w6 final

Running head: ASHFORD GENERAL HOSPITAL 1

Ashford General Hospital Proposal

Student Name

Ashford University

March 15, 2017

SOLUTIONS FOR ASHFORD HOSPITAL 2

Executive Summary

Ashford General Hospital has been serving out community here in California for over 50

years. Within our general area we are the only 24 hour emergency care facility with our urgent

care facility maintaining extended care hours to meet the demands of our patients (Frates, 2014).

This type of care makes for demands on our nursing staff here at Ashford General. With nursing

shortages on the rise, we have to content and find new ways of retention of our staff all the while

maintaining our quality of care to our patients.

These issues are going to be of more concern as we look to the future to maintain our

staffing needs within our community. The importance of education to our facility is up most and

the ability to provide benefits to staffing will help to bring about fundamental change to Ashford

General. We are indeed ready for change and it comes at a time when staffing is short and

educational of talent is extremely important. Providing change through education talent, benefits,

and packages will help to make Ashford General a place to stay and not stray away from.

Change is going to have to come from within and in order for that to happen Ashford

General is going to employ talent from schools across the United States. We will want to provide

for this talent and provide for our permanent staff already with us. It is important that we

administer a change for the good all the while we provide the quality of care that has been

provided for 50 years from Ashford General.

SOLUTIONS FOR ASHFORD HOSPITAL 3

Ashford General Hospital

Ashford General Hospital has been serving out community here in California for over 50

years. Within our general area we are the only 24 hour emergency care facility with our urgent

care facility maintaining extended care hours to meet the demands of our patients (Frates, 2014).

This type of care makes for demands on our nursing staff here at Ashford General. With nursing

shortages on the rise, we have to content and find new ways of retention of our staff all the while

maintaining our quality of care to our patients.

By the year 2017, the entire healthcare industry is going to be facing a crisis of nursing

shortages (Nursing shortage). We too are facing this crisis. Sixty eight percent of our nursing

staff is now over the age of 45 and are facing retirement. Nationwide the retention rate of staff is

at 65%, while we are sitting at a 61% retention rate. The perception of our nursing staff is that

the work is getting too physical demanding. This type of perception is bringing on the state of

burn-out. Our attempts at bringing in per diem nurses and traveling nurses for the past two years

hasn’t proven a viable solution to our increasing nursing shortage (Frates, 2014). We must find a

better way to offset this shortage in order to keep our retention rate high and our nursing staff

morale high.

Other Solutions

Ashford General isn’t the only hospital that is going through this type of crisis. There are

other hospitals that have went through nursing shortages and have found solutions to their

problems. We will review some of these hospitals and go over some solutions that will help us.

This needs to be implemented within the next two years to offset the shortages that we will

indeed be facing.

SOLUTIONS FOR ASHFORD HOSPITAL 4

The Cleveland Clinic located at 2049 East 100th Street in Cleveland has had the same

issues that we have facing now. They have been able to implement in solutions that have been

proven to have helped them with their problem with the nursing shortage. The clinic has

implemented in what they call a “mom shift”. They have provided their nursing staff with more

hours that are daily oriented. The hours of operation are from 9 to 2 and helps to keep the staff

from having to work 12 to 15 hours a day. This type of situation has proven to help keep the

nursing staff available if there is other problems that arise outside of those “mom shift” hours.

They feel more inclined to come in to offer help to the clinic on a need to basis.

The clinic has also started to give the tenured nursing staff the ability to have the

summers off. This way they are vested in the clinic and can have time off to be with friends and

families. They too can be offered time to come in if they choose to come in when needed. They

have also helped out the nursing staff that are with children. They partnered with KinderCare

Learning Centers to provide day care for their staff (Liewellyn, 2007). These solutions have

helped the Cleveland Clinic to retain more staff and bring morale levels higher.

The John Hopkins Medical Center located 600 North Wolfe Street in Baltimore has given

their nursing staff the ability to have their children’s tuition fees cut in half. They have also

implemented in better hours for the nursing staff so that they have more time for their children

and families (Feldman, 2003). These types of changes has helped John Hopkins retain their

nursing staff and keep their morale levels high.

San Antonio Community Hospital located at 999 San Bernardino Rd, Upland California

has started a very interesting program for its nursing staff. San Antonio has actually started a

concierge service to their staff. This service has a lot of perks for the staff. The staff is able to be

provided with laundry and dry cleaning services. This helps to improve the hours that they

SOLUTIONS FOR ASHFORD HOSPITAL 5

nursing staff is available. Other perks for the staff include movie rentals, package and mail

shipment pickup and drop off. San Antonio has also started to provide nursing staff with movie

tickets and film developing to help with retention and morale boosters (Kitson, Silverston,

Wiechula, Zeitz, Marcoionni, & Page, 2011). By providing these perks, the staffing has started to

stay and not stray from San Antonio all the while the morale level is getting better.

Beth Israel Deaconess Medical Center located at 330 Brookline Avenue in Boston has

looked into higher education methods to help retain staff. It should be noted that Beth Israel is

also a Harvard Medical teaching facility as well. They are offering up to their nursing staff a

generous tuition assistance program so higher education can be achieved among its staff. Beth

Israel has also started to look into offering up housing allowances that help the nursing staff that

are located further away the ability to stay closer (Stone & Feeg, 2013). They have also began to

offer more flexible hours to the staff so they don’t get the over exhaustion of long hours and the

feeling of burn out. Looking at increasing pay raises has also helped to get staff retention and

morale levels higher.

Orange County Hospitals has been facing the crisis just the same as we are with not

having enough staff on hand to help with the demand of facilities. They too have went the route

of using short term staffing to help reduce the amount of regular staff that is needed. This type of

program has helped Orange County to rotate this staffing throughout their facilities but it wasn’t

impacting the quality of care that was being received to patients. They were able to retain the

same staff. The long term goals of Orange County haven’t been fully established but they are

able to keep retention of their personnel through this system (Nevidjon & Erickson, 2001). The

quality of care has also been established as the personnel are able to move through the series of

hospitals without much changes to procedures.

SOLUTIONS FOR ASHFORD HOSPITAL 6

Viable Solutions

Ashford General has established itself within the community that it serves. We are part of

a 50 year history in the community and California. Our 263-bed hospital is the only hospital with

24 hour emergency care and extended urgent care hours. With our nursing staff hitting retirement

blocks, it is time that Ashford General starts to move towards better retention rates of staff and

explore viable solutions to the nursing shortage will are facing.

Ashford General needs to look at a change of philosophy with our nursing staff. It is

completely viable that we can implement in our human resource department to start recruiting

talent right out of the gate. We can have them scour the schools for the talent that we want to

have working here at Ashford General. This way we are getting the best and brightest from these

schools. In order to attract in this talent, we need to look at generating out benefit packages that

are attractive to this talent (Stone & Feeg, 2013). I would like for Ashford General to look into

benefits that promote higher levels of education to all of our staff. In order to have the best we

need to train the best. It has been shown that nurses start looking at higher education once they

have some experience under their belts (Nardi & Gyurko, 2013). By offering up tuition benefits

we can help to maintain our nursing staff within our facility and help to promote our facility as a

higher learning establishment.

I would like to see our facility offer up the ability to provide packages that go above and

beyond to our nursing staff. This is up most recognizable by how we present hours to our staff. If

we need to implement in changing of hours for our staff then we must confront this one head on.

We all want to be with our families and the nursing staff should have this benefit as well. I would

like to provide to them the ability to select from mom shifts and promote a system of well-being

for our staff.

SOLUTIONS FOR ASHFORD HOSPITAL 7

Environment of Change

As mentioned earlier, I want Ashford General to be a new educational awareness facility.

This is going to take a big change from our human resource department and our marketing

departments. They are going to have to go and see some of these medical school students and

bring them on board to our facility. They will be working directly with the school and the

students to provide them with benefits packages that will entice them to come here.

Also, our administration will have to be on board with this type of change. We will

provide the needed educational awareness for any questions that will be coming to them in the

form of calls, in house, or the marketing promotions that we will start to promote.

Third party investors will be able to see the changes that are being met and want to be on

board with educational awareness and the benefits it brings to the hospital. The board will have

to promote this out to community and establish this so that the community can see that

educational awareness is being established here at Ashford General.

The next solution would be to provide out benefits packages to our new and tenured staff.

This would take our human resource department to draw up packages that fit the needs of our

staff. We would want to have the marketing departments to work with human resources to show

that this plan benefits our staff and the community as a whole.

Accounting and third party investors will be a part of this measurement as it will require

that will provide more funding towards benefits packages geared towards our staff.

Again, our board is going to have to convey to the community that we are looking for

better ways to internally provide for our staffing and that from this we will not lose the quality of

care that they have come to see from Ashford General.

SOLUTIONS FOR ASHFORD HOSPITAL 8

Education / Talent / Benefits

This will not be an easy change. I would propose that within each department we have

change agents that will be a part of a board that meets to make sure that we are meeting phases of

change. We are going to have to go and select talent from schools that will help bring them to

our facility. In order for this phase to be implemented we will have to start reaching out to

schools making them aware of our particular needs and have human resources to go and meet

with these students (Nardi & Gyurko, 2013). We will have to provide the benefits packages that

bring them on board so we can start to retain them within Ashford General.

Accounting and marketing will have to work together to show the new face of Ashford

General. We will want to promote us now as an educational awareness facility and with that we

are going to have to spend time on face change and policy deployment. Our administration will

have to be able to answer questions and be guided on what will be changing within the

departments. The board will have to see what changes are being done and provide to the

community how Ashford General is changing to meet the new wave of Ashford General. We will

provide these changes through the use of Kaizen events where we will meet and explore the

changes that are happening and make sure that the best possible solutions are being

implemented.

From a fiscal impact measurement, we are already having to provide for short term

contracts and day to day nursing staff as the shortage remains intact. The main cost of these

measurements can be reduced as change flows through out departments. Once we have a process

of flow from new staffing coming in and older staffing retiring, we can then start to look at how

we could review benefits packages from within to our staffing (Santiago, 2000). In order for us

to take this million mile, walk we have to begin with the first step.

SOLUTIONS FOR ASHFORD HOSPITAL 9

We want to provide for our nursing staff a change for the better. In order to do this we

need to have departments rethink the roles that are being portrayed by our nursing staff. Another

important issue is the fact that we have to have our staff empowered to make the right decisions

and come up with the solutions within those departments. There isn’t a reason for ethical, legal,

or diversity risk to be a factor in our decisions to make these changes. We want to make Ashford

General the place to be for new talent and change the philosophy.

Conclusion

As Ashford General reinvents itself over the course of the next two years, it is important

that it retains the staff it has while bring in newer talent with benefits that provide for the needs of

this staff. As we become more aware through educational awareness and providing benefits that

fit the needs of our staffing we can become a leader in our region. We will have to aggressively go

through recruitment and retention as we look at the macroeconomics of our facing the change.

Change will be at the forefront of what we are to accomplish. We are going to unfreeze

what we have been doing for so long. By providing day to day nurses and short contract nursing.

We are going to through a transformation at Ashford General. We are going to reach out to schools

to find talent to bring in and employ at Ashford General. In order for this to happen we have to

transform not only policy but our philosophy to change. We will bring all departments together

through Kaizen events in order to make sure that we are making the right changes and implement

in changes as we go. Once we have our plans together, we will refreeze our departments so they

can take up on these changes (Frates, 2014).

There is speculation that the nursing shortage is being mislead and that reasons behind the

lagging is the fact that students are not getting the right jobs when they graduate. The first and

foremost fact is that they don’t want to start at the bottom and work their way up (Dolan, 2011).

SOLUTIONS FOR ASHFORD HOSPITAL 10

This could come from the fact that they don’t want to waste time at the bottom, but might be

beginning to see that gaining knowledge from all areas helps with the overall experience at the

jobs that they are taking.

Through all of this, we want to make Ashford General a change for good. These ideas will

take some time to get solidified but with the time and adjustment being two years, we have the

ability to promote Ashford General in a new positive light to patients, staff, stakeholders, and our

community.

SOLUTIONS FOR ASHFORD HOSPITAL 11

References

Dolan, T. B. (2011). Has the Nursing Shortage Come to an End?. ONS Connect, 26(8),

8-12.

Feldman, H.R. (2003). The nursing shortage [electronic resource]: Strategies for

recruitment and retention in clinical practice and education / Harriet R. Feldman,

editor. New York: Springer Pub., c2003.

Frates, J. (2014). Health Care Management Theory in Action. San Diego, CA:

Bridgepoint Education, Inc.

Kitson, A., Silverston, H., Wiechula, R., Zeitz, K., Marcoionni, D. & Page, T. (2011).

Clinical nursing leaders’, team members’ and service managers’ experiences of

implementing evidence at a local level. Journal Of Nursing Management, 19(4),

542-555. doi:10.1111/j.1365-2834.2011.01258.x

Liewellyn, J. (2007). How is your hospital coping with the nursing shortage? Hfm

(Healthcare Financial Management), 6140.

Nardi, D. A., & Gyurko, C. C. (2013). The global nursing faculty shortage: Status and

solutions for change. Journal Of Nursing Scholarship, 45(3), 317-326.

doi:10.1111/jnu.12030

Nevidjon, B., Erickson, J. (January 31, 2001). "The Nursing Shortage: Solutions for the

Short and Long Term". Online Journal of Issues in Nursing. Vol. 6 No. 1,

Manuscript 4. Available:

www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/O

JIN/TableofContents/Volume62001/No1Jan01/NursingShortageSolutions.aspx

Nursing shortage ‘critical’ by 2017. (2014). Kai Tiaki Nursing New Zealand, 20(11), 7.

Stone, A. M., & Feeg, V. D. (2013). In debt and misled: New graduate voices on the

SOLUTIONS FOR ASHFORD HOSPITAL 12

“nursing shortage”. Dean’s Notes, 35(1), 1-3.

Santiago, R. (2000). Nursing shortage growing critical. (cover story). Crain’s Cleveland

Business, 21(32), 1.