Scenario:

For this assessment, assume you are the executive director for a for-profit home care agency and you are experiencing a shortage of staff in nursing. You are having to turn away clients because you are not able to provide staff to make the visits. Your task is to complete the cost-benefit analysis to determine what your best course of action is. You are currently short of four full-time nurse positions to meet your current client load. Each full-time nurse position equates to 20 clients per week, with one hour for a visit and one hour for travel and documentation time for each client. This means you will need to reduce by 80 clients per week or add staff. Your current client load for the agency is 160 clients. You have two management nurses that process intakes, manage quality, ensure compliance, and perform audits for pending federal surveys. They are salaried and do not see clients in the home currently.

Your task is to find a long-term solution to your staffing problem. Pick from one of the four categories to focus your efforts:

• Staffing.
• HR benefits.
• Technology/wearable health care technology.
• Telehealth.

You have a surplus in a budget line of 1,00,000 dollars to address this issue. You may review the articles in the suggested reading list for this assessment to give you a start. Please offer at least three solutions that you would recommend, and the cost-benefit associated with each one. Also, please note the opportunity cost for each option.

Preparation:

Example Option 1: Loan Repayment

Proposal: Offer loan repayment for 3 years of service.

Benefit:

• Increase pool applying for positions.
• Reduce turnover with signed contract of three-year commitment.
• Immediate ability to fill open positions as nurses are already licensed.

Cost:

• 4,000 dollars per nurse over a three-year period adding current loan payment to first paycheck of the month.

Opportunity Cost:

• To recruit the four nurses needed would cost 16,000 dollars total. That would then preclude the purchase of the telehealth option as that option would utilize the entire 100,000 dollars surplus budget; however, this option would allow for a combination of other solutions to be used as well, as there would be money left over.

Detailed Explanation:

My reason for choosing scholarship repayment is because it allows for the immediate recruitment of nurses to our organization. This option can be handled as bonus payment, so as not to require extensive contracts with universities or community colleges themselves. It fills our immediate need quickly, but also commits the employee to a minimum term of three years with our organization that will also reduce our turnover and give us a chance to get ahead of the nursing shortage. There are several drawbacks to this plan however.

One is that our current nurses may also have outstanding loans and may feel slighted that their loyalty is not being rewarded with the loan repayment option. This could lead to a morale and company culture issue, ultimately resulting in the turnover of current nursing staff due to hard feelings. This may require the option to repay loans of the current staff, which may cost an additional 50,000 dollars depending on how many current nurses would wish to participate. This option also could be difficult to enforce should the new recruits decide not to stay. Obtaining repayment may prove burdensome and cost more in legal fees to recover than would actually be recovered. However, based on our research, this is something that new nurses are seeking in their employment and is a benefit that other organizations are not offering, which sets us apart and makes us an attractive place to work. That benefit coupled with the option to use the balance of surplus budget for other recruitment efforts makes this an option that we would like to pursue.

Instructions:

• Include an executive summary with an overview of the purpose and content of the cost-benefit analysis.
• Proposal: Brief description of the option.
• Benefit: List the benefits associated with this option.
• Cost Associated: List the costs associated with this option.
• Opportunity Cost: List what might be given up if this option is selected.
• Detailed Explanation: Explain how the cost-benefit analysis for the option aligns with organizational needs and future growth.
  • Address the following for each option:
    • Non-monetary benefits, such as improved customer satisfaction, associated with the option.
    • Non-monetary costs associated with the option. For example, productivity may decrease initially as people adjust to new policies and procedures associated with the option. At the same time, productivity is likely to increase once people adjust to the new policies and procedures.
    • Although these factors may be difficult to quantify, successful health care leaders are able to weigh nonmonetary and monetary considerations when making their purchasing and budgeting decisions.
  • Spell out the pros and cons between this option and the issue presented in this assessment.
  • Explain how the concept of opportunity cost applies to the option.