Hospital Expansion Analysis

Hospital Expansion Analysis Case Study 1: The Case for Open Heart Surgery at Cabarrus Memorial Hospital- Chemplavil Brief Introduction: Cabarrus Memorial Hospital (CMH) is a large, public hospital located in North Carolina, that prides itself in cultivating a never wavering commitment to its community. Having first opened in 1935, over time CMH has found powerful allies in both Mr. Cannon, owner of Cannon Mills with considerable political and financial influence, and Duke University Medical Center, with who they have formed an educational affiliation and unique teaching arrangement. Due to the boards failure to foresee several front-hand issues, CMH finds itself at a crossroad of sorts. Currently CMH does not have their own open heart surgery program, compelling patients to seek open heart surgery or coronary angioplasties elsewhere. Concerned with the tremendous burden placed on the members of their community and their families to travel to such far lengths to receive adequate care, the board of trustees is considering adding a program of this caliber to their repertoire of cardiac services.    A SWOT analysis and service area structural analysis (Porter) was performed to determine if CMH should apply for a certificate of need (CON) to open a new cardiovascular service program moving forward. Discussion of Key Issues: The potential implementation of a full-service cardiac surgery program in CMH required careful consideration of its existing service area, opposition from competition, need for cardiovascular surgeries, the role of Duke in the proposal, relevant costs, and the likeliness of acquiring approval from North Carolinas DHHS for the CON. Evaluation of CMHs current service area was primarily based upon zip code analysis of current cardiac catheterization and radiation oncology patients, pinpointing Concord and Kannapolis as major sources of patient coverage. With Mr. Cannons help, extensive market development strategies should promote their newly enhanced cardiovascular care and help CMH expand their territory to include farther communities like Rowan County and Stanley County, shaking off bordering service area competition like University, Stanly, and Memorial Hospitals. Study of the population epidemiology points to an inevitably growing need for expanded cardiovascular services, namely open heart surgeries and angioplasties. Projections indicated the at-risk population growth over the next ten years will grow by 31.2% in Cabarrus county, location of CMH. The growing rate of the target, at-risk service area population (45-64) will likely lead to higher rates of open heart procedures (1.39 in North Carolina currently). Proposed costs of the program would total at $2.87 million for year one, $3.81 million for year two and $6.24 million for year three. However, it is known that CMH has sufficient reserve cash to finance the whole project without even acquiring a loan! Based on these projections alone, CMH will reach their break-even point rather quickly, likely sometime after year three, making the addition of a cardiac unit a profitable endeavor. The existing open heart surgery programs in Charlotte, Winston-Salem, and Greensboro are 25 to 60 miles from the service population. This incredulous distance has created confusion and an immense burden for many patients who seek continuity of care as travel times may take up to two hours. It may be wise to consider swiftly bring on home town hero, Dr.   Christy, as part of the new cardiovascular surgery medical staff to embolden the communitys support of CMH and put its patients at ease. Duke can continue its educational affiliation with CMH, and cases needing specialized care would still be referred to Duke. The DHHS of North Carolina awards the CON to centers that achieve an 80% utilization rate for the cardiac surgery suite. Unfortunately, open heart cases from Cabarrus County and Rowan County currently however around only around 73% utilization. CMH will need to make use of adaptive strategies such as the expansion of scope planning that would include market development, product development and market penetration strategies to substantially increase their current volume to hit that threshold. Situational Analysis: SWOT analysis provided detailed findings of the strengths and weaknesses of the internal environment, in addition to the opportunities and threats of the external environment, regarding the current cardiac care CMH provides (Ginter, Peter). Exhibit I: SWOT Analysis Recommendation: CMHs status as a modern, well equipped facility implies that it has the necessary infrastructure to build a cardiac unit, pending a few structural additions. CMHs renovation project would total $3,273,180, and no loans will be needed due to its sufficient reserve fund. Pending a two-year trial run, CMH should track the added comprehensive care that would result from the opening of one heart surgical suite for adult patients, while moving angioplasty to the current cardiac catheterization laboratory. The proposed duration of this project would likely take 3 years and would require the assignment of three dedicated cardiac surgical ICU beds as well as seven telemetry beds to support the open heart program with an almost overwhelming 400 proposed procedures per year from the onset of the program. Benchmarks for Success and Contingency Plans: Implementation of this new program will complicated, but justified. The board should create and follow an action and strategic plan to oversee the creation of this new surgery program. Timelines, benchmarks, and a balanced scorecard will be used to monitor the progress of the plan, and to ensure the standards are being met (Bloomquist P, Yeager). Written reports, like a GANTT chart, which may plot the incurred heart operations against time, can also be used to monitor planning, costs, effectiveness, and resources used by the program (Cellucci L, 2009). Taking corrective action will be dependent on evaluation criteria that will be created by the board and redirection will take place if necessary. If added comprehensive care progress is not being met according to the action and strategic plans, program strategies will be outsourced to an outside consultant. If Dr. Christy is not satisfied with CMHs offer and relocates elsewhere, CMH may be pressed to ask the two surgeons from Duke Medical Center to act as interim on-call heart surgeons or even come on full time to continue the program. If the programs restraining forces continue to outweigh its driving forces, and fails to provide the proposed benefits, termination of the program may be likely. References: Bloomquist P, Yeager J. Using Balanced Scorecards to Align Organizational Strategies. Healthcare Executive; Jan/Feb 2008. pp.24-28. Cellucci, L. W., Wiggins, C. (2010). Essential Techniques for Healthcare Managers. Health Administration Press: Chicago. Ginter, Peter M. Strategic Management of Health Care Organizations. San Francisco, Calif: Jossey-Bass, 2015. Print.

A Career in Education Essay -- career essays

A career in education can be a rewarding yet challenging field. Becoming a teacher is a unique career in which there will be various titles, from being a communicator, social worker, disciplinarian, evaluator, role model, and at times a parent. Being able to change the lives and mold minds of young children is something I have always wanted to do. Throughout my research and personal interview, I have discovered what my salary will be like, the lifestyle impact, future projections, and the credential requirements needed to accomplish becoming an educator. The requirements for becoming an educator vary from state to state because each state has its own set of rules when it comes to their educators. For example, Wisconsin requires that their educators have a Bachelor’s degree, pass the Praxis II exam and the edTPA (Teacher Performance Assessment) and that they know how to communicate, have knowledge of what they are teaching, understand different learning styles, children’s growth, know how to evaluate, manage a classroom and plan lessons (Teacher Education, Professional Development & Licensing). For UWM graduation requirements, I must complete a human relations class so that I know how to understand different cultures and how to communicate with different types of people. I also must have credits in fine arts, social sciences, and natural sciences; a minimum cumulative GPA of 2.75 in all professional education coursework, a full day/semester during the final year of the program for field experience, and earn a C or bette r in student teaching to be eligible (Academic Programs). According to the Bureau of Labor Statistics, the future employment projection for educators is expected to grow 17% from 2010 to 2020 simply because of... ...th long working hours teachers deal with a lot of emotional and physical stress; dealing with parents, administrators and behavioral issues, educators have to keep personal and emotional reactions separate from their professional reactions, when it comes to dealing with behavior issues in the classrooms and also dealing with difficult parents; learning how to cope and deal with tension and even sometimes hostile environments are all a part of being a teacher. Dealing with superiors is also stressful for teachers because although as an educator our job is to evaluate students, teachers also are evaluated themselves, and evaluations can heavily determine if they will continue to have a job in that specific school (Robin Grusko and Judy Kramer). Although there are beautiful and rewarding things that come with being a teacher, the personal life can be challenging.

Kola Nuts

Kola-Nut: The Symbol of Hospitality (title) †¢It is a bitter brown seed containing caffeine †¢In the past, has been added to drinks to diminish hunger and fatigue †¢The offering of a Kola-Nut is very important in the igbo culture and is only offered to very important guests †¢This offering of the Kola-Nut has three steps that must be followed. The first step is the presentation of the kola-nuts.The next is the breaking of the kola-nut and the third is the distribution of the kola-nuts †¢Presentation of the kola-nut can only be done by privileged men †¢Kola-nut is passed around until it finally comes back to the guest †¢Elder will then hold up kola-nut and say a prayer †¢Then kola-nuts are eaten Onyemaechi, Uzoma. â€Å"Igbo Culture and Socialization. † Igbo Culture. University of Michigan, 26 May 2012. Web. 29 Oct. 2012. . Widjaja, Michael. â€Å"Kola Nut. † Igbo Culture and Igbo Language. N. p. , 4 Nov. 2011. Web. 29 Oct. 2012. . â€Å"Kola Nut. † Energy. N. p. , 16 July 2011. Web. 29 Oct. 2012. . Igbo Foods * The Yam is a staple food for Igbo people and civilization * Yam was always abundant, helpful during lean times * The Iwaji or New Yam festival each year celebrates importance of vegetable in Igbo culture.Prayers offered up and thanks given to the gods and spirits of traditional folklore. * Yam made in many ways * Can be pealed and boiled or pulped into a doughy consistency to produce pounded yam * Also ate a lot of pumpkins and gari (cassava powder) dumplings * Regular Meals * Typically soup with meat or fish * Sided with yams, garri (tapioca), semovita, or jollof rice Hafner, Dorinda. A Taste of Africa . Berkeley, CA: Ten Speed Press, 1993. Imoisi, Janice. Cooking Nigerian Style: Delicious African Recipes .Houston, TX: Gayle Publishing. , 2000. Widjaja, Michael. â€Å"Food and Recipes. † Igbo Food and Recipes. Michael Widjaja, 2000. Web. 29 Oct. 2012. . Agwu, Kene. â€Å"Yam and the Ig bos. † BBC News. BBC, 8 Jan. 2008. Web. 30 Oct. 2012. . â€Å"ANAM CITY Blog. † Yam Preservation A «. N. p. , n. d. Web. 30 Oct. 2012. .

25 Pick Up Lines From Movies

25 Pick Up Lines From Movies At the outset, lets make it clear to all men reading this article: pick up lines usually dont help land you a date. In most cases, you will only end up offending the woman you wish to woo. If you try a funny pick up line, you run the risk of the joke falling flat. A nerdy one may never make the mark, especially if the woman does not understand your jargon. A clever pick up line may not cut ice if the woman does not like Mr. Smarty Pants. Some men believe that flattery can help them win a date. While women love to be showered with attention, they can easily see through fake flattery. Often such pick up lines become juicy tidbits for women to share among their girlfriends over cocktails. What Makes Pick Up Lines Fun? Pick up lines could be great starting points for conversation. It can help break the ice, but it does not guarantee you a date. For instance, a woman was approached by a man with a pick up line, â€Å"Well, here I am, what are your other two wishes?† Now, this line did not work its magic on her. She quipped, â€Å"I wish that you’d buy your drink and then disappear.† The man realized that she was not interested and walked away with dignity. Who Should Not Use Pick Up Lines? If you lack the confidence to approach a woman, dont use pick up lines. They will repel  women. If you are shy and find it tough to meet new people you should refrain from pick up lines too. Pick up lines work if you exude confidence and an aura of sexiness. Are you a charming, debonair man with a magnetic personality? If yes, you can try using pick up lines. Of course, if you were to approach an equally confident and bold woman, she will quite likely snub your overtures. Pick up lines with sexual undertones usually put off women who view men as predators who are only looking for sex. So dont try to pick women with cheesy lines like, â€Å"If youre feeling down, I can feel you up.† Lines like that wont earn you a date, but will surely earn you a slap! Think of pick up lines as a part of a mating ritual. After all, it’s a delicate dance, where both the man and the woman need to be attracted to each other. What Women Really Think About Pick Up Lines Women who are looking for a lifetime partner are usually not impressed by pick up lines. Some women find pick up lines amusing if not flattering, but most women prefer to start a conversation with a simple, Hi, I am Tom! or something similar. What Men Think About Women Using Pick Up Lines Should women use pick up lines? Do men like to be approached with a pick up line? Maybe this is going out on a limb here, but most men would probably love it if women approached them with pick up lines. The bold, seductive woman gets maximum attention. Pick up lines could be cheesy, corny or funny. Men would enjoy a sporting woman who has the confidence to approach men for a date. Of course, needless to say, the woman should also exude confidence. Her sex appeal would win her brownie points. Pick Up Lines From Movies Here are some seductive, pick up lines from movies. These pick up lines are great conversation starters. If you are a movie buff and you want to woo someone who shares your interest, use a pick up line from this collection. Whats more, you can use these lines on Valentine’s Day to express your love to your girlfriend or wife. Clark Gable, Gone with the WindYou need kissing badly. Thats whats wrong with you. You should be kissed often, and by someone who knows how. Will Smith, HitchNow on the one hand, its very difficult for a man to even speak to someone who looks like you. But on the other hand, should that be your problem? George Clooney, Intolerable CrueltyYour husband had told me you were the most beautiful woman hed ever met. I didnt expect the most beautiful woman Id ever met. John Cusack, The Sure ThingHow would you like to have a sexual encounter so intense, it could conceivably change your political views? Ralph Fiennes, The English PatientSwoon - Ill catch you. Owen Wilson, Wedding CrashersYou know how they say we only use ten percent of our brains? I think we only use ten percent of our hearts. Jimmy Stewart, You Cant Take It with YouI hear voices, too. Voices that say, If you dont kiss her soon, youre a chump. John Gilbert, Flesh and the DevilYou know... when you blow out the match... thats an invitation to kiss you? Bradley Cooper,  The HangoverMaam in the leopard dress... you have an amazing rack. Ingrid Bergman, CasablancaIs that canon fire, or is it my heart pounding? Ryan Gosling, The NotebookI want you. I want all of you. Forever. You and me. Every day. Steve Carell, AnchormanI would like to extend to you an invitation to the pants party. Brad Pitt, Thelma and LouiseI may be an outlaw, darling. But youre the one stealing my heart. Mike Myers, Austin Powers: The Spy Who Shagged MeLets hop on the good foot and do the bad thing. Natalie Portman, No Strings AttachedYou give me premature ventricular contractions. You make my heart skip a beat. Sean Connery, You Only Live TwiceNow whats a nice girl like you doing in a place like this? Tom Cruise, Vanilla SkySee, Ive got this little problem. Ive got a stalker... I need a cover. I need for you to pretend were having a scintillating conversation, and you are wildly entertained. Sam Rockwell, The Hitchhikers Guide to the GalaxyWanna see my spaceship? Will Ferrell, AnchormanI dont know how to put this, but... Im kind of a big deal. Matthew Perry, Fools Rush InYou are everything I never knew I always wanted. Steve Martin, My Blue HeavenYou know, its dangerous for you to be here in the frozen foods section - because you could melt all this stuff. Nicolas Cage, Leaving Las VegasI really wish youd come home with me. Youre so cute, and Im really good in bed, too, believe me. Jack Nicholson, As Good As It GetsYou make me want to be a better man. Jack Lemmon, The ApartmentI used to live like Robinson and Crusoe, shipwrecked among eight million people. But one day I saw a footprint in the sand and there you were. Gerard Butler, PS I Love YouI know what I want, because I have it in my hands right now. You.

How Does Reedsy Select its Publishing Professionals

How Does Reedsy Select its Publishing Professionals How Does Reedsy Select its Publishing Professionals? "How do you select the editors and designers featured on your marketplace?" This is one of the questions we get most often at Reedsy, probably because we can’t help bragging (loudly and often) about the quality of our publishing professionals.The curation of our marketplace is what makes us a truly incomparable player in the industry. Over 15,000 publishing professionals (editors, designers, illustrators, publicists, marketers and translators) have applied to be featured on our site. Currently, only 1,100 have been accepted.Reviewing thousands of profilesSo how do people apply, exactly? It's pretty simple: professionals only need to sign up through our landing page and indicate during the onboarding process that they want to register as "professionals". Once signed up, we prompt them to fill in a Reedsy profile - a page that compiles all their professional information, from work experience to portfolio items to work philosophy.These profiles are public, which means Reedsy pro fessionals can use them as websites or landing pages for all professional activity. More importantly, profiles form the core of our quality control process.First, we make sure professionals who are serious about being listed on Reedsy complete their profile as exhaustively as possible. Our curation team reviews all new, fully finished profiles once a week, at which point they separate the ones who merit inclusion on our marketplace from the rest. If you visit our service pages, you will see a few examples of professionals who have been accepted, and will be able to click through to their public profiles.Our selection criteriaSo how do we determine who to activate? Naturally, the decision is ultimately somewhat subjective as it is made by actual people (not algorithms), but our curation team uses a list of tangible criteria to keep the decision as objective as possible. Here are a few criteria all our professionals meet:be a full-time professional in the field you are applying for (e diting, design, publicity, translation, marketing, ghostwriting)demonstrate experience on at least 10 published books that are well-reviewed on Amazon Goodreadshave experience in every "genre" listed in the profilehave 5+ years experience in your professionThe Reedsy marketplace is competitive, which means professionals meeting all the above criteria are not automatically accepted. These are "minimum criteria" that need to be supplemented with one or more of the following:significant experience working at a renowned traditional publishing companysignificant experience working as a freelance contractor for a renowned traditional publishing companyhistory of high-quality work with a bestselling author, or on a bestselling bookreceipt of a distinguished award in your fieldSome of our editors have worked on books by authors such as Ken Follett, Isabel Allende, George R.R. Martin, Hugh Howey or J.K. Rowling. Because of this, we tend to become more and more selective as our marketplace k eeps growing, and our current acceptance rate is at 1%. That said, we're always on the lookout for more professionals who meet our criteria.Naturally, we do our best to ensure that all information entered by the professionals on their profiles is accurate, and will often verify our professionals' portfolios by searching books' "acknowledgements" sections for mentions of their editors and cover artists.A constant quality controlSo, once I’m in, I’m in forever? Well, not quite. Our curation work doesn’t stop once the professional has been accepted based on the information provided in their profile. We closely monitor our professionals’ work through Reedsy and regularly survey our authors at the end of their collaborations.On rare occasions, we've had to â€Å"deactivate† one of our professionals because of unprofessional behavior, but we have not hesitated to do so - nor will we in the future. Reedsy acts as a third-party guarantor for authors in th eir collaborations on the platform, so it is our duty to keep monitoring our professionals’ work on the marketplace.Our team also keeps an eye on the marketplace to ensure we have sufficient professionals listed and available in each genre. It is by successfully juggling supply and demand that we have been able to build a safe haven for authors and professionals alike - and that’s what Reedsy is all about.

Business Analysis & Requirements Frameworks Essay

Business Analysis & Requirements Frameworks - Essay Example He is in charge of operation in the development together with the different Project Leaders including Software Trainers, Business analysts, Software Developers and one Technical Author. The study finds out that there are about ten different projects running at any time in Ambridge Software Ltd. The different departments are expected each to contribute to the development of software in Ambridge Software Ltd through specialization (Kotonya & Sommerville, 1998). There are different scenarios that occur from time to time, and prompt different actions to create transformation. 2. Introduction This study evaluates different scenarios and recommends the appropriate actions for the management of the scenario in Ambridge Software Ltd (Robertson & Robertson, 2006). It considers the position of a staff member of Ambridge Software Ltd in relation to the decisions of Software development, as well as the position of an employee of one of the clients of Ambridge Software Ltd (Sommerville & Sawyer, 1997). This takes place in various scenarios, involving different authorities including the project managers, Software Developer, Software Trainer, Technical author, Business analysts and support staff. The scenarios further consider the different stages of software development such as functional specification, Design specification, programming phase. Each leader has responsibilities to manage in the process of the development process (Kotonya & Sommerville, 1996). This report selects scenario 1 where the company realizes that there is the realization that misunderstanding led to certain unplanned changes on some projects. In this, there was poor understanding between the customers and the development team in Ambridge Software Ltd. The system developers apparently failed to understand the software requirements and their documentation (Macaulay, 1996). From the scenario, it was appropriately decided that there should be an update in the protocol and system documentation will be insta lled (Yeates & Paul, 2006). In the initial stages, there was a meeting held with the Ambridge Software Ltd customer at different durations before the beginning of development project. At the same time, there are three intervals every month while the project is in progress (Goquen & Linde, 1993). The processes and the stages involve the development of reports to the project coordinator. The project leader then has the task to distribute the information to the members of the teams who are working on the project. 2. Scenario One: Report 2.1. Discussion The division of labor and specialization is a special opportunity for the Ambridge Software Ltd staff to exercise their knowledge, experience and skills in the development of the software. There should be an understanding between the customers and the development team such that the final product is satisfactory and considerate of the issues affecting the Ambridge Software Ltd customers (Finkelstein et al, 1992). This requires frequent vi sits to the customers’ sites to identify their needs. It becomes easy to know how the system can implement them. The second recommendation is to involve the customers in the process of testing and evaluation of the system. This removes the misunderstanding between the development team and the customers. 2.2. Recommended Approach 2.2.1. Cost and benefit Analysis The costs involved here include the costs of travelling

Ethical Aspects of Euthanasia Research Paper Example | Topics and Well Written Essays - 1000 words

Ethical Aspects of Euthanasia - Research Paper Example Voluntary euthanasia takes place when death is hastened at the request of the patient. The ethical issues that arise are the respect for individual autonomy, as well as the obligation of the medical practitioners to respect patients’ informed choices. Euthanasia claims to relieve the patient of suffering. It is also argued that if a patient has the right to choose and make informed decision about his medical treatment, he also has the right to decide when to die (Chaloner, 2007). The opponents claim that this could have a damaging effect on the individual and the society. The opponents argue that palliative care should be improved but in terminal cases, no amount of medicine would make any difference. Moreover, the psychological need of the terminally ill patients to be relieved of the suffering should be of equal importance as the physiological needs. This is individual autonomy and an individual must have the freedom to do what he wants to and when he wants to do. John Stuar t’s Harm Principle also asserts that the individual has a right over his own body and mind. This principle restricts the power of physicians and others in the medical field to arrive at decisions about the patient when the decision affects none other than the patient himself. Autonomy again gives rise to certain apprehensions. For an individual to arrive at the decision, he should be competent enough to decide on a course of action. Is he in the right frame of mind? Secondly, if autonomy of the patient is respected, the autonomy of the medical professionals also needs to be respected. Hence, if the autonomy of the doctors is also respected the patient loses the right to receive assistance to die. Rights and duties are interwoven. Hence, it can also be interpreted that the health professionals have a duty to assist the terminally ill patients to die. Other arguments that abound are that a competent