HI305 Unit 8 Budget Worksheet Example

Overtime, Temps or a Vendor: A Unit 8 Budget Worksheet Pricing Three Ways to Clear a Document Imaging Backlog of 38,000 Pages and Hold the Queue Steady for the Rest of the Year

[Student Name]

Purdue University Global

HI305: Management of Health Information

Unit 8 Budget Worksheet

[Instructor Name]

[Date]

The hospital, the wage rates, the quotes and the volumes are composite; the methods and sources cited are real.

The Two Jobs to Be Paid For

The department has two needs. The first is a one-time backlog of about 38,000 pages, roughly nine days of work. The second is an ongoing gap: even with the half position the director approved, arrivals exceed capacity by about 900 pages a week, until the emergency department moves its discharge checklist to electronic signature, expected in about sixteen weeks. Using the new rate of 220 pages for each productive hour, the backlog needs about 173 productive hours and the ongoing gap about 4 hours a week, or 64 hours over sixteen weeks. Total: about 237 productive hours of work.

Option 1: Overtime

The specialists' average wage is 21.50 dollars an hour, so overtime costs 32.25 dollars an hour. Overtime hours are about 90 percent productive, since no meetings or training occur in them, so 237 productive hours need about 263 paid hours. Cost: about 8,480 dollars. Hidden costs: fatigue. To clear the backlog in four weeks, each of five specialists would work about ten extra hours a week. Long hours are linked to higher rates of injury and error, and the quality analyst saw indexing accuracy fall during the last overtime push (Dembe et al., 2005). The worksheet adds an estimated two hours a week of extra quality review, about 690 dollars over sixteen weeks at the analyst's rate. Adjusted total: about 9,170 dollars.

Option 2: Temporary Specialist

A staffing agency quotes 34 dollars an hour for a document imaging temp with health records experience, for a minimum of twelve weeks at 40 hours. Productivity for a temp in the first two weeks is expected at about half the standard, rising to about 85 percent. Over twelve weeks the temp would produce about 330 productive hours, more than the 237 needed. Cost: 480 hours at 34 dollars is 16,320 dollars. Hidden costs: orientation time from a trainer, about 30 hours at 21.50, or 645 dollars, and 100 percent review of the temp's first week of indexing. Adjusted total: about 17,100 dollars. Benefit: the extra capacity would cover absences during the period.

Option 3: Outside Scanning Vendor

A vendor quotes 0.09 dollars a page for preparation, scanning and indexing at its facility, with pickup twice a week. The full need of about 52,400 pages, the backlog plus sixteen weeks of the gap, would cost about 4,720 dollars. Hidden costs: the vendor requires a business associate agreement and security review, standard steps before any outside party handles records (Oachs & Watters, 2020), about 20 hours of the privacy officer's and supervisor's time, roughly 1,100 dollars. Paper leaves the building for up to a week, so documents physicians are waiting for would be delayed. The vendor indexes to the patient but not to the encounter, so the team would spend an estimated 1.5 seconds a page completing encounter indexing, about 22 hours or 470 dollars. Adjusted total: about 6,290 dollars. The vendor is cheapest on paper and slowest for the pages that matter most. A physician waiting to sign a record cannot wait a week for a consent form to come back from another building.

What the Worksheet Leaves Out

The worksheet does not price the cost of doing nothing, because that cost falls outside the department. Records with missing pages stay incomplete, physicians are asked to sign against partial information, and the hospital moves closer to the thirty-day completion deadline. It also does not include the savings when the emergency department moves its checklist to electronic signature, since the date is not firm. If that change arrives early, the ongoing gap shrinks and every option costs less.

Comparison

Adjusted cost: vendor about 6,290 dollars, overtime about 9,170, temp about 17,100. Speed to clear the backlog: overtime about four weeks, temp about five, vendor about three, with the delay for each batch in transit. Risk to accuracy: highest with overtime, moderate with the temp in the first weeks, moderate with the vendor and the encounter indexing step. Capacity for absences: only the temp adds it.

Recommendation

The worksheet recommends a mix. Send the oldest 25,000 pages of the backlog, mostly records already completed by physicians, to the vendor, at about 3,500 dollars including the setup costs shared across the work. Clear the remaining 13,000 pages and the ongoing gap with limited overtime of no more than four extra hours a week per person, about 5,600 dollars. Total about 9,100 dollars, close to the cost of overtime alone, with less fatigue and no paper leaving the building that physicians still need. The temp option is set aside unless absences rise. Budgets in health information departments are easier to defend when hidden costs such as quality review and setup time are counted openly, as here (McWay, 2020).

References

Dembe, A. E., Erickson, J. B., Delbos, R. G., & Banks, S. M. (2005). The impact of overtime and long work hours on occupational injuries and illnesses: New evidence from the United States. Occupational and Environmental Medicine, 62(9), 588-597. https://doi.org/10.1136/oem.2004.016667

McWay, D. C. (2020). Today's health information management: An integrated approach (3rd ed.). Cengage Learning.

Oachs, P. K., & Watters, A. L. (Eds.). (2020). Health information management: Concepts, principles, and practice (6th ed.). AHIMA Press.