The manager's role in downsizing pediatric services.

Abstract

T HE PEDIATRIC NURSE well versed in the current MANAGER is issues in health care delivery, which focuses on reducing costs, increasing competition, and maintaining a high quality of care. These goals have resulted in changes in health care organizations as they have attempted to improve the financial bottom line while attracting a higher market share in profitable services. To achieve this, pediatric programs are carefully examining their services to determine which areas should be increased, which services should remain stable, and which services should be phased out. Inpatient stays have declined, and patients are generally more acutely ill if they are hospitalized. If the need for services declines, beds and units are closed and nurses may be laid off. Services that are showing an increase are judiciously staffed and conservatively managed until it can be determined that such increases are not a short-term trend. The pediatric nurse manager is now expected to be highly competent in managing the labor needs of pediatric services. Labor is the most expensive cost of any health care delivery program, and it is also the variable that can be controlled on a daily basis by astute management. Thus, it is important that the manager have a clear understanding of how to reduce labor costs on both a temporary and permanent basis, as well as a thorough understanding of how to manage a reduced operation.