Nursing Staff Integration Into In-House Hospice Programs
This two-part report presents an organizational change plan for integrating existing nursing staff into an in-house hospice program within a healthcare facility. Part one introduces the proposed change, describes the hospice care landscape in the United States, and outlines how mandatory overtime will be used to train nursing professionals in hospice philosophy and holistic patient-centered care. Part two examines the financial and market rationale for the change, including Medicare and Medicaid reimbursement structures, and details implementation and monitoring strategies. Key metrics such as shift workload, absenteeism, training outcomes, and staff morale are identified as essential indicators for evaluating the program's success.
- Introduction and Organizational Context: Overview of hospice integration plan and stakeholders
- Description of the Proposed Change: History and rationale for in-house hospice training
- Compatibility With Organizational Culture: How change fits existing mission and staff structure
- Rationale for the Proposed Change: Why hospice services belong in this facility
- Financial Support and Market Analysis: Medicare, Medicaid, and reimbursement justification
- Implementation and Monitoring Strategy: Training phases, monitoring metrics, and staff roles
- Conclusion: Summary of change goals and overtime approach
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What makes this paper effective
- The paper is organized as a two-part report, each with a clear introduction and conclusion, giving it a professional, structured feel appropriate for a healthcare administration context.
- It grounds the proposed change in real-world healthcare trends — the aging population, Medicare reimbursement data, and national nursing shortages — making the argument practical and evidence-supported.
- The monitoring plan is specific and actionable, listing measurable indicators (absenteeism, errors, training outcomes, morale) rather than relying on vague managerial language.
Key academic technique demonstrated
The paper demonstrates applied change management analysis by linking organizational theory (Derby's modeling of organizational change) to a concrete healthcare scenario. It uses cited evidence to support each stage of the argument — from the historical development of hospice care to financial justification — showing how academic sources can be integrated into a practical policy proposal.
Structure breakdown
Part one covers the organizational background, the nature of the proposed change, its compatibility with existing culture, and the rationale for selecting it. Part two shifts to financial and market justification, followed by a detailed implementation and monitoring framework including assigned staff roles. Both parts conclude with summaries that reinforce the core argument. The report moves logically from problem identification through solution design to evaluation planning.
Introduction and Organizational Context
This two-part report aims to create a plan for an organizational change involving mandatory overtime for nursing professionals in both hospital and long-term care settings. The proposal is to incorporate the nursing staff into an in-house facility hospice program. This combining of responsibilities is an idea that will gain considerable momentum on a national basis in the near future, because the comprehensive project not only helps to improve the final days for fatally ill patients, families, and friends, but also provides a social service to the immediate community. It will raise the level of respect and confidence in the facility, create a new source of revenue, and may even open potential academic and educational offerings for other facilities looking to follow suit. The program will require some mandatory overtime for nursing staff in order to train, provide service, and support patients, family members, and friends.
It is important to note that this change will affect all key stakeholders, including the facility, administration, patients, families and friends, the broader community, and, of course, the nursing team.
The United States healthcare system has been growing rapidly. It encompasses far more than nursing staff — it includes health plans, physicians, hospitals, clinics, consumers, public health programs, and hospice organizations. As one source notes: "Governmental initiatives and not-for-profit foundation funding bolstered the spread of hospices here. In 1978, the National Cancer Institute awarded grants to three hospices as demonstration projects to investigate the costs associated with care and to describe the actual manner in which care was provided to patients. Shortly thereafter, the Health Care Financing Administration (HCFA) was charged by Congress and the Carter Administration to initiate a research and demonstration study to examine the costs, benefits, and feasibility of having Medicare pay for hospice care. Existing hospice programs were invited to apply" (Hospice Benefits and Utilization in the Large Employer Market).
The aging of America's population has been widely documented. The current median age is rising, and more Americans will require hospice services. This facility currently provides these services through external hospice organizations, which are often severely short-staffed. Hospice programs do not aim to cure fatal diseases; rather, their goals center on providing help with the pressures related to caring for terminally ill patients, usually in the final stages of life. Hospice programs also assist patients with confirmed life-threatening illnesses, with the goal of providing an acceptable quality of life — keeping patients as comfortable and pain-free as possible. As Rubenfeld and Scheffer (1995, p. 100) observe, "Nurses need to identify patients' strengths so they can use those strengths to help overcome the problems."
Description of the Proposed Change
Since the late 1970s, hospice services were traditionally performed in a patient's personal residence. "In 1977, the National Hospice Organization (NHO) was formed in the United States" (Hospice Benefits and Utilization in the Large Employer Market). However, an increasing number of hospice organizations have been called upon to serve healthcare facilities such as free clinics, hospitals, and nursing homes. This trend will only grow as more Americans reach the stage of life where hospice services are required.
Just as there are significant shortages of qualified nursing professionals across all areas of healthcare, hospice programs have had to seek additional assistance from alternative sources. Accordingly, this facility proposes to train existing nursing professionals to administer the nursing care required for both potential and current hospice recipients.
References
Derby, E. (2002). Modeling organizational change. Retrieved February 12, 2005, from
Jackson, B., Gibson, T., & Staeheli, J. (Eds.). (2000, March). Hospice benefits and utilization in the large employer market. U.S. Department of Health and Human Services. Retrieved February 12, 2005, from
Rubenfeld, M. G., & Scheffer, B. K. (1995). Critical thinking in nursing. J. B. Lippincott.
Social Security Administration. (1993). Social security programs in the United States. Social Security Bulletin, 56(4).
National Hospice and Palliative Care Organization. (2004). Strategic blueprint. NHPCO. Retrieved February 12, 2005, from http://www.nhpco.org/templates/1/homepage.cfm
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