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Homework answers / question archive / MANAGING CUSTOMER UtIVIAINu  CASE  Memorial Hospital  Memorial Hospital is a 265-bed regional health care facility located in the mountains of western North Carolina

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


Memorial Hospital 
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 10.3, 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 10.4 provides a historical monthly breakdown of the average daily pa-tient 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 changing pay structures, and temporary nurse availability and cost pwo.licieg, quickly approaching, Fry is collecting information to plan next year's ith levels. staffing The nurses at Memorial Hospital work a regular schedule of 10-hour days per week. The average regular-time pay across all n four grades is $12.00 per hour. Overtime may be scheduled when necesrssia lr However, because of the intensity of the demands placed on nurses; , ony". limited amount of overtime is permitted per week. Nurses may be schedulml for as many as 12 hours per day, for a maximum of 5 days per Week. over. time is compensated at a rate of $18.00 per hour. In periods of extreme) 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 may nurses away from hospitals with higher pay and greater flexibility, This situ. ation has caused Memorial to guarantee its full-time staff nurses pay fora minimum of 30 hours per week, regardless of the demand placed on nursing services. In addition, each nurse receives 4 weeks of paid vacation each year, However, vacation scheduling may be somewhat restricted by the projected demand for nurses during particular times of the year. 

Number of Beds 
Patients per Nurse 
Patient Census* 
Intensive Care Cardiac Maternity 

Pediatric Surgery Post-Op Emergency General 
*Yearly average per day e The hospital employs 20 surgical nurses. Routine surgery is scheduled on Tuesdays and Fridays; five surgeries can be scheduled per day per operating room (bed) on these days Emergencysu is scheduled as needed. IDaily equivalents are used to schedule nurses because patients flow through these wards in relatively short periods of time, A daily equivalent of 5 indicates that throughout a tYP of five patients are treated in the ward. ;cal day, an aver° 
20 25 30 40 5 15 10 120 
2 10 
4 15 


8 (T—F daily equivalent)t 
5 (daily equivalent)t 

At present, the hospital employs 130 nurses, including 20 surgical nurses. The other 110 nurses are assigned to the remaining seven major ar-eas of the hospital. The personnel department informed Fry that the average cost to the hospital for hiring a new full-time nurse is $400 and for laying off ° r firing a nurse is $150. Although layoffs are an option, Fry is aware of the hospital's objective of maintaining a level workforce. After looking over the information that she collected, Darlene Fry wants to consider staffing changes in all areas except the surgery ward, which is already correctly staffed. 

Ward Intensive Care 
Cardiac Maternity 
Pediatric Surgery Post-Opt Emergencyt 

J F M 13 10 8 18 16 8 8 22 23 24 20 18 18 10 8 7 6 4 4 110 108 100 

7 15 13 12 13 
24 17 7 7 98 
MONTH 7 14 10 25 
16 • 8 95 
Source: This case was prepared by Dr. Brooke Saiadin, Wake Forest University, North Carolina, as a basis for Reprinted with permission. *Average surgeries per day on Tuesday and Thursday. -"Daily equivalents 

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