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  • Subject Name : Cost and Quality Management

Introduction 

Medical Centre of St. Dismas which is a profit-less rehabilitation Centre that provide medical facilities to the people who are catastrophically ill and severely injured. The rehabilitation Centre market researchers reported that there was a decline in the admissions of the patients. To get a hold on the future of the organization, the CEO and the board, Fred Splient M.D. conducted a major strategic planning meeting to discuss the efforts needed to grow the business.  Therefore to tackle this problem and considering the consequences of the problem, the hospital CEO appointed an ALF Project Team of Steering Committee to provide an action plan. The report mainly focus on the cost and quality management of the hospital. In March 2019 a Business Development team was appointed by the CEO of the hospital which presented its report in May 2019 which highlighted some of the core issues to be taken care by recommending him to open a convalescent home facility for the patients. The facility will act as a profit allowance of the Rehabilitation Centre which will help the Centre to generate a profit and will be not only be subjected to the strict guidelines of the hospital’s accrediting agencies. As an adjuvant organization, the Board will still have control over the Centre.

Cost control problem

In the course of execution of the project, process for project production management and keeping the records becomes the mandatory tools for the managers and other members during the development process. These devices serve the different motives for taking down the financial operations which will occur to give managers an indication of the problems and progress related to the scheme. The duty of the project control system is to basically provide a clear sign of the existence and extension of the problems.

We have critically analyzed the problems which are related to resource utilization, managing, accounting and control during a project (Woodhouse et al, .2016).  We have emphasized on the project management on the basis of the accounting information provided. The interpretation of project accounts is not easy until the project is completed because there is always a chance of increase in the estimated cost while the project is in process. The accounting results can be confusing even after the completion of the project. In the process of management problems, we will be discussing some of the common problems related to accounting systems and conventions.

Resource PlanningA chief financial officer was appointed to estimate and determine the cost of the budget required for the action plan. The financial officer helped in validating the flow of the cash and profit from the facility operations. According to the consultant hired, St.Dismas should focus on the middle economic class aged population since there were many up - scale facilities in the area.The project control procedures mainly focus on the identification of deviations from the project plan in place of possible areas for cost savings. At the advanced stage control of the project becomes an important aspect of the process (Cordeiro et al, .2018).

Resource planning is the most integral part of any action plan. It includes all the resources which will be needed to implement the plan. The ALF Committee project team appointed different personnel for each task to determine the resources needed to implement the action plan like dietary officer was appointed to list out all the resources which will be needed to feed the patients (Cordeiro et al, .2018).  Similarly the list of resources for medicines required monthly, building charges etc. were asked from the concerned officers. Based on the report from all the departments an action plan was made keeping in mind the number of each resources and their cost.

Cost estimating 

For estimating the net cost of the project, a contractor was appointed by the Chief Financial Officer, who received an estimation of construction cost which was approximately $70 per square foot with a standard deviation of $3.36. The overall cost estimated by the CFO for the facility construction would be around $8, 500, 00 to $11,000,000 which includes cost of furnishings, a sheltered connection and land for the hospital. It was also estimated that the net income would be between $9.000 and $12,000 per unit per year. Therefore, it can be computed that the net cash flow for the full project would be around $1,500,000 per year.

table showing item and the respective required expenditure

Cost budgeting 

Based on the study of the action plan it was observed that the team has kept a large portion of the estimated portion for the medical section. The team proposed to purchase too expensive equipment which is not necessary for the site (Abbasi et al, .2018). The team even need to cut down the cost in the furnishings of the hospital, as the hospital needs to be renovated and the old furniture can be kept in use because the budget of the hospital will be around $95,000,000 which is less than the estimated cost of the project. The hospital need to spend, more in the area of medicine purchase and in expanding the area for sheltered homes.

table representing cost budgeting

Budget Summary

Based on the study of the action plan, it was observed that the budgeting was done by considering the estimated cost of the resources and most of the resources cost was measured on the per unit scheme for the resources such as land, studio units for the light assisted patients, bath units, common space, furniture, kitchen equipment, phone bills and IS systems. The heavy assisted area was given a separate space in the budget with a studio apartment and large bath units of approximately 5 units whereas light assisted unit is assigned 15 apartments.

Quality Management Plan

Quality Management Plan serves as guiding plan for the project manager which helps him/her to manage the quality and gives an assurance for a set of activities of a project. The QMP serves the purpose of describing the plan to manage the quality of the resources throughout the lifecycle of the project (Abbasi et al, .2018). The plan lays out a set of procedures and policies which are relevant to the project. The project processes helps in defining the role and responsibilities of the concerned people. The Quality Management Plan is designed by a contractor. The quality refers to the degree of the project requirements. 

Customer focus 

The Quality Management Plan should be planed according to the requirements of the customers of the hospital. The main requirement of the St. Dismas needs to focus on two major aspects which are a brief initiative, was to be more profitable in the distribution of inpatient care and a long-period strategy, to expand new programs and services that would capitalize on the existing, highly competent rehabilitation therapy staff and St. Dismas’ excellent reputation in the region.

Leadership 

To become a leader in the market of healthcare, the hospital need to ensure that it provides a quality service to the patients and facilities. The hospital is right now facing  a decline in admissions due to the less number of beds to accommodate a large number of patients which increasing on a daily basis due to the accidents occurring every day. So, therefore the hospital needs to expand its space for the immediate care section where the accidents cases can be provided first aids.

Continuous improvement 

The hospital can improve its services by providing medicines which are made by a mixture of good quality salts. The hospital can have a regular monthly inspection of the medicine stock to clear up the expire and unaffected stock of the medicine. The action plan has already mentioned the need to purchase the good quality equipment which is even a bit expensive. 

Evidence-based approach 

The contractor of the Quality Authority Plan has used an evidence-based approach to design the action plan for the quality assurance of the chosen facility design which is a freestanding apartment-like facility with a sheltered connection to the Hospital for the access to the kitchen and hospital services. The facility would consist of   100 units with 15 to 30 of the units mentioned as “heavy - assisted” and will be built to provide space to the physically and medically disabled. The other units would be “light - assisted “and will be bit large size apartments. The number of patients it could accommodate would be approximately 110 to 150 residents, who will be mostly single occupants instead of couples. The light-assisted apartments could hold residents who required only minor medical and social interventions. The residents of the heavy-assisted section will address to the patients who would require more medical needs and would require assistance getting around. The Business Development team has recommended this kind of programming model, because many assisted living facilities are erected across the country, but few had a medical focus and offered the types of services that St. Damis can provide to the patients like physical and occupational therapy programs along with a few behavior management programs.

References

Abbasi, S., Shooshtari, S., & Tofighi, S. (2018). Integrating a model quality management system (QMS) in the hospital incident command system (HICS) in Iran. Pharmocophore, 9(1), 104-111.

Cordeiro, A. L. A. O., Fernandes, J. D., Maurício, M. D. A. L. L., Silva, R. M. O., Barros, C. S. M. A., & Romano, C. M. C. (2018). Structural capital in the nursing management in hospitals. Texto Contexto Enferm, 27(2), 1-10.

Kamau, J. K., Rotich, G., & Anyango, W. (2017). Effect of budgeting process on budget performance of state corporations in Kenya: A case of Kenyatta National Hospital. International Academic Journal of Human Resource and Business Administration, 2(3), 255-281.

Mosadeghrad, A. M., & Ashrafi, E. (2017). The impact of quality management on patient satisfaction in a hospital: brief report. Tehran University Medical Journal TUMS Publications, 75(3), 228-234.

Woodhouse, D., Bale, M., Palmer, S., & Tocher, W. (2016, May). An evolution in cost effective power utility grounding asset management: Plan, design, build, assess & operate. In 2016 IEEE/PES Transmission and Distribution Conference and Exposition (T&D) (pp. 1-5). IEEE.

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