| Course | EDN 810 The Nature of Health Care Organizations and Systems |
|---|---|
| Module | Module 5 |
| Paper type | Strategic initiative proposal |
| Length | About 1,110 words, 7 pages |
| Format | APA 7 student paper |
| School | Aspen University |
| Program | Doctor of Education |
| Updated | September 2026 |
Free sample paper for EDN 810 Module 5
Hospital Care Without the Hospital: A Value-Adding Strategic Initiative for a Regional Health System
Student Name
Doctor of Education Program, Aspen University
EDN 810: The Nature of Health Care Organizations and Systems
Instructor Name
Month Day, Year
Hospital Care Without the Hospital: A Value-Adding Strategic Initiative for a Regional Health System
A strategic initiative should create value that patients, payers and the organization can see. This paper proposes a hospital-at-home program for a composite regional health system whose hospitals run above 95% occupancy most weekdays, forcing patients to wait in emergency departments for beds and leaving older patients exposed to hospital-acquired complications.
The Problem
High occupancy causes boarding in emergency departments, delays surgery and strains staff. For older adults, hospital stays bring risks of delirium, falls, infections and loss of function. Many patients admitted for conditions such as heart failure, pneumonia or cellulitis need hospital-level monitoring and treatment but not the hospital building itself.
The Evidence
Levine et al. (2020) randomized acutely ill adults to home or hospital care; the home group cost about 38% less after adjustment, needed fewer tests, scans and consults, moved more and returned to the hospital less often within 30 days. The trial supports home hospital care as a way to improve value without compromising safety for selected patients.
Value as the Aim
Porter's notion of value, the health results patients care about divided by the cost of achieving them, is the right measure for the initiative (Porter, 2010). Hospital at home aims to maintain or improve outcomes such as recovery and function while lowering costs, and to free hospital beds for patients who need them.
Goals and Measures
The table sets out the initiative's goals, measures, targets and owners.
| Goal | Measure | Target in year two | Owner |
|---|---|---|---|
| Free hospital capacity | Bed days avoided | 4,400 per year | Chief operating officer |
| Maintain safety | Escalations back to hospital; adverse events | Escalations under 8% | Chief medical officer |
| Improve patient experience | Patient experience scores | Top quartile | Chief nurse executive |
| Reduce cost | Cost per episode versus inpatient | At least 25% lower | Chief financial officer |
| Support staff well-being | Staff engagement in the program | Above system average | Program director |
Eligibility and Clinical Model
Eligible patients are adults in the emergency department or early in a hospital stay with selected conditions, stable enough for home care, living within 30 minutes of a hub and with a safe home environment. Care includes daily physician or advanced practice visits, twice-daily nurse visits, remote monitoring, intravenous medications, mobile imaging and laboratory services and a 24-hour response line.
The Nursing Role
Nurses are central to the model: they assess patients at home, administer treatments, teach families, monitor for deterioration and coordinate with physicians and community services. The program will recruit experienced acute care nurses and train them in home assessment, remote monitoring and independent judgment.
The Financial Case
At an average daily census of 12 patients, the program would avoid about 4,400 bed days a year, allowing the system to admit more surgical and complex patients without building new beds. Start-up costs of $3.2 million cover staff, monitoring technology, vehicles and training. Payment comes from a federal waiver for acute hospital care at home, commercial contracts and savings from avoided capacity costs.
Fit With the Quadruple Aim
The initiative addresses all four aims: better experience for patients at home, better outcomes through fewer hospital complications, lower cost per episode and a new model of practice that many nurses and physicians find rewarding (Bodenheimer & Sinsky, 2014).
Risks
Risks include clinical deterioration at home, staffing shortages, technology failures, reimbursement uncertainty and inequity if patients without stable housing or caregivers are excluded. Mitigations include clear escalation protocols, a dedicated staffing pool, backup communication, diversified payment and social work support to widen eligibility.
Implementation Phases
Phase one, in months one to six, builds the team, protocols and technology and begins with two conditions at one hospital. Phase two expands to all three hospitals and six conditions. Phase three adds direct admission from clinics. Each phase ends with a review of safety, experience and cost before expansion. Expansion will pause if escalations exceed the target for two consecutive months.
Evaluation
Evaluation will compare outcomes and costs for home hospital patients with similar inpatients, track escalations and adverse events and gather patient and staff experience. Every quarter, leaders and the board will see the numbers. An independent analyst will review the first year's results before full expansion.
Equity in Eligibility
Hospital-at-home programs often exclude patients without stable housing, caregivers or reliable utilities, which could widen disparities. The program will include social work assessment, temporary caregiver support and help with utilities so that eligibility depends on clinical and safety criteria rather than wealth.
Stakeholder Support
The initiative needs support from emergency physicians, hospitalists, nurses, finance, information technology, insurers and patients. Early meetings with each group will explain the evidence, hear concerns and adjust the design. A patient and family advisor will join the design team.
Technology Requirements
The program requires remote monitoring devices, secure video, integration with the electronic health record and reliable connectivity. Backup communication, such as cellular hotspots and phone lines, will be provided for patients with poor internet access.
Regulatory and Payment Considerations
The program must meet federal waiver requirements for acute hospital care at home, including in-person visits, monitoring and response times. Commercial contracts will be negotiated separately. Because payment rules may change, the business case includes a scenario in which federal payment ends and the program must rely on capacity savings and commercial contracts.
Communicating the Initiative
Communication will emphasize patient benefits and safety, presenting the program as an option for suitable patients rather than a way to empty beds. Stories from early patients and families will help staff and the community understand the model.
Alternatives Considered
The system also considered building a new patient tower and expanding observation units. A tower would cost far more and take years; observation units would add limited capacity. Hospital at home offered faster, cheaper capacity with potential quality benefits, making it the preferred option.
Governance of the Initiative
A steering committee of clinical, operational and financial leaders will oversee the program, approve expansion between phases and review safety events. A patient and family advisor will sit on the committee. Clear governance ensures that decisions balance growth with safety and that problems reach leaders quickly.
Workforce Impact
The program creates new roles for experienced nurses, paramedics and advanced practice clinicians, offering career paths that may help retention. It also requires careful scheduling so that recruiting for the program does not drain inpatient units already short of staff.
Conclusion
Hospital at home offers the composite system a value-adding strategic initiative: freeing capacity, reducing complications and costs and improving experience for selected patients. Built on trial evidence, measured against clear targets and implemented in phases with attention to safety, equity and staff, it aligns the organization's interests with those of its patients.
References
Bodenheimer, T., & Sinsky, C. (2014). From triple to quadruple aim: Care of the patient requires care of the provider. Annals of Family Medicine, 12(6), 573-576. https://doi.org/10.1370/afm.1713
Levine, D. M., Ouchi, K., Blanchfield, B., Saenz, A., Burke, K., Paz, M., Diamond, K., Pu, C. T., & Schnipper, J. L. (2020). Hospital-level care at home for acutely ill adults: A randomized controlled trial. Annals of Internal Medicine, 172(2), 77-85. https://doi.org/10.7326/M19-0600
Porter, M. E. (2010). What is value in health care? New England Journal of Medicine, 363(26), 2477-2481. https://doi.org/10.1056/NEJMp1011024
What the EDN 810 Module 5 instructions ask for
Creating strategic initiatives that add value is one of the outcomes in Aspen's catalog description of EDN 810, and because the Module 5 prompt stays with enrolled students, this example proposes one initiative in full. A proposal of this kind usually needs six parts: the problem stated in patient and operational terms, evidence that the initiative works elsewhere, measurable goals with owners, a financial case, the main risks with mitigations and a phased plan for implementation. Say plainly what value means here, for patients and for the budget, since a doctoral reader will test the proposal against that definition. Compare your initiative with at least one alternative so the choice looks reasoned rather than assumed. Include equity in eligibility, the effect on staff and a rule that would pause or stop the program if results fall short.
Inside the EDN 810 Module 5 example
The proposal is a hospital-at-home program for a composite regional health system whose hospitals run above 95% occupancy most weekdays, leaving patients waiting in emergency departments for beds. It opens with that problem, then summarizes the randomized trial by Levine and colleagues, in which home hospital care cost about 38% less after adjustment and patients returned to the hospital less often within 30 days. Value is defined through Porter, and a four-column table sets goals, measures, year-two targets and owners, including 4,400 hospital bed days avoided. Later sections describe eligibility, the clinical model, the nursing role and a $3.2 million start-up budget, then test the plan against the quadruple aim. The second half weighs risks, phases, evaluation, equity, stakeholders, technology, regulation and payment, and compares the program with a new patient tower and expanded observation units.
Reading the EDN 810 Module 5 grading rubric
Initiative proposals are graded on a clear problem, strong evidence, measurable goals, a credible business case, attention to risk and a realistic plan. The APA reference list is short but primary: the Levine randomized trial in the Annals of Internal Medicine, Porter's definition of value and Bodenheimer and Sinsky on the fourth aim. The goals table is the backbone, since each later section explains how one goal will be reached or measured, and the bed-day arithmetic stays consistent from the table to the financial case. Instructors reward foresight, so the paper plans for payment beyond the federal waiver for acute hospital care at home. Comparing the program with a new tower and with observation units shows the choice was made against alternatives. Named mitigations for each risk and a governance plan complete the case.
Common EDN 810 Module 5 mistakes, and how to avoid them
The weakest initiative proposals are chosen because they sound innovative, and then the numbers never appear. Others describe a program without asking who will staff it, which is where many hospital-at-home plans actually struggle. Anchor your proposal in trial evidence or a strong evaluation, not a vendor case study. Show start-up and ongoing costs separately and walk the reader through your savings arithmetic in plain steps. Name the first two conditions you would admit, the decision point at the end of phase one and the safety result that would pause enrollment. Ask a finance colleague to check your estimates before you submit, because a doctoral reader will. If the business case feels daunting, a tutor can help you estimate costs and savings from public data and your organization's own volumes.
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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EDN 810 Module 5 questions, answered
What does EDN 810 Module 5 usually ask for?
Aspen's EDN 810 covers creating strategic initiatives that add value, so a proposal for such an initiative is typical. Confirm with your classroom prompt.
What is hospital at home?
Hospital-level care, including monitoring and treatment, delivered in a patient's home for selected acute conditions.
What did the randomized trial of home hospital care find?
Lower costs, fewer tests and consultations, more activity and fewer readmissions compared with usual hospital care.
Where can I find a free EDN 810 Module 5 sample paper?
The hospital-at-home proposal is shown above, with a table of goals, measures, targets and owners.
What makes a strategic initiative add value in EDN 810 Module 5?
It improves results patients value set against what they cost, with evidence, measurable targets and a sound business case.