Health Care: Business Case for Quality

The Essentials, published by the American Association of Colleges of Nursing, dictate that
graduates of MSN and DNP programs have certain skills, including organizational and systems leadership,
the ability to translate evidence into practice, and the ability to function on a multidisciplinary team to improve client outcomes.
Spearheading a quality improvement project requires each of the above skills. By this level, students are
usually comfortable navigating evidence, but have not yet managed the business components of
leading a quality improvement project. Healthcare is, in fact, a business, and to continue to positively
affect client outcomes, the care provided must be sustainable financially.
For this assignment you will be discussing a problem in the institution where you work or at an
institution where you are precepting or plan to work. Ultimately, this assignment builds a case for why
change is needed and why administration should accept your proposed solution. It needs to be well
researched and thorough. The following steps outline what you need to accomplish for this assignment.
Additional questions are welcome and should be posted in the Course Q&A. Point allocations and
additional grading considerations are provided on the rubric below the directions.
Step 1: Approval. Receive approval on your topic from your faculty. A business case that is
submitted without prior approval will receive a 10% deduction. Your faculty are here to
help you identify ideas that will be successful. See Business Case Topic Selection Discussion for
instructions on what to submit.
Step 2: Introduction. Introduce your business case. A good introduction should be one (1)
paragraph grabbing the reader’s attention. The last sentence should end with a single  thesis or purpose statement.
Step 3: Current Situation. Describe the current situation. Include organizational specific data
(address cost and incidence of the problem at minimum) that support the existence and
impact of this problem.
Establish and support the need for change. This may be include suboptimal outcomes, wasted materials, prolonged stays or readmissions, or inefficient use of human resources for example. This section should be supported with monetary figures, percentages, incidences, and all other relevant figures.
Step 4: Proposed Solution. Research and identify studies, guidelines, articles, etc., that address solutions to your identified problem. Select and introduce your proposed evidence-based solution for the problem that you have identified at your organization. Summarize current evidence-based research or current professional and clinical guidelines that support your proposed solution.
You can adapt the plan or evidence to your setting, but you must be able to provide APA formatted citations of the literature that supports your solution. This section should show application of the evidence that you found by addressing the expected changes in the costs, percentages, incidences, and other relevant figures that you introduced in the previous section. For example, how much can this change impact the current incidence of the problem? How much money will be saved if the implementation is successful?
Step 5:
Step 6:
Step 7:
Market Analysis.
Complete a SWOT analysis and include as an appendix. You may
use the template provided to you in Required Resources or one of your choosing. You
are responsible for ensuring that your chosen template contains all required components.
Follow the link provided to you on SWOT in your Required Resources for this module.
The resource poses questions that help you identify the strengths, weaknesses, opportunities,
and threats affecting your project. You know your organization better than anyone; don’t be afraid
to think outside the box. For example, technology implementation
can be a challenge in an older work population.
Implementation.
Describe your plan for implementation. This is a timeline that should
outline and provide details of needed steps and timeframes in which each is to be accomplished.
Questions to consider include: Where will you begin? Do you need administrative approval? Will
a team or committee need to be created with designated roles and responsibilities? Will job
descriptions need to be developed? Will a policy need to be revised
or developed? Do materials or supplies need to be purchased? What provider and staff
education is needed? This section should address the detailed answers of the above
questions.
Present this section in an APA-formatted bulleted list. In sequential order, address
each step necessary beginning with approval and ending with “go live.” Bullets can and
should have more than one sentence to fully include the necessary details. Each bullet
should also address the timeframe needed to complete each step.
Evaluation. The evaluation has two components: client-centered and financial.
A. Identify (a) structure, (b) process, and (c) outcome measures to evaluate the effectiveness of your plan’s implementation. Begin with the end in mind and identify the outcome measures (goals/benchmarks/metrics). Describe the processes
(process measures) contributing to the identified problem and identify measurement
criteria that indicate they are improving. Identify any structure measures that are
present or needed to achieve the selected outcome measures. Clearly identify in
your writing which measures you consider to be your outcome, process, and structure measures.
Review your Required Resources for further assistance.
B. Return on Investment (ROI). The administrative team will expect you provide an
evaluation plan that best measures the ROI and breakeven. You must find statistical
and economic data to show that your plan will improve the ROI. Begin by comparing
the cost of the current situation to the the cost of the new plan. Determine how
much money would be gained or saved by implementing your plan and how. For
example, do you expect decreased length of stay, decreased costs of complications,
or less equipment waste?
Calculate the expected return on investment (ROI) and breakeven. Use the ROI
and breakeven formulas provided in the Required Resources and review the examples provided
to you there. Remember that revenue and profits are not the same
thing. A typical timeframe to ensure that a plan is working is at least one year Discuss and
explain your math and results.
Step 8: Budget. You need to include a budget for your project also as an appendix. The budget
should be a table with line items that include (a) description of expenses required,
(b) cost for each, (c) quantity for each expense, and (c) total cost for each expense.
Consider the cost to educate staff, marketing, salaries if hiring staff, equipment, physical
space, etc. Each expense should be denoted as a direct or indirect cost. It should be
clear how you came up with the total costs. Address whether the project is revenuegenerating or
expense-reducing.
You will need to use real figures. Do not make up numbers. You can find these numbers
from the literature, or it may be that you will need to ask an administrator or an individual
who orders supplies for these figures, and cite this as personal communication in the
body of your paper. All figures and economic data will need a reference.
Your implementation plan and budget should be congruent. The expenses presented
here should be easily connected to the steps you outlined in your implementation plan.
Step 9: Conclusion. Conclude the paper. It should address the major takeaways from your
assignment. No new information should be present in a conclusion.
Step 10: Executive Summary. List the major points of your plan in an Executive Summary. The
executive summary should convey what the project is, why it is being proposed, what
the projected results will be, and the ROI. The document should be single spaced, use
bullet point formatting, and be written in complete sentences. The use of headings is
strongly recommended. An overview of the total budget should be included. If the proposed
program or initiative will generate revenues, estimates of the revenue and profits
should be included in the executive summary. Remember to include the bullet points
that would “sell” your idea to administration. See Required Resources for executive
summary guidance. Submit this section as an appendix as well.
The Business Case for Quality: Rubric
/1 Introduction. One paragraph that ends with a thesis statement. The thesis statement
should be no longer than 1 sentence summarizing the purpose of the paper.
/3 Description of the current situation, state of practice, and summary of existing
conditions. Current situation and why change is needed. Supported with substantial
organizational data.
/3 Description of the new program or proposed solution. Presentation of detailed, evi
dence-based solution that fixes the above problem.
/2.5 Market Analysis. SWOT analysis using provided template. Submitted as appropriately
formatted appendix.
/3 Implementation Plan. Detailed, clear, and realistic timeline of the implementation
process.
/4 Evaluation Plan.
A. Structure, process, and outcome measures (3 points)
B. Return on Investment (ROI) (3 points)
/3 Budget. Line item program budget. Submitted as appropriately formatted appendix.
/1 Conclusion. Summary of essential points. No new information.
/2 Executive Summary. Single-spaced, bulleted document summarizing essential points
using complete sentences. Submitted as appropriately formatted appendix.
/2.5 Scholarship.
TOTAL POINTS /25
Additional Notes:
• The paper should be organized with headings per APA format. At minimum, everyone should have one,
Level I heading for each section of the rubric. Depending on writing style, students may prefer to
use
both Level I and Level 2 headings for the evaluation section. Headings should be present in the
same
order in which they are presented in the rubric.
• The paper should be written in a formal, scholarly style and based on primary resources.
Correct APA
format is required. The paper should be approximately 5-6 pages in length (excluding title page,
reference pages, and appendices) and should have a minimum of 10 peer-reviewed references.
References should be timely: published within the previous five (5) years.
• For submission, each paper should be “named” according to the file naming policy of the
course.
• Each paper, with appendices, should be submitted to turnitin.com. Remember to remove title
and reference pages prior to Turnitin submission.
• Submission Instructions: Each paper should be submitted in Word or PDF format to the
appropriate
assignment area. There will be one document uploaded to the Assignment area.
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