What is the management-research question hierarchy for Akron Children’s Hospital?

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Northeastern Ohio is a highly competitive health-care market, especially for the care of seriously ill children. With powerhouse health care institutions like the Cleveland Clinic venturing into the children’s care segment, Akron Children’s needed a way to differentiate itself. The research profiled in this case helped develop the positioning of Akron Children’s hospital and its promotional approach that resulted in an increase in its bed-occupancy rate, a key metric in the health care industry.


The Scenario


The Midwestern hospital market is fiercely competitive, especially in Northeast Ohio. Akron Children’s Hospital, which competes in this environment, was established in 1890 and today is the region’s largest pediatric care provider with 253 beds. It offers 30 practice areas of medicine and surgery, specialized for children. Akron Children’s operates, however, in the shadow of two nationally recognized hospitals in nearby Cleveland: Rainbow Babies & Children’s Hospital and the Cleve- land Clinic. Rainbow, with 244 beds, has been ranked among the top five children’s hospitals nationwide by both U.S. News and World Report and Child magazine (which rates neonatal care at Rainbow second in the nation). The Cleveland Clinic, with 47 child beds, is not ranked for pediatric excellence but has earned a reputation as one of the top three hospitals in the country.


Even in such company, Akron Children’s has also distinguished itself for medical excellence. It was the first to grow human skin for treatment of burns and the first to offer intra-operative MRI for removal of brain tumors. It cares for the largest Hemophilia B population in the world, is one of only two U.S. hospitals with a pediatric palliative care program (which eases pain for terminally ill patients), and is the only hospital among its competitors to offer cancer support programs for teens.


Although innovative, larger, and well regarded, Akron Children’s was being overshadowed by competitors in its core markets. It needed a communications strategy to distinguish itself and to convey its commitment to children and to the highest-quality and most medically advanced care.


The Research


Akron Children’s turned to long-time re- search and communication partner, Marcus Thomas LLC, for insights and recommendations. As the firm’s vice president and director of research, Jennifer Hirt-Marchand, explained, “Akron Children’s had limited under- standing of how parents arrive at the difficult decision of where to take their children when acute care [requiring more than three days of hospitalization] is necessary.” Akron Children’s wanted to overcome this challenge, and, since it faced a difficult market in Cuyahoga County where its competitors were based, it also needed to devise a strategy to expand beyond its Summit County home into Portage, Mahoning, and Medina counties.


Marcus Thomas was asked to identify consumers’ hospital-choice decision process and to index perceptions associated with hospitals in the market. Initial research revealed that although consumers gave high survey ratings to medical capabilities and care they perceived as high-quality, their decisions in selecting hospitals were often driven more by emotion.


To peel down to the emotional core driving these decisions, Marcus Thomas conducted an observation study in the first phase of research. It negotiated per- mission to shadow physicians, parents, and child patients as they worked through testing, diagnosis, and treatment. Marcus Thomas researchers “were flies on the wall while kids attended checkups, were admitted to the ER, were undergoing surgery, prepping for surgery, and more,” according to Hirt-Marchand. “We spent days in the hospital watching the interactions of patients with physicians, nurses and other staff members.”


Researchers listened to, watched, and recorded first-hand physical and emotional reactions and heart-wrenching conversations. Marcus Thomas partner and creative director Joanne Kim shared, “We watched how the doctors talked to the children about their health problems, in kids’ terms, rather than talking just to the parents. We observed how parents were encouraged to stay with their children at the hospital 24/7 and how this philosophy helps children with the healing process. We saw how the staff, facility, food—everything about Akron Children’s—truly focused on kids being kids.”


Their analysis resulted in what Marcus Thomas believed could be a compelling brand promise, one that could be owned exclusively by Akron Children’s Hospital:


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 goal of helping every child reach his or her full potential. If a parent believed the brand promise, then they would trust Akron Children’s



1. What is the management-research question hierarchy for Akron Children’s Hospital?


Management question:


 Research question:


            Investigative questions:




2. What are the advantages/disadvantages of an observation study for this research?


3. If you were designing such an observation study, what would you direct researchers to record/look for/listen for?

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