Nursing Informatics- evidence-based practice and technology Article

Nursing Informatics- evidence-based practice and technology - Article Example Health information technology has made it possible for medical researchers to create a database of information gleaned from the research. It is possible to use health information technology to search online journals for evidence-based practice on how to optimize the flow of patients in and out the emergency rooms. Evidence-based practices that are used to optimize patient flow in other hospitals can be accessed via different databases (Thede, 2008). The flow of patients in the emergency rooms is a key component of quality care in any emergency department. Health Information Technology supports evidenced based practice by allowing medical practitioners to publish research results in online databases. Medical professionals from different places can access these databases (Thede, 2008). Health Information Technology has made it possible to disseminate information fast, which helps in improving efficiency in evidence-based

Four Seasons Hotels Essay Example for Free

Four Seasons Hotels Essay The Four Seasons Company, as per current financial, seems very profitable and the earnings per share are increasing each year. From 1997 to 1998 EPS increased by 66% and from 1998 to 1999 it increased by 22%, actually from 1997 to 1999, the value has more than doubled. The main reason for the increase seems to be a total net earnings increase of 112% in two years. (See Exhibit # 1 for figures). This is a result of increase in revenues and also because costs increased less than revenues. This indicates that in addition to higher sales, efficiency improvements have been effective as yearly costs for operating items dropped 68% and the interest costs also have decreased by 105%, making it interest income. Based on this information, the company is recommended to continue their emphasis on high personal service and quality for their hotels as the customer base are not price sensitive but concerned about service and luxury. It is important to have non-complaining, satisfied customers as this  group is more satisfied than those where service recovery is needed, even when service recovery is performed at a high level. Also, satisfied customers are more loyal and a key to continue having a financially strong company. A key to this development is to continue to focus on employee satisfaction and employment procedures as this is resulting in low turnover (compared to the industry average), highly experienced and motivated staff and consequently excellent service. Also, the strong financials support FSHs (costly) growth strategy, and would further indicate that the company has the back-bone to support such a strategy. 3.0 Leverage the website for marketing purposes The Four Season Hotel (FSH) should further leverage their impressive website. First, they should maximize the site for mass marketing purposes. For example, the site would allow customers to appreciate all FSH properties, and a customer who has never seen a FSH can view rooms, conference halls, restaurants etc. The website can further provide up-to-date information on vacancies, promotions, city tours etc. This same information could be updated at any time to reflect specials across respective FSH. For instance, the Milan hotel might anticipate low vacancy one week, and could attempt to fill some vacancies by listing a Milan resident special on the site e.g. with a two night stay and get a free dinner in the restaurant. Internal marketing is another great possibility for the FSH, as long as the high tech is followed by high touch, and the system is not used to replace the human element. The intranet site should focus on cost-saving promotions, healthy competition between across respective FSHs, employee feedback pages etc. Management should use the intranet as an additional medium to disseminate information to employees and as a means to obtain information from employees. An easy to use e-commerce site for the hotel would be interesting for select  Four Seasons customers. Again, this should not replace the high touch that the FSH brand is identified with, but rather add another convenience for its customers. For example, some customers like making their reservation via the Internet and having an additional option with regards to making a hotel booking could turn out positively. 4.0 Establish and manage a common customer awareness database The hotel should change the existing database containing guest preferences into a centralized database available to all FHS properties. This should be deemed a high priority. It would be a typical one-time fix to enhance customer satisfaction and for implementation it could leverage FSHs existing intranet platform. The main driver for a change of this sort would be its potential to further improve the FSHs customer service. For example, as existing FSH customers are highly concerned about time there should be no need for them to fill in forms with preferences for each new hotel they arrive at. Also, it would be perceived as impressive for the customer arriving at a new hotel where the personnel would already know their preferences. This would increase the feeling of intimacy and personal touch during the hotel stay and consequently enhance customer loyalty and satisfaction. Additionally, the fact that only 9% of Four Seasons hotel guests are using multiple properties should not lower the importance of making such a change. In fact, 9% of their customer base means that approximately 400.000 customers each year use multiple Four Seasons Hotels. (See Exhibit #1) Also, the positive word-of-mouth this change would bring will most likely increase the number of guests staying at multiple properties. Furthermore, as the hotel has a growth strategy, the number of hotels and rooms will continue to increase and as such enhance the need for the common database. Also, in addition to customer satisfaction, having one database for all hotels would decrease costs for the chain in the long run as it will not have to maintain 50+ different databases. 5.0 Four Seasons management should solicit select feedback from customers. The idea here is quite simple and essentially comes down to ensuring that the hotel maintains its brand. The FSH has done very well by establishing a strong brand and enjoys a high % of repeat customers. Management and employees alike know what the Four Seasons stands for and the experience they aim to offer the customer. That said, and as technology races forward it is important for businesses to leverage it where possible and profitable. The key for the Four Seasons is to leverage it in a way that does not negatively impact their brand i.e. detract from the overall customer experience offered by Four Seasons employees, which is highly personal, intimate and customer oriented. For example, management could solicit feedback from customers as to whether they would use an automated (electronic) checkout service and whether customers view this as something consistent with the Four Seasons brand. This selective feedback could be centralized at first in that it is sponsored by the corporate office (so as to solicit feedback that could be leveraged across all properties) and then tweaked per location to take into consideration cultural specifics etc. Findings could be leveraged across properties and stored in the central database to eventually maintain, reinforce and ultimately improve the Four Seasons brand, customer experience and ultimate profitability. 6.0 Implement a Seasons Pass Loyalty Program Enhancing Customer Loyalty. Implementing a Loyalty program contributes to making guests feeling special, which undoubtedly makes a difference in his or her experience. A loyalty program could even extend to other value chain partners, thereby, allowing for further tracking of guest preferences. Without a loyalty program, FSH loses out on building strong relationships with its guests. As switching costs are minimal, loyalty is low unless a competitor differentiates and thereby increases its odds of attracting return guests. In order to compete successfully within this tier, a reputable brand name is imperative, which also represents a significant barrier to entry for potential new entrants. The common database will undoubtedly enhance the relationships because clients enjoy the sense of community that is established when being part of a loyalty club. Therefore it is important to have mechanisms in place to ensure guests to remain loyal to FSH and choose the company as his or her accommodation provider. To facilitate this, the hotel should introduce a frequent guest card, the Seasons Pass, which will serve two functions: 1. Track guest activities within FSH so that their preferences can be recorded. 2. Allow guests to collect points every time they stay at a Four Seasons property and use them towards service companies affiliated with Four Seasons, creating loyalty as a result. It will also aid individual FSH locations to better understand which facilities within the hotel or resort are the most sought after and will be able to segment the information based on the region of the world or type of consumer (leisure or business). Through partnering with external companies such as high-end car rental companies, airlines, and travel agencies, FSH will be able to offer guests a solution to every decision they may encounter during their stay. Thus the Seasons Pass and the networked database will ultimately be the bridge to building and maintaining positive guest relationships. Exhibit 1: Financial data for the Four Seasons Hotels EOY 1997 to EOY 1999: Exhibit # 2: Number of customers using multiple Four Season Hotels each year * Assumed average coverage rate through the year is based on information in case, The Roccoco New York Hotel by Anna S. Mattila. Using the rate accomplished by the Roccoco New York boutique hotel. ** As no information of number of customers per room is provided, one per room is assumed.

How Continuous Quality Improvement Can Address Medical Errors

How Continuous Quality Improvement Can Address Medical Errors This paper will cover medical errors and how Continuous Quality Improvement can address them. Health care managers have addressed the issue of medical errors for many years. Medical errors can be caused by lack or communication and leadership. Quality improvement in the health care environment is a hot topic and managers are researching ways in which they can increase the quality of care that a patient receives. The quality of care that a patient receives can be the determining factor as to whether they live or die. It is critical that managers develop policies and implement control measure to control the rise of medical errors. Attention to medical errors escalated over five years ago with the release of a study from the Institute of Medicine (IOM), which found that between 44,000 and 98,000 Americans die each year in U.S. hospitals due to preventable medical errors (Kaiseredu, 2010). Hospital errors rank between the fifth and eighth leading cause of death, killing more Americans than breast cancer, traffic accidents or AIDS. Serious medication errors occur in the cases of five to 10 percent of patients admitted to hospitals. These numbers may understate the problem because they do not include preventable deaths due to medical treatments outside of hospitals (kaiseredu, 2010). Health care managers, along with the Food and Drug Administration, have study the medical error reports to determine the cause of errors. Medical errors are one of the leading causes as to why health care has declined. To improve healthcare managers must determine how to decrease the mortality rates. Managers can determine this by studying and analyzing medical reports. These reports provided managers with detailed information on what procedure was being conducted or what medication the patient was administered. In a study by the FDA that evaluated reports of fatal medication errors from 1993 to 1998, the most common error involving medications was related to administration of an improper dose of medicine, accounting for 41% of fatal medication errors. Giving the wrong drug and using the wrong route of administration each accounted for 16% of the errors. Almost half of the fatal medication errors occurred in people over the age of 60. Older people may be at greatest risk for medicati on errors because they often take multiple prescription medications (Stoppler Marks, 2010). History has shown that many surveys and research studies have been conducted, so that providers can learn where and why mistakes are being made. Once providers have a clear understanding, they can implement control measure to insure these mistakes do not occur. National Patient Safety Foundation Survey: The National Patient Safety Foundation (NPSF) commissioned a phone survey in 1997 to review patient opinions about medical mistakes. The findings showed that 42% of people believed they had personally experienced a medical mistake. In these cases, the error affected them personally (33%), a relative (48%), or a friend (19%) (Wrongdiagnosis, 2010). Patients that were given the survey have experienced the following medical errors: Misdiagnosis (40%), Medication error (28%), Medical procedure error (22%), Administrative error (4%), Communication error (2%), Incorrect laboratory results (2%), Equipment malfunction (1%), and Other error (7%). Patient safety should be the number one concern for health care organizations. Health care managers are held accountable for ensuring that patients are provided with quality care. They are also accountable for the patients that are injured or die due to a providerà ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬Ãƒ ¢Ã¢â‚¬Å¾Ã‚ ¢s medical error. The health care industries along with scientific researchers have developed tools in which the quality of care can be measured. Organizations can use these tools to determine if effective care is being provided. Once they have determined the level of care they are providing, they can educate providers on what they are doing both wrong and right. The most common method used to determine the quality of care, is through the use of surveys. Health care organizations can provide staff and patients with surveys to determine what areas the organization can improve and sustain. These surveys will not be provided to every patient the provider has treated but only a selected few will be surveyed. Quality measurement in the healthcare industry requires a large amount of resources and funding. Researchers will most likely use methods that have worked before and have provide them with data; they could use to enhance the level of care the organization is providing. Healthcare researchers are constantly trying to find ways in which the completely eliminate medical errors. Due to the continuous cycle of experienced providers leaving and new providers being hired, medical errors in many cases will never be eliminated. Health care organizations can however implement the necessary control measures to ensure that patients are not misdiagnosed or the wrong limb is not amputated (Cohen, 2007). Healthcare organizations can decrease medical errors by establishing a continuous quality improvement plan that calls for the development of a multidisciplinary team to research and investigate the causes of medical errors. The Department of Veteran Affairs uses a CQI model developed by the Joint Commission to reduce the number or medical mistakes made by providers. Joint Commissions surveys all the Veteran Affairs Medical centers to see whether their staff is following the medical policies and regulations in providing quality care. Joint Commission has also established policies regarding how health care organizations will report and handle sentinel events. A sentinel event is an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof. Serious injury specifically includes loss of limb or function. The phrase, or the risk thereof includes any process variation for which a recurrence would carry a significant chance of a serious adverse outcome. Such events are called sentinel because they signal the need for immediate investigation and response (Jointcommission, 2010). In conclusion medical errors can occur at anytime while a patient is receiving care. It is important that health care providers communicate and provide education to their staff on reducing the number of medical errors, the facility has encountered. Medical errors can lead to the organization being sued by the patient or the patient family member. Law suites can be devastating for any organization to go through and can reduce the amount of funds that have been allotted to providing quality care. Therefore it is important that medical errors are reduced and even eliminated.

Essay --

Depression. The lifeless force that makes a home on the top of your back, weighing you down completely taking you over like a parasite; you see what it wants you to see, a world of gray blobs doing meaningless tasks day after day. Everything is trite. Nothing excites you. You are in a rut that gets deeper and deeper with each passing day, and as time passes, the possibility of escaping dwindles. You have empty feelings, there is no hope; you are fatigued by daily activities and suffer insomnia or restlessness. The thought of food disgusts you. Or perhaps it’s the only thing you have to comfort yourself. More than 20 million citizens in the United States suffer from depression; this is the life they have to look forward to. (â€Å"Depression† n.d.) Society is quick to judge on any kind of discrepancy: fashion, intellect, monetary class, and personality. What is everyone going to think when you have to skip your weekly luncheon and mani-pedi with your girlfriends for a depression counseling session? You have to cut corners on all expenses to pay for your treatment and it isn’t going unnoticed. A 2012 study by the University of Wisconsin Oshkosh and the University of South Florida sought to find answer this: Dopeople judge me for spending money on Depression treatments? Two situations were created: in Experiment 1, random participants read a paper written by a student struggling with academic stress and school-related issues who would set aside a large sum of money to pay for depression treatment (Hong, Lishner, Gum, & Huss, 2012, p. 878). In Experiment 2, participants read another paper written by a depressed student who opted out of seeking treatment or received free treatment (Hong et a.l, 2012). Results found that pa rticipants we... ...They also found that there was a significant difference between depressed college students who were physically active and those who were not. Physical activity has been known to improve emotional self being like depression, anxiety, stress and self-esteem (Taliaferro, L. J., 2009). Practicing physical activity at least three to four times a day reduces the chances of being depressed.Till this day depression is one of the highest causes of death in young adults (Taliaferro, L. J., 2009). Depression is a major health issue, and will continue to be so unless we take action. Instead of feeling that lifeless force pushing you down get up and try doing some aerobic exercises. Fight to feel happy again. Life is a gift, never believe that you should take away your life in order to not feel pain and always have hope for the future. After all, we are responsible for ourselves.

A Comparison of Migrant Workers in The Grapes of Wrath and Of Mice and

Migrant Workers in The Grapes of Wrath and Of Mice and Men      Ã‚  Ã‚  Ã‚   John Steinbeck wrote about what surrounded him. At the time he was writing, the nineteen-thirties, a great depression was plaguing the United States. Many people were out of work. Many farmers were losing their farms and homes. An extreme drought had also wrecked the farms of the Midwest and made them into what is now referred to as the "dust bowl". It was a terrible time to be poor, and most were. People died of malnutrition every day. In California, where Steinbeck resided, migrant workers dominated the workforce. Thousands traveled from all around to pick fruit in the farms of the Salinas Valley for minuscule wages. Thousands more could not find suitable Many people theorize why the depression happened. Speculation in the stock market was one reason. The dust bowl also multiplied the depression's effects. The depression did happen to coincide with another event though. It happened soon after the last frontier vanished from the United States. There was no longer free land for the taking. The long held American dream was no longer simple and cheap to achieve. Many Americans simply wanted their own plot to take and set up their lives, but the depression made this an impossibility. Steinbeck wrote about this class of people. Throughout his writing he uses many minor themes and biblical references to get his point across, but the ubiquitous theme is the story of the poor, depression era migrant worker simply trying to retain dignity, achieve the ever important American dream of owning their own plot of land, and end the depravity that is the life of a migrant worker. Characters in Steinbeck's writing always have dreams. Many of the cha... ...h-Allusions." 2001: 3pp. Online. 22 March 2003. www.123helpme/2690.html Groene, Horst. "The Dispossessed Farmer." Bloom 23-24."Of Mice and Men-Lonely Characters." 2001: 3pp. Online. 22 March 2003. www.essay bank.co.uk/free_coursework/1148.html "Of Mice and Men and Migrant Workers." 2001: 3pp. Online. 22 March 2003. www.123helpme/1105.html Parini, Jay. "The Masterpiece The Grapes of Wrath." 2002: 3pp. Online. 6 March 2003. http://web4.infotrac.galegroup.com/81433&dyn=9tar_fmt?sw_aep=unio58461 Railton, Stephen. "The Joads and Their Oppressors." Bloom 31. Steinbeck, John. The Grapes of Wrath. New York, NY: Penguin Books, 2002. -. Of Mice and Men. New York, NY: Penguin Books, 2002. Visser, Nicholas. "Audience and Closure in The Grapes of Wrath." 1994: 13pp. Online. http://web4.infotrac.galegroup.com/0136&dyn=45tar_fmt?sw_aep=unio58461   

Morality †Macbeth Essay

Morality is the reference to codes of conduct that are brought forward by a society. It is evident in the play Macbeth that making moral decisions is superior to making immoral choices. In the end of the play the result of the characters moral and immoral choices all comes to fruition. Consequently the actions of those who acted morally dealt with their situation much better than those who did not. Morality is the reference to codes of conduct that are brought forward by a society. It is evident in the play Macbeth that making moral decisions is superior to making immoral choices. In the end of the play the result of the characters moral and immoral choices all comes to fruition. Consequently the actions of those who acted morally dealt with their situation much better than those who did not. There were some characters in the play that knew exactly what was right and wrong, but still chose to ignore their integrity. Lady Macbeth demonstrates immoral behavior throughout the whole play which results in a tragic conclusion for everyone. For instance, she devised the plan to kill the king knowing very well that it was wrong to do so. In addition, she was tempted by the opportunity for power and convinced Macbeth to go along with the plan even though he was thinking about not doing it. â€Å"What beast was’t, then, /That made you break this enterprise to me? / When you durst do it, then you were a man;† (Shakespeare. 1. 7. 48-50). Macbeth was mainly depicted in the play to be immoral however he did seem to have some good morals in the beginning. He was perceived as a great warrior and was thought so highly of that Duncan granted him the title of Thane of Cawdor. Throughout the rest of the play there is a decline in Macbeth’s character after he immorally killed the King for no good reason other than power. â€Å"I am settled, and bend up/ Each corporal agent to this terrible feat. † (Shakespeare 1. 7. 80). This decision sparked a whole bunch of murders which resulted in a catastrophic ending for both Macbeth and his wife. There is some evidence in the play that would suggest that acting immorally will bring you good results. For instance, Macbeth knew that he would not become king since Duncan already revealed that his son Malcolm would be the imminent king. In order to fulfill the ambition that he was feeling he knew he had to act immorally. This turned out to be a great decision because Macbeth ended up with what he wanted which was to become the king. â€Å"Thou has it now: king, Cawdor, Glamis, all. † (Shakespeare. 3. 1. 1). Although Macbeth did get what the witches prophesied, the immoral behavior had its consequences. For example, towards the end of the play everything had turned against him including his own people and his wife committed suicide. â€Å"The Queen, my lord, is dead. † (Shakespeare 5. 5. 17). In Macbeth it is very blatantly depicted that choosing to indulge in immoral behavior will result in negative consequences. It is apparent at the end of the play that all of the immoral actions that took place resulted in a very disastrous ending.

Antivirus Programs

Today, people rely on computers to create, store, and manage critical information, many times via a home computer network. Information transmitted over networks has a higher degree of security risk than information kept in user’s home or company premises. Thus, it is crucial that they take measures to protect their computer and data from loss, damage, and misuse resulting from computer security risks. Antivirus programs are an effective way to protect a computer against viruses. An antivirus program protects a computer against viruses by identifying and removing any computer viruses found in memory, on storage media, or on incoming files.[1] When u purchases a new computer, it often includes antivirus software. Antivirus programs work by scanning for programs that normally are read from but not modified. In addition, many antivirus programs automatically scan files downloaded from the Web, e-mail attachments, opened files, and all types of removable media inserted in the computer (Karanos 201-205). One technique that antivirus programs use to identify a virus is to look for virus signatures, or virus definitions, which are known specific patterns of virus code. According to Shelly and Cashman (Antivirus Programs), many vendors of antivirus programs allow registered users to update virus signature files automatically from the Web at no cost for a specified time. Updating the antivirus program’s signature files regularly is important, because it will download any new virus definitions that have been added since the last update. Methods that guarantee a computer or network is safe from computer viruses simply do not exist. Installing, updating, and using an antivirus program, though, is an effective technique to safeguard your computer from loss.