Budget planning fundamentals and practices

Nursing Budget Planning

Cost-Effectiveness of Continuing Education

Understanding the limits of annual budgets is a difficult position to take within the context of an emergency room. Governing costs can get in the way of continual staff renewal. Yet, by keeping staff up-to-date on innovative technologies and medical concepts can actually help create a more cost-effective ER unit.

Reviewing the budget planning process must include a learning needs assessment approach. This is defined by research as "any systematic approach to collecting and analyzing information about the educational needs of individuals or organizations," (UAMS 2010, p 1). Thus, the approach aims to explore potential downfalls that are creating individualized needs within the department itself. Research states that "Need assessment can also be identified as a gap, the difference or distance between what is occurring in practice and what is expected (the desired outcome), or, the difference between what is and what should be," (UAMS 2010, p 1). It is an important part of any medical practice, because it keeps staff competent and ready even during changing technological times. Such strategies keep staff trained and well-versed in the latest technology being implemented and treatments coming out (UAMS 2010). This importance is then heightened within the context of an ER Unit, where every detail counts in the race to act fast and actually save lives.

The ER patient population is a varied, yet vulnerable one. There is a wide range of population -- stemming from different socio-economic and cultural backgrounds. Most of these individuals are in desperate need of emergency care, and so prove a highly vulnerable patient population. Additionally, there is a large low-income population (Thompson & Glick 1999). Thus, there are many patients who are unable to get their needed health care any where else.

Within this context, the ER's budget is extended beyond reasonable limits. Thus, in order to find where best it can be more cost-effective, a needs assessment model will need to collect data for analysis. Through thorough needs analysis research that will help collect data from a variety of sources to compile measurable needs within the unit. Thus may include bringing in third party consultants as well as getting "medical staff input," (UAMS 2010, p 2). Reviewing admissions and diagnosis data, including incident notes, and administering a patient satisfaction survey are all good and cost-effect methods for analysis. External data can also be sought out as a way to help pick out common trends. Yet, this step includes individualizing national data to help construct a better image of the unit needs; "Of greatest importance is your effort to individualize the data to your membership, audience and situation" (UAMS 2010, p 4). Additionally, tests determining staff competence, both diagnostic tests as well as self-assessment exercises, can help assess continuing staff education needs.

Cost-benefit analysis for staff development shows that continuing education is effective in lowering later long-term costs of operation. According to external research, "A medical terminology course is a good investment for staff without clinical backgrounds," (UAMS 2010, p 1). Keeping staff medically informed so that they can best deal with the variety of cases seen within the context of an ER unit. Within the vulnerable population inside the ER are individuals who inappropriate use its services. Research states that "patients who inappropriately overuse the ER has become a national health care priority as ER costs per-visit are generally three times higher than a comparable care in an outpatient clinic," (Thompson & Glick 1999, p 1). Studies have shown these individuals to include the mentally ill and "socially vulnerable" population, including the poor, who otherwise have no access to typical health care services without insurance (Thompson & Glick 1999, p 2). Yet, in the modern context, care can be provided in other care locations. A well trained and experienced staff can help filter out those individuals who can provide referrals to more appropriate health settings. With all the new health reforms that will be taking effect in the near future, it is important to keep staff updated on their knowledge of them. The 25 RNs, 20 LPNS, and 25 UAPS on staff can all help filter patients to better resources and save valuable time with physicians. The recent reform bill expands healthcare coverage to many of those inappropriately using the ER now -- therefore this population can be eliminated, but only if staff can help inform such individuals regarding their rights and where they can find more appropriate care.