The project must be typewritten, double spaced and very limited in length (maximum 12 pages).

Part I (25%)

A NP researcher randomly sampled 100 women aged 50-65 years and measured their minutes of exercise in the past week, BMI, and depression. Depression was measured using a Likert type scale consisting of 20 items. The summation score ranged from 20 to 100 and the higher the score, the higher the level of depression. The Pearson correlation coefficients (r’s) are summarized in the following table. For the analyses, statistical significant level was set at α=0.05.

Table 1: correlation among minutes of exercise, BMI and depression

Exercise in past week (minutes)

BMI

BMI

-0.15

Depression score

-0.30*

0.20

*p < 0.05

1. Write a research and null hypotheses regarding the relationship between exercise and depression.

2. Based on the test statistics in table 1, what is your conclusion regarding your research hypothesis? (Hint: discuss both the magnitude and direction of the relationship).

3. What proportion of variance is shared by minutes of exercise and depression among women 50-65 years of age?

4. For the relationship between minutes of exercise and BMI, 

a. what was the estimated power of the statistical test? (Using the power table on page 202, table 9.1, Polit 2010). 

b. What was the risk that a type II error was committed?

5. If -0.20 is a good estimation of population correlation, what sample size would be needed to achieve power of 0.80 at a significance α=0.05?

PART II. (25%)

Using the “N6208 Final Project Data”, 

a). select two variables with nominal or ordinal level measurements, and perform the descriptive statistics (frequency and percentage). [Please select only dichotomous variables from the following list: poverty, smoker, PoorHealth]. 

b). perform the bi-variate descriptive statistics using crosstabulation. 

c). Hand calculate the ARs, ARR, RR, and OR. Show all your calculations.

d). Perform a chi-square analysis. 

e). Using APA format, write a full report with the following sections:

1. Introduction: Describe your research question and hypothesis. Include the variables, measurement levels, the bivariate research question, and the hypothesis [for example, the event of adverse risk (using your variable name here, for instance, alcohol usage) will be higher/or lower in the risk exposed group (i.e., marijuana use) compare to the non-exposed group (non-users of marijuana)].

2. Method: Include the sample description (sample size, eligibility criteria) and statistical methods used for data analysis. (The sample information can be found in “Polit Dataset Description” in SPSS Data Sets folder).

3. Results: Include frequencies and percentages for the two variables, crosstabulation results, risk indexes (ARs, ARR, RR, and OR), and chi-square test results. Include a summary table for the results and write your interpretation.  (Attach SPSS outputs).

4. Discussion: Write a report including summary and interpretation of the findings reported in the previous sections relative to the research questions you posed in your introduction.

Part III. (50%)

Run a one-way ANOVA using the dataset “N6208 Final Project Data”. The Dataset contains 462 cases from the original PolitDatasetA. Two variables will be used for this analysis: Satisfaction and Houseproblem.

The variable Houseproblem is created using the variable housprob, a summary index of eight variables about current housing problems for the women in this sample—for example, whether or not they had their utilities cut off, had vermin in the household, had unreliable hear, and so forth. The variable housprob is a count of the total number of times the women said “yes” to these eight questions. The variable housprob is recoded into Houseproblem based on number of housing problems. The coding for Houseproblem is: 1=no housing problems, 2=one housing problem, and 3= two or more housing problems.

Satisfaction measures the overall satisfaction with material sell-being. This variable is a summated rating scale variable for women’s responses to their degree of satisfaction with four aspects of their material sell-being—their housing, food, furniture, and clothing for themselves and their children. Each item was coded from 1 (very dissatisfied) to 4 (very satisfied), so the overall score for the four items could range from a low of 4 (4 X 1) to 16 (4 X 4). Higher score indicates greater satisfaction. This scale has an internal consistency Cronbach’s alpha of 0.90. The content validity and construct validity have been established in previous research.

For this analysis, use the variable Houseproblem as the independent (group) variable and variable Satisfaction as the outcome variable. To run the one-way ANOVA, click Analyze → Compare Means → Oneway. In the opening dialogue box, move Satisfaction into the Dependent List and Houseproblem into the slot for Factor. Click the Options pushbutton, and click Descriptives and Homogeneity of Variance, then continue. Next, click the Post Hoc pushbutton and select LSD. Click continue, then OK, and answer the following questions using compete sentences: 

1. What are the mean levels of       satisfaction in the three groups? Report the mean, SD, minimum, maximum       and sample size in a table.
2. Write a research question.
3. Write the research hypothesis (Ha)       and the null hypothesis (Ho).
4. What was the value of the F statistic and its p-value?
5. Can the null hypothesis be       rejected?
6. What were the degrees of       freedom?
7. According to the LSD test,       were any group means significantly different from any others? If yes,       which ones?
8. Write a paragraph summarizing all       the results.
9. Attach the relevant SPSS       printouts.

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In preparation for this hypothetical coaching exercise, identify one individual, staff member, or employee (from your current organization or a past setting) who could benefit from coaching. Create a pseudonym for him or her.

Use the six-step coaching process to develop a coaching and development plan

Submit a 5- to 7-page paper in which you do the following:

Step One: Determine your intention.

· Describe your intention and purpose for coaching this specific individual.

· Explain the goals, skills, and/or competencies you have in mind, and define your primary focus.

· Explain how you would engage this individual in identifying these and other development opportunities.

Step Two: Assess the performer.

· Identify the individual’s strengths and level of development.

· Explain the leadership style and interventions that would be most appropriate to help this individual achieve his or her identified goals, skills, and/or competencies.

Step Three: Clarify expectations and parameters.

· Describe the roles and expectations of both you and the individual.

· Outline the learning opportunities you could provide and the order in which they should be approached.

· Identify the specific objectives to be achieved for each learning opportunity.

· Explain the coaching best practices you would apply and why.

Step Four: Carry out the coaching intervention.

· List the coaching questions you might develop to ensure that learning opportunities and interventions are applied as needed, and explain how any additional development opportunities might help to address your intended coaching goals.

Step Five: Observe performance.

· Explain the observation method you will use to assess whether or not your coaching has been effective.

Step Six: Give feedback.

· Describe how you will administer feedback to this individual.

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Section 3: Quality Measurement and Assessment

Pneumonia 30 day readmission is the quality improvement issue

Think about the quality improvement issue that you are addressing and the associated plan that you are developing. Consider the following:

· What is the overall purpose, or aim, of doing this work?

· What would you hope to achieve for the organization by undertaking this project? What are the objectives of this initiative?

· What value would this work add to the organization?

· How would this work improve practice and create outcomes with impact?

Consider how addressing this quality improvement issue would align with the organization’s mission, vision, values, and strategic goals and objectives. How does it relate to regulatory issues, and other matters that are significant for the organization? If you notice a misalignment, use this as an opportunity to refine your focus.

With this in mind, continue to hone your development of this Assignment, integrating the concepts addressed here into Section 3.

To complete:

Write a 3- to 5-page paper that includes:

· An introduction to your quality improvement plan, including the overarching aim of this initiative and an explanation of how it aligns with the mission, vision, values, and strategic goals and objectives of the organization, as well as regulatory issues and other matters that are significant for the organization

· An overview of the current situation with regard to this quality improvement issue in the organization

· A description of measures and indicators

· A presentation on data related to this issue, including:

· Actual historical and current data and/or a description of the methods that you would use to collect and analyze the data

· Methods for collecting and analyzing data in the future, including when you would do this

· A description of realistic, evidence-based targets

Be sure to cite evidence from the literature to justify your selection of the measures and indicators, as well as the performance targets. 

Section 4: Quality Improvement Strategies

Through your work on Section 3 of the Course Project, you have examined the gap between current performance and evidence-based targets and considered how addressing this gap relates to organizational priorities and large-scale aims for quality improvement.

In this section of the Course Project, you begin to think about quality improvement strategies that could help to bridge this gap. As noted in the Sadeghi, Barzi, Mikhail, and Shabot text, this is referred to as performance-driven planning.

Since the publication of the Institute of Medicine’s report “Crossing the Quality Chasm,” a good deal of attention has been paid to the need to examine processes that contribute to outcomes (Ernst, Wooldridge, Conway, Dressman, Weiland, Tucker, and Seid). As the USAID has noted, interventions “will not create the desired outcome to improve the quality of care unless the overall process of care delivery is also improved.” Therefore, attention to process redesign is a central aspect of cultivating strategies for improvement.

To prepare:

· Refer to the modified Donabedian model (access, structure, process, outcome, and patient experience) presented in Chapter 9 of the Sadeghi, Barzi, Mikhail, and Shabot text.

· Recall the performance targets that you identified for Section 3 (in Week 6). What does the recommendation that performance-driven planning should “begin with the end in mind” suggest given your established goals?

· Review the information presented in Chapter 9 of the Sadeghi, Barzi, Mikhail, and Shabot text, and think about how you would assess the organization’s strengths and weaknesses related to the performance gaps you identified in Section 3 (Week 6).

· Based on the above, start to think of specific evidence-based strategies that could be implemented to close/minimize the performance gaps you have identified. Consider both interventions (what) and processes (how). Focus on strategies that are supported by the latest research and could create systems-level change. These may be tentative for now, but be sure to identify at least one that specifically lends itself to a change in process (i.e., practice, protocol, pathway, activity).

Throughout this course you have been considering the relationship between structure, process, and outcomes as it relates to health care quality. Looking at outcomes, alone, may not tell the “whole story.” For instance, if you are concerned with improving fall rates, evaluating the process—related activities or practices—can help you identify factors that contribute to outcomes and develop strategies for improving them.

For this section of your Course Project, you create a process map to examine a current process related to your quality improvement issue. You will use the results of the process mapping to redesign a process to help minimize or close the performance gap(s). As you proceed, keep in mind the importance of maintaining a patient-centered focus so the patient experience is not negatively affected by any changes in process.

To prepare:

· Review the instructions provided in the Learning Resources for creating a process map.

· With your quality improvement issue in mind, as well as the other work you have completed on your Course Project thus far, think about how creating a process map could help you to better understand your quality improvement issue and redesign an associated process.

· Create a process map using Microsoft Word or PowerPoint.

· Refine the strategies for promoting systems-level change to minimize or close the performance gap(s) that you began to think about in Week 7. As part of this, identify a way to redesign at least one process based on your analysis of the process map that you have created.

To complete:

· Write a 2- to 3-page paper in which you describe quality improvement strategies that you selected related to your quality improvement issue.

· Finalize your process map, which will be submitted along with the paper.

Process map help

https://www.isixsigma.com/tools-templates/process-mapping/practical-guide-creating-better-looking-process-maps/

Provides detailed description of how to create a process map

http://www.miltonkeynesccg.nhs.uk/resources/uploads/files/NHS%20III%20Handbook%20serviceimprove.pdf

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This is the second part to the first question I posted. ( Below is the information for the proposed change)

Creating a balanced scorecard for the new stroke nurse position is critical. The balanced scorecard will track improvements to the quality of patient outcomes and financial outcomes (Jeffs, Merkley, Richardson, Eli, & McAllister, 2011). With the balanced scorecard allows for leadership to see where and how to grow the new stroke nurse position. 

Collecting data is how you can justify if the new change is working “Create a Balanced Scorecard of Robust Measures, Meaningful Targets, and Strategic Initiatives,” 2014). Data collection is mandated by the joint commission to maintain comprehensive stroke certification. The stroke nurse will collect and monitor patients progress during admission and give follow-up calls around up to 90 days after discharge from the hospital. This will allow for leadership to see an improvement in the outcome of stroke patients. After six months the collected data from before stroke nurse and after stroke nurse can be compared. The hospital is expected to have an increase in a stroke patient with the new comprehensive stroke certification. This will create an increase in revenue which will help offset the cost of the stroke nurse program. 

References

Create a Balanced Scorecard of Robust Measures, Meaningful Targets, and Strategic Initiatives. (2014). Balanced Scorecard Evolution, 221-267. doi:10.1002/9781118915011.ch6

Jeffs, L., Merkley, J., Richardson, S., Eli, J., & McAllister, M. (2011). Using a nursing balanced scorecard approach to measure and optimize nursing performance. Nursing Leadership, 24(1), 47-58. doi:10.12927/cjnl.2011.22334

Section 4: Budgeting and Timeline Tools

As you have been examining this week, budgeting and timeline tools are vital for determining necessary resources and planning for a proposed change. For your Course Project, you use these types of tools to assess resources that may be required for the successful implementation of your strategic plan.

To prepare:

• Review the information on budgeting in this week’s Learning Resources. Which tools (e.g., Revenue Projection Model, Capital Budgeting Analysis, Depreciation Calculator, Profit and Loss Projection) would be most useful for developing your strategic plan? 
• Use one or more budgeting tools to outline the financial resources for your proposed change. Reflect on any challenges that arise as you evaluate the financial resources required for this change now and in the future.
• Review the information on PERT and other timeline tools in this week’s Learning Resources, including Dr. Huston’s presentation in the media program.
• Use PERT or another tool to analyze and represent the activities that need to be completed to successfully plan and implement your proposed change. Be sure to note dependencies (e.g., a task/milestone that must be completed in order to trigger the next step) and realistically assess the minimum time needed to complete the entire project.  

To complete:

• Outline the financial resources for your proposed change. Describe the budgeting tool(s) you used to arrive at these determinations. Explain what challenges, if any, you encountered through the budgeting process. Provide documentation (e.g., Excel worksheets) to support your analysis.
• Outline the timeline for the implementation of your proposed change using PERT or another timeline tool. Consider how your timeline can allow leeway for variance.

By Day 7

Submit:

• Section 3: Balanced Scorecard
• Section 4: Budgeting and Timeline Tools (which includes an outline of financial resources and a timeline)

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Post by Day 3 and Respond by Day 6

To participate in this Discussion:
Week 8 Discussion

Course Project: Developing a Strategic Plan

Section 3: Balanced Scorecard

As you continue to develop your Course Project, it is important to consider how to evaluate the effects of your planned change on performance. Based on the work you have done thus far on your Course Project, this week you create a balanced scorecard.

To prepare:

• Review your work on the summary of the issue and SWOT analysis from previous weeks.
• Review the information about and examples of balanced scorecards presented by Dr. Carol Huston in this week’s media program and in the other Learning Resources. Conduct additional research to see additional examples of balanced scorecards and to deepen your understanding of how balanced scorecards are used in various organizations.
• Reflect on the comments related to balanced scorecards exchanged in this week’s Discussion.
• Conceptualize a balanced scorecard that could be used to measure and evaluate the impact of your planned change on performance, and determine if the costs are justified in terms of the outcomes. Consider what you would measure in terms of finances, customers, internal process, and learning and growth.
• Think about how you would gather valid and reliable data.
• Begin to create your balanced scorecard, which will be submitted next week.Course Project: Developing a Strategic Plan

Section 3: Balanced Scorecard

To prepare:

As introduced in Week 8,continue to refine your balanced scorecard. (Refer to Week 8 for the preparatory instructions as necessary.) Your balanced scorecard is one tool you can use to evaluate the effects of your planned change on performance.

To complete:

• Create a balanced scorecard that could be used to measure and evaluate the impact of your planned change on performance, and determine if the costs are justified in terms of the outcomes.
• Include what you would measure in terms of finances, customers, internal process, and learning and growth.

Section 4: Budgeting and Timeline Tools

As you have been examining this week, budgeting and timeline tools are vital for determining necessary resources and planning for a proposed change. For your Course Project, you use these types of tools to assess resources that may be required for the successful implementation of your strategic plan.

To prepare:

• Review the information on budgeting in this week’s Learning Resources. Which tools (e.g., Revenue Projection Model, Capital Budgeting Analysis, Depreciation Calculator, Profit and Loss Projection) would be most useful for developing your strategic plan? 
• Use one or more budgeting tools to outline the financial resources for your proposed change. Reflect on any challenges that arise as you evaluate the financial resources required for this change now and in the future.
• Review the information on PERT and other timeline tools in this week’s Learning Resources, including Dr. Huston’s presentation in the media program.
• Use PERT or another tool to analyze and represent the activities that need to be completed to successfully plan and implement your proposed change. Be sure to note dependencies (e.g., a task/milestone that must be completed in order to trigger the next step) and realistically assess the minimum time needed to complete the entire project.  

To complete:

• Outline the financial resources for your proposed change. Describe the budgeting tool(s) you used to arrive at these determinations. Explain what challenges, if any, you encountered through the budgeting process. Provide documentation (e.g., Excel worksheets) to support your analysis.
• Outline the timeline for the implementation of your proposed change using PERT or another timeline tool. Consider how your timeline can allow leeway for variance.

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