The budget for capitol expenditures is usually part of a comprehensive financial budget controlled by upper level executives. One reason for a capital expenditure proposal may include purchase of new equipment to improve productivity. (Baker, Baker, & Dworkin, 2018).
Importance of Understanding Capitol Budgeting
A nurse manager’s understanding of the principles of capital budgeting is critical in making decisions that affect the effective functioning of the department. The manager must become proficient in reading and understanding organizational budget reports (analyze financial statements), and be able to prepare a basic unit budget and analyze costs in light of the more comprehensive financial expenditure budget of the organization. This is necessary because “department funding requests represent the first step” (Baker & Baker & Dworkin, 2018) in decision making regarding capital expenditure funding. The manager will most likely have to compete with other departments for capital investment funding, and thus must be able to produce convincing and substantial statistics regarding proposal for funds and investments to improve the nurse practice environment. (Baker & Baker & Dworkin, 2018; Danna, 2014)
Demonstrating the Need for New Technology
Being able to invest in technology that will enhance the efficiency and patient satisfaction is a worthwhile investment a manager can make for a department or unit. An electronic patient tracking system is a technology that is needed in the Endoscopy/ GI Lab of the Atlanta Veterans Medical Center to assist in real-time visibility of patients. In consultation with management, the reason why this technology is needed will be clearly stated. Evidence will be presented as to the necessity of this technology in enhancing operational flow, and increasing productivity, as well as increasing patient satisfaction. The cost of acquiring capital expenditure and the expected useful life of this technology will be weighed against the cost of decreased efficiency, and the cost of decreased market share in a competitive environment due to decreased patient satisfaction and subsequent decreased patient volume. In emphasizing the advantages of the electronic patient tracking system, leaders may be invited to conduct a direct visualization of daily work flow of the Lab.
Demonstrating the Benefits of New technology
A patient tracking board is an important and useful innovation to assist in real-time visibility as patients move through the various phases of the busy outpatient Endoscopy Lab. It will enable nurses, physicians and families to follow patients as they move through the different phases of the procedure. In compliance with HIPPA regulations for patient privacy, each patient is given a unique numeric ID so that family members can check the status of their loved ones without disclosing their names and procedures to others in the waiting areas. Presently there is no effective way of tracking patients as information is recorded on a whiteboard, inside the unit and updated by an ancillary staff member who has other assigned pre and post- procedural patient care duties. Families are constantly enquiring about the status of loved ones because they have no way of tracking the patient’s progress. They often voice dissatisfaction with information provided as staff involved in direct patient care are not always able to notify families of procedural delays, or end time. Waiting for family members during surgical or diagnostic procedures, unexpected delays, lack of communication, can produce feeling of fear and anxiety. Institute for Healthcare Communication (2019), Joint Commission (2014) and the Healthy People Initiative (2013) all view communication as paramount in enhancing patient- and family-centered care. An electronic patient tracking system can alleviate anxiety of family members by providing them with timely and consistent communication, making for a better patient/ family focused experience. Improving communication with family members may reduce patient anxiety and provide for a better patient/ family focused experience. (Miller, 2015; Campbell, 2012). Plans to increase volume to 60 procedures daily are presently underway; although the tracking board is supplemental to the information delivered by procedural staff to a family (does not take the place of interpersonal interaction), it is a way of bring technology to patients and families. The technology can be utilized in conducting time and motion analysis of patient flow through the endoscopy unit to detect areas of inefficiencies which can lead to targeted quality improvement initiatives.
As stated by Zelman, McCue, & Glick (2009), a hospital inability to update and maintain its facilities can impact its ability to attract and retain physicians and patients, causing reduction in patient volume resulting in financial distress. Any effective internal strategy for improving a department or health care facility must include measures to improve operational flow and throughput to meet the demands of increasing volume. In today’s customer-centric health care environment, it is imperative to implement information technology products and systems to improve patient safety, remain competitive and to survive financially. An electronic patient tracking system can increase throughput and revenues through improved operational efficiencies and work flow processes (Dietrich, 2010).
Baker, J. J., Baker, R.W., & Dworkin, N.R. (2018). Health Care Finance: Basic Tool for Non-Financial Manages. (5th ed.). Burlington, MA: Jones and Bartlett Learning.
Campbell, K. R. (2012). How families cope with the surgical waiting room. Retrieved from http://www.kevinmd.com/blog/2012/06/families-cope-surgical-waiting room.html
Danna, D. (2014). Essential Business Skills for Nurse Managers. Retrieved from: http://www.strategiesfornursemanagers.com/content-…
Dietrich, D (2010). Electronic Patient Tracking Systems: A Healthy IT Investment for Emergency Departments. Retrieved from: https://www.medscape.com/viewarticle/717534
Healthy People. (2013). Health communication and health information technology. Retrieved from: http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=18
Institute for Healthcare Communication (2019). Impact of communication in healthcare. Retrieved from: https://healthcarecomm.org/about-us/impact-of-comm…
Joint Commission. (2014). Advancing effective communication, cultural competence, and patient-and family-centered care. Retrieved from: https://www.jointcommission.org/assets/1/6/ARoadma…
Miller, J. (2015). Patient Tracking Systems: Reducing the Cost of Healthcare and Waiting Room Anxiety. Retrieved from: http://blog.avidex.com/patient-tracking-systems-reducing-the-cost-of-healthcare-and-waiting-room-anxiety/
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.
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