| Course | NR 543 Information Workflow in Healthcare |
|---|---|
| Week | 7 |
| Paper type | Future state proposal |
| Length | About 1,000 words, 2 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | MSN, Nursing Informatics |
| Updated | September 2026 |
Free sample paper for NR 543 Week 7
Future State Proposal: Inpatient MRI Screening Moved to Admission for Stroke Patients, a Ready List for Open Slots and One Shared Status View, With the Person Who Absorbs Each Piece of Moved Work Named Out Loud
Student Name
College of Nursing, Chamberlain University
NR 543: Information Workflow in Healthcare
Instructor Name
Month Day, Year
Future State Proposal: Inpatient MRI Screening Moved to Admission for Stroke Patients, a Ready List for Open Slots and One Shared Status View, With the Person Who Absorbs Each Piece of Moved Work Named Out Loud
The Principle
Removing a wait does not delete the work inside it. The work moves to whoever is standing closest. A future state that shows shorter waits without showing who now does more has hidden its costs, and the people who absorb them usually discover this in the first week and quietly revert. This proposal redesigns the inpatient brain MRI process for our stroke and neuroscience unit to protect the constraint identified in the bottleneck brief, the limited inpatient scanner slots, and it names, for each change, the person who takes on the moved work and what they give up in exchange.
What the Current State Shows
The current process takes a median of almost 18 hours from order to report, with under an hour of work. The inpatient slot is the constraint: six slots a day against demand of about 47 a week. About 15% of slots are lost or partly lost because the patient is not ready, most often because MRI safety screening is incomplete. For patients who cannot answer screening questions, the screening wait and the return of incomplete forms to the unit are the longest delays in the process. Three unofficial workarounds, a technologists' spreadsheet, a charge nurse group text and a printout behind the desk, keep the process moving but carry privacy and reliability risks.
Change 1: Screening at Admission for Likely MRI Patients
What changes. For patients admitted to the stroke unit with a suspected stroke or transient ischemic attack, most of whom will need an MRI, the admitting nurse will complete the MRI safety screening form at admission, while family who accompanied the patient are usually still present. If implant information is uncertain, the nurse records what is known and who can confirm it.
Who absorbs the work. The admitting nurse, who gains about ten minutes of work on roughly 60% of stroke unit admissions. In exchange, the nurse loses the later task of hunting for relatives by phone hours after they have gone home, which the observation day showed can take much longer. The unit's nurse manager has agreed to adjust the admission workload expectation accordingly.
Why it helps the constraint. Patients arrive in the slot queue already screened, so fewer slots are lost to incomplete forms. Professional guidance requires screening before scanning and encourages using all sources, including family and records, when patients cannot answer (Kanal et al., 2013). Admission is when those sources are most available.
Change 2: A Ready List for Open Slots
What changes. Radiology will keep a short list of inpatients who are fully screened, have transport arranged and could be scanned at 30 minutes' notice. When an assigned patient is not ready, the slot goes to the next patient on the ready list instead of going unused.
Who absorbs the work. The MRI lead technologist, who maintains the list, and the unit clerks, who must keep ready patients' transport arranged on short notice. The technologists already do this informally through the group text; the change makes it official and removes the need for personal phones. The clerks gain a few calls a day and lose the late transport requests that currently cause lost slots.
Why it helps the constraint. Every slot is used. If the ready list recovers most of the lost slots, the effective inpatient capacity rises by about one scan a day without any new scanner time.
Change 3: One Shared Status View and Secure Notification
What changes. The record's reporting tools will provide a single view listing all pending inpatient MRIs, with protocol, screening, schedule and transport status, visible to radiology and to the unit. When a technologist returns an incomplete screening form, the charge nurse receives a notification through the hospital's secure messaging system, not the record inbox.
Who absorbs the work. The informatics team, which builds the view and notification, and the charge nurse, who receives notifications that previously went to a group text. The technologists' spreadsheet and the printout behind the desk become unnecessary, which removes work for the technologists and the day charge nurse.
Why it helps. It replaces the workarounds with official tools that keep their strengths, as a review of nurses' workarounds suggests redesign should when workarounds reveal real process gaps (Debono et al., 2013).
What the Future State Does Not Change
The proposal does not add scanner slots, change radiology's protocol priorities or alter report turnaround. Those steps are not the constraint, and changing them would not increase the number of patients scanned. Lean improvement emphasizes working on the whole flow and the places where waste most affects patients (Mazzocato et al., 2010); this proposal concentrates on the constraint and the steps that feed it.
Expected Effect and Measures
If the changes work, lost inpatient slots should fall from about one a day to fewer than one a week, and the median time from order to scan for stroke unit patients should fall by several hours, mainly for patients who cannot answer screening questions. The measures will be slots used and lost each day, screening completion at admission, the number of returned screening forms and the median time from order to scan. Each change will also be checked for its cost to the person absorbing it: admission time for nurses, calls for clerks and notifications for charge nurses. If any of those costs proves larger than expected, the change will be revised with the people carrying it, not defended.
References
Debono, D. S., Greenfield, D., Travaglia, J. F., Long, J. C., Black, D., Johnson, J., & Braithwaite, J. (2013). Nurses' workarounds in acute healthcare settings: A scoping review. BMC Health Services Research, 13, Article 175. https://doi.org/10.1186/1472-6963-13-175
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
NR 543 Week 7 instructions, in plain terms
The seventh week moves the course from diagnosis to design. Instructions commonly ask for a description of the proposed process, how it addresses the problems identified, the people and systems affected, implementation considerations and measures of success. Start from your earlier analysis and say which problem each change targets. Describe each change concretely: what happens, when and by whom. For every change, name who takes on new work and what work they lose, since hidden costs are why redesigns fail. Say what you are deliberately leaving unchanged and why. Propose a sequence for introducing the changes. Choose measures for both the benefit and the cost to staff. Support the design with sources on lean, workarounds or safety guidance, cited in APA 7.
How this NR 543 Week 7 example is built
The proposal opens with the principle about moved work and summarizes the current state in one paragraph. Three change sections follow, each divided into what changes, who absorbs the work and why it helps the constraint. Screening moves to admission, adding about ten minutes for the admitting nurse and removing the later search for relatives. A ready list lets radiology fill any slot whose patient is not prepared, with clerks taking a few more transport calls. A shared status view and secure notification replace the spreadsheet, group text and printout. A section states what the future state leaves alone. The paper ends with expected effects, measures of benefit and cost, and a staged rollout with a review after each stage.
Reading the NR 543 Week 7 grading rubric
Future state proposals are typically evaluated on clear links to the current state analysis, specific and feasible changes, attention to stakeholders and implementation, and measurable outcomes. Naming who absorbs each piece of moved work is the feature that most often separates a thoughtful proposal from an optimistic one. Tying every change to the constraint shows the design follows the analysis. Saying what will not change shows discipline. A staged rollout, with the simplest change first, reads as realistic. Measures that track both the benefit and the burden on staff demonstrate balance. Evidence from safety guidance and workaround research supports the choices, and precise APA 7 references with a professional, readable style carry the proposal to full marks.
NR 543 Week 7 help from the desk
Proposals often show shorter waits without saying who does the extra work, which is exactly how redesigns get quietly abandoned. Name the person for each change. Another weakness is proposing many changes at once with no order, leaving no way to tell which one worked. Stage them. Some students design a new system that requires major technology spending when a change in timing or role would do. Check whether a simpler step solves the problem. Avoid changes that do not connect to the constraint or the problems you found. Include measures for staff burden, not only for patient flow. Do not promise precise results; give an expected direction and size. If a stakeholder has agreed to something, say so, and if agreement is still needed, say that too.
Get a NR 543 Week 7 example written to your instructions
Send the assignment page, the rubric and the current state work you already have, and a Week 7 example is written to fit it and returned inside 24-48h. The first is free. If your earlier weeks produced any timings at all, include them, since a future state that cannot be subtracted from a present one is only a wish.
More NR 543 papers and MSN samples
- NR 543 Week 1: Order to Scan Discussion
- NR 543 Week 2: Process Observation Notes
- 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 8: Workflow Redesign Paper
- NR 542 Week 7: Collection Design Brief
- NR 541 Week 7: Change Governance Memo
- NR 515 Week 7: Integration Proposal, Consult Notes
- NR 512 Week 7: Documentation Case Analysis
NR 543 Week 7 questions, answered
How ambitious should the future state be?
Small enough that the unit could do it, which is a harder discipline than it sounds. Proposals that require a new system convert the assignment into a purchase request and lose the section that was actually being marked. One removed handback and one changed trigger is a full proposal.
What if I have no real numbers from the earlier weeks?
Use estimates and label them as estimates throughout. A proposal built on figures marked approximate is markable; one built on figures presented as exact when they were guessed is not, and markers can usually tell. State the basis once at the start and the rest of the paper stays honest.
Should the proposal include a timeline?
A short one, if the prompt asks for it. Sequencing matters more than dates in this assignment, because some changes cannot begin until another is finished. A list ordered by dependency, with a note on which item is waiting on a build queue, does more for the marks than a chart of months.
Where can I find a free NR 543 Week 7 sample paper?
The MRI future state proposal above is the NR 543 Week 7 sample, available to read from top to bottom. If you are redesigning a different process, give us your current state findings and a proposal naming who absorbs each change can be written.
What makes an NR 543 future state proposal realistic?
Naming who takes on each piece of moved work and what they lose in exchange, staging the changes and measuring staff burden as well as flow. The sample does this for three changes to inpatient MRI.