The Director of Nursing (DON) at a large urban hospital is tasked with increasing the hospital's profits and improving quality. What action by the DON is best?
a. Engage in monopsony with regional hospitals.
b. Hire more nonprofessional ancillary staff.
c. Implement policies to prevent hospital-acquired infections.
d. Purchase capital budget items only when necessary.
C
The provisions of the Affordable Care Act encourage quality improvement through the development of reliable quality measurements and enforcing accountability. Specifically, the Act reduces payments to hospitals with 25th percentile or higher rate of hospital-acquired infections. To avoid losing that money and to show quality, the DON would implement policies that are designed to prevent hospital-acquired infections. Monopsony is the practice of hospitals setting nurses' wages to maximize profits. This does not ensure quality. Hiring more nonprofessional staff may save money but does not improve quality. Purchasing capital budget items only when necessary may be a sound financial strategy but may have a deleterious effect on quality. The only option to both improve profit and quality is to prevent hospital-acquired infections.
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