MMHA 6999 Week 5 Strategic Decision Memo Example

Course	MMHA 6999 Strategic Leadership Management
Week	Week 5
Paper type	Decision memo
Length	About 870 words, 5 pages
Format	Memo, APA 7 citations
School	Walden University
Program	Master of Healthcare Administration (MHA)
Updated	October 2026

Free sample paper for MMHA 6999 Week 5

Memorandum

To: Board of Directors, Juniper Valley Health

From: Chief Strategy Officer (MMHA student)

Date: Month Day, Year

Re: Recommended decision on obstetric services at Alder Creek, and what the rejected options would have delivered

Decision

I recommend that the board approve consolidating births from Alder Creek Hospital at Juniper Valley Regional Hospital, effective in fifteen months, while keeping prenatal and postpartum care, emergency obstetric readiness and a family transport and lodging program at Alder Creek. This is Option B from the options analysis, which scored highest against criteria the board set before the options were described, using the kind of transparent multi-criteria scoring recommended for health priority setting (Baltussen & Niessen, 2006). The decision is not reversible in practice once the unit's staff disperse, so I ask the board to make it with the costs of the alternatives in view.

What this page is doingThe memo commits in its first sentence and names the irreversibility, which tells the board this is a real decision rather than a direction.

Why This Option

Option B scored highest on safety and staffing sustainability, the two criteria that most affect whether mothers and babies are cared for well over the next five years. The regional hospital has around-the-clock obstetric, anesthesia and neonatal coverage and delivers about 1,300 babies a year. Alder Creek, with about 140 births a year and two of three delivering physicians retiring, cannot sustain that coverage. The decision protects the system's strengths in emergency presence and its clinic network, which the position assessment identified as the foundations of its strategy.

What the Rejected Options Would Have Delivered

Every choice also costs whatever the strongest road not taken would have produced. Economists call this opportunity cost, and in health care it means naming the benefits that would have flowed from the options not chosen (Palmer & Raftery, 1999). The board should see them plainly.

I name these costs because families in Alder Creek will lose something real. Rural counties that lose hospital obstetric services have seen more unplanned births away from maternity care and more preterm births (Kozhimannil et al., 2018). The decision is defensible only if the system funds what reduces those risks.

Table 1

What Each Rejected Option Would Have Delivered

Option rejected	What it would have delivered	Why it was not chosen
A: Full local birth service retained	About 140 births a year within 15 minutes of most Alder Creek families; no travel in labor; continued local identity of the hospital	Recruitment of two obstetric-trained family physicians is uncertain after 14 months with no applicants; anesthesia coverage cost rising sharply; safety at risk if coverage gaps occur
C: Midwife-led low-risk birth center	Perhaps 80 to 100 local low-risk births a year with midwifery care; lower cost than full service	No cesarean capability on site; depends on rapid transfer over 48 miles in winter; midwife recruitment also difficult
D: Partnership with the larger system	Shared cost of coverage; local births continued	Would cede the system's position in the region to a competitor and depend on a partner's commitment it cannot control

The rejected options would each have kept more births local. That benefit is real, and the decision gives it up.

What the System Commits to Fund

The decision includes four commitments, which the resourcing plan will cost in detail. Prenatal and postpartum clinics at Alder Creek continue, with telehealth links to the regional maternal-fetal medicine service. Alder Creek's emergency department will be equipped and trained for emergency births and obstetric hemorrhage, with quarterly drills. A transport and lodging program will offer families near term a place to stay near the regional hospital and transport in labor. And a nurse navigator will contact every pregnant patient at Alder Creek by twenty weeks to plan where and how she will deliver.

Why Now

Delay is itself a choice. If the board waits a year, the two retiring physicians will have left, the unit will rely on temporary coverage of uncertain quality and nurses will begin leaving for other jobs, as some already have. A transition planned now can be orderly, with prenatal care, emergency readiness and lodging in place before the last birth at Alder Creek. A transition forced by a staffing collapse would be abrupt, with none of those protections ready. The options analysis showed that the result does not depend on finances, so waiting for a better budget year would not change the answer, only the conditions under which the change happens.

How Success Will Be Judged

The board will receive quarterly reports on births to Alder Creek-area families: where they occurred, how many were unplanned births outside the regional hospital, travel times in labor, emergency department obstetric events and outcomes for mothers and newborns. The first report will come three months after consolidation. If unplanned births outside a hospital rise above an agreed threshold, the board should expect a review of the readiness and transport programs.

Risks

The main risks are rapid labor before arrival at the regional hospital, loss of community trust and departure of Alder Creek nurses who do not wish to transfer. The emergency readiness program addresses the first. A carefully sequenced communication plan addresses the second. The system will offer every obstetric nurse a position at the regional hospital or in Alder Creek's emergency department or clinics.

Board Action Requested

Approve consolidation of births at Juniper Valley Regional effective in fifteen months, with the four commitments above, and direct the chief executive to present the resourcing and change plans at the next meeting.

What this page is doingThe request asks for one decision with its conditions attached, so the board cannot approve the cut without the commitments.

References

Baltussen, R., & Niessen, L. (2006). Priority setting of health interventions: The need for multi-criteria decision analysis. Cost Effectiveness and Resource Allocation, 4, 14. https://doi.org/10.1186/1478-7547-4-14

Kozhimannil, K. B., Hung, P., Henning-Smith, C., Casey, M. M., & Prasad, S. (2018). Association between loss of hospital-based obstetric services and birth outcomes in rural counties in the United States. JAMA, 319(12), 1239-1247. https://doi.org/10.1001/jama.2018.1830

Palmer, S., & Raftery, J. (1999). Opportunity cost. BMJ, 318(7197), 1551-1552. https://doi.org/10.1136/bmj.318.7197.1551

MMHA 6999 Week 5 instructions, in plain terms

Decision memos ask you to commit to a course of action and defend it to decision makers. Put the decision itself in the subject line and again in the opening sentence. Explain briefly why this option, drawing on earlier analysis rather than repeating it. Then do what many memos avoid: name what each rejected option would have delivered, so the board sees the full cost of the choice. Use the idea of opportunity cost to frame that section. List the commitments that make the decision acceptable and treat them as conditions. Address why the decision should be made now. Say how success will be judged and what risks remain. End with a single board action that includes the conditions, so the decision cannot be approved without them.

How the MMHA 6999 Week 5 example is put together

The memo states the decision and its irreversibility, then explains why it scored highest. A section cites Palmer and Raftery on opportunity cost, and Table 1 lists what each rejected option would have delivered and why it was not chosen. A paragraph cites Kozhimannil and colleagues and states that the decision is defensible only with protective funding. A section lists four commitments. Sections explain why delay is itself a choice and how success will be judged quarterly. A risks section covers rapid labor, community trust and nurse retention. The board action asks for approval with the commitments attached.

Reading the MMHA 6999 Week 5 rubric

Decision memos are graded on commitment and honesty. A decision stated plainly at the start earns the foundation. A brief rationale grounded in earlier analysis earns the next share. Naming what rejected options would have delivered, framed as opportunity cost, earns significant credit, because it shows the decision maker understands what is being given up. Commitments treated as conditions show ethical seriousness. Addressing timing, measures and risks demonstrates completeness. A single board action with conditions shows professional judgment. Memo format and concise writing are expected. References should support the cost and risk arguments. Graders also look at whether the memo's commitments match the resourcing plan that follows, since a commitment without money is a promise only.

Common MMHA 6999 Week 5 mistakes, and how to avoid them

Decision memos often hedge, offering a direction rather than a decision. Write the decision in the first sentence. Then be honest about what the other options would have given people, because the board and the community will ask. Attach the commitments that protect those affected and make them part of the motion. Explain why now. Say what you will measure. If you need to write a decision memo for a hard choice at work, our writers can help you draft one that commits clearly and names its costs openly. Read your memo as the person most hurt by the decision would read it, and fix any sentence that sounds evasive.

Get a MMHA 6999 Week 5 example written to your instructions

Send the memo prompt, the options work it follows and the rubric the classroom uses, and a finished MMHA 6999 Week 5 decision memo returns inside 24-48 hours, the first sample costing nothing, both rejected options argued at full strength. No actual decision sits behind it, since the health system in the memo was invented for the page.

More MMHA 6999 papers and MHA samples

MMHA 6999 Week 5 questions, answered

Where can I find a free MMHA 6999 Week 5 sample paper?

The decision memo, with its rejected-options table, is posted here at no cost.

What does the MMHA 6999 Week 5 memo decide?

To move deliveries to the larger hospital and back the move with local prenatal visits, emergency birth readiness, a navigator and family lodging.

How are the rejected options priced?

By naming what each would have delivered, such as local births within fifteen minutes of home, and why each was not chosen.

Why is delay treated as a choice?

Waiting would let the physicians retire and nurses leave, forcing an abrupt change without protections in place.

How will success be judged?

Through quarterly reports on where births occurred, unplanned births outside a hospital, travel times and maternal and newborn outcomes.