Consultative Change Proposal
Selecting an Organization
Select a healthcare organization in your area for this assessment. The organization must deliver
healthcare services to the public. The organization may be any size, but it must have
organizational complexity, including:
Interdisciplinary staff (e.g., physicians, advanced practice nurses, physicians assistants,
nurses, social workers, psychiatrists, physical therapists)
Multiple departments (e.g., nursing, support services, ancillary services)
Multiple layers of leadership (e.g., administrative staff, department directors,
There is a broad range of organization types that are appropriate for this assignment, including,
but not limited to:
Long-term acute care facilities (LTACs)
Home care or hospice organizations
Ambulatory surgery centers
Public health departments
Lastly, the organization that you choose must provide the public with the types of information
described in the “Preparing for the Interview” section below.
Selecting a Nurse Leader
After researching the organization, please choose a nurse leader from within the organization
to interview. Your nurse leader should be a change agent in the organization. The nurse leader
you interview does not need to have an advanced nursing practice degree. However, your
chosen interviewee should have a formal leadership role in the organization.
When selecting your nurse leader, consider the ways in which the nurse leader is actively
involved in enacting change in the organization. Please also review the questions in the
“Interview Questions” section to understand what topics your interview should cover.
The following list includes examples of nurse leaders to interview. The list is not intended to be
exhaustive; your nurse leader may have a different role than is listed below. If you are unsure
whether your chosen nurse leader meets the requirements, or if you have any difficulty finding
a nurse leader to interview, please contact your assigned course mentor.
Chief nurse executive
Clinical nurse specialist
Nursing unit director
Nursing department manager
Nurse project manager
Nurse case manager
Nursing team lead or committee chair
Public health nurse
Preparing for the Interview
Determine if the organization has a website and review the information that the organization
makes available to the public. Familiarize yourself with the organization's mission statement,
organizational chart, list of departments, and other information, such as public quality data.
Consider the following as potential sources of public information for your research:
o Organizational mission and vision statements
o Organizational values
o Organizational statistics (e.g., number of employees, number of patients,
o Annual goals and reports
o Marketing materials
Published organizational performance documents
o HCAHPS reports
o County health rankings*
Comparisons to other healthcare organizations in the area**
Press (e.g., newspapers, Internet articles)
Conversations or additional interviews with stakeholders (employees and patients)
* Access the “Rankings” tab of the County Health Rankings website to gain a better
understanding of what affects health in your community and where an advance nurse leader
might need to focus improvement efforts: http://www.countyhealthrankings.org/
** Visit the Medicare Compare website to compare the organization you have chosen with
others in the area: http://www.medicare.gov/forms-help-and-resources/find-doctors-hospitals-
Note: Be sure to manage the interview to keep within the allotted time frame while covering all
of the topics listed below.
1. What is your role and its scope within the organization?
2. What organizational goals do you support in your role?
3. Who are the stakeholders that you serve on your job (both internal and external)?
4. What are you responsible for delivering and to whom?
5. What is the mission of your organization? Is this published and available to staff and the
6. How does the organization operationalize its mission?
7. How does the mission statement guide or direct organization polices, leader interactions
and roles, and day-to-day operations?
8. Identify one strength of your organization.
9. Identify one weakness of your organization.
10. What are the major opportunities for improvement facing your organization?
11. What systems have been put in place to support patient safety (e.g., electronic health
records, employee education and development programs, barcode scanning, handoff
Evidence-Based Practice and Quality Improvement Activities
12. To what extent does your role participate in quality improvement efforts?
13. In what ways does your organization incorporate evidence-based practice into care delivery
14. Does your organization educate staff about National Patient Safety Goals? If so, explain
what these efforts entail.
Consultative Change Proposal Outline (Requirements)
Your 7–10 page paper should be written according to APA style guidelines and structured as
a. Purpose of consultation
b. Overview of the consultation process
II. Organizational Analysis
a. Description of organization
Include as much of the following information as is available to you:
• Type and location of organization
• Number of employees and patient encounters (approximate)
• Departmental map, organizational chart, or leadership structure
• Service area (e.g., size, age, demographics)
• Services provided
b. Primary needs of population served by this organization
Consider: What are the primary health risks impacting the community (e.g., smoking,
drug addiction, communicable disease, homelessness, poverty)?
III. Nurse Leader Interview Summary
a. Nurse leader role
Consider: How does role align with role defined in The Essentials of Master’s Education
in Nursing? Also consider the domains of influence or actual authority the nurse leader
has in the organization.
b. Characteristics of organization
• Evidence-based practice activities
• Quality improvement projects
IV. Recommendation for Organization Change
Consider: How does the change address the organization's weaknesses? How does it
address the community's needs?
c. Measurement of effectiveness
Consider: Identify a national benchmark of performance and describe a clear plan to
measure the effectiveness of your proposed change over time.