DDHA 9500 Week 9 Alignment Check Example

Reading the Offload Prospectus Cold: An Alignment Check of Problem, Purpose and Approach, Five Shared Terms Tracked and Three Shifts Repaired

Student Name

Walden University

DDHA 9500: DHA Project Prospectus

Instructor Name

Month Day, Year

Reading the Offload Prospectus Cold: An Alignment Check of Problem, Purpose and Approach, Five Shared Terms Tracked and Three Shifts Repaired

The Three Sections, Quoted

Table 1

Current Wording of the Three Sections

Wording is quoted from the current drafts, revised since the earlier weeks, rather than summarized, so nothing is repaired by accident in transcription.

Terms That Appear in More Than One Section

Population. The problem's opening sentences speak of ambulance crews, county residents and patients on stretchers; its final sentence names no population. The purpose and approach name adult arrivals by ambulance. This is a shift: the problem describes who bears the consequences, while the purpose and approach describe the unit measured. Both are legitimate, but a reader may ask why residents, named as the first group harmed, never reappear.

Setting. "The three hospitals," "three community emergency departments of one regional system" and "hospital by hospital" are consistent.

Exposure. "Boarding of admitted patients," "the count of admitted patients held in the emergency department each hour" and "the boarding count for the hour of arrival" are consistent in meaning, with the purpose adding the hourly unit that the approach requires.

Outcome. The problem's opening sentence frames the gap as waits beyond a 30-minute interval, and its final sentence speaks of "offload time." The purpose names "ambulance patient offload time." The approach reports both median offload time and the share exceeding 30 minutes. This is a mild shift: the problem leans toward a threshold, the purpose toward a continuous measure.

Time frame. The two-year period appears in the purpose and, through the data plan, in the approach but not the problem, which is acceptable, since the problem need not state a study period.

Terms That Appear in Only One Section

"Offload role" appears only in the approach, as an adjustment. It is justified by the literature summary, but a reader encountering it for the first time in the approach may wonder why it matters. "Adult" appears in the purpose and approach but never in the problem. Single-column terms are the more common drift, because they enter while one section is being written and are never carried back.

Proposed Edits, One Against Each Shift

For the population shift, add a sentence to the end of the problem statement: "The project measures the problem at the level of individual adult ambulance arrivals, the point at which crews, residents and patients are all affected." This tells the reader why the unit differs from the groups harmed.

For the outcome shift, revise the purpose to name both forms: "ambulance patient offload time, including the share of arrivals waiting more than 30 minutes." The approach already reports both, so the purpose should promise both.

For the single-column term, add one clause to the approach where the offload role is introduced: "because a dedicated offload role may shorten handovers independently of boarding (see the literature summary, Claim 2)." This connects the adjustment to the argument that justifies it. The literature summary draws on Greaves et al. (2017) for that point.

Why the Check Matters Now

Drift is invisible while writing because each section reads well on its own. It becomes visible to a committee member who reads the prospectus straight through. Creswell and Creswell (2018) describe the purpose statement as the organizing center of a proposal, and the edits above bring the problem and approach back into line with it, so that the committee reads one argument rather than three related ones. Li et al. (2019) note how varied offload delay measures are across studies, which is a further reason to keep the outcome defined identically in every section.

References

Creswell, J. W., & Creswell, J. D. (2018). Research design: Qualitative, quantitative, and mixed methods approaches (5th ed.). SAGE.

Greaves, T., Mitchell, M., Zhang, P., & Crilly, J. (2017). The impact of an emergency department ambulance offload nurse role: A retrospective comparative study. International Emergency Nursing, 32, 39-44. https://doi.org/10.1016/j.ienj.2016.12.005

Li, M., Vanberkel, P., & Carter, A. J. E. (2019). A review on ambulance offload delay literature. Health Care Management Science, 22(4), 658-675. https://doi.org/10.1007/s10729-018-9450-x