| Course | HLTH 4393 Quality Management for Healthcare Administrators |
|---|---|
| Module | Module 5 |
| Paper type | Quality improvement proposal with measures |
| Length | 1,160 words, about 4 pages plus title and reference pages |
| Format | APA 7 student paper |
| School | American College of Education |
| Program | B.S. in Healthcare Administration |
| Updated | September 2026 |
Free sample paper for HLTH 4393 Module 5
Twenty-Four Thousand Dollars for an On-Time Second Troponin: A Quality Improvement Proposal to the Executive Team, With a Family of Measures and a Plan to Hold the Gains
Student Name
American College of Education
HLTH4393: Quality Management for Healthcare Administrators
Module 5 Assignment
Instructor Name
November 2, 2026
The Request
This proposal asks the executive team of our composite community hospital to approve about $24,000 and six months of protected team time to lift the share of emergency troponin results that post on time, now 58%, to 90%, and to adopt a plan that keeps it there. It draws together the work of the preceding four modules: the quality definition and measure, the process map, the analysis of 26 weeks of data and the plan for tests of change.
The request is modest because the problem lies in how the process is arranged, not in the laboratory's capacity. The analysis showed that most late results are caused by second draws that happen late and specimens that wait before they are sent. Both can be changed with software, two printers and new routines.
Why It Matters
The hospital adopted a two-hour high-sensitivity troponin pathway for chest pain, consistent with the national guideline's preference for high-sensitivity troponin and structured clinical decision pathways (Gulati et al., 2021). The pathway's value depends on timing. When results are late, low-risk patients who could go home wait in beds that the department needs for others, and physicians under pressure may decide without the second result. Discharged pathway patients currently spend a median of 5.1 hours in the department. About 8,600 emergency troponin tests are ordered each year, so a delay that seems small for one patient becomes thousands of bed-hours across a year.
The problem also touches equity. Results for patients in hallway beds and on night shift meet the standard far less often than others. The gap is widest for exactly the patients the department can least afford to overlook, those who arrive when staffing is thinnest. Care that is timely for some patients and not others falls short of the aim that quality should not vary by personal characteristics or circumstances (Institute of Medicine, 2001). A patient who arrives at 2 a.m. and is placed in a hallway should not wait longer for the same blood test than a patient who arrives at noon.
What Will Change
Three changes, each aimed at a cause found in the data, will be tested through small plan-do-study-act cycles before being spread. The second troponin will become a timed order due two hours after the first collection, with a clock on the tracking board that changes color as the draw comes due. Portable label printers on collection carts will let nurses label and send specimens at the bedside, and a standard of sending each troponin within five minutes of collection will replace the basket where specimens now wait. Finally, second troponins will be drawn by venipuncture rather than through intravenous catheters, if a two-week test confirms that this lowers hemolysis without adding meaningful time or discomfort.
Resources and Return
The costs are two portable label printers with cart mounts, about $2,800; roughly 60 hours of informatics time to build and test the timed order and tracking board icon, about $4,200; brief training for about 90 emergency nurses during shift huddles, about $2,500; and two hours a week of team time for six members over 20 weeks, about $14,400. The total is about $24,000, most of it staff time.
The return is measured mainly in time and safety. About 2,600 patients a year leave the department from the pathway without admission. If their median stay falls by 40 minutes, the department recovers roughly 1,700 bed-hours a year, the equivalent of adding a bed around the clock for more than two months. Reducing hemolysis from 2.8% to 1% would avoid about 150 redraws a year, each an extra needle stick and a delay of close to an hour. These benefits are not direct revenue, but in a department that regularly holds patients in hallways they are worth more than the cost.
A Family of Measures
Progress will be judged by a family of measures rather than a single number. The outcome measure is how long pathway patients who go home spend in the department, a median now of 5.1 hours, with a target of 4.4. It was chosen over a rarer outcome, such as missed heart attacks, because it moves month to month and because it is what patients and emergency physicians actually feel when results are late. The main process measure stays exactly as defined in the first module, the one-hour order-to-result standard, displayed weekly on the p-chart with the baseline center line of 58%, with a target of 90% by March. Two supporting process measures show whether each change is working: second draws collected within ten minutes of their due time, and median time from collection to laboratory receipt. The balancing measures are the hemolysis rate, which must not rise above 2.8%, a short staff survey on workload after each cycle and a case review of any patient discharged from the pathway who returns within 30 days with a heart attack. Every measure will be stratified by shift and bed location so the equity gap can be seen closing, or not.
Holding the Gains
Many improvements fade once the project team disbands. Silver et al. (2016) describe tools that help sustain change, including process control and performance boards, standard work that writes down the current best practice so it is applied the same way every time, and short improvement huddles, many built on visual management that lets any staff member tell normal from abnormal at a glance. They also stress that context, including leadership support and data infrastructure, can decide whether a project thrives. This plan uses those tools. The timed order and bedside labeling will be written as standard work in the department's orientation materials. The p-chart will stay on the department's performance board after the project ends. A weekly five-minute huddle item will review any red clocks from the previous week. Ownership will pass from the project team to the emergency nurse manager and laboratory supervisor jointly, with a response plan: if the p-chart shows a shift below the new center line, they will convene a review within two weeks.
Spread and Decision
If the changes hold, the same approach can serve other timed laboratory tests in the emergency department, such as repeat lactate measurement for patients with suspected sepsis, and troponin testing on the inpatient units. Those extensions are not part of this request. The decision requested today is approval of the $24,000, to protect the team's time through March, and to receive a report on the family of measures in April and again three months after the project closes. The team will bring the p-chart, the stratified results and the staff survey to each report, so the executive team sees not only whether the target was met but for whom and at what cost to the people doing the work.
References
Gulati, M., Levy, P. D., Mukherjee, D., Amsterdam, E., Bhatt, D. L., Birtcher, K. K., Blankstein, R., Boyd, J., Bullock-Palmer, R. P., Conejo, T., Diercks, D. B., Gentile, F., Greenwood, J. P., Hess, E. P., Hollenberg, S. M., Jaber, W. A., Jneid, H., Joglar, J. A., Morrow, D. A., ... Shaw, L. J. (2021). 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR guideline for the evaluation and diagnosis of chest pain: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation, 144(22), e368-e454. https://doi.org/10.1161/CIR.0000000000001029
Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. National Academies Press. https://doi.org/10.17226/10027
Silver, S. A., McQuillan, R., Harel, Z., Weizman, A. V., Thomas, A., Nesrallah, G., Bell, C. M., Chan, C. T., & Chertow, G. M. (2016). How to sustain change and support continuous quality improvement. Clinical Journal of the American Society of Nephrology, 11(5), 916-924. https://doi.org/10.2215/CJN.11501015
What the HLTH 4393 Module 5 instructions ask for
In most sections, HLTH 4393 Module 5 brings the course together in a proposal addressed to decision-makers. Prompts typically ask you to present the quality problem and the evidence for it, describe the changes you recommend, state the resources required, define a set of measures with targets, and explain how gains will be sustained and possibly spread. Some versions specify the audience, such as a board or quality committee, and a page limit; others ask for an executive summary at the start. Graders expect earlier modules to be reflected, so bring forward your measure, analysis and improvement plan rather than starting over. Write for readers who have not seen your earlier papers, and review the Canvas prompt for whether a budget table is expected.
How this HLTH 4393 Module 5 example is built
The worked proposal opens with a precise request and explains why the cost is small. A case for change links the measure to patient flow, clinical decisions and equity, citing the chest pain guideline and the six aims. The changes are summarized in plain language for executives. Resources are itemized and weighed against benefits expressed in bed-hours and avoided redraws. A family of measures sets baselines and targets for outcome, process and balancing measures and adds stratification for equity. The sustainability section applies published tools, standard work, a performance board and huddles, and names owners and a trigger for action. The paper closes by listing possible spread and restating the exact decision requested.
Reading the HLTH 4393 Module 5 rubric
Proposal rubrics in quality management usually reward a clear problem statement with evidence, interventions linked to causes, a feasible resource plan, a complete set of measures and a credible sustainability plan. The measures criterion often carries heavy weight: graders look for outcome, process and balancing measures with baselines and targets. The sustainability criterion rewards specific mechanisms, such as standard work, ownership and response plans, over general statements about continued monitoring. Many rubrics also score audience awareness, so a clear request and plain language help. Integration of earlier course work earns points, and scholarly support with APA 7 formatting completes the rubric.
HLTH 4393 Module 5 help: mistakes that cost points
Proposals often lose marks by restating the whole course project at length and burying the request. Another common problem is a single measure with no balancing measure, so nobody can see whether the gain was paid for with harm in another part of the process. Students also write sustainability plans that say only that the team will continue monitoring. Name who owns the measure after the project, where it will be displayed and what triggers action. Put numbers on costs and benefits even when benefits are not revenue. Keep spread ideas separate from the current request. If your proposal concerns falls, readmissions or clinic access instead, send your earlier modules and rubric, and a Module 5 proposal can be drafted from that work.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official American College of Education document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
More HLTH 4393 and B.S. in Healthcare Administration sample papers
- HLTH 4393 Module 1: Quality Measure Definition
- HLTH 4393 Module 2: Process Map and Root Cause
- HLTH 4393 Module 3: Quality Data Analysis
- HLTH 4393 Module 4: PDSA and Lean Improvement Plan
- HLTH 4363 Module 4: Tactics and Channel Plan
- RES 4353 Module 3: Critical Appraisal of a Study
- HLTH 4203 Module 3: Health Disparity Analysis
- HLTH 4303 Module 3: Elopement Risk Management Plan
HLTH 4393 Module 5 questions, answered
What does HLTH4393 Module 5 usually ask for?
HLTH4393 frequently ends with a quality improvement proposal to leadership: the problem and its evidence, the changes, the resources needed, a set of measures with targets and a plan to sustain results. Your classroom's instructions decide the audience and format.
What is a family of measures in quality improvement?
A small set of measures that together show whether an improvement works: an outcome measure, process measures for each change, and balancing measures that watch for harm elsewhere.
How do you sustain a quality improvement?
Write the new practice as standard work, keep the data visible on a performance board, review it in regular huddles, and give named owners a clear trigger for action when performance slips.
Where can I find a free HLTH 4393 Module 5 sample paper?
On this page. It carries the whole Module 5 proposal to an executive team for emergency troponin turnaround, with costs of about $24,000, a family of measures with targets and a plan to hold the gains.
How do you justify a quality proposal without revenue?
Quantify operational benefits such as bed-hours recovered, repeat tests avoided and safety risks reduced, and show that the cost is small relative to them.