Assignment: Hospital Transformation Through Zero Based Budgeting Paper

Assignment: Hospital Transformation Through Zero Based Budgeting Paper ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Assignment: Hospital Transformation Through Zero Based Budgeting Paper I’m trying to study for my Writing course and I need some help to understand this question. Assignment: Hospital Transformation Through Zero Based Budgeting Paper Read the Hospital transformation through zero based budgeting PowerPoint presentation zero_based_budgeting.docx zero_based_budgeting.pdf Zero-Based Budgeting Read the Hospital transformation through zero based budgeting PowerPoint presentation. The Board of Directors of Windsor Memorial Hospital has hired you to be their zero-based budget consultant. Specify how Windsor Memorial Hospital can implement a zero-based budget and provide your recommendations to the Board of Directors of the Hospital. Explain the benefits of implementing your recommendations and justify why you are making these specific recommendations. Your paper must include an introduction, thesis, and conclusion. Your paper must be four to five double-spaced pages in length (excluding title and reference pages) and formatted according to APA style as outlined in the Ashford Writing Center. Utilize three scholarly and/or peer-reviewed sources (excluding the course text) that were published within the last five years. Cite your sources within the text of your paper and provide complete references for each source used on the reference page. Hospital Transformation through Z Zero Based B d Budgeting B d ti Windsor Regional Hospital g p Orientation Session Medical Programs/Departments June 18 & 19, 2008 Agenda „ Project Background & Objectives „ Organizational Transformation Through ZBB „ Improving Performance of the Organization „ Medical Programs/Departments Workshops/Workbooks „ Project Organization „ Project Schedule „ Questions © 2008 Hay Group. All Rights Reserved 2 Background „ „ „ „ „ Unprecedented U d t d growth th iin programs, services, i patient ti t volume, l staffing t ffi and d facilities; now $270 million in revenues and activity Growth has resulted in operating losses and a working capital deficit of approximately i l $55 million illi WRH has worked hard to significantly reduce operating costs: ? From 26% higher than expected cost per weighted case five years ago ? To only 10% above expected cost per weighted case currently ? But, this is still a problem for negotiations with LHIN and MOHLTC WRH must continue to transform operations p to achieve efficiencyy breakthroughs that will provide additional cost reductions Zero Based Budgeting (ZBB) provides a tool to rethink approaches to service delivery to reduce costs © 2008 Hay Group. All Rights Reserved 3 Zero Based Budgeting „ „ Historically, hospital budgets have been set based on adjustments to the Historically budget for the prior year After several years, budgets don’t necessarily reflect what is currently needed if they are based on: ? ? ? „ Year over year adjustments: ? ? „ Past operating characteristics Past technologies Past inter inter-departmental departmental interactions/interdependencies May not reflect changes in processes, practices and need May be based more on relative success in negotiations during budget processes rather than on relative need Building a budget from zero, rather than adjusting last year’s budget: ? ? Allows it to reflect current requirements and conditions, conditions not historical anomalies Provides an opportunity/stimulus to incorporate more current and best practices © 2008 Hay Group. All Rights Reserved 4 Objectives for Transformation Through ZBB 1 Re-think methods of providing care 1. 2. Create more efficient processes; restructure inefficient processes 3. Eliminate unnecessaryy activityy 4. Balance workloads; better balance workload with staffing 5. Improve quality of worklife for employees 6. Reduce costs without compromising effectiveness of delivering those services. 7 A 7. At a minimum, result l in hospital h l operating at ‘Expected ‘E dC Costs per Weighted Case’ © 2008 Hay Group. All Rights Reserved 5 Organizational Transformation through ZBB Organizational Transformation Focus of approach to transformation is to deliver four key results: „ Accelerate realization of vision ? Outstanding Care, No Exceptions! „ Improve quality of care and customer services „ Improve quality of worklife „ Reduce service costs © 2008 Hay Group. All Rights Reserved 7 Key Assumptions For Budgeting „ „ Patient P ti t volume l ((measured d iin episodes i d off care)) will ill be b maintained: i t i d ? No decreases in necessary care ? No increases in elective activity Patient days will be the same or be reduced: ? More outpatient care in place of inpatient care ? Shorter lengths of stay „ Patient mix will be the same „ Range of medical services will be the same „ W k content Work t t per episode i d off care will ill be b the th same or reduced d d „Assignment: Hospital Transformation Through Zero Based Budgeting Paper Departmental workload will be the same or reduced „ No reductions in salary or wage rates for staff © 2008 Hay Group. All Rights Reserved 8 Improving the Performance of the Organization Zero Based Budgeting „ „ „ „ ZBB ffocuses on bbuilding ildi bbudgets d t ffrom “b “bottom tt up”” rather th th than “t “top down” d ” ZBB involves completely rethinking services and requirements rather than using incremental changes from prior years ZBB at WRH will involve rethinking and designing anew the approaches to providing and supporting care so as to: ? Minimize unnecessary activity ? Balance workload and staffing ? Maximize efficiency ? Maintain or improve quality ? Minimize costs New budgets for new approaches to providing and supporting care © 2008 Hay Group. All Rights Reserved 10 Process for ZBB ZBB workshops will be held in 2 streams: „ Medical Programs/Departments „ Hospital Functional Centres © 2008 Hay Group. All Rights Reserved 11 ZBB for Medical Programs/Departments „ „ „ „ Workk with W ith medical di l and d administrative d i i t ti lleadership d hi off medical di l programs/departments to define anew the hospital’s approach to providing an episode of patient care I i i l session Initial i to provide id an orientation i i to ZBB at WRH A series of 5 workshops with leadership of all medical programs/departments: 1. Identifying best practices 2. Service delivery models, content of care 3. Workflow, delays, discharge planning 4. Materials content of care and sourcing 5. Review Followingg each workshop, p, representatives p of each pprogram/department g p will complete a workbook related to workshop content © 2008 Hay Group. All Rights Reserved 12 Medical Programs/Departments Participating in ZBB Workshops „ „ „ „ „ „ „ Emergency Medicine Family Medicine Medicine CCU ICU Surgery Anaesthesia „ „ „ „ „ „ „ Oncology Ob & Gyn Paediatrics NICU Psychiatry Rehabilitation Continuing Care Other Heads of Service / Medical Directors will support Programs/Departments in completing workbooks and/or will support Functional Centres in budget development. © 2008 Hay Group. All Rights Reserved 13 ZBB for Functional Centres „ „ „ „ Work with hospital departments to rethink approaches to service delivery, delivery service interdependencies, staffing and costs Start with initial session to provide an orientation to ZBB at WRH A series of 7 workshops for 5 groupings of managers: 1. Identifying best practices 2. Considering services offered 3. Considering service delivery models 4. Considering derivation of departmental workload 5. Considering benefit hours, sick time, etc. 6. Considering materials content and sourcing 7. Defining actions to implement zero based budgets Followingg each workshop, p, Department p Managers g will complete p a workbook related to workshop content © 2008 Hay Group. All Rights Reserved 14 Groupings of Functional Centres ƒ Patient Care Services ƒ Therapeutic Services ƒ Diagnostic Services ƒ Support Services ƒ Administrative Services © 2008 Hay Group. All Rights Reserved 15 Medical Programs/Departments g p Workshops/Workbooks ZBB Workshops/Workbooks for Medical Programs/Departments „ ZBB will consider all elements of the hospital’s p care processes, p , including: g ? ? ? ? ? ? ? ? ? ? ? ? „ Admission decisions Most responsible physician models Service delivery models Process of care Content of care Materials content of care and sourcing W k flow Work fl Delays in care Discharge planning Discharge Post discharge care ALC days New/changed patient care processes will provide new ZBB estimates of workload for hospital Functional Centres © 2008 Hay Group. All Rights Reserved 17 ZBB for Patient Care Programs/Medical Departments „ „ „ „ „ A series of 5 workshops p with leadership p of all medical pprograms/departments: g p 1. Identifying best practices; 2. Service delivery models, content of care 3. Workflow, delays, discharge planning 4. Materials content of care and sourcing 5. Review Workshops will be led by Hay Group consultantsAssignment: Hospital Transformation Through Zero Based Budgeting Paper Dr. Isser Dubinsky and Adam Topp Following each workshop, representatives of each program/department will complete a workbook related to workshop content Program/department leadership will be supported by hospital administrative staff Initial data to support process developed by Hay Group using: ? Discharge Abstract Data/NACRS Data ? Management Information System Data ? Extant literature © 2008 Hay Group. All Rights Reserved 18 Workshop/Workbook 1: Identifying Best Practices In the first workshop/workbook you will be asked to: „ Identify the characteristics of high performing medical programs/departments that might be emulated by WRH To assist in this process we will provide you with: „ „ „ Data comparing the performance of WRH medical programs and departments with high performing hospitals across Canada Advice on how to contact and query high performing medical programs and departments to identify best practices that have contributed to their exemplary levels of performance. Advice on how to identify examples of best practices from the medical and administrative literature that can contribute to improved quality and p care efficiencyy of patient © 2008 Hay Group. All Rights Reserved 19 Workshop/Workbook 2: Considering Service Delivery Models & Content of Care I this In thi workshop/workbook k h / kb k you will ill be b asked k d to: t „ „ Identify best practices in service delivery that reduce resources used in an episode of patient care Determine if care delivery models are optimally using outpatient care as an alternative to admission (e.g., considering more use of outpatient surgery, more use of day hospital care, use of clinical observation/decision units rather than admission for ED patients, rapid follow up clinics/diagnostics for ED patients rather than admission, etc.) Continued on next page © 2008 Hay Group. All Rights Reserved 20 Workshop/Workbook 2: Service Delivery Models & Content of Care – Continued „ „ Determine if the content of an episode of care at WRH is optimal: ? What services are required for all patients? ? What services are required only for selected patients? ? Are there services being provided to patients that might be reduced or eliminated? For example, p WRH might g consider: ? Less use of psychology ? More selective use of clinical dietetics, OT, Clinical Nurse Specialists, diagnostic services, etc. ? More selective (and more intensive) use of discharge planning ? More use of more discriminating standard care plans © 2008 Hay Group. All Rights Reserved 21 Workshop/Workbook 3: Work Flow; Delays in Care & Discharge Planning In this workshop/workbook p y you will be asked to: „ „ Identify best practices in work flow to reduce delays in care & reduce ALOS For example, WRH might consider: ? Standard St d d order d sets/medical t / di l di directives ti so th thatt care iis nott d dependent d t on th the attendance of the physician ? Independent case finding by allied health professionals ? Availability A il bilit off (selected) ( l t d) di diagnostic ti services i 24/7 ? Priority (morning) access to diagnostic services by inpatients ? Rapid turnaround of test results for inpatients/ED patients ? Assignment: Hospital Transformation Through Zero Based Budgeting Paper More M active i care management off patients i by b physicians h i i ? More immediate assignment of MRP ? Weekend and holiday discharges ? Follow up clinics for “unattached” patients Continued on next page © 2008 Hay Group. All Rights Reserved 22 Workshop/Workbook 3: Work Flow; Delays & Discharge Planning – Continued „ „ Identify Id tif approaches h tto reducing d i d delays l iin di discharge h after ft completion l ti off an episode of acute care For example, WRH might consider: ? Writing discharge orders that would expedite discharge ? Organizing care for ALC patients that would expedite discharge ? Utilizing a wider variety of post acute care destinations, etc. © 2008 Hay Group. All Rights Reserved 23 Workshop/Workbook 4: Considering Materials Content of Care & Sourcing In this workshop/workbook you will be asked to: „ Consider the medical surgical equipment, devices, drugs and supplies that are being used at the hospital: ? What Wh t is i really ll required i d ffor patients? ti t ? ? Are there opportunities to be more selective in the use of supplies, drugs, special diets, devices, etc.? ? Are there opportunities to use lower cost medications? ? Are there opportunities for standardization? ? Are there ways to reduce unit costs by consolidating ordering? © 2008 Hay Group. All Rights Reserved 24 Workshop 5: Review Session Hay Group Consultants will summarize: „ Actions identified and required to implement the new care processes „ Impact p of new pprocesses on ppatient days y and functional centre workloads You will be asked to: „ Confirm initiatives and potential impact © 2008 Hay Group. All Rights Reserved 25 Project Organization HayGroup Project Team Project Director: Mark Hundert Project Manager: Irene Petersen Gray Medical Departments „ „ Dr. Isser Dubinsky Dr Adam Topp Functional Centres: „ Patient Care Services – Irene Petersen Gray, Adam Topp „ Therapeutic Services – Kelly Jennings „ Diagnostic Services – Adam Topp „ Support Services – Robert Kimsto „ Administration – Robert Kimsto © 2008 Hay Group. All Rights Reserved Communication „ Alyssa Montmarquette Workshop/ Workbook Design g „ Paula Kerr 27 Project Schedule Project Schedule Week Ending Ongoing 25-Sep 19-Sep 12-Sep 05-Sep 29-Aug 22-Aug 15-Aug 08-Aug 01-Aug 25-Jul 18-Jul 11-Jul 04-Jul 27-Jun 20-Jun 13-Jun 06-Jun 30-May 23-May Activity 1.0 Project Organization & Planning 2.0 Project Communication 2.1 Initiating Process 2.2 Communications Planning 2.3 Communications Delivery 3.0 Medical Dept. Zero Based Budgeting 3 1 Orientation Session 3.1 4.1 Orientation 4.2 ZBB Workshops Break Week 3.3 Derive Departmental Workloads 4.0 Dept / Functional Centre ZBB Break Week 3.2 ZBB Workshops 4.3 Inter-workshop activities 4.4 Refinement of ZBB 5.0 WRH Zero Based Budgets 5.1Consolidate ZBBs 5.2 Summarize recommendation 5 3 Review & approval 5.3 5.0 Implementation © 2008 Hay Group. All Rights Reserved 29 Medical Programs/Departments Workshop Dates & Times „ Workshop 1: Wed June 25 Wed., 0700 0900 0700-0900 „ Workshop 2: Thurs., July 10 0700-0900 „ Workshop 3: Tues., July 15 0700-0900 „ Workshop 4: Thurs., July 24 0700-0900 „ Review Workshop: Thurs., July 31 0700-0900 © 2008 Hay Group. All Rights Reserved 30 Q esti ns Questions …Assignment: Hospital Transformation Through Zero Based Budgeting Paper Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10

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