Hospice Business Plan
Organizational Summary
The nursing home cares for residents mostly drawn from the local community. It offers no hospice care currently. The nursing home has a nurse to staff ratio of 1:8. It charges $80 per day for nursing and assisted care services. Most of the clients are covered by Medicare although a few have private insurance.
Service Description
The nursing home offers two forms of services currently: assisted living and skilled nursing care. Elderly assistants provide and assist the residents in carrying out activities of daily living. The residents are allowed to socialize with other residents and to plan their own schedules. Residents with special health needs are housed in a separate section where they receive skilled nursing care. The nursing staffs consist of three full-time and two part-time registered nurses. The home also has one attending physician who reviews patients weekly and whenever necessary.
Needs Assessment Plan
The needs assessment plan incorporated a survey of the number of patients requiring palliative care in the community, the number of facilities in the locality and neighboring towns offering palliative services, trends in referral of patients for palliative services over the last five years in the affiliate hospital and other surrounding hospitals, alternative organizations providing hospice services in home settings, and a pilot survey.
The needs assessment revealed:
- Most of the other nursing homes are providing identical services and at similar prices hence it is hoped that addition of a hospice-unit will give the nursing home a cutting edge.
- There is an increased need for hospice services at the national level particularly related to an increase in the number of baby boomers requiring end-of-life care.
- Changes in demographics have resulted in a decrease in the number of family caregivers as more females in the community have taken on formal jobs hence families are looking for alternative care environments for their patients with palliative needs.
- Some community members who feel that they do not have the emotional, physical, and intellectual resources to provide palliative care to their loved ones have voiced their interest in a local hospice unit.
- The hospital affiliated to the nursing home is forced to refer its patients with palliative needs to other distant facilities.
- The pilot survey conducted so far has indicated an acute need for a hospice unit since the 9 bed allocated for hospice services are already filled up.
Goal
Implementation Strategy and Timeline
The nurse manager will meet with the architect of the hospice unit to ensure that the renovations are good for the hospice unit as well as practical for the needs of the nursing home. Immediate needs such as staffing, installation of equipment, construction of a work area for the hospice, and education of staffs on the various aspects of hospice care, will be addressed in the initial phase. An electronic medical records system for the hospice unit will be implemented. During the renovation phase, it is expected that the renovation of each room will take approximately 3-5 days to renovate, therefore, one bed will always be maintained empty to facilitate movement of patients during the renovation phase. The overall implementation strategy and timeline is summarized in the table below.
Outcome Assessment
The assessment plan of the hospice unit will focus on three major aspects:
- Satisfaction of the clients/families with the quality of services provided (Hallenbeck et al., 2007).
- Satisfaction of the staffs with the working conditions, salary, and working relationships amongst other factors (Hackett & Palmer, 2010).
- Financial analysis of the costs associated with running the hospice unit.
The initial two elements will be evaluated via surveys of clients/families and staffs. These outcome criteria were identified from previous studies on hospice units.
References
Hackett, A. & Palmer, S. (2010). An investigation into the perceived stressors for staff working in the hospice service. International Journal of Palliative Nursing, 16(6), 289-297.
Hallenbeck, J., Hickey, E., Czarnowski, E., Lehner, L., & Periyakoil, V. S. (2010). Quality of care in a veterans affairs nursing home-based hospice unit. Journal of Palliative Medicine, 10(1), 127-137.
