DNP 7100 Organizational & Systems Leadership

Course Overview
DNP 7100 prepares students to lead complex healthcare organizations and systems with strategic vision, relational intelligence, and systems-thinking competence. Students examine leadership theories, organizational behavior, change management frameworks, and quality improvement methodologies within the context of healthcare. Emphasis is placed on the DNP-prepared nurse's role in leading interprofessional teams, driving organizational transformation, navigating power and political dynamics, and building cultures of safety and high reliability. Students will apply systems-thinking tools, Lean/Six Sigma concepts, and human factors principles to real-world healthcare improvement challenges. The course culminates in a systems leadership project proposal relevant to the student's practice environment.

Learning Outcomes
•Apply leadership theories including transformational, servant, authentic, and adaptive leadership to healthcare organizational contexts.
•Analyze organizational culture, climate, and behavior as factors influencing quality, safety, and staff performance.
•Lead interprofessional teams through evidence-based change management using frameworks such as Kotter, Lewin, and ADKAR.
•Apply systems-thinking tools including causal loop diagrams, fishbone analysis, and process mapping to healthcare problems.
•Evaluate quality improvement methodologies (Lean, Six Sigma, PDSA) for application in clinical and operational settings.
•Design strategies for building high-reliability organizations and sustaining cultures of safety.
•Develop a systems leadership change proposal grounded in evidence and aligned with organizational strategic priorities.

Weekly Schedule & Assignments
Each week builds sequentially toward course and program competency goals. Complete readings before engaging in assignments.

Wk Topic Assignment Guide & Instructions
1 Leadership Theory in Healthcare Contexts
Leadership Theory Comparative Paper
Compare transformational, servant, and authentic leadership theories across five dimensions: core assumptions, leader behaviors, follower outcomes, applicability to nursing, and research evidence. Write a 3-page paper in APA 7th edition. Conclude with which theory best aligns with your current leadership style and why.

Organizational Culture & Climate
Organizational Culture Assessment
Using the Competing Values Framework (CVF) or Organizational Culture Assessment Instrument (OCAI), assess the culture of your current or most recent healthcare employer. Identify dominant and recessive culture types. Write a 2-page analysis of how the culture affects patient outcomes and staff performance.

Systems Thinking in Healthcare
Causal Loop Diagram Exercise
Select a systemic healthcare problem (e.g., nurse burnout, medication errors, readmissions). Build a causal loop diagram with at least eight variables illustrating reinforcing and balancing feedback loops. Submit the diagram with a 1-page narrative explaining the dynamics and key intervention leverage points.

Change Management Frameworks
Change Model Application
Select Kotter's 8-Step Model, Lewin's Force Field Analysis, or ADKAR. Apply it to a planned or needed change in your clinical environment. Map each stage/element to specific actions, stakeholders, and timelines. Write a 2-page change application paper with a visual model diagram.

Strategic Planning & Vision Setting
SWOT Analysis & Strategic Priorities
Conduct a SWOT analysis of your unit, department, or organization relative to a strategic challenge. Identify three strategic priorities based on the SWOT findings. Write a 2-page strategic planning brief with specific, measurable recommended actions aligned with organizational mission and values.

Interprofessional Team Leadership
Team Effectiveness Assessment & Plan
Using the TeamSTEPPS framework or Hackman's Team Effectiveness Model, assess the effectiveness of an interprofessional team you work with or have observed. Identify two performance gaps. Develop a 2-page team improvement plan with evidence-based leadership strategies for each gap.

Quality Improvement: PDSA & Lean
Lean Process Improvement Analysis
Map a care delivery process in your setting using a flowchart or value stream map. Identify waste (using Lean's 8 wastes) and non-value-added steps. Propose three specific Lean-based improvements. Write a 2-page improvement analysis with your process maps and proposed future-state workflow.

Six Sigma & Data-Driven Improvement
DMAIC Project Brief
Apply the Six Sigma DMAIC framework to a quality problem in your practice setting. Complete each phase (Define, Measure, Analyze, Improve, Control) at a summary level with at least one tool per phase (e.g., SIPOC, control chart, fishbone, pilot plan, control plan). Submit a 3-page DMAIC project brief.

High Reliability Organizations & Patient Safety
HRO Gap Analysis
Review the five HRO principles (preoccupation with failure, reluctance to simplify, sensitivity to operations, commitment to resilience, deference to expertise). Assess your organization against each principle. Write a 2-page gap analysis identifying strengths and two priority areas for HRO development with recommended actions.

Power, Politics & Influence in Healthcare
Stakeholder Power Analysis
Identify a significant organizational decision or change initiative in your setting. Map stakeholders using a power-interest grid. Analyze sources of power and political dynamics at play. Develop a 2-page influence strategy describing how a DNP leader can build coalitions and navigate resistance effectively.

Human Factors & Ergonomics in Safety
Human Factors Incident Analysis
Obtain or construct a de-identified case study of a clinical adverse event or near-miss. Apply a human factors framework (e.g., SEIPS, Swiss Cheese Model) to analyze contributing system factors. Write a 2-page root cause analysis identifying systemic vulnerabilities and recommended design-level improvements.

Financial Stewardship & Resource Management
Budget Impact Analysis
Identify a proposed clinical initiative in your practice setting (e.g., new staffing model, technology adoption, protocol change). Conduct a basic budget impact analysis estimating costs, projected savings, and return on investment over one year. Write a 2-page financial justification memo suitable for leadership review.

Workforce Development & Succession Planning
Workforce Development Plan
Identify a critical competency gap in your clinical unit or department. Design a targeted 3-month workforce development plan addressing the gap through education, mentorship, or role restructuring. Write a 2-page plan including goals, methods, timeline, responsible parties, and measurable outcomes.

Sustainability & Sustaining Change
Change Sustainability Plan
Select a quality improvement initiative implemented in your organization. Evaluate its sustainability using the NHS Sustainability Model or a comparable framework. Identify two threats to sustainability and develop a 2-page sustainability plan with specific strategies to embed the change into organizational culture.

Systems Leadership Change Proposal
Develop a formal 5-page systems leadership change proposal for a significant improvement initiative in your organization. Include: problem statement with supporting data, theoretical/conceptual framework, stakeholder analysis, proposed intervention with timeline, evaluation plan, and budget estimate. This proposal may inform your DNP project.