| Course | NU708 Advanced Systems Leadership: Transforming the Health Care Organization |
|---|---|
| Unit | Unit 7 |
| Paper type | Stakeholder analysis |
| Length | About 1,180 words, 7 pages double-spaced |
| Format | APA 7 student paper |
| School | Purdue University Global |
| Program | Doctor of Nursing Practice (DNP) |
| Updated | October 2026 |
Free sample paper for NU708 Unit 7
Who Can Stop It, Who Wants It, Who Needs It Now: A Unit 7 Stakeholder Analysis for Spreading an Insulin Discharge Bundle
[Student Name]
Purdue University Global
NU708: Advanced Systems Leadership: Transforming the Health Care Organization
Unit 7 Stakeholder Analysis
[Instructor Name]
[Date]
The hospital, its people and their positions are composite and illustrative; the frameworks cited are real.
Why a Stakeholder Analysis Now
The Unit 6 business case recommended phased approval, which means the bundle's spread will be decided not once but several times, at the finance committee, the bed meeting, the pharmacy and therapeutics committee and on each unit. Bryson (2004) argues that attention to stakeholders is most useful early in a change, when it can still shape the design, and that the analysis should include those with power to block as well as those who will be affected. A plan built only for supporters tends to meet its opponents for the first time at the meeting that decides it.
Two Frameworks
The power-interest grid, described by Bryson (2004) among several stakeholder techniques, asks two things of every group: whether it can shape or stop the change, and how closely it is watching. High-power, high-interest groups are key players to manage closely; high-power, low-interest groups must be kept satisfied; low-power, high-interest groups should be kept informed and often become allies; low-power, low-interest groups need monitoring.
Mitchell et al. (1997) add a sharper test. Their test, put in this hospital's terms, asks of each group whether it can force the bundle's fate at a meeting, whether its stake in insulin discharges would strike a fair observer as rightful, and whether its need is pressing this quarter. Groups that answer yes three times are labeled definitive by Mitchell and colleagues, and the engagement plan starts with them. The second framework helps here because some groups with little formal power, patients most of all, have strong legitimate and urgent claims.
The Stakeholders
Chief nursing officer. High power and high interest. Sponsored the pilot and has staked some credibility on it. Interest: a visible quality win and a practice model nurses value.
Chief financial officer. High power, moderate interest. Will approve or defer the second educator. Interest: a return that holds under cautious assumptions and costs that do not grow quietly.
Hospitalist group. High power over discharge timing, moderate interest. Interest: predictable length of stay, few delays and no new tasks.
Bed management and the emergency department. High power at the daily bed meeting, low interest in the bundle itself. Interest: beds by midafternoon.
Pharmacy. Moderate to high power, since dispensing timing is its decision; moderate interest. Interest: workflow that does not add steps without staff, and safe handling of pens.
Unit managers on the eight new units. Moderate power on their units, variable interest. Interest: staffing that allows demonstrations without overtime.
Staff nurses. Low formal power, high interest. On the pilot units they were the bundle's strongest advocates. Interest: time to teach and fewer distressing discharges.
Diabetes educator. Low formal power, very high interest, and at risk of overload.
Information technology and the electronic record team. Moderate power, low interest. Interest: a build that fits the queue.
Patients and families, through the patient and family advisory council. Low formal power, high interest, highest legitimacy and urgency.
The group with no formal power, patients starting insulin, holds the strongest legitimate and urgent claim, and the bundle exists for them.
Salience and Priorities
Under the salience test of Mitchell et al. (1997), the chief nursing officer is definitive: power, legitimacy and urgency all present. The chief financial officer and the hospitalist group are dominant, with power and legitimacy but low urgency about this change. Bed management is a dangerous stakeholder in Mitchell's sense, with power and urgency about beds but a weaker legitimate claim on how discharges are taught. Patients and families are dependent stakeholders, with legitimacy and urgency but no power, and they rely on others, in this case nurses and the advisory council, to advocate for them.
The practical priority order is therefore: secure the chief nursing officer's formal decisions, satisfy the chief financial officer and the hospitalists, neutralize the bed meeting's resistance with data and give patients' voices a formal channel.
The Two Groups Most Likely to Resist
The hospitalist group's position is that discharge orders should be written when a patient is medically ready, without waiting for teaching. Behind it are interests that the bundle can serve: hospitalists are measured on length of stay, they dislike unpredictable holds and they have seen discharge initiatives add work without benefit. Their wariness has a basis: at one academic center, discharges before noon were associated with slightly longer stays, possibly because patients were held overnight to meet the target (Rajkomar et al., 2016). A readiness rule that is predictable, triggered by a defined flag on the day insulin starts, serves those interests better than ad hoc holds.
Bed management's position is that any delay costs a bed. Its interest is the number of boarding patients in the emergency department. The business case's capacity estimate, about 3.4 bed-days freed per avoided return, translates the bundle into bed management's own terms.
Engagement Plan
1. Chief nursing officer: monthly briefing; request two formal decisions, protected champion time and a readiness rule the bed meeting must honor.
2. Chief financial officer: a one-page summary of the business case with the break-even point and the phased approval; quarterly updates on returns avoided.
3. Hospitalist group: present at their monthly meeting with a hospitalist co-lead; propose the readiness flag on the day insulin starts so holds are rare and predictable.
4. Bed management: add a monthly line to the bed meeting report showing returns among patients on new insulin and bed-days lost to them.
5. Pharmacy: a joint workflow test of early pen dispensing on one unit before any policy change.
6. Unit managers: a two-hour assignment adjustment on demonstration days, modeled on 5 West.
7. Staff nurses: the champion network, with local adaptations shared monthly.
8. Diabetes educator: a defined caseload limit until the second position is filled.
9. Information technology: submit the build request with the chief nursing officer's sponsorship to move it up the queue.
10. Patients and families: present the bundle and its teaching materials to the advisory council, and ask two members to join the steering group.
Monitoring
The analysis will be revisited at each phase of approval. Signs that it needs revision include a stakeholder moving on the grid, such as hospitalists becoming more interested after the readiness flag goes live, or new stakeholders appearing, such as a payer interested in the results.
Conclusion
The bundle's spread depends on groups with very different stakes. The chief nursing officer holds every attribute of salience and must make two formal decisions. The hospitalists and bed management can block the change, but their interests in predictable stays and available beds can be served by the bundle if it is framed in their terms. Patients have the strongest claim and no power, so the plan gives them a formal place in the decisions.
References
Bryson, J. M. (2004). What to do when stakeholders matter: Stakeholder identification and analysis techniques. Public Management Review, 6(1), 21-53. https://doi.org/10.1080/14719030410001675722
Mitchell, R. K., Agle, B. R., & Wood, D. J. (1997). Toward a theory of stakeholder identification and salience: Defining the principle of who and what really counts. Academy of Management Review, 22(4), 853-886. https://doi.org/10.2307/259247
Rajkomar, A., Valencia, V., Novelero, M., Mourad, M., & Auerbach, A. (2016). The association between discharge before noon and length of stay in medical and surgical patients. Journal of Hospital Medicine, 11(12), 859-861. https://doi.org/10.1002/jhm.2529
What the NU708 Unit 7 assignment asks for
Unit 7 asks students to identify everyone with a stake in their change and decide how to engage each group. Prompts usually call for a list of stakeholders with their interests, an assessment of power and influence, a tool such as a power-interest grid, attention to likely resistance and a specific engagement plan. Instructors expect groups to be named precisely, by role or department, and their interests to be stated from those groups' own point of view. Patients and families should appear even when they hold little formal power. Many sections reward a second framework, such as salience, used to set priorities. The analysis should be tied to the decisions ahead, the meetings and committees where the change will be approved or blocked, so the plan says who must be engaged before which decision.
Inside the NU708 Unit 7 example
The analysis explains why stakeholders matter now: the phased approval means several decisions in several rooms. Bryson's grid and the salience test are introduced in the change's own terms. Ten groups follow in bold-headed paragraphs, each with power, interest and what it wants, ending with patients and families under a highlighted line about their claim, with a margin note on why the second framework was added. The salience section labels each key group and sets the priority order. The two groups most likely to resist, hospitalists and bed management, are examined position by interest, with Rajkomar's study behind the hospitalists' caution and a second note on separating positions from interests. A numbered engagement plan gives one action per group, and a monitoring section names what would prompt revision.
NU708 Unit 7 rubric: what earns full points
Most points in a stakeholder analysis go to the depth of the stakeholder descriptions: groups named precisely, interests stated as the group would state them and power assessed realistically. Correct use of the chosen tool is scored next, so a grid placement should be explained. Graders reward attention to resistance and to groups with little formal power. The engagement plan is often the largest single criterion and earns most when each action is specific, assigned and timed to a decision. A second framework used to set priorities adds credit. Monitoring or revision triggers show that the analysis will be used. Clarity, scholarly support for the frameworks and APA 7 complete the rubric, and plans that offer resistant groups something they value tend to score above plans that only inform them.
NU708 Unit 7 help: mistakes that cost points
Stakeholder analyses most often lose credit by listing groups without saying what each wants or can do. Another frequent problem is treating every group as either a supporter or an obstacle, with no attention to interests that might be served. Some papers leave out patients because they have no vote, or leave out information technology because it seems technical, and both omissions weaken the plan. Engagement plans that say "communicate regularly" for every group earn little. Writers also lose points for grids with no explanation of placement. Start by listing every meeting where your change will be decided and who sits in each room, then work backward to the groups that influence them. A custom stakeholder analysis can map the groups around the change you are leading.
Get an NU708 Unit 7 example written to your instructions
Send the change, the groups involved and the analysis instructions with the rubric. A custom analysis maps each stakeholder's interest and influence and plans how to engage them. Delivery is within 24-48h, and a first analysis is free. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
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NU708 Unit 7 questions, answered
What is a power-interest grid?
A tool that places stakeholders by how much power they have over a change and how much interest they have in it, guiding how closely to engage each.
Should resistant stakeholders be included?
Yes. Understanding why a group resists is often the most useful part of the analysis.
Does a stakeholder analysis need an engagement plan?
Usually, with a specific approach for each key group.
Where can I find a free NU708 Unit 7 sample paper?
This page contains a complete NU708 Unit 7 stakeholder analysis for spreading an insulin discharge bundle, with ten groups, a power-interest grid, a salience test, the interests behind resistance and a ten-part engagement plan.
Why does the NU708 Unit 7 sample call bed management a dangerous stakeholder?
In the salience framework, a dangerous stakeholder has power and urgency but a weaker legitimate claim. Bed management controls discharge pressure daily and needs beds urgently, but its claim over how discharges are taught is limited.