| Learning Objective #1: Describe the major sources and consequences of risk and uncertainty in nursing environments under normal and extreme operating situations. | |||
| Learning Objective #2: Select and use appropriate actuarial and statistical tools for analyzing, predicting, and managing variations in levels of nursing service demand in normal and extreme situations. |
Nurses play important roles in managing volatile demand for nursing services due to the impact of risk and profit sharing finance mechanisms and rising in-patient acuity characteristics and must evaluate and choose between alternative allocation strategies so their choices work under both usual circumstances and during periods of sudden, unexpected, and occasionally even overwhelming demand. Using insurance risk management principles and tools, nurse leaders can analyze past data, better manage future risk and uncertainty, and be better prepared for unexpected demands associated with local and regional disasters.
Insurance risk management tools and procedures for rate-making, loss analysis, and loss reserving were reviewed and applications to nursing environments and data are demonstrated. Nurse leaders can employ these tools to plan, coordinate, and manage usual and unusual demands for services while most efficiently allocating resources.
Insurance companies manage risk and uncertainty by analyzing and adjusting past operating data to predict future demands that reflect anticipated shifts in underwriting standards and changing externalities such as market competition, inflation, changing claim frequency or severity, and litigation practices. Nurse leaders can use similar tools to more accurately predict nursing service, resource, and supply demands in the face of shifting reimbursement practices, organizational restructuring, market competition, and changing organizational policies to make better management decisions and better advocate for nursing in budgeting processes.
Nurse leaders incorporating shifts in: prospective payment plans; capitation and managed care agreements; retrospective audits; case-mix, and patient assignment strategies will better manage scarce resources, maintain their ability to respond to unusually high service demands during crises, and better understand organizational strengths, weaknesses, and vulnerabilities. Few institutions can manage a hurricane Katrina, but nursing leaders can better use organizational data to make management decisions that will perform well under less demanding scenarios.
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See more of The 17th International Nursing Research Congress Focusing on Evidence-Based Practice (19-22 July 2006)