Integrated Health was a large private, nonprofit health care system .pdf
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Integrated Health was a large private, nonprofit health care system located in Tempe,Arizona. A year ago, the decision was made to implement a computerized medication administration record (MAR) at Integrated Health. During the first year, the MAR system would be implemented at Central Hospital of Tempe. After the bugs were worked out, the computerized MAR would be implemented system-wide. The MIS department at Central Hospital was designated as the initiator and direction setter for the project. Art Smith, the Chief Information Officer at Central Hospital assigned Kate Cohen, a programmer/analyst, as project leader. Kate had the responsibility for developing and implementing the MAR project at Central. Kate did the programming work for the MAR and assembled a team from Pharmacy Services, Nursing Services, and Internal Auditing. Members of the project team provided feedback on the software, made suggestions related to user training, and worked on an implementation schedule. Both team members and outside observers recognized the difficulty in developing and implementing the MAR in one year. Nurses antagonism toward the project surfaced after their suggestions and recommendations were rejected without explanation. The MAR project was also affected when a management shakeup occurred during the project development phase. The MAR was implemented and immediately failed. By 10:00 a.m. on the first day of the implementation, users complained that the system did not work and was too complicated. After hearing nurses complaints, physicians expressed concern about patient safety. At 1:30 p.m., Central Hospitals computer system crashed, and the MAR project was suspended. Early the next morning, we find Kate contemplating what she is going to say when she meets with Central Hospitals management group later in the afternoon. Question: 4) Discuss the resistance to change in the case and the strategies that can be adopted to reduce the resistance 5) Evaluate the importance of trustworthy leadership and trusting followers in managing change in the case.
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Integrated Health was a large private nonprofit health care.pdf
Integrated Health was a large private, nonprofit health care system located in Tempe,Arizona. A
year ago, the decision was made to implement a computerized medication administration record
(MAR) at Integrated Health. During the first year, the MAR system would be implemented at
Central Hospital of Tempe. After the bugs were worked out, the computerized MAR would be
implemented system-wide. The MIS department at Central Hospital was designated as the initiator
and direction setter for the project. Art Smith, the Chief Information Officer at Central Hospital
assigned Kate Cohen, a programmer/analyst, as project leader. Kate had the responsibility for
developing and implementing the MAR project at Central. Kate did the programming work for the
MAR and assembled a team from Pharmacy Services, Nursing Services, and Internal Auditing.
Members of the project team provided feedback on the software, made suggestions related to
user training, and worked on an implementation schedule. Both team members and outside
observers recognized the difficulty in developing and implementing the MAR in one year. Nurses
antagonism toward the project surfaced after their suggestions and recommendations were
rejected without explanation. The MAR project was also affected when a management shakeup
occurred during the project development phase. The MAR was implemented and immediately
failed. By 10:00 a.m. on the first day of the implementation, users complained that the system did
not work and was too complicated. After hearing nurses complaints, physicians expressed
concern about patient safety. At 1:30 p.m., Central Hospitals computer system crashed, and the
MAR project was suspended. Early the next morning, we find Kate contemplating what she is
going to say when she meets with Central Hospitals management group later in the afternoon.
Introduction
Background and context are clear and well-developed. The purpose/aim and organization of the
submission are clearly articulated. The submission is linked to the objectives..
Marita Schifalacqua, RN, MSN, NEA-BC, FAAN,Chris Costello, M.docx
Marita Schifalacqua, RN, MSN, NEA-BC, FAAN,
Chris Costello, MEng, MBA, and Wendy Denman, RNC, BBM, BSN, MSN
Roadmap for Planned Change, Part 2
Bar-Coded Medication Administration
hange—savored by some and feared by many.
How do you as nurse leaders use your
knowledge and insight to move forward and transfer
your vision for quality and safety into reality? What do
you need to do to get key stakeholders on the bus and,
in some cases, even drive the bus? The roadmap for
planned change allows for an infrastructure of thought
brought to increase the likelihood for successful
change. Successful change is important to our patients
and to us as providers of that care.
This article, the second of a two-part series,
focuses on the application of change theory and the
elements of project management most critical to
successfully implementing a bar-coded medication
administration (BCMA) program. Examples will be
from one hospital’s experience, Saint Francis Medical
Center in Grand Island, Nebraska, to a health
system’s (Catholic Health Initiatives, Denver, Colorado)
approach to planning for 30 hospitals.
The definition of the BCMA program includes a
consistent, integrated information technology strategy,
with a focus on point-of-care BCMA to ensure that the
right person receives the right medication, in the right
dosage, via the right route, at the right time (five
rights). The bar code on medication is scanned before
administration to patients.
C
April 200932 Nurse Leader
Nurse Leader 33www.nurseleader.com
APPLICATION OF CHANGE THEORY AND
PROJECT MANAGEMENT
The first article discusses concepts and tools of both change
leadership and project management that lend support in plan-
ning and managing large- or small-scale change. Change lead-
ership is a common methodology of theory and tools that,
when used routinely, are central to integrating a change man-
agement model with the people side of change.
Project management is an application of knowledge, skills,
tools, and techniques customized to the initiative.The project
management elements discussed in the first article that are
most critical to successfully implementing planned change are
project charter, project budget and budget management, proj-
ect plan and schedule management, project staff organization,
project communications management, and project risk and
issue management.
CURRENT STATE ANALYSIS
Changing a process as complex as BCMA can and will
impact a variety of stakeholders. It is important to review
the process of medication administration from the time the
medication enters the facility through the time that the med-
ication is billed to the patient. Employees working in depart-
ments that will experience change with BCMA need to
know that their role is important and that their viewpoint
is valued.
Leadership
The chief nursing officer and vice president of ancillary services
were the executive cosponsors of the project.There was a
BCMA stee ...
Case Study—Memorial Health System CPOE ImplementationHCS483 V.docx
Case Study—Memorial Health System CPOE Implementation
HCS/483 Version 3
1
University of Phoenix Material
Case Study—Memorial Health System CPOE Implementation
Memorial Health System is an eight-hospital integrated health care system in the Midwestern United States. The health system has two downtown flagship tertiary care hospitals, each licensed for more than 700 beds, located in the two major metropolitan areas served by the system. The remaining six hospitals are community-based facilities, ranging in size from 200 to 400 beds. These hospitals are located in the suburban and rural areas served by Memorial Health System.
Four years ago, the system’s board of directors approved a multi-million-dollar initiative to install an enterprise-wide clinician provider order entry (CPOE) system intended to dramatically reduce medical errors. Today, the system is far from fully implemented, and, in fact, has been removed from all but one of the two tertiary care facilities, where it remains in pilot adopter status.
At the time, the board approved the CPOE initiative, the project was championed by Fred Dryer, the CEO, and was closely supported by Joe Roberts, the chief information officer (CIO) of the health system. Even during its proposal and evaluation by the board, the project was considered controversial by some of the health system’s stakeholders. For example, many of its physicians, who are community-based independent providers, were adamantly opposed to the CPOE system. They worried that their workload would increase because CPOE systems replace verbal orders with computer-entered orders by doctors. Dr. Mark Allen, a primary care physician commented, “The hospital is trying to turn me into a 12-dollar-an-hour secretary, and they aren’t even paying me 12 dollars an hour.”
In securing board approval, Dryer and Roberts presented an aggressive implementation plan that called for the requirements analysis, Request for Proposal (RFP), vendor selection, and project implementation to be completed in less than 18 months in all eight hospitals. During the discussion with the board, several of the members questioned the timeline. One noted, “It took you 2 years to set up e-mail, and everyone wanted e-mail. This will affect every clinician in every hospital. Do you really think you can do this in 18 months?”
In an effort to demonstrate results, Dryer and Roberts demanded results from the clinical and IT team formed for the project. By this time, a rushed requirements analysis had been completed, an RFP issued, a vendor selected, and a contract signed. The acquisition process took a little more than 6 months, leaving a year for the implementation.
In protest, a number of prominent physicians took their referral business to the other health system in the area that seized upon the controversy by promising that they would not use a CPOE. Shortly thereafter, the two leading champions for CPOE—Dryer and Roberts—left Memorial. The chief medical officer, Barbar ...
You will write two pages (not including your title page) expressin.docx
You will write two pages (not including your title page) expressing your current worldview in regard to the subject of Administration of Justice Organizations. This paper’s content will include how the presentation in the Module/Week 1 Reading & Study folder influences your worldview.
Marita Schifalacqua, RN, MSN, NEA-BC, FAAN,
Chris Costello, MEng, MBA, and Wendy Denman, RNC, BBM, BSN, MSN
Roadmap for Planned Change, Part 2
Bar-Coded Medication Administration
hange—savored by some and feared by many.
How do you as nurse leaders use your
knowledge and insight to move forward and transfer
your vision for quality and safety into reality? What do
you need to do to get key stakeholders on the bus and,
in some cases, even drive the bus? The roadmap for
planned change allows for an infrastructure of thought
brought to increase the likelihood for successful
change. Successful change is important to our patients
and to us as providers of that care.
This article, the second of a two-part series,
focuses on the application of change theory and the
elements of project management most critical to
successfully implementing a bar-coded medication
administration (BCMA) program. Examples will be
from one hospital’s experience, Saint Francis Medical
Center in Grand Island, Nebraska, to a health
system’s (Catholic Health Initiatives, Denver, Colorado)
approach to planning for 30 hospitals.
The definition of the BCMA program includes a
consistent, integrated information technology strategy,
with a focus on point-of-care BCMA to ensure that the
right person receives the right medication, in the right
dosage, via the right route, at the right time (five
rights). The bar code on medication is scanned before
administration to patients.
C
April 200932 Nurse Leader
Nurse Leader 33www.nurseleader.com
APPLICATION OF CHANGE THEORY AND
PROJECT MANAGEMENT
The first article discusses concepts and tools of both change
leadership and project management that lend support in plan-
ning and managing large- or small-scale change. Change lead-
ership is a common methodology of theory and tools that,
when used routinely, are central to integrating a change man-
agement model with the people side of change.
Project management is an application of knowledge, skills,
tools, and techniques customized to the initiative.The project
management elements discussed in the first article that are
most critical to successfully implementing planned change are
project charter, project budget and budget management, proj-
ect plan and schedule management, project staff organization,
project communications management, and project risk and
issue management.
CURRENT STATE ANALYSIS
Changing a process as complex as BCMA can and will
impact a variety of stakeholders. It is important to review
the process of medication administration from the time the
medication enters the facility through the time that the med-
ication is billed to the patient. Employ.
Prepare Communication PlanRegular communication with all st.docx
Prepare
Communication Plan
Regular communication with all stakeholder groups, whether expected to be primary users such as nursing staff and physicians or ancillary users such as laboratory technicians, pharmacists, other clinicians, administrators, billing staff, and housekeepers, helps reduce the uncertainty inherent in adopting health information technology (HIT) and engages all stakeholders at the appropriate level of participation in planning, implementing, and identifying opportunities for improvement.
The ADKAR model of communication (depicted below) recognizes a continuum of key messages for projects that introduce a great amount of change—such as adopting HIT.
It illustrates the relationship between communicating and project phases. As soon as the need for HIT arises, Awareness building needs to begin. As the HIT vision unfolds, creation of Desire helps turn uncertainty into interest. Throughout the planning process, stakeholders need to become more Knowledgeable about HIT in order to make decisions appropriate to their role in the project. During implementation, stakeholders need to understand their Abilities, build capability, and celebrate using HIT. Communication does not end with implementation, however, as continued success during ongoing operations requires Reinforcement. The ultimate goal is to celebrate successful implementation and optimal utilization.
Instructions for Use
Build your communication plan using this template. Use task management software (e.g., Microsoft Outlook, Microsoft Project) for ease of tracking and keeping the plan up-to-date. Ideas are included on what to communicate to whom, how, and when. Some communications are two-way, such as meetings, phone calls, and discussions; but many are one-way, including memos, bulletin boards, and newsletters. One-way communication lacks an immediate feedback mechanism, so plan ways to obtain feedback. Be sure to communicate using plain language not “techie-speak.”
Key Message
To Whom
From Whom
Medium
When
Date
1.
The organization is interested in post acute transitions of care and we want you to participate on a steering committee.
Key stakeholders
Administrator
Director of nursing (DON)
Medical director
Individual contacts
When organization leadership recognizes need for HIT to support post acute care transitions
2.
The organization is interested in HIT as it relates to transitions of care, and we want board support.
Board of directors
Administrator
Meeting
When steering committee has formed
3.
The organization is interested HIT to support post acute transitions of care and we want to let all staff know of this interest and become excited about learning and adopting best practices around care transitions and medication management.
All staff
Administrator
Various: all staff meeting, newsletters, supervisor communications, other means within your organization
When steering committee has formed
Repeat regularly as needed
4.
Safe post acute care tr.
A crucial factor for successful implementation of e health projects in develo...
The International Institute for Science, Technology and Education (IISTE). Science, Technology and Medicine Journals Call for Academic Manuscripts
IRJET- A System for Complete Healthcare Management: Ask-Us-Health A Secon...
https://www.irjet.net/archives/V5/i3/IRJET-V5I3777.pdf
Recommended
Integrated Health was a large private nonprofit health care.pdf
Integrated Health was a large private, nonprofit health care system located in Tempe,Arizona. A
year ago, the decision was made to implement a computerized medication administration record
(MAR) at Integrated Health. During the first year, the MAR system would be implemented at
Central Hospital of Tempe. After the bugs were worked out, the computerized MAR would be
implemented system-wide. The MIS department at Central Hospital was designated as the initiator
and direction setter for the project. Art Smith, the Chief Information Officer at Central Hospital
assigned Kate Cohen, a programmer/analyst, as project leader. Kate had the responsibility for
developing and implementing the MAR project at Central. Kate did the programming work for the
MAR and assembled a team from Pharmacy Services, Nursing Services, and Internal Auditing.
Members of the project team provided feedback on the software, made suggestions related to
user training, and worked on an implementation schedule. Both team members and outside
observers recognized the difficulty in developing and implementing the MAR in one year. Nurses
antagonism toward the project surfaced after their suggestions and recommendations were
rejected without explanation. The MAR project was also affected when a management shakeup
occurred during the project development phase. The MAR was implemented and immediately
failed. By 10:00 a.m. on the first day of the implementation, users complained that the system did
not work and was too complicated. After hearing nurses complaints, physicians expressed
concern about patient safety. At 1:30 p.m., Central Hospitals computer system crashed, and the
MAR project was suspended. Early the next morning, we find Kate contemplating what she is
going to say when she meets with Central Hospitals management group later in the afternoon.
Introduction
Background and context are clear and well-developed. The purpose/aim and organization of the
submission are clearly articulated. The submission is linked to the objectives..
Marita Schifalacqua, RN, MSN, NEA-BC, FAAN,Chris Costello, M.docx
Marita Schifalacqua, RN, MSN, NEA-BC, FAAN,
Chris Costello, MEng, MBA, and Wendy Denman, RNC, BBM, BSN, MSN
Roadmap for Planned Change, Part 2
Bar-Coded Medication Administration
hange—savored by some and feared by many.
How do you as nurse leaders use your
knowledge and insight to move forward and transfer
your vision for quality and safety into reality? What do
you need to do to get key stakeholders on the bus and,
in some cases, even drive the bus? The roadmap for
planned change allows for an infrastructure of thought
brought to increase the likelihood for successful
change. Successful change is important to our patients
and to us as providers of that care.
This article, the second of a two-part series,
focuses on the application of change theory and the
elements of project management most critical to
successfully implementing a bar-coded medication
administration (BCMA) program. Examples will be
from one hospital’s experience, Saint Francis Medical
Center in Grand Island, Nebraska, to a health
system’s (Catholic Health Initiatives, Denver, Colorado)
approach to planning for 30 hospitals.
The definition of the BCMA program includes a
consistent, integrated information technology strategy,
with a focus on point-of-care BCMA to ensure that the
right person receives the right medication, in the right
dosage, via the right route, at the right time (five
rights). The bar code on medication is scanned before
administration to patients.
C
April 200932 Nurse Leader
Nurse Leader 33www.nurseleader.com
APPLICATION OF CHANGE THEORY AND
PROJECT MANAGEMENT
The first article discusses concepts and tools of both change
leadership and project management that lend support in plan-
ning and managing large- or small-scale change. Change lead-
ership is a common methodology of theory and tools that,
when used routinely, are central to integrating a change man-
agement model with the people side of change.
Project management is an application of knowledge, skills,
tools, and techniques customized to the initiative.The project
management elements discussed in the first article that are
most critical to successfully implementing planned change are
project charter, project budget and budget management, proj-
ect plan and schedule management, project staff organization,
project communications management, and project risk and
issue management.
CURRENT STATE ANALYSIS
Changing a process as complex as BCMA can and will
impact a variety of stakeholders. It is important to review
the process of medication administration from the time the
medication enters the facility through the time that the med-
ication is billed to the patient. Employees working in depart-
ments that will experience change with BCMA need to
know that their role is important and that their viewpoint
is valued.
Leadership
The chief nursing officer and vice president of ancillary services
were the executive cosponsors of the project.There was a
BCMA stee ...
Case Study—Memorial Health System CPOE ImplementationHCS483 V.docx
Case Study—Memorial Health System CPOE Implementation
HCS/483 Version 3
1
University of Phoenix Material
Case Study—Memorial Health System CPOE Implementation
Memorial Health System is an eight-hospital integrated health care system in the Midwestern United States. The health system has two downtown flagship tertiary care hospitals, each licensed for more than 700 beds, located in the two major metropolitan areas served by the system. The remaining six hospitals are community-based facilities, ranging in size from 200 to 400 beds. These hospitals are located in the suburban and rural areas served by Memorial Health System.
Four years ago, the system’s board of directors approved a multi-million-dollar initiative to install an enterprise-wide clinician provider order entry (CPOE) system intended to dramatically reduce medical errors. Today, the system is far from fully implemented, and, in fact, has been removed from all but one of the two tertiary care facilities, where it remains in pilot adopter status.
At the time, the board approved the CPOE initiative, the project was championed by Fred Dryer, the CEO, and was closely supported by Joe Roberts, the chief information officer (CIO) of the health system. Even during its proposal and evaluation by the board, the project was considered controversial by some of the health system’s stakeholders. For example, many of its physicians, who are community-based independent providers, were adamantly opposed to the CPOE system. They worried that their workload would increase because CPOE systems replace verbal orders with computer-entered orders by doctors. Dr. Mark Allen, a primary care physician commented, “The hospital is trying to turn me into a 12-dollar-an-hour secretary, and they aren’t even paying me 12 dollars an hour.”
In securing board approval, Dryer and Roberts presented an aggressive implementation plan that called for the requirements analysis, Request for Proposal (RFP), vendor selection, and project implementation to be completed in less than 18 months in all eight hospitals. During the discussion with the board, several of the members questioned the timeline. One noted, “It took you 2 years to set up e-mail, and everyone wanted e-mail. This will affect every clinician in every hospital. Do you really think you can do this in 18 months?”
In an effort to demonstrate results, Dryer and Roberts demanded results from the clinical and IT team formed for the project. By this time, a rushed requirements analysis had been completed, an RFP issued, a vendor selected, and a contract signed. The acquisition process took a little more than 6 months, leaving a year for the implementation.
In protest, a number of prominent physicians took their referral business to the other health system in the area that seized upon the controversy by promising that they would not use a CPOE. Shortly thereafter, the two leading champions for CPOE—Dryer and Roberts—left Memorial. The chief medical officer, Barbar ...
You will write two pages (not including your title page) expressin.docx
You will write two pages (not including your title page) expressing your current worldview in regard to the subject of Administration of Justice Organizations. This paper’s content will include how the presentation in the Module/Week 1 Reading & Study folder influences your worldview.
Marita Schifalacqua, RN, MSN, NEA-BC, FAAN,
Chris Costello, MEng, MBA, and Wendy Denman, RNC, BBM, BSN, MSN
Roadmap for Planned Change, Part 2
Bar-Coded Medication Administration
hange—savored by some and feared by many.
How do you as nurse leaders use your
knowledge and insight to move forward and transfer
your vision for quality and safety into reality? What do
you need to do to get key stakeholders on the bus and,
in some cases, even drive the bus? The roadmap for
planned change allows for an infrastructure of thought
brought to increase the likelihood for successful
change. Successful change is important to our patients
and to us as providers of that care.
This article, the second of a two-part series,
focuses on the application of change theory and the
elements of project management most critical to
successfully implementing a bar-coded medication
administration (BCMA) program. Examples will be
from one hospital’s experience, Saint Francis Medical
Center in Grand Island, Nebraska, to a health
system’s (Catholic Health Initiatives, Denver, Colorado)
approach to planning for 30 hospitals.
The definition of the BCMA program includes a
consistent, integrated information technology strategy,
with a focus on point-of-care BCMA to ensure that the
right person receives the right medication, in the right
dosage, via the right route, at the right time (five
rights). The bar code on medication is scanned before
administration to patients.
C
April 200932 Nurse Leader
Nurse Leader 33www.nurseleader.com
APPLICATION OF CHANGE THEORY AND
PROJECT MANAGEMENT
The first article discusses concepts and tools of both change
leadership and project management that lend support in plan-
ning and managing large- or small-scale change. Change lead-
ership is a common methodology of theory and tools that,
when used routinely, are central to integrating a change man-
agement model with the people side of change.
Project management is an application of knowledge, skills,
tools, and techniques customized to the initiative.The project
management elements discussed in the first article that are
most critical to successfully implementing planned change are
project charter, project budget and budget management, proj-
ect plan and schedule management, project staff organization,
project communications management, and project risk and
issue management.
CURRENT STATE ANALYSIS
Changing a process as complex as BCMA can and will
impact a variety of stakeholders. It is important to review
the process of medication administration from the time the
medication enters the facility through the time that the med-
ication is billed to the patient. Employ.
Prepare Communication PlanRegular communication with all st.docx
Prepare
Communication Plan
Regular communication with all stakeholder groups, whether expected to be primary users such as nursing staff and physicians or ancillary users such as laboratory technicians, pharmacists, other clinicians, administrators, billing staff, and housekeepers, helps reduce the uncertainty inherent in adopting health information technology (HIT) and engages all stakeholders at the appropriate level of participation in planning, implementing, and identifying opportunities for improvement.
The ADKAR model of communication (depicted below) recognizes a continuum of key messages for projects that introduce a great amount of change—such as adopting HIT.
It illustrates the relationship between communicating and project phases. As soon as the need for HIT arises, Awareness building needs to begin. As the HIT vision unfolds, creation of Desire helps turn uncertainty into interest. Throughout the planning process, stakeholders need to become more Knowledgeable about HIT in order to make decisions appropriate to their role in the project. During implementation, stakeholders need to understand their Abilities, build capability, and celebrate using HIT. Communication does not end with implementation, however, as continued success during ongoing operations requires Reinforcement. The ultimate goal is to celebrate successful implementation and optimal utilization.
Instructions for Use
Build your communication plan using this template. Use task management software (e.g., Microsoft Outlook, Microsoft Project) for ease of tracking and keeping the plan up-to-date. Ideas are included on what to communicate to whom, how, and when. Some communications are two-way, such as meetings, phone calls, and discussions; but many are one-way, including memos, bulletin boards, and newsletters. One-way communication lacks an immediate feedback mechanism, so plan ways to obtain feedback. Be sure to communicate using plain language not “techie-speak.”
Key Message
To Whom
From Whom
Medium
When
Date
1.
The organization is interested in post acute transitions of care and we want you to participate on a steering committee.
Key stakeholders
Administrator
Director of nursing (DON)
Medical director
Individual contacts
When organization leadership recognizes need for HIT to support post acute care transitions
2.
The organization is interested in HIT as it relates to transitions of care, and we want board support.
Board of directors
Administrator
Meeting
When steering committee has formed
3.
The organization is interested HIT to support post acute transitions of care and we want to let all staff know of this interest and become excited about learning and adopting best practices around care transitions and medication management.
All staff
Administrator
Various: all staff meeting, newsletters, supervisor communications, other means within your organization
When steering committee has formed
Repeat regularly as needed
4.
Safe post acute care tr.
A crucial factor for successful implementation of e health projects in develo...
The International Institute for Science, Technology and Education (IISTE). Science, Technology and Medicine Journals Call for Academic Manuscripts
IRJET- A System for Complete Healthcare Management: Ask-Us-Health A Secon...
https://www.irjet.net/archives/V5/i3/IRJET-V5I3777.pdf
1. Assignment #2 Technology Project pertinent to their pract
1.
Assignment #2
Technology Project pertinent to their practice environment
THIS WEEK DUE PART II AND THOSE TO SUBMIT THE ENTIRE PROJECT (PAPER) . PART I ALREADY WITH CORRECTIONS SUGGESTED, IF ANY, AND PART II
Grading Criteria for Assignments #1 & 2
Technology Project Paper Part 1 (20 points of grade)
Technology Project Paper Part 2 (20 points of grade)
Student to identify a Technology Project pertinent to their practice environment. This proposal must include:
Executive Summary; Description of Project; Rationale Topic chosen; Research-supported by evidenced based recent literature; Project Clinical Goals & Objectives; Market/Financial Project Analysis;
Plan for Evaluation; Plan for Alternative Assumptions & Strategies.
Include how this project is applicable to the present Healthcare system in terms of the issues of healthcare access, quality & cost. Include 2 MSN Essentials.
Minimum 10 pages, double spaced,
Maximum 15 pages, double spaced, APA format.
Part 1:
• Identify Topic of Project Proposal (2 points)
• Description of project & Background Discussion (5 points)
• Goals & Objectives & Significance discussion (5 points)
• Include evidenced based research to support paper, at least three (5 points)
• Overall: Focused, Ideas with clarity, Overall compliance with grammar & APA 6th format (3 points). Include cover page and reference used on part I
Part 2:
*10 pages, double spaced, APA format style including cover and reference pages
• Financial Proposal analysis (4 points)
• Alternative plan of actions (4 points)
• Proposed project plan to include: (8 points)
o Project activities
o Timeline
o Budget
o Evaluation Plan
• Executive Summary at end of project (4 points)
Top of Form
2
2
Technology Project Paper Part 1
Electronic Health Records
Florida National University
Jose Cardentey
Health Care Informatics
Professor Jacquelin Alonso
January 28,2022
Electronic Health Records Proposal
Executive Summary
The healthcare sector has making bold strides in reducing the number of medical errors which have been claiming the lives of many patients by adoption of numerous technology to determine the technology that will be most effective. among these technologies is Electronic Health Records whose goal is to improve the documentation of patient information to guide practitioners when prescribing medication and keeping track of the patient outcomes. The deployment of this technology in the health facility calls for collaboration with different shareholders in different disciplines in the health sector. For successful implementation, the proposal provides a list of activities that need to executed. They include development of the lead committee who will oversee the accomplishment of the project goals, strategies to manage the EHR system and the strategies to manage changes that will face the system due to the rapidly changing business environment. The goal of this report is to analyze the background of the technology and briefly descr ...
Health Information Technology Workforce Development Program Presentation
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February 10, 2011 BDPA Charlotte Program meeting.
Presented by:
Karen D. Hill, RHIA
Recruitment/Placement Specialist
ONC HIT Grant
Health Sciences Division
Central Piedmont Community College
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This slides wer presented at the Medicine 2.0 conference at Stanford University on 09.17.11 and include data that was collected as part of a research collaboration b/w Bob Miller (Hopkins), Bryan Vartabedian (Baylor), Molly Wasko (UAB), and the team at CE Outcomes. This research was funded in part by the Medical Education Group at Pfizer, Inc.DII - Mapping Organizational Readiness Assessments to an Implementation Frame...
November 1, 2017
Isomi Miake-Lye, PhD
VA Greater Los Angeles Healthcare System
“Unpacking Organizational Readiness for Change: Mapping Organizational Readiness Assessments to an Implementation Framework”
A presentation of the Southern California Regional Dissemination, Implementation and Improvement Science Webinar Series
Provided by the UCLA CTSI
1 Making IT Happen Strategies for Implementing the EMR.docx
1
Making IT Happen: Strategies
for Implementing the EMR
EHR
In 1994, the Computerbased Patient Record Institute
founded the Davies Awards of Excellence and managed
the program until merging with the Healthcare
Information and Management Systems Society (HIMSS)
in 2002. The award has annually highlighted healthcare
providers who successfully led efforts to transform their
organizations through technology, with the award largely
focusing on the implementation of healthcare information
technology (IT) in larger institutions, ranging from rural
health systems to big city hospitals. [
The awards are named in honor of Dr. Nicholas E.
Davies, an Atlantabased practice physician committed to
the ideal of improving patient care through better health information management. As a member
of the Institute of Medicine’s Patient Record Study Committee, Dr. Davies helped coin the term
"computerbased patient record," now more widely known as electronic medical records and
electronic health records (EMREHR). A tireless advocate for IT solutions, Dr. Davies was
chairpersonelect of the American College of Physicians when he was tragically killed in a plane
crash with Senator John G. Tower of Texas in April, 1991. His spirit lives on in the Davies
Award of Excellence.
In 2003, HIMSS extended the awards to include ambulatory practices with EMREHRs and in
2004 added yet another category for public health. Sponsored by HIMSS, the Nicholas E. Davies
Award Program encourages and recognizes excellence in the implementation of EMREHR
systems through showcasing concrete examples, understanding and sharing the value of EMR
EHR systems, offering visibility and recognition for their projects and sharing successful
implementation strategies.
The papers are evaluated in terms of EMREHR implementation, strategy, planning, project
management, and governance. The clinicians who submit entries discuss the functionality of their
EMREHRs and how those systems met the needs of staff and patients. Additionally, they speak
to how the technology design works to bring about the desired functionality and the institutions’
return on investment.
The purpose of this white paper, and the three others in this collection, is to give healthcare
providers a survey of best practices in EMREHR implementation, solid examples of leadership,
and a glimpse at the return on their investment (ROI) the EMREHR offers. This paper, focused
on implementation, surveys the varying approaches that different organizations take in
implementing EHR technology, whether they choose the "slowroll" or the "big bang" approach
to instituting healthcare IT.
Most of the information in these papers comes from Davies “organizational” winners between the
2
years 2001 and 2005—the postY2K era—when EMREHR vendors began aggressively adding
more modernized features to their clinical systems, and EMREHR implementation became more
sophisticated. Large hospital .
He a lth In fo rm a tio n Te c h n o lo g y Eva lu a tio
He a lth In fo rm a tio n Te c h n o lo g y
Eva lu a tio n To o lkit
2009 Up d a te
Prepared for:
Agency for Healthcare Research and Quality
U.S. Department of Health and Human Services
540 Gaither Road
Rockville, MD 20850
www.ahrq.gov
Contract No. 290-04-0016
Prepared by:
Caitlin M. Cusack, M.D., M.P.H., NORC of the University of Chicago
Colene M. Byrne, Ph.D., Center for IT Leadership, Partners HealthCare System
Julie M. Hook, M.A., M.P.H., John Snow, Inc.
Julie McGowan, Ph.D., F.A.C.M.I., Indiana University School of Medicine
Eric Poon, M.D., M.P.H., Division of General Medicine and Primary Care,
Brigham and Women's Hospital
Atif Zafar, M.D., Regenstrief Institute Inc.
AHRQ Publication No. 09-0083-EF
June 2009
http://www.ahrq.gov/�
Health Information Technology Evaluation Toolkit: 2009 Update i
This document is in the public domain and may be used and reprinted without permission except
those copyrighted materials that are clearly noted in the document. Further reproduction of those
copyrighted materials is prohibited without the specific permission of copyright holders.
Suggested Citation:
Cusack CM, Byrne C, Hook JM, McGowan J, Poon EG, Zafar A. Health Information
Technology Evaluation Toolkit: 2009 Update (Prepared for the AHRQ National Resource Center
for Health Information Technology under Contract No. 290-04-0016.) AHRQ Publication No.
09-0083-EF. Rockville, MD: Agency for Healthcare Research and Quality. June 2009.
Acknowledgments
The authors would like to thank numerous members of the AHRQ National Resource Center’s
Value and Evaluation Team for their invaluable input and feedback: Davis Bu, M.D., M.A.
(Center for IT Leadership); Karen Cheung, M.P.H. (National Opinion Resource Center); Dan
Gaylin, M.P.A. (National Opinion Resource Center); Julie McGowan, Ph.D. (Indiana University
School of Medicine); Adil Moiduddin, M.P.P. (National Opinion Resource Center); Anita
Samarth (eHealth Initiative); Jan Walker, R.N., M.B.A. (Center for IT Leadership); and Atif
Zafar, M.D. (Indiana University School of Medicine). Thank you also to Mary Darby, Burness
Communications, for editorial review.
The authors of this report are responsible for its content. Statements in the report should not be
construed as endorsement by the Agency for Healthcare Research and Quality or the U.S.
Department of Health and Human Services.
Health Information Technology Evaluation Toolkit: 2009 Update ii
Contents
Introduction ................................................................................................................... 1
Section I: Developing an Evaluation Plan ............................................................... 3
I. Develop Brief Project Description ...............................................................3
II. Determine Project Goals .................................................................. ...
I worked furiously but need your help with this cover letter.
You are required to submit a one page covering letter, composed of a short statement (max 300 words per question) in response to the two targeted questions.
1 QUALITY IMPROVEMENT STUDENT PROJECT PROPOSAL IMPR.docx
1
QUALITY IMPROVEMENT STUDENT PROJECT PROPOSAL:
IMPROVING HANDOFFS IN SAN FRANCISCO GENERAL
HOSPTITAL’S EMERGENCY DEPARTMENT
TMIT Student Projects QuickStart Package ™
1. BACKGROUND
Setting: Emergency departments are “high-risk” contexts; they are over-crowded and
overburdened, which can lead to treatment delays, patients leaving without being seen by a
clinician, and inadequate patient hand-offs during changing shifts and transfers to different
hospital services (Apker et al., 2007). This project will focus on the Emergency Departments in
county hospitals, specifically San Francisco General Hospital. SFGH has the only Trauma Center
(Level 1) available for the over 1.5 million people living and working in San Francisco County
(SFGH website)
Health Care Service: This paper will focus on intershift transfers, the process of transferring a
patient between two providers at the end of a shift, which can pose a major challenge in a busy
emergency department setting.
Problem: According to the Joint Commission on Accreditation of Healthcare Organizations
(JCAHO), poor communication between providers is the root cause of most sentinel events,
medical mistakes, and ‘‘near misses.” Furthermore, a recent survey of 264 emergency
department physicians noted that 30% of respondents reported an adverse event or near miss
related to ED handoffs (Horwitz, 2008). A similar survey notes that 73.5% of hand-offs occur in
a common area within the ED, 89.5% of respondents stated that there was no uniform written
policy regarding patient sign-out, and 50.3% of those surveyed reported that physicians sign out
2
patient details verbally only (Sinha et al., 2007). At SFGH, handoffs occur in the middle of the
ED hallway, usually next to a patient’s gurney. Sign-out is dependent on the Attending and
Residents on a particular shift; thus, it is non-uniform, and hand-offs are strictly verbal.
Barriers to Quality: In a 2005 article in Academic Medicine, four major barriers to effective
handoffs were identified: (1) the physical setting, (2) the social setting, and (3) communication
barriers. Most of these barriers are present during intershift transfers at SFGH. The physical
setting is usually in a hallway, next to a whiteboard, never in private. Presentations are frequently
interrupted, and background noise is intense from the chaos of an overcrowded emergency room.
Attendings frequently communicate with each other and assume that the resident can hear them.
Solet et al. suggests that Residents are unlikely to ask questions during a handoff if the
information is coming from an Attending physician. All transfers are verbal, none are
standardized, and time pressures are well known, since sign-out involves all working physicians
in the ED at one time.
2. THE INTERVENTION
The Institute for Health Care Improvement (IHI) lays out several steps for conducting a quality
improvement ...
Univ. of IL Physicians Q Study
Physicians\' Opinions on Information Technology: Using Preference Profiles for Market Segmentation
Enterprise System Implementation at Alexandra Hospital .
The Alexandria Hospital is a small public hospital found in the Midwestern part of Singapore. The hospital that was established as a British Military Hospital in 1938 and after serving for thirty-three years was handed to the Singapore government by the British administration and renamed to Alexandria Hospital.
The hospital has undertaken many initiatives to upgrade its major facilities to serve the patients better. It began rethink how to enhance patient services via the exploitation of technology.
The decision was to implement the Clinical Digital Dashboard (CDD) and the Clinical Connection Suite (CCS).
Although they were pressured from the Health Minister challenge to form a health care center that provides continuous focus on patients, But the main objectives of implementing these system were to include all patient's issues in one database to improve the hospital operation and delivering a seamless, safe, and patient centric health care...
Is it possible to register Dinosaurs as a mark for a fast food res.pdf
Is it possible to register "Dinosaurs" as a mark for a fast food restaurant? Which of the following
statements is correct? The mark "Dinosaurs":
Select one:
cannot be registered as a fast food restaurant because it is deceptive [a]
can only be used for the category of services provided at a zoo [c]
can be registered as a fast food restaurant because it relates to an animal name [b]
can be registered for a fast food restaurant as it is not descriptive for this category of business [d]
cannot be registered for a fast food restaurant as it is a generic term [e].
Internal sex organs The internal (S.....x organs), describe them..pdf
Internal sex organs: The internal (S.....x organs), describe them.
Testis, what is the topography?
What is the external and Internal structure of the lobules.
What is the external and internal structure of the Tubuli Recti?
What is the external and internal structure of the Contortii?
What is the external and internal structure of the Rete Testicularis?
What is the external and internal structure of the deferent ducts.
What are the internal Functions of Testi (add an s to the i) Describe, in a sentence or two, in a
sentence or two please be specific.
What is the Endocrine Part of testis. Describe, in a sentence or two please be specific.
Epididymis: Please, describe the structure of the Epididymis?
Epididymis: The specific topography of Epididymis?
Epididymis: The specific function of Epididymis?
Ejaculator (add a y) to the previous word) ducts: Their specific structure
The topography of Ejaculatory ducts.
The functions of the Ejaculator (add a y to previous word ) ducts.
The Ways of ejaculation in order.
The Bulbo-uretral gland: name its structure
The Bulbo-uretral: what is the Bulbo-uretral?
The topography of the Bulbo-uretral?
The functions of the Bulbo-uretral?
The External sx(add an e) organs Specifically the P. add(enis) to the P
Name, the coats and structure of the Scrot add a (um)
The Topography of the Scrot ( add a um)?
Male urethra: Describe the Male Urethra
Topography: What is the topography of the Urethra
What is the structure of Urethra?
What are the parts of Urethra?
What are the Constrictions of Urethra?
What are the expansions of the Urethra?
What are the expansions of the Urethra?
What are the specific openings of Urethra?
What are the functions of the Urethra?
What are the functions of the Urethra?
What are the, internal organs of Urethra?
What are the internal organs of the se (add an x) organs.
Ovary: External structure, what is the External structure of the Ovary?
Ovary: Topography, what is the Topography of the Ovary?
Ovary: Internal structure, what is the internal structure of the ovary and function.
The Ovary as the organ of internal secretion.
Tubae Uterinae: Topography; External/Internal
Structure of the uterine tube; function.
Uterus: Topography, Physiological Position of the uterus, Ligaments of the Uterus and
Mesenteric Of the Uterus.
External and internal structure of the uterus.
Cervix of uterus.
Vagin( add an a, to end of previous word): its external and internal structure
Topography of
External s.....x organs: vagin add an(a) to the previous word the vestibule, hymen and the labium
minus and labium majus,
Also, the clitor.
External and internal structure of the uterus.
Cervix of uterus.
Vag (girls part), its external and internal structure, topography.
External sex organs: vagin (add an a) vestibule, hymen, labium minus and labium majus, clitor. -
Perineum in general.
Particular importance the Structure of perineum.
Its triangles of perineum and their borders.
Structure of urogenital diaphragm and pelvic diaph.
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1. Assignment #2 Technology Project pertinent to their pract
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THIS WEEK DUE PART II AND THOSE TO SUBMIT THE ENTIRE PROJECT (PAPER) . PART I ALREADY WITH CORRECTIONS SUGGESTED, IF ANY, AND PART II
Grading Criteria for Assignments #1 & 2
Technology Project Paper Part 1 (20 points of grade)
Technology Project Paper Part 2 (20 points of grade)
Student to identify a Technology Project pertinent to their practice environment. This proposal must include:
Executive Summary; Description of Project; Rationale Topic chosen; Research-supported by evidenced based recent literature; Project Clinical Goals & Objectives; Market/Financial Project Analysis;
Plan for Evaluation; Plan for Alternative Assumptions & Strategies.
Include how this project is applicable to the present Healthcare system in terms of the issues of healthcare access, quality & cost. Include 2 MSN Essentials.
Minimum 10 pages, double spaced,
Maximum 15 pages, double spaced, APA format.
Part 1:
• Identify Topic of Project Proposal (2 points)
• Description of project & Background Discussion (5 points)
• Goals & Objectives & Significance discussion (5 points)
• Include evidenced based research to support paper, at least three (5 points)
• Overall: Focused, Ideas with clarity, Overall compliance with grammar & APA 6th format (3 points). Include cover page and reference used on part I
Part 2:
*10 pages, double spaced, APA format style including cover and reference pages
• Financial Proposal analysis (4 points)
• Alternative plan of actions (4 points)
• Proposed project plan to include: (8 points)
o Project activities
o Timeline
o Budget
o Evaluation Plan
• Executive Summary at end of project (4 points)
Top of Form
2
2
Technology Project Paper Part 1
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The healthcare sector has making bold strides in reducing the number of medical errors which have been claiming the lives of many patients by adoption of numerous technology to determine the technology that will be most effective. among these technologies is Electronic Health Records whose goal is to improve the documentation of patient information to guide practitioners when prescribing medication and keeping track of the patient outcomes. The deployment of this technology in the health facility calls for collaboration with different shareholders in different disciplines in the health sector. For successful implementation, the proposal provides a list of activities that need to executed. They include development of the lead committee who will oversee the accomplishment of the project goals, strategies to manage the EHR system and the strategies to manage changes that will face the system due to the rapidly changing business environment. The goal of this report is to analyze the background of the technology and briefly descr ...
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EHR
In 1994, the Computerbased Patient Record Institute
founded the Davies Awards of Excellence and managed
the program until merging with the Healthcare
Information and Management Systems Society (HIMSS)
in 2002. The award has annually highlighted healthcare
providers who successfully led efforts to transform their
organizations through technology, with the award largely
focusing on the implementation of healthcare information
technology (IT) in larger institutions, ranging from rural
health systems to big city hospitals. [
The awards are named in honor of Dr. Nicholas E.
Davies, an Atlantabased practice physician committed to
the ideal of improving patient care through better health information management. As a member
of the Institute of Medicine’s Patient Record Study Committee, Dr. Davies helped coin the term
"computerbased patient record," now more widely known as electronic medical records and
electronic health records (EMREHR). A tireless advocate for IT solutions, Dr. Davies was
chairpersonelect of the American College of Physicians when he was tragically killed in a plane
crash with Senator John G. Tower of Texas in April, 1991. His spirit lives on in the Davies
Award of Excellence.
In 2003, HIMSS extended the awards to include ambulatory practices with EMREHRs and in
2004 added yet another category for public health. Sponsored by HIMSS, the Nicholas E. Davies
Award Program encourages and recognizes excellence in the implementation of EMREHR
systems through showcasing concrete examples, understanding and sharing the value of EMR
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implementation strategies.
The papers are evaluated in terms of EMREHR implementation, strategy, planning, project
management, and governance. The clinicians who submit entries discuss the functionality of their
EMREHRs and how those systems met the needs of staff and patients. Additionally, they speak
to how the technology design works to bring about the desired functionality and the institutions’
return on investment.
The purpose of this white paper, and the three others in this collection, is to give healthcare
providers a survey of best practices in EMREHR implementation, solid examples of leadership,
and a glimpse at the return on their investment (ROI) the EMREHR offers. This paper, focused
on implementation, surveys the varying approaches that different organizations take in
implementing EHR technology, whether they choose the "slowroll" or the "big bang" approach
to instituting healthcare IT.
Most of the information in these papers comes from Davies “organizational” winners between the
2
years 2001 and 2005—the postY2K era—when EMREHR vendors began aggressively adding
more modernized features to their clinical systems, and EMREHR implementation became more
sophisticated. Large hospital .
He a lth In fo rm a tio n Te c h n o lo g y Eva lu a tio
He a lth In fo rm a tio n Te c h n o lo g y
Eva lu a tio n To o lkit
2009 Up d a te
Prepared for:
Agency for Healthcare Research and Quality
U.S. Department of Health and Human Services
540 Gaither Road
Rockville, MD 20850
www.ahrq.gov
Contract No. 290-04-0016
Prepared by:
Caitlin M. Cusack, M.D., M.P.H., NORC of the University of Chicago
Colene M. Byrne, Ph.D., Center for IT Leadership, Partners HealthCare System
Julie M. Hook, M.A., M.P.H., John Snow, Inc.
Julie McGowan, Ph.D., F.A.C.M.I., Indiana University School of Medicine
Eric Poon, M.D., M.P.H., Division of General Medicine and Primary Care,
Brigham and Women's Hospital
Atif Zafar, M.D., Regenstrief Institute Inc.
AHRQ Publication No. 09-0083-EF
June 2009
http://www.ahrq.gov/�
Health Information Technology Evaluation Toolkit: 2009 Update i
This document is in the public domain and may be used and reprinted without permission except
those copyrighted materials that are clearly noted in the document. Further reproduction of those
copyrighted materials is prohibited without the specific permission of copyright holders.
Suggested Citation:
Cusack CM, Byrne C, Hook JM, McGowan J, Poon EG, Zafar A. Health Information
Technology Evaluation Toolkit: 2009 Update (Prepared for the AHRQ National Resource Center
for Health Information Technology under Contract No. 290-04-0016.) AHRQ Publication No.
09-0083-EF. Rockville, MD: Agency for Healthcare Research and Quality. June 2009.
Acknowledgments
The authors would like to thank numerous members of the AHRQ National Resource Center’s
Value and Evaluation Team for their invaluable input and feedback: Davis Bu, M.D., M.A.
(Center for IT Leadership); Karen Cheung, M.P.H. (National Opinion Resource Center); Dan
Gaylin, M.P.A. (National Opinion Resource Center); Julie McGowan, Ph.D. (Indiana University
School of Medicine); Adil Moiduddin, M.P.P. (National Opinion Resource Center); Anita
Samarth (eHealth Initiative); Jan Walker, R.N., M.B.A. (Center for IT Leadership); and Atif
Zafar, M.D. (Indiana University School of Medicine). Thank you also to Mary Darby, Burness
Communications, for editorial review.
The authors of this report are responsible for its content. Statements in the report should not be
construed as endorsement by the Agency for Healthcare Research and Quality or the U.S.
Department of Health and Human Services.
Health Information Technology Evaluation Toolkit: 2009 Update ii
Contents
Introduction ................................................................................................................... 1
Section I: Developing an Evaluation Plan ............................................................... 3
I. Develop Brief Project Description ...............................................................3
II. Determine Project Goals .................................................................. ...
I worked furiously but need your help with this cover letter.
You are required to submit a one page covering letter, composed of a short statement (max 300 words per question) in response to the two targeted questions.
1 QUALITY IMPROVEMENT STUDENT PROJECT PROPOSAL IMPR.docx
1
QUALITY IMPROVEMENT STUDENT PROJECT PROPOSAL:
IMPROVING HANDOFFS IN SAN FRANCISCO GENERAL
HOSPTITAL’S EMERGENCY DEPARTMENT
TMIT Student Projects QuickStart Package ™
1. BACKGROUND
Setting: Emergency departments are “high-risk” contexts; they are over-crowded and
overburdened, which can lead to treatment delays, patients leaving without being seen by a
clinician, and inadequate patient hand-offs during changing shifts and transfers to different
hospital services (Apker et al., 2007). This project will focus on the Emergency Departments in
county hospitals, specifically San Francisco General Hospital. SFGH has the only Trauma Center
(Level 1) available for the over 1.5 million people living and working in San Francisco County
(SFGH website)
Health Care Service: This paper will focus on intershift transfers, the process of transferring a
patient between two providers at the end of a shift, which can pose a major challenge in a busy
emergency department setting.
Problem: According to the Joint Commission on Accreditation of Healthcare Organizations
(JCAHO), poor communication between providers is the root cause of most sentinel events,
medical mistakes, and ‘‘near misses.” Furthermore, a recent survey of 264 emergency
department physicians noted that 30% of respondents reported an adverse event or near miss
related to ED handoffs (Horwitz, 2008). A similar survey notes that 73.5% of hand-offs occur in
a common area within the ED, 89.5% of respondents stated that there was no uniform written
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2
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Barriers to Quality: In a 2005 article in Academic Medicine, four major barriers to effective
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barriers. Most of these barriers are present during intershift transfers at SFGH. The physical
setting is usually in a hallway, next to a whiteboard, never in private. Presentations are frequently
interrupted, and background noise is intense from the chaos of an overcrowded emergency room.
Attendings frequently communicate with each other and assume that the resident can hear them.
Solet et al. suggests that Residents are unlikely to ask questions during a handoff if the
information is coming from an Attending physician. All transfers are verbal, none are
standardized, and time pressures are well known, since sign-out involves all working physicians
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Ovary: Topography, what is the Topography of the Ovary?
Ovary: Internal structure, what is the internal structure of the ovary and function.
The Ovary as the organ of internal secretion.
Tubae Uterinae: Topography; External/Internal
Structure of the uterine tube; function.
Uterus: Topography, Physiological Position of the uterus, Ligaments of the Uterus and
Mesenteric Of the Uterus.
External and internal structure of the uterus.
Cervix of uterus.
Vagin( add an a, to end of previous word): its external and internal structure
Topography of
External s.....x organs: vagin add an(a) to the previous word the vestibule, hymen and the labium
minus and labium majus,
Also, the clitor.
External and internal structure of the uterus.
Cervix of uterus.
Vag (girls part), its external and internal structure, topography.
External sex organs: vagin (add an a) vestibule, hymen, labium minus and labium majus, clitor. -
Perineum in general.
Particular importance the Structure of perineum.
Its triangles of perineum and their borders.
Structure of urogenital diaphragm and pelvic diaph.
Interview TWO consumers who have used sharing economy service, such .pdf
Interview TWO consumers who have used sharing economy service, such as Zip Car, Airbnb
and Snapgoods. How would you characterize their experiences compared to the more traditional
models? in your own words.
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is 0.1 less than 0.51? Nonreactive S/CO Nonreactive Nonreactive
S/COS/CONonreactiveNonreactiveNon-Reactive:<0.51Equivocal:0.510.9Reactive:>=1.0.
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Is it morally justifiable to use a denial-of-service attack to shut down a web server that distributes
child pornography? Please use the ethical framework to evaluate and explain your position
a. Deontological Ethics
b. Consequentialism
c. Prima-Facia ethics
d. Virtue Ethics
e. Contractarianism
f. Utilitarian analysi.
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Interpret the part of Figure 2A that refers to Clusia in the dry season (above).
Interpret the part of Figure 2A that refers to Clusia in the dry season (above)..
Introduction Now that the Card and Deck classes are completed, th.pdf
Introduction:
Now that the Card and Deck classes are completed, the next class to design is ElevensBoard.
This class will contain the state (instance variables) and behavior (methods) necessary to play
the game of Elevens.
Here's the code:
import java.util.List;
import java.util.ArrayList;
/**
* The ElevensBoard class represents the board in a game of Elevens.
*/
public class ElevensBoard {
/**
* The size (number of cards) on the board.
*/
private static final int BOARD_SIZE = 9;
/**
* The ranks of the cards for this game to be sent to the deck.
*/
private static final String[] RANKS =
{"ace", "2", "3", "4", "5", "6", "7", "8", "9", "10", "jack", "queen", "king"};
/**
* The suits of the cards for this game to be sent to the deck.
*/
private static final String[] SUITS =
{"spades", "hearts", "diamonds", "clubs"};
/**
* The values of the cards for this game to be sent to the deck.
*/
private static final int[] POINT_VALUES =
{1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 0, 0, 0};
/**
* The cards on this board.
*/
private Card[] cards;
/**
* The deck of cards being used to play the current game.
*/
private Deck deck;
/**
* Flag used to control debugging print statements.
*/
private static final boolean I_AM_DEBUGGING = false;
/**
* Creates a new ElevensBoard instance.
*/
public ElevensBoard() {
cards = new Card[BOARD_SIZE];
deck = new Deck(RANKS, SUITS, POINT_VALUES);
if (I_AM_DEBUGGING) {
System.out.println(deck);
System.out.println("----------");
}
dealMyCards();
}
/**
* Start a new game by shuffling the deck and
* dealing some cards to this board.
*/
public void newGame() {
deck.shuffle();
dealMyCards();
}
/**
* Accesses the size of the board.
* Note that this is not the number of cards it contains,
* which will be smaller near the end of a winning game.
* @return the size of the board
*/
public int size() {
return cards.length;
}
/**
* Determines if the board is empty (has no cards).
* @return true if this board is empty; false otherwise.
*/
public boolean isEmpty() {
for (int k = 0; k < cards.length; k++) {
if (cards[k] != null) {
return false;
}
}
return true;
}
/**
* Deal a card to the kth position in this board.
* If the deck is empty, the kth card is set to null.
* @param k the index of the card to be dealt.
*/
public void deal(int k) {
cards[k] = deck.deal();
}
/**
* Accesses the deck's size.
* @return the number of undealt cards left in the deck.
*/
public int deckSize() {
return deck.size();
}
/**
* Accesses a card on the board.
* @return the card at position k on the board.
* @param k is the board position of the card to return.
*/
public Card cardAt(int k) {
return cards[k];
}
/**
* Replaces selected cards on the board by dealing new cards.
* @param selectedCards is a list of the indices of the
* cards to be replaced.
*/
public void replaceSelectedCards(List selectedCards) {
for (Integer k : selectedCards) {
deal(k.intValue());
}
}
/**
* Gets the indexes of the actual (non-null) cards on the board.
*
* @return a List that contains the locations .
Investigue la historia de Enron. Hablar de la empresa. �Que hici.pdf
Investigue la historia de Enron.
Hablar de la empresa.
Que hicieron mal?
Cmo tergiversaron a la empresa?
Al principio y al final de Enron, tenga cuidado con los detalles en la pantalla grande. Qu viste?
Pista. Mira las seales.
Cmo te hace sentir la pelcula al saber lo que Enron le hizo a miles y miles de trabajadores que
perdieron sus trabajos? Ms de 4.000 empleados de Enron fueron despedidos cuando cerraron. La
AFL-CIO dijo que ms de 28.500 trabajadores han perdido sus empleos solo en Enron,
WorldCom y la firma de contabilidad Arthur Andersen..
Internal control systems areA. Developed by the Securities and Ex.pdf
Internal control systems are:
A. Developed by the Securities and Exchange Commission for public companies.
B. Developed by the Small Business Administration for non-public companies.
C. Developed by the Internal Revenue Service for all U.S. companies.
D. Required by Sarbanes-Oxley (SOX) to be documented and certified if the company's stock is
traded on an exchange (a public company).
E. Required only if a company plans to engage in interstate commerce.
Instrucciones Contesta las preguntas en oraciones completas. Trate .pdf
Instrucciones: Contesta las preguntas en oraciones completas. Trate de conectar sus respuestas
con la informacin del texto. Despus de haber publicado sus respuestas antes del viernes, comente
una respuesta de tres compaeros de clase diferentes antes del domingo. Asegrese de contribuir a
la discusin, no solo de estar de acuerdo o en desacuerdo con sus colegas. Escribe en oraciones
completas.
Responde las siguientes preguntas:.
Investigue un poco y describa dos o tres escenarios en los que ser�a.pdf
Investigue un poco y describa dos o tres escenarios en los que sera preferible usar un tubo
punzante en lugar de una placa de crecimiento. ( Pista : Qu usan las bacterias para ayudarse a
moverse? Se puede usar la motilidad para ayudar a identificar muchas bacterias patgenas
mdicamente importantes, como las Enterobacteriaceae?).
Investigue un poco sobre los proveedores de nube personal. �Qu� ti.pdf
Investigue un poco sobre los proveedores de nube personal. Qu tipo de acuerdo de nivel de
servicio (SLA) ofrecen? Est dispuesto a almacenar su informacin con un proveedor de nube
personal que no ofrece SLA? Por qu o por qu no?
Investigue un poco sobre los proveedores de nube personal. Qu tipo de acuerdo de nivel de
servicio (SLA) ofrecen? Est dispuesto a almacenar su informacin con un proveedor de nube
personal que no ofrece SLA? Por qu o por qu no?.
Investigate the five core missions of DHS and discuss how they promo.pdf
Investigate the five core missions of DHS and discuss how they promote communications to
build a resilient community and secure private sector. Consider your community and explain
how stakeholders and first responders work together with DHS to communicate information to
the public..
Innovation Brewing of Sylva filed a trademark application for the co.pdf
Innovation Brewing of Sylva filed a trademark application for the company name. A much
bigger company Bells Brewing of Kalamazoo, Michigan, opposed the application. The bigger
brewery has claimed that the Innovation name infringed on its unregistered slogans bottling
innovation since 1985 and inspired brewing. Bells said in the action that the Innovation Brewing
name was a basis for a likelihood of confusion by customers between the two companies. Why is
the protection of trademarks important to each brewery in this case? Discuss two reasons..
Instructions1. Create a title slide deck that must include your.pdf
Instructions:
1. Create a title slide deck that must include your Full Name, Student ID, and a current image of
you.
I am unsure how to add an image to the file.
In your video include:
1) Run the 'systemctl status httpd' command to show that your web server is running. Show that
you have implemented ssl certificate on your system by using https:// in the url in the final step
when you open your web page
2) Show that you have configured your webserver to use the public_html folder for all users by
showing the changes to userdir.conf file
3) Show the web page you have created in public_html directory
5) Change to the user/public_html directory and display the contents of the directory and then
display the .htaccess file
6) Navigate to the /etc/httpd/conf directory and show the configuration files that implement the
htaccess
7) Open a browser and display the index.html file.
INTRODUCCI�N Koss Corporation es una empresa de Milwaukee cuyo negoc.pdf
INTRODUCCIN Koss Corporation es una empresa de Milwaukee cuyo negocio principal es el
diseo, fabricacin y venta de auriculares estreo y accesorios relacionados. Michael Koss es el
director ejecutivo; su padre, John Koss, fund la empresa en 1958. La empresa tiene marcas y
patentes de sus productos para diferenciarse de la competencia. Koss Corp. tiene una junta
directiva de seis hombres, incluidos Michael y su padre. John tiene 81 aos y se desempea como
presidente de la Junta. Michael tiene 57 aos y se desempea como vicepresidente, presidente,
director ejecutivo, director de operaciones y director financiero. Los otros miembros de la Junta
han servido 25 aos. Ni Michael ni los otros miembros de la Junta tienen antecedentes financieros.
Michael se gradu de la universidad con un ttulo en antropologa. Aunque Koss Corp. es una
empresa multimillonaria, solo emplea a 73 personas, lo que los auditores consideran una pequea
empresa. Michael ha trabajado para Koss Corp. desde 1976 y gana un salario base de $295,000;
su compensacin total, incluidas las opciones, supera los 800.000 dlares. LA FUNCIN DE
CONTABILIDAD El trabajo de contabilidad estuvo a cargo de Sujata Sue Sachdeva,
vicepresidenta de finanzas, secretaria y directora de contabilidad; en una pequea empresa, los
empleados suelen tener ms de una responsabilidad. Sue, cuya familia era de la India, haba estado
empleada en la empresa durante 17 aos. Era una empleada valiosa y confiable y ganaba alrededor
de $200,000 por ao. Tena dos asistentes: Julie Mulvaney, contadora senior, y Tracy Malone,
contadora junior. Sue les dijo a sus amigos y compaeros de trabajo que su familia era muy rica y
tena un estatus social muy alto en la India. Inform que ella y su esposo pasaron su noche de
bodas en el Taj Mahal. Era importante para ella y su familia vivir en la mejor zona, asistir a las
mejores escuelas y socializar con los miembros de la sociedad reconocida de Milwaukee. Sue
particip en varias juntas de caridad, organiz lujosas fiestas para sus eventos que costaron
millones de dlares y compr todos los artculos que no se vendieron en las subastas de caridad que
organiz. Sue tambin tena reputacin de ser una jefa exigente: sus asistentes deban ayudarla con los
eventos de caridad y Sue los invitaba a almorzar casi todos los das. Julie y Tracy tambin fueron a
la casa de Sue para ayudarla a desempacar y guardar los muchos artculos caros que compr. Sue
amaba la ropa, los zapatos y los accesorios de diseador y compr ms de 20,000 artculos en un
perodo de cinco aos, de 2004 a 2009. Compr tantos artculos que no caban en su casa. Entonces,
alquil una unidad de almacenamiento y una suite de dos oficinas para almacenar sus compras no
utilizadas. Adems, Sue hizo algunas compras que nunca recogi en los minoristas. Sue no pudo
pagar todas estas compras con su salario de $200,000 ni con el salario de $600,000 de su esposo
mdico. Su trabajo en Koss Corp. le brind una oportunidad adicional de obtener los fondos
necesarios par.
Introduction William Clay Ford, Jr., was staring out the window of.pdf
Introduction
William Clay Ford, Jr., was staring out the window of
his office in Dearborn, Michigan, lost in thought. The
future of Ford Motor Company was hanging in the
balance, and no one was certain how best to save this
once-great company. Question after question without
any easy answers kept going through his mind. . . . How
much longer can Ford survive with the large losses? Will
it have to sell off assets or financially restructure? Can
it cut enough costs, and where should it cut? Will the
union leaders realize the situation, and how much will
they be willing to help? When will Chinese competitors
enter the U.S. market? How can Ford develop its product
offerings to adjust for higher fuel costs? How can
Ford improve its product offering to reverse or at least
stop the market share losses? How much more market
share will it lose?
The magnitude of the situation seemed overwhelming.
In order to overcome these challenges, it seemed as if
Ford would have to restructure every aspect of its business.
It would require improved product offerings with cuttingedge
design and high quality; improved operation with
more flexibility and lower costs; and improved marketing
with better brand image and customer interest. Ford was at
a crossroads, and the way ahead remained shrouded in fog.
History
Ford has gone through many evolutions since its humble
beginnings on June 16, 1903.1 Henry Ford began this
corporation, now synonymous with the assembly line,
the Industrial Revolution, and the American Dream,
with 11 business associates and $28,000 in capital.2 Ford
Motor Company continued along with minimal leadership
problems until the death of its president, Edsel Ford,
Case 10
in 1943. Intense dissension about who should succeed
Edsel Ford continued until Henry Ford, at the age of 79,
returned from retirement to lead the company. For the
next two years under Henry Ford the company operated
with massive losses of $10 million dollars per month.3
Finally, in 1945, Henry Ford was forced to step down and
Henry Ford II assumed the role of president.4 Henry Ford
II managed to successfully maneuver the company back
to productivity and empowered Robert McNamara and
his group (planning and financial analysis) to transform
Fords leadership style from a tyrannical dictatorship to a
powerful, professional oligarchy.5 Over the next 20 years,
Ford Motor Companys presidents and CEOs turned over
13 times.6 The current CEO, Alan Mulally, was appointed
in September 2006 to take over for William Clay Ford, Jr.,
who had served as both president and CEO since 2001.
William Clay Ford, Jr., led Ford Motor Company to three
straight years of profitability followed by a sharp decrease
in profits marked by a $1.44 billion loss in the first half
of 2006.7 These losses motivated Ford Motor Company
to search for a new CEO from outside the industry, Alan
Mulally, formerly of Boeing Corporation. Mulally stood
out as a qualified successor because he demonstrated the
leadership skills Ford.
Intro to ProgrammingExercise 1University_Athletics.pyMake a cl.pdf
Intro to Programming:
Exercise 1:University_Athletics.py
Make a class called UniversityAthletics.
The __init__() method for UniversityAthletics should store two attributes:
a university_name
a sport.
Make a method called describe_athletics() that prints these two pieces of information.
Make a method called in_season() that prints a message indicating that the sport is in season.
Make an instance called athletics from your class. Print the two attributes individually, and then
call both methods..
International MARCOM fails and WhyConsider the International Mark.pdf
International MARCOM fails and Why?
Consider the International Marketing Communication process and how an organization with
little MARCOM experience in a foreign country might mitigate potential communication errors?
Consider the elements of a Canadian communications message for a Canadian product - music,
imagery, talent, words, and format. What encoding might take place to deliver that message in
Brazil (a high-context culture).
International Fisher Effect suggests thatGroup of answer choices.pdf
International Fisher Effect suggests that:
Group of answer choices
None of the listed options
Currency exchange rate between two countries represents the difference in the price of identical
goods
Currency exchange rate between two countries represents the difference in interest rates as well
as the difference in expected rate of inflation
Currency exchange rate between two countries represents the difference between the demand and
supply of the respective currencies.
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Home assignment II on Spectroscopy 2024 Answers.pdf
Home assignment II on Spectroscopy 2024 Answers.pdf
TESDA TM1 REVIEWER FOR NATIONAL ASSESSMENT WRITTEN AND ORAL QUESTIONS WITH A...
TESDA TM1 REVIEWER FOR NATIONAL ASSESSMENT WRITTEN AND ORAL QUESTIONS WITH A...
Integrated Health was a large private, nonprofit health care system .pdf
- 1. Integrated Health was a large private, nonprofit health care system located in Tempe,Arizona. A year ago, the decision was made to implement a computerized medication administration record (MAR) at Integrated Health. During the first year, the MAR system would be implemented at Central Hospital of Tempe. After the bugs were worked out, the computerized MAR would be implemented system-wide. The MIS department at Central Hospital was designated as the initiator and direction setter for the project. Art Smith, the Chief Information Officer at Central Hospital assigned Kate Cohen, a programmer/analyst, as project leader. Kate had the responsibility for developing and implementing the MAR project at Central. Kate did the programming work for the MAR and assembled a team from Pharmacy Services, Nursing Services, and Internal Auditing. Members of the project team provided feedback on the software, made suggestions related to user training, and worked on an implementation schedule. Both team members and outside observers recognized the difficulty in developing and implementing the MAR in one year. Nurses antagonism toward the project surfaced after their suggestions and recommendations were rejected without explanation. The MAR project was also affected when a management shakeup occurred during the project development phase. The MAR was implemented and immediately failed. By 10:00 a.m. on the first day of the implementation, users complained that the system did not work and was too complicated. After hearing nurses complaints, physicians expressed concern about patient safety. At 1:30 p.m., Central Hospitals computer system crashed, and the MAR project was suspended. Early the next morning, we find Kate contemplating what she is going to say when she meets with Central Hospitals management group later in the afternoon. Question: 4) Discuss the resistance to change in the case and the strategies that can be adopted to reduce the resistance 5) Evaluate the importance of trustworthy leadership and trusting followers in managing change in the case