W2A2 Healthcare Budget Request Paper NURS 6211

W2A2 Executive Summary

Affordable Health at home care solutions

As healthcare needs continue to be a priority for patients, families, and facilities there are gaps that exist for patients within communities. Providing adequate support throughout the continuum of care is paramount for individuals with disabilities and special needs. Enabling patients to have a meaningful quality of life in his or her after discharge from a facility is important. Having a productive life in a patient’s home by providing a safe and productive transition from facility to facility helps bridge gaps in care. The main goals of care coordination is designed to meet the needs and preferences in the delivery of high-quality, high-value health care (AHRQ, 2018).

W2A2 Healthcare Budget Request Paper

Problem

Continuity of care among patients is an important aspect when discharging from inpatient settings to home. Transition of care has become an issue causing readmission rates soar. Prevention of further health complications and rehospitalization for disabled, chronically ill, elderly, individuals with disabilities, and special needs is important. There has been a gap in continuity of care among discharge planners within facilities. The problem identified is ineffective transition of care between facilities need to be improved.

Stakeholder groups

The stakeholder groups will include the board of directors, consumers, office staff, direct staff, community participants, doctors, nurses, patients, and family members. All stakeholders will play a vital role in the delivery of care to help with the transition of care model to improve quality of care by preventing readmission to the hospital. Other individuals involved in the process will be social workers, pharmacist, case manager, nurse navigators, and therapy team.

The team will be located on mobi go buses and virtual stations in his or her home; unless a visit is needed to a facility by the requesting agency.

The stakeholder’s groups responsible for assisting address the healthcare issue will be the doctor, nurses, administrative & leadership staff, families, and patients. Discharge planning begins on admission and each person involved must remain cognitive about the plan of care. For example, if a patient is to be discharged within the next ten days after a left knee replacement, the home environment along with adequate support must be evaluated prior to discharge.

Healthcare product and/or service

Resolution

The services proposed will be mobi virtualized discharge planning unit and medical homes for patients discharging from facilities. Having a mobi virtualized discharge unit and non-skilled medical home will allow engagement with the stakeholders prior to discharge from a facility. The virtualized mobi discharge unit will allow collaborating teams the ability to inspect the patients home via a 2D or 3D effect. With the capabilities of technology, there will be a series of individuals involved during the process. There has been a shift for the future of medical homes and leaders see a substantial increase in the utilization because of payment and delivery reforms. Home-based care is well positioned to drive progress toward key U.S. health care system–wide goals (Landers, Madigan, Leff, Rosati, McCann, Hornbake, MacMillan, Jones, Bowles, Dowding, Lee, Moorhead, Rodriguez, & Breese, 2016 W2A2 Healthcare Budget Request Paper). Many patients prefer to receive care in the home, so the use of high-quality home-based care could support the goal of patient-centered care. Home health care is also a relatively low-cost setting of care (Landers, et. al, 2016).

Conclusion

Transition of care from a facility to home requires ongoing assessment needs. The only way to promote safe effective discharge is to engage all stakeholders. It is important the identification of all high-risk readmissions are carefully monitored. Collaboration and communication care teams can help close the gap to ensure patient care needs are met.

W2A2 Healthcare Budget Request Paper References

  • Agency for Healthcare Research and Quality. (2018). Care Coordination. Retrieved from http://www.ahrq.gov/incepcr/care/coordination.html.
  • Landers, S., Madigan, E., Leff, B., Rosati, R. J., McCann, B. A., Hornbake, R., MacMillan, R., Jones, K., Bowles, K., Dowding, D., Lee, T., Moorhead, T., Rodriguez, S., & Breese, E. (2016). The Future of Home Health Care: A Strategic Framework for Optimizing Value. Home health care management & practice28(4), 262–278. https://doi.org/10.1177/1084822316666368

Healthcare Budget Request Sample 2

W2A2 Executive Summary

 In the Georgetown community, a new medical building was developed, and there is a need for an electronic medical record (EMR). There is some shortfalls within the healthcare system and hence the need to establish a system that can improve the flow of information. This new implementation of the EMR system is going to be a significant change to the organization. Successful implementation of this change involves not only new technology but also about the people.

Digital innovation has transferred the world drastically; hence the information plays a significant role in healthcare delivery and helps address the health problems and challenges faced by clinicians and healthcare professionals. The perioperative service is critical to Modern Medical. This department is challenging that provides complex clinical care involving several teams, with high cost, sophisticated technologies, and a large array of supplies, instruments, and implants. These variables create a complex environment and have been a source of some patient safety-related adverse incidence in the past. Systems are needed to solve this gap in traditional reimbursement systems. The proposed solution will allow the staff to manage Operating rooms, capture clinical data, track the use of equipment and instrument, and produce reports to aid in reimbursements. Also, OR managers and directors will have access to a wealth of information that will enable them to make informed decisions that directly impact patient safety satisfaction, operational efficiencies, improved OR utilization, and financial performance.

The stakeholder groups that will be impacted by the implementation of EMR are physicians, staff, patients, scheduling department, super-user/trainers, IT department, billing department, laboratory department and insurance company (Health.gov, 2019). These stakeholders can make or break the implementation process, their perspectives, knowledge, ability, and willingness is vital to this implementation. Stakeholders should be involved in each phase of the implementation process, to give support, provide suggestions for design, and participate in the evaluation and continuous quality improvement activities. The stakeholders responsible for assisting to address this health gap are; clinicians, finance department, Information Technology department, OR manager, and staff members. They play a crucial component in the selection, buy-in, and decision-making process.

Electronic medical records (EMR) shows to be promising for facilitating healthcare improvement. Hence, the opportunity has presented itself for implementing such a system. EMR is a computerized medical information system that replaces paper-based medical practice. According to Abdekhoda (2016), patient clinical information is collected and shared by EMR, as it is the tool to create legible and structured patient information records. The primary use of the EMR is for digital storage system for patient records. This system provides healthcare organizations with services such as decrease medical errors, increase the effectiveness of healthcare services, and reduce healthcare costs. EMR implementation can be expensive and can take time and energy for staff members to fully integrate the system into healthcare (Roussel et al., 2020). The technology makes it easier to report quality data and has the potential to improve quality, permanence, and safety and effective healthcare services.

In conclusion, EMR implementation is timely, complete, and provides accurate information about patient healthcare delivery. As such implementing this system can yield a positive return on investments to the healthcare organization.

References

  • Abdekhoda, M., Ahmadi, M., Dehnad, A., Noruzi, A., & Gohari, M. (2016). Applying electronic medical records in health care: Physicians’ perspective. Applied Clinical Informatics, 7(2), 341-354. doi:10.4338/ACI-2015-11-RA-0165
  • Hartzler, A., McCarty, C. A., Rasmussen, L. V., Williams, M. S., Brilliant, M., Bowton, E. A., Clayton, E. W., Faucett, W. A., Ferryman, K., Field, J. R., Fullerton, S. M., Horowitz, C. R., Koenig, B. A., McCormick, J. B., Ralston, J. D., Sanderson, S. C., Smith, M. E., & Trinidad, S. B. (2013). Stakeholder engagement: a key component of integrating genomic information into electronic health recordsGenetics in medicine: official journal of the American College of Medical Genetics15(10), 792–801. doi.org/10.1038/gim.2013.127
  • HealthIT.Gov. (2019) Who are key stakeholders during electronic health record (EMR) implementation? https://www.healthit.gov/faq/who-are-key-stakeholders-during-electronic-health-record-ehr-implementation
  • Roussell, L., Thomas, P., & Harris, J. (2020). Management and Leadership for Nurse Administrators (8th ed). James and Bartlett Learning.

W4A3 Projected Expenses and Revenues (Five Year)

When evaluating the profitability of a project, it is crucial to assess the returns that the company or investment project generates against the costs of producing these incomes. The Projected Expenses and Revenues (Five Year) shows a total expenditure amounting to $1,509,867 compared to total revenues or benefits of $1,631,436. Interestingly, the expenditures are during the start of the project, over the second year, and during the fifth Year with other years recording zero costs. This implies that the project requires a minimal interval of sustenance costs over the project’s economic life. The estimates then project a $1,631,436 gain, which means that the project is profitable and generates revenue over the five periods. The estimated financial impact of this proposal is a projection of benefits realizable within the time frame. However, further analysis of ROI could provide a better indication.

Investment Return (ROI) is an investment efficiency measure used to assess or compare the performance of investments. There are crucial aspects that need to be sighted when interpreting the calculated ROI – total returns and total costs. This percentage metric is intuitively easy to comprehend and incorporates the net return (numerator) because investment returns can be a gain (positive) or loss (negative). The project’s ROI yields a positive figure of 8.05% to imply that the health care should anticipate net returns worth 8.05% of their initial investment outlays and additional investments throughout 5-years. These results for the organization indicate that if the project is successfully implemented, the company will expect the estimated percentage gain on its investment. However, this measure is favorable for a company intending to choose between two investment projects so that it becomes possible to select a project with a higher return on investment ratio that promises more efficiency in income generation.

W6A4 Projected Budget (Five Year)

In healthcare just like in all segments of the economy, budget is very important. A clearly and well defined budget is essential as it helps a healthcare organization to better comprehend the funds that can be spend on various sections of the project and how much spending should be selected to each.

Every project has some startup expenses which are incurred before the project commences and starts getting revenues. In this project we have four startup expenses. These are expenses for training staff, server, and hardware and software setup and software license. The table below shows the costs for each of the expenses and also its percentages.

Expenses/ Cost  Year 0 Percentage
Startup expenses
Software License  $      160,000 23%
Hardware & software setup  $ 217,000.00 31%
Server  $ 115,000.00 16%
Training (Staff)  $ 217,000.00 31%
Total startup expenses  $ 709,000.00 100%

Training of staff and hardware and software setup have the highest costs as they both have 31% of the startup expenses. The server is the least with 16%.

Surplus or deficit is a figure that shows if a business is making positive cash flows or negative ones. It shows if the firm is making profits or not. We have deficits from year one to year 4. In year 5, the healthcare business will have a surplus. Thus it will have made its profits.

Year Deficit/ Surplus
Year 1  $      (688,206.00)
Year 2  $      (382,983.00)
Year 3  $      (142,760.00)
Year 4  $        (71,630.00)
Year 5  $       168,593.00

The table below shows the estimated budget together with the Return on Investment for the years from 1 to 5. We can see that from year 1 to year 4, the ROI is negative. This means that the company is not efficient enough on the revenues compared with the cost. In year 5, the ROI is positive which is equal to 0.16. This means that the money that was invested is realizing gains thus the company is performing well financially.

Expenses/ Cost Year 0 Year 1 Year 2 Year 3 Year 4 Year 5 Grand Total
Start up expenses
Software License  $160,000
Hardware & software setup  $217,000
Server  $115,000
Training (Staff)  $217,000
Total startup expenses  $709,000
Operating Expenses
Cost/ procedure @25/ procedure x150  $      3,750  $       3,750  $      3,750  $         3,750  $         3,750
software support  $    45,000  $    50,000  $       50,000
contingency 20%  $  110,000  $    15,000  $       15,000
3rd party interface  $    30,000  $       30,000
Total operating Expenses  $  188,750
 
Total Expenses  $709,000  $  188,750  $       3,750  $    68,750  $       33,750  $       68,750  $     363,750
 
Revenue/Savings
New medical record creation  $  111,664  $   204,093  $  204,093  $     204,093
Charge Capture  $    32,880  $     32,880  $    32,880  $       32,880  $       32,880
Chart management  $    45,000  $     50,000  $    50,000  $       50,000  $       50,000
Improved coding  $    20,000  $     22,000  $    22,000  $       22,000  $       22,000
Total Revenue/Savings  $          –  $  209,544  $   308,973  $  308,973  $     104,880  $     308,973  $  1,241,343
Return on investment -0.77 -0.42 -0.15 -0.07 0.16
Total revenue  $          –  $  209,544  $   518,517  $  827,490  $     932,370  $  1,241,343
Total expenses  $  897,750  $   901,500  $  970,250  $  1,004,000  $  1,072,750
Deficit/ Surplus  $ (688,206)  $  (382,983)  $(142,760)  $     (71,630)  $     168,593

There are numerous benefits of electronic medical record (EMR), such as improved quality of care, medical error prevention, and unnecessary care costs. However, one significant barrier to the adoption of EMR systems is the cost issue. Implementing an electronic medical record system in the primary care can result in a positive financial return on investment to the health care organization. The magnitude of the return is sensitive to several key factors.

References

  • Choi, J. S., Lee, W. B., & Rhee, P. L. (2013). Cost-benefit analysis of electronic medical record system at a tertiary care hospital. Healthcare informatics research19(3), 205–214. https://doi.org/10.4258/hir.2013.19.3.205
  • Masters, R., Anwar, E., Collins, B., Cookson, R., & Capewell, S. (2017). Return on investment of public health interventions: a systematic review. J Epidemiol Community Health, 71(8), 827-834.

W10/11A6 Organizational Statement Analyses

W10/11A6 Summary/Elevator Speech (PPT slides)

<Include a handouts view or other printout of your “elevator speech” here, that highlights the value of your proposal, incorporating selling points from your analyses that you believe make the business case for nurse entrepreneurship and leadership’s commitment to your proposed healthcare product or service>