NR 711 Week 5 Budget Variance Report Example

FY2028 Variance Report: Video Patient Monitoring on 4 West, Approved Against Actual

Student Name

College of Nursing, Chamberlain University

NR 711: Fiscal Analysis and Project Management

Instructor Name

Month Day, Year

FY2028 Variance Report: Video Patient Monitoring on 4 West, Approved Against Actual

What Was Approved

In April 2027 the patient safety capital committee approved $96,000 in capital for video monitoring on 4 West and added a contingency reserve of $4,800, held by the director of clinical engineering. The operating budget carried $15,110 one-time for training and parallel running and $119,520 recurring to cover the license and half the cost of one monitor technician. The approved total for FY2028, 1 July 2027 to 30 June 2028, was therefore $235,430. This report compares each approved line with what was spent, explains each difference by what happened and recommends what to do with the balance. The approved figure is the anchor throughout, because a report of spending alone cannot tell a reader whether the project kept its promise (Finkler et al., 2013).

The Comparison

Table 1

Video Monitoring on 4 West, FY2028 Approved and Actual

Note. Note. A plus sign marks spending above the approved line; a minus sign marks spending below it. The differences sum to the total.

What Happened, Line by Line

Installation ran $5,160 over. When the electricians opened the walls in rooms 14 and 15 in May 2027, both turned out to be plaster over block with no conduit path, and the only safe route was surface raceway along the corridor ceiling. The change order was signed on 22 May. The same discovery explains the delay described below.

The central station ran $550 over because a third screen was added in the third week. With six patient tiles on each of two screens, the technicians could not see a patient's hands at night, which is the cue they most need before a patient stands. The third screen was the item the costing sheet had named and left out, at almost exactly the figure it gave.

The contingency reserve was not spent as its own line; it absorbed $4,800 of the $5,710 capital overrun. The remaining $910 was charged to the hospital's capital overrun account with the chief financial officer's approval on 12 June 2027. The capital block therefore closed $910 above its approved total including the reserve.

Training cost $2,440 less than approved. The vendor trainer agreed to run twenty-minute sessions for two weeks, each one opening a shift, so most nurses learned the system inside paid shift time. Only 76 nurse hours needed backfill, against 116 planned.

Parallel running cost $4,032 more, double the plan. Cameras 7 and 11 dropped off the network repeatedly in the first week, and the nurse manager kept sitters in place until the unit had gone fourteen consecutive days with no dropout. That took 28 days instead of 14. The decision was right, and it should be costed into the next unit's plan as the expected case.

The technician share was $10,106 under, because the installation delay moved go-live from 1 July to 5 August. The unit is charged its share only from go-live, so it paid for 47 weeks rather than 52.

The license cost exactly what was approved, and that is not good news either. The license term began on the contract date, so about $1,385 of license value ran for five weeks with no camera switched on.

The Underspend Is Not a Saving

The project closed $7,604 under its approved total, and it would be easy to report that as good management. It was not. Almost all of it is the technician share that went unspent because the project started late. That money was set aside in July and sat unused until this report, eleven months later, while the unit's own residency preceptor allowance, $21,600, went unfunded for lack of a donor line. Had the unit told the finance office in August that the technician charge would start five weeks late, the $10,106 could have been released then. Money held for a purpose that is not happening is a request elsewhere that waited for nothing (Dunham-Taylor & Pinczuk, 2015).

What the Program Was Meant to Return

The approved case expected about 6,930 sitter hours avoided in a full year, which over 47 weeks is about 6,264. The unit avoided 5,410. The shortfall of 854 hours, worth about $22,435 at the FY2028 loaded rate of $26.27, has one main cause: in October and November the weekend charge nurse position was vacant, and the morning review of sitter orders did not happen on Saturdays and Sundays. Sitter hours on those weekends ran at the old rate. The review was restored on 2 December, and from December to June the unit met its pro-rated target in every month but February. Falls are not in this table. Published evaluations of video surveillance track falls and sitter use side by side over a longer period (Quigley et al., 2019), and the unit will report its fall counts once a full twelve months of camera data exist.

Where the Balance Goes

The operating lines closed $8,514 under approval: training $2,440 under, parallel running $4,032 over and the technician $10,106 under. I recommend releasing the full $8,514 to the finance office now, before the fiscal year closes, rather than asking to carry it forward. The program does not need it, since FY2029 is fully budgeted on its own lines. I would ask that the finance office consider it against the unfunded residency preceptor allowance, but that decision belongs to the director of nursing and the finance office, not to this project.

The $910 capital overrun stays as reported. It cannot be offset against operating savings, because the two come from different funds, and netting them would hide a capital overrun inside an operating report.

What Changes for FY2029

Three things change. The second unit to adopt video monitoring should budget 28 days of parallel running, not 14. The license should start on go-live, which the vendor has agreed to in the renewal draft. And weekend sitter review now has a named owner, the weekend house supervisor, whenever the charge nurse position is vacant.

Check on the Differences

The nine differences add to $7,604 under: $550, $5,160 and $4,032 over, totaling $9,742; and $4,800, $2,440 and $10,106 under, totaling $17,346. Approved minus actual, $235,430 less $227,826, gives the same figure.

References

Dunham-Taylor, J., & Pinczuk, J. Z. (2015). Financial management for nurse managers: Merging the heart with the dollar (3rd ed.). Jones & Bartlett Learning.

Finkler, S. A., Jones, C. B., & Kovner, C. T. (2013). Financial management for nurse managers and executives (4th ed.). Elsevier Saunders.

Quigley, P. A., Votruba, L., & Kaminski, J. (2019). Outcomes of patient-engaged video surveillance on falls and other adverse events. Clinics in Geriatric Medicine, 35(2), 253-263. https://doi.org/10.1016/j.cger.2019.01.005