The new project requires a whole new facility. It will support the work of the old complex but will mainly deal with the inpatient admissions. It will require new staff and new equipment. The paper presents the requirements to facilitate the initiation of the project in the new complex.
Description of Project
La Verne Medical Hospital Center has had a massive influx of patients in need of medical care. The Affordable Care Act has allowed the citizens access to medical services through expansion of the insurance services (Cokins 275). Now the short-stay patients can occupy beds for not more than 23 hours. Therefore, the new 5-story building will have Medical-Surgical beds and Intensive Care Unit beds. The new 50-bed nursing wing should begin operations by January 1st, 2017.
Basic Workload Calculation
The new nursing unit will be run at an 80% capacity (40 beds) so we will need to budget 40 beds (50 X 0.80) for a full year (365 days). The result is equal to 14,600 patient days. However, these patient days contain two different levels of nursing services: 6 hours per day for medical-surgery patients and 12 hours per day of ICU patients.
30 medical-surgery patients beds X 365 days = 10,950 patient days
10 ICU patient beds X 365 days
= 3650 patient days
14,600 patient days
Productive Time Calculation
The budget task is to find out the number of nursing hours that can provide 14,600 days of patient care (both medical-surgical and ICU) (Osborne and Ball 525). 1.0 Full-time Equivalent (FTE) is equal to 2080 hours per year (40 hours/ week X 52 weeks). But we need to calculate productive time—the time employees worked.
Nonproductive time for the nursing staff is:
Vacation takes 15 days, Holidays (7days), and 4 Sick Days. The unproductive days total to 26 days.
Productive Time per FTE: 2080 – 208 = 1872 hours
Required FTE Calculation
Required FTEs equal workload divided by productive hours, therefore:
30 medical-surgical beds = 10,950 patient days X 6 hours/ patient care = 65,700 hours
10 ICU patient beds = 3,650 patient days X 12 hours/ patient care = 43,800 hours
14, 600 patient days 109,500 hours
109, 500 = Required Patient Care Hours = 58.49 FTEs (based on acuity)
1872 Productive Time per FTE
The calculation for multiple shifts for 24-hour care. 58.49 FTEs X 1.4 = 81.886 FTEs
Calculation for nurse specialties. ICU@ 43,800 hours/year = 40% of FTEs
Medical-surgery@65,700 hours/year = 60% of FTEs
Management and supervision (nurse manager position) will need 4.95 FTEs
Therefore the salaries and employment benefits will be as follows;
Explanation of Program
The new hospital wing will need 11 security guards and one security supervisor. On each floor of the building, there will be two guards. One should be at the entrance to check and assist every visitor entering the premises (Cokins 275). Another would be in the middle corridors patrolling for any security issues. It would be on the three middle floors. The upper level would only need one security guard. It is the room where most of the laboratory and radiology activities will be taking place. Therefore, there would be no visitors on this floor (Weygandt, Kimmel and Kieso 492).
The ground floor will require five security personnel. One would supervise the parking lot to ensure that all vehicles adhere to the parking rules. The second guard will be at the entrance of the building. He or she will direct all the visitors and patients to their preferred locations. She will also be able to advise them accordingly (Pride 323). At the door, he or she can direct them to pick pamphlets that clarify the kind of services they require from the hospital. At the main entrance- gate- to the hospital compound there will be two guards. A lady and a man will direct the visitors and ensure that there are law and order at the gate.
The hospital will need to contract for several services. For instance, it will require the services of some specialists. Hiring all the doctors that the hospital needs is very expensive. Therefore, it will have to contract some of the services. Some of the specialists it will sign contracts with include Gynecologists, Ear, Nose and Throat physicians, and allergists. Others include Dermatologists, Herpetologists, Nephrologists, Obstetrician, and Psychiatrists. The hospital has found these to be the primary needs for most of the patients. There are other special needs that patients present to the hospital, but the medical center is still working on their modalities. After a year, there will be a need to reorganize the services it offers to the citizens.
Some of the intended services that the hospital will provide in future include;
Apart from contracting for services, the hospital will hire the following;
Other areas that the management will be looking at include;
For the time being, La Verne New will lease some laboratory equipment in the nearby hospital. They will assist the medical doctors and the radiology department to get the services that are currently not in the hospital. The management will use approximately $15,000 after negotiations on the affordability and profitability of the services (Goodman 365).
Much of the organization’s costs will go towards the purchase of equipment. For now, the hospital will just need the small equipment as the services stabilize for the future (Pride 323). The purchases will include;
- Six ECG machines with about three-year guarantee
- About 100 blood pressure monitors
- Five 24-hour ABPM monitors
- Spirometry and nebulizers
- Cautery equipment
- Pulse oximeters
- Dopplers
- Ophthalmoscopes
- Vaccine fridges
- Ear irrigation systems
- Examination lamps
- Ear thermometers
- Surgery coaches
- Scales-Height measures
- Vacuum autoclaves
- Operating instrument set
- Defibrillator
- Ventilator ICUs
- Pulse oximeters
- Patient Monitors for ICU
- Patient Monitor, anesthesia
- Oxygen concentrator
- Examination Lamp
- Uterine Aspiration Set
- Scale for newborn children
During the year the hospital will also carry out an analysis to establish the needs of other equipment and be able to plan for the next financial year. Instruments like X-ray film processor tabletops, film viewers, unit universals, and X-ray mobile are some additional needs assessment equipment (Strauss 652). For the time being the hospital may continue using the services of the current facility. There will be the need for ultrasound equipment, electrocardiographs, additional operating theater lights, operating tables, anesthesia trolleys, syringe pumps, electrosurgical units, and suction pumps.
The budgeted utility will comprise electricity, water, and transport. As the services increase for medication, there will be a gradual increase in this cost. However, the management will try to manage the efficient utilization of such services to ensure quality production. The organization will invest in energy-saving equipment to prevent the costs from escalating.
Objectives
To employ the hiring of full-time Registered Nurses. They will admit, discharge and transfer patients. The main clients to attend to will be those who spend less than 23 hours in the hospital. They will also direct patients to the right staff and connect families with their admitted family members.
To start a new cost center. The purpose of the leadership will be to manage and provide guidance on the revenues and expenses in the new nursing unit.
Option1. Do nothing and use the current staff on the inpatient unit to run the new 50-bed nursing unit. However, it will increase overtime expenses and affect the staff satisfaction.
Option2. Hire additional 82.0 RN FTEs by December 2016 to enhance services at the new facility (Osborne and Ball 525). The Registered Nurses will have responsibilities that include overseeing the ADT process. Most of their work will be in the job specifications.
Develop a new cost center which shall provide safe, cost-effective care for high-acuity short-stay patients. It will track the revenue and expenses associated with the new nursing unit (Strauss 652). It will develop mechanisms that help the hospital to save money.
Explanation of the program and its implementation
The plan will require the development of job descriptions. There will also be a need to advertise for the new positions and shortlist the applicants who meet the terms of employment. Interviews will concentrate on the job specifications. The process shall take three months. By January 2017, the new staff should be joining the new hospital complex.
Timeline and schedule for implementation
October 1–15: Develop job description
October 15–17: Post job internally
October 17–25: Accept applications
October 25–October 14: Conduct interviews
November 14–16: Make offer
November 16–20: Meet with finance to secure cost center
November 20–22: Meet with admissions to review coding
December 2: Begin project with RN scheduled Monday–Friday
Evaluation of program
The success of this new nursing unit or lack of it will be under evaluation in 90 days after starting operation by January 1, 2017, and again at six months following the onset of the new unit. The department will provide various reports. They will comprise work schedules, the organization’s productivity, and patient satisfaction and suggestion forms. They will also explain the productivity levels and financial status of the hospital
Financial
Mortgage Annual Payments.
For the current year, the hospital will pay $273,200 to retire the construction loan.
Total Revenue
The hospital seeks to get the budgeted patient care revenue from offering its services using the 80% bed capacity. But there are other means to raise revenue for the organization. Grants would enable the hospital to purchase very urgent tools and equipment for medication. The nurse manager can assign the risk control department to establish the needs within the organization.
The gifts can assist the hospital to adjust the cost per patient day for inpatient. The subordinate staff is another cost center to consider (Goodman 365). During the monthly review of financial reports, their expense can be attached to the gifts revenue for the time being. The adjustments can be happening on each reporting day.
The public cafeteria within the compound can help raise hospital funds with projections of about $40,000 in the first year (Weygandt, Kimmel and Kieso 492). It can also allow outside catering for various events. The customers who frequent the cafeteria can pick pamphlets and share them with friends and relatives. The revenue from the cafeteria can assist the hospital to cater to the various costs (Osborne and Ball 525).
Benefit-Cost Analysis
The project involves direct costs such as direct labor by the nursing staff, overheads such as electricity, advertising, cleaning supplies, and the investigation and analysis department. Without the laborers in the organization, there would be no services. And if services lack in the hospital, there would be no revenue. Electricity makes all the electric gadgets within the firm to operate. Without the utilities in the organization, patients and staff would not enjoy the services of the organization.
The new facility will ease the burden on La Verne. It will be easy to allocate costs to specific revenues and run the organization interdependently. In the future, La Verne New will be able to operate independently of its sister hospital. It also specializes in the kind of patients it admits. The management should proceed with the new venture. Apart from serving people, it will also become profitable in the long run.
Works Cited
Cokins, Gary. Performance Management. Hoboken, N.J: John Wiley & Sons, 2009. Print.
Goodman, Philip B. Accounting Savvy for Business Owners: [A Guide to the Bare Essentials]. Hoboken, NJ: CPA911 Publishing, 2010. Print.
Osborne, Stephen P and Amanda Ball. Social Accounting and Public Management. London, UK: Routledge, 2011. Print.
Pride, William M. Foundations of Business. New York, NY: Cengage Learning, 2017. Print.
Strauss, Steven D. The Small Business Bible. Hoboken, NJ: Wiley, 2012. Print.
Weygandt, Jerry J, Paul D Kimmel, and Donald E Kieso. Accounting Principles. Hoboken, NJ: J. Wiley & Sons, 2012. Print.