Implement a case summary for Memorial Hospital Case

PART 2 MANAGING CUSTOMER DEMAND 420 Patient Census Patients per Nurse TABLE 10.3 WARD CAPACITY DATA 10 Number of Beds 2 15 Ward 20 4 Intensive Care 10 25 4 Cardiac 30 22 4 Maternity 40 + Pediatric 5 8 (T-F daily equivalent) 5 Surgery 15 3 5 (daily equivalent)+ Post - Op 10 8 98 Emergency 120 General * Yearly average per day the hospital employs 20 surgical nurses. Routine surgery is scheduled on Tuesdays and Fridays; five surgeries can be scheduled per day per operating room (bed) on these days. Emergency Sultans is scheduled as needed. * Daily equivalents are used to schedule nurses because patients flow through these wards in relatively short periods of time. A daily equivalent of 5 indicates that throughout a typical day, an average of five patients are treated in the ward. TABLE 10.4 AVERAGE DAILY PATIENT CENSUS PER MONTH In MONTH a li J A S 0 N D staff C M A M F em Ward 9 10 12 7 14 7 use Intensive Care 13 10 13 15 18 14 20 13 12 12 13 mc Cardiac 18 16 15 ma 8 13 13 14 10 8 res Maternity 8 12 13 10 24 25 21 22 20 18 20 21 19 Pediatric 22 23 24 16 22 21 18 20 22 Surgery 20 8 17 16 8 7 17 10 10 7 8 9 10 Post-Op 10 EmergencyT 6 4 7 8 5 5 4 3 4 6 Genera 110 108 100 98 95 90 38 92 102 07 94 demand, temporary part-time nurses may be hired for a limited period of time. cost to the hospital for hiring a new full-time nurse is $400 and for laying off Temporary nurses are paid $15.00 per hour. Memorial Hospital's policy limits or firing a nurse is $150. Although layoffs are an option, Fry is aware of the the proportion of temporary nurses to 15 percent of the total nursing staff. hospital's objective of maintaining a level workforce. Finding, hiring, and retaining qualified nurses is an ongoing problem for After looking over the information that she collected, Darlene Fry wants hospitals. One reason is that various forms of private practice lure many nurses away from hospitals with higher pay and greater flexibility. This situation has to consider staffing changes in all areas except the surgery ward, which is already correctly staffed. caused Memorial to guarantee its full-time staff nurses pay for a minimum of 30 hours per week, regardless of the demand placed on nursing services. In addition, each nurse receives 4 weeks of paid vacation each year. However, QUESTIONS vacation scheduling may be somewhat restricted by the projected demand for nurses during particular times of the year. 1. Explain the alternatives available to Darlene Fry as she develops a nurse- At present, the hospital employs 130 nurses, including 20 surgical staffing plan for Memorial Hospital. How does each alternative plan meet nurses. The other 110 nurses are assigned to the remaining seven major the objective stated by the CEO? areas of the hospital. The personnel department informed Fry that the average 2. Based on the data presented, develop a nurse-staffing plan for Memorial Hospital. Explain your rationale for this plan. Source: This case was prepared by Dr. Brooke Saladin, Wake Forest University, North Carolina, as a basis for classroom discussion. Copyright @ Brooke Saladin. Reprinted with permissionl. *Average surgeries per day on Tuesday and Thursday. Daily equivalentsCASE Memorial Hospital Memorial Hospital is a 265-bed regional health care facility located in the mountains of western North Carolina. The mission of the hospital is to provide vary considerably by type of ward and time of year. Table 10.4 provides a quality health care to the people of Ashe County and the six surrounding coun- historical monthly breakdown of the average daily patient census per ward. ties. To accomplish this mission, Memorial Hospital's CEO has outlined three The director of nursing for Memorial Hospital is Darlene Fry. Each fall objectives: (1) maximize customer service to increase customer satisfaction, she confronts one of the most challenging aspects of her job: planning the (2) minimize costs to remain competitive, and (3) minimize fluctuations in work- nurse-staffing levels for the next calendar year. Although the average demand for nurses has remained relatively stable over the past couple of years, the force levels to help stabilize area employment. staffing plan usually changes because of changing work policies, changing The hospital's operations are segmented into eight major wards for the pay structures, and temporary nurse availability and cost. With fall quickly purposes of planning and scheduling the nursing staff. These wards are listed approaching, Fry is collecting information to plan next year's staffing levels. in Table 10.3, along with the number of beds, targeted patient-to-nurse ratios, The nurses at Memorial Hospital work a regular schedule of four 10-hour and average patient census for each ward. The overall demand for hospital days per week. The average regular-time pay across all nursing grades is services remained relatively constant over the past few years even though the $12.00 per hour. Overtime may be scheduled when necessary. However, population of the seven counties served increased. This stable demand can because of the intensity of the demands placed on nurses, only a limited amount of overtime is permitted per week. Nurses may be scheduled for as be attributed to increased competition from other hospitals in the area and the many as 12 hours per day, for a maximum of 5 days per week. Overtim rise in alternative health care delivery systems, such as health maintenance is compensated at a rate of $18.00 per hour. In periods of extremely hig organizations (HMOs). However, demand for Memorial Hospital's services does