| Course | NURS 6421 Supporting Workflow in Healthcare Systems |
|---|---|
| Week | Week 5 |
| Paper type | Gap analysis |
| Length | About 1,010 words, 6 pages |
| Format | APA 7 student paper |
| School | Walden University |
| Program | Master of Science in Nursing (MSN) |
| Updated | September 2026 |
Free sample paper for NURS 6421 Week 5
Six Gaps, Ranked by What They Cost the Staff Who Live With Them: A Gap Analysis of Referral and Rooming Work in a Composite Sleep Medicine Clinic
Student Name
College of Nursing, Walden University
NURS 6421: Supporting Workflow in Healthcare Systems
Instructor Name
Month Day, Year
Six Gaps, Ranked by What They Cost the Staff Who Live With Them: A Gap Analysis of Referral and Rooming Work in a Composite Sleep Medicine Clinic
Sources of Evidence
This analysis draws on three earlier pieces of work on the same composite sleep medicine clinic: the Week 1 account of the rooming sequence, the Week 3 current-state map of the referral process and the Week 4 task analysis of booking one referred patient. Each gap below is traced to the artifact and the step that shows it, so a reader can check the claim against its source. The desired state for each gap comes from what the clinic's leaders and staff said they wanted when asked during the mapping interviews, not from an outside benchmark.
The Gaps
Table 1
Current State, Desired State, Evidence and Rank
| Gap | Current condition | Desired condition | Distance | Evidence | Rank |
|---|---|---|---|---|---|
| A. Referral status and scheduling live in two systems | Scheduler searches for the same patient twice and must return to the first system to close the referral | One place shows a referral's status and its booking | Every booking requires two searches and one return trip | Task analysis actions 4, 10, 17 | 1 |
| B. Referrals not closed after booking | Referral stays open when action 17 is missed; patient is called again | Referral closes when the appointment is booked | Repeat calls several times a week, by staff estimate | Task analysis action 17 | 2 (symptom of A) |
| C. Incomplete referrals on arrival | About one in four arrives without notes or insurance details | Nine in ten arrive complete | Loop A runs for a quarter of all referrals | Process map steps 3 and 4, Loop A | 3 |
| D. Duplicate referrals in the queue | Returned pages logged as new referrals | One referral per patient per request | Scheduler removes duplicates by hand | Process map Loop A note; task analysis action 5 | 4 (symptom of A and C) |
| E. Authorization status out of date | Approvals arrive by fax and are entered later | Status updated the same day an answer arrives | Visits booked before approval, later canceled | Task analysis action 7; map Loop B | 5 |
| F. Vital signs taken in the hallway | Blood pressure, weight and neck circumference measured in an alcove within earshot of others | Measurements taken in a private space | Every morning when rooms are full | Week 1 rooming account | 6 |
Why Rank by Staff Burden
The gaps are ranked by the time and interruption they impose on the staff who work around them, measured by how often the gap appears in the observed work and how many steps it adds each time. Cost in dollars was not used, because none of the earlier work measured money, and inventing a budget figure would break the chain from observation to claim. Staff burden also reflects what process improvement literature recommends mapping be used for, which is understanding how work is actually done so that improvement targets real problems rather than assumed ones (Antonacci et al., 2018). The ranking has a limit worth naming: gap F, the hallway vital signs, ranks last on staff burden but carries a privacy and dignity cost for patients that the burden measure does not capture. A ranking by patient impact would move it higher, and the clinic's leaders should see both views before choosing where to start.
Two Symptoms and One Cause
Gaps B and D looked like separate problems during the mapping work. Reading them against the task analysis showed that both follow from gap A. Referrals stay open because closing them requires a return to the first system after the booking already feels complete. Duplicates survive because neither system checks the other for an existing referral when new pages arrive. Fixing B with a reminder to schedulers, or D with a weekly cleanup, would treat the symptom and leave the cause in place. Human factors frameworks describe how outcomes emerge from interactions among the parts of a work system, which is why a problem seen in one step often originates in another (Holden et al., 2013). If gap A is closed, B should largely disappear and D should shrink to the portion caused by gap C.
What This Analysis Cannot See
Three limits apply. First, the evidence comes from two observed mornings and a set of interviews; the authorization coordinator's work, behind gap E, was described rather than observed. Second, the analysis sees the clinic from the inside and cannot see why referring offices send incomplete referrals, which may have its own causes, such as the referral form they are given. Third, the burden estimates for gap B rely on staff recall. Interruptions studied in other settings have been shown to change how tasks are completed and whether they are completed at all (Westbrook et al., 2010), and a timed observation of the scheduler across a full week would test whether the burden ranking holds. Until then, the ranking should be treated as a well-supported starting point rather than a measurement.
Gaps Considered and Excluded
Two further problems came up in interviews and were considered but not included. The first was provider template length: two providers said their new-patient template was too long. It was excluded because nothing in the observed referral or rooming work touched the template, so there was no evidence in this term's artifacts to size it. The second was waiting room crowding on Monday mornings. It was excluded as a gap in its own right because it appears to be a consequence of gap F and of the rooming sequence described in Week 1, rather than an independent problem. Naming the excluded items matters for two reasons. It shows the committee that the list of six is a choice rather than an inventory of everything wrong, and it keeps both concerns visible for the next round of work, when observation of provider visits could supply the evidence the template question lacks. The clinic's leaders may still choose to act on either concern sooner, but they would be acting on report rather than on observed work, and the analysis should say so.
References
Antonacci, G., Reed, J. E., Lennox, L., & Barlow, J. (2018). The use of process mapping in healthcare quality improvement projects. Health Services Management Research, 31(2), 74-84. https://doi.org/10.1177/0951484818770411
Holden, R. J., Carayon, P., Gurses, A. P., Hoonakker, P., Hundt, A. S., Ozok, A. A., & Rivera-Rodriguez, A. J. (2013). SEIPS 2.0: A human factors framework for studying and improving the work of healthcare professionals and patients. Ergonomics, 56(11), 1669-1686. https://doi.org/10.1080/00140139.2013.838643
Westbrook, J. I., Coiera, E., Dunsmuir, W. T. M., Brown, B. M., Kelk, N., Paoloni, R., & Tran, C. (2010). The impact of interruptions on clinical task completion. Quality and Safety in Health Care, 19(4), 284-289. https://doi.org/10.1136/qshc.2009.039255
The Walden NURS 6421 Week 5 instructions
Gap analysis prompts in this course usually ask you to compare the current state of a workflow with a desired state, identify the gaps, support each with evidence and prioritize them. Many sections want the gaps drawn from earlier assignments, such as the observation, map and task analysis. The paper is often three to five pages with a table. Define where the desired state comes from, such as a stated goal or a policy, and choose a ranking method you can defend with the evidence you have. If you have no financial data, rank by something you did measure, like time, frequency or interruption. Many sections also ask you to note which gaps you will address next, which a single closing sentence can do.
How the NURS 6421 Week 5 example is put together
A short opening lists the three earlier artifacts used as evidence and says where the desired states came from. Table 1 lists six gaps with current and desired conditions, distance, evidence traced to specific map steps and task analysis actions, and rank. The ranking section explains why staff burden was used, admits that the hallway vital signs gap ranks low on burden but high on patient privacy, and cites a process mapping review. The next section shows how two gaps follow from the split between systems. A limits section names what was described rather than observed, and a final section explains two excluded concerns.
NURS 6421 Week 5 rubric: what earns full marks
Gap analysis rubrics usually score identification of gaps, evidence for each, clarity of current and desired states, prioritization, analysis of causes and writing. Evidence is judged by whether each gap can be traced to observed work or a documented source. Desired states should come from the organization rather than an ideal. Prioritization earns credit when the method is explained and applied consistently. Cause analysis rewards noticing when gaps share an underlying cause. Many rubrics also credit an honest statement of limits. Writing covers the table, clear headings and APA references for the sources that support the method. Some rubrics also look for gaps grouped by cause, which prepares the ground for the future-state work.
NURS 6421 Week 5 help: mistakes that cost marks
The most common loss is a list of problems with no evidence behind them, or with evidence that could not be checked. Another is ranking by an invented cost. Some analyses treat every gap as independent and miss that fixing one would remove two others. Others describe the desired state as perfection. Tie each gap to a specific step or action in your earlier work, say where the desired state came from, rank by what you measured, look for shared causes and admit what your evidence cannot show. Finally, name any concerns you left out and why, so the reader knows the list is a choice.
Get a NURS 6421 Week 5 example written to your instructions
Two things make a gap analysis fit: the prompt itself, and whichever earlier artifacts your section wants referenced. Send those alongside the rubric, and the NURS 6421 gap analysis that follows carries the same table structure and the same ranking discipline, set in a composite clinic. No employer material goes into it. First custom sample free, inside 24-48h.
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NURS 6421 Week 5 questions, answered
Should gaps be ranked by cost in dollars?
Only if you actually have financial data and the prompt asks for it. The example ranks by staff burden, because that is what the observation and task analysis of earlier weeks measured. Inventing a dollar figure to make a ranking look rigorous is the fastest way to lose the evidence row you already earned. Burden measured honestly outranks currency invented for effect.
How many gaps should the analysis carry?
Your prompt decides, and nothing about that is published by Walden. Six works well in the example because it is enough to force ranking and few enough that each one keeps its evidence. A list of twelve thinly supported gaps scores below a set of five where every row can be traced. Ranking only means something once there are more gaps than obvious answers.
Where can I find a free NURS 6421 Week 5 sample paper?
The complete gap analysis, with the table, ranking defense, cause analysis, limits and excluded items, can be read here at no cost. An analysis built on your own earlier artifacts can be drafted on request.
Where does the desired state come from in a NURS 6421 gap analysis?
From the organization: a stated goal, a policy, a standard it has adopted or what its leaders and staff say they want. The example uses staff and leader statements from the mapping interviews.
Can a NURS 6421 gap analysis include patient impact?
Yes, and it should when a gap affects patients directly. The example ranks by staff burden but flags one gap, hallway vital signs, whose patient privacy cost would move it higher on a different scale.