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Developing a Culture of Evidence-Based Practice Discussion

Discussion: Developing a Culture of Evidence-Based Practice

Discussion Week 8 – NURS 6052

Discussion: Developing a Culture of Evidence-Based Practice

As your EBP skills grow, you may be called upon to share your expertise with others. While EBP practice is often conducted with unique outcomes in mind, EBP practitioners who share their results can both add to the general body of knowledge and serve as an advocate for the application of EBP.

In this Discussion, you will explore strategies for disseminating EBP within your organization, community, or industry.

To Prepare:

· Review the Resources (See below references and attached PDF documents) and reflect on the various strategies presented throughout the course that may be helpful in disseminating effective and widely cited EBP.

· This may include: unit-level or organizational-level presentations, poster presentations, and podium presentations at organizational, local, regional, state, and national levels, as well as publication in peer-reviewed journals.

· Reflect on which type of dissemination strategy you might use to communicate EBP.

Instructions:

1. Post at least two dissemination strategies you would be most inclined to use and explain why.

2. Explain which dissemination strategies you would be least inclined to use and explain why.

3. Identify at least two barriers you might encounter when using the dissemination strategies you are most inclined to use.

4. Be specific and provide examples.

5. Explain how you might overcome the barriers you identified.

** At least 3 References**

Resources from School – References (attached documents)

Gallagher-Ford, Lynn MSN, RN, NE-BC; Fineout-Overholt, Ellen PhD, RN, FNAP, FAAN; Melnyk, Bernadette Mazurek PhD, RN, CPNP/PMHNP, FNAP, FAAN; Stillwell, Susan B. DNP, RN, CNE Evidence-Based Practice, Step by Step: Implementing an Evidence-Based Practice Change, AJN, American Journal of Nursing: March 2011 – Volume 111 – Issue 3 – p 54-60 doi: 10.1097/10.1097/01.NAJ.0000395243.14347.7e

Newhouse, R. P. , Dearholt, S. , Poe, S. , Pugh, L. C. & White, K. M. (2007). Organizational Change Strategies for Evidence-Based Practice. JONA: The Journal of Nursing Administration, 37(12), 552-557. doi: 10.1097/01.NNA.0000302384.91366.8f.

Melnyk, B. M. (2012). Achieving a High-Reliability Organization Through Implementation of the ARCC Model for Systemwide Sustainability of Evidence-Based Practice. Nursing Administration Quarterly, 36(2), 127–135. doi: 10.1097/NAQ.0b013e318249fb6a.

Melnyk, B. M. , Fineout-Overholt, E. , Gallagher-Ford, L. & Stillwell, S. B. (2011). Evidence-Based Practice, Step by Step: Sustaining Evidence-Based Practice Through Organizational Policies and an Innovative Model. AJN, American Journal of Nursing, 111(9), 57-60. doi: 10.1097/01.NAJ.0000405063.97774.0e.

Melnyk, B. M., Fineout-Overholt, E., Giggleman, M., & Choy, K. (2017). A Test of the ARCC (c) Model Improves Implementation of Evidence-Based Practice, Healthcare Culture, and Patient Outcomes. WORLDVIEWS ON EVIDENCE-BASED NURSING, 14(1), 5–9. /orders/doi-org.ezp.waldenulibrary.org/10.1111/wvn.12188

INSTRUCTIONS: Respond to your colleague by offering additional ideas to overcome the barriers to strategies suggested by your colleagues and/or by offering additional ideas to facilitate dissemination.

**At least 2 references per reply, and they need to support information in the reply**

Main Post – Donique McClinton

COLLAPSE

Top of Form

Main Post

Dr. Frazer and Classmates

Dissemination Strategy 1 and its Possible Barrier

Agreeing with Melnyk & Fineout-Overholt (2018), creating awareness and interest should be the first strategy to disseminate evidence-based practice within an organization. To prepare an organization for change, leadership is essential (Newhouse et al., 2007). Leadership must gather their staff and explain that modifications are necessary and required to be utilized.

Spreading awareness and interest can present challenges as many employees may ignore the announcements, advertisements, and newsletters that were utilized. As employees enter the organization, many focus on the task at hand and not the bigger picture. Those employees may only view the attended EBP as “if the job wants us to work a certain way, they will tell us personally.” This way of the employees’ thinking is a barrier to diffusing awareness and interest of EBP.

Dissemination Strategy 2 and its Possible Barrier

According to Melnyk & Fineout-Overholt (2018), an additional strategy to disseminating EBP can build knowledge and commitment. Conducting a transdisciplinary team training in which leadership and employees learn about the EB and how to accomplish it (Melnyk, 2012) will lead to all staff being in unity.

Along with building knowledge and commitment of the EBP, barriers can emerge. Some colleagues may disagree and disapprove of the need for the new EBP, as many seasoned colleagues are too familiar with how tasks were performed in the “old days.” Those colleagues require further education and explanation, by leadership, on how the EBP can improve topics.

Least Inclined Dissemination Strategy

I believe that the least persuasive strategy can be pursuing integration and sustained usage. Melnyk & Fineout-Overholt (2018) described this strategy includes celebrations of the local unit’s progression, public acknowledgment, and individualized memos to staff. This comes in the form of the famous repetitive pizza parties given by management, that many staff are appreciative of but wishfully think they deserve more.

This strategy requires improvement to fully grasp the staff’s attention to show the organization’s appreciation properly. Pay-for-performance incentives have placed organizations under pressure to increase their level of care and avoid sentinel incidents (Melnyk, 2012), which may be a more persuasive strategy than a nutriment incentive.

References

Melnyk, B. M. (2012). Achieving a high-reliability organization through implementation of the ARCC model for systemwide sustainability of the evidence-based practice. Nursing Administration Quarterly, 36(2), 127-135. Doi: 10.1097/NAQ.0b013e318249fb6a

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice(4th ed.). Philadelphia, PA: Wolters Kluwer.

Newhouse, R. P., Dearholt, S., Poe, S., Pugh, L. C., & White, K. M. (2007). Organizational change strategies for evidence-based practice. Journal of Nursing Administration, 37(12), 552-557. Doi: 0.1097/01.NNA.0000302384.8f

**At least 2 references per reply, and they need to support information in the reply**

Ethel Uzoma

RE: Discussion – Week 9 Main post

COLLAPSE

Top of Form

Evidence-Based Decision Making

Dissemination is the act of sharing and distributing information through different materials to a specific audience to increase their reach for evidence and effectively use evidence-based literature. It occurs through various channels, social contexts, and settings spreading knowledge of evidence-based practice (EBP) interventions on a wide scale within or across practice settings.

Dissemination Strategies I would be most inclined to use and why

I would be most bent on using passive and active dissemination strategies. Passive strategies include sending mass emails and information publications or posting details about evidence to a website and scientific publications in a searchable database for an untargeted audience (Vedel et al., 2018). The approach is less costly in terms of translating knowledge and is highly feasible. In contrast, active dissemination strategies comprise efforts that spread knowledge to a targeted group through practical guidance, prompts, and information media campaigns (Melnyk et al., 2011). I would use active dissemination to increase the reach of motivation and people’s ability to apply and use evidence. Both strategies would be effective in ensuring widespread EBP use on various clinical practices and interventions.

Dissemination Strategies I would be least inclined to use and why

The dissemination strategy that I would be least inclined to use is passive because it involves untargeted information dissemination. Here, the message is untailored, and the delivery is unplanned or uncontrolled. Hence, it is generally ineffective and only results in minimal practice changes.

Two Barriers I might Encounter when using the Dissemination Strategies, I am most inclined to use.

I would be most inclined to use active dissemination because it involves communicating facts actively by targeting a specific audience. Lack of EBP knowledge and fear of the unknown is the most critical barrier in using the approach, making it hard to convince colleagues to come on board and understand the process (Brownson et al., 2018).

How I might Overcome the Barriers I identified

To overcome this barrier, it is critical for the strategy to include resources for learning about EBP, which should be emphasized and taught through nursing schools and selected development centers. Active dissemination is also costly and time-consuming, leading to burnout and stress (Gallagher-Ford et al., 2011). However, this can be overcome by increasing resources and the number of personnel involved in dissemination.

References

Brownson, R. C., Eyler, A. A., Harris, J. K., Moore, J. B., & Tabak, R. G. (2018). Getting the word out: New approaches for disseminating public health science. Journal of Public Health Management and Practice, 24(2), 102–111. /orders/doi.org/10.1097/PHH.0000000000000673

Gallagher-Ford, L., Fineout-Overholt, E., Melnyk, B. M., & Stillwell, S. B. (2011). Evidence-based practice, step by step: Implementing an evidence- based practice change. The American Journal of Nursing, 111(3), 54–60. /orders/doi.org/10.1097/10.1097/01.NAJ.0000395243.14347.7e

Melnyk, B. M., Fineout-Overholt, E., Gallagher-Ford, L., & Stillwell, S. B. (2011). Evidence-based practice, step by step: Sustaining evidence-based practice through organizational policies and an innovative model. The American Journal of Nursing, 111(9), 57–60. /orders/doi.org/10.1097/01.NAJ.0000405063.97774.0e

Vedel, I., Le Berre, M., Sourial, N., Arsenault-Lapierre, G., Bergman, H., & Lapointe, L. (2018). Shedding light on conditions for the successful passive dissemination of recommendations in primary care: A mixed methods study. Implementation Science, 13(1), 1–12. /orders/doi.org/10.1186/s13012-018-0822-x

A Test of the ARCC Model Improves Implementation of Evidence-Based Practice

Original Article

A Test of the ARCC C© Model Improves Implementation of Evidence-Based Practice, Healthcare Culture, and Patient Outcomes Bernadette Mazurek Melnyk, RN, PhD, CPNP/PMHNP, FAANP, FNAP, FAAN • Ellen Fineout-Overholt, RN, PhD, FNAP, FAAN • Martha Giggleman, RN, DNP, NEA-BC • Katie Choy, RN, DNP, CNS, NEA-BC

Keywords

ARCC, evidence-based

practice, organizational

culture, patient outcomes

ABSTRACT Background: Although several models of evidence-based practice (EBP) exist, there is a paucity of studies that have been conducted to evaluate their implementation in healthcare settings.

Aim: The purpose of this study was to examine the impact of the Advancing Research and Clinical practice through close Collaboration (ARCC) Model on organizational culture, clinicians’ EBP beliefs and EBP implementation, and patient outcomes at one healthcare system in the western United States.

Design: A pre-test, post-test longitudinal pre-experimental study was conducted with follow-up immediately following full implementation of the ARCC Model.

Setting and Sample: The study was conducted at a 341-bed acute care hospital in the western region of the United States. The sample consisted of 58 interprofessional healthcare professionals.

Methods: The ARCC Model was implemented in a sequential format over 12 months with the key strategy of preparing a critical mass of EBP mentors for the healthcare system. Healthcare professionals’ EBP beliefs, EBP implementation, and organizational culture were measured with valid and reliable instruments. Patient outcomes were collected in aggregate from the hospital’s medical records.

Results: Findings indicated significant increases in clinicians’ EBP beliefs and EBP implementation along with positive movement toward an organizational EBP culture. Study findings also indicated substantial improvements in several patient outcomes.

Linking Evidence to Action: Implementation of the ARCC Model in healthcare systems can en- hance clinicians’ beliefs and implementation of evidence-based care, improve patient outcomes, and move organizational culture toward EBP.

INTRODUCTION AND BACKGROUND It is well known that evidence-based practice (EBP) improves healthcare quality, safety, and patient outcomes as well as fos- ters clinicians’ active engagement in their practices. Nurses who use an evidence-based approach to care and practice in cultures that support EBP are more empowered as they are able to make a difference in the care of their patients. Although the positive impact of EBP has been demonstrated through multiple studies, major barriers exist that prevent EBP from becoming the standard of care throughout the world. These barriers include (a) inadequate EBP knowledge and skills of clinicians, (b) misperceptions that EBP takes too much time, (c) organizational culture and politics, (d) lack of support from nurse leaders and managers, and (e) inadequate resources and investment in EBP (Jun, Kovner, & Stimpfel, 2016; Melnyk et al., 2016; Melnyk, Fineout-Overholt, Gallagher-Ford, & Ka-

plan, 2012). Aside from equipping clinicians with the knowl- edge and skills needed to attain the EBP competencies and con- sistently implement evidence-based care, findings from studies have indicated that clinician access to EBP mentors can play a key role in their implementation of EBP and the development of organizational cultures that support the delivery of evidence- based care (Fineout-Overholt & Melnyk, 2015; Melnyk, 2007).

Although several EBP models exist, most are process mod- els that outline the steps of EBP or the sequence of conducting an EBP project. EBP process models include the Johns Hopkins Nursing Evidence-Based Practice Model (Dearholt & Dang, 2012), the Iowa Model of Evidence-Based Practice to Promote Quality Care (Titler et al., 2001), the Model for Evidence-Based Practice Change (Rosswurm & Larabee, 1999), and the ACE Star Model of Knowledge Transformation (Stevens, 2012). Unlike EBP process models, the Advancing Research and

Figure 1. The Advancing Research and Clinical Practice Through Close Collaboration (ARCC) Model.

Clinical practice through close Collaboration (ARCC) Model is a system-wide model to advance and sustain EBP in healthcare systems (see Figure 1). The first step in implementing the ARCC Model is an organizational assessment of the current EBP culture in order to identify strengths and major barriers to EBP in the healthcare system so that strategies can be implemented to remove those barriers. At the core of the ARCC Model is a critical mass of EBP mentors who, through intentional strategic initiatives, assist point of care clinicians in enhancing their beliefs about the value of EBP and their confidence in implementing it. As a result, ARCC contends that heightened EBP beliefs in clinicians result in greater implementation of evidence-based care, which ultimately leads to higher job satisfaction, less staff turnover, and improved patient outcomes. Several studies now support the relationships among key constructs in the ARCC Model (Levin, Fineout-Overholt, Melnyk, Barnes, & Vetter, 2011; Melnyk, 2012; Melnyk & Fineout-Overholt, 2002; Melnyk et al., 2004; Melnyk, Fineout-Overholt, & Mays, 2008; Melnyk, Fineout- Overholt, Giggleman, & Cruz, 2010; Wallen et al., 2010).

AIM The purpose of this study was to examine the impact of the ARCC Model on organizational culture, clinicians’ EBP beliefs and EBP implementation, and patient outcomes at one health- care system in the western region of the United States.

DESIGN A pre-test, post-test longitudinal pre-experimental study was conducted with follow-up immediately following full imple- mentation of the ARCC Model. Institutional Review Board ap- proval was obtained from the authors’ institution as well as the organization’s research subject review board.

SETTING AND SAMPLE This study was conducted at Washington Hospital Healthcare System, a 341-bed acute care hospital in the San Francisco bay area. The sample consisted of 58 interprofessional health- care professionals, with complete follow-up data for 45 partic- ipants. Participants were point of care nurses, administrators, nurse managers, clinical nurse specialists, respiratory thera- pists, occupational therapists, physical therapists, dieticians, social workers, and pharmacists. Although physician cham- pions participated in the projects, they were not part of the data collection. Only the project teams participated in data collection.

METHODS The ARCC Model was implemented in a sequential format over 12 months with the key strategy of preparing a critical mass of EBP mentors for the healthcare system. Intensive EBP workshops were first provided to the 58 participants in order to enhance their knowledge and skills in the seven steps of

Original Article Table 1. Examples of PICOT Questions Formulated by the EBP Teams

� In ventilated intensive care unit patients (P), howdoes early ambulation (I) compared to routinely scheduledambulation (C) affect length of stay andepisodesof ventilator associatedpneumoniawhile in the intensive care unit (T)

� In congestive heart failure patients (P), howdoes comprehensive pre-discharge education (I) compared to standardpre-discharge education (C), affect readmission rates to thehospital (O)?

EBP. In addition, content and skills building in the workshops focused on how to facilitate individual behavior change of clin- icians to implement EBP and how to facilitate an EBP organi- zational culture. The 58 participants were divided into working teams of six to eight members who were to collaborate on an EBP change project to improve patient outcomes within the hospital. Each team was then charged with formulating a PICOT (Patient population, Intervention or Issue of inter- est, Comparison intervention or issue, Outcome, and Time for the intervention to achieve the outcome if relevant) question about an important clinical issue, systematically searching for the best evidence, and critically appraising and synthesizing the evidence culminating in a recommendation for practice. See Table 1 for examples of PICOT questions developed by the teams. Strategic plans were then developed by the inter- professional EBP mentor teams to implement and evaluate the impact of the EBP changes on clinical outcomes within their organization. After implementation and evaluation of the prac- tice changes were completed, the final step for the teams was to submit their projects for presentation at local, regional, or national conferences to disseminate their successes to others within the healthcare community.

OUTCOMES Study variables were measured with the following valid and reli- able instruments. The Evidence-Based Practice Beliefs (EBPB) Scale Melnyk & Fineout-Overholt, 2003a) measured clinicians’ beliefs about EBP and their ability to implement it. The 16-item Likert scale has established face, content, and construct valid- ity with internal consistency reliabilities greater than .85 across multiple studies (Melnyk et al., 2008). Responses on the scale range from 1 (strongly disagree) to 5 (strongly agree). Examples of items on the scale include (a) I am clear about the steps in EBP, (b) I am sure that I can implement EBP, and (c) I am sure that evidence-based guidelines can improve care.

The Evidence-Based Practice Implementation (EBPI) Scale measured delivery of evidence-based care (Melnyk & Fineout- Overholt, 2003b). Participants respond to each of the 18 Likert scale items on the EBPI by answering how often in the last eight weeks they have performed certain EBP activities, such as (a) generated a PICOT question about my practice, (b) used evi-

dence to change my clinical practice, (c) evaluated the outcomes of a practice change, and (d) shared the outcome data collected with colleagues. The EBPI has established face, content, and construct validity as well as internal consistency reliabilities greater than .85 across multiple studies (Melnyk et al., 2008).

The Organizational Culture and Readiness Scale for System-Wide Integration of Evidence-Based Practice (OCR- SIEP) measured the organization’s culture and its readiness for system-wide EBP (Fineout-Overholt & Melnyk, 2006). This instrument contains 26 Likert scale items that identify a de- scription of the existing support in the current culture for EBP, which offers insight into the strengths and opportunities for fostering evidence-based care within a healthcare system. The OCRSIEP scale has established face and content validity along with excellent internal consistency reliability of greater than .85 across multiple samples (Melnyk & Fineout-Overholt, 2015). Examples of items on the OCRSIEP include the following: (a) To what extent is EBP clearly described as central to the mission and philosophy of your institution? (b) To what extent do you believe that EBP is practiced in your organization? And (c) To what extent is the nursing staff with whom you work committed to EBP?

Patient Outcomes Aggregate data were gathered by the teams, including data from the hospital’s medical records (e.g., number of cases of ventilator associated pneumonia, hospital readmission rates) before and after implementation of the ARCC Model to evaluate relevant patient outcomes as results of the EBP projects.

Analyses T tests and effect sizes were calculated for study variables to evaluate pre-to-post differences. A p value of .05 was set for statistical significance.

RESULTS Findings indicated that the clinicians’ EBP beliefs, EBP im- plementation, and movement of organizational culture toward EBP significantly increased over the 12-month project. Specif- ically, clinicians’ EBP beliefs (n = 45) increased significantly from baseline (M = 60.7, SD = 7.6) to follow-up (M = 64.9, SD = 6.7; t = 4.2; p = .00; effect size = .62, which is a medium to large positive effect for ARCC). EBP implementation also significantly increased from baseline (M = 17.8, SD = 10.3) to follow-up (M = 51.9, SD = 16.8; t = 12.9; p = .00; effect size = 2.3, indicating a large positive effect for ARCC). In addition, organizational culture and readiness for EBP increased signifi- cantly from baseline (M = 80.9; SD = 90.8) to follow-up (M = 90.8; SD = 14.7; t = 3.9; p = .00; effect size = .70, which is a medium to large positive effect for ARCC). In addition, as a result of implementing the ARCC Model, evidence-based interventions improved key patient outcomes (see Table 2).

A Test of the ARCC C© Model Improves Implementation of Evidence-Based Practice

Table 2. Project Outcomes From Implementation of the EBP Changes

� Apractice change to early ambulation in the ICU led to a2.7 reduction in ventilator days (11.6–8.9) andno ventilator associatedpneumonia.

� With the implementation of apressure ulcer prevention nursing standardizedprocedure onamedical-surgical unit, the acquiredpressure ulcer ratewas significantly decreased from6.07%to0.62%1year later.

� Comprehensive educationof congestive heart failure patients led to a 14.7%reduction in hospital readmissions.

� After implementation of family centered care on the pediatric unit, 75%of parents perceived theoverall quality of care as excellent compared to22%pre-implementation.

� Thepercentageofmothers not supplementing their breast milkwith formula increased from61.7% to71.1%after the evidence-basedbaby friendly hospital initiativewas implemented.

� After implementation of a nurse-initiatedpain protocol in the emergency room(ER),wait time for painmedication decreased from46minutes to 13minutes and length of stay in theERalsodecreased from120minutes to91minutes.

DISCUSSION Findings support the positive impact of implementing the ARCC Model on clinicians’ EBP beliefs and a dramatic in- crease in EBP implementation in those who participated in the project. Organizational culture at the hospital shifted greatly toward system-wide EBP. Most important, as a result of imple- menting ARCC, there were multiple improvements in patient outcomes.

The establishment of a cadre of EBP mentors is cen- tral to building an organizational culture of EBP and im- plementing evidence-based care. The EBP mentors in this study garnered the knowledge and skills needed to successfully implement and evaluate EBP changes within the hospital as well as to work with their colleagues in creating an EBP culture in which to deliver high-quality evidence-based care. These findings affirm that culture eats strategy and assists clini- cians in making EBP the social norm within a system (Mel- nyk, 2016b). Without a culture and environment that supports EBP, high-quality evidence-based care will not sustain (Melnyk, 2016a).

Numerous healthcare systems and hospitals throughout the United States and globe have implemented the ARCC Model in their efforts to build and sustain an EBP culture and environ- ment in their organizations. As a part of building this culture, position descriptions have been created or changed to include responsibilities as an EBP mentor. For example, at The Ohio State University Wexner Medical Center, the primary responsi- bility of the clinical nurse specialists throughout the healthcare system is to serve as EBP mentors for point of care staff in improving patient outcomes. Part of this role is ensuring

compliance with the EBP competencies for advanced practice nurses (Melnyk, Gallagher-Ford, & Fineout-Overholt, 2016; Melnyk, Gallagher-Ford, Long & Fineout-Overholt, 2015).

Research is needed to further confirm the advantages of using particular EBP models in real-world practice settings, including how implementation of these models impact both clinician, leader and patient outcomes (Dang et al., 2015). Com- parative effectiveness studies that evaluate the benefits of in- dividual models as well as combining models also are needed. Those hospitals and systems who use an EBP model to guide implementation of evidence-based care should document their experiences and outcomes in order to better understand the model’s usefulness in facilitating EBP and share this impor- tant information with others who might use the model (Gra- ham, Tetroe, & KT Theories Research Group, 2007). Return on investment by including cost outcomes also should be eval- uated. WVN

LINKING EVIDENCE TO ACTION

� The ARCC Model is an evidence-based system- wide model for advancing the implementation and sustainability of EBP.

� A key strategy in the ARCC model is the develop- ment of a critical mass of EBP mentors who assist point of care clinicians in the consistent imple- mentation of evidence-based care.

� Use of ARCC EBP mentors enhances the EBP be- liefs and EBP implementation of clinicians and strengthens the EBP culture of an organization.

� An organizational culture of EBP is central to sup- porting sustainable high quality evidence-based care.

� Implementation of the ARCC Model can substan- tially improve patient outcomes.

Author information

Bernadette Mazurek Melnyk, Associate Vice President for Health Promotion, University Chief Wellness Officer, Dean and Professor, College of Nursing, Professor of Pediatrics & Psychiatry, and College of Medicine, The Ohio State Univer- sity, Columbus, Ohio; Ellen Fineout-Overholt, Mary Coulter Dowdy Distinguished Professor of Nursing, College of Nurs- ing & Health Sciences University of Texas at Tyler, Tyler, Texas; Martha Giggleman, Healthcare Consultant & Advocate Liver- more, California; Katie Choy, Senior Director, Nursing Practice and Education, Washington Hospital Healthcare System, Fre- mont, California

Original Article Address correspondence to Dr. Bernadette Mazurek Melnyk,

The Ohio State University, 145 Newton Hall, 1585 Neil Avenue, Columbus, OH 43210; Melnyk.15@osu.edu

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Stevens, K. R. (2012). Star model of EBP: Knowledge transformation. Academic Center for Evidence-based Practice, TX: The Univer- sity of Texas Health Science Center at San Antonio.

Titler, M. G., Kleiber, C., Steelman, V. J., Rakel, B. A., Budreau, G., Everett, L. Q., & . . . Goode, C. J. (2001). The Iowa Model of evidence-based practice to promote quality care. Critical Care Nursing Clinics of North America, 13(4), 497–509.

Wallen, G. R., Mitchell, S. A., Melnyk, B. M., Fineout-Overholt, E., Miller-Davis, C., Yates, J., & Hastings, C. (2010). Implement- ing evidence-based practice: Effectiveness of a structured mul- tifaceted mentorship programme. Journal of Advanced Nursing, 66(12), 2761–2771.

doi 10.1111/wvn.12188 WVN 2017;14:5–9

Copyright of Worldviews on Evidence-Based Nursing is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder’s express written permission. However, users may print, download, or email articles for individual use.

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Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.

Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

APA Format and Writing Quality

Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.

Use of Direct Quotes

I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source. Discussion: Developing a Culture of Evidence-Based Practice

LopesWrite Policy

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Late Policy

The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

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NURS 6501 Module 1 Assignment: Case Study Analysis

Module 1 Assignment: Case Study Analysis,NURS 6501: Advanced Pathophysiology

NURS 6501 Module 1 Assignment: Case Study Analysis

An understanding of cells and cell behavior is a critically important component of disease diagnosis and treatment. But some diseases can be complex in nature, with a variety of factors and circumstances impacting their emergence and severity.

Effective disease analysis often requires an understanding that goes beyond isolated cell behavior. Genes, the environments in which cell processes operate, the impact of patient characteristics, and racial and ethnic variables all can have an important impact.

An understanding of the signals and symptoms of alterations in cellular processes is a critical step in the diagnosis and treatment of many diseases. For APRNs, this understanding can also help educate patients and guide them through their treatment plans.

In this Assignment, you examine a case study and analyze the symptoms presented. You identify cell, gene, and/or process elements that may be factors in the diagnosis, and you explain the implications to patient health.

To prepare:

By Day 1 of this week, you will be assigned to a specific case study for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

The Assignment (1- to 2-page case study analysis)

Develop a 1- to 2-page case study analysis in which you:

Explain why you think the patient presented the symptoms described.
Identify the genes that may be associated with the development of the disease.
Explain the process of immunosuppression and the effect it has on body systems.

By Day 7 of Week 2

Submit your Case Study Analysis Assignment by Day 7 of Week 2.

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at /orders/academicguides.waldenu.edu/writingcenter/templates). All papers submitted must use this formatting.

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Titanic Case Study Analysis ( Ethical Perspective)

For this assignment, research an engineering ethics case study of your choice and demonstrate an ability to analyze the the issue from an ethical perspective. Summarize the most important facts about the case, and explain why particular decisions or actions were immoral.

*At least two academic sources.

· Explain the details of the issues/cases you are discussing.

◦ What decisions were made in this case? Why did the participants do what they did?

◦ Were the relevant decisions/actions moral? Why or why not?

◦ What happened leading up to the failure? What were the focal and auxiliary consequences?

◦ What building and professional codes were in place at the time? Were they followed?

◦ Be specific about the people, places, companies, decisions, events, etc. involved in each case.

· Use relevant concepts from class to support your point of view on the issue.

◦ How do each of the moral theories and principles weigh in? Don’t “force it,” but use moral theory when appropriate to support your view.

◦ From an ethical perspective, what is the ultimate conclusion you have arrived at through your research of the issue?

◦ How did individuals related to the case fail to be professional and/or moral?

Read full instructions attached below.

PHIL 215 – Engineering Ethics

Paper #3

Due: November 14th

Format: 4 pages, 12 pt. Times New Roman, 1”margins, double-spaced,

stapled, Works Cited pg, in-text citations (author p#)

Paper #3 – Case Study Assignment

For this assignment, research an engineering ethics case study of your choice and demonstrate an ability to analyze the the issue from an ethical perspective. Summarize the most important facts about the case, and explain why particular decisions or actions were immoral.

· Choose at least one real-world case study to investigate.

· Choose any case which involved engineers and some type of moral dilemma/controversy.

· Be sure to choose a real case, not a fictional “decision scenario”

· Try to select a topic not covered in class.

· Do some independent research and use at least two high-quality, in-depth, academic sources.

· Utilize CSU research databases and online engineering ethics databases in your research.

· See the instructor if you have trouble selecting a topic.

· Explain the details of the issues/cases you are discussing.

· What decisions were made in this case? Why did the participants do what they did?

· Were the relevant decisions/actions moral? Why or why not?

· What happened leading up to the failure? What were the focal and auxiliary consequences?

· What building and professional codes were in place at the time? Were they followed?

· Be specific about the people, places, companies, decisions, events, etc. involved in each case.

· Use relevant concepts from class to support your point of view on the issue.

· How do each of the moral theories and principles weigh in? Don’t “force it,” but use moral theory when appropriate to support your view.

· From an ethical perspective, what is the ultimate conclusion you have arrived at through your research of the issue?

· How did individuals related to the case fail to be professional and/or moral?

Remember :

· Think about what your final conclusion will be – what claim do you want to make? Mention this in your introductory paragraph.

· Use evidence (premises) which demonstrate that your point of view is right. Draw on what you have learned about moral principles and theories.

· This assignment is intended to help you practice researching and analyzing a moral failure in the engineering world. The 8-page Term Paper will follow the same essential guidelines.

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Variance Analysis and Benchmarking Projec

Variance Analysis and Benchmarking Project

OPTION #1: VARIANCE ANALYSIS AND BENCHMARKING

Your supervisor has asked you to prepare some calculations based on the company’s data and then research publicly available similar competitor information to see how your company is performing within the industry. Your company, CarryIt Inc., produces mass quantity, inexpensive tote bags for promotional marketing purposes, which is a very competitive business.

Here is the available data for your company:

Labor hours .25;
Labor rate $11.75/hour;
Materials input .5 yds. fabric;
Materials price $1.50/yd.; and
Variable overhead rate $5.00 per direct labor hour.

You are also able to find an industry profile report via a Dun & Bradstreet database that has selected data from a few other companies in similar businesses as well as some industry statistics.

Here’s the data available:

Unit Variable Cost Item	Star Company	GoldBag Corporation	PromoTotes LLC	Industry Data
Labor hours	.35	.20	.30	.30
Labor rate	$11.25	$11.95	$12.50	$11.65
Materials input	.45 yds.	.675 yds.	.50 yds.	.55 yds.
Materials price	$1.65/yd.	$1.35/yd.	$1.55/yd.	$1.50/yd.
Variable OH rate	$6.00 per direct labor hour	$5.25 per direct labor hour	$4.70 per direct labor hour	$5.45 per direct labor hour

For your task, in Microsoft Excel, compute the following measures:

Total variable cost per unit for CarryIt, the competitors, and the industry average.
What is the percentage of the total for each component (materials, labor, and variable overhead)?
Assume industry data is your benchmark. What are the price and efficiency variances for direct materials and direct labor for each company?
What is the percentage over standard by company and by variance?

Below the computations in Excel, please summarize your observations about how CarryIt’s performance stacks up to its competition from the benchmarking exercise in 2-3 well written paragraphs. Include suggestions for areas of improvement and comments on areas where the company does well.

Submit your responses in an Excel spreadsheet, neatly organized. Your paper must be formatted according to CSU-Global Guide to Writing and APA Requirements (Links to an external site.). Reference Lynda.com in the CSU-Global Library (Links to an external site.) for Microsoft Excel tutorials or use the Excel Tutorials link found in the classroom if assistance is needed.

Review the Module 6 Critical Thinking Rubric for full details on how you will be graded on this assignment.

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Create a baseline demographic table and a 2-to-3 page narrative summary

Statistics is the art and science of data collection and interpretation. It is an art because it requires a combination of creativity, an eye for what makes sense, and personal judgment about how to use the end result. It is a science because it requires a systematic way of organizing, transforming, analyzing, describing, and interpreting data. Even if you dislike math, you can still enjoy statistics because it is not just about doing calculations or performing mathematical gymnastics. Most of the mathematics that makes learners uncomfortable is hidden inside statistical technological tools that we can use with relative ease in health care to make important discoveries. So relax—we are going to let technology do most of the work!

In this assessment, we focus on the cornerstone of quantitative research: the variable. One of the many things that makes the health care field so fascinating (and challenging) is the variation we find from one human to the next. Age, gender, eye color, heart rate, ethnicity, emotional response, and food preferences are some of the differences we find in our communities around the globe. In the language of statistics, each of these characteristics is called a variable. Some characteristics, like gender, have little variation, while other characteristics, like age, can have a much larger amount of variation.

Throughout this course, you will see that variables have special names based on their functional roles in the experiment. For example, when a variable is associated with the intervention (such as treatment, where we design the experiment to allow for only two options: practicing yoga versus not), it is referred to as an independent variable.

And when a variable is associated with an outcome in the experiment (for example, stress—which we decide, arbitrarily, will have only three possible levels: high, medium, and low) that is used to measure the direct consequences of the experimental treatment, we refer to this as a dependent variable.

The sneaky thing about statistics is that depending on the circumstances, the independent variable is often referred to in other terms, such as the controlled, explanatory, or predictor variable. If you consider this briefly, the names make sense because you are controlling who gets which treatment, where the treatment really is the key factor in explaining (or predicting) any outcome. The dependent variable may also be referred to as response, outcome, output, or experimental variable. In this course, we will try to be fairly consistent, using the terms independent and dependent.

Overview

The baseline demographic table plays an important role in reporting study results. It summarizes key characteristics of participants numerically (such as age, gender, and ethnicity) at the beginning of a study, before any intervention takes place. Baseline demographic tables are often among the first tables found in the results section of capstone papers, dissertations, and peer-reviewed publications as well. For this assessment, you will create a baseline demographic table and narrative summary using the linked Resources.

Demonstration of Proficiency

By successfully completing this assessment you will address the following scoring guide criteria, which align to the indicated course competencies.

Competency 1: Describe underlying concepts and reasoning related to the collection and evaluation of quantitative data in health care research.
- Write a summary narrative about statistical results.
Competency 2: Apply appropriate statistical methods using common software tools in the collection and evaluation of health care data.
- Perform descriptive statistics for selected variables in a data set.
- Create a demographic table populated with descriptive data for specific treatment groups.
- Use appropriate statistics for a given data measurement level.
Competency 3: Interpret the results and practical significance of statistical health care data analyses.
- Explain the clinical significance of a demographic table.
Competency 5: Address assignment purpose in a well-organized text, incorporating appropriate evidence and tone in grammatically sound sentences.
- Articulate meaning relevant to the main topic, scope, and purpose of the prompt.
- Apply APA formatting to in-text citations and references.

Instructions

Software

The following statistical analysis software is required to complete your assessments in this course:

IBM SPSS Statistics Standard or Premium GradPack, version 22 or higher, for PC or Mac.

You have access to the more robust IBM SPSS Statistics Premium GradPack.

Please refer to the Statistical Software page on Campus for general information on SPSS software, including the most recent version made available to Capella learners.

Part 1: Baseline Demographic Table

Use the Yoga Stress (PSS) Study Data Set [XLSX] for this assessment.
Follow the steps described in this assessment to use SPSS for performing a descriptive statistical analysis for the following selected variables from the Yoga and Stress Study data set: Age, Gender, Race, Military Status, Pre-intervention Psychological Stress Score.
Using How to Create a Demographic Table [PPTX], create a demographic table and populate the table with the results of descriptive analysis.
- Use the type of descriptive statistics most appropriate for the particular kind of data measurement level of each variable being reported.
- Include appropriate univariate statistics for the variables for each treatment group: Age, Gender, Ethnicity, Education, and current Military Status.
- Use appropriate statistics for a given data measurement level.

Part 2: Interpretive Summary

Write a summary narrative about statistical results.
Prepare a properly formatted demographic table that includes appropriate univariate statistics for the variables for each treatment group.
- Explain the practical significance of a demographic table.
Use the unit readings, media resources, and collaborative insights from the discussions for general guidance in reporting a demographic table.

Additional Requirements

Length: 2–3 typed, double-spaced pages of content plus title and reference pages.
Font: Times New Roman, 12 points.
APA Format: Your title and reference pages must conform to APA format and style guidelines. See the APA Module for more information. The body of your paper does not need to conform to APA guidelines. Do make sure that it is clear, persuasive, organized, and well written, without grammatical, punctuation, or spelling errors. You also must cite your sources according to APA guidelines.

Please review the scoring guide before submitting your assessment. The requirements outlined above correspond to the grading criteria in the scoring guide, so be sure to address each point. In addition, you may choose to review the performance-level descriptions for each criterion to see how your work will be assessed.

HDAP 8070-02 DATA

Patient ID	AGE	GENDER	RACE	EDUCATION	MIL_STATUS	PRE_PSS	POST_PSS
3001	23	Male	African American	Graduate education or above	active duty	25	20
3002	26	Male	Asian	College graduate	active duty	22	15
3003	33	Male	Caucasian	Some college	active duty	17	16
3004	35	Male	Hispanic	Some college	active duty	32	25
3005	48	Male	African American	Graduate education or above	active duty	22	14
3006	51	Female	African American	College graduate	active duty	18	16
3007	22	Female	African American	Some college	active duty	14	12
3008	18	Female	Asian	Some college	active duty	22	16
3009	44	Female	Caucasian	College graduate	active duty	23	20
3010	40	Female	Native American	Some college	active duty	33	36
4001	30	Male	Native American	College graduate	US Civilian	22	21
4002	55	Male	Two or more races	Less than HS	US Civilian	25	15
4003	57	Female	African American	College graduate	US Civilian	13	10
4004	47	Female	African American	Less than HS	US Civilian	12	12
4005	39	Male	Asian	HS graduate	US Civilian	17	12
4006	29	Male	Caucasian	HS graduate	US Civilian	10	10
4007	33	Male	Caucasian	Graduate education or above	US Civilian	34	22
4008	44	Female	Hispanic	College graduate	US Civilian	18	12
4009	55	Female	Hispanic	College graduate	US Civilian	12	10
4010	60	Female	Native American	College graduate	US Civilian	16	9

How to Create a Demographic Table

Let’s look first at what a demographic (or baseline characteristics) table looks like in healthcare journals. Look in Google Images to find other examples.

Note that this column has the variables of interest

N = number of study participants

MEAN for interval/ratio data and (standard deviation) values

These columns report the data. In this case there were two groups that were studied.

Numbers of participants and (%) for categorical data

Click on INSERT  Table functions at the top of MS Word. You can then select the number of rows and columns you need for your table.

Note that the variable column also has information about how the data is reported, such as the unit of measure (such as yrs) and the statistics being used (for example, mean, SD, n, %).

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Assignment: Evidence-Based Practice Paper

What are the differences between individual and population health disparities? What makes a population vulnerable? Explain how each vulnerable population discussed in Chapter 3 experiences health disparities. Include how health policies, laws, and the culture of the United States shapes and influences these disparities.
Scott, Britton and McLemore (2019) discuss structural racism and the ethics of care related to black mothers. Explain the concept of “mother blame” narratives and how they can affect nursing care. How is mother blame related to structural racism? Explain the strategies to optimize health equity in birth outcomes. What is reproductive justice, and can the concept of ethical care for this population be applied to other vulnerable populations?
What is your reaction to the message from the ANA President Jennifer Kennedy (2023)? Were you aware of the issues that nurses of color face? How can nurses reshape nursing to achieve respect and inclusion for patients and nurses?
Discuss the difference between stigma and a diagnosis, as presented in the article by Fisher et al (2020). How does stigma affect people with ID and DD? Why are these patients considered to be a vulnerable population? What are the ethical considerations in caring for this population? How can you advocate for this population?
Reference
Robin-Tyler and Teitelbaum (2019). Essentials of health justice: a primer. Chapter 3: Population Health Disparities, pp. 33-60.
Scott, A., Britton, L., and McLemore, M. (2019). The ethics of perinatal care for Black women: dismantling the structural racism in
“mother blame” narratives. Journal of Perinatal and Neonatal Nursing, 33(2), 108-115. doi: 10:1097/JPN.0000000000000394.
Kennedy, J. (2023). Practice Matters: Vital actions. American Nurse Journal, 18:2. p. 20.
Fisher, K., Robichaux, C., Sauerland, J., and Stokes, F. (2020). A nurse’s ethical commitment to people with intellectual and
developmental disabilities. Nursing Ethics, 27(4), 1066-1076. 10.1177/0969733019900310

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Assessment 2: Capstone Proposal

Create a 2-3 page proposal that analyzes your business topic, defines the scope and strategy for how you will go about your capstone project, and explains how your proposed project allows you to demonstrate the MBA program outcomes.

Introduction

Based on the feedback you received from faculty on your capstone summary in Assessment 1, you should now have a firm grasp on the scope of your project. In fact, if someone asks you what your project is about, you should have an “elevator speech” prepared. That is, you should have memorized 1–3 sentences that explain the topic, problem, and scope in a clear and concise way. With just these few sentences, explaining your project to someone while on a short elevator ride would be no trouble at all! Additionally, having such a clear vision will help you with this assessment and the project overall.

For this assessment, you will formally propose your capstone project.

Preparation

Review the MBA Capstone Project Description [PDF].

Assessment Description

Write a business proposal that formally proposes your capstone project and ends by asking for permission to continue, just as you might propose a project to a supervisor or client.

Include, at minimum, the following information:

Analyze a business challenge or opportunity.
- Include an introduction about your proposal.
- Summarize the capstone project topic, scope, and components; saying that your capstone will comprise a paper and presentation is not enough.
- Establish the premise of your paper; for example, if your plan is to talk about how Dillard’s department store can come back after a huge financial loss, you should include citations that establish its dramatic financial loss.
Define the strategy, scope, and action plan that you will use to complete the capstone project.
- Provide a general action plan on how you will research, analyze, and identify recommendations or solutions to this business challenge or opportunity.
- Discuss the general type of data sources you will be using to inform your analysis. Provide at least two specific sources that you are considering. These resources should be from credible sources such as the Wall Street Journal, IBIS, et cetera. Use the excellent Research Guide – MBA for locating credible resources from the Capella library’s business databases and article collections.
- Include the process or steps on how you will access the data necessary for analysis of a business topic or challenge.
Write a conclusion.
- Include a wrap-up that ensures your supervisor/client that your project will meet all requirements, be valuable to them, and be completed on time.
- Be sure to conclude by asking for permission to continue to the next step.

Your proposal should be organized using these sections:

Introduction.
Summary.
Discussion of the Proposal.
Strategy and Scope.
Action Plan.
Conclusion.

Submission Requirements

Style: Your proposal should follow professional style, as described in the corresponding MBA Academic and Professional Document Guidelines (available in the MBA Program Resources), including single-spaced paragraphs. It should use subheadings and be well organized and well written.
Communication: Ensure written communication is free of errors that detract from the overall message and quality.
APA guidelines: Format your citations according to current APA style.
Resources: Use at least two citations from credible sources.
Length: Your proposal should be 2–3 pages (single-spaced, professional style).
Font and font size: Use 12 point, Times New Roman.

ePortfolio

You should consider adding this to your personal ePortfolio. Writing formal proposals is a business fundamental; this proposal deliverable demonstrates this skill, and you might consider showing it to potential employers and clients.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

Competency 1: Apply foundational knowledge and an understanding of business systems, processes, and technology within and across core disciplines.
- Analyze a business challenge or opportunity.
Competency 2: Integrate information across disciplines and from differing perspectives.
- Define the strategy, scope, and action plan that will be used to complete the capstone project.
Competency 7: Communicate clearly and effectively in a business environment.
- Write coherently to support a central idea with correct grammar, usage, and mechanics as expected of a business professional.

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MBA-FPX5910 Assessment 5: Capstone Presentation

Create a 10-20 slide presentation with recorded audio that demonstrates how you would present and deliver your capstone project to your intended audience. Your presentation should be persuasive, use visual and graphical elements, and demonstrate professional speaking and presentation techniques.

Often in a business environment you will be asked to give a presentation of your knowledge, research, or plan to a group of stakeholders. In this assessment, you will present your capstone project. Imagine that your audience is a leader in the organization or industry that you chose, that they have not read your paper, and that you need to present the highlights to them in less than 10 minutes. This presentation should contain all of the main elements found in your paper and incorporate appropriate charts or graphics, as well as cite academic and business resources appropriately.
Assessment Description
Prepare and record a short presentation of your capstone project. Ensure that your presentation meets these expectations:

Create a persuasive presentation using techniques to make a compelling business case and recommendations.
- Write in a style that is appropriate for presenting in a professional setting and appropriate for your intended audience.
- Add your commentary in the speaker’s notes area for each slide. This provides additional context to your slides, and it will be very efficient to have the speaker’s notes ready when you record the audio.
- Use design techniques that enhance your message and information.
Apply visual and graphic elements effectively to support the business case and recommendations.
- Your presentation should include charts, graphs, or any illustrative evidence that supports the business case you made in the written part of your project.
- If you use existing charts or graphs, remember to credit the source using proper APA format for citations and references; for instance, figures should have in-text citations after their titles.
Apply professional speaking and presentation techniques for telling the business story that connects with the audience.
- Your presentation must include slides with a recorded audio of you delivering your presentation to your intended audience.
- Use best practices of professional speaking and presenting to achieve a strong presentation.
Submission Requirements
Communication: Communicate in a manner that is scholarly, professional, respectful, and consistent with expectations for professional practice. Original work and critical thinking are required. Your presentation must be free of errors that detract from the overall message.
Media presentation: Your presentation of your capstone paper should have presentation slides with audio recording of how you would present to your intended audience. Your presentation should be minimum of 10 slides and maximum of 20 slides, and should not exceed 8 minutes. Add speaker’s notes or a transcript to ensure accessibility for everyone.
Resources: Include citations at the end of the presentation. Remember to cite your sources for graphics and visuals used.
APA guidelines: Resources and citations are formatted according to current APA style and format.
Font and font size: Use an appropriate size and weight for a presentation, generally 24–28 points for headings and no smaller than 18 points for bulleted text. For PowerPoint tips, refer to the PowerPoint Presentations Library Guide.
Uploading Process
You may upload your presentation in any of the following ways:
Using Kaltura Media. (Refer to the MBA Program Resources for a Kaltura tutorial.)
As a file in ePortfolio; share the link with faculty.
A PowerPoint file with your recorded audio presentation. For this option, give yourself extra time to upload the PowerPoint, since large files may take more time to complete the uploading process.
The link to your presentation that you uploaded to your YouTube channel.
Whichever option you choose, be sure to indicate what it is in the submission box faculty know what type of file or link they are looking for.
Note: It is up to you to ensure that faculty can access your presentation. Dead links or failed technology may result in your receiving no credit for this assessment; thus, it is recommended that you test your link and recording on a computer that is not logged into the Capella system to ensure that it works properly before submission. You should allow sufficient time to test and troubleshoot issues.
EPORTFOLIO
You should consider adding this presentation to your personal ePortfolio. The ability to be persuasive, to communicate effectively, and to present information visually and orally is paramount for business leaders today. This presentation demonstrates your ability to communicate business analysis and recommendations effectively and is an important aspect of your portfolio.
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:
Competency 7: Communicate clearly and effectively in a business environment.
- Create a persuasive presentation that uses writing and designing techniques to make a compelling business case and recommendations.
- Apply visual and graphical elements effectively to support the business case and recommendations.
- Apply professional speaking and presentation techniques for telling the business story that connects with the audience.

MBA Capstone Project Description

MBA Capstone Project Description Throughout your MBA program, you have worked to develop as a business professional and prepare to meet future challenges as a business leader. Your program culminates in the capstone project, which forms the primary focus of MBA-FPX5910, the final course you will take in the program. The capstone project is intended to provide you the opportunity to demonstrate your MBA program outcomes by:

• Planning and executing the strategic and tactical elements of a comprehensive project.

• Integrating and demonstrating the business leadership skills and techniques you have learned throughout the MBA program.

• Communicating your analysis and recommendations for a real organization both in written form and in a formal presentation.

• Completing your MBA program with an experience that reinforces and integrates what you have learned throughout your MBA program.

The following information outlines the requirements and work associated with the capstone project for MBA-FPX5910.

Capstone Project Examples You have a wide variety of choice when it comes to choosing a capstone project that is personally interesting and rewarding to you. It is your responsibility to propose a capstone topic and scope that will allow you to demonstrate all of the MBA program outcomes.

Examples of project types that might be proposed to meet these requirements include, but are not limited to:

• A strategic plan developed for an organization to use that helps them solve a problem or take advantage of an opportunity.

• A strategic analysis conducted on a selected part or area of an organization.

• A case study developed on a selected part of or situation within an organization.

• An intervention developed to address an organizational issue; for example, a workshop or training activity. The intervention should be broad-based enough to demonstrate the program-level outcomes.

• A consulting report developed to analyze a problematic issue within an organization; the issue and analysis should be broad-based enough to demonstrate program-level outcomes.

You may propose other project types for the capstone project so long as you are able to identify how the proposed project satisfies the requirement of demonstrating the program-level outcomes. When choosing your project type and/or topic, keep in mind that it must result in recommendations, next steps, or some other type of actionable, evidence-based takeaways for your intended audience, user, or subject of the project.

Capstone Project Selection and Proposal Guidelines The organization must be real, not fictitious. This may be an organization to which you have direct access for data gathering or one for which you will gather data via published sources. In either case, it must be an organization for which you can gather the data needed to complete the project. If need be, you may be allowed to use a disguised name for the organization in the project report, but you must disclose to faculty what actual organization is being used as the setting for the project.

There are certain organizations that we want you to avoid using for your capstone. These organizations have been overly covered in the various business courses and might not be “fresh” enough for you to showcase your MBA outcomes. For that reason, we encourage you to select more low-profile organizations, or ones you can easily access for researching and analyzing. Do not select these organizations for your capstone project:

• Airlines: Southwest, American, Delta, United

• Retailers: Amazon, Target, Walmart

• Tech Companies: Apple, Google, Netflix

• Auto Companies: Ford, Tesla, Toyota, Volkswagon

• Beverage Companies: Pepsi, Coke, Starbucks

• Burger King & McDonald’s

• Harley-Davidson Motor Company.

• Johnson & Johnson

• Proctor & Gamble

• Kellogg’s

• Uber

• Any other company that your instructor posts in Announcements

When proposing a capstone project, you will be required to briefly identify how the proposed project ensures the demonstration of all seven program outcomes.

The scope of effort required should be such that it is doable in a 15–20 page paper, which is to be submitted in Assessment 4.

Capstone Project Requirements The capstone course project must demonstrate your achievement of the MBA program outcomes. The following table is taken from the Capstone Project Scoring Guide, at the Proficient level. It outlines the expectations, at a minimum, for demonstrating each program outcome. (For the best grade possible, strive to meet the grading criteria at the Distinguished level.)

MBA Program Outcome Grading Criteria (at the Proficient Level) 1. Apply foundational knowledge

and an understanding of business systems, processes, and technology within and across core disciplines.

Applies foundational knowledge (theories, models, practices) and an understanding of business systems, processes, and technology within and across core disciplines.

2. Integrate information across disciplines and from differing perspectives.

Integrates most relevant supportive and conflicting information (data, insights, best practices) across disciplines from differing primary functional perspectives individually and holistically.

3. Think critically and analytically to provide evidence-based solutions to business challenges and opportunities.

Develops logical, well-supported, solutions based on relevant, sound, logical, and credible evidence (data, insights, analyses, best practices) to solve business challenges and opportunities.

4. Apply innovative, strategic, and sustainable approaches to business practice and planning.

Applies innovative, strategic, and sustainable (long- term) approaches to business practice and planning.

5. Lead and collaborate in virtual, global, and culturally diverse environments.

Applies leadership and collaboration principles and strategies for virtual, global, and culturally diverse environments.

6. Integrate principles of ethics and integrity into business decisions.

Integrates principles of ethics and integrity into business decisions by assessing ethical implications and resolving ethical conflicts and dilemmas.

Capstone Deliverables You will plan, execute, and deliver your capstone project; it should include the components and requirements listed in this table.

Assessment Brief Assessment Description Submission Requirements Assessment 1: Capstone Project Summary

You will develop a brief summary of your capstone project so that faculty can approve your organization choice and scope and provide appropriate guidance. The project summary will also list out each program outcome and how the topic allows you to demonstrate mastery of each.

• Double spaced, academic style.

• Use at least one resource from the Capella library and one from the Wall Street Journal.

• Length is 2–3 pages.

Assessment 2: Capstone Proposal

Once your topic and scope are approved, you will submit a formal proposal that includes a concise analysis of your business topic. You will also explain how you will leverage your leadership strengths assessment results and coaching experience (provided by BetterUp), as well as your knowledge and experience as a leader, to support your capstone work.

• Single spaced, professional style.

• Use at least two resources from the Capella library.

• Reference your BetterUp leadership strengths assessment results and coaching experience.

• Length is 2–3 pages.

Assessment 3: Annotated Outline

To help you stay on track and receive faculty feedback, you will create an annotated outline of your paper. This document will list all of the major sections and sub-sections of your paper and include some resources.

• Double spaced, academic style.

• Use at least four resources from the Capella library, in addition to Internet resources.

• Length is 2–5 pages. Assessment 4: Capstone Project

The final written project report will be a formal document prepared for the key stakeholders of your project. The structure and length of the document will vary according to the type of project being undertaken, but the report is expected to be substantial.

In Appendix A, you can view the Capstone Project Scoring Guide. Be sure to review these criteria often throughout your project to ensure you are fulfilling the expectations of the MBA program outcomes.

• Single spaced, professional style.

• Use at least six resources from the Capella library, in addition to Internet resources.

• Length is 15–20 pages.

Assessment 5: Reflection and Goal Setting (Note: this assessment is not part of the Capstone paper)

This paper will summarize how your strengths—as identified in the BetterUp leadership assessment and improved through your coaching—helped you to create an effective capstone project. Your paper will include a reflection of your growth, how you have applied your strengths, & how you would apply those strengths further to enact the recommendations you made in your Capstone paper.

• Single spaced, professional style.

• Reference your BetterUp strength assessment results and coaching

• Length is 2-4 pages

Assessment 6: Capstone Presentation

This formal oral presentation will be supported by a PowerPoint presentation including slides with notes. You will record the oral presentation and upload it to the courseroom for formal review by faculty. Your presentation should present all facets of the capstone project.

• Presentation slides with audio recording of you presenting to your audience.

• Length is 10–20 slides. • Not to exceed 8 minutes of

run time.

Credible Resources The majority of your resources should be from credible sources such as peer-reviewed, scholarly journals and articles found in the Capella library. Other resources/databases, also available from the Capella library, are the Wall Street Journal, Harvard Business Review, Lexis Nexis, IBIS, et cetera. By now you should have solid skills in navigating the Capella library, but just in case you need a refresher, remember that we have a custom library guide, Research Guide – MBA, which is an excellent place to start your research.

You may also use additional Internet resources (such as blogs, websites, white papers, et cetera), but evaluate and vet these sites/resources diligently to ensure you are using information that is credible and evidence based. Use this information to determine whether or not the resource is credible: Sources: What Can You Use for Your Research?; make sure you explore the source types listed on the left.

Appendix A – Capstone Project Scoring Guide

Criteria Non-performance Basic Proficient Distinguished

Apply foundational knowledge and an understanding of business systems, processes, and technology within and across core disciplines.

References but does not apply fundamental, practical foundational knowledge (theories, models, practices) and a functional understanding of business systems, processes, and technology.

Applies fundamental, practical foundational knowledge (theories, models, practices) and a functional understanding of a limited set of business systems, processes, and technology within but not across core disciplines.

Applies foundational knowledge (theories, models, practices) and an understanding of business systems, processes, and technology within and across core disciplines.

Applies a balance of theoretical and practical foundational knowledge (theories, models, practices) and an in- depth understanding of a full range of business systems, processes, and technology within and across core disciplines. Justifies approach to integrating foundational knowledge, business systems, processes, and technology within and across core disciplines.

Integrate most relevant supportive and conflicting information (data, insights, best practices) across disciplines from differing primary functional perspectives individually and holistically.

Analyzes information from a singular discipline or perspective or poorly analyzes information across disciplines from few differing primary functional perspectives.

Analyzes but does not integrate limited information (data, insights, best practices) across disciplines from few differing primary functional perspectives individually but not holistically.

Integrates most relevant supportive and conflicting information (data, insights, best practices) across disciplines from differing primary functional perspectives individually and holistically.

Evaluates supportive and conflicting information (data, insights, best practices), integrating insights across disciplines from multiple diverse functional and strategic perspectives individually and holistically.

Develop logical, well- supported solutions based on relevant, sound, logical, and credible evidence (data, insights, analyses, best practices) to solve business challenges and opportunities.

Develops unsupported (that is, emotional testimonials, anecdotes, or lack of evidence) solutions and solutions that are not logically connected to business challenges and opportunities.

Develops unsupported (that is, emotional testimonials, anecdotes, or lack of evidence) solutions or solutions that are not logically connected to business challenges and opportunities.

Develops logical, well- supported solutions based on relevant, sound, logical, and credible evidence (that is, data, insights, analyses, or best practices) to solve business challenges and opportunities.

Develops logical, well- supported solutions based on relevant, sound, logical, and credible evidence (that is, data, insights, analyses, or best practices) to systematically solve business challenges and opportunities relevant to all applicable stakeholders and cross- functional departments.

Apply innovative, strategic, and sustainable (long-term) approaches to business practice and planning.

Does not apply or poorly applies elements of innovative, strategic, and sustainable approaches to business practice and planning.

Applies some elements of innovative, strategic, and sustainable approaches to business practice and planning.

Applies innovative, strategic, and sustainable approaches to business practice and planning.

Integrates and justifies innovative, strategic, and sustainable approaches to business practice and planning that appropriately challenge the status quo while recognizing change management implications.

Apply leadership and collaboration principles and strategies for virtual, global, and culturally diverse environments.

Does not describe or poorly describes leadership or collaboration strategies.

Describes leadership and collaboration principles and strategies that may or may not be appropriate to virtual,

Applies leadership and collaboration principles and strategies for virtual, global, and culturally diverse environments.

Assesses leadership and collaboration principles, strategies, and opportunities in virtual, global, and culturally

global, and culturally diverse environments. diverse environments

and integrates flexible perspectives and collaborative approaches in business.

Integrate principles of ethics and integrity into business decisions by assessing ethical implications and resolving ethical conflicts and dilemmas.

Does not assess or poorly assesses principles of ethics and integrity.

Assesses principles of ethics and integrity by analyzing ethical implications but may overlook important ethical considerations.

Integrates principles of ethics and integrity into business decisions by assessing ethical implications and resolving ethical conflicts and dilemmas.

Integrates principles of ethics and integrity into business decisions by assessing ethical implications, resolving ethical conflicts and dilemmas, and making right and just decisions for the organization and the larger business community.

Write coherently to support a central idea with correct grammar, usage, and mechanics as expected of a business professional.

Does not write coherently nor use grammar and mechanics as expected of a business professional; writing has major errors.

Writes somewhat coherently to support ideas, but writing has some grammar, mechanics, or other errors that detract from credibility as a business professional.

Writes coherently with minimal or minor errors to support a central idea with correct grammar, usage, and mechanics as expected of a business professional.

Writes coherently to support a central idea with correct grammar, usage, and mechanics as expected of a business professional; writing is free from errors and formatted appropriately for the purpose or audience.

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Assessment 4: Capstone Project

Running head: CAPSTONE PROJECT

Capstone Project

Andrea Ware

MBA-FPX 5910: MBA Capstone Experience

Assessment 4: Capstone Project

May, 2020

Executive Summary

The project seeks to provide a strategic analysis of how the organization can take advantage of its workforce to improve the quality of service delivery to the increasingly diverse customer base. It is founded on the recognition of how diversity management contributes a lot to value-based healthcare delivery. Ultimately, diversity training will help lower costs and maximize outcomes for patients, ensure higher patient satisfaction and better care efficiencies for Kaiser Permanente, and reduced healthcare spending combined with better overall health for the communities served. The program will augment the organization’s efforts to build and manage a diverse as well as a culturally competent workforce. The overall strategy entails conducting a study on the benefits of a high-quality diversity training program, especially one designed and administered online.

The strategic analysis shows how the organization can take advantage of its workforce to improve the quality of service delivery to an increasingly diverse customer base. It is also demonstrated that Kaiser Permanente can take advantage of its diverse workforce to improve the quality of service delivery to the increasingly diverse customer base through diversity training. Diversity management will contribute a lot to value-based healthcare delivery. Ultimately, the program will help lower costs and maximize outcomes for patients, ensure higher patient satisfaction and better care efficiencies, and reduce healthcare spending combined with better overall health for the communities served by Kaiser Permanente.

Based on the findings of the study, recommendations that focus on the creation of an organization capable of meeting the diverse needs of all stakeholders will be provided. Ultimately, the project will result in the recommendation for the implementation of a company-wide diversity training program. However, before the implementation of a full-scale program, as recommended by Jacobs et al. (2017), a pilot program will be rolled out to a multidisciplinary sample of 100 employees at the organization.

Introduction

Kaiser Permanente was founded in 1945 by Henry J. Kaiser (an industrialist) and Sidney Garfield (a physician). It is an integrated managed care consortium that is based in Oakland, California, United States. Kaiser Permanente operates as three distinct yet interdependent entities, such as Kaiser Foundation Hospitals, the Kaiser Foundation Health Plan, Inc. (KFHP), and the regional Permanente Medical Groups (Kaiser Permanente, n. d.). The organization’s mission entails providing high-quality care by continuously striving to improve care in line with the organization’s vision of being a leader in total health, primarily through efforts meant to make lives better (Kaiser Family Foundation, n.d.).

The mission has been made possible with the help of more than 300,000 personnel, including over 80,000 physicians and nurses, that work in 39 hospitals operated by the organization as well as over 700 medical offices. Although the organization’s ratings for quality care have been high (Kaiser Family Foundation, n.d.), it has to contend with challenges linked to the diversity of not only its workforce but also the customers served. By the end of 2016, Kaiser Permanente reported that it had more than 60% of the total workforce as members of racial, ethnic, as well as cultural minorities. It was also reported that more than 73% of the organization’s workforce are women (Johnson, 2017).

The project seeks to provide a strategic analysis of how the organization can take advantage of its workforce to improve the quality of service delivery to the increasingly diverse customer base. For instance, the project provides a strategic analysis of how the organization can take advantage of its workforce to improve the quality of service delivery to an increasingly diverse customer base. It is founded on the recognition of how diversity management contributes a lot to value-based healthcare delivery.

Opportunity for Improvement

One of the key business opportunities that can enable the organization to achieve its mission of providing high-quality care and realize its vision of being a leader in total health is diversity management, which can be achieved by providing diversity training (Borkowski, 2015). Carr-Ruffino (2016) accentuates that the competitive advantage attributed to diversity management within today’s health care organizations cannot be underestimated because the organizations serve a highly diverse customer base nowadays. A high-quality diversity training program can be indispensable to the delivery of high-quality care to today’s increasingly diverse communities, chiefly since it would augment the organization’s efforts to build and manage a diverse as well as culturally competent workforce (Carr-Ruffino, 2016; Vanderbroeck & Wasserfallen, 2017).

The Business: Kaiser Permanente

Background and Current State

Kaiser Permanente is essentially a strategic partnership between three distinct yet interdependent entities, such as Kaiser Foundation Hospitals, the Kaiser Foundation Health Plan, Inc. (KFHP), and the regional Permanente Medical Groups. It provides health care plans and services that range from preventive care, emergency care, and screening diagnostics to prenatal care and immunization. Some of the organization’s priorities include community health support, care innovation, clinical research, and health education. Innovative ideas that Kaiser Permanente has embraced since its founding include prepayment, population-based approach to care, group practice, prevention/total health, and clinical information technology (Kaiser Family Foundation, n.d.).

It boasts of a workforce of more than 300,000 personnel, including over 80,000 physicians and nurses, that work in 39 hospitals operated by the organization as well as over 700 medical offices (Kaiser Family Foundation, n.d.). A study by Johnson (2017) reported that Kaiser has more than 60% of the total workforce as members of racial, ethnic, as well as cultural minorities. It was also reported that more than 73% of the organization’s workforce are women. The increasing diversity poses new challenges for the organization, ranging from

As noted above, the organization’s mission entails providing high-quality care by continuously striving to improve care, and this has been augmented by hiring, training, and retaining the right people that continue to help the firm make lives better. Currently, the focus of the management is on the management of the organization’s highly diverse population through the use of programs like GenKP, KPability, KP Asian Association (KPAA), and KP LatinX Association (KPLA). These programs have proven to be effective when it comes to enabling the company make the lives of its over 12 million members and approximately 300,000 employees and physicians better (Kaiser Family Foundation, n.d.).

Importance of Managing the Issue for the Organization

According to Taylor-Ford and Abell (2015), workplace diversity is a reality that healthcare organizations must contend with, especially since getting it right can be critical to efforts to create a workforce capable of delivering on the mission while enabling the organization to minimize the risk of violating employment laws, such as equal opportunity legislations. Understandably, effective management of diversity will play a critical role in enabling Kaiser Permanente to improve the productivity of its workforce, besides improved organizational efficiency and effectiveness linked to decreased conflicts and effective problem solving due to improved creativity and innovation. Kaiser Permanente can implement diversity training as an effective solution to workplace diversity challenges, such as poor accommodation of divergent values and beliefs, conflicts due to poor management of ethnic and cultural differences, poor communication, and poor appreciation of creativity and innovation attributed to the diversity of ideas and perspectives (Johnson, 2017; Vanderbroeck & Wasserfallen, 2017).

Ultimately, effective management of diversity translates to improved productivity of its workforce, besides improved organizational efficiency and effectiveness linked to decreased conflicts and effective problem solving due to improved creativity and innovation. Diversity training is seen as an effective way to augment the organization’s efforts to build and manage a diverse as well as culturally competent workforce capable of serving the United States’ highly diverse population (Carr-Ruffino, 2016; Vanderbroeck & Wasserfallen, 2017). The solution is evidence-based, and thus, the recommendations provided for implementation are evidence-based. This approach will improve the productivity of Kaiser Permanente’s workforce, besides improving organizational efficiency and effectiveness linked to decreased conflicts and effective problem solving due to improved creativity and innovation.

Role of Diversity Management in the Healthcare Industry

In 2004, the Institute of Medicine (IOM) reported that the number of employees associated with minority populations would increase due to how the number of minorities that was estimated at 27% of the U.S. population was projected to be ~37% in 2025. This has already been felt by healthcare organizations like Kaiser Permanente that must strive to ensure effective delivery of care to an increasingly diverse customer base. Creating and maintaining a diverse workforce was cited in a study by Carr-Ruffino (2016) as one of the strategies that organizations in the industry must consider. However, Taylor-Ford and Abell (2015) maintain that the implementation of this strategy requires organizations to consider diverse methods.

Carr-Ruffino (2016) accentuates that the competitive advantage attributed to diversity management within today’s health care organizations cannot be underestimated because the organizations serve a highly diverse customer base nowadays. Ultimately, diversity training, as one of the diversity management strategies, will help lower costs and maximize outcomes for patients, ensure higher patient satisfaction and better care efficiencies for Kaiser Permanente, and reduced healthcare spending combined with better overall health for the communities served. Taylor-Ford and Abell (2015) and Vanderbroeck and Wasserfallen (2017) recommend diversity management through diversity training as one of the strategies that organizations must consider to improve access to care for ethnic and racial minorities, besides enhancing patient-clinician communication and patient and employee satisfaction.

Current Approaches to Diversity Management

Kaiser Permanente focuses on transforming its workplaces into communities rather than providing diversity training. Some of the elements of diversity and inclusion efforts include GenKP, KPability, KP Asian Association (KPAA), and KP LatinX Association (KPLA). The programs are based on the acknowledgment of the fact that a competent and ethnically diverse and accepting workforce is critical to the delivery of western medicine (Kaiser Family Foundation, n.d.). Ensuring that a workforce is culturally competent is a daunting task for nearly every organization (Vanderbroeck & Wasserfallen, 2017). Kaiser Family Foundation uses the programs to improve the competence of its workforce and this explains why it is currently ranked 20th on the Fortune’s list of 100 best workplaces for diversity (Kaiser Family Foundation, n.d.).

GenKP is a program dedicated to providing employees with opportunities for networking, collaboration, as well as professional development and KPAA promotes professional development as well as culturally competent care. Kaiser Family Foundation empowers its employees with disabilities to optimize their talents as well as achieve their goals with KPability, and KP LatinX Association (KPLA) works by inspiring as well as empowering all employees associated with LatinX communities to achieve their full potential. It is by inspiring and empowering employees to achieve their full potential that Kaiser Permanente can drive performance and quality, particularly relative to the competition (Kaiser Family Foundation, n.d.).

Strategic Analysis

SWOT Analysis

Rothaermel (2017) asserts that the purpose of a SWOT analysis is to enable an organization to enhance its understanding of the internal and external environments based on the analysis of the company’s strengths, weaknesses, opportunities, and threats. Kaiser Permanente’s SWOT analysis can be beneficial in enabling the company utilize its strengths to address it weaknesses and exploit opportunities in order to address the threats.

Strengths	Weaknesses
1. Continued use of industry-leading expertise and advanced technology. 2. An integrated health care delivery system. 3. Improved patient outcomes due to innovation and use of advanced technologies. 4. Aligned structure and incentives. 5. Integrated information technology. 6. Strong brand name in the industry.	1. Inadequate staff engagement as well as education. 2. Physician education & adherence to guideline. 3. Poor patient compliance with ordered medications. 4. Poor employee motivation and job satisfaction. 5. High employee turnover. 6. Inability to attract new patients.
Opportunities	Threats
1. Diversity training to foster cultural competence. 2. Investment in research and development to foster innovation. 3. Investment in big data and analytics. 4. Artificial intelligence and robotics. 5. Expansion to underserviced areas across the country.	1. Increasing competition (stiff competition). 2. Cost of healthcare is increasing. 3. Unintentional actions that diminish the quality of care. 4. Increasingly sophisticated cybercriminals (security breaches).

VRIO Analysis

The VRIO (value, rarity, imitability, and organization) strategic framework is useful as a strategic analysis tool as it complements a SWOT analysis by providing an analysis of the internal environment of an organization in terms of the competitive advantage accrued to resources and competencies (Mazzei & Noble, 2017). Kaiser Permanente’s VRIO analysis (below) shows that Kaiser Permanente should focus more on its workforce (human resources) and leadership and HRM competencies to gain a competitive advantage.

Resources/Competencies	Value	Rarity	Imitability	Organization	Competitive Advantage?
Brand Name	Yes	Yes	Yes	Yes	Exploited
Workforce (Human Resources)	No	No	Yes	Yes	Unexploited
Marketing	Yes	Yes	Yes	Yes	Sustained
Leadership and HRM	No	Yes	No	No	Unexploited
Distribution Network	Yes	No	Yes	Yes	Exploited

PESTEL Analysis

Rothaermel (2017) accentuates that the purpose of a PESTEL analysis is to analyze a company’s external business environment, especially as it considers factors like political, economic, sociocultural, technological, ecological, and legal factors. Kaiser Permanente is affected by these factors, and thus, must strive to minimize their adverse impact on the organization.

Political factors

· The pressure to deliver high-quality, affordable, and value-driven care to all Americans from the political class (policymakers).

· America’s political stability provides a favorable business environment for the companies in nearly every industry.

Economic factors

· Inflation and interest rates impact the cost of healthcare delivery.

· Unemployment affects affordability, and thus, increases the number of uninsured Americans.

Social factors

· The growing presence of minority populations.

· The high number of Americans still impedes access to care without healthcare insurance; the number rose from 25.6 million in 2017 to 27.5 million in 2018.

Technology

· Technological innovation and effective integration of technology has allowed for automation of processes like billing and prescription.

· Technology can help minimize billing and other medical errors, including incidences of fraud in billing.

· E-learning has enhanced employee training.

Legal factors

· Health and safety laws impact how decisions are made within the modern-day healthcare system.

· Healthcare organizations must adhere to laws and regulations related to intellectual property.

· Privacy and confidentiality must be protected.

Environmental factors

· Healthcare organizations should prioritize sustainable business practices.

Business Opportunity

Based on the strategic analysis and background information on Kaiser Permanente, it is evident that the focus should be on the organization’s workforce (human resources) and leadership and HRM competencies to gain a competitive advantage. Hence, diversity management achieved through diversity training is essential to the achievement of the organization’s mission of providing high-quality care and realize its vision of being a leader in total health.

Diversity Training

Diversity training is seen as an organizational opportunity to manage the organization’s highly diverse workforce. It is based on the recognition of the fact that diversity management contributes a lot to value-based healthcare delivery. Ultimately, diversity training will help lower costs and maximize outcomes for patients, ensure higher patient satisfaction and better care efficiencies for Kaiser Permanente, and reduced healthcare spending combined with better overall health for the communities served, as discussed by Provost, Lanham, Leykum, McDaniel Jr, and Pugh (2015). Diversity training will allow Kaiser Permanente to:

· Become attractive and appealing to high-quality talent, especially as an inclusive employer,

· Ensure that all talents are represented through learning and development,

· Retains diverse talents while managing exits more effectively,

· Ensure that all employees are understood and trained for an improved onboarding experience,

· Promote talent progression and performance,

· Cater to all talents’ needs and expectations,

· Improve decision making since Larson (2017) reports that a diverse team makes the right decision 87% of the time.

Fig. 1: Impact of diversity on decision making (Larson, 2017)

A high-quality diversity training program can be indispensable to the delivery of high-quality care to today’s increasingly diverse communities, chiefly since it would augment the organization’s efforts to build and manage a diverse as well as culturally competent workforce (Carr-Ruffino, 2016; Vanderbroeck & Wasserfallen, 2017). Diversity management contributes a lot to value-based healthcare delivery. Diversity training as a business opportunity is an important component of the organization’s strategic workforce plan design to lower costs, and maximize outcomes for patients, guarantee higher patient satisfaction as well as improve care efficiencies. Other benefits cited by Provost et al. (2015) encompass reduced healthcare spending, combined with better overall health for the communities served.

Implementation

A high-quality diversity training program designed as well as administered online. Emphasis will be placed on equipping the employees with skills and knowledge that will help them become culturally competent, thus, enabling them to serve increasingly diverse communities, which Vanderbroeck and Wasserfallen (2017) describe as being critical to cultural diversity. What is important to note is that implementing the diversity training program online will afford the organization an excellent opportunity to save on the cost of implementation while augmenting learning by enabling the employees to learn from almost anywhere. The appropriateness of an online diversity training program is also attributed to how Kaiser Permanente’s employees are scattered in different geographical locations across the United States, and the training can also be carried out concurrently. E-learning is also described by Ahmad and Thressiakutty (2018) as being highly adaptable, and thus, it is suitable when it comes to enabling learners to study and learn at their own pace, which improves the adoption of the material being learned.

The adaptability of e-learning also allows employees with different learning styles in an organization to establish and maintain a steady pace of learning. However, before the implementation of a full-scale program, it is recommended that a pilot program be rolled out to a multidisciplinary sample of 100 employees at the organization. This will make a lot easier to determine the program’s feasibility, as noted by Jacobs et al. (2017), and thus, be able to establish a more effective way to deliver diversity training to Kaiser Permanente’s geographically diverse employees. Generally speaking, successful implementation of the online diversity training will help augment the organization’s existing diversity and inclusion programs since research by Ahmad and Thressiakutty (2018) assert that new strategies are cost-effective and seamless to implement if they align with the current initiatives. Some of the critical aspects of the program include:

· Exposure to diverse facets of the modern-day health care.

· Development of key skills and knowledge like cross-cultural communication deemed critical to culturally competent care.

· Lectures, demonstration, and professional development.

· Leadership training achieved through teamwork as well as collaborative projects.

· Coaching and continuous assistance led by distinguished professionals or subject matter experts.

· Simulation labs to foster creativity and innovation when it comes to addressing diversity-related problems that would impact the delivery of high-quality and culturally competent care.

· Possible opportunities to conduct research on a wide range of topics, such as cultural awareness and health disparities.

· Mock interviews and exam reviews for physicians, nurses, and pharmacists.

Essentially, the implementation will be made seamless by the fact that the value drives the current programs that the organization places on the rich diversity of its workforce. Kaiser Permanente encourages an open, inclusive work environment that supports as well as empowers employees. Online diversity training implemented quarterly for both new and existing employees will be made possible by the organization’s longstanding commitment to diversity, equity, and inclusion designed to guarantee culturally competent care to its over 12 million members. The firm’s continued use of industry-leading expertise and advanced technology will also improve the effectiveness of the implementation process (Kaiser Family Foundation, n.d.).

A multidisciplinary team should be constituted to help with the creation and implementation of a diversity training program. For instance, the team should comprise of experts from different fields, such as subject matter experts on online training and diversity management, physicians, nurses, and other healthcare professionals. Importantly, the diversity of ideas will increase the chances that diversity training as a business opportunity is implemented seamlessly and innovatively. Murphy, Curtis, McCloughen (2016) recommend this as an approach to ensuring that all learning needs are identified and addressed more effectively.

Ethical Considerations

According to Ahmad and Thressiakutty (2018), ethics play a significant role in healthcare, and it is for this reason that healthcare organizations must ensure that they adhere to established ethical principles. Ethical values are indispensable for any healthcare provider (Haddad & Geiger, 2019). For instance, adherence to principles designed to ensure beneficial patient-physician relationships (beneficence and nonmaleficence) cannot be underestimated (Ahmad & Thressiakutty, 2018). Some of the ethical considerations applicable to Kaiser Permanente include respect for individuals and valuing privacy and confidentiality.

Respect for Individuals

The delivery of care should be with compassion and respect for the inherent dignity, worth, as well as unique attributes of all persons (Haddad & Geiger, 2019). Respect for individuals is an indispensable ethical consideration at Kaiser Permanente, especially when it comes to the delivery of care and implementation of initiatives to improve employee performance. Recognizing the highly diverse nature of the current workforce, employee development programs should reflect respect for the enrolled individuals. It will be an excellent way to foster self-determination and foster continuous learning.

Privacy & Confidentiality

Healthcare organizations like Kaiser Permanente are expected to promote, advocates for, and protects the rights, health, as well as safety of the patient, as noted by Haddad and Geiger (2019). Therefore, it is important to consider ensuring that private and confidential information are protected from unauthorized access. Private and confidential information should only be shared when deemed necessary, such as for the training, as suggested by Cohen (2018). The protection of private and confidential data ought to be a priority to confidence in the organization’s healthcare delivery system and employee training or learning system. More specifically, as a healthcare organization the obligation to safeguard patient information is solely relied upon their ability to follow policies, procedures and protocol. Professionals then have an obligation to hold that information in confidence.

Other ethical considerations include accountability and responsibility for practice, decision-making, and taking action in keeping with the obligation to provide high-quality patient care. It is also vital to consider roles and settings that help advance the profession, besides protecting human rights, promoting health diplomacy, as well as reduce health disparities, as suggested by Haddad and Geiger (2019) and Cohen (2018).

Leadership and Collaboration Aspects

Key leadership and collaboration aspects include problem-solving, the ability to build relationships, and ability to think creatively and strategically. It is reasoned that the proposed solution, diversity training, will augment the organization’s efforts to foster creativity and innovation, and the ability to think creatively and strategically will be an indispensable strength in the realization of this benefit.

Problem-Solving

Problem-solving is an important aspect of nearly every leadership style, such as transformational leadership. The identified opportunity is meant to empower leaders to develop solutions to problems like conflicts within their workplaces (Taylor-Ford & Abell, 2015).

Build Relationships

Good relationships are critical to improved collaboration, and diversity training provides an excellent opportunity for leaders to eliminate barriers to effective collaboration. Improved conflict management and resolution critical to leadership efforts to foster collaboration (Taylor-Ford & Abell, 2015).

Thinking Creatively and Strategically

Kaiser Permanente is essentially a strategic partnership between three distinct yet interdependent entities, such as Kaiser Foundation Hospitals, the Kaiser Foundation Health Plan, Inc. (KFHP), and the regional Permanente Medical Groups (Kaiser Permanente, n. d.). One of the key business opportunities that can enable the organization to achieve its mission of providing high-quality care and realize its vision of being a leader in total health is diversity management, which can be achieved by providing diversity training as recommended by Borkowski (2015).

Conclusion

Ensuring that a workforce is culturally competent is a daunting task for nearly every organization. Even so, the project demonstrates that Kaiser Permanente can take advantage of its diverse workforce to improve the quality of service delivery to the increasingly diverse customer base through diversity training. Online diversity training will be appropriate to train the organization’s over 300,000 personnel, including over 80,000 physicians and nurses, that work in 39 hospitals operated by the organization as well as over 700 medical offices. Diversity management will contribute a lot to value-based healthcare delivery. The implementation process will be made seamless by the fact that the current programs are driven by the value that the organization places on the rich diversity of its workforce. Kaiser Permanente encourages an open, inclusive work environment that supports as well as empowers employees. Eventually, the program will help lower costs and maximize outcomes for patients, ensure higher patient satisfaction and better care efficiencies, and reduce healthcare spending combined with better overall health for the communities served by Kaiser Permanente.

Recommendations

· Before the implementation of a full-scale diversity training program, it is recommended that a pilot program be rolled out to a multidisciplinary sample of 100 employees at the organization. This will make a lot easier to determine the program’s feasibility, as noted by Jacobs et al. (2017).

· Kaiser Permanente should consider implementing a full-scale diversity training program online to account for the fact that its employees are scattered in different geographical locations across the United States, besides as a strategy to save on the cost of implementation.

A multidisciplinary team should be constituted to help with the creation and implementation of a diversity training program. Murphy et al. (2016) recommend this as an approach to ensuring that all learning needs are identified and addressed more effectively.

References

Ahmad, W., & Thressiakutty, A. T. (2018). Effect of teacher’s training on enhancing self-determination among individuals with intellectual disability. Indian Journal of Social Psychiatry, 34(1), 16.

Borkowski, N. (2015). Organizational behavior, theory, and design in health care. Jones & Bartlett Publishers.

Carr-Ruffino, N. (2016). Leadership opportunities for managing diversity. In Handbook of Research on Race, Gender, and the Fight for Equality (pp. 298-320). IGI Global.

Cohen, S. H. (2018). Privacy and confidentiality issues in federal-state cooperative programs of the Bureau of Labor Statistics. Retrieved, 3, 27.

Haddad, L. M., & Geiger, R. A. (2019). Nursing Ethical Considerations. Retrieved from /orders/www.ncbi.nlm.nih.gov/books/NBK526054/

Jacobs, R. H., Guo, S., Kaundinya, P., Lakind, D., Klein, J., Rusch, D., … & Atkins, M. (2017). A pilot study of mindfulness skills to reduce stress among a diverse paraprofessional workforce. Journal of Child and Family Studies, 26(9), 2579-2588.

Johnson, S. K. (2017). What 11 CEOs have learned about championing diversity. Harvard Business Review. Retrieved from /orders/static1.squarespace.com/static/5ae89190aa49a17d6e450047/t/5b0d933f88251b7c897e8263/1527616321046/what+11+ceos+have+learned+about+championing+diversity.pdf

Kaiser Family Foundation. (n. d.). About us. Retrieved from http://kff.org

Kaiser Permanente. (n. d.). Diversity & inclusion. Retrieved from /orders/www.kaiserpermanentejobs.org/diversity-and-inclusion/

Larson, E. (2017). New Research: Diversity + inclusion = Better decision making at work. Retrieved from /orders/www.forbes.com/sites/eriklarson/2017/09/21/new-research-diversity-inclusion-better-decision-making-at-work/#3626eec74cbf

Mazzei, M. J., & Noble, D. (2017). Big data dreams: A framework for corporate strategy. Business Horizons, 60(3), 405-414.

Murphy, M., Curtis, K., & McCloughen, A. (2016). What is the impact of multidisciplinary team simulation training on team performance and efficiency of patient care? An integrative review. Australasian emergency nursing journal, 19(1), 44-53.

Provost, S. M., Lanham, H. J., Leykum, L. K., McDaniel Jr, R. R., & Pugh, J. (2015). Health care huddles: Managing complexity to achieve high reliability. Health care management review, 40(1), 2-12.

Rothaermel, F. (2017). Strategic management concepts (3rd ed.). New York, NY: McGraw-Hill.

Taylor-Ford, R. L., & Abell, D. (2015). The leadership practice circle program: an evidence-based approach to leadership development in healthcare. Nurse Leader, 13(2), 63-68.

Vanderbroeck, P. & Wasserfallen, J. B. (2017). Managing gender diversity in healthcare: getting it right. Leadership in Health Services, 30(1), 92-100.

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Assessment 1 MBA Capstone Experience

Assessment 1

Capella University

Adam Garza

08-01-2021

Company Introduction

ExxonMobil is the largest publicly traded international oil and gas company. Originating as a regional kerosene marketer, Exxon Co. merged with Mobil in 1999 and has since built an organization that applies technology and innovation to meet expanding energy needs. As a leader in the industry, ExxonMobil has access to many resources, massive refiners, and petroleum products to perform optimally in energy and chemical manufacturing (Lee, 2021). ExxonMobil tackles the challenge of meeting global energy needs through its investments and sponsorships, including various research facilities in multiple countries and energy-based services. Furthermore, they have sponsored exploration voyages for oil and natural gas hotspots on six continents and invested in next-generation technologies (Lee, 2021).

Statement of Scope

This project’s scope will focus on the various internal and external strategies ExxonMobil employs to stay relevant in a world where climate change, sustainability, and environmental responsibility have become ever so important. Environmental issues have not always been the primary concern of ExxonMobil. However, the market is continuously moving in that direction, and ExxonMobil is faced with the challenge of meeting these new market needs (Kolk & Levy, 2001, p. 501). Furthermore, climate change issues are a current topic of interest for many businesses. ExxonMobil serves as an example of a company that continues to incorporate new approaches in business that would have otherwise conflicted with its past business models. Ultimately, the goal has always been to identify future needs to keep the company relevant by any means. This project will assess these goals according to the company’s structure and organizational strategies. The result should be a comprehensively innovative, strategic, and sustainable approach to dealing with changing market demands due to climate change and other environmental factors.

The project will analyze the various frameworks of the company through VRIO, PESTEL, SWOT, and five forces analyses. Various sources include the company website; the University Library will be utilized to obtain the appropriate information. Examples of the necessary data for this project include the company’s finances, logistics, and other business operations. Access to such data may be limited due to confidentiality, privacy, legal matters, and company and consumer information protection rights. A member of the organization can be contacted to request such information to mitigate these challenges. Employees from a variety of departments should be contacted.

Demonstration of Outcomes

ExxonMobil and the challenges it faces provide an excellent opportunity to test and demonstrate leadership skills. This project will allow for practice in applying foundational knowledge, understanding business systems and processes, integrating information access disciplines, and providing an evidence-based solution to a relevant business issue. For example, the VRIO, PESTEL, SWOT, and five forces analyses apply foundational knowledge to business systems, processes, and technology. They provide an overview of threats and opportunities that can be assessed and integrated according to the research and existing rules and regulations. The research will be from many perspectives, which heightens the importance of accurately integrating information to reach an evidence-based solution ultimately. This outcome will be supported by numerical data, including balance statements and cash flow.

Conclusion

Thus far, ExxonMobil has been able to accomplish sustainability throughout the years despite the challenges it faced. If the company is to remain relevant it must develop new strategies to overcome new challenges. Climate change, among other environmental factors, poses significant threats to the company’s sustainability. Research and analysis will be necessary to determine different aspects of the organization to derive impactful strategies that help the organization maintain its status as an industry leader.

References

Kolk, A., & Levy, D. (2001). Winds of Change: Corporate Strategy, Climate Change, and Oil Multinationals. European Management Journal, 19(5), 501-509. DOI: 10.1.1.594.5121

Lee, J. (2021). Exxon Can’t Catch a Break. The Wall Street Journal. /orders/www.wsj.com/articles/exxon-cant-catch-a-break-11627666841

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