Organizational Analysis Rubric
Points
Introduction paragraph (one paragraph). There must be a thesis statement at the end of the paragraph that tells the reader the purpose of paper and what will be discussed.
0.5
Before you begin the analysis of the hospital, establish healthcare organizations in the 21st century as complex adaptive systems.
What does a leader need to understand about change in a CAS?
Discuss the leadership challenges of transformation of complex systems.
2
Introducing the Organization
Identify an organization you selected for review from the list. Review the organization’s website.
Provide a basic introduction to the organization.
Give an overall description the mission, values and community work of the organization.
Describe the size of the organization.
3
Is the organization a for-profit or not -for profit-structure?
Evaluate the Community Needs assessment for the facility and/or the annual report or if the organization is a for-profit, the annual report for shareholders. What opportunities for the future work of the organization are identified? .
Can’t find the Community Health Needs assessment for a not-for-profit facility? Look at other information available on the site and summarize what you can and note the report is not readily available. Interestingly, the report is required every 3 years and should be available but you may find the facility you are reviewing is out of compliance.
https://www.irs.gov/charities- non-profits/community-health-needs-assessment-for-charitable- hospital-organizations-section-501r3
2
Culture:
1 point: Describe Edgar Schein’s definition of culture including artifacts, espouse values and assumptions.
1 point Examine the organizations human resources information as well as any literature or websites describing the organization. Based on Schein’s definition of culture, seek outward evidence of the culture by reviewing the selected organization’s newsletters, ads, and pictures.
1 point
Describe the observable culture of the organization based on Edgar Schein’s model.
3
Price Transparency: From the CMS website: Hospital price transparency helps Americans know the cost of a hospital item or service before receiving it. Starting January 1, 2021, each hospital operating in the United States will be required to provide clear, accessible pricing information online about the items and services they provide in two ways: 1. As a comprehensive machine- readable file with all items and services. 2. In a display of shoppable services in a consumer-friendly format.
Can you find the transparent cost of a hospital item on the hospital’s website? Was it difficult to find?
Choose any two items and compare the cost of the items at the facility selected for the organizational analysis (OA) to a facility in the same region. For example, if the facility for the analysis in Wyoming, choose another Wyoming hospital for comparison. Is the OA facility a lower or higher cost provider? You must include the amounts of each item that you compared .
2
What do Others Say About the Organization?
Recognition: Is the organization listed as a Malcolm Baldridge Award recipient? https://www.nist.gov/baldrige/award-recipients
1 point Discuss the reasons an organization might consider applying for the
Malcolm Baldridge Award.
Did the organization list other certifications such as Stroke designation, or Cardiac designations, etc.?
1 point: Is the facility Magnet designated? What value would Magnet designation potentially bring to the facility?
https://www.nursingworld.org/organizational-programs/magnet/find-a- magnet-organization
2
Public Reported information about the facility:
Using the Hospital compare site located at https://www.medicare.gov/care-compare/?providerType=Hospital&redirect=true
How many stars does the facility have?
How does the facility compare to other facilities nationally?
Are there opportunities for improvement?
3
CMS complaints: Have there been investigated complaints regarding failure to comply with the CMS Conditions of Participation ?
See the public information available at: https://www.cms.gov/Medicare/Provider-Enrollment-and- certification/CertificationandComplianc/Hospital
Information is located in the file labeled: Full Text Statements of Deficiencies Hospital Surveys – 2021Q4 (ZIP)
Briefly describe the purpose of the CMS Conditions of Participation (CoPs).
What does a finding of Immediate Jeopardy mean to the facility? As an advanced practice nurse, why is it important for leadership to understand the CoPs?
3
Assess the LeapFrog scores for the hospital
https://www.hospitalsafetygrade.org/your-hospitals-safety-grade
What is the letter grade for the facility? What does the score mean?
What are the specific concerns contributing to the score. Avoid all discussion of staffing. Although Leapfrog does provide some staffing information, the staffing information is too broad to reach a conclusion related to a quality concern. Seek specific concerns which may contribute to the grade such as high infection rates, long wait times, falls, etc.
1.5
Conclusions:
Summarize the essential points of the analysis of the organization.
What conclusions were reached based on the assessment?
.5
Scholarship: The assignment will be submitted consistent with the Guidelines for Organizational Analysis Assignment described in this document. See the scoring rubric for page limits and the minimum number of references supporting the work.
Total points
2.5
25
