1. The first is the case study ( Quantitative Analysis )

profileMichelle_Michy
201911180135314._report_tamplate.docx

The Burn Care Unit Case Study

Table of Contents Glossary of Abbreviations iv Executive Summary v Introduction 1 Review of the Staffing Plan ? Staffing Plan at the Burn Care Unit ? Current Nurse Staffing ? Cost Comparison Computations ? Strategy Formulation ? 1. First Strategy ? 2. Second Strategy ? 3. Third Strategy ? 4. Fourth Strategy ? 5. fifth Strategy ? Recommendations ? Conclusion ? References ? Appendix ? Appendix ? Appendix ? Appendix ?

Glossary of Abbreviations Used

ADC - Average Daily Census

CEO - Chief Executive Officer

DC - Direct Care

FTE - Full Time Equivalent

HN - Head Nurse

HPPD - Hours per patient per day

IT - Information Technology

LPN - Licensed Practical Nurse

NA - Nursing Aide

NIS - Nursing Information System

RN - Registered Nurse

US - Unit Secretary

VP - Vice President

Executive Summary

Should be 3 pages single spaced. It should include what the recommendations are, and a little bit of background is fine also.

Running head: THE BURN CARE UNIT CASE STUDY

THE BURN CARE UNIT CASE STUDY

Introduction

Write …

Review of the Staffing Plan

Edit and change as needed

Improvement in the efficiency of services and processes is always the goal of any organization. The same is true for hospitals whose primary function is to provide treatment and care to patients as well as alleviate their discomforts during their confinement. Cost control and the efficient use of resources are responsibilities of hospital managers and administrators, but the delivery of efficient care and services to the patients are the responsibilities of nurses (Khomami & Rustomfram, 2019).

it should expand

Staffing Plan at the Burn Care Unit

write …

Current Nurse Staffing

write …

Cost Comparison Computations

write … or you could change the sub-title and write about something fit in

Strategy Formulation

Edit and change as needed

Several strategies will be formulated and evaluated to realize the goal of saving $500,000 annually on labor costs at the Burn Care Unit. This will involve a mix of reviewing the daily staffing plan, an alternative program for the Baylor Plan, and automation of some tasks. The following points will be considered in the strategy formulation:

· The 3.5 hours of direct care requirements for each acuity point is maintained

· The regular RNs will not be financially disadvantaged

· The efficiency and quality of the unit will not be compromised

it should expand

These are the five strategies that you should use in this section below. it is just a guideline for you to use and expand.

I created a set of spreadsheets for the current situation. Based on the current situation, the total labor costs are $5,283,048.61. Here are a list of proposed strategies that must be detailed in the paper:

· Strategy #1

Eliminate weekday overtime. Rather than having regular employees split between weekly employees and weekend employees, create a schedule where everyone works three 12-hour shifts and one 6-hour shift per week. That will eliminate all overtime during the week but still need to pay weekend overtime since that seems to be mandated by law. This strategy will save $411,763.87

· Strategy #2

Change ratio of RN to LPN from 19 to 4 to 15 to 8. This was discussed in detail in the paper but the actual cost savings weren’t details. Cost saving from this strategy is $259,332.98

· Strategy #3

We need to right-size the labor force. The current labor force is not sufficient to provide the required care. We need to add labor such that the minimum hours of care are provided. This strategy will increase costs by $282,463.65

· Strategy #4

Increase efficiency by 5%. It was noted in the case that the cost of doing so would require an initial investment of $200,000. Savings from this strategy will be $443,231.74, which will yield a net savings in year 1 of $243,231.74

· Strategy #5

To help offset the loss of OT pay, add 4% to the hourly rates for regular employees. This will add costs of $101,764.33.

Table of strategy:

strategy #

Description

Change in Cost

1

Eliminate Weekday Overtime

-$411,763.87

2

Change Labor Mix

-$259,332.98

3

Right-size Labor Force

+$282,463.65

4

Investment to increase efficiency

+$200,000

4

Savings from increased efficiency

-$443,231.74

5

4% increase in pay to regular employees

+$101,764.33

Total

Save $530,100.60

Strategy 1: ……………………………………………………….

This should be almost 3 pages based on Excel proposed 1 which in (proposed spreadsheet. zip file)

and based on strategy 1 above.

Table … Cost Savings Due to Elimination of Weekday Overtime

Existing Schedule

Revised Schedule

Difference (Cost Savings)

$ 5,283,049

$ 4,871,285

$ 411,764

Strategy 2: ……………………………………………………….

This should be 3-4 pages based on Excel proposed 2 which in (proposed spreadsheet. zip file)

and based on strategy 2 above

Table … Alternative Staffing Plan based on 3.5 Direct Care per Acuity ((table should be fill in numbers)

DC Hours/ staff

Given Staffing Plan

Alternative Staffing Plan

Based on Table

Number

Hours DC

Number

Hours DC

HN

RN

LPN

NA

US

Total

LPNs to replace some RNs?

This section should be edited and expanded as needed

Table … Difference Between RN and LPN

RN

LPN

Education

4-year BS Nursing or

2-year Associate Degree

1-year Licensed Vocational Nurse Course

Licensing Requirement

NCLEX

NCLEX-PN

Duties

- administer and monitor patient medications

- perform Basic Life Support etc

- wound care

- insert, manage, and discontinue intravenous catheters and intraurethral catheters

- develop a care and wellness plan for each patient

- take vital signs and address abnormalities

- admit and discharge patients

- maintain accurate documentation

- safely transfer patients into and out of bed or chair

- supervise LPNs

- Ensure patients safety

- administer medications

- chart medical records

- take vital signs

- change wound dressings

- collect specimens such as blood and urine

- insert and care for urinary catheters

- care for patients with ventilators and tracheostomy tubes

- insert and care for patients with nasogastric tubes

- provide feedings through tubes

- assist patients with eating, bathing, dressing, etc.

- monitor patients

- perform emergency CPR

- execute the nursing plan formulated by the RN

write …

Table 12 shows the cost-effectiveness of implementing the proposed Staffing Plan using the given rates.

Table 12 Comparative costs of Annual Payroll for Existing Staffing Plan and Effects of Strategies 1 & 2 based on Appendix 3

Existing Plan

Revised Staffing Plan

Difference (Cost savings)

$ 5,283,049

$ 4,547,119

$ 735,930

Due to Strategy 1: $ 411,764

Due to Strategy 2: $ 324,166

According to Table 12, the unit could realize annual cost savings of $324,166 by changing the staffing plan only assuming all other things as unchanged.

write and expand …

Strategy 3: ………………………………………………..

This should be almost 3 pages based on Excel proposed 3 which in (proposed spreadsheet. zip file)

and based on strategy 3 above

add table or graph

Strategy 4: …………………………………………

This strategy should include Improving in TSS Technology Support System.

This should be almost 3 pages based on Excel proposed 4 which in (proposed spreadsheet. zip file)

and based on strategy 4 above

Add graph or table if needed

Build GANTT chart for TSS Project as appendix

Strategy 5: ………………………………………..

This should be almost 3 pages based on Excel proposed 5 which in (proposed spreadsheet. zip file)

and based on strategy 5 above

Add graph or table

Recommendations

should summary the strategies and suggest some improvement to be considered when applying the strategies. and create additional supportive strategies if needed as below.

should be almost 2 pages

· Upon implementation of the recommended strategies, it is also proposed that the CEO should assign somebody or a team to monitor and evaluate the results of the project so that adjustment could be made in case of a negative impact especially to the quality of care and patients’ safety which are top priorities.

Conclusion

should summary the paper, mentioned the strategies, and summary cost of saving for each strategy.

Table … Summary of Cost Savings

 

Year 1

Year 2

Year 3

Strategy1 (Eliminate…)

$ 411,764

$ 411,764

$ 411,764

Strategy2 …..

Strategy3 ……

Strategy4 ……

Strategy5 …….

Total Savings

References

Khomami, H.M., & Rustumfram, N. (2019). Nursing efficiency in patient care; A comparative study in perception of staff nurse and hospital management in a trust hospital. Journal of Family Medicine and Primary Care. May 2019, 8(5), 1550-1557. DOI: 10.4103/jfmpc.jfmpc_37_19

Appendix 1

Computed Annual Salary from Census and Acuity Data (Current Situation)

Pay Period

ADC

Acuity

Worked FTE by Type

Computed Payroll

Regular

Flex-pool

Agency

Total

Regular

Flex-pool

Agency

Total

1

Sep

19.7

2.50

84.00

-

-

84.00

$ 148,481.85

$ -

$ -

$ 148,481.85

2

Sep

19.7

2.60

83.00

-

-

83.00

$ 146,634.32

$ -

$ -

$ 146,634.32

3

Oct

21.2

2.60

88.00

-

-

88.00

$ 155,871.99

$ -

$ -

$ 155,871.99

4

Oct

25.7

2.58

98.00

-

-

98.00

$ 174,347.34

$ -

$ -

$ 174,347.34

5

Nov

28.8

2.90

99.00

-

-

99.00

$ 176,194.88

$ -

$ -

$ 176,194.88

6

Nov

36.3

2.87

99.40

10.00

10.60

120.00

$ 176,933.89

$ 17,356.98

$ 18,222.40

$ 212,513.27

7

Nov

39.3

2.76

99.00

9.50

21.50

130.00

$ 176,194.88

$ 16,489.13

$ 17,311.28

$ 209,995.28

8

Dec

36.3

3.20

99.80

9.70

15.50

125.00

$ 177,672.90

$ 16,836.27

$ 17,675.73

$ 212,184.90

9

Dec

39.3

3.40

100.30

9.10

20.60

130.00

$ 178,596.67

$ 15,794.85

$ 16,582.38

$ 210,973.90

10

Jan

39.3

3.10

100.40

9.30

21.30

131.00

$ 178,781.42

$ 16,141.99

$ 16,946.83

$ 211,870.24

11

Jan

39.3

3.20

106.31

8.90

13.80

129.01

$ 189,700.36

$ 15,447.71

$ 16,217.94

$ 221,366.00

12

Feb

39.3

3.60

105.64

10.00

6.36

122.00

$ 188,462.51

$ 17,356.98

$ 18,222.40

$ 224,041.88

13

Feb

39.3

3.40

106.50

11.80

6.71

125.01

$ 190,051.39

$ 20,481.23

$ 21,502.43

$ 232,035.05

14

Mar

39.3

3.60

106.78

12.60

12.62

132.00

$ 190,568.70

$ 21,869.79

$ 22,960.22

$ 235,398.71

15

Mar

36.3

3.40

106.31

12.90

4.79

124.00

$ 189,700.36

$ 22,390.50

$ 23,506.90

$ 235,597.75

16

Apr

33.3

3.20

104.50

12.60

4.90

122.00

$ 186,356.32

$ 21,869.79

$ 22,960.22

$ 231,186.33

17

Apr

30.3

3.10

106.50

12.50

1.01

120.01

$ 190,051.39

$ 21,696.22

$ 22,778.00

$ 234,525.61

18

Apr

30.3

2.90

106.02

12.90

1.08

120.00

$ 189,164.57

$ 22,390.50

$ 23,506.90

$ 235,061.97

19

May

26.5

2.90

105.36

12.00

0.64

118.00

$ 187,945.20

$ 20,828.37

$ 21,866.88

$ 230,640.45

20

May

26.5

2.70

104.22

10.10

1.69

116.01

$ 185,839.01

$ 17,530.55

$ 18,404.62

$ 221,774.18

21

Jun

25.1

2.50

102.51

11.60

1.90

116.01

$ 182,679.72

$ 20,134.09

$ 21,137.98

$ 223,951.80

22

Jun

25.1

2.20

101.46

9.90

2.64

114.00

$ 180,739.81

$ 17,183.41

$ 18,040.18

$ 215,963.39

23

Jul

22.7

2.40

97.19

9.20

1.61

110.00

$ 172,850.84

$ 15,968.42

$ 16,764.61

$ 205,583.86

24

Jul

21.5

2.50

90.00

-

-

90.00

$ 159,567.06

$ -

$ -

$ 159,567.06

25

Aug

19.7

2.50

90.00

-

-

90.00

$ 159,567.06

$ -

$ -

$ 159,567.06

26

Aug

19.7

2.30

89.00

-

-

89.00

$ 157,719.53

$ -

$ -

$ 157,719.53

Total

$ 4,590,673.95

$ 337,766.75

$ 354,607.90

$ 5,283,048.61

Appendix 2

Computed Annual Salary from Census and Acuity Data, with no Weekday Overtime (Strategy #1)

Pay Period

ADC

Acuity

Worked FTE by Type

Computed Payroll

Regular

Flex-pool

Agency

Total

Regular

Flex-pool

Agency

Total

1

Sep

19.7

2.50

84.00

-

-

84.00

$ 135,190.68

$ -

$ -

$ 135,190.68

2

Sep

19.7

2.60

83.00

-

-

83.00

$ 133,510.64

$ -

$ -

$ 133,510.64

3

Oct

21.2

2.60

88.00

-

-

88.00

$ 141,910.84

$ -

$ -

$ 141,910.84

4

Oct

25.7

2.58

98.00

-

-

98.00

$ 158,711.26

$ -

$ -

$ 158,711.26

5

Nov

28.8

2.90

99.00

-

-

99.00

$ 160,391.30

$ -

$ -

$ 160,391.30

6

Nov

36.3

2.87

99.40

10.00

10.60

120.00

$ 161,063.32

$ 17,356.98

$ 18,222.40

$ 196,642.70

7

Nov

39.3

2.76

99.00

9.50

21.50

130.00

$ 160,391.30

$ 16,489.13

$ 17,311.28

$ 194,191.71

8

Dec

36.3

3.20

99.80

9.70

15.50

125.00

$ 161,735.34

$ 16,836.27

$ 17,675.73

$ 196,247.33

9

Dec

39.3

3.40

100.30

9.10

20.60

130.00

$ 162,575.36

$ 15,794.85

$ 16,582.38

$ 194,952.59

10

Jan

39.3

3.10

100.40

9.30

21.30

131.00

$ 162,743.36

$ 16,141.99

$ 16,946.83

$ 195,832.18

11

Jan

39.3

3.20

106.31

8.90

13.80

129.01

$ 172,672.41

$ 15,447.71

$ 16,217.94

$ 204,338.05

12

Feb

39.3

3.60

105.64

10.00

6.36

122.00

$ 171,546.78

$ 17,356.98

$ 18,222.40

$ 207,126.15

13

Feb

39.3

3.40

106.50

11.80

6.71

125.01

$ 172,991.61

$ 20,481.23

$ 21,502.43

$ 214,975.28

14

Mar

39.3

3.60

106.78

12.60

12.62

132.00

$ 173,462.03

$ 21,869.79

$ 22,960.22

$ 218,292.04

15

Mar

36.3

3.40

106.31

12.90

4.79

124.00

$ 172,672.41

$ 22,390.50

$ 23,506.90

$ 218,569.80

16

Apr

33.3

3.20

104.50

12.60

4.90

122.00

$ 169,631.53

$ 21,869.79

$ 22,960.22

$ 214,461.54

17

Apr

30.3

3.10

106.50

12.50

1.01

120.01

$ 172,991.61

$ 21,696.22

$ 22,778.00

$ 217,465.83

18

Apr

30.3

2.90

106.02

12.90

1.08

120.00

$ 172,185.19

$ 22,390.50

$ 23,506.90

$ 218,082.59

19

May

26.5

2.90

105.36

12.00

0.64

118.00

$ 171,076.37

$ 20,828.37

$ 21,866.88

$ 213,771.62

20

May

26.5

2.70

104.22

10.10

1.69

116.01

$ 169,161.12

$ 17,530.55

$ 18,404.62

$ 205,096.29

21

Jun

25.1

2.50

102.51

11.60

1.90

116.01

$ 166,288.25

$ 20,134.09

$ 21,137.98

$ 207,560.32

22

Jun

25.1

2.20

101.46

9.90

2.64

114.00

$ 164,524.20

$ 17,183.41

$ 18,040.18

$ 199,747.79

23

Jul

22.7

2.40

97.19

9.20

1.61

110.00

$ 157,350.43

$ 15,968.42

$ 16,764.61

$ 190,083.45

24

Jul

21.5

2.50

90.00

-

-

90.00

$ 145,270.93

$ -

$ -

$ 145,270.93

25

Aug

19.7

2.50

90.00

-

-

90.00

$ 145,270.93

$ -

$ -

$ 145,270.93

26

Aug

19.7

2.30

89.00

-

-

89.00

$ 143,590.89

$ -

$ -

$ 143,590.89

Total

$ 4,178,910.08

$ 337,766.75

$ 354,607.90

$ 4,871,284.74

Appendix 3

Computed Annual Salary from Census and Acuity Data, with the Proposed Staffing Plan (Strategy #2)

Pay Period

ADC

Acuity

Worked FTE by Type

Computed Payroll

Regular

Flex-pool

Agency

Total

Regular

Flex-pool

Agency

Total

1

Sep

19.7

2.50

84.00

-

-

84.00

$ 126,247.93

$ -

$ -

$ 126,247.93

2

Sep

19.7

2.60

83.00

-

-

83.00

$ 124,688.73

$ -

$ -

$ 124,688.73

3

Oct

21.2

2.60

88.00

-

-

88.00

$ 132,484.70

$ -

$ -

$ 132,484.70

4

Oct

25.7

2.58

98.00

-

-

98.00

$ 148,076.64

$ -

$ -

$ 148,076.64

5

Nov

28.8

2.90

99.00

-

-

99.00

$ 149,635.83

$ -

$ -

$ 149,635.83

6

Nov

36.3

2.87

99.40

10.00

10.60

120.00

$ 150,259.51

$ 16,221.30

$ 17,102.40

$ 183,583.20

7

Nov

39.3

2.76

99.00

9.50

21.50

130.00

$ 149,635.83

$ 15,410.23

$ 16,247.28

$ 181,293.34

8

Dec

36.3

3.20

99.80

9.70

15.50

125.00

$ 150,883.19

$ 15,734.66

$ 16,589.33

$ 183,207.17

9

Dec

39.3

3.40

100.30

9.10

20.60

130.00

$ 151,662.78

$ 14,761.38

$ 15,563.18

$ 181,987.35

10

Jan

39.3

3.10

100.40

9.30

21.30

131.00

$ 151,818.70

$ 15,085.81

$ 15,905.23

$ 182,809.74

11

Jan

39.3

3.20

106.31

8.90

13.80

129.01

$ 161,033.54

$ 14,436.95

$ 15,221.14

$ 190,691.63

12

Feb

39.3

3.60

105.64

10.00

6.36

122.00

$ 159,988.88

$ 16,221.30

$ 17,102.40

$ 193,312.57

13

Feb

39.3

3.40

106.50

11.80

6.71

125.01

$ 161,329.78

$ 19,141.13

$ 20,180.83

$ 200,651.74

14

Mar

39.3

3.60

106.78

12.60

12.62

132.00

$ 161,766.36

$ 20,438.83

$ 21,549.02

$ 203,754.21

15

Mar

36.3

3.40

106.31

12.90

4.79

124.00

$ 161,033.54

$ 20,925.47

$ 22,062.10

$ 204,021.10

16

Apr

33.3

3.20

104.50

12.60

4.90

122.00

$ 158,211.40

$ 20,438.83

$ 21,549.02

$ 200,199.25

17

Apr

30.3

3.10

106.50

12.50

1.01

120.01

$ 161,329.78

$ 20,276.62

$ 21,378.00

$ 202,984.40

18

Apr

30.3

2.90

106.02

12.90

1.08

120.00

$ 160,581.37

$ 20,925.47

$ 22,062.10

$ 203,568.94

19

May

26.5

2.90

105.36

12.00

0.64

118.00

$ 159,552.30

$ 19,465.56

$ 20,522.88

$ 199,540.74

20

May

26.5

2.70

104.22

10.10

1.69

116.01

$ 157,774.82

$ 16,383.51

$ 17,273.42

$ 191,431.75

21

Jun

25.1

2.50

102.51

11.60

1.90

116.01

$ 155,108.60

$ 18,816.70

$ 19,838.78

$ 193,764.09

22

Jun

25.1

2.20

101.46

9.90

2.64

114.00

$ 153,471.45

$ 16,059.08

$ 16,931.38

$ 186,461.91

23

Jul

22.7

2.40

97.19

9.20

1.61

110.00

$ 146,813.69

$ 14,923.59

$ 15,734.21

$ 177,471.49

24

Jul

21.5

2.50

90.00

-

-

90.00

$ 135,603.09

$ -

$ -

$ 135,603.09

25

Aug

19.7

2.50

90.00

-

-

90.00

$ 135,603.09

$ -

$ -

$ 135,603.09

26

Aug

19.7

2.30

89.00

-

-

89.00

$ 134,043.89

$ -

$ -

$ 134,043.89

Total

$ 3,898,639.40

$ 315,666.42

$ 332,812.70

$ 4,547,118.52

Appendix 4

add it from (Strategy #3) and Excel file similar to the above appendix.

Appendix 5

add Gantt Chart from (Strategy 4)

Appendix 6

add it from (Strategy #3) and Excel file similar to the above appendix.