Jen Budget Explanation

One of the major functions of a nurse manager is managing a budget and allocating resources necessary to manage the unit or facility effectively. “Major steps in the budgeting process include gathering information and planning, developing unit budgets, developing cash budgets, negotiating and revising, and using feedback to control budget results and improve future plans”(Yoder-Wise, 2012, p. 244). The nurse manager must be able to accommodate variances and acclimate the budget in both the projections and up-to-date expenditures. Proficiency in managing a unit level budget is essential for both a favorable variance and optimal patient outcomes. Budgeting entails reviewing revenues and expenses, staffing costs, supplies, and capital equipment costs (Contino, 2001). This case study examines personnel, overtime (OT), supplies, travel, equipment, and staff education and the manner in which management can address these factors.

We know that he had sustained an at home fall. We learn that he has a history of pain and a prescription for oxycodone for back pain. We know that his vital signs on admission appear stable; he was not showing any signs of respiratory distress. As we look at the staff that was listed that day we do get the sense the hospital may have been short staffed. Staffing report shows there was one MD, one RN and one LPN managing at least 4 patients including- one patient was a child. Evidence based research has proven that the nurse to patient ratio is directly related to the patient outcomes (Stanton, 2004). It is important that we consider the staffing level that this rural ED as we know short staffing can be blamed for not being able to take the full amount of time needed to do a proper health history. A detailed health history is an imperative part of the care process; it is used by the staff to accurately assess any acute changes that may take place in the patient throughout their stay.

There was additional backup staff present (including a respiratory therapist) that could have been called upon for help, yet they never were. The charge nurse or nurse supervisor could have stepped in at this point to provide additional help. A lack of present nursing staff and support can lead to unfavorable patient outcomes, as is the case with Mr. B. Additionally, the staff on duty could have lacked training regarding protocols or their training could have been out of date.

They compare this actual spending to their budgeted amounts for all line items, and variances are calculated. Variances are the differences between the what was budget and what was actually spent.

Research has shown that hospitals are operating on tight budget all over the world, and they need

Hospitals are no longer being reimbursed for “never” events, which encompass situations a patient may encounter during a hospital stay, such as hospital-acquired infections, pressure ulcers, and falls. It is imperative for the nursing profession to hold knowledge and appreciation of how patient care outcomes influence the organizations monetary bottom-line.

Overages in salary expense of $115k were somewhat offset by Purchased Services being $73k under budget for the month. Benefits were $80k under budget for March and $325k under budget YTD. Chargeable supplies were $72k over budget for March, a by-product of strong Orthopedic volumes in the OR. The accrual for the Medicaid Enhancement Tax continues to be in excess of budget, due to taxable revenue being over budget in FY15 and much of FY16. Other Expenses were $52k under budget for the month.

This course is designed as an introduction to the terminology, processes, functions, and financial reports commonly encountered in health care operations. This course introduces the concepts of basic managerial financial functions, such as budgeting, reimbursement methods, and the responsibilities of health care financial

Multiple studies demonstrate a relationship between lower patient-to-nurse ratios and improved patient outcomes (Garrett, 2008; Penoyer, 2010; Unruh, 2008). Patient outcomes addressed in the various studies included falls, infections, length of stay, mortality, patient safety, patient satisfaction, postoperative complications, pressure ulcers, quality of care and unplanned extubation with reintubation. A 2004 report from the Agency for Healthcare Research and Quality (AHRQ) stated that adverse events can increase the cost of a total treatment by 84%, length of stay by 5.1 to 5.4 days and probability of death by 4.67% to 5.5% (Garrett, 2008).

The first topic focused on in an article by Stimpfel et al. (2012) looked at the effect of longer shifts on nurses. Compared to the past, nurses are working twelve-hour shifts, instead of eight-hour shifts. The reason for these changes in shift lengths is for it to allow for nurses to have more flexibility in their schedules and to give them more time at home. This study revealed that the hours actually worked by nurses are unpredictable. Due to the fluctuations of patient needs and unanticipated staffing on the unit, leads to nurses having to work over their scheduled time (Stimpfel et al. 2012). This study also pointed out that there are no national policies for nurses that dictate the maximum number of hours a nurse can work. Nurses often end up working several hours over their shift because they feel forced into working those hours and thereby leading to burnout.

One of the main roles of a hospital administrator is financial planning. When Rebecca Payne gave the news that the Archibalds would have to pay a generous amount of money before giving further treatment to their son, it was shocking. She did not imply anything about financing the high priced surgery. As an administrator, Payne should've informed the family more about how they could of helped their son more quickly. Although Payne states that she and the hospital has done all they can plus more, that is not true. “A healthcare admin should be able to ensure that corrective action is administered fairly in a healthcare facility” Like many other administrators today, Payne was named the bad guy of the situation which indeed was a correct label for her. Giving a patient and their family the best medical services they deserve and need was one of her main jobs. Being able to lie to a sick child’s parent is indeed not the ideal administrator that anyone would want to have in their hospital. Although it may be hard to fathom, there are people out there managing health systems like Rebecca Payne in the film John Q. One of the main solutions that Payne or any administrator in this situation could have done was made it in anyway easier for the family to resolve the financial issues. Suggesting financing options would of helped the family and the hospital come to more of an

did not have all the information available and some of the patients are lost to

The first image that comes to mind when most people think of an emergency department is the critically injured patient, as has been immortalized by television and Hollywood, wheeled in with an entire army of nurses and doctors in tow. To be honest, this is what I, too, expected - and yet my first memory of working in an emergency department was not of a particularly sick patient or observing an interesting procedure, but the realization that many of the patients were suffering from complications of completely preventable conditions. Patients with uncontrolled hypertension and diabetes were being started on dialysis or sent to the operating room for amputation, a scene I saw far more often than the car crash and gunshot victims I expected to swarm the floor. The dissonance was striking, to say the least.

In conclusion, operating budget and variance analysis are very important to a business. Using the operating budget and variance analysis is the best way to get the most accurate information on how well a business is doing and can greatly affect how management makes decisions for the

The personnel budget, being the largest part of the operating budget, consists of multiple factors such as the average daily census, patient acuity, personnel required relating to full-time equivalents (FTEs), as well as productive and non-productive hours. The supplies include medical and office supplies, minor equipment, orientation and training, and travel expenses. Although budgets are based on assumptions, using the previous year’s expenses for personnel and supplies, helps the nurse manager/leader to accurately predict the next year’s budget.