DNP 835 Topic 6: quality and sustainability part three
A framework that could support any programme is not supporting yours. The test is whether your design would look different if you had chosen a different theory.
Editorial process
Last reviewed · August 15, 2026
Part three is where the theory finally does work
Part three asks for a theoretical framework that supports the design and implementation of your programme, and there is a simple test for whether you have used one: would your design look different under a different framework? If not, the framework is decoration. A framework earns its place by constraining choices. The Consolidated Framework for Implementation Research directs you to assess the inner and outer setting before designing, which produces a readiness assessment your programme would otherwise not have. Normalisation process theory pushes you toward whether staff can make the practice routine, producing workflow work. Plan-Do-Study-Act commits you to small rapid cycles, which changes your measurement interval. Name the constraints your framework imposes and then show them in the design. Choose the framework before designing rather than after, which sounds obvious and is routinely reversed: a design assembled first and then labelled with a framework produces exactly the decorative version this section is checking for.
Expected outcomes is the other word to take literally. These are forward statements and they should be specific enough to be wrong: the measure, the direction, the magnitude and the timeframe. Expected improvement in hand hygiene compliance is not an expected outcome. A rise in observed compliance from sixty-two to eighty percent within twelve weeks is one, and it is falsifiable, which is what makes it useful. Derive the magnitude from something — the effect reported in the literature, or the gap to benchmark you established in part one — rather than picking a round number. Include process outcomes alongside the clinical one so you can tell a programme that was never delivered from one that was delivered and did not work, since those two failures look identical in the outcome data and call for opposite responses. State the assumptions behind each expectation too, so a reader can see which of them would have to fail for the outcome not to appear.
Likely learning objectives
Inferred from the brief — check these against your own rubric.
- 01Select a framework that constrains design rather than decorating it.
- 02Trace design decisions back to the framework's constructs.
- 03Write expected outcomes that are specific enough to be falsified.
- 04Separate implementation failure from intervention failure by measurement.
Read the full question
Review every instruction before using the planning guidance that follows.
Course-wide instructions that accompany this question
Name: Assignment Rubric Grid View List View Excellent Good Fair Poor Summarize your interpretation of the frequency data provided in the output for respondent’s age, highest school grade completed, and family income from prior month. 32 (32%) – 35 (35%) The response accurately and clearly explains, in detail, a summary of the frequency distributions for the variables presented. The response accurately and clearly explains, in detail, the number of times the value occurs in the data. The response accurately and clearly explains, in detail, the appearance of the data, the range of data values, and an explanation of extreme values in describing intervals that sufficiently provides an analysis that fully supports the categorization of each variable value. The response includes relevant, specific, and appropriate examples that fully support the explanations provided for each of the areas described. 28 (28%) – 31 (31%) The response accurately summarizes the frequency distributions for the variables presented. The response accurately explains the number of times the value occurs in the data. The response accurately explains the appearance of the data, the range of data values, and explains extreme values in describing intervals that provides an analysis which supports the categorization of each variable value. The response includes relevant, specific, and accurate examples that support the explanations provided for each of the areas described. 25 (25%) – 27 (27%) The response inaccurately or vaguely summarizes the frequency distributions for the variables presented. The response inaccurately or vaguely explains the number of times the value occurs in the data. The response inaccurately or vaguely explains the appearance of the data, the range of data values, and inaccurately or vaguely explains extreme values. An analysis that may support the categorization of each variable value is inaccurate or vague. The response includes inaccurate and irrelevant examples that may support the explanations provided for each of the areas described. 0 (0%) – 24 (24%) The response inaccurately and vaguely summarizes the frequency distributions for the variables presented, or it is missing. The response inaccurately and vaguely explains the number of times the value occurs in the data, or it is missing. The response inaccurately and vaguely explains the appearance of the data, the range of data values, and an explanation of extreme values, or it is missing. An analysis that does not support the categorization of each variable values is provided, or it is missing. The response includes inaccurate and vague examples that do not support the explanations provided for each of the areas described, or it is missing. Summarize your interpretation of the descriptive statistics provided in the output for respondent’s age, highest school grade completed, race and ethnicity, currently employed, and family income from prior month. 45 (45%) – 50 (50%) The response accurately and clearly summarizes in detail the interpretation of the descriptive statistics provided. The response accurately and clearly evaluates in detail each of the variables presented, including an accurate and complete description of the sample size, the mean, the median, standard deviation, and the size and spread of the data. 40 (40%) – 44 (44%) The response accurately summarizes the interpretation of the descriptive statistics provided. The response accurately explains evaluates each of the variables presented, including an accurate description of the sample size, the mean, the median, standard deviation, and the size and spread of the data. 35 (35%) – 39 (39%) The response inaccurately or vaguely summarizes the interpretation of the descriptive statistics provided. The response inaccurately or vaguely evaluates each of the variables presented, including an inaccurate or vague description of the sample size, the mean, the median, the standard deviation, and the size and spread of the data. 0 (0%) – 34 (34%) The response inaccurately and vaguely summarizes the interpretation of the descriptive statistics provided, or it is missing. The response inaccurately and vaguely evaluates each of the variables presented, including an inaccurate and vague description of the sample size, the mean, the median, the standard deviation, and the size and spread of the data, or it is missing. Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria. 5 (5%) – 5 (5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria. 4 (4%) – 4 (4%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment is stated, yet is brief and not descriptive. 3 (3%) – 3 (3%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment is vague or off topic. 0 (0%) – 2 (2%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion was provided. Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation 5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors. 4 (4%) – 4 (4%) Contains a few (1 or 2) grammar, spelling, and punctuation errors. 3 (3%) – 3 (3%) Contains several (3 or 4) grammar, spelling, and punctuation errors. 0 (0%) – 2 (2%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list. 5 (5%) – 5 (5%) Uses correct APA format with no errors. 4 (4%) – 4 (4%) Contains a few (1 or 2) APA format errors. 3 (3%) – 3 (3%) Contains several (3 or 4) APA format errors. 0 (0%) – 2 (2%) Contains many (≥ 5) APA format errors. Total Points: 100 Name: Assignment Rubric
Turn the brief into deliverables
- 01A named theoretical framework with its key constructs.
- 02Design decisions visibly derived from those constructs.
- 03An implementation plan consistent with the framework.
- 04Expected outcomes with measure, direction, magnitude and timeframe.
- 05Process measures alongside the outcome measures.
Framework, design, implementation, expected outcomes
The framework and its constructs
Introduce the framework and what it directs attention to.
How the framework shapes the design
Show design decisions following from specific constructs.
Implementation plan
Set out delivery, sequencing and who does what.
Expected outcomes
State falsifiable expectations with magnitude and timeframe.
Process measurement
Specify how you will know the programme was actually delivered.
Choosing a framework that constrains your design
Recommended databases
- Implementation Science
- PubMed Central
- AHRQ
- CINAHL
Search sequence
- 1.Choose a framework and read a study that applied it rather than one that named it.
- 2.List the constructs and mark which will change your design.
- 3.Find a published effect size for your intervention to derive a target from.
- 4.Decide the process measure that would reveal an undelivered programme.
Reference shortlist
These are authoritative starting points, not a ready-made bibliography. A qualified reviewer must confirm that each source fits the assignment and supports the claim beside which it is cited.
Nothing here is cleared for citation until you have read it.
- 01
Quality Improvement Methods (LEAN, PDSA, SIX SIGMA)
StatPearls, NCBI Bookshelf · 2024
Sets out the main improvement methods and what each commits a design to, which is the constraint test in practice.
- 02
Where Do Models for Change Management, Improvement and Implementation Meet? A Systematic Review of the Applications of Change Management Models in Healthcare
Journal of Healthcare Leadership · 2021
Compares change, improvement and implementation frameworks, which is how to choose one rather than default to it.
- 03
Implementation strategies for large scale quality improvement initiatives in primary care settings: a qualitative assessment
BMC Primary Care · 2023
An implementation study reporting both process and outcome, which is the separation this paper needs to build in.
- 04
Types of Health Care Quality Measures
Agency for Healthcare Research and Quality (AHRQ) · 2024
The measure classification that makes the process-versus-outcome distinction operational.
Review before submission
Common mistakes
- Naming a framework that has no effect on the design.
- Writing expected outcomes too vague to be wrong.
- Picking a target magnitude with no derivation.
- Measuring only outcomes, so a failed rollout looks like a failed intervention.
Submission checklist
- Would your design differ under another framework?
- Can each expected outcome be shown false?
- Does the magnitude come from evidence or from your part one gap?
- Are there process measures as well as outcome measures?
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Aaron Bishop
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