Set 2 Questions
Variances Reporting
Nurse leaders must have a thorough understanding of variance reporting because these reports provide information about the differences between an actual budget and a forecasted budget (Finkler, Jones & Krover, 2013). A nurse leader can use data gathered from these reports to better understand budgetary deficiencies, hence allowing him or her to develop more accurate budget forecasts in the future. Variance reports can also help a nurse leader identify the causes of variances. By recognizing the causes early on, nurse leaders can put appropriate actions in place to prevent further exacerbating existing variances. Nurse leaders can also use variance reports as a tool with which to gauge work center productivity.
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An activity report can provide operational statistics such as occupancy rate, average daily census, and average length of stay (Finkler, Jones & Krover, 2013). Though these numbers are important and have a great influence on the operational budget, a nurse leader needs more information in order to justify staffing. Nurse leaders can obtain additional information from workload reports. Patient classification system measure workload by assigning each patient a classification level based on his or her unique care needs and then determine the number of care hours required per patient per day. Many organizations express this in hours per patient day (HPPD) or relative value units (RVU) (Finkler et al., 2013). Workload reports are useful because they can identify changes in patient mix that can increase or decrease the need for nursing personnel. Bi-weekly fulltime equivalent (FTE) reports are also useful because they convey to nurse leaders exactly how many man-hours were used by each FTE (Liberty University, 2015). Furthermore, the report provides a breakdown of productive time; contract hours, paid time off (PTO), and overtime. It also accounts for nonproductive time such as time spent on education, training, and orientation (Liberty University, …show more content…
This system provides annual statics on Medicare payment amounts for institutional providers. A nurse leader can use HCRIS to find other similar institutions with whom to compare reimbursement rates and use this information to make necessary adjustments (“Healthcare Cost Report”, 2016). Lastly, nurse leaders can also use cost-to-charge ratios, volume-based measures, per diem rates, and balanced scorecards to gain better insight of unit reimbursement (Liberty University,
Flinker S., Ward D., Calabrese T., (2013). Accounting Fundamentals for Health Care Management, 2nd edition.
Furthermore, uncertainty of new reimbursement models, diminishing reimbursement, and complicated compliance regulations are playing the role of a catalyst for streamlining the Chargemaster process in majority of healthcare organizations. A good example of these challenges was prompted by the Center for Medicare and Medicaid with the release of data and chargemasters from several healthcare facilities. The release of the chargemasters sends a wave shock across the healthcare industry as it depicts a huge price discrepancies among health care providers, and due to this exposure many healthcare organizations attempt to rectify their charges. The main purpose the CMS release the chargemasters was to encourage transparency in hospital’s billing
With the passage of the Affordable Care Act (ACA), the Centers for Medicare and Medicaid Services (CMS) has initiated reimbursement based off of patient satisfaction scores (Murphy, 2014). In fact, “CMS plans to base 30% of hospitals ' scores under the value-based purchasing initiative on patient responses to the Hospital Consumer Assessment of Healthcare Providers and Systems survey, or HCAHPS, which measures patient satisfaction” (Daly, 2011, p. 30). Consequently, a hospital’s HCAHPS score could influence 1% of a Medicare’s hospital reimbursement, which could cost between $500,000 and $850,000, depending on the organization (Murphy, 2014).
The reason for the controversy of the Hospital Consumer Assessment of Healthcare Providers & Systems, referred to as HCAHPS (pronounced “H-caps”), is the tie that the Center for Medicare and Medicaid Services (CMS) placed between the scores of the assessment and healthcare reimbursement (Westbrook, Babakus, & Grant, 2014). There are two sides to consider when addressing HCAHPS/Press Ganey surveys as they directly affect hospital reimbursement. Patient satisfaction, quality of care, and how they portray their hospital stay contributes to the reimbursement that hospital receives. The nurse-patient relationship plays a large role in influencing the quality of care than patients feel that they are receiving.
Today health care systems are expected to meet set standards and core measures to earn everything from accreditation and recognition to payment. Reports need to filled to accomplish this, as well as what is being done to improve areas that may not be meeting standards. One way this is done is by utilizing dashboards. The purpose of this paper is to analyze the data from a dashboard and develop a nursing plan for improvement of a low scoring area.
Nurses are the largest and the most trusted professional group in the health care system. They are highly educated and skilled in their areas of practice. However, today’s nurses are experiencing an ever increasing workload, which negatively impacts their ability to deliver safe patient care (Berry & Curry, 2012). This paper explores four published journals that report on survey results on nursing workload and their direct correlation with patient care outcomes. The purpose of this paper is to address the ongoing nursing workload issues and explore the reasons behind it.
Completing acuity scores identifies patient current needs and illness severity, allowing nurses to plan care that meets the patient’s requirements during the shift. RATIONALE: Based on the literature research, attaining acuity scores promoted improvements in the delivery of care, workload of a nurse, and patient assignments. Combining each of these aspects, it revealed that care is adequately planned to meet the patient's needs according to their acuity score. Acuity score determines the equality of patient assignments to nurses, which enhances their level of workload.
Many nurses face the issue of understaffing and having too much of a workload during one shift. When a unit is understaffed not only do the nurses get burnt out, but the patients also don’t receive the care they deserve. The nurse-patient ratio is an aspect that gets overlooked in many facilities that could lead to possible devastating errors. Nurse- patient ratio issues have been a widely studied topic and recently new changes have been made to improve the problem.
Many nurses, including myself, face the issue of understaffing and having too much of a workload during one shift. Nurses get burnt out more quickly when working on an understaffed unit. The patient also suffers by not receiving the care they deserve. The issue of nurse-patient ratio is a touchy area
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
I enjoyed taking this class. I did not know what to expect at first, but this class has proven to be challenging and very informative. I have learned a lot about the pharmacological principle of different drugs, which I will use in my practice as a family nurse practitioner. Each week we were given different case study, which we had to find a differential diagnosis based on our patient’s sign and symptoms and also choose the correct pharmacological agent to treat our patient. This was a time-consuming process to come up with the correct diagnosis and treatment. I learned about different pharmacological agents to treat different diseases. I also learned about different medication dosage, side effect and the mechanism of action for different drugs. I was introduced to a different database, such as Epocrates and Micromedex to look up different drugs. The case scenarios gave me the practice that I needed to become familiar with different medications, their action, dosage, side effect, adverse effect and their mechanism of action. By taking this class I am better prepared to meet the MSN program outcome.
Hospitals recognized the need for the case management model in the mid 1980’s to manage the lengths of stay of hospitalized patients and the treatment plans (Jacob & Cherry, 2007). In 1983, the Medicare prospective payment program was implemented which allowed hospitals to be reimbursed a set payment based on the patient’s diagnosis, or Diagnosis Related Groups (DRG), regardless of what treatment was provided or how long the patient was hospitalized (Jacob & Cherry, 2007). To keep the costs below the diagnosis related payment, hospitals ...
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.
Several consequences of high nursing workload have been proven to hinder the quality of patient care. Carayon and Gurses’s research (2008) indicates that heavy workload can contribute to errors, shortcuts, guideline violations, and poor communication with physicians and other providers, thus compromising the quality and safety of patient care. In addition, the research not only implies that patients may not receive proper care, but also they can experience less satisfaction with
The leaders will follow staff nurses during report offering advice and providing guidance. (Ferris, 2013) Strong leadership and communication skills are essential in order to create an atmosphere of trust. Those qualities will also initiate change in the attitudes and behaviours of staff in a complex environment. (Evans, 2012) Binders will also be placed at each nursing station to allow the nurses to write down any concerns or feedback management may need to know about the process. Then, weekly management will review the feedback left in the binder and address with the nurses during staff