Select budgeting tools for strategic plans Select timeline tools

Need 1-2 pages answering the following passage:

Budgeting and Timeline Tools

Students will:

Select budgeting tools for strategic plans

Select timeline tools for strategic plans

Analyze the process of creating a budget and timeline for strategic plan issues

To prepare:

Review the information on budgeting in this week’s Learning Resources. Which tools (e.g., Revenue Projection Model, Capital Budgeting Analysis, Depreciation Calculator, Profit and Loss Projection) would be most useful for developing your Strategic Plan?

Review the information on PERT and other timeline tools, in this week’s Learning Resources, including Dr. Huston’s presentation in the media program. Use PERT or another tool to analyze and represent the activities that will need to be completed to successfully plan and implement your proposed change. Be sure to note dependencies (e.g., a task/milestone that must be completed in order to trigger the next step), and realistically assess the minimum time needed to complete the entire project.

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Describe the budgeting tool(s) you will use and the steps you plan to take in order to identify the financial resources necessary for your Strategic Plan issue. Explain your rationale for your selected tool(s) and plans.

Explain your plans for outlining the timeline for implementation of your proposed change. Explain which timeline tool(s) you will use and how they will represent the activities needed to successfully plan and implement your project.

Explain how your timeline can allow leeway for variance.

References:

Martin, B. C. (2019). Objectives. In Strategic planning in healthcare: An introduction for health professionals (pp. 85–93). Springer.

Martin, B. C. (2019). Strategies and operational plans. In Strategic planning in healthcare: An introduction for health professionals (pp. 95–115). Springer.

Penner, S. J. (2017). Reporting and managing budgets. In Economics and financial management for nurses and nurse leaders (3rd ed., pp. 111–140). Springer.

Penner, S. J. (2017). Budget planning. In Economics and financial management for nurses and nurse leaders (3rd ed., pp. 141–162). Springer.

Penner, S. J. (2017). Special purpose, capital, and other budgets. In Economics and financial management for nurses and nurse leaders (3rd ed., pp. 163–198). Springer.

Bjerke, M. B., & Renger, R. (2017). Being smart about writing SMART objectives. Evaluation and Program Planning (61), 125–127.

This is the basis of my proposed change or plan:

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Historical Perspective

Historically, the nation has experienced cyclical issues with severe nurse shortages. The shortage over the years has had different underlying causes. During the 1980’s through the early 1990’s the driving force was nurses leaving the profession due to the AIDS/HIV epidemic. The current nursing shortage is being fueled or shaped by the COVID-19 pandemic and failed nursing retention activities. The COVID-19 pandemic has increased the staffing needs of every organization, due to an overwhelmed healthcare system. Additionally the burden of an aging population caused by the Baby Boomer generation, with greater healthcare needs is projected to intensify the nursing shortage for the next 10-20 years (Rosseter, 2019). The demand for nurses has trended up with 59% of hospitals nationwide establishing a goal of increasing their nursing staff (NSI Nursing Solutions, 2020). Increased nursing staff is associated with reductions in hospital-related mortality, failure to rescue and reduced length of stay for patients (Rosseter, 2019).

Strategic Planning Issue

According to Sardisco, (2020), the first and most important step in strategic planning is to identify the need, and issue that is the focus of the strategic plan. The issue selected for this strategic plan is the nursing shortage the organization is currently experiencing. The organization has done a great job recruiting new grad nurses, due to relationships with area nursing schools. This resulted in a great pool of qualified applicants that expressed a strong desire to begin their career at our medical center. Candidates are motivated by richness of experience available through the medical center. With the exception of one other major facility in the state, nurses often the equivalent of 3-4 years of experience in our facility opposed to other facilities in the area. That is the blessing of being a leader in educating and training the next generation of healthcare professionals (University of Maryland Medical Center, 2020). The curse is that the majority of the new grad nurses leave within 12-18 months after they are hired, other organizations recognize the quality of training and proficiency of the nurses, resulting in their hiring a fully trained, highly proficient nurse. This is a major factor and contributor to a greater than 50% turnover rate in the past 5 years (University of Maryland Medical Center, 2020). Lack of full nurse staffing on every shift has led to increased medical errors, medication errors, patient falls, and reduced quality of patient care. This is in direct contrast to the organization’s goal of delivering the highest level of healthcare to all patients, and improving patient outcomes (University of Maryland Medical Center, 2020).

Mission statements, vision statements and values are vital to the success of any strategic plan. MacLeod (2016, p. 18), found that a leader must take time to articulate the mission, values and vision before developing a strategy, absent this foundation the strategic planning is doomed to failure. As a part of the organizational mission statement, the goals are to deliver superior healthcare, train the next generation of healthcare professionals, and discover innovative ways to improve patient and health outcomes worldwide (University of Maryland Medical Center, 2020). To achieve this goal nurse staffing must be at the optimal level to ensure best possible patient care and outcomes. Saville, Griffith, Ball, & Monks (2019), found that inadequate nurse staffing led to unsafe patient care, less than optimal outcomes, and increased patient mortality. This should be considered a totally unacceptable result all leaders of the organization, patients have the expectation of the highest level of care, best possible outcomes, and highest possible quality of life.

This issue was selected due to the challenges of recruitment, retention, and satisfaction, of the nursing staff. The one consistent challenge for any organization has been nurse retention. Turnover is a major issue in this organization, with 50-60% of nurses leaving during the first two years after initial hiring. The average national cost of recruiting and training a new grad nurse to proficiency is approximately $52,100.00, resulting in an average hospital spending anywhere between $4 –$6 million annually due to turnover, or inability to retain nurses (Sherman, 2020). Strategically planning to overcome this continued challenge of nursing turnover, research has shown marked improvement in patient outcomes and mortality rates, decrease in hospital acquired infections, decrease in length of stays, and overall improvements in nurse satisfaction and well-being (American Association of Colleges of Nursing, 2019). The proposed strategic plan would address the issue through three strategies. The first is to implement liberal and flexible overtime policies to ensure that nurses are available to work when required. This would increase nurse staffing when patient census increases. The second is to form strategic partnerships to effectively recruit and retain nurses. The final strategy is to increase nurse wages to overcome identified challenges to retain nurses who leave to escape burnout, for higher wages, and better, less stressful work conditions (Catalano, 2015).

The Nurse Residency program was one of the methods used to address the nursing shortage in the past. Windey, Schivinski & Tyrna (2017), found the Nurse Residency Program an effective tool to enhance an organization’s ability to overcome challenges of it nursing shortage. The goal of the program is to forge relationships with nursing grads through training and guiding them to proficiency, with the desired result of retaining them long term. Our organization currently uses this system, with limited long term success.

The stakeholders would be patients, their families, nursing school faculty, nursing students, current nurses, unit managers, and executive staff of the organization. The plan would form multi-disciplinary shared governance committees with representatives from every discipline and every level from staff nurses to executive staff. Every member of this group shares an interest in the successful outcome of the plan.

Summary

Every organization should focus on retaining the valuable resources or nurses they have developed, with an aggressive nurse retention plan. Many nurses leave their current position due to burnout and lack of job satisfaction. IHI Triple Aim found this so one factor so vitally important, they added an additional aim of nurse job satisfaction to create the IHI Quadruple Aim. Moloney, etal (2018), found that many nurses leave their organizations due to increased workload, lack of resources, and general job dissatisfaction. Moloney, etal (2018), also found a greater ratio of work to personal life (due to increased overtime created by the nursing shortage), led to nurses leaving the profession. It is more cost effective for organizations to find ways to increase nurse retention, than to repeat the cycle of hiring and training new nurses every six months.

References

American Association of Colleges of Nursing. (2019). Fact sheet: Nursing shortage. Retrieved from https://www.aacnnursing.org/Portals/42/News/Factsheets/Nursing-Shortage-Factsheet.pdf

NSI Nursing Solutions. (2020). 2020 NSI National health care retention & RN staffing report. Retrieved from https://www.nsinursingsolutions.com/Documents/Library/NSI_National_Health_Care_Retention_Report.pdf

Catalano, J. (2015). Nursing now! today’s issues, tomorrow’s trends. (7th ed.). Philadelphia, PA: FA Davis Company.

MacLeod, L. (2016). Mission, Vision and Values Statements: The Physician Leader’s Role. Physician Leadership Journal, 3(5), 18–25.

Moloney, W., Boxall, P., Parsons, M., & Cheung, G. (n.d.). Factors predicting Registered Nurses’ intentions to leave their organization and profession: A job demands-resources framework. JOURNAL OF ADVANCED NURSING, 74(4), 864–875. https://doi-org.ezp.waldenulibrary.org/10.1111/jan.13497

NSI Nursing Solutions. (2020). 2020 NSI National health care retention & RN staffing report. Retrieved from https://www.nsinursingsolutions.com/Documents/Library/NSI_National_Health_Care_Retention_Report.pdf

Rosseter, R. (2019). Nursing Shortage. Retrieved from https://www.aacnnursing.org

Sardisco, R. (2020). Steps to Successful Strategic Planning. Retrieved June 10, 2020, from https://www.smallbusiness.chron.com

Saville, C. E., Griffiths, P., Ball, J. E., & Monks, T. (2019). How many nurses do we need? A review and discussion of operational research techniques applied to nurse staffing. International Journal of Nursing Studies, 97, 7–13. https://doi-org.ezp.waldenulibrary.org/10.1016/j.ijnurstu.2019.04.015

Sherman, R. (2020). Fueling RN professional growth. American Organization for Nursing Leadership. Retrieved from https://www.aonl.org/publications/voice/fueling-rn-professional-growth-steps-adopt-leader-coach-mindset#:~:text=RN%20turnover%20now%20averages%20%2452%2C100,costs%20(NSI%2C%202019

University of Maryland Medical Center. (2020). Mission, Vision, and Values. Retrieved from   https://www.umms.org/ummc/about/mission-vision

Windey, M., Schivinski, E., & Tyrna, J. (2017). Strategic Planning. Retrieved from https://www.nursingcenter.com

 

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