| Course | DNP 835 Strategic Leadership and Business Management |
|---|---|
| Module | Module 5 |
| Paper type | Business case with return on investment |
| Length | About 1,019 words, 6 pages |
| Format | APA 7 student paper |
| School | Aspen University |
| Program | DNP |
| Updated | September 2026 |
Free sample paper for DNP 835 Module 5
Does It Pay? A Business Case With Return on Investment for Bringing the Acute Care for Elders Model to 5 West
Student Name
Doctor of Nursing Practice Program, Aspen University
DNP 835: Strategic Leadership and Business Management
Instructor Name
Month Day, Year
Does It Pay? A Business Case With Return on Investment for Bringing the Acute Care for Elders Model to 5 West
Nurse leaders are increasingly asked to justify clinical initiatives in financial terms. A business case does not replace clinical and ethical reasons for a change, but it shows executives what the organization will spend, what it can expect in return and how confident those estimates are. This paper presents the business case for adopting the acute care for elders model on 5 West, a 30-bed medical unit at a composite community hospital, including costs, quantified and unquantified benefits, return on investment, sensitivity analysis and a recommendation.
The Opportunity
5 West admits about 1,400 patients aged 70 and older each year. Their average length of stay is 5.2 days, 12 experienced a fall with injury last year, 31% leave for a skilled nursing facility rather than home, and the unit's delirium screening suggests that about one in five develops delirium during the stay. Pooled evidence from geriatric units built on the model reports falls roughly halved, delirium reduced, stays about 0.61 days shorter, lower costs and more patients going home rather than to nursing homes (Fox et al., 2012), and a community hospital trial showed that the model improved care processes and satisfaction without raising length of stay or cost (Counsell et al., 2000).
Costs
First-year costs total $142,000: $68,000 for a half-time geriatric clinical nurse specialist including benefits; $31,000 for pharmacist time for medication review; $18,000 for environmental changes such as handrails, lighting and chairs; $15,000 for staff education time; and $10,000 for project management and data analysis. Ongoing annual costs after the first year are estimated at $105,000, since environmental and most training costs are one-time.
The finance department reviewed each figure, and salary costs use the hospital's current rates with benefits, so executives can trace every number to its source. No capital purchase requiring depreciation is included, which keeps the analysis simple. Costs are shown for the first year separately from later years because executives weigh the initial outlay differently from the recurring commitment.
Quantified Benefits
The business case quantifies two benefits conservatively. First, length of stay: the analysis assumes a reduction of 0.3 days per patient, about half the meta-analytic estimate, because 5 West will adopt the model's elements without becoming a separate geriatric unit. For 1,400 patients, that frees 420 bed-days. Valued at the hospital's variable cost of $450 per bed-day, rather than its much higher average cost, the saving is $189,000. Because the hospital often runs near capacity, freed bed-days also allow additional admissions, which the case notes but does not count. Second, falls with injury: a 25% reduction would prevent 3 of the unit's 12 injurious falls. Serious fall-related injuries add substantial costs and hospital days (Wong et al., 2011); using the hospital's own finance estimate of $14,000 in added cost per injurious fall, the saving is $42,000.
Total quantified first-year benefits are therefore about $231,000.
| Item | Assumption | First-year value |
|---|---|---|
| Shorter stays | 0.3 days x 1,400 patients x $450 variable cost per day | $189,000 |
| Fewer injurious falls | 3 fewer x $14,000 added cost | $42,000 |
| Total quantified benefit | $231,000 | |
| Total cost | $142,000 | |
| Net benefit | $89,000 |
Return on Investment and Sensitivity
Return on investment is the net benefit divided by the cost: $89,000 divided by $142,000, or about 63% in the first year, rising in later years because ongoing costs are lower. The estimate is sensitive to the length-of-stay assumption. If the reduction were only 0.15 days, the length-of-stay saving would fall to $94,500, total benefits to $136,500, and the first-year return would be slightly negative, about minus 4%, though still positive in the second year. If the reduction matched the meta-analytic 0.61 days, the return would be about 200%. Presenting the range lets executives see that the investment carries modest financial risk and substantial upside.
Unquantified Benefits
Several benefits are not counted. Delirium is costly: one analysis estimated total costs attributable to delirium of $16,303 to $64,421 per patient over the following year (Leslie et al., 2008), although much of that cost falls on payers and other providers rather than the hospital. Fewer discharges to skilled nursing facilities benefit patients and payers and may matter to the hospital under value-based contracts. Better patient and family experience, lower nurse turnover associated with more satisfying work, and preparedness for age-friendly health system recognition also add value that is real but hard to price.
Leaving these out keeps the case conservative; including even a small share of them would raise the expected return considerably.
Risks to the Return
Several risks could reduce the return. If staffing shortages prevent nurses from carrying out mobility and toileting protocols consistently, the clinical benefits and the length-of-stay effect will shrink. If hospitalists do not attend interdisciplinary rounds, discharge planning will not start earlier. And if bed management places many younger patients on 5 West during busy periods, fewer older patients will benefit. The project plan addresses each risk, with protocol audits, a rounds attendance measure reported to the hospitalist group and a bed priority rule, and the 12-month review will report whether they occurred. Executives should also know that the savings from shorter stays appear as capacity rather than cash unless the freed beds are used for additional admissions or allow reductions in temporary staffing.
Recommendation
The recommendation is to approve the project with the first-year budget of $142,000, with a formal review at 12 months comparing actual length of stay, injurious falls and discharges to skilled nursing facilities against the business case. The financial return is likely positive under conservative assumptions, and the clinical benefits for older patients are supported by evidence regardless of the financial result.
Conclusion
A business case for the acute care for elders model on 5 West shows first-year costs of $142,000 against conservatively quantified benefits of about $231,000, a return of about 63%, with sensitivity analysis showing modest downside risk and substantial upside. Stating assumptions openly, valuing benefits at variable cost and presenting a range allow executives to make an informed decision, while the unquantified benefits for patients remain the reason the project matters.
References
Counsell, S. R., Holder, C. M., Liebenauer, L. L., Palmer, R. M., Fortinsky, R. H., Kresevic, D. M., Quinn, L. M., Allen, K. R., Covinsky, K. E., & Landefeld, C. S. (2000). Effects of a multicomponent intervention on functional outcomes and process of care in hospitalized older patients: A randomized controlled trial of Acute Care for Elders (ACE) in a community hospital. Journal of the American Geriatrics Society, 48(12), 1572-1581. https://doi.org/10.1111/j.1532-5415.2000.tb03866.x
Fox, M. T., Persaud, M., Maimets, I., O'Brien, K., Brooks, D., Tregunno, D., & Schraa, E. (2012). Effectiveness of acute geriatric unit care using acute care for elders components: A systematic review and meta-analysis. Journal of the American Geriatrics Society, 60(12), 2237-2245. https://doi.org/10.1111/jgs.12028
Leslie, D. L., Marcantonio, E. R., Zhang, Y., Leo-Summers, L., & Inouye, S. K. (2008). One-year health care costs associated with delirium in the elderly population. Archives of Internal Medicine, 168(1), 27-32. https://doi.org/10.1001/archinternmed.2007.4
Wong, C. A., Recktenwald, A. J., Jones, M. L., Waterman, B. M., Bollini, M. L., & Dunagan, W. C. (2011). The cost of serious fall-related injuries at three Midwestern hospitals. The Joint Commission Journal on Quality and Patient Safety, 37(2), 81-87. https://doi.org/10.1016/S1553-7250(11)37010-9
Reading the DNP 835 Module 5 assignment instructions
Aspen does not publish the DNP 835 Module 5 prompt outside the classroom, so the example stands on the catalog's short description of the course. A business case paper usually asks you to estimate costs and benefits of a project, calculate a return on investment, test your assumptions and make a recommendation. Your prompt may require a specific format, such as a table of costs and benefits, a break-even point or net present value. Some instructors supply cost figures; others ask you to find them. Check the length and sources, and state every assumption in the paper so the grader can follow your math. Putting the assumptions in a short table before the calculation is a simple way to do that.
Inside the DNP 835 Module 5 example
The example is about 1,020 words under eight headings. The opportunity section links the model's evidence to local volumes. Costs lists first-year expenses by category. Quantified benefits estimates savings from shorter stays and fewer injurious falls, using variable cost per bed-day. Return on investment and sensitivity calculates the return and shows how it changes when key assumptions move. Unquantified benefits names value the paper chose not to count, such as delirium prevention. Risks to the return lists what could reduce savings. The recommendation states what leaders should approve and on what conditions. The conclusion restates the numbers and the clinical purpose behind them.
Where the marks sit in the DNP 835 Module 5 rubric
The rubric for a business case will reward accurate calculations, transparent assumptions and a sound recommendation. This example earns calculation points with a clear return formula and figures a reader can check, and the margin notes explain why conservative, variable-cost assumptions make the case credible to finance leaders. The sensitivity analysis shows analytic maturity, which graders often score under critical thinking. Separating quantified and unquantified benefits shows honesty about what the numbers capture, which is exactly what a skeptical chief financial officer would test first. The recommendation meets the decision criterion. Organization follows the structure finance teams expect. Format credit depends on citing the evidence for each benefit and on consistent number formatting.
DNP 835 Module 5 help: mistakes that cost marks
The most common mistake is using average cost per day to value shorter stays, which overstates savings because most hospital costs are fixed in the short term. Use variable cost. Students also count every possible benefit in dollars, which makes the case look inflated. Be conservative and list the rest separately. Another frequent gap is the sensitivity analysis; a single return figure hides how uncertain it is. Show a range. Papers also skip risks, such as lower volumes or partial adoption. Name them. Finally, keep the clinical purpose visible. A business case in a nursing program should show that the project is good for patients as well as for the budget.
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 Aspen University 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.
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DNP 835 Module 5 questions, answered
What does DNP 835 Module 5 usually ask for?
Aspen's DNP 835 description includes business management for health care projects, so a business case with return on investment for a nursing initiative is a typical assignment. Check your classroom for the prompt.
Why use variable cost rather than average cost for bed-days?
Because shortening a stay saves mainly the variable costs of care, such as supplies and some staff time, not fixed costs like buildings. Using average cost overstates savings.
What is a sensitivity analysis?
Recalculating the result under different assumptions, such as smaller or larger effects, to show how much the conclusion depends on uncertain inputs.
Where can I find a free DNP 835 Module 5 sample paper?
The complete business case with return on investment for an acute care for elders unit is printed on this page with notes on each section, and reading it is free. If you need a business case for a different project, request one through the form.
How do I calculate return on investment for DNP 835 Module 5?
Subtract total costs from total quantified benefits, divide by costs and express the result as a percentage. State every assumption behind the benefits, value bed-days at variable cost and test the result with a sensitivity analysis, as this example does.