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Discussion board response Discussion board response Bhela, I concur with your post d Finance and Economics in Healthcare Delivery that any organizational budget process has to encompass both the top-down and bottom-up approaches in their financial matters. Again, I agree with your elucidation that the biggest advantage of the bottom-up approach is that upper management does not impose the budget plan forcefully like is in the case in my organization. Since my organization uses a top-down approach, I have observed a number of problems within the organization associated with imposing the budget to the employees.
For instance, many of the employees look demoralized in their activities as they feel devalued as their contributions in terms of input to the budget formulation does not matter (Zelman, McCue and Glick, 2009)). There is however one issue in particular I am interested in and would want you to clarify. Does your organization has a specific way of collecting employees, supervisors, and lower-level managers ideas or contributions to the budget? Does it happen during weekly meetings or do the employees forward their contributions or input to their supervisors who then forward it to the top managers?
Martusciello, your post was interesting and I learnt a lot from your research. I had not imagined that a change in staffing matrix could be reason enough to deviate from a budget as you have noted in your post. It is true that when cases where some of the staff resigns or are on leave puts the management in a hard situation whereby they have to hire new employees temporarily. This according to Zelman, McCue and Glick (2009) translates to additional expenses as such expenditure in terms of salaries for the temporary staff is not initially planned.
I also agree that unplanned situations such as an influx or surge in the number of patients could cause deviation from a budget. Your organization did the right thing to employ the additional eleven nurses to float to units. I am interested to know, did the surge in patients affect the nurses in any way in terms of burnout and elevated stress levels? ReferenceZelman, W., McCue, M., & Glick, N. (2009).Financial management of health care organizations: An introduction to fundamental tools, concepts, and applications(3rd ed.). Hoboken, NJ: Jossey-Bass.
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