Date of Graduation
Summer 7-24-2025
Document Access
Project/Capstone - Global access
Degree Name
Master of Science in Nursing (MSN)
College/School
School of Nursing and Health Professions
Program
Kaiser cohort MSN capstone
First Advisor
David Ainsworth
Abstract
Problem: Middle managers in healthcare experience high levels of stress, heavy workloads, and burnout. At a large medical center in Northern California, middle managers reported low perceptions of organizational support for well-being despite an abundance of available resources.
Context: Baseline data indicated a perceived support score of 6.5 out of 10 on the Employee Interest Survey and a People Pulse Culture of Health score of 60 for assistant nurse managers (ANMs), both below regional benchmarks. These findings suggested inadequate engagement with organizational well-being resources.
Interventions: A six-month performance improvement initiative, guided by the ADKAR change model and Lean principles, implemented two key interventions: (1) the Digital Oxygen Mask Toolkit, a centralized SharePoint site housing well-being resources, and (2) a cross-department leadership well-being committee. After two PDSA cycles, focus shifted from a broad middle-manager (macrosystem) approach to a single ANM microsystem. One-on-one engagement and rounding with ANMs supported adoption and cultural integration.
Measures: Outcomes included pre- and post-intervention Employee Interest Survey and People Pulse Culture of Health scores. Process measures evaluated toolkit usage and committee participation. Balancing measures assessed perceptions of added stress. The target outcome was to increase the Employee Interest Survey score for perceived organizational well-being support to 7.5.
Results: Perceived organizational support for well-being rose from 6.5 to 8.5 on the Employee Interest Survey, and the ANM Culture of Health score improved from 60 to 70. The well-being toolkit received 278 views from 34 users. Although initial committee participation was strong, time constraints limited sustainability. Qualitative feedback indicated that leader-to-leader conversations at the microsystem level were more effective, prompting a strategic shift toward microsystem-focused engagement.
Conclusion: Digital tools improved awareness, but relational, localized strategies proved more effective in fostering engagement and supporting leadership well-being.
Recommended Citation
Marque, Lydia, "From Surviving to Thriving: The Oxygen Mask Approach for Middle Management" (2025). Master's Projects and Capstones. 1918.
https://repository.usfca.edu/capstone/1918
