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     As the CNO of my current healthcare organization having to restructure a top heavy nursing department with the intention of reducing financial loss, we must evaluate the best way to restructure the department without inadvertently losing employees in the process, as well as flattening the line to reduce additional cost. As a leader we must evaluate and assess all three decision-making models and integrate the problem at hand in each scenario.

            Overall, the PDSA makes the most sense in a scenario as sensitive to the possibility of resistance to change such as healthcare organizational changes. The PDSA Model also known as the Plan-Do-Study-Act or Plan-Do-Check-Act model is a methodology tool used as a part of the Institute for Healthcare improvements’ Model for Improvement. The PDSA tool is ultimately utilized to improve quality of care, in return improving healthcare safety disparities, patient adverse events, and producing a timely, effective, patient-centered solution to disparities, in this case nursing staffing shortages in healthcare organizations (Polit & Beck, 2017). The cycle consists of four steps, the first step is “plan”, planning a change in this case such as implementing to reduce leadership roles. Second step to the PDSA cycle is “do”, healthcare organization carries out the plan on a small scale or pilot program. In this scenario, the shift in personnel/staff  will be implemented on medical surgical units only where based from previous studies, the med-surg units are often times short staffed and hold lowest job satisfaction scores (Donnelly & Kirk, 2015). The third step is “study”, data and review analysis take priority, in this phase where researchers, administrators and leadership identify outcomes and lessons learned. The final step is “act”, essential step to facilitating effective change by gathering learned information, data and disseminating to associates to implement effective change.

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