| Course | NR 631 Nurse Executive Concluding Graduate Experience I |
|---|---|
| Week | 5 |
| Paper type | Aim and measure brief |
| Length | About 830 words, 4 pages |
| Format | Memo with APA 7 citations |
| School | Chamberlain University |
| Program | MSN, Nurse Executive |
| Updated | October 2026 |
Free sample paper for NR 631 Week 5
Memorandum
To: Director of Perioperative Services
From: Day Charge Nurse, Preoperative Holding
Date: 30 September 2026
Re: Aim and measure for the first-case readiness project, rooms 3 to 6
Aim
In operating rooms 3 to 6, the share of weekday elective first cases in the room within five minutes of the scheduled 07:30 start will rise from 58% to 75% over the pilot weeks of 16 November to 18 December 2026, excluding Thanksgiving week.
The Measure, as the Report Would Be Built
Count: weekday elective first cases in rooms 3 to 6 whose patient-in-room time is no later than 07:35, divided by all weekday elective first cases in rooms 3 to 6 scheduled for 07:30 in the same weeks.
In the count: every case scheduled as the first case of the day in those rooms by 15:30 the day before.
Kept out, with the reason: add-on and emergency cases, since they are not on the list the readiness check uses; cases canceled before the patient arrived, since they never had a start; weekend cases, since the pilot runs on weekdays only; and Thanksgiving week, since the elective schedule is thin and the pre-admission testing staff are on holiday rotation.
What starts the clock: the scheduled start time in the published schedule at 15:30 the day before. What stops it: the patient-in-room time entered by the circulating nurse. If two people ran this count from the same report, they would get the same total, because both times come from fixed fields and the exclusions are stated.
Secondary count: among late first cases in rooms 3 to 6, the number with preoperative readiness as the primary delay code. This shows whether the change acts on the problem it targets.
Balancing count: the number of first-case patients in rooms 3 to 6 canceled on the day, since a readiness call that discovers problems early could lead to more cancellations the day before. A rise would need explaining.
Baseline
58%: 271 of 468 weekday elective first cases in rooms 3 to 6, January to June 2026, from the OR information system first-case report, using the definition in the monthly quality packet. Readiness was the primary code in 71 of 197 late starts. Day-of-surgery cancellations: 9.
Why 75%
The OR Executive Committee's target is 85%. Readiness accounted for 36% of late starts; if half of those were prevented, about 35 more cases in six months would be on time, which would move the rate to roughly 66%. Reaching 75% would also need some fall in other codes, which is possible since a ready patient tends to pull other steps forward, but it is a stretch. The aim is set where it is because the committee will judge the pilot against its own 85% target, and an aim of 66% would look like accepting the gap.
Why These Dates
The dates belong to the hospital's year, not the course. The information systems change freeze runs from 2 to 13 November, so the report needed for weekly tracking cannot be built until 16 November. The week of 21 December is the last before the holiday schedule thins elective surgery. The OR Executive Committee meets on 12 January 2027, the first meeting at which a full set of pilot figures can be presented. Those three fixed points set the window.
Displaying It
Weekly percentages plotted as a run chart, with the six-month baseline as a line, and the median and spread of minutes late each week. A change in the spread matters as well as the rate, since successful first-case work tends to narrow the spread of start times rather than move everything earlier (Tiwari et al., 2018). The approach follows the Model for Improvement's three questions about aims, measures and changes (Langley et al., 2009).
What This Measure Cannot See
Whether later cases in the day start on time; first-case gains may not carry through (Wachtel & Dexter, 2009).
Whether delay codes are accurate; the secondary count depends on them.
Patients' experience of the readiness call.
The effect of seasonal changes in case mix during the pilot weeks.
Fallback Aim
If the director agrees to only two rooms or the report is not ready by 16 November, the fallback is: in rooms 3 and 4, from 57% to 70% over the same weeks, counted by hand from the daily OR board log. The fallback keeps the same definition so the results can still be compared with the baseline.
Who Will Run the Count
The OR Information Systems analyst will build it, and the day charge nurse in preoperative holding will check the first two weeks against the OR board log by hand. If the two totals differ by more than one case in a week, the definition will be reviewed before the next week's figure is reported.
Decision Requested
Agreement to this aim and measure by 9 October, so that the request for the report can join the analyst queue before the freeze.
References
Langley, G. J., Moen, R. D., Nolan, K. M., Nolan, T. W., Norman, C. L., & Provost, L. P. (2009). The improvement guide: A practical approach to enhancing organizational performance (2nd ed.). Jossey-Bass.
Tiwari, V., Ehrenfeld, J. M., & Sandberg, W. S. (2018). Does a first-case on-time-start initiative achieve its goal by starting the entire process earlier or by tightening the distribution of start times? British Journal of Anaesthesia, 121(5), 1148-1155. https://doi.org/10.1016/j.bja.2018.05.043
Wachtel, R. E., & Dexter, F. (2009). Reducing tardiness from scheduled start times by making adjustments to the operating room schedule. Anesthesia & Analgesia, 108(6), 1902-1909. https://doi.org/10.1213/ane.0b013e31819f9fd2
Reading the NR 631 Week 5 instructions
Put the aim alone at the top in one sentence holding what changes, for whom, by how much and by when. Define the measure so the person who builds the report could reproduce it: what is counted, what is left out and why, and what starts and stops the clock. Give the baseline with its source and months. Justify the date against your site's own calendar, such as system freezes, budget cycles or committee meetings, not the course calendar. Add a balancing measure if the change could cause harm elsewhere. List what the measure cannot detect. Close with a smaller fallback aim and the decision you need, with a date.
Inside the NR 631 Week 5 example
The sample's aim sentence covers weekday elective first cases in rooms 3 to 6 rising from 58% to 75% over pilot weeks set by the hospital's calendar. The count uses the scheduled start at 15:30 the day before and the circulator's in-room time, with add-ons, cancellations, weekends and Thanksgiving week excluded for stated reasons. A secondary count tracks readiness codes and a balancing count tracks same-day cancellations. The baseline is 271 of 468 cases. The dates follow from the change freeze, the holiday schedule and the January committee meeting. The brief lists four things the measure cannot see, names who checks the count and offers a two-room fallback at 57% to 70%.
Where the points sit in the NR 631 Week 5 rubric
The costliest aims cannot fail because they promise a direction, such as better teamwork, without a number or a date. Close behind are measures loose enough that two counters get two totals, usually because nothing says what starts the clock. Dates chosen to match the end of term rather than anything at the site lose marks reliably. Some briefs propose a change in something the site does not record. Others give a percentage target with no baseline behind it, or an aim larger than the problem statement it came from. A brief with no fallback leaves the sponsor with only yes or no. Some briefs also drop the balancing measure, which leaves the sponsor unable to see whether the change caused harm somewhere else in the process.
NR 631 Week 5 help: mistakes that cost points
Writing an aim that holds up under a sponsor's questions usually takes several drafts. We can help you fit your aim into one sentence, define your measure so a report builder could reproduce it and tie your dates to your site's calendar. We can also help you choose a balancing measure and a fallback aim. The project, the baseline and the final wording all remain under your control. Most aims become clearer once someone else tries to count the measure from your definition and finds the gap, so a second reading of the count before submission is usually worth the time it takes.
Get a NR 631 Week 5 example written to your instructions
Send the week's instructions along with whatever you can say about the measure and any date somebody has already fixed for you. An aim and measure brief is drafted around them and comes back within 24 to 48 hours, free on a first request, with any figure you have not yet obtained left clearly marked as a gap for you to fill.
More NR 631 papers and MSN samples
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- NR 631 Week 4: Evidence Review
- NR 631 Week 6: Approval Map
- NR 631 Week 7: Project Schedule
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NR 631 Week 5 questions, answered
Does the deadline have to fall inside the term?
Often the assignment requires it, and where it does, the aim has to be small enough for that to be honest. Where a longer horizon is allowed, the stronger brief still names something visible before the course ends, because an aim whose first sign of life arrives after everyone has stopped watching is much harder to get anybody to agree to now.
How precise does the target number have to be?
Precise enough to be wrong. A brief promising measurable improvement has committed to nothing, while one promising a fall from a stated figure to another stated figure can be checked by anybody. Where the starting value is still unconfirmed, several sections accept a target expressed against it, provided the brief names the report that will settle that value and roughly when.
Can the aim change after this week?
It commonly does, and a documented change is treated very differently from a silent one. What faculty object to is an aim that has quietly grown between weeks, since the evidence and the assessment underneath it no longer reach that far. Where the site asks for something smaller, record the request, who made it and the date, then carry the revised sentence everywhere it appears.
Where can I find a free NR 631 Week 5 sample paper?
The full aim and measure memo for the four-room first-case readiness pilot appears on this page.
Why are the NR 631 Week 5 dates tied to the hospital calendar?
A change freeze, the holiday schedule and the January committee meeting set when the pilot can run and be reported, which the course calendar does not.