MHA 624 Week 6 Final Paper

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MHA 624 Week 6 Final Paper Click Link Below To Buy: http://hwcampus.com/shop/mha-624-week-6-final-paper/ Contact Us: [email protected] Executive Summary Ashford General Hospital has been face with a nursing shortage due to retirement, low retention rates, nurses feeling exhausted and overworked. This nursing shortage is not only affecting Ashford General Hospital, it is also affecting many hospitals within the United States. Nursing shortages has not only affected the safety of the nurses that are being overworked, the shortage has also affected patient satisfaction which could potentially cause a financial burden for the organization as well as human resource issues. In order to doctor this nursing shortage and possible future crisis, a proposal for change has to be implemented immediately. Ashford General Hospital leadership and stakeholders have to put together this strategic plan that would provide patient with good quality care by addressing the nursing shortage. This will be done by joining forces with nursing colleges and universities which will provide the organization with nursing student support for exchange for training/ education by experienced professionals as well as the commitment to work for the organization upon graduation. This strategy have been successful at five other hospital, however three of the hospitals are located within the Bay area of California such as John Muir Medical Center in Walnut Creek, Washington Hospital and Eden Medical Center in Castro Valley. In addition to satisfying the nursing shortage and patient care, the new strategies will also give the hospital more of an opportunity to become more diverse, ethically and culturally which will impact and benefit not only the organization but it will benefit the patients as well as the community. Ashford General Hospital newly implemented plan will also provide support management which will assist the staff and leadership with understanding the mission and vision of the organization as well as how understanding how these changes will benefit the hospital, staff and patients. Leadership will also provide viable information which will generate into monthly reports that will show the growth of the organization as well as short comings throughout this process and will allow direction on adjustments if needed as a way to fully manage the operations, finance and business of Ashford General Hospital. Introduction Many hospitals within the United States including Ashford General Hospital are facing challenges with the Staffing of nursing and nursing shortages that continue to increase. According to John Hopkins of Nursing, this nursing shortage has become a global issue (Walker,2010). There are many stakeholders that are affected by the nursing shortage, such as the nurses, patients, physicians, administrators, as well as the insurance companies. This major nursing shortage stem from thousands of baby boomers that have retired, will retire, younger nurses leaving due to being overworked, stress and becoming burned out (Cook,2015).This can result in higher mortality rates, increased nurse burn-out rates, increased medical errors, higher readmission rates as well as negligence and malpractice lawsuits (American Association of College of Nursing, 2014). In addition patients’ dissatisfaction as well as employee dissatisfaction can lead to the organization experiencing financial strain. When patients are not satisfied with their care, they may feel that they are not receiving the best quality of care; which ultimately can lead them to other health care organizations as well as dissatisfied staff. The importance of Ashford General Hospital new proposal is vital to the growth and success of the organization. Therefore through new leadership, support management, communication and motivation, Ashford will use resources to implement changes throughout its system. This proposal will discuss the solutions that have been implemented at five hospitals within the United Stated that can assist with thesame issues that Ashford General Hospital is currently experiencing in order to increase nursing staff, improve patient satisfaction and increase support management throughout the organization. Current Issues Ashford General Hospital is Experiencing Ashford General Hospital has been experiencing a nursing shortage, therefore to resolve this shortage issue and prevent further nursing staffing issues in the future; Ashford General Hospital has turned to other organizations that have once experienced these same problems for guidance to resolve this matter. However before our Ashford's leadership team can began to correct the issue of the nursing shortage, the problem had to be completely dissected by doing so the hospital administration leadership first began by utilizing the classical analytical problem solving method which involves defining the problem, generating alternative solutions, evaluating alternatives, implementing and following up on solutions as well as obtaining and providing feedback (Frates,2014). Ashford General Hospital leadership teams have been aware of the increasingly nursing shortage for sometime but were unsure on how to effectively address the situation. However as the new Chief Executive Officer, I have put together two teams to aid in addressing the nursing shortage among other issues that have arisen due to the shortage. The first team consists of leadership, hospital executives, administration, physicians and nurses which will assist with help analyze the current state of the organization as well as assist with the new strategic plan. The other team will consist of human resources, finance department, marketing, quality assurance, patient safety and patient advocacy. With the assistance of all of these stakeholders, it was found that 70% of the nursing staff was heading forwards retirement and nursing burn-out rates were sky rocketing which has caused financial hardship for Ashford General Hospital due to increasing leave of absence and vacations. This has caused the organization to spend excess dollars paying out for disability, vacation as well as paying short term workers and registry in order to fulfill needs while staff is away on leave. Describe Solutions Implemented at other Hospitals Facing the Same Issues As previously mentioned the nursing shortages are not uncommon in the United States during this time of the changing faces of health care. Ashford’s marketing team and executive teams have researched hospitals around the United States and found several of the same issues that were resolved with many different strategies. Ashland Healthcare Center in Wichita Kansas experienced a nursing shortage as well as a severe shortage of qualified health care physicians, small staff, heavier workloads and less pay in this rural area (Szabo,2011). Although Ashland Healthcare Center is located in a small rural area, this organization was able to resolve the shortage issue with using resources to bring other willing professional that were looking for a change. Because it has been identified that rural areas are a historically struggle to recruit and retain well trained health professionals, the Ashland Health care Center proactively outsource and reach out to professionals in other states that are looking to relocate and work in rural areas in order to resolve the shortage of nurses and other professionals (Szabo,2011). The other organizations found to have these same issues are located in the Bay area just as Ashford General Hospital. These organizations include John Muir Medical Center, Washington Hospital and Eden Medical Center. John Muir Medical Center in Walnut Creek, Washington Hospital and Eden Medical Center in Castro Valley implemented this strategy as a solution to their nursing shortage. These three hospitals in the California Bay area have been successful bypairing the new student nurses with a nurse manager who serves as the new nurses mentor and coach, guiding, directing, and supervising the new nurse within a designated unit (Childers,2015). The collaboration between the hospitals and schools helped to fulfill the need of the increasing nursing shortage as well as provide new nursing graduates with support and additional training in a complex clinical environment, which resulted in an increased nurse’s retention rate of 75 %( Childers,2015). Making Changes within an organization to address issues such as nursing shortages and patient satisfaction also involves the organization contribution to the community (Frates,2014).This mandate for nonprofit hospitals to justify their exemption from corporate income and property taxes is a public relations opportunity in disguise because it allows hospitals to be explicit about how fulfilling their mission benefits their community (Frates,2014).Cheyenne Regional Medical Center in Wyoming experienced a nursing shortage, but in order to remedy the shortage residency programs were offered to nursing students. The Cheyenne Regional Medical Center hired new college graduates, reached out to the foreign nursing programs such as the Filipino nursing programs as well as encourages the Licensed Practical Nurses on staff to earn their nursing degrees in return of the medical center contribution of $5,000 per year (Orr,2015). The above mentioned efforts provide insight on the importance of upholding their mission to provide the best care to the stakeholders (patients and workers) and community. Describe Two Solutions That Are The Most Viable to Ashford General Hospital to Implement Within The Next Two Years: Leaders can impact the capacity to foster change and innovation, and the role of first level leaders- those who supervise effectiveness (Aarons,Ehrhart,Farahnak&Hurlburt, 2015). Therefore Ashford General Hospital will began to close the huge gap of the nursing shortage by implementing a education assistance program that would allow nursing students and graduates an opportunity to receive education funding and clinical training in return for a commit to work for the organization. Ashford General Hospital will began to close the gap of the nursing shortage by joining forces with nursing schools and universities as an incentive to offer top notch clinical training from experienced nurses in return for the new nursing graduates to commit to working for the organization. This will provide top quality hands on training, education, and help boost the confidence of new nurses in training by combining clinical experience with classroom experience which will aid in decreasing the nurse burn-out rates. Ashford General Hospital will also implement quality improvement to ensure that the new strategizing to fill the nursing shortage is providing the organization with the support needed to address patient satisfaction, patient safety and the organizations finances. The quality improvement will support the administrators and leaders to ensure that Ashford General Hospital is financially able to continue to expand on their collaboration efforts with nursing schools and universities as well as offer tuition assistance to nurses that commitment to working for the organization. Quality improvement is will address patient care and safety prior to problems occurring as well as providing a guide that would essentially assist the top leaders of the organization from a business and financial stand point. Quality improvement will provide an opportunity for Ashford’s administrators and leaders to expand services where it may be needed and remove services that are not needed in order to improve the quality of care and properly allot funds for services. The organization will utilize this method to enhance the effectiveness of intervention strategies by providing professional development, clinical documentation, risk management, patient safety as well as quality improvement (Frates,2014). By implementing quality improvement it will assist will closing the nurse shortage gaps, bringing on new nurses to educate and hire them will all aid in increasing the patient satisfaction scores as well as preventing patient safety mishaps. Lastly improving communication by effectively communicating, properly documenting, providing feedback to staff and teaching the proper protocols to patient safety, encourage and motivated staff to help provide quality patient care. “Motivation is influenced by the value of the reward and expected probability of the effort resulting in the reward which encourage employees to performance higher and take pride in their work” (Frates, 2014). Stakeholder Analysis: As part of the new plan that is beginning proposed at Ashford General Hospital to help remedy the current issues that the organization is faced with, it is recognized that the stakeholder’s involvement is very importance. Stakeholders attributes include power, legitimacy, urgency, interest, influence, resistance and feedback among multiple stakeholders (Yip,Phaal& Probert,2014). Therefore both internal, external and interface stakeholders will be part of the collaboration throughout the new plan. The internal stakeholders will include the executives, managers, administrative leaders, physicians and the director of nursing. The interface and external stakeholders will consist of human resources, finance department, marketing, quality assurance a, patient advocacy and community organizations such as local nursing colleges and universities with in the Bay area. Both stakeholder groups is an important part of the strategic planning process, which is especially useful in generating knowledge of relevant individuals, groups, and organizations in order to understand their interests, agendas, interrelationships, resources and vulnerabilities (Frates,2014). Because many people will be impacted by the dynamics of change at Ashford General Hospital, the organization will carefully and diligently work with both stakeholder groups while implementing this change. There are many questions that must be considered when implementing changes to an healthcare organization such as, who is impacted, what change processes may be required, what fiscal impact would occur and will there be any ethical, legal, and diversity risk factors involved with the new Ashford General Hospital plan. This current nursing shortage is currently impacting the existing nurses on staff and other personnel at Ashford Hospital, by having to work a heavier duty load and longer hours in order to get the required work done which is causing them to fall short on patient care. The patients are being impacted do to the hospital short comings on the nursing staff as well as the quality of care. This issue can result in patient safety mishaps, negligence as well as possible fatalities which will further put the organization in turmoil with possible lawsuits. In order to reassure patient safety as well as nursing safety needs and manpower, the current process must be revised. This change requires all stakeholders within the organization to come together and implement education assistance programs specifically in the nursing field for those who are looking to advance their careers and become nurses. However, this incentive is attached to a promise and committed to those in the program to dedicate at least four years with the organization as working nurses. Another change would be to join forces with surrounding nursing schools so that students can receive clinical training as well as classroom education as another incentive to assist with closing the nursing shortage gap. Lastly, the organization will strengthen the quality assurance process as well as patient advocacy in order to ensure that patient safety is put at the top priority which is in line with the mission and vision of Ashford General Hospital. What Fiscal Impact Would Occur and What Are The Ethical, Legal, and Diversity Risk Factors Involved? The current issues with the shortage are creating fiscal impact because of the increased personnel costs due to a lack of nursing stability. The fact that Ashford General Hospital has resulted to utilizing per diem and traveling nurses to fulfill the short term nursing needs in order to fill in staffing shortages has created fiscal concerns. By utilizing traveling nurses, this have not only began to affect the finances of the organization but has also created ethical concerns to patient care. Outsourcing created conflicts of interest between organizational concerns for fiscal soundness and professional ethical commitments to patient care and the patient welfare ( Bristol,2005). These are examples of why implementing a new strategic plan to revamp the nursing shortage would benefit the organization as a whole. Also by becoming a learning/teaching organization this will allow everyone to be more cautious, conscious and accountable for delivering the best quality care. This will also decrease and prevent lawsuits, malpractices and workers compensation because of nurse’s injuries due to overworking and taking on heavier patient loads. However by implementing the new plan this will allow risk factors and early indicators to mobilize ethics consultations and earl interventions which would prevent conflicts and enhance quality of care (Pavlish,Brown-Saltzman,Hersh,Shirk,Nudelman, &Olga, 2011). This new plan will positively affect the finances of Ashford General Hospital. This will increase the patient population due to high patient satisfaction, increased qualified and stable nursing staff as well as increased funding provided by communities for education funding. This new plan will prevent the increased utilization of outsourcing in healthcare which poses a variety of ethical and strategic problems by the growing use of per diem contract "paragraph" to provide patient care services in place of the hospital's regular healthcare team, whose salaries and benefits often represent significant portions of institutional budgets (Bristol,2005). Conclusion Ashford General Hospital is faced with the challenge of nursing shortages that continue to have increased over many years and will continue to increase as baby boomers retire. This can result in higher mortality rates, increased nurse burn-out rates, increased medical errors, higher readmission rates as well as negligence and malpractice lawsuits (American Association of College of Nursing, 2014). Therefore in order for Ashford General Hospital to begin to close the gap of the nursing shortage, the organization has turned to many hospitals within the United States for guidance. They helped with this growing issue such as providing tuition reimbursement in return for the new nursing graduates commitment to work at Ashford General Hospital, collaborating with nursing colleges and universities in order to allow hands on training as well as classroom assistance and lastly, provide professional development for staff members that are looking to earn a degree in nursing. These new strategies will not only assist with the nursing shortage but it will provide quality improvement, quality assurance, improve patient satisfaction scores and patient safety improvements.

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MHA 624 Week 6 Final Paper Click Link Below To Buy: http://hwcampus.com/shop/mha-624-week-6-final-paper/ Contact Us: [email protected] Executive Summary Ashford General Hospital has been face with a nursing shortage due to retirement, low retention rates, nurses feeling exhausted and overworked. This nursing shortage is not only affecting Ashford General Hospital, it is also affecting many hospitals within the United States. Nursing shortages has not only affected the safety of the nurses that are being overworked, the shortage has also affected patient satisfaction which could potentially cause a financial burden for the organization as well as human resource issues. In order to doctor this nursing shortage and possible future crisis, a proposal for change has to be implemented immediately. Ashford General Hospital leadership and stakeholders have to put together this strategic plan that would provide patient with good quality care by addressing the nursing shortage. This will be done by joining forces with nursing colleges and universities which will provide the organization with nursing student support for exchange for training/ education by experienced professionals as well as the commitment to work for the organization upon graduation. This strategy have been successful at five other hospital, however three of the hospitals are located within the Bay area of California such as John Muir Medical Center in Walnut Creek, Washington Hospital and Eden Medical Center in Castro Valley. In addition to satisfying the nursing shortage and patient care, the new strategies will also give the hospital more of an opportunity to become more diverse, ethically and culturally which will impact and benefit not only the organization but it will benefit the patients as well as the community. Ashford General Hospital newly implemented plan will also provide support management which will assist the staff and leadership with understanding the mission and vision of the organization as well as how understanding how these changes will benefit the hospital, staff and patients. Leadership will also provide viable information which will generate into monthly reports that will show the growth of the organization as well as short comings throughout this process and will allow direction on adjustments if needed as a way to fully manage the operations, finance and business of Ashford General Hospital. Introduction Many hospitals within the United States including Ashford General Hospital are facing challenges with the Staffing of nursing and nursing shortages that continue to increase. According to John Hopkins of Nursing, this nursing shortage has become a global issue (Walker,2010). There are many stakeholders that are affected by the nursing shortage, such as the nurses, patients, physicians, administrators, as well as the insurance companies. This major nursing shortage stem from thousands of baby boomers that have retired, will retire, younger nurses leaving due to being overworked, stress and becoming burned out (Cook,2015).This can result in higher mortality rates, increased nurse burn-out rates, increased medical errors, higher readmission rates as well as negligence and malpractice lawsuits (American Association of College of Nursing, 2014). In addition patients’ dissatisfaction as well as employee dissatisfaction can lead to the organization experiencing financial strain. When patients are not satisfied with their care, they may feel that they are not receiving the best quality of care; which ultimately can lead them to other health care organizations as well as dissatisfied staff. The importance of Ashford General Hospital new proposal is vital to the growth and success of the organization. Therefore through new leadership, support management, communication and motivation, Ashford will use resources to implement changes throughout its system. This proposal will discuss the solutions that have been implemented at five hospitals within the United Stated that can assist with thesame issues that Ashford General Hospital is currently experiencing in order to increase nursing staff, improve patient satisfaction and increase support management throughout the organization. Current Issues Ashford General Hospital is Experiencing Ashford General Hospital has been experiencing a nursing shortage, therefore to resolve this shortage issue and prevent further nursing staffing issues in the future; Ashford General Hospital has turned to other organizations that have once experienced these same problems for guidance to resolve this matter. However before our Ashford's leadership team can began to correct the issue of the nursing shortage, the problem had to be completely dissected by doing so the hospital administration leadership first began by utilizing the classical analytical problem solving method which involves defining the problem, generating alternative solutions, evaluating alternatives, implementing and following up on solutions as well as obtaining and providing feedback (Frates,2014). Ashford General Hospital leadership teams have been aware of the increasingly nursing shortage for sometime but were unsure on how to effectively address the situation. However as the new Chief Executive Officer, I have put together two teams to aid in addressing the nursing shortage among other issues that have arisen due to the shortage. The first team consists of leadership, hospital executives, administration, physicians and nurses which will assist with help analyze the current state of the organization as well as assist with the new strategic plan. The other team will consist of human resources, finance department, marketing, quality assurance, patient safety and patient advocacy. With the assistance of all of these stakeholders, it was found that 70% of the nursing staff was heading forwards retirement and nursing burn-out rates were sky rocketing which has caused financial hardship for Ashford General Hospital due to increasing leave of absence and vacations. This has caused the organization to spend excess dollars paying out for disability, vacation as well as paying short term workers and registry in order to fulfill needs while staff is away on leave. Describe Solutions Implemented at other Hospitals Facing the Same Issues As previously mentioned the nursing shortages are not uncommon in the United States during this time of the changing faces of health care. Ashford’s marketing team and executive teams have researched hospitals around the United States and found several of the same issues that were resolved with many different strategies. Ashland Healthcare Center in Wichita Kansas experienced a nursing shortage as well as a severe shortage of qualified health care physicians, small staff, heavier workloads and less pay in this rural area (Szabo,2011). Although Ashland Healthcare Center is located in a small rural area, this organization was able to resolve the shortage issue with using resources to bring other willing professional that were looking for a change. Because it has been identified that rural areas are a historically struggle to recruit and retain well trained health professionals, the Ashland Health care Center proactively outsource and reach out to professionals in other states that are looking to relocate and work in rural areas in order to resolve the shortage of nurses and other professionals (Szabo,2011). The other organizations found to have these same issues are located in the Bay area just as Ashford General Hospital. These organizations include John Muir Medical Center, Washington Hospital and Eden Medical Center. John Muir Medical Center in Walnut Creek, Washington Hospital and Eden Medical Center in Castro Valley implemented this strategy as a solution to their nursing shortage. These three hospitals in the California Bay area have been successful bypairing the new student nurses with a nurse manager who serves as the new nurses mentor and coach, guiding, directing, and supervising the new nurse within a designated unit (Childers,2015). The collaboration between the hospitals and schools helped to fulfill the need of the increasing nursing shortage as well as provide new nursing graduates with support and additional training in a complex clinical environment, which resulted in an increased nurse’s retention rate of 75 %( Childers,2015). Making Changes within an organization to address issues such as nursing shortages and patient satisfaction also involves the organization contribution to the community (Frates,2014).This mandate for nonprofit hospitals to justify their exemption from corporate income and property taxes is a public relations opportunity in disguise because it allows hospitals to be explicit about how fulfilling their mission benefits their community (Frates,2014).Cheyenne Regional Medical Center in Wyoming experienced a nursing shortage, but in order to remedy the shortage residency programs were offered to nursing students. The Cheyenne Regional Medical Center hired new college graduates, reached out to the foreign nursing programs such as the Filipino nursing programs as well as encourages the Licensed Practical Nurses on staff to earn their nursing degrees in return of the medical center contribution of $5,000 per year (Orr,2015). The above mentioned efforts provide insight on the importance of upholding their mission to provide the best care to the stakeholders (patients and workers) and community. Describe Two Solutions That Are The Most Viable to Ashford General Hospital to Implement Within The Next Two Years: Leaders can impact the capacity to foster change and innovation, and the role of first level leaders- those who supervise effectiveness (Aarons,Ehrhart,Farahnak&Hurlburt, 2015). Therefore Ashford General Hospital will began to close the huge gap of the nursing shortage by implementing a education assistance program that would allow nursing students and graduates an opportunity to receive education funding and clinical training in return for a commit to work for the organization. Ashford General Hospital will began to close the gap of the nursing shortage by joining forces with nursing schools and universities as an incentive to offer top notch clinical training from experienced nurses in return for the new nursing graduates to commit to working for the organization. This will provide top quality hands on training, education, and help boost the confidence of new nurses in training by combining clinical experience with classroom experience which will aid in decreasing the nurse burn-out rates. Ashford General Hospital will also implement quality improvement to ensure that the new strategizing to fill the nursing shortage is providing the organization with the support needed to address patient satisfaction, patient safety and the organizations finances. The quality improvement will support the administrators and leaders to ensure that Ashford General Hospital is financially able to continue to expand on their collaboration efforts with nursing schools and universities as well as offer tuition assistance to nurses that commitment to working for the organization. Quality improvement is will address patient care and safety prior to problems occurring as well as providing a guide that would essentially assist the top leaders of the organization from a business and financial stand point. Quality improvement will provide an opportunity for Ashford’s administrators and leaders to expand services where it may be needed and remove services that are not needed in order to improve the quality of care and properly allot funds for services. The organization will utilize this method to enhance the effectiveness of intervention strategies by providing professional development, clinical documentation, risk management, patient safety as well as quality improvement (Frates,2014). By implementing quality improvement it will assist will closing the nurse shortage gaps, bringing on new nurses to educate and hire them will all aid in increasing the patient satisfaction scores as well as preventing patient safety mishaps. Lastly improving communication by effectively communicating, properly documenting, providing feedback to staff and teaching the proper protocols to patient safety, encourage and motivated staff to help provide quality patient care. “Motivation is influenced by the value of the reward and expected probability of the effort resulting in the reward which encourage employees to performance higher and take pride in their work” (Frates, 2014). Stakeholder Analysis: As part of the new plan that is beginning proposed at Ashford General Hospital to help remedy the current issues that the organization is faced with, it is recognized that the stakeholder’s involvement is very importance. Stakeholders attributes include power, legitimacy, urgency, interest, influence, resistance and feedback among multiple stakeholders (Yip,Phaal& Probert,2014). Therefore both internal, external and interface stakeholders will be part of the collaboration throughout the new plan. The internal stakeholders will include the executives, managers, administrative leaders, physicians and the director of nursing. The interface and external stakeholders will consist of human resources, finance department, marketing, quality assurance a, patient advocacy and community organizations such as local nursing colleges and universities with in the Bay area. Both stakeholder groups is an important part of the strategic planning process, which is especially useful in generating knowledge of relevant individuals, groups, and organizations in order to understand their interests, agendas, interrelationships, resources and vulnerabilities (Frates,2014). Because many people will be impacted by the dynamics of change at Ashford General Hospital, the organization will carefully and diligently work with both stakeholder groups while implementing this change. There are many questions that must be considered when implementing changes to an healthcare organization such as, who is impacted, what change processes may be required, what fiscal impact would occur and will there be any ethical, legal, and diversity risk factors involved with the new Ashford General Hospital plan. This current nursing shortage is currently impacting the existing nurses on staff and other personnel at Ashford Hospital, by having to work a heavier duty load and longer hours in order to get the required work done which is causing them to fall short on patient care. The patients are being impacted do to the hospital short comings on the nursing staff as well as the quality of care. This issue can result in patient safety mishaps, negligence as well as possible fatalities which will further put the organization in turmoil with possible lawsuits. In order to reassure patient safety as well as nursing safety needs and manpower, the current process must be revised. This change requires all stakeholders within the organization to come together and implement education assistance programs specifically in the nursing field for those who are looking to advance their careers and become nurses. However, this incentive is attached to a promise and committed to those in the program to dedicate at least four years with the organization as working nurses. Another change would be to join forces with surrounding nursing schools so that students can receive clinical training as well as classroom education as another incentive to assist with closing the nursing shortage gap. Lastly, the organization will strengthen the quality assurance process as well as patient advocacy in order to ensure that patient safety is put at the top priority which is in line with the mission and vision of Ashford General Hospital. What Fiscal Impact Would Occur and What Are The Ethical, Legal, and Diversity Risk Factors Involved? The current issues with the shortage are creating fiscal impact because of the increased personnel costs due to a lack of nursing stability. The fact that Ashford General Hospital has resulted to utilizing per diem and traveling nurses to fulfill the short term nursing needs in order to fill in staffing shortages has created fiscal concerns. By utilizing traveling nurses, this have not only began to affect the finances of the organization but has also created ethical concerns to patient care. Outsourcing created conflicts of interest between organizational concerns for fiscal soundness and professional ethical commitments to patient care and the patient welfare ( Bristol,2005). These are examples of why implementing a new strategic plan to revamp the nursing shortage would benefit the organization as a whole. Also by becoming a learning/teaching organization this will allow everyone to be more cautious, conscious and accountable for delivering the best quality care. This will also decrease and prevent lawsuits, malpractices and workers compensation because of nurse’s injuries due to overworking and taking on heavier patient loads. However by implementing the new plan this will allow risk factors and early indicators to mobilize ethics consultations and earl interventions which would prevent conflicts and enhance quality of care (Pavlish,Brown-Saltzman,Hersh,Shirk,Nudelman, &Olga, 2011). This new plan will positively affect the finances of Ashford General Hospital. This will increase the patient population due to high patient satisfaction, increased qualified and stable nursing staff as well as increased funding provided by communities for education funding. This new plan will prevent the increased utilization of outsourcing in healthcare which poses a variety of ethical and strategic problems by the growing use of per diem contract "paragraph" to provide patient care services in place of the hospital's regular healthcare team, whose salaries and benefits often represent significant portions of institutional budgets (Bristol,2005). Conclusion Ashford General Hospital is faced with the challenge of nursing shortages that continue to have increased over many years and will continue to increase as baby boomers retire. This can result in higher mortality rates, increased nurse burn-out rates, increased medical errors, higher readmission rates as well as negligence and malpractice lawsuits (American Association of College of Nursing, 2014). Therefore in order for Ashford General Hospital to begin to close the gap of the nursing shortage, the organization has turned to many hospitals within the United States for guidance. They helped with this growing issue such as providing tuition reimbursement in return for the new nursing graduates commitment to work at Ashford General Hospital, collaborating with nursing colleges and universities in order to allow hands on training as well as classroom assistance and lastly, provide professional development for staff members that are looking to earn a degree in nursing. These new strategies will not only assist with the nursing shortage but it will provide quality improvement, quality assurance, improve patient satisfaction scores and patient safety improvements.

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