Saturday, December 7, 2019
Question: Discuss about the BMJ Supportive and Palliative Care. Answer: Introduction: Palliative care is an essential medical and nursing care for improving quality of life of persons with life-limiting illness. Palliative care refers to a specialized nursing and medical care for patients with life limiting health conditions (Glaser, Strauss, 2017). The palliative care provides relief to patients that improve their quality of life. Palliative care has a role in relieving patients suffering and their families through a holistic assessment and treatment of psychosocial, physical, and spiritual symptoms. Personal values and beliefs shape palliative care provider interactions that are important to delivering effective palliative care. The following essay a self reflection that explains how to provide best holistic end of life care to a person while managing personal values and beliefs and their effect to interaction with a patient. Holistic end of life care is a comprehensive approach for assessing and treating persons in their last days of living. A holistic approach aims at assessing and treating the physical, spiritual, and psychosocial aspect of a palliative patient. The approach recognizes that patients are human beings and are made up of mind, body and the spirit. Balboni et al. (2016) defined holistic end of life care as a comprehensive care that acknowledges and recognizes a person as a whole and there exist interdependency among ones social, psychological, biological, and spiritual aspects. A holistic care approach has to include medication, communication, self-help, education and complimentary treatment (Morton, Fontaine, Hudak, Gallo, 2017). The approach considers all the aspects that affect the treatment process and the patients emotions, thoughts, opinion, attitude and cultures. The holistic end of life care approach is based on equality, relative openness, respect, mutuality as the patient under care is allowed to participate in decision making. The holistic end of life care has several benefits to palliative care providers, patients, and their families. First, holistic approach increases the nurses understanding of the patient physical illness and their specific needs. The holistic approach is comprehensive and involves educating patients to increase their self awareness. The patients are able to understand their condition and its effects that enable nurses to get a clear inquiry of the patients suffering (Gillan, Van der Riet, Jeong, 2014). Secondly, the holistic care approach enables communication between the nurse and the patient. Communication is important to creating therapeutic relationship in palliative care (Balboni et al. 2016). The therapeutic relationship between the nurse and the patient enable the nurse to provide education on self care and have a conversation that reveals patients feelings, emotions, and desires while receiving health care. Thirdly, the palliative care provider is able to understand the patie nts culture, values, and belief. The nurse understands the likely attitude, perspective and values that the patient holds. This enables the nurse to appreciate and offer a respectable palliative care to the patient. Holistic end of life care is also beneficial to the patients families. The approach takes family into considerations when making patients palliative decisions. Aged people like to be close to their families and help offer emotional support to the patient (Mathews, Johnston, 2017). The nurse is also able to provide stress, anxiety or depression treatment to the family as a result of one member unhealthy condition. Another benefit of holistic care approach is that patients have dignified death. The patients are involved in decision making and conversation and their death is not a surprise (Glaser, Strauss, 2017). Patients are able to plan for their advance care. The patients is also able to identify substitute decision maker in case the patient cannot communicate or unab le to make sound decisions. Holistic end of life care is therefore beneficial in providing comprehensive nursing care that improves quality of life through psychological, social, physical, and spiritual approach to assessing and treating patients. Personal values and beliefs of a nurse have an impact when interacting with a palliative patient. Personal values are stable and longlasting beliefs that an individual hold as important and set standard orders that a person lives and make choices (Connor, 2017). Beliefs develop into values when someone commits to them and grow to being important in their life. It is important for a nurse to understand personal values to make rational, responsible, consistent, and clear decisions. Personal beliefs and values of a nurse in palliative affect nurses relationship with the patients and their family. My personal belief and values have been shaped by my background. My decisions while providing holistic palliative care will be highly influenced by personal values and beliefs. One of my personal values and belief that can affect interactions with palliative patient is spirituality. Spiritual care is an important aspect to providing a holistic end of life care. Spiritual care involves a nurse recognizing and responding to human spirit needs. I think spiritual care and spiritual wellness of a patient are culturally bound and there is not standard method of offering spiritual care. I also think that spirituality care should be a role of spiritual experts such as pastoral team. Gardner, (2017) stated that spiritual care difficulties are caused by nurses differing beliefs and perception of spirituality as contentious, taboo and sensitive subject hence assuming it importance in holistic health care delivery. Centeno, Ballesteros, Carrasco, Arantzamendi, (2016) found that nurses spiritual awareness and understanding can improve end of life care delivery. Human beings need spiritual care to when faced with trauma, sadness, or ill health that leads them to struggl e with self worth, meaning of life, expressing themselves, and require faith support. Spiritual care help treat spiritual distress to restore patients belief system. According to my personal beliefs and values, I find it uncomfortable to talk about death with a patient. I understand the importance of communication in delivering quality palliative care but find it hard when it has to be a topic on preparing the patient for last days. I belief death is something that takes loved ones life away leaving grief and agony to family and friends. I feel like talking much about death leads to death occurring earlier than it would have happened if I didnt talk about it. Coelho et al., (2016) stated that communication is an important aspect of providing a holistic palliative care. Conversations about death enable the patient to share about their agenda and preferences. Communication helps nurses to identify and address all needs of the patient which is central to holistic approach to palliative care. Teixeira, (2016) acknowledged that communication in palliative care is a complex challenge to excellent care. Therefore lack of proficient when communicating ca n overlook patients goals and wishes of the care undermining the holistic palliative care. In summary, personal beliefs and values influence a nurses ability to provide effective and holistic end of life care. Palliative patients need a holistic end of life care to relieve pain, improve quality of life, and have a dignified death. I found that I have to change my perspective and attitude about spiritual care and communication and appreciate their role in providing holistic palliative care. Spiritual care helps to treat spiritual distress while effective communication enhances conversations with the patient that enable them to prepare and have a dignified death. Therefore, nurses should understand and appreciate a holistic approach to providing effective palliative care. References Balboni, M. J., Sullivan, A., Enzinger, A. C., Epstein-Peterson, Z. D., Tseng, Y. D., Mitchell, C., ... Balboni, T. A. (2014). Nurse and physician barriers to spiritual care provision at the end of life. Journal of pain and symptom management, 48(3), 400-410. Centeno, C., Ballesteros, M., Carrasco, J. M., Arantzamendi, M. (2016). Does palliative care education matter to medical students? The experience of attending an undergraduate course in palliative care. BMJ supportive palliative care, 6(1), 128-134. Coelho, S. P., Costa, T., Barbosa, M. M., Capelas, M. L., De Mello, R. A., Sa, L. (2016). Palliative Home Care, for a Holistic Approach to the Patient and Family. Palliative Medicine, 30(6), NP294. Connor, S. R. (2017). Hospice and palliative care: The essential guide. Taylor Francis. Gardner, F. (2017). Critical spirituality: A holistic approach to contemporary practice. Routledge. Gillan, P. C., van der Riet, P. J., Jeong, S. (2014). End of life care education, past and present: a review of the literature. Nurse Education Today, 34(3), 331-342. Glaser, B. G., Strauss, A. L. (2017). Awareness of dying. Routledge. Morton, P. G., Fontaine, D., Hudak, C. M., Gallo, B. M. (2017). Critical care nursing: a holistic approach (p. 1056). Lippincott Williams Wilkins. Mathews, G., Johnston, B. (2017). Palliative and end-of-life care for adults with advanced chronic obstructive pulmonary disease: a rapid review focusing on patient and family caregiver perspectives. Current opinion in supportive and palliative care, 11(4), 315-327. Teixeira, E. (2016). Mindfulness Meditation: One Holistic Approach to Reduce Pain and Suffering in Patients with Chron-ic and/or Life Threatening Diseases.(2016) J Palliat Care Pain Manage 1 (2): 1-2. J Palliat Care Pain Manage, 1(2).
Saturday, November 30, 2019
Introduction The target market for the proposed cardiac center is Dammam city in Saudi Arabia. This is given the fact that there is lack of a cardiac center in the region. The proposed cardiac center will offer services addressing cardiac problems and complications, advice to patients and simple surgical procedures to people of all ages. Even if the new cardiac center will be located at Dammam city, it is noted that it may attract patients and professionals from other parts of the country.Advertising We will write a custom report sample on Marketing Plan for a New Cardiac Center specifically for you for only $16.05 $11/page Learn More This report is going to address issues surrounding the establishment of the proposed cardiac center in the city. The report will cover several aspects of this new venture. Dammam is a small city in Saudi Arabia. It is the capital city of Eastern Province in this country. According to Armstrong et al. (2009), the town is the economic hub of the worldÃ¢â¬â¢s most oil-rich region. As far as size is concerned, Dammam is third after Riyadh and Jeddah. Historians are of the view that the city was initially inhabited by an Al Dossary clan as far back as the early 1920s. The inhabitants were immigrants from neighboring Bahrain. The developments in this region are attributed to the huge oil deposits that were discovered there in the 1940s and 1950s. The oil deposits account for about 25 percent of the total oil deposits in the world. There is no specialized cardiac center in Dammam city. People are forced to travel for long distances to find such services. The purpose of this marketing plan is to address issues revolving around the setting up of a new cardiac center in Dammam city. It is noted that it is not fair to have patients travel very far in search of healthcare. This is the idea behind this proposal. It is aimed at addressing or alleviating the problems that people in this and surrounding regions fac e trying to access quality health care. The proposed cardiac center is named Tabibu Hospital. Tabibu hospital is a small hospital located at the center of Dammam city. Although it is a small facility, it is noted that Tabibu Cardiac Center will have the facilities that are needed to cater for the health needs of the population in the city and surrounding areas. The hospital will have 50 beds which even though not sufficient for the large population of the city, will help in providing the much needed treatment for cardiac conditions. The hospital is expected to serve the whole of Dammam city as far as cardiac cases are concerned. So far, the premises are ready. This means that the investors already have the physical facilities needed to establish the hospital. The organization has received funding from two donors who are willing to support the establishment of the facility. Additionally, the government has agreed to provide a loan through the Saudi Arabian National Bank.Advertising Looking for report on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More Mission Statement The mission statement of this cardiac center is: Provide quality and affordable services to the residents of Dammam and surrounding areas with the aim of reducing the number of cardiac complications and mortality rates. Services Offered The cardiac center intends to offer a myriad of services both to the patient and to the community in Dammam and Saudi Arabia as a whole. Tabibu hospital intends to offer services touching on cardiac consultations and advice, Electro- Cardio Graph examination (ECG), diagnosis of cardiac problems, cardiac catheterization, pacemaker insertion and other basic surgery services. It is noted that consultation and offering advice to the patients and to the members of the community as a whole are the major services that will be provided by expert cardiologists. The cardiac center has five of them already engaged (Hiam, 2009). Advice will be given by the doctors and the nurses during patient visits. Diagnosis will only be done by a cardiologist after thorough examination. The thorough examination will include an ECG and consultations with other doctors. The organization already has an ECG machine which is operated by an expert in this field. This means that operating the machine is not a problem. It is however noted that there is a pressing need for a sophisticated and ultra- modern machine for the hospital. There is need for another person or another specialist to assist the current machine operator. Catheterization, insertion of pacemakers and other minor surgeries will be done by the team of cardiologists, anesthetists and surgical nurses. It is noted that the cancer center can use specialists from other hospitals. Anesthetists from other hospitals will be used in case the three employed by the organization are occupied or unavailable. There is also the need to have a day bed facility in the cardiac center. The center will have a day bed for the less serious patients who need supervision for a day or a few hours. However, there will also be facilities for those patients needing closer attention for a prolonged period of time. The 50 beds will be used for patients who need supervision for a longer period of time. The cardiac center will also work together with other hospitals in dealing with very serious cases. The very serious cases will be referred to larger hospitals with better facilities. There is need to transfer patients from this hospital to another and to bring the patient to the hospital in case of medical emergencies. For the purposes of emergency and transfer of critical patients, the cardiac center is planning to buy an ambulance soon after opening. Plans are also underway to acquire land where the cardiac center can construct a bigger hospital.Advertising We will write a custom report sample on Marketing Plan for a New Cardiac Center specifically for you for only $16.05 $11/page Learn More The number of beds will need to be increased to about 100 in 3 months. Another service that will be offered by the proposed Tabibu cardiac center will be open heart surgery. This is another service that the center would like to offer at least a year after obtaining land. The services are to be charged as follows: Consultation and advice Ã¢â¬â $90 ECG Ã¢â¬â $100 Cardiac catheterization Ã¢â¬â $200 Pacemaker insertion Ã¢â¬â $300 Basic surgery Ã¢â¬â between $ 900- $ 2000Advertising Looking for report on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More These charges are inclusive of bed where applicable. The drug charges will be determined separately after prescription. The prices are however subject to review after more research is carried out after Tabibu begins offering services. This means that the prices can be reviewed either upwards or downwards depending on the findings of the assessments carried out. The charges may vary depending on the prevailing market conditions that will determine the cost of inputs such as drugs used during operation. Market According to recent census records, 30% of Dammam population is composed of two major groups. The first group is the very old who are aged 70 years and above and the second group is the very young aged 10 years and below. 5% of the population is made up of obese people and most men are smokers. All these are factors that predispose the population to a myriad of cardiac problems (Gilligan Wilson, 2009). All of these people are vulnerable to cardiac conditions such as heart failu re as a result of their age and their lifestyle. There is evidently the need for a cardiac center to cater for the populationsÃ¢â¬â¢ cardiac needs. This is through the provision of advice, treatment and early diagnosis of cardiac conditions so that prompt treatment can be provided. The most vulnerable members of the population need periodic screening to ensure that cardiac conditions are detected early enough. This is the only way that the conditions can be dealt with effectively. Since most of the inhabitants of Dammam city are middle working class, it is noted that they will be able to pay for the services offered by the cardiac center. This is keeping in mind the fact that the cardiac center will save them the trouble and inconveniences of traveling to other places to search for medical care. However, just like any other society, Dammam city has a number of people who are poor. For the minority poor population, the cardiac center has liaised with various government agencies so that they can be offered quality services at subsidized prices. This collaboration with government agencies and other stakeholders will also go a long way in offering emergency services due to the close location of our services to the consumer. For instance, if a person falls sick at night, it will be easier to bring them to the hospital which is closer than flying them all the way to other facilities across or outside town. In terms of quality of service, the hospital has qualified members of staff in all the fields. There are also a few positions open for the people in Dammam city as a token of appreciation after they accepted to host the cardiac center. Currently there are no direct competitors in this city apart from a small training center which occasionally offers such services. Advertisement will be done to sensitize the people on the availability of services. This is especially so considering that many people are unaware of the availability of services in the hospitals. This is despite of the critical role that the cardiac center will play in their lives. Factors that usually affect the market of other services will not apply in the case of this hospital. For example, factors like seasons will not affect the market as it does not determine in any way when and where people get sick. There is no correlation between falling sick and season. This is unlike other services such as tourism which are dependent on weather patterns in European and American nations. However, the poor people and those in the rural areas may find it difficult to reach the hospital. To address this problem and avail the services conveniently, the hospital plans to offer mobile clinics where basic services like advice and consultations can be provided. With time the hospital will seek for funding from some of the stakeholders so as to open branches in nearby towns. The management has also consulted one of the hospitals in the region which offers mobile clinics. This is to enable Tabi bu cardiac center to join them on their excursions. This will definitely help in reaching the market (Kotler et al., 2008). Competition As mentioned earlier in this report, there is no cardiac center in Dammam and thus competition will be from other cardiac centers located far from Dammam city. Location is thus an advantage on the part of the cardiac center. It is noted that in cases of emergencies, the first choice for the residents will be Tabibu Hospital. From the local authorities, the management got information that people are not happy with the services offered by the hospital near this city. As a result, the people are forced to travel very far in search of medical services. The opening of a cardiac center near them will be welcomed. It is also noted that culture or the peopleÃ¢â¬â¢s way of life can be a source of competition. However in this case, culture as indirect competition will not be there. But several legal requirements are yet to be met (Godin, 2009). That is bein g taken care of by the insurance company. The Environmental Impact Assessment that has been done in the area showed that expansion will be problematic. The report does not provide for the expansion of the hospital as it will increase the amount of waste emitted into the environment. As a result, the cardiac center plans to use the local council in finding a bio- digester so the waste problem can be addressed once and for all. The hospital could face socio- economic competition from a small percentage of the population and the significance of this is possible decline of profits (Gilligan Wilson, 2009). As already indicated in the paper, there is a training college within the area that should be taken into consideration when analyzing competition. The training college in the area may be an indirect source of competition. The college trains cardiologists and sometimes holds mobile clinics where they look at some of the cardiac cases before transferring them to their main hospital in a nearby city. The training college offers transport to the patient but they do not pay for the treatment. This is the major weakness that Tabibu hospital will capitalize on probably through subsidized fees. After carrying out independent research, Tabibu hospital has realized that most cardiac cases are serious. To this end, the hospital has a location advantage over the competitors (Hiam, 2009). The new cardiac center project is likely to succeed because its strengths surpass its weaknesses. It involves the introduction of services that are not currently available and hence acceptable to the community. The project brings with it accessible services. The hospital has a strong and positive relationship with the relevant authorities that deals with the poor members of the society. This will help in off- setting the medical bills of such patients. The hospital also offers high quality services with the help of highly qualified personnel. The hospital has technologically advanced equipm ents (Kotler et al., 2008). The management however foresees a few difficulties in some areas. This is for example difficulties in reaching people in the rural areas, access to capital, pricing and space. The latter is to allow for the expansion of the facility. The hospital has about 30% of the current budget and needs a lot of money to be able to offer good services. The rest of the budget (70 percent) is yet to be financed. Pricing Price is influenced by both internal and external factors. Internal pricing variables are expenses involving capital, research, labor, distribution, utilities and all other costs (Armstrong et al., 2009). According to Godin (2009), capital is the amount of money invested in the business and all assets that the hospital owns. This is for example all the machines that the hospital will buy. Labor in this case will include the total amount of time that staff members spend in the hospital including overtime. Kotler et al. (2008) says that distribution is th e ways through which the services will reach the consumer. This is for instance hiring people to disseminate information about the services offered through word of mouth, media advertising among others. Utilities in this case are bills that are incurred through mandatory expenses like water, electricity, transport, advertising for business promotion, purchase of daily supplies like syringes, bandages and telephone bills among others (Phillip, 2009). External variables to be considered during pricing include prices of the competitors in the market. With time, prices are bound to be revised depending on the marketÃ¢â¬â¢s growth rate. However, customer needs will be put in mind so that the hospital does not push customers away due to overpriced services (Godin, 2009). The hospital is not intending to incur losses. There are deliberate efforts to price services in a way that will make the consumers comfortable while at the same time making it possible to smoothly run the hospital and offer quality services. It is for this reason that the hospital has proposed strategies to price products (Kotler et al., 2008). In the process, it will be able to know whether it is making a profit or incurring losses and take necessary actions. This is a process that will take some time and needs a lot of research and careful planning which will be done by qualified marketers. For the sake of simplicity, the management could trust the leader and price products in the same way. In such a case, it will find out how much the best and most popular hospital charges for similar services and use the same criteria. They probably followed the same procedure during pricing of their products. Tabibu could also price the products higher than the competitors in order to understand how much the customers are willing and able to pay. It should however be noted that pricing services higher or lower than the competitors will be for a short period as a way of testing the market. There will be revie w of prices after we have properly assessed the market. Basically, the above are just pricing processes but after sometime, the prices will be calculated by multiplying total cost with the mark- up percentage to get the retail price (Armstrong et al., 2008). Distribution This is the way through which the available services reach the consumer or the market (Kotler et al., 2008). In our case, we intend to use various methods ranging from advertising to creating a good image. Advertising will be done by our public relationsÃ¢â¬â¢ officer through the local media channels, the internet and the local newspaper. Since our services are to be provided to a wide range of customers, media advertising will be done through television and radio. We are to publish a website containing all the information like the services offered and how to contact us (Gilligan Wilson, 2009). The prices will however not be stated in the website to avoid being taken advantage of by our customers. The very first thing that attracts anyone to a product is the image (Hiam, 2009). We are aiming at creating a beautiful logo that will attract our customers especially when doing internet marketing. The same logo will appear on the business cards. The most effective method in our case is to hire marketers who will then spread information about the services offered by word of mouth. For the purposes of saving on expenses, we will buy supplies in bulk (Godin, 2009). We have located a nearby warehouse where we can store supplies of non-perishables goods like disinfectants, soaps, brooms, bandages and syringes among others. This will help in saving space in the already crammed hospital. The warehouse is in a clean, secure and accessible location. Promotion Mix We intend to use local television networks, local newspapers, leaflets, radio and internet to market our products. Having a healthy nation is the mission of our hospital. The hospital will be located in a quiet suburb in Dammam city. A hotline w ill be provided so that our staff can go and provide the necessary services or give advice on what to do through the hotline. We need about $ 100,000 for the first year for advertisement. There will be production of leaflets with information about our services, contacts and location. The leafletsÃ¢â¬â¢ and postersÃ¢â¬â¢ production will cost about $10,000, newspaper adverts will cost $50000 and the rest will cost approximately $39000 for a whole year. There will be an opening party for the hospital where we will invite the businessmen and offer free cardiac services during the day including the use of public address. Sales Forecasting Our market covers the people in the middle and higher classes. About 90% of the population is literate and thus able to understand what we will be offering. We aim at providing quality services at reasonable rates. For the small percentage that is poor, we have a special way of dealing with their payments through the social worker at the hospital. W e have spoken to the relevant government authorities and they are willing to help foot the hospital bill of the people who need the service but are unable to pay for it. It difficult to forecast sales in this case (Hiam, 2009) but it is important so as to know how many employees are required and when. It is also important to determine the combination of promotional mix to be used and supplies to buy. Kotler et al. (2008) suggests micro and macro forecasting as the suitable methods for doing this. Macro- forecasting involves making deductions on what will happen in the market depending on total market price. Micro- forecasting is done on specific services offered. The above however depends on the availability of information, timing, position of service at the life cycle and accuracy. The more accurate the forecast is the higher the costs. It is hard to make a forecast when a product is on its introductory phase than when it is in its maturity phase (Gilligan Wilson, 2009). Precise f orecasts can be made when the business has being operating for a long time. A more precise method would be to conduct this at least a year after the commencement of services in order to improve accuracy. We have also planned to make this a requirement at the end of every year to know how far we have gone. Action Plan According to Armstrong et al. (2009), there are various marketing strategies. In this case, market dominance is the most appropriate considering our target market of Dammam city population. We can use the 3Cs model developed by Kenich Ohmae (Gilligan Wilson, 2009) where we focus on the corporation, customer and competitors. For the corporation (hospital in this case), we strategize with an aim of maximizing our strengths against our competitors. This should be done is such a way that we also consider the cost effectiveness of what our suppliers offer and the customer paying a minimal fee for the services offered. The next C is for customer who is a very important perso n to the business. We thus have the responsibility of ensuring that the customer is satisfied in all ways and has a reason to use our services again. The prices of our services will be minimal and the quality of the services high. We will continue to ensure this happens through occasional in- service training of our staff especially those who come into contact with the customers. We will also keep advertising and employ extra members of staff who are skilled. The next C is for competitors who are the greatest threat to any business. We have done a thorough research on what our competitors offer, how they do it, their strengths and weaknesses. With this knowledge, we can avoid making the same mistakes and capitalize on their weaknesses. One of the advantages we have over them is that we have concentrated on cardiac services making us able to provide better services. Location is another advantage we have over our competitors. Being in a position to offer services to a customer when ne eded will go a long way as a market strategy. After implementing the 3PÃ¢â¬â¢s we will then use the 4CÃ¢â¬â¢s proposed by Jerome McCarthy in our marketing strategy (Kotler et al., 2008). The first P is for product or in this case, our services. Apparently, products go through a cycle of growth and every marketer should be aware of this. In our case, I would say after intensive treatment and information, cases of cardiac conditions may reduce and we may have to do a service mix to cater for the income. The next P is for pricing which should be adapted to cater for all areas of the business. Promotion is what is denoted by the next P and this involves advertising, personal selling and other ways of promoting the business. The means of doing promotions should be appropriate depending on the market. The last P is for place meaning that services should be provided when required and where required. The ambulance and hospital van will be used for this purpose. Either one of the two str ategies will be used but the first one is more preferable. Production Fluctuations are bound to occur due to the nature of our services. From the research carried out, we have concluded that demand is almost impossible to predict. Production will be leveled by volume. This is where we make a record based on which days are busiest and how many patients we expect to serve. On such a day, we make sure that we have enough staff and perishable and non- perishable supplies. This will ensure smooth operation and provision of services and also reduce wastage in terms of man power and perishable supplies. We plan to use demand leveling. Here, we can manipulate demand. In some cases, treatment is not an emergency. For instance, a customer who needs the insertion of a pacemaker can take some time. We can ask the patients with certain conditions to be seeing the doctors on certain days. This way, we save on salaries paid to part time staff members hired only on demand. As discussed above, we wi ll at times use local people in the hospital. Using local labor is cheaper than imported labor. This is given that no costs are incurred in importing it. Table 1: Simple Budget for Tabibu Hospital for the Year 2011 Income Expenses Grants $100000 Loans $97000 Donations $45000 Suppliers- $198000 Equipment- $200000 DoctorsÃ¢â¬â¢ salary- $195000 NursesÃ¢â¬â¢ salaries- $82500 Other personnel- $95000 Utilities- $90000 Totals $242 000 $860500 References Armstrong, G., Harker, M., Kotler, P., Brennan, R. (2009). Marketing: An introduction. New York: Prentice Hall. Gilligan, C., Wilson, R. M. (2009). Strategic marketing planning. Massachusetts: Butterworth-Heineman Publishers. Godin, S. (2009). All marketers are liars: The power of telling authentic stories in a low trust world. Chicago: Prentice Hall. Hiam, A. (2009). Marketing for dummies. New York: John Wiley and Sons Publishers. Kotler, P., Armstrong, G., Wong, V., Saunders, A. J. (2008). Principles of marketi ng. New York: Pearson Education. Phillip, K. (2009). Marketing insights from A to Z: 80 concepts every manager needs to know. New York: John Wiley and Sons. 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Monday, November 25, 2019
Friday, November 22, 2019
Summer is over and the school year is in full swing. It may be tempting to put off college applications for just a little bit longer, but college application season is here and there are plenty of things you need to do now to prepare. If youÃ¢â¬â¢re considering applying early decision somewhere, youÃ¢â¬â¢ll need to get started on your applications sooner rather than later. And even if you arenÃ¢â¬â¢t, there will be fall deadlines for scholarships, special programs, and even summer programs for next year that are rapidly approaching, and those will quickly be followed by regular decision application deadlines.Ã In this post, we outline five key things you can start doing now to jump-start your college application season. YouÃ¢â¬â¢ve only got one shot at this; why not get ahead by starting early? Unless you are one of the lucky few whoÃ¢â¬â¢s entirely confident and content with your scores from junior year, itÃ¢â¬â¢s likely youÃ¢â¬â¢ll take the SAT or ACT at least one more time before you apply to college. In fact, itÃ¢â¬â¢s smart to schedule a date early in the fall so that, if worst comes to worst, you can even take the test two more times before your applications go out.Ã Here are the calendars for important standardized tests that you may want to schedule for the fall: In addition, although your senior year Advanced Placement exams wonÃ¢â¬â¢t likely make it on your college applications, itÃ¢â¬â¢s still a good idea to get those exam dates on the calendar as soon as possible, too, especially if you want a particular test location. By succeeding on AP exams, you can sometimes earn advanced standing or even college credit when you matriculate. The 2018 AP Exam Calendar is already available online. Add those dates to your personal calendar now, so that none get double-booked. Ã Ã The Common App essay prompts have been released and many supplemental essay prompts have already been released. ThereÃ¢â¬â¢s no reason why you shouldnÃ¢â¬â¢t start to plan your essays now. You can preview the Common App essay prompts online to get started. Begin by reading through them and seeing if any catch your interest immediately. If nothing sticks out right away, try to narrow your choices down to the top two or three possibilities. Now is a great time to reflect on your summer experiences as possible topics for your college essays. Next, do some brainstorming about what you might write. This can be a little difficult if you arenÃ¢â¬â¢t feeling particularly inspired, but donÃ¢â¬â¢t worry. There are plenty of resources to help. Check out these posts to get your creative juices flowing: Once youÃ¢â¬â¢ve come up with a few ideas for what you might write about, start to outline your top ideas. These can be fairly rough outlines to start with. The idea right now is just to get you thinking about the directions you might take your essay in, and then choose the one that resonates with you the most. Estimating your chance of getting into a college is not easy in todayÃ¢â¬â¢s competitive environment. Thankfully, with our state-of-the-art software and data, we can analyze your academic and extracurricular profile and estimate your chances. Our profile analysis tool can also help you identify the improvement you need to make to enter your dream school. You have a direct hand in most of what goes into your college application by writing your essays and achieving grades and test scores. But your personal recommendations are an outsiderÃ¢â¬â¢s perspective of all your hard work, and you have very little, if any, say over what gets written in them. To ensure that your recommendations shine and reflect as highly as possible on your achievements as a student and your contributions as a member of the community, youÃ¢â¬â¢ll need to think carefully about who writes them. Now, before the school year starts is a great time to think about this. The people who write your recommendations should be those who have worked closely with you in the past and, preferably, have known you for an extended period of time. They should be teachers or mentors who respect you and recognize you for all youÃ¢â¬â¢re capable of achieving. These could even be teachers, mentors, or supervisors with whom you worked closely over the summer. Here are a few resources to help as you consider who will write your recommendation letters: ItÃ¢â¬â¢s likely that youÃ¢â¬â¢re already accumulating piles of paperwork. There are score reports from standardized tests. There are shiny brochures from the colleges of your dreams and scholarship applications gathering dust. ItÃ¢â¬â¢s hard to keep track of it all, but itÃ¢â¬â¢s in your best interest to keep hard copies of everything, just in case you ever need them. If you havenÃ¢â¬â¢t started a filing system to keep track of all those papers, now is the perfect time. You can use a portable file tote, color-coded hanging folders, or even an accordion file. Label a folder for each college youÃ¢â¬â¢re considering applying to, along with a folder for standardized test information and scores, school records and transcripts, scholarships, and financial aid. If you visited any schools over the summer, be sure to include some notes about the people you spoke with, what you did, and what you liked or did not like. By creating the file system before the school year picks up, you make it easy to put things in the right place when piles of papers start coming home with little time to deal with them. YouÃ¢â¬â¢ve done it Ã¢â¬â youÃ¢â¬â¢ve reached senior year and before you know it, youÃ¢â¬â¢ll be graduating! This year is going to be unlike any other before it. Not only are you focusing on the here and now, but this year more than ever before your future is taking shape and becoming a reality. Now is the time to take a critical look at your profile as a college applicant and at the experiences you hope to gain during your senior year. Use this insight to set some concrete goals for the school year before it starts. Some of your goals might be entirely motivated by college applications, like increasing your SAT scores or earning a merit scholarship. Others might be more focused on personal achievements, like being voted captain of the lacrosse team or passing your final martial arts test. Still more goals might be social in nature Ã¢â¬â you have senior prom and your last spring break with your high school friends to look forward to. Writing down your goals before the school year begins means that youÃ¢â¬â¢ll have clearer vision for achieving them and hitting the ground running when school starts back up. The summer before senior year is an exciting time. ThereÃ¢â¬â¢s a lot to cherish now, in these dwindling months as a high schooler, yet thereÃ¢â¬â¢s so much to prepare for and look forward to in the near future. Once the school year starts, it might seem to blaze past at lightning speed. Get started organizing for college applications now, and make sure that you have a head start once college admissions season is fully underway. To learn more about the college applications process or to get some additional insight into your college applications, consider the benefits Ã¢â¬â¢s Applications Guidance service. Here, youÃ¢â¬â¢ll be paired with a personal admissions specialist who can provide step-by-step guidance through the entire application process, including how to perfect your approach to the personal essay.
Wednesday, November 20, 2019
Inportance of HR Policy and Other Factors in Employee Engagement - Essay Example The findings of this research will provide insight of Human Resource (HR) department that has earned a fundamental status in any organization in the recent history. It facilitates the formation of an effective infrastructure in which employees can excel and achieve goals in accordance with the vision of the company. HR functions encompass the art of providing an environment for the managers such that they are able to engage their employees and achieve desired results. Alfres, Truss, Soane, Rees and Gatenby defined employee engagement as the presence and active participation of the employee in the happenings of the organization, alongside maintaining effective and meaningful relations with the colleagues. Lockwood stated that the employees who possess greater levels of commitment with the organization tend to perform 20% better than the others and there are 87% less chances of them leaving the organization. Therefore, it can be said that better organizational results can be linked to greater employee engagement. A performance driven environment that is fuelled by competent employees is achieved by the presence of effective HR policies. Humane, flexible and clear HR policies ensure a fair and amiable working environment that helps to engage employees by protecting their rights and interests. However, the formulation of valuable HR policies is not the only factor that is used to attain employee engagement in the organization.... Figure 2: ManagersÃ¢â¬â¢ practices influence the level of employee engagement and ultimately the business results (Vance, 2006) Alfres, Truss, Soane, Rees, and Gatenby (2010) considered the following factors to bear great relevance when employees rate their line managers; communication, trust and level of fairness. Along these lines, the managers are expected to assign tasks in a fair manner in accordance with the skills and expertise of the employees. The employees expect clear and unambiguous guidelines from their managers so that the employees can direct their efforts in a consistent direction and produce results according to the expectations of the managers. Vance (2006) discussed the job characteristics model from the 1970s that increased the attention on the relation of job design with job satisfaction. This model promotes the consideration of the following aspects; skill variety, clear identification of task, relevance of task, independence to perform the task and feedback o f the performance. Line managers are also responsible for ensuring that the efforts of the employees are rewarded in an according manner. 2.2 Team Cohesiveness and Mutual Support Mutual understanding and cohesiveness are important traits of any team since these factors work towards the enhancement of employee engagement. Albercht (2010) stated that exchange of knowledge, skills and abilities (KSAs) helps the employees to improve their work performance and stay directed towards the achievement of the goals of the team. Mutual support promotes an amiable environment in the team which develops personal relations within team members; such relations provide the feeling of belonging to a specific establishment.
Tuesday, November 19, 2019
The quality of education - Essay Example ation as it started to take steps at commercializing accomplishments with affordable mass accessibility, which led to disproportionate number of academic resources to serve each learner and poor ratio between scarce number of teachers to the growing student population. This according to W. Brown was the consequence of mismanagement of both the financial and political systems in their failure to balance priorities with state budgeting and marketing education with impertinent models that had mostly been strategically business-oriented. With the facts briefly yet sufficiently presented, W. Brown devoted the second half of her address to enhance her claims from an informative level to a more persuasive and dynamic rate of appeal she occurred to bring her audience to not only listen but empathize on acting with urgency as she encouraged the listeners to advocate the thoughtful conviction that the consequence of education with poor quality is dangerous ignorance in the sense that an improperly educated mass could possible run the risk of yielding to certain self-governing incapacities toward personal development as well as impaired discernment of democracy in the future. Based on the authorÃ¢â¬â¢s knowledge of the prevailing situation both of the cause and experienced reality of the effects thereafter considering how effectively she delivered concrete examples by comparing the past and current conditions of public education in California, Wendy Brown did acquire unquestionable grounds for summoning authorities as well as concerned parties to take this matter seriously. Her arguments are clear enough that it sensibly establishes a good critique of the problematic systems and factors that essentially determine the measure of quality in public education so that this is channeled across to every individual understanding with a sense of direction and commitment towards proper resolution. It is quite significant and interesting to be involved with the aforementioned issue,
Saturday, November 16, 2019
Accident, Illness and Emergency Policy for Childminders Essay The safety of children in my care is paramount and it is my policy to take necessary steps to keep children safe when they are in my care. I will promote good health, will prevent accidents and take steps to prevent the spread of illness and infection. I have a responsibility to all children in my care to ensure that a safe and healthy environment is provided at all times. I hold contact details of parents (or another appropriate person, such as grandparent) at all times, provided by parents and stored securely within the childÃ¢â¬â¢s records. I hold written permission from each of the childrenÃ¢â¬â¢s parents in the childÃ¢â¬â¢s record form files to enable me to seek emergency treatment for their child if itÃ¢â¬â¢s needed. As a registered childminder I am required to notify Ofsted of any serious accidents, illnesses or injuries of any child whilst in my care within 14 days of an incident occurring. I will ensure that my pets are safe to be around children and do not pose a health risk. ACCIDENT POLICY As a registered childminder, I am legally required to have a valid first aid certificate. This enables me to administer basic first aid treatment, and my first aid boxes are clearly labelled and easily accessible and are stored in the outside and inside play-roomÃ¢â¬â¢s. Parents are asked to sign an accident book if injuries occur whilst in my care. Also if a child should come into my care with an injury of any kind, the parent will be asked to sign the book reporting the injury.Ã Parent/guardian will be contacted immediately. I will use my best judgement as to how other children will be looked after. You would be consulted about this by phone. There is a parent ring round provision in the event of an emergency to inform all parents of children under my care. If an accident or incident involving a child in my care may result in an insurance claim I will contact my public liability insurance provider to discuss my case and be allocated a claim number. This may involve discussing details of the child in my care with a third party. ACCIDENT PROCEDURE In the event of an accident whilst the child is in my care, I will: Ã¢â¬ ¢ deal with any minor accidents. Ã¢â¬ ¢ record all information, including names of witness(es), in the accident book. Ã¢â¬ ¢ request parents, on picking up the child / children, to sign the accident book and read the information regarding the incident. Ã¢â¬ ¢If I am unable to get hold of parents or other named appropriate adult, he/she will immediately be taken to see a doctor at Bishops Waltham Health Centre Ã¢â¬â or hospital if necessary and I will stay until parent arrives In the event of an accident in the home: Ã¢â¬ ¢ Parents must inform me of any accident at home and record it in the accident at home area of the accident book. Further observation of injury on a child which has not been reported to me by the parent nor occurred whilst in my care, parents will be asked for information on the incident and instructed to write in the back of the accident book. In the event of me being subject to an accident: If I have an accident, I will get the nearest responsible adult to help, while my emergency back-up people are being contacted. I will do my best at all times to make sure the children in my care are safe, reassured and kept calm. ILLNESS POLICY I will do everything I can to take care of your child if they are feeling unwell by comforting them and giving them appropriate medicine you have approved and have signed a declaration permitting me to administer. If I am in need of support or advice regarding a serious illness or incident involving a child in my care I may contact National Childminding Association who will log information regarding the incident with regard to their safeguarding policy. A NCMA designated officer will be assigned to my case and all the information given to them will be kept confidentially unless their appear is to be a child protection issue which will be reported accordingly. ILLNESS PROCEDURE You must inform me if your child has been ill overnight or the previous day. I might have other children I am taking care of and need to ensure your child does not have an infectious illness. Medicines will be kept in a safe place and will be logged in the Ã¢â¬Ëmedicine bookÃ¢â¬â¢. However, if you child arrives ill, I will take a decision as to whether the child is fit to attend or not. If not, the parent will be asked to take the child home. If your child becomes ill whilst in my care, I will: 1.Contact you for agreement to administer Ã¢â¬ËcalpolÃ¢â¬â¢ (if appropriate and agreed) and if your child remains ill after one hour you will be asked to collect your child and make a doctors appointment. 2.You will be required to keep your child at home until they are recovered so that your child can be cared for on a one to one basis at home. 3.In the following circumstances children may be required to stay at home: Diarrhoea and/or vomiting, a rash, conjunctivitis. 4.If I am unable to get hold of parents or other named appropriate adult, he/she will immediately be taken to see a doctor at Bishops Waltham Health Centre Ã¢â¬â or hospital if necessary and I will stay until parent arrives Infectious illness: In the event of your child contracting chicken-pox, mumps, measles etc, or a fever or temperature of 101 degrees Fahrenheit, or 38 degrees centigrade or over your child will not be able to attend under my care and must remain at home. EMERGENCY POLICY Parent/guardian will be contacted immediately. In the event of an accident requiring hospital treatment, I will attempt to inform the parents immediately and take the child to hospital. I will stay with the child until the parents arrive. EMERGENCY PROCEDURE As a registered Child-Minder and trained paediatric first aider, I will ensure that the most appropriate treatment is given or acted upon for your child in my care; however if I have more than 1 child in my care, I will use my best judgement as to how other children will be cared for. Initial action will be reporting the incident to the parent by phone. We practice a parent ring round provision in the event of an emergency to inform all parents of children under my care. If parents do not arrive or I am unable to contact them, I will stay with the child until the appropriate treatment has been given and then return home where your child would be cared for until the arrival of the parent