-Proposal for restructuring to meet organizational commitment and governmental budget reform -Organization currently overstaffed in the senior management division -Senior Vice President and Vice President positions will be eliminated. Savings to the organization approx. $1M -Eliminating 1 Assistant Director from each division will reduce salary commitment by $300K annually. -Each division will reduce coordinators by 50% - positions permanently eliminated -Increase in number of direct care nurses in both divisions with an increase in case load by each of 5% -Estimated increase revenue from increase direct care staff ( from reassignment of coordinators) - minimum 150 additional patients with average program length of stay 2 weeks, average reimbursement $2000 - $8 -$10M annually.
-Revised structure has resulted in elimination of several senior management and lower management positions -Goal to reduce overhead expenses, eliminate duplication of responsibilities and maximize resources -With aging population, increase life span and cut in healthcare budget, maximum resources needed on the frontline (Direct Care Nurses – LPN and RN). -Team Managers are necessary to ensure efficient coordination of services and assume additional responsibilities from coordinators. Coordinators will be reassigned direct care responsibilities along with the projected 10% increase in RN and 25% in LPN Liaisons are needed to continue the referral process from the hospitals and community – Current staffing capable on handling projected increase in referrals over next 12 months.
A person with a bachelor’s degree but has more experience will save the organization significant sums of money, because a Masters Degree will generally demand a higher wage than a person with a Bachelor’s Degree. Home healthcare is one of the fastest-growing sectors in healthcare. “According to a report from CMS' National Health Statistics Group, health spending will remain relatively steady from 2007”(George 2007, p.1). Extreme salaries paid to Senior Vice Presidents of Operation will reduce the earnings of companies and slow organizational growth. “ The growth of organizations will be slowed because revenue will be used to pay the income of the organizations senior management”(Shih, M.D., Davis, 2008) . The duties of the senior VP can be combined and or delegated to other individuals that are with the organization to perform specific tasks, which are of a pay scale that does not constitute a waste of time, talent and capital of the organization.
Organizations today are moving to a less hierarchy in organizations today. Less administrative inefficiency where professionals administrate professionals (Werther, 2008). Computer technology has enabled the ability of executives to access decision-making data extremely efficiently these days, allowing time for more actual management. This compresses the organizational structure allowing more close relationships and strong teamwork to develop. Having too many top executives may lead to political games and departments fighting for funding. In 2002, the World Health Organization had six top executives with the same job costing the organization lots of money in overhead expenses. These large expenses left the organization asking for more donations and departments fighting over funding for different projects. (Yamey, 2002) Poor communication within an organization can lead to developing issues during the implementation process of any project. Organizations that have too many top executives can delay the decision making process due to lengthy debates about leadership. Another reason for the poor communication is due to management undermining the decisions that were made leading to confusion during implementation. (Nowicki and Summers, 2008)
In most organizations in any industry, administration positions can become overly crowded very quickly. When faced with an impending 15% drop in revenue, an organization would be swift in preparing for the necessary changes that must occur in preparation of cutting costs. Being that the company currently employs four assistant directors, eliminating one of these positions would save the organization much needed costs. The remaining three assistant directors will be more than able to fulfill their responsibilities. This is clearly an example of maximizing to minimize. The termination of two assistant directors will allow the organization to recoup the 15% reduction in revenue and benefit form the administrator’s salary.
“ As the population ages, the volume of home health care agency users will grow, requiring the need for agencies to employ even more direct care givers”( Flynn & Deatrick, 2003, pg. 6). The requirement for fewer managers to direct them will increase. “ Discontentment among home care staff nurses is believed to be a major contributor to the shortage of trained nurses”( Lee, Rock, 2005) . Merging some responsibilities of management to free up operating dollars will allow an organization to utilize its capital fully and increase patient satisfaction.
Eliminating the Senior Vice President of Operations <ul><li>Reducing the degree needed will save the organization money </li></ul><ul><li>Home healthcare agencies growth is predicted to increase </li></ul><ul><li>The salary of the Senior Vice President of Operations will reduce projected advances </li></ul><ul><li>Home healthcares increase in revenue and annual growth will be nullified by increasing salaries. </li></ul><ul><li>Duties can combined and or delegated to other individuals . </li></ul>
Also elimination of VP of Operations <ul><li>Duplication of hierarchy </li></ul><ul><li>Computer technology has assisted in data handling and reporting </li></ul><ul><li>Organizational structure is compressed </li></ul><ul><li>Reduce political issues and debates among management </li></ul><ul><li>Improve communication between leadership and employees </li></ul>
Elimination of One Assistant Director From Each Division <ul><li>The remaining two Assistant Directors will clearly be able to fulfill the duties created by the termination </li></ul><ul><li>This will be an example of minimizing to maximize </li></ul><ul><li>The elimination of this position’s salary will enable the organization to deal with the impending 15% decrease in revenue </li></ul>
Reduction of In-House Coordinators/ Increase Direct Care Nurses <ul><li>Employment of more direct care givers </li></ul><ul><li>Fewer managers needed to oversee staff </li></ul><ul><li>Discontentment among home care staff </li></ul><ul><li>Merge responsibilities of management </li></ul>
References <ul><li>Flynn, L., & Deatrick, J A (Winter 2003). Home care nurses' descriptions of important agency attributes. Journal of Nursing Scholarship , 35, 4. p.385(6). Retrieved August 22, 2008 from General OneFile via Gale: h ttp://find.galegroup.com/ips </li></ul><ul><li>George, P, (2007), American Society of Home Healthcare Publications , Volume 13, Issue 7, Retrieved August 19, 2008 from http://www. homecaremag .com </li></ul><ul><li>Lee, J. S., & Rock, B D (Feb 2005). Challenges in the new prospective payment system: action steps for social work in home health care. Health and Social Work , 30, 1. p.48(8). Retrieved August 22, 2008 from General OneFile via Gale: http://find.galegroup.com/ips </li></ul>
References <ul><li>Nowicki, M. and Summers, J. (February 2008). When Participative Management Leads to Garbled Communication: Are you Clear and Concise When you Communicate with your Employees? Healthcare Financial Management. Retrieved August 24, 2008 from http://findarticles.com/p/articles </li></ul><ul><li>Shih, A, M.D., Davis, K, (2008), Organizing the U.S. Health Care Delivery System, Retrieved August 19, 2008 from http:// ebscohost .com </li></ul><ul><li>Werther, W., (2008 ). Productivity and Margin compression in mature industries: The special case of healthcare in the United States. University of Miami. Retireved August 23, 2008 from www.icpqr.org/news/keynotes-pdf </li></ul><ul><li>Yamey, Gavin. (November 16, 2002). Education and Debate: WHO in 2002. BMJ Medical Publication of the Year. Retrieved August 24, 2008 from http://www. bmj .com/ cgi /content/full </li></ul>