As Administrator of Long Island Hospital of New York City, I noticed that the Emergency room is always full of patients standing around. To address this problem of concern I will be using the five-step process of managing techniques. I’ve determined that the nurse on staff would be responsible for this area at this time to ensure and expedite care by managing patients in the waiting room. I am first going to let a supervisor investigate the issue and report it back to me. If I feel the problem is not changing or making progress, I will then take matters into my own hands. My investigation will reveal that more nursing homes and extended care facilities need to be linked to the hospital so that patients can be transferred on the weekend to free up space for emergencies. Therefore, if patients are transferred more emergency beds can be available to patients who need to be taken care of right away. This decreases the time in the waiting room. As the administrator, I will instruct the supervisors to reach out and research ways we can affiliate our hospital with nursing homes and extended care facilities. From here on out, I will have to consider how these affiliations will work out with our hospital budget. I may start with connecting with one or two facilities at a time, later adding on two more. Keywords: Administrator, Hospital, Investigate, Nursing home, Extended Care Facilities Long Island Hospital of NYC Having the title of an administrator of a hospital comes with a lot of responsibility and organization. As a single individual, you cannot be everywhere at one time. Therefore, you assign responsibilities and functions to others such as doctors, supervisors, nurses, surgeons, and other medical members that are involved in primary care. The emergency room is a very important part of the hospital, by it being filled with patients and them having long waits can be very improper and cost-cutting if the patients leave. As an administrator, what do we do to accommodate patients? Who will be responsible for making sure the patients come first in the waiting room? Who will investigate this issue of concern? How will the patients waiting time be decreased? Long Island Hospital of NYC The type of structure this hospital hold is a vertical organizational structure. I say this because it has different layers of management that contain staff employed in specific, narrow, roles. This structure also keeps the hospital in order and make sure all tasks are getting done. This structure is very traditional and has a top-down organizational model. My hospital has a vertical structure would consist of Board of directors, Hospital Administration, Director of Nursing, Supervisor of Nursing, Head Nurses, and Staff Nurses. Please view the attached document for Long Island Hospital of NYC organizational chart. Reports have been coming into Long Island Hospital of NYC of the emergency department to capacity. Patients have been complaining and having to find another hospital to go to. There has been nowhere to sit and all the beds in the back rooms have been filled. From my observation, the staff has been doing everything that is needed to keep the traffic moving in and out of the waiting room. As the administrator, my top priorities are patient satisfaction, quality improvement initiatives, and staff cooperation. To solve this problem of concern in my hospital, I will use managerial and supervisory planning techniques. Determining the Nurse on staff is responsible for patients in the emergency room, before doing anything I will let the director of nursing and the nurse supervisor investigate the issue. Once the issue has been investigated, all the staff have been reviewed, everything has confirmed, and reported back to me I will then review things myself and determine how my staff and I will network and become linked with outside facilities. Hospitals building bonds with nursing homes can have many effects. Narrow networks of partners can cause providers to improve quality care. (Butcher, 2015) Also due to high readmission rates, hospitals can face Medicare penalties. Worldwide, about 18% of all patients that discharge from the hospital are readmitted within 30 days. Hospitals are held directly responsible for the costs incurred by Medicare to patients discharged to nursing homes. To improve patient care, reduce readmissions, and control value, hospitals participating in accountable care organizations or bundled payment advantages have a powerful motive to work closely with nursing homes. (Butcher, 2015) Hospitals should always keep in mind that patient rehab is the most expensive surrounding, followed by a skilled nursing facility and then home care. Limiting Patient Elimination Long Island Hospital of NYC has decided to address an increasing issue of concern in the emergency waiting room. Overloaded with patient’s that all need to be taken care of, the emergency department came up with an evidence-based task with one of the extended care facilities they researched. This facility granted a 2-year contract of taking in patients from the hospital, that has been taken care of but need their stay to be extended. This contract is an intermediate-range plan that the department managers and extended facility managers and administrators both agreed to. They came up with a goal to transfer patients that need to stay more than a week to the extended care facility for 2-years, should this work out they will re-evaluate the plan and add-on a contract with a nursing home. Following all guidelines discussed in the contract, this will satisfy patients and reduce the waiting time in the emergency department. Also, it will help fill vacant spaces in the facility and have a positive effect on their budget. For 2 years the contract will be active, and the transporting of patients will be monitored to see if this plan is effective.