Strategic Leadership Implementation

To fulfill the needs of patients in this Strategic Leadership Implementation Financial Stability Improvement, a healthcare system that is fast transforming requires effective leadership to drive change. Strategic leadership entails establishing and pursuing core objectives, such as lowering healthcare costs, maintaining development, and enhancing the quality of health services (Kumar et al., 2015). While leaders concentrate on enhancing healthcare service delivery, a variety of methods are used to assess every component of treatment in order to guide quality improvement. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey is one of the most highly regarded instruments in the United States for guiding quality care delivery and process improvement.

The HCAHPS ratings displayed on Hospital Compare, which is part of the government’s Medicare website, enable consumers to make fair and objective comparisons between hospitals and state and national averages on significant metrics linked to the patient’s unique viewpoint on the treatment received. This debate examines how strategic leadership may be utilized to increase HCAHPS scores via the introduction of evidence-based strategies and stakeholder participation. Click here to see a custom paper on Strategic Leadership Implementation

HCAHPS Ratings at the Banner Boswell Medical Center

Survey Questions


Patients who said that their nurses “Always” communicated effectively

74. Patients whose physicians “Always” communicated well with them were shown to have better health outcomes.

72. Patients who said that they “Always” got assistance when they requested it were deemed to have “Always” received prompt assistance.

69. Patients who said that personnel “always” discussed medications prior to administering them.

60. Those who indicated that their room and bathroom were “Always” clean

60. Patients who claimed that the environment surrounding their room was “Always” peaceful at night.

47. Patients who said that they were given instructions on what to do throughout their rehabilitation at home

88. Patients who “Strongly Agree” they comprehended their treatment after they were discharged from the hospital.

50. Patients who rated their hospital a score of 9 or 10 on a scale from 0 (worst) to 10 (best) (highest)

65.Patients who said YES, they would absolutely recommend the hospital, would

68. State and Countrywide Averages

Strategic Leadership Implementation

The Medicare and Medicaid services have a two-star rating for Banner Boswell Medical Center, and the HCAHPS survey findings show that there is potential for improvement in a number of areas. According to the most recent survey results, the institution compares well with Arizona and national averages. The first factor is the percentage of patients who felt that their nurses “Always” communicated effectively, which is 74% compared to 77% and 81% for the state and national averages respectively (U.S. Centers for Medicare and Medicaid Services (a), n.d.). The score for physicians’ communication is 72 percent, which is somewhat below the state and national averages of 76 percent and 82 percent, respectively. The healthcare institution seems to do well on the metric of patients who reported receiving assistance “Always” when they requested it. The hospital average is 69%, which is two percentage points higher than the state average and one percentage point below the national average. Patients who claimed that personnel “always” explained medications to them before dispensing them had a score of 60%, compared to averages of 65% and 66% for the state and country. Click here to see a custom paper on Strategic Leadership Implementation

The cleanliness and nighttime stillness of the rooms at Banner Boswell Medical Center seem to be much below the state and national norms. The institution has a score of 60% for cleanliness, compared to 72% and 76% respectively for the state and national standards. The score for silence is 47%, which is lower than the state and national averages of 57% and 62% respectively. The hospital relies heavily on patients who reported receiving recuperation instructions at home. The findings reveal an 88% score compared to a state score of 86% and a national score of 87% (U.S. Centers for Medicare and Medicaid Services (a), n.d.). 50% of patients “Strongly Agree” they understood their treatment before leaving the hospital, compared to 51% of patients in the state and 54% of patients nationwide. Patients who gave their hospital a rating of 9 or 10 on a scale from 0 (lowest) to 10 (highest) indicate a score of 65% compared to the state and national averages of 69% and 73% respectively. 68% of patients would recommend the hospital, compared to 69% for the state and 72% for the country.

In contrast to Other Hospitals

Banner Boswell Medical Center is compared to Arrowhead Hospital and Banner Baywood Medical Center in Arizona. The Medicare and Medicaid services have evaluated all three hospitals as two-star acute care facilities. All three institutions are below the state and national averages for the proportion of patients who said that their nurses “Always” communicated well. Boswell medical facility had a score of 74%, while Arrowhead and Banner Baywood received scores of 73% and 70%, respectively (U.S. Centers for Medicare and Medicaid Services (b), n.d.). Seventy-two percent, seventy-two percent, and seventy percent, respectively, were awarded to each of the three facilities for doctor communication. These scores are lower than the state and national averages of 76% and 82%, respectively. Sixty-nine percent of patients at Boswell Medical Center, sixty-four percent at Arrowhead, and fifty-five percent at Banner Baywood Medical Center indicate that they get quick assistance.

Strategic Leadership Implementation
The percentage of patients at Banner Boswell Medical Center who claimed that personnel “Always” explained medications to them before to dispensing them is 60%, which is two and four percentage points lower than their peers. The same can be stated about room cleanliness, as Banner Boswell rated 60% compared to Arrowhead’s 68% and Baywood’s 65%, respectively. Nighttime silence is rated poorly in every facility. Banner Boswell has a score of 47%, whereas Banner Baywood and Arrowhead have scores of 52% and 50%, respectively (U.S. Centers for Medicare and Medicaid Services (b), n.d.). These scores are well below the state and national norms, showing potential for improvement. Banner Boswell has fared better in terms of the percentage of patients who reported receiving instructions about what to do at home throughout their recuperation. The facility has an 88% rating, compared to 85% for the other two facilities.

Understanding the care provided during a hospital stay is crucial for judging the quality of services provided. Banner Boswell’s performance in this area is superior to that of the other institutions, which earned 49% and 45%, respectively. In addition, patients who rated their hospital with a score of 9 or 10 on a scale ranging from 0 (worst) to 10 (best) indicate that the three hospitals performed adequately. Banner Boswell has a score of 65%, compared to Arrowhead’s 67% and Banner Baywood’s 64% (U.S. Centers for Medicare and Medicaid Services (b), n.d.). The last area of comparison is the percentage of patients who said they would absolutely recommend the hospital. Boswell and Arrowhead tied with a 68% score, while Banner Baywood Medical Center received a score of 65%. Click here to see a custom paper on Strategic Leadership Implementation

Response Ratios to Surveys

Depending on the amount of surveys completed, the response rates for surveys at the three locations vary. The hospital with the greatest number of performed surveys, 1827, also has the lowest survey response rate, 17% (U.S. Centers for Medicare and Medicaid Services (c), n.d.). Banner Boswell Medical Center comes in second place with 596 completed questionnaires and a 30% survey response rate. The Banner Baywood Medical Center has the fewest completed surveys, 511, and the lowest survey response percentage, 26%, as indicated in the table below.

Population Profile and List of Services

Banner Boswell Medical Center, located on West Thunderbird Boulevard in Sun City, Arizona, offers a range of healthcare services to the area it serves. The hospital is committed to enhancing patient care by continually concentrating on patient outcomes and service, educating an engaged team, and using cutting-edge technology. Banner Health, with more than 50,000 workers nationwide, is the biggest non-profit employer in Arizona and one of the largest in Northern Colorado. Patients from Sun City, a city with a total population of 39,348 are primarily served by this hospital. Diverse ethnic and racial backgrounds are represented in the population. 94.93% of the population is white, while 2.92 % is black or African-American (United States Census Bureau, 2019). Other races constitute 0.51 percent of the overall population, while Asians make up 0.99 percent. In this area, the median household income is $50,139, and 9.09% of the population lives below the poverty level.

Banner Boswell Medical Center has served as the linchpin of community healthcare focusing in ailments of the elderly. This indicates that the bulk of the population serviced is above 65 years old. The healthcare facility offers numerous healthcare services, such as cancer care, emergency services, endoscopy, geriatric care, imaging, integrative therapy, neurology, orthopedics, wound care, endocrinology, renal care, cardiology services, intensive care, palliative care, surgery, nutrition, and women’s health (Banner Health, 2020). The Heart Center at Banner Boswell is nationally renowned for its care and expertise in cardiovascular preventative care, diagnostic services, medical and surgical treatment, and rehabilitation. Truven Health Analytics, a prominent national health care research, and quality assessment firm, named the facility among the top 100 hospitals in the country.

Cultural Dynamics

Hospital-based HCAHPS ratings rely on the quality of connections between healthcare professionals and patients. With more than fifty percent of HCAHPS survey questions concentrating on communication, culture plays a crucial role in achieving favorable patient outcomes. To foster a culture of safety and belonging, the institution must first assure the diversity of its healthcare staff. Diversity helps that members of the healthcare team have a better understanding of the patient, particularly those with similar racial and cultural origins. By introducing interpreting services, the institution may further cultural awareness. These treatments may enhance the engagement and communication between patients and healthcare professionals. Diversity in the institution may increase HCAHPS ratings for discharge information, nurse communication, and medication communication.

Dynamism in Education

Healthcare delivery is a two-way process that requires ongoing contact between the patient and the healthcare professional. When a patient has a poor level of knowledge, it may be challenging for physicians to offer adequate treatment. Education has a significant role in deciding treatment acceptance and impacts the knowledge of care throughout the healing process. In addition, successful communication depends on the language used and the comprehension of fundamental medical concepts. If the patient is poorly informed, HCAHPS ratings might be impacted in areas such as knowledge of care following discharge and communication by nurses and physicians. Inadequate communication and comprehension may potentially delay medical measures, leading to discontent. On the other side, educated patients are able to articulate their issues and get the appropriate care, resulting in greater patient satisfaction.

Dynamism Socioeconomic

Access to healthcare services and the perception of the care delivered are influenced by a person’s socioeconomic standing, as measured by income and poverty levels. Because of their financial resources, individuals from affluent socioeconomic backgrounds seek medical treatment with high hopes of recovery. This perspective has a significant impact on how individuals interact with healthcare professionals and how they perceive their treatment. The outcome is a greater knowledge of care, enhanced contact with clinicians, and improved HCAHPS ratings. Poor socioeconomic position influences healthcare-seeking behavior, such as favorable connections with care providers, communication during care delivery, and the quality of services obtained. Certain hospital treatments are unaffordable for these patients, and their dissatisfaction stems from their inability to get the desired care. The resulting low HCAHPS ratings are a reflection of the broken connections between patients and healthcare professionals.


Financial Impact

There is a correlation between improved provider care, patient satisfaction, and reimbursement, as shown by the results of recent studies. There is evidence that Medicare and Medicaid payments are influenced by the quality of treatment evidenced by higher HCAHPS ratings (Akinleye et al., 2019). Good HCAHPS ratings have a short-term effect of increasing the money available to healthcare organizations for the purpose of enhancing their processes. These institutions are able to extend their operations and attract more patients, hence increasing their income. Medicare and Medicaid Services retain a certain proportion of compensation when HCAHPS ratings are inadequate. This necessitates that the organization struggle to generate enough income to maintain basic services. Long-term, increased HCAHPS ratings create more money, resulting in organizational development and growth (Akinleye et al., 2019). Additional patients might be attracted to the hospital by implementing innovative procedures. Due to a drop in Medicare funding and a decline in customer income, poor performance results in a financial shortfall for the organization.

Bearing on Quality

Healthcare organizations employ HCAHPS surveys to identify areas in need of development in order to realize outcomes more effectively. Following the gathering of findings, the hospital evaluates regions that did badly and executes quality-improvement measures. The HCAHPS ratings assist the organization in establishing objectives and implementing alternative strategies to enhance the quality of services provided (Akinleye et al., 2019). For instance, ineffective communication between nurses and physicians is indicative of a lackluster organizational performance. The firm might then opt to concentrate on increasing communication in order to get better outcomes. Inadequate communication between healthcare teams may result in substandard results, such as an increase in medication mistakes, a delay in patient care response, and an increase in death rates. In addition, poor HCAHPS ratings undermine the morale of healthcare employees, who may lose faith in their management, resulting in a breakdown in communication and coordination of services.

Strategic Leadership Implementation Financial Stability Improvement Scores’ Motives

The first category with low HCAHPS ratings is patients’ perception that their room and bathroom were “Always” clean, which received a score of 60%. In this regard, the state average is 72% whereas the national average is 76%, providing potential for development. According to hospital statistics, inadequate hygiene is attributable to a shortage of supported personnel and poor coordination of services among available employees. In addition, the hospital mostly accepts older people with a variety of diseases that prevent them from caring for themselves. These patients are likely to make keeping cleanliness in patient rooms and restrooms challenging. The second category with a low HCAHPS score is patients’ perceptions that the area around their room was “Always” peaceful at night. The findings of the poll reveal a score of 47%, compared to the state average of 57% and the national average of 62%. The proximity of the nursing station to the patient rooms and the absence of defined norms for hospital quiet hours are the primary sources of nighttime noise in the institution.

Strategic Leadership Implementation Financial Stability Improvement Change in Organization

Organizational change refers to the process through which the structure, strategy, operational procedures, technology, and organizational culture are modified to meet predetermined objectives. Banner Boswell Medical Center requires improvement in the areas of cleanliness and nighttime tranquility. These two areas of patient care may be enhanced by the employment of more support personnel and the implementation of a regular strategy for maintaining hygiene, among other techniques. These improvements may assist to guarantee that patient rooms are maintained clean at all times, which can have a beneficial effect on a hospital’s HCAHPS score. Second, the institution should establish clear norms for quiet hours between 10 p.m. and 4 a.m. so that patients may obtain sufficient rest. All services at the nursing desk, except admissions, should be performed before or after quiet hours. These modifications have the potential to enhance the patient experience, resulting in higher HCAHPS ratings in the indicated areas.

Structure, Methodology, and Results

The quality enhancement techniques that will be introduced will seek to increase the cleanliness of rooms and restrooms and reduce nighttime noise. In an effort to increase cleanliness, the healthcare organization will devise a strategy to ensure that patient rooms are regularly cleaned. In addition, management will review the quantity of subordinates available to do cleaning duties, particularly at night, to ensure that all shifts are filled. Maintaining a consistent schedule of peaceful hours between 10 p.m. and 4 a.m. will be the primary goal of nighttime noise reduction. During night shifts, the nursing department will work with other healthcare experts to ensure that the policy is strictly adhered to.

The process of adopting these strategies will include establishing a quality improvement team that will collaborate with management to establish objectives and timeframes for each activity. The healthcare professionals will be informed of the new developments and the significance of QI procedures to the enhancement of HCAHPS ratings. The anticipated result is an increase in the cleanliness of patient rooms and restrooms throughout the day and night. In addition, the quiet hours policy should be observed, and the nurse managers should provide a status report on the strategy’s efficacy. The two practices should enhance the HCAHPS ratings of patients who stated that their room and bathroom were “Always” clean and patients who indicated that the area around their room was “Always” peaceful at night.

Strategic Leadership Implementation Enhancing Institutional Quality

Evidence-based practice is a method that enhances quality, safety, and patient outcomes by using healthcare’s best practices. Quiet time intervention is a method supported by scientific data that has been found to enhance patients’ sleep quality and have beneficial physiological impacts on patients (Lim, 2018). In addition, the approach creates a better work atmosphere and boosts patient satisfaction. This evidence-based technique will be used to enhance organizational quality and promote higher HCAHPS scores. Shared governance is a method that entails cooperation and responsibility in the context of resolving practice and patient care-related issues via collaborative effort. Diverse healthcare teams, including nurses, physicians, subordinate personnel, and hospital management, will be involved in the implementation of the two methods. These teams will be able to provide suggestions for the new practice shift and identify measurements they believe will assist enhance the new program.

Responsibility Sharing

Patients, healthcare professionals, and other stakeholders are collectively responsible for the enhancement of healthcare quality. During the quality improvement process at the institution, the patients will actively evaluate the new programs and provide feedback. To involve medical professionals in shared responsibility, the Chief Medical Officer will be advised on committee participation strategies. By serving in committees, members will be able to evaluate organizational performance and give comments. Working with the finance department will ensure that the HCHAPS scores are analyzed and feedback is provided in a timely manner, demonstrating payer responsibility. In addition, the department will supply clinical and claims data to improve healthcare organizations’ views on patients’ health state. Management will be requested to encourage employees’ engagement in committees and frequent input on organizational procedures and performance in order to foster shared responsibility.

Strategic Leadership Implementation Trends in Technology

Today’s healthcare service delivery is defined by the inclusion of technology to enhance the quality of patient care. The new plan will integrate the use of technology, particularly for the documenting of patients utilizing electronic health record systems. Utilizing computer systems will facilitate the early organization of activities by healthcare professionals, hence reducing nighttime paperwork. Second, findings will be communicated through the hospital’s website and patient portals, showcasing the use of technology. In addition, the facility may adopt the strategy of replacing the overhead pager system, which is a major source of noise and annoyance at night, with individualized phone communication.

Enhancing Healthcare System

By using evidence-based methods, Banner Boswell Medical Center may enhance the quality of its services. Implementing measures such as the usage of quiet hours and the development of regular cleaning programs can assure the delivery of high-quality services to patients, hence increasing their happiness. Methods such as the usage of communication whiteboards will guarantee that patients are promptly informed about their treatment and given the chance to ask questions or voice concerns. Concerning the cost of healthcare delivery, integrating communication methods will increase patient happiness, hence improving HCAHPS ratings. Increased reimbursements will result from enhanced HCAHPS ratings. Implementing and enhancing hourly nursing rounds would improve patients’ access to timely care. In addition, the organization may endeavor to improve interpretation services across all hospital departments in order to improve service accessibility. Using the communication whiteboards to facilitate conversation between patients and healthcare practitioners will enhance patient-centered care. In addition, after the adoption of the new techniques, patients and families will be able to provide feedback about the enhancement of care delivery.

Strategic Leadership Implementation Financial Stability Improvement

Improving HCAHPS ratings will be the emphasis of Banner Boswell Medical Center’s approach to increase its financial stability. Today, reimbursement is based on the HCAHPS survey’s evaluation of the quality of care provided by healthcare organizations. The most effective strategy of enhancing the hospital’s financial stability will be to prioritize patient-centered care. Improving physician communication, including patients in their treatment, and using whiteboards will increase patient-centered care. These techniques will increase quality, reduce readmission rates, and increase reimbursements to stabilize the financial situation of the organization.

Strategic Leadership Implementation Responsibility and Function of Stakeholders

The hospital management, nurses, and subordinate employees will execute the new methods. Involving every member of the healthcare team, the administration will coordinate the stages of implementation. Second, the administration will be actively engaged in the allocation of the necessary resources for the implementation of the new change. This will include allocating funds, coordinating with permanent stakeholders, and monitoring the success of implementation.

In order to provide a tranquil atmosphere for patients during night shifts, the nursing staff will be responsible for instituting quiet periods. During the implementation, nurses will serve as patient educators and advocates, react swiftly to patient needs, perform hourly rounds, and offer feedback to nurse managers. In addition, the team will analyze the plan’s progress and suggest further actions to attain the desired outcomes. In order to maintain a safe and clean environment, it will be the responsibility of the subordinate staff to keep the patient rooms and restrooms clean. The staff will evaluate the cleanliness of patient rooms and restrooms on an hourly basis and offer input to the QI team about the plan’s efficacy.

Strategic Leadership Implementation Accountability for Stakeholders

Regular communication will be utilized to actively engage the nurses, administration, and subordinate employees in order to guarantee stakeholder participation. Each week, representatives from each department will deliver their progress reports at briefing meetings organized by the team charged with enhancing quality. The administration department will maintain accountability by monitoring the execution plan, confirming deadline adherence, and disciplining those who fail to reach the established criteria.


Prior to adopting a new policy, method, or organizational strategy, it is essential to teach workers effectively in order to ensure success. In addition to HCAHPS survey questions, training should be offered for any new technologies, policies, or procedures. The new practice of assuring peaceful hours from 10 p.m. to 4 a.m. will need training for nurses. Regarding the development of a cleaning strategy, junior personnel will be instructed on how to conduct periodic evaluations of patient rooms and restrooms. In addition, training will be needed for the usage and maintenance of the new equipment that will be acquired to expedite the cleaning process.

Strategic Leadership Implementation Financial Stability Improvement Plan Implementation

Initiating the change will be the appointment of a task group to lead employees and other stakeholders through the implementation process. The implementation phase will last six months, with reviews conducted every two months. The first month will consist of allocating resources, selecting the QI team, and communicating the strategy to the stakeholders. In addition, the time will be utilized to acquire cleaning equipment and design a new policy on quiet hours and hourly room inspections by subordinate employees. Beginning in the second month, nurses will be required to adhere to a plan governing hygiene and observe quiet hours. Training of nurses and junior personnel will commence between the second and third month. In addition, throughout this time period, the nurses, patients, and other staff will be informed about the practice guidelines, implementation schedule, and assessment procedures.

After establishing a firm foundation for implementation, the third to fifth month will be utilized to assess knowledge of training, complete execution of nighttime quiet hours, and compliance with hourly cleaning rounds by subordinate employees. At this stage, input will be gathered intermittently for assessment purposes. The QI team will meet weekly to discuss progress and deliver results to administration. At the conclusion of each month, audits will be conducted to check that nurses and subordinates are adhering to the established rules. The sixth month will include rounding and getting evaluation data for the effectiveness of the intervention activities. We will summarize the success of the treatments using HCAHPS questionnaires and patient interviews.

Assessing the Success of the Strategic Plan

The effectiveness of the strategic plan will be determined based on the HCAHPS ratings for the cleanliness of the rooms and the preservation of a calm atmosphere at night. The first review will be conducted after six months, but the effectiveness of the strategy will be assessed after one year. The technique of analysis is comparing the current HCAHPS scores with the old scores on the recognized survey components.

Involvement of Stakeholders

Administration, nurses, and junior cleaning personnel will be the major stakeholders in the assessment procedure. The hospital administration will assess the performance of the strategy by analyzing the responsibility and collaboration of the process improvement team. The team will also conduct an analysis of the HCAHPS scores and disseminate the findings to the rest of the team. The nurses and subordinate cleaning personnel will be a member of the team that provides feedback on the whole procedure and any areas that may need future development.

Results Communication

Internal communication of the outcomes will be conducted through the hospital’s newspaper, direct engagement with stakeholders, emails, and memos to division heads. During daily rounds and staff meetings, there will be direct contact with patients and other members of the staff. External communication will comprise the use of the hospital’s website, local newspapers, and social media such as the organization’s Instagram and Facebook pages. In addition, patient portals will be implemented to facilitate direct connection with customers outside of the healthcare institution.


Akinleye, D. D., McNutt, L. A., Lazariu, V., & McLaughlin, C. C. (2019). Correlation between hospital economics, treatment quality, and patient safety. PloS One, 14(8), e0219124.

Banner Health. (2020). Medical center named Banner Boswell.

Kumar, S., Kumar, N., Adhish, V. S., & Reddy, R. S. (2015). Strategic management and leadership for health professionals – the ability to use resources to accomplish health objectives. Indian Journal of Community Medicine: An Official Publication of the Indian Association for Preventive and Social Medicine, 40(3), 158–162.

Lim R. (2018). A review of the research concerning the advantages of quiet time treatments in critical care units. Nursing Standard, Royal College of Nursing (United Kingdom), 1987, 32(30), 41–48.

Centers for Medicare & Medicaid Services (n.d.-a). Comparative analysis of hospitals based on patient feedback.

Centers for Medicare & Medicaid Services (n.d.-b). Comparative Patient Experience Surveys of Hospitals

Centers for Medicare & Medicaid Services (n.d.-c). Hospital compare: Survey of patients’ experiences-details.


Census Bureau, United States. (2019). Arizona – Fast Facts

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