0 Congestive Heart Failure Rogert Castro South University Online Evidence Table Worksheet I. PICOT Question: Does an effective discharge plan (I) compared to routine care (C) influence Readmission rates (O) in patients, 65 years and older, who have been discharged after hospitalization with Congestive heart failure (P) over 30 days after discharge (T)? Plus 1. Will you have a comparison group, or will subjects be their own controls? Yes, there will be a comparison group. The study population will have personalized post-discharge outpatient follow-up appointments, while the control group will not have the usual care. 2. Is a ‘time’ appropriate with your question—why or why not? The allocated time is suitable for the study and will provide more time to follow up for patients after discharge. 0 II. Evidence Synthesis Database: PubMed (Parrinello et al., 2011) (Ryan et al., 2013) (Shao et al., 2013) (Lee et al., 2016) (Sharma et al., 2010) Synthesis (p) Population Comprised of 22 discharged CHF patients 398 patients from heart failure discharge The intervention group had 47 heart failure patients actively attending cardiac clinics. 11,985 eligible adults hospitalized for HF 62 746 COPD patients years old. All the studies comprised of a study population that was either hospitalized for HF or heart related conditions such as COPD. (i) Intervention Early and personalized congestion guided ambulatory program. 7-day follow-up visits. Self-management initiatives centered on the self-efficacy construct, in elderly patients with heart failure. The timing and type of post-discharge follow-up An early follow-up visit with the patient’s pulmonologist or primary care physician. From the studies, there are several intervention methods and approaches that have been studied by scientists capable of decreasing readmissions (c) Comparison (c) Comparison 21 subjects for the control group No control group The Control group had 46 patients that received the usual care 7,935 eligible controls. Usual care and no follow-up These are primary studies, and it is proper for them to have controls as part of the research design to lower the effects of variables. (o) Outcome. Improved clinical compensation, enhanced quality of life, and a decrease in readmissions A reduction in 30- day readmission rate. Significantly improved confidence for salt and fluid control, self-management behavior, and reduction in heart failure-related symptoms. Risks of readmission within 30 days after discharge. A reduction in readmissions and emergency department visits. Majority of the intervention measures taken significantly reduce readmission cases and risks for readmission. (t) time Six months of follow up visits. 30 days follow up visits. 12 weeks follow up visits. 30 days 30 days Each study had a proper time frame that allowed the studies to be completed and answer the clinical question III. Evaluation Table Citation Design Sample ...

1. 1
Strategic Improvement3
Business Plan Assessment: Strategic Improvement
Strategic Planning & Implementation
9/6/2021
Strategic Improvement
The purpose of the strategic plan in week two assignments was
to show how Mexican Chipotle plans to work towards its
damaged reputation and earn consumer trust and confidence. As
highlighted in the assignment, Chipotle has faced ethical blows
in its operation, which led to its closure. However, after
resuming its functionality, the company had lost its positive
public image, affecting consumer trust and confidence.
Therefore, developing a great and workable strategic plan is
vital and paramount for Chipotle because it will restore its
public image and improve its competitive advantage and attract
more customers. Thus, Chipotle's strategic plan aims to attract
customers, increase the company's competitive advantage, and
increase the general productivity of the company.
The key objectives of Chipotle’s strategic plan are to maintain
its existing customers and do the best it can to attract more
customers. Such objectives can only be achieved if the company
strategically plans and approaches market development aspects.
For instance, after Niccol took over, he employed

2. differentiation as a market development initiative in the
company (Thompson, 2019). This is a strategy that targets a
narrow market, hence improving the company’s overall
competitive advantage. Chipotle intends to give its customers
variations of products to choose from with a target for a narrow
market. This will increase the competitive advantage within the
company and strengthen its overall operations in the business
market.
The strategic plan reveals that Chipotle is focused on improving
its processes to ensure the safety of both the people and the
environment. The company intends to strategically differentiate
its products, with a focus on the production of food with only
natural ingredients. Initially, Chipotle used to process products
from both natural and synthetic materials. However, after the
ethical blow where many customers suffered from food
poisoning, the company has learned its lesson and resolved to
focus on the safety and health of the consumers (Thompson,
2019). Niccol has ensured that Chipotle sources its rice, beans,
and cilantro from organic suppliers. This implies that Chipotle
is focusing on having the best food quality instead of saving
money on ingredients. This will eventually turn the company
into a healthy living entity, which will change the narrative
regarding the reputation of the company into what consumers
love.
Chipotle has a performance culture based on employee
development and promotion of employees from within the
company. Employees are given a path of ascension and
opportunities to advance their employment levels and job
positions. More so, the company provides the workers with a
balanced work-life and financial incentives to the employees.
The company has also resolved on trying things on a small scale
before transitioning to a larger scale. More so, unlike the
previous CEO, Ells, Niccol intends to give its consumers what
they ask for. For instance, most of its consumers have asked for
nachos and Quesadillas in their menu; therefore, Niccol has
asked his team to experiment with this on the menu and in the

3. recipes. The company has also worked on its product and
service delivery by hiding consumers' calls regarding the need
to have a loyalty program. Niccol and his team tested the
loyalty program in more than 150 locations, which ensured that
by 2019, Chipotle had digital pickup points to allow people to
pop up and picking their orders without queuing for long.
The key performance indicators at Chipotle include product mix
performance value, which are the frequently ordered items on
the menu; the rate of client retention; the rate of customers in
house per hour; and the online order values and reward
anniversaries. These KPIs will help the company to have robust
marketing effort segmentation.
I would recommend that Chipotle’s management should carry
out employee training and awareness to ensure that they work
alongside the strategic plan. More so, the company should have
a digital medium to diversify its customer base through reviews.
The only means to adapt to the changing environment is by
training the relevant stakeholders as well as recruiting talents
that resonates with the company’s vision.
In conclusion, Chipotle is working hard to restore its reputati on,
consumer trust and confidence after its 2008-2018 fallouts.
Having a great strategic plan is essential to achieving these
objectives. Therefore, Niccol, Chipotle's CEO, is strategically
doing all he can to ensure that the consumers are safe by using
organic ingredients and giving them what they love instead of
saving money.
References
Thompson, A. A. (2019). Chipotle Mexican Grill’s Strategy in
2018: Will the New CEO Be Able to Rebuild Customer Trust
and Revive Sales Growth?
OG
Vulnerable populations are at increased risk of receiving
variation in medical care based on financial circumstances or

4. social aspects such as age, race, gender, ethnicity, sexual
orientation, spirituality, disability, or socioeconomic or
insurance status ("Care of Vulnerable Populations," 2006).
Where I work, we get people all over the state sent to us for the
procedures that we do at our hospital. Many of these patients
are non-English speakers, which makes this experience even
more traumatizing. These patients become vulnerable to adverse
health outcomes. When you are ill, it is essential to be able to
communicate with the medical staff. The language barriers
cause inferior health outcomes. I often see that these patients
won’t express how they feel or communicate to the healthcare
staff what they need, some feel scared or wait for their family to
come to let the staff know what's going on, which then causes
very poor outcomes. Nowadays, I think it's much worse because
the family is not in the hospitals or the patients don’t say
anything to the family because they don’t want to worry them.
As a future Advance Registered Nurse, I believe that systematic
efforts should be made to reach out to the non-English speaking
communities and provide them with education on health-related
research and prevention as well as intervention programs, get
them more involved in their health (Jang et al., 2016). I also
believe that here should educate and provide the healthcare staff
on how to take care of a non-English speaking patient, for
example, provide paper education in different languages. I know
many use the blue phone, for translation but if your anything
like my hospital it's not always easy to find a blue phone. Let
the patient feel safe by letting them know that you are there for
them, and they can call you anytime, get families involved as
much as possible and the list can go on, but none of this can
happen if we don’t educate our staff or provide the right tools
for them.
JD
Sadly, in Los Angeles, California (CA), seeing
homeless people daily is not unusual. There are areas lined up
with tents under bridges, along sidewalks, and in trenches.

5. Homeless people not living in a tent may live in their car or an
RV for shelter. The space in shelters is limited. However, this
author has encountered several homeless patients not wanting to
be in a shelter due to rules, regulations, restrictions, and lack of
privacy. Characteristics of homelessness are people suffering
from mental health issues, addictions, and financial disparities.
Wheldon et al., (2020) describe vulnerable populations as those
excessively burdened by disease and inadequate health due to
their location, financial, and cultural hurdles to health care.
There are more complex issues and characteristics of why
people are homeless, such as sexual identity, run-aways, and
human trafficking. Research has shown location and culture can
have a great influence on predictions and susceptibility of
chronic health issues, such as cancer and cardiovascular disease
(Wheldon et al., 2020). Advanced practice nurses (APNs)in
California or elsewhere can start by not having biases of non-
white cultures and uphold the nursing professional code of
ethics for all populations (Fitzgerald et al., 2017). Having an
upstream approach to advocate for homelessness is an important
intervention for APNs. Opportunities to advocate for safe and
affordable housing are to engage in the Fair Housing Act to
prevent discriminations and to support more funding for rental
help programs (Williams et al., 2018).
1
STRATEGIC PLAN IN COMPANIES
2

6. Strategic Plan Research
Strategic Implementation and Implementation
Strategic Plan
Strategic plans refer to organizational game plans aimed at
attracting consumers, achieving a competitive advantage, and
increasing profitability. A company's strategic plan succeeds
due to its ability to compete differently with its competitors by
operating uniquely and innovatively compared to other ventures
within the same industry. Organizational strategic plans evolve
with time because, during operations, managers can decide to
improve on the strategy, or a company might face unanticipated
developments and market conditions that can force managers to
change their strategies (Plowman, 2019). Therefore, a strategic
plan must be consistent, have a durable competitive advantage
and have an outstanding performance. I will use Chipotle
Mexican Grill to analyze the strategic plan within the restaurant
or fast-food industry.
Chipotle Mexican Grill is a restaurant that was founded in 1993
with the idea of serving quality food to its customers. The
company has been using high-quality ingredients, receipts, and
cooking methods in making their food. The restaurant and
Chipotle stores are uniquely designed with distinctive materials,
giving the restaurant an architectural style that is more natural
and less modern. Twenty years into the company's operation,
Chipotle had opened over 2000 stores across several states in
the US. However, from 2008 through to 2018, the company has
faced ethical blows in its operations, especially after the FDA
and other medical organizations established the increasing rates
of food poisoning in its operations (Thompson, 2019). This led
to the closure of all Chipotle stores in 2016, giving the company
a few months to rethink its strategic plan. With the negative
publicity the company had received, its reputation in the food
market became a concern. The company also lost consumer

7. trust, loyalty, and confidence, making it necessary to develop a
new strategic plan that will restore its previous relationship
with the consumers.
When Niccol took over the company amidst all these issues, he
focused on strategically doing all he could to win back
consumer loyalty, trust, and confidence. The company is
focused on maintaining the current consumers and attracting
potential ones. This is achievable through the company's
competitive advantage strategy, which focuses on
differentiation which targets a narrow market. Chipotle is
targeting a narrower market by giving its consumers variations
in product choices, which is a unique way of operation
compared to its competitors, such as Moe's.
Chipotle’s external and internal environments play a vital role
in its strategic planning, which is evident in its SWOT analysis.
As it focuses on regaining and restoring consumer trust and
confidence, the company management ensures that it works hard
on outdoing its competitors because they are the biggest thr eat
to its operations. Therefore, Niccol's management has resolved
on using a differentiation strategy to gain a competitive
advantage. Today, consumer preferences have changed, and
many people are health conscious, unlike before (Thompson,
2019). Therefore, differentiation and focusing on natural
ingredients in foods will be essential. Furthermore, Chipotle's
corporate social responsibility and environmental sustainability
are exercised in its choice of natural ingredients and sustainable
process of food production. The company is also focused on
producing and selling health-conscious foods to ensure the
safety of consumers across the states.
References
Plowman, S. (2019). A Strategic Audit of Chipotle Mexican
Grill, Inc.
Thompson, A. A. (2019). Chipotle Mexican Grill’s Strategy in
2018: Will the New CEO Be Able to Rebuild Customer Trust
and Revive Sales Growth?.