Examine the burden of disease in the United States to provide important information on which parameter is to base decisions on public health priorities.

To do this, we will utilize mortality data for the United States. In the first part of this assignment, you will download and examine mortality data for your home state.

Go to USA Causes of Death by Age and Gender

• Choose your home state under the Choose State option (panel on left hand side)
• Select BOTH under the Choose gender option in the middle panel.
• Scroll down to the bottom of the page, and read the fine print to learn for which year the mortality data have been tabulated.
• Copy and paste the relevant mortality data into Excel.
  • Drag your mouse over all of the Cause of Death rows, (50 rows), right click, and select Copy,
  • Open Excel and paste your selection into Excel. You should have a spreadsheet with 50 row and 19 columns (Columns A-S).

For the first part of the assignment, you will prepare a histogram of the leading causes of death (regardless of age) in your state. Follow the steps below in order to prepare your histogram:

• Sort the Data
  • The numbers of deaths, all ages, are given in Column C.
  • Select all the columns.
  • Then, select Data>Sort>Sort by Column C, Values, largest to smallest. (Make sure that my data has headers is not selected.
  • You now have the leading causes of death in your state in Column A (cause) and Column C (frequency).
• If you already know how to draw a histogram in Excel, proceed to do so with Columns A and C, making sure to truncate the data to the 30 leading causes.
• If you do not know how to draw a histogram in Excel, here’s one method:
  • Choose the Chart Wizard, chart type column, chart sub-type clustered column (Step 1).
  • Click Next for Step 2.
  • At Step 2, Click the Series button, which will open a new box.
  • Click Add under Series,
    • Enter Causes of Death in the Name box;
    • Clear the Values box, then
    • Drag your mouse over the 30 largest frequencies for the Values; and,
    • Drag your mouse over the first 30 causes of death (Column A) for the Category (X) axis labels box.
• Click Next, and you’ll be brought to the Chart Options box.
• Add a suitable title (e.g., Leading Causes of Death, 2010, your state)
• Label the Y axis Frequency.
• Click Next, and place the histogram in a new worksheet.

You now have a histogram with the leading causes of death for your state. This presents one picture of the burden of disease in your state, but it isn’t the only picture. We shall now look at a different metric: years of life lost due to each cause.

Module VI concentrates on the following course outcomes—

· Identify the human, fiscal and material resources necessary to efficiently achieve quality health care outcomes.

· Definitions of financial terms often used in healthcare will be identified. Different types of budgets and budget preparation will be reviewed. The role of the nurse manager in the budget process will be discussed in detail, as well as ethical issues associated with budgets in healthcare.

Reading Assignment

Sullivan: Chapters 14, 15, 16

American Nurses Association Policy Statement on Workplace Advocacy:http://nursingworld.org/MainMenuCategories/HealthcareandPolicyIssues/ANAPositionStatements/workplace.aspx (Links to an external site.)

Overview

Budget and Finance

 Financial issues in healthcare often seem remote to the nurse and the nurse must have an understanding of financial matters of the health care delivery system, including the viability of the workplace, and the opportunities to optimize healthcare for the welfare of their patient. Key behaviors needed by nurse managers and those who care for groups of patients is ability to: understand the budgeting process; recognize general types of budgets; distinguish between direct and indirect costs; be familiar with the steps of a typical budgetary process and cost out nursing services. Different types of budgets include: operating budget, performance budget, capital budget, expense budget, zero-based budget, product line budget, cash budget. Operational plans, cost center, expense, revenue and profit are other key concept that will be addressed in the readings.

 A budget is a formal plan for managing financial resources. The budget document indicates the expected income and expected expenses of an organization, department, or individual. It provides a method of tracking cost and, therefore, a way to examine where saving s could be made. The total organizational budget is usually separated into two distinct sections: the operating budget and the capital budget.

 Budget planning procedures vary from organization to organization. However, some parts of the process are common to all organizations. These include steps to gather information before budget preparation such as making an environmental assessment, stating mission and goals, making assumptions about the future setting operational objectives, obtaining the budget guidelines, preparing budget manuals and budget projections packages (last year’s budgets, sets of forms all used in estimating future expenses).

 Environmental assessment for budget purposes includes the environments that are both internal and external to the organization. As part of the internal assessment, the budget planners will identify the strengths and weaknesses of the organization. The external environment takes into account the changing needs of the population, shifts in third-party payment patterns, reimbursement, service contracts and loss or gain of physicians/programs and mergers.

 With the economic climate of health care in turmoil, greater attention is being given to reduce cost while maintaining or improving the quality of care. The nursing budget can account for as much as half an organization’s total expenses nurse managers at all levels are facing significant pressure to become proficient in the budgeting process, to allocate resources, and control and monitor expenses.

Staffing, Scheduling

When asked “what professional issues keep you up at night?” nurse managers will often report staffing issues as the cause. The science of allocating the right human resources for the right work at the right time, taking care of the right population of patients is combined with the art of effective communication to create a healthy and healing environment for both patients and their caregivers. Staffing plans are based on a projected year and need to be closely aligned with the budgeting process. Staffing of personnel in healthcare facilities is regulated and directed by federal and state laws, professional accrediting organizations and professional standards. Forecasting and calculating full time equivalent (FTE). Forecasting takes into account both productive and non-productive time. A number of variables are involved in calculating FTEs. Some of these include shift rotation, weekend needs, length of shifts. The Power Point slides for this unit will outline calculation of FTEs. Also, state laws such as the Nurse Practice Act guide the responsibility of the nurse in regards to floating to another unit or not. These laws may vary from state to state. The nurse needs to know the organization’s policy and its congruency with state and federal laws. Scheduling process in an organization may be centralized or staff may do self-scheduling. This may vary from unit to unit based on philosophy and organizational guidelines. There is also computer software for scheduling. Managers in healthcare as in other organizations need to evaluate productivity. Each unit has different numbers for calculating productivity. How is nurse productivity evaluated on your S482 clinical unit? Leadership has a great deal of influence on productivity. Environments that have a culture of civility, team work and respect for the worker are a few examples of factors that contribute to productivity.

Assignment questions: Post answers in Forums Module VI. See calendar for due date.

1. Discuss steps in developing the unit or department budget. Who all is involved?

2. How is the cost of nursing care incorporated into a budget?

3. How does a nursing unit determine how many nurses are needed for a 12 month period?

4. Differentiate among various types of budgets: fixed, variable, capital budgets.

5. Describe how to calculate hours necessary to equate to one FTE.

Advocating for Public Health Policy

Imagine that you have been chosen to represent a public health advocacy group as they begin a campaign to get legislation related to a health issue passed in your state legislature. You have been tasked with the role of presenting a proposed policy to the legislature and advocating that the legislature vote for the policy. You have been told that you will have 10 minutes to present to the legislature. Your presentation should be informative, but also persuasive. The legislature will need to make a decision about whether or not to vote for the policy based on your presentation. Your presentation should be structured exactly as if you were “live” in front of the legislature advocating for them to adopt the policy you are proposing.

For your assignment, you will need to select a public health topic of interest to you (you are encouraged to choose one related to your academic major or intended field of work) and a public health policy related to addressing the topic. You may select an actual proposed policy or create one that you think would effectively address the topic. Your presentation should provide enough information about the topic and the proposed policy that a reasonably educated legislator should be able to make an informed decision. Be sure to consider the various questions that a legislator might have about the issue and proposed policy, such as long-term costs and benefits, potential effects on business and industry (especially those that support politicians’ campaigns), and how the policy will support the health and productivity of state residents.

For this assignment, you should create an approximately 10 minute presentation* that addresses each of the following points:

• Discuss the public health issue that your proposed policy is intended to address. Questions to consider:
  • Who does this health issue affect?
  • What is the impact of this health issue on the community?
  • Why does this health issue need to be addressed?
• Explain the proposed public health policy. Questions to consider:
  • Who will be affected by this policy?
  • How will this policy address the health issue?
  • What will change by enacting this policy?
• Evaluate the impacts of the proposed policy. Questions to consider:
  • What are the costs and benefits of the policy?
  • What are the risks of enacting or not enacting the policy?
  • How will the lives of people who are affected by the health issue change if this policy is enacted?
• Create an influential presentation that affects voting behaviors of legislators. Questions to consider:
  • What information about this policy would potentially affect the voting behavior of legislators from across the political spectrum (eg. conservative, moderate, liberal, progressive; particularly those who might not support the policy based on political orientation)?
  • What are the most important messages that legislators need to hear about this policy?
  • How would the constituents of the legislators voting for this policy feel about this policy and a legislator who votes for it?
  • What information would a legislator need to “sell” the policy to consitutents who were perhaps not in favor of adopting the policy?

Option #2: Healthcare Reform and 21st Century Healthcare Information Systems

Prepare a paper that addresses the following requirements:

• Analyze and evaluate the implications of 3–5 major initiatives associated with healthcare reform on the designing and planning of 21st century healthcare information systems.
• Evaluate the challenges associated with each trend and ways to overcome them.
• Include an assessment on the impact the each initiative may have on the following:
  • Leadership, governance, and the role of a healthcare chief information officer (CIO)
  • Strategic health management information system (HMIS) planning and organizational culture
  • Characteristics and capabilities of an enterprise resource planning system
• Review legislation and regulations that could influence the implementation of health information management systems.
• Explain how CIOs might assess the merits of each initiative on vision, mission, and strategy.
• Predict the global trends in the adoption of major standards and use of HMIS over the next five years.

Requirements:

• Your paper should be 8-10 pages in length and conform to APA format
• Include at least four scholarly references in addition to the course textbook.
• Remember, you must support your thinking/opinions and prior knowledge with references. All facts must be supported. In-text references used throughout the assignment must be included in an APA-formatted reference list.