Case Study: Nursing Fiscal Plan

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[. . .] This incentivizing will give a reason to offer strong customer service and this will be a win/win for all involved. Only those that put in the effort will be rewarded and the patietns and family of patients will see the benefit. Nurses that cannot or will not offer quality customer service and/or medical care should be monitored, mentored and, if need be, disciplined and/or removed from the situation. Any way that can be reasonably used to decrease burnout and dissatisfaction can be dealt with but the nurses need to do their job if they wish to remain with the hospital.

The staff can be solicited for feedback and they should be absolutely involved in the process to improve customer service and quality of care. They must be involved for two major reasons. First, they are the best source of good ideas because they are on the front lines and see most everything that affects their job and they must also be involved because the chances of them offering buy-in were they not involved would be much lower and this will lead to ineffectual results down the road.

However, the proverbial "inmates" should not run the asylum. Outcomes and decisions should be based on consensus and the verdict of the group unless the overall cost to service or the hospital as a whole is not acceptable. Truly, this should probably not be a problem over the long-term but the hospital just needs to be careful about what is implemented and why. The employees should absolutely be involved but the executives need to be careful about any final decisions.

In terms of structure that should be used to make these decisions, a good cross-section of managers and even a few tenured and/or respected employees should be part of the feedback and discussion progress. It's a good idea to loop in both managers and non-managers because neither party would know everything that is necessary to eliminate all the applicable problems. Probably the best forum would be a roundtable discussion and it would be best if it's in person rather than remotely but plenty of good options exist for both remote and in-person forums. An anonymous drop box can be offered for ideas that some people want to offer or issues that need to be brought to the attention of the decision-makers but perhaps are too sensitive to utter personally in front of others. The purpose of the meetings should be three-fold….to increase employee retention, to increase quality of care and to increase customer satisfaction perceptions with patients and patients' families.

Also, the task force in question here needs to be led and managed by a skilled facilitator that can loop in people that ramble or arcs of discussion that are not helpful to the three goals listed above. Also, it should be stressed that discussions that are more appropriate for an HR-level discussion (rather than a public one) should remain as such so as to avoid any uncomfortable or legally compromising situations, as can easily happen with HR-related issues.


In closing, the hospital covered in the report above is not in dire shape fiscally but the mismanagement of the money has led to some very tenuous and problematic situations. The amount of money in question here is not the problem but how it's being spent is absolutely a problem. If the problems being rendered by these bad choices is not addressed quite quickly, a slippery slope will occur and the aftermath of these bad choices will become more and more pervasive.

Works Cited

Brennan, CW, and BJ Daly. "Patient Acuity: A Concept Analysis." Journal of Advanced

Nursing 65.5 (2009): 1114-1126. CINAHL with Full Text. Web. 29 Apr. 2013.

Ekwall, A, M Gerdtz, and E. Manias. "The Influence of Patient Acuity on Satisfaction

With Emergency Care: Perspectives of Family, Friends and Careers." Journal Of

Clinical Nursing 17.6 (2008): 800-809. CINAHL with Full Text. Web. 29 Apr.


Gloria Korpi, et al. "The High Cost Of Low-Acuity ICU Outliers." Journal of Healthcare

Management 57.6 (2012): 421-433. Academic Search Premier. Web. 29 Apr.


Ian Stiell, et al. "Adverse Events among Patients Registered In High-Acuity Areas Of

The Emergency Department: A Prospective Cohort Study." CJEM: Canadian

Journal of Emergency Medicine 12.5 (2010): 421-430. Academic Search

Premier. Web. 29 Apr. 2013.

M Radford, et al. "How To Keep Score of Acuity And Dependency." Nursing

Management - UK 16.8 (2009): 14-19. CINAHL with Full Text. Web. 29 Apr.


Appendix I -- Expense Analysis

Budget Item


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Cite This Case Study:

APA Format

Nursing Fiscal Plan.  (2013, April 29).  Retrieved July 15, 2019, from

MLA Format

"Nursing Fiscal Plan."  29 April 2013.  Web.  15 July 2019. <>.

Chicago Format

"Nursing Fiscal Plan."  April 29, 2013.  Accessed July 15, 2019.