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Zero Based Budget Proposal Paper

Morgan Horn

NUR 4243 – Business of Healthcare in Complex Systems

Ashley Cavanna, MSN, RN

December 3, 2021

I pledge…….Morgan Horn
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Zero Based Budget Proposal on Reducing Hospital Readmissions for Heart Failure

Patients

Process

In deciding what to focus on for my budget proposal, I chose to review what causes an

increase in healthcare costs throughout hospital settings. There are many factors that contribute

to this but the one aspect I chose to research was the rising healthcare costs for hospital

readmissions of heart failure patients. There have been many evidence-based practice studies that

have reviewed causes for readmissions and how healthcare team members can work together to

promote proper follow-up care and prevention of further readmissions. I read several articles on

processes that can be implemented to improve transition of care from hospital to home for heart

failure patients while continuing to improve their quality of life. One in particular was ensuring

follow-up appointments withing 1 to 3 days from hospital discharge. This method I used was a

qualitative measure because I was able to understand the health problem and its barriers and

work toward identifying how to fix it.

In researching this topic, I found that the patients are key in continuing proper transitions

of care and need a lot of education on why it is important to keep in close contact with their

healthcare providers. It can be a challenge to ensure that patients agree with the plan of care and

can be a barrier when attempting to reduce hospital readmissions. Another thing to consider that

may create a barrier for this proposal is having access to healthcare personnel who are willing to

take the time to ensure all appointments are done and completed within the time frame. You

must consider the manpower that is needed to maintain mandatory follow-up appointments and

ensure all heart failure patients are seen. It will take time to consider the different roles that will
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be needed in this process and the best way to ensure all patients are receiving the continued care

they deserve after discharge. Nurses will need to be hired prior to the initiation of the change and

education given on when to follow-up and specific questions to ask the patient in relation to their

symptoms. Education and in-services will be key in giving these nurses confidence in

understanding the importance of these appointments. The educated nurses will also be helpful in

addressing the patients about continued care and will hopefully reduce the risk of noncompliance

in these patients.

Presentation

It will be important when talking with my selected audience to discuss the number of

heart failure patients that are readmitted each month due to lack of symptom management and

my estimated goal of decreasing that rate by 10% within a 6-month period of time. I will reiterate

the importance of team communication between the doctors and nurses and case managers to

schedule appointments and follow through with them. I plan on discussing the average amount

of money spent on a readmitted patient and how much money can be saved with proper

transitional care from hospital to home. I will draw attention to the consideration of needing

several healthcare personnel involved in this project to ensure all patients are receiving the

mandatory telehealth follow-up appointments within 3 days of discharge. This process will

require these personnel to be paid accordingly but will benefit healthcare costs overall in the long

run.

Reflection

I enjoyed working on this exercise and learning more about the process of health policy

change. I especially liked researching about my topic of heart failure readmissions because I
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personally work with these patients on a daily basis. It is a struggle seeing these patients suffer

and be readmitted for things that could have been prevented with proper follow-up care. There

is so much that can be done to improve the care of heart failure patients and their quality of

life. I learned a lot more about costs of readmissions and the strain it can put on the healthcare

system as well as the patient and their family. It was great learning about the finance part of

the healthcare system because I am always just so involved in direct patient care and don’t

necessarily consider costs of medical care, procedures and tests. I definitely have gained a new

perspective on the process of caring for people and the importance of good quality care

without spending lots of money to do so. A timely follow-up appointment post discharge can

really reduce healthcare costs and keep patients healthy and out of the hospital.