| Course | DHA 700 Introduction to Health Administration in Doctoral Study (DHA/700) |
|---|---|
| Week | 5 |
| Paper type | Governance and management paper |
| Length | about 1,166 words, 4 double-spaced pages plus title page and references |
| Format | APA 7 student paper |
| School | University of Phoenix |
| Program | DHA |
| Updated | September 2026 |
Free sample paper for DHA 700 Week 5
Twenty Minutes on Quality Out of Three Hours: Strengthening Board Governance and Management Practices in a Rural Health System
[Student Name]
University of Phoenix
DHA/700: Introduction to Health Administration in Doctoral Study
Week 5 Assignment
[Instructor Name]
[Date]
The rural health system, its board, meeting agendas, dashboards and reforms are composites written for a model paper; research findings come from the sources cited.
After a quarterly board meeting of the composite rural health system, the chief operating officer reviewed the minutes and counted: of three hours, about two went to the budget and a new outpatient building, forty minutes to physician recruitment and twenty minutes to clinical quality, mostly a slide of infection rates presented without discussion. The executive wondered whether the board's attention matched its responsibility. This paper examines governance and management and proposes reforms.
Two Different Jobs
The board's job is governance: it sets mission and strategy, hiring and evaluating the chief executive, overseeing quality, safety and finances and ensuring the organization serves its community and complies with law. Management is the work of executives and managers: running operations, allocating resources and leading staff to achieve the board's goals. When boards drift into operations or managers make strategic decisions without the board, accountability blurs.
Fiduciary Duties
Board members of a nonprofit health system owe duties of care, acting with the diligence of a prudent person; loyalty, never letting personal interests outweigh the organization's; and obedience, keeping the organization true to its charitable mission. Oversight of quality and patient safety is part of the duty of care.
Board Structure
Thirteen people sit on the composite system's board, among them local business owners, a banker, clergy, an educator and two physicians, with the chief executive attending without a vote. It has finance, audit, quality and executive committees. The quality committee meets quarterly but rarely reports substantive findings to the full board.
Evidence: Boards and Quality
When Jha and Epstein surveyed board chairs from a thousand hospitals chosen to represent the nation, quality of care made the top two for less than half, and most chairs said their boards had never been trained in it. Boards at hospitals with strong quality scores behaved differently from those at weak ones, spending more time on quality and using more data, which led the authors to see boards as a lever for improvement (Jha & Epstein, 2010). A board that spends twenty minutes on quality is telling its managers what matters.
Evidence: Management Practices and Outcomes
Management matters at the front line. Researchers adapted a method for measuring management in manufacturing and scored 18 practices across four dimensions, standardizing care, tracking key performance indicators, setting targets and incentivizing employees, in 597 hospital cardiac units; fewer than 20% of hospitals scored at best practice on more than nine measures, and stronger management practices were significantly associated with lower 30-day heart attack mortality and better performance on all six process measures, though not with readmissions (McConnell et al., 2013).
Evidence: Boards and Management Together
Governance and management are connected. Tsai and colleagues surveyed hospitals on both sides of the Atlantic and traced a chain: good boards went with good managers, and good managers went with good care. Where boards kept clinical quality in view, frontline managers watched performance more closely; where boards actually used quality measures, managers were better at setting targets and running operations (Tsai et al., 2015).
Why Boards Drift Toward Finance
Boards gravitate toward finance for understandable reasons. Members often come from business and banking, financial reports are familiar and precise and financial failure feels immediate. Quality data are unfamiliar, harder to interpret and often presented in technical terms. Without deliberate design, agendas follow members' comfort rather than the organization's most important risks.
Assessing the System's Board
Measured against this evidence, the board falls short in three ways. Quality receives little time and appears at the end of agendas. Members receive financial dashboards monthly but quality data only quarterly and in raw form. No member has had training in quality or safety.
Assessing the System's Management
Management is mixed. The regional hospital's intensive care unit standardizes care with protocols and posts performance data, but other units track few indicators, targets are rarely set and staff recognition is unrelated to quality. Managers report that they focus where the board focuses, which is on finances.
Reform One: Put Quality First
Quality and safety will be the first substantive item on every board agenda, with at least 45 minutes and a discussion led by the quality committee chair.
Reform Two: A Concise Quality Dashboard
The board will receive a one-page monthly quality dashboard with ten measures, including mortality, hospital-acquired infections, falls, readmissions, emergency department boarding times and patient experience, compared with targets and peers and shown in trends.
Reform Three: Board Education
Every board member will complete an orientation on quality and safety and attend an annual education session. One seat on the next slate will be filled by someone with quality or patient safety expertise.
Reform Four: Patient and Community Voice
A patient story will open each board meeting, and a community advisory council will report twice a year.
Reform Five: Management Routines
Each unit will adopt the four management practices: standardize key processes, track a small set of indicators daily or weekly, set targets and recognize teams that meet them. Managers will be trained, and unit results will roll up to the board dashboard.
The Medical Staff's Role
Physicians and nurses are essential partners in governance of quality. The medical staff's quality committee will present to the board twice a year, and the system's top physician and nurse executives will sit on the board's quality committee. Clinical leaders bring interpretation that board members lack, helping the board ask better questions rather than simply receiving numbers.
Measuring the Reforms
The chief operating officer will track board agenda time spent on quality, the percentage of units with posted indicators and targets, board members trained and, over two years, changes in the dashboard measures.
Board Self-Assessment
Once a year, members will rate the board's own work on time spent on quality, members' understanding of the dashboard, the quality committee's effectiveness and the chief executive's accountability for quality goals. Results will shape the next year's education and agenda, making governance itself subject to improvement.
Linking Executive Evaluation to Quality
The chief executive's annual goals, set by the board, will include quality and safety targets alongside financial ones, with a share of incentive pay tied to them. This signals to managers throughout the system that quality counts in how leaders are judged.
Anticipating Resistance
Some board members may view quality as the medical staff's business rather than theirs, and some managers may see indicators as more paperwork. The chief executive and board chair will lead the change, and early wins will be shared.
Conclusion
The board's twenty minutes on quality reflected a common pattern: boards that prioritize finance over quality and managers who follow the board's lead. Research shows that board attention to quality is linked to better management and that strong management practices are linked to lower mortality. Putting quality first, giving the board a concise dashboard, training members, hearing from patients and building management routines on every unit can align governance and management with the system's mission.
References
Jha, A., & Epstein, A. (2010). Hospital governance and the quality of care. Health Affairs, 29(1), 182-187. https://doi.org/10.1377/hlthaff.2009.0297
McConnell, K. J., Lindrooth, R. C., Wholey, D. R., Maddox, T. M., & Bloom, N. (2013). Management practices and the quality of care in cardiac units. JAMA Internal Medicine, 173(8), 684-692. https://doi.org/10.1001/jamainternmed.2013.3577
Tsai, T. C., Jha, A. K., Gawande, A. A., Huckman, R. S., Bloom, N., & Sadun, R. (2015). Hospital board and management practices are strongly related to hospital performance on clinical quality metrics. Health Affairs, 34(8), 1304-1311. https://doi.org/10.1377/hlthaff.2014.1282
What the DHA 700 Week 5 instructions ask
The fifth DHA 700 assignment usually addresses governance and management of health organizations. Prompts may ask students to distinguish the roles of boards and executives, describe fiduciary duties and board structures, explain how boards oversee quality, finance and strategy, describe management practices and systems and assess how governance and management affect performance, often with a recommendation for improvement. Some versions ask students to evaluate their own organization's board; if so, describe its agenda, data and training candidly. Strong papers use evidence linking governance and management to outcomes, analyze a real board's practices, distinguish oversight from operations and propose concrete reforms with ways to measure them.
How this DHA 700 Week 5 example is built
A board meeting where finance and construction consumed most of the agenda and quality got twenty minutes opens the paper. Governance and management are distinguished, and board duties are described. Evidence from a national survey of board chairs shows that many boards give quality low priority and receive little quality training. Evidence from cardiac units links management practices such as standardizing care, tracking indicators, setting targets and incentives to lower mortality. Evidence from US and English hospitals ties board engagement to management quality. The system's board and management practices are assessed. A reform plan with measures, board self-assessment, executive accountability and strategies for resistance closes the paper.
DHA 700 Week 5 grading rubric: where the points go
The governance and management week is typically graded on a clear distinction between governance and management, accurate use of evidence on their effects and a practical plan for improvement. Graders look for board and executive roles explained, fiduciary duties and structures described, oversight of quality, finance and strategy discussed, management practices defined, research linking governance and management to performance cited accurately, an assessment of an organization and reforms with measures. Health services research on boards and management strengthens the paper, especially studies linking practices to patient outcomes. Proposing changes to agendas and dashboards earns credit. Attention to board composition and training also earns marks. Scholarly style and correct citations round out the grade. Papers that blur oversight and operations usually score lower, as do reforms without measures.
DHA 700 Week 5 help: mistakes to avoid
Many DHA 700 Week 5 papers describe boards and executives in general terms. Look at a real board: what is on its agenda, how much time goes to quality, what data it sees and what training members receive. Distinguish governance, setting direction and holding leaders accountable, from management, running the organization. Use research that links board attention to quality and management practices to patient outcomes. Assess your organization against that evidence. Then, with that evidence in hand, propose specific reforms, such as quality first on the agenda, a concise dashboard, training for new members and management routines for tracking and targets, with measures to see whether they work.
Related DHA 700 sample papers
Other DHA 700 week samples
- DHA 700 Week 1: Scholar-Practitioner Role
- DHA 700 Week 2: US Health System Structure
- DHA 700 Week 3: Financing and Payment
- DHA 700 Week 4: Organizational Theory
- DHA 700 Week 6: Leadership in Health Administration
- DHA 700 Week 7: Reading and Synthesizing Research
- DHA 700 Week 8: Scholarly Problem Paper
DHA 700 Week 5 questions, answered
What does DHA/700 Week 5 usually ask for?
The fifth doctoral paper usually addresses governance and management, distinguishing board and executive roles, describing duties and practices and linking both to organizational performance.
Where can I find a free DHA 700 Week 5 sample paper?
Anyone can read the governance paper above free; margin notes explain each reform. Describe your organization's board; we draft the first paper without charge.
Do hospital boards focus on quality?
Often not. In one national survey of board chairs, quality ranked in the top two concerns for under half of boards, and few boards had any training on the subject.
Do management practices affect patient outcomes?
A study of 597 hospital cardiac units found that management practices such as standardizing care, tracking performance, setting targets and incentives were associated with lower heart attack mortality and better care processes.
What is the difference between governance and management?
Governance sets direction, oversees performance and holds leaders accountable on behalf of the community; management runs the organization day to day to achieve those goals.
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