| Course | DHA 711 Administration of Complex Health Care Systems (DHA/711) |
|---|---|
| Week | 5 |
| Paper type | Multi-organizational management paper |
| Length | about 1,169 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 711 Week 5
Managing What You Do Not Own: Building a Post-Acute Partner Network With Eighteen Independent Nursing Homes and Home Health Agencies
[Student Name]
University of Phoenix
DHA/711: Administration of Complex Health Care Systems
Week 5 Assignment
[Instructor Name]
[Date]
The network, its partners, agreements, data and results are composites written for a model paper; research findings come from the sources cited.
In one February week, 14 patients in the network's hospitals were medically ready for discharge but waited for nursing home beds, some for more than a week. Meanwhile, readmissions from nursing homes were rising. The network owned hospitals, clinics and a home health agency but no nursing homes. The regional vice president was asked to fix the problem without buying anything. This paper describes how the network built a partner network with independent post-acute providers and what it learned about managing organizations it does not own.
Managing Without Authority
Inside the network, leaders can set policy and expect compliance. Across organizational lines, they cannot. Nursing home administrators answer to their own owners, many of them regional chains, and home health agencies compete for referrals. Any partnership would rest on shared interests, agreements and trust. The first task was understanding what each partner wanted: nursing homes wanted steady referrals, timely information about incoming patients and help with complex cases; the network wanted faster placements and fewer readmissions.
Choosing a Governance Mode
Network governance theory offers options. Provan and Kenis describe three modes: networks governed collectively by their members, networks led by one member organization and networks run by a separate coordinating body created for the purpose, and they argue that the fitting mode depends on the level of trust among members, the number of members, how far members agree on goals and whether the network needs skills of its own (Provan & Kenis, 2008).
Applying the Framework
With eighteen partners, moderate trust and partners wary of being dominated by the hospital system, the team judged that shared governance would be unwieldy and a hospital-led model would feed suspicion. It created a small network administrative organization: a coordinator, a data analyst and a council with seats for four nursing homes, two home health agencies and the network, staffed by the coordinator rather than hospital executives.
What Collaboration Could Add
Lasker and colleagues argue that the collaborative advantage of partnerships comes from synergy, combining partners' different perspectives, resources and skills in ways that create solutions no single partner could develop, and that this synergy can be assessed and strengthened (Lasker et al., 2001). Nursing homes knew what information they needed at admission; hospitals knew which patients were likely to return; together they could redesign transitions.
Why Not Buy Nursing Homes
The board had asked whether the network should simply acquire nursing homes. The team advised against it: acquisition would require large capital, bring a different regulatory and staffing model the network did not know and, based on evidence about integration, might not improve coordination on its own. A partnership could deliver most of the benefit with less risk and could be expanded or restructured as the network learned.
Selecting Partners
The network invited all nursing homes and home health agencies within its region to apply, using criteria that included quality ratings, staffing, willingness to share data, capacity to accept complex patients and commitment to joint improvement. Eighteen joined; three declined, citing concerns about data sharing.
The Partnership Agreement
Each partner signed an agreement covering commitments to accept referrals within 24 hours when beds are available, to share quality data quarterly, to participate in joint reviews of readmissions and to meet agreed standards for transitions. The network committed to send complete discharge information before arrival, to provide clinical support through a hospitalist and pharmacist on call and to refer patients preferentially to partners while honoring patient choice.
Designing Hand-Offs Around Patients
Kodner and Spreeuwenberg argue that integrated care must be understood from the patient's perspective, meaning care that feels connected to the person receiving it, whatever the financial and organizational arrangements behind it (Kodner & Spreeuwenberg, 2002). The partnership designed hand-offs around that idea: a standard transition packet, a warm hand-off call between nurses, medication reconciliation within 24 hours and a follow-up call from the hospital's care manager.
Sharing Data
The network gave partners read-only access to the shared electronic record for their patients and built a dashboard showing each partner's readmissions, transfer times and quality measures alongside the network average. Partners could see their own data and anonymized peer comparisons.
Liaisons and Clinical Support
Two nurse liaisons visit partner facilities weekly, help with complex admissions and bring problems back to the hospitals. A hospitalist rounds virtually on high-risk patients during their first week in a nursing home.
Incentives
The partnership shares a portion of savings from the network's accountable care organization with partners that meet readmission and quality targets, funds staff training and gives partners priority access to network specialists.
Trust and Power
Power was unequal: the network controlled referrals and money. The team built trust by sharing data openly, giving partners real votes on the council, keeping promises about discharge information and acknowledging hospital failures, such as incomplete medication lists, in joint reviews. Partners believed the network was serious when it admitted its own mistakes first.
Including Home Health
The network's own home health agency joined the partnership alongside independent agencies on equal terms. This mattered for trust: independent agencies feared the network would steer patients to its own agency. The agreement committed the network to honor patient choice and to report referral patterns openly, and the data showed referrals divided roughly in proportion to patient preference and agency capacity.
Conflict
Conflicts arose over patient choice, since the network could not require patients to use partners, and over partners that accepted referrals slowly. The council handled disputes, and one partner that repeatedly missed commitments was placed on an improvement plan and later left the network.
Results After Eighteen Months
Days waiting for placement fell by 41%, 30-day readmissions from partner facilities fell from 22% to 17% and partner satisfaction with hospital communication rose substantially. Two partners improved their quality ratings.
Sustaining the Network
The partnership's costs, about $620,000 a year for the coordinator, analyst, liaisons and virtual hospitalist, are funded from the network's accountable care savings and reduced hospital days. The council reviews the business case annually. Sustaining the network also means refreshing relationships as administrators turn over, which is frequent in nursing homes; the coordinator meets every new administrator within a month of arrival.
Measuring Partnership Health
The council surveys partners annually on trust, communication, decision-making and perceived benefit, adapting questions on synergy, and reviews the results openly.
Lessons for Managing Without Ownership
The team drew five lessons: begin with partners' interests, choose governance that partners trust, write clear agreements with commitments on both sides, share data generously and invest in relationships through liaisons and joint problem-solving.
Conclusion
The network solved a problem it could not command away by building a partner network with independent nursing homes and home health agencies. Network governance theory guided the choice of an administrative organization, partnership synergy explained what collaboration could add and a patient-centered view of integrated care shaped hand-offs. Agreements, data, incentives and trust produced shorter waits and fewer readmissions without ownership.
References
Kodner, D. L., & Spreeuwenberg, C. (2002). Integrated care: Meaning, logic, applications, and implications. A discussion paper. International Journal of Integrated Care, 2(4), Article e12. https://doi.org/10.5334/ijic.67
Lasker, R. D., Weiss, E. S., & Miller, R. (2001). Partnership synergy: A practical framework for studying and strengthening the collaborative advantage. The Milbank Quarterly, 79(2), 179-205. https://doi.org/10.1111/1468-0009.00203
Provan, K. G., & Kenis, P. (2008). Modes of network governance: Structure, management, and effectiveness. Journal of Public Administration Research and Theory, 18(2), 229-252. https://doi.org/10.1093/jopart/mum015
What the DHA 711 Week 5 instructions ask
The fifth DHA 711 assignment usually addresses management across multiple organizations. Prompts may ask students to describe interorganizational relationships such as alliances, networks, joint ventures and contracts, analyze why organizations collaborate, choose a governance mode, design agreements, data sharing and incentives, address trust, power and conflict and evaluate the partnership's performance. Some versions ask students to analyze a partnership in their own organization; if yours does, name each partner, what it gains and what it fears. Strong papers recognize that authority does not extend across organizational lines, match governance to conditions, align incentives, build trust deliberately and measure both partnership health and results for patients.
How this DHA 711 Week 5 example is built
A week in which 14 medically ready patients waited in network hospitals for nursing home beds opens the paper. The problem of managing partners the network does not own is framed. Network governance theory compares three modes and the conditions that favor each. Partnership synergy explains what collaboration can add. The network builds a preferred post-acute network: selection criteria, a network administrative organization, agreements, shared data, liaisons and incentives. Integrated care from the patient's perspective guides design of hand-offs. Trust, power imbalances and conflict are addressed. Results after eighteen months, partnership health measures and five lessons for leading without authority close the paper.
DHA 711 Week 5 grading rubric: where the points go
The multi-organizational management week is typically graded on a sound analysis of interorganizational relationships, a well-justified governance design and attention to trust, incentives and results. Graders look for the reasons partners collaborate, a governance mode chosen with theory, agreements and data sharing described, incentives aligned, power and conflict addressed and performance measured for the partnership and for patients. Network and partnership research strengthens the paper, particularly theory used to choose a governance structure. Recognizing the limits of authority across organizations earns credit, as does explaining why partners would choose to stay. Planning for conflict and exit also earns marks. The final points go to scholarly prose and correct citations. Papers that treat partners as subordinates usually score lower; a plan silent on underperforming partners loses credit too.
DHA 711 Week 5 help: mistakes to avoid
Many DHA 711 Week 5 papers describe partnerships as if the lead organization can simply direct its partners. Across organizational lines, you lead through agreements, incentives, data and trust, not authority. Start with why each partner would join and what each fears, since those interests will shape every agreement. Use network governance theory to choose a structure that fits the number of partners, their trust and their goals. Write agreements that spell out commitments, data sharing and how disputes will be settled. Share information both ways. Measure how the partnership is working and whether patients benefit. Finally, plan for partners who leave or underperform, and decide in advance how the network will respond.
Related DHA 711 sample papers
Other DHA 711 week samples
- DHA 711 Week 1: Complex Health Systems
- DHA 711 Week 2: Theory Applied to a System
- DHA 711 Week 3: System Structure Analysis
- DHA 711 Week 4: Strategic Planning Across Units
- DHA 711 Week 6: Governance Structures
- DHA 711 Week 7: Strategic Decision Critique
- DHA 711 Week 8: System Recommendations
More DHA sample papers
DHA 711 Week 5 questions, answered
What does DHA/711 Week 5 usually ask for?
The fifth complex systems paper usually addresses managing across multiple organizations, analyzing partnerships, choosing governance, aligning incentives, building trust and measuring results.
Where can I find a free DHA 711 Week 5 sample paper?
Read the partner network paper above without charge; each design choice has a note. Describe your partnership, and your opening paper costs nothing.
What is a network administrative organization?
A separate entity created to govern and coordinate a network of organizations, useful when many members, moderate trust and a need for specialized network-level skills make shared or lead-organization governance less effective.
What is partnership synergy?
The added value a partnership creates by combining partners' perspectives, resources and skills, allowing it to develop solutions no single partner could achieve.
Why do hospitals form post-acute networks?
To shorten delays in discharging patients, improve hand-offs and quality after discharge and reduce readmissions and total costs, especially under value-based payment.
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