Staffing and Productivity
The nurse executive is responsible for budget planning for the division. Areas of focus include strategies to improve productivity and feasible tactics to reduce agency staff and overtime (OT) for the division. Identified in this paper is the importance of operational and financial performance indicators for the organizations internal goals. Focus on benchmarking through data analysis is vital. In addition, setting realistic goals that are compulsory to promote cost savings, while maintaining patient safety as a priority is important in creating an improved patient experience. In planning for modifications to obtain a favorable budget, adjusting full time equivalents (FTEs) to fluctuating volumes is important. To improve the productivity plan effectively are evaluation and management of scheduling, staffing, and skill mix are necessary to obtain favorable productivity.
Division Productivity
Nursing productivity relates both to proficiency of care provided and the effectiveness correlated to quality of that care. The division’s productivity exemplifies the organization’s ability to curtail resources for each of the units of services without undesirably affecting patient care. Poor productivity measurements relate to the amount of input resources used without significantly increasing the output as specified by Dunham-Taylor and Pinczuk (2010). The majority of units exceeded productivity expectations, while others do not meet expectations. There were several reasons why productivity did not meet target-such as utilization of FTEs not adjusted for actual volumes, agency and overtime hours.
FTE Utilization
Significant areas of the summary report where variances between actual and targeted FTEs were not fl...
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...ed productivity goals.
Summary
Nurse executives need a systematic understanding of the budget planning process and the challenges that organizations face in sustaining favorable performance. Utilizing this acquired knowledge will enable achievement of desired goals to improve the productivity of the division. Benchmarking provides important operational and financial indicators in addressing realistic goals and reducing unwanted agency staff, while adjusting FTEs for a cost savings favorable budget. Continuous development with best practice for strategic planning of the budget with scheduling and appropriate skill mix is essential for the nurse executive to evaluate to ensure ultimate connotation. I really appreciate the following quote addressed by Finkler & McHugh (2008), “Benchmarking should be used to show the way to true improvements in productivity” (p. 441).
Without participating in a longitudinal study, it is difficult to truly assess the efficacy in mandating nurse staffing ratios. It is difficult to measure the benefits of mandated staffing due to numerous confounding variables. These confounding variables include the resources available at specific hospitals in addition to the populations that they serve. Hospital volume, RN job satisfaction and the relationship between physicians and nurses have also been shown to affect patient outcomes (Duval et al., 2007).
In spite of the shortage among nurses, there are number of options and recommendations that can better help to maintain an adequate staff level and provide greater strategies needed to increase nursing. The choices open to cover for insufficient staff range from reallocating and postponing work, relocating staff within unit or from other units, to employing temporary additional nurses according to Buchan and Seccombe (1995). In health care, some of these options may not be available because ...
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,
Many health care professionals are wondering why shortage transpired when managed care cost initiatives, implemented throughout the country, are dramatically decreasing the length of patient stays (Upenieks, 2003). In fact, such a situation should be resulting in a nursing oversupply. As the nursing shortage ensues, the need for recruiting and retaining highly skilled nurses committed to the organization will become necessary to maintain high-quality patient care. The recent national nurse shortage has resulted in higher nurse workloads; fewer support resources, greater nursing dissatisfaction, and burnout, making it more difficult to provide optimal patient care (Upenieks, 2003). The primary role of nursing is to provide the best possible care to patients.
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
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.
Departmental budgeting is a concern in this scenario, the administrator must ensure that all departments are operating effectively and review their operational efficiencies when planning the wider budget. In reviewing the statement of operations data over the last 3 years it appears that operating expenses have risen approximately 11.45% (Hospital Scenario, n.d.). In designing the administrator should review this increase in the cost of operations and attempt to determine why these are
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.
The financial planning tool enables availing of proper funds for staffing. Managers have more insight on operations, and can alter them as required to improve their revenues and quality of healthcare services. The integrated system budget provides a reference point of efficiency at the firm level instead of the system level. The advantage of using integrated budget as a reference is that the information needed can be obtained relatively easily from financial
Mandatory staffing is an issue that needs to be addressed on the business side, patient side and the nursing side. According to Rajcki a study published in the Journal of the American Medical Association in October 2002 linked higher patient-to-nurse ratios in hospitals with increased patient mortality and increased nurse dissatisfaction with their jobs. The study, which looked at outcome data from more than 230,000 surgical patients discharged from 168 hospitals, found that each additional patient per nurse was associated with a 7% increase in the likelihood of patient mortality, and a 15% increase in job dissatisfaction for the nurses. (Rajcki, 2009)
This case study is intended to analyze the movie When a Man Loves a Woman, and to provide worst and best case scenarios for treatment. This film depicts a family that is struggling with a family member’s alcoholic dependency. The mother, Alice Green, is a school counselor who has an addiction to alcohol that is causing her to experience problems in her life as a result of her use. Her husband, Michael Green, is an airline pilot that is very protective Alice and often steps in and takes over for Alice, even in her role as a mother. Alice has two children, Jess and Casey, which also bear witness to their mother’s deterioration from alcohol addiction.
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.
Nurse staffing ratios in healthcare is an ongoing issue throughout the country. With healthcare being run like a business, the bottom line is sometimes thought to be more important than the safety of the patients. One will see through this paper that by reviewing patient outcomes and mortality, nurse staffing ratios can affect the quality and safety of patient care. II. Literature Review
Finkler, S. A., Kovner, C. T. & Jones, C. B. (2007). Financial management for nurse
Write 2 mini case studies. One should recount an effective coaching or counseling situation. The other recount an ineffective coaching or counseling situation. The case should be based on a real event, either from your own personal experience or from the experience of someone you know well. Use principles of supportive communication and listening in your cases.