SCIENTIFIC MERIT ACTION RESEARCH TEMPLATE (SMART) FORMa..docx

SCIENTIFIC MERIT ACTION RESEARCH TEMPLATE
(SMART) FORM
a.k.a. “Research Plan”
School of Public Service LeadershipScientific Merit Process
Learners who are doing action research for their dissertation
will use this form to go through the process of scientific merit
review. The goals of this process are: (1) to facilitate the
planning of the details of your action research project, (2) to
ensure that the proposed project has rigor and allows for
scientific merit review, and (3) to facilitate your progress
through the dissertation. This is not an addition to your
dissertation but rather a step to assist you in obtaining mentor,
committee, school, and IRB approval more efficiently. You
must obtain mentor, committee, and school approval of your
Research Plan before submitting your IRB application.
Scientific Merit Criteria
The following criteria will be used to establish scientific merit.
The purpose of the review will determine if the proposed
project:
1. Contributes to society by improving a practice
2. Documents need for change by utilizing evidence-based
needs assessment
3. Meets certain “Hallmarks” of a good action research project
including:
a. Action research design
i. Practical
ii. Participatory
iii. Defined Action PlanScientific Merit ApprovalYour
completed SMART form will be approved, not approved, or

deferred for major or minor revisions. Your committee will use
a checklist to determine if the study meets the criteria for
scientific merit and the committee will provide specific
feedback designed to identify any issues that need to be
resolved related to the scientific merit. You will have up to
three opportunities to submit this form for committee approval.
Obtaining scientific merit approval does not guarantee you will
obtain IRB approval. The IRB review will focus on ethical
issues. A detailed ethical review will be conducted during the
process of IRB approval.Recommendations for How to Use This
FormThe SMART form is intended to help you and your mentor
plan the design and details of your dissertation. Once your
mentor approves your SMART form, your entire committee will
review the form for scientific merit. When the entire committee
approves your SMART form, then it will be submitted for
school approval. It is recommended that you use this form in a
step-by-step way to help plan your design. Expect that you will
go through a few revisions before your mentor and committee
approve this form.
Tips for filling out the SMART form:
· Prepare your answers in a separate Word document, as editing
and revising will be easier.
· Copy/paste items into the right-hand fields when they are
ready.
· Don’t delete the descriptions in the left column!
· Don’t lock the form, as that will stop you from editing and
revising within the form.
· Leave no blank spaces in the form. If an item does not apply
to your study, type “NA” in its field.

· Read the item descriptions carefully. Items request very
specific information. Be sure you understand what is asked
(Good practice for your IRB application!).
· Use primary sources to the greatest extent possible as
references. Textbooks (Patton, Leedy and Ormrod, etc.) are not
acceptable as the only references supporting methodological and
design choices. Use them to track down the primary sources.
Upcoming Milestone Steps:
Milestone Group 1
Milestone 1: Learner Completed CITI Modules
Milestone 2: Committee approved topic (Sections 1 & 2 of
SMART form)
Milestone 3: Mentor Approved Research Plan (complete
SMART form)
Milestone Group 2
Milestone 4: Committee Approved Research Plan
Milestone 5: School Approved Research Plan
Milestone 6: University Approved IRB
Milestone 7: Committee Conference Call
Section #1
To be completed by Learner1.1 Learner Name
Aslie Burnett1.2 Learner Program

Doctor of Health Admin: Health Care Leadership1.3 Learner
Email
[email protected]1.4 Learner Phone
(832)651-42101.5 Mentor Name/Email
Dr. Heather Alonge / [email protected]
1.6 Committee Member #1 Name/Email
Dr. Tyler Zerwekh1.7 Committee Member #2 Name/Email
Dr. Nita Stika1.8 Dissertation Title
Leadership effectiveness in Healthcare Human Resource and
Patient Management 1.9 Site Selected
Hospital Corporation of America (HCA) -pending1.10 Contact
Info for Site Approver & Expected Approval Date
(Pending )
Section #2
To be completed by Learner
2.1 Project
Write approximately one paragraph that describes the action
research project and the basis for it being addressed.
2.2 Contribution to Society
Using citations, answer the following questions in order:
1. How does your project improve a current practice?
2. If your action research project is successful, how could your
project impact your field of interest?
3. What are the practical implications of your project? For
example, what will be the impact of this project on your sample,
your site location, or your workplace?
2.3 Need and Evidence to Make Change
Provide current information on your needs assessment or
analysis for change. Include the cost-benefit analysis if

indicated by design.
2.4 Theoretical Foundation
Describe the theory or theories that serve as the backbone of
your project. Provide references for each theory.
2.5 Researcher Positionality:
· Insider
· Insider w/collaboration
· Reciprocal collaboration
· Outsider, collaboration w/ insiders
Define your role, position, and how positionality will impact
your research study.
2.6 Research Questions and Project Goals/Objectives
List the research questions or project goals. These should align
with the need for organizational structure or activities/outcomes
of the project.
Section #3
To be completed by Learner
3.1 Action Plan
Provide detailed steps to implementing your research plan. This
should read like a recipe for conducting your project.
Be sure to include all the necessary details so that someone else
would be able to follow this and replicate the project exactly.

3.2 Results
Describe your program evaluation and dissemination of results
plan.
3.3. Measures and Instruments
List and describe each data collection instrument or
measurement tool you will use. This includes questionnaires,
formal interview protocols, forms, etc. Include:
a. Data type(s) generated by each measure
b. Available psychometric information (including validity and
reliability coefficients)
c. How this data will be used
Attach a copy of each instrument you plan to use as an appendix
to your SMART form.
3.4 If Modifying an Instrument:
Describe any pilot test or field test that may be required for any
instruments. Type NA if not applicable. Field tests must be
done:
a. For new instruments or questions developed by the learner.
b. With expert panelists. Field tests require no IRB review. A
pilot test requires IRB review.
3.5 Assumptions
Identify the key assumptions of the project; use citations to
support their adoption.
3.6 Limitations
Evaluate the weaknesses of your project at this time. Indicate

areas to be improved before starting your project and areas that
cannot be improved. Give reasons for not redesigning to address
any of the limitations identified.
3.7 Population and Sampling
Describe the key stakeholders or population of your project.
Briefly describe the characteristics of this sample, including:
a. Demographics
b. Inclusion criteria, if any
c. Exclusion criteria, if any
Describe how you plan to select the sample. Include the steps
you will take to include participants.
3.8 Sample Size
What is the expected sample size? Provide citations to support
the sample size decision.
3.9 Expected Site
Describe the organization or site(s) from which you expect to
draw your sample.
3.10 Site Permission
Who is authorized to provide permission to use this
organization or site? Does the site have an IRB? What do you
need to do to obtain permission to access the stakeholders,
population, or data source?

3.11 Participant Contact
How will potential participants first be contacted? How will
participants be contacted following the study?
3.12 Data Analysis
Describe analysis procedures for each data type including:
audiotapes, transcripts, videotape, field notes, photos,
descriptive analysis, other quantitative analysis, etc.
Describe all methods and procedures for data analysis
including:
a. Types of data to be analyzed
b. Organization of raw data
c. Management and processing of data
d. Preparation of data for analysis
e. Storage and protection of data
3.13 Ethical Considerations
Describe any ethical considerations given the sample population
and/or topic. Please explain as fully as possible.
Describe any ethical concerns about defined researcher
positionality. Address any potential for coercion.
3.14 Risk Assessment
Is your study more than minimal risk? Refer to your CITI
course for more information about minimal risk. Please explain.
To be completed by Mentor
Mentor: Name
Member #1: Name

Member #2: Name
Date & Reason for Deferral (if needed)
Topic Approval
SMART Approval
First Review
Second Review (if needed)
Third Review (if needed)
Faculty Chair consult (if needed)
NOTES:
Please attach the formal letter requesting permission, and letter
of approval (on letterhead) to the end of this SMART form prior
to submission for School approval.

3
Running head: LEADERSHIP EFFECTIVENESS IN
HEALTHCARE
LEADERSHIP EFFECTIVENESS IN HEALTHCARE
19Leadership Effectiveness in Healthcare Human Resource
and Patient Management
Ashlie Burnett
Capella University Leadership Effectiveness in Healthcare
Human Resource and Patient Management
Background
The healthcare system in the United States is undergoing major
changes because of the need to reduce the high costs associated
with the system. These high costs are associated with the
treatment rather than prevention approach that has characterized
the system, thereby leading to a rise in treatment costs for
chronic illnesses such as heart-related problems and cancer,
which are preventable illnesses that result from poor lifestyle
choices and improper delivery of preventive care. Healthcare
reform is therefore tending towards preventive healthcare
delivery and long-term primary care for patients. This reform
approach to healthcare delivery poses various challenges to

quality healthcare delivery. One of these challenges is
leadership in employee and patient engagement. Delivery of
long-term primary care and preventive care through more
engaging delivery of healthcare services requires a leadership
model and leadership competencies that will lead to long-term
health of patients and human resource practices that create a
favorable working environment for quality of care delivery.
This is very important because of the changes in the healthcare
system.
One of the changes that will affect leadership effectiveness and
human resource management is the aging American population,
which will create a dependent population in need of long-term
healthcare delivery. In addition, the healthcare reforms are
expected to lead to increases in the number of patients
accessing healthcare services, necessitating new models of
leadership. The increasing number of patients means that there
will be increased the need for more healthcare practitioners.
According to the American Hospital Association (2013), the
number of healthcare professionals in the system might not be
enough to handle the higher number of patients who will enter
into the healthcare system as part of the healthcare reform
process. The association estimates that this surplus number of
patients might be in the millions. This creates a potential human
resource problem in that workers might suffer from workplace
burnout or experience psychological problems because of
overstrain. These problems need addressing in order to ensure
that there is the quality of care in healthcare organizations and
that the employees are motivated. The action research project is
therefore designed to advance scientific knowledge on
leadership effectiveness in healthcare institutions on various
aspects.
Leadership effectiveness in the action research encompasses

various components of effectiveness that are deemed important
for healthcare organizations operating in an environment where
healthcare reform has a significant influence on employee and
patient outcomes. These components include job satisfaction,
employee and patient quality of care, and managing employee
burnout and the psychological health of the patients and the
employees. The focus of the advancement of research is on
appropriate leadership model for the healthcare organizations
and the qualities a leader should embody in such an
environment. The action research is based on a case study of
Hospital Corporation of America (HCA) in Houston, Texas.
The HCA is a chain of hospitals with a unique operating
environment as shown in the hospitals’ financial success during
the recession when most hospitals were having financial
difficulties. According to Creswell and Abelson (2012) who
were writing to the New York Times, the hospital has engaged
in practices that could be potentially harmful to the patient and
the healthcare professional in order to make higher earning
through the healthcare system. The hospital’s dealings with
private equity firms, including Bain Capital has produced the
$33 billion increase in investment between 2006 and 2012
(Creswell and Abelson, 2012). The hospital has not been ethical
in obtaining the high financial results.
Creswell and Abelson (2012) point out that the hospital was
involved in various lawsuits such as the Medicare fraud from
which the hospital disentangled itself through a $1.7 billion
settlement. One of the strategies the hospital has used is the
high billing it passes on to patients, Medicare and insurance
companies for the services offered at the hospital. In addition to
patient reduction strategies such as reducing the number of in-
patients, the hospital also instituted measures to cut costs of
payroll expenditure for its medical staff (Creswell and Abelson,

2012). This undoubtedly put pressure on the medical staff.
Interviews conducted and presented by the Creswell, and
Abelson (2012) show that there is the potential for reduced job
satisfaction and psychological problems in the hospital's
different branches because of the human resource policies. HCA
doctors say that there is pressure in the hospitals to increase the
profits because the hospitals are linked to private equity funds
(Creswell and Abelson, 2012). This could create significant
workplace strain that could negatively influence patient and
employee outcomes. A study of the practices at the hospital
could provide a clearer picture of state of the employee and
patient quality of care at the hospitals and advance knowledge
on the leadership competencies and models that could lead to
improvements in the system.
Statement of the Problem
The HCA hospital branches and the Houston Texas branch, in
particular, might need to change its human resource and patient
management policies in order to adapt to the changing
healthcare environment. There is no clear indication on how the
reform process geared towards long-term preventive care could
influence the hospital's operations. The hospital has approached
health care with the aim of making profits through outpatient
treatment where the patients are treated and discharged. With
the healthcare reforms focused on long-term care and more
involvement with the patient, the human resource and patient
practices at the hospital might not be adaptive to the new
healthcare environment. In addition, there are provisions in the
new legislations on healthcare; patients will have much more
influence in the healthcare system than the hospitals, creating
the need for a new form of leadership where the doctors are
more engaged with the patients.

The Affordable Care Act (ACA) provides various provisions
that could hurt the current human resource and patient practices
at the HCA. The ACA aims to ensure that there is a reduction of
healthcare costs relative to administrative costs. This means that
hospitals cannot charge patients for administration but strictly
on treatment and preventive care. Preventive care is another
change brought by the ACA that could potentially influence the
HCA. The ACA covers preventive care freely at no additional
charges for the patient. It also gives the patient the ability to
choose the doctor they prefer from the list of doctors offered
under the different coverage (HHS, 2015). This means that if
the HCA wants to remain competitive, as it has been in the past
in terms of generation of profits, it should engage in practices
that lead to the creation and maintenance of the best human
resource and access to quality of care for the patients. The
human resource and the patients need the attention of the
hospital in terms of leadership practices in order for the hospital
to remain successful in the new healthcare reform environment.
There needs to be recognition that in the healthcare environment
where long-term engagement with the patient is the focus of
care, the organization should ensure that it preserves employee
welfare so that it can have access to an engaging and
cooperative workforce that is able to diligently follow-up on
patient cases in the long-term. Patients and doctor interaction
needs to occur in an environment where the leadership is
concerned about the employee and patient welfare to produce
the best possible results in healthcare. The management needs
to engage more with the two aforementioned stakeholders in
management and leadership. There needs to be research on
participatory leadership and other similar leadership models for
implementation in the new healthcare environment where
patient and employee engagement are increasing in importance.
Since the healthcare reforms will progressively usher in a new
era of healthcare where the patient gains prominence as a

stakeholder, organizations need to change their leadership to
more engagement with the stakeholders, especially those with
private equity firm backing such as the HCA.
Contribution to Society
The research hopes to provide data that can lead to the
improvement of patient engagement and more accountability in
health care organizations, especially those with private interests
such as those aligned with private equity firms such as the
HCA. By conducting research on the leadership effectiveness at
the HCA, Houston, the action research will provide insights on
the means such hospitals could use to manage effectively their
human resources and patients in order to improve healthcare
outcomes. This will lead to ethical and more patient-centered
hospital practices that are consonant with the healthcare reform
initiatives instituted by the government. In addition, the action
research will aid in the complex and long-term process of
institutionalizing the healthcare reform through providing
leadership models and approaches to leadership in healthcare
that produce the best quality of care outcomes for employees
and the patients.
Need for Change
The American Hospital Association (2013) report points out
various issues regarding leadership in American hospitals that
highlight the much-needed changes in human resources
considering the changing healthcare environment due to
reforms. The report notes that hospitals should engage in
workforce planning. This is the process of estimating the future
needs of the hospital in terms of employee talent and expertise.
The process involves evaluating the current workforce
competencies, then creating a future workforce profile
according to changing needs, and finally closing the gaps that

exist between the current and the future workforce profile
(American Hospital Association, 2013). The action research
follows a similar format where the paper conducts research to
find out how the changing healthcare environment is creating
changes in the leadership of healthcare organizations and its
interaction with the employee and patient stakeholders.
Various researches and studies justify the need for current
action research. According to a 2010 report by the Bureau of
Labor Statistics, the number of professionals working in the
healthcare profession is set to increase in number. There is also
set to be increased diversification in terms of healthcare
delivery. These changes are expected to occur between 2008 and
2018, which is a higher rate than all of the professions. (Bureau
of Labor Statistics, 2010). The increase in some professionals
working in the healthcare industry means healthcare institutions
will need leadership and management competencies more than
before to manage effectively the large human resource. The
HCA has engaged in employee downsizing but will have to
reconsider such approaches to leadership and management in the
future if it wants to remain competitive and offer the quality of
care to employees and patients. This brings to question on
considerations on management and leadership.
Various changes should occur in an evolving healthcare
environment. Thompson (2007) says that there are internal and
external domains that comprise the healthcare environment that
should influence management decisions (Thompson, 2007;
Atkinson, 2011). The management should, therefore, ensure that
it has leadership that considers both domains of influence on the
organization, such as the policy and regulatory environment as
external factors and patient and employee engagement as
internal factors. Atkinson (2011) says that the new healthcare
environment requires leaders that can transform the

organization because the healthcare environment in the United
States is a dynamic environment. As Thompson (2007) has
already pointed out, there is a need for managers in leadership
roles to consider how internal and external factors interact
dynamically to produce changes in the healthcare environment.
The action research will, therefore, highlight the issues in the
HCA concerning employee and patient outcomes. The research
will investigate leadership effectiveness at the organization to
ascertain to provide leadership models and qualities that should
comprise the management in a dynamic healthcare environment.
The action research project is necessary considering the HCA's
record of malpractices concerning patient and employee conduct
and treatment.
Theoretical Foundation
In dealing with the identified problem of organizational
leadership effectiveness problem identified at HCA, it is
important to consider that the organizational environment in
healthcare, and in many other organizations in diverse sectors,
is changing towards systems architecture. As Thompson (2007)
has pointed out, the interaction of internal and external
environment factors determine the nature of the operating
environment in healthcare. Luckett and Grossenbacher (2003)
also expressed similar views in that they adopted systems
thinking in their work on action research projects. The
healthcare environment is one where there is increasing
dynamism, which requires a different style of leadership model
that promotes qualities that lead to adaptation to the dynamic
operating environment. Atkinson (2011) proposed
transformational leadership as one of the means that healthcare
organizations can thrive in a changing and challenging
healthcare environment where the reform process is going to
influence significantly the activities of hospitals and employees.

Based on the dynamic nature of the healthcare environment
already established in the preceding sections, the theory
endorsed for the action project is the shared leadership model.
This leadership model is deemed consonant for the health care
environment of the near future because of its capacity to elicit
the networked working environment that is necessary for the
long-term patient environment. The American Hospital
Association (2013) highlights one essential component of the
human resource management in healthcare organizations that
are relevant for the current action research project. The
organization states that hospitals need to ensure that their
hospital workforce-planning model is up to date concerning the
changing operating environment. The American Hospital
Association (2013) echoes the sentiments made by Thompson
(2007), Atkinson (2011) on the internal and external
environmental factors that leadership should consider when
making decisions. American Hospital Association (2013) states
that the organization’s strategic direction, which is the internal
environment, is important in healthcare leadership but the
organization also needs to consider the ‘big picture’, which is
the external environment, in its workforce-planning process.
The organization recommends that healthcare organizations
should ensure that they track the changes in legislation such as
the Affordable Care Act in order to understand how the external
environment is going to influence their internal operations. This
is a good example of the dynamism required in the healthcare
environment. In addition, the increase in number of healthcare
professionals predicted by the Bureau of Statistics (2010) means
that teamwork is going to be a key consideration in leadership
models in healthcare. Before delving into the shared leadership
model and the research conducted to establish its empirical
significance as an evidence-based theory, it is important to
consider first the various characteristics that make an effective
leader in a dynamic healthcare environment.
Atkinson (2011) and Robbins and Davidhizar (2007) provide

various roles that a leader should play in a dynamic
environment. The researchers state that leaders have a large role
to play in the healthcare organization in terms of engendering
teamwork, improving self-esteem and ensuring that the work
environment is one that engenders job satisfaction, thereby
leading to feelings of well-being. Other researchers express
similar sentiments and suggest that transformational leadership
could lead to operating environments that promote employee
and, therefore, patient well-being through quality of care
delivery (Atkinson, 2011; Robbins and Davidhizar, 2007;
Marshall, 2011; Trossman, 2010). Employees in a hospital
environment need a leader concerned with their psychological
health. This means that the patients also benefit from the
quality of care made possible by employees who feel like they
work in an environment where the leadership cares about their
wellbeing.
Based on the considerations made thus far, the shared
leadership model appears to be a robust leadership model that
enables the manifestation of the leadership qualities and
characteristics identified in the preceding paragraph. Shared
leadership is an idea that is in contrast with the attitudes of
most American organizations where the top-down approach is
the most favored. Leaders are seen as individuals who manage
other individuals in a hierarchical model. This model is rather
rigid for an environment where there are constant changes in the
internal and external environment. For a more dynamic
leadership approach that does not involve a strict hierarchical
structure, the shared leadership model might provide
improvements to the current leadership at HCA and hospitals
around the country that are feeling the changes of the healthcare
reforms.
Shared leadership is important in organizations such as
knowledge organizations such as those in healthcare because of
the teamwork required to manage the knowledge generation and

archival process. Avolio, Walumbwa, and Weber (2009) point
out that in organizations where hierarchy is not as important as
effective leadership in teamwork, then shared leadership is a
more effective model for the organization’s leadership process
(O’Toole et al., 2002; Avolio, Walumbwa, and Weber, 2009; ).
Within teams, organizations are able to reach the goals of the
organization and individual goals in a manner that produces the
best results for the organization (Bennis, 1999). There are
various psychological advantages to the employee and
consequently the quality of care to the patient when shared
leadership is employed.
Shared leadership leads to reduced competition between
employees, thereby reducing the feelings of stress that come
from working in an overly competitive working environment
(Hooker and Csikszentmihalyi, 2003). Other benefits of shared
leadership that increases employee motivation and job
satisfaction include social support and the shared purpose that
is characteristic of teams (Wood, 2005). Shared leadership,
according to Wood (2005), is inseparable from teams. Wood
(2005) found that the structure of the team is not important
when it comes to the success of shared leadership models. This
means that the shared leadership model leads to a fluid
management style that allows amorphous and dynamic
structures to exist alongside the rigid structures of the
organization.
Finally, the shared leadership model supports the knowledge
management aspect of healthcare organizations, which is an
important aspect of ensuring that patients get high quality of
care in healthcare institutions. Knowledge management requires
teamwork to generate the intellectual capital that makes a
healthcare organization more successful (Pearce and Manz,
2005). Other researchers, Greenberg-Walt and Robertson
(2001), state that in organizations where knowledge is a

significant aspect of the operations of the organizations, shared
leadership will increase in importance since it contains the
framework for the management of such knowledge within the
teams that generate such knowledge. Jackson (2000) carried out
research in a hospital setting. His study provides important
empirical research on the potential for application of the shared
leadership model in the healthcare setting. According to his
study at St. Joseph’s Healthcare Hospital, horizontal rather than
vertical team structures that promote the shared burden of the
healthcare environment based on teamwork, ownership, equity
and accountability would produce better results in terms of
knowledge management and other functions (Jackson, 2000).
The shared leadership model, therefore, appears as the best
model for the dynamic, knowledge-driven and teamwork-based
hospital environment.
Shared leadership is the selected model for the action research
project at HCA in Houston, Texas. The hospital’s management
could benefit from the implementation of a leadership model
that considers the changing operating environment where
patient engagement will become more important in healthcare
delivery. In addition, the expected increase in healthcare
professionals means that the hospital will have to institute
better human resource measures that lead to employee
motivation, job satisfaction and psychological well-being to
ensure quality of care delivery to the patient. These
considerations and the other ones mentioned in the preceding
sections on the theoretical foundation will form the basis of the
research objectives and questions.
Investigator Position
The role of the researcher is to act as an outside and

independent observer that will analyze the internal environment
through the case study in order to evaluate whether it is
consonant with the external environment. The researcher will
develop the questionnaires for the research based on the
theoretical model developed for the case study. This will ensure
that the research collects relevant data for evaluation on
whether the hospital’s leadership is working effectively and
make required recommendations based on the findings.
The action researcher will also offer recommendations on
sample selection of the employees and the management in order
to obtain insights into the leadership effectiveness from
different perspectives. Data on patient outcomes might be
obtained from the hospital database, and the action researcher is
supposed to organize these efforts to ensure access to such data.
Research Questions and Objectives
The main objectives of the action research project, which are
used in the development of the research question, include
finding out how well the hospital's internal environment fits
with the changing external environment of the healthcare
system. HCA is a hospital that has benefitted financially from
the previous healthcare system through the various human
resource and patient practices conducted by the organization as
shown by Creswell and Abelson (2012). The new healthcare
reforms such as affordable care and the focus on the patient's
long-term health might cause problems for the hospital in terms
of income-generating activities. The hospital needs to ensure
that it adapts to this new environment to remain as one of the
top hospitals in the country and deliver the quality of care to the
patients and the employees.

Another objective is to find out the leadership practices in the
hospital, how adaptive they are in ensuring that employees and
patients have the well-being that is required for better quality of
care outcomes. Employee well-being is a major concern at the
hospital based on the profile of the hospital. Based on the
objectives, the following are the research questions developed
for the study:
· How adaptive are the hospital’s human resource and patient
outcomes to the changing healthcare environment?
· Is the hierarchical leadership model at the hospital conducive
to best practices in terms of human resource and patient
outcomes?
· What is the employee rating of well-being at the company?
· Do business considerations trump quality of care for patients?
Action Plan
Look
Information gathering will involve the acquisition of interview
information from the respondents. In addition, the research team
will observe the surroundings of the hospital to pick up
qualitative information such nonverbal cues that might provide
information about the nature of leadership at the hospital. The
researchers will also look at secondary sources to get multiple
perspectives on the effective leadership issue.
Think
This phase will involve the analysis and evaluation of the
primary, and secondary information gathered. The analysis will

involve a synthesis of the various perspectives observed to
acquire an objective and empirically valid analysis of the
leadership situation at the hospital.
Act
Finally, the researcher will demonstrate the findings from
primary and secondary data sources that there need to be
improvements to the system to ensure that it is in tandem with
the changes in the healthcare environment. The main aim is to
show the need for a leadership model that is dynamic and
adaptive enough to ensure that the hospital has favorable
outcomes in the future.
Dissemination Plan
The information acquired will be published in reputable
journals where it will advance knowledge on leadership.
Informal articles meant for blogs and news outlets such as
government agencies associated with healthcare reform will
form additional outlets for dissemination for the public that
might not have access to professional journals.
Action Research Data Collection Methods
The data collection method for the action research is the case
study method where the research will collect qualitative data
through questionnaires and surveys. This will provide the
primary data needed for the research. In addition, the case study
will require secondary data as well to augment the primary data.
The synthesis of primary and secondary data will provide a
more comprehensive analysis of the organization's internal and

external environment and, therefore, provide a better basis for
recommendations and interventions.
Assumptions
The following are the major assumptions made for the paper:
· The action research assumes that the healthcare environment
predictions made will come into effect
· The project assumes that private hospitals will be equally
affected by the healthcare reform process as government
hospitals
· The HCA at Houston is assumed to have similar organizational
structure and practices as other branches of the HCA
Limitations
The following are the limitations of the research:
· The qualitative research design means that the data obtained
from the research is not easily generalizable to other hospital
institutions
· The HCA is a hospital with private equity firm financing and,
therefore, might not be representative of the other hospitals
without such funding
· The future of health care reform might change in case of
changes in government during elections shortly

Summary
The action research project is supposed to ensure that there is
an effective leadership model in place for hospital institutions
that can produce the best outcomes in terms of patient and
employee well-being. The case chose for the study, which is
HCA in Houston Texas is a good example because of the
malpractices involving patients and employees such as
excessive billing and employee downsizing. These practices
might not be adaptive for the future healthcare environment that
is one destined to focus more on the patient. In addition, the
focus on long-term preventive care means that the hospitals will
have to engage more with patients, necessitating a workforce
that can work in teams to ensure the quality of care for the
patients.
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