This is a case in which an employee encountered an ethical crisis. The organisation was responsible for commissioning healthcare, and it was as if her unconscious was demanding of her professional self: ‘are you going to give me your money or your life?’ Choosing ‘money’ would mean going along with what the organisation was demanding of her at the cost of others’ lives, while postponing the question(ing) of her life; choosing ‘life’ meant confronting the issues the organisation was facing; and resigning meant giving up on either choice.
This encounter between the ‘one alone’ approach of the organisation and the incompleteness of its responses to its citizen-patients reflected a radical non-rapport between the different ways-of-being of the organisation and of the citizen-patient as the organisation’s other, in which the organisation faced a lack experienced as a demand for something more that in this case it was refusing.
This paper considers how the current contractual arrangements between the organisation and its service-providers served the interests of the powers-that-be and examines the gendered assumptions built into these contractual arrangements. The paper considers how a different understanding of leadership would create ways of balancing interests that were en-gendering by working with the non-rapport inherent to the relation between the organisation and the lives of its citizen-clients. The paper will provide some Lacanian background to this way of understanding organisation and consider its implications for the ethical crisis that the contractor faced.
Delivered by Prof Frances Ruane, Chairperson of the Expert Group on Resource Allocation in the Health Sector, Executive Director of the ESRI at the IPHA Annual Meeting 2010.
This monograph provides an assessment of the current hospital-physician landscape and outlines an innovative vehicle for advancing hospital-physician relationships that has the potential to improve care delivery and coordination, clinical quality, and patient cost. Our findings and recommendations address:• Changes in the market place.• The concept of an integrated medical staff model.• The role of operational clinical integration, enabled by an Electronic Medical• Record, toward creating virtual medical staffs.• Benefits to the hospital, physicians, patients and community.• What boards and senior management can do to move toward the model.
A study of direct treatment costs in relation to private health insurance sta...DR. AMIT KUMAR GUPTA
A study of direct treatment costs in relation to private health insurance status of hospitalised patients in private hospitals in Delhi (Summary of MD Thesis by Dr AK Gupta, NIHFW, University of Delhi, 2013)
Delivered by Prof Frances Ruane, Chairperson of the Expert Group on Resource Allocation in the Health Sector, Executive Director of the ESRI at the IPHA Annual Meeting 2010.
This monograph provides an assessment of the current hospital-physician landscape and outlines an innovative vehicle for advancing hospital-physician relationships that has the potential to improve care delivery and coordination, clinical quality, and patient cost. Our findings and recommendations address:• Changes in the market place.• The concept of an integrated medical staff model.• The role of operational clinical integration, enabled by an Electronic Medical• Record, toward creating virtual medical staffs.• Benefits to the hospital, physicians, patients and community.• What boards and senior management can do to move toward the model.
A study of direct treatment costs in relation to private health insurance sta...DR. AMIT KUMAR GUPTA
A study of direct treatment costs in relation to private health insurance status of hospitalised patients in private hospitals in Delhi (Summary of MD Thesis by Dr AK Gupta, NIHFW, University of Delhi, 2013)
Greece: Primary Care in a time of crisis. 2nd VdGM Forum, Dublin 2015Evangelos Fragkoulis
2nd Vasco Da Gama Movement Forum, Dublin 2015
The Effect of the Economic Crisis on the Health Systems of the peripheral countries: Greece, Ireland, Spain, Portugal and Italy.
Review the shortage of medical professionals and the increasing need for advanced practitioners to serve in primary care roles
Identify the current barriers that prevent CNP from practicing to the full extent of their education, scope and training
Outline concrete ways in which these barriers can be effectively removed so as to improve autonomy for CNP’s and quality of care for patients.
Presentation Objectives:
1) Define SBIRT and identify components of this evidence-based intervention for identifying, reducing, & preventing problematic use, abuse & dependence on alcohol & illicit drugs
2) Learn how to use the all the components of the SBIRT app, including, but not limited to the screening, brief interventions & referral to treatment features included in this app
3) Recognize the critical need for more research related to occupational therapy intervention and SBIRT, as well as potential obstacles to implementation of SBIRT in treatment settings & resources for continuing education on this topic.
Jacquie White, Deputy Director of NHS England Long Term Conditions, Older People & End of Life Care and Claire Cordeaux SIMUL8 Executive Director for Health & Social Care were invited by Centers for Medicare & Medicaid Services to discuss how NHS England work in chronic disease.
Greece: Primary Care in a time of crisis. 2nd VdGM Forum, Dublin 2015Evangelos Fragkoulis
2nd Vasco Da Gama Movement Forum, Dublin 2015
The Effect of the Economic Crisis on the Health Systems of the peripheral countries: Greece, Ireland, Spain, Portugal and Italy.
Review the shortage of medical professionals and the increasing need for advanced practitioners to serve in primary care roles
Identify the current barriers that prevent CNP from practicing to the full extent of their education, scope and training
Outline concrete ways in which these barriers can be effectively removed so as to improve autonomy for CNP’s and quality of care for patients.
Presentation Objectives:
1) Define SBIRT and identify components of this evidence-based intervention for identifying, reducing, & preventing problematic use, abuse & dependence on alcohol & illicit drugs
2) Learn how to use the all the components of the SBIRT app, including, but not limited to the screening, brief interventions & referral to treatment features included in this app
3) Recognize the critical need for more research related to occupational therapy intervention and SBIRT, as well as potential obstacles to implementation of SBIRT in treatment settings & resources for continuing education on this topic.
Jacquie White, Deputy Director of NHS England Long Term Conditions, Older People & End of Life Care and Claire Cordeaux SIMUL8 Executive Director for Health & Social Care were invited by Centers for Medicare & Medicaid Services to discuss how NHS England work in chronic disease.
Investing in specialised services - the prioritisation framework, pop up uni,...NHS England
Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event.
Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
More information is available online: www.expo.nhs.uk
Efforts to place the patient at the center of medical research, spurred by the Affordable Care Act’s founding of the Patient Centered Outcomes Research Institute, have begun to change the way clinical research is conceptualized and conducted. Such efforts hold great promise, but also raise potential challenges for ethical oversight. How should oversight bodies approach the presence of patients in potentially unfamiliar research roles, such as investigator? What forms of patient involvement in research, if any, warrant increased scrutiny from oversight bodies? How do we keep the patient voice from being ‘captured’ by special interest groups? This symposium brought together a diverse group of patients and community members, policymakers, bioethicists, and regulatory officials to address these and other issues.
Meeting the challenge together... delivering care in the most appropriate set...NHS Improvement
Meeting the challenge together... delivering care in the most appropriate setting (October 2008). This document has been designed to support the pilot sites (now starting to test new ideas working with partners in primary care and social care) but will also be of interest to other organisations attempting to reform inpatient care (Published October 2008).
DR TIM LEIGHTON AND KATHERINE JENKINS - WHAT CAN THE PAST TEACH US ABOUT THE ...iCAADEvents
The presentation and workshop will be a participatory session discussing the future of addictions counselling, and how decades of experience can inform best practice whilst also combining cutting edge research and treatment methods. Addictions counselling with individuals, couples, families and groups has become more complex and challenging. How can we de ne and describe the training and quali cations needed to ensure the best practice and the most e ective interventions? What is the relationship between the quality framework and the therapeutic work? The workshop will explore tensions that arise in practice as experienced by the audience, and suggest ways to get the training, support and continuing professional development you need. Tim and Katherine will be encouraging the audience to share their own thoughts and ideas.
Rethinking Value Based Healthcare
Around the world healthcare providers are busy exploring how value-based healthcare can both improve the efficiency and effectiveness of healthcare delivery and seed new opportunities for innovation. Continuing our collaboration with Denmark, we are very pleased to release a new perspective on how VBHC can have greater impact in practice. Based on insights from a recent event hosted by DTU Executive Business Education and undertaken in partnership with Rethink Value, this point of view looks at the key issues for patients, physicals, providers and payers.
It explores some of the associated implications for healthcare systems worldwide, highlights several leading early examples of VBHC in practice and looks at how it can have impact at scale. Recommendations focus on the structure of care, key metrics, moving beyond pilots, changes in reimbursement models and the need for greater insight sharing and deeper collaboration.
For related Future Agenda research see www.futureofpatientdata.org
The Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents is an initiative designed to improve care for people living in nursing facilities who are enrolled in Medicare and Medicaid.
Through this initiative, CMS will partner with independent organizations to improve care for long-stay nursing facility residents. These organizations will collaborate with nursing facilities and States to provide coordinated, person-centered care with the goal of reducing avoidable hospital stays.
In this webinar, staff from the Medicare-Medicaid Coordination Office (MMCO) and the CMS Innovation Center will provide an overview of the initiative, and offer information about how to apply.
More at: http://innovations.cms.gov/resources/Duals_rahnfr_apply.html
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It’s not uncommon to arrive at the moment within a consultation when the client feels confronted by an unavoidable career crisis: leave because s/he can’t see any future staying; or stay because s/he sees no alternative to accepting the limitations being imposed by the larger system. This paper examines three cases, one up close, in which the client had come up against a wall: one providing on-line gambling, one procuring military capabilities, and one providing intensive social care. In each case there existed possible courses of action that could have provided better outcomes and made greater commercial sense, but which were nevertheless judged as beyond the pale by the existing powers. The challenge for the client is to use the crisis while not taking it personally. The paper explores the psychoanalytic basis of the walling off as a systemic defense against innovation and the challenge to leadership in overcoming it.
Big-A Agile methods enable an enterprise to develop software and systems rapidly in response to new requirements for products and services. Small-a agility is about flexibility in general, apparent in how individuals, workgroups and enterprises respond to new kinds of requirement. In both cases there is a separation between the ‘design-time’ within which a response can be developed and the ‘run-time’ within which it is deployed operationally. Requisite agility is this same general flexibility, but where no such separation is possible between design-time and run-time: the enterprise becomes entangled with the client’s context-of-use so that the response to new requirements has to happen in the client’s real time. Requiring the support of platform architectures, this entanglement creates a double challenge to the governance of an enterprise. It needs to be able to collaborate effectively across enterprise boundaries, but it also needs to develop the requisite agility at the level of the enterprise that enables it to respond in real time to new forms of demand.
Thinking psychoanalytically about desire in organizations - why we need a 3rd...Boxer Research Ltd
Psychoanalytic understanding has approached the organization as being like the ego in its pursuit of sovereign autonomy, its inter-subjective discursive practices organizing its work in relation to its markets. The corporate entity has been approached as an a priori. Psychoanalytic understanding has addressed the ways in which individuals take up roles within the life of an organization, but not the ways in which an organization may support a multiplicity of roles one-by-one in the lives of its citizen-clients.
The a priori status of the sovereign corporate entity leads to the unconscious being referred to as descriptively unconscious, ‘below the surface’ of the inter-subjective practices it supports. The implication is that what lies ‘below the surface’ can in principle be made conscious. This repressed unconscious is distinct from the wider compass of the radically unconscious. Distinguishing the repressed from this radically unconscious enables us to establish a ‘beyond’ of the libidinally-invested-in identifications supported by the organization. Defenses against anxiety may thus become defenses against a ‘beyond’ of innovation, through which a posteriori organization might support innovative roles in the lives of its citizen-clients.
We need to understand how a radically unconscious valency for innovation becomes realized. This would enable us to address how individuals might support identifications with an organization when it was itself having to innovate continuously ‘under their feet’. Without such an understanding, we can only expect an organization to betray its citizen-clients through serving its a priori interests to the exclusion of ‘others’.
Creating value in ecosystems: the place of the well-bounded organisationBoxer Research Ltd
How are our consulting and managing skills standing up to a world that is changing its demands on us? We may work with individuals and groups, but the contexts in which we work with individuals and groups are changing. These contexts, once defined by well-bounded organizations, are becoming a turbulent sea of stakeholders and ecosystems each with its competing demands and challenges. These dynamic contexts change the place of the organization, and impact on the way the organization is able to sustain support for the unconscious valencies of its managers and staff.
Innovations that respond to these dynamic contexts are resisted because they disrupt the ways in which the well-bounded organization supports the identities of its managers and staff. This presentation considers how responses to the changing place of the organization arising from this disruption may be understood as a symptom of unconscious foreclosure, in which what has no place to be thought arises in the environment as a symptom: “what has been rejected from the symbolic reappears in the real”. In order to understand the nature of this foreclosure, the presentation examines the challenges facing the well-bounded organization using the example of an organization seeking to provide intensive social care subject to the UK’s regulatory regimes.
What kind of Governance is appropriate to the distributed collaborations across ULS systems?
How are the changing services provided by the operational components of ULS systems to be enabled to achieve levels of cooperation and collaboration that can satisfy requirements for fast system evolution?
How are we to enable the distributed collaborations across ULS systems to be edge-driven?
How are the processes of orchestration and synchronisation to work in ULS systems?
How are people to be taken into consideration as first-class components of ULS systems?
The impact of governance approaches on system of-system environmentsBoxer Research Ltd
Governments worldwide are turning to Information and Communication Technology (ICT) based systems of systems, commonly termed Electronic Government (eGovernment), to enable more timely, efficient and effective interaction with their citizens and with the business community. Citizens and businesses have dynamic and evolving demands related to the complexity of their lives and operational environments, respectively. A major challenge for government is to be able to understand the value derived from investment in eGovernment in order to improve its consequent ability to respond to the variety of demands of its citizens and businesses. To be able to understand the value derived from planned investments in eGovernment, their analysis needs to extend beyond the familiar approaches that address economies of scale and scope to encompass economies of alignment. These economies of alignment arise from being able to reduce the costs of the multiple forms of collaboration needing to be supported by systems of systems in providing greater responsiveness.
Building organizational agility into large scale software-reliant environmentsBoxer Research Ltd
The tempo at which an enterprise creates new uses for its systems is different from that of its acquisition or systems development processes. The military continues to confront the issue of how fielded systems can support the agility needed by its deployed forces. This problem of diverging tempos applies to a variety of large-scale, software-reliant enterprisessuch as those found in healthcare and digital communications. This paper posits four realities underpinning an approach to this problem space: the governance-demand double challenge, edge-driven perspective, stratification, and demand cohesion. It uses a particular case example to show how these concepts support the modeling and analysis of the enterprise as a socio-technical system of systems. The paper argues that analyses based on this approach are necessary for making this problem space tractable.
Systems of systems engineering and the pragmatics of demandBoxer Research Ltd
Systems of systems that manage health care or enable Albert’s “power to the edge” are expected to provide the flexibility to engage multiple enterprises in innovative, collaborative, ways to solve problems. This paper describes a systems engineering approach to engineer infrastructure that will support the restriction of systems of systems behavior at the time of use rather than at design time. We present a process for describing demands within their context of use, and how organizational variations in collaborative approaches (geometries-of-use) can be re-lated to variations in these demands-in-context (pragmat-ics), thus giving a way to engineer a systems-of-systems’ agility i.e. its ability to adapt to changing demands.
Enterprise architecture for complex system of-systems contextsBoxer Research Ltd
An enterprise architecture is an accepted, widely used means for an organization to capture the relationship of its business operations to the systems and data that support them. Increasingly, enterprises are participating in complex system-of-systems contexts in order to meet changing customer demands that require them to collaborate with other enterprises in new and innovative ways. For a complex system-of-systems context, a shortcoming of enterprise architecture is that it presumes a single enterprise or a single, ultimate source of control.
This paper explores an approach to reasoning about distributed collaboration in the complex system-of-systems, multi-enterprise context, in which this single, ultimate source of control does not exist. It outlines the ways in which the long-used Zachman Framework for enterprise architecture would need to be modified to account for multi-enterprise collaboration and decentralized governance. It proposes a concept of stratification to meet this need and puts forward the main characteristics of the methods needed to model the stratified relationships of complex systems-of-systems to their contexts-of-use.
An approach to modeling interoperability within an ecosystem facing rapid tempos of change in the nature of demands. The approach identifies interoperability risks of existing architectures and drives economic modeling of the impact of changes in architecture.
The use of Projective Analysis (PAN) modeling tools to establish the value of increased agility in responding to increasingly multi-sided demands being made on operational capabilities. The approach addresses the need to reduce cohesion costs by creating economies of alignment as well as economies of scale and scope.
Competing within Ecosystems: determining requisite agility in system-of-syste...Boxer Research Ltd
How architecture becomes the key strategic enabler of requisite agility by
- not separating 'design-time' from 'run-time'
- continuous assessment and mitigation of hazards to agility
- developing a capability for horizontal governance
Supporting Social Complexity in Collaborative EnterprisesBoxer Research Ltd
The presentation explores the need for enterprises to capture new forms of indirect value in ecosystems, and the demand this creates for platform architectures that can support customers within these contexts.
The Team Member and Guest Experience - Lead and Take Care of your restaurant team. They are the people closest to and delivering Hospitality to your paying Guests!
Make the call, and we can assist you.
408-784-7371
Foodservice Consulting + Design
Oprah Winfrey: A Leader in Media, Philanthropy, and Empowerment | CIO Women M...CIOWomenMagazine
This person is none other than Oprah Winfrey, a highly influential figure whose impact extends beyond television. This article will delve into the remarkable life and lasting legacy of Oprah. Her story serves as a reminder of the importance of perseverance, compassion, and firm determination.
Artificial intelligence (AI) offers new opportunities to radically reinvent the way we do business. This study explores how CEOs and top decision makers around the world are responding to the transformative potential of AI.
Modern Database Management 12th Global Edition by Hoffer solution manual.docxssuserf63bd7
https://qidiantiku.com/solution-manual-for-modern-database-management-12th-global-edition-by-hoffer.shtml
name:Solution manual for Modern Database Management 12th Global Edition by Hoffer
Edition:12th Global Edition
author:by Hoffer
ISBN:ISBN 10: 0133544613 / ISBN 13: 9780133544619
type:solution manual
format:word/zip
All chapter include
Focusing on what leading database practitioners say are the most important aspects to database development, Modern Database Management presents sound pedagogy, and topics that are critical for the practical success of database professionals. The 12th Edition further facilitates learning with illustrations that clarify important concepts and new media resources that make some of the more challenging material more engaging. Also included are general updates and expanded material in the areas undergoing rapid change due to improved managerial practices, database design tools and methodologies, and database technology.