| Course | D158 Strategically Planning the Execution of a Healthcare Improvement Project |
|---|---|
| Task | Task 1 |
| Paper type | Stakeholder and resource map |
| Length | About 1,000 words, 3 pages |
| Format | APA 7 |
| School | Western Governors University (WGU) |
| Program | MSN Leadership and Management |
| Updated | September 2026 |
Free sample paper for D158 Task 1
Stakeholder and Resource Map: Preparing to Execute a Patient Blood Management Program in a Community Hospital
Student Name
Leavitt School of Health, Western Governors University
D158: Strategically Planning the Execution of a Healthcare Improvement Plan, Task 1
Course Instructor
Month Day, Year
Stakeholder and Resource Map: Preparing to Execute a Patient Blood Management Program in a Community Hospital
Purpose
Leadership has approved, and the chief medical officer will sponsor, a patient blood management program for the medical and general surgical services of the composite 350-bed hospital, built on a revised transfusion order set, a real-time alert when red cells are ordered for a patient whose hemoglobin is above the restrictive threshold, education, clinician-level feedback and a half-time nurse coordinator. This map identifies the people whose behavior or support the program depends on, what each stands to gain or lose, how much influence each has and how each should be engaged. It then inventories the resources the program needs against what already exists, and records the barriers honestly. The map guides the implementation plan that follows.
Stakeholder Map
Stakeholders were identified with the transfusion committee and rated for interest in the change and influence over its success. The table summarizes each role; the text below explains the engagement approach for the most important.
| Stakeholder | Interest in the change | Influence | What they could lose | Engagement approach |
|---|---|---|---|---|
| Hospitalists (18 physicians, 6 advanced practice providers) | Moderate; value evidence, dislike alerts | High; order most medical transfusions | Autonomy, time spent on alerts | Co-design alert wording; present local data at group meeting; feedback reports |
| General surgeons (9) | Low to moderate; some favor higher hemoglobin after surgery | High | Perceived control over postoperative care | Surgical chief as champion; allow guideline-based 8 g/dL threshold where appropriate |
| Medical and surgical staff nurses (about 220) | High; administer and monitor every unit | Moderate; often prompt orders | Time for education | One-hour module; charge nurse huddle messages; teach reassessment after one unit |
| Blood bank supervisor and technologists | High; manage inventory and shortages | Moderate | Short-term workload during change | Member of project team; share usage data weekly |
| Chief medical officer and chief nursing officer | High; strategy and budget owners | Very high | Credibility if the program fails | Monthly executive updates; sponsor role |
| Information technology analysts | Neutral | High for build timing | Competing project priorities | Formal request through governance; clear specifications |
| Patients and families | High; safety and informed choice | Low direct, high moral | Nothing if done well | Patient information sheet on transfusion decisions; patient advisory review |
| Finance department | High; savings | Moderate | None | Agree savings methodology before launch |
Engaging the Highest-Influence Groups
Hospitalists and surgeons hold the most influence because they write the orders. Resistance is likely to center on alerts and on autonomy. The engagement approach is to involve them in the design rather than present a finished tool: two hospitalists and one surgeon will review the alert wording and the list of acceptable reasons to proceed, and the thresholds will follow international guidelines, which set 7 g/dL as the usual trigger for stable adult inpatients and a higher 8 g/dL trigger for patients with heart disease or after orthopedic operations (Carson et al., 2023). Local data will be presented by a respected physician rather than by administrators. Nurses are the largest group and often shape orders by reporting a low hemoglobin with an implied request; their engagement focuses on how to report a value together with the patient's symptoms and on the one-unit-then-reassess practice.
The sequence of engagement matters as much as its content. Building a guiding coalition before announcing a change is one of the first steps in widely used models of organizational change (Kotter, 2012), so a sponsor group made up of the two chief clinical executives, the surgical chief and a respected hospitalist will meet before any department hears about the alert. Each will speak for the program in their own meetings, which gives clinicians a message from peers they trust rather than from the project team alone.
Resource Inventory: Needed Versus Existing
Staff hours. Needed: a 0.5 full-time equivalent blood management nurse coordinator; about 120 analyst hours for the order set and alert; 0.1 full-time equivalent analyst time for monthly reports; about 220 nurse education hours. Existing: none of the coordinator role; analyst hours approved in the business case but not yet scheduled; the education department can host the nursing module in its learning system.
Equipment and systems. Needed: electronic record build for the order set and alert; a report pulling transfusions with the most recent hemoglobin. Existing: the record already supports best practice alerts and captures hemoglobin values and blood product administration; the blood bank's system exports unit data.
Space and time. Needed: slots at department meetings for physician sessions; protected time for nurse education. Existing: monthly hospitalist and surgery meetings; nurse education days scheduled quarterly.
Money. Needed: $92,000 in year one. Existing: approved in the business case, to be released in two tranches.
Barriers Recorded Honestly
Three barriers are real. The information technology department has a backlog, and the alert may wait behind higher-priority projects unless the chief medical officer escalates it through governance. Alert fatigue is widespread: in a study of primary care clinicians, the chance of accepting a reminder fell by 30% with each additional reminder in an encounter, and repeated alerts for the same patient further reduced acceptance (Ancker et al., 2017), so a poorly targeted alert will be ignored. Some surgeons may not accept restrictive thresholds, and forcing the issue could harm relationships. Two further risks are smaller: turnover among nurses could erode education gains, and a regional blood shortage during implementation could confuse the message by restricting supply for reasons unrelated to the program. Each barrier has an owner in the implementation plan.
Summary
The program's success depends on physicians who order transfusions, nurses who shape and administer them, and information technology staff who build the tools. The map shows where support is strong, where resistance is likely and which resources are already in place. The implementation plan will sequence the work so that the record build, engagement of high-influence groups and education happen in the right order.
The map will be revisited at each decision gate in the implementation plan, because stakeholder positions change once a program is live: a surgeon who resists in the planning stage may become an advocate once the feedback reports show good outcomes, and a supportive group may cool if the alert fires too often.
References
Ancker, J. S., Edwards, A., Nosal, S., Hauser, D., Mauer, E., & Kaushal, R. (2017). Effects of workload, work complexity, and repeated alerts on alert fatigue in a clinical decision support system. BMC Medical Informatics and Decision Making, 17(1), 36. https://doi.org/10.1186/s12911-017-0430-8
Carson, J. L., Stanworth, S. J., Guyatt, G., Valentine, S., Dennis, J., Bakhtary, S., Cohn, C. S., Dubon, A., Grossman, B. J., Gupta, G. K., Hess, A. S., Jacobson, J. L., Kaplan, L. J., Lin, Y., Metcalf, R. A., Murphy, C. H., Pavenski, K., Prochaska, M. T., Raval, J. S., . . . Pagano, M. B. (2023). Red blood cell transfusion: 2023 AABB international guidelines. JAMA, 330(19), 1892-1902. https://doi.org/10.1001/jama.2023.12914
Kotter, J. P. (2012). Leading change. Harvard Business Review Press.
What the D158 Task 1 instructions ask
The first D158 task asks you to prepare for executing an approved improvement project. Most versions ask you to identify stakeholders, analyze their interest and influence, plan how you will engage the most influential groups, inventory the resources needed against those available and identify barriers. The project usually continues from D156, so the problem and business case are already set. Evaluators look for a map specific to the project, with stakeholders named by role and rated with reasons, an engagement plan that anticipates real objections, and a resource inventory that shows gaps rather than assuming everything is available. The engagement plan should say who will speak to each group.
How this D158 Task 1 example is built
The map begins by restating the approved program and its sponsor. Stakeholders are listed in a table with interest, influence and what each needs to hear, which turns the map into a planning tool. The engagement section focuses on the groups that can make or break the change and describes the likely objections and the evidence that answers them. The resource inventory compares needed and existing resources category by category, staff hours, technology, education and data, so gaps are visible. The barriers section names three real obstacles and what would reduce each. A short summary connects the map to the implementation plan in Task 2.
Where the D158 Task 1 rubric puts the marks
Each D158 Task 1 aspect receives competent, approaching competence or not evident. A stakeholder identification aspect checks that the relevant groups are included. An analysis aspect looks for interest and influence rated with reasons. An engagement aspect wants strategies for high-influence stakeholders that address likely resistance. A resource aspect asks for needed and existing resources compared. A barriers aspect rewards honest identification of obstacles. Evaluators favor maps that the next task can use directly, and research on decision support or physician engagement should be cited where it shapes the strategy. Evaluators notice when each stakeholder's rating comes with a reason, such as prescribing authority or control of the order set, and when the engagement plan names the evidence that will answer the expected objection. Honest barriers are credited, not penalized.
D158 Task 1 help: what sends it back
Stakeholder maps are returned most often because they list groups without analysis. Rate interest and influence and say why. Second, engagement plans are generic, such as holding meetings. Describe the objection you expect and the evidence or person that will answer it. Third, resource inventories assume what exists is enough. Compare needed with available and show the gap. Fourth, barriers are softened or omitted; evaluators credit honesty, and Task 2 needs real barriers to plan around. Finally, keep the map tied to the approved project. A generic map of hospital stakeholders will not help you write the implementation plan. Revisit the map once the plan is drafted.
Get a D158 Task 1 example written to your instructions
Send the D158 Task 1 instructions and the rubric aspects as your course of study states them, along with the improvement project you are carrying through the sequence. We write a custom example to those aspects, with stakeholders analyzed, resources inventoried and barriers rated, and return it in 24-48h. The first custom sample is free.
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D158 Task 1 questions, answered
How many stakeholders should the map hold?
Enough to cover everyone able to advance or stall the change, usually six to ten roles in a unit-level project. Include the quiet ones, such as informatics build staff, supply chain and educators, since they often decide whether a start date holds. Every entry has to carry analysis, so a longer list only helps if each line does work.
Does the map need a real organization?
A clearly described setting is usually enough, unless your instructions require otherwise. State size, service lines and staffing, then hold those facts steady across the rest of the sequence, and keep confidential material out of it. What gets read is whether the analysis fits a specific organization, not whether that organization could be identified.
What does this stage hand to Task 2?
Three things: the people whose support is required, the resource gaps that must close before work begins, and the barriers that decide where risk sits. The applied part turns those into a sequence with owners and decision gates. A vague map produces a sequence nobody could follow, so effort spent here pays off there.
How many stakeholders should a D158 map include?
Enough to cover everyone who can affect or is affected by the project, often eight to twelve groups. The sample rates each for interest and influence in a table.
Where can I find a free D158 Task 1 sample paper?
The stakeholder table, engagement plan and resource inventory are reproduced above with notes. Tell us your project in the D158 instructions and the first tailored map is yours free.