Justification of Proposed Solution

1. Problem or Issue
This is where you state the problem or issue that you have identified collaboratively with your resource person related to practice, policy, population, or education that aligns with organizational priorities.

A1a.  Explanation of Problem or Issue
Here explain the problem with substantial support and include why it is applicable to your chosen area of practice and healthcare environment.

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A2. Investigation
Here discuss with detail “How” you investigated the problem. Use the COS to guide this discussion. Do an external investigation (Are there articles in professional journals about the topic? Are there recommendations from professional organizations about the topic? )  Do an organizational assessment (national source documents, evidence from a stakeholder or resource person).

A2a.  Evidence of Problem
Here include your appropriate evidence (data) to substantiate the problem. According to Smith & Smith (2014), then state what the article reported. Your data from your resource person and other stakeholders goes here.

A3.  Analysis
Here explain what the data from your investigation means and support the state of the situation with the current data reported above.

A3a.  Areas Contributing to Problem or Issue
Here from the analysis above substantiate areas that might be contributing to the problem or issue. (Example:  If the problem is inadequate pain control and your evidence and analysis substantiates that patients do not ask for pain medication because of fear of addiction this would be a contributing factor).

A4.  Proposed Solution or Innovation
Here provide an explanation of your solution. What are you proposing to do about the problem?

A4a. Justification of Proposed Solution
Here use your results of your investigation and analysis to support why your solution is justified. Explain why your solution is a good idea.

A5. Implementation Resources
Here provide recommendations with sufficient detail of resources to implement the proposed solution. Example from COS. Time, Materials, Personnel, Money

A5a. Cost Benefit Analysis
Here provide a cost benefit analysis of the proposed solution
Equate cost and benefits into dollars. Time can be converted into dollars by using an average salary 25.00 X 1.5 hrs. = 37.50 Benefits can be equated as dollars or timeliness, efficiency, safety, saved revenue, improved health of population. Cost-Benefit Analysis

A6. Timeline
Here include a specific time frame from start to finish, step-by-step, needed to implement your proposal.

A7. Identification of Key Stakeholders or Partners
Here identify the Key Stakeholders that are important for the implementation of the solution. Do not use real names (titles OK) to maintain confidentially.

A7a.  Importance of Key Stakeholders
Here discuss, with support,  why each of the Key Stakeholders are important for the implementation of the solution.

A7b.  Engagement with Key Stakeholders
Here discuss how you met with the Key Stakeholders. Include their input and feedback and how you intend to work with each of them.

A7c. Success
Discuss with detail how you will work with the Key Stakeholders to achieve success. How will you get their buy-in to ensure success of the project?

A8. Implementation
Discuss with detail the how of solution implementation. Include a plan from start to finish

A8a.  Evaluation for Success of Implementation
Provide a detailed discussion of your Evaluation  Plan and how your plan will be evaluated for success.

Section B: Personal Reflection –
For examples to these prompts, review Population Case Study Example in the COS Population Case Study Example

B1. Role of Scientist
Here discuss how you fulfilled the role of a Scientist during this project using the definition of the role and the case study as a guide.

B2. Role of Detective
Here discuss how you fulfilled the role of a Detective during this project using the definition of the role and the case study as a guide.

B3.  Role of Manager of Healing Environment
Here discuss how you fulfilled  the role of manager of the healing environment using the definition and the case study as a guide.

C. Verification Form
Attach a copy of  your completed “Professional Verification Form” from the organizational leader advising you in the leadership experience.

D. Sources
Provide in-text citations and  references in APA style.

Common areas or discussions can be combined for flow of the paper. Be very clear which area you are discussing by using labeled sections.

Examples:
Problem/Explanation of the problem
Investigation/Evidence/Analysis/Areas Contributing to the Problem
Proposed solution/Justification of solution
Implementation Plan/Timeline
Implementation of Resources/Cost Benefit Analysis
Identification of Key Stakeholders/Importance of KSH’s/Engagement with KSH’s
Success/Evaluation for Success
Roles of Scientist, Detective, and Manager of the Healing Environment

Choosing Your Subject
You will develop a project within a practice setting that allows you to demonstrate and grow leadership skills.  Identify a problem area in a practice setting that aligns with organizational priorities that you specifically want to address. Your project will fall into one of the following broad areas.
Policy
Developing, explaining, or acting on policies that emanate from legislative, regulatory, and professional practice. This sphere has high visibility and high impact across a wide area.
For example:
•    rule development,
•    high-level professional nursing organizations,
•    legislation or testimony related to a nursing practice,
•    regulations from state boards, or
•    the process of policy development.
Practice
Participating in or implementing actions within your practice environment. These have a specific, patient-centered care focus, i.e., changing practice, challenging status quo, process of policy development.
For example:
•    hospital organizational procedures,
•    evidence based practices (EBP),
•    quality indicators (QI),
•    meeting Joint Commission standards,
•    evaluating outcomes,
•    ethics,
•    root cause analyses,
•    Six Sigma teams.
Population
Recognizing effects and recommending processes that affect a specific population.
For example, process or policy development to address:
•    a disaster response plan,
•    epidemic (e.g., pertussis, West Nile), or
•    a particular patient demographic (e.g., infant PKU screening, children with diabetes, teen pregnancy, elderly nutrition gaps).
Education
Creating educational outreach or products.
For example:
•    poster presentation,
•    grand rounds,
•    process or policy development,
•    patient education,
•    peer education,
•    continuing education development,
•    Benner’s recommendations regarding nursing education.

Background Research
Do some serious research about the problem you’ve selected. Find and document evidence answering the following questions:
•    Why is this issue important, timely, and relevant to your current situation?
•    Are there articles in professional journals about this topic?
•    Are there recommendations from professional organizations about this topic?
Write up your background research as a part of your project submission.
•    Discuss your investigation of the problem or issue. Include evidence to substantiate the problem or issue (e.g. organizational assessment, national source documents, evidence from a stakeholder).
•    Analyze the state of the situation using current data. Analyze areas that might be contributing to the problem or issue.
•    If you use sources, include all in-text citations and references in APA format.
o    When using sources to support ideas and elements in a paper or project, the submission MUST include APA formatted in-text citations with a corresponding reference list for any direct quotes or paraphrasing. It is not necessary to list sources that were consulted if they have not been quoted or paraphrased in the text of the paper or project.
o    No more than a combined total of 30% of a submission can be directly quoted or closely paraphrased from outside sources, even if cited correctly. For tips on using APA style, please refer to the APA Handout web link included in the APA Guidelines section.
Proposing a Solution
Now you will propose a realistic and measurable solution or innovation for the problem or issue. You will need to
•    justify your proposed solution or innovation based on the results of your research investigation and analysis.
•    include a basic plan of how to implement your solution in your environment.
•    consider the proposed solution from the viewpoint of the manager of the healing environment.
•    consider the expected impacts of your proposed solution and unanticipated consequences.
Write up your proposed plan not only as a part of your project submission but also to be reviewed by a leader in your organization.
Details of Your Solution
Any implementation of a project will require resources. Think broadly about resources in all of the following areas.
Time
•    to develop the project.
•    to instruct others in the changes to their workflow.
•    to get staff up to speed using the new function.
Materials
•    for the project itself.
•    to communicate the changes to others.
•    that may be unused or wasted from current practices.
Personnel
•    How might they respond to changes in their work environment?
•    Are there some who may actively oppose your implementation?
•    Does your proposal require more staff?
•    Does your proposal reduce need for staff?
•    What will happen to those no longer needed?
Money
•    for materials as noted above.
•    for additional staff training, and lost time for them at work.
•    to pay more/less highly educated staff.
Include a cost benefit analysis of your proposed solution or innovation. For more detailed instructions on a cost benefit analysis and money matters, review the following in the Contemporary Nursing e-text:
•    chapter 7 (“Paying for Health Care in America: Rising Costs and Challenges”)
•    chapter 25 (“Managing Time: The Path to High Self-Performance”)
Include a specific section or table in your project to discuss the resources needed for your project.
Key Stakeholders
Identify key stakeholders and/or appropriate partners that are important for the implementation of your solution or innovation.
•    Discuss why each key stakeholder and/or appropriate partner is important for the implementation of the solution or innovation.
•    Summarize your engagement with the key stakeholders and/or appropriate partners, including the input and feedback you received.
•    Discuss how you intend to work with those key stakeholders and/or appropriate partners in order to achieve success.
Implementation Plan
Write a clear plan of how your proposed solution or innovation would be implemented. Use the plan to answer the following:
•    Who will need to give authorization to implement the proposal?
•    Who will be needed to train others or actually do the implementation?
•    Who will need to be trained in the new practices?
•    How will you communicate with all these people?
•    How will you communicate with those who will be impacted even if they don’t participate (e.g., patients)?
•    What is the timeline for implementation based on your proposal?
•    What are the criteria to judge success of the proposal?
Evaluation Plan
Evaluation of a project must be included in the original plan. Evaluation includes both how you will gather data about the impact and outcomes of the project, and the criteria for success.
Now, put this information together with the project you have chosen and begin to lay out the process to plan your solution and implementation of the solution. Be sure that your written plan is clear and covers the project in detail. Although you may not have authority in your current practice to actually implement this solution, your project should include everything that would be required.
Personal Reflection
Review the following diagram:
•    Nursing Conceptual Model
Explain how you fulfilled the following roles during your process of investigation and proposal development:
•    Scientist
•    Detective
•    Manager of the healing environment
Your reflection needs to cover:
•    What (What was the problem?)
•    How (How did you investigate the problem?)
•    When (How long did you investigate the problem?)
•    Why (Why was the problem of interest to you, your facility, or healthcare community)
•    Who (Who were your team members and why?)
Your reflection may also include:
•    What responses did you get from others related to your topic?
•    Who did you seek feedback from? (Name, title, role)
•    Why did you seek feedback from this person?
•    Did any of the feedback you received surprise you? Why?
•    Rubric (all elements are addressed and information is consiste

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