Tag: implementing

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30 days, decreases quality of life, and increases pain, morbidity and mortality.4

On international level, hospital- acquired PUs (some- times called decubitus ulcers) are very common.5 Although many of these cases are preventable, their point prevalence in Canadian hospitals for example is measured to be 25.1%.6 Unfortunately, the high rates of such condi- tion are associated with subsequent high burden on the healthcare system and the national economy considering the high cost of their management, and the frequent occurrence of associated significant morbidity and mortality.5 According to the Ontario Case Costing Initia- tive database in 2013 using the European Pressure Ulcer Advisory Panel (EPUAP) staging system, it was estimated that the cost of management of stage II ulcer is up to US$40 000 and can reach more than double this price for managing a single case of stage IV ulcer.7 A good example of the burden that PU add to the national economy was measured in USA; it was estimated that hospital acquired PUs increase the financial expenses on healthcare systems between US$6 and US$15 billion annually.8

The National Pressure Ulcer Advisory Panel (NPUAP), the EPUAP and the Pan Pacific Pressure Injury Alliance (PPPIA)9 have defined PU as a ‘lesion or a trauma to the skin and/or underlying tissue usually over a bony promi- nence and is the result of undiminished pressure, or pres- sure combination with shear, friction and moisture’. It is a degenerative progress attributable to biological tissues (skin and underlying tissues) being exposed to pressure and shearing forces. The pressure constrains the proper blood circulation and causes cell death, tissue necrosis and the development of ulcers.9 While the quality of PU prevention and treatment has increased considerably over the past years, PUs remains a global concern because of its frequency of occurrence and negative consequences for patients and families as well as for the healthcare system.10 Incidence of PUs for hospitalised patients ranges from 9% to 18%, among which the elderly popu- lation appears to be the most common group to develop the ulcers.11 At the same time, many elderly patients are more vulnerable to be ‘stuck’ at a certain stage of PU for a long period of time and sometimes for the remainder of their lives.12 This may result in longer length of hospital stay, heavier burdens for the healthcare system and family members, worst quality of life for elderly patients, which may also influence their mental health such as emotional stability.13 14

NPUAP, EPUAP and PPPIA9 developed the Pressure Ulcer Prevention Practice Guideline (PUPPG), which involves a range of evidence- based recommendations for PUs prevention that could be applied by healthcare profes- sionals globally. Frequently used PU prevention strategies recommended in this guideline includes PU risk assess- ment, regular repositioning, prevention management plan, appropriate use of support surfaces and protection, continence management, patient education, skin protec- tion, nutritional assessment and adequate nutrition.15 It also includes some recommendations specifically for

elderly people—‘protect aged skin from skin injury asso- ciated with pressure and shear forces’, taking into consid- eration that an aged person’s skin is vulnerable.15

A number of studies have been conducted on the implementation of PU prevention strategies among hospitalised patients. One cluster randomised trial conducted in Canada revealed that multidisciplinary PU prevention groups are more cost effective than usual care and yields no significant improvement in the treatment of PUs.16 Despite the existence of the guidelines on the prevention of PU, their effective utilisation in preventing PUs among hospitalised elderly patients varies in settings and countries. Also, although a number of studies have assessed strategies used in preventing PUs, there appears to be little or no information on systematic reviews that have assessed the effectiveness of guidelines used in PU prevention for elderly patients in hospitals. This study, therefore, aims to systematically review studies imple- menting PU prevention strategies recommended in the PUPPG for the prevention of PUs among hospitalised elderly patients globally.

OBJECTIVE The objective of this review is to assess the effectiveness of each of the strategies included in the PUPPG guide- line in reducing the incidence and prevalence of hospital acquired PUs in hospitalised elderly patients in compar- ison to no strategy (usual practice), or other strategies. The review question is: what is the effectiveness of imple- menting each of the PU prevention strategies included in the PUPPG in decreasing the incidence and prevalence of PUs among hospitalised elderly patients compared with no strategies (basic usual care) or different preven- tion strategies?

METHODS Study design This will be a systematic review and meta- analysis of published and unpublished studies that have assessed the use of PU prevention strategies in hospital settings among hospitalised elderly patients. The systematic review protocol has been developed and reported following the Preferred Reporting Items for Systematic Reviews and Meta- Analyses (PRISMA) criteria (see online supple- mental appendix 1).17

Inclusion criteria Population included This systematic review will focus on studies that involved all vitally stable (not admitted in the intensive care unit) bed ridden hospitalised patients aged 60 or above.

Interventions All studies that assessed the effect of PU preventive strat- egies found in the PUPPG, that were implemented on vitally stable bed ridden hospitalised patients aged 60 and

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above with an aim to decrease the occurrence of PUs, will be included in this review. Interventions will be limited to use of risk assessment, skin assessment, skin care, nutri- tion, position and repositioning, education and training, and medical devices care.

Comparator Interventions will be compared with other strategies to identify the most effective among them and/or will also be compared with no interventions (regular basic management).

Outcomes In this study, the primary outcome will be directly related to the incidence of the disease among elderly hospitalised patients (incidence shall be considered as the propor- tion of hospitalised patients who developed PUs while in hospital). Included studies must measure study duration related incidence of the disease and/or its point preva- lence and /or stage of PU (severity) as a measure of the effectiveness of the preventive strategies.

Types of studies We will focus only on Quantitative studies—experimental and quasi- experimental studies. These might include randomised and non- randomised controlled trials in addition to comparative and before- and- after studies.

Language Only studies written in English will be included in this systematic review.

SEARCH STRATEGY We will use a three- step strategy to find published and unpublished studies on PUs and their management. First, we will conduct an initial search through the Medline Ovid database using an analysis of text words found in the title and abstract, and the index terms used to describe the article. Second, we will use identified keywords and index terms to search for studies in identified databases. Finally, we will use the reference list of selected studies from the first and second searches to look for additional studies not found in the databases. For this study, we will consider only studies either published or unpublished in English.

The databases that shall be searched for this review will include Medline Ovid, Cumulative Index to Nursing and Allied Health Literature, PubMed, Embase, Cochrane library, Scopus and Web of Science. See online supple- mental appendix 2 for the example searching strategy and results in Medline (Ovid). All these databases will provide published studies. To find unpublished studies on our topic, we will use Google, Grey Literature reports and the Centers for Disease Control and Prevention.

The keywords we will use for our initial searches in Medline Ovid will include ‘pressure ulcers’, ‘pressure sore’, ‘bed sore’, ‘pressure injuries’, ‘prevention strate- gies’, ‘elderly patients’ and ‘hospital’.

Study screening and selection The titles, abstracts and full text of studies selected for this study will be reviewed by two independent researchers to identify studies that potentially meet the inclusion criteria outlined above. The Covidence software will be used for title, abstract and full- text screening. After importing references and inclusion/exclusion criteria into the Covi- dence software, two independent reviewers will screen titles of included studies according to the eligible criteria. Conflicts between those two reviewers will be resolved through discussion with a third reviewer. The same proce- dures shall be used for abstract screening. Following the abstract screening, full texts of these potentially eligible studies will be retrieved and independently assessed for eligibility by two reviewers. Any disagreement between the two reviewers over the eligibility of a particular study will also be resolved through discussion with the third reviewer. The process of study selection will be reported using the PRISMA flow diagram.17

Assessment of methodological quality Two independent reviewers will be used to assess the methodological validity of the quantitative papers that will be selected for retrieval prior to their inclusion in the review using standard critical appraisal tools from the Joanna Briggs Institute for Meta- Analysis of Statistics Assessment and Review Instrument (see online supple- mental appendix 3). All disagreement between the two reviewers shall be settled through discussions.

Data extraction After screening and selecting studies, key information from those studies will be extracted into an excel sheet for further analysis. We shall use a data extraction tool adapted from the standardised data extraction tool from the Joanna Briggs Institute Meta- Analysis of Statistics Assessment and Review Instrument (JBI- MAStARI). Considering the infor- mation, we will need for the data synthesis of our study, we shall use the JBI- MAStARI to develop a data extraction tool specifically for quantitative research data extraction (see online supplemental appendix 4). The tool will be used to extract: (1) Study characteristics of reviewed papers, such as authors, year of publication, journal; (2) Methods of the study, including study design (randomised control trial (RCT), quasi- RCT, longitudinal, retrospective), research purpose and/or questions; (3) participant characteristics, country where the study took place, setting, population, sample size, age, sex, ethnicity, socioeconomic status and/ or education level; (4) PU prevention strategies used in experimental group and control group (if applicable), (5) outcome measures and results and (6) conclusions of reviewed papers and any comments from reviewers. Two reviewers will independently perform data extraction. Authors of reviewed papers will be contacted in case of any missing details about their studies.

Data synthesis A meta‐analysis of outcomes combining various studies included in the review shall be done. We will assess

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statistical heterogeneity with I2, which will indicate the percentage of the total variation across studies: 0%–40% low heterogeneity, 30%–60% moderate heterogeneity, 50%–90% may represent substantial heterogeneity and 75%–100% is considerable heterogeneity. If there is a substantial amount of heterogeneity (75%), then sources of heterogeneity will be examined through subgroup and sensitivity analyses. We will also use χ2 test to test the heterogeneity and consider p<0.05 as statistically signifi- cant. A fixed‐effects model will be selected for significant homogeneous studies; otherwise we will apply a random‐ effects model. All outcomes will be summarised using ORs and 95% CI. An OR <1 will represent a lower rate of outcome among the group of patients who were treated following the guidelines. Publication bias will be assessed by visual inspections of funnel plots and Egger’s test.

We will also provide a narrative synthesis of the find- ings from the included studies. The narrative synthesis shall be structured by describing the studies according to the type of intervention used. This will include the three categories of interventions recommend in the PUPPG guideline9: 1. Prevention of PUs, including risk factors and risk as-

sessment, skin and tissue assessment, preventive skin care and emerging therapies for prevention of PUs.

2. Interventions for prevention and treatment of PUs, such as nutrition in PU prevention and treatment, re- positioning and early mobilisation, repositioning to prevent and treat PUs, support surface and medical device- related PUs.

3. Treatment of PUs, for example, assessment of PUs and monitoring of healing, pain assessment and treatment, wound care, assessment and treatment of infection and biofilms, wound dressings for treatment of PUs and surgery for PUs. Results will be presented in tables, figures and graphs, followed by discussion. Publication bias will be assessed in all analyses synthe- sising 10 or more studies to ensure adequate power in the analysis.18 For investigation of the effect of small studies and publication bias, data from included stud- ies will be entered into a funnel plot asymmetry test if we have at least 10 studies in the meta- analysis. Egger’s statistical test will be implemented using STATA/SE V.13 (StataCorp). The quality of supporting evidence will be assessed by the Grades of Recommendation, Assessment, Development and Evaluation.19

Patient and public involvement No patient involved.

Ethics and dissemination This review will only use published literature and will not recruit participants. Therefore, no formal ethical approval or consent is necessary. It is anticipated that this systematic review will provide a detailed summary of the evidence of the effectiveness of the PUPPG in preventing the occurrence of PUs among elderly patients in hospital. It is also expected that the study will provide

recommendations on the best PU preventive strategies applicable in healthcare settings. We aim to publish the research findings in a peer- reviewed scientific journal to promote knowledge transfer, as well as in various media, such as: conferences, seminars, congresses or symposia in a traditional manner.

Author affiliations 1Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada 2School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada 3School of Nursing, University of Ottawa, Ottawa, Ontario, Canada 4Xiangya School of Nursing, Central South University, Changsha, Hunan, China 5Department of Radiology, University of Ottawa, Ottawa, Ontario, Canada 6Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada

Acknowledgements The authors would like to thank Lindsey Sikora (librarian) for counselling in developing the searching strategies.

Contributors AWB, HM and WC contributed to the conception of the research question and writing of the protocol. HM, AWB, WC, MDFM and DAF contributed to the development of search strategies, eligibility criteria and methodology for data synthesis. HM, AWB, WC, MDFM and DAF contributed to drafting of the protocol and provided approval for the final version of this protocol. HM, AWB and WC will work in duplicate to screen the titles and abstracts of all the materials obtained using the search strategy to exclude the articles that do not meet the eligibility criteria. HM, AWB and WC will evaluate the potentially eligible studies with the full text and further exclude studies with documentation of the reason for exclusion. All authors will contribute to the bias assessment strategy and data extraction criteria. HM, AWB and WC will independently extract data from the included studies. HM, AWB and WC will analyse the data and draft the manuscript. All authors will read, provide feedback and approve the final manuscript.

Funding This work was supported by Hunan Provincial Key Laboratory of Nursing, grant number (2017TP1004), Hunan Provincial Science and Technology Department, China.

Competing interests None declared.

Patient consent for publication Not required.

Provenance and peer review Not commissioned; externally peer reviewed.

Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer- reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

Open access This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY- NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non- commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non- commercial. See: http:// creativecommons. org/ licenses/ by- nc/ 4. 0/.

ORCID iDs Wenjun Chen http:// orcid. org/ 0000- 0001- 5398- 8508 Dean A Fergusson http:// orcid. org/ 0000- 0002- 3389- 2485

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2 Nursing in Practice. Management of pressure ulcers | nursing in practice. Available: https://www. nursinginpractice. com/ article/ management- pressure- ulcers [Accessed 30 Jan 2019].

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3 Cano A, Anglade D, Stamp H, et al. Improving outcomes by implementing a pressure ulcer prevention program (PUPP): going beyond the basics. Healthcare 2015;3:574–85.

4 Dalvand S, Ebadi A, Gheshlagh RG, Ghanei Gheshlagh R. Nurses’ knowledge on pressure injury prevention: a systematic review and meta- analysis based on the pressure ulcer knowledge assessment tool. Clin Cosmet Investig Dermatol 2018;11:613–20.

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10 Chaboyer W, Bucknall T, Gillespie B, et al. Adherence to evidence- based pressure injury prevention guidelines in routine clinical practice: a longitudinal study. Int Wound J 2017;14:1290–8.

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12 Garcia AD, Thomas DR. Assessment and management of chronic pressure ulcers in the elderly. Med Clin North Am 2006;90:925–44.

13 Chiari P, Forni C, Guberti M, et al. Predictive factors for pressure ulcers in an older adult population hospitalized for hip fractures: a prognostic cohort study. PLoS One 2017;12:e0169909.

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16 Stern A, Mitsakakis N, Paulden M, et al. Pressure ulcer multidisciplinary teams via telemedicine: a pragmatic cluster randomized stepped wedge trial in long term care. BMC Health Serv Res 2014;14:83.

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19 Guyatt GH, Oxman AD, Vist GE, et al. Grade: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 2008;336:924–6.

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/handbook/current

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Effects of implementing Pressure Ulcer Prevention Practice Guidelines (PUPPG) in the prevention of pressure ulcers among hospitalised elderly patients: a systematic review protocol
- Abstract
- Background
- Objective
- Methods
  - Study design
  - Inclusion criteria
    - Population included
    - Interventions
    - Comparator
    - Outcomes
    - Types of studies
    - Language
- Search strategy
  - Study screening and selection
  - Assessment of methodological quality
  - Data extraction
  - Data synthesis
  - Patient and public involvement
  - Ethics and dissemination
- References
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Explain the difficulties in
implementing the strategy or the reason managers said the strategy was
selected.

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(the article
you select must be from 2018 or newer.)
– Select an article from Business Week, Forbes, or Wall Street Journal that you
think describes a strategic initiative for a company in a case where a company is
pursuing one of the strategies discussed in Chapter 7. Answer these questions
and be specific.
o What specific strategy was selected? Explain the difficulties in
implementing the strategy or the reason managers said the strategy was
selected.
o Based on what you know about the company, was this a good strategic
move? Why?
– Select an article from Business Week, Forbes or Wall Street Journal that you
think describes a strategic initiative for a company in a case where a company is

pursuing some type of international strategy. Answer these questions above for
that company and be specific

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How implementing the business plan would be beneficial for the organization

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You want to propose a new way to solve a problem at your workplace. To describe your implementation for this change, use the following information to submit a business plan detailing the need for this change to the head of your department.

For this assignment, complete the “Business Plan” template. Write a 500-750 word summary detailing how implementing the business plan would be beneficial for the organization. Explain how the plan would be a good return on investment for the organization.

Provide two to four scholarly resources, in addition to information from your textbook.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

Rubric

Business Plan Template

Business plan is clear and concise

Summary of how business plan is beneficial for the organization is clear, concise, and makes connections to current research.

Explanation of how the plan is a good return on investment for the organization is clear, concise, and makes connections to current research

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Implementing the strategic recommendation

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Describe in some detail how the firm should go about implementing the strategic recommendation. (the strategic recommendation will be provided) Provide a timeline for implementation, a list of the resources or capabilities the company needs to acquire or develop, some assessment of costs involved (to the extent available financial information allows), the organizational/structural changes required and problems that might be encountered during the implementation. Talk in specifics. Discuss the conditions under which your strategic recommendation might not work

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Factors do you see as critical to implementing and sustaining a culture of quality?

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What factors do you see as critical to implementing and sustaining a culture of quality?

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500 word count

3 references No older then 5 years old

1 biblical reference to quality

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The CEO and CIO have accepted your recommendations for implementing an enterprise EDMS for Hollywood Organic Co-op’s 5 locations

Imagine this scenario:

The CEO and CIO have accepted your recommendations for implementing an enterprise EDMS for Hollywood Organic Co-op’s 5 locations. They have requested that you develop a business requirements document (BRD) that details the requirements and design for an enterprise EDMS.

Write a 3- to 4-page BRD that addresses creating a new EDMS to store and track all of Hollywood Organic Co-op’s e-documents. In your BRD:

Identify at least 5 types of e-documents and other content that can be created (e.g., letters, spreadsheets, reports, or paper images).
For each type of e-document, provide an example e-document that may exist within Hollywood Organic Co-op.
Identify which content items are considered PII.
Define the key personnel within Hollywood Organic Co-op who require access to the data within the EDMS.
Describe appropriate logical access controls for the EDMS based on the roles within the organization that require access to each type of e-document.

Construct this assignment as a bulleted list, document table, or other method of your choice in a Microsoft Word document. A narrative or formal paper is not required.

Cite references to support your assignment.

Format your citations according to APA guidelines

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What are the “business cases” for implementing sustainability practices at Amazon?

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ACCT 356v9: Assignment 2

Credit Weight:15% of your final grade

Due Date: After completing Lesson 11

Scope:Covers Lessons 6–11

· Part 1: Case: Sustainability (30 marks)

· Part 2: Performance Evaluation(20 marks)

· Part 3: Customer Profitability Analysis (20 marks)

· Part 4: Probabilities(20 marks)

· Part 5: Nonprofits(10 marks)

Part 1: Case: Sustainability (30 marks)

Amazon is the largest internet-based retailer in North America. Amazon started as a book seller but quickly expanded into other household items such as electronics, entertainment, furniture, home décor, beauty, and other retail items. Amazon sells goods directly to consumers and, in Canada, ships itsproducts from warehouses across the country. In addition to direct sales, however, Amazon also offers its platform as a place where third-party retailers can list and sell their products. Shipping for these third-party sales may be handled by the external retailer, not Amazon. This means that items in a consumer’s shopping cart may be shipped by multiple shippers. It is not uncommon for an order of five items ordered throughAmazon at one time, for example, to arrive as five separate packages from five different locations.

Amazon Prime is a subscription service offered through Amazon that covers all shipping fees. Customers pay an annual fee that includes shipping and other customer perks like media streaming.

Required:

1. What are the “business cases” for implementing sustainability practices at Amazon? Your Lesson 6 reading (Whelan, T., & Fink, C. The comprehensive business case for sustainability) discusses the business cases for implementing sustainability practices. Describe at least five reasons why sustainability would be advantageous to Amazon’s business. Discuss why each reason would be beneficial for Amazon specifically. (10 marks)

2. Discuss five challenges that Amazon might encounter with implementing sustainability practices. (10 marks)

3. Looking at Amazon’s sustainability report for the most current year, answer the following:

a. Discuss three areas of sustainability that Amazon does well. (6 marks)

b. Discusstwo areas that Amazon could improve on in terms of itstriple bottom line. (4 marks)

*Do not forget to provide references and citations (using APA) if you cite external information.

Part 2: Performance Evaluation (20 marks)

Hightech Industries specializes in manufacturing medical equipment, a field that has become increasingly competitive. Last year, Pedro Rodriguez, president of Hightech, decided to revise the bonus plan (based entirely on operating income at the time) to encourage division managers to focus on areas that were important to customers and that added value without increasing cost. In addition to introducing a profitability incentive, the revised plan includes incentives for reduced rework costs, reduced sales returns, and on-time deliveries. The company’s new plan calculates and awards bonuses semi-annually on the following basis: a base bonus is calculated at 2% of operating income; this amount is then adjusted by the following factors related to rework, deliveries, and sales returns:

Rework

· The bonus is reduced by excess of rework costs above 2% of operating income

· No adjustment is made if rework costs are less than or equal to 2% of operating income.

Deliveries

· The bonus is increased by $4,000 if more than 98% of deliveries are on time and by $1,500 if 96–98% of deliveries are on time.

· No adjustment is made if on-time deliveries are below 96%.

Sales Returns

· The bonus is increased by $2,500 if sales returns are less than or equal to 1.5% of sales.

· The bonus is decreased by 50% if sales returns are over 1.5% of sales.

Note: If the calculation of the bonus results in a negative amount for a period, the manager simply receives no bonus, and the negative amount doesnot carry forward to the next period.

Results for Hightech’sWestand East divisions for 2021, the first year under the new bonus plan, follow. In 2020, under the old bonus plan, the WestDivision manager earned a bonus of $20,295 and the East division manager a bonus of $15,830 based on 2% of revenues. The old bonus plan did not adjust for rework, on-time deliveries, or sales returns.

	West Division	East Division
Jan-Jun 2021	Jul-Dec 2021	Jan-Jun 2021	Jul-Dec 2021
Revenues	$3,150,000	$3,300,000	$2,137,500	$2,175,000
Operating income	$346,500	$330,000	$256,500	$304,500
On-time delivery	95.4%	97.3%	98.2%	94.6%
Rework costs	$8,625	$8,250	$4,500	$6,000
Sales returns	$63,000	$52,500	$33,560	$31,875

Required

1. Why is revenue alone not an ideal measure of performance? What specifically about the revised performance measures compels the managers of the East and West divisions to pursue the company’s goals? (6 marks)

2. Calculate the semi-annual bonuses earned by each manager for eachsix-month period and in total for the 2021 year. (10 marks)

3. The managers were not advised of the new plan until after their first bonus in June 2021. What effect did the change in the bonus plan have on each manager’s actual behaviour in the second half of 2021? What changes, if any, would you make to the new bonus plan? (4 marks)

Part 3: Customer Profitability Analysis (20 marks)

Mark’s Comedy Emporium provides entertainment for birthday parties. Over the last year Mark’s has entertained at over 150 birthday parties and it seems the Mark’s business is booming! Customers generally must book six to eight months in advance to secure a spot, and the company has parties booked solid for the next six months. Business is busy, customers are extremely happy, and employees are happy, but Mark is barely breaking even. He cannot understand, with his business being so successful, why he is barely able to pay himself a wage. Mark has asked you to help him figure out what he is doing wrong.

The services provided at each party vary. Some customers only want a clown to perform, and they handle the other party details themselves. Other customers want a full package—clown, food, cake, entertainment, cleanup, party favours, decorations, and costumes for the kids. Mark’s can provide the following services at a party:

· Clown: Most parties include a clown who performs for one hour at the party. Mark pays a clown $40 per party.

· Food (excluding cake): When customers order food for their party through Mark’s, he outsources this service to Carl’s Catering. Carl charges an average of $12 per child for food.

· Cake: Mark sources birthday cakes through his sister, Sarah, who runs a small bakery and makes custom cakes for Mark’s. Her smallest cake is 8” in diameter (serves up to 10 kids) and costs $40. She also makes a 10” cake for $60 (serves up to 20 kids).

· Cleanup: Mark’s provides cleanup service. Cleaning staff are paid $15 per hour, and cleanup averages two hours per 20 kids. Cleanup is a variable cost based on number of kids attending the party.

· Party favours: Party favour bags can also be ordered through Mark’s. These cost $5 per bag to assemble.

· Decorations: Mark’s will also fully decorate a party. Decorating staff are paid $15 per hour, and it takesone hour to decorate a party for 20 kids. Decorations cost an average of $50 for party of 20 kids. Decorating staff and decorations are fully variable based on the number of kids.

· Costumes. Mark’s also provides costumes for parties so that kids can dress up based ona theme. On average, costumes cost $40 each and can be worn 25 times before they need to be replaced. Costumes are cleaned after eachuse at a cost of $5 each.

Mark has set up a fee schedule for each service as follows:

Service	Fee charged to customer
Clown	$60 per party
Food	$15 per child
Cake	$2 per child
Cleanup	$2 per child
Party favours	$6 per child
Decorations	$2 per child
Costumes	$6 per child

In atwo-week period, Mark catered six parties with the following services:

Customer	1	2	3	4	5	6
# of kids attended	20	25	45	15	5	12
Clown	Y	Y	Y	Y	N	Y
Food services	Y	Y	N	N	Y	N
Cake	Y	N	N	Y	Y	N
Cleanup	Y	Y	N	N	Y	N
Party favours	Y	Y	N	N	Y	N
Decorations	Y	Y	Y	N	Y	N
Costumes	N	N	Y	N	Y	N

Required

1. Calculate the customer-level operating income for each customer by preparing a customer profitability analysis. Rank the customers according to profitability. (10 marks)

2. Mark would like to earn a return of 50% on costs. What price should he have charged per child for each customer to earn a 50% return on costs? How does this compare the original fee he charged per child? What are the main reasons for this variance? Create a new fee schedule for Mark’s based on your analysis. (10 marks)

Part 4: Probabilities (20 marks)

Jack Elementary has plans to build a new playground in 2021.The school received a $120,000 government grant to be used for building the playground. They hope to break ground in May 2021 and complete the project by the start of school in September. Before they can start the project, however, they must dismantle the existing playground that no longer meets current safety standards. They also plan to complete soil testing once the existing playground is dismantled, as several residential properties in the community have tested positive for soil contamination. Due to recent news articles, parents are concerned about the potential for soil contamination and are demanding a full test to ensure their kids are not playing on a contaminated playground.

Rayna May, the principal, has compiled the following estimates for the new playground:

Cost for dismantling existing equipment	$22,000
Salvage value from selling the metal from existing equipment	$7,000
Soil testing	$18,000
New playground equipment	$45,000
Cost of installation	$16,000
Cost of resurfacing play area in rubber	$55,000
Cost of landscaping (including $5,000 for gravel)	$22,000
Cost of removing and replacing soil	$73,000

The costs for installation, resurfacing, landscaping, and soil removal are the costs quoted by professional contractors. Ms. May was approached by the president of the student council, JayWong, who has volunteered the council’s time for installing and landscaping the new playground. This will save the school approximately $25,000 in costs and Mayhas decided to accept this offer, as two of the council members who will be helping are journeymen carpenters.

The school has two options for dealing with the potentially contaminated soil. The first option is to forgo the soil testing and simply resurface the play area with a poured-rubber matting that can cover the entire play surface. This will cost approximately $55,000—a significant portionof the playground budget. The other option is to perform the soil testing and address the outcome if needed. A municipal worker has estimated that there is a 40% chance that the soil is contaminated. If the soil proves to be contaminated, the school will either need to resurface the area with rubber matting for $55,000, or it can have the contaminated soil removed and replaced for $73,000 plus the cost of gravel. Rayna is wondering what they should do and has asked for your help.

Required

Prepare an analysis of the potential project costs for the following scenarios. Note: There is noneedfor gravelif the play area isresurfaced. However, if the soil is not contaminated or if they need to remove and replace the soil, the gravel will be needed.

1. Resurface the ground without testing the soil. (5 marks)

2. Complete the soil testing. In this case there are two options:

a. Complete the soil testing and remove/replace the soil if contaminated.

b. Complete the soil testing and resurface if contaminated.

Use the probabilities provided by the municipal worker to determine a weighted cost for each of these outcomes. (10 marks)

3. What option would you recommend for the school? Why? What other non-financial considerations mightyou need to include in your decision? (5 marks)

Part 5: Nonprofits (10 marks)

The Peachland Research Centre is an agricultural research facility that is funded through provincial and federal grants. Most of the centre’s work is focused on developing new innovations that help produce higher yields in crops and better quality of food products. Recently the centre has becomeinterested in biofuels. It plans to implement a new project that has the objective of growing switch grass, a crop that has potential to replace fossils and decrease dependence on them.

In January 2020, the government has committed a one-time grant of $800,000 to the centre that will be restricted to purchasing land that will be used to produce biofuels. With this grant, the centre is planning to purchase a 200-acre plot of land for growing switch grass. They have estimated that they will require three workers to clear, plant, maintain, and harvest the crop. They anticipate that they will need these additional staff for eight months of the year. The staffing costs will be approximately $15 per hour for approximately eight hours per day, 20 days per month. Other costs will include seeds, water, and utilities at $3 per tonne, while accumulated depreciation on the equipment will total $10,000.

Once the crop has been harvested, they will send the grass to a facility that will manufacture fuel pellets. This will cost the centre approximately $10 per tonne of grass. Each acre that is planted is expected to return two tonnes of switch grass. Once the fuel pellets are produced, the organization is planning to sell the pellets to local homeowners who have converted their standard gas furnaces to pellet furnaces. It is estimated that approximately two acres of switch grass will be required to heat an average-sized home for the winter. The cost to the homeowners will be $100 per tonne of grass.

Marty McGuire, the director of the Peachland Research Centre, has asked you to provide an overall budget for this venture. He is hoping that your report will support his belief that this project is viable and will be self-sustaining. He tells you that it is very important for the project to support itself through the sale of pellets.

Required

1. Prepare a budget for the project. Does this appear to be a viable venture for the Peachland Research Centre? What changes, if any, need to be made to improve the project’s viability? (7 marks)

2. Every project comes with a degree of risk. What are the specific risks associated with this venture, and how can the centre mitigate these risks? (3 marks)

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After implementing your capstone, you will have an opportunity to conduct a post-assessment and evaluate the success of the project

Question: After implementing your capstone, you will have an opportunity to conduct a post-assessment and evaluate the success of the project. Before getting the results, what do you expect to learn from the post-assessment? Do you feel your capstone project was successful? What could you have done differently or improved upon?

Answer: The post-assessment will help in analyzing the state of the capstone project and how have the strategies involved have fared for the remote work program This helps in analyzing any pitfalls that are needed to be checked to ensure optimized capstone simulation. To be able to understand the metrics which are dominant in determining the results in post-assessment will be a big boost for understanding the capstone project.

This capstone project has been successful if the implied strategies are accurately executed and the results are favourable for the organization. There could have been more detailed scenarios to help in making decisions impacting the business environment. The explanation of all the necessary fields or a training module to understand the interface would be essential and helpful. Thus these improvements can be considered in the capstone project.

Tilles, S. (2014, August 1). How to evaluate corporate strategy. Harvard Business Review. Retrieved October 31, 2021, from https://hbr.org/1963/07/how-to-evaluate-corporate-strategy

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Discuss the financial and health benefits that can be realized by implementing an electronic health record (EHR).

Post author By admin
Post date August 26, 2021
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The use of health information technology (HIT) has increased dramatically over the past decade, resulting in the federal government enacting several pieces of legislation such as the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009. Continuing to build on your proposal for a healthcare facility from Weeks 1 and 2, you are assigned to research and discuss the following:

3-4 pages not including the title page and references

Discuss the financial and health benefits that can be realized by implementing an electronic health record (EHR).
Research and explain the estimated cost of implementing an EHR and the estimated cost of managing an EHR over the long run.
Discuss current security concerns surrounding HIT and the EHR.
Discuss how electronic health records can be used for decision-making and problem-solving.
Choose 1 piece of federal legislation (e.g., HIPAA, HITECH Act, Meaningful Use), and discuss the requirements that legislation imposes on the use of HIT and the EHR.

Note: You must use at least 3 scholarly references.

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Construct a work-back schedule that presents the steps involved in implementing your project

Post author By admin
Post date August 7, 2021
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Project rollout begins after a project has been implemented, tested, and judged stable and functional enough to be moved into production. The project rollout process comprises specific steps that must be scheduled carefully to enable the project to hit production deadlines and meet business expectations.

For this assignment, you will create an implementation project plan, which outlines the steps involved in implementing your project. This document is sometimes called a work-back schedule because you begin with the date that your project needs to go live, and then work back from there to determine what needs to be done when.

You will also conduct a post-mortem on the work you have submitted to date. Post-mortem (from the Latin for “after death,” but referring to it in the context of business) is the analysis of a project’s process and results conducted by key project stakeholders after the project has been moved into production, which means it’s functionally complete. The goal of a post-mortem is to identify what went right and what went wrong post-implementation so that project managers can apply these lessons learned to future projects.

For this three-part assignment, you will:

Construct a work-back schedule that presents the steps involved in implementing your project.
Construct a post-mortem using the template on the work you have submitted to date in this course.
Create updated project documents based on the results of your post-mortem.

Review the Project Implementation Plan Example.

Create a project implementation plan for your project based on the example document. You may use Microsoft Word or other software to create your project implementation plan.

Complete the Post-Mortem template based on your experiences with completing the course project over the last five weeks.

Update the project documents you have submitted thus far in the course based on your completed post-mortem.

Submit your project implementation plan, post-mortem, and updated project documents

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