Prepare a 4–5 page capital budget for a major capital acquisition.

In today's health care environment, the focus on major purchases, as part of the capital budget, has emphasized the need for newer and better technology. Although the need to invest in capital equipment and technology has been ongoing, the nursing workforce must also have a safe and pleasant work environment.

This assessment provides an opportunity for you develop a capital budget for a major facility improvement that will benefit patients, nurses, and the organization.

Most nurse leaders work with operating budgets, but will also have input into capital budgets. A capital budget is typically developed separately from the operating budget and is usually developed to purchase items that are often referred to as big-ticket items that will enhance the capacity or services of an organization. For example, capital budgets may cover land purchase for the future site of a new outpatient surgical center, construction of a new building or build-out for renovation of an already existing building, or replacement of old equipment.

It is important to remember that health care is also a major business. While for health care providers, patient care and safety are priorities, health care institutions must operate from a business model in order to survive financially. As nurse leaders or executives, you often have a role to play in developing a capital budget to improve care at some level. In addition, a rapidly changing health care environment requires nurse leaders who have the financial management and budgeting skills to ensure that large capital expenditures further the mission and goals of the organization.

You are the unit manager of a 50-bed, step-down unit, and it is time for you to prepare your annual capital budget. You have seen a significant turnover in your nursing staff in the past three years; a review of exit interviews and patient surveys indicates low nurse satisfaction, poor morale, and complaints of an antiquated and depressing work environment. You have researched the impact of a positive working environment on staff productivity and morale and decided to request a renovation of the nurses' lounge as the main purchase in your capital budget. You will present your request as a quality improvement investment.

As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. You are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community. Note that these questions are for your own development and exploration and do not need to be completed or submitted as part of your assessment.

• How would you approach the process of designing a capital budget? For example:
  • What steps would you need to take?
  • What resources would you access?
  • Will you collaborate with other executives or staff?
  • How will you tie the vision for the capital expenditure to the organization's mission and goals?
• What challenges do you anticipate in justifying a capital budget to administrative leaders in an organization?
• What criteria might a particular health care organization or service provider apply to evaluate the return on a capital investment?

Prepare a capital budget for a facility renovation. Assemble your budget figures in a table, using a format of your choice. You may use either Microsoft Word or Excel to create your budget table.

• Describe the capital acquisition.
• Justify the need for the capital acquisition.
• Prepare the capital budget.
• Describe the process for calculating costs.
• Present a plan for budget management.
• Explain how the capital acquisition will affect the financial health of the organization.
• Present budget data and information clearly and accurately.