| Course | NR 543 Information Workflow in Healthcare |
|---|---|
| Week | 8 |
| Paper type | Workflow redesign paper |
| Length | About 970 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 8
Workflow Redesign Paper: Why the Wait for a Ready Patient at the MRI Slot Is Worth More Than Every Other Wait in the Process, Shown From Our Unit's Own Numbers
Student Name
College of Nursing, Chamberlain University
NR 543: Information Workflow in Healthcare
Instructor Name
Month Day, Year
Workflow Redesign Paper: Why the Wait for a Ready Patient at the MRI Slot Is Worth More Than Every Other Wait in the Process, Shown From Our Unit's Own Numbers
The Claim
The claim of this paper is narrower than it first appears. It is not that the inpatient MRI process on our stroke and neuroscience unit is slow, which everyone already knew, or that all its waits should be shortened. It is that one particular wait, the gap between an MRI slot becoming available and a patient being ready to fill it, is worth more than all the others combined, and that the unit's own numbers already show why. A redesign that attends to that wait will change what patients experience; a redesign that attends to the more visible waits will not.
What the Process Looked Like
Following one request from order to scan showed 21 hours elapsed and 48 minutes of work. Observation of three requests on one weekday showed that every request waited in the same three kinds of places: the morning protocol queue, the screening form and the slot queue. Two weeks of timestamps for 38 requests turned those observations into a current state map with eight steps, three queues and two loops: a screening loop in which incomplete forms returned to the unit, and a lost-slot loop in which a patient not ready at the slot time lost the slot. The median elapsed time from order to report was almost 18 hours; the median work time was under an hour.
Lean approaches to improvement begin from the current state as observed rather than as remembered (Mazzocato et al., 2010). The observed state differed from staff sketches mainly in its loops, which nobody had drawn.
Why This Wait Is Worth More
The argument rests on the bottleneck analysis. Demand for inpatient MRI averaged 47 requests a week against 42 inpatient slots. The slot is the only step where demand exceeds capacity, so it governs how many patients are scanned. Time saved at any other step, such as a faster protocol queue, would move requests into the slot queue sooner without increasing the number scanned; the saved time would simply be spent waiting for a slot instead. This is the central insight of the theory of constraints: a system's output is set by its constraint, and improvements elsewhere do not raise it (Goldratt & Cox, 2004).
The wait for a ready patient at the slot is different. When a slot opens and the assigned patient is not ready, the slot is lost or partly lost, and on a constrained resource that capacity cannot be recovered later. About 15% of inpatient slots were being lost this way, roughly one a day. Recovering them would do more to reduce the backlog than any improvement to the protocol queue, transport or reports, because it increases the output of the only step that limits output.
Why Patients Were Not Ready
The handoff analysis and workaround write-up explained why patients were not ready. The main cause was incomplete MRI safety screening, especially for patients who could not answer questions about implants because of aphasia or confusion. Professional guidance requires screening before any patient enters the scanner area (Kanal et al., 2013), so an incompletely screened patient cannot use a slot however long it is held. The return of an incomplete form to the unit was the longest handoff in the process, a median of more than two hours before a nurse saw it. Staff had built workarounds, a technologists' spreadsheet and a charge nurse group text, to cope. The workarounds worked, but they carried privacy and reliability risks and depended on particular people.
The Redesign
The redesign has three changes, each aimed at the wait for a ready patient. Screening moves to admission for stroke unit patients likely to need MRI, when family are most often present, with the admitting nurse absorbing about ten minutes of work and losing the later search for relatives. Radiology keeps a ready list of fully prepared patients to fill any slot whose assigned patient is not ready. And a single status view with secure notifications replaces the spreadsheet, group text and printout. A review of nurses' workarounds suggests that workarounds should be treated as signals of process gaps and replaced with designed solutions rather than simply prohibited (Debono et al., 2013). The redesign does this.
What the Redesign Leaves Alone
The redesign deliberately leaves the protocol queue, transport speed and report turnaround alone. Each could be improved, and each improvement would be visible to the department that made it. None would change the number of patients scanned. That is the discipline the claim requires: attending to the wait that matters most means declining, for now, to work on waits that matter less, even when they are easier to measure or more satisfying to fix.
How the Claim Will Be Tested
If the claim is right, lost slots should fall toward one a week and the median time from order to scan should fall for stroke unit patients, especially those who cannot answer screening questions, without any change in scanner hours. If lost slots fall but the backlog persists, demand has outrun even full capacity, and adding evening slots becomes the right next step. If lost slots do not fall, the diagnosis of why patients are not ready was incomplete, and the observation should be repeated. Each outcome is useful. The paper's claim can be wrong, and the measures are chosen so that the unit would find out.
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
Goldratt, E. M., & Cox, J. (2004). The goal: A process of ongoing improvement (3rd rev. ed.). North River Press.
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
What the NR 543 Week 8 assignment asks for
The final week asks you to bring the course's analyses together into a single redesign argument. Typical instructions request a summary of the current state, the problem and its evidence, the proposed redesign, its expected impact, implementation and evaluation, and a reflection on the informatics role. State one clear claim early, ideally narrower than the whole process. Summarize earlier findings briefly and use them as evidence rather than repeating them. Explain why the problem you chose matters more than others, using data. Present the redesign in enough detail to be tested. Say what you are not changing. Describe how you will know whether the claim was right, including what result would prove it wrong. Name the people who carry the change. Cite the theory and evidence behind each step in APA 7.
How the NR 543 Week 8 example is put together
The paper opens by stating its claim and what the claim is not. A section reviews the process as the course found it: one request followed, three observed, 38 mapped, with medians for elapsed and work time. The central section argues from the bottleneck analysis that only the slot limits output, so a lost slot is lost capacity while faster protocols only move waiting elsewhere. A section explains why patients were not ready, tying it to screening guidance and the returned-form handoff. The redesign section summarizes three changes. Another states what is deliberately left alone and when it will be revisited. The paper closes with a test of the claim that allows for three outcomes and a paragraph on the staff who absorb the new work.
Where the points sit in the NR 543 Week 8 rubric
Redesign papers are generally assessed on a clear thesis, integration of earlier course work as evidence, soundness of the redesign, a credible evaluation plan and quality of writing and sources. A narrow, testable claim gives the paper direction and usually earns more than a broad promise to improve efficiency. Using prior analyses as evidence, rather than restating them at length, shows synthesis. Explaining why one problem outweighs others, with numbers, demonstrates judgment. An evaluation that names what would disprove the claim marks mature thinking. Attention to the people who absorb the changes shows awareness of implementation. Instructors expect accurate APA 7 references across the course's sources and prose that a nurse leader could act on directly.
Common NR 543 Week 8 mistakes, and how to avoid them
Final papers often try to fix everything, which leaves no clear argument and no way to test success. Choose one claim. Another weakness is pasting earlier assignments in full; summarize each finding in a sentence or two and use it as evidence. Some writers describe the redesign but never explain why it targets the right problem; make that case with data. Avoid evaluation plans that can only confirm success. Say what result would show you were wrong. Remember the people who will do the new work, and plan to check their burden. Keep the paper readable for a manager who did not take the course. Check that numbers match across sections, since a final paper that cites different medians in two places loses credibility quickly with any reader.
Get a NR 543 Week 8 example written to your instructions
Send us the final paper prompt, the rubric and whatever you produced in the earlier weeks, and the example is written so the argument actually runs from your own observations. It comes back inside 24-48h and costs nothing the first time. Tell us which wait you want it built around, or ask us to pick from what you send.
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 7: Future State Proposal
- NR 542 Week 8: Data Management Paper
- NR 541 Week 8: Practice Role Paper
- NR 515 Week 8: Informatics Synthesis Paper
- NR 512 Week 8: Informatics Position Paper
NR 543 Week 8 questions, answered
How much of the earlier work can I reuse?
The material, freely; the wording, sparingly. Most sections expect the final paper to draw on the process you have been following all term, and rewriting the same observation from scratch wastes effort. What gets marked down is a paper where the seams are visible, so rewrite each borrowed passage to serve the argument it now sits inside.
What counts as a measurable fix in this course?
Something with a number attached that somebody could collect again in three months without a special project. Elapsed time from request to result, the count of handbacks per week, the number of items still queued at the end of a shift. Satisfaction and confidence are legitimate additions but cannot carry the evaluation alone.
Does the paper need a formal quality improvement model?
Many sections require one and name it in the prompt, so check there first. Where a model is required, it should organize the paper rather than appear as a paragraph describing it. The test is simple: if removing the model's name changed nothing about the document, it was decoration rather than structure.
Where can I find a free NR 543 Week 8 sample paper?
The redesign paper arguing that the ready-patient wait matters most is presented above as the NR 543 Week 8 sample, fully visible here. If your final paper targets a different process, send us your course findings and a redesign paper built on them can be drafted.
How narrow should the NR 543 Week 8 claim be?
Narrow enough to test. The sample argues that one wait, a ready patient at the MRI slot, outweighs every other wait, and names what result would show the claim was wrong.