Production And Operation Essay Example for Free

Production And Operation Essay1(a). The word beatnik is specify as the process of approximating or estimating the magnitude of an objective in relation with some units of measurement. I t usu wholey involves the assignment of nun-negative real numbers to the sub snipsThe line convergenceionivity is as well as defined as the measure of the production process make divided by the number of unit of input. For instant, labor productivity is usually measured as the ratio of the labor output per hour and input. Therefore, the quantitative aspects of the input and output are put into consideration (Christopher Voss (1984). Generally, productivity of higher education is defined in shapes of how much individuals and the friendship as a whole are gaining from the educational sector, considering the resources that they employ. It also shows whether the system is wasteful in any way as well.The issue of productivity is looked at in two dimensions. That is, the efficiency perspective and the effectiveness perspective. Efficiency looks at the level as well as the quality of the education services obtained from the accessible resources. A sector that produces higher quality or greater quantity of outputs drill the same resources, then it said to have improved efficiency.On the separate hand, effectiveness focuses on the extent which the needs and demands of the customers are met by the providers. The stakeholders in this case include the students, local communities, faculty, the state governments and the nation at large. Therefore, its gather that productivity improvement is a multidimensional process which depends on the goals and missions of the particular system at hand.Under measure productivity, the general approach that is industrious loosely is the development of measures of both the effectiveness and efficiency. These measures are then employed together so that productivity improvement is measured. Through the use of input and output measures, at t hat place could be either the technical efficiency ratios used to measure the physical output per unit input, or the use of economical efficiency ratios that compare and personal credit line the outcomes to the inputs.However, the present problems that hinder the measure of the input and the output do not make easy for the creation of these measures. Therefore, it is necessary to rely on direct measures where the resources employed by the attention are put across together with the outcome and the quality of the services.In situations where the industry produces multiple outputs, these outputs are always weighted using some criterion and then summed.b). Looking at the relationship between scheme and operations management, we first define the terms. The word strategy refers to the long term plan of actions that is designed to meet the set aims and goals. On the early(a) hand, operations management refers to the process of ensuring that all the activities that are meant to be carri ed on in the industry are carried on in to achieve the set up goals and regulations.For the operation management process to be successful there has to be the long term goals that must be strategically set. These goals are the key drives of all the processes that take place in the entire industry. Therefore, the strategy used should be the one that is doable and relevant to the operations at hand.The production management process should also be in line with the long term action plans that are set so that it will be easier to meet the set goals. The process should be handled in a formal manner in order to promote or make the whole production process easier. These set goals as well as the long term actions should be made known to the employees of the company and the state-supported as well so that they can contribute towards the achievement of the same.For instant, in a higher education industry, they should set long term actions to produce the opera hat students or to be the best re search institutions. The goals set should be those that are achievable and the community as well as the students, the lecturers and the non teaching staff should all be informed about all these.c). The terms Cost of Poor Quality (COPQ) refers to the cost that are generated due to the production of defective materials. These include those costs that are used in bridging the gap between the desired and actual service quality and products. It also consists of the costs of losses in terms of the opportunities caused by the loss of recourses that are later used to correct the defects.COPQ includes all the labor costs, the re officiate costs, material costs and the disposition costs. However, it does not include the detection as well as the prevention cost. For instant, in the tourism industry can have the COPQ whereby the services offered to the tourists are not to the standard due to lack of tolerable accommodation or workers. Hence, to rectify this, they employ more workers and build up or renovate their buildings in order to improve there services.On the other hand the term cost of quality is widely used but mostly misunderstood. It is defined as the cost of not creating a quality product or services. This cost increases every time work is re through with(p). For instant, in the tourism industry, they incur this cost when their workers fail to offer perfect services to the tourists as they may end up being discouraged from visiting the country again.d). A toy market that is ready to sell its new products has to follow different procedures in order to reduce the time that it will re quire to sell these products. First, there will be need for a massive advertisement either in the papers, televisions and live shows so that they can inform the consumers on the products. This in tern will keep the potential customers aware of the products in a manner that they will be encouraged to purchase these products that they will need to purchase.Another main point that the toy manufacturing company should take into consideration is the quality of the toys that they produce and sell to the customers. The toys that of inviolable quality will unimpeachably take less time as compared to the toys of bad quality.The price of the products, that is the price which the toys are disposed at will also affect the time that the products will take in the market. Cheap or affordable products will take short time in the market as compared to the dear(predicate) products or unaffordable products. When the company that is manufacturing the toys plans the type of toys that they produce, they should take into consideration the technology at hand and the age that they are targeting. For instant, toys are basically meaningful to the one-year-old children hence should be designed in a manner that they will be attractive to the children and can be handled by them as well. This will definitely reduce the marketing time for the new products.2). The three basic capacity exp ansion strategies include the process focussed strategy, the instant focused strategy, and the product focused strategy. These are all aimed at improving the production management and control systems as a whole. Under the process focused strategy, the available facilities are create by the process itself and all the similar processes are put together. There is also the presence of a low volume, but high variety products, as well as the presence of a jumbled flow. This strategy has its merits and demerits in general. The advantages of this strategy areAvailability of great product flexibility that ensures that the products are change incase of any need.Availability of more general equipment that are used to handle many tasks at a time.And there is room for low bang-up investment thus even the poor can afford to invest in the business.The disadvantages areNeed for very highly trained personnel which expensive to higher and fire.Availability of more difficulty production planning c ontrol process that needs a haulage of money to run and consumes a lot of time.And poor equipment control process hence more expense to organization since these equipments may spoil any time or get lost.Under the repetitive focused strategy, the facilities are often organized by the use of assembly lines. It is mainly characterized by the use modules which are combined for many output options (Philip E. Hicks (1919).The advantages of this strategy are that it is seen to be more structured than the process focused strategy and enables Quasi-customization. It also enjoys economical advantage of a continuous process since it makes maximum use of modules.The product focused strategy has facilities that are organized by the products (Jay Hezier (1996). There is also room for high volume, low variety products and is usually found in the discrete unit manufacturing company and the continuous process of manufacturing.The advantages of this strategy includeLower variable costs per unit whic h reduce the production costs in general leading to reduction in selling prices.Availability of lower but more specialized labor skills hence production is efficient and meets the demands of the consumer. gap of easier production planning and control hence saves time and reduces production cost as well.And the presence of equipment utilization and maintenance.The disadvantages areHigh probability of lower product flexibilityNeed for more specialized equipments that are expensiveAnd need for a very high capital investment thus closes doors for the poor in the society.3). It is not easy for the arts to be designed as well as be incorporated in order to meet all the characteristics in the principles. However, it is grand to note that jobs should form a coherent whole independently or through involving the related jobs. The whole mental process of the job should ensure that there is a significant contribution to the completion the services and the products (Meric S. Gertler (2004). I t should also ensure that there is provision of a variety of pace, location, method and skills that are necessary. It should also provide feedback of the performance to the other people directly. Discretion and time control should be given chance as well as the sequence and the pace of work efforts.The job should also ensure that some responsibility for outcomes is included there is room for learning and problem solving within the competence of the individual. It should also be done in a way that it leads towards a desirable future. The individuals should be free to develop in a way that they find relevant. melodic line specialization is defined as the process of separation of the organizational activities into tasks that are distinct and involves the process of assigning different tasks to different people. On the other hand, job enrichment is seen as the need of employees by giving opportunities to them in order to range heir abilities. For instant, in an institution that deals with learning, there are different departments that deal with different things at a time. Each department has its heads that are the key decision makers.A job that is enriched has a variety of tasks as well as varying challenges in difficulties, a meaningful work, has a feedback, encouragement and good communication. Job enrichment includes the process of turning the employees efforts into performance, links the employees performance to the rewards directly, and makes sure that the employees are interested in the reward. For instant, in an organization, employees who have performed well in their work are given promotions at the end of a certain period of time in order to locomote them.On the other hand, job specialization ensures that the employees are good in a particular section as compared to the other sections hence can work best when given the chance of working there. In most cases, it does not involve rewards but takes into consideration the ability of the employee and the ex periences at hand (Richard B. Chase (1998). Job specialization also ensures that there is decentralization of activities and powers. Decisions here are made at the different levels depending on who is in charge of the area affected. This does not hold in to the case of job enrichment since the main aim here is to motivate the employeesReferencesRichard B. Chase (1998). Production and Operation Management. McGraw-Hill College, ISBN007517102Jay Hezier (1996). Production and Operation Management. Prentice Hall PTR, ISBN0132444844.Meric S. Gertler (2004). Manufacturing Culture The institutional Geography of Industrial Practice. Oxford University Press, ISBN0198233825.The Encyclopedia Americana A Library of Universal Knowledge, page 484.Philip E. Hicks (1919). Industrial Engineering and Management. McGraw-Hill, ISBN0070288070.Christopher Voss (1984). Research in Production/Operations Management. Gower Pub. Co., U.S.A, ISBN 0566007592

SAT Testing Essay Example for Free

sit Testing EssaySAT, as a basis for college admission, is mollify relevant. However, the value of SAT should be limited in its use in evaluating students who took the test individually. Ranking based on SAT results are not a reliable taproom of the quality of trails. They only determine the quality of the students who took the test. (Are SAT Scores)The results may be swayed by controlling the number of students allowed to take the test and ensuring that these students sustain good academic standing. In fact, research shows that most of the schools in the top ten send very few students mostly coming from the top 10% of their class, while schools be at the bottom 10 send more than half of their students with diverse academic standing. Moreover, most of the students in top ten schools watch from more frugalally well-to-do families than those from the bottom 10 schools. (See Are SAT Scores)Moreover, this policy of ranking schools may be oppressive to students from lower econ omic brackets. Most students who are bright and talented, but came from poorer families forget not afford to go to schools that normally rank high in SATs. Giving school ranking very high regard will put these people in a more disadvantage position with respect to their opportunity to initiate good quality college education. Even if it be assumed that SAT results are reliable, there will be several students from those schools that deserve to have college education, but will negatively affected by the SAT ranking of his or her school.School admission should be based on individual student merit, not on the reputation of the school from which the students attended. Examination results to the individuals who took them. Examination should be given only to those who are interested in pursuing college education. While ranking may still be made, a high rank will give a school nothing more than bragging rights. It should not be conclusive as regards the admission of students. It is the stu dents that will be admitted to college, not the schools from where they get their high school diploma. Therefore, it is the students individual performances that should be given more importance and not the reputation and ranking of their high schools.ReferenceAre SAT scores worse than meaningless? Testing state ranking Brief Article Statistical Data Included. the States Today (Society for the Advancement of Education). Dec 2001. FindArticles.com. Retrieved July 19, 2007, from http//findarticles.com/p/articles/mi_m1272/is_2679_130/ai_81110769

Dolls House

Dolls HouseComparing the Views on Wowork forces Po stickion in Jane Austens assumption and Prejudice and Henrik Ibsens A Dolls House solicitThe research conducted in order for this essay to be written wasnt worry that which would be conducted during a science experi manpowert or a mathematical chore solving. The research undertaken for this essay was precise analytical. It delved deeply into devil famous literary works of the nineteenth century. The research was mainly carried out because of the interesting difference amid the two works and the extremely strong female protagonists. What the main idea of this research essay was was comparing the views on womens positions in Pride and Prejudice by Jane Austen and A Dolls House by Henrik Ibsen. The literary works argon only when seventy long time unconnected, yet callers views alternated so drastically in those seventy years that it is difficult non to be interested in studying the two works. To truly visualize the views of women in these two publications, one must(prenominal) read the two thoroughly as hale as research what kinds of events were occurring at the quantify of the publications. When Pride and Prejudice was publi discharge, order in the book was identical to society in real animation. When A Dolls House was published, womens rights were line of descent to become to a greater extent prominent in society. Of course, even wherefore, at that place were still some old fashioned learning abilitys. Torvald Helmer was the range of a function of what Ibsen disapproved of. As many tribe analysed, Ibsen wrote this cheer to make the world move forward quicker. It is unknown whether or non his play actually do a huge impact however, womens position in society has changed drastically since. tied(p) between the two publications, there was a dramatic change. Nora Helmer was an inconceivable character to Jane Austen. By the time Ibsen had his play performed, women were beginning to specify i ndependently and seek independence. The findings evident in this essay will non change the world or check-out procedure global warming. However, they do make a person think how differently purport was lived in the nineteenth century.IntroductionFor a period in history, the only thing that seemed to plague women was the prospect of marriage. Even if a cleaning lady didnt necessarily want to bond she would be forced into thinking of it because it was all that surrounded her. In the early 19th century, it was not hard to understand that women in society were believed to be simple creatures, who didnt want more than a lovely home to sit in and neighbouring women to gossip with.In 1813, Pride and Prejudice, a novel that supported all these social models, was introduced to the world. This novel was written by Jane Austen and is probably one of the well-nigh famous love stories of all time simply because all women love to read nigh a love that survived the good and bad times. Jane Austen was a woman in the time where marriage was all one should think of as a young lady. Not seventy years later, a play was performed for the low gear time, titled A Dolls House. This play was written by playwright Henrik Ibsen and illustrated strongly contrasting themes to those present in Pride and Prejudice. Whilst Pride and Prejudice centres on a woman in want of a economize, A Dolls House focuses on the some new(prenominal) side of marriage the side of marriage nobody valued revealed when it was starting time performed. Ibsen wrote his play at the time when women were beginning to be thought of in society as something more than just females. In his play, Ibsen created a character that began see past the prettiness of marriage with her husband. She began to think for herself and understand that there is more to learn about the world and one cannot know it un slight one seeks it.Two writers, little than seventy years apart, with entirely different attitudes as to how t he world should be seen, in the eyes of a woman. Both existed in the same century, yet they were worlds apart when it came to societys views on women and their position. Jane Austen believed it only natural for marriage to be on a young lady of marriageable ages mind. Henrik Ibsen, on the other hand, thought it inappropriate to video display marriage as al musical modes being a traditional destiny. Ibsen portrayed women as independent or, at the very least, seeking independence. He succeeded when attempting to portray women as more than hopeless young ladies whose life goals were to be married. Both are entirely conflicting stories some(prenominal) are incredibly successful.Character ComparisonsTwo very different stories would obviously tack together up two very different protagonists. Pride Prejudice and A Dolls House are no exception the former, Elizabeth white avens the latter, Nora Helmer. They are vastly different but are not the only characters that are comparable in the two novels.Elizabeth Bennet compared to Nora HelmerElizabeth lives with her mother who is a lady who badgered and riled her five daughters about marriage. Elizabeth, being a woman in the times when marriage and economy was everything to a woman, has differing views to her society. Elizabeth does not believe in betrothing herself to someone she is not compatible with. Elizabeth is a unique woman. Compared to all other women in that time, she is intellectual and cares about more than money and worldly possessions. She does not want to espouse a man she cannot converse with. Even though Elizabeth is a different woman who fancied more than the average woman in the early 1800s, she still wanted to marry a man she could live with. If she didnt, she would have to be married to him for life in misery. Divorce was not ever thought of in the times of Elizabeth Bennet and her sisters. Therefore, if you were betrothed to somebody, you would be betrothed to them for the whole of eternity. It w as considered completely unladylike and ungrateful, also, to leave your husband. If a woman was married to a man who was supporting her well and who was giving her all she wanted and she decided to leave him, society would look at her as an unappreciative wife who is not satisfied with anything. It was not understand in those old times that two people were not compatible. All that was thought of when marriage was brought up was if hes a man who can support this woman with whatever happens. Consequently, Elizabeth wanted to marry but she wanted to marry someone she was compatible with, someone she could spend the rest of her life with and not regret it. matrimony is what she wanted but it wasnt the marriage that her mother or the rest of society would ever understand.Nora Helmer is a house-wife. She knits and shops, just as a house-wife should. She neer complains that her life isnt satisfying. However, Ibsen was guileful enough to conceal her true feelings until later on in the play. As the audience analyses Nora, it is realised that her life was never pleasing there was always something wanting(p) in everything she ever did and never did she realise it until it was almost too late. Nora is tired of living in a home where she is treated as a maam would be treated pampered and adored for her physicality. Eventually, she realises that living with Torvald Helmer is not the way she wants to live. There is so much to see out there in the world so much to learn about and here she is, living in a dolls house, confined to a town that is not wide enough for her mind, nor exciting enough. Finally, she leaves her swart life in the dolls house, to live her own life, to learn things shes never known before, to travel to places she has only ever heard of. She wanted to experience life, as shed never seen it before and she could not do that whilst living under the same roof as Torvald Helmer.Both these women are of great depth and intrigue. Both Elizabeth and Nora ha ve different thoughts to those of the normal flow of their surroundings. Elizabeth didnt want to marry for money and end with a husband who couldnt even converse with her, unusual as it was in her time. Nora did not want to be imprisoned in a home, which offered no comfort, no excitement, no learning opportunities. Both characters are similar in the ways that they both went against the usual course of those around them. However, they are different in the things they wanted ultimately. Elizabeth wanted to marry someone compatible. Nora wanted to stay away from marriage life and learn more about the world and herself before committing to anything more. Pride and Prejudice ends with both Elizabeth Bennet and Jane Bennett celebrating their marriages to Fitzwilliam Darcy and Charles Bingley. A Dolls House, on the other hand, ends with Nora walking to the world, ready to encompass whatever the world has to offer. In less than seventy years, the stories written about women and their posit ion changed drastically. Women were beginning to be seen as more capable and as more equal. It was also known that marriage was not all that would cross their minds. After all, it isnt that women are desperate to get married the society and the situation society baffle women in only made it seem that way and by the time Henrik Ibsen wrote his play, those types of thoughts were beginning to waver.Torvald Helmer compared to Nils Krogstad and Dr. castTorvald Helmer is a man who believes in particular positions for men and women. He doesnt believe women should provide, as Kristina Linde is planning to do for Nils Krogstad. He is a traditional man with an outdated way of thinking living in a society, which is promptly changing. Torvald Helmer is stuck in the times, which Austen described in her novel. He is, however, only joined by a few. In A Dolls House there are two other male characters whose way of thinking was definitely changing with that of society. Nils Krogstad and Dr. Rank both believe in equality of men and women. Ibsen created these two characters as a way of contrasting to Torvald. Both Krogstad and Rank have different views. Krogstad completely agrees with the idea of Ms. Linde working to provide for her family. I ran a little shop, then a lilliputian school, and anything else I could turn my hand to. (Ibsen, H. A Dolls House. Act one summon 157). Rank also would sit and have many discussions with Nora, treating her like an equal adult. Torvald never once had a serious conversation with her, which proves how little he thought of the supposed equality between them. In the beginning of the play, it seems to the audience that everybody thinks as Torvald does when Kristina states, A wife cant borrow without her husbands consent (Ibsen, H. A Dolls House. Act 1, page 160). From this statement, it seems as though the society Nora is living in is just like the society Elizabeth Bennet was living in. Nora also states, I was lucky enough to get a cabood le of copying to doit was tremendous fun sitting there working and earning money. It was almost like being a man. (Ibsen, H. A Dolls House. Act 1, page 162). This line suggests that women were not to work as men did in that society. However, when Dr. Rank is introduced, these ideas change. When Rank enters the home intending to see Torvald, he does not go away when he hears he is busy. Rather, he sits with Nora and converses with her, like equal adults. Bankrupt In less than a month, perhaps, I shall lie rotting in the churchyard (Ibsen, H. A Dolls House. Act 2, page 191). Rank discusses matters of seriousness with Nora, whilst Torvald does not. It is clear that Rank has a mind that is changing with the changing society. Helmers too sensitive to be able to face anything ugly I wont have him in my sick room (Ibsen, H. A Dolls House. Act 2, page 191). Rank explains that Torvald is very sensitive. It is understood that he does not even speak of serious things with people other than No ra. He is clearly the left(p) one in this novel because everybody else has the same frame of mind but he seems to be stuck in the daytimes that were even changing in Pride and Prejudice.Mr. Fitzwilliam Darcy compared to Mr. Charles BingleyTwo other men that are contrasting characters are Mr. Fitzwilliam Darcy and Mr. Charles Bingley of Pride and Prejudice. Both have distinct views on society and the ideas that society lives on. Both men are owners of a very large fortune Mr. Darcy slightly wealthier than Mr. Bingley. The two are the best of friends however, their characters could not be more dissimilar. At the first roll at Meryton, each of their characters is decided by the surrounding society. Mr. Bingley was good looking and gentlemanlike he had a pleasant countenance, and easy, unaffected mannershe was live and unreserved. (Austen, J. Pride and Prejudice. Volume 1, chapter 3, page 12). Mr. Bingley is liked by everyone that was acquainted with him almost instantly. It was his lively disposition. Mr. Darcy soon drew the attention of the room by his fine, tall person, with child(p) features, noble mein and the report which was in general circulation within five minutes of his entrance, of his having ten thousand a year. (Austen, J. Pride and Prejudice. Volume 1, chapter 3, page 12). He is looked at as handsome and even more handsome when theyve heard of his fortune. However, their views on Mr. Darcy soon change. (He) danced only once, declined being introduced to any other lady, and spent the rest of the eventide in walking about the room, speaking occasionally to one of his own party. He was the proudest, most disagreeable man in the world. (Austen, J. Pride and Prejudice. Volume 1, chapter 3, page 12). The mens differences do not only go so deep as personalities. They are also different in what they want ultimately. Of course, as was the tradition at the time, they each want to marry however, Mr. Bingley is not so fussy with who his future bride is to be. Mr. Bingley is much quicker to label a woman as accomplished also, which adds to the differing views of him and his friend. It is awe-inspiring to me how young ladies can have patience to be so very accomplished, as they all are, quotes Mr. Bingley (Austen, J. Pride and Prejudice. Volume 1, chapter 8, page 35). Mr. Darcy, of course, scolds him for thinking such a thing. It is clear that Mr. Darcy has a much more different idea of what an accomplished woman is. After describing an accomplished woman, Mr. Bingley listens to Mr. Darcys words, All this she must possess and to all this she must yet add something more substantial, in the improvement of her mind by extensive reading, (Austen, J. Pride and Prejudice. Volume 1, chapter 8, page 35). To the indorser, it is obvious that Mr. Darcy, intentionally or not, is describing Elizabeth Bennet as accomplished. It is even more evident what the two friends views on women are when they choose their wives. Mr. Bingley chooses Jane for her unmistakable beauty and kind nature and nothing more. His affection for her is not based on an intelligent mind or extensive reader. Mr. Darcy, on the other hand, favours Elizabeth. Although she is not as handsome as Jane, her mind is more developed. She takes delight in reading and having intellectual conversations. Mr. Darcy clearly wants this for a bride. By joining Mr. Darcy with Elizabeth and Mr. Bingley with Jane in matrimony in the end of the novel, it is clear what Austen wants the reader to learn marry someone you are compatible with. Although Mr. Bingley marries Jane for her attractiveness, their marriage was compatible because each is kind natured and good spirited. The two are not intellectuals, like Mr. Darcy and Elizabeth. In fact, they are kinda the opposite, yet their marriage still works. When comparing the two main men of this novel, it is possible to say that Mr. Darcy and Mr. Bingley are the male counterparts to Jane and Elizabeth Bennet, which is peradve nture why their marriages worked in the end.Writers aimAs writers, both Austen and Ibsen had distinct break ups for writing what they did. When reading their works, it is clear to many that each wanted to encourage the public to begin to think differently to the society they lived in. Austen did agree with her society, essentially. She approved of marriage but wanted the reason for marriage to change in the mind of the public. Ibsen, however, promoted womens independence and ensured his audience went away with new ideas about the equality between the sexes.Jane Austen wrote Pride and Prejudice to allow woman the understanding that marrying for money, instead of compatibility, was never the correct path to walk on. Even though both Jane and Elizabeth did marry wealthy men, they did it for love rather than the money involved. They married for the important fact that they connected with their partners on a higher level than how highly they thought of the money they possessed. In the times when Austen published this novel, the thinking of Elizabeth and Jane were never believed to be possible. Austen took this to her advantage and publicized intellectual thinking and brought thoughts of compatibility into relationships. Other than Elizabeth and Jane Bennett in Pride and Prejudice, the characters generally think about marrying for support and security more than anything else. Naturally, she disapproved of women marrying bad men. By creating a character like Elizabeth, the audience could understand that she most definitely frame it kind of inappropriate for a man and woman to marry without any love. However, Austen didnt completely disapprove of women marrying for money. She understood that there are certain circumstances, which cannot be avoided sometimes. In her novel, she wrote about Charlotte Lucas, who was a girl uncertain of her economic future. She married Mr. Collins for his apparent wealth and the belief that she would be financially secure with him as a husband. Although she understood her uncertain economic future, Austen used this comparison to her benefit. Charlotte and Mr. Collins marriage became one of comfort, not one of love and affection. Austen did not forget to remind the reader that their marriage was anything but successful because Charlotte married for money. She also disapproved of marriage based solely on attraction, as was Mr. and Mrs. Bennets relationship. Her father captivated by youth and beauty, and that sort of good humour, which youth and beauty generally give, had married a woman whose weak understanding and liberal mind, had very early in their marriage put an end to all real affection for her (Austen, J. Pride and Prejudice. Volume 3, chapter 42, page 194). Their marriage was all that Austen was against. What she disapproved of, also, was the reality that women could not inherit fortunes. For example in the graphic symbol of Mr. Bennett who had four daughters and no sons, he would have to pass his fortu ne on to the next male in the family, who was Mr. Collins, who hadnt even been acquainted with the Bennet family. Austen did not understand why Mr. Bennetts daughter couldnt take over his fortune, when they obviously deserve it much more so than Mr. Collins. She showed her disapproval of this by using the voice of Mrs. Bennet. I do think it is the hardest thing in the world, that your estate should be entailed away from your own children, (Austen, J. Pride and Prejudice. Volume 1, chapter 15, page 54). In the end, what could be said about Austens purpose to write such a deep and meaningful novel is that she meant great things for it. She wrote to teach women of the world that they should find their place in the world. Their minds should not constantly wheel around marriage and finding marriage. They should learn to be comfortable with their surroundings and themselves and only think of marriage when a man that is compatible with them comes along and steals their nervus with what h e does and says, and not with how much money he possesses.Henrik Ibsen wrote his play in a time when womens rights were starting to become noticed. Womens right to independence played a magnificent role in Ibsens A Dolls House. That is essentially what he was building towards, right from the commencement of the play. The entire purpose for his writing of this play was to broadcast the fact that women should begin thinking for themselves. He wanted women to believe they could make it on their own that they did not need a man to help them along the way. Henrik Ibsen wrote this play not seventy years after Jane Austen wrote her novel. Immediately as the first few pages are read, it is quite obvious that Ibsen is looking in to the future. His construction of Nora is quite fantastic. As a reader, it is interesting to note that Nora Helmer is a completely inconceivable character for Jane Austen. Never would Austen even think that a woman could leave her husband in order to learn more abou t herself and the world. Nora is an excellent model of what many women thought about in the late 19th century. Marriage was beginning to lose its rose-coloured magic. The stories speaking of happy marriages were slowly beginning to melt away to reveal much less pretty images. Ibsen succeeded when attempting to write these thoughts down as a play. He succeeded in the fact that when the audience watched as Nora walked to the world, a new woman, they all cheered and agreed with all her reasoning. Because Noras action provoked this reaction, it is apparent that his missionary work was fulfilled. His mission to rid the minds of all people of the inequality between men and women was accomplished. By employing the use of Kristina Linde, who worked and provided for her family for many years, Ibsen showed that it was not a bad thing. Kristina learnt more about herself and the cruel world she lived in. Evidently, it might have worn her out and tired her however, she came out of it a better, more-rounded and more experienced woman who could take on anything and not suffer down. Unlike Nora, who was frustrated all her life because she was missing something she desperately wanted. She moved from her fathers home, where she was treated like a doll, to her husbands home, where she received the same treatment. She never worked a day in her life, and because of this, she never stopped dreaming of it. When she did work, behind her husbands back (for that was the only way she could), she commented that they were the three most enjoyable weeks of her life. Ibsen used Noras character to show that a woman who has been treated as though she is a fragile porcelain doll for all of her existence will not ever know how to truly think for herself. He used this character to show that having everything done for you and never knowing truly what the world around you is about is something one should never hope for. Even though Ms. Linde was awfully weary, Ibsen made his audience believe th at this is the life, which should be sought after.In Pride and Prejudice, the society that Elizabeth Bennett lived in was not one which questioned a lot of things. Whatever is put in front of them, they believe it. They did not question things that seemed unusual to them. They did not question for fear their thoughts and beliefs would be confused and proved wrong. propensity for society did not exist in Austens Pride and Prejudice, unlike in A Dolls House. Nora wanted to learn more about the society and world she lived in. Elizabeth Bennett and the people she knew really only cared for the people they were already acquainted with. They would not go out of their way to learn more about what is happening in other parts of the world, or even the country. In A Dolls House Ibsen made it clear that Nora wanted to see as much of the world as she possibly could. In Pride and Prejudice, Austen only wrote about marriage and the never-ending quest to find the right person to marry. Whilst Aus ten showed that marriage was what all women wanted ultimately, Ibsen showed that marriage life could be restricted. Ibsen also showed that traditional husbands implement several restrictions on their wives, which eventually denies the women the ability to grow, emotionally and physically. Ibsen attempted to tell the audience that if a man did everything for his wife and protected her from everything, there is no possible way she could grow into a more developed, more experienced, more agreeable person.ConclusionTwo novels different in purpose but equally great. Jane Austen lived in a different society to Henrik Ibsen. She agreed with the most part of her society, except that women shouldnt marry for financial security they should marry those that are like them. Her novel ended in two compatible marriages. Marriage was still the ultimate destination for women as well as men but it wasnt the kind of marriage that her society looked at. Women then were expected to marry for security and a fine house. Austen wanted to change these ideas and ensure that women believed that the fortune of a man is not what should be looked at when looking for a potential husband. Ibsen did not agree with his society. In fact, he wrote his play in order to change the society he lived in. His play went against everything the society believed in. Women were not allowed to leave their husbands whenever they wanted to. That is why he wrote the play he wanted womens positions to change and they did. When Nora walks to the world, she received cheers from the crowd. Independence, from then on, was desired and thats what Ibsen wanted. Both of the novels are fantastically written and the message is printed loud and clear. As the years go on, it is evident that each of these literary works has made an enormous impact on society. Ibsen helped womens fight for independence move more rapidly, whilst Austen made women all over the world seek a man that was like them, not just had a fortune th at could buy them a home big enough for one hundred.BibliographyBooks1. Austen, Jane. Pride and Prejudice. England Penguin, 1996.2. Ibsen, Henrik. A Dolls House. England Penguin, 19653. Spence, Jon. Becoming Jane Austen. 2nd ed. capital of the United Kingdom Continuum, 2007.Websites1. Cummings, Michael. J. A Dolls House by Henrik Johan Ibsen A Study Guide. Retrieved 18/07/09.2. Haker, Ann. Pride and Prejudice by Jane Austen. Retrieved 18/07/09.3. Pride and Prejudice Jane Austen. Retrieved 13/07/09.4. Pride and Prejudice. Retrieved 13/07/09. 5. Pride and Prejudice. Retrieved 05/02/10.6. Yurgaitis, Daniel. A Dolls House. February 16, 2004. Retrieved 18/07/09.

Impact of the National Health Services Direc

Impact of the National hygienicness work DirecEvaluate the Impact of the National Health dishs cypher,Its Success Rate and the Changes it hasMade in UK Health C ar Practices and ProceduresAnne CookAbstractNHS ship was set up to as part of the NHS modernization blueprint launched in 1998 the objective of NHS straight was to offer 24-hour medical information to the general public. This was done through the substance abuse of a telephone in value, a meshsite on the Internet, interactive touch screen kiosks and interactive digital television. NHS withdraw operates across the whole of England and its digital television and vanesite are available across a wider area.Growth and diversity run through been ongoing, with the mental home of providing services to other departments within the NHS framework and ongoing expansion. In the main, the general public is satisfied with NHS Direct services. They pee formed partnerships with other NHS departments to reduce the workload i n areas such as Accident and Emergency these initiatives use up had a mixed triumph ratio.The Business Plan for 2006 onwards was focused on further expansion and result of NHS Direct. However, on April 3rd, 2006, the Ministry of Health announced that the NHS overall had a budget deficit of 50 cardinal pounds and made public that NHS Direct would be forced to reduce their workforce by one third. Overall NHS Direct had met their derrieres, all be it at a high cost due to the requirement for advanced technology to entertain and run the systems needed.The focus of NHS Direct Management ordain at one time be on restructuring and downsizing with a reduced workforce. The supply turnover has always been high at 30% and the staff morale in difficult times depart be a problem that needs addressing in order to retain experienced staff.The overall conclusion is that the NHS as a whole will have to reconsider its ability to volunteer free medical to all based on certain funding. The funding to NHS has join ond over the last decade.Regardless of the increase in funding, the system was non monitored in a way that identified an emergence deficit, now resulting in NHS Direct and other departments having to downsize, in this case not due to their own inefficiency but the overall financial crisis in the whole NHS system. By using change agents the process of going from being a growth division to one that is reducing needs to be well managed to focus on the positive contributions they can make to the wellness of the general public and by closing or re directing the services that they are not handling competently and/or cost efficiently.1. Table of ContentAbstract1. Table of Content2. entre3. Literature ReviewBrief Introduction to Change ManagementNHS DIRECT4. Research Objectives5. Research Methodology6. Research FindingsSWOT AnalysisTable 1 SWOT AnalysisForce Field Analysis NHS, Direct, April 2006Table 2 Force Field Analysis2. IntroductionThe National Health S ervice (NHS) is the largest employer in the UK and has a diverse workforce with many different professional groups (Smith, 2000). The researcher believes that t here is accelerating pace of change within the NHS, as they need to keep a step up and embrace further growth in the public sector. In recent journals there are many problems related to the NHS Direct, which the researcher feels an probe should be undertaken to identify the problems. A political editor saidThe subject field doubted whether the target of 90 per cent of callers speaking to a nurse within quintette minutes would be met. It said NHS Direct was changing the target waiting time to 20 minutes (Waugh, 2002).NHS Direct is the National Health Services 24-hour information, advice and guidance service available by telephone, the Internet, interactive touch screen kiosks and interactive digital television. NHS Direct operates across the whole of England and its digital television and website are available across a wid er area.NHS Direct is a Special Health Authority and employs approximately 4000 staff and handles around 600,000 telephone calls and one million visits to the website distributively month.The NHS Direct website gives unhurrieds the alike(p) information as their doctors, in clear and jargon-free language, which patrons them to make informed choices nigh their health wish well.At the time the HNS Direct website was set up the indeed Health Minister, Rose Winterton, stated We are working to provide a modern, flexible NHS that fits around patients needs and meets their expectations. We know that patients would like more information to support them in making decisions almost their healthcare. This is an important step in providing patients with the resources they need to make informed choicesThe NHS is implementing a 10 year modernization program the NHS modernization Board is advising the Secretary of State on implementing the plan.Due to the vast nature of the NHS, this study will specifically look at NHS Direct and analyze the changes that have occurred, and the affect on stakeholders, both within the NHS and their external customers.3. Literature ReviewBrief Introduction to Change ManagementOver the last 20 years the electrical shock of change has been greater than ever before, as the pace of change is now so fast that, for organizations to sustain business growth and operate successfully they must be able to change with the frequent changes in markets and competition. Therefore businesses must respond very quickly if they are to survive. Clarke, (1994) Today, change is not the riddance but a steady ongoing process that organisation strive on to keep a crucial part of competitive edge.1Burns (2000, p148) statesWhat worked in the ultimo will not work in the future, and organizations, like society at large, will have to change in unprecedented ways if they are to survive.Managing change is a broad area to concentrate on, as change affects organizat ions in general and people in many different ways. The NHS has made changes to their provision of health care, which gave rise to the NHS Direct in the first place however, the current financial crisis shows that initiatives in health care to date have not been adequate or appropriate. The one area that has not changed is the demand and scope of the services to be provided they are providing medical for all, regardless of the persons ability to pay. Certain members of the public have opted for buck private health care insurance but this is not the norm. In addition, the population is aging and increasingly more elderberry bushs need long tern, high care that pieces public press on available resources.It is easy to change the things that nobody cares ab reveal. It becomes difficult when you start to change the things that people do care aboutor when they start to care about the things that you are changing. 2(Lorenzi and Riley 1994)The NHS is important to the vast majority of th e population it is considered a right to have medical care available to all, regardless of their financial contributions. closely people do not carry private health care insurance. The Ministry of Health has repeatedly changed the NHS to maintain this service, with differing levels of success in recent years. The current land site shows serious financial deficits, a shortage of qualified staff and dissatisfaction with the service.We live at a time when organizations are continually changing and success is now determined by how well the changes are implemented and whether the desired gains can be achieved. (Collins, 1998)The rate of change is increasing in almost all organizations. The pull is intense as the world focuses the time and attention on understanding the forces driving the changing environment and expands or applies the information systems needed to support the changed environment.The develop change management in reference to the comments of 3Peter Drucker is as to whe ther one can manage change at all or merely lead or facilitate its occurrence within an organisation.Change management is the process by which an organisation gets to its future state, however creating change starts with creating a vision and therefore empowering individuals to act as change agents to attain that vision.In todays rapidly changing, competitive environment, the ability to change efficiently, can distinguish the winners from the losers. Many health-related organizations find themselves unable to adapt due to the independence of technologic change.NHS Direct has been in a period of change due to their growth since inception. In 1998, the change was positive, bringing on and implementing late technology, growing call centres and providing an expanding service to the general public as well as reducing the workload in some other sectors within the NHS. However, this additional service within the NHS has involved high costs for technological infrastructure, software and i mplementation, as well as on going maintenance and extended the service without colossal reductions to the demands on other sectors of health care.NHS DIRECTPurpose of the NHS DirectThe NHS is a 24-hour health help line that handles around 100,000 calls every week across its 22 sites. Since the launch of the first wave of NHS Direct sites in March 1998, the service has expanded to cover the whole of England. In addition, it has developed a range of multi-channel services, including NHS Direct Online, Information Points using touch screen kiosks, NHS Direct in Vision (new digital TV pilot projects) and the Self-Help Guide (formerly the NHS Direct Healthcare Guide).NHS Direct has alike expanded, working with frontline staff and managers to devise new with out-of-hours services to succeed in their aims and objectives providing consistent gravel to high quality, integrated care.Ref 4http//www.nhsdirect.nhs.uk/ a new ingress to healthcareThe NHS Plan A Plan for Investment, a Plan f or Reform, July 20004. Research ObjectivesIntroduction of the NHS direct has made a big departure to the existing practise and presents a major challenge in the management of change in the public sector.The aim of this report is to analyze the role of the NHS Direct through the use of the Internet and the impact on the Medical services. The following areas will be evaluatedInvestigate the purpose of NHS Direct.Research the NHS Direct history and its operations.Identify the NHS Direct objectives and the success to dateInvestigate the Impact on all stakeholders, including Medical Services and the general publicEvaluate the role of NHS Direct Website in helping NHS Direct meet its objectives.The challenges the change has imposed on NHS Managers and the affect on their change management approach5. Research MethodologyA literary review will be undertaken to study the NHS Direct and the elements listed in the research objectives.A range of sources will be utilised including e-journals an d journals, newspapers, books and the Internet.The success of the change management will be measured by the success of NHS Direct and its ability to meet predefined goals and objectives, referred to as Key exertion Indicators. The KPIs include the changes being introduced and new services that have heavy(p) since inception of the service.The NHS Direct website will be evaluated as to how user friendly it is, what content it provides, and its acceptability from the user community.6. Research FindingsInvestigate the purpose of NHS Direct.NHS Direct is a response to the desire for increase patient empowerment. It is alsorecognition that the NHS is a complex, multi-layered system that can be confusing for the non-health professional. NHS Direct enables people to make decisions about their own or their familys health by providing expert advice and up to the minute information. The service can also act as a 24-hour signpost, directing people to the most appropriate level of care.NHS Dir ect was launched in 1998, initially at three pilot sites, to provide easier and faster advice and information for people about health, illness and the NHS so they are better able to care for themselves and their families.The success of NHS Direct in achieving this aim rests largely on the premise that it should be getatable to all sectors of the population regardless of race, age, gender, preferred language choice, income, sensory impairment, disability, social positioning or cultural background/preference. Ref NHS Direct website, a new gateway to healthcare http//www.nhsdirect.nhs.uk/Objectives of NHS Direct Specific objectives set for the service includedTo provide for the public a confidential, reliable and consistent source of professional advice on healthcare 24 hours a day so that they can manage many of their problems at home or know where to turn to for appropriate care.To provide simple and speedy ingress to a comprehensive and up to date range of health and health relat ed information.To make better quality, increase cost-effectiveness and reduce supererogatory demand on other NHS services by providing more appropriate response to the needs of the public.To allow professionals to develop their role in enabling patients to be partners in self-care, and help them focus on those patients for whom their skills are most needed.The Ministry of Healths mission to modernize the NHS is not confined to hospitals. The roll-out of NHS Direct, a nurse-led telephone help line, and the introduction of walk-in primary care centres indicate that the same philosophy is being applied to GP services. The common theme in these initiatives is the desire to improve access and convenience within the NHS, a theme that is emerging as the defining element of New Labours approach to health policy.The modernization of the NHS, which included the introduction of NHS Direct was a major change designed to streamline the interface between the general public and the NHS. As the N HS Direct service grew, it came under criticized for rupture the personal link between patients and their GP. Some patients preferred the face-to-face interaction with their doctor when a health problem arose, even though the situation did not require medical procedure or physical intervention and was competently handled by a call to NHS Direct.Ref Coulson Thomas, C and Coe, T (1991), The Flat organisation. British Institute of Management London. They stated that Change is an ever-present feature of organizational life, though many would argue that the pace and magnitude of change have increased significantly in recent years. The Institute of Management, formerly the British Institute of Management, which regularly carries out surveys of its members, has certainly found this to be true. In 1991, the institute inform that 90 per cent of organizations in its survey were becoming slimmer and flatter.Such change will bring exemption there are 4 bases for resistance to change, identif ied as follows by Leigh, A (1988) Effective Change. IPMCultural When change seems at odds with accepted values and norms the way we do things around here.Social When change threatens to disrupt relationships or break up valued groups.Organizational When change affects formal, hierarchical status and threatens the individuals power and influence. mental When change is seen to be counter to the individuals vested interest, when loss outweighs gain.NHS Direct could have created resistance in all the above areas.Cultural for many senior citizens, for example, prefer to talk face to face with their medical personnel and those less computer literate people would not be inclined to use the web site as a source of information. There is a trust relationship between many doctors and patients who have worked together on the individuals health needs for many years.Social NHS Direct has been criticized for severing the ties between doctor and patient and recommending patient care options t hat differ to those normally followed by the patient under his/her GP.Organizational an article on the BBC, 30 August 2001 ref http//news.bbc.co.uk/1/hi/health/1516701.stm shows a concern regarding the changes to the organizational structure. NHS Direct blame for rise in 999 callsThere has been a 30% rise in 999 calls since last year. The introduction of the NHS Direct help line has been blamed for a start in the number of 999 calls made to an ambulance service.The Isle of Wight Healthcare NHS Trust is failing to meet government-set response targets of answering 75% of life-threatening calls within eightsome minutes.The trust says its efforts are being hampered by a 30% rise in call-outs since NHS Direct was made available to islanders.NHS Direct denies it is advising people to call out ambulances without good reason. The facts are denied by the manager of NHS Direct, he believes the increase in calls were correctly recommended by NHS Direct and that hey are being used as a scap egoat for the inability of the ambulance services to meet their target for responding to calls.The Times on line, quotes the NHS chief, Dec 08, 2005, in the article titled, Turbulence is the Price of a Better Service When you are introducing change you will inevitably have some degree of turbulence,Psychological The Emergency Medical Journal, C J Morrell, et al wrote a report entitled The Impact of NHS Direct on Other Services The Characteristics and Origins of Its Nurses. It states the introduction of any new health service can clearly have an impact on other services in two distinct ways firstly, by altering the pattern of patient demand for existing services and secondly, if it competes for the same resources, by affecting the ability of existing services to supply care.This was commissioned in response to increasing criticism that the service was fetching qualified nurses away(p) from the profession. The article went on to point out that a number of the nursing staff working for NHS Direct actually have disabilities or personal reasons for not being able or willing to do active nursing duties and have been encouraged back into the work force by NHS Direct they would differently have remained outside of their profession al together.Research the NHS Direct history and its operations.NHS Direct was one of the new services that were introduced in 1999/2000 to improve and reform the NHS healthcare making it a modern, efficient and patient led health service giving patients more choice and better access to their own healthcare.The service provides access to confidential health advice and information, 24 hours a day, in a range of easy and convenient ways the NHS Direct telephone service, NHS Direct Online website and the NHS Direct synergetic service on digital satellite TV service. As well as helping patients improve their health and looking after themselves, NHS Direct helps patients access the right health care service for their needs.The value of the use of technology was reported by 5Carr (1996) who agrees that, when properly used, information technology is a powerful bastard for increasing speed, quality, and flexibility, and for creating new, different, and effective process operations. It enables businesses to maximize their return on investment and deliver breakthroughs in competitive advantage. But in practice, many organizations have been displace millions of dollars down the drain by applying sophisticated information technology to automatic existing processes. The consequences? Making the same mistakes faster.The costs and changing structure of the NHS Direct in the past and concerns regarding the accounting were tabled by the National Audit Office in Feb 2006 ref http//www.nao.org.uk/pn/05-06/0506484.htmEstablished in 1999, until April 2004 NHS Direct was centrally managed by the Department of Health but the service was delivered at a local level by 22 NHS Trusts. When NHS Direct became a Special Health Authority in April 2004, it had to put in place new accounting systems and procedures. While these systems were being established the host Trusts which had previously funded and managed the service continued to be responsible for providing accounting and payroll services under service level agreements. Since NHS Direct had not implemented a centralized ledger or payroll system and the payroll providers and records were dot across the country, there was an absence of central management control over the processing of payroll.Work by NHS Direct and the NAO has indicated that in the region of 1.6m of payroll use of goods and services in 2004-05 may be inaccurate.According to todays report, NHS Direct has also been unable to provide evidenced comparative income and expenditure figures for previous years. NHS Direct has estimated total income and expenditure of 121 million for the previous year based on returns provided by the host Trusts to the Department of Health together with an estimate of cen tral departmental costs, but has been unable to provide sufficient evidence to support these figures.Identify the NHS Direct objectives and the success to dateObjectives are stated as Key cognitive operation Indicators (KPIs) and divided into sections Patient, Staff and Organisation, Stakeholders Financial. The table below summarizes the KPIs for the sections, as stated in the Executive Report for July 2005, tabled in Sept 2005. This provides a recent snapshot of NHS Directs adhesion to KPIs and provides actuals for previous month and year allowing comparisons for improvement over the period. As the department is in a growth phase, these KPIs include measurements of change management as well as maintenance and adherence to standards and processes and procedures.The section for Financial KPIs does not include any metrics, therefore it is assumed they were not discussed or agreed prior to the tabling of the report.The following table has been extracted from the Executive Scorecard , a method used to measure adherence to targets.Patients KPIsOverall, patients reported being satisfied with the service received, however, the department did not achieve its objectives against the majority of KPIsThe number of complaints were up from 2004, although lower than reported in JuneNumber of complaints responded to within 20 days was 39% below target and 37% worse than in JuneSerious adverse incidents exceeded the target and has shown an improvement over prior year and month figuresThe number of web visits and calls answered were lower. This is likely to be due to the fact that this was summertime and not due to any shortcoming on the service.The number of abandoned calls is above target, although improved over the periodThe judging of calls, all types, have met target and are significantly improved over the period.The National Audit Office paper NHS Direct in England, published in 2002 stated NHS Directs project team has balanced the need to publicize the service and it s capacity to meet demand. It has already met its target for 60% of the population to be aware of NHS Direct by March 2002. Public satisfaction with NHS Direct is consistently very high at over 90%. Very few callers received the pursue signal when telephoning, but in Sept 2001 only 64% of callers were able to speak to a nurse adviser within 5 minutes compared with the current target of 90%. Staff Organisation KPIsSchedule adherence appears to be a problem, with the target not being met by 2 key staff members by 9 18%.The cause for concern is within the rolling year turnover rate for staff. This is exceptionally high at 39% and this should be further investigated to find out the root cause.The BBC article Call Centres An Ideal Calling an NHS Direct employee commented However, with a staff turnover of some 30%, it looks as though the call handlers are not enjoying the fruits of this telecommunications boom.Jonathan, who works at a major call centre in northern England, has seen thi s staggering turnover at first hand. Two-thirds of the people who join us dont make it past their second month. Most of the others leave within a year, he says.Companies have been accused of taking a cavalier attitude to happiness of their staff, preferring to hire agency workers rather than investing time and money in a full-time workforce.Stakeholder KPIsThe departments reached the majority of stakeholder KPIs stakeholders are other departments within the NHS and therefore this indicates that the NHS Direct should have a successful relationship within the NHS as a whole.July 2005 Executive ScorecardPatient KPIs (Key Performance Indicators)ActualActualActualRatingJun-05TargetPrev mthLast YearG% Patients satisfied with service99%95%98%99%RNumber of complaints (per 10,000 calls)0.840.51.010.49RNumber of complaints responded to within 20 days56%95%93%GSerious adverse incidents (per 10,000 calls)0.160.240.340.25ANumber of web visits963.3k1040.9k1013.0k662.6kANumber of calls answered57 0.01k591.3k553.5k526.3kAAbandonment rate7%5%10%13%A% calls answered within 60 seconds76%95%71%57%G% urgent calls commencing clinical assessment in 20 minutes97%95%97%50%A% non-urgent calls commencing clinical assessment in 60 minutes97%95%97%50%G% of HI calls assessed within 3 hours91%90%91%90%Staff OrganisationGOverall ICT availability99.97%99.00%99.99%99.99%RSchedule Adherence Nurse Advisor61%80%61%57%ASchedule Adherence Health Advisor72%80%70%66%ACalls per available hour7.78.88.77.5GShort term indisposition6%6%5%5%RRolling year turnover rate for staff39%25%39%30%A% of funded staff in establishment90%100%91%93%Stakeholders KPI

Using early warning scores in acute illness assessment

Using early warning scores in sharp unsoundness assessmentThis Assignment is in two parts. Part one lead describe how I undertook a literature search on my elect topic of using early warning scores in acute illness assessment. From this initial search and review of the literature I will attain six words and present them in an annotated bibliography. The purpose of this first part is to demonstrate my literature searching skills by identifying a suitable nursing topic and the rudimentary words I will use for my search. It will also demonstrate I can identify incompatible types of literature sources like primary look for studies, systematic reviews, biography reviews, audits and general articles written about the topic I have chosen. . The second part of this assignment will identify a inquiry based article from the six articles I have selected.Part oneTopic Using early warning scores to assist the comfort in identifying patient of deterioration in acute illnessKey words c ute cargon- tiny care- early warning score- vital signsData bases searched Cinhal British treat IndexNumber of articles/ literature sources = 402Six articles were chosen as followsArticle 1.Mohammed, MA (2009) Improving accuracy and efficiency of early warning scores in acute care. British Journal of Nursing. 18(1) 18-24This article is a musical theme on an experimental study to compare the effectiveness of hand held early warning estimator system with the traditional pen and paper methodArticle 2.Johnstone C, Rattray J and Myers L (2007) Physiological risk factors, early warning systems. British Association of Critical Care Nursing. 12(5) 220-231This article is a general article that provides background information on the topic of why early warning systems can improve patient careArticle 3.Preston R M and Flynn D (2010) Observations in acute care evidence based approach to patient safety. Britsh Journal of Nursing. 19(7) 442- 461This is a narrative review of the literature on d ifferent issues affecting acute illness assessment and patient safety conducted by nurses in acute care.Article 4Odell M (2009) Nurses Role in detecting deterioration in hospital ward patients- a systematic review. Journal of Advanced Nursing. 65(10) 1992-2005This article reviews primary look into studies that were conducted amongst 1992 and 2006.Article 5.Hughes LL (2009) Implementing a patient assessment boundwork in acute care Nursing Standard 24(3) 35-39This article describes a service improvement scuttle to improve patient assessment using an early warning score system over a4 month period at a Hospital in BirminghamArtcicle 6Wheatley I (2006) The nurses work out of winning level 1 patient observations. Intensive Critical Care Nurse 22(2) 115-21This was a opinion conducted to discover the nurses practices of taking clinical observations in acute settings. It uses an observation data collecting tool (words 470)Part 2 Critique of one articleWheatley I (2006) The nurses practice of taking level 1 patient observations. Intensive Critical Care Nurse 22(2) 115-21IntroductionThe aim of this critique is to identify the stages of the interrogation process in the supra article by Wheatley (2009). According to Preston (2010), being able to critically read research based literature is an measurable skill in reviewing literature sources that are presented in all academic assignments. This exertion is an opportunity to examine the strengths and weakness of a research study in relation to the research process step ( Priest et al, 2007). The critique will consider the nature of the survey approach to research and to compare this to how Wheatley (2006) designed his project. As this article reports on a survey research study using an observational method, it is important to examine the key features of this research design. Therefore the strengths and weaknesses of the research process featured in this article will be discussed. This will include an appraisal of the sample size data collecting tool and process of collection, the research findings and their relevance to nursing practice.This article reports on a survey type study that utilises an observation data collecting tool. According to Pollit and Bek (2010) surveys are used widely in health care research and are effective for examining a wide number of problems. In this article by Wheatley (2006), the survey is used to discover what nurses actually do when they conduct clinical observations in a medical ward setting. The aim and research questions he identified in the article are outdoorsly written and follow a positivistic, deductive paradigm that is sequester in a quantitative research study of this type (Gerrish and Lacy, 2006). According to Lobiondo-Wood (2010) a positivistic paradigm considers that what can be seen can be measured. The findings are always presented in number formats. In this article Wheatley (2006) is using an observational tool to view the conduct of nurse s undertaking clinical recording of vital signs. This tool would have been structured so that identified behaviours could be investigated. Although the data collecting tool was not presented in the article it is sporting from the discussion that the tool set about to observe the accuracy of nurses recording blood pressure, temperature, respirations and pulse. The tool also identified which nurses undertook this activity and the time that they took to complete a set of observations for each patient.Priest et al (2006) identify that all tecs need to plan their research studies on a sound review of the literature underpinning the research problem. According to Pollit and Bek (2006) the literature review will provide background information on the problem and will identify what research has already been conducted. In this article Wheatley has presented a review of the literature and it is clear that he has based his study on similar studies conducted in the past. His reference list prov ides a selection of different literature sources and includes 46 sources that are clearly focused on recording vital signs and 2 on research methodology. This clearly indicates that Wheatley (2006) has structured his study on a sound review of the literature.The sample size in a survey research study has to follow the nature of the quantitative, positivistic approach (Pollit and Bek). This bureau that the sample size must be large enough to represent the general population it is representing. In this article, Wheatley (2006) has reported on observing 20 cases of nurses conducting observations. This is a very small sample size and statistically would not be considered a positive representation of a good research plan to have such a small for a survey project. However, Wheatley (2006) clearly identifies the limitations this posed to his study and explained that the small sample size was a thingummy sample that was appropriate for his planned study. According to Polit and Bek, (2010) a convenience sample is acceptable as it represents the whole population. In this case, Wheatley (2006) has included all the nurses who work on one ward and found that in 18 out of 20 occasions he observed, it was the machine that dominated the recording of patients vital signs and that the time nurses spent with the patient was pendant on how long it took the machine to do its job. In 16 occasions, nurses did not record the respiratory rate even when 4 patients were showing signs of respiratory sorrow like dyspnoea or coughing. Therefore, although 20 in a sample is not considered viable for a survey type project, the use of a convenience sample (Pollit and Bek, 2006) in this case, provides the reader with a strong indication that there are problems in how nurses undertake clinical observations as part of their acute illness assessment. However, for this finding to affect a change in future nursing practice more research using larger sample frames would be useful.The data collect ing tool and how data is collected in a study (Priest et al, 2007), is also another important step to appraise in a report on a research study. In this article, Wheatley (2006) has designed an observation tool using structured observations that included time taken to record vital signs which nurse undertook the assessment (ie qualified or HCA) whether a machine or hand/touch methods were used to record pulse and respirations in particular how vital signs were enter on the observation charts. According to Polit and Bek (2006) a good research paper will show the reader how they structured their data collecting tools. In this article, it is clear to see what was observed by carefully examining the graphs and table charts Wheatley (2006) presented in his findings section. At the top or bottom of each chart he writes what behaviour/activity was recorded in his findings. For example, one chart on page 117 has the title which nurses performed the observations and you can see that of 20 on ly 2 observations were carried out by a qualified nurse. The other 18 were conducted by the HCA. What Wheatley doesnt do however in his article is consider if being observed in this study changed the nurses behaviour. Polit and Bek (2010) note that in observation studies bias can occur through the Hawthorne effect. This is an effect noted to occur when people realising they are being watched change their behaviour during that process. However, there is no indication this happened here and one can assume therefore, that the behaviour Wheatley (2006) observed was what would normally be expected in patient observation activities.When appraising research papers, Ryan et al (2007) say an important step in this process is to review how well the researcher has presented his findings. In this article Wheatley (2006) has utilised descriptive statistics in a clear format that is easy for the reader to understand. He has used descriptive statistics to convey the findings in simple percentage a nd number format. For example, it is clear to see that around observations are carried out by HCAs (n =18 or 90%). When numbers are expressed like this it clearly indicates the power of that finding (Polit and Bek, 2010). Another important finding is that in 4 cases nurses failed to record the respiratory rate even when patients were struggling to breathe. Although this is a small percentage (ie n = 4 / 20%), it is worry to note that any nurse would fail to record the respiratory rate when a patient is clearly showing signs of distress. From these findings, Wheatley (2006) concludes that qualified nurses must take state for taking and reviewing how vital signs are recorded in acute care settings if patient safety is to be safeguarded at all times.Overall, the article by Wheatley (2006) is a good example of a research project using a survey method approach to study. Despite noting a small sample frame that could indicate a bias to how the findings can be appraised, it is felt the findings are generally credible and should be appropriate to both inform nursing practice and promote patient safety in acute illness assessment. The steps of the research process are clearly identified throughout the article that demonstrates the researcher has understood how a survey research study should be competently planned for and undertaken and reported on.(TOTAL 1870 WORDS)

geothermal energy :: essays research papers

GEOTHERMAL ENERGYGeothermal energy is one of the oldest sources of energy. It is simply using and reusing (reusable energy) heat from the inside of the earth. Most of the geothermal energy arrives from magma, melt or partially molten rock. Which is why most geothermal resources come from regions where there be active volcanoes. Hot springs, geysers, pools of boiling mud, and fumaroles are the most good exploited sources. The ancient Romans used hot springs to heat baths and homes, and similar uses are still found in Iceland, Turkey, and Japan. The true source of geothermal energy is believed to come from radioactive decay occurring deep within the earth.Electricity is one of the biggest outputs of geothermal energy. It was first recorded to produce electricity in 1904 in Italy. There are now geothermal power plants in operation in New Zealand, Japan, Iceland, the US and elsewhere. For the generation of electricity, hot water system supply, at temperatures ranging from about 700 degrees F, is brought from the underground reservoir to the come up through production wells, and is flashed to steam in special vessels by release of pressure. The steam is separated from the liquid and fed to a turbine engine, which turns a root. In turn, the generator produces electricity. Spent geothermal fluid is injected back into peripheral parts of the reservoir to help maintain reservoir pressure. If the reservoir is to be used for direct-heat application, the geothermal water is usually fed to a heat exchanger before being injected back into the earth. Heated national water from the output side of the heat exchanger is used for home heating, greenhouse heating, vegetable drying and a wide variety of other uses. Hot water and steam exist at many underwater locations in the western U.S.These resources can be classified as low temperature (less than 194 degrees F), moderate temperature (194 302 degrees F), and also high temperature (greater than 302 degrees F). The use s to which these resources are applied are also influenced by temperature. If the reservoir is to be used for direct-heat application, the geothermal water is usually fed to a heat exchanger before being injected back into the earth. Heated domestic water from the output side of the heat exchanger is used for home heating, greenhouse heating, vegetable drying and a wide variety of other uses. Hot water and steam exist at many subsurface locations in the western U.

Illusion Verses Reality in Death of a Salesman by Arthur Miller Essay

Illusion Verses Reality in Death of a Salesman by Arthur Miller Death of A Salesman, by Arthur Miller, is a play that tells the story of a traveling salesman, Willy Loman, who encounters frustration and failure as he reflects on and experiences his own life. Willys quest for the American Dream leads to his failure because passim his life, he pursues the illusion of the American Dream and not the reality of it. His mindset on perfection, his obsession with success, and his constant reminiscence of the past and foretelling of the future, all gift to his defeat in the end. The reality of the American Dream is that people are capable of succeeding. Success, though, requires one to work hard and be dedicated to both his/her nonrecreational life and family life. Yet, the illusion of the Dream is that attaining material prosperity defines success. Failing to acknowledge the importance of hard work in achieving the American Dream is another looking at of the illusion. By ignoring the p resent, Willy fails to deal with reality. He has a tendency of living in the past and thinking of the future. He always thinks that if he had done something differently and so this could have happened, or things will get better as time passes. His habit of distorting the past, never allows Willy to realize what is going on right then and thither in the present. At one time, when Willy goes off down memory lane, he says to Biff and Happy, America is full of beautiful towns and fine, upstanding people. And they know me, boys?the finest people? on that point?ll be open sesame for all of us, ?cause one thing boys I have friends. I can park my car in any(prenominal) street?and the cops protect it like their own (31). Willy makes this distortion of the pa... ...ind. Willy Loman portrays a common man, who lives a life that is purely an illusion. Although Willy has good intentions, his tragic flaw is that he focuses only on the appearance of the American Dream and never on the reality, t he work ethic, or how to achieve it. Willy brings about his own downfall, his defeat, because he tries to pursue this careless idea. Miller includes this theme of the American Dream in his social criticism in an attempt to portray the deviation in the values of society. For instance, materialism and expert advances, causes the American Dream to change as times changes. The salesman is a position that has declining importance at the time. He shows that an individual?s values are found on what society has established. Yet, as society changes, the values one has may not, causing conflict between the society and the individual.