Strategic Plan Evaluation Assignment Discussion

Section 1: Summary of Issue

Nursing Burnout Data

Maintaining a healthy and robust nursing staff is essential for the successful functioning of any health care organization. Following the recent COVID pandemic, significant changes in payment sources for healthcare, and a continually changing healthcare environment coupled with the worldwide nursing shortage, a substantial amount of evidence documents the effect of these phenomena on nursing burnout and its subsequent adverse effects on nurses and their patients. Nursing burnout is a syndrome resulting from chronic stress at work that manifests in myriad consequences to the nurse’s well-being and overall health (Salvagioni et al., 2017)Strategic Plan Evaluation Assignment Discussion.

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Likewise, the nursing shortage has led to longer shifts and higher patient-to-nurse ratios. This undermines quality of patient care and can also cause fatigue, injury, and stress (Garcia et al., 2019). All of these factors contribute to nursing burnout. Burnout among health workers has harmful consequences for patient care and safety. Reducing burnout and stabilizing the workforce in healthcare has become a fundamental healthcare goal globally. Health care organizations are encouraged to invest in efforts to improve the workplace environment to promote wellness and resiliency for nurses (Salvagioni et al., 2017)Strategic Plan Evaluation Assignment Discussion.

A review of data at Golisano Children’s Hospital, reveals a significant upward trend in nursing turnover, sick calls, and open vacancy rates. Likewise, an upward trend has been identified in filling vacant positions over time. Simultaneously, nursing satisfaction is at an all-time low.

Attempts to Address the Issue

Millions of dollars have been spent on nursing bonuses for the staff who remain, to work extra shifts, which is neither financially sustainable for our hospital, nor physically and mentally sustainable for the staff. Interviews and communication with nursing reveal that high patient ratios, short staffing, long and extra required shifts, poor work-life balance, and lack of empowerment over their environment contribute significantly to burnout, fatigue, and exhaustion. However, patient volume forecasting for the region is expected to reach all-time highs within the next several months.

Sincere attempts by Golisano’s senior leadership have been marginally effective. These attempts include significant market adjustments, bonuses for extra shifts worked, the implementation of realistic and accessible mental health services for employees, initiatives for rewarding employees for their hard work and dedication, and increased initiatives and resources for recruiting employees.  The attempts to stabilize the environment are appreciated, but not enough.

The Strategic Plan

The internationally recognized American Nurses Credentialing Center (ANCC) Magnet Recognition Program’s Journey to Excellence is based on research and is designed to improve work environments, employee satisfaction, staff empowerment, patient safety, quality of care, and patient satisfaction (Rodriguez-Garcia et al., 2020). The literature supports that healthcare organizations that achieve Magnet Recognition provide a multitude of opportunities: practical orientation, training, more meaningful professional development opportunities, improved workload, and patient staff ratios, establish well-defined practice guidelines, have increased nurse empowerment through the development of shared governance, decreased turnover rates, increased staff and patient satisfaction and improved patient safety (Rodriguez-Garcia et al., 2020)Strategic Plan Evaluation Assignment Discussion. The proposal to embark on the magnet journey will place Golisano Children’s Hospital in the best position to attract and retain top talent and produce outcomes that rival the highest performing children’s hospitals nationally.  Our goal is to see a 15% improvement on pre-pandemic metrics for employee turnover, employee satisfaction, employee engagement, patient safety, quality of care metrics, and patient satisfaction.

The Stakeholders

Involvement in the strategic planning process by various stakeholders often yields better outcomes and a heightened sense of ownership, ensuring the project’s success (Orton, 2022). It is essential to engage stakeholders by sharing information purposefully and consistently, asking for their input in meetings, surveys, newsletters, staff meetings, and open forums to build and support ongoing engagement in the strategic planning and implementation process (Martin, 2018). Engaging stakeholders in the entire process helps build enthusiasm and ownership and ensures that all know where and how they fit into the plan (Orton, 2022)Strategic Plan Evaluation Assignment Discussion. Key stakeholders to be involved in Golisano Children’s Hospital’s Journey to Excellence strategic plan are those who have a vested interest in the success of the project and include senior leadership, nursing leadership, nursing and support staff employees, patients, representation from human resources, finance, information technology, the board of directors and community partners. Each will bring a unique perspective to the project and the children’s hospital’s success.

The Mission, Vision, and Values

The senior leadership and project teams must agree on how the children’s hospital’s mission, vision, and values align with the Journey to Excellence initiative and how the strategic plan for this project fits with our overall direction and goals. Golisano’s (2022) mission is “To be a trusted partner, empowering healthier lives through care and compassion.” The vision is “To inspire hope and be a national leader for advancing health and healing and values include respect, excellence, compassion, and education”. Our values foster an environment of respect for one another; striving for excellence with the highest standards of safety and quality, compassion to care for everyone as if they are family while creating a healing environment; and education through individual and organizational learning opportunities to continue improving our healthcare delivery and outcomes. The Children’s hospital’s mission, vision, and values are in direct alignment with the Journey to Excellence strategic plan and will provide stability within our chaotic and unpredictable healthcare climate.

 Section 2: SWOT Analysis

SWOT Analysis

A SWOT analysis was conducted to identify strengths, weaknesses, opportunities, and threats to prepare a case supporting the Golisano’s “Journey to Excellence” initiative. The hospital formed a multidisciplinary team of nurse leaders, staff nurses, certified nursing assistants, information technology team and finance personnel under the lead of the Chief Nursing Executive. The following data were considered: concepts and metrics; nursing turnover rates, nursing vacancies, sick-leave rates, nursing qualifications, nursing educational resources, nursing workload measures, nursing satisfaction, patient satisfaction, significant adverse clinical events and incidents, and nursing-specific quality indicators (patient falls, pressure ulcers, CAUTI, CLABSI), were investigated by conducting staff interviews, reviewing satisfaction surveys, hosting town hall communications, and reviewing historical data and reports. The results of this analysis not only provided detailed and thorough information for the SWOT analysis but were crucial in providing a baseline measurement to track progress throughout the strategic plan. The SWOT analysis results will form the foundation for a range of reporting indicators that will measure progress and identify the key areas to focus on that will require varying levels of leadership attention (David, Creek & David, 2019)Strategic Plan Evaluation Assignment Discussion.

Organizational Strengths

The SWOT analysis identified two of our hospital’s top strengths; our culture and our high scores for nursing-sensitive indicators such as falls, pressure injuries, and CLABSI rates. Cultural strengths included patient and family-centered care embedded in daily interactions and future planning, a commitment to the community, a strong sense of teamwork and interdepartmental collaboration, and patient safety.

Organizational Weaknesses

The two leading organizational weaknesses identified in the SWOT analysis were the lack of shared governance including lack of autonomy and influence over their work environment and understanding metrics such as the budget that drive patient care ratios. The more employees understand how their work is aligned with the company’s greater purpose, the more fulfilled and driven they will be. Employees become more engaged when they can expand their skills and grow—investing in employee development and helping them achieve their aspirations signals them that their work has meaning and purpose. (Rodriguez-Garcia et al 2020). The Journey to Excellence strategic plan offers the possibility of turning these weaknesses into opportunities for our hospital.  Organizations with strong shared governance structures consistently report a strong healthy work force, including improvements in staff satisfaction and engagement as well as improved patient outcomes (Rodriguez-Garcia et al., 2020)Strategic Plan Evaluation Assignment Discussion.

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Market Opportunities

Two market opportunities identified in the SWOT analysis were staff involvement in nursing and evidence-based practice research and developing a shared governance structure. Shared governance provides the infrastructure for decentralizing decision-making. It offers a process that allows professional nursing staff and managers to contribute collectively to decision-making about patient care, nursing practice, and the work environment (Rodriguez-Garcia et al., 2020).

Environmental Threats

Finally, two critical environmental threats identified in the SWOT analysis were record low staff satisfaction surveys and an exponential increase in the number of nurses leaving the hospital for high-paying travel nurse assignments. Lucrative shift incentives and bonus contracts offered by our hospital are no match for the likely unstainable wages and benefits currently offered by traveling companies.  It is believed that the decline in employee satisfaction surveys are clearly related to the deteriorating work environment.

Conclusion

Fortunately, our organizational threats and weaknesses pose exciting opportunities. The proposed Journey to Excellence strategic plan, offers a reliable and proven blue print to help mitigate employee satisfaction, patient satisfaction and patient outcomes, by aiming to improve and stabilize the issues that are encouraging nurses to leave and take travel assignments. If a safe, strong, and empowered environment is created, there are a few reasons to leave and more reasons to stay Strategic Plan Evaluation Assignment Discussion.

Section 3: Goals, Objectives, and Strategies

Strategic Plan Goals

           Organizational structure, including shared governance, professional models of care, autonomy, and professional development, including evidence-based care implementation, are standards foundational to achieving Magnet recognition (Rodriguez-Garcia et al., 2020). A gap analysis conducted at Golisano Children’s Hospital revealed a need to develop a shared governance structure and a dedicated research team and are the basis for two overarching program goals that will guide the Journey to Excellence. The first goal is to improve employee satisfaction and engagement by forming a strategic team that will develop a shared governance council structure and will implement this model by the 3^rd quarter of 2023. The second goal is to improve patient outcomes by creating a strategic team and work environment that supports the increased use of evidence-based practice and research across the children’s hospital by implementing a nursing research department by the 1^st quarter of 2024. These two goals are in direct alignment with the Journey to Excellence Strategic Plan and fulfillment of the hospital’s mission statement to be a “national leader for advancing health and healing” (Mission & Vision, 2022)Strategic Plan Evaluation Assignment Discussion.

Strategic Plan Objectives

Shared governance in nursing is a professional practice model that promotes shared decision-making and nursing empowerment by making nurses accountable for decisions impacting processes, policies, and procedures at the point of patient care (Rodriguez-Garcia et al., 2020). The gap analysis revealed that although fragmented elements of shared governance exist in the children’s hospital, the councils and practices are inconsistent, and individual department councils are not connected to larger system councils. Objectives for shared governance implementation include the need to develop a team of Magnet Journey champions and writers who will conduct a search for a Magnet Consultant firm to guide the Journey to Excellence. The consultant will provide education, and training and help develop our council structure strategy roadmap by the 4^th quarter of 2022 and to develop a budget that includes staff education, council leadership training, hours needed for staff participation and backfill of nursing positions that would increase employee engagement and sense of purpose by the 3^rd quarter of 2023.The Chief Nursing Executive will be responsible for these objectives.

Magnet-designated organizations demonstrate their commitment to evidence-based practice through involvement in nursing research. Many of the principles around which Magnet hospitals revolve include research as one of their core components (Rodriguez-Garcia et al., 2020)Strategic Plan Evaluation Assignment Discussion. A nursing research program will provide the necessary education, information, and support to enhance facilitators. It will minimize barriers to searching, appraising, and using research literature, translating research results into clinical practice, and conducting new nursing research that leads to evidence-based practice implementation, thereby improving patient outcomes. The following objectives will be implemented too create a Research department consisting of one Doctor of Philosophy (PhD) prepared nurse and one administrative assistant who would be responsible for guiding research and education for shared governance council members in selection, development, and implementation of evidence-based practice (EBP) and research projects by the 3^rd quarter of 2023. Secondly, to locate and renovate a dedicated office for the new Research team. A space will be created to accommodate a 2–4-person team with the purpose of coordinating nursing quality improvement and research by the 2^nd quarter of 2023. Thirdly, to create a budget to purchase computers, laptops, National Association of Children’s Hospitals and Related Institutions (NACHRI) benchmarking databases, library access and office supplies/furniture that the research coordinator will use to coach and mentor shared governance council members as they develop EBP that would serve all patients receiving care in the hospital by the 2^nd quarter of 2023. The Chief Nursing Executive will be responsible for these objectives.

Strategic Plan Strategies

Developing and following strategies that align with the vision and mission of the hospital that explain to stakeholders what you are doing and why you are doing it are critical to the success of your strategic plan. Organizational strategies are the driving force behind action plans and scorecards that help track progress toward established goals and objectives. Using a differentiation strategy, would support the “Journey to Excellence” strategic plan which capitalizes on the highly regarded reputation of the Children’s hospital. A meaningful difference not yet achieved by competing healthcare organizations would be highlighted. The achievement of Magnet designation would be valued by all involved stakeholders and would potentially increase market share and revenue for the Children’s hospital.

Goal, Objective, Strategies Success, Monitoring and Evaluation

The strategic plan, goals, objectives, and strategies aren’t stagnant documents. All components should continue to evolve and change as time goes on. An implementation framework document will be created for each goal and objective that will include the following five key elements: the objective, strategy for completion, resource requirements, target completion date and responsible leader. The plan will be reviewed at monthly senior team meetings and the framework will be updated according to the success, challenges, or barriers faced each step of the plan (Fry & Baum, 2015)Strategic Plan Evaluation Assignment Discussion. Strategies for success will be developed in the format of process and outcome objectives. Process objectives will focus on the steps that need to be completed to reach the outcome and help stakeholders see the impact as it is being achieved.  Process objectives for the first goal objectives and strategies will be measured by evaluating if the hired consulting firm completed the required training and education, a shared governance structure was developed and implemented, and a budget was created and approved for human resources needed as outlined in the objectives. Process objectives for the 2^nd goal would include the hiring process completion of the PhD coordinator and a developed and approved budget for the office space renovation, equipment, and office supplies. Outcome objectives will focus on goal completion and the intended effect of the program at producing change (Martin, 2016). For the first goal, outcome objectives will evaluate if the consulting firm was hired, the shared governance structure was implemented and if there is a significant improvement in employee satisfaction and engagement. For the second goal, outcome objective will evaluate if a PhD coordinator was hired, if the office space, equipment space was completed.

Stakeholder Relevancy

           Shared governance is designed to integrate nursing’s core value system and belief model into practice. This decision-making paradigm shift improves patient safety, quality, employee engagement, and satisfaction (Brennan & Wendt, 2021). Shared governance benefits patients and members of the community as with the implementation of evidence-based practices, patient outcomes improve. Healthcare facilities and organizations that use a shared governance model of nursing tend to have lower rates of spikes in healthcare costs as shared governance considers ideas from teams who develop and implement measures to promote high-quality, more cost-effective care (Brennan & Wendt, 2021)Strategic Plan Evaluation Assignment Discussion.

Research involvement indicates the presence of a staff that is active and dedicated to the dynamic field of healthcare in which new findings consistently inform best practices for patients. Ultimately, nursing will have a more significant stake in contributing to an evidence-based culture that resonates throughout the hospital. Evidence supports that nursing research benefits patients by improving patient outcomes and reducing length of stay and costs associated with hospitalizations (Ludwick et al, 2018)Strategic Plan Evaluation Assignment Discussion.

Section 4: Core Team of Change Champions

Change Champions

Change as ambitious as the Journey to Excellence requires team members committed to the process vision. These individuals drive the three C’s of change management: commitment, collaboration, and communication in implementing changes and ensuring sustainability (De Clercq & Pereira, 2021). Change champions must represent the interests of all stakeholders’ viewpoints, thus ensuring the effectiveness of the project. Change champions for the Journey to Excellence initiative include the chief operations officer, chief nurse executive, assistant nursing superintendent, charge nurse, nurse informaticist, the local coordinator for the nurse association, and the director of the family advisory council. These parties represent the spectrum of stakeholders, from senior organizational leadership to bedside nurses and patients to the community. Senior leadership support and goodwill are vital to successfully funding and implementing the strategic plan. In contrast, the charge nurses and the association coordinator provide insights into the plan’s impacts on bedside nurses, nurse assistants, and nursing workflows. Family advisory support ensures that the changes that are proposed represent the needs expressed by the patients and their family members that are cared for in the children’s hospital.

Stakeholder Involvement

The plan’s stakeholders comprise its executors and beneficiaries. Executors include the chief financial officer, chief operations officer, chief nurse executive, director of nursing, supervisors, and charge nurses. These individuals are responsible for planning, funding, organizing, directing, and evaluating throughout the project’s planning, implementation, and review stages. Beneficiaries are nursing staff, patients, and the community at large. Introducing a shared governance structure and creating a dedicated research team will require nurses’ active engagement in planning and implementing the initiative. Their input is essential as they have the most contact with the needs the strategic plan must satisfy. In addition, nurses and patients will provide feedback through which achievement of the plan’s goals will be evaluated and modified as needed.

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Communication and Collaboration

Stakeholder engagement underpins the success of any project (Silvius & Schipper, 2019). Stakeholders for the strategic plan include senior leadership, nursing leadership, nurses, patients, support staff, the board of directors, human resource representatives, finance, information technology specialists, and community partners such as a family advisory board member. To facilitate communication and collaboration, representatives from all stakeholder groups will be involved in all planning, progress and evaluation meetings pertaining to the initiative. Participation in regularly scheduled meetings allows all parties to share their unique perspectives and knowledge. Representatives will be asked to submit monthly reports detailing the project’s implementation, current challenges that include possible solutions, and thoughts on future actions.

A dedicated chat room will be created on the staff portal, an open forum where staff can share and receive information. The chat room will be the primary communication mode with stakeholders. Other modes of communication will be Teams channels for updates and occasional communications, town-hall presentations, lunch and learn sessions, and nursing bulletin information and updates.

Engagement and Motivation

To stay engaged and motivated in the strategic plan, stakeholders must have a sense of ownership (Moro Visconti & Martiniello, 2019). Nurses, patients, support staff, the executive team, and mid-tier management must feel that the plan represents their interests. For staff, the goals are manageable workloads and involvement in policy formulation and review; for patients, the goal is improved care outcomes; for management, the goals are improved productivity and staff retention; and for executive leadership, the goals are enhanced profitability, valuation and improved performance in quality measures. Clear, open, and respectful communication where all feel free to share information, challenges, and successes are essential to motivating and engaging the plan’s stakeholders (Neill et al., 2020)Strategic Plan Evaluation Assignment Discussion.

Section 5: Budgeting and Timeline Tools

Budgeting

The budget for implementing the strategic plan was developed using the activity-based budgeting model. Activities to developing shared governance council structure and creating a research department include: hiring a Magnet Consultant, identifying and renovating space for research office, staff education and training, developing the council structure strategy roadmap, developing budgets, purchasing office supplies and equipment, backfilling nursing positions, and recruiting the PhD research coordinator and administrative assistant. The budgeting items from these activities and their costs are outlined in the table below:

The increase in operating expenses for the new nurses hired and the research department are projected for 5 years in the table below. Additional revenues, cost savings and the net returns from implementing the initiative are also indicated: Strategic Plan Evaluation Assignment Discussion

Implementing the Journey to Excellence Strategic Plan will cost Golisano Children’s Hospital $44,800,000 in initial investment. The gains are in increased market valuation, staff cost savings, and increased revenue from additional patients and increased profitability. Though the facility realizes net losses for the first two years, the initiative breaks even in the third accounting period with net profits steadily increasing to $43,460,000. According to research literature, the Journey to Excellence is likely to yield improved patient outcomes, improved organizational performance, increased employee and patient satisfaction, and decreased staff turnover (Halm, 2019). These are the assumptions used to predict the increase in patient numbers, share valuation, returns per patient and decrease in staff management costs (Graystone, 2019).

Implementation Timeline

Plan start date: April 1, 2022 – SWOT and Gap analysis

The critical path for the project (longest timeline) is that denoted by nodes 1-3-4-7-8-12-13.

Dependencies between activities are indicated by the arrows in the diagram, with predecessor events on the left and successor events on the right (Voit et al., 2020). The plan’s activities take two paths commensurate with the two objectives of shared governance and research involvement. The duality of the implementation effort provides an allowance for variance. The research pathway can be crashed so that the research department is operational long before the due date of December 30, 2023. Alternatively, the governance pathway and associated activities can be stretched past the due date of June 30, 2023, and remain within the plan’s critical path (Al-Fawaeer et al., 2021)Strategic Plan Evaluation Assignment Discussion.

Section 6: Balanced Scorecard

Measuring and Evaluating Impact

A balanced scorecard (BSC) is a management tool used to identify and improve internal processes and external outcomes (Kefe, 2019). As such, the elements of the BSC are quantitative, well-defined, traceable, and easy to measure with available data. The goals of the Journey to Excellence Strategic Plan are staff involvement in nursing and EBP research, and a culture of shared governance. The metrics via which these goals are evaluated include nurse and patient satisfaction, nursing vacancies, nursing turnover rates, sick leave rates, nurse-patient ratios, care coordination, attention to special needs, missed care events, promptness, and significant adverse clinical events (Behrouzi, & Ma’aram, 2019)Strategic Plan Evaluation Assignment Discussion.

Addressing burnout among nurses requires Golisano Children’s Hospital to hire additional staff in a competitive market given the issue of nurse shortage. The hospital sees attaining Magnet recognition as a pathway to a solution, given that such status implies a favorable workplace for nurses. Developing a shared governance council structure and implementing a nursing research department have already been determined as overarching objectives to satisfy to gain Magnet status. The balanced scorecard captures those objectives to specific organizational aspects, and outlines how these will be measured, targets to accomplish, and requisite subordinate initiatives. For instance, backfilling vacant positions will increase nurse/patient ratio, lessening the workload and improving patient safety. Also, nurse retention is likely to be better and sick-leave rates lower in an organization with optimal staffing ratios. The balanced scorecard will facilitate evaluation as it outlines objectives to guide the change initiative and annual targets against which to compare actual results.

Cost Justification

A decrease in staff turnover and vacancy rates and an improvement in patient and nurse satisfaction will provide cost savings to the organization. In addition, implementing evidence-based nursing practices will improve the facility’s nursing-specific quality indicators (CAUTI, medication errors, fall rates, pressure ulcers).  Improvements in these publicly reported indicators will enhance the hospital’s reputation, increasing the number of patients and revenues. Achieving Magnet Recognition status will also boost the facility’s stock valuation. While the scorecard measures and tracks changes in indicators against targets, the synergies between patient wellness, staff empowerment, and leadership support will change corporate culture and ultimately improve outcomes. These gains justify the significant cost outlay that the project demands.

Section 7: Evaluation Plan

Evaluation Information

The strategic plan will be evaluated in two aspects: processes and outcomes. Information used to evaluate the implementation process includes: tasks completed, completion dates, costs, personnel recruitment costs and salaries, staff training schedules, and contracts for research office renovation and Magnet Consultant (Roberts et al., 2019). This information will convey the progress of the implementation process in terms of timing and resource utilization. Evaluating outcomes will use information relating to: the project budget, share price, nurses hiring rates, nurse experience and education level, staff and employee satisfaction surveys, nurse-sensitive quality and safety indicators, number of applications for advertised vacancies, and number of patients served (Harrison & Thompson, 2015)Strategic Plan Evaluation Assignment Discussion. These data will indicate whether the plan’s intended outcomes of achieving Magnet status had the desired impact on market valuation, care outcomes, capacity to retain and attract skilled caregivers, and market share. The data will additionally show the effect of applying evidence-based nursing practices on clinical processes and care quality.

Data Analysis Frequency

The data gathered for evaluation purposes on the process dimension will be evaluated every two weeks. Two weeks is the shortest period on the project implementation timeline, and using it as the analysis timescale will ensure minimal delays in evaluating activities. With a sound relational model, analysis is easy and only new data inputs are needed. A two-week analysis period will allow early detection of deviations and prompt interventions. Evaluating the outcomes dimension will be done on a monthly basis after the research department is operational and the shared governance structure has been implemented.

Monitoring Goals, Objectives, and Vision for the Strategic Plan

The Strategic Plan is largely a structural and process change designed to enhance Golisano Children’s Hospital’s operations for employee wellness and patient outcomes. The implementation framework document will ensure the plan’s objectives of shared governance and evidence based practice are adhered to. Tracking key patient safety indicators (PSIs) will provide information on the accomplishment of the goal of improving patient outcomes while monthly employee surveys will show how staff view the hospital and their working conditions. Plotting changes in PSIs, staff satisfaction, learning and growth and clients served will indicate the performance trend relative to the facility’s vision of being a national leader for advancing health.

Keeping Stakeholders Informed

Nurses, patients, support staff, shareholders and the executive team are interested in the Strategic Plan’s effectiveness at satisfying their needs. The parties require different types of information and different modes of communication are thus necessary. The chat room, patient portal, town-hall presentations, bulletins and Teams channels will be used to inform nurses, support staff and patients on the progress of the implementation process and changes in outcomes. Executive leadership and shareholders need more detailed analyses, which will be communicated via reports evaluating Golisano Children’s Hospital’s financial statements, outlining the project’s costs and monetary returns. Management will use staffing reports to inform the executive team the impact of the Strategic Plan on the facility’s human talent pool, changes in its quantity and quality, variances from expected results and potential interventions (Desarno et al., 2021)Strategic Plan Evaluation Assignment Discussion.

Handling Potential Deviations or Needed Changes

Deviations occur often in plans due to unanticipated variations in the external operating environment (Mittal, 2019). The first action is to determine if the deviations are positive (such as costs cuts) or negative (such as extended timelines). Positive changes will be recorded, exploited and duly communicated to stakeholders using the methods mentioned above. Negative deviations will similarly be communicated to stakeholders and approvals sought for additional funding and other resources as required (Martin, 2018). Changes to goals and objectives will require adjustments to the fundamental structure of the implementation framework. The core team will assess how the change affects the implementation process and revert to the planning stage to establish project activities, related costs and a new timeline. These will be communicated to executive leadership for authorization and then to other stakeholders through the chat-room and progress meetings.

Section 8: Executive Summary

This Strategic Plan addresses the issue of staff shortages that has resulted in prevalent nurse burnout, diminished quality of care and reduced care capacity. Increasing remuneration fails to empower nurses, improve work-life balance and staff health. American Nurses Credentialing Center (ANCC) Magnet Recognition Program’s Journey to Excellence will improve the work environment, patient safety, patient satisfaction, quality of care, employee satisfaction and empowerment. The goals of the Strategic Plan are improving employee engagement and enhancing patient outcomes. These goals are backed by the objectives of creating a shared governance culture, and establishing a research department to collate research literature and guide implementation of quality improvement practices. Items included in the plan include SWOT analysis, stakeholder analysis, engagement and communication plans, change champions, the constitution of the core team, and an implementation schedule. The budget summarizes the Plan’s costs and returns, which the board can appreciate has positive returns on investment.

A constrained workforce negatively affects patient outcomes given that healthcare is a human service and is knowledge work. Golisano needs both sufficient numbers of nurses and a staff employing evidence-based practices in care delivery. Presently, the high nurse-patient ratios, sick leaves, and numerous vacancies are decreasing quality of care and leading to high costs of care, lost reimbursements, low patient numbers and low profitability. This can be changed by hiring more nurses, making workloads manageable so that the nurses can give their best. The current labor market is tough and we cannot rely on bonuses to retain and attract talent. Golisano needs to be a place in which nurses want to work. Failure to address the staffing problem will see patient complaints, lawsuits, poor reputation and dwindling profits become customary.

ANCC Magnet Recognition is the highest standard of nursing excellence a hospital can have. Attaining such status will boost Golisano Children’s Hospital’s appeal to nurses, and consequently, to clients. In addition, it will result in a more empowering organizational structure, higher quality of care, quality of leadership, market valuation and profitability. With Magnet Recognition, the facility will be inordinately attractive to skilled nurses even in a highly competitive environment. Changing the structure and process dimensions of the hospital to address the issue of nurse burnout will yield a 3.5% increase in profit per patient, lower staff turnover rates to 10%, and increase year-on-year number of clients by 90%. The effort will cost a total of $217,695,000 in the first five years, which is offset by returns of $263,160,000. By the fifth year, the initiative is projected to have a net yield of $43,460,000. The gains in prestige, patient numbers, profits per client, market valuation, and savings in staffing costs and reduced cost of care outweigh the costs, making the Journey to Excellence Strategic Plan feasible for the hospital. Strategic Plan Evaluation Assignment Discussion

Section 9: References

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