| Course | NR 588 Advanced Nursing Leadership Across Complex Systems |
|---|---|
| Week | 8 |
| Paper type | Strategic decision paper |
| Length | About 1,110 words, 4 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | MSN, Nurse Executive |
| Updated | October 2026 |
Free sample paper for NR 588 Week 8
Strategic Decision Paper: Formalize the Partnership With Maple Grove for Two Years Rather Than Build a Three-Facility Preferred Network Now or End the Pilot
Student Name
College of Nursing, Chamberlain University
NR 588: Advanced Nursing Leadership Across Complex Systems
Instructor Name
Month Day, Year
Strategic Decision Paper: Formalize the Partnership With Maple Grove for Two Years Rather Than Build a Three-Facility Preferred Network Now or End the Pilot
The Recommendation
Formalize the partnership with Maple Grove for two years, from July 2027, with the day nurse practitioner, the night telehealth service and the shared readmission metric, and defer any broader preferred network until July 2028.
Criteria, Set Before Comparing
I agreed four criteria with our Chief Nursing Officer and Maple Grove's administrator before comparing options:
1. Expected reduction in 30-day readmissions among our patients discharged to skilled nursing facilities.
2. Net cost to each organization over two years.
3. What each organization must give up.
4. Whether it can be stopped cheaply if it fails.
The Options
Option A: end the pilot in June 2027.
Option B: formalize the partnership with Maple Grove for two years.
Option C: build a preferred network of three facilities, including Maple Grove, with the same services at each.
Options Priced on Both Sides
Option A. Hospital: saves the nurse practitioner's salary and its share of the night service, about $170,000 a year, but loses the readmission reduction and the knowledge of which discharges fail. Maple Grove: loses the nurse practitioner and the night service at no direct saving, since it pays nothing for the day service. Readmissions from Maple Grove likely return to about 23%.
Option B. Hospital: about $170,000 a year (day nurse practitioner about $119,000 plus its night service share of about $50,000), against expected benefits of about $90,000 from the night service and about $72,000 from the day service's reduction to date. Net cost close to zero. Maple Grove: pays about $34,000 a year for its night share against about $60,000 in expected benefit. Readmissions expected to fall from 23% to about 18%.
Option C. Hospital: roughly three times the cost, about $500,000 a year, for services at three facilities taking about 70% of our facility discharges. Benefit is uncertain at the two other facilities, which have lower star ratings and have not been tested. Maple Grove: gains little, and loses some of its advantage over other facilities. The other two facilities: would need to accept the same obligations without having seen the pilot.
What the Other Party Surrenders
Under option B, Maple Grove commits for two years to calling before non-emergency transfers, sharing its transfer log monthly, briefing agency nurses each night and paying 40% of the night service. It gives up some control over night transfers and some privacy over its performance data. In return it keeps full control over admissions, which the agreement protects.
The hospital surrenders flexibility: two years of nurse practitioner salary and night service cost committed to one facility, and a promise not to discharge after 17:00 on Fridays without the facility's agreement.
A Note on Patient Choice
Any arrangement with one facility must respect patients' right to choose where they go after the hospital. Federal discharge planning rules require hospitals to give patients a list of available facilities and to respect their choice; as I understand them, they also allow hospitals to share quality information to help patients decide. Option B does not steer patients; it improves care for those who choose Maple Grove. Option C would need careful review by counsel before any facility was described to patients as preferred.
Why B and Not C
Option C would reach more patients but would ask two untested facilities to accept obligations that took Maple Grove six months to work through, including the night call problem. Rahman et al. (2013) found that the strength of the hospital and facility relationship mattered for readmissions, and that strength takes time to build. A second year with Maple Grove would produce the evidence and the agreement templates that option C would need.
Why B and Not A
Ending the pilot would give up a reduction of about three percentage points in readmissions already achieved, and the night service, aimed at the remaining avoidable transfers, has not yet started. Mor et al. (2010) described readmissions from nursing facilities as common and costly; walking away from a working arrangement would return both organizations to that pattern.
What Each Side Explains to Its Own Board
The hospital explains a two-year commitment of about $170,000 a year that roughly pays for itself and reduces readmission penalties. Maple Grove's administrator explains a $34,000 annual cost that returns about $60,000 and strengthens its standing in Medicare's incentive scheme for these facilities. Both are defensible in their own terms.
What the Evidence Behind B Is
The reduction so far comes mainly from the day nurse practitioner, consistent with published work showing that structured support for recognizing changes in condition reduces transfers from nursing facilities (Ouslander et al., 2011). The night service is expected to add to that, but has not yet run. Option B is therefore partly an investment in an untested piece, which is why the review conditions below matter.
Risks of Option B
Maple Grove could change ownership or leadership during the two years. The agreement allows either party to end it with notice, so the hospital's exposure is limited to the notice period. Agency staffing at night could worsen, reducing the night service's use. The nurse practitioner could leave; the hospital would need to recruit within 60 days or the day service would lapse.
What Option B Teaches for Option C
If the partnership continues, the hospital will have a tested agreement, a shared metric with a settled definition and a cost-sharing formula. Those are the parts that took six months to work out with Maple Grove and that a second or third facility would need from the start.
The Condition That Would Change My Mind
If, by December 2027, readmissions from Maple Grove have not fallen below 20%, or night calls before transfer remain below 60%, I would recommend option A at the July 2028 review. If they have fallen below 18% and night calls are above 75%, I would recommend option C for 2028, starting with the better-rated of the two other facilities.
Next Step
The paper goes to both organizations' leaders in the same week, so neither hears the recommendation second.
Approval by our Chief Nursing Officer and Chief Financial Officer, and Maple Grove's administrator and regional vice president, by 31 May 2027, so the renewal can be signed before the current agreement ends on 30 June.
References
Mor, V., Intrator, O., Feng, Z., & Grabowski, D. C. (2010). The revolving door of rehospitalization from skilled nursing facilities. Health Affairs, 29(1), 57-64. https://doi.org/10.1377/hlthaff.2009.0629
Ouslander, J. G., Lamb, G., Tappen, R., Herndon, L., Diaz, S., Roos, B. A., Grabowski, D. C., & Bonner, A. (2011). Interventions to reduce hospitalizations from nursing homes: Evaluation of the INTERACT II collaborative quality improvement project. Journal of the American Geriatrics Society, 59(4), 745-753. https://doi.org/10.1111/j.1532-5415.2011.03333.x
Rahman, M., Foster, A. D., Grabowski, D. C., Zinn, J. S., & Mor, V. (2013). Effect of hospital-SNF referral linkages on rehospitalization. Health Services Research, 48(6, Pt. 1), 1898-1919. https://doi.org/10.1111/1475-6773.12112
NR 588 Week 8 instructions, in plain terms
The Week 8 paper is a recommendation with its costs shown, not a summary of the term. Name the choice in the opening paragraph, set out the two or three options genuinely available and pick one. Price every option for both organizations, not only your own. Set your criteria before comparing. Say what the other party gives up under your recommendation, and defend it in terms their board would use. Name the condition that would change your mind. Most rubrics mark down a recommendation serving only the writer's employer, a weak option set that flatters the preferred choice and criteria that appear after the analysis.
How this NR 588 Week 8 example is built
The sample recommends a two-year formal partnership in its first lines. Four criteria were agreed with both organizations' leaders beforehand. Three options are priced for the hospital and the facility: ending the pilot, formalizing it and building a three-facility network. What each party surrenders is listed. A note on patient choice rules follows. The paper argues why the network is premature and why ending would waste results already achieved. Evidence, risks and lessons for a future network are set out. Each side's board case is stated, and figures for night calls and readmissions are named as the conditions that would change the recommendation. Margin notes mark the recommendation, the pricing and the reversal conditions against the rubric.
Where the points sit in the NR 588 Week 8 rubric
The most expensive failure is a recommendation that serves only the writer's employer; this paper prices every option for the facility too. An option set nobody believes costs the next share, and all three options here are real, with the network argued seriously. Criteria appearing after the analysis lose a row, while these were agreed beforehand with both organizations. Ignoring what the other party must explain to its board loses marks, and the paper states each side's case. Naming the results that would reverse the recommendation earns the final criterion and shows the decision answers to evidence. Describing what the partnership teaches for a future network shows the choice builds toward the larger option.
NR 588 Week 8 help: mistakes that cost points
Weak NR 588 Week 8 papers summarize each week's work and end with a recommendation. Others price only their own organization's costs. Many offer two weak options beside the preferred one. Criteria are often introduced after the comparison, which looks fitted. Few say what would change the writer's mind. Put the recommendation first, agree criteria before comparing, price every option for both sides and write what the partner gives up. End with the figures that would make you reverse course. If your decision differs, send the options and both sides' costs, and a sample paper can compare them the same way. State what your partner surrenders as clearly as what it gains.
Get a NR 588 Week 8 example written to your instructions
Send the final assignment prompt, the rubric and the scenario your section set, and a complete Week 8 decision paper comes back written to those instructions inside 24-48h, free the first time. Tell us which decision you want recommended if you already have a view, and the example will argue that side properly instead of hedging between them.
More NR 588 papers and MSN samples
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NR 588 Week 8 questions, answered
How is this different from the papers earlier in the course?
The audience moves. Earlier work is addressed to a counterpart you are bargaining with, and this one goes to the people above both of you, who are not choosing between the two organizations so much as deciding whether the arrangement is worth their support. That changes the tone: less persuasion of a peer, more evidence a senior reader can act on quickly.
Can I recommend doing nothing?
Yes, if you argue it as a decision rather than as a default. Doing nothing has costs too, and a paper that prices them, names what would have to change before the parties revisit it, and sets a date for that review, can score as well as one recommending action. What fails is the paper that reaches no recommendation at all and calls it balance.
How much of the earlier weeks should the final paper reuse?
Reuse the situation and the analysis, not the documents. A decision paper referring to the measure proposed in an earlier week or the arrangement drafted before it reads as a coherent term of work. Copying whole sections across, though, runs into originality checks in many classrooms, so rewrite the material into the shorter form the final paper needs.
Where can I find a free NR 588 Week 8 sample paper?
The full strategic decision paper recommending a two-year hospital and facility partnership is published on this page.
What would change the recommendation in the NR 588 Week 8 paper?
Readmissions still above 20% or night calls below 60% by December 2027 would lead to ending the pilot; strong results would justify a wider network in 2028.