NURS-FPX6218: Leading the Future of Health Care
Assessment 1: Proposing Evidence-Based Change
Course Information
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Course Code: NURS-FPX6218
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Course Title: Leading the Future of Health Care
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Program: MSN in Nursing Leadership and Administration (FlexPath)
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Assessment Number: 1
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Prerequisite: NURS-FPX6026; NURS-FPX6020 or NURS-FPX6021
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Credit Points: 4
Assessment Overview
This assessment requires you to assume the role of a nurse leader proposing an evidence-based change initiative within a healthcare organization or community setting. You will identify a significant clinical or operational issue, conduct a comparative analysis of how non-U.S. healthcare systems address similar challenges, and develop a comprehensive change proposal supported by scholarly evidence and financial projections.
The purpose of this assessment is to evaluate your ability to synthesize leadership theory, evidence-based practice, and systems thinking to drive sustainable healthcare improvement. You will demonstrate competencies in strategic planning, cross-cultural healthcare analysis, and fiscal stewardship essential for advanced nursing leadership roles.
Learning Outcomes
Upon successful completion of this assessment, you will demonstrate proficiency in the following course competencies:
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Competency 1: Analyze the nurse leader’s role in leading high-performing healthcare teams and creating buy-in from stakeholders, colleagues, constituencies, and interdisciplinary teams.
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Competency 2: Examine the impact of cultural, ethical, and regulatory considerations on healthcare decision making and strategic vision.
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Competency 3: Implement a future-looking strategic vision to ensure sustainable gains in quality and safety.
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Competency 5: Apply scholarly writing standards to communicate evidence-based strategies that support organizational and population health outcomes.
Task Description
Select a healthcare issue affecting your local organization, community, or patient population. This issue may involve clinical quality, patient safety, access to care, chronic disease management, health disparities, or operational efficiency. Develop an executive summary report that proposes an evidence-based change initiative to address this issue, incorporating comparative analysis from at least two non-U.S. healthcare systems and a preliminary financial impact assessment.
Healthcare Issue Options
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Clinical Quality: Medication errors, hospital-acquired infections, pressure injury prevention, fall reduction, or care coordination gaps.
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Chronic Disease Management: Diabetes complications, heart failure readmissions, COPD exacerbation prevention, or obesity-related conditions.
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Access and Equity: Rural healthcare access, mental health service gaps, health insurance coverage barriers, or disparities in maternal health outcomes.
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Operational Efficiency: Nurse staffing ratios, patient throughput, electronic health record optimization, or supply chain management.
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Population Health: Substance abuse prevention, adolescent mental health, aging population care needs, or community health promotion.
Assessment Requirements
Part 1: Executive Summary and Issue Identification (15%)
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Provide a concise executive summary (150–200 words) outlining the proposed change, target population, and anticipated outcomes.
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Describe the selected healthcare issue with supporting epidemiological data, organizational metrics, or community health indicators.
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Explain the significance of the issue in terms of patient outcomes, organizational performance, or population health burden.
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Identify the healthcare setting (acute care, ambulatory, community-based, long-term care) and relevant stakeholders affected by the issue.
Part 2: Comparative Healthcare Systems Analysis (25%)
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Select two non-U.S. healthcare systems (e.g., United Kingdom NHS, Australia’s Medicare, Canada’s provincial systems, Germany’s statutory insurance, Japan’s universal coverage, or Scandinavian models).
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Analyze how each system addresses the identified healthcare issue, including policy frameworks, clinical guidelines, prevention strategies, and resource allocation approaches.
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Compare outcomes data where available (morbidity, mortality, patient satisfaction, cost-effectiveness, access metrics).
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Identify specific practices, technologies, or organizational models from these systems that could be adapted to the U.S. context.
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Cite government health ministry reports, WHO data, peer-reviewed comparative health policy literature, or OECD health statistics.
Part 3: Evidence-Based Change Proposal (30%)
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Articulate a clear, measurable change goal using SMART criteria.
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Describe the proposed intervention(s) supported by systematic reviews, clinical practice guidelines, or implementation science literature.
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Identify desired outcomes including clinical endpoints, process measures, patient experience indicators, and population health improvements.
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Address potential barriers to implementation (organizational culture, resource constraints, regulatory requirements, stakeholder resistance) and propose mitigation strategies.
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Discuss the role of interprofessional collaboration in achieving sustainable change.
Part 4: Financial and Health Implications (20%)
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Project the financial impact of implementing the proposed change, including startup costs, operational expenses, and anticipated cost savings or revenue generation.
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Analyze the return on investment (ROI) or cost-effectiveness of the intervention using available evidence.
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Discuss health implications if the change is not implemented, including progression of disease burden, increased healthcare utilization, and quality-of-life impacts.
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Identify potential funding sources (grants, quality improvement budgets, value-based care incentives, public health initiatives).
Part 5: Leadership and Strategic Vision (10%)
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Articulate how the proposed change aligns with a future-looking strategic vision for the organization or community.
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Describe your role as a nurse leader in championing this change, including communication strategies, stakeholder engagement, and coalition building.
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Discuss cultural, ethical, and regulatory considerations influencing the change process.
Formatting and Submission Requirements
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Length: 4–6 pages of content, excluding title page and reference list.
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Format: APA 7th edition, including title page, headings, in-text citations, and reference list.
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Font: Times New Roman, 12-point, double-spaced.
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Margins: 1 inch on all sides.
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References: Minimum of 8 scholarly or professional sources published within the last 5 years (2021–2026), including at least 2 sources related to comparative healthcare systems.
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Writing Standards: Adhere to Capella University scholarly writing standards; use clear, concise, and grammatically correct language appropriate for executive communication.
Competency-Based Scoring Guide
Table
| Criteria | Non-Performance | Basic | Proficient | Distinguished |
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| Competency 1: Issue Identification and Significance | Does not identify a healthcare issue or provides no supporting data. | Identifies a healthcare issue but provides minimal or irrelevant data; stakeholder analysis is superficial or missing. | Identifies a significant healthcare issue supported by relevant epidemiological or organizational data; identifies key stakeholders affected by the issue. | Identifies a complex, high-priority healthcare issue with comprehensive data from multiple sources; conducts thorough stakeholder analysis including power, interest, and influence mapping; demonstrates sophisticated understanding of issue interdependencies. |
| Competency 2: Comparative Systems Analysis | Does not analyze non-U.S. healthcare systems or provides inaccurate comparisons. | Describes non-U.S. systems superficially without meaningful comparison or identification of transferable practices; sources may be outdated or unreliable. | Analyzes two non-U.S. healthcare systems with accurate descriptions of their approaches; identifies specific practices adaptable to the U.S. context; supports analysis with credible sources. | Conducts sophisticated comparative analysis using multiple data points and outcome metrics; critically evaluates strengths and limitations of each system; proposes innovative adaptations tailored to the local U.S. context with strong evidence base. |
| Competency 3: Evidence-Based Change Proposal | Does not propose a change or provides an unsupported, vague intervention. | Proposes a change but lacks SMART criteria, evidence base, or meaningful outcome measures; barrier analysis is superficial. | Develops a SMART change goal with evidence-based intervention; identifies measurable outcomes and realistic barriers with mitigation strategies. | Develops an exceptional change proposal with clearly articulated SMART goals; intervention is grounded in high-quality systematic reviews and implementation science; outcomes are multidimensional and measurable; barrier analysis is comprehensive with creative, evidence-based mitigation strategies. |
| Competency 3: Financial and Health Impact Analysis | Does not address financial or health implications. | Provides minimal financial or health analysis with unsupported projections or missing elements. | Projects reasonable financial impact including costs, savings, and funding sources; discusses health implications of implementation and non-implementation. | Provides rigorous financial analysis with detailed projections, ROI calculations, and sensitivity analysis; health implications are thoroughly explored with epidemiological modeling; identifies innovative funding mechanisms and value-based care alignment. |
| Competency 1: Leadership and Strategic Vision | Does not address leadership role or strategic vision. | Describes leadership role generically without specific strategies for stakeholder engagement or strategic alignment. | Articulates a clear leadership role with specific communication and engagement strategies; aligns change proposal with organizational or community strategic priorities. | Demonstrates exemplary leadership vision with sophisticated stakeholder engagement plans including coalition building, negotiation strategies, and change management frameworks; strategic alignment is compelling and forward-looking with attention to sustainability and scalability. |
| Competency 5: Scholarly Writing and APA | Writing lacks purpose, organization, or adherence to scholarly standards; significant APA errors. | Writing conveys purpose but lacks clarity, organization, or consistent adherence to APA style; limited use of evidence. | Writing is clear, organized, and adheres to APA style; incorporates supporting evidence and maintains professional executive tone throughout. | Writing is exceptionally clear, compelling, and precise; seamlessly integrates high-quality evidence from diverse sources; demonstrates sophisticated command of APA 7th edition; maintains an authoritative, executive-level tone suitable for C-suite or board presentation. |
Compose a 4–6 page evidence-based change proposal for NURS-FPX6218 that analyzes a healthcare issue, compares non-U.S. system approaches, and projects financial and health outcomes using APA 7th edition and scholarly sources.
Write a 4–6 page executive summary proposing an evidence-based healthcare change initiative for Capella’s NURS-FPX6218, incorporating international comparative analysis and financial impact assessment.
Develop an evidence-based change proposal with comparative health systems analysis for NURS-FPX6218.
Sample Change Proposal Excerpt: Reducing Diabetic Peripheral Neuropathy Through Systematic Foot Care
Diabetic peripheral neuropathy affects approximately fifty percent of individuals with diabetes and represents a leading cause of non-traumatic lower limb amputation in the United States. In the local healthcare systems of Colorado, inadequate foot examination practices and limited patient education contribute to progression from manageable neuropathy to severe complications including ulceration, infection, and amputation. This change proposal advocates for implementing systematic annual foot examinations, structured patient education programs, and interprofessional care coordination modeled on successful international frameworks.
The United Kingdom’s National Health Service provides a compelling comparative model through the National Institute for Health and Care Excellence guidelines on diabetic foot problems, which mandate annual foot risk stratification for all diabetes patients with more frequent assessments for high-risk individuals. The NICE framework specifies examination frequency, referral pathways to multidisciplinary foot care teams, and standardized documentation that enables population-level monitoring of foot care quality. Outcomes data indicate that regions with high NICE guideline adherence experience lower major amputation rates compared to areas with inconsistent implementation. Australia’s Diabetes Feet Australia initiative offers a complementary approach emphasizing digital health integration, including mobile applications for daily foot self-checks and telehealth-enabled specialist consultations for rural populations. The DFA model leverages technology to overcome geographic barriers while maintaining clinical rigor through standardized assessment tools and clear escalation protocols. Both systems demonstrate that structured, protocol-driven foot care with robust interprofessional collaboration yields superior outcomes compared to ad hoc examination practices.
Adapting these international models to the Colorado context requires establishing a diabetic foot care registry to track examination completion rates, risk stratification accuracy, and complication incidence. Nurse-led foot care clinics would conduct annual examinations using monofilament testing, vibration perception assessment, and visual inspection, with results documented in a standardized format accessible to primary care, endocrinology, and podiatry providers. Patient education would incorporate digital tools including smartphone-based foot care checklists and video tutorials on daily self-examination, addressing health literacy barriers through multilingual materials and culturally tailored messaging. Pharmacological management would align with American Diabetes Association guidelines, with nurses monitoring medication adherence and glycemic control as modifiable risk factors for neuropathy progression. Financial projections indicate startup costs of approximately $180,000 for clinic infrastructure, staff training, and digital platform development, with anticipated savings of $420,000 annually through prevented hospitalizations, reduced emergency department utilization, and avoided amputation procedures. Return on investment would be realized within eight months of full implementation, with sustained savings accruing from improved population health outcomes and reduced long-term disability costs.
International Models and Local Adaptation Strategies
Comparative health policy research reveals that countries with integrated primary care systems achieve better chronic disease outcomes at lower per-capita costs than fragmented models. The NHS approach succeeds partly because general practitioners serve as care coordinators with clear accountability for population health outcomes, while Australia’s hybrid public-private system leverages digital innovation to extend specialist reach. For U.S. healthcare organizations, adaptation requires navigating a more fragmented payer landscape and addressing reimbursement barriers that discourage preventive foot care. Value-based care contracts, particularly Medicare Advantage and accountable care organization arrangements, create financial incentives for preventive interventions that reduce downstream costs. Nurse leaders can champion this alignment by demonstrating how systematic foot care supports shared savings targets and quality bonus metrics. Evidence from Hicks and Selvin (2019) indicates that aggressive glycemic management and structured foot surveillance reduce neuropathy incidence by approximately thirty percent over five years, translating to substantial cost avoidance in populations with high diabetes prevalence. The proposed change aligns with Triple Aim objectives by improving patient experience through proactive care, enhancing population health through complication prevention, and reducing per-capita costs through avoided acute interventions.
Leadership Strategies for Sustainable Implementation
Successful change implementation in healthcare organizations depends less on the technical merits of the intervention and more on the leader’s ability to build coalitions, manage resistance, and sustain momentum through early wins and visible progress. A common misconception among emerging nurse leaders involves assuming that evidence alone will persuade stakeholders to adopt new practices. In reality, organizational change requires deliberate attention to culture, power dynamics, and perceived threats to professional autonomy. For the diabetic foot care initiative, anticipated resistance may emerge from primary care physicians concerned about additional documentation burden, podiatrists protective of their specialist role, and administrators focused on immediate budget constraints. Effective leaders address these concerns through co-design approaches that involve skeptics in solution development, pilot programs that generate local evidence, and storytelling that connects data points to individual patient narratives. The Kotter change model provides a useful framework: establishing urgency through complication data, forming a guiding coalition of clinical champions, creating a vision of complication-free patient futures, communicating that vision through multiple channels, empowering action by removing structural barriers, generating short-term wins through pilot outcomes, sustaining acceleration by integrating foot care metrics into organizational dashboards, and anchoring changes in organizational culture through policy revision and staff onboarding. Evidence from Errida and Lotfi (2021) on organizational change management determinants supports this phased approach, noting that successful transformations typically require eighteen to thirty-six months for full cultural integration. Nurse leaders must maintain visibility and advocacy throughout this timeline, celebrating milestones while remaining vigilant for backsliding into previous practice patterns.
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Anchor every proposed intervention to specific evidence from systematic reviews, clinical guidelines, or implementation science literature.
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Quantify outcomes whenever possible using metrics relevant to organizational dashboards and payer reporting requirements.
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Address stakeholder resistance proactively by identifying specific concerns and tailoring engagement strategies to each constituency.
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Connect financial projections to value-based care incentives and population health management contracts.
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Demonstrate cultural competence by adapting international models to local demographic, linguistic, and socioeconomic contexts.
References
Aalaa, M., Amini, M. R., Delavari, S., Mohajeri Tehrani, M. R., Adibi, H., Shahbazi, S., Shayeganmehr, Z., Larijani, B., Mehrdad, N., & Sanjari, M. (2022). Diabetic foot workshop: A strategy for improving the knowledge of diabetic foot care providers. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 16(7), 102543. https://doi.org/10.1016/j.dsx.2022.102543
American Diabetes Association Professional Practice Committee. (2021). 12. Retinopathy, neuropathy, and foot care: Standards of medical care in diabetes. Diabetes Care, 44(Supplement 1), S203–S212. https://doi.org/10.2337/dc21-S012
Campbell, M., Escobar, O., Fenton, C., & Craig, P. (2018). The impact of participatory budgeting on health and wellbeing: A scoping review of evaluations. BMC Public Health, 18(1), 822. https://doi.org/10.1186/s12889-018-5735-8
Errida, A., & Lotfi, B. (2021). The determinants of organizational change management success: Literature review and case study. International Journal of Engineering Business Management, 13, 1–15. https://doi.org/10.1177/18479790211016273
Hicks, C. W., & Selvin, E. (2019). Epidemiology of peripheral neuropathy and lower extremity disease in diabetes. Current Diabetes Reports, 19(10), 86. https://doi.org/10.1007/s11892-019-1212-8
Kiyani, M., Yang, Z., Charalambous, L. T., Adil, S. M., Lee, H.-J., Yang, S., Pagadala, P., Parente, B., Spratt, S. E., & Lad, S. P. (2020). Painful diabetic peripheral neuropathy: Health care costs and complications from 2010 to 2015. Neurology: Clinical Practice, 10(1), 47–57. https://doi.org/10.1212/CPJ.0000000000000671
National Institute for Health and Care Excellence. (2019). Diabetic foot problems: Prevention and management (NICE Guideline NG19). https://www.nice.org.uk/guidance/ng19
Organisation for Economic Co-operation and Development. (2023). Health at a glance 2023: OECD indicators. OECD Publishing. https://doi.org/10.1787/health_glance-2023-en
Selvarajah, D., Kar, D., Khunti, K., Davies, M. J., Scott, A. R., Walker, J., & Tesfaye, S. (2019). Diabetic peripheral neuropathy: Advances in diagnosis and strategies for screening and early intervention. The Lancet Diabetes & Endocrinology, 7(12), 938–948. https://doi.org/10.1016/S2213-8587(19)30081-6
World Health Organization. (2022). Global diabetes compact: A strategic framework for 2021–2030. WHO Press. https://www.who.int/publications/i/item/9789240041890
Assignment Preview: Assessment 2
Week/Assessment: Assessment 2 — Assessing Community Health Care Needs
Description: For the next assessment, you will conduct a comprehensive community health needs assessment using a virtual windshield survey methodology. Select a specific community and systematically evaluate its health status, available resources, environmental factors, and social determinants of health. Your assessment will include demographic and epidemiological data analysis, identification of health disparities and vulnerable populations, evaluation of existing healthcare services and gaps, and prioritization of community health needs based on significance, feasibility, and stakeholder input. Submit a 5–7 page report in APA 7th edition format with a minimum of 6 scholarly sources. This assessment builds directly on the change proposal skills developed in Assessment 1 by grounding organizational change in community-level health assessment data.