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Ashford General Hospital Proposal

April 8, 2020

AshfordGeneral Hospital Proposal

ExecutiveSummary

TheAshford General Hospital is a U.S. based health care facility thatwas established in 1942 by the army. In the recent past, the hospitalhas been facing numerous challenges that include high staff turnover,lack of motivation among the employees, emotional burnout, and thedevelopment of a perception that the job is physically demanding.These challenges threaten the going concern of the organization sincethey have limited its capacity to deliver quality care.

Thereare five solutions that have been implemented by health carefacilities that face similar challenges. The first solution of theimprovement of the working conditions in order to increase jobsatisfaction among the nurses. The second solution involves theapplication of modern technology, which has been shown to reduce thedemand for human labor, thus addressing the challenge of staffshortage. The third solution is the development of measures that willincrease the number of students who select nursing as a career.Fourth, the establishment of a partnership between the health carefacility and an institution of higher learning with the objective ofsupporting the school of nursing increases the supply of qualifiednurses. Lastly, matching compensation with effort has been shown toreduce staff turnover by increasing the motivation of employees. Outof the five solutions, an improvement in the working conditions isthe most sustainable option.

Keywords:Viable solution, emotional burnout, partnership, staff turnover,strategic management.

AshfordGeneral Hospital Proposal

Healthcare facilities face numerous challenges that limit their capacity toserve their clients. The Ashford General Hospital is one of thepoplar health care facilities that are based in the U.S. The hospitalwas founded in 1942 in White Sulphur Springs (West VirginiaHumanities Council, 2017). It was established by the U.S. army, butits geographical coverage has expanded to include several areas,including Hanworth, Staines, Teddington, and Shepperton, amongothers. This paper will address the case study of Ashford GeneralHospital. The hospital has experienced some challenges, such as theworkforce aging, emotional burnout, and physically demanding. In thispaper, a description of five solutions implemented in otherhospitals, explanation of two viable resolutions that are viable forAshford General Hospital, and the recommendation for the best optionwill be discussed.

Solutionsimplemented in five hospitals in the U.S. using the strategicplanning theory.

PossibleSolutions Implemented By Other Health Care Facilities

Improvementof the working conditions in order to reduce the nurse turnover

Thehigh rate of nurse turnover is among the leading cause of theirshortage in the health care facilities. The turnover involves thedeparture of the members of staff who feel dissatisfied with theworking conditions, which motivated them to look for betteropportunities. Johns Hopkins University Hospital addressed the issueof shortage of nurses by enhancing their working conditions. This wasaccomplished through the establishment the Nurse Support Programthrough which the hospital empowers its health care professionals(Shapiro &amp Krause, 2017). For example, the program seeks toincrease the coping skills of nurses through a wide range ofstrategies, including informal debriefing, retreats, mentorship,counseling, and celebratory dinners.

Theprogram has also made the hospital a suitable place of work for thenewly recruited college graduates. This is because the program guidesthe hospital inspiring, modeling, supporting, nurturing, andencouraging nurses (Shapiro &amp Krause, 2017). This has allowed thehospital to accommodate new nurses, who bring a technologicallysophisticated and global perspective into the workplace. Based onthis analysis, an improvement in working conditions has helped JohnsHopkins University Hospital to address the challenge of nurseshortage in two ways. First, the health care facility is able toretain nurses who are already employed. Secondly, the hospital hasmanaged to attract fresh graduates who become more productive oncethey are mentored, nurtured, and supported.

Theuse of technology to reduce reliance on human labor

Technologicaldevelopment is associated with an increase in the level of efficiencyand prevention of human errors. Efficiency is achieved when fewerresources (including time and money) are spent to accomplish the sametask. The UCSF medical center is one of the American health carefacilities that have used the concept of efficiency to resolve thechallenge of nurse shortage. In 2010, the hospital launched itsprogram that involved the establishment of the world largest and themost superior robotic pharmacies (Gebhart, 2012). Thistechnology-based solution was developed in phases. The medical centerstarted with the establishment of the automated drug picking system,followed by sterile preparation machines, and fill operations. Thesystem reduced the shortage of nurses and pharmacists concurrently.According to Gebhart (2012) the automated system had the capacity tocarry over 400,000 oral solid as well as sterile injection doses atthe same time and with zero errors. Therefore, the machine reducesthe job vacancies for nurses and pharmacists who were required toadminister prescribed medication to over 400,000 patients. The newtechnology is more preferable because it resolved the shortage ofnurse and reduced medical errors at the same time. Therefore, the newtechnology is a viable solution that addresses the issue of nurseshortage by increasing efficiency and replacing the human labor.

Increasingthe number of students who pursue nursing as a career

Oneof the key factors that have contributed towards the shortage ofnurses is the decline in the number of nurses who select nursing as aprofession. The findings of a study conducted by George University(2015) indicated that the current nursing schools are unable tosupple sufficient number of nurses who can meet the market demand. Inother words, the numbers of graduate nurses who leave colleges eachyear are less than new vacancies. Upon the realization of thischallenge, the Johnson and Johnson Health Care System that is basedin San Francisco develop a program for sponsoring more nursingstudents as a measure to reduce their shortage (Erickson, 2017). Thehealth care has encouraged more students to pursue nursing byproviding a two billion dollars worth of scholarships (Erickson,2017).

Thesystem also provides learners with faculty fellowship opportunities,which serves as a source of motivation. While announcing the successof this program, the senior vice president of the Johnson and JohnsonHealth Care System stated that the health care facility hascontributed towards the decline in the shortage of nurses inMassachusetts by increasing enrollment in the nursing schools(Erickson, 2017). The health care system also announced that it wouldinvest over $ 30 million in projects that would improve thepopularity as well as the image of nursing as a profession. Byincreasing the number of students who graduate from the nursingschools each year, the stakeholders in the health care sector willmake it easier for hospitals to recruit new nurses in order to servethe ever growing population of patients, thus reducing the shortage.

Partnershipbetween hospitals and institutions of higher learning

Apartfrom providing the health care service to patients, hospitals cancontribute towards an increase in the population of nurses. This canbe achieved by providing academic opportunities. By convertinghospitals into centers for nursing education, the health carefacilities will be able to train their own professionals and supplythe excess number of nurses to other hospitals (American Associationof College of Nursing, 2017). Hospitals address the challenges (suchas the lack of teaching staff and technical capacity) associated withthe process of founding nursing schools by establishing the strategicpartnerships with institutions of higher learning.

TheProvidence Health System of Alaska, Alaska Regional Hospital, theFairbanks Tribal Health Consortium and Alaska Native Tribal HealthConsortium announced their partnership with the University ofAlaska-Anchorage in 2002. In this partnership, the health carefacilities provided over 1.8 million to finance the establishment ofa nursing school that could supply them with nurses each academicyear (AACN, 2017). The program had doubled the number of nursegraduates by the year 2006. This was a reliable strategy thatguaranteed the hospitals that they would never suffer from theshortage of qualified nurses since they developed the capacity tomonitor the quality of training and regulate enrollment in order tomeet their demand. The hospitals were converted into centers oflearning since they were expected to provide internship programs fornursing students, which would equip them with practical skills.

Matchingcompensation with efforts

Althoughmoney is not the only source of motivation, employees feel that theirefforts are being recognized when the level of compensation iscommensurate with their contribution towards the success of theorganization. The relationship between compensation and motivationhas been used in the past to address the challenges of staff turnoverand shortage. For example, Mission Health, which is a health carefacility that is based in Ashville, established a comprehensivecompensation program that guides the management in the process ofawarding bonus to nurses for any extra effort that they make abovewhat is expected of them. The bonus for the certified staff rangesbetween $ 5,000 and $ 10,000 (Gooch, 2016). The amount that isawarded as a bonus depends on length of employment, commitment ofindividual nurses, and the length of time they have been working withthe facility.

Anadditional bonus that ranges from $ 1,000 to $ 5,000 is awarded forreferral services, but the exact amount that the nurses get dependson the job position (Gooch, 2016). The two categories of bonusmotivate nurses to continue working with the hospital since there isroom for personal development and an opportunity to make more money.This measure shields the hospital from the risk of nurse shortagesince the existing workforce is motivated and potential employees areeasily attracted to join the organization. Therefore, the hospital isthe assurance of an adequate supply of nurses.

TheMost Viable For Ashford General Hospital

Animprovement in the working conditions

Theworking conditions have a direct relationship with the morale of themembers of staff as well as their intention to leave theorganization. It is the primary duty of the employer to ensure thatemployees are provided with an environment that they need in order toremain productive and deliver quality services to customers. From thecase study, the nurses suffer from emotional burnout, which is anindication of poor working conditions. In addition, these nurses feelthat the job is physically demanding, and this is a risk factor forburnout. The poor working conditions have contributed towards thehigh turnover of nurses. The hospital can adopt a model that was usedby Johns Hopkins University Hospital to enhance the workingconditions for its nurses. The model was comprised of a program thatallowed the health care facility to nurture, support, celebrate, andcounsel nurses (Shapiro &amp Krause, 2017). However, these areshort-term measures for the management of burnout.

Theprograms will also help the management of Ashford General Hospitaladdress the challenge of emotional burnout among nurses. The modelwill also allow the hospital to organize informal debriefings andgatherings, which give nurses an opportunity to express issues thataffect them in the work settings without fear (Shapiro &amp Krause,2017). Therefore, the management will be able to comprehend thecauses of burnout and address them before they lead to nurseturnover. The process of establishing a safe working environmentrequires a direct contact between nurses and the management teams,which is accomplished through the establishment of formal as well asinformal forums. This will help the management to understand theunderlying causes of the burnout and development long-term solutions,such as the recruitment of additional nurses on a permanent basis.

Partneringwith an institution of higher learning to support the nursing school

Fromthe case study, Ashford General Hospital suffers from the risk ofshortage of nurses since about 68 % of them are above 45 years, whichmeans that they will retire soon. By establishing a partnership withinstitutions of higher learning, the hospital will have an easyaccess to young nurses. This will make it possible for the hospitalto replace the retiring nurses, thus reducing the risk of shortage.The viability of this solution has been confirmed by a case in whicha group of hospitals partnered with University of Alaska-Anchorage inorder to support the school of nursing. This measure empowered thehospitals by allowing them to control the quality of nurse trainingand annual intake, thus giving them a chance to control the supply ofprofessionals to their respective facilities (AACN, 2017). Byadopting a similar measure, Ashford General Hospital will be able tomatch the demand for nurses with their supply.

StakeholderGroup Analysis

Adecision to establish a safe working environment will affect fivemajor stakeholders. These stakeholders include nurses, hospitaladministrator, patients, human resource, and department of finance.Job satisfaction will increase among nurses since they will beworking under good conditions. A good working environment isassociated with an increase in the quality of care, which suggeststhat patient outcomes will improve (Raziq &amp Maulabakhsh, 2015).Hospital administrators will be required to work harder in order tomonitor changes in the working environment. The finance departmentwill also adjust the annual budget with the objective of sourcingfunds for financing changes (such as the recruitment of new nurses)in the current working condition. The human resource manager willhave an extra burden of managing new nurses.

Oneof the key change processes that will be required is the adjustmentof the recruitment policy in order to replace the current short-termcontract with permanent employment. A permanent employment has thecapacity to enhance staff retention than short-term contracts(Mooi-Reci &amp Dekker, 2015). Therefore, the need for additionalfunds to recruit nurses on a permanent basis is the major fiscalimpact of this solution. The need to hire young nurses in order toaddress the issue of retirement of over 68 % of the nurses couldraise ethical concerns since potential candidates who are older mightbe discriminated against during recruitment.

Thestakeholders who will be affected by the implementation of the secondsolution include patients, hospital’s management, nursing students,finance, and human resource managers. The solution will involvecollaboration between the hospital and an institution of higherlearning. The measure will lead to an adequate supply of well trainednurses, which will help patients to access health care easily. Apartnership between the hospital and a university give nursingstudents internship opportunities, which enhances their competence(Corwin, Corbin &amp Mittelmark, 2012). The management of theAshford General Hospital will be required to develop policies andagreements that will guide the two organizations, which is a complextask. The finance manager will be expected to provide the resourcesrequired to support the nursing school and students who will getinternship opportunities in the hospital. The human resource managerwill assume an extra burden of managing and guiding nursing students,besides the current workforce.

Oneof the key changes that will be required in a reform in theemployment policy in order to allow the human resource manager toinclude nursing students in the list of service providers. Thesolution will also have some fiscal implications because theuniversity will make some financial contribution to support thenursing school. The high population of older nurses who are about toretire is among the key challenges that Ashford General Hospitalintends to address. This suggests that the hospital will recruityoung nurses from nursing school. The solution will introduce thechallenge of diversity based on age-gap. In addition, the partnershipbetween the two organizations will require legal contracts in orderto define and document the obligations of each one of them.

RecommendedSolution

Thefirst solution, an improvement in the working condition, is the mostviable alternative. The solution meets the needs of the currentworkforce. It will also attract potential employees who will considerthe hospital as an employer of choice. A suitable working environmenthas a positive impact on the job satisfaction, morale, and retentionof nurses (Raziq &amp Maulabakhsh, 2015). Instead of investing inthe training of new nurses, the hospital will attract those who havealready been educated and certified, which will reduce the cost ofimplementing the solution. In addition, the HR manager will berequired to manage qualified nurses as opposed to the nursingstudents. The hospital will also be able to recruit nurses from allage groups, thus enhancing interpersonal relationship among themembers of staff (Corwin, Corbin &amp Mittelmark, 2012). Althoughthe cultural shift will be quite limited, a lot of changes in humanresource management will be required since contract nurses will beemployed on a permanent basis. In overall, the improvement in theworking conditions will provide a long-term solution to the issue ofstaff turnover, without incurring a lot of expenses.

Thedecision to improve the working condition should be included in thestrategic planning process of the hospital. The application of thestrategic planning theory facilitates the determination of the scopeand direction of the organization in the long-term, which isaccomplished by matching the environment with resources (Ibraimi,2014). The ultimate objective of investing in strategic planning isto satisfy the interests of all stakeholders. Therefore, theintegration of working conditions in the strategic plan will directthe organization in the process of satisfying the interest of thestakeholders, who include demoralized nurses.

Conclusion

Theestablishment of an appropriate working environment is the mostviable solution that should be used to address the key challengesthat Ashford General Hospital has been facing. An appropriate workingenvironment resolves the issue of staff shortage by increasing themotivation of the members of the existing workforce. It also makesthe organization an employer of choice for potential job seekers,which make easy to source new employees when the need arises.However, the process of establishing the desired work environmentshould be integrated into the organization’s strategic plan inorder to make it a lasting and a sustainable solution.

References

AmericanAssociation of College of Nursing (2017). Leading initiatives. AACN.Retrieved March 31, 2017, fromhttp://www.aacn.nche.edu/aacn-publications/issue-bulletin/using-strategic-partnerships

Corwin,L., Corbin, H. &amp Mittelmark, B. (2012). Producing synergy incollaborations: A successful hospital innovation. TheInnovation Journal: The Public Sector Innovation Journal,17 (1), 1-16.

Erickson,J. (2017). Massachusetts mobilizes in response to nursing shortagecrisis. BusinessWire, Inc.Retrieved March 31, 2017, fromhttp://www.businesswire.com/news/home/20070315005717/en/Massachusetts-Mobilizes-Response-Nursing-Shortage-Crisis

Gebhart,F. (2012). UCSF launches automated pharmacy. UBMMedical, LLC.Retrieved March 31, 2017, fromhttp://drugtopics.modernmedicine.com/drug-topics/news/modernmedicine/modern-medicine-feature-articles/ucsf-launches-automated-pharmacy

GeorgeUniversity (2015). Nursing:Supply and demand through 2020.Washington, DC: Georgetown University.

Gooch,K. (2016). How five health systems are recruiting, retaining nursesduring an RN shortage? HospitalReview.Retrieved March 31, 2017, fromhttp://www.beckershospitalreview.com/human-capital-and-risk/how-5-health-systems-are-recruiting-retaining-nurses-during-an-rn-shortage.html

Ibraimi,S. (2014). Strategic planning and performance management: Theoreticalframeworks analysis. InternationalJournal of Academic Research in Business and Social Sciences,4 (4), 124-149.

Mooi-Reci,I. &amp Dekker, R. (2015). Fixed-term contracts: Short-termblessings or long-term scars? Empirical findings from the Netherlands1980-2000. BritishJournal of Industrial Relations,52 (1), 112-135.

Raziq,A. &amp Maulabakhsh, R. (2015). Impact of working environment on jobsatisfaction. ProcediaEconomics and Finance,23, 717-725.

Shapiro,S. &amp Krause, J. (2017). Solving the shortage. JohnsHopkins University.Retrieved March 31, 2017, fromhttp://web.jhu.edu/jhnmagazine/summer2008/features/solving.html

WestVirginia Humanities Council (2017). Ashford General Hospital. WestVirginia Humanities Council.Retrieved March 31, 2017, fromhttps://www.wvencyclopedia.org/articles/304

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