Describe where the physician practice and the hospital fall on the continuum of patient care.
Analyze how providers at each location try to return their patients to their highest level of functioning.
Explain how a physician practice communicates with the hospital to foster high-quality, efficient, and effective patient care.
Analyze three peer-reviewed articles that each discuss one of the topics above.
Description or summary presents the what of the article, but analysis will pursue the question of so what?
Why do these ideas matter and/or how are these ideas connected?
What are the potential gaps or questions that remain?
Organize your paper with the following headings:
Title Page.
Agenda.
Introduction.
Professional introduction (1 paragraph).
You have license to be creative as you imagine the background you would bring to a position like this one.
Agenda (bullet points).
Preview the main goals of the lunch-and-learn.
Refer to some of the scholarly sources you will summarize.
Continuum of Care.
Describe where the physician practice and the hospital fall on the continuum of patient care.
Analyze a peer-reviewed article that discusses where the physician practice and the hospital fall on the continuum of patient care.
Care Quality.
Describe how a physicians practice maximizes patient care quality to return them to the highest level of function, addressing quality standards such as:
Maximizing value-based reimbursement.
Positive patient experience.
Maintaining operational efficiency.
Analyze a peer-reviewed article that discusses how a physicians practice maximizes patient care quality to return them to the highest level of function.
• Operational Strategy. o Describe the communication between the hospital system and medical practices to provide effective, efficient, and high-quality care. o Examine a peer-reviewed publication that examines how hospital systems and medical practices interact to promote effective, efficient, and high-quality treatment. • Concluding. o Summarize the key points of your lunchtime lecture. o Make judgments based on data from at least two of the articles you summarized. o Provide concrete examples to illustrate how these concepts can be applied in real-world situations.
1. Assume that currently, 54 beds have been allocated to each hospital, and that the averageservice time of stroke patients in ICU beds, i.e., 1/μ, is four weeks. Please assume there are52 weeks per year throughout the analysis. What is the throughput and capacity rate for each hospital given the arrival times in the above table?
2. (10 points) What is the utilization, i.e., (λ/54μ), of each stroke hospital?Assume the coefficient of variation (CV) of both the arrival and service processes for allhospitals is equal to one.
3a. (15 points) What is the average waiting time in the queue (in minutes) and the average flowtime of the system (in minutes) for each stroke hospital with utilization strictly less than one?
3b. (5 points) What can you say about the average waiting time of the hospitals that have autilization strictly greater than one?
4. (10 points) What is the minimum number of ICU beds that each unstable hospital shouldhave to serve all of its stroke patients?
5a. (15 points) How many ICU beds do we need in each stroke hospital to ensure that all hospitalshave a utilization less than or equal to 90%? How does the total number of ICU beds under the proposed bed allocation policy compare with the total number of beds under the policy that allocates 54 ICU beds to each stroke hospital?
5b. (5 points) What would be the average waiting time (in minutes) in each hospital under thebed allocation policy proposed in Question 5a?
6. (15 points) What is the minimum number of beds you should allocate to each stroke hospitalto ensure that the average waiting time of each stroke hospital is less than or equal to 10minutes?
Can you please calculate the specific numbers for all questions? for example for question 1: throughput is min(arrival, capacity). the capacity for all the hospitals is 702 patients a year because each hospital has 54 beds and 1 patient takes 4 weeks and there is 52 weeks in a year so (52/4= 13 ) and then (13x 54= 702 patients a year). so would the throughput rate for hospital 2 be 702?
IT Infrastructure Project: Designing WAN Networks Assignment Instructions
Project Background
Reference Figure 1. Global Care Hospital is a network of four large hospitals in the U.S. You have recently purchased the organization, naming it [Your Firstname Lastname] Global Hospital. Please refer to the hospital as “place your name here” Global Hospital.
Figure 1. Global Hospital Network Design
Jane Doe Global Hospital owns a network of hospitals supported by four (4) office buildings. Their original design, depicted in Figure 1, was categorized as a medium-size network for 200 to 1,000 devices. They have well surpassed this and added new services in telemedicine. In addition, it has several flaws. You, as their senior network engineer, are tasked with the job of a complete re-design. This design must support a large-size network for over 1,000 devices, address the current design flaws per figure 1, and meet the future needs of a globally capable hospital IT infrastructure. *Note, each of the office buildings in Figure 1 also contains additional routers, switches, workstations, and servers that would support a typical hospital office building of this hospital size. Include these devices to meet the rubric requirements as you design the detailed version of this network. Regardless, only one workstation is needed per network switch to show working functionality.
Overview
In this project, you will study performance improvements in a congested, wired WAN environment that can be solved to varying degrees by a new IT infrastructure design and fully functional implementation in Cisco Packet Tracer.
Instructions
Project Requirements
· Take screenshots demonstrating your network, servers, configurations, and protocols properly functioning in the new design. Screenshots must include a unique piece of information identifying the student’s computer along with a proper operating system date/time. Submit these as appendices in the Word document.
· Submit a working Packet Tracer lab, typically this file has a .pkt file extension.
· This will include the fully operational new IT infrastructure design
· All devices in the lab must be named with your first name and last name
· Example: Jane_Doe_Router_1
· All hardware and software should be configured properly and should be able to communicate securely using optimized networking designs, configurations, and protocols
· Packet Tracer IT Infrastructure Re-Design Requirements
· You must start with a blank/new Packet Tracer file, existing labs or modified labs of existing solutions will receive a zero without exception
· Include the existing hospital network design but optimized/improved
· LANs must function using the OSPF protocol
· Buildings 1 and 3 must connect to buildings 2 and 4 using a properly selected and configured WAN protocol
· Design a large-size network for over 1,000+ devices
· An appropriate WAN design supported by research is necessary
· Add appropriate routers and switches to support this new design
· Design and configure at least one appropriate networking protocol, IPv4 or IPv6
· Design IP addressing that will scale to over 1,000 devices
· Use proper network address translation (NAT)
· Add appropriate security into the design, at least one (1) significant improvement
· Add sufficient modularity, resiliency, and flexibility into the design, at least one significant improvement for each for a total of three (3) optimizations
· Design and implement the following new services and systems
· Assure each service supports telemedicine
· A Healthcare Enterprise Resource Planning (ERP) system
· Requires four front-end web servers
· Requires load balancers that balance traffic to the front-end web servers
· Requires two database servers
· Requires a storage area network (SAN) to store all data
· A website hosted on a web server in each ISP, accessible by all workstations
· Two new user workstations in each building that uses the new services and services properly
· Show these services working on each workstation in your project (e.g. the Healthcare ERP, the websites in the ISPs)
· Paper Requirements (Introduction, Literature Review, and Conclusion)
· Submit a properly formatted APA paper in Microsoft Word
· Here is an example paper: https://owl.english.purdue.edu/owl/resource/560/18/
· Table of Contents that automatically adjusts page numbers of the main headings
· Introduction
· Introduce the primary goals and objectives of the project
· Include more than 5 scholarly sources and 500 words in the Introduction and Conclusion combined
· Review of literature that supports the new system simulation, model, and design
· Include appropriate IT frameworks and standards in which to design a large enterprise class IT infrastructure and network
· Address system feasibility, RAS (reliability, availability, serviceability), security, and disaster recovery
· Include at least 10 scholarly journal articles focusing on relevant research on the problems being addressed
· Meets the length requirement of 1,000 words
· Packet Tracer design explanation
· Explain each of the additions and improvements
· Reference the primary configurations and how these were developed
· Include running configurations from routers/switches as appendices
· Conclusion
· Highlight any limitations, managerial implications, and conclusions of the project deliverables and outcomes
· The assignment includes over 2,000 words of original student authorship that shows excellent mastery and knowledge of IT infrastructure design. There are also over 10 unique scholarly peer reviewed journal articles from well-respected IT journals included that directly relate to and sufficiently support the working designs and scenarios.
· Save the file as Lastname_Firstname_ProjectPhaseI. Include your name in the assignment file itself and submit your file to Blackboard.
· Any assignment without working Packet Tracer files or without screenshots that do not include a visible date and timestamp from the operating system and a unique desktop element to identify the student’s work will not be accepted.
· To copy screenshots to Microsoft Word:
· Press the “Print Screen” key on your keyboard. The key is usually located at the upper right corner of a keyboard.
· You can also use the “snipping tool” in Windows
· For Windows users, open application “Paint” and paste the screen shot over. “Paint” usually can be accessed this way: Start All Programs Accessories. For users of other operating systems, use a similar application.
· In “Paint”, select the graph or area needed and copy it. You need to click this icon in order to be able to select an area. The icon is listed on the left side of the window.
· Paste the selected area to a word processor.
· Save the file as Lastname_Firstname_ProjectPhaseI
Ms. Jones, a 28-year-old African American female , is present into the hospital beacuse of an infected wound on her foot. Her speech is clear and concise and well- structured. Throughout the interview, she maintain eye contact while freely sharing information.
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General Survey
Ms. Jones is stting upright on the exam table, alert and oriented x3, friendly and well nourished. She is calm and appropriately dressed for the weather.
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Chief Complaint
“I got this scrape on my foot a while ago, and I thought it would heal up on its own, but now it’s looking pretty nasty. And the pain is killing me!”
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History Of Present Illness
One week ago, Ms. Tina was going down her steps with no shoes and stumbled scratching her right foot on the edge of the step and was taken to the emergency room by her mother where an x-ray was performed and the site showed no abnormality. They cleaned her injuries and Tremadol was reccomended for pain and she was told to remain off of her foot and to keep it very clean and dry at all times as she was realeased home. her foot became swollen 2 days aglo as the pain exacerbated and she saw grayish whte pus draining from the wound and that is when she started taking Tramadol. She rated her agony of pain as a 7 out of 10 on her wounded foot nevertheless; she says it emanates to her whole foot and that there was drainage initially when the episode previoulsy began. Ms. Tina has been cleaning the injury with cleanser and soap and applying Neosporin to the wound two times each day and occasionaly applied peroxide. The pain was depicted as throbbing and very still and sometimes sharp shooting pain or torment when she puts weight on her foot. She can not accomadate her tennis shoes on her right foot so she had been wearing flip tumbles or slippers everyday. The pai pills have eased the excruciating pain for few hours and she reported having fever. She has lost 10 pounds in barley a month accidentally and has work for two days as she reported. She denied any ongoing sickness and feels hungrier than expected. Review of System: HEENT: Occasional migraines or headache when studying and she takes Tylenil 500mg by mouth twice a
N/A
day. Ms. Tina reports more awful vision in the course of recent months ands no contact or restorative lenses. She denies any congestions, hearing problem or soar throat however, she admits infrequent running nose. Neurological: Occasional migrain revealed, no dizziness, syncope, loss of motivation, ataxia, loss of tingling in her extremities or furthest point. Respiratory: No brevity or shortness of breath, hac k or cough or sputum. Cardiovascular: No chest discomfort or pain and absence of palpitation but mild edema on the right foot. Gastrointestinal: No anorexia, nsasuea sickness, regurgitating or vmitting, loss bowels or diarrhea
Medications
Metformin 850mg PO BID for diabetes (She has not taken the medication for a while). Albuterol Proventil inhaler 90mcg MDI 1-3 puffs Q4hr PRN for Asthma (last use 3 days ago). Tramadol 50mg PO TID for pain (Last use this morning). Advil 600mg PO TID for menstrual cramps (Last use 3weeks ago). Tylenol 500mg-1000mg PO PRN for headaches.
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Allergies
Penicillin: Rash/hives Ms. Jones is allergic to cats and dust. She states that whenever she is exposed to cats and dust, she develops runny nose, swollen and itcy eyes. She denies food and latex allergies.
N/A
Medical History
Ms. Jones was diagnosed with asthma at the age of 2 1/2years. she had tons of astham attack when she was a child, however, denied any ongoing attack. Her last asthma attack was in high school and she was hospitalized. Her last asthma exacerbation was 3days ago and was relief with the use of the inhaler. She reports using the inhaler no more than 2-3times a week Her asthmas is trigger by cat, dust and by running up stairs. She uses Albuterol Provntil inhaler when she experience exacerbations. At the age of 24 years old she was diagnosed with diabetes type2. she had stop takin her diabetes medication, Metformin for a while and does not monitor her blood sugar at home in light of the fact that she is tired of manging it. she reports that the diabetes medication makes her felt sick constantly, and she was uncomfartable. She says she controls her diabetes by watching what she eats and seetle on more advantageous nourishment decision, however, does not appear to be stressed over her regimen. She states that she had a blood surgar checked in the ER a week ago and was told that her blood surgar was high but has forgotten the number. Her first sexaul encounter was at the age of 18 with men. She has used oral contraceptives in the past and stopped using it a while ago. She last visited her OB/GYN four years ago for STI testing which was negative. She reports uncertainty about past partners and STI testing. Her last menstrual period was 2weeks ago.
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Health Maintenance
Ms. Jones last eye exam was when she was a kid, and have not have an eye exam since then. Her last dental exam was a few years ago when she was a kid. Her immunization is up to date and report receiving all necessary chilhood immunizations. She received her last tetanus vaccine in the past year. She denies receiving the Human papillomavirus vaccine and the flu vaccine. She has not have the mammogram but had an exam where the doctor felt her breasts around for lumps. She has not had pap smear for the past years.
N/A
Family History
Ms. Jones father died in an auto collision at the age of 58. He had hypertension, Type 2 Diabetes (DM2), high cholesterol. she has two siblings, a 24 year old brother who is obese and a 14 years old sister who was diagnosed with asthma and hayfever. her uncle on father’s side was alcohol dependent and her 82 year old paternal grandmother had hypertension and high cholesterol. Her paternal grandfather died at age 65 from colon cancer and had hypertension, Diabetes Type 2, high cholesterol. Her maternal grandfather died at age 78 from stroke and had hypertension and high cholesterol; maternal grandmother died of stroke at age 73 and had hypertention and high cholesterol. Her paternal grandmother is still living and is diagnose with hypertension. She denies any
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diagnoses of depression or mental health, thyroid issues, cancer.
Social History
It has been three weeks ago since Ms. Tina had alvohol and drinks socially around twice every week, 4 or fewer beverages when around friends. She denied smoking cigarettes however, she used to smoke pot each of the week and halted or stopped, and has not smoked pot since 20 years of age as it troubled her asthma. She is exposed to second hand smoke when out with companions. She spends sometimes watching television and going out to bars and clubs and also enjoys drinking diet coke. She works as a supervisor at a Mid-American Copy and Ship while in high school and would be completing her bachelor’s degree in accounting. She has never been pregnant, no children and has never been married but hopes to have a family in the future. At the moment she is dwelling with her mother and her sister follwing the passing of her father. Ms. Tina drives her sister to her appointments, for grocery shopping and looks after her mother. She reports being increasingly worried following the passing of her father for a couple of months and did not complete school and reports not having any desire to get up certain days. She has since taking gradually and has gotten back up with school work and acknowledges confidnce is a major piece of her life and being associated with Baptist Church since she was was a child. She appeared to be extemely worried about missing work.
N/A
School and stressed over her foot being infected.
Review of Systems
HEENT: Occasional migraines or headache when studying and she takes tylenol 500mg by mouth twice a day. Ms. Tina reports more awful vision in the course of recent months and no contact or restorative lenses. She denies any congestions, hearing problem or soar throat however, she admits infrequent running nose. Neurological: Occasional migrain revealed, no dizziness, syncope, loss of motion, ataxia, lost of tingling in her extremities or in furthest point. Respiratory: No brevity or shotness of breath, hack or cough or sputu. Cardiovascular: No chest discomfort or pain and absence of palpatation but mild edema on the right foot. Gasrintestinal: No anorexia, nasuea sicknesss, regurgitating or vomiting, loss bowels or diarrhea. She has seen increment in hunger thirst. Genotourinary: No igniting with burning urination, no present or past pregnancy. At 11 year old started menstruating and her periods were unpredictable and kept going for 9-10 days and her last menstrual period was three weeks ago. No adjustment or change in bladder or bowel control. Musculoskeltal: No mucsle, joint, back pain or stifness, and previous history of broken bones or wounds. Mental or psychiateic: Denies depression. Endochronology: Denied night sweats however, report of polyuria, polydipsia which began about a month ago. Awakens more than once pernight to urinate and sometimes every hour or two during the
(No Model Documentation Provided)
days. Hematologic: No frailty or anemia and no bleeding. Skin: Dark skinaround the neck and saw some facial hair development as of late. No past surgeries. Denies sexual activites. Last sexual activity was two years back and did not use condom as she was on conception prevention. Denied any sexually transmitted disease.
Objective
Ms. Tina weighs 90 kilograms, and she is 170 centimeters tall with a Body Max Index of 31. Her vital signs incorperates Blood pressure 142/82, Pulse 86, Resporatory rate 19, Temperature 101.1 Farenheit, Pulse Oximetery 99% on RA. Her Random Blood Glucose level is 238. Wound estimate or measure is 2cm x 1.5cm deep situated on the ball of her right foot mild erythema around wound site and little serousanguinous drainge. The roght foot wound is swab and sent to the laboratory or processing center for culture and sensitivity. Wound is cleaned with normal saline and applied dry sterile dressing that is intact or flawless
CLICK HERE TO MAKE YOUR ORDERon Ms. Jones, a 28-year-old African American female , is present into the hospital beacuse of an infected wound on her foot.
TEXTBOOK: Introduction to the Financial Management 6th or 7th edition by Michael Nowicki.
Question 1.
You are the new chief executive officer at Memorial Hospital. Memorial is a nonprofit hospital with 300 beds and is located in a busy metropolitan area directly adjacent to a large university. Memorial is the only hospital within a 20-mile radius of campus but constructed on a new, competing hospital that has just started within five miles. Identify three forecast content items. How will they be measured and what is the expected status of the content items in the future? Which forecasting techniques should you use? Why?
Question 2
It discusses Budgeting. (without concentrating on the math) What is the overall concept of this and why is it done (how does it benefit managers)?
Question 3
Review the Ratio Analysis Practice Problems. What is the overall concept of these (as a whole) and why is it done (how does it benefit managers)?
Question 4
Think about everything that is happening right now with health care change in this country, what do you think about our present and future in terms of healthcare in this country?
Question 5
You are the financial manager of clerk Pediatrics Center and you have a meeting with the board of directors in a month. You need to create a financial analysis of the organization. You have also been asked to compare Clark Pediatrics to other pediatric healthcare organizations in the area to create a trend comparison, What must you do to complete a financial analysis? What information do you need for both horizontal analysis and vertical analysis? What sources can you use for comparison? What kind of decisions can be made regarding this information?
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Enjoy Please Note-You have come to the most reliable academic writing site that will sort all assignments that that you could be having. We write essays, research papers, term papers, research proposals You are the new chief executive officer at Memorial Hospital. Memorial is a nonprofit hospital with 300 beds and is located in a busy metropolitan area directly adjacent to a large university.
When a new product or service is offered, revised, rebranded, or offered to new potential customers, there is often a marketing campaign to build awareness. In the mid-20th century, these campaigns mi
You are the Vice President of Nursing Services in a nondenominational community hospital, and you receive a complaint from a patient, who is a Wiccan. The patient and her primary care nurse, Penny Baker, were discussing her religious practices and how she prays, when another nurse, Ruth Goose, walked into the room, stated, ”Thou shalt not suffer a witch amongst you,” and told Penny not to discuss the “satanic religion” with the patient anymore. The patient demands an apology and threatens to go to the media. She feels she has been discriminated against because she is a Wiccan and that her patient care experience was poor during her hospitalization because of her spiritual beliefs. You convene a meeting with Penny and her immediate supervisor, Ruth Goose.
Ruth Goose is wearing a large gold cross on her neck. Penny wears no jewelry and is dressed in her blue scrubs. When you ask Penny what happened, Ruth answers for her. “She did the right thing. We don’t have to pray with witches. They worship Satan. It’s blasphemy. What’s next? Human sacrifice?” Penny can’t get a word in edgewise. Ruth keeps repeating, “Thou shalt not suffer a witch amongst you, it says so in Leviticus!”.
What should you do?
Please complete responses below in essay format and APA citations .
Discussion Questions
1. What are the facts of this case?
2. What is the nature of the organizational behavior problem?
3. What are the 3 factors contributing to this dilemma?
4. What are the top 3 management issues in this case?
5. Who should be responsible for addressing these organizational issues?
6. What kind of differences in spiritual and religious practices are you familiar with? What if the patient had asked Penny to pray with her? Should she have done so? Discuss the pros and cons of praying with patients.
7. Provide your reflections and personal opinions as well as your recommendations for addressing the issue of praying with patients
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Ms. F, 48 years old, has been admitted to the hospital with severe abdominal pain. Earlier that day she had generalized abdominal pain, followed by a severe pain in the lower right quadrant of her abdomen, accompanied by nausea and vomiting. That evening she was feeling slightly improved and the pain seemed to subside somewhat. Later that night, severe, steady abdominal pain developed, with vomiting. A friend took her to the hospital, where examination demonstrated lower right quadrant tenderness and mild abdominal rigidity. Fever and leukocytosis indicated infection. A diagnosis of acute appendicitis, with possible perforation, was indicated, with immediate surgery.
Discussion Questions
Why is the sequence of pain (location and type of pain) significant in the diagnosis of acute appendicitis? Describe the rational for each type of pain. Does this sequence confirm the diagnosis?
Using the pathophysiology, describe the reason for:
the pain subsiding and then recurring.
leukocytosis and fever.
abdominal rigidity.
Ms. T, age 28 years, has noticed urgency, frequency, and dysuria recently, as well as an unusual odor to the urine. Urinalysis indicated a heavy concentration of Escherichia coli in the urine, some pus, and WBCs. Ms. T was prescribed antibiotics, which she took for the first few days. This seemed to give her relief, but she then stopped taking the medication. Within a few days, the symptoms returned, but she decided to “just live with it.”
Discussion Questions
Explain why women are predisposed to cystitis.
What preventive measures are important in reducing recurrence?
Discuss other signs and symptoms that may indicate cystitis.
What potential problems may she experience if she does not adhere to the treatment prescribed?
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Please read chapters 1 and 3 along with the articles located in the reading material section and then address the discussion board questions for the week both chapters are uploded and articles copy and pasted
You are Chris North, VP of Human Resources for Sunshine State Hospital in Orlando Florida and have been asked by the President of the Hospital to consider mandatory flu shots for all employees of the Hospital. What would you do?
How would you advise the President on how to move forward? Is it a good idea or not?
Things to consider: Should it be for all employees? Should it be for health care workers only?
Would you terminate the employment of those who do not comply?
Sunshine State Hospital is unionized, and represented by Local 2001 – Nurse Professional Association.
How, if at all, does this change your response to question 1.
What are your personal thoughts in response to the article?
An Indiana hospital (Links to an external site.) has fired eight employees, including at least three veteran nurses, after they refused mandatory flu (Links to an external site.) shots, stirring up controversy over which should come first: employee rights or patient safety. The hospital imposed mandatory vaccines, responding to rising concerns about the spread of influenza.
Ethel Hoover wore all black on her last day of work as a nurse in the critical care unit at Indiana University Health Goshen Hospital. She said she was in “mourning” because she would have been at the hospital 22 years in February, and she’s only called out of work four or five times in her whole career , she said.
“This is my body. I have a right to refuse the flu vaccine,” Hoover, 61, told ABCNews.com. “For 21 years, I have religiously not taken the flu vaccine, and now you’re telling me that I believe in it.”
More than 15,100 flu cases have been reported (Links to an external site.) to the Centers for Disease Control and Prevention since Sept. 30, including 16 pediatric deaths. Indiana’s flu activity level is considered high, according to the CDC (Links to an external site.), which last month announced that the flu season came a month.
When Hoover first heard about the mandate, she said she didn’t realize officials would take it so seriously. She said she filed two medical exemptions, a religious exemption and two appeals, but they were all denied. The Dec. 15 flu shot deadline came and went. Hoover’s last day of employment was Dec. 21.
Fellow nurse Kacy Davis said she and her colleagues were “horrified” over Hoover’s firing, calling her their “go-to” nurse and a “preceptor.”
“It was a good place to work,” Hoover said. “We’ve worked together all these years. We’re like a family.”
The hospital said in a statement that it implemented the mandate to promote patient safety based on recommendations from the American Medical Association, the American Nurses Association, and the Centers for Disease Control and Prevention. It announced the mandate in September. Of the hospital’s 26,000 employees statewide, 95 percent complied. That means 1,300 employees did not comply, but only eight were fired.
“IU Health’s top priority is the health and wellbeing of our patients,” said hospital spokeswoman Whitney Ertel. “Participation in the annual Influenza Patient Safety Program is a condition of employment with IU Health for the health and safety of the patients that we serve, and is therefore required.”
The CDC recommends (Links to an external site.) flu shots for everyone older than six months of age. Dr. William Schaffner, chair of preventive medicine at Vanderbilt University Medical Center in Nashville, Tenn., said hospital patients are especially vulnerable to flu complications because their bodies are already weakened.
“I cannot think of a reason for any health care professional to decline influenza immunization that’s valid,” said Schaffner, a former president of the National Foundation for Infectious Diseases, adding that people with egg allergies may have to avoid the flu shot to prevent anaphylactic shock, but even that hurdle has been remedied. The Food and Drug Administration approved an egg-free vaccine (Links to an external site.) in November.
Schaffner said invalid excuses to avoid the shot include being afraid of needles and simply promising to stay home when they’re sick. Patients now have the option of a vaccine nasal spray if they want to avoid needles. And since flu victims become contagious before they start to feel sick, they can get patients sick even if they stay home when they have symptoms.
Over the last several years, hospitals have been moving toward mandatory vaccinations because many only have 60 percent vaccination rates, Schaffner said. He is leading an effort for a similar mandate at Vanderbilt University Medical Center.
Nurses in particular tend to be the most reluctant to get vaccinated among health care workers, Schaffner said, citing his opinion.
“There seems to be a persistent myth that you can get flu from a flu vaccine among nurses,” he said. “They subject themselves to more influenza by not being immunized, and they certainly do not participate in putting patient safety first.”
In October 2011, Vanderbilt broke the world record for number of vaccines administered in an eight-hour period in an event called Flulapalooza. (Links to an external site.) From 6:50 a.m. to 2:50 p.m., they vaccinated 12,647 people. By that evening, more than 14,000 people had been vaccinated, and there were no severe adverse reactions, he said.
But still, Hoover’s lawyer, Alan Phillips, says his client had the right to refuse her flu shot under Title VII of the Civil Rights Act of 1964 (Links to an external site.), which prohibits religious discrimination of employees. Religion is legally broad under the First Amendment, so it could include any strongly held belief, he said, adding that the belief flu shots are bad should suffice.
“If your personal beliefs are religious in nature, then they are a protected belief,” Phillips said.
Phillips, who is based out of North Carolina, has made a name for himself fighting for employees’ rights to get out of mandated flu shots, but he has never needed to go to court. Although he usually handles a couple dozen health care workers per year, he had 150 this fall in 25 states.
Dr. Damon Raskin, an internist with his own practice in the Pacific Palisades in Los Angeles, said hospitals should mandate flu vaccines as a matter of public safety. The flu can lead to complications like pneumonia and death, said Raskin, who is also affiliated with the Cliffside Malibu Addiction Rehabilitation Center.
“I think if the health care worker has some problem with religious faith then perhaps during flu season, they shouldn’t do that job,” Raskin said, suggesting that the worker do something administrative instead during flu season. “It’s not fair to the patient. The people who are most at risk are in the hospital.”
2nd article
Talks with Jim CollinsJim Collins speaks at the SHRM 2012 Annual Conference. Photo by Steven E. Purcell
ATLANTA—“The single most important strategic pillar of any great enterprise is people,” best-selling author Jim Collins said in his Tuesday keynote session at the SHRM 2012 Annual Conference.
After spending nine years studying why some companies thrive in uncertainty or even chaos, while others do not, for his latest book Great by Choice: Uncertainty, Chaos, and Luck—Why Some Thrive Despite Them All (HarperBusiness, 2011), Collins concluded that “it all begins with people.”
The most important executive skills for building a great organization are “the ability to pick the right people, to make disciplined people decisions and to make sure all key seats are filled with the right people,” Collins told attendees.
Collins, whose previous works include Good to Great, How the Mighty Fall and Built to Last, has spent nearly a quarter of a century studying great companies that endure—how they grow, how they attain superior performance, and how good companies can become great companies.
“It’s very dangerous to study success … so we don’t,” he said. “We study the contrast between success and failure … between great and good.
“Greatness is not primarily a function of circumstance … it is a matter of conscious choice and discipline,” he noted.
Level 5 Leaders
Collins described five levels of leadership competence. The first level includes highly capable individuals, followed by contributing team members at level two, competent managers at level three, effective leaders at level four and executives at level five.
According to Collins’ research, the greatest leaders share a common trait: they are level five leaders. “Level five leaders have an ‘X factor’ that is different than level four leaders,” Collins explained: humility.
Though Collins mentioned a few great leaders with “very healthy confidence,” such as Bill Gates and Steve Jobs, he said that the critical difference is that for level four leaders, “it really is about them.” By contrast, level five leaders’ “ego and ambition and confidence and drive are channeled outward into a cause, into a purpose, into an organization or into a quest that is not about them,” he said.
“Success coupled with arrogance inevitably leads to failure,” he added. “It is outrageous arrogance to neglect people and simultaneously expect them to deliver their best.
“No single leader by himself or herself can make a great company,” Collins added. “Level five leaders understand this; they have to build an entire team to make a company great.”
Triad of Behaviors
Level five leaders possess other key behaviors, Collins has found. These include:
Fanatic discipline. Such leaders are “disciplined people who engage in disciplined thought and who then take disciplined action.” But he warned attendees not to confuse discipline with bureaucracy. “The purpose of bureaucracy is to make up for undisciplined people,” he said.
As an example, Collins compared Roald Amundsen’s successful 1910-12 South Pole expedition and Robert F. Scott’s ultimately fatal Antarctic expedition during that same time to describe the kind of discipline level five leaders use to pursue results. “Discipline also means not going too far,” he said.
Empirical creativity. “Creativity is the natural human state … discipline is not,” Collins noted. “The really rare combination is finding out how to marry the two so we amplify creativity rather than destroy it.
Productive paranoia. “The only mistakes you can learn from are the ones you survive,” Collins noted. This means preparing before bad stuff happens, he said. The ultimate hedge against uncertainty, he said, is who you have on the other end of the rope.
Right People for Key Seats
When looking for people to hold key seats, Collins said level five leaders seek those who:
• Share core values.
• Don’t need to be tightly managed.
• Understand they do not have a job; they have responsibilities.
• Do what they say they will do 100 percent of the time.
In addition, such individuals tend to look outward when good things happen, and give credit to others. However, when bad things happen they look in the mirror and take responsibility.
“It all starts and ends with people,” he noted.
Collins ended the session with a “to do list” for attendees that reiterated some of the points he made throughout the session. Among his suggestions:
• Banish the word “job” and replace it with “responsibilities.”
• Start a “stop doing” list. “Work is infinite; time is finite,” he said. “If you have more than three priorities, you have none.”
• Commit to challenging all young leaders to become level five leaders. “We need legions,” he said. “We need a level five generation.”
Rebecca R. Hastings, SPHR, is an online editor/manager for SHRM
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Resources: Strategic Plan Presentation Grading Criteria
Now that you have completed your review of the Stevens District Hospital Strategic Planning Scenario, you have been asked to provide a presentation to the governing board of the hospital. This board is comprised of the president of the hospital, four business leaders from the community, and three leaders of the medical staff.
Create a 10- to 12-slide (not including the title & reference slide) Microsoft® PowerPoint® presentation that summarizes your analysis and goals created. Your presentation should:
Provide an overview of the market.)
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Describe itemized resources that may be needed.
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