Nursing Resource Allocation Management

Introduction

In most cases, resources allocated for healthcare and hospitals are limited. As such, hospitals face budget constraints and are required to deliver healthcare with a limited capacity of resources. Additionally, research has revealed that high allocation of resources does not translate into efficacy in healthcare, especially when cost-effective interventions are not adopted (Sibbald, Gibson, Singer, Upshur, & Martin, 2010). Mostly, efficacy is hindered by practice such as inapt uses of medicine, errors associated with medical activities, substandard care, waste, and fraudulent activities. Thus, hospital management must formulate a resource allocation model that enhances efficacy (Ayvaz & Huh, 2010).

This paper evaluates resource allocation processes in a healthcare facility (mesolevel) and gives recommendations or changes that would improve efficiency.

Resource allocation management

As mentioned earlier, resources available in many hospitals have limited capacity to deal with the diverse healthcare demands. As such, healthcare facilities endeavor to adopt efficient and effective resource management strategies.

Notably, the facility management faces the challenge of providing the best services to all patients with limited resources. As such, the overall goal of resource allocation management is to enhance efficacy by allocating resources appropriately.

The facility management heavily relies on variables such as resource availability, decision space, financing arrangement, availability/or use of information, and the organizational culture.

Some of the crucial resources that require thoughtful allocation include beds, medication, and surgical equipment.

Managing surgical resources allocation

Managing surgical resources in any hospital is vital since misuse could lead to grave medical errors and huge wastage (Navarro-Martínez, et al., 2015). Additionally, surgical and intraoperative practices are resource-intensive accounting for more than any other single practice in many hospitals. Resources used in surgical operations include operating rooms, nurses, time, equipment, and surgeons.

Therefore, the facility management strives to minimize wastage, reduce medical errors, and realize positive outcomes. The hospital adopts a two-phase management model. The first phase deals with general allocation, which allocates resources to all surgical demands while the second phase allocates the resources based on urgency and competitive bidding.

Managing bed allocation

Managing bed resources is a vital aspect of facility resource management. Therefore, hospital leadership assigns the responsibility of managing bed capacity to the senior-most floor nurse. The nurse has the pertinent experience, skills, and sound judgment in bed allocation. Nurses assess the urgency of each case to determine patients to be admitted and the duration for each admission.

Additionally, the facility employs a scientific approach based on changes relating to both elective and acute patient flow.

Managing human resource

The healthcare sector currently faces a nurse shortage. However, these facilities cannot run without nurses, physicians, and support staff. Planning and implementation processes rely heavily on people working in a particular facility. Therefore, human resource management is a vital aspect of the effective and efficient use of each hospital employee (Khatri, Wells, McKune, & Brewer, 2010).

The most crucial aspect of managing the human resource in this facility is the shift and patient allocation.

The facility considers the shift process and allocation of particular nurses to particular patients very crucial. Therefore, the nurse administrator is responsible for managing the nurse roster.

Additionally, the facility has coherent and properly laid down strategies on hiring, training and development, remuneration, and dismissal among other HR aspects. Further, the facility HR Department relatively strikes a balance between culture and HRM by making efforts to comprehend the interrelationship between the two. Consequently, the relationship between medical outcomes and human resource practices is evident.

Team nursing care model can help to manage issues of nursing staff shortage.

Systems and processes adopted

Researchers have shown that formalized resources allocation processes are ideal and, therefore, it is recommended that health facilities adopt them where appropriate (Smith, et al., 2013). The formal processes are vividly evident, especially as one goes up the management hierarchy. Thus, resource allocation processes are more formalized at the highest management levels relative to the lower hierarchy. Notably, formalization processes are relatively self-developed. Although they can be linked to certain established models, the derivation is not direct. Conversely, the formalization of the processes is tailored to meet the specific needs of a given facility.

It is imperative to note that the formalization of the resource allocation processes is enhanced by the size of the facility, particularly in relatively large ones. Although there are diverse views and political contestations when making decisions, consensuses are oftentimes used to adopt processes that enhance efficacy. Besides, historical patterns are usually considered in budgetary allocation.

Furthermore, systems involved in resource allocation in health facilities depend on social justification and equity. As such, a rational system in any facility will uphold social values and allocate resources fairly (Clark & Weale, 2012). The facility management and stakeholders, in general, are committed to values such as transparency and equity. Consequently, the processes and systems of allocation adopted highly emphasize stakeholders’ participation and accountability.

Resource allocation and distribution determination

The hospital is faced with competing demands for resources. Determining the allocation and distribution of resources among competing medical needs in a hospital is a rather complex exercise (Barasa, Molyneux, English, & Cleary, 2014). Therefore, for the facility to allocate resources and distribute them sufficiently, the following aspects are considered. First, the management makes assessments of health implications and financial costs that could be incurred if a certain problem is not addressed. The allocation of resources, therefore, is determinant to the level of implications.

Second, the management considers the scale of a problem as a key factor in determining resource allocation. For instance, the number of people affected by a certain epidemic will prompt the management to make the appropriate allocation. The higher the numbers of the affected people (directly and indirectly) the higher the resource allocation.

Third, the resource allocation process takes into consideration all the stakeholders, including patients, nurses, governments, and the public.

Fourth, the morbidity, mortality and other aspects of a problem impact are central to allocation. As such, the facility management factor in the consequences of a health problem prioritizing resource allocation to those problems with dire impact on health, social, economic and environment.

Fifth, the hospital management takes advantage of other concurrent initiatives meant to address healthcare issues in the community. For instance, the government, NGOs, and other institutions occasionally participate in health initiatives and, therefore, reduce demand on specific health needs. Thus, the hospital leverages such initiatives and reduces allocations on affected issues.

Sixth, the facility management evaluates the sustainability of individual programs by assessing the immediate and future improvements. Programs with the potential to give immediate and sustainable benefits receive a relatively bigger capital allocation.

Lastly, the hospital evaluates the degree of certainty of a program to determine the amount of resources required. The hospital employs evidence-based mechanism by carrying out systematic reviews of effects of similar programs in the society to ensure effective resource allocation.

Recommendation for the resource allocation process

Research has demonstrated that models adopted by hospitals in resource allocation highly influences efficacy. This paper, therefore, recommends the following changes in healthcare facility resource allocation.

First, the facility should adopt Discrete Event Simulation (DES) in the planning process. DES has been used by a considerable number of healthcare managers and proved viable (Thorwarth, Rashwan, & Arisha, 2015). As such, DES is accepted and appreciated as an efficiency enhancement tool. DES is relatively reliable, and it allows the facility management to predict demands for medical services and, consequently, make effective and efficient resources allocation. Further, DES helps the management to make comprehensive analyses and allows for optimization of system parameters.

Healthcare facilities face considerable complexity among interlinked resources and their purposes in multiple flow scenarios. The facility, therefore, should employ effective Multiple Participant Pathway Modeling (MPPM) techniques. As such, active and passive pathways are labeled as per the nature of allocated resources. The complexity associated with MPPM can be converted to a simplified and analytical illustration to be used as a formula to enhance swift and correct decision-making.

These decision-making support tools can support efficient resource allocation in healthcare facilities.

Second, human resource makes a considerable contribution to enhancing hospital efficacy. As such, the facility needs to adopt a formula that will bring the best out of all personnel (Hamidi, 2016). For instance, the management needs to strike a balance between the number of non-medical and medical staff. As such, the facility needs to increase the number of doctors and nurses and carry out constant training to have a rich clinical skill-mix. Further, the management can implement an integer linear program to improve efficiency in routine and shifts, which has proved to work in a number of hospitals (Bachouch, Guinet, & Hajri-Gabouj, 2011).

Third, studies have shown that facilities have trouble in evaluating the efficacy of resource allocation process and system. Nonetheless, evaluation is crucial and should be done regularly as needs arise (Sibbald, Gibson, Singer, Upshur, & Martin, 2010). It is recommended, therefore, that the facility management should make an evaluation. The evaluation process will aim at assessing the efficacy and potential to improve outcomes, providing concrete and informed guidance in decision-making.

Fourth, in many hospitals, surgeries are associated with elongated length of stay. The longer a patient stays in a hospital, the more the resources are used (Kulkarni, Ituarte, Gunderson, & Yeh, 2011). It is recommended that hospitals should adopt clinical pathways, which will improve efficacy after surgery while maintaining high-quality outcomes.

Lastly, evaluation processes need to be done in a more scientific manner by using reliable techniques to gather data to determine effectiveness of resource allocation. As such, a more reliable information can be used to guide resource allocation decisions.

Conclusion

This paper has evaluated resources allocation in a healthcare facility. It has shown that hospital management plays a key role in resource allocation and management. Although resources allocated to the facility are limited, the management strives to achieve efficacy. Further, it is evident that the hospital adopts relatively formalized processes in resource allocation while emphasizing on equity and social values. Lastly, the paper demonstrates that the facility should follow a more established procedure in determining resource allocation and distribution. The hospital management should therefore adopt some of these recommendations to improve the efficiency in resource allocation.

References

Ayvaz, N., & Huh, W. T. (2010). . Journal of Revenue and Pricing Management, 2010(9). 386–398.

Bachouch, R. B., Guinet, A., & Hajri-Gabouj, S. (2011). A Decision-Making Tool for Home Health Care Nurses’ Planning. Supply Chain Forum An International Journal, 12(1). 14-20.

Barasa, E. W., Molyneux, S., English, M., & Cleary, S. (2014). . Health Policy and Planning, 30(3), 386-396.

Clark, S., & Weale, A. (2012). Social Values in Health Priority Setting: a conceptual framework. Journal of Health Organization Management, 26(3), 293-316.

Hamidi, S. (2016). . Cost Effectiveness and Resource Allocation, 2016(14), 3.

Khatri, N., Wells, J., McKune, J., & Brewer, M. (2010). Hospital Topics, 84(4), 9-20.

Kulkarni, R. P., Ituarte, P. H.-G., Gunderson, D., & Yeh, M. W. (2011). . Journal of the American College of Surgeoons, 212(1), 35-41.

Navarro-Martínez, J., Gálvez, C., Rivera-Cogollos, M. J., Galiana-Ivars, M., Bolufer, S., & Martínez-Adsuar, F. (2015). . Annals of Translational Medicine, 3(8), 111.

Sibbald, S. L., Gibson, J. L., Singer, P. A., Upshur, R., & Martin, D. K. (2010). . BMC Health Services Research, 2010(10), 131.

Smith, N., Mitton, C., Bryan, S., Davidson, A., Urquhart, B., Gibson, J. L.,… Donaldson, C. (2013). . BMC Health Services Research, 2013(13), 247.

Thorwarth, M., Rashwan, W., & Arisha, A. (2015). An Analytical Representation of Flexible Resource Allocation in Hospitals. Flexible Services and Manufacturing Journal, 26(93), 1989 – 2014.

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