Developing of a business case and project scope statement for a new project

• Proposed Project Title
• Background
• Business Need/Opportunity
• Viable Option(s) - Reasons for avoiding the rest of the options
• Implementation Approach
• Cost Benefit Analysis
• Recommendation

You are the Manager of the Emergency Department in a small, but busy rural hospital. You report to the Director of Nursing who also has responsibility for the 4 in-patient units in the hospital. Together, and with support from the Chief of Emergency Medicine, you have been analyzing the increasing emergency room visits over the last 3 years. It is common knowledge that this increase in visits is a result of the loss of 2 of the local family physicians who left your small town 3 years ago. The CEO of your hospital has been working closely with members of town council on a recruitment campaign and have found 2 physicians who can start in 10 months-time.

In the meantime, however, you have come up with an idea to manage the increased volumes by managing the throughput of patients in the department. Your observations are that patients who must be admitted are often waiting in the emergency department up to 24 hours for an inpatient bed. These "admitted but holding" patients are taking up exam rooms in the emergency department that could be used to see patients from the waiting room. Several of the emergency room physicians have told you that they could see more patients if there were more rooms to see them. You know that your Director has an old ward room on one of her inpatient units 2 floors above the emergency department that is not on the current inpatient census. This ward room is used mainly during the flu season as overflow or surge space. You believe that you can creating ED Annex in this space, for the admitted but holding patients until their inpatient rooms become available. This will free up some space in the department to move patients through the system.

Background:

* The charge nurse has been vocal about their lack of support for this plan.

* The nurses are unionized.

* The local paper regularly reports about the long wait times and town locals have been vocal in the "letter to the editor" section. They want to see a solution.