Eight Steps to Writing a Decentralized Nursing Budget
Step OneÂ
The first step is determining the organization’s productivity goals for the upcoming fiscal year. Changes that should be considered include measures of patient outcomes and utilization. Â
Step Two
Consider the projected workload and the number of days expected to complete the workload for the upcoming year. With current staffing issues that include high turnover rates, it is important to look at these numbers for the projected year. These numbers can be formulated by computer assisted technology that can create a close estimate of the projected workload based on current trends. Â
Step Three
The number of patient care hours needs to be budgeted in order to maintain efficient staffing volume and ratios based on patient load in a specific department.Â
Step FourÂ
Scheduling of staff must be considered and includes ensuring that the budget includes patient care hours based on days of the week and by shifts. Acuity can change on a nursing unit based on the shift, days of the week, and the number of typical patients so it is imperative that these topics are considered when reviewing factors related to the budget.Â
Step Five
As important as it is to focus on patient care hours and staffing schedules when reviewing the budget, it is equally important to plan nonproductive hours as well. These include vacation, holidays, sick leave, and medical leave and must be reviewed to consider how many staff will be utilizing these days and how to ensure the staffing needs are still met.Â
Step Six
The sixth step of decentralized budgeting consists of graphing and/or charting both productive and nonproductive hours. Part of this includes forecasting how both patient days and staffing needs may increase and decrease over the next year.  Â
Many times, a unit can realize how productive or unproductive time is being used by graphing and charting. By doing this, a unit can view how productive time has been spent such as patient care, conferences, educational activities, administrative meetings, and orientation versus unnecessary time management that could be avoided.Â
Step Seven
Estimating the costs of the necessary supplies and services that must be purchased is another important area to be considered based on the current year and what may be anticipated in the next year.  Â
Typically, this is an area that may have an increase since supplies and services tend to rise with each passing year.Â
Step Eight
The last step is the anticipation of capital expenses and investments for the upcoming year and these include large purchases that would need to be reviewed before making the decision to purchase.
Once these eight steps have been considered, a review of the proposed budget should be formulated and the accounting department will review the budget carefully. If approved by the various administrators and managers, the budget will be sent again to the accounting department and the board of directors. Â
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