The Memorial Hermann, Memorial City Hospital is a not-for-profit facility located in the heart of West Houston, and has been serving the community since 1971 (Memorial Hermann website, 2013). Building on a 40 year legacy of caring for the community in West Houston, Memorial City has emerged as an advanced, award-winning academic medical center, offering high level care typically found only in the Texas Medical Center (Memorial Hermann website, 2013). The 33 storey Memorial Hermann Tower has 426 licensed hospital beds, and recently acquired the Women and Children's Memorial Hermann currently serving women and children within the West Houston metropolis is dedicated to provide high quality health services in order to improve the health of the people in West Texas and the nation as a whole (Memorial Hermann website, 2013).
Intensive care unit (ICU) is a hospital in to a hospital (Maniou, 2012). Increase in medical complexities in highly acute patients owing to physiological compromises resulted in the development of ICU in the last fifty years (Society Critical Care Medical Guideline Committee. 1999) .With increasing constraints in healthcare resources, it is imperative that effective utilization of expensive resources such as intensive care become priority without compromising the quality care delivery system (Weissman, 1997).The SICU expansion plans to meet the growing need to cater for the critically ill population within the metropolis and beyond with available resources.
Strategic planning will help determine where an organization intends to go over a pre-determined period of time (Paschall, 2013).The move to expand SICU is based on a prediction of an increase in workload volume, and an anticipated increase in demand for care to high level acute patients while supporting the move with a break-even analysis to determine its the financial viability. Growth potential within the facility, availability of nursing and other health care staff to meet the demand for critical care as well as the recruitment of surgeons and physicians while retaining and empowering the current healthcare providers with new and improved critical care innovations are opportunities awaiting the organization upon completion of the proposed 20 bed SICU expansion. The project's long term goal is to continually deliver cultural and spiritually based quality care to the growing population within the Houston metropolis.
The graph demonstrates a gradual upper trend in the projected revenue based on number of SICU patient days and a good predictor for future increase both in revenueand workload volume. Forecast information about the likely volume of services can be compared with break-even volume to predict whether there will be profit or loss (Finkler & Kovner, 2000).
The fiscal year at the Memorial Hermann Hospital begins in July and ends June of each year (T. Wasgren, personal communication, March 30, 2013). The anticipated monthly salaries will be $797,113 with total salaries including benefits as $14,348, 034 for 18 months. Supply expense includes: Medical supplies costing $3,054 monthly, and $54,972 for 18 months. System development charges which consists of biomed, behavioral services and laundry will cost $1,092 monthly and $19,656 for 18 months. Monthly general supplies will cost $3,300 and $59,400 for 18 months. Monthly cost of education and orientation will be $10,522 and $189,396 for 18 months. Total expenses for the next 18 months beginning July 2013 will be $14,671,458.
Thetotal revenue of $16,236,159 for the next 18 months. Monthly cash flow have been derived by subtracting the monthly expenses from the monthly patient revenue with a total cash flow of $1,564,701. In order to finance the 20 bed SICU expansion, it is anticipated that a line of credit in the amount of $1,500,00 will be used in financing the short term (ST) plan towards the project. It is expected that the line of credit will be utilized for 6 months with a monthly payment of $250,000. To finance the proposed expansion, it is anticipated that a bond will be issued to finance the expansion in the amount of $20,000,000, a 6% interest rate and loan payable in 20 years yielding a monthly repayment amount of $1,743,691. Total cash available to finance the project will be the sum of the short and long term loan to the amount of $20,250,000 for July 2013. Cash from financing activity for the subsequent months were derived by adding both the short and the long term loans with the monthly repayment amount totaling $1,493,691 for the next 17 months. With $20,000,000 as the cash available for investing in the proposed expansion, the cash flow available to use monthly was derived by adding the initial cash flow with both the cash flow from financing activity and the cash flow from investing activity. The monthly and cumulative cash flow for the first month will be $341,671, and the subsequent months derived by adding the prior month's cumulative cash flow with the current month's cash flow. Total expenses which includes personnel salaries and wages, capital, supply and marketing expenses for the next 18 months towards the proposed SICU expansion will be $14,890,278.
It is apparent that the organization will need an upfront investment to actualize the expansion of the current SICU which involves renovating an old unit. Based on the regression, the decision to proceed with the execution of the project will be financially viable owing to the projected increase in the number of patient days, and revenue to be generated for the next three years. The move towards expanding the organization's SICU by 20 beds will not only set the pace for its healthcare competitors, but make available cost effective quality, patient-focused care delivered by its finest experts and healthcare professionals in various specialties who are dedicated to serving the growing West Houston community and beyond, while generating revenue to support its various charities and other non-for profit organizations it supports.
Ackley, B. J., Ladwig, G. B. Swan, B. A., & Tucker, S. J. (2007). Evidence- based nursing care guidelines: Medical surgical interventions (1st ed.). Philadelphia, PA: Mosby, Inc.Finkler, S., & Kovner, C. (2000). Financial management for nurse managers and executives. Philadelphia: W. B. Saunders Company.Finkler, S. A., Kovner, C. T., & Jones, C. B. (2007). Financial management for nurse managers and executives.(4th ed.). Philadelphia, PA: W. B. Saunders.Kowal, C. D. (2010). Implementing the critical care pain observation tool using the IOWA Model. Journal of The New York State Nurses' Association, 4-10.Memorial Hermann website. (2013). http://www.memorialhermann.org/ locations/memorial-city/Paschall, L. (2013). Implementing a strategic plan. The Dental Assistant, 15-16.
SICU Expansion Powerpoint Presentation
The University of Texas at Arlington College of
In partial fulfillment of the requirements of
N5342 MANAGEMENT OF NURSING OPERATIONS
Dr. SYLVAIN TREPANIER, DNP, RN, CENP
MAY 3rd , 2013
Hospital, Memorial City
• Located in West Houston
• 33 Storey Tower with 426
• Exceptional Healthcare
Assessment of Need
•Hospital in to a hospital
•Increased medical complexities
•Effective utilization of resources
•Increasing demand for critical care
Mission & Vision
• Optimize healthcare
• Incorporate new
• Improve Critical Care
• Leader in Healthcare
• High level acute care
• Recruit Physicians
• Growth Potential
• Increasing Volume
• Retain Surgeons
3 Year Revenue Regression Graph
• Medical Supplies-
• Office Supplies-$59,400
• Total -$14,671,458
Business Plan-18 Months
• Total Revenue-$16,236,159
• Total Cash Flow-$1,564,701
• ST Debt Plan-6Months-Line of Credit-$1,500,000
• LT Debt Plan-Bond Issuance-$20,000,000
• Interest-6% payable in 20 years
• Monthly repayment-$1,743,691
• Total cost for 20 bed SICU-$14,890,278
Ackley, B. J., Ladwig, G. B. Swan, B. A., & Tucker, S. J. (2007). Evidence-
based nursing care guidelines: Medical surgical interventions (1st ed.).
Philadelphia, PA: Mosby, Inc.
Finkler, S., & Kovner, C. (2000). Financial management for nurse managers
and executives. Philadelphia: W. B. Saunders Company.
Finkler, S. A., Kovner, C. T., & Jones, C. B. (2007). Financial management for
nurse managers and executives.(4th ed.). Philadelphia, PA: W. B.
Kowal, C. D. (2010). Implementing the critical care pain observation tool using
the IOWA Model. Journal of The New York State Nurses' Association, 4-10.
Memorial Hermann website. (2013). http://www.memorialhermann.org/
Paschall, L. (2013). Implementing a strategic plan. The Dental Assistant, 15-