Care Setting SOAR Analysis 6200A2

Appreciative Inquiry Discovery and Dream

Appreciative Inquiry (AI) refers to a motivational, organizational change intervention that is often used to improve healthcare quality and safety. Merriel et al. (2022) note that AI aims to encourage organizations to focus on the positive and investigate the best of “what is” before thinking of “what might be”, deciding “what should be”, and experiencing “what can be.” One of the issues that has been noted in the long-term care setting is an increase in Hospital Acquired Infections (HAI). HAIs are a critical quality and safety priority in the institution, due to residents’ increased vulnerability related to age and comorbidities. The discovery phase of AI will entail identifying organizational strengths supporting infection prevention, while the dream phase will entail envisioning strategies to improve outcomes. This analysis presents an assessment of the long-term care setting using the Strengths, Opportunities, Aspirations, and Results (SOAR), as well as the relevant skills and leadership characteristics that would be beneficial in pursuing quality and safety improvement projects from the AI approach and SOAR analysis results.

The Organization’s Leadership Structure in Promoting Quality and Safety Goals

The care setting’s leadership structure includes executive leaders, the director of nursing, the infection prevention team, nurse managers, and the other staff forming the interprofessional team. The leaders play a foundational role in promoting quality and safety outcomes through alignment with regulatory requirements and implementation of quality assurance and performance improvement programs. For instance, leaders operationalize infection prevention in the institution by establishing and enforcing policies and monitoring the staff’s compliance with these policies. In addition, the interprofessional team strengthens the structure by each member playing their role, especially in safety issues such as infection prevention.

However, there is a gap between leadership intent and practice execution, due to variability in frontline adherence to practices such as hand hygiene, leading to increased HAIs. To address the issue, the leaders should move beyond policy enforcement toward behavioral and system-level interventions. Studies show that behavioral and system-level interventions such as real-time auditing, feedback mechanisms, and embedding protocols into workflow design promote compliance with policies and protocols (Patel et al., 2025). In addition, active staff engagement in the development of policies and protocols would enhance the effectiveness of quality and safety interventions by promoting acceptance and ownership by the staff involved.

Organization Strengths Critique

The institution demonstrates various strengths, promoting the overall quality and safety. These strengths include interdisciplinary collaboration and a strong emphasis on staff education and competency development. The involvement of different disciplines in quality and safety initiatives not only promotes success but also supports a holistic approach to resident care and reduces fragmentation (Resnick et al., 2023). Additionally, there are regular in-service trainings and workshops to ensure staff possess the knowledge necessary to provide safe and quality care. However, while education is important, knowledge alone does not translate to behavior change, thus the need for behavioral reinforcement strategies. Overall, these strengths contribute to organizational goals by promoting standardized care and improving compliance with regulatory requirements. The strengths’ impact can further be maximized by, for instance, integrating training with real-time feedback to reinforce learning.

Area of Concern

One area of concern arising from the SOAR analysis is inconsistent hand hygiene protocol compliance among staff. The issue directly undermines the organization’s mission to provide safe, high-quality resident-centered care. Barriers to hand hygiene compliance in LTC settings include time constraints, high workload, limited access to supplies, and lack of real-time accountability (Haenen et al., 2022). Improvements in this area would entail implementing a multifaceted hand hygiene improvement initiative, entailing real-time observation and feedback, staff engagement, and addressing barriers through workflow redesign.

Reaching Organizational Goal to Improve Quality and Safety

Based on the identified area of concern, the organization should strive to address the issue, hence reach its goals to improve quality and safety. A strategic initiative to help the organization address the issue would entail the development of a comprehensive hand hygiene excellence program that integrates standardized protocols and guidelines, continuous education and competency validation, data-driven monitoring and transparent reporting, leadership support, and recognition and incentive systems to reinforce compliance. This initiative supports organizational aspirations by embedding hand hygiene into the culture of care and aligning with high-reliability principles such as commitment to resilience by proactively identifying and addressing risks.

Outcome Measurements Accomplishment Through the Organizational Leadership Structure

Meaningful quality outcomes in infection prevention will be achieved through robust measurement systems supported by the leadership structures. The key performance indicators include hand hygiene compliance rates, HAI rates, and staff adherence to infection control protocols in general. Evidence-based practices strongly support the use of these metrics, indicating that hand hygiene compliance is associated with a significant reduction of HAIs (Wu et al., 2024). In addition, benchmarking against national standards will enhance the organization’s ability to achieve and maintain high performance.

Relevant Skills and Leadership Characteristics

Various leadership skills and characteristics are required to advance initiatives recommended from the AI and SOAR analysis. The relevant skills include communication and analytical skills. Effective communication is needed to facilitate identification of barriers and promote collaborative problem-solving, both of which require clear, consistent messaging of expectations and collecting feedback. In addition, the leaders should possess analytical skills to enable them to interpret data, evaluate interventions, and make evidence-based decisions. The relevant leadership characteristics include transformational leadership, which is crucial as it fosters a shared vision, motivates staff, and promotes a culture of safety. Moreover, the leaders should have emotional intelligence to be able to support staff and address resistance.

Conclusion

By leveraging organizational strengths, addressing gaps in hand hygiene compliance, and implementing strategic, evidence-based initiatives, the organization can significantly reduce hospital-acquired infections. The leadership structure will play a central role in driving these improvements. However, it is essential to address behavioral and system-level challenges. Through transformational leadership, data-driven decision-making, and staff engagement, the organization can achieve its aspiration of becoming a high-reliability environment.

References

Haenen, A., de Greeff, S., Voss, A., Liefers, J., Hulscher, M., & Huis, A. (2022). Hand hygiene compliance and its drivers in long-term care facilities; observations and a survey. Antimicrobial Resistance and Infection Control, 11(1), 50. https://doi.org/10.1186/s13756-022-01088-w

Merriel, A., Wilson, A., Decker, E., Hussein, J., Larkin, M., Barnard, K., O’Dair, M., Costello, A., Malata, A., & Coomarasamy, A. (2022). Systematic review and narrative synthesis of the impact of Appreciative Inquiry in healthcare. BMJ Open Quality, 11(2), e001911. https://doi.org/10.1136/bmjoq-2022-001911

Patel, S. B., Iqbal, F. M., Lam, K., Acharya, A., Ashrafian, H., & Darzi, A. (2025). Characterizing behaviors that influence the implementation of digital-based interventions in health care: Systematic review. Journal of Medical Internet Research, 27, e56711. https://doi.org/10.2196/56711

Resnick, B., Vellega, A., & Levy, C. (2023). The interdisciplinary care team approach in long-term care: Where are we and where do we need to go? Journal of the American Medical Directors Association, 24(4), 407–409. https://doi.org/10.1016/j.jamda.2023.02.003

Wu, J. Y., Lin, Y. C., Lee, S. Y., Chen, C. P., Cheng, S. H., Cheng, C. Y., Ching, C. T. S., Wang, H. D., Yeh, C. C., Chen, W. J., Chen, W. W., & Liao, L. D. (2024). IoT-based hand hygiene compliance monitoring system and validation of its effectiveness in hospital environments. Global challenges (Hoboken, NJ), 8(12), 2400124. https://doi.org/10.1002/gch2.202400124

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Care Setting SOAR Analysis

Write a 3-4 page analysis of your care setting that supports development of a strategic plan and includes both the discovery and dream phases of an appreciative inquiry (AI) project and a strengths, opportunities, aspirations, and results (SOAR) analysis of the healthcare setting.

Identifying analysis techniques for assessing competitive advantage is important for building healthcare strategy. Sustaining healthcare competitive advantage requires that leaders understand environmental demands to assist with minimizing weakness and threats from the external environment. This assessment provides you with an opportunity to examine your healthcare environment to determine whether what is being accomplished in your organization, department, team, community project, or other care setting is making a positive difference.

Note: You will use the results of this analysis to develop a strategic plan in Assessment 3.

Master’s-level nursing leaders need to be able to apply critical thinking and analysis skills in order to discover not only what makes their care settings great, but also to find opportunities to improve gaps. The ability to identify, understand, and leverage opportunities for improvements and consistent high achievement can help nursing leaders ensure their care settings are reliably able to deliver improvements in quality and safety. An understanding of different methods for analyzing a healthcare setting is also important to ensure the right tool is being applied in appropriate circumstances.

You have been tasked to conduct an analysis of your care setting that will result in two potential pathways for later creating a strategic plan to improve quality and safety. This analysis will include organizational structure. In order to accomplish this, you have been asked to present the discovery and dream phases of an appreciative inquiry (AI) project using the principles of the SOAR model and apply this to the practicum or organization care setting. You will be provided with an opportunity to reflect on the results, as well as evaluate the leadership characteristics and skills that would be desirable for the person leading the potential initiatives that could grow out of your analyses.

Your work for this assessment will inform some aspects of your later assessments. Look ahead to those assessments to see how they all fit together.

As a part of this assessment, you will be completing a SOAR analysis and must include the completed SOAR Analysis Template [DOCX] document in your submission as a separate attachment. This is a good time to reflect on your readings from Week 2 for examples on the use of SOAR.

You may also want to read the Care Setting SOAR Analysis rubric to better understand how each grading criterion will be assessed.

The requester of the analysis has stated that you should be sure to address the following in your report.

Note: The bullet points below correspond to grading criteria in the rubric. Be sure your work is, at minimum, addressing each of the bullets.

Part 1: Appreciative Inquiry Discovery and Dream

• Appraise how the organization’s leadership structure of this care setting promotes quality and safety goals.
• Explain the results of your SOAR analysis, including:
  • S:Critique the strengths of the organization and how it promotes quality and safety. How are they used to achieve the organization’s goals?
  • O:Explain one area of concern you identified in your SOAR analysis that is relevant to your care setting’s mission, vision, and values. How do you propose pursuing improvements in this area of concern?
  • A:Describe how the organization could reach its goals to improve quality and safety. What strategic initiative supports the organization’s aspirations?
  • R:Describe how meaningful quality outcomes measurements are accomplished through the organizational leadership structure. What evidence-based practices support your approach?
• Present an analysis of relevant skills and leadership characteristics that would be beneficial in pursuing quality and safety improvement projects that could grow out of the AI approach and SOAR analysis results.

Part 2: SOAR Analysis

• Complete and submit the SOAR Analysis Template [DOCX]and submit as a separate attachment.

Address Generally Throughout Report

• Communicate clearly and effectively with stakeholders and colleagues.
• Incorporate supporting evidence using APA style citations and references, and adhering to organizational, professional, and scholarly communication standards.

Submission Requirements

• Length:3–4 double-spaced, typed pages, not including title page, references, or attached SOAR template. Your report should be succinct yet substantive.
• SOAR Template:Submit SOAR analysis template as a separate attachment.
• References:Cite a minimum of 3–5 sources of scholarly or professional evidence to support your analysis.
• APA formatting: Resources and citations are formatted according to current APA style.
• Scoring Guide
• Use the scoring guide to understand how your assessment will be evaluated.
• Collapse All
• Criterion 1
• Appraise how the organization’s leadership structure of this care setting promotes quality and safety goals.
• Distinguished
• Appraises how the organization’s leadership structure of this care setting promotes quality and safety goals and proposes pursuing improvements in this area of concern.
• Proficient
• Appraises how the organization’s leadership structure of this care setting promotes quality and safety goals.
• Basic
• Appraises either quality or safety goals for the care setting, but does not appraise both.
• Non Performance
• Does not appraise how the organization’s leadership structure of this care setting promotes quality and safety goals.
• Criterion 2
• Critique the strengths of the organization and how it promotes quality and safety.
• Distinguished
• Critiques the strengths of the organization and how it promotes quality and safety and addresses how strengths could be used to achieve organizational goals.
• Proficient
• Critiques the strengths of the organization and how it promotes quality and safety.
• Basic
• Critiques the strengths of the organization, but fails to analyze it as it relates to quality and safety goals.
• Non Performance
• Does not critique the strengths of the organization and how it promotes quality and safety.
• Criterion 3
• Explain one area of concern you identified in your SOAR analysis relevant to your care setting’s mission, vision, and values.
• Distinguished
• Explains one area of concern you identified in your SOAR analysis relevant to your care setting’s mission, vision, and values. Proposes pursuing improvements in the area of concern.
• Proficient
• Explains one area of concern you identified in your SOAR analysis relevant to your care setting’s mission, vision, and values.
• Basic
• Explains one area of concern identified in the SOAR analysis but does not relate it to your care setting’s mission, vision, and values.
• Non Performance
• Does not explain one area of concern identified in the SOAR analysis relevant to your care setting’s mission, vision, and values.
• Criterion 4
• Describe how the organization could reach its goals to improve quality and safety.
• Distinguished
• Describes how the organization could reach its goals to improve quality and safety. Presents strategic initiatives that support organizational aspirations.
• Proficient
• Describes how the organization could reach its goals to improve quality and safety.
• Basic
• Describes how the organization could reach its goals, but does not relate it to quality and safety.
• Non Performance
• Does not describe how the organization could reach its goals to improve quality and safety.
• Criterion 5
• Describe how meaningful quality outcomes measurements are accomplished through the organizational leadership structure.
• Distinguished
• Describes how meaningful quality outcomes measurements are accomplished through the organizational leadership structure. Includes evidence-based practices and research to support your approach.
• Proficient
• Describes how meaningful quality outcomes measurements are accomplished through the organizational leadership structure.
• Basic
• Description of outcomes measurements is either insufficient or lacks explanation for how measurements can be accomplished through organizational leadership.
• Non Performance
• Does not describe how meaningful quality outcomes measurements are accomplished through the organizational leadership structure.
• Criterion 6
• Present an analysis of relevant skills and leadership characteristics that would be beneficial in pursuing quality and safety improvement projects that could grow out of the AI approach and SOAR analysis results.
• Distinguished
• Analyzes the relevant skills and leadership characteristics that would be beneficial in pursuing quality and safety improvement projects that could grow out of the AI/SOAR analysis results; identifies areas of uncertainty or knowledge gaps.
• Proficient
• Presents an analysis of relevant skills and leadership characteristics that would be beneficial in pursuing quality and safety improvement projects that could grow out of the AI approach and SOAR analysis results.
• Basic
• Partially or incompletely analyzes the relevant skills and leadership characteristics that would be beneficial in pursuing quality and safety improvement projects that could grow out of both the AI and SOAR analysis results.
• Non Performance
• Does not present an analysis of relevant skills and leadership characteristics that would be beneficial in pursuing quality and safety improvement projects that could grow out of the AI approach and SOAR analysis results.
• Criterion 7
• Complete and submit the SOAR analysis template as a separate attachment.
• Distinguished
• Complete and submit the SOAR analysis template as a separate attachment; analysis is thorough and detailed.
• Proficient
• Completes and submits the SOAR analysis template as a separate attachment.
• Basic
• Submits the SOAR analysis template as a separate attachment, but analysis is incomplete.
• Non Performance
• Does not complete and submit the SOAR analysis template as a separate attachment.
• Criterion 8
• Communicate clearly and effectively with stakeholders and colleagues, incorporating supporting evidence using APA style citations and references, and adhering to organizational, professional, and scholarly communication standards.
• Distinguished
• Communicates clearly and effectively with stakeholders and colleagues. Supports assertions, arguments, and conclusions with relevant, credible, and convincing evidence. Exhibits strict and nearly flawless adherence to organizational, professional, and scholarly communication standards, including APA style and formatting.
• Proficient
• Communicates clearly and effectively with stakeholders and colleagues, incorporating supporting evidence using APA style citations and references, and adhering to organizational, professional, and scholarly communication standards.
• Basic
• Clear, effective communication is inhibited by insufficient supporting evidence, inconsistent APA style citations and references, and minimal adherence to applicable communication standards.
• Non Performance
• Does not communicate clearly and effectively with stakeholders and colleagues, incorporating supporting evidence using APA style citations and references, and adhering to organizational, professional, and scholarly communication standards.