| Course | HC 405 Healthcare Quality |
|---|---|
| Unit | Unit 8 |
| Paper type | Improvement pitch memo |
| Length | About 820 words, 4 pages |
| Format | Business memo with analysis, APA 7 references |
| School | Herzing University |
| Program | BS in Healthcare Administration |
| Updated | October 2026 |
Free sample paper for HC 405 Unit 8
Memorandum
To: Facility Administrator; Medical Director
From: Quality Improvement Lead
Date: March 2, 2026
Re: Request to extend fragile-access tagging and staggered changeovers to all second-shift rows
The Request
I am asking you to approve, by Friday, March 6, extending two tested changes to all four second-shift rows from March 9: an orange tag at the station for every new or difficult vascular access, placed by the first shift, and staggered connection times for second-shift patients, with matching staggered finish times on the first shift. The cost is about $1,050 in supplies and training and about 13 staff hours to set up, with a few minutes of staff time each shift after that.
The Problem
In 2025, 58 vascular access events reached patients at Gulfview: needles placed through the vessel, needles dislodged during treatment, and bleeding that would not stop after needle removal. Thirty-five of them, 60%, happened on the second shift, and most came right as patients were going on or coming off the machine, when each technician is juggling several changeovers together. Events rose every quarter, from 11 in the first quarter to 18 in the fourth. Seven of the events shortened a patient's treatment, and two sent a patient to the emergency department for bleeding.
What Has Been Tested
Four small tests in February, starting with one technician on one shift, showed that the tag was placed for 93% of flagged patients once it was added to the first shift's closing checklist, and that staggering starts in pairs removed nearly all moments when a technician had to connect and disconnect at once. On the two rows where both changes ran for a week, there were no access events, and patients started treatment slightly sooner, not later. One week proves little, which is why the request is to extend and measure, not to declare success.
What the First Shift Will Look Like
At 10:45 a.m., before first-shift patients come off, each first-shift technician checks the flagged list read at the 10:30 huddle and places orange tags on the second-shift stations in their row. First-shift patients on each row finish in two pairs, 15 minutes apart, as their schedules already reflect. At 11:00, the second-shift technician connects the first pair; at 11:15, the second. For any tagged station, the technician either uses the portable ultrasound, now kept on a cart on the floor, or asks the senior technician to cannulate. The charge nurse checks tags and timing on a one-page sheet.
Resources
Staff hours, one-time: six hours for the charge nurse to rebuild the first- and second-shift schedules for all four rows; one hour of training for each of seven second-shift and first-shift technicians who were not in the tests, seven hours. Staff hours, ongoing: about five minutes per shift for tag placement and two minutes at the huddle.
Supplies: reusable orange station tags, $40; a rolling cart to keep the portable ultrasound on the floor, $650; ultrasound gel and probe covers for the first quarter, $180.
Purchases: none beyond the supplies above. Training time at the average technician rate of $24 an hour for the seven hours comes to $168. Total cash cost about $1,040, rounded to $1,050 for contingency.
Measurement
What gets counted: access events on the second shift that reached a patient, taken from event reports each month; the share of flagged patients with a tag, and the number of overlapping changeovers, from the charge nurse's sheet, weekly for the first month and monthly after; and, as a balancing measure, the average minutes from scheduled chair time to start of treatment for second-shift patients, from machine start times, monthly. Who counts: the charge nurse for the weekly sheet, the quality lead for monthly figures. Where it is reported: a run chart for each measure at the monthly quality committee, which is responsible for tracking the facility's improvement projects (42 C.F.R. § 494.110). Monthly tracking of this kind, with the prediction recorded before each change, follows the improvement method used in the tests (Langley et al., 2009).
Decision point: June 30. If second-shift events average one or fewer a month for April through June without longer waits, the changes become standard work. If events fall but not to that level, the team will test the next cause identified in the analysis, experience levels on the second shift. If waits rise, the staggering will be adjusted before anything else is added.
Why It Is Worth It
Each event that reaches a patient means pain, a hematoma or lost treatment time, and occasionally an emergency visit. National vascular access guidance stresses skilled cannulation and close attention to fistulas that are new or hard to needle, because repeated injury shortens an access's useful life (Lok et al., 2020). These changes cost very little, can be reversed in a day if they cause problems, use equipment the center already owns, and were designed and tested by the technicians who will use them.
References
Condition: Quality assessment and performance improvement, 42 C.F.R. § 494.110 (2025).
Langley, G. J., Moen, R. D., Nolan, K. M., Nolan, T. W., Norman, C. L., & Provost, L. P. (2009). The improvement guide: A practical approach to enhancing organizational performance (2nd ed.). Jossey-Bass.
Lok, C. E., Huber, T. S., Lee, T., Shenoy, S., Yevzlin, A. S., Abreo, K., Allon, M., Asif, A., Astor, B. C., Glickman, M. H., Graham, J., Moist, L. M., Rajan, D. K., Roberts, C., Vachharajani, T. J., & Valentini, R. P. (2020). KDOQI clinical practice guideline for vascular access: 2019 update. American Journal of Kidney Diseases, 75(4, Suppl. 2), S1-S164. https://doi.org/10.1053/j.ajkd.2019.12.001
HC 405 Unit 8 instructions, in plain terms
Unit 8 asks you to write a memo pitching an improvement to a decision maker. Expect a request with a date, the problem, what has been tested, what the change will look like, resources, measurement and why it is worth it. Students often ask how persuasive the memo should be. Let tested results do the persuading, and keep the tone plain. Put the request and deadline in the first sentence. Show what the change looks like in practice, so the reader can picture it. List staff hours and costs honestly. Say what will be counted, how often and by whom. End with the benefit to patients, since that is why the change matters.
How the HC 405 Unit 8 example is put together
The memo opens with the request, the two changes and the start date. The problem section gives the year's access events and the share on the second shift. The tests section summarizes four cycles and their results. The practice section walks through the first shift's closing steps and the second shift's paired starts, with times. The resources section lists hours for rebuilding schedules and training each technician. The measurement section names monthly event counts, tag compliance and overlapping changeovers, with who reports each. The final section describes the pain, hematomas and lost treatment time each event causes and connects the change to national vascular access guidance on careful cannulation.
Where the points sit in the HC 405 Unit 8 rubric
Herzing's rubric for an improvement pitch memo typically covers the request, problem, evidence from testing, the future state, resources, measurement and benefit. Evidence from tests weighs most heavily, since a decision maker approves spread when small trials have already shown the change works. Request points reward a clear ask with a date. Problem criteria look for local counts. Future state credit goes to a concrete description of the new routine. Resource points reward hours and costs stated honestly. Measurement should name counts, frequency and owners. Benefit should be stated in patient terms. Langley's improvement guide, the KDOQI vascular access guideline and the federal QAPI condition support the memo.
HC 405 Unit 8 help before you submit
Pitch memos in HC 405 Unit 8 fall short most often by burying the request in the final paragraph. Another frequent problem is relying on enthusiasm rather than test results. Students often describe the change vaguely, so the reader cannot picture it. Resources are left out or understated. Measurement has no owner. The deadline is missing. Patient benefit is assumed rather than stated. The memo runs long. Questions the reader is likely to ask, such as what happens if patient transport runs late, are left unanswered. Front-line staff support is not mentioned. Finally, let the tests make the case, because graders reward a memo that a busy administrator could approve in five minutes and still feel confident about a week later.
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HC 405 Unit 8 questions, answered
How long should the memo be?
Whatever the instructions permit, and short inside it. One to two pages is the normal expectation for a proposal of this kind, and working within that constraint is itself being assessed. Material that will not fit belongs in an attachment, not crammed into the body, because a memo that carries everything has stopped being a memo and become a report.
What if I cannot count the problem?
Say so and propose the count as the first step. A memo admitting that nobody currently measures the thing, then asking for two weeks of tallying at the desk, is a stronger document than one that borrows a national rate and hopes it applies. Absence of data is itself a finding about the workplace, and approvers recognize it as an honest one.
Should the memo cite sources?
Lightly, and only where a source does work. One or two references showing the change has succeeded elsewhere strengthen the ask; a page of citations turns the memo back into a paper. Check your instructions, since some sections require a reference list even for a workplace document, in which case keep it at the end and out of the argument.
Where can I find a free HC 405 Unit 8 sample paper?
Read the complete HC 405 Unit 8 improvement pitch memo here at no charge, a request to spread two tested changes across a dialysis center's second shift. Ask for a custom memo for another improvement.
How do I write a memo proposing a quality improvement?
Lead with the request and a date, state the problem with local numbers, summarize what testing showed, describe the new routine, list resources and measures, and end with the patient benefit. This sample does that.