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Terms in this set (111)
Incremental (line-by-line) budget
the finance department distributes a budget worksheet listing each expense item or category on a separate expense line. The expense line is usually divided into salary and nonsalary items. A budget worksheet is commonly used for mathematical calculations to be submitted for the next year.
the budgeted amounts are set without regard to changes that may occur during the year, such as patient volume or program activities, that have an impact on the cost assumptions originally used for the coming year.
is developed with the understanding that adjustments to the budget may be made during the year based on changes in revenues, patient census, utilization of supplies, and other expenses.
is the smallest area of activity within an organization for which costs are accumulated. They may be revenue producing, such as laboratory and radiology, or non-revenue producing, such as environmental services and administration.
-Nursing units are typically considered this
If managers are responsible for controlling both costs and revenues and if their financial performance is measured in terms of __________, then the manager is responsible for a profit center.
are costs that will remain the same for the budget period regardless of the activity level of the organization, such as rental payments and insurance premiums.
depend on and change in direct proportion to patient volume and patient acuity, such as patient care supply expenses. If more patients are admitted to a nursing unit, more supplies are used, causing higher supply expenses.
are expenses that directly affect patient care. For example, salaries for nursing personnel who provide hands-on patient care are considered direct costs.
are expenditures that are necessary but do not affect patient care directly. Salaries for security or maintenance personnel, for example, are classified as indirect costs.
also known as the annual budget, is the organization's statement of expected revenues and expenses for the coming year, coincides with the fiscal year.
a specified 12-month period during which the operational and financial performance of the organization is measured.
Represents the patient care income expected for the budget period. Actual payment generated by a given service or procedure will not equal the charges that appear on the patient bill.
Consists of salary and non-salary items. Expenses should reflect patient care objectives and activity parameters established for the nursing unit.
Identifies physical renovations, new construction, and new or replacement equipment. Capital items exceed a certain dollar value.
identifies patient-related supplies needed to operate the nursing unit. In addition to supplies, other operating expenses—such as office supplies, rental fees, maintenance costs, and equipment service contracts—may also be paid out of the nursing unit's non-salary budget.
Projects the salary costs that will be paid and charged to the cost center in the budget period. In addition to anticipated salary expenses, factors such as benefits, shift differentials, overtime, on-call expenses, and bonuses and premiums may affect the _______ budget.
Paid time off (PTO), medical, vision, dental, retirement, etc.
Some facilities use a set percentage to determine shift differential: 10% for evenings, 15% for nights, and 20% for weekends and holidays, for example. If the hourly rate is $22.00, for instance, then the cost for a nurse working evenings would be $22.00 plus $2.20 for each hour worked.
Fluctuations in workload, patient volume, variability in admission patterns, and temporary replacement of staff due to illness or time off all create overtime in the nursing unit.
e.g., vacations, holidays, personal days
Full-time equivalent (FTE)
is a full-time position that can be equated to (FTE of 1.0) 40 hours of work per week for 52 weeks, or 2,080 hours per year.
Hours Per Patient Day
Tracking _______ helps to ensure each of the units in a hospital are meeting financial targets in order to remain financially healthy.
Tracking changes in benchmarks will provide a uniform method of sharing strategies that improve productivity, while simultaneously measuring quality using other measures such as patient satisfaction surveys.
the difference between budgeted and actual nursing care hours provided.
Nonsalary expenditure variance
Deviation from the budget as a result of changes in patient volume, supply quantities, or prices paid.
Monitoring tool used to compare actual numbers of employees to the number of budgeted FTEs for the nursing unit.
The difference between budgeted and actual hourly rates paid.
The difference between the amount that was budgeted for a specific cost and the actual cost.
Differences in the budget as a result of increases or decreases in patient volume.
A budgetary approach that assumes the base for projecting next years budget is zero; Managers are required to justify all activities in their proposed expenditure.
Scheduling a set staff mix for every shift so that adequate staff are available at all times.
Full-time equivalent (FTE)
The percentage of time and employee work that is based on a 40 hour work week.
Nursing care hours (NCHs)
The number of hours of patient care provided per unit of time.
Patient classification systems (PCSs)
System developed to objectively determine workload requirements and staffing needs.
Internal or external groups of workers that are used as supplemental staff by an organization.
A staffing model in which managers and their staff completely manage staffing and schedules.
The type of staff necessary to perform the work of an organization.
Process of balancing the quantity of staff available with the quantity and mix of staff needed by an organization.
Behavior-oriented performance evaluation
A system for appraising employee performance based on organizational values, position descriptions, cluster behaviors, specific examples, and developmental goals.
A staff members goals for the coming year against which performance will be judged.
The process of interaction, written documentation, formal interview, and follow up that occurs between managers and their employees to give feedback, make decisions, and cover fair employment practice law.
Systems, policies, procedures, position descriptions, and evaluation components essential to providing consistent, high-quality nursing practice
A process by which other employees assess and judge the performance of professional peers against predetermined standards.
A critical component of performance evaluation the fosters reflection; the deliberate process of critically thinking about one's performance.
The ability to perform skilled knowledgeably and safely.
4 P's or marketing
product, price, promotion, place
is the available position(s) within the organization. Consider several aspects of the position and organization, such as these: Professionalism • Standards of care • Quality • Service • Respect • Reputation • Organizational culture
refers to the physical qualities and location, such as these:
• Accessibility • Scheduling • Parking
includes the following:
• Pay and differentials • Benefits • Sign-on bonuses • Insurance • Retirement plans
includes the following:
• Advertising • Public relations • Direct word of mouth • Personal selling (e.g., job fairs, professional meetings)
Motivational theories that emphasize individual needs or the rewards that may satisfy those needs.
•Management Assumptions (X/Y)
•ERG (Existence, Relatedness, Growth)
•Herzberg's Two Factors
•McClellands (Achievement, Affiliation, Power)
The motivational theory that suggests effort and job satisfaction depend on the degree of equality or perceived fairness in the work situation.
The motivational theory that emphasizes the role of rewards and their relationship to the performance of desired behaviors.
The technique used to illuminate negative behavior, in which a positive reinforcer is removed in the undesired behavior is extinguished.
The motivational theory that suggest that the gold self is the motivational force.
A program to reward a high-performing employee without promoting the employee to a management position.
The factors that initiate and direct behavior.
And educational method using observation in practice by which employees learn new skills after being employed.
A process by which staff development personal and managers ease a new employee into an organization by providing relevant information.
Inexperience individual who is this new employees in acquiring the necessary knowledge and skills to function effectively in a new environment.
Motivational theories that emphasize how the motivation process works to direct an individual's effort into performance
A process used to inhibit an undesired behavior by applying a negative reinforcer
Reinforcement theory (behavior modification) shaping
The motivational theory that views motivation as learning and Proposes that behavior is learned through a process called operant conditioning.
Harassment between employees of equal rank.
Employees who never reach the expected level of competence.
_____ in healthcare threatens not only the victim (the "target") but also poses a danger to patients. _______ increases staff dissatisfaction and can lead to absenteeism, turnover, and litigation.
At times, an instance of bullying is not so obvious. Lack of civility is an example. Uncivil behavior creates an environment that also endangers patients.
Describe the specific situation
Express your concerns about the action
Suggest other alternatives
Consequences should be stated
Red lags for substance abuse
Incorrect narcotic counts, corrections on MAR, wastage, pt. report inadequate pain control
Any violent act, including physical assaults and threats of assault, directed toward persons at work or on duty.
Intervention to possible violence
•To intervene, identify the person whose behavior is disruptive and speak with the person privately.
•When faced with a potentially violent situation, try to keep calm even when another person is screaming threats or abuse.
•Try to get the person away from others.
•Verbal threats often precede a physically violent event.
1.State the problem.
2.Tell how the problem is affecting the work unit and/or organization.
3.State what you want to have happen.
4.Ask if the person is willing to do what you asked.
Watch for threatening behaviors
•Arms raised in fighting position
•Standing too close or advancing
•Holding weapon of any kind
•Movement toward exit
training to improve strength or self-control
The day-to-day process of helping employees evaluate and improve their performance.
Timely and ongoing
Constructive and positive
The day-to-day process of helping employees improve their performance.
The nurse must be:
The most effective means of resolving conflict, in which the conflict is brought out in the open and attempts are made to resolve it through knowledge and reason.
1. Prepare before the meeting
2. In a neutral voice describe the behavior without attacking the person
3. Solicit employees reason for behavior and listen with empathy
4. Explain why behavior cannot continue and ask for solutions
5. Place note on file and set follow update (step for manage)
The process of increasingly severe warnings for repeated violations that can result in termination.
The firing of an employee
First step in a formal disciplinary process. The direct supervisor verbally informs an employee of the performance issue. Verbal warnings must by documented in writing.
Repeat violation or as first action if warranted; permanent in employee record
The informal norms within a work unit that determine how employees of the unit view absenteeism
The total number of distinct absence periods, regardless of their duration
The events that affect employees ability to attend
When an employee is inspired by an organization, willing to invest effort, likely to recommend the organization, and planning to remain in the organization
Absenteeism that is not under the employees control
When an employee is terminated by his or her employers
And organizations ability to hold onto employees and prevent them from leaving
The effect of a higher starting pay for new nurses, or rewarding those with fewer years of experience with higher increases, the results in the salaries of long-term employees being at or below those of less experienced nurses.
Total time lost
The number of schedule days in employee misses
The number of staff members who vacate a position
Absenteeism that is under the employees control
When an employee chooses to leave an organization
Family & Medical Leave Act (FMLA)
All public employers (federal, state, and local) and all private employers employing 50 or more individuals must provide their eligible employees with leave of up to 12 weeks during any 12-month period for the employee's own serious illness, the birth or adoption of a child, the placement of a foster child into the household, or the care of a seriously ill child, spouse, or parent.
An unassertive, cooperative tactic used in conflict management when individuals neglect their own concerns in favor of another's concerns
A conflict management technique in which the participants deny the conflict exists
All parties working together to solve a problem
An all out effort to win, regardless of the cost
A conflict management technique in which the rewards are divided between both parties
The consequence of real or perceived differences in mutually exclusive goals, values, ideas, attitudes, beliefs, feelings, or actions
The most effective means of resolving conflict, in which the conflict is brought out in the open and attempts are made to resolve it through knowledge and reason
A conflict strategy in which a solution that meets everyone's needs is agreed-upon
The negative feelings between two or more parties
A conflict management technique that forces an immediate and to conflict but leaves the cause unresolved
Use of a third-party mediator to help settle disputes
A conflict management technique in which the conflicting parties give and take on various issues
One's perception of another's position in a conflict
A behavior that can be positive or negative and may mean opposition to change or disobedience; At times, and effective approach to handling power differences
The stage of conflict occurs when a mutually agreed-upon solution is arrived at and both parties commit themselves to carrying out the agreement
Managing conflict by complementing one's Opponent, downplaying differences, and focusing on minor areas of agreement
The stage of conflict that occurs when one person or group defeats the other
The removal of at least one party from the conflict, making it impossible to resolve the situation
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