Running head: ZERO BASED BUDGET 1

Zero Based Budget

Janet Heath

Bon Secours Memorial College of Nursing

Business of Health Care in Complex Systems

NUR 4240

Julie Selvey MSN, RN

February 17, 2016

On my honor, I pledge that I have neither given nor received help with this assignment

and am in compliance with the BSMCON Honor System. Janet Lorraine Heath
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Zero Based Budget

Overview

For at least 30 years, health-care organizations have faced unprecedented financial

challenges as a result of shrinking reimbursement and rising costs (Marquis & Huston, 2015, p.

205). Financial concepts are a part of the changes in healthcare in which nurses have a

significant role and participation in fiscal planning has become a fundamental and powerful

tool for nursing (Marquis & Huston, 2015, p. 206). My proposal, based on a Zero Based

Proposal Plan, is to change the current ankle splint that is being used in the emergency

department to a more cost effective and user friendly ankle splint. Ultimately, the new splint will

provide higher satisfaction to patients and staff. In order to have this change implemented, I

propose the following objectives to support the change.

The Materials Management Department is the audience in which I will do an oral

presentation to in order to initiate the proposal of a new ankle splint that I would like to be

adopted by my organization. Obviously, the third alternative is what I recommend and is what

this presentation plans to suggests by pointing out the benefits associated with the new ankle

splint.

Objective: To change the ankle splint used in the emergency department to a splint that

is easier to apply, more comfortable, and will save money in the long run. A splint that will

provide better patient satisfaction, less application time for nursing staff, and to decrease the

expense charged to the department and patients. Even though the current splint is less expensive

than the proposed splint, it will save money in the long run and the patient satisfaction and safety

scores will increase.

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Driving Force: The splint that is currently being used is difficult to apply, has too many

steps for application, straps are too long, and patients complain about the comfort of the splint

which frequently causes another visit to the emergency department before an appointment with

an orthopedic can be obtained. The driving force is that the medical staff, as well as, the patients

would be more satisfied. Also, it would be safer because there is less risk for tripping over the

straps that are too long. Finally, the application and patient education that the new splint requires

is less complicated and easier to understand.

Restraining Force: It is difficult to convince management to change something that is

already active. Therefore, the number of ankle splints that are in stock would, probably, need to

be depleted before a change would be considered. Also, the additional costs would have to be

offset by proving the extra time needed to apply the splint cost more in man hours.

Alternative 1: Keep the current ankle splint which costs $20, which is $4 less than the

proposed ankle splint which amounts to $24. (W. Usher, personal communication, February 2,

2016).

Advantage: To keep the ankle splint that is being used now would be

advantageous because it would not cost the hospital money to restock or train employees to

apply a different splint. Also, it is less expensive.

Disadvantage: the patient population would continue to be uncomfortable due to

having an improperly fitting splint that is difficult to apply. The medical staff would continue to

be frustrated because the splint is difficult to apply and the extra straps are hard to keep intact

and are a safety hazard for the patient. It takes approximately five minutes longer to apply the

current ankle splint as opposed to the splint that I am proposing. (W. Usher, personal

communication, February 2, 2016).

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Alternative 2: Change to a more comfortable, easy application, but more expensive

ankle splint. There are splints that go up to $75. (W. Usher, personal communication, February

2, 2016).

Advantage: The nursing staff, as well as, the patients would have increased

satisfaction rates.

Disadvantage: It is not cost effective, therefore, it would be counterproductive

for the hospital finance department.

Alternative 3: To change the ankle splint to a moderately priced ankle splint that is easy

to apply and comfortable for the patient. Wayne Usher, Materials Management, stated that

the ankle splint costs $24 which is $4 more than the splint that is currently being used but the

more expensive splint is worth the money in the long run because it takes staffing at least five

minutes longer to apply the splint that is being used now and patients report that it is very

uncomfortable (W. Usher, personal communication, February 2, 2016).

Advantage: It will take less time for the medical staff to apply the splint and

explain the procedure to the patient. The patient will have a more comfortable fitting splint with

fewer straps which will help prevent tripping and falling. Increased comfort level and ease of

application will help avoid unnecessary visits to the emergency department before being seen by

orthopedics.

Disadvantage: The splints that are stocked will have to be replaced with the new

ankle splints and staff will need instruction on application. Also, the additional price will be a

drawback.
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Process

The methods that I used in the process of researching this product are as outlined. After

developing an objective, I evaluated the driving and restraining forces, reviewed the alternatives

to this change, established the dollar amount for each alternative, and decided whether the

advantages of changing the ankle splint outnumbered the disadvantages. In order to determine

the alternatives to changing the current ankle splint with a different one, I reviewed the pros and

cons associated with this change and researched benefits associated with changing the splint.

The current splint replaced one that was an older model but was 1 times more expensive. The

current splint cost $20 and the replacement would be $4 more expensive. (W. Usher, personal

communication, February 2, 2016). Even though, it is slightly more expensive, the current

model has parts that come loose, fits improperly, are difficult to apply, and takes longer to apply.

Any money saved from the cost of the product, is lost in the time wasted by medical staff during

application. The foot strap is too short which causes discomfort for patients because it is too

tight. After researching several medical supply websites, receiving feedback from peers, and

patients, I interviewed Materials Management. After combining the resources, I realized that I

had a valid proposal.

The challenges that I experienced when preparing this presentation were related to budget

and cost effectiveness. After communicating the problems associated with our current splint and

discussing the safety risks, as well, the proposal was taken more seriously. Also, I mentioned the

rate of readmission into the emergency department that are related to this particular splint. After

pointing out the benefits and risks associated with each splint, the Materials Management

Department seemed more favorable about my proposal.

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Presentation

During presentation to the Materials Management Department, a flip board with all

alternatives listed, will be used. Also, an example of each alternative would be available, as well

as, a trained person to demonstrate the application of each splint to estimate timing involved to

apply and reported comfort level from each volunteer. The dollar amount for the splints will be

posted above the samples. Volunteers in the group would describe their experience and give

opinions on the splint that has the highest rating.

Reflection

After reflecting back on this exercise, I realize that finance is not my strong point and

find it to be more of a challenge than I realized. However, I find it interesting and have learned

more than I ever thought I would about how finance and nursing go hand in hand. Before this

class, I did not see the connection between nursing and finance. After this module, I realize the

importance that each has on the other.

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References

Marquis, B. L., & Huston, C. J. (2015). Leadership roles and management functions in nursing:

Theory and application (8th ed.). Philadelphia, PA: Wolters Kluwer.

Usher, Wayne. (2016, February 2). Materials Management. (Janet Heath, Interviewer)