls for physicians, consistent triage documentation, Spanish-language access and a recruiting advantage. Morning notes will let practices follow up on overnight concerns.

Costs and Funding

The contract costs $302,000 a year. The group currently pays physicians a call stipend totaling $180,000 a year, which will be reduced to $60,000, leaving a net cost of $182,000. Filling one vacancy faster would more than cover it.

Risks and Responses

Triage errors: monthly review of all escalations and any adverse events, with contract terms for corrective action. Patient dissatisfaction with a nonlocal nurse: a patient survey after three months. Integration delays: a go-live condition that notes reach the record.

Implementation

Contract signed by May 15; integration testing in June; patient notices by portal and phone message in late June, with practice staff mentioning the change in person at visits, since a change in how patients reach their doctor deserves a richer channel than a notice alone (Daft & Lengel, 1986); go-live July 1; three-month review in October.

Decision Requested

Approve the two-year Vendor B contract at $302,000 a year and the reduction of the call stipend, effective July 1.

Conclusion

Separating the request, the report and the proposal gave the board a fair competition, objective findings and a clear argument. Each document did one job, and together they supported a decision that relieves physicians while protecting patients who call at night.

References

Daft, R. L., & Lengel, R. H. (1986). Organizational information requirements, media richness and structural design. Management Science, 32(5), 554-571. https://doi.org/10.1287/mnsc.32.5.554

Huibers, L., Smits, M., Renaud, V., Giesen, P., & Wensing, M. (2011). Safety of telephone triage in out-of-hours care: A systematic review. Scandinavian Journal of Primary Health Care, 29(4), 198-209. https://doi.org/10.3109/02813432.2011.629150

Stefl, M. E. (2008). Common competencies for all healthcare managers: The Healthcare Leadership Alliance model. Journal of Healthcare Management, 53(6), 360-373. https://doi.org/10.1097/00115514-200811000-00004