NR 631 Week 8 Proposal Pitch Example

Proposal Pitch: A Request for Ten Nurse Hours a Week and a Four-Week Pilot of Afternoon Readiness Calls for First Cases in Rooms 3 to 6

Student Name

College of Nursing, Chamberlain University

NR 631: Nurse Executive Concluding Graduate Experience I

Instructor Name

Month Day, Year

Proposal Pitch: A Request for Ten Nurse Hours a Week and a Four-Week Pilot of Afternoon Readiness Calls for First Cases in Rooms 3 to 6

Format

A ten-minute slot at the Director of Perioperative Services' meeting with the Chief Nursing Officer on 21 October 2026. A one-page read-ahead goes to both two days earlier. Four slides, one idea each.

The Request, First

"I am asking for three things: a pre-admission testing nurse for two hours each weekday afternoon, starting 16 November and running four weeks; a standing item at the 15:30 huddle across those weeks; and your agreement to take the readiness call to the OR Executive Committee on 10 November."

That is the opening sentence of the meeting and the first line of the read-ahead. The audience is deciding, not learning.

The Gap, in One Local Figure

"In rooms 3 to 6, 58% of first cases started on time from January to June. In more than a third of the late ones, the cause was something that could have been fixed by phone the afternoon before."

The director and CNO already know the 58% and the suite-wide 61.5% from the monthly quality packet. One figure is enough.

What It Asks of Your People

Pre-admission testing: one nurse for about two hours each weekday afternoon, from 13:30, checking the next day's first cases in four rooms against a six-item list and phoning the surgeon's office or the patient about anything open. The hours come from chart preparation for the following week, which the pre-admission testing manager has agreed can move to the morning. No overtime.

Preoperative holding: a five-minute read of the readiness list at 06:00 each morning.

The 15:30 huddle: open items named by room, with the surgeon's office response.

Information systems: about six analyst hours for a weekly report, already in the queue.

The Aim, Unchanged

The aim is read out exactly as agreed in the brief, not rewritten for the meeting: four rooms, the patient in by 07:35 for a 07:30 start, 58% rising to 75%, across the four pilot weeks from mid-November to just before the holiday schedule, Thanksgiving left out. The measure and its exclusions are also unchanged. Any figure in the pitch that differs from earlier documents would be checked first, so none does.

The Smaller Version, Offered

"If ten hours is too many, two rooms and five hours gives a fallback aim of 57% to 70% in rooms 3 and 4, counted by hand." Offering it before being asked shows the request has been sized, and it gives the director a yes that costs less.

The Slides

1. The request, in one sentence.

2. The 58% and the readiness share, as two numbers and a run chart of six months.

3. The afternoon call, as a timeline from 13:30 to 07:30 next day.

4. The aim sentence and the two dates the director will hear results: 8 December, interim, and 12 January, full.

No slide carries a paragraph.

The Read-Ahead

One page, written to be decided from: the request; the 58% with its source; the change described in hours by role; the aim; the smaller version; the approvals already obtained, which are the pre-admission testing manager's yes on condition of no overtime and the quality improvement determination due 10 October; and the one approval still needed from the people in the room.

What the Pitch Does Not Promise

It does not promise that first cases will start on time. Other hospitals improved their rates by redesigning preoperative work (Coffey et al., 2018) or fixing documentation (Singh et al., 2023), but the effect here is unknown until the pilot runs. The pitch says what will be measured and when, and promises only to report what happens, including a shortfall.

Anticipated Questions

Why not all 12 rooms? Ten hours covers four; the other eight give a comparison.

Will surgeons object? The office managers are being briefed before the committee hears it, and results will be reported by room and code, not by surgeon.

What if the offices do not answer? The nurses will log the share of calls returned by 16:30; if that is under half after two weeks, the project comes back to the director.

Who Is in the Room, and What Each Needs to Hear

The director needs to hear that the hours exist and that no overtime results, because the director carries both the budget and the pre-admission testing team's goodwill. The CNO needs to hear how the pilot links to the nursing goals for the year and when the first results will appear, because the CNO will be asked about the figure by the board's quality committee. Neither needs the literature review; one sentence noting that similar changes worked elsewhere is enough.

Rehearsal

The pitch was timed twice with the pre-admission testing manager listening, and ran at seven and eight minutes, leaving time for questions. The manager's one change was to state the no-overtime condition earlier, which the final version does, so that the director hears the answer to the obvious objection before having to raise it.

Why This Shape

Executives decide from the document and confirm in the meeting. A clear request, with a reason to act now and a visible early result date, is what moves a decision forward (Kotter, 2012).

Why Now

Three dates make October the moment to decide. The analyst queue will close to new builds during the freeze from 2 November. The committee meets on 10 November and not again until 8 December. And the elective schedule thins after 18 December. A decision in November would leave a pilot of two weeks at best, too short to show anything.

What a Yes Sets in Motion

If the director and CNO agree, the student sends the readiness script to the pre-admission testing manager the next morning, the surgeons' office managers receive the agreed letter the same week and the committee agenda item is confirmed. If they choose the smaller version, the same steps apply to rooms 3 and 4 only. If they decline, the student will ask which part of the request was the obstacle, and record the answer for the next attempt.

After the Meeting

A one-paragraph email the same day restating whatever was decided, with the date it takes effect and the name of the role that will act first, copied to the pre-admission testing manager.

References

Coffey, C., Jr., Cho, E. S., Wei, E., Luu, A., Ho, M., Amaya, R., Pecson, M., Dalton, F. V., Kahaku, D., Spellberg, B., & Sener, S. F. (2018). Lean methods to improve operating room elective first case on-time starts in a large, urban, safety net medical center. The American Journal of Surgery, 216(2), 194-201. https://doi.org/10.1016/j.amjsurg.2018.05.002

Kotter, J. P. (2012). Leading change. Harvard Business Review Press.

Singh, D., Cai, L., Watt, D., Scoggins, E., Wald, S., & Nazerali, R. (2023). Improving operating room efficiency through reducing first start delays in an academic center. Journal for Healthcare Quality, 45(5), 308-313. https://doi.org/10.1097/JHQ.0000000000000398