Linda Watson has recently accepted a position as the assistant
administrator for the department of nursing at St. Joseph Hospital. There
have been both personnel and financial problems at St. Joseph Hospital, and
recently, the Catholic Healthcare System purchased the hospital. Like Linda,
all of the management staff is new. Linda’s first priority is to assist the nurse
managers in preparing their cost centers’ personnel budgets for the coming
fiscal year. She has decided to begin with the nurse manager on 1 West, a
step-down nursing unit. Linda wants to do extensive data collection and
create a solid base for making projections.
Information needed to be collected to prepare a budget.
In order to develop an effective budget, Linda will need to collect data
that focuses on staffing workloads and projected financial impacts.
Information such establishing expected patient volume, nurse-patient ratios,
number of FTEs, staffing skill mix, productive versus non-productive time,
determine hours per patient day (HPPD), minimum staffing, wages ranges,
and total care hours (Leger, 2018). Determining the appropriate composition
of staffing mix, composition, of full-time, part-time and per-diem employees
can provide the flexibility necessary to utilize staffing resources without
causing a negative variance. In addition, Linda, would also need to
determine the acuity index which is a numeric calculation of the acuity of
each patient on a given nursing unit. Lastly, Linda should also look at
historical budget data to base the budget based on previous trends (Rundio,
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