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Memorial Hospital is a 265-bed regional health care facility located in the mountains of western North Carolina

Memorial Hospital is a 265-bed regional health care facility located in the mountains of western
North Carolina. The mission of the hospital is to provide quality health care to the people of
Ashe County and the six surrounding counties. To accomplish this mission, Memorial Hospital’s
CEO has outlined three objectives: (1) maximize customer service to increase customer
satisfaction, (2) minimize costs to remain competitive, and (3) minimize fluctuations in
workforce levels to help stabilize area employment.
The hospital’s operations are segmented into eight major wards for the purposes of planning and
scheduling the nursing staff. These wards are listed in Table 15.4, along with the number of beds,
targeted patient-to-nurse ratios, and average patient census for each ward. The overall demand
for hospital services remained relatively constant over the past few years even though the
population of the seven counties served increased. This stable demand can be attributed to
increased competition from other hospitals in the area and the rise in alternative health care
delivery systems, such as health maintenance organizations (HMOs). However, demand for
Memorial Hospital’s services does vary considerably by type of ward and time of year.
Table 15.5 provides a historical monthly breakdown of the average daily patient census per ward.
The director of nursing for Memorial Hospital is Darlene Fry. Each fall she confronts one of the
most challenging aspects of her job: planning the nurse-staffing levels for the next calendar year.
Although the average demand for nurses has remained relatively stable over the past couple of
years, the staffing plan usually changes because of changing work policies, changing pay
structures, and temporary nurse availability and cost. With fall quickly approaching, Fry is
collecting information to plan next year’s staffing levels. The nurses at Memorial Hospital work
a regular schedule of four 10-hour days per week. The average regular-time pay across all
nursing grades is $12.00 per hour. Overtime may be scheduled when necessary. However,
because of the intensity of the demands placed on nurses, only a limited amount of overtime is
permitted per week. Nurses may be scheduled for as many as 12 hours per day, for a maximum
of 5 days per week. Overtime is compensated at a rate of $18.00 per hour. In periods of
extremely high demand, temporary part-time nurses may be hired for a limited period of time.
Temporary nurses are paid $15.00 per hour. Memorial Hospital’s policy limits the proportion of
temporary nurses to 15 percent of the total nursing staff. Finding, hiring, and retaining qualified
nurses is an ongoing problem for hospitals. One reason is that various forms of private practice
lure many nurses away from hospitals with higher pay and greater flexibility.

Apr 29 2020 View more View Less

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