Case Study : Managing Variable Budget

Over the last decades both public and private hospitals have been experiencing severe financial situations (Everhart, Neff, Al-Amin, Nogle, & Weech-Maldonado, 2013). The financial shortage is associated with delay or even lack of governmental sponsorship and competition from their rivals. Enacting the policy will mount financial pressure on these hospitals that are on cost-cutting strategies. The salaries and wages of nurses are dominating the costs of operation in the hospitals and therefore adding more staff to correct the understaffing will be like creating another problem (Goddard, 2003). Contrary, Empirical studies prove that adequate nurse staffing produces better outcomes for both the staffs and the patients (Donaldson & Shapiro, 2010). These do not mean that the financial performance of the health centers will be at stake. Quality is associated with profitability. Understaffing leads to increased workloads, fatigue and job dissatisfaction. These situations that can be corrected on the implementation of proper staffing policies (Everhart, Neff, Al-Amin, Nogle, & Weech-Maldonado, 2013). The policy aims at offering quality service, reasonable patient-doctor ratios, reducing high mortality rates, improving the health of patients through proper examination and disease diagnosis among other

When considering requests such as a new piece of equipment, staff training, and supplies for the unit, a manager must consider the overall budget, constraints, and variances. If equipment has a useful life of more than one year and exceeds the minimum cost level of the facility, the manager may request the cost originates from the capital budget of the facility (Yoder-Wise, 2012). Large equipment such as a patient lift, which costs $3000 per lift, would be beneficial to the staff and

3. How many operations could the hospital perform per day before running out of bed capacity? How well would the new resources be utilized relative to the current operations? Why?

Currently the clinic sees about 45 patients per day and they have capacity to handle 85. If they continue how they are operating the clinic is looking at a loss of $3,173. At this rate the clinic will not be able to make a profit in spite of inflation over the next couple years.

The American Nurses Association supports a legislative model in which nurses are encouraged to create staffing plans specific to each unit. This approach will aide in establishing staffing levels that are flexible and can be changed based on the patients needs, number of admissions to the unit, discharges and transfers during each shift (“Nurse staffing plans,” 2013). This model will assist in keeping the unit staffed appropriately and organized in need of a change during each shift. Without an organized plan like this, a nurse may be required to take on a new admission and already have too big of a workload.

Budgeting is extremely important for the nurse leader. Furthermore, the budgeting process of the hospital is very important to look at. According to Prefontaine, a couple months before budget was due, she would estimate where it would be spent. The planning process includes three major categories: major medical equipment, minor medical equipment, and employees. Major medical equipment is any larger equipment the hospital would use. An example would be how many more beds the hospital needed. The team leader is also responsible for finding quotes on how much these items would cost. Minor medical equipment is basically anything other than the large medical

As the charge nurse of the acute care, the nurse interviewed is in charge of 6 employees in that specific department, but on the weekend she leads the entire hospital. Although being a nurse leader has its challenges, it’s great when everyone works together to achieve their goals and it becomes very fun. In regards to a budget, she has to conduct one for her responsibilities in infection control. This comes with many obstacles as it is hard to predict the budget for the entire year, and this was never taught to nurses in school or as part of job training (R. H., personal communication, November 12, 2016).

In this task, the budget schedule and proformas as well as the flexible budget were reviewed. Below you will find my analysis and recommended corrective actions as well as how management by exception applies.

214) “The ACA and the need for APRNs, nurse faculty, and nurse researchers would have increased dramatically under any scenario.” (L R Cronenwett [RWJF Iniative on the Future of Nursing], 2010, table 1). “Not only must schools of nursing build their capacity to prepare more students. Nursing need to focus on fundamental improvements in the delivery of nursing care to improve patient safety and quality is key.” (IOM, 2010, p. 208)

Healthcare changes occurring today along with shrinking budgets and reimbursement rates for hospitals has forced institution CEOs to do more with less. Changes and restructuring of various health facilities require nursing leaders with flexibility and adaptability. Nurse leaders must also consider budgetary constraints, cost effectiveness, patient safety, and quality care while maintaining focus on improved patient outcome. The responsibility of ensuring patients receive safe and high quality care belongs to every employee in the hospital, including support staff such as IV therapy. In this hospital, this led to the development of a nurse director position to oversee the

The delivery of healthcare has evolved and changed over the years and with the advances in science and technology, the ability to provide safe, quality care to all patients has been impacted by the changes. With the rising healthcare costs and decrease in reimbursement for care provided, organizations must look for ways of cost containment to maintain viability for the future. Fabre (2005) noted that administrators are struggling to maintain financial stability and retain competent nurses during these difficult

UCC attempts to use Per Diem MD's and Nurses. Department currently has 4 Per Diems MD's and 2 Per Diem LVN's. Per Diem MD's are encouraged to pick up extra hours, but most work outside of KP or are used to cover special medical leaves in MOB's. Thereby, limiting availability to UCC. Per Diem LVN's are going back to school and limit their availability to department. Manager has hired a Per Diem RN and will be working on hiring another Per Diem RN in January 2016. Part time employees also provide limited amount of hours on a needed basis. Due to lack of appropriate staffing mixture, availability for overtime becomes available to MD's and Nurses outside of department. In 2015, overtime spending resulted in $500K in ancillary and 1.3

In order to try to better distribute funds and resources, Reid must first evaluate each department, job, positions, and evaluate what it lacks and has a surplus of. During his evaluation of the employees he must decide what type of staff he needs to fill each position for a job. In order to successfully perform this evaluation Reid should evaluate them based on the job description, attendance, and efficiency. Attendance and efficiency should be evaluated because these are two critical things that the nursing staff lack and affect the quality of care. Once Reid performs these evaluations he should then begin to make budget cuts where needed in order to allocate the to funds to departments who will bring in more customers and

Nevada does not have a bill to create a legislative committee to deal with tax budgeting. Research can prove why the bill (ab143) has a positive outcome in Nevada. The first reason why this bill should be created is that Nevada will have a greater income tax rate which will improve the function of the state government. Second, the local government does not have to worry about dealing with lending the money but using it, but the state does, and they have to maintain a structured budget to be able to provide that money to each government system. Finally, views against this bill are that it can run the state billions of dollars which will affect not only their budget but their economics and business. These two positive reasons are the solution

In the medical fraternity, nurses make up the largest healthcare profession. The care of patients depends on the well-being of the nurses, and issues affecting them may affect patients, directly or indirectly. As a profession, nursing, can be both an extremely rewarding and challenging activity. A number of problems exist, and most are becoming worse because of lack of lack of mechanisms to address these issues. The three greatest issues affecting nursing today include improving health education, lack of respect for nurses and cost cutting. Although these problems are not clinical, they influence the efficiency of the performance of nurses in their delivery of services.