HCA 822 Analyzing the Existing Organizational Culture
You are three weeks into the job asking for money to study a culture that has been profitable. The audience is the board that just fired your predecessor, and that is the whole persuasive problem.
Editorial process
Last reviewed · August 25, 2026
Persuading the board that just fired your predecessor
The scenario is doing more work than it appears to. The organisation has been stable and profitable, so nothing in the numbers says anything is wrong, and your evidence for a cultural problem is explicitly described as anecdotal, gathered during interviews. You are new, you have no results yet, and you are asking the board to spend money and accept short-term instability on the strength of your impression. Meanwhile the same board has just removed a CEO amid rumours of impropriety, which cuts both ways: they have direct reason to believe something below the surface escaped their oversight, and they are also unlikely to want that period reopened in public. A deck that opens by asserting the culture is broken loses the room. One that treats the assessment as risk management for a board that has already been surprised once has a chance. They have been surprised once already and would rather not repeat it.
So build the argument on what an instrument gives them that a new CEO's judgement cannot: a measurement they can compare against later, taken by an outside party, before you have had time to shape the answer. The instrument choice then follows from that framing rather than from a features table. The OCAI is short, maps to four competing-values profiles and yields a current-versus-preferred gap the board can read on one slide; the OCI is longer, produces twelve behavioural styles and is better suited to identifying the specific norms that let a concealed problem persist. Pick one, say what you are trading away, and price it. The timeline slides are where credibility is won or lost, because the pre-assessment communication is what determines whether staff answer honestly after a public dismissal, and the closing slide has to be an unambiguous request for approval rather than a summary.
Likely learning objectives
- Frame a costly assessment as risk management for a board that has already been surprised.
- Justify an instrument choice against the decision it has to support.
- Design pre-assessment communication that protects response honesty.
- Close a persuasive deck with an explicit, specific ask.
Assignment instructions
Read the full question
Review every instruction before using the planning guidance that follows.
The chief executive officer (CEO) of a well-established health care organization has brought the organization into a period of sustained stability and profitability. However, the CEO was recently and unexpectedly released by the Board of Directors amid rumors of impropriety on the part of the CEO. You have been hired as the new CEO. During the interview process, you anecdotally assessed the culture of the organization and believe a cultural shift is in order. The magnitude of the expected shift is unclear, and you have decided to approach the Board about conducting a lengthy and costly cultural assessment to help you plan for the expected changes in culture. At risk are the stability and profitability of the organization. General Requirements: Use the following information to ensure successful completion of the assignment: Review the information in the module about the Organizational Culture Assessment Instrument (OCAI) and the Organizational Culture Inventory (OCI). This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the HCA 822 Analyzing the Existing Organizational Culture expectations for successful completion. Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center. This assignment requires that at least two additional scholarly research sources related to this topic, and at least one in-text citation from each source be included. Directions: Prepare a persuasive presentation (15-20 slides, exclusive of the reference list) that you could deliver to the Board of Directors explaining the rationale for and benefits of cultural assessment and your preferred assessment instrument. Speaker notes must be included for each slide. The presentation must do the following: Provide a persuasive argument for performing a cultural assessment of the organization leading to the improvement of the current culture at the risk of temporary instability or short-term loss of profitability. Provide a rationale for your choice of assessment instruments. Sketch a timeline for the assessment process outlining the pre-assessment communications, the assessment window, the data analysis period, and the post-assessment communications. Deliver a specific request for Board approval of this plan.
What HCA 822 requires in the deck
- 01A persuasive presentation of 15-20 slides, exclusive of the reference list.
- 02Speaker notes for every slide.
- 03A persuasive argument for assessing culture despite temporary instability or short-term loss of profitability.
- 04A rationale for the choice of assessment instrument, informed by the OCAI and OCI.
- 05A timeline covering pre-assessment communications, the assessment window, data analysis and post-assessment communications.
- 06A specific request for Board approval of the plan.
- 07At least two additional scholarly sources with an in-text citation from each, in APA style.
Slide sequence built around the ask
The situation as the board sees it
State the stability, the profitability and the recent removal without spin.
What the assessor is likely looking for
A fair statement of the counter-argument before the case is made.
Why anecdote is not enough, including your own
Concede the weakness of interview impressions and use it as the reason to measure.
What the assessor is likely looking for
Self-aware framing that turns a weakness into the argument.
What a formal assessment produces
Describe a baseline, external administration and comparability over time.
What the assessor is likely looking for
Outputs a board could act on, named specifically.
OCAI versus OCI
Compare the two on what decision each supports, then choose.
What the assessor is likely looking for
A trade-off stated, not a features list.
Timeline and communications
Lay out pre-assessment messaging, the window, analysis and feedback to staff.
What the assessor is likely looking for
Communication designed to protect response honesty.
The ask
Request approval with a figure, a window and a decision date.
What the assessor is likely looking for
An unambiguous, specific request.
Where the culture-instrument evidence sits
Recommended databases
- PubMed Central
- AHRQ
- NCBI Bookshelf
- University library databases
Search sequence
- 1.Read on safety culture measurement to see how validated culture instruments are used in health care.
- 2.Look up the competing values framework behind the OCAI for its four profiles.
- 3.Find change management literature for the instability the board is being asked to accept.
- 4.Check evidence linking culture measures to outcomes so the benefit is not asserted.
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.
Surveys on Patient Safety Culture
Agency for Healthcare Research and Quality · 2024
AHRQ's culture surveys, as a worked example of instrument administration and benchmarking.
The AHRQ Hospital Survey on Patient Safety Culture: A Tool to Plan and Evaluate Patient Safety Programs
Advances in Patient Safety, Agency for Healthcare Research and Quality, NCBI Bookshelf · 2008
The AHRQ hospital survey on patient safety culture, for how a culture instrument is planned and evaluated.
Change Management In Health Care
StatPearls, NCBI Bookshelf · 2023
Change management in health care, for the instability the board is being asked to accept.
Patient safety culture as a quality strategy
European Observatory on Health Systems and Policies, in Improving healthcare quality in Europe · 2019
Patient safety culture as a quality strategy, for the link between culture measures and outcomes.
Culture of Safety
AHRQ Patient Safety Network · 2024
Safety culture, for the norms that allow a concealed problem to persist.
Before you submit the presentation
Common mistakes
- Asserting the culture is broken on the strength of interview impressions.
- Comparing OCAI and OCI on features rather than on the decision each supports.
- Treating the timeline as a formality instead of the honesty-protection mechanism.
- Ending on a summary slide with no explicit ask.
- Ignoring that profitability is the board's counter-argument.
Submission checklist
- Does the opening acknowledge that the numbers currently look fine?
- Is the instrument choice justified by the decision it supports?
- Do the timeline slides address staff honesty after a public dismissal?
- Is there a slide that states the approval being requested?
- Are speaker notes present on every slide?
- Is the deck inside 15-20 slides excluding references?
Use this guide to plan and review your own work. Follow your institution's rules and read Brinevia's academic-integrity policy.
Written by
Maren Caldwell
MSN, RN, CNE
Medical-surgical nursing, pharmacology and NCLEX preparation
Maren is a registered nurse with over 15 years of clinical and educational experience in medical-surgical nursing. She writes on NCLEX preparation, patient care fundamentals, pharmacology and evidence-based practice.
Reviewed by
Dr. Tessa Redmond
DNP, RN, CNE
Evidence-based practice and clinical education
Tessa is a doctorally-prepared nurse educator. She reviews Brinevia content for clinical accuracy and alignment with current evidence-based guidelines.