There are macro and micro-economic factors that could directly or indirectly influence your business operations.

There are macro and micro-economic factors that could directly or indirectly influence your business operations. The social science that studies the choices that individuals, businesses, governments, and entire societies make as they cope with scarcity, the incentives that influence those choices, and the arrangements that coordinate them is called economics. (Edition 931) The economic subject matter is broad and can be very complex; nevertheless there are major questions that economist must consider when that wanting to provide clarity for defining the economic scope of a business organization. Fundamentally, there are two major questions and are listed below:  How do choices end up determining what, how, and for whom goods and services get produced?  When do choices made in the pursuit of self-interest also promote the social interest? “Micro-ethical questions arise primarily for subordinates in an organization and concern what should be done when the demands of conscience conflict with perceived occupational requirements.” (Brummer, J. 81-91) “Macro-ethical questions arise principally for superiors and concern the setting of policy for the organization in general.” (Brummer, J. 81-91) International ethical quandaries are a significant challenge to those businesses that opt to engage in globalized business operations. Although, the law may vary from country to country, it is one of the most important aspects of globalized business. Needless to say, although however, is that traditional cross-cultural ethics are superseding major factor that tends to plunder. The application of a moral code of conduct to the strategic and operational management of a business is called business ethics. Even though ethics can be debatable, there have been many years spent in corporate governance trying to determine or define these business related ethics or codes of conduct. Nevertheless, there are three major levels of business ethics. To classify these elements they have been categorized into the following categories:  the macro level  the corporate level  the individual level The international relationships and the role of business on an international scale characterizes the macro level. At the macro level the role of business in the national and international organization of society and the relative morality of different political/social systems, free enterprises and centrally planned economies. The social responsibility of ethical issues facing individual corporate entities (private and public sector) when developing and implementing strategies is at the corporate level. Lastly, behavior and actions of individuals within organizations can be allocated at the individual level. The concept of morality is that it is "proper behavior" and "knowing the difference between “right and wrong". (et al) Therefore, morality provides the underlying foundations and establishes the tone, in which businesses should conduct itself professionally. Unfortunately, in the more recent years, complications with business ethics and morality abroad, has been on a constant rise. Many of the ethical issues arise as a result of poor human management. More concisely, some of the ethical issues are in relation to the hiring, management and dismissal of the people who work in your business. It is unfortunate, that some organizations don’t realize that the people who work in your business also have certain rights that are bound to ethics. On the other hand, microeconomics is the study of financial issues from the perspective of individual economic units, such as a single household, small business or individual. The minimum wage has a number of positive and negative effects on businesses, families and individual workers, from a microeconomics perspective. For clarity purposes, minimum wage is a prescribed wage level that must be met or exceeded by employers in all employment contracts, as set forth in the Fair Labor Standards Act. Likewise, the issue of minimum wage, has been contested time and time again and remains a very highly sensitive and debatable topic. Notwithstanding, one of the main arguments in opposition to raising the minimum wage is that higher wages increase operating costs for small business. Furthermore, the traditional high Global Competitive Reports (GCR), which has raised issues on multiple levels according to the US, is largely attributable to fallacies poor science and ideology. “The GCR purports to be an objective scientific instrument, but is in fact based on ideology that (mis)leads governments, corporations and individuals to make decisions that are unethical in their application and effects”. (Bergsteiner, H., & Avery, G, 392) Immense differences between Eastern and Western cultures and business environments, that once meet in theory in national and regional organizations are now failing. . “Differences in style and culture that may once have appeared to be trivial are having major impacts on the ability of global organizations to maintain uniform standards of practice and operating procedures.” (Finfleman, J., & Lopez, O.) Lastly, the issues with the environmental sustainability which involves making decisions and taking action that are in the interests of protecting the planet. Currently, environmental sustainability is a topical issue that receives plenty of attention from the media and from different governmental departments. This is a result of the amount of research going into assessing the impact that human activity can have on the environment. References Brummer, J. (1985). Business Ethics: Micro and Macro. Journal of Business Ethics, 4(2), 81-91. Edition, Custom. SKS 5000-Business Strategies for Organizational Effectiveness within the Global Perspective VitalSource eBook for Northcentral University. Pearson Learning Solutions. VitalBook file. Strubler, D., Park, S., Agarwal, A., & Cayo, K. (2012). DEVELOPMENT OF A MACRO-MODEL OF CROSS CULTURAL ETHICS. Journal Of Legal, Ethical & Regulatory Issues, 15(2), 25-34. Bergsteiner, H., & Avery, G (2012). When Ethics are Compromised by ideology: The Global Competitiveness Report. Journal Of Business Ethics, 109(4), 391-410 Finfleman, J., & Lopez, O. (2012). Global consulting in a culturally diverse world; Ethical and legal implications. Consulting Psychology Journal: Practice And Research, 64(4), 307-324. Doi:10.1037/a0031675

Non-Adherence, Whether Intentional or Not

Non-Adherence, Whether Intentional or Not Often times patients being prescribed medication that will discontinue use, more than likely making this decision themselves and without informing their health care provider or health professional. As a result, there are major costs and even the possibility of death associated with its discontinuation. The most common is partial non- adherence. This partial non-adherence is much more prevalent than that of full discontinuation in which it to can also be detrimental. More frequently, patients are adjusting their medication regimen without properly being informed. There are many reasons for failure to comply with medical advice and some of them we will be discussing throughout this paper. We will examine the data from those patients who take their regime as prescribed, those who do not take their prescribed regime and those who don’t do not have a proposed regular regime. The extent to which an individual follows medical advice is a major concern in every medical specialty (Osterberg & Blaschke, 2005). There has been much awareness put forth in an attempt to encourage patients to follow the doctor’s recommendations as prescribed. In addition, the lack of influence in the communication between patients and healthcare professionals is also overwhelming. Particularly, if no clear agreement is formed with the patient at the beginning of the treatment process, then surely in the end should be of no consequence. A doctor has a duty to explain, in terms understandable to the patient, what he or she intends to do before a patient begins a course of treatment. To adhere with the ideology of informed permission, physicians must equip patients with the necessary information for them to make a educated and informed decision. This includes the intended benefits of, alternatives to, and the possible risks and complications of that treatment or procedure. Recent studies, have shown that untimely discontinuation was found to be less than half in patients who recalled being told to take the medication for at least 6 months compared with those not given this information (Bull et al, 2002b). It has proven even more difficult when patients lack insight into their condition. A lesser-known coequal to the doctrine of informed consent is informed refusal. Informed refusal cases occurs when patients claim that they were not made aware that refusing the proposed medical or surgical treatment or consultation would be a risky idea. Patients argue that their physician did not inform them of the potential harm that could result from not undergoing the recommended treatment or consultation; and, that if their physician had appropriately informed them of the consequence of refusal, they would have discerened that the benefits outweighed those risks and would have consented to having the recommended treatment/procedure. Patient adherence to a medication regimen is central to good patient outcomes. In addition, adherence is the quality of the provider/patient relationship. Effective provider/patient communication is empirically linked to positive outcomes of care including patient satisfaction, health status, recall of information, and adherence . Provider discussions help patients understand their illness and weigh the risks and benefits of treatment. Healthcare providers are an essential part of the five interacting dimensions of medication adherence identified by the World Health Organization (WHO) (See Figure 1 and Table 1), which include social/economic factors, medical condition-related factors, therapy-related factors, and patient behaviors. Identifying strategies for improving medication adherence are the responsibility of all involved, but the focus of this Time Tool is on the provider’s role in medication adherence. Figure 1. Five Interacting Dimensions of Adherence Appendix A Table 1. Factors Reported to Affect Adherence Appendix B Poor adherence to prescribed medication is associated with reduced treatment benefits and can obscure the clinician’s assessment of therapeutic effectiveness. Non-Adherence is thought to account for 30% to 50% of treatment failures . Non-Adherence leads to worse medical treatment outcomes; higher, avoidable hospitalization rates; institutionalization for the frail elderly; and increased healthcare costs . Attention to adherence is especially important in the current economic climate where we are seeing an uptick in patients foregoing medications by not filling or refilling prescriptions and hoarding medications due to high costs. Considering all of the factors listed in Table 1 that contribute to poor adherence, on the surface, it would appear that the provider role is very small. Yet this is not the case. Physicians play an essential role in medication adherence. Patients who trust their physicians have better two-way communication with their physician. Trust and communication are two elements critical in adherence advantages. Numerous studies show that physician trust is more important than treatment satisfaction in predicting adherence to prescribed therapy and overall satisfaction with care. Physician trust correlates positively with acceptance of new medications, intention to follow physician instructions, perceived effectiveness of care, and improvements in self-reported health status. A recent meta-analysis of physician communication and patient adherence to treatment found that there is a 19% higher risk of no adherence among patients whose physician communicates poorly than among patients whose physician communicates well . Statistically, the odds of patient adherence are 2.26 times higher if a physician communicates well. This translates into more than 183 million medical visits that need not take place if strong interpersonal physician/patient communication occurs. Communication contributes to a patient’s understanding of illness and the risks and benefits of treatment. Hence, the major challenge is to improve: • Verbal and nonverbal communication (patient-centered care) • Interviewing skills (improved competency) • Discussions and provide greater transmission of information (task-oriented behavior) • Continuous expressions of empathy and concern (psychosocial behavior) • Partnerships and participatory decision-making (patient-centered care) Poor adherence to medical treatment is widespread and well recognized, as are its consequences of poor health outcomes and increased healthcare costs (See Figure 2) . Non-Adherence to medications is estimated to cause 125,000 deaths annually. Consider these other statistics: • Overall, about 20% to 50% of patients are non-adherent to medical therapy • People with chronic conditions only take about half of their prescribed medicine • Adherence to treatment regimens for high blood pressures is estimated to be between 50 and 70 percent • 1 in 5 patients started on warfarin therapy for atrial fibrillation discontinue therapy within 1 year o Underuse of anticoagulant therapy for prevention of thromboembolism is attributed to the risk factors of younger age, male gender, low overall stroke risk, poor cognitive function, homelessness, higher educational attainment, employment and reluctant receptivity of medical information • Rates of adherence have not changed much in the last 3 decades, despite WHO and Institute of Medicine (IOM) improvement goals • Overall satisfaction of care is not typically a determining factor in medication adherence • Adherence drops when there are long waiting times at clinics or long time lapses between appointments • Patients with psychiatric disabilities are less likely to be compliant • Non-Adherence results in an economic burden of $100 to $300 billion per year.  Annually, Non-Adherence costs $2,000 per patient in physician visits  The rate of Non-Adherence is expected to increase as the burden of chronic disease increases • Non-Adherence accounts for 10% to 25% of hospital and nursing home admissions (Figure 3). Recent research has found medication Non-Adherence to result in:  5.4 times increased risk of hospitalization, re-hospitalization, or premature death for patients with high blood pressure  2.5 times increased risk of hospitalization for patients with diabetes  More than 40 percent of nursing home admissions Cross tabulation of reasons for not taking medications as prescribed and the rate of taking medications as prescribed . Appendix C If No, Why? Did you take your drugs as prescribed? Total No Yes No response 2 48 50 1.30% 75.7% 77.00% Cost of medications 6 0 6 6 0 6 3.90% 0.00% 3.90% The nature/busy schedule of work 4 0 4 2.60% 0.00% 2.60% Don't like taking medications 4 0 4 2.60% 0.00% 2.60% Too much medications 1 0 1 0.70% 0.00% 0.70% Side effects(When I feel worse) 10 0 10 6.60% 0.00% 6.60% Forgetfulness 2 0 2 1.30% 0.00% 1.30% When I feel better 8 0 8 5.30% 0.00% 5.30% Total 37 48 50 24.30% 75.70% 100% Majority of the respondents 50 (75.7%) take their medications as prescribed, while 37 (24.3%) do not. In Table 6, the reasons for not taking their medications as prescribed were attributed to cost of the medications 6(3.9%), the nature and busy work schedules 4(2.6%), dislikes for medications 4(2.6%), too much medications 1(0.7%), side effects of medications-when feeling worse 10(6.6%), forgetfulness 2 (1.3%), when feeling better 8(5.3%). However, discontinuing medications when feeling worse, and well were the most common causes of medication non- adherence. Studies revealed some of these factors: cost of the medications. Cost is a crucial issue in patient’s adherence especially for patients with chronic diseases as the treatment period could be life-long. A number of studies found that patients who had no insurance cover, were more likely to be non-adherent to treatment. Side effects of the medications feeling worse, feeling better. Patient’s knowledge about their disease and treatment is not always adequate. Some patients lack understanding of the role their therapies play in the treatment others lack knowledge about the disease and consequences of poor adherence from the study. The statistical (chi square) analysis showed a significant association with P < 0.01. In conclusions, interventions that will address these problems of non-adherence are imperative in order to improve adherence the more. Some of alternative interventions include the healthcare providers improving on the areas of patient education and counseling, communication between them and patients, medication selection with cost consideration and intolerable side effects of the medications, shorter wait time and accessibility of the clinics to the patients. References Smith DH, Kramer JM, Perrin N, et al. A randomized trial of direct-to-patient communication to enhance adherence to beta-blocker therapy following myocardial infarction. Arch Intern Med. 2008; 168(5): 477-483. BENNETT, BRIGGS, TRIOLA (2013). Statistical Reasoning for Everyday Life. ,, 1-77. Osterberg, L. & Blaschke, T. (2005) Adherence to medication. New England Journal of Medicine, 353, 487–497. Mitchell, A. J., & Selmes, T. (2007). Why don't Patients take their medicine? Reasons and Solutions in Psychiatry. Advances in Psychiatric Treatment, 13:336-346. Retrieved from http://apt.rcpsych.org/content/13/5/336.full.pdf+html Bull, S. A., Hu, X. H., Hunkeler, E. M., et al (2002a) Discontinuation of use and switching of antidepressants: influence of patient–physician communication. JAMA, 288, 1403–1409. Bultman, D. C. & Svarstad, B. L. (2000) Effects of physician communication style on client medication beliefs and adherence with antidepressant treatment. Patient Education and Counseling, 40, 173–185. DiMatteo MR. Variation in patients’ adherence to medical recommendations. Medical Care. 2004; 42(3); 200-209.

Why Going to Church Can Make You Fat

Main Task: Analyze Statistics in the News In your activity resources above are three news articles that report on scientific studies and make recommendations on the basis of them. Write a paper analyzing these articles. For each article answer these questions and give reasons for your answers: Why Going to Church Can Make You Fat 1. What evidence does the article provide for an association (correlation) between the phenomena discussed? According to the data provided from the Coronary Artery Risk Development in Youth Adults study provided by the researchers at Northwestern University, people who went to church at least once a week were more than twice as likely as people with no religious involvement to become obese. In addition, previous and or past research noted a correlation between religiosity and weight gain. 2. Drawing on your text’s discussion of how to interpret correlations, what would you want to check to be confident that there is actually a correlation? We would want to know what causes weight gain, what population was sampled, what was the average age group being studied, what religious entities were analyzed, what situations may have taken place that provided a situation to intake unhealthy foods, what other cultural practices occurred, what other practices lead to (caused) increased weight gain, what other kind of social events may have taken place where food was being served? 3. What is the argument that the relationship is causal? The most common kind of evaluation everyone encounters is testing of a causal model. This is the measure property of an individual. Causal models are typically evaluated, initially, with data that describe an association or correlation between variables. The mere suggestion, that religious activities somehow promote weight gain is in itself a casual implication without any further substantiating data being provided. 4. Is the argument for the causal relationship convincing? In my opinion, in this particular case it is quite convincing. Previous research has been done that concurred with the ideology that those who attended church likely had more interactions within social networks, therefore providing more opportunities to entertain with food. 5. If the argument is not convincing, what additional evidence is needed to make a convincing argument that the relationship is causal? Although, the study of a smaller sampling will be easier to work with, it cannot possibly provide or represent the entire population exactly. We would want to know the sample proportions relative to a close or normal distribution, and its mean that would be closer to the population proportion. 6. Does it make sense to make changes in your life based on the article? In my particular situation, it would make sense to change in my life, because when you know better you do better. Also, the information being provided offers informed information and thus causing awareness. Why Having Kids Is Bad for Your Health 1. What evidence does the article provide for an association (correlation) between the phenomena discussed? The evidence provided in this study does offer some evidence of the correlation between moms and their counterparts as it relates to health issues. The researchers focused on some sample that we can look at with hope that it will be representative of the population. 2. Drawing on your text’s discussion of how to interpret correlations, what would you want to check to be confident that there is actually a correlation? More concisely, we would want to check the margin of error for the sample mean, population mean or population standard deviation. Without it we cannot know the true range in which 95% of all sample means would lie. Also, we should ask ourselves does this statement make sense? 3. What is the argument that the relationship is causal? Lead researcher in this study said that “All parents can relate to the idea of demands and trade-offs”. Rochman, B. (2011, April 11) although however, I’m not certain that the aforementioned statement that “All” parents can relate is in fact accurate or not, I do agree somewhat with the notion that parents do have a desire to do better but for other reasons stated cannot prepare healthier meals. 4. Is the argument for the causal relationship convincing? This particular example is convincing enough, in that I can identify with what is being said. Even though, there are certainly other variables that could also yield the same results having children can definitely be a contributing factor. Notably, the time that once was allocated for exercise and other healthy activities is now being pushed aside to deal with the daily demands of parenting. 7. If the argument is not convincing, what additional evidence is needed to make a convincing argument that the relationship is causal? A clear visual of the interpretation of this idea would make this argument more convincing. The use of the 95% confidence interval can be very useful with proper interpretation. Also, determining what other activities the parentless subject were participating in that the parents were not would also help to identify other probable variables. 5. Does it make sense to make changes in your life based on the article? Changing your life after reading this article may not be an issue if you have already been affected by this scenario. Personally, I can identify and or can relate to this claim therefore, it would make sense to just make the best of the situation that is already at hand. On other hand if this has not already happened to you that you can in fact be proactive and informed and attempt to make better decisions. The Link Between Sleep and Weight 1. What evidence does the article provide for an association (correlation) between the phenomena discussed? A recent study following a group of 40-60 year old women for five to seven years whilst tracking their weight and sleeping patterns found that women who reported having trouble falling asleep, waking up frequently at night , or having trouble staying asleep were significantly more likely to have “major weight gain”. 2. Drawing on your text’s discussion of how to interpret correlations, what would you want to check to be confident that there is actually a correlation? You would want to know if there were other underlying issues that also contributed to the weight gain and or the lack of sleep. Therefore the sampling distributions would be useful information when making these types of claims. 3. What is the argument that the relationship is causal? According to Kakar sleep is associated with body weight for two reasons. 1. First, people who are sleep-deprived may have less energy throughout the day and therefore less motivation to exercise regularly. 2. In fact, people who don’t sleep enough report getting less excessive than people who get enough sleep every night. 4. Is the argument for the causal relationship convincing? Yes, this argument is convincing because other research and studies have implicated that when the body sleeps or is at rest that it heals and process foods more efficiently. Therefore, it is a high probability that this claim is in fact valid to some degree. 5. If the argument is not convincing, what additional evidence is needed to make a convincing argument that the relationship is causal? The additional evidence needed to make argument more convincing would be to show how in other cases sleep has lead to other ailments. In addition, provide data showing where those who got more sleep had better BMI than their counterparts. 6. Does it make sense to make changes in your life based on the article? Yes, in this instance like the others it is always best to make better decisions and choices you have been informed and enlighten about particular subject matters. In conclusion, cause and correlation are often misinterpreted or misconstrued. Correlation is a relationship between two or more subjects: when one increases, the other increases, or when one increases, the other decreases. On the other hand cause is something that is the result. The most significant point is that a correlation between two things does not definitely mean that one causes the other. If there is a relationship between two phenomena, A and B, it could be that A causes B, or it could be that B is responsible for A; other possibilities are that some other element is the reason or cause for both A and B, or that they have independent causes that are the same. References BENNETT, BRIGGS, TRIOLA (2013). Statistical Reasoning for Everyday Life. ,, 1-77. McCoy, Krisha, MS (2010). Studies show that skimping on sleep may lead to weight gain. But can getting shut-eye help you lose weight?. The Link Between Sleep and Weight, , 1. Retrieved from http://w ww.everydayhealth.com/sleep/101/tips/snooze-control-suggested-for-overweight-children.aspx Park, Alice (2011). Why Going to Church Can Make You Fat. Behavior, , . Retrieved from http://healthland.time.com/2011/03/24/why-go ing-to-church-can-make-you-fat/ Rockman, Bonnie (2011). Why Having Kids Is Bad for Your Health. Parenting, , . Retrieved from http://healthland.time.com/2011/0 4/11/is-parenthood-bad-for-your-health/?iid=WBeditorspicks Shaoxu, S., & Lei, C. (n.d). Editorial: Efficient discovery of similarity constraints for matching dependencies. Data & Knowledge Engineering, 87146-166. doi:10.1016/j.datak.2013.06.003 Trevor, C., Dominic, W., Roger W., S., Peter, D., & Thomas C., R. (n.d). Discovering discovery patterns with predication-based Semantic Indexing. Journal Of Biomedical Informatics, 451049-1065. doi:10.1016/j.jbi.2012.07.003 Tomasallo, C. D., Hanrahan, L. P., Tandias, A., Chang, T. S., Cowan, K. J., & Guilbert, T. W. (2014). Estimating Wisconsin Asthma Prevalence Using Clinical Electronic Health Records and Public Health Data. American Journal Of Public Health, 104(1), e65-e73. doi:10.2105/AJPH.2013.301396 Auto Detailing Supplies Inc.

Nichols’s Geriatrics professionals provide ongoing primary care for older people including home visits and primary care to nursing home patients.

Nichols’s Geriatrics professionals provide ongoing primary care for older people including home visits and primary care to nursing home patients. The department emphasizes coordinating services and providing the support necessary to maintain patients in their own home, if possible. Outpatient consultations for memory loss and other specific geriatric syndromes are also available. Nichols’s Geriatric Health Services can perform a comprehensive geriatric assessment of patients, provide case management and outpatient social services, assist with applications for financial assistance and coordinate physician and social worker visits to the home or skilled nursing care facility. First, my employees need to firmly know what is expected of them. They should be able to quote these goals when asked, and have the meaning of these goals engrained into their memory. This way they will always have a unified focus on where they are now, and where they need to be headed. Secondly, our goal is to meet long-term company objectives. For example, improving customer satisfaction ratings from whatever percentage to 100%. Operations managers have many goals such as: reduce cost, reduce variability and improved logistics flow, improved productivity, improve quality of customer service, and continuously improved business processes. However, reducing cost is always at the forefront within an organizational goal. Staffing also plays an important role as for the cost and patient care. “It is widely acknowledged that information technology (IT) and business resources need to be well aligned to achieve organizational goals.” (Wagner, H., Beimborn, D., & Weitzel, T. (2014 pp. 241-272) In order to reach maximum efficiency, there were certain long-term goals we wanted to achieve and are as follows: Improve health care quality and access Improve treatment for mental illness and chemical Dependency Improve senior safety and well-being Improve long term care Increase employment and self-sufficiency Use effective treatment to enhance outcomes Reinforce strong management to increase public trust Strengthen data-driven decision making (with empowerment) Value and develop employees Improve internal and external partnerships Thirdly, by providing integrated health care services that are holistic, comprehensive and cost effective, we are able to address some of the more functional objectives . For example, A. IMPROVE HEALTH CARE QUALITY AND ACCESS B. IMPROVE TREATMENT FOR MENTAL ILLNESS AND CHEMICAL DEPENDENCY C. IMPROVE ELDERLY SAFETY AND WELL-BEING D. IMPROVE LONG TERM CARE E. INCREASE EMPLOYMENT AND SELF-SUFFICIENCY F. USE EFFECTIVE TREATMENT TO ENHANCE OUTCOMES G. REINFORCE STRONG MANAGEMENT TO INCREASE PUBLIC TRUST H. STRENGTHEN DATA-DRIVEN DECISION MAKING I. VALUE AND DEVELOP EMPLOYEES We will actively pursue possibilities and evaluate new opportunities for fulfilling the organization's vision and strategic objectives by performing what is known as Internal Assessment. We must understand why the organization has succeeded in the past, what it will take to succeed in the future, and how it must change to acquire the necessary capabilities to succeed in the future. “These policy changes have implications for hospitals to be managed more cost effectively and efficiently.” (Kippist, L., & Fitzgerald, A. (2012).pp. 34-47)To do this, we must: • evaluate the organization's capacities--its management, program operations • evaluate the organization's resources--people, money, facilities, technology, and information. • review the organization's current capacities and future needs. • compile a list of the strengths and weaknesses that will have the greatest influence on the organization's ability to capitalize on opportunities. For example, Organization-wide Supervisors / Managers Employees Savings Time Savings Clarification of Expectations Accuracy Reduced Conflicts Improved Self-assessment Accountability Visible Accountability Improved Performance Productivity Efficiency Career Paths Retention Consistency Job Satisfaction Communication Performance Performance Patient-centered care has become a central focus for the nation’s health system, “yet patient experience surveys indicate that the system is far from achieving it.” (Li, C., & Yu, C. (2013). pp. 3319-3690) Based on interviews with leaders of patient-centered organizations and initiatives, this report identifies seven key factors for achieving patient-centered care at the organization level: 1) top leadership engagement, 2) a strategic vision clearly and constantly communicated to every member of the organization, 3) involvement of patients and families at multiple levels, 4) a supportive work environment for all employees, 5) systematic measurement and feedback, 6) the quality of the built environment, and 7) supportive information technology. Fourthly, by creating and implementing an effective performance management process which will enable managers to evaluate and measure individual performance and optimize productivity by: • Aligning individual employee's day-to-day actions with strategic business objectives • Providing visibility and clarifying accountability related to performance expectations • Documenting individual performance to support compensation and career planning decisions • Establishing focus for skill development and learning activity choices • Creating documentation for legal purposes, to support decisions and reduce disputes In conclusion, one of the challenges of health reform, for those managing hospitals, is a need to have a unified position in their collective ownership of managing the organization. Also, forward thinking companies are taking steps to successfully address this negative view of performance management. They are implementing innovative solutions that ensure processes deliver real results and improve performance. References 1). (2010, 10). Healthcare Operations Management Roles and Goals. StudyMode.com. Retrieved 10, 2010, from http://www.studymode.com/essays/Healthcare-Operations-Management-Roles-And-Goals-434049.html 2. Kippist, L., & Fitzgerald, A. (2012). BREAKING DOWN PROFESSIONAL BOUNDARIES: HOW CAN DOCTORS AND MANAGERS WORK TOGETHER TO BETTER MANAGE HEALTH CARE ORGANISATIONS?. Employment Relations Record, 12(1), 34-47. 3. Li, C., & Yu, C. (2013). Performance evaluation of public non-profit hospitals using a BP artificial neural network: the case of Hubei Province in China. International Journal Of Environmental Research And Public Health,10(8), 3619-3633. doi:10.3390/ijerph10083619 4. Wagner, H., Beimborn, D., & Weitzel, T. (2014). How Social Capital Among Information Technology and Business Units Drives Operational Alignment and IT Business Value. Journal Of Management Information Systems,31(1), 241-272. doi:10.2753/MIS0742-1222310110 5. Śliwczyński, B. (2011). OPERATIONAL CONTROLLING - A TOOL OF TRANSLATING STRATEGY INTO ACTION. Logforum, 7(1), 46-59.

Epidemiology

Epidemiology By Kenya Nichols The branch of medicine that deals with the incidence, distribution, and possible control of diseases and other factors relating to health as well as the understanding of the causes and patterns of health and illness is called Epidemiology. When something happens in our health communities like for instance, the latest epidemic EBOLA the “disease detectives" or epidemiologists are called in to investigate the cause of the disease and help with the creation and implementation of control mechanisms to control the spread of the disease. Epidemiologists also perform fieldwork to determine what causes disease or injury, what the risks are who is at risk and how to prevent further incidences. Epidemiologist also understands the demographic and social trends that result from disease and injury. These research specialists base their research findings on empirical research findings, opinion pieces, and methodological developments in the field of epidemiologic research. Epidemiology also includes the science that studies the patterns, causes, injury patterns and effects of health and disease conditions particularly within the human populations. It is the cornerstone of public health, and informs policy decisions and evidence-based practice by identifying risk factors for disease and targets for preventive healthcare. Epidemiologists help with study design, collection, and statistical analysis of data, and interpretation and dissemination of results (including peer review and occasional systematic review). Epidemiology has helped develop methodology used in clinical research, public health studies, and, to a lesser extent, basic research in the biological sciences. For example, more recently we have had break-outs like that of EBOLA, west nile, swine flu and various other contagious diseases. These recent epidemics have certainly stirred up interest in knowledge of how to fight disease and prevent the spread thereof. We have been encouraged by health care professionals to change our habits and way of life in a manner that includes “regular physical activities that should be an integral part of an active lifestyle and the proper use of one's time.” (Mavrić, F., Kahrović, I., Murić, B., & Radenković, O. (2014)pp.29-38) Major areas of epidemiological study include disease etiology, transmission, outbreak investigation, disease surveillance and screening, bio-monitoring, and comparisons of treatment effects such as in clinical trials. Epidemiologists rely on other scientific disciplines like biology to better understand disease processes, statistics to make efficient use of the data and draw appropriate conclusions, social sciences to better understand proximate and distal causes, and engineering for exposure assessment. The epidemiologist researchers to carry out long-term, in-depth studies of disease and are able to; discover some inherited factors could influence the course of disease, including response to treatment, disease progression, development of new disease, survival and quality of life of the patients. A collaborative work has been done and “this analysis identified particular populations at risk for coinfection, which can be used by viral hepatitis and HIV screening, prevention, and treatment programs to integrate, enhance, target, and prioritize prevention services and clinical care within the community to maximize health outcomes.” (Sanchez, M., Scheer, S., Shallow, S., Pipkin, S., & Huang, S. (2014)pp. 124-195) Epidemiology, taken from the free Merriam Webster online dictionary literally meaning "the study of what is upon the people", is derived from Greek epi, meaning "upon, among", demos, meaning "people, district", and logos, meaning "study, word, discourse", suggesting that it applies only to human populations. Clinical Epidemiology aims at promoting the quality of clinical and patient-oriented health care research through the advancement and application of innovative methods of: • conducting and presenting primary research; • synthesizing research results; • disseminating results; • and translating results into optimal clinical practice; • With special attention to the training of new generations of scientists and clinical practice leaders. It might behoove us to understand more descriptively a community that might involve exploring factors related to: People (socioeconomics and demographics, health status and risk profiles, cultural and ethnic characteristics) • Location (geographic boundaries) • Connectors (shared values, interests, motivating forces) • Power relationships (communication patterns, formal and informal lines of authority and influence, stake holder relationships, resource flows) There are also certain other factors that also should be taken into account that may affect ones potential to become victim to disease. For instance, hypertension, tobacco-use, harmful use of alcohol, overweight/obesity, and khat-chewing , drug abuse, lack of exercise and the spiritual state of being is also important as well as the current state and condition of health the person is already in. All of these issues mentioned, play and intricate role in the ability to be able to protect oneself for contacting disease. Ultimately, epidemiologists work within the limits or bounds of a particular describable goal or basic aim. This goal is to find people who are at high risk of developing disease through better understanding of how genes or traits can be easily tested to guide treatment for each patient, and to improve survival and quality of life among patients. “However, studies regarding NP-delivered health promotion and disease prevention suggest room for improvement.” (Thomas, J. J., Hart, A., & Burman, M. E. (2014) pp. 221-228) For the past few years, researchers have provided evidence to support the claim that the actual social environment in which people dwell, and their lifestyles and behaviors, can influence the occurrence of disease or illness. It has also been denoted that any group of people can have long-term health improvements including mental and psychological health when they become more involved in family and the communities in which they reside and work together to for positive outcome in the change in their personal lifestyles. “Overall, the major non-communicable diseases and related risk factors are highly prevalent, and evidence-based interventions should be designed.” (Misganaw, A., Mariam, D., Ali, A., & Araya, T. (2014), pp 1-13) Public health professionals work on behalf of the people for disease prevention, control and health promotion by the ability to use education, further development of healthy lifestyles, research and program implementation. While the purposes are to better understand the causes and natural history of disease, the ultimate goals are to improve early detection, develop patient-specific treatment plan, and help achieving better quality of life. In conclusion, the future of epidemiological studies in the context of new molecular biology technologies and genomic analysis are still uncertain though they are key critical components at this time. “The identification of multiple viruses during respiratory illness is increasing with advances in rapid molecular testing; however, the epidemiology of respiratory viral co infections is not well known.” ( Martin, E., Fairchok, M., Stednick, Z., Kuypers, J., & Englund, J. (2013)pp. 982-989) References Martin, E., Fairchok, M., Stednick, Z., Kuypers, J., & Englund, J. (2013). Epidemiology of multiple respiratory viruses in childcare attendees. The Journal Of Infectious Diseases, 207(6), 982-989. doi:10.1093/infdis/jis934 Mavrić, F., Kahrović, I., Murić, B., & Radenković, O. (2014). THE EFFECTS OF REGULAR PHYSICAL EXERCISE ON THE HUMAN BODY. / AUSWIRKUNGEN REGELMÄSSIGER KÖRPERLICHER AKTIVITÄTEN AUF DEN MENSCHLICHEN ORGANISMUS. Physical Culture / Fizicka Kultura, 68(1), 29-38. Misganaw, A., Mariam, D., Ali, A., & Araya, T. (2014). Epidemiology of major non-communicable diseases in Ethiopia: a systematic review. Journal Of Health, Population, And Nutrition, 32(1), 1-13. Sanchez, M., Scheer, S., Shallow, S., Pipkin, S., & Huang, S. (2014). Epidemiology of the viral hepatitis-HIV syndemic in San Francisco: a collaborative surveillance approach. Public Health Reports (Washington, D.C.: 1974),129 Suppl 195-101. Thomas, J. J., Hart, A., & Burman, M. E. (2014). Continuing Education: Improving Health Promotion and Disease Prevention in NP-Delivered Primary Care. The Journal For Nurse Practitioners, 10221-228. doi:10.1016/j.nurpra.2014.01.013

Health care professionals engage in all sorts of activities.

Health care professionals engage in all sorts of activities. Health care professionals engage in all sorts of activities, ranging from planning, organizing, decision making, staffing, leading or directing, communicating as well as motivating. These professionals are often assuming the roles as department or unit managers or supervisors, or they may participate in only a few of these traditional functions such as training and the development of employees. In the health care industry proponents of mandatory, inpatient nurse-to-patient staffing ratios have lobbied state legislatures and the United States Congress to enact laws to improve overall working conditions in hospitals. As a result, it is important to have some type of regulation in place to govern and monitor the situation as it continues to develop and progress. Internal Control Mechanism are methods of managing variables in a desirable way. Control Mechanism is methods of managing variables in a desirable way. “Although formal and informal control mechanisms are often simultaneously used to govern systems development projects, considerable disagreement exists about whether the use of one strengthens or diminishes the benefits of the other.” (Tiwana, A. (2010). For example, a Health care managers at Nichols Health Care might install a variety of control mechanisms to help them monitor workers and adjust the flow of materials and other production inputs to maximize overall production efficiency in generating the desired amount of outputs. Given the increasingly diverse nature of operations and the dynamic transfer of officials within an organization, a systematic internal control mechanism is of great importance. “The importance of the control mechanism is shown to be greatest when the process is subject to high demand intensity, particularly when the demand process is sporadic.” (Vaughan, T. S. (2009). Display the status of the accomplishment of routine scheduled preventive maintenance activities by the plant engineering department. By creating monthly article to assist in publicizing the plant engineering department system including a fully functional operational report, announcing his/her determination to achieve certain goals and the efforts made by the engineering department to design the system and preventative maintenance efforts made. The engineering department also used a variety of methods to inform employees of the significance, function, and scope of the system in an effort to reach a consensus and foster determination to reach goals. Track the number of repeat patient chart requests fulfilled beyond a started two-hour response –time limit. Daily monitoring refers to the process of self- auditing within the internal control system and includes assessing whether the control environment is satisfactory, whether risk assessment is timely and accurate, whether control operations are appropriate and accurate, and whether information and communication systems include the proper items. Monitoring can be on-going or done on a case-by-case basis. Follow the processing of a letter of complaint from its initial Receipt to the disposition of the problem. Weekly monitoring of risk assessment refers to recognizing the internal and external factors that prevent goals from being achieved, and assessing the potential risk and impact of a variety of factors. The result of assessments can assist the organization in designing, amending and implementing necessary control operations. Track the timeliness of the clinical laboratory’s responses to STAT test requests. Daily control of activities that refers to designing a comprehensive control framework and setting control procedures at all levels. This guarantees that instructions from the board and manager are carried out, including approvals, authorization, certification, adjustment, reexamination, routine inventory, record verification, division of labor, guaranteeing asset safety, projects, budgets or comparison with previous results. Track the department’s financial operating results as compared with the departmental budget. Information refers to the targets of an information system, such as recognition, consideration, processing and reporting. The system includes operations, financial reporting and adherence to regulations by financial and non-financial information. Communication refers to the relay of information to various people, and to internal and external communications. The internal control system requires information from production planning to supervision and offers a mechanism for the person requiring specific information to obtain it. Report on employment turnover throughout the organization by quarter and by year. The goal of internal audits is to assist the board and managers to investigate and reexamine any problems in internal controls and to judge operational results. Audits also provide constructive suggestions to ensure the continuous and effective implementation of internal control systems. Audits are also used to examine and make amendments to the system. To ensure the objectivity of internal auditing work, auditing departments are usually directed by the board or president and operate independently. Case: The Employee-Retention Committee Meeting, Chapter 9 pages 318-320 in your text. Follow the instructions to complete the exercise and include at least three scholarly references in addition to course resources to support your analysis. “The findings suggest that relationship conflict, limited career prospects, and unsolicited work roles and responsibilities were amongst the common reasons for intended and actual turnover of key employees.” (Gialuisi, O., & Coetzer, A. (2013) A detailed critique of the Employee Retention Committee meeting, has many proofs that it was poorly managed and definitely without order or any real sense of professionalism. Therefore, I have created a list of occurrences or omissions that I believe indicates faulty committee practice and are as follows: a. The meeting did not start on time as requested; therefore, the meeting or the chairman of the committee was also not taken seriously. What should have been done was an inter-office Memo sent to all the invitees and includes all the managers and then sends the invite to meeting via outlook or messenger or some other form of media. For instance, you can always send a broadcast email to anybody and include a group of people that you would like to receive the message. b. The people invited showed up to the meeting when they saw fit; What should have been done was excuse the late show stoppers and advise them that they will be invited to next meeting and will be notified via a email or office memo with meeting exact information. Ask them to sign document that they willingly did not participate in a business meeting. c. No roll call; therefore no accountability of the information that was to be given What should have been done was a document should have been created with all of names of those invited. The document should have been sent around the room for everyone to sign and date. d. Side-bar discussions in the meeting room; distractions from the focus of the meeting What should have been done was that they were asked to discuss with everyone in the room what so important that they saw fit to disturb this business meeting. ; What should have been done; was a meeting room reservation should have already been reserved in advance and confirmed that would be adequate enough to hold everyone invited to the meeting. e. Acquiring adequate time and space were neglected; What should have been done, was just like the previous which was make reservation for the appropriate occasion. f. Meeting was constantly being obstructed by external parties; What should have been done, was advise all those attending to silence all cell phones and pagers and the start of the meeting. In addition, put a notice on the door there is a meeting in progress in this room. g. Disrespect of others and the time they are losing to make the meeting; What should have been done was the facilitator should have had all of the information needed for the meeting printed well before the time of the meeting was supposed to be held. h. Missing materials or lack meeting preparation for documents. (etc, reports, printouts, brochures) What should have been done, was that all documents should have been ordered or printed and ready for distribution before the attendees showed up to the meeting room, not once they arrived. i. The facilitator of meeting not prepared (fumbling through papers); What should have been done, was the chairman should have been prepared even if no one else even knew what was going on in the meeting. He should have been on point and ready to deliver his message no matter what and able to conclude and resolve any issues that the people may have at the time of his meeting. j. Missing the crux if the meeting; What should have been done was he should have resolved those issues in regards to the replacement of a leaving employee, and opened the communication lines for the employee retention program or pursuit or any other relative matters at that point. k. Never coming to any resolution or any conclusions about any of the topics needing to be discussed as a result of not being prepared the What should have been done, was since he was not ready for the meeting to reschedule so that everyone will not have so much down time and the people resume to the business as usual. How I would structure and position such a Employee Retention Committee: The primary employee retention strategies have to do with creating and maintaining a workplace that attracts, retains and nourishes good people. This covers a host of issues, ranging from developing a corporate mission, culture and value system to insisting on a safe working environment and creating clear, logical and consistent operating policies and procedures. “Since increasing financial benefits is considered as an unsustainable strategy in employee retention, firms have begun to consider flexible working as an alternative tool.” (Idris, A. (2014). The environmental employee retention strategies address three fundamental aspects of the workplace: the ethics and values foundation upon which the organization rests; the policies that interpret those values and translate them into day-to-day actions, and the physical environment in which people work. The overall goal is to make your company a place where people want to come to work. A sampling of environmental employee retention strategies includes the following: • Clarify your mission. • Create a values statement. • Communicate positive feelings. • Stay focused on the customer. • Be fair and honest. • Cultivate a feeling of family. • Promote integrity. • Do not tolerate sub-par performance. • Insist on workplace safety. • Reduce the number of meetings. • Make work fun. In conclusion, “this positive relationship is most widely recognized through the impact that employee retention has on increasing a firm's level of the knowledge transfer antecedent, absorptive capacity, thereby increasing the potential value of the stocks of knowledge within the organization.” (Larkin, R., & Burgess, J. (2013) In addition, one of the greatest challenges facing employers today is finding and keeping good employees. By regularly taking the pulse of your people get you a better sense of what is going on. From time to time, bring in an outside third party to get a more objective view of how your people really feel. Find out if they really know your vision, mission and values. At the same time, give employees plenty of information about how the company is performing and where it is going. When people buy into your clearly stated corporate values and have the information they need to get the job done, they are more than happy to stick around a while longer. References 1. Gialuisi, O., & Coetzer, A. (2013). An exploratory investigation into voluntary employee turnover and retention in small businesses. Small Enterprise Research, 20(1), 55-68. doi:10.5172/ser.2013.20.1.55 2. Idris, A. (2014). Flexible Working as an Employee Retention Strategy in Developing Countries. Journal Of Management Research (09725814), 14(2), 71-86. 3. Larkin, R., & Burgess, J. (2013). THE PARADOX OF EMPLOYEE RETENTION FOR KNOWLEDGE TRANSFER. Employment Relations Record, 13(2), 32-43. 4. Tiwana, A. (2010). Systems Development Ambidexterity: Explaining the Complementary and Substitutive Roles of Formal and Informal Controls. Journal Of Management Information Systems, 27(2), 87-126. doi:10.2753/MIS0742-1222270203 5. Vaughan, T. S. (2009). Alternative control mechanisms for cyclical scheduling systems. International Journal Of Production Research, 47(22), 6321-6332. doi:10.1080/00207540802262135 Auto Detailing Supplies Inc.

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