Yoder-Wise's Leading and Managing in Canadian Nursing 3rd Edition Yoder-
Chapter 14: Managing Costs and Budgets
Waddell/Walton: Yoder-
Wise’s Leading and Managing in Canadian Nursing, Third Edition
MULTIPLE CHOICE
The chief nursing office of a Magnet hospital has conducted a study of ways to impro
ve health care services. Health care services that add value for patients:
Accomplish health care goals.
Minimize costs.
Decrease the number of services used.
Involve the use of high-technology treatments.
ANS: B
Models of reimbursement affect which services and approaches (e.g., decreasing the numb
er of services used) might be financially viable and add value for patients. Nurses need to
become aware of business models in health care organizations and of fundamental conce
pts of economics; such models and concepts serve as general guidelines for minimizing c
osts, regardless of the model of reimbursement in use.
DIF: Cognitive Level: Understand REF:
Page 278 TOP:
Nursing Process: Assessment
The standard of care in a certain labour and delivery unit is 14 hours per patient day (
HPPD), and on an average day, three patients are in labour. Analysis of the past mo n
th indicates the unit was averaging 38 hours of care. What is the productivity rating f
or this
situation? NURSINGTB.COM
a. 91%
b. 101%
c. 111%
d. 271%
ANS: C
Many hospitals use HPPD as one measure of productivity. For this example, the standard
of care is 14 HPPD; therefore, 42 hours of care are required for three patients for 1 day.
When 38 hours of care are provided for 1 day, the productivity rating is 111% (42/38 = 1
.11), meaning either that productivity was increased or that needed care was not delivered
. The quality component must be considered in any productivity model related to care.
DIF: Cognitive Level: Analyze REF:
Page 283 TOP:
Nursing Process: Implementation
The chief nursing office continues to seek ways to improve health care services to pati
e nts and to save the hospital money. However, with most physicians paid on a fee-for-
service contract, the chief nursing office faces a challenge. Fee-for-
service can provide incentive for:
Offering fewer services to fewer patients.
Using fewer services per patient.
Increasing utilization of diagnostic procedures.
Requiring second opinions.
,NURSINGTB.COM
, Yoder-Wise's Leading and Managing in Canadian Nursing 3rd Edition Yoder-
ANS: B
Payment for physicians is largely through fee-for-
service arrangements, which can provide incentive for a physician to do more, rather than
less, work. Most physicians are connected to the system not as employees but as indepen dent
contractors, who drive the use of services such as diagnostic tests, procedures, and in
-
hospital bed days. Physicians are not directly accountable for the costs borne by a health
region/hospital network or community care environment.
DIF: Cognitive Level: Understand REF:
Page 275 TOP:
Nursing Process: Planning
In a nurse managers‘ meeting, the chief nursing officer encourages the managers to brai
nstorm ways to reduce costs. Nurse managers have the greatest effect on reducing costs
b
managing:
Supplies.
Staffing. Fixed
costs. Medication
costs.
ANS: B
Because staffing constitutes the largest portion of any health care budget, managing the m
i x and numbers of staff required for patient care to meet identified outcomes will have th
e largest effect on budgets.
DIF: Cognitive Level: Understand REF: Pages 279–
280 TOP:
Nursing Process: A s s e s s m e n
t
N R I G B.CM
USNT O
The chief nursing officer works with her nurse managers by helping them understand how to
develop and implement a budget. How would a nurse manager best describe a budget?
A day-to-day plan for operations.
A unit of service.
A statement of revenues and services.
A financial plan.
ANS: D
The budget is an overall financial plan. An organizational budget is a formal plan that is
stated in terms of dollars and includes proposed revenues and expenditures.
DIF: Cognitive Level: Understand REF:
Page 281 TOP:
Nursing Process: Assessment
A nurse manager gives approval for two staff nurses to attend a national conference. W
h en reviewing the budget, the nurse manager looks at which line item?
Cash budget.
Capital budget.
Operating budget.
Supply and expense budget.
ANS: C
Chapter 14: Managing Costs and Budgets
Waddell/Walton: Yoder-
Wise’s Leading and Managing in Canadian Nursing, Third Edition
MULTIPLE CHOICE
The chief nursing office of a Magnet hospital has conducted a study of ways to impro
ve health care services. Health care services that add value for patients:
Accomplish health care goals.
Minimize costs.
Decrease the number of services used.
Involve the use of high-technology treatments.
ANS: B
Models of reimbursement affect which services and approaches (e.g., decreasing the numb
er of services used) might be financially viable and add value for patients. Nurses need to
become aware of business models in health care organizations and of fundamental conce
pts of economics; such models and concepts serve as general guidelines for minimizing c
osts, regardless of the model of reimbursement in use.
DIF: Cognitive Level: Understand REF:
Page 278 TOP:
Nursing Process: Assessment
The standard of care in a certain labour and delivery unit is 14 hours per patient day (
HPPD), and on an average day, three patients are in labour. Analysis of the past mo n
th indicates the unit was averaging 38 hours of care. What is the productivity rating f
or this
situation? NURSINGTB.COM
a. 91%
b. 101%
c. 111%
d. 271%
ANS: C
Many hospitals use HPPD as one measure of productivity. For this example, the standard
of care is 14 HPPD; therefore, 42 hours of care are required for three patients for 1 day.
When 38 hours of care are provided for 1 day, the productivity rating is 111% (42/38 = 1
.11), meaning either that productivity was increased or that needed care was not delivered
. The quality component must be considered in any productivity model related to care.
DIF: Cognitive Level: Analyze REF:
Page 283 TOP:
Nursing Process: Implementation
The chief nursing office continues to seek ways to improve health care services to pati
e nts and to save the hospital money. However, with most physicians paid on a fee-for-
service contract, the chief nursing office faces a challenge. Fee-for-
service can provide incentive for:
Offering fewer services to fewer patients.
Using fewer services per patient.
Increasing utilization of diagnostic procedures.
Requiring second opinions.
,NURSINGTB.COM
, Yoder-Wise's Leading and Managing in Canadian Nursing 3rd Edition Yoder-
ANS: B
Payment for physicians is largely through fee-for-
service arrangements, which can provide incentive for a physician to do more, rather than
less, work. Most physicians are connected to the system not as employees but as indepen dent
contractors, who drive the use of services such as diagnostic tests, procedures, and in
-
hospital bed days. Physicians are not directly accountable for the costs borne by a health
region/hospital network or community care environment.
DIF: Cognitive Level: Understand REF:
Page 275 TOP:
Nursing Process: Planning
In a nurse managers‘ meeting, the chief nursing officer encourages the managers to brai
nstorm ways to reduce costs. Nurse managers have the greatest effect on reducing costs
b
managing:
Supplies.
Staffing. Fixed
costs. Medication
costs.
ANS: B
Because staffing constitutes the largest portion of any health care budget, managing the m
i x and numbers of staff required for patient care to meet identified outcomes will have th
e largest effect on budgets.
DIF: Cognitive Level: Understand REF: Pages 279–
280 TOP:
Nursing Process: A s s e s s m e n
t
N R I G B.CM
USNT O
The chief nursing officer works with her nurse managers by helping them understand how to
develop and implement a budget. How would a nurse manager best describe a budget?
A day-to-day plan for operations.
A unit of service.
A statement of revenues and services.
A financial plan.
ANS: D
The budget is an overall financial plan. An organizational budget is a formal plan that is
stated in terms of dollars and includes proposed revenues and expenditures.
DIF: Cognitive Level: Understand REF:
Page 281 TOP:
Nursing Process: Assessment
A nurse manager gives approval for two staff nurses to attend a national conference. W
h en reviewing the budget, the nurse manager looks at which line item?
Cash budget.
Capital budget.
Operating budget.
Supply and expense budget.
ANS: C
