Cost of Change 

Reflect on the following statement included in the Comprehensive Unit-based Safety Program (CUSP), an innovative approach to improve safety developed by Johns Hopkins.

Unless nurse managers can express the financial advantages of a change in process, the organization may not approve purchases of more hand hygiene dispensers, bar coding equipment, and other patient safety supplies.

Think of a process you would like to change in your setting. What financial information would you need to gain the support of senior leaders? Who might you involve to obtain this information?

For example, you want to use a bladder scan to reduce the incidence of UTIs. In addition to the billable charges and net reimbursement and the cost of a UTI for your setting and the annual number of UTIs (we’ll address this later in the course), you would need to know: 

• Initial cost such as the purchase of the bladder scan, including shipping (this is a FIXED COST)
• Annual operating expenses such as supplies, cost of common replacement parts, batteries, training costs (these are VARIABLE COSTS) and depreciation spread over the accounting “life” of the machine, in other words, you need to know how long the bladder scan will last (this is a FIXED COST)