Term Paper on "Nurse Leadership and Financial Management"

Term Paper 9 pages (2444 words) Sources: 1+

[EXCERPT] . . . .

Nursing: Line-Item Budget

NURSING: MAGNET RECOGNITION PROGRAM DESIGNATION

The objective of this work is to create a budget for Magnet Recognition Program designation and describe how these resources will advance professional nursing. Nurse Leader's experiences with budget development after often 'lock-step'. Often the data are based on historical tracking and nurse leaders need only to confirm the data. The purpose of this assignment is to allow an opportunity to develop a budget that supports the advancement of the nursing profession, a responsibility of nurse leaders. In developing this budget, developed will be an organizational strategy and research the strategy so the most recent professional information and data are used. These data will support the budget that is developed an analysis of the organizational implications will be required. Fro the purpose of this assignment the MD Anderson Cancer Hospital of the MEDVAMC will be used.

INTRODUCTION

According to the University of Virginia document online entitled: "Magnet Designation": "Magnet designation signifies that an institution's nurses have high levels of education, adhere to the highest professional standards, and provide the best patient care." (2006) The document states that "Magnet recognition provides consumers with the ultimate benchmark to measure the quality of care they can expect to receive." (Ibid) According to Medical Center Chief Clinical Officer and Chief Nursing Officer Pamela F. Cipriano: "Being recognized as a Magnet institution signifies not only excellence in nursing care and professionalism, but it also acknowledges the collaboration throughout the organization to support quality of care, shared governance and the promotion of nurses as leaders." (Ibid) It has been shown through independent studies that "patients have shorter lengths of stay, higher satisfaction, higher nurse-to-patient ratios and lower mortality rates. Nurses are more satisfied with their work and Magnet recognition strengthens nursing recruitment and retention efforts." (Ibid)

MISSION SUMMARY

The stated mission of the M.D. Anderson Cancer Center is: "To eliminate cancer in Texas, the nation and the world through outstanding programs that integrate patient care, research and prevention, and through education for undergraduate and graduate students, trainees, professionals, employees and the public.

VISION SUMMARY

The stated vision of the M.D. Anderson Cancer Center is that they: "shall be the premier cancer center in the world, based on the excellence of our people, our research-driven patient care and our science. The vision includes the following:

PRIDE:

Patients are number one.

Research advances clinical care.

Individual employees make a difference.

Dedication leads to quality.

Excellence is achieved through education.

MEDVAMC states that it will maintain and advance its position as a quality healthcare institution by being:

The healthcare provider of choice;

The employer of choice;

The leader in research and education; leader in innovative healthcare delivery; leader in building health communities.

VALUES SUMMARY

The values of MEDVAMC include:

Our commitment is to Veterans by being responsive, respectful, trustworthy and compassionate.

Working as a team to provide excellent in patient care and research.

Utilizing accurate data and information for decision -making as we practice and good stewardship of resources while incorporating new and innovative ways to stay at the forefront of healthcare delivery.

Effective and timely communications with outpatients, staff, union, partnership, volunteers, academic affiliates and corporate body.

STRUCTURES SUMMARY

The leadership at the MD Anderson Cancer Center is a governmental agency design with the top position being that of the Medical Center Director. The Medical Center Director has basically the same responsibilities as the CEO. The Medical Center Director is responsible with management of what is one of the most complex medical facilities for the VA in the U.S. with more than 2,750 employees and an annual budget of $410 million. Because of these facts it is believed that the power base of the Medical Center Director is legitimate. The Associate Director serves as the 'CEO' for MD Anderson Cancer Center and is responsible for day-day-day operations and management of the facility. The Associate Director is in charge of the annual budget for the facility as well. These facts are the basis of the power base of the Associate Director being stated to be legitimate. The CNO serves as a key member of the top management for the medical center providing both leadership and expert knowledge for the state of the art VA medical facility in Houston Texas as well as four community-based outpatient clinics in SE Texas. Because of these facts It is believed that the power base of the CNO is a combination of expert, legitimate and reward.

The Michael E. DeBakey Veterans Affairs Medical Center (MEDVAMC) serves as the primary health care provider for approximately 200,000 veterans in southeast Texas. When the patients for the satellite clinics in Beaumont, Lufkin, Galveston, Clear Lake and Texas City are added the patient's total approximately 750.000 outpatients in fiscal year 2005 and a total of 11, 854 veterans were admitted as inpatients with 237 being admitted to the Transitional Care Center in fiscal year 2005. MEDVAMC uses a vertical structure and is inline with congressional mandates and organizational structure for all VA facilities set out by the government.

I. FORMS OF POWER

In the work entitled "Power and Politics" it is held that: "Power, authority and influence have no standard definitions. Hapton, Summer and Web have noted that "influence is the process by which one person follows another's advice or suggestion." Power is stated to be a "persona or positional attribute that enables one to influence." (AUTHOR OF POWER AND POLITICS, YEAR OF PUBLICATION)

There are six suggested forms that power may take which are those of:

Coercive power - based on fear of punishment

Reward power - based on hope for reward

Legitimate power - based on belief that influence has formal authority

Referent power - based on charismatic leader traits

Expert power - based on the leader's special expertise.

Representative power - based on the democratic delegation of power to a leader.

In order to vest power with nursing staff within the organization provision of educational and training needs are essential as well as associated expenses such as travel, periodical subscriptions, as well as are expenses for initiatives such as weekend retreat classes for education and training. If nursing is to be advanced at the MEDVAMC and even into the broader nursing community empowerment of nursing staff through provisions paying expenses in their making that advancement is crucial.

In the work entitled: "First Progress Report on the Implementation of the Individual Budget Pilot Programme" (2006) it is stated that the task is to develop and model new approaches to organizing and delivering services and supports. The key success indicators are:

1. A significant extension to the degree of choice and control experienced by people using services and supports and associated outcome improvements

2. Alignment/integration of different resource streams

3. Achievement of improvements within the resource envelope. (First Progress Report on the Implementation of the Individual Budget Pilot Program, 2006)

In respect of key elements, local models for individual budgets should:

Allocate resources transparently.

Streamline the assessment process across agencies.

Bring together a variety of streams of support and/or funding, from more than one agency.

Give individuals the ability to use the budget in a way that best suits their own particular requirements.

Allow support from a broker or advocate, family or friends, as the individual wishes. (First Progress Report on the Implementation of the Individual Budget Pilot Program, 2006)

Fixed budgets are 'traps' that trap one into thinking that there is not room for financial manoeuvring. (Managing the Investigative Site (2006) The Research Roundtable Online available at: http://www.researchroundtable.com/)

The Balm of Gilead Center for Cooper Green Hospital located in Jefferson County, Alabama is a "comprehensive program for end-of-life care supported in large part through funding for the Initiative for Excellence in End-of-Life Care of the Robert Wood Johnston Foundation." The organization is partnered with the Jefferson County Department of Health and the Care Team Network at the University of Alabama at Birmingham (UAD) and have also established partnerships with "local foundations, colleges and universities, religious institutions, civic groups and professional groups" in order to meet the costs of patients and their families as well as those of staff and community education and "outreach to the broader community." (Bailey, 2000) The vision of this center is described as "holistic" and one that "emphasizes comfort and pain-free living" stating that the care provided "incorporates medical, emotional and social services as well as spiritual care." Care is provided to "underserved people with terminal illnesses who do not have a place to live or do not have support services at home...[and]...regardless of their ability to pay." (Bailey 2000) Funding resources include Medicare, Medicaid, Non-insured, VA, and third party funding. (Bailey, 2000)

II. LINE-ITEM BUDGET

REVENUE - MEDICARE/MEDICAID/VA/NON-INSURED/THIRD PARTY FUNDING.

PERSONNEL EXPENSES (INCLUDING FRINGE BENEFITS)

SALARY/WAGES

HEALTHCARE

MEDICAL INSURANCE

DENTAL INSURANCE

VACATION LEAVE

SICK LEAVE

EDUCATION

SEMINARS

TRAVEL

FOOD

OFFICE SUPPLIES

NON-CAPITAL EQUIPMENT

PUBLICATIONS/SUBSCRIPTIONS

DUES

BOOKS

CELEBRATIONS

HOLIDAY

BIRTHDAY

EMPLOYEE ANNIVERSARY/RETIREMENT

MARRIAGES / BIRTHS

DETAILED NOTES TO ACCOMPANY THESE ITEMS)

III. EVALUATION TEMPLATE FOR PROGRESS MONITORING

According to Grigsby in the work entitled:… READ MORE

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