Business Plan Proposal essay
Reducing nurse to patient staffing ratio is an effective step that the health care organization can do today, in the time of economic recession and growing health care costs. Reducing nurse to patient staffing ratio has a number of benefits, among which cost efficiency is one of the major benefits. Reducing nurse to patient staffing ratio will also contribute to the overall improvement of the organizational performance but the health care organization need to improve the professional skills and abilities of nurses to maintain the high level of quality of health care services delivered to patients. Therefore, reducing nurse to patient staffing ratio will allow the health care organization to save costs and to maintain the high quality of health care services.
INTRODUCTION
In actuality, the national health care system faces a deep downturn because the economic recession made health care services unaffordable for a large part of the population. In such a situation, health care organizations have to save costs to obtain financial resources for the further development and maintenance of the high quality of health care services. However, tools available to health care organizations to save costs are limited because health care organizations cannot cut spending at cost of the quality of health care services because the quality of health care services is the health of patients. In such a context, reducing nurse to patient staffing ratio may be an effective tool that can help the health care organization to save costs and to maintain the high quality of services, but the change should be conducted carefully to maintain the high quality of services and positive organizational culture.
PROPOSAL AND GOAL STATEMENT
Therefore, the reduction of the nurse to patient staffing ratio from 4 to 1 to 6 to 1 can be beneficial for the health care organization because it is cost efficient and allows the organization to maintain the high quality of health care services. The major goal of the current proposal is to develop the plan of reducing nurse to patient staffing ratio that can help the health care organization to save costs and to provide patients with the high quality of health care services. In such a way, the health care organization can implement the change that can facilitate the development of its performance maintaining the quality of health care services and saving costs that is particularly important in the time of the economic recession.
EXPLANATION OF THE CHAGE
In actuality, the introduction of the change is essential for overcoming negative effects of the economic recession. At this point, it is important to place emphasis on the fact that the health care organization should focus on saving costs because the economic recession has raised substantially health care costs and decreased revenues of the health care organization. To put it more precisely, the rise of health care costs was the direct effect of the economic recession. In such a situation, many patients cannot afford health care insurance, while the coverage of patients by such programs as Medicaid and Medicare is insufficient to cover all health care costs patients need to pay and the health care organization needs to spend to provide patients with health care services of the high quality. In such a way, the health care organization faces the deficit of funding health care services it has to provide for its patients. In such a situation, the health care organization can benefit from the introduction of reduction of nurse to patient ratio because this change can save costs of the health care organization spends on the personnel and increase financial resources of the health care organization available for the further investment in the health care services and their improvement.
LITERATURE REVIEW
In actuality, the reduction of nurse to patient ratio can have a positive effect, although some researchers may doubt in its efficiency. At this point, it is important to place emphasis on the fact that individual institution would not likely encounter wage pressure by reducing its own PTN ratio, if all the hospitals in one state simultaneously adopted lower ratios as a result of legislation, there could be substantial pressure on wages (Rothberg, et al., 2005). What is meant here is the fact that the health care organization can reduce nurse to patient staffing ratio and benefit from it, if other health care organizations maintain the nurse to patient staffing ratio unchanged. The reason is that, if mass reduction of nurse to patient ratio begins, nurses are likely to demand raises in wages as well as unions can oppose to the mass reduction and job cuts. In addition, there is a risk of losing well-qualified employees, who, being uncertain in their future, can change their job. In contrast, when one health care organization reduces nurse to patient ratio, it can benefit because the organization can choose the best nurses or promote them to the higher qualification. In such a way, the health care organization can save costs and maintain the high quality of services.
At this point, it is possible to refer to the experience of some health care organizatios. The California Workforce Initiative estimated that complying with a 4:1 ratio in California would require a 5% increase in the total number of RNs after accounting for some RNs returning to work or increasing their hours under better conditions. Assuming a 5% increase in supply and an elasticity of 0.6 would result in an 8.3% increase in hourly wage at a PTN ratio of 4:1 (Rothberg, et al., 2005). At the same time, researchers (Rothberg, et al., 2005) did not assume a decrease in wages for ratios above average, because decreased staffing at an institution is also associated with higher hourly wages. In such a way, the reduction of nurse to patient ratio may lead to rise of wages but the raise in wages may not outweigh possible job cuts benefits because cost saved on job cuts may be higher compared to rise in wages. Moreover, the rise in wages will increase nurses’ job satisfaction that will lead to the improvement of their performance.
Traditionally, higher staffing ratio are an indicator of higher quality, a higher number of regulatory deficiencies are associated with lower quality (Bowblis & North, 2011). However, such a view on the nurse to patient ratio is uncertain because the higher staffing does not necessarily mean the quality of health care services being delivered by nurses. In this regard, the qualification of nurses is more important than their number.
In fact, healthcare systems responding to a difficult economic environment, Intermountain Healthcare has challenged past assumptions (e.g., staffing ratio, premium pay, revenue cycle management, supply chain management, patient registration and financial assistance process), solicited input from our volunteer board members and community advisory councils, and made improvements in operational efficiency (Clark, et al., 2010). Reducing nurse to patient ratio will increase the operation efficiency a fewer staff will work more responsibly and effectively because each nurse will do her best to retain her position in the health care organization.
Specialists (Twigg, 2010) argue that policy makers, health departments, Chief Executives and Nurse Leaders need to ensure that adequate nurse staffing includes a high proportion of registered nurses to prevent adverse patient outcomes. Staffing, policies, and procedures, and charting/name identification are the categories that employees of many hospitals feel either contributed to or reduced the probability of errors with patients’ care (Rathert, 2006). Therefore, reducing nurse to patient ratio can improve the quality of health care services and save costs of the health care organization.
APPLICATION OF CHANGE THEORY
The application of the proposed change, i.e. reducing nurse to patient ratio, is an essential response to the change in the business environment. The health care organization will meet its current needs as well as needs of employees. If the health care organization refuses from the change, employees may feel dissatisfied because the organization cannot promote them without cutting jobs, while, if employees stop progressing, they fail to meet their needs and their job dissatisfaction grows. The introduction of the change will include the following stages: the communication of the change to the personnel; gaining the support of the change from the part of the personnel; implementation the change; monitoring and control over the implementation of the change. The main point is to overcome possible resistance from the part of employees that can be achieved through motivation of employees by means of rising wages for nurses.
FINANCING THE CHANGE AND ANALYSIS
The health care organization can fund the change using the costs saved on the job cuts. To put it more precisely, as the health care organization cuts nurse positions, than it can raise wages to nurses that stay in the organization. In addition, the health care organization can spend saved costs on training of nurses to improve their professional skills and abilities. In such a way, the health care organization can improve the quality of nursing care.
EVALUATION
The introduction of the change is essential. The health care organization cannot ignore its current problems, which are likely to aggravate, if no changes are introduced. In fact, reducing nurse to patient ratio from 4 to 1 to 6 to one is the best solution of current problems of the health care organization because job cuts will bring additional financial resources, while the quality of services will remain unchanged. In addition, the health care organization can keep progressing because 6 to 1 ration is quite good, taking into consideration 8 to 1 ratio that is a norm nationwide.
SUMMARY
Thus, reducing nurse to patient ratio can bring positive effects and help the health care organization to maintain its performance successfully. The reduction is necessary because the health care organization faces the problem of rising health care costs and scarce financial resources. Therefore, the health care organization needs to save costs and the reduction of nurse to patient ratio is the best change because it saves costs and maintains the high quality of health care services.
