| Course | NR 543 Information Workflow in Healthcare |
|---|---|
| Week | 2 |
| Paper type | Process observation notes |
| Length | About 1,050 words, 3 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | MSN, Nursing Informatics |
| Updated | September 2026 |
Free sample paper for NR 543 Week 2
Process Observation Notes: Following Three Inpatient MRI Requests Through One Weekday on a Stroke Unit, With Every Empty Stretch Timed and Attributed to Whoever Was Waiting or Being Waited On
Student Name
College of Nursing, Chamberlain University
NR 543: Information Workflow in Healthcare
Instructor Name
Month Day, Year
Process Observation Notes: Following Three Inpatient MRI Requests Through One Weekday on a Stroke Unit, With Every Empty Stretch Timed and Attributed to Whoever Was Waiting or Being Waited On
Purpose and Method
These notes record direct observation of how inpatient brain MRI requests moved through a 32-bed stroke and neuroscience unit and the radiology department on one weekday, from 7:00 a.m. to 7:00 p.m. Two people can watch the same hour of work and come away with different documents. The one that is useful has the empty stretches in it, timed and attributed, because a process is made of waits as much as tasks. The notes therefore record not only what people did but, for each request, what it was waiting for between actions and who it was waiting on.
I followed three MRI requests ordered that morning, labelled A, B and C. I shadowed the unit, the protocol workstation in radiology and the MRI scheduling desk in turn, and confirmed times from order audit trails and the MRI scheduling log afterward. A review of time and motion studies in clinical settings found wide variation in how observations are defined and recorded and called for clear definitions of tasks and timing (Zheng et al., 2011). Before observing, I defined five states a request could be in: being worked on, waiting in a queue, waiting for information, waiting for a slot and waiting for transport. Every minute of each request's day was assigned to one of those states.
Request A
7:52 Order entered by the neurology resident on rounds (3 minutes). 7:55 to 9:48 Waiting in queue: order sits in the radiology protocol worklist; the neuroradiologist is reading overnight emergency studies. 9:48 Protocol assigned (2 minutes). 9:50 to 10:20 Waiting for information: MRI safety screening form not started. The nurse is giving morning medications to five patients. 10:20 Nurse opens the form with the patient, who can answer questions; form completed (9 minutes). 10:29 to 11:15 Waiting for a slot: scheduler has the request but the next inpatient slot is 1:00 p.m. 11:15 Slot assigned for 1:00 p.m. (2 minutes). 11:17 to 12:25 Waiting for a slot. 12:25 Transport requested by the unit clerk (1 minute). 12:26 to 12:58 Waiting for transport. 12:58 Patient leaves unit. 1:05 to 1:28 Scan. Totals: elapsed 5 hours 36 minutes; worked about 40 minutes including transport and scan; longest wait, protocol queue, 1 hour 53 minutes.
Request B
8:10 Order entered (4 minutes). 8:14 to 10:05 Waiting in queue for protocol. 10:05 Protocol assigned (3 minutes). 10:08 to 5:40 Waiting for information. The patient has aphasia and cannot answer screening questions. The chart records a pacemaker was "possibly" placed years ago at another hospital. The nurse calls the daughter's phone at 10:30 and again at 1:15, with no answer. The daughter arrives at 5:25 p.m. 5:40 Screening completed with the daughter, who confirms there is no pacemaker; the earlier note referred to a loop recorder that was removed (14 minutes). 5:54 to 6:30 Waiting for a slot. Scheduler has gone home; the evening technologist schedules for 2:00 a.m. Totals at 7:00 p.m.: elapsed 10 hours 50 minutes; worked about 25 minutes; longest wait, information, 7 hours 32 minutes.
Request C
9:25 Order entered (3 minutes). 9:28 to 11:40 Waiting in queue for protocol. 11:40 Protocol assigned (2 minutes). 11:42 to 12:05 Waiting for information. 12:05 Screening completed with the patient (8 minutes). 12:13 to 3:30 Waiting for a slot; next inpatient slot 3:30 p.m. 3:10 Transport requested; 3:15 to 3:48 waiting for transport; the patient arrives late, and the slot is given to an emergency patient. 3:48 to 5:15 Waiting for a new slot. 5:15 to 5:40 Scan. Totals: elapsed 8 hours 15 minutes; worked about 45 minutes; longest wait, slot, 3 hours 17 minutes, plus a lost slot.
What the Empty Stretches Show
Across the three requests, the time spent being worked on was small: 25 to 45 minutes each. The empty stretches varied, but three kinds recurred. Every request waited about two hours in the radiology protocol queue in the morning, while the neuroradiologist cleared overnight emergency studies. Every request waited for the MRI safety screening form, briefly when the patient could answer, and for most of the day when the patient could not. And every request waited for a slot, because inpatient MRI slots were limited and fixed.
The screening wait deserves attention because of what it was waiting on. Safety screening before MRI is required to identify implants and other hazards, and professional guidance places responsibility for screening before any patient enters the scanner area (Kanal et al., 2013). The screening itself took minutes; the wait was for someone who knew the answers. For patients who could not speak for themselves, that wait depended on when a relative arrived.
What the Observation Could Not See
The notes cover one weekday, three requests and one unit. They do not show weekends, when protocol and scheduling staffing differ, or patients from other units. Being observed may also have changed behavior; the nurse for request B remarked that, without an observer present, a call to the daughter's workplace might have come sooner or later than it did. Observation studies of clinical work are known to vary in their methods and in how they account for such effects (Zheng et al., 2011). The notes are a detailed picture of one day, not a measurement of the process, which will need data from more requests.
What Comes Next
These notes will be the raw material for the current state map. They already point to three waits worth mapping precisely: the morning protocol queue, the screening form for patients who cannot answer and the fixed inpatient slots. Lean approaches to health care improvement treat waiting as waste to be understood and reduced (Mazzocato et al., 2010), but reducing a wait first requires knowing whose it is. The notes attribute each wait to a queue or a person so that the map can show where responsibility for the time sits.
References
Kanal, E., Barkovich, A. J., Bell, C., Borgstede, J. P., Bradley, W. G., Froelich, J. W., Gimbel, J. R., Gosbee, J. W., Kuhni-Kaminski, E., Larson, P. A., Lester, J. W., Nyenhuis, J., Schaefer, D. J., Sebek, E. A., Weinreb, J., Wilkoff, B. L., Woods, T. O., Lucey, L., & Hernandez, D. (2013). ACR guidance document on MR safe practices: 2013. Journal of Magnetic Resonance Imaging, 37(3), 501-530. https://doi.org/10.1002/jmri.24011
Mazzocato, P., Savage, C., Brommels, M., Aronsson, H., & Thor, J. (2010). Lean thinking in healthcare: A realist review of the literature. Quality and Safety in Health Care, 19(5), 376-382. https://doi.org/10.1136/qshc.2009.037986
Zheng, K., Guo, M. H., & Hanauer, D. A. (2011). Using the time and motion method to study clinical work processes and workflow: Methodological inconsistencies and a call for standardized research. Journal of the American Medical Informatics Association, 18(5), 704-710. https://doi.org/10.1136/amiajnl-2011-000083
What the NR 543 Week 2 assignment asks for
Week 2 in this course centers on watching a process directly and writing down what happens. The prompt will likely want your method, the process observed, a timed record of steps and waits, and early observations about delays or rework. Plan the observation before you start: which items you will follow, where you will stand and what you will write for each event. Record the time of every action, the person who performed it and what the item was waiting for afterward. Follow more than one item, because a single case can mislead. Keep interpretation separate from the record, then add a short section on what the gaps suggest. Name what your observation could not capture. A source on process analysis or handoffs, cited in APA 7, supports the method.
How this NR 543 Week 2 example is built
The notes begin with purpose and method: three requests, one weekday, a fixed rule for what counts as an event. Each request gets its own section with timed entries. Request A moves from order to scan by early afternoon. Request B waits for a relative who can confirm whether the patient has an implant, because the patient has aphasia. Request C is ready but loses its slot when transport is called too late. A section on the empty stretches shows that most elapsed time sat between entries rather than inside them. Another section admits what one day could not show, such as weekend patterns and messages sent outside the record. The notes close with the plan to collect timestamps for a larger sample before drawing any map.
Reading the NR 543 Week 2 grading rubric
The grading grid for observation notes generally looks at a clear method, accurate and detailed records, attention to both work and waiting, and sound early interpretation that does not overreach. Notes that time every event and say what the item waited on show a disciplined observer. Following three items instead of one shows the writer understands variation. Separating what was seen from what it might mean protects the credibility of the record. A frank section on the limits of a single day is usually rewarded, because it prepares the reader for the larger data collection that follows. Linking the method to published work on process analysis earns the evidence points. Tidy formatting, consistent time notation and APA 7 citations finish the picture for the instructor.
NR 543 Week 2 help: mistakes that cost points
Observation notes often slide into opinion within the first few lines, describing a process as inefficient before recording anything. Write the record first and save judgment for later. Another problem is timing only the work and not the waits, which hides where the day went. Mark what each item was waiting for between events. Some students observe a single item and generalize from it; follow at least two or three. Be careful with patient details, recording bed numbers or letters instead of names. Do not ignore the channels you cannot see, such as texts or phone calls, but say plainly that you could not capture them. Short, factual entries read better than long narrative. Finish with questions the observation raised, since those guide the next assignment in the course.
Get a NR 543 Week 2 example written to your instructions
Send the assignment page and the observation template your section uses, and a Week 2 example comes back inside 24-48h, free the first time. One thing we do not supply: the hours you spent watching a real unit, the permission you were given, and anything a real patient sat inside. That log is yours to write. We build the example around a described setting.
More NR 543 papers and MSN samples
- NR 543 Week 1: Order to Scan Discussion
- NR 543 Week 3: Current State Map
- NR 543 Week 4: Handoff Analysis
- NR 543 Week 5: Workaround Write-up
- NR 543 Week 6: Bottleneck Brief
- NR 543 Week 7: Future State Proposal
- NR 543 Week 8: Workflow Redesign Paper
- NR 542 Week 2: Data Question Brief
- NR 541 Week 2: Requirement Statement
- NR 515 Week 2: System Inventory for One Referral
- NR 512 Week 2: Data Definition Brief, Oxygen Flow
NR 543 Week 2 questions, answered
What if the process I watch never stalls during the hour?
That is a finding rather than a failure, and it is worth writing down plainly. A process that runs clean at ten in the morning and jams at six in the evening tells you the delay is about arrival rate rather than about the steps, which is exactly the kind of observation the later weeks can build on.
Can I use my own memory instead of watching?
Some sections allow a reconstruction where observation is impossible, and if yours does, say so in the header rather than letting the reader assume. Reconstructed notes are recognizable anyway: they are too tidy, they contain no interruptions, and every duration is a round number. Admitting the method costs less than being caught by it.
How long should the observation run?
Long enough to see the item cross at least one handover, which is often shorter than people expect. A single hour that covers a complete cycle beats a whole shift of disconnected fragments. If the process spans days, most sections accept a mix: watched segments for the busy parts, time stamps for the overnight gap.
Where can I find a free NR 543 Week 2 sample paper?
The observation notes for requests A, B and C are posted above as the NR 543 Week 2 sample, with every section visible. If you observed another process, tell us what you followed and notes in the same structure can be written for you.
How many items should I follow for the NR 543 Week 2 observation?
At least two or three, so a single unusual case does not shape your conclusions. The sample follows three MRI requests ordered on the same weekday morning.