Planning alternative delivery systems. An organizational assessment.

The tendency to react to circumstance rather than to initiate on its own agenda has been a prevalent response of the nursing profession, in particular, and the health care industry, in general. With retrospective reimbursement, hospitals were reimbursed for what they spent, one of the factors that fostered a reactive mode of analysis and management. With the advent of the prospective reimbursement system--a system that implies the need for forecasting--the mandate for nurse executives to take a proactive stance in managing their product line is clear. The resulting economically constrained environment has challenged nurse executives to devise strategies for efficient patient care delivery without sacrificing commitment to quality. These strategies must be planned to respond to the current changing environment and adapted to meet future changes.