Political Landscape Analysis
Political Landscape Analysis
• Using the case scenario provided, write a 3–4 page analysis of the organization’s political landscape, including formal and informal power structures at play and their impact on culture, policy, and communications.
Understanding the political landscape of an organization is key when developing strategic priorities. Knowing the key players and how to leverage relationships will help you develop a strategic plan that is meaningful to all stakeholders. Gaining stakeholder buy-in is the key to success when attempting to meet the strategic goals outlined on a balanced scorecard.
This assessment provides an opportunity for you to gain insight into organizational power structures and their effects on organizational culture, policies, and communications.
Demonstration of Proficiency
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
• Competency 2: Analyze formal and informal power structures in an organization.
o Analyze the formal and informal lines of power within an organization.
o Incorporate organizational power dynamics as a factor in executive-level decision making.
o Identify the appropriate source of power for achieving a primary strategic objective.
Competency 4: Recommend policy changes that support a strategic plan.
o Assess the potential impact or influence of power on organizational policy.
Competency 5: Address assessment purpose in effective written or multimedia presentations, incorporating appropriate evidence and communicating in a form and style consistent with applicable professional and academic standards.
o Articulate meaning relevant to the main topic, scope, and purpose of the prompt.
o Apply APA formatting to in-text citations and references.
Preparation
For this assessment, use the following case scenario:
You are a new nurse executive at a community-based hospital system in the southeastern region of the United States. The system is not-for-profit and serves five rural counties. The system comprises one flagship hospital, three smaller critical access hospitals, and a number of clinics and urgent care centers. The health care system serves a diverse population of insured, Medicare, Medicaid, and uninsured patients. The hospital is Joint Commission accredited and for three years in a row has been rated as a Top 100 Hospital.
Historically, the hospital system has been physician-centric, meaning that the physician staff have had the power to influence change, policy, and protocol. The current chief executive officer (CEO) was recently hired from a large university-affiliated hospital system. The chief medical officer (CMO) started the organization’s orthopedic program (one of the most lucrative service lines) and has been with the organization for more than 25 years. He is well respected in the local community and serves on a number of community boards. In light of this strong influence from the department of medicine, nursing has struggled over the past five years. You are the second chief nursing officer (CNO) in four years. The hospital board is applying pressure to seek Magnet designation, which was recently lost due to poor leadership by your predecessor.
The hospital has recently adopted the hospitalist model to cover all in-patients. The hospitalist group was developed by physician leaders in the organization and operates as a separate department within the organization. The hospitalist group desires to become a limited liability corporation (LLC) to maximize benefit offerings but needs a larger staff to make this happen. They have presented a proposal to executive leadership to transfer all advance practice registered nurses (APRNs) working in the organization (there are more than 50) to the hospitalist group, which is housed under the department of medicine. The CMO is spearheading this initiative. Traditionally, ARPNs were hired and managed by the department of nursing.
As the new CNO, you have been approached by a group of 15 APRNs who are against the transition as it will severely impact their scope of practice, in addition to affecting their paid time off, salary, and work hours. The CMO has offered to make APRNs eligible for the annual physician hospitalist bonus structure, as an incentive. At the same time, the CMO has informally proposed that a new policy be created for APRN hospital privileges. If the APRNs choose not to join the hospitalist group, they will not be eligible for hospital privileges. In the state in which the organization is located, a supervising physician is required for APRN practice.
Instructions
Analyze the organization’s political landscape. Examine formal and informal power structures at play and how they affect organizational culture, policies, and communications at all levels.
Lessons learned from your analysis of the organization’s political landscape will provide useful insight into important contextual factors for consideration as you work through Assessments 2, 3, and 4.
Note: Remember that you can submit all or a portion of your draft analysis to Smarthinking for feedback, before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback.
Analysis Format and Length
Format your document using APA style.
Use the APA Style Paper Template [DOCX]. An APA Style Paper Tutorial [DOCX] is also provided to help you in writing and formatting your analysis. Be sure to include:
o A title page and references page. An abstract is not required.
o A running head on all pages.
Use the following section headings to ensure thorough content coverage and flow.
o Formal and Informal Lines of Power.
o Organizational Power Influences on Executive-Level Decision-Making.
o The Impact of Power on Organizational Policy.
o Sources of Power.
Provide a short conclusion to your analysis in the form of a summary or editorial.
Your analysis should be 3–4 pages in length, excluding the title and references pages.
Evaluation
The following tasks correspond to the grading criteria in the assessment scoring guide, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed.
Analyze the formal and informal lines of power within the organization.
o What source of power is being used by the different stakeholders? For example: authority, rewards, coercion, expertise, reputation, personal power.
o Describe the effects of power structures on organizational culture, policies, and communications at all levels.
Incorporate organizational power dynamics as a factor in executive-level decision making.
o Based on your analysis of internal power structures and your perspective as CNO, what would be the best way to respond to the concerns of the ARPNs in this scenario, and why?
o What support for your response can be found in the evidence-based literature?
o What underlying assumptions might influence your decision making?
Assess the potential impact or influence of power on organizational policy.
o What is the basis for your conclusions?
Identify the appropriate source of power for achieving a primary strategic objective.
o For example: authority, rewards, coercion, expertise, reputation, personal power.
o What evidence do you have to support your conclusion?
Articulate meaning relevant to the main topic, scope, and purpose of the prompt.
o Write with a specific purpose and audience in mind.
o Adhere to scholarly and disciplinary writing standards.
o Proofread your writing to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your analysis.
Apply APA formatting to in-text citations and references.
NURS8010 Executive leadership in Contemporary Nursing
Assessment 2 Instructions
Strategic Plan Appraisal
• Write a 4–5 page critical appraisal of an organization’s strategic plan from the perspective of a nurse executive, taking into consideration the organization’s mission, vision, and other contextual factors.
A strategic plan is constructed from a clear, well-articulated vision and a comprehensive environmental scan. An analysis of the internal and external environments provides a clear picture of the current state and the potential hurdles to overcome in reaching the desired future state. Leaders can then establish goals and objectives that are specific, measurable, acceptable, realistic, timely, and rewarding.
Strategic objectives balance short-term and long-term opportunities and consider the needs of all key stakeholders. From the objectives flow the strategies and tactics for achieving the goals. Building skill in strategic planning positions the DNP nurse as one who makes things happen.
This assessment provides an opportunity for you to critically examine an organization’s strategic plan. An understanding of the organization’s vision, mission, and strategic priorities is crucial to departmental strategic planning that aligns with, and supports, organizational priorities.
Demonstration of Proficiency
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
• Competency 1: Analyze organizational priorities at the system level.
o Analyze an organization’s strategic plan.
o Evaluate the validity of data and analytical strategies used to develop organizational priorities.
o Explain how input from stakeholders might have been elicited and incorporated into the development of strategic priorities.
o Create a balanced scorecard for an organization.
Competency 5: Address assessment purpose in effective written or multimedia presentations, incorporating appropriate evidence and communicating in a form and style consistent with applicable professional and academic standards.
o Articulate meaning relevant to the main topic, scope, and purpose of the prompt.
o Apply APA formatting to in-text citations and references.
Preparation
For Assessments 2, 3, and 4, you will appraise an organizational strategic plan, develop a departmental strategic plan, and propose a quality improvement initiative, respectively. The choice of health care setting as the context for this work is up to you. You may choose the organization in which you currently work, an organization in which you worked previously, or an organization about which you would like to learn more. You will use this health care organization, and a department or division within the organization, as the basis for the remaining assessments in this course.
After choosing your organization, obtain a copy of the organization’s strategic plan. Most large health systems post their strategic plans, visions, and missions on the Internet.
Note: Remember that you can submit all or a portion of your draft appraisal to Smarthinking for feedback, before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback.
Instructions
Write a critical appraisal of the organization’s strategic plan. Identify strategic priorities and orient yourself to the key performance indicators (KPI) the organization uses to drive quality.
Note: Lessons learned from your appraisal will inform your work in Assessments 3 and 4.
Appraisal Format and Length
Format your document using APA style.
Use the APA Style Paper Template [DOCX]. An APA Style Paper Tutorial [DOCX] is also provided to help you in writing and formatting your appraisal. Be sure to include:
o A title page and references page. An abstract is not required.
o A running head on all pages.
o Appropriate section headings.
Your appraisal should be 4–5 pages in length, excluding the title page and references page.
Use the following section headings to ensure thorough content coverage and flow.
o Strategic Plan Analysis.
o Validity of Data and Analytical Strategies.
o Stakeholder Input.
o Balanced Scorecard Perspective.
Evaluation
The following tasks correspond to the grading criteria in the assessment scoring guide, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed.
Analyze an organization’s strategic plan.
o Approach your analysis from a systems perspective.
o What priorities appear to take precedence?
o How well do the priorities align with the mission and vision of the organization?
Evaluate the validity of data and analytical strategies used to develop organizational priorities.
o What data was most likely used to develop key performance indicators (KPIs)?
o For example: patient satisfaction data, 30-day readmission data, other internal performance indicators or external regulatory measures.
o What was the source of the data?
o For example: Centers for Medicare and Medicaid Services (CMS), internal data, public health data, financial data.
Explain how input from stakeholders might have been elicited and incorporated into the development of strategic priorities.
o For example, strategic priorities can be developed by the board of directors, elicited from employee focus or patient advocacy groups, or derived from a combination of these approaches.
o You may need to interview an organizational stakeholder for this information. If this information is unavailable to you, identify the stakeholders you would approach for their inputs.
Create a balanced scorecard for an organization.
o Use four standard balanced scorecard domains: 1) financial, 2) customer, 3) internal processes, and 4) learning and growth.
o Are the organization’s strategic priorities balanced, or do one or more priorities receive more emphasis than the others?
Articulate meaning relevant to the main topic, scope, and purpose of the prompt.
o Write with a specific purpose and audience in mind.
o Adhere to scholarly and disciplinary writing standards.
o Proofread your writing to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your appraisal.
Apply APA formatting to in-text citations and references.
NURS8010 Executive leadership in Contemporary Nursing
Assessment 3 Instructions
Strategic Plan Development
• Develop a strategic plan for a department or division within a health care organization, taking a balanced scorecard approach.
Nurse leaders will be increasingly called upon to collaborate in strategic planning as they partner in the redesign of health care in the United States (Institute of Medicine, 2011). To be an integral partner in health care redesign, nurse leaders must be able to leverage political power and data in strategic planning. Analytical tools, such as the balanced scorecard and SWOT analysis, are used to construct a solid, defensible strategic plan.
This assessment provides an opportunity for you to develop both the knowledge and skills required for strategic planning, using a balanced scorecard approach. With insight into the importance of an organization’s political landscape and a comprehensive understanding of the priorities of the organization you are studying, you are well-prepared to develop a strategic plan for a department or division within that organization.
Demonstration of Proficiency
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
• Competency 3: Propose a strategic plan that integrates feedback from other disciplines and aligns with organizational priorities.
o Create a balanced scorecard for a department or division.
o Identify departmental strategic priorities.
o Evaluate the effects of organizational policies on departmental strategic priorities.
o Align departmental strategic priorities with elements of an organization’s strategic plan.
Competency 4: Recommend policy changes that support a strategic plan.
o Evaluate the effects of organizational policies on departmental strategic priorities.
Competency 5: Address assessment purpose in effective written or multimedia presentations, incorporating appropriate evidence and communicating in a form and style consistent with applicable professional and academic standards.
o Communicate clearly and concisely in a form and style appropriate for the audience and the substance, purpose, and context of the message being conveyed.
Reference
Institute of Medicine, Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing. (2011). The future of nursing: Leading change, advancing health. Washington, DC: National Academies Press.
Preparation
For this assessment, remember to use the same health care setting you chose in the previous assessment.
Departmental strategic priorities must align with organizational priorities. To prepare for this assessment, consider how you might best represent these alignments graphically in an attractive, professional manner. For example, you might choose a crosswalk table, Venn diagram, or other format that clearly illustrates these alignments. Be creative in your approach. Use the organization’s colors or design your own color scheme. Keep in mind that these conceptual representations are intended for executive leaders and other stakeholders in the organization and community.
Note: Remember that you can submit all or a portion of your draft plan to Smarthinking for feedback, before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback.
Instructions
Develop a strategic plan that establishes top priorities for a department or division, aligned with the organization’s strategic plan, which you appraised in Assessment 2. Include the following elements in your plan:
A balanced scorecard for the department or division. The following interactive media may help you in constructing your balanced scorecard:
o A Balanced Scorecard for Change.
A minimum of four departmental strategic priorities, one from each balanced scorecard domain (financial, customer, internal processes, learning and growth).
Graphical representations showing alignments between the departmental strategic priorities and the organization’s strategic plan.
Strategic Plan Format and Length
Format your document using APA style.
Use the APA Style Paper Template [DOCX], linked in the Resources. An APA Style Paper Tutorial [DOCX] is also provided to help you in writing and formatting your appraisal. Be sure to include:
o A title page and references page. An abstract is not required.
o A running head on all pages.
o Appropriate section headings.
Your appraisal should be 3–5 pages in length, excluding the title page and references page.
Use the following section headings to ensure thorough content coverage and flow.
o Departmental Strategic Priorities.
o Effects of Organizational Policies.
Add your balanced scorecard and graphical representations of priority alignments as appendices.
Evaluation
The following tasks correspond to the grading criteria in the assessment scoring guide, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed.
Create a balanced scorecard for a department or division.
o Each scorecard domain must include an objective, performance metric, benchmark target, and prospective initiative.
Determine departmental strategic priorities.
o Include at least one strategic priority for each balanced scorecard domain (financial, customer, internal processes, learning and growth).
o Why are these priorities important?
o Are these priorities feasible?
o For example, do they reflect departmental objectives, available resources, and a specific time frame?
o Explain.
Evaluate the effects of organizational policies on departmental strategic priorities.
o How do existing policies hinder or facilitate what you hope to accomplish?
Align departmental strategic priorities with elements of an organization’s strategic plan.
o Represent the alignments graphically in a crosswalk table, Venn diagram, or any other format that clearly illustrates the alignments.
Communicate clearly and concisely in a form and style appropriate for the audience and for the substance, purpose, and context of the message being conveyed.
o Consider the needs of your audience.
o Be succinct and mindful of communication best practices.
o Carefully review your materials to avoid errors that could distract the audience and make it more difficult for them to focus on the substance of your strategic plan.
NTRODUCTION
Strategic planning is paramount for organizational success. The definition of strategic planning is an organization’s process of defining its strategy or direction and making decisions on allocating its resources to pursue this strategy.
The strategic plan is used to communicate organizational goals, the actions needed to achieve those goals, and all of the other elements critical to organizational stakeholders. Although this process and document may take several different forms, there are seven key steps in strategic planning.
To successfully complete an organizational change project, the DNP learner must connect the project goals to the organizational goals. The DNP learner needs to understand how the organizational strategic plan was developed.
The seven key steps in strategic plan development include:
1. Identify the mission statement.
2. Create a future vision.
3. Develop core values and guiding principles.
4. Create long-term goals and SMART objectives.
5. Establish an action roadmap with timelines.
6. Build a communication plan.
7. Establish an implementation plan.
Question 1 of 2
Why is it important to align your strategic plan with departmental strategic priorities?
Question 2 of 2
Why is a communication plan important in strategic planning?
NURS8010 Executive leadership in Contemporary Nursing
Assessment 4 Instructions
Quality Improvement Proposal
• Propose a high-level quality improvement initiative for a selected departmental strategic priority, and choose an effective method of presenting your proposal to executive leaders and other stakeholders in the organization and community.
Quality improvement and management in health care has its roots in the business world and the teachings of quality gurus such as W. Edwards Deming, Joseph Juran, Phillip B. Crosby, and AvedisDonabedian. As health care costs rose in the late 1960s, payers wanted assurance that their investments resulted in improved health. More importantly, patients and health care professionals wanted assurance that their participation resulted in safe, effective care with positive long-term benefits.
As 21st century health care organizations strive for high reliability, executive leadership is tasked with keeping the organization focused on quality and safety. In the previous assessments, you identified an organization’s strategic priorities and provided a comprehensive assessment of stakeholder and leadership influence. High-reliability organizations align quality and safety with strategic goals. Your work in previous assessments will help you identify one strategic priority for improvement.
From the nursing unit level to the executive office, quality equates with attention to the processes and functions that drive and support safety, efficiency, effectiveness, and satisfaction. The DNP-prepared nurse is in a unique position to blend knowledge of systems theory with an understanding of quality management. Added to this mixture is the DNP-prepared nurse’s exquisite appreciation for the holistic needs of individuals and groups.
This assessment provides an opportunity for you to propose a quality improvement initiative that supports a departmental strategic priority.
Demonstration of Proficiency
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
• Competency 3: Propose a strategic plan that integrates feedback from other disciplines and aligns with organizational priorities.
o Explain the rationale for establishing a strategic priority.
o Present the key points from a SWOT analysis of a chosen strategic priority.
o Identify key performance indicators for measuring the success of a quality improvement initiative.
o Explain the value of stakeholder feedback and the process for collaborating with stakeholders on a proposed quality improvement initiative.
o Explain how one contemporary change theory could be used to facilitate changes inherent in implementing a quality improvement initiative.
Competency 4: Recommend policy changes that support a strategic plan.
o Make policy recommendations to support a proposed quality improvement initiative.
Competency 5: Address the assessment purpose in effective written or multimedia presentations, incorporating appropriate evidence and communicating in a form and style consistent with applicable professional and academic standards.
o Communicate clearly and concisely in a form and style appropriate for the audience and for the substance, purpose, and context of the message being conveyed.
Preparation
Choose one strategic priority from the departmental strategic plan you developed in Assessment 3 as the focus of a proposed quality improvement initiative.
Note: Remember that you can submit all or a portion of your draft proposal presentation to Smarthinking for feedback, before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback.
Instructions
Develop a presentation of your proposed high-level quality improvement initiative for executive leaders and other stakeholders in the organization and community.
Be creative in showcasing your proposal. Choose a presentation method you consider to be both engaging and likely to garner the necessary support and buy-in. For example, you might consider any of the following methods, or something different.
Marketing brochure.
Newsletter.
Video.
Audio or video slide presentation.
Executive summary.
Whichever method you choose, consider the information needs of your intended audience, their communication preferences, and possible time constraints on processing your proposal.
Video Recording
If you choose video as your preferred presentation method, Kaltura is the recommended tool for video recording. Refer to Using Kaltura for more information about this courseroom tool. You are also free to use any other technology of your choice (such as a video camera or smart phone) to record your video; however, please inform the faculty facilitator of your decision not to use Kaltura to avoid potential technical problems associated with file formats.
To record your video, you will need a built-in or external microphone and/or video camera (webcam or other device). Check that your recording equipment and software is working properly and that you know how to record and submit your video. Be sure to set up and test your equipment ahead of time.
Note: If you use assistive technology or any alternative communication methods to access course content, please contact [email protected] with any access-related questions or to request accommodations.
Evaluation
The following tasks correspond to the grading criteria in the scoring guide, so be sure to address each point in the presentation of your proposed quality improvement initiative. Read the performance-level descriptions for each criterion to see how your work will be assessed.
Explain the rationale for establishing a strategic priority.
o Describe the overarching aim and focus of your proposed quality improvement initiative.
o Use the evidence-based literature to provide broad rationale for establishing this priority.
Present the key points from a SWOT analysis of a chosen strategic priority.
o Consider the organization’s political landscape and strategic priorities.
Identify key performance indicators for measuring the success of a quality improvement initiative.
o For example: infection rates, customer satisfaction, financial performance indicators, productivity, nurse satisfaction, or other internal metric.
o These indicators could align with those identified on the departmental balanced scorecard.
Explain the value of stakeholder feedback and the process for collaborating with stakeholders on the proposed quality improvement initiative.
o Identify key stakeholders and explain why their support for this initiative is crucial to its success.
o Explain how you will leverage stakeholder feedback.
Explain how one contemporary change theory could be used to facilitate changes inherent in implementing a quality improvement initiative.
Make policy recommendations to support the proposed quality improvement initiative.
o Your recommendations could entail developing a new policy, revising a current policy, or retiring a current policy.
o Describe the policy implications of this initiative and their impact on the organization.
o Justify your recommendations.
Communicate clearly and concisely in a form and style appropriate for the audience and for the substance, purpose, and context of the message being conveyed.
o Consider the needs of your audience.
o Be succinct and mindful of communication best practices.
o Carefully review your media and materials to avoid errors that could distract the audience and make it more difficult for them to focus on the substance of your proposed initiative.
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