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Current Issue: In the mist of the healthcare reform, hospitals have found themselves inundated with an increase of hospital admissions stemming from newly insured people. My organization in particular had strategically planned for an increase of membership in the beginning of 2014, however the numbers were just slightly over the expected outcome. As of January 1st, Its membership has doubled over their expectations, where the hospital is not prepared to care for so many admissions.
The hospital is currently operating at capacity on a daily basis and patients are left in the emergency department for several hours. The nurse to patient ratio has been maxed at Department of Health System requirements; break-relief nurses have been pulled to care for atients as well as the charge nurses leaving the units without adequate support in the event of an emergency. Nurses are not receiving their lunch breaks and now an increase in sick calls has been happening as well.
Patient satisfaction has gone down, they are complaining to the management that they do not get the adequate response by their nurse when they call. An increase of falls has been occurring as well as inappropriate admissions from the emergency room. Staffing must be addressed by taking into consideration patient safety and satisfaction as well as the physical wellness of our staff. Decision Tools and Techniques: Historical data, past performances and past managerial experiences are made readily available when making decisions.
Several tools and techniques are utilized when confronted with dilemmas. The considered opinion and devil’s advocate, factor analysis matrix and the decision tree are just a few tools that can be used. For the purpose of addressing the current issue, the considered opinion and devil’s advocate will be used. When using this particular tool, additional information is needed in order to make a sound decision. Statistical and empirical data would be most beneficial as well as inancial data.
The considered opinion can be seen as follows; hiring more staff, not allowing the charge nurse and the break-relief nurse to take an assignment, diverting emergency room calls to surrounding facilities. Playing the devil’s advocate would not want to divert patients to another hospital because the hospital will have to payout funds to the other facility. Hiring staff would not be advisable because it takes approximately six weeks to hire and put them through new employee orientation and the need is now, obtaining registry staff can put an added stressor on staff because they are not fully pdated on policies and work flow of the units.
By not giving the charge nurse and the break-relief nurse an assignment may lead to decrease in member satisfaction because they will be waiting in the emergency room longer, however giving them an assignment may also lead to increase patient falls with injuries and fines paid to employees because of missed meal breaks leading to a financial stress on the budgets.
Decision: While hiring more staff nurses would be ideal it would not be an immediate solution to what is acutely occurring. What needs to happen is always side ith patient safety and that would mean to hire registry personnel, it would only take one week to orientate them and would give the units extra needed help on the floor, these nurses can be contracted to work anywhere from eight to thirteen weeks at a time, this allows time to hire full time and part time employees.
Another decision would be not to pull the break-relief nurse or the charge nurse to take an assignment, buy not doing this will help save thousands of dollars per pay period by not paying for missed meal breaks, and will also help decrease the amount of sick calls received which leads to ecrease in productivity.