| Course | NR 706 Healthcare Informatics & Information Systems |
|---|---|
| Week | 2 |
| Paper type | Governance structure critique |
| Length | About 1,100 words, 6 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | MSN, Nursing Informatics |
| Updated | October 2026 |
Free sample paper for NR 706 Week 2
Governance Structure Critique: Judging the Committees That Would Govern a Clinical Communication Platform, With Proportionate Recommendations
Student Name
College of Nursing, Chamberlain University
NR 706: Healthcare Informatics & Information Systems
Instructor Name
Month Day, Year
Governance Structure Critique: Judging the Committees That Would Govern a Clinical Communication Platform, With Proportionate Recommendations
The Arrangement Being Judged
The three-hospital system's technology governance, as set out in two charters approved in 2023: the information technology steering committee and the clinical informatics council. A third body, the platform project team, will be chartered if the purchase is approved. The critique asks whether this arrangement could govern a clinical communication platform well, not whether it governs the electronic record adequately, which it has done for years.
Judgment 1: Money Without Clinical Membership
The steering committee has seven voting members: the finance chief as chair, the information and operations chiefs, the nursing and medical executives, the vice president of finance and the director of information technology infrastructure. Two of seven are clinicians. For a platform whose main effect is on how nurses and physicians reach each other and respond to alarms, that balance is thin. Clinical consequences reach the committee only through the two clinical executives and through the council's recommendations.
Judgment 2: Cadence Against the Pace of Change
The clinical informatics council meets quarterly. A clinical communication platform vendor typically releases updates monthly, and changes to alarm routing rules may be needed weekly during the first months. A quarterly council cannot review changes that arrive monthly; in practice the project team or an analyst would decide them alone. That is a gap in oversight exactly where patient safety risk sits, since a routing error could send a cardiac alarm to the wrong phone.
Judgment 3: No Quorum Rule
A body that cannot show who decided cannot show that it decided. The council's charter has no quorum rule. Its minutes from 2025 show three meetings with four of eleven members present, at which recommendations were recorded. Without a quorum rule, the council cannot show that any recommendation represents the council rather than the members who happened to attend. The steering committee's charter requires five of seven voting members.
Judgment 4: Who Keeps the Record
The steering committee's minutes and decisions are kept by the chief financial officer's office in the finance document system, with a decision log. The council's minutes are saved by whichever co-chair's assistant took them, on a shared drive with no named owner. When the council recommended against a design in 2024, nobody could later find the minutes showing why. A platform with alarm routing rules needs a single record of every configuration decision and who approved it.
Judgment 5: Where Nursing Sits
This judgment repeats the point of the first week's post because it matters most for a platform nurses will carry. Covered in my first post: nursing's largest voice sits in the council, which cannot bind money and meets least often. The chief nursing officer votes on the steering committee but is one of seven. If the platform's alarm design is contested, the nurses who will carry the phones have no seat where money is decided and only an advisory seat, meeting quarterly, where design is reviewed. A proportionate fix is to give the council's nursing co-chair a standing invitation to present at the steering committee whenever a clinical communication item is on its agenda, without adding a vote.
Proportionate Recommendations
Not a new governance structure. Three changes proportionate to the problems:
1. Add a quorum rule to the council charter: six of eleven members, including at least one nurse and one physician.
2. Create a standing alarm and communication subcommittee of the council for the platform's first two years, meeting every two weeks, with authority delegated by the council to approve routing rule changes within limits the council sets.
3. Name the clinical informatics office as custodian of the council's minutes and decision log, kept in the same document system as the steering committee's.
None of these requires new staff or new committees at the executive level, and each could be adopted at the council's next meeting.
How the Judgments Were Formed
From the two charters, minutes of the steering committee and council for 2024 and 2025, conversations with both council co-chairs and the chief information officer, and the record of the 2024 design decision whose reasons were lost. Each judgment above can be traced to one of those sources, and the co-chairs read a draft before submission. They disputed none of the facts, and one supplied the 2025 attendance figures; one co-chair disagreed that quarterly meetings are a problem for the electronic record, which the critique accepts, while maintaining that a communication platform with monthly releases is different.
Writing for the People Being Critiqued
The critique will be read by the chief information officer and the council co-chairs, who built the current arrangement and made it work for the electronic record. It credits that: the steering committee has approved every major electronic record upgrade on schedule, and the council's design reviews have caught problems before go-live. The gaps appear because a communication platform changes faster and touches alarms, not because the current bodies failed.
What Happens Without the Changes
Without a quorum rule, a recommendation on alarm routing could be made by four people and later disputed. Without a subcommittee, routing rule changes during the first months would be made by analysts on request, with no clinical review and no record. Without a named custodian, the reasons for configuration choices would be lost within a year, as the 2024 design decision's reasons were. Each gap is small on its own; together they would leave the platform's most safety-critical settings governed by whoever was available.
How Other Organizations Have Handled It
Health systems that deploy alarm routing to phones commonly establish an alarm management committee with clinical and technical members, often under a national safety goal on alarm management that hospitals must address. The recommendation follows that common pattern rather than inventing a new body. Communication technology changes interprofessional work in ways that need clinical oversight, since what helps physicians can increase interruptions for nurses (Wu et al., 2011).
Why Governance Matters Here
Unintended consequences of clinical systems often arise from decisions made without the right people or the right review (Ash et al., 2004). Alarm notifications add to the volume nurses already manage, and the literature treats the resulting desensitization as a safety problem in its own right (Sendelbach & Funk, 2013). A governance arrangement that reviews routing rules quarterly would struggle to manage either.
References
Ash, J. S., Berg, M., & Coiera, E. (2004). Some unintended consequences of information technology in health care: The nature of patient care information system-related errors. Journal of the American Medical Informatics Association, 11(2), 104-112. https://doi.org/10.1197/jamia.M1471
Sendelbach, S., & Funk, M. (2013). Alarm fatigue: A patient safety concern. AACN Advanced Critical Care, 24(4), 378-386. https://doi.org/10.4037/nci.0b013e3182a903f9
Wu, R., Rossos, P., Quan, S., Reeves, S., Lo, V., Wong, B., Cheung, M., & Morra, D. (2011). An evaluation of the use of smartphones to communicate between clinicians: A mixed-methods study. Journal of Medical Internet Research, 13(3), e59. https://doi.org/10.2196/jmir.1655
Reading the NR 706 Week 2 instructions
Work in judgment mode, not description. Take a structure you can point to, such as a committee charter or organizational chart, and say what is wrong or missing: a body with money and no clinical members, a meeting cadence slower than the changes it must approve, no quorum rule, no named keeper of the record. Set each body's meeting frequency against how often the system it governs will change. Ask who is custodian of decisions. Keep recommendations proportionate to the problems, not a new structure. Write for the people being critiqued, crediting what works, and say how your judgments were formed. Say how you formed each judgment.
How this NR 706 Week 2 example is built
The sample judges the steering committee as having money but only two clinical votes of seven, the council as meeting quarterly against monthly platform releases and weekly routing changes, the council as lacking a quorum rule after three meetings with four of eleven present, and its minutes as having no keeper after a 2024 decision's reasons were lost. It recommends a quorum of six including a nurse and a physician, an alarm and communication subcommittee meeting every two weeks with delegated authority, and the clinical informatics office as record custodian. It credits the current bodies' electronic record work and explains what happens without the changes. It records that the co-chairs read the draft and disputed none of the facts. Each recommendation could be adopted at the council's next meeting without new staff.
Reading the NR 706 Week 2 grading rubric
Governance critiques lose most when they describe committees accurately and never judge them, which leaves the reader without a finding. Next is a critique that ignores cadence, though a committee meeting quarterly cannot oversee monthly changes. Many critiques miss quorum rules and record keeping, which decide whether a body's decisions can be shown to exist. Recommendations that propose an entirely new governance structure are rarely adopted and look disproportionate. Critiques written as accusations alienate the executives who would have to act. Few say how judgments were formed, which makes them hard to check. Critiques that never trace a lost decision also leave the record-keeping problem abstract. Graders look for a concrete instance. Writing that blames current leaders also makes adoption less likely.
NR 706 Week 2 help from the desk
Judging a governance arrangement you work within, fairly and specifically, is uncomfortable but useful. Reading the charters and minutes together, we can find the gaps in membership, cadence, quorum and record keeping and frame proportionate recommendations. We can also help you write for the people being critiqued, crediting what works. Showing a draft to one committee member before submitting often corrects a fact and softens the tone appropriately. The critique is yours. Recording how your judgments were formed is worth doing too. A colleague's read helps too.
Get a NR 706 Week 2 example written to your instructions
Send the case, the charter or whatever your section supplied, along with the rubric, and a custom NR 706 Week 2 critique gets written to those exact materials. It arrives inside 24-48h and the first one costs nothing, so you can set your own judgment beside a finished one while there is still time to revise.
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NR 706 Week 2 questions, answered
What counts as a governance structure here?
Any arrangement that decides about systems: a standing information technology committee, a clinical informatics council, an executive group signing capital requests, or all three together. What the week is not asking about is a project team's internal process. The test is whether the body persists between projects and whether anything it agrees to binds somebody afterward.
How much of the piece should describe the structure?
Less than students expect. Whoever marks the assignment can usually see the same chart, so a long restatement earns very little. Roughly a fifth of the length establishes what is being examined, and the remainder goes on findings, consequences and the changes worth making. Where description does earn marks, it is by surfacing something the chart itself conceals.
Do I need a governance framework from the literature?
Doctoral sections generally expect one, and naming a framework gives the findings a spine somebody else can argue with. What matters is using it rather than citing it. If the framework distinguishes input from authority, sort each body into those categories and show what the sorting reveals about the arrangement under review.
Where can I find a free NR 706 Week 2 sample paper?
This page holds the full governance structure critique for a clinical communication platform in a three-hospital system.
Why does the NR 706 Week 2 critique recommend an alarm subcommittee?
The council meets quarterly, but alarm routing rules may need changes weekly at first, so a subcommittee meeting every two weeks closes the oversight gap.