November 18, 2019

Describe two factors she should consider when deciding whether to increase or decrease the current number of full-time equivalents (FTEs) on her unit for the next fiscal year.

Chamberlain College of Nursing: NR-533- Financial Management in HC Org Budgeting Preparation (graded) The largest element of a nursing units operating budget is usually labor. As the nurse leader of her unit, Debbie is preparing her initial annual budget. Describe two factors she should consider when deciding whether to increase or decrease the current number of full-time equivalents (FTEs) on her unit for the next fiscal year. FINANCIAL Budgeting Concepts As we begin this weeks lesson, it is important to reflect upon the importance of the operating budget to ensure adequate resources for a specific department or area and understand the integral role of the nurse leader in this process. The operating budget is a plan for the organizations revenues and expenses. It usually covers a period of 1 year, most often referred to as the fiscal year (Finkel, Jones, & Kovner, 2013). Depending upon the organization, the fiscal year may be January 1 to December 31, or it may be July 1 to June 30 or other dates as established by the organization. Preparing the operating budget is one of the most time-consuming aspects of the managers role. It is important to understand the goals of the organization for the following year. That information will provide the manager guidance in preparing the budget, and the goals for the cost center for the manager focus on what should be accomplished in the coming year in that cost center. Every organization will have a set process and guidelines for budget preparation. Most organizations also offer training and mentoring for novice leaders to assist in the budgeting process. Seasoned leaders also may have questions, and support is generally available. The role of the nurse leader in the annual budget process may differ between organizations. In some organizations, the nurse leader may submit a list of capital items and the rationale for requesting this item. Some leaders may have more of a say than other leaders in what gets approved and what areas are cut from the budget. The control and analysis of costs within an organization are critical as the loss (deficit) or profit (surplus) of an organization depends upon the costs and the revenues. Purpose of Budgeting The budgeting process has many benefits for the organization. These benefits include identifying cost areas where designated funds will be allotted; improving the financial planning of the organization; providing overall feedback for specific areas; assisting with projecting monthly spending patterns throughout the organization; and assigning financial accountability and responsibility for specific areas. Some organizations incentivize their managers and senior leaders with a bonus if they meet certain measures by the end of the fiscal year, specifically related to salary expenses, retention, and employee turnover rates. Typically, financial data are tracked at least monthly, quarterly, and yearly. Some organizations may have a more frequent or less frequent monitoring, review, and reporting process. Types of Budgets There are several types of budgets in which the nurse leader may be involved in preparing or offering input. As we discussed, the operating budget is concerned with profit and loss for a specific department or area. The program budget may be for a specific service line or program. The capital budget is generally reserved for larger expense items needed for the designated area. Budgeting Approaches As mentioned earlier, the budgeting process is very complex. There are several approaches. Incremental, fixed, zero-based, or a continuous budget approach are generally needed to incorporate all aspects of the budget. An incremental approach considers the percentage increase in salaries due to inflation. The average range is 25%. The fixed approach considers an amount that does not change based on usage. In a zero-based approach, all expenses and revenues start at zero, and every expense is justified. In the flexible approach, adjustments to the set budget target levels are considered based on change in volume or activity; volume or activity can consist of patient census, number of operations, and many other variables. The continuous budget approach maintains the current budget by updating projections monthly or quarterly during the 12-month period. Below are some definitions that will be helpful to refer to throughout the course. Print Shuffle Hours per Patient Day Hours per patient day (HPPD) is the number of hours of nursing care required or delivered per patient. To calculate HPPD, the total care hours required for the year are divided by the number of patient days for the year. Card 1 of 15 View each term then click Flip Card to see the definition. Previous Card Flip Card Next Card Budget Preparation In the budget preparation process, some tough questions will have to be answered, such as whether employees will get a raise during the next year; whether they can replace the old operating suite; or whether they can add a new service line. Personnel costs are typically the largest and most complicated item in the budget. Variable and fixed costs are included in the budget preparation process. To project for variable costs, the easiest way to determine this is to divide the current year-to-date (YTD) actual cost results by the number of months left to get an average monthly amount; then multiply that result by 12 months to determine the projected annual cost. To determine the fixed costs in your budget, include specific events that will occur such as nurses week events, and include a reasonable average estimated amount per month (that is comparable to the previous year) to ensure that funds will be included in the following year. If the expenditure pattern has changed and has become more or less than the previous year, the budget should be adjusted to reflect the change accordingly. Revenue is another critical factor for healthcare organizations to survive. Managers generally work hard to keep patient satisfaction high, improve the quality of care, control costs, and keep staff and clients happy, among other factors (Finkler, Jones, & Kovner, 2013). The following information summarizes the steps in the operating-budget process. Image Description Summary This week, we started our introduction to the course and explored operating-budget concepts. We also reflected on the role of the nurse leader related to operating budgets in healthcare organizations. Understanding budgeting concepts will provide nurse leaders an opportunity to control and manage costs in their departments. Next week, we will discuss forecasting, which is an essential role of the nurse leader to provide information about the future. Reference Finkler, S., Jones, C., & Kovner, C. (2013). Financial management for nurse managers and executives. (4th ed.). St. Louis, MO: Saunders. Chapter 1: Introduction and Overview Chapter 13: Operating Budgets Chapter 16: Controlling Operating Results Required Article: Hamrock, E., Paige, K., Parks, J., Scheulen, J., and Levin, S. (2013, March/April). Discrete event simulation for healthcare organizations: A tool for decision making. Journal of Healthcare, 58 (2), 11024. Finkler, S., Jones, C., & Kovner, C. (2013). Financial management for nurse managers and executives. (4th ed.). St. Louis, MO: Saunders. Page or paragraph numbers must be included with quotes per APA. See APA re how to format references and in-text citations i.e. capitalization issues and use of the ampersand versus the word (and). Including at least one in-text citation and matching reference. Check for grammar and spelling
November 18, 2019

What tangible and intangible resources will be needed to implement your project?

Week 1 discussion Types of Nursing Models and Frameworks of EBP What are some of the models and frameworks of EBP currently in use? How does the strength of the evidence determine translation into practice? Why is it important to integrate both evidence-based practice and patient and family preferences? What is the nurse’s responsibility when EBP and patient and family practice do not match? Week 2 discussion The Clinical Question and Systematic Reviews Your capstone change project begins this week when you identify a practice issue that you believe needs to change. The practice issue must pertain to a systematic review that you must choose from a list provided to you in Course Resources. Choose a systematic review from the list of approved reviews based on your interests or your practice situation. Formulate a significant clinical question related to the topic of the systematic review that will be the basis for your capstone change project. Relate how you developed the question. Describe the importance of this question to your clinical practice previously, currently, or in the future. Describe what a research-practice gap is. Week 3 discussion Feasibility of Your Design Proposal and Importance of Communication Now that you have identified your capstone change project, it is time to look its feasibility. What tangible and intangible resources will be needed to implement your project? What improved outcomes do you anticipate will occur that could indicate the project produced a successful return on investment (ROI) of these resources? How will you communicate your plan for change with key decision makers so that they will support the allocation of the resources you are seeking? Week 4 discussion Evaluating Quality Patient Outcomes How can data provide information to evaluate quality patient outcomes? Give an example of data that can reflect poor quality in care. How can quality improvement be a daily task in patient care? Why does continuous quality improvement need to be associated with change? Week 5 discussion Core Competencies for Nurses Explore the website for the Quality and Safety Education for Nurses (QSEN) initiative at http://www.qsen.org. How can the QSEN competencies for nurses be implemented into your workplace or professional nursing setting? If you are not currently employed as a nurse, consider a previous work setting that would have benefited from implementation of the QSEN competencies. Week 6 discussion Implementing Change Despite Resistance Change can be difficult to implement. Now that you are almost finished with your change project, if you were to implement your project in your clinical practice, what type of resistance do you expect from staff? List at least three ways that you can lessen the resistance you may encounter to help ensure the success of your project. Week 7 discussion Healthcare Policy: What You Need to Know About the Affordable Care Act Please go to www.whitehouse.gov/blog/2016/03/23/look-six-years-affordable-care-act to read the latest about the Affordable Care Act from the White House. Respond to the questions below. What are some benefits of the healthcare reform that has been prompted by the Affordable Care Act (ACA)? Why is it important to be aware of changes in healthcare policy? Why do you believe we spend more on healthcare than any other country but have the worst outcomes? Week 8 discussion Your Future! Now that you are very close to completing this major accomplishment in your nursing career, what are your plans for your future? Please share your plans to keep up to date in your chosen specialty and nursing in general. What professional and nursing organizations do you plan to actively participate? Have you considered continuing your education to pursue a graduate degree?Week 1 discussion Types of Nursing Models and Frameworks of EBPWhat are some of the models and frameworks of EBP currently in use? How does the strength of the evidence determine translation into practice? Why is it important to integrate both evidence-based practice and patient and family preferences? What is the nurse’s responsibility when EBP and patient and family practice do not match?Week 2 discussion The Clinical Question and Systematic ReviewsYour capstone change project begins this week when you identify a practice issue that you believe needs to change. The practice issue must pertain to a systematic review that you must choose from a list provided to you in Course Resources.Choose a systematic review from the list of approved reviews based on your interests or your practice situation.Formulate a significant clinical question related to the topic of the systematic review that will be the basis for your capstone change project.Relate how you developed the question.Describe the importance of this question to your clinical practice previously, currently, or in the future.Describe what a research-practice gap is.Week 3 discussion Feasibility of Your Design Proposal and Importance of CommunicationNow that you have identified your capstone change project, it is time to look its feasibility.What tangible and intangible resources will be needed to implement your project?What improved outcomes do you anticipate will occur that could indicate the project produced a successful return on investment (ROI) of these resources?How will you communicate your plan for change with key decision makers so that they will support the allocation of the resources you are seeking?Week 4 discussion Evaluating Quality Patient OutcomesHow can data provide information to evaluate quality patient outcomes? Give an example of data that can reflect poor quality in care. How can quality improvement be a daily task in patient care? Why does continuous quality improvement need to be associated with change?Week 5 discussion Core Competencies for NursesExplore the website for the Quality and Safety Education for Nurses (QSEN) initiative at http://www.qsen.org. How can the QSEN competencies for nurses be implemented into your workplace or professional nursing setting? If you are not currently employed as a nurse, consider a previous work setting that would have benefited from implementation of the QSEN competencies.Week 6 discussion Implementing Change Despite ResistanceChange can be difficult to implement. Now that you are almost finished with your change project, if you were to implement your project in your clinical practice, what type of resistance do you expect from staff? List at least three ways that you can lessen the resistance you may encounter to help ensure the success of your project.Week 7 discussion Healthcare Policy: What You Need to Know About the Affordable Care ActPlease go to www.whitehouse.gov/blog/2016/03/23/look-six-years-affordable-care-act to read the latest about the Affordable Care Act from the White House.Respond to the questions below.What are some benefits of the healthcare reform that has been prompted by the Affordable Care Act (ACA)?Why is it important to be aware of changes in healthcare policy?Why do you believe we spend more on healthcare than any other country but have the worst outcomes?Week 8 discussion Your Future!Now that you are very close to completing this major accomplishment in your nursing career, what are your plans for your future? Please share your plans to keep up to date in your chosen specialty and nursing in general. What professional and nursing organizations do you plan to actively participate? Have you considered continuing your education to pursue a graduate degree?
November 18, 2019

Equine Racing Gambling Odds

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November 18, 2019

Write an essay that clearly addresses the following for the wicked problem you identified: –Explain the background of the urban planning problem being addressed –Discuss why the problem is a “wicked” one: –Why is the problem itself difficult to define? –Why are the causes of the problem uncertain? –Why is there no obvious solution? –How is the problem linked to other problems? –Discuss the public sector and private sector stakeholders involved, and how conflicting values contribute to the “wicked” nature of the problem

Explain the background of the urban planning problem being addressed –Discuss why the problem is a “wicked” one: PUP 301 Introduction to Urban Planning Assignment 1—Wicked Urban Problems in the News Assignment Overview Wicked urban problems are all around us. They also appear in the news…often surrounded by controversy. Such wicked problems help illustrate the politically-charged nature of urban planning. This assignment requires you to conduct an analysis of the news to identify an example of a “wicked” urban problem that is making headlines. Completing the Essay Search the news for articles addressing urban issues that fit the four criteria for “wicked” problems discussed in class. Your task for this assignment is to identify a real-life example that illustrates the political, and often controversial, nature of the planning process. The example you find can be local or in another city, can relate to any of the functional areas of planning (e.g. transportation, housing, economic development, environmental planning, etc.), and may be project-specific or focused on larger comprehensive planning activities. Pick a case study (NOT the South Mountain Freeway discussed in class) for which you can find adequate details and information about the urban problem being addressed. You must find a minimum of three sources of information about your case study. All sources must be properly cited and referenced. Write an essay that clearly addresses the following for the wicked problem you identified: –Explain the background of the urban planning problem being addressed –Discuss why the problem is a “wicked” one: –Why is the problem itself difficult to define? –Why are the causes of the problem uncertain? –Why is there no obvious solution? –How is the problem linked to other problems? –Discuss the public sector and private sector stakeholders involved, and how conflicting values contribute to the “wicked” nature of the problem Your written essay should be roughly 2-3 single-spaced pages in length, and should be written in essay format (i.e. include an introductory and concluding paragraph, and content paragraphs consisting of well-structured complete sentences). Assignments are due Thursday 5/24 by 3:00PM. Assignments should be submitted electronically as a Word or PDF document under the “Assignments” tab on Blackboard before the due date and time. After that point, the link will no longer be visible. NO late essays will be accepted. All essays should reflect your own individual work. Direct quotes must be cited properly using a consistent citation style throughout. Be sure to include a list of the 3 (minimum) sources used to complete the assignment. Your essay should be thoroughly proofread for spelling, punctuation, and grammatical errors. Essays containing excessive proofreading errors will not be accepted for credit.
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