This paper will allow students to fully analyze a specific system (potentially one in which the student may work in the future) from the perspective of a specific role (NP, CNM, CNS, Manager, Administrator, Leader). Students will work in groups of TWO to submit ONE paper that will receive ONE grade. If students want to negotiate working alone, or in groups of three, this will need to be negotiated and approved by the instructor EARLY in the course. It is recommended that you work with another student who has similar goals (e.g. CNM, NP, CNS, Administrator).

1. Describe the following dimensions of your particular system and identify the consequences for this organization related to the dimensions using knowledge you have gained from the literature and course content. (For example, if the system you are describing is a staff-HMO, primary care clinic in an urban environment with a majority of reimbursement coming from Medicaid and private pay, what does that mean for the provider, for the client, for the quality and access, given what is stated in the literature?) (10 pts)
   
   
   1. Type of system (e.g. government, public, private, for profit;acute; long term care; primary care);
   2. Regulation/Policy influences (include govermental, accrediting bodies, and other)
   3. Relationship to larger health care system (e.g. independent, part of integrated delivery system, part of continuum of care, payors, market share and competitiveness)
   4. Patient mix & Financing influences (e.g. diversity, payor mix, continuum of health services <Barton, p5>)
   5. Types of Programs/Product (Product Lines, Disease Management)
   6. Organizational design (from Mintzberg)-- How is work coordinated and what are consequences
   7. Leadership roles available for clinicians and administrators/managers
   8. Basic underlying assumption or "espoused theory" of organization's mission
   9. Cost, access (equity) and quality issues (how does this system address? What is your analysis of how they address? What quality endeavors do they or should they have?)
      
      
2. Present the IDEAL role you are analyzing and include the following dimensions as well as the OBSTACLES that may be present in achieving this ideal: (5 pts.) Reference literature where appropriate:
   
   
   1. Job title and description (if available)
   2. Location within the organizational chart
   3. Key organizational relationships (e.g. MDs, RNs, Administrators)
   4. Relationship with patients/enrollees/consumers/payers (direct or indirect)
   5. Requirements for job (e.g. education, credentialing, experience)
   6. Circle of influence of this role (what leverage could this role have in the organization to effect quality and equity of care)
   7. What intrapreneurial or entrepreneurial endeavors may be available to this type of role
   8. Potential of role expansion
   9. Involvement in quality endeavors
   10. Strengths and weaknesses of this role
   11. Involvement in emerging models of care delivery
       
       THESE FIRST TWO PARTS ARE DUE FOR PEER REVIEW AND INSTRUCTOR FEEDBACK ON JUNE 19TH (HAND IN THREE COPIES, TWO FOR PEER REVIEW AND ONE FOR INSTRUCTOR; if three people are working on paper than hand in four copies, three for peers and one for instructor).
       
        
3. Given the material covered in this systems course, demonstrate how knowledge of the concepts covered in this course including systems thinking, leadership, conflict resolution, change theory, and group dynamics can maximize your leverage in this new system, and overcome the obstacles identified in Part II above. (14 pts) Remember to utilize and reference literature. For example, you might demonstrate a scenario related to increasing collaboration with physician partners, or your administrative team so outcomes might be enhanced. You might identify how to utilize your knowledge to enhance group functioning among diverse members and thus improve team functioning. You might identify a 'potential problem' to be anticipated in this setting and identify how you would maximize your leverage for high quality outcomes. Make sure to identify your circle of influence vs your circle of concern.
   
   
4. Summary:A self reflection of your own learning and journey of enlightenment during this semester of new readings, new insights, and new relationships of collaborative inquiry. (1 point)

NOTE: Many people have trouble with WRITING in their first graduate courses. The Writing Center is available on campus and it is strongly encouraged that you seek their assistance if you struggle with writing. It will be required to synthesize and reference the literature from this course in your paper. DO NOT USE EXCESSIVE QUOTES!!!!! You need to synthesize, integrate and apply NOT MERELY SUMMARIZE or QUOTE.

FINAL PAPER DUE June 28th, 2000 . Grades will be due July 3rd so there is very little time and thus no opportunities for late papers. Any paper not received by June 28th will be given an Incomplete grade for the course (see bulletin for Incomplete guidelines) ** Paper should be typed according to APA format (1994 APA manual available in the bookstore). The APA format provides direction for citation of sources, bibliography format, grammar, use of punctuation, and typing guidelines. PLEASE PROOF READ YOUR PAPER! (Length is variable, but as a guideline 15-25 pages is range; after 30 pages I STOP reading!)

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