this assignment, you will be writing a 1,000-1,250-word essay describing the differing approaches of nursing leaders and managers to issues in practice. To complete this assignment, do the following:

Select an issue from the following list: nursing shortage and nurse turn-over, nurse staffing ratios, unit closures and restructuring, use of contract employees (i.e., registry and travel nurses), continuous quality improvement and patient satisfaction, and magnet designation.
Compare and contrast how you would expect nursing leaders and managers to approach your selected issue. Support your rationale by using the theories, principles, skills, and roles of the leader versus manager described in your readings.
Identify the approach that best fits your personal and professional philosophy of nursing and explain why the approach is suited to your personal leadership style.
Use at least two references other than your text and those provided in the course.
Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

 

PART 1

 

The genesis of Health Management Information Systems (HMIS) goes back to the roots of numerous areas, including:

[removed]		computing privacy.
[removed]		information economics
[removed]		multidimensional data sets.
[removed]		medical policies.

 

An information-inquiring culture has transparent:

[removed]		information discovery.
[removed]		Core values.
[removed]		direct reports.
[removed]		accounting and finances.

 

An information-discovery culture ensures:

[removed]		critical information about due processes.
[removed]		sharing of insights freely and encourages employees to collaborate.
[removed]		sensitivity for privacy.
[removed]		giving up the power of controlling others.

 

The data input phase includes:

[removed]		data acquisition and data verification.
[removed]		data storage and data classification.
[removed]		data retrieval and data presentation.
[removed]		data retrieval only

 

A healthcare services organization may develop or adopt various types of cultures, including:

[removed]		an information-functional culture
[removed]		an information-secrecy culture.
[removed]		an information-blast culture.
[removed]		an information-hording culture.

 

 

 

Computational functions support:

[removed]		further data analysis.
[removed]		data transfer.
[removed]		sensitive data.
[removed]		decreasing costs.

 

Emerging trends that are encouraging heathcare executives to become interested in developing innovative, integrative, and cost-beneficial HMIS solutions include:

[removed]		wireless, user-friendly portables.
[removed]		tape recordings.
[removed]		X-ray films.
[removed]		accessible records.

 

The majority of computerized patient record systems have capabilities to reject invalid data with the use of techniques including:

[removed]		batched totals and range checks.
[removed]		mechanically processed coded data.
[removed]		data integrity.
[removed]		patient demographics.

 

As a trustworthy leader, the senior executive must have the ability to:

[removed]		exude trust from their direct reports and corresponding followers.
[removed]		develop a “top-down” working relationship with followers.
[removed]		articulate how or why certain things are or are not being executed without explanations.
[removed]		dictate to others on how to manage their time.

 

The executive largely responsible for articulating the organizational vision and mission is the:

[removed]		COO
[removed]		CMO
[removed]		CTO
[removed]		CEO

 

Shared values portray:

[removed]		the total competencies of the organization.
[removed]		the interactive coordination among the hired employees.
[removed]		the common goals, objectives, and beliefs of most members of the organization.
[removed]		morals of the employees of an organization.

 

The role of the CEO or CIO to oversee the use of HMIS in any healthcare services  organization requires that the individual has been trained and has experience and mastered a certain set of:

[removed]		rules and laws.
[removed]		strategic, tactical, and operational IT competencies.
[removed]		department goals and strategies.
[removed]		efficient business processes.

 

The executive who oversees the daily heathcare services delivery operations is the:

[removed]		CEO
[removed]		COO
[removed]		CMO
[removed]		DFO

 

Because it is an art form, motivation requires that the CIO have special skills and elevated expertise, including:

[removed]		turning over goal setting responsibilities to the employees.
[removed]		allowing employees to position specific individuals in the appropriate spaces throughout the organization.
[removed]		being as specific as possible when detailing the goals and objectives for their employees.
[removed]		assuming staff will institute a collaborative spirit with a strong sense of team belonging.

 

Defensive strategies come into play when:

[removed]		an organization is to be constantly at the leading edge of its product offering.
[removed]		the uniqueness of certain aspects of the business activities is maintained.
[removed]		cost advantage is gained through economies of scale and cost-effectiveness.
[removed]		when the stage of the industry and/or product life cycle is experiencing a steady decline due to its ongoing maturity.

Real-world HMIS practices:

[removed]		can be learned by reading cases in textbooks.
[removed]		are not necessary for learning.
[removed]		can be learned by reading published theories.
[removed]		are not easily replicated.

 

URL stands for:

[removed]		uniform relocation lab.
[removed]		universal resource locators.
[removed]		uniform restructuring link
[removed]		usability relocation link

 

For breast cancer patients who may have distinct needs for care and coping, several researchers have found that these patients:

[removed]		typically do not seek information regarding treatment plans.
[removed]		actively engage in online and interpersonal interactions via support groups.
[removed]		tend to disincline investigating medical progress.
[removed]		do not require the normal level of emotional support from medical staff.

 

Online health information seeking should be of concern for health administrators for myriad reasons, including that it:

[removed]		increases social isolation often associated with stigmatizing medical conditions.
[removed]		reduces patient-physician interactions.
[removed]		increases deficiencies in the health insurance and registration processes.
[removed]		engages faster diffusion of medical findings.

 

The Internet is not void of particular weaknesses for underrepresented population information, such as:

[removed]		fragmentation of health information.
[removed]		verifiable facts.
[removed]		credible sources.
[removed]		wealth of information.

 

The primary purposes of the Internet Engineering Task Force (IETF), Internet Architecture Board (IAB), and Internet Engineering Steering Group (IESG) are to:

[removed]		restructure the Internet.
[removed]		function as Internet regulating bodies.
[removed]		develop an Internet hub infrastructure.
[removed]		develop a network system.

Online activities include:

[removed]		spreadsheet development.
[removed]		ACCESS reports.
[removed]		communications.
[removed]		PowerPoint presentations.

Determinants of site success such as Trusera (invitation only), DailyStrength, PatientsLikeMe, and Caring.com rest with a triad of:

[removed]		blog ratings, site ratings, and community forum ratings.
[removed]		member numbers, daily hits, and word of mouth.
[removed]		theory, research, and practice.
[removed]		accuracy, veracity, and verifiability.

Online extraction of relevant health information by both experts and laypersons have proliferated due to:

[removed]		decreased computing literacy.
[removed]		less availability.
[removed]		advances in Web-based interface technology.
[removed]		extremely high cost.

The Internet has facilitated the use of information and communication technology (ICT) to:

[removed]		discourage the constant use of the Internet for medical information.
[removed]		sustain patients with a variety of illnesses.
[removed]		increase social isolation.
[removed]		treat diseases.

 

PART 2

Customer relationship management (CRM) software must be designed with the following in mind.

[removed]		An in-depth recognition of its customers’ specific needs.
[removed]		Strategic communication is for different types of software.
[removed]		Enhancement of existing programs and services.
[removed]		Creative services that would progress and fulfill the organizational long-term goals.

 

The goal for ERP is:

[removed]		to achieve single data-entry points throughout the organization.
[removed]		to maintain non-standardized,  unique processes.
[removed]		to succeed even with the lack of business process reengineering.
[removed]		to maintain the use of paper-based orders.

 

The primary goals of supply chain management (SCM) are:

[removed]		to achieve increased efficiencies with regard to information flows and exchanges between the organization and its external parties.
[removed]		to satisfy the need for economies of scale.
[removed]		to increase the volume of daily purchasing.
[removed]		to decrease efficiencies with regard to information flows and exchanges.

 

How can ERP software be used to facilitate data integration?

[removed]		Maintaining separate processes as previously developed.
[removed]		Using insurance companies to sort it out.
[removed]		Amalgamating existing business processes in an organization.
[removed]		Using health professional associations.

 

Primary storage, or main memory is:

[removed]		the central processing unit (CPU) of a computer.
[removed]		the program instructions and data provides the CPU with a working storage area.
[removed]		random-access memory (RAM).
[removed]		read-only memory (ROM).

 

 

A key high-profile enterprise software system that has emerged in the HMIS landscape is:

[removed]		supply chain management (SCM).
[removed]		just-in-time (JIT) inventory.
[removed]		health maintenance organization (HMO).
[removed]		Internet explorer (IE).

 

What has often been referred to as the “brain” or “heart” of a computer?

[removed]		CPU
[removed]		RAM
[removed]		CU
[removed]		ROM

 

Customer relationship management (CRM) is a major HMIS enterprise software system that:

[removed]		has a predetermined budget.
[removed]		can enable owners to personalize their heathcare services benefits online.
[removed]		has a set listing of highly recommended and non-participating physicians and specialists.
[removed]		does not maintain research information on prescription drugs.

 

Issues that may arise with a RHINO setup like the Mayo Clinic’s include problems with:

[removed]		maintaining separate processes as previously developed.
[removed]		using insurance companies to iron out problems.
[removed]		difficulties with patients.
[removed]		data shadowing and the need for creating interfaces to communicate among disparate platforms and software.

 

The rapid advancements of e-commerce and managed care placed new demands on the healthcare industry in the 1990s to:

[removed]		establish information infrastructures that work with the Foxfire browser.
[removed]		establish information infrastructures that facilitate timely and interoperable patient formation.
[removed]		establish information that works with Internet explorer (IE).
[removed]		establish information that does not contain firewalls.

 

Consolidation, sometimes purported as a “market-sheltering activity” occurs when:

[removed]		the central processing unit (CPU) of a computer is shared.
[removed]		the program instructions and data provides the CPU with a working storage area.
[removed]		two or more comparable healthcare services organizations combine to augment or preserve market power.
[removed]		read-only memory (ROM) is shared.

 

One definition of community health information networks (CHIN) is:

[removed]		A network of stakeholders within a defined region who are committed to improving the quality, safety access, and efficiency of healthcare through the use of HIT.
[removed]		A special interest group (SPIG).
[removed]		Improved efficiency and effectiveness of healthcare services delivery.
[removed]		A not-for-profit organization.

 

One definition of regional health information organizations (RHINO):

[removed]		A network of stakeholders within a defined region who are committed to improving the quality, safety access, and efficiency of healthcare through the use of HIT.
[removed]		A special interest group (SPIG).
[removed]		Improved efficiency and effectiveness of healthcare services delivery.
[removed]		For-profit organization.

 

Open systems, as characterized by the Internet, electronic data interchange (EDI), and extranets, offer:

[removed]		two-way access for external agencies.
[removed]		eliminate the need for the exchange of standard-formatted transactions.
[removed]		no requirement for electronic ordering.
[removed]		no requirement for electronic invoicing through EDI.

 

For practice management systems delivered from private healthcare organizations and hospitals, electronic billing and patient scheduling are being developed for numerous benefits, including:

[removed]		keeping manual follow-up procedures.
[removed]		reducing, or possibly eliminating, all paper-based forms for which healthcare services organizations are especially vulnerable.
[removed]		increase the accuracy of billing/coding.
[removed]		eliminating electronic order processing.

 

What is the ultimate and primary goal for the CHIN evolution and the RHINO movement?

[removed]		Consumer privacy.
[removed]		Internal policies.
[removed]		The development of Health maintenance organizations (HMOs).
[removed]		The establishment of a national health information network (NHIN).

 

EHR will be one of the most costly project expenditures that a healthcare services organization will undertake, with regard to the investments of time and money and the resultant challenge of returns on investments (ROI). This is due to:

[removed]		the significance of the returns to be realized from an EHR implementation remains a concern for many healthcare executives.
[removed]		the program instructions provide the CPU with a working storage area.
[removed]		two or more comparable healthcare services organizations combine to augment or preserve market power.
[removed]		read-only memory (ROM) is shared.

 

A Web-based PHR system will empower patients with:

[removed]		remote patient monitoring for older patients that cannot be added since patients do not need to be concerned about their chronic states of health.
[removed]		access to their own records and help them take a more active role in managing their own health.
[removed]		privacy since physicians will be the only people allowed to view records.
[removed]		accessibility for all caregivers since the records are open for viewing.

 

Possible risks in trusting all your personal health records with a carrier such as Google Health include:

[removed]		a network of stakeholders within a defined region who are committed to improving the quality, safety access, and efficiency of healthcare through the use of HIT.
[removed]		information that could be sold to, or mined by, people from organizations that are unknown to the patient.
[removed]		improved efficiency and effectiveness of healthcare services delivery.
[removed]		a not-for-profit organization could safe keep your records.

 

Healthcare databases have been in existence for as long as there have been data storage devices, and in addition to a computer data-processing database, they can include.

[removed]		the volumes of patient files lining the shelves of a physician’s clinic.
[removed]		healthcare organizational policies and decisions.
[removed]		query languages such as SQL.
[removed]		processes as outlined in a documentation manual.

 

Google Health pays particular attention to security and privacy issues, which clearly restricts:

[removed]		infrastructures that work with the Foxfire browser.
[removed]		information that facilitates timely and interoperable patient data.
[removed]		the transmission or release of the subscriber’s information to third parties without the subscriber’s consent.
[removed]		information that does not contain firewalls or other protections.

 

When combined with various other workflow tools, computerized physician order entry (CPOE) can also be useful in providing information about:

[removed]		manual follow-up procedures.
[removed]		reducing paper-based forms.
[removed]		patient scheduling.
[removed]		eliminating electronic orders.

 

Electronic health records can:

[removed]		improve upon unique non-standardized processes.
[removed]		eliminate single data-entry points throughout the organization.
[removed]		significantly increase the risk for medical errors.
[removed]		enhance the quality of healthcare services delivery.

 

Closely related to, and often functioning as part of, EHR, a computerized physician order entry (CPOE) system is basically:

[removed]		a competitive system within an amalgamation of systems.
[removed]		an internal policies document approved by the Board of Directors.
[removed]		automated order-entry system that captures the instructions of physicians with regard to the care of their patients.
[removed]		information on research of prescription drugs.

 

Three categories of healthcare data are required, almost universally, by healthcare services
organizations for supporting their planning and decision-making activities, and one of these is:

[removed]		vital statistics.
[removed]		environmental statistics.
[removed]		census statistics.
[removed]		consensus statistics.

 

 

 

Callista Roy and Betty Neuman’s theories view the person (individual, group, or community) as a holistic adaptive system that constantly interacts with the internal and external environments. Both theories view the person as being the center of nursing and present health/wellness and illness as parts of the same continuum, however there are some key assumptions that are different. As such, select one of the theories and identify 1 assumption of the theory and discuss how the care rendered for this patient by an advanced practice nurse would be structured (assessment, diagnosis, planning, intervention, evaluation) according to the theory. Give 2 specific examples of interventions that you anticipate will be included in the patient’s care.   

Mr. Reynolds is a 32 year-old male patient hospitalized on the orthopedic unit of the hospital. He is status-post motorcycle accident and right leg below the knee amputation. He has a history of Depression and Schizophrenia. He is currently separated from his wife and estranged from his family. He is awaiting social work for placement in a rehabilitation facility, where he will continue his recovery.

I need at least 2 references 

 

Throughout this course, you’ve examined the importance of anticipating financial fluctuations that may impact your organization’s ability to provide services. While financial managers have no time machines or crystal balls, they do have expense forecasts. Expense forecasting is one of the preeminent tools that financial managers can use to prepare their organizations for future fiscal turbulence. In this Assignment, you will examine a scenario and generate a corresponding expense forecast in Excel.

Before pursuing an opportunity or making a major purchase, financial decision makers must first ascertain if the expenditures are justified. Determining whether a new process, system, or purchase will yield worthwhile returns is no easy task. However, managers have a variety of tools to help them decide whether the new expenditure is warranted. Analyzing a venture’s benefit/cost ratio, marginal profit and loss statement, and break-even points enable nurse managers to make educated decisions about how they choose to commit their funds.

Note: For those Assignments in this course that require you to perform calculations you must:Use the Excel spreadsheet template for the Week 3 assignment
Show all your calculations and formulas in the spreadsheet.
Answer any questions included with the problems (as text in the Excel spreadsheet).

 

Expense Forecasting

In this Application Assignment you calculate scenarios focusing on benefit/cost ratio analysis, marginal profit and loss statements, and break-even analysis. For these scenarios, you will utilize the provided figures to perform calculations and then make recommendations about the viability of the investment opportunities 

Expense Forecasting Scenario

Your department has performed 20,000 procedures during the first six months (January–June) of 20X1. Spending during that period of time was $210,000 for fixed expense items and $1,200,000 for variable expense items. Of those amounts, $50,000 of fixed expense money was spent on preparing for a Joint Commission survey. Volume is anticipated to be 10% higher in the second half of the year. On November 1st, two new procedure technicians will begin work. The salary and fringe benefit costs for each are $96,000/year. Based on the information provided, prepare an expense forecast for 20X1.

Annualization for Fixed:  (Adjusted Total for Year to Date Expense/6) * 12 =Total Annualized Amounts

Annualization for Variable (Adjusted Total for Year to Date Expense/ 20,000) * 40,000 =Total Annualized Amounts.

Financial Analysis Cycle

Marginal Profit and Loss Statement Scenario

You are examining a proposal for a new business opportunity – a new procedure for which demand is expected to be 1,400 units the first year, growing by 600 units a year thereafter. The price charged per procedure is $1,000. The collection rate is anticipated to be 80%. Each procedure consumes $300 of supplies. Salary cost is estimated to cost $540,000 each year, fringe benefits are 25% of salaries, rent for the facility is $55,000/yr and operating cost are $120,000/yr.

Questions:

1. Develop a marginal profit and loss statement for this business opportunity.Based on that analysis, should this opportunity be pursued?

Break-Even Analysis Scenario

You can charge $1,075 for a new service. Demand is anticipated to be 8,000 units a year. Your business is able to handle up to 16,500 units annually, so capacity should not be a problem. The average collection rate is 80%. The new service has annual fixed costs of $4,700,000. Variable cost per unit of service is $420.

Question: Use break-even analysis to determine if this new service is financially viable. If the business is not financially viable, what steps could you take to make a case to proceed with implementation?  Explain your decision.

Benefit/Cost Ratio Analysis Scenario

You are considering the acquisition of a new piece of equipment with a useful life of five years. This new technology will make your clinical operation more efficient and allow for a reduction of 10 FTEs. The equipment purchase price is $4,500,000 plus 10% installation fee. The purchase price includes service for the first year, an item that has an annual cost of $10,000. There is a potential for additional volume of 150,000 units in the first year, growing by 30,000 each year thereafter. The price charged per unit is $15.00 with a 50% collection rate. The staff being eliminated are paid $12.50 per hour. The fringe benefits rate is 20%. The hurdle rate is 7.5%.

Questions: After reviewing Dr. Ward’s Video and the calculations below, please answer the following questions:

• What is meant by  benefit/cost ratio, average payback period and ROI  and why are the all  important to understand when purchasing new equipment?
• Based on this information, would you pursue this opportunity?
• Explain your decision  in 250-500 words in the text box below.

References:

 

Baker, J. J., Baker, R. W., & Dworkin, N. R.  (2018). Health care finance: Basic  tools for nonfinancial managers (5th ed.). Burlington, MA: Jones and  Bartlett Learning.

Chapter 14, “Trend Analysis, Common Sizing, and Forecasted Data” (pp. 149-160)
The focus of this chapter is the use of trend analysis and forecasting to develop future budgets and make financial decisions about capital purchases, programs, and personnel.
Chapter 15, “Using Comparative Data” (pp. 161-173)
In this chapter, you are introduced to the criteria for identifying other health care organizations that are comparable to your own. Data from these organizations can then be used to evaluate your own organizational performance.
Chapter 19, “Estimates, Benchmarking, and Other Measurement Tools” (pp. 223-231)
In this chapter, you continue exploring the concept of financial benchmarking. The chapter focuses on the importance of benchmarking for identifying performance gaps.

Zelman, W., McCue, M., & Glick, N. (2009). Financial management of health care organizations: An introduction to fundamental tools, concepts, and applications (3rd ed.). Hoboken, NJ: Jossey-Bass.
Retrieved from the Walden Library databases.
Chapter 5, “Working Capital Management” (pp. 187–231)
This chapter examines the concept of working capital. The authors explore the specifics of current assets and the management of the working capital cycle.
Chapter 11, “Responsibility Accounting” (pp. 468–497)
Review: This chapter explores the trend toward the decentralization of health care organizations and the challenges this presents. This chapter also describes responsibility centers, or organizational units intended to achieve specific tasks.

Mulva, S., & Dai, J. (2009) Health care facility benchmarking. HERD, 3(1), 28–37.
Reprinted by permission of Sage Publications via the Copyright Clearance Center.

This article describes a national health care facility’s benchmarking program. It is designed to compare measures of capital project performance.

Agency for Healthcare Research and Quality. (2013). Measuring and benchmarking clinical performance. Retrieved from www.ahrq.gov

Ettorchi-Tardy, A., Levif, M., & Michel, P. (2012). Benchmarking: A Method for Continuous Quality Improvement in Health. Healthcare Policy, e101-e119. Retrieved fromhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3359088/