NURS FPX 6216 Budget Negotiations and Communication

Budget Negotiations and Communication

Prepared operating budget

NURS FPX 6216 Budget Negotiations and Communication

An operating budget was created for a 35-bed health care setting with 20 full-time equivalents (FTE) to plan and manage different health care activities, processes, finance, and quality initiatives to increase efficiency and effective management (BS, 2021). As a result, it is important to adopt strategies to perform budget negotiation and communicate the budget to stakeholders effectively (Penner, 2017). The purpose of the report is to create a strategic plan to ensure profitability and fiscal success, increase and meet staff productivity, justify equipment and service costs, and analyze the alignment of budget with the organization’s mission and goals.

NURS FPX 6216 Budget Negotiations and Communication

The operating budget included revenue and expense calculation along with funds for quality initiative activities, equipment procurement, service and resource cost, infrastructure cost, and other aspects. The budget for FY 2021 was based on some actual and some forecasted calculation. The budget had projected revenue of $2,209,100 thousand and expenses of $1,126,700 thousand with a final budget of $432,400 thousand (BS, 2021). However, actual costs may vary. Thus, it is critical to manage the budget to increase fiscal success and profitability (Voda et al., 2018). 

Strategic plan to ensure profitability and fiscal success

The first strategy is to make the plan strategic instead of just operational as it identifies the need for improvements and reduces the risk of following an unsuccessful budget plan. For example, $200000 is invested in infection prevention (BS, 2021). Considering the cost, a fixed pointer might result in the need for finance in other areas. This creates a gap in operation as well as the outcome. As a result, strategies should be drafted and implemented to address such underutilization or overutilization of the allocated funds (Gapenski & Reiter, 2016). 

The second strategy is to implement a budget tracking process where interprofessional collaboration is integrated to understand the actionable operational tactics to effectively utilize the resources. This process helps in automating the progress as all the information is recorded and tracked to see whether the process is going towards achieving financial success (Hill, 2018). For example, procuring resources whenever needed can increase the cost. Also, procuring resources when there is no need for the foreseeable future also increases cost. Thus, tracking the resources and procuring resources based on need and disaster prevention help in better financial success (Anderson et al., 2020). 

NURS FPX 6216 Budget Negotiations and Communication

The third strategy is to adopt dynamic budgeting to increase the effective use of funds. For example, patient days are expected to be 110200 with an increased number of patients in 2021 compared to 2020 (BS, 2021). This creates a need to recruit more nurses to reduce the burden on them (Amirkhani et al., 2019). The fourth strategy is to implement different models at different units. For example, performance-based pricing will be beneficial in different service units and value-based pricing can be used in units such as pharmacy (Garrison & Towse, 2017). 

Another strategy is to implement key performance indicators to evaluate the performance of units against their objectives and funds utilized to increase accountability, transparency, and outcome analysis (Kress et al., 2016). The next important strategy is to define the roles and responsibility of health care professionals and educate them about the budget and plan to increase profitability by keeping the quality and cost-effective services (Barasa et al., 2016). 

General business and financial strategies

Reports by Aguiar et al. (2018), Barasa et al. (2016), Than et al. (2017) highlighted the effects of budgeting and its strategies on public health and financial success of the organization. Further, health care should adopt unit-based long-term planning, an emergency strategy such as strategy for COVID-19, corporate strategy to increase shared decision-making, employee motivation, communication, risk assessment and management (Barasa et al., 2016), tax optimization, asset management, and transformational leadership to achieve success (Ogamba & Nwaberiegwu, 2020). 

Assumptions, knowledge gap, and areas of uncertainty 

    The first assumption is health care will not face serious issues due to the economic conditions of the country (Garrison & Towse, 2017). The second assumption is that dynamic budgeting is based on proper analysis. The third assumption is that actual costs will be near to projected cost (Reiter, 2020). The two knowledge gaps include the effects of the global pandemic on health care access and the effectiveness of quality initiative programs. 

Plan to meet staff productivity goals

The budget has fund allocation to increase staff, training, paid-leave, and education funds. As a result, it has staff productivity goals. The strategic plan mentioned has quality improvement initiative, role and performance-based services, employee motivation, transformational leadership to practice professionally and increase productivity, accountability, transparency, and outcome analysis to effectively utilize the resources (Ogamba & Nwaberiegwu, 2020). Flexible schedules, implementing overtime policy, recruiting specialist nurses, and capping overtime play a critical role in increasing productivity (Lu & Lu, 2017).

NURS FPX 6216 Budget Negotiations and Communication

As the plan and budget have the infrastructure, emergency management, resources, and equipment, it helps in reducing idle time. Value and performance-based initiatives are critical in increasing productivity (Garrison & Towse, 2017). Key quality indicators will help in identifying the performance of certain units, which further aid in identifying productivity issues in other units (Kress et al., 2016). Studies by Domingo & Rene (2021), Hall et al. (2016), Vali et al. (2017) highlighted the need for a productivity plan for staff to increase quality outcome. 

The rationale for rejecting alternate approaches

Using only a value-based or performance-based productivity plan is not suitable for all units as different units face different challenges and they have different roles (Garrison & Towse, 2017). For example, the performance of health care staff in ED and ICUs are different from the performance of nurse educators as ED nurses concentrate on practice whereas nurse educators focus on the value of the information (Domingo & Rene, 2021). Thus, it is rejected to consider just one approach.  

NURS FPX 6216 Budget Negotiations and Communication

Justifying equipment and service costs

The operating budget has allocated $20,300,000 for residents, $245,000,000 for supplies and equipment, $1,720,000 for service facilities and lease, $16.2 thousand for data centre, and $17.2 thousands for radiology (BS, 2021). As the organization aims to implement quality of care for the increased patient count in FY 2021, it is justified to spend enough to manage the health care. 

Also, the data centres and informatics units are important in modern health care to protect the patient’s data, store health care information, safeguard insurance details, research and increase networking between devices and units (Lee et al., 2020). As a result, it is justified. Further, lease and other facilities are basic necessary to accommodate different facilities and patients. The cost of the equipment and service was calculated based on the previous year’s budget, market analysis, and few assumptions, which includes increasing health care cost, need for technology, and unit-based equipment cost (Than et al., 2017). 

NURS FPX 6216 Budget Negotiations and Communication

Equipment cost assumptions

    There are three major assumptions. The first assumption is that the in-patient count will increase. As a result, it increases the need for more equipment. The second assumption is that health care costs will increase (Than et al., 2017). The third assumption is that patients will need different facilities to increase quality care and patient satisfaction. 

Analyzing department, unit, or project alignment with the organization’s mission and goals

The budget and strategic plan creates a link between departments, units, or projects to achieve organizational goals and mission as the strategic plan includes the need for interprofessional collaboration to increase the effective use of funds and to track the spending to dynamically allocate the budget. Further, staff training and quality initiatives were implemented to achieve the goal of high-quality care and key performance indicators help in linking the outcome to different units. The insurance policies and other measures aimed to protect the patients to fulfil the organizational goal to achieve safety and security. 

Shared decision-making, staff productivity strategy, identifying and tracking overtime patterns (Vali et al., 2017), implementing online project boards for meetings, training employees to practice effectively (Hall et al., 2016), and increasing nurse to patient ratio plans in the budget help in increasing productivity and patient satisfaction, which are an integral part of organization’s mission (BS, 2021). 

References

Aguiar, P., Giglio, A., Perry, L., Penny-Dimri, J., Babiker, H., & Tadokoro, H. et al. (2018). Cost–effectiveness and budget impact of lung cancer immunotherapy in South America: strategies to improve access. Immunotherapy10(10), 887-897. https://doi.org/10.2217/imt-2017-0183

Amirkhani, T., Aghaz, A., & Sheikh, A. (2019). An implementation model of performance-based budgeting. International Journal Of Productivity And Performance Management69(2), 382-404. https://doi.org/10.1108/ijppm-05-2018-0171

NURS FPX 6216 Budget Negotiations and Communication

Anderson, D., Cronk, R., Best, L., Radin, M., Schram, H., Tracy, J., & Bartram, J. (2020). Budgeting for environmental health services in healthcare facilities: a ten-step model for planning and costing. International Journal Of Environmental Research And Public Health17(6), 2075. https://doi.org/10.3390/ijerph17062075

Barasa, E., Cleary, S., Molyneux, S., & English, M. (2016). Setting healthcare priorities: a description and evaluation of the budgeting and planning process in county hospitals in Kenya. Health Policy And Planning, czw132. https://doi.org/10.1093/heapol/czw132

Barasa, E., Cleary, S., Molyneux, S., & English, M. (2016). Setting healthcare priorities: a description and evaluation of the budgeting and planning process in county hospitals in Kenya. Health Policy And Planning, czw132. https://doi.org/10.1093/heapol/czw132

BS. (2021). Preparing and managing an operating budget.

Domingo, & Rene, T. (2021). How non-value added work affects the productivity of healthcare professionals. Management In Healthcare5(1). Retrieved 7 May 2021, from.

Gapenski, L., & Reiter, K. (2016). Healthcare finance: an introduction to accounting and financial management (6th ed.).

Garrison, L., & Towse, A. (2017). Value-based pricing and reimbursement in personalised healthcare: introduction to the basic health economics. Journal Of Personalized Medicine7(3), 10. https://doi.org/10.3390/jpm7030010

Hall, L., Johnson, J., Watt, I., Tsipa, A., & O’Connor, D. (2016). Healthcare staff wellbeing, burnout, and patient safety: a systematic review. PLOS ONE11(7), e0159015. https://doi.org/10.1371/journal.pone.0159015

Hill, J. (2018). accounting fundamentals for health care management. Tritech digital media.

Kress, D., Su, Y., & Wang, H. (2016). Assessment of primary health care system performance in nigeria: using the primary health care performance indicator conceptual framework. Health Systems & Reform2(4), 302-318. https://doi.org/10.1080/23288604.2016.1234861

NURS FPX 6216 Budget Negotiations and Communication

Lee, H., Choi, Y., Van Nguyen, T., Hai, Y., Kim, J., Bahja, M., & Hocaoğlu, H. (2020). COVID19 led virtualization: green data center for information systems research. Information Systems Management37(4), 272-276. https://doi.org/10.1080/10580530.2020.1818901

Liu, C., Hebert, P., Douglas, J., Neely, E., Sulc, C., & Reddy, A. et al. (2020). Outcomes of primary care delivery by nurse practitioners: Utilization, cost, and quality of care. Health Services Research55(2), 178-189. https://doi.org/10.1111/1475-6773.13246

Ogamba, I., & Nwaberiegwu, C. (2020). Persistent challenges to healthcare systems and the role of strategic and collective leadership. British Journal Of Healthcare Management26(12), 1-5. https://doi.org/10.12968/bjhc.2020.0091

Penner, S. (2017). Economics and financial management for nurses and nurse leaders. Springer Publishing Company, LLC.

Reiter, K. (2020). Gapenski’s healthcare finance: an introduction to accounting and financial management, Seventh Edition (7th ed.). Health Administration Press.

Than, T., Saw, Y., Khaing, M., Win, E., Cho, S., & Kariya, T. et al. (2017). Unit cost of healthcare services at 200-bed public hospitals in Myanmar: what plays an important role of hospital budgeting?. BMC Health Services Research17(1). https://doi.org/10.1186/s12913-017-2619-z

Vali, L., Tabatabaee, S., Kalhor, R., Amini, S., & Kiaei, M. (2017). Analysis of Productivity Improvement Act for Clinical Staff Working in the Health System: A Qualitative Study. Global Journal Of Health Science8(2). https://doi.org/10.5539/gjhs.v8n2p106Voda, A., Bostan, I., & Tiganas, C. (2018). Impact of macroeconomic and healthcare provision factors on patient satisfaction. Current Science115(1), 43. https://doi.org/10.18520/cs/v115/i1/43-48