Management action plan (MAP) is a series of steps that are required for achieving a specific goal with certain resources within a definite time period. This paper would focus on an action plan for an identified opportunity for improvement (OFI) in a hypothetical hospital, named XYZ hospital, and the course of action for this purpose would be developed. Along with that, list of possible actions would be stated so that measurable goals could be set after which, accountability, measuring and monitoring would be formulated. Identification of the Problem or Opportunity for Improvement (OFI)

Every business tries to hire the most qualified and experienced employees for the best performance of their organization; same stands true for hospitals. The highly skilled staff, in the form of doctors and nurses, is required for provision of better services to the patients in a high performing hospital (Lowe, 2012, p. 29). The investment in employee recruitment and training should be considered as a valuable asset so that knowledge management of the hospital or any organization becomes problem-free. Nurse turnover causes troubles and proves to be a major hindrance in providing a healthy treatment to the patients. Increase in nurse retention requires high job satisfaction (Pietersen, 2005, p. 19) and for that, hospitals need a stable and trained nurse staff for effective patient care. It has been reported that financial costs of losing a nurse is equivalent to the salary of a single nurse (Hunt, 2009, p.3). Moreover, a hospital loses about $300,000 per year if the annual nurse turnover increases (Hunt, 2009, p. 3). It causes problems like decrease in quality of healthcare services provided to the patients, lengthy stays within the hospital due to nurse staff shortages, and greater chances of hospital acquired illnesses that do not meet standards of medical qualifications. Additionally, if such conditions prevail, the hospitals are likely to lose patients as they would not be satisfied with the service quality due to lack of staff. This is a significant concern for the hospitals as losing nursing staff would cost them not only in financial terms, but also in terms of their reputation. It also affects other factors as well, such as shortage of nursing staff puts greater work pressures on the remaining nurses, which causes work overload for them, and that can lead to more nurse turnovers (Jacky, 2011). Hiring new nurses and training them demands increased incurring of costs, which would lead to extra financial costs to the hospitals (Jones & Gates, 2007).

Hence, this identifies an opportunity for improvement (OFI) for the hospitals where nurse retention rates should be increased and nurse turnovers must be decreased for better provision of healthcare services to the patients, along with a secure position in the healthcare industry. For an effective implementation of a management action plan (MAP), it is crucial to know what causes this problem and for that, it is imperative to understand the causes of nurse turnovers. Several factors are included in these causes such as work overload, lack of clarity for their job tasks, not gaining respect as they expected when they first joined the organization, critical issues affecting work and poor communication for their resolution by the management, pay inequalities, absence of trust and coordination between the coworkers, difficult work schedule or work being too demanding physically (Hunt, 2009, p. 5; Asegid, Belachew, & Yimam, 2014, p. 4). It is obvious that nurse retention rates could be improved if they are satisfied with their job; according to Locke and Hanne, job satisfaction are certain aspects of one's job that interests a person and motivate him to work with motives (Bhatnagar & Srivastava, 2012). Besides, there are five facets to job satisfaction: salary, advancement opportunities, the work itself, efficacy of supervisions, and interrelations with co-workers (Bhatnagar & Srivastava, 2012).

In the next sections of the paper, certain goals would be determined based on these causes so that possible actions could be determined for an effective implementation of MAP in XYZ Hospital. The steps for attaining those goals would be mentioned and priorities would be set for better comprehension of the responsibilities and completion date could be set.

Clarification of Measurable Goals

The primary objective is to reduce nurse turnover rate in the hospitals and for that it is necessary to increase their job satisfaction rates. The overall success of the organization depends upon retaining the 'knowledge capital' within the hospital. Few measurable goals would help in addressing the issue in appropriate manner, and the goals are:

Maintaining a suitable nurse-to-patient ratio so that each nurse is not overloaded with a number of patients...

The realistic constraints that might occur as we begin to create the plan include reluctance of the top management or coworkers to contribute in the implementation of the plan. Other than that, limitations can be time and money related since it is clearly not known how much time would be required for MAP execution and whether enough resources are available for the plan. Often the true costs are either overestimated or underestimated and it is difficult to know how much costs would be incurred in the plan. There might be some factors that might have been overlooked and might appear when the plan is in execution, such as unexpected price increases like that in the market of nurses' salaries. In addition to that, the management also needs to time to see what additional activities the nurses are performing or are not performing so that allocation of resources is done effectively and the use of resources is made in MAP implementation.
List of Possible Actions

Before identifying a list of actions to achieve the measurable goals mentioned above, the possible root causes of the OFI need to be determined. Several reasons have been stated before that lead to increased nurse turnover; however, there are other factors as well, such as no upward mobility, nursing being a second career choice, demanding work environment, poor practicing hospital environment, and a stereotyped image of nurses (Flinkman, Isopahkala-Bouret, & Salantera, 2013). Presented here within is the list of actions that are generated as certain ideas and options for mitigating the identified problem for OFI. After much brainstorming, the ideas are mentioned as follows:

i. Making jobs more attractive to nurses would help to attract an increased number of new nurses and also retain the existing ones. This can be done by increasing compensation and benefits, supporting flexible work timings, providing career development opportunities and improving organization's employment policies.

ii. Screening and short listing nurses that are 'fit for the job'. It is imperative to know which nurses would fit what kind of job duties since it would be detrimental for both the hospital services and the nurses themselves if they do not fit the job responsibilities. This can be done by carrying out structured assessments tools for the evaluation of job fitness, and presenting realistic job previews before they are hired.

iii. After the nurses are hired, they should be guided to communicate clearly to the appropriate departments and authorities within the hospital premises.

iv. Management of nurses is vital and this can be done by providing them opportunities to give their inputs and perform with their full potential. They should then be rewarded and should constantly be assisted with their career development. In addition to that, nurses should be given little autonomy for scheduling their work routines so that they could manage between work and homes.

v. Building team work and providing support from the coworkers would help them gain confidence and feel comfortable in the work environment.

vi. Taking notice whenever they are under stress and addressing their underperformance issue due to this very reason would be beneficial for the hospital. There should be 'staff counselors' that would be solely appointed for helping the hospital staff members, especially nurses, whenever they are under strain so that their tensions do not meddle with their hospital responsibilities and do not affect the health care service quality for the patients.

Analyzing and Prioritizing Key Action Steps

It is indispensable to review the above-mentioned list of actions so that certain steps should be prioritized. The list is stated here again and the important ones are bolded.

i. Making jobs more attractive to nurses would help to attract an increased number of new nurses and also retain the existing ones. This can be done by increasing compensation and benefits, supporting flexible work timings, providing career development opportunities and improving organization's employment policies.

ii. Screening and short listing nurses that are 'fit for the job'. It is imperative to know which nurses would fit what kind of job duties since it would be…