Operating Budget of Monroe Outpatient Surgery Center Comprehensive Nursing Essay Example

Operating Budget of Monroe Outpatient Surgery Center Comprehensive Nursing Essay Example

The healthcare industry and hospitals experience increasing operational costs and diminishing reimbursements, necessitating hospitals persistently finding approaches to enhance efficiency and productivity. A surgical center is similar to the operating room regarding cost intensity, hence the need for efficient and effective management. (Operating Budget of Monroe Outpatient Surgery Center Comprehensive Nursing Essay Example)Also, the financial performance of the operating room is linked to effective collaboration among the surgical, anesthesia, nursing, and allied providers. This paper presents the operating budget of Monroe Outpatient Surgery Center for the month ending June 30, 2022, an analysis of its operation efficiency, and recommendations to improve operational efficiency.(Operating Budget of Monroe Outpatient Surgery Center Comprehensive Nursing Essay Example)

Operating Budget

Monroe Outpatient Surgery Center Operating Budget June 30, 2022
Revenues	$
Procedures	200,000
Total Revenues	200,000
Expenses
Professional Fees	120,000
Surgical Supplies	24,000
Salaries	10,500
Occupancy	8,200
Communications	1,200
Depreciation	4,000
Total Expenses	167,900
Profit/Loss	32,100

Schedule 2

Education/Meetings	FTEs	Hours	Total Hours
Manager	1.0	10	10
RN	1.0	10	10
Unit Secretary	0.8	8	8
Nurse Tech	0.5	5	5
Sub Total Education/Meeting	3.3	33	33

Orientation	Head Count	Hours	Total Hours
Manager	1	8	8
RN	4	8	32
Unit Secretary	1	6	6
Nurse Tech	2	4	8
Sub Total Orientation	8	26	54

Schedule 3

Regular
Skill Mix	Job Title	Hourly Wage	FTE	Total Hours	Total Wages
Manager	NURSEMANAGER.	$56	1.0	40	$2,240
RN	RN	$38	1.0	40	$1,520
NT/NA	NT	$16	0.5	20	$320
Unit Secretary	US	$15.7	0.8	36	$565.2
Sub Total Regular			3.3	136	$4,645.2

Overtime
Skill Mix	Job Title	Hourly Wage	FTE	Total Hours	Total Wages
RN	RN	$42.6	1.0	10	$426
Manager	Nurse Manager	$61	1.0	12	$732
NA	NA	$20	0.5	6	$120
Unit Secretary	US	$18.5	0.8	8	$148
Overtime			3.3	36	$1,426

Other Pay
Category	Job Title	Hourly Wage	FTE	Total Hours	Total Wages
Charge Differential	Nurse Manager	$56	1.0	8	$448
On Call	RN	$40	1.0	8	$320
Call Back	NA	$19	0.5	6	$114
Sub Total Other Pay			2.5	22	$882

Replacement FTE
Skill Mix	Job Title	Hourly Wage	FTE	Total Hours	Total Wages
Total from Schedule 2			1.0	40	$1,520
RN	PRN Pool	$42	0.5	20	$840
RN	Float Pool	$38	0.3	12	$456
RN	Agency	$40	0.2	8	$320
Sub Total Replacement FTEs			1.0	40	$1,616

Education
Skill Mix	Job Title	Hourly wages	FTE	Total Hours	FTEs Annualized	Total wages
Manager	Nurse Manager	$56	1.0	10	520	$29,120
RN	RN	$38	1.0	10	520	$19,760
Unit Secretary	Unit Secretary	$15.7	0.8	8	416	$6,531.2
Nurse Tech	Nurse Tech	$16	0.5	5	360	$5,760
Sub Total Education/Meeting			3.3	35	1,816	$61,171.2

Orientation
Skill Mix	Job Title	Hourly Wage	FTE	Total Hours	FTEs Annualized	Total Wages
Manager	Nurse Manager	$56	1.0	8	416	$23,296
RN	RN	$38	1.0	8	416	$15,808
Unit Secretary	Unit Secretary	$15.7	0.8	6	312	$4,898.4
Nurse Tech	Nurse Tech	$16	0.5	4	208	$3,328
Sub Total Orientation			3.3	26	1352	$47,330.4

Schedule 4

Categories	FTEs	Total Hours	Total Wages
Sub Total Regular	3.3	136	$4,645.20
Overtime	3.3	36	$1,426.00
Total Direct Care FTEs		172	$6,071.20
Sub Total Replacement FTEs	1.0	40	$1,616.00
Sub Total Other Pay	2.5	22	$882.00
Sub Total Education/Meeting	3.3	35	$1,176.37
Sub Total Orientation	3.3	26	$910.20
Total		295	$10,655.77

Monroe Outpatient Surgery Center (MOSC) was profitable in June per the operating budget. Basing success on profit and loss, MOSC was successful. However, profitability does not always equate to operational efficiency because small margins indicate less efficiency. Using the operating ratio to determine operational efficiency is a more accurate approach to determining whether the MOSC was successful. The operating ratio can be obtained by dividing operating costs by total revenues. A lower operating ratio is desired because it indicates significant revenues relative to operating costs.(Operating Budget of Monroe Outpatient Surgery Center Comprehensive Nursing Essay Example) On the contrary, a higher operating ratio implies that the facility is less efficient in achieving revenues or controlling operating costs. MOSC’s operating ratio is 167,900/200,000, 0.8395 or 84%. This operating ratio is relatively higher, implying that MOSC is less efficient in generating revenues or controlling operating costs. An ideal operating ratio for most companies is between 60% and 80%. Anything above 80% is not suitable for the company. The smaller the value, the better, and MOSC needs strategies to increase its operational efficiency.(Operating Budget of Monroe Outpatient Surgery Center Comprehensive Nursing Essay Example)

Strategies to Improve Operation Efficiency

Like operating rooms, surgical centers are crucial components of hospital systems, contributing significantly to the workforce and revenues. Therefore, efficiently managing the surgical center would help improve patient outcomes and maximize MOSC profits. Various factors influence the efficiency of the surgical center, including case scheduling, staff and equipment allocation, time spent on anesthesia preparation and induction, and that spent on procedure and patient preparations (Cunningham, 2019). Case cancellations and long waiting lists contribute most to inefficiencies experienced in surgical units. A well-managed MOSC will lead to high surgical turnover, fewer postoperative complications, better patient-centered outcomes, and greater client satisfaction.(Operating Budget of Monroe Outpatient Surgery Center Comprehensive Nursing Essay Example)

To track performance and efficiency, MOSC can adopt parameters, including case-duration estimation, pre-admission screening, average turnover time, patient-in-to-incision time, and percentage of the on-time first case starts to measure operating room (OR) utilization. Estimating accurate case duration can help determine case scheduling by measuring the proportion of surgical cases where the time spent in the operating room is within 15 minutes of the anticipated in-room duration (Ohradius, 2019)(Operating Budget of Monroe Outpatient Surgery Center Comprehensive Nursing Essay Example). This measurement offers insights into the effort needed to ensure that cases are completed within the estimated time. The second parameter, the percentage of the on-time first case starts, helps determine the number of first cases that begin on time (Ohradius, 2019). It can be adapted to inform efforts to reduce first-case delays linked to OR inefficiencies across the board, from the operating room to reception to the recovery room. A higher percentage of on-time first-case starts is fundamental as it implies greater operational efficiency.(Operating Budget of Monroe Outpatient Surgery Center Comprehensive Nursing Essay Example)

The third parameter is pre-admission screening, which measures the number of cases with a pre-anesthetic checkup before the procedure. This measurement is linked to the number of case cancellations and delays because inadequate pre-screening is a cause of a considerable number of cancellations and delayed starts (Ohradius, 2019)(Operating Budget of Monroe Outpatient Surgery Center Comprehensive Nursing Essay Example). The fourth parameter is patient-in-to-incision, which measures the aggregate time between the client going to the operating room and the first incision. The parameter varies depending on the type of procedure and anesthetic. Lastly, MOSC can adopt the average turnover time to measure the time between a patient exiting the room and when the next client enters the operating room (Ohradius, 2019). Multiple factors are associated with a higher-than-anticipated average turnover time, including communication breakdown and poor coordination between the surgical te(Operating Budget of Monroe Outpatient Surgery Center Comprehensive Nursing Essay Example)am. Improving communication and coordination can help improve operational efficiency.

The operating budget provides an overview of the organization’s performance, and analyzing the data using the operating ratio indicates a low operational efficiency. MOSC can achieve considerable improvements in operational efficiency by analyzing more data about the facility’s performance and devising strategies to increase revenues and control costs. From the data provided, it is challenging to determine which costs to minimize. But specific strategies linked to increasing operational efficiency with no direct economic impact can be adopted, including personal accountability, streamlining procedures, bolstering interdisciplinary teamwork, and ensuring accurate data collection. MOSC management should ensure transparent and coordinated time management for the different procedures and effective organization of staff (Cunningham, 2019). In this case, clear management and leadership are required to motivate surgical staff.(Operating Budget of Monroe Outpatient Surgery Center Comprehensive Nursing Essay Example)

Research indicates lean process improvement techniques can help improve efficiency and quality while managing costs. For instance, process mapping shows that late resident arrival in the preoperative holding leads to delayed first-case starts (Cunningham, 2019). Inefficiencies can also arise from resident teaching rounds. These can be managed by utilizing standardization, checklists, and removing non-value-added activities. Another approach is adopting the parallel fashion of patient processing. Most facilities use the linear method, which involves one patient moving through their day from the registration to the recovery room linearly and has only one patient occupying the surgical team’s efforts at a specific time (Cunningham, 2019). Parallel patient processing would increase MOSC efficiency and patient throughput while maintaining stable costs. Effective scheduling, appropriate choice of anesthetic techniques, operations monitoring, and parallel patient processing can help improve operational efficiency.(Operating Budget of Monroe Outpatient Surgery Center Comprehensive Nursing Essay Example)

Additional strategies that can help MOSC evaluate and enhance operational efficiency include technology adoption to streamline administrative tasks and procedures. Adopting information systems helps improve patient data management, communications between the surgical team and the patient, and care coordination. For instance, adopting electronic medical records would help improve care delivery and save on paperwork, taking time away from patient care (Medical Device News Magazine, 2023)(Operating Budget of Monroe Outpatient Surgery Center Comprehensive Nursing Essay Example). The organization can improve case scheduling by adopting apps for smartphones and tablets, minimizing inefficiencies attached to case scheduling. Moreover, AI-based systems can help manage time spent in the operating room and reduce complications by facilitating intraoperative guidance during surgical procedures through visualization enhancement (Malik et al., 2023). Other technologies that can help improve operational efficiencies include imaging techniques and touch screen ability in monitors utilized for endoscopies and imaging, generating instant-high-definition images of the entire surgical procedure. Generally, MOSC adopting technology can improve operational efficiency.(Operating Budget of Monroe Outpatient Surgery Center Comprehensive Nursing Essay Example)

Reducing costs is fundamental to achieving greater operational efficiency. Considerable costs are associated with instrument processing delays. According to Dyas et al. (2018)(Operating Budget of Monroe Outpatient Surgery Center Comprehensive Nursing Essay Example), most instruments in the standardized tray are not routinely utilized during most surgeries. Creating a streamlined instrument tray can improve operative efficiency and lower costs. Per the study, two trays with 98 total head and neck surgical sets instruments were reduced to a single tray with 36 instruments. These changes reduced the tray weight from 27 pounds to 10 pounds and tray preparation time from 8 minutes to 3 minutes (Dyas et al., 2018). The associated cost-savings for the new tray were $31.62 per operation. Annually, this strategy would save the hospital about $28,000 for instrument processing alone (Dyas et al., 2018). The study also identifies unmeasured cost savings, including decreased instrument wear, replacement frequency, reduced operating room setup time, and decreased decontamination costs. Conclusively, cost reduction can be achieved by improving the efficiency of the various tasks and functions in the surgical center, including those not directly tied to revenue and costs. For instance, time-saving through reduced delays per operation is linked to significant cost savings. MOSC can benefit from these proactive strategies.(Operating Budget of Monroe Outpatient Surgery Center Comprehensive Nursing Essay Example)

Conclusion

The operating room is labor and resource intensive, with multiple operational functions that increase operating costs. However, significant revenues are attached to surgical procedures; hence surgical units contribute remarkably to the revenues of a hospital system. Nonetheless, failure to control operating costs can lead to losses or small margins, which imply low operational efficiency. MOSC was successful based on profit and loss analysis but was inefficient based on the operating ratio. The parameters highlighted can help MOSC track its operations and efficiency, and the strategies recommended can help improve operational efficiency, including increased profits and improved patient outcomes.(Operating Budget of Monroe Outpatient Surgery Center Comprehensive Nursing Essay Example)

References

Cunningham A. J. (2019). Improving operating room productivity and efficiency – are there any simple strategies? Romanian Journal of Anaesthesia and intensive care, 24(2), 87–88. https://doi.org/10.21454/rjaic.7518.242.cnn(Operating Budget of Monroe Outpatient Surgery Center Comprehensive Nursing Essay Example)

Dyas, A. R., Lovell, K. M., Balentine, C. J., Wang, T. N., Porterfield, J. R., Jr, Chen, H., & Lindeman, B. M. (2018). Reducing cost and improving operating room efficiency: examining surgical instrument processing. The Journal of surgical research, 229, 15–19. https://doi.org/10.1016/j.jss.2018.03.038(Operating Budget of Monroe Outpatient Surgery Center Comprehensive Nursing Essay Example)

Malik, A., Kumar, S., Basu, S., & Bebenroth, R. (2023). Managing disruptive technologies for innovative healthcare solutions: The role of high-involvement work systems and technologically-mediated relational coordination. Journal of Business Research, 161, 113828.(Operating Budget of Monroe Outpatient Surgery Center Comprehensive Nursing Essay Example)

Medical Device News Magazine. (2023, May 3). Improving operational efficiency: 8 tips for healthcare institutions. https://infomeddnews.com/improving-operational-efficiency-8-tips-for-healthcare-institutions/(Operating Budget of Monroe Outpatient Surgery Center Comprehensive Nursing Essay Example)

Ohradius. (2019, November 15). Improving efficiency in the operating room. Radius Anesthesia of Ohio. https://radiusohio.com/improving-efficiency-in-the-operating-room/#(Operating Budget of Monroe Outpatient Surgery Center Comprehensive Nursing Essay Example)

https://www.ncbi.nlm.nih.gov/