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Ashford General Hospital is a 263-bed regional hospital located in California, serving its community for more than 50 years. The hospital maintains the only 24-hour emergency department in the area and an "extended hours" urgent care clinic. Similar to other hospitals in the United States, Ashford General Hospital is encountering a nursing shortage. Sixty-eight percent of the nursing staff is over the age of 45, facing retirement. The retention rate on nurses is 61%, compared to 65% nationwide. Many of the nursing staff find the work too physically demanding and have a feeling of emotional burn-out as well. In the past two years, the hospital has used both per diem nurses and traveling nurses who sign short-term contracts to fill individual shifts and accommodate short-term staffing needs arising from staff vacations or medical leaves. This has not only driven up personnel costs but also resulted in lower scores on patient satisfaction surveys. Ashford General Hospital faces significant challenges in nurse staffing ahead as it grapples with these issues, and the hospital board is very concerned. They know there must be some changes made in order to prevent a major financial and human resources crisis in the future. As the newly hired CEO, you are asked to present a proposal in the next board meeting.

For your Final Paper, you will create a 10 to 15 page proposal (excluding title and reference pages) for the Ashford General Hospital Board of Directors. In your proposal, you will:

Include an executive summary.

Research and describe solutions implemented at five other hospitals in the US that were dealing with these same issues.

Based on your research, describe two solutions that are the most viable for Ashford General Hospital to implement within the next two years.
Create a total of two stakeholder group analyses for two solutions you select. Each analysis should include at least five stakeholder groups involved (e.g. patients, hospital executive administration, accounting, Human Resources (HR), marketing, third-party payers, etc.). As part of your analysis, address the following questions:

Who is impacted?

What change processes may be required?

What fiscal impact would occur?

What are the ethical, legal, and diversity risk factors involved?

Based upon the stakeholder group analyses, recommend the best solution for Ashford General Hospital with detailed justification. Explain why you feel it is the most viable and appropriate solution given the financial impact, HR issues, and interpersonal dynamics of hospital personnel, cultural shift, and change management.

To prepare your board proposal, including the textbook, utilize at least 10-to-12 scholarly and/or peer-reviewed sources that were published within the past five years, as well as hospital or foundation websites. All sources must be cited according to APA style as outlined in the Ashford Writing Center.

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