| Course | DDBA 8560 Seminar in Healthcare Managerial Decision Making |
|---|---|
| Week | Week 1 |
| Paper type | Discussion post |
| Length | About 570 words, 4 pages |
| Format | Discussion post, APA 7 citations |
| School | Walden University |
| Program | Doctor of Business Administration (DBA) |
| Updated | October 2026 |
Free sample paper for DDBA 8560 Week 1
Week 1 Discussion: Where the Manager's Decisions End
A Seam, Not a Wall: Sorting Three Decisions in a Surgical Service Between Manager and Surgeon and Arguing That First-Case Start Time Belongs to Neither Side Alone
Three Decisions and Their Owners
In a composite surgical service at a 300-bed community hospital in Michigan, with eleven operating rooms, three recurring decisions show where the line between management and clinical judgment falls. Block allocation, how many operating room blocks each surgical group receives each week, belongs to the perioperative services director, advised by a committee. Same-day discharge eligibility, which patients may go home the day of surgery, belongs to the surgeon and anesthesiologist. First-case start time, whether the 7:30 a.m. cases begin on time, is the contested one.
Why the First Two Sort Cleanly
Mintzberg (1979) described the professional bureaucracy, in which trained professionals in the operating core control their own work through standards learned in their professions, while administrators manage the support structure around them. Discharge eligibility sits in the operating core: it depends on the patient's condition, the procedure and clinical judgment no administrator can substitute for. Block allocation sits in the support structure: it is a question of distributing a scarce resource according to volume, utilization and strategy. Glouberman and Mintzberg (2001) split health care into four worlds, cure, care, control and community, which run on different assumptions, and these two decisions belong plainly to cure and to control respectively.
Why the Third Does Not
First-case start time is set by two things at once. A scheduling rule, owned by the manager, determines when the room, staff, instruments and patient must be ready. A readiness judgment, owned by the surgeon, determines when the surgeon is present, has reviewed the patient and is prepared to begin. Last quarter, 41 percent of first cases in this service started more than ten minutes late. Audit notes attribute about half of delays to surgeon arrival and about half to room or patient readiness. Neither side can fix the problem alone: a manager who tightens the rule without surgeons' agreement will see it ignored, and a surgeon who arrives on time to an unready room gains nothing.
My claim is that first-case start time belongs to a joint decision, with the rule and the readiness standard set together. That claim could be wrong. If audit data showed delays coming almost entirely from one side, the decision would belong to that side.
The Literature That Disagrees
Glouberman and Mintzberg's four worlds imply that decisions should be sorted into one world or another, and their analysis emphasized how separate the worlds tend to be. Denis et al. (2001) studied hospitals as pluralistic organizations and found that strategic change succeeded when leadership was shared across clinical and managerial roles, which supports treating some decisions as joint. I side with the second view for start times, but I concede the first: for most decisions, clear ownership is better than joint ownership, which can diffuse responsibility.
Question for Classmates
Which decision in your organization sits on the seam, and what data would show which side owns it?
Reply to Tanya
Tanya, you assign bed placement entirely to nursing supervisors. Do hospitalists' discharge timings not set the beds available, making it a seam as well?
Reply to Omar
Omar, you call formulary decisions purely clinical. The pharmacy budget constrains which drugs are stocked; does the pharmacy and therapeutics committee not include a finance representative in your hospital?
References
Denis, J.-L., Lamothe, L., & Langley, A. (2001). The dynamics of collective leadership and strategic change in pluralistic organizations. Academy of Management Journal, 44(4), 809-837. https://doi.org/10.2307/3069417
Glouberman, S., & Mintzberg, H. (2001). Managing the care of health and the cure of disease: Part I. Differentiation. Health Care Management Review, 26(1), 56-69. https://doi.org/10.1097/00004010-200101000-00006
Mintzberg, H. (1979). The structuring of organizations. Prentice-Hall.
What the DDBA 8560 Week 1 instructions ask for
The first discussion asks you to sort decisions in a health care setting by who owns them. Choose three recurring decisions from one service and assign each an owner in a single sentence. Ground the clear cases in organizational theory about professional work and administration. Then make a claim about the contested decision that could turn out to be wrong, and say what evidence would show it. Bring in literature that disagrees with your claim and concede what it gets right. Ask peers which of their decisions sits on the seam, and write two replies that question how a classmate sorted one decision. Keep the main post near five hundred words, with a short reference list, so classmates can engage it fully.
How this DDBA 8560 Week 1 example is built
The sample's opening names block allocation, discharge eligibility and first-case start time in operational terms. The second section places the first two using the professional bureaucracy, where the operating core controls its work, and the worlds of cure and control. The third section explains that start time combines a scheduling rule the manager owns with a readiness judgment the surgeon owns, and cites audit notes attributing delays roughly half to each. The claim is stated as falsifiable: if delays came almost entirely from one side, that side would own the decision. Replies question Tanya's bed placement and Omar's formulary assignment. A concession paragraph grants that clear ownership usually beats joint ownership, which can blur responsibility, and limits the claim to start times.
Reading the DDBA 8560 Week 1 rubric
The heaviest weight falls on falsifiability, the chance that the position could prove wrong. A post that sorts decisions without committing on the contested one has described an organization chart and argued nothing. Scholarly support is read for fit rather than count: two primary sources applied to the sorting outweigh six cited in passing. The concession earns credit when it narrows the claim and loses credit when it abandons it. Data from the service, even rough audit figures, strengthen the argument. Replies are marked on whether they reopen a classmate's sorting with a specific reason. Use of service data, such as late-start percentages, shows the writer can ground a theoretical claim in operations.
DDBA 8560 Week 1 help: mistakes that cost marks
Pick decisions you know well, preferably ones that recur weekly or daily. For each, ask who would be blamed if it went wrong and who could change it tomorrow; the answers often differ, which is a sign of a seam. State your claim about the hard case in one sentence and add a clause saying what would prove it wrong. Read Mintzberg on the professional bureaucracy before choosing other sources. Keep the concession short. In replies, name a party your classmate left out of a decision and explain why that party matters. If your setting is not surgical, the same method works for clinic templates, discharge timing or staffing decisions.
Get a DDBA 8560 Week 1 example written to your instructions
Send the Week 1 discussion prompt, the rubric and the reply count your section enforces, and a post built on the surgical, ambulatory or inpatient setting you know comes back inside 24 to 48 hours, the first one free. A classroom that restricts which frameworks may be cited gets a post argued from those alone.
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DDBA 8560 Week 1 questions, answered
Where can I find a free DDBA 8560 Week 1 sample paper?
The surgical service post and its replies to Tanya and Omar are free to read below the facts table.
Which decisions does the DDBA 8560 Week 1 post sort?
Operating room block allocation, same-day discharge eligibility and first-case start time.
Who owns block allocation?
The perioperative services director, advised by a committee, since it distributes a scarce resource.
Why does first-case start time belong to neither side alone?
It depends on a scheduling rule the manager owns and a readiness judgment the surgeon owns.
What evidence could prove the claim wrong?
Audit data showing that delays come almost entirely from one side.