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Operating budgets in hospitals
Nurse staffing and patient satisfaction
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Thus far the unit’s budget preparations have been completed through the collection of data from personnel expenses, non-personnel expenses, and workload figures; thus, BestCare Nursing Unit’s net revenue has been estimated at $6.5 million for the fiscal year. However, a 10% operational budget reduction has been called upon by the Chief Financial Officer; therefore, required reductions must be accomplished without negatively affecting quality patient care. Conducted research reveals that approximately 43% of nurses favor strengthened staffing rather than increased pay or shifts (SuccessFactors, Inc., 2009). Therefore, in order to accomplish the directive budget reductions and maintain control of the unit’s labor costs, modifications
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The contract labor budget is noted as an over budget item; therefore, a 1.30% reduction will be executed thereby reducing costs down to $257,727 for the fiscal year. The reduction in the contract labor budget will allow nursing leaders to allocate to other resources within the budget (Williams, 2008). Since nursing staff makes up a large portion of the operational budget, nurses will be empowered to play an active role in the units cost containment efforts, particularly since they have direct contact with patient care which places them in a position to recognize inefficiencies and implement cost-saving reductions (Finkler et al., 2013; MacLeod, 2014; Williams, 2008). Inefficient use of supplies is costly (MacLeod, 2014); therefore, additional reductions will be accomplished through specific cost containment efforts with particular attention to both cleaning (-$20,000) and formulary supplies (-$10,000) books/publications ($-90,000), and telephone expenses ($-9,000) as the detected areas with which we were over budget. Furthermore, a unit based cost containment program will be implemented as research has shown that staff can play a pivotal role in helping mitigate costs through sensible control and utilization of supplies and medical equipment (Finkler et al., 2013; Mukuna, Mwaura-Tenambergen,
This article is a comprehensive look at staffing on hospital units. It used a survey to look at characteristics of how the units were staffed – not just ratio, but the experience and education level of the nurses. It evaluated several different categories of hospital facilities – public versus private, academic medical centers versus HMO-affiliated medical centers, and city versus rural. It is a good source because it shows what some of the staffing levels were before the status quo of the ratio legislation passed in California. It’s main limitation as a source is that it doesn’t supply any information about patient outcomes.
It is clear that statewide mandated nurse-to patient ratios result in drastic financial changes for every hospital impacted. Hospitals often have to compensate for hiring more nurses by laying off support staff. Mandated ratios also result in an increase in holding time in emergency rooms . (Douglas,
With today’s technology and the specialized skills of doctors, nurses, and therapists, patients who need long term care of acute problems can obtain these services at institutions known as postacute care providers. One type of facility that falls under this title is the Long Term Acute Care Hospital (LTACH) (Munoz-Price, 2009, p. 438). This paper will discuss services provided by LTACHs, the role of the Chief Nursing Officer (CNO) in these facilities, and Medicare reimbursement effected by patient satisfaction surveys.
The Centers for Medicare and Medicaid Services (CMS) have recently begun requiring hospitals to report to the public how they are doing on patient care. Brown, Donaldson and Storer Brown (2008) introduce and explain how facilities can use quartile dashboards to transform large amounts of data into easy to read and understandable tool to be used for reporting as well as to determine areas in need of improvement. By looking at a sample dashboard for an inpatient rehab unit a greater understanding of dashboards and their benefits can be seen. The sample dashboard includes four general areas, including nurse sensitive service line/unit specific indicators, general indicators, patient satisfaction survey indicators and NDNQI data. The overall performance was found to improve over time. There were areas with greater improvement such as length of stay, than others including RN care hours and pressure ulcers. The areas of pressure ulcers and falls did worse the final quarter and can be grouped under the general heading of patient centered nursing care. The area of patient satisfaction saw a steady improvement over the first three quarters only to report the worst numbers the final quarter. A facility then takes the data gathered and uses it to form nursing plan...
Finkler, S. A., Kovner, C. T. & Jones, C. B. (2007). Financial management for nurse
On April 17th 2013, Senator Barbara Boxer (California) introduced a federal bill that is aimed to reduce nursing shortages by establishing a minimum nurse-to-patient ration in hospitals. She is also ordering whistleblowing protection for nurses who report quality-of-care violations. The law requires that every hospital implement a written hospital-wide staffing plan that will guide the assignments to...
The nurse to patient ratio is unrealistic in many hospitals. In most cases it is almost impossible to give each patient the true amount of detailed care they really need. This is seen in most cases where there is one nurse assigned to 16 patients and each patient requires a different level of attention. Nurses are pressed for time, forcing them to cut corners, resulting in an increase in nosocomial infections and patient deaths. “The past decade has been a unsettled time for many US hospitals and practicing nu...
In the past two decades, there has been a push for appropriate staff to client ratios. However, measuring client needs and nursing efforts have been around since 1922 (Lewinski-Corwin, 1922, pp. 603-606). The earliest recorded effort was by the New York Academy of Medicine. Superintendents and nurses from ten training schools documented the time spent providing bedside care. From complied information, the researchers revealed each client required an average of five hours and four minutes of care in a 24-hour period. From these observations, they evaluated staffing issues in New York City. At that time, none of the hospitals were sufficiently staffed (Lewinski-Corwin, 1922, pp. 603-606).
Thousands of nurses throughout the nation are exhausted and overwhelmed due to their heavy workload. The administrators do not staff the units properly; therefore, they give each nurse more patients to care for to compensate for the lack of staff. There are several reasons to why
Nurse to patient ratios are extremely paramount in assisting with overall patient mortality and wellness of our nurses. It is an issues which unfortunately affected by legislation of our government (which is affect specifically on a monetary basis). My research via Academic Search Complete allowed me to identify topics that assist my PICOT question, and enables me to further analyze and research to find out what issues directly affect is matter. Proper nurse to patient ratio, operational costs, government regulation, nurse work life and health, patient wellness, and nursing procedures and duration of those procedures are all affected by this topic and we must ensure that all are properly balanced.
Since the 1990’s, the interest in nursing and the profession as a whole has decreased dramatically and is still expected to do so over the next 10-15 years according to some researchers. With this nursing shortage, many factors are affected. Organizations have to face challenges of low staffing, higher costs for resources, recruiting and reserving of registered nurses, among liability issues as well. Some of the main issues arising from this nurse shortage are the impact of quality and continuity of care, organizational costs, the effect it has on nursing staff, and etc. However, this not only affects an organization and community, but affects the nurses the same. Nurses are becoming overwhelmed and are questioning the quality of care that each patient deserves. This shortage is not an issue that is to be taken lightly. The repercussions that are faced by both nurses and the organization are critical. Therefore, state funding should be implemented to private hospitals in order to resolve the shortage of nurses. State funds will therefore, relieve the overwhelming burdens on the staff, provide a safe and stress free environment for the patient, and allow appropriate funds needed to keep the facility and organization operational.
Factors such as, heavy workloads, stress, job dissatisfaction, frequent medical errors, and intention of leaving the job are all common for nurses to experience, especially during the nursing shortage crisis. Not only do the nurses suffer during a shortage, but the patients ' health outcomes suffer even more. For instance, there are higher rates of infectious diseases and adverse patient outcomes, such as urinary tract infections (UTIs), upper gastrointestinal bleeding, shock, pneumonia, prolonged hospital stays, failure to rescue, and mortality. As a result, this leads to higher re-admission rates for patients. Furthermore, high patient-to-nurse ratios cause heavy workloads due to an inadequate supply of nurses, an increased demand for nurses, a reduction in staffing and an increase in overtime, and a shortened length of stay for patients. Without the heavy workloads that nurses have to endure on a daily basis, there would more time for nurses to communicate more effectively with physicians, insurance companies, and patients and their families. Those heavy workloads are the result of hospitals reducing the nursing staff and implementing mandatory overtime policies just to meet unexpectedly high demands. Unfortunately, the nursing shortage has affected nurses ' mental and physical health. For example, the most common health concerns for nurses include cardiovascular health, occupational injuries and illnesses, and emotional and physical exhaustion. Therefore, safe-staffing ratios/levels have to become the main
Organizational changes that reduce cost. The M&S reduced its management levels to reduce the cost.
Bedside nurses want to change staffing levels to assure that they have enough time to both keep up with the constantly evolving health care and to provide safe patient care. Yet, healthcare employers consider that reducing nurse patient ratio is an unnecessary expense that has not been proven to improve quality of patient care (Unruh, 2008). Employers emphasize that raising nursing staffing level is not cost-effective. In fact, in accordance with ANA’s report (2013), a study, in the Journal of Health Care Finance, confirmed that reducing patient-nurse ratios increased hospital costs, but did not lower their profitability. Higher hospital costs were attributed to wages and benefits allocated to newly hired nurses. Yet, according to Cimiotti et.al (20112), it is more costly for hospitals to not invest money on nursing.
...ventory and operational expenses decrease. Once the constraint is determined, the five-step process is followed to find out how to fix or correct the restraint.