Health Care Case
                   Study:
            Sensitivity Analysis




Regine Roy, Dianne Smith, Dorian Rozier, Tara Brown
   HCS 405 – Health Care Financial Accounting
                   April 28, 2011
              Professor Theron Angry

                                                      1
OBJECTIVES

 Discuss Patton-Fuller’s Nursing Shortage
   o The Advantages
   o The Disadvantages
   o The Best Choice

 Explain the affects of giving raises to Patton-Fuller nurses

 Explain The Use of Trend Analysis to plan for staffing at Patton-Fuller

 Summarize the trend data and how comparative data facilitates
      forecasting at Patton-Fuller




                                                                            2
PATTON-FULLER’S NURSING
                  SHORTAGE
 Patton-Fuller is a cardiac specialty facility with invasive procedures being
       done everyday.

 Based on the financial statements, 20% of the budget is spent on
       nurses wages

 Initially the nurse ratio was 5:1 and needs to be changed




                                                              Regine Roy   3
NURSE 5:1 RATIO DISADVANTAGE



 Nurse Burnout

 Lack of employee retention

 Job dissatisfaction

 Poor quality in patient care

 Prone to medical errors




                                 Regine Roy   4
NURSE 4:1 RATIO ADVANTAGE


 Implement team nursing

 Get $1 per hour and better benefits

 Less nurse burnout levels

 Better employee retention

 Better quality in patient care

 Nurse able to focus better on the patient




                                              Regine Roy   5
BEST CHOICE FOR PATTON-FULLER

 4:1 ratio in nursing staff regardless of the department

 Better Nurse Ratio = Better Care = Better Facility

 Better Facility = More Clients = More Revenue = Happy CEO




                                                            Regine Roy   6
AFFECT OF NURSE RAISES

        Negative

 Increase in cost per month

 Cutting cost else where to cover cost of raises

 Other Departments requesting a raise

 Paying out more money – Less coming in


                               Positive


               Happier Employees – Getting Paid their worth



                                                               Tara Brown   7
NURSING STASTICS

2,000,000
1,800,000
1,600,000
1,400,000
1,200,000
1,000,000
  800,000
  600,000                                   $30
  400,000
  200,000                                   $31
        0




               Nursing Cost Per Month
                                        Tara Brown   8
TREND ANALYSIS

 Financial and statistical performance comparison over period of time

 Differences between current assets and current liabilities

 An aspect of technical analysis that tries to predict the future based
      on past data




                                                          Dianne Smith     9
RECOMMENDATIONS

   Internal Analysis      Obtain staff feedback
                            through in house surveys
   Surveys

                           Use manageable ratios of
   Delivery                nurse to patient to avoid
                            negative ratings in
                            quality.

   Competitiveness

                           Performance
                            management incentives.


                                   Dianne Smith   10
SUMMARIZING THE TRENDS ANALYSIS

 Patton Fuller’s Cardiac Hospital is a
  600 bed facility that generally utilizes
  60% occupancy.

 Based on the trend analysis the
  nurses were burned out based on a
  5 to 1 ratio.

 Changing the ratio to 4 to 1 will
  ease the nurse work load.

 Increasing the nurses salary $ 1 per
  hour will increase the employee
  moral and maintain employee
  retention.


                                             Dorian Rozier   11
COMPARATIVE DATA
 Changes in daily and monthly census
  affects the patient revenue.

 Based on the patients census, it
  determines the nurse patient ratio.

 The cost of the nurses is based on the
  existing 5 to 1 ratio and a salary of
  $30.00 an hour.

 The data estimated what the nursing
  cost would be if given a $1 per hour
  raise or changing the ratio to 4 to 1 .



                                                            12
                                            Dorian Rozier
REFERENCES



Carlson, J. (2010). Rallying for ratio. Modern Healthcare 40(24), 8 – 9.
         Retrieved from Health Source: Nursing/Academic Edition
         database.

University of Phoenix. (2011). Analyzing financial indicators for decision
          making [Computer Software]. Retrieved from University of Phoenix,
          Simulation, HCS405-Health Care Financial Accounting website




                                                                           13

Patton fuller final presentation

  • 1.
    Health Care Case Study: Sensitivity Analysis Regine Roy, Dianne Smith, Dorian Rozier, Tara Brown HCS 405 – Health Care Financial Accounting April 28, 2011 Professor Theron Angry 1
  • 2.
    OBJECTIVES  Discuss Patton-Fuller’sNursing Shortage o The Advantages o The Disadvantages o The Best Choice  Explain the affects of giving raises to Patton-Fuller nurses  Explain The Use of Trend Analysis to plan for staffing at Patton-Fuller  Summarize the trend data and how comparative data facilitates forecasting at Patton-Fuller 2
  • 3.
    PATTON-FULLER’S NURSING SHORTAGE  Patton-Fuller is a cardiac specialty facility with invasive procedures being done everyday.  Based on the financial statements, 20% of the budget is spent on nurses wages  Initially the nurse ratio was 5:1 and needs to be changed Regine Roy 3
  • 4.
    NURSE 5:1 RATIODISADVANTAGE  Nurse Burnout  Lack of employee retention  Job dissatisfaction  Poor quality in patient care  Prone to medical errors Regine Roy 4
  • 5.
    NURSE 4:1 RATIOADVANTAGE  Implement team nursing  Get $1 per hour and better benefits  Less nurse burnout levels  Better employee retention  Better quality in patient care  Nurse able to focus better on the patient Regine Roy 5
  • 6.
    BEST CHOICE FORPATTON-FULLER  4:1 ratio in nursing staff regardless of the department  Better Nurse Ratio = Better Care = Better Facility  Better Facility = More Clients = More Revenue = Happy CEO Regine Roy 6
  • 7.
    AFFECT OF NURSERAISES Negative  Increase in cost per month  Cutting cost else where to cover cost of raises  Other Departments requesting a raise  Paying out more money – Less coming in Positive  Happier Employees – Getting Paid their worth Tara Brown 7
  • 8.
    NURSING STASTICS 2,000,000 1,800,000 1,600,000 1,400,000 1,200,000 1,000,000 800,000 600,000 $30 400,000 200,000 $31 0 Nursing Cost Per Month Tara Brown 8
  • 9.
    TREND ANALYSIS  Financialand statistical performance comparison over period of time  Differences between current assets and current liabilities  An aspect of technical analysis that tries to predict the future based on past data Dianne Smith 9
  • 10.
    RECOMMENDATIONS  Internal Analysis  Obtain staff feedback through in house surveys  Surveys  Use manageable ratios of  Delivery nurse to patient to avoid negative ratings in quality.  Competitiveness  Performance management incentives. Dianne Smith 10
  • 11.
    SUMMARIZING THE TRENDSANALYSIS  Patton Fuller’s Cardiac Hospital is a 600 bed facility that generally utilizes 60% occupancy.  Based on the trend analysis the nurses were burned out based on a 5 to 1 ratio.  Changing the ratio to 4 to 1 will ease the nurse work load.  Increasing the nurses salary $ 1 per hour will increase the employee moral and maintain employee retention. Dorian Rozier 11
  • 12.
    COMPARATIVE DATA  Changesin daily and monthly census affects the patient revenue.  Based on the patients census, it determines the nurse patient ratio.  The cost of the nurses is based on the existing 5 to 1 ratio and a salary of $30.00 an hour.  The data estimated what the nursing cost would be if given a $1 per hour raise or changing the ratio to 4 to 1 . 12 Dorian Rozier
  • 13.
    REFERENCES Carlson, J. (2010).Rallying for ratio. Modern Healthcare 40(24), 8 – 9. Retrieved from Health Source: Nursing/Academic Edition database. University of Phoenix. (2011). Analyzing financial indicators for decision making [Computer Software]. Retrieved from University of Phoenix, Simulation, HCS405-Health Care Financial Accounting website 13

Editor's Notes

  • #4 The past decade has been a turbulent time for US hospitals and practicing nurses.  News media have trumpeted urgent concerns about hospital understaffing and growing hospital nurse shortage (Carlton,2010). Considering the fact that Patton Fuller is a specialty hospital, the administrators have to take into consideration the patient  mix in the unit.
  • #5 Nurses nationwide consistently report that hospital nurse staffing levels are inadequate to provide safe and effective care.  Physicians agree, citing inadequate nurse staffing as a major impediment to the provision on high quality of care (Carlson 2010).  The shortage of hospital nurses may be linked to unrealistic nurse workloads.  Forty percent of hospital nurses have burnout levels that exceed the norms of health care workers.  Job dissatisfaction among hospital nurses is four times greater than the average for all US workers, and one in five hospital nurses report that they intend to leave their current jobs within a year (Carlson 2010).
  • #6 Team Nursing, on the other hand, is a system developed in the 1950’s to answer the need of more nurses in a hospital. This is where one nurse is in charge of leading group comprising 4-6 different members such as nursing aids and unlicensed assistive personnel to care for a group of patients equating to 15-20 (Carlson, 2010). Patient care is delivered through the coordination and cooperation of each team member through delegation of assignments with respect to the team member’s level of responsibility and accountability. Delegation of patients and duties are done at the beginning of the shift, while a summary of care given and outcomes resulting from patient care is conveyed at the end. Any action that is done by unlicensed assistive personnel, nursing aid or nurse volunteer is the responsibility and accountability of the team leader, the registered nurse. The advantage of team nursing is that the total number of absences and leaves related to over-work and medical conditions related to stress and fatigue is lessened. This is due to the sharing of workload between each team members, enabling them to do a huge amount of work in such a short time without undue exertion. This delegation of duties will also enable team members to hone their skills in different nursing tasks, and also improve their ability to communicate and coordinate. Each can also learn from each other during team conference while discussing on ways how to go about in caring for different patients (Carlson,2010).
  • #8 Based on the previous financial records Patton-Fuller is struggling and giving the nurses a raises can affect the bottom line for this facility.
  • #9 Jan - $30 - 1,911,078 $31 - $1,974,781 difference of $63,703March - $30 – $1,769,190 $31 - $1,828,163 difference of $58,973June - $30 - $1,045,194 $31 - $1,080,034 difference of $34,840September $30 - $1,050,392 $31 - $1,085, 405 difference of $35,013December $30 - $1,888,210 $31 - $1,951,150 difference of $62,940
  • #10 Patton-Fuller Community Hospital (PFCH) faces a common problem relating to the delivery of quality care and maintaining a manageable nurse to patient ratio. An attempt at projecting the financial performance over the upcoming years proves to be challenging because of the state of the economy, nursing shortage and the possibility  of a health care reform
  • #11 PFCH success in the future depends largely on quality care and patient satisfaction. Happy work environment promotes more productivity and productivity increases the hospital financial future.
  • #12 Patton Fuller’s hospital has to analyze the employment trends in health care that are associated with staffing shortages. In the health care world whether, in a hospital, a clinic, doctor’s office trend analysis are key in decision making.
  • #13 Data is meaningful when compared to some meaningful figures such as census and nurse patient ratio. Comparison figures from previous periods benefits when a trend analysis is evaluated.