|Type of paper:||Essay|
|Categories:||Budgeting Nursing management|
A budget is the amount of money allocated for a specific purpose and the summary of the expenditures along with a proposal on how to meet them. It is a plan or tool used by managers to ensure that they provide quality services to patients. According to Roussel, Thomas and Harris (2015), a reasonable budget should be flexible, balanced; has set standards and utilizes available resources. Nurse managers use budgets to keep in check the personnel and the cost of supply. Every healthcare manager should be conversant with all the budgets used in hospital, especially the operating budget because he is the one closest to the patients and understands more on what is required to provide excellent services in the sector.
Types of Budgets used in Healthcare
The central budgets used in a healthcare delivery unit are statistical budget, operating, cash, and capital budgets. A statistical budget is prepared to measure the activities of each department to know the amount of money to allocate. The departments for diagnosis measures the number of procedures to be provided for the following year while nursing departments give details on the anticipated number of patient days. The knowledge of past performance is used for forecasting hence very crucial and runs for the previous five years. Comparison of the future may give both favorable and unfavorable reports. If damaging the organization will then require to lower overtime and sick time thus maintaining FTEs in the budget. Every department should give feedback based on its operation, and the financial manager should act as the final decision maker as most units tend to overestimate their reports. However, this is done after careful consideration of the records; a year ago. For instance, during Christmas, the budget should be a bit low as fewer patients will be expected.
An operating budget is made to help monitor daily activities of the organization, resources available, personnel and supplies, and usually, run for one year. Every nursing unit is considered to have its cost thus has an operating budget. The expenses incurred in nursing are not supposed to generate revenue. Revenues and costs are the main elements of operating budget. Revenue is the money received when a patient visits the healthcare premise or inpatient money from Medicare, Medicaid, and private insurers.
Expenses encompass all costs incurred in staff activities, supplies and any other costs running in the healthcare unit. The nursing expenses include employment cost: salaries and wages, money paid for overtime, holidays, education and other benefits; non-salary expenses: supplies of items used to provide care for patients, office supplies like pens, pencils, files, repair and maintenance and travel ( Collins, 2016). Another operating expense is interdepartmental cost. They are costs incurred by a different department but charged in the budget of your unit. Interdepartmental prices include costs from a pharmacy which stocks items used in healthcare delivery and central supply. Central supply provides stock for things like glucometer strips, IV kits among others. Once the items stocked are depleted, it restocks and adds the expenses to the healthcare sector
A cash budget is an estimation of cash inflows and outflows for an organization over a specific period. The budget is used to determine whether the amount of cash available is enough for the entity to continue functioning. It helps an organization to avoid cash shortage when incurring a lot of expenses. Without money, one cannot deliver healthcare in the desired manner. Thus a cash budget should be made for it to survive. The disbursement rates of Medicare and Medicaid are unpredictable as they continue changing, predicting cash flow needs a lot of thought and planning.
It should, therefore, be done on a monthly basis to see possible shortages and seek possible financing solutions (Collins, 2016). Financial managers should focus on investing and managing the cash they have rather than looking for ways of getting it.
A capital budget gives a summary of plans for acquisitions of health care facilities and equipment. Every health facility must determine how much of its capital it should allocate for renovations and expansion projects. A proper examination of the current financial status of the healthcare facility should be done to see whether there is a need for future financing. It can be done by giving a capital worksheet to each department and requesting them to list their capital budgets. When allocating resources, prioritize the most critical facilities and give allocation based on needs and money available.
Impacts of Healthcare Budgets to Nursing Practice
The formulation of budgets is essential for the survival of any health care facility especially the small hospitals. The budgets help me in giving quality care to patients as the budget process, and financial statements identify problems and areas of improvements, therefore, allowing supervisors and administrators to maintain and strengthen excellence. The budgets also help me to plan on how to do my visits to the patients. I am conversant with the budget of the healthcare thus I will not have a problem. The I will not dwell on getting the exact equipment but instead look for ways of attending to my patients.
The capital and statistical budgets help me to report on my sector in the healthcare facility. In case the operating budget is meager, I will know that there might be no leaves and the overtimes pays may as well be reduced. Budget cuts will make some workers be laid off.
I will therefore at risk of losing my job due to lack of enough funds to cater for salaries and other expenses. The cut means that we provide essential services provided in the hospital. These services may include behavioral health, obstetrics, managing chronic diseases, and diabetes.
Staffing Ratio and its Measurement Methods
The staffing ratio refers to the number of patients allocated to one nurse. The standard staffing ratio usually ranges from 1:5 to 1:8. However, studies show that there is no exceptional nursing staff to patient ratio is applied to all acute inpatient wards. Allocating more patient is to one team may mean high rates of patient falls, infections, an error in giving medication or even death. The current staffing ratio does not provide for safe nurse practicing because the nurses strain to meet their daily duties. The staffing ratio should vary depending on the condition of patients. For those with chronic and more severe diseases and are in the intensive care unit can operate at a rate of one nurse to one patient. The ratio will ensure safety in providing for healthcare. For the pregnant patients, the ratio can increase to one nurse to three patients
According to Giacalone (2015), one can measure nurse staffing as full-time equivalent employment, the number of nursing hours per patient, the share of registered nurses in total nursing staff, nurse to patient levels of other metrics. The staffing ratio can be computed from productive direct patient care nursing hours. Assuming that each patient day comprises of twenty-four hours, the number of patients per nurse is got by dividing the productive nursing hours divided by patient days multiplied by twenty-four. However, this conversion is not reliable because each patient may not have an average of 24hours per day and the productive nursing hours reported by hospitals may not be limited to direct patient care.
Another way to measure is the use of FTEE. We get it by adding the number of full-time nurses to a fraction of the part-time nurses. The share of full time to part time nurses is proportionate to some hours per week that the part times work. We can also calculate FTEE by converting the number of productive nursing hours. An FTEE nurse is assumed to work for 52weeks yearly at 40hours per week giving a total of 2,080 hours per year. However, this is the case every time as there are hours used for sick leave and vacation thus the hours are less than 2,080. The actual number is therefore assumed to be 1,768. We can consequently get FTEE by dividing the total nursing hours by 1,768.
Functions of Ancillary Staff
Ordinarily, most people think that doctors, dentists, and nurses are the primary healthcare providers. However, the so considered primary providers cannot function effectively in the absence of ancillary services. Ancillary department staff gives ancillary services. These are supplemental services provided to patients to support the diagnosis and treatment of conditions; exclusive of room and board (Bryant & Nix, 2015). They fall under three main categories: diagnostic, therapeutic and custodial. We can find these services in hospitals, medical offices, and free-standing sites. In hospital therapeutic ancillary services are provided. Although the ancillary staff is not primary workers in a healthcare facility, they are employed in the healthcare facility to offer their services.
Some works of ancillary staff in a hospital include; washing and dressing patients, serving and feeding patients, making beds and helping patients move around and monitoring the condition of the patients by taking temperatures, pulse, respirations weight. Ancillary services provided by health centers and GP surgery to include; sterilizing equipment, doing health checks, restocking consulting rooms and doing health education work.
I would change the current budget in the world by increasing the amount of cash allocated to hospitals. Healthcare facilities are crucial in every country and need to be addressed with a lot of care. There are services that one cannot suspend; surgery and chronic patients' attendance. Therefore, all facilities required to attend to this services should be availed. I will ensure that the operating budget for every health entity is increased to enable them to cater for expenses incurred. The budget should not lead to cost cuts as this may mean no leave or sick pay.
I will change the budget to ensure that it is enough to cater for nurse salaries who will attend to patients in the best ratio possible. Overworking employees can as well lead to health problems.
If the current budget is left the same, patients will not get the required attention from nurses. To get quality services, we should guarantee employee safety; therefore, nurses will not be willing to work if safety facilities are unavailable. Lack of essential facilities like x-ray machines means patients will not get x-ray services. Generally, in future, if we do not change the current budget is not changed, healthcare practitioners will not provide adequate services to patients, and in the long run, it will result in deaths.
Sources of Healthcare Funding
According to Johnson (2017), the government, insurance and the people themselves cater for healthcare. The government pays above 50% of the total costs. However, the government's money comes from taxpayers meaning we settle indirectly. Insurance companies are another source of fund for health care entities. The insurance companies charge premiums which are paid by the citizen then pool the risk and redistribute money to hospitals. If I am to change the budget, I will seek funds from donors and come up with projects made to generate funds for the healthcare. I would ensure that all the money allocated is used well without corruption from greedy fellows.
In five years, my employer will still exist. However, in ten to fifteen years time, he may not live due to the working conditions in the healthcare. Research shows that long-standing posture during work can cause hemorrhoids and varicose veins. Workers can also suffer from self-injuries and infections when addling healthcare facilities.
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