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Fiscal and Resource Utilization in Nursing
Many people consider healthcare as a business that is grounded on caring for others and this is the largest contributor to runaway fiscal and resource utilization. The ongoing healthcare reform agenda demands that the cost of healthcare costs is kept at a minimum without compromising the goal to ensure quality and affordable care experiences to all clients (Martinez-Gonzalez et al., 2015). In an effort to ensure strict accountability relative to the application of healthcare resources both fiscal and material, the nursing leader seeks to introduce a program proposal that encourages maximum use of available resources at minimum cost. This implies that the nursing leaders must take into consideration financial and resource utilization issues, availability of both types of resources, strategic decisions relative to resource utilization as well as key performance indicators measuring program outcomes.
Financial and Resource Utilization Issues
The deficit of qualified healthcare professionals is not resigned to the U.S. and is indeed a global issue. According to Martinez-Gonzalez et al. (2015), it is projected that the shortage in staffs like physicians, nurses, and midwives is expected to rise to 12.9 million come 2035 (Martinez-Gonzalez et al., 2015). The current situation on the ground clearly paints this picture even though there has been a consistent increase in the numbers of fresh specialists. This is largely due to the unexpected outcome where there are less medical graduate students entering the healthcare industry. Another issue is associated with the unprecedented rise in persons demanding care for different degenerative and chronic condition therefore placing a substantially huge work load on primary care physicians as well as resulting in greater healthcare expenditures for the facilities (Salmond & Echevarria, 2017). Human resource shortages are bound to negatively impact on the program objectives translating to the unsustainability of the proposed nursing program.
The nursing leader also has to take into account a number of issues which leader to ineffective fiscal and resource utilization. These include poor accountability of steps taken to enhance quality outcomes, weak quality improvement infrastructures, failure to exploit peer accountability, improper application of set guidelines as well as ineffective application of clinical information systems (Foss et al., 2014). These are factors that have the potential to derail the accurate application of the fiscal and other resources available to the nursing leader given that it also negatively impacts on the human resource at disposal. For instance, failure to capitalize on peer accountability inadvertently translates poor usage of clinical information systems (Salmond & Echevarria, 2017). This not only undermines timely and precise communication but also suppresses full participation as well as eroding the benefits of teamwork. Availability of Fiscal and other Resources
Healthcare facilities generate fiscal returns from the payments of services they offer to the society. The reform agenda continuing to permeate through the entire industry has transformed how the society is paying for its healthcare needs. What the country has now is an intricate web of healthcare payers which include insurance firms, government agencies, as well as consumers at an individual level (Salmond & Echevarria, 2017). The fact that many people remained healthcare uninsured means that there are persons receiving care services without an appropriate safety net. While this does not normally involve people seeking preventive care, it encompasses very many Americans receiving emergency care as demanded by healthcare related legislation (Salmond & Echevarria, 2017). This is an issue that translates in healthcare institutions losing money as opposed to generating revenues from engaging in the business of caring. The fact that resource utilization remains high while fiscal performance is decreasing presents a challenge for the nursing leader’s program since the institution is aiming towards cost cutting measures.
As a healthcare institution, there are numerous resources that the nursing leader can exploit towards successfully implementing the program (Salmond & Echevarria, 2017). For instance, the presence of a robust human resource department is critical towards providing the right setting for training initiatives with regard to ensuring the program comes to fruition. Secondly, the leadership is a vital resource towards enabling collaborations with other departments towards effectively placing the initiative into application. More importantly, it is an institution that has all the physical infrastructure necessary as well as the information technology systems that through the program initiated by the nursing leader needs (Salmond & Echevarria, 2017). This is critical towards ensuring it can be employed effectively towards not only limiting resource wastage but also radically enhancing safety as well as quality outcome experiences among patients.
This implies that the nursing leader will have to embrace the fact that to ensure success of the program, it is imperative that nurses take upon tasks that are traditionally designated to primary care physicians. Qualified nurses have the potential to be professionally motivated towards expanded responsibilities (Salmond & Echevarria, 2017). This implies that there is the need to increase the scope of practice among the nursing leader’s team working on the program towards the performance of tasks focused on achieving desired outcomes. Therefore, the most strategic decision in which the leader can take is towards pursuing a model of care that integrates nurses as an abundant and underutilized resource. This is purposeful direction to follow given that it will quickly translated to optimized resource utilization and more extensive as well as professional engagements with patients. This is a necessary road to follow since it will work to appraise patient care experiences across the continuum of care as the nursing leader will be in a position to engage primary care physicians in collaborations (Salmond & Echevarria, 2017). For instance, they can be a significant resource utilized towards supervising, delegating, and transforming the context of care in a way that benefits the facility in regard to fiscal and resource utilization as well as the facility’s cost cutting initiatives.
In assessing the outcomes realized from running the program, the nursing leader has to critically consider the value gained in terms of cost and more importantly, quality of care. However, there are numerous other quality of care related aspect that fiscal metrics tend to fail to assess. These include nursing care characteristics associated with values such as expertise in clinical competencies. The Objective Structured Clinical Examination (OSCE) is an exam which although tailored to assess students (McWilliam & Botwinski, 2012). The nursing leader can use it to measure performance in relation to clinical behaviors of her team’s members in their interactions with standardized patients privy to the program. It can be used to assess performance at the individual level for nursing staff involved in the program (Foss et al., 2014). These include aspects such as organization of patient engagements, facilitative behavior, ability to check patient understanding, and the capacity to honestly admit to a lack of knowledge in a given area (McWilliam & Botwinski, 2012). The results of the exam can work to determine whether the program targets are achieved or not and where shortfalls emerge (Foss et al., 2014). This is critical towards measuring the improvement of quality even as the nursing leader is able to champion for greater fiscal and resource utilization through cost cutting initiatives.
The nursing leader’s vision behind implementing the program is an aim towards advancing good health amongst clients by not only increasing value but also appraising quality of care. After taking into consideration the challenges present in the leader’s quest to actualize the program, it is imperative to take stock of the utilization of financial and other resources at the institution. Understanding both the weaknesses and strengths encountering the program, the nursing leader can then make strategic decisions towards capitalizing on the resources available for utilization. Measuring on the value added to quality of care outcomes relative to the resource utilization is the most significant part of the process as it ensures that the nursing leader understands fully if set goals are attainable in the short and longer term or not.
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Martinez-Gonzalez, N. A., Rosemann, T., Djalali, S., Huber-Geismann, F., & Tandjung, R. (2015). Task-shifting from physicians to nurses in primary care and its impact on resource utilization: a systematic review and meta-analysis of randomized controlled trials. Medical Care Research and Review, 72(4), 395-418.
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