Summary Needs Statement
Demographics:
· Age-27
· Sex-Females
· Family available-Yes
· Family involvement-Yes
· Social network-Yes
· Income-Yes
· Housing-Yes
· Working-Yes
Presenting Problem – What brought person to agency?
Medical Status - Summary of what is known from assessment
· The physical disability or illness the client reports
low self-esteem issues
· Medical issues identified whether treated or not treated
· What specific ways it effects the client’s social and occupational functioning and activities of daily living.
· Perceived overall health status:
· Medications
Intellectual & Mental Health Status - Summary of what is known from assessment
· Mental functioning:
· Describe the client’s mental functioning.
The client’s functioning habits are up and down. Our goal is to have the client in a safe environment, we want to client to feel comfortable at all times.
· Has Mental health diagnosis been completed - results
· Cognitive functioning:
· Ability to think and reason?
· Able to participate and make decisions?
Yes the client is able to participate in the program with no issues and also at their work place. The decision making has gotten a lot better from where we started.
Social & Environmental Factors - Summary of what is known from assessment
· Open to outside help?
The client has been very open to outside help. The client’s close cousin has been willing to help more and more and they also have seen a big improvement in the past few weeks. I can see where the client loves to see when people of the family cares, it help them relax and get through the week.
· Impairment prohibits functioning?
· Supportive work environment?
· Social support:
· Neighbors? Friends? Community?
· Family support:
· What support, or help can be expected?
· Ethnic/religious affiliation:
· Membership? Help or hindrance?
Functional Status – Summary of what is known from assessment.
Specific Needs to be addressed in the care or treatment plan
An intraorganizational model for
developing and spreading quality
improvement innovations
Katherine C. Kellogg
Lindsay A. Gainer
Adrienne S. Allen
Tatum O"Sullivan
Sara J. Singer
Background: Recent policy reforms encourage quality improvement (QI) innovations in primary care, but
practitioners lack clear guidance regarding spread inside organizations.
Purpose: We designed this study to identify how large organizations can facilitate intraorganizational spread of
QI innovations.
Methodology/Approach: We conducted ethnographic observation and interviews in a large, multispecialty,
community-based medical group that implemented three QI innovations across 10 primary care sites using a new
method for intraorganizational process development and spread. We compared quantitative outcomes achieved
through the group_s traditional versus new method, created a process model describing the steps in the new
method, and identified barriers and facilitators at each step.
Findings: The medical group achieved substantial impr.
This document defines organizational behavior as understanding, predicting, and controlling human behavior at work. It discusses how organizational behavior examines how individuals, groups, and organizational structure impact behavior in organizations. The document outlines several key questions organizational behavior seeks to answer and levels of analysis including individual, group, and organizational processes. It also discusses fundamental concepts in organizational behavior like motivation, human dignity, and individual differences. The document then covers goals of organizational behavior at the individual, group, and organizational levels. Finally, it identifies challenges and opportunities for organizational behavior, such as managing diversity, improving quality and productivity, and coping with change.
Characteristics of successful changes in health care organizations: an interv...BenDarling7
Health care organizations are constantly changing as a result of technological advancements, ageing
populations, changing disease patterns, new discoveries for the treatment of diseases and political reforms and
policy initiatives. Changes can be challenging because they contradict humans’ basic need for a stable
environment. The present study poses the question: what characterizes successful organizational changes in health
care? The aim was to investigate the characteristics of changes of relevance for the work of health care
professionals that they deemed successful
Cochrane Health Promotion Antony Morgan Explor MeetSonia Groisman
This document discusses NICE's role in providing public health guidance in the UK and some issues related to evaluating evidence on health inequalities. It describes NICE's process for developing guidance, which involves scoping topics, reviewing evidence, and making recommendations. However, it notes some limitations, such as a lack of evidence on effective interventions to reduce health inequalities and conceptual gaps in understanding the causes of inequalities. It argues NICE needs to improve its methods for evaluating evidence on inequalities, including getting the right review questions, considering different types of evidence, and better conceptual frameworks for analyzing causes of inequalities.
This document summarizes a session at the 2015 CADTH conference on engaging patients in defining value and drug development. It provides an overview of the session which included panels discussing defining value from the patient perspective and models of patient engagement. It also summarizes some of the key points discussed, such as the need to include patient perspectives throughout the drug development process to better measure what is meaningful to patients and alternative approaches to patient engagement like patient and community engagement researchers. The document advocates that embedding meaningful patient measures can help weight evidence from the patient perspective.
The document discusses challenges in transforming healthcare systems and applying systems engineering approaches. It notes that while the US leads in medical advances, gaps remain in translating research into practice. Systems transformation requires integrating changes across multiple levels, sustaining gains over time, and spreading successful redesigns. Implementation science provides frameworks to study how research gets applied in real-world settings. Strategies include incorporating user needs, using data for decision making, and taking account of past implementation studies to promote evidence-based quality improvement.
NHS Improving Quality was invited to take part in a recently held event that celebrated the work that is being done in partnership between the Pennine Acute Hospitals NHS Trust and AQuA to deliver a Quality Improvement Methodologies Programme (QuIMP).
Gillian Phazey, Learning and Organisational Development Manager at Pennine Acute Hospitals NHS Trust explains:
'The Learning and Organisational Development and Governance teams at the Pennine Acute Hospitals NHS Trust have been working collaboratively with AQuA to deliver a Quality Improvement Methodologies Programme (QuIMP) to support staff in developing knowledge and skills in this topic. The programme has been specifically designed to support colleagues wanting to gain an introduction to the fundamentals and concepts of quality improvement. So far, two cohorts of staff, from clinical and non-clinical areas of the Trust have completed the programme, and have completed quality improvement projects in their own work area to apply their knowledge. On 17th July a celebration event was held for cohort 2 where staff presented their work in poster or presentation form, the aim of which is to share and spread learning across the Trust. Projects were wide ranging, from introducing new processes to reduce complaints and drug errors, to improving patient experience by implementing new tools and techniques. The day was a great success with the Chief Executive and Chief Nurse in attendance. The Trust is highly supportive of this approach in equipping staff with these important techniques, and the programme supports not only our internal quality agenda and objectives, but more widely responds to the recommendations of the Berwick report. The next cohort is starting in September this year.'
Fiona Thow, Patient Safety Collaborative Delivery Lead at NHS Improving Quality delivered a keynote speech, (link to presentation slides) providing a national perspective on the plans for improving patient safety and took the opportunity to introduce the national safety collaboratives. She also highlighted the need for organisations and individuals to think differently about safety for both patients and staff.
Ader et al (2015) The Medical Home and Integrated Behavioral Health Advancing...Ben Miller
This document discusses recommendations for advancing the integration of behavioral health and primary care. It recommends:
1. Building demonstration projects to test integrated care approaches and evaluate them using standardized measures.
2. Developing training programs for integrated care teams, which typically include the patient, primary care provider, behavioral health specialist, and care manager.
3. Implementing population-based strategies to improve behavioral health and strengthen relationships between practices and community resources.
This document defines organizational behavior as understanding, predicting, and controlling human behavior at work. It discusses how organizational behavior examines how individuals, groups, and organizational structure impact behavior in organizations. The document outlines several key questions organizational behavior seeks to answer and levels of analysis including individual, group, and organizational processes. It also discusses fundamental concepts in organizational behavior like motivation, human dignity, and individual differences. The document then covers goals of organizational behavior at the individual, group, and organizational levels. Finally, it identifies challenges and opportunities for organizational behavior, such as managing diversity, improving quality and productivity, and coping with change.
Characteristics of successful changes in health care organizations: an interv...BenDarling7
Health care organizations are constantly changing as a result of technological advancements, ageing
populations, changing disease patterns, new discoveries for the treatment of diseases and political reforms and
policy initiatives. Changes can be challenging because they contradict humans’ basic need for a stable
environment. The present study poses the question: what characterizes successful organizational changes in health
care? The aim was to investigate the characteristics of changes of relevance for the work of health care
professionals that they deemed successful
Cochrane Health Promotion Antony Morgan Explor MeetSonia Groisman
This document discusses NICE's role in providing public health guidance in the UK and some issues related to evaluating evidence on health inequalities. It describes NICE's process for developing guidance, which involves scoping topics, reviewing evidence, and making recommendations. However, it notes some limitations, such as a lack of evidence on effective interventions to reduce health inequalities and conceptual gaps in understanding the causes of inequalities. It argues NICE needs to improve its methods for evaluating evidence on inequalities, including getting the right review questions, considering different types of evidence, and better conceptual frameworks for analyzing causes of inequalities.
This document summarizes a session at the 2015 CADTH conference on engaging patients in defining value and drug development. It provides an overview of the session which included panels discussing defining value from the patient perspective and models of patient engagement. It also summarizes some of the key points discussed, such as the need to include patient perspectives throughout the drug development process to better measure what is meaningful to patients and alternative approaches to patient engagement like patient and community engagement researchers. The document advocates that embedding meaningful patient measures can help weight evidence from the patient perspective.
The document discusses challenges in transforming healthcare systems and applying systems engineering approaches. It notes that while the US leads in medical advances, gaps remain in translating research into practice. Systems transformation requires integrating changes across multiple levels, sustaining gains over time, and spreading successful redesigns. Implementation science provides frameworks to study how research gets applied in real-world settings. Strategies include incorporating user needs, using data for decision making, and taking account of past implementation studies to promote evidence-based quality improvement.
NHS Improving Quality was invited to take part in a recently held event that celebrated the work that is being done in partnership between the Pennine Acute Hospitals NHS Trust and AQuA to deliver a Quality Improvement Methodologies Programme (QuIMP).
Gillian Phazey, Learning and Organisational Development Manager at Pennine Acute Hospitals NHS Trust explains:
'The Learning and Organisational Development and Governance teams at the Pennine Acute Hospitals NHS Trust have been working collaboratively with AQuA to deliver a Quality Improvement Methodologies Programme (QuIMP) to support staff in developing knowledge and skills in this topic. The programme has been specifically designed to support colleagues wanting to gain an introduction to the fundamentals and concepts of quality improvement. So far, two cohorts of staff, from clinical and non-clinical areas of the Trust have completed the programme, and have completed quality improvement projects in their own work area to apply their knowledge. On 17th July a celebration event was held for cohort 2 where staff presented their work in poster or presentation form, the aim of which is to share and spread learning across the Trust. Projects were wide ranging, from introducing new processes to reduce complaints and drug errors, to improving patient experience by implementing new tools and techniques. The day was a great success with the Chief Executive and Chief Nurse in attendance. The Trust is highly supportive of this approach in equipping staff with these important techniques, and the programme supports not only our internal quality agenda and objectives, but more widely responds to the recommendations of the Berwick report. The next cohort is starting in September this year.'
Fiona Thow, Patient Safety Collaborative Delivery Lead at NHS Improving Quality delivered a keynote speech, (link to presentation slides) providing a national perspective on the plans for improving patient safety and took the opportunity to introduce the national safety collaboratives. She also highlighted the need for organisations and individuals to think differently about safety for both patients and staff.
Ader et al (2015) The Medical Home and Integrated Behavioral Health Advancing...Ben Miller
This document discusses recommendations for advancing the integration of behavioral health and primary care. It recommends:
1. Building demonstration projects to test integrated care approaches and evaluate them using standardized measures.
2. Developing training programs for integrated care teams, which typically include the patient, primary care provider, behavioral health specialist, and care manager.
3. Implementing population-based strategies to improve behavioral health and strengthen relationships between practices and community resources.
Outcomes research tests evidence-based interventions to see how they impact individuals, groups, and populations. It examines the effects on both patients and healthcare providers. The Patient Protection and Affordable Care Act, Accountable Care Organizations, Center for Medicare and Medicaid Services, Agency for Healthcare Research and Quality, and Patient Centered Outcomes Research Institute all play roles in outcomes research. Outcomes research can help improve patient care by identifying effective interventions and understanding different treatment outcomes. However, outcomes may differ based on patient demographics and reported data could be skewed.
Improving the Health Outcomes of Both Patients AND PopulationsCHC Connecticut
NCA Clinical Workforce Development, Team-Based Care 2019 Webinar Series
Webinar broadcast on: May 23, 2019 | 2 p.m. EST
In this webinar experts will share their journey in planning, preparing and launching a population health initiative. With the goals of impacting population health outcomes while ensuring cost effectiveness, our experts designed interventions to eliminate gaps in care, particularly among special populations.
This document summarizes research on worksite wellness programs conducted over several decades. It discusses:
1. Studies implemented in over 100 worksites of various sizes, reaching over 100,000 people and achieving participation rates of 75% or more. These studies reduced cardiovascular disease (CVD) risks by 50% or more.
2. Later research tested different models of worksite wellness programs and found that programs offering personal outreach, counseling, and ongoing follow-up achieved greater improvements in health risks like high blood pressure than programs relying only on health education.
3. Subsequent studies confirmed that worksite programs can effectively address health issues like alcohol use when they incorporate screening, individual outreach, and a
As new payment models emerge that emphasize value over volume, providers are being compelled to look more closely at how to motivate patients—especially those with multiple chronic conditions—to actively manage their care, make better decisions and change behaviors. This editorial webinar will explore the relationships between engagement and improved health outcomes, greater patient satisfaction and better resource utilization. Our panel of experts will share proven strategies for building patients' confidence, disseminating self-management tools and making the best use of your care team.
The document discusses several models of health and wellness including Leavell and Clark's Agent-Host-Environment Model, Dunn's Levels of Wellness, and the Health Locus of Control Model. It also examines the Health Belief Model and profiles 24 innovative care delivery models identified by the Robert Wood Johnson Foundation that focus on improving quality, satisfaction and reducing costs. Reasons for the nursing shortage include the pressures of cost containment, need for increased services and frustration with inefficient priorities that prevent nurses from practicing to their full abilities.
Running head SKILLS ASSESSMENT PAPER1SKILLS ASSESSMENT PAPE.docxtodd521
Running head: SKILLS ASSESSMENT PAPER
1
SKILLS ASSESSMENT PAPER
4
Skills Assessment Paper
Summary of Skills
For the development of an organization to be successful and effectively achieve set goals and objectives, strong management and organization skills will be required (Bateman & Snell, 2007). Our Team A brings a broad spectrum of skills and talents coming from life, educational and work-related experiences. Each member of the team possesses unique skill sets that will bring fresh ideas, techniques and creative solutions to challenges in the development of our consulting firm.
A thorough evaluation of our team member’s skills, suggests that our key strengths lie within teamwork and dedication, creating presentations, critical thinking, problem-solving techniques, communication, research, and observations. With these skills, this team will be able to successfully achieve most tasks necessary in the development of a consulting firm. This team will need to use these skills to collaborate efforts in a cooperative manner to create, plan, develop and accomplish the goals of the consulting firm. This evaluation also portrays a strong dedication to learning and improving which is beneficial in the development of new skills that may be needed.
Most members of our team currently have educational and professional experience that proves an intense desire to improve and advocate change and educate communities to collaborate an effort enhancing the lives of individuals. This desire will effectively promote positive changes both within communities as well as at a societal level. The team’s overall commitment is to meet basic human needs through education, focusing on identification of challenges and prevention, as well as assist in overcoming personal and organizational obstacles that individuals may face. Our team is committed to improving the overall quality of life through advocacy and action.
The first type of consulting firm that we could possibly work with would be a human services/independent living consulting program. This program would collaborate with a client’s care givers, doctors and independent care organizations to assist in facilitating a client’s independence and improve or maintain health. This consulting firm would collaborate efforts to create an independent, long-term care plan that will enhance the develop of daily living skills, educate on services and programs available, exercise the right to make healthy living choices, and encourage pro-active involvement of all care-giving professionals in the pursuit of personal growth, presence, and participation in the long term care process. This program will improve and emphasis respect and dignity through the promotion of independence.
PLEASE ADD THE OTHER TWO TYPES HERE!
The types of problems these consulting firms might solve.
Inflexible regulatory and legal issues create competitive obstacles human services providers face when offering health services to communities.
Running head COMPREHENSIVE ASSESSMENT PART TWO1 .docxtodd271
This document contains a reflection on outcomes from a nursing course. It discusses applying various theories, such as the biopsychosocial model of chronic pain, to better understand and manage chronic non-cancer pain. It also covers demonstrating leadership in healthcare policy, applying data analysis skills to vulnerable populations, advocating for ethical leadership, and participating in a quality improvement evaluation of a dialysis center. The student reflects on applying the knowledge and skills gained from each outcome area to their DNP project focused on improving care for patients with chronic non-cancer pain.
This document outlines a plan for developing a needs assessment related to clinical pathways for ED admissions for intractable pain and social admissions. It includes reviewing strategies to overcome organizational barriers, identifying legal and ethical considerations, finalizing a theoretical needs assessment plan, and beginning an annotated bibliography with 6 sources related to the needs assessment topic.
I HEART QM: ONE CBO’S EXPERIENCE WITH QUALITY MANAGEMENTCDC NPIN
1) Cascade AIDS Project implemented an evidence-based HIV prevention intervention called Healthy Relationships and conducted outcome monitoring with 105 participants as part of the CDC-funded Community-based Organization Behavioral Outcomes Project.
2) Retention rates for follow-up surveys at 90 and 180 days were high at 74% and 71%. Risk behaviors generally declined from baseline to follow-up.
3) Lessons learned include that community-based organizations can successfully conduct outcome monitoring, which provides opportunities to evaluate program impact and make improvements based on results.
Clearing the Error: Patient Participation in Reducing Diagnostic ErrorJefferson Center
To generate new, patient-centered insights into diagnostic error, we convened diverse groups in public deliberation to recommend and evaluate actions that patients and/or their advocates would be willing and able to perform to improve diagnostic quality.
Understanding the Dynamics of Successful Health System Strengthening Interven...HFG Project
This study will conduct case studies and a cross-case analysis of six successful health system strengthening interventions supported by USAID. The objectives are to understand how the interventions were implemented, identify factors that facilitated or constrained success, determine common factors across cases, and provide recommendations for future interventions. The study will involve selecting cases, conducting case studies using documents and interviews, analyzing common themes across cases, and developing policy recommendations. A technical advisory group will provide input to ensure the study addresses USAID priorities and evidence needs.
Quality circles originated in Japan after World War II and were inspired by W. Edwards Deming. Quality circles involve voluntary small groups of 6-12 employees who meet regularly to identify improvements in their work area. In healthcare, quality circles are used to (1) identify outstanding features of care, (2) identify obstacles to change, and (3) identify the need for more research. Examples of using quality circles in healthcare include reducing hospital-acquired infections, improving job satisfaction, and enhancing communication.
The document provides an orientation for behavioral health services at House of New Hope. It introduces the executive director and describes the organization's mission to help those in need through faith-based services. It discusses House of New Hope's treatment philosophy which focuses on empowering individuals and supporting their recovery and well-being rather than viewing their conditions as defining them. The document also outlines the roles of clinical support staff and describes the shift in behavioral health from a traditional medical model to one centered on individual-driven recovery.
Improving practice through evidence not only helps lower healthcare improve.docxwrite4
- Improving healthcare practices through evidence-based research can help lower costs, improve outcomes and safety, and increase job satisfaction for medical professionals.
- It is important to disseminate information about evidence-based practices in order to advance the healthcare system, though it often takes years for research results to be implemented in practice.
- Strategies for disseminating evidence-based practice information include unit-level education, posters, and champions to help reinforce positive results.
Make sure they have a variety of ways to provide feedback and actively seek within and outside of the Healthcare Services Don’t assume patients will always provide feedback without being asked. Instead, seek to engage them and collect it whenever possible. Visit Here:-
Accomplishing Reform Successful Case Studies Drawn From The Health Systems O...Carrie Tran
The document summarizes key findings from a book that collected case studies of successful health care reforms from 60 countries. It discusses common factors that contributed to the reforms' success, including having champions who drove change, building momentum over time through perseverance, and engaging stakeholders in collaboration and communication. The reforms addressed a wide range of issues like quality improvement, access to care, use of data and technology, and more. While reforms face many challenges, the case studies demonstrate that with strategic planning and the right conditions, health systems around the world can accomplish meaningful improvements.
Presentations from the patient safety conference held at Teesside University on 1 and 2 September 2014 - Students at the forefront of continuing and improving our culture of safe care
Webinar on Quality Improvement Strategies in a Team-Based Care Environment CHC Connecticut
Building a quality improvement (QI) infrastructure within team-based care is an organizational strategy that will establish a culture of continuous improvement across departments and improve quality in all domains of performance. Many positions in primary care now require QI training as part of employees' professional development.
Our expert faculty discuss tools you can use to build and implement a QI infrastructure within your team-based setting to improve patient care.
Panelists:
• Deb Ward, RN, Senior Quality Improvement Manager, Community Health Center, Inc.
• Kathleen Thies, PhD, RN, Consultant, Researcher, Weitzman Institute
House of New Hope is a statewide Christian nonprofit providing behavioral health services in Ohio since 1992. It utilizes a recovery-based treatment philosophy that views mental health conditions as disabilities that can be managed, rather than illnesses to be cured. The provider acts as a partner rather than director, focusing on strengths rather than just symptoms, and assisting clients in managing their conditions long-term through empowerment and community reintegration. Language and approach emphasize clients' abilities rather than limitations.
The document provides guidance on creating an effective core team to lead efforts in reducing unwarranted variations in care. It recommends involving people with the right skills, such as a program director, facilitator, project manager, champion, and analytics staff. The core team should establish communication ground rules, provide support to team members, and recruit clinician project leads. Having the right team composition and providing training and support helps ensure variation reduction work is done collaboratively and successfully.
Assignment 1 Dealing with Diversity in America from Reconstructi.docxdeanmtaylor1545
Assignment 1: Dealing with Diversity in America from Reconstruction through the 1920s
For History 105: Dr. Stansbury’s classes (6 pages here)
Due Week 3 and worth 120 points. The formal deadline is Monday at 9am Eastern time, Jan. 21. But, due to the King holiday, no late penalty will be imposed if submitted by the end of Jan. 22.
[NOTE ON ECREE: The university is adopting a tool, called ecree for doing writing assignments in many classes. We will be using the ecree program for doing our papers in this class. More instructions on this tool will be posted. You are welcome to type your paper in MS-Word as traditionally done—and then to upload that file to ecree to revise and finish it up. Or, as we suggest, you may type your paper directly into ecree. When using ecree, you should use CHROME as your browser. As posted: “Please note that ecree works best in Firefox and Chrome. Please do not use Internet Explorer or mobile devices when using ecree.”]
BACKGROUND FOR THE PAPER: After the Civil War, the United States had to recover from war, handle western expansion, and grapple with very new economic forms. However, its greatest issues would revolve around the legacies of slavery and increasing diversity in the decades after the Civil War. In the South, former slaves now had freedom and new opportunities but, despite the Reconstruction period, faced old prejudices and rapidly forming new barriers. Immigrants from Europe and Asia came in large numbers but then faced political and social restrictions. Women continued to seek rights. Yet, on the whole, America became increasingly diverse by the 1920s. Consider developments, policies, and laws in that period from 1865 to the 1920s. Examine the statement below and drawing from provided sources, present a paper with specific examples and arguments to demonstrate the validity of your position.
Topic and Thesis Statement—in which you can take a pro or con position:
· Political policies and movements in the period from 1865 to the 1920s generally promoted diversity and “the melting pot” despite the strong prejudices of a few. (or you can take the position that they did not). Use specific examples of policies or movements from different decades to support your position.
After giving general consideration to your readings so far and any general research, select one of the positions above as your position—your thesis. (Sometimes after doing more thorough research, you might choose the reverse position. This happens with critical thinking and inquiry. Your final paper might end up taking a different position than you originally envisioned.) Organize your paper as follows with the four parts below (see TIPS sheet and TEMPLATE also), handling these issues:
1. The position you choose —or something close to it—will be the thesis statement in your opening paragraph. [usually this is one paragraph with thesis statement being the last sentence of the paragraph.]
2. To support your position, use thre.
Assignment 1 Why are the originalraw data not readily us.docxdeanmtaylor1545
Assignment 1
:
Why are the original/raw data not readily usable by analytics tasks? What are the main data preprocessing steps? List and explain their importance in analytics.
Refer to Chapter 3 in the attached textbook:
Sharda, R., Delen, D., Turban, E. (2020). Analytics, Data Science, & Artificial Intelligence: Systems for Decision Support 11E.
ISBN: 978-0-13-519201-6.
Discuss the process that generates the power of AI and discuss the differences between machine learning and deep learning.
Requirement:
****Separate document for each assignment.****
Minimum 300-350 words. Cover sheet, abstract, graphs, and references does not count.
Add references separately for each assignment question.
Double Spaced and APA 7th Edition Format
No plagiarized content please! Attach a plagiarized report.
Check for spelling and grammar mistakes!
$5 max. Please bid if you agree.
Assignment 2
:
What are the privacy issues with data mining? Do you think they are substantiated?
Refer to Chapter 4
in the attached textbook:
Sharda, R., Delen, D., Turban, E. (2020). Analytics, Data Science, & Artificial Intelligence: Systems for Decision Support 11E.
ISBN: 978-0-13-519201-6.
Requirement:
****Separate document for each assignment.****
Minimum 300-350 words. Cover sheet, abstract, graphs, and references does not count.
Add references separately for each assignment question.
Double Spaced and APA 7th Edition Format
No plagiarized content please! Attach a plagiarized report.
Check for spelling and grammar mistakes!
$5 max. Please bid if you agree.
.
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Outcomes research tests evidence-based interventions to see how they impact individuals, groups, and populations. It examines the effects on both patients and healthcare providers. The Patient Protection and Affordable Care Act, Accountable Care Organizations, Center for Medicare and Medicaid Services, Agency for Healthcare Research and Quality, and Patient Centered Outcomes Research Institute all play roles in outcomes research. Outcomes research can help improve patient care by identifying effective interventions and understanding different treatment outcomes. However, outcomes may differ based on patient demographics and reported data could be skewed.
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In this webinar experts will share their journey in planning, preparing and launching a population health initiative. With the goals of impacting population health outcomes while ensuring cost effectiveness, our experts designed interventions to eliminate gaps in care, particularly among special populations.
This document summarizes research on worksite wellness programs conducted over several decades. It discusses:
1. Studies implemented in over 100 worksites of various sizes, reaching over 100,000 people and achieving participation rates of 75% or more. These studies reduced cardiovascular disease (CVD) risks by 50% or more.
2. Later research tested different models of worksite wellness programs and found that programs offering personal outreach, counseling, and ongoing follow-up achieved greater improvements in health risks like high blood pressure than programs relying only on health education.
3. Subsequent studies confirmed that worksite programs can effectively address health issues like alcohol use when they incorporate screening, individual outreach, and a
As new payment models emerge that emphasize value over volume, providers are being compelled to look more closely at how to motivate patients—especially those with multiple chronic conditions—to actively manage their care, make better decisions and change behaviors. This editorial webinar will explore the relationships between engagement and improved health outcomes, greater patient satisfaction and better resource utilization. Our panel of experts will share proven strategies for building patients' confidence, disseminating self-management tools and making the best use of your care team.
The document discusses several models of health and wellness including Leavell and Clark's Agent-Host-Environment Model, Dunn's Levels of Wellness, and the Health Locus of Control Model. It also examines the Health Belief Model and profiles 24 innovative care delivery models identified by the Robert Wood Johnson Foundation that focus on improving quality, satisfaction and reducing costs. Reasons for the nursing shortage include the pressures of cost containment, need for increased services and frustration with inefficient priorities that prevent nurses from practicing to their full abilities.
Running head SKILLS ASSESSMENT PAPER1SKILLS ASSESSMENT PAPE.docxtodd521
Running head: SKILLS ASSESSMENT PAPER
1
SKILLS ASSESSMENT PAPER
4
Skills Assessment Paper
Summary of Skills
For the development of an organization to be successful and effectively achieve set goals and objectives, strong management and organization skills will be required (Bateman & Snell, 2007). Our Team A brings a broad spectrum of skills and talents coming from life, educational and work-related experiences. Each member of the team possesses unique skill sets that will bring fresh ideas, techniques and creative solutions to challenges in the development of our consulting firm.
A thorough evaluation of our team member’s skills, suggests that our key strengths lie within teamwork and dedication, creating presentations, critical thinking, problem-solving techniques, communication, research, and observations. With these skills, this team will be able to successfully achieve most tasks necessary in the development of a consulting firm. This team will need to use these skills to collaborate efforts in a cooperative manner to create, plan, develop and accomplish the goals of the consulting firm. This evaluation also portrays a strong dedication to learning and improving which is beneficial in the development of new skills that may be needed.
Most members of our team currently have educational and professional experience that proves an intense desire to improve and advocate change and educate communities to collaborate an effort enhancing the lives of individuals. This desire will effectively promote positive changes both within communities as well as at a societal level. The team’s overall commitment is to meet basic human needs through education, focusing on identification of challenges and prevention, as well as assist in overcoming personal and organizational obstacles that individuals may face. Our team is committed to improving the overall quality of life through advocacy and action.
The first type of consulting firm that we could possibly work with would be a human services/independent living consulting program. This program would collaborate with a client’s care givers, doctors and independent care organizations to assist in facilitating a client’s independence and improve or maintain health. This consulting firm would collaborate efforts to create an independent, long-term care plan that will enhance the develop of daily living skills, educate on services and programs available, exercise the right to make healthy living choices, and encourage pro-active involvement of all care-giving professionals in the pursuit of personal growth, presence, and participation in the long term care process. This program will improve and emphasis respect and dignity through the promotion of independence.
PLEASE ADD THE OTHER TWO TYPES HERE!
The types of problems these consulting firms might solve.
Inflexible regulatory and legal issues create competitive obstacles human services providers face when offering health services to communities.
Running head COMPREHENSIVE ASSESSMENT PART TWO1 .docxtodd271
This document contains a reflection on outcomes from a nursing course. It discusses applying various theories, such as the biopsychosocial model of chronic pain, to better understand and manage chronic non-cancer pain. It also covers demonstrating leadership in healthcare policy, applying data analysis skills to vulnerable populations, advocating for ethical leadership, and participating in a quality improvement evaluation of a dialysis center. The student reflects on applying the knowledge and skills gained from each outcome area to their DNP project focused on improving care for patients with chronic non-cancer pain.
This document outlines a plan for developing a needs assessment related to clinical pathways for ED admissions for intractable pain and social admissions. It includes reviewing strategies to overcome organizational barriers, identifying legal and ethical considerations, finalizing a theoretical needs assessment plan, and beginning an annotated bibliography with 6 sources related to the needs assessment topic.
I HEART QM: ONE CBO’S EXPERIENCE WITH QUALITY MANAGEMENTCDC NPIN
1) Cascade AIDS Project implemented an evidence-based HIV prevention intervention called Healthy Relationships and conducted outcome monitoring with 105 participants as part of the CDC-funded Community-based Organization Behavioral Outcomes Project.
2) Retention rates for follow-up surveys at 90 and 180 days were high at 74% and 71%. Risk behaviors generally declined from baseline to follow-up.
3) Lessons learned include that community-based organizations can successfully conduct outcome monitoring, which provides opportunities to evaluate program impact and make improvements based on results.
Clearing the Error: Patient Participation in Reducing Diagnostic ErrorJefferson Center
To generate new, patient-centered insights into diagnostic error, we convened diverse groups in public deliberation to recommend and evaluate actions that patients and/or their advocates would be willing and able to perform to improve diagnostic quality.
Understanding the Dynamics of Successful Health System Strengthening Interven...HFG Project
This study will conduct case studies and a cross-case analysis of six successful health system strengthening interventions supported by USAID. The objectives are to understand how the interventions were implemented, identify factors that facilitated or constrained success, determine common factors across cases, and provide recommendations for future interventions. The study will involve selecting cases, conducting case studies using documents and interviews, analyzing common themes across cases, and developing policy recommendations. A technical advisory group will provide input to ensure the study addresses USAID priorities and evidence needs.
Quality circles originated in Japan after World War II and were inspired by W. Edwards Deming. Quality circles involve voluntary small groups of 6-12 employees who meet regularly to identify improvements in their work area. In healthcare, quality circles are used to (1) identify outstanding features of care, (2) identify obstacles to change, and (3) identify the need for more research. Examples of using quality circles in healthcare include reducing hospital-acquired infections, improving job satisfaction, and enhancing communication.
The document provides an orientation for behavioral health services at House of New Hope. It introduces the executive director and describes the organization's mission to help those in need through faith-based services. It discusses House of New Hope's treatment philosophy which focuses on empowering individuals and supporting their recovery and well-being rather than viewing their conditions as defining them. The document also outlines the roles of clinical support staff and describes the shift in behavioral health from a traditional medical model to one centered on individual-driven recovery.
Improving practice through evidence not only helps lower healthcare improve.docxwrite4
- Improving healthcare practices through evidence-based research can help lower costs, improve outcomes and safety, and increase job satisfaction for medical professionals.
- It is important to disseminate information about evidence-based practices in order to advance the healthcare system, though it often takes years for research results to be implemented in practice.
- Strategies for disseminating evidence-based practice information include unit-level education, posters, and champions to help reinforce positive results.
Make sure they have a variety of ways to provide feedback and actively seek within and outside of the Healthcare Services Don’t assume patients will always provide feedback without being asked. Instead, seek to engage them and collect it whenever possible. Visit Here:-
Accomplishing Reform Successful Case Studies Drawn From The Health Systems O...Carrie Tran
The document summarizes key findings from a book that collected case studies of successful health care reforms from 60 countries. It discusses common factors that contributed to the reforms' success, including having champions who drove change, building momentum over time through perseverance, and engaging stakeholders in collaboration and communication. The reforms addressed a wide range of issues like quality improvement, access to care, use of data and technology, and more. While reforms face many challenges, the case studies demonstrate that with strategic planning and the right conditions, health systems around the world can accomplish meaningful improvements.
Presentations from the patient safety conference held at Teesside University on 1 and 2 September 2014 - Students at the forefront of continuing and improving our culture of safe care
Webinar on Quality Improvement Strategies in a Team-Based Care Environment CHC Connecticut
Building a quality improvement (QI) infrastructure within team-based care is an organizational strategy that will establish a culture of continuous improvement across departments and improve quality in all domains of performance. Many positions in primary care now require QI training as part of employees' professional development.
Our expert faculty discuss tools you can use to build and implement a QI infrastructure within your team-based setting to improve patient care.
Panelists:
• Deb Ward, RN, Senior Quality Improvement Manager, Community Health Center, Inc.
• Kathleen Thies, PhD, RN, Consultant, Researcher, Weitzman Institute
House of New Hope is a statewide Christian nonprofit providing behavioral health services in Ohio since 1992. It utilizes a recovery-based treatment philosophy that views mental health conditions as disabilities that can be managed, rather than illnesses to be cured. The provider acts as a partner rather than director, focusing on strengths rather than just symptoms, and assisting clients in managing their conditions long-term through empowerment and community reintegration. Language and approach emphasize clients' abilities rather than limitations.
The document provides guidance on creating an effective core team to lead efforts in reducing unwarranted variations in care. It recommends involving people with the right skills, such as a program director, facilitator, project manager, champion, and analytics staff. The core team should establish communication ground rules, provide support to team members, and recruit clinician project leads. Having the right team composition and providing training and support helps ensure variation reduction work is done collaboratively and successfully.
Similar to Summary Needs StatementDemographics· Age-27· Sex-Female.docx (20)
Assignment 1 Dealing with Diversity in America from Reconstructi.docxdeanmtaylor1545
Assignment 1: Dealing with Diversity in America from Reconstruction through the 1920s
For History 105: Dr. Stansbury’s classes (6 pages here)
Due Week 3 and worth 120 points. The formal deadline is Monday at 9am Eastern time, Jan. 21. But, due to the King holiday, no late penalty will be imposed if submitted by the end of Jan. 22.
[NOTE ON ECREE: The university is adopting a tool, called ecree for doing writing assignments in many classes. We will be using the ecree program for doing our papers in this class. More instructions on this tool will be posted. You are welcome to type your paper in MS-Word as traditionally done—and then to upload that file to ecree to revise and finish it up. Or, as we suggest, you may type your paper directly into ecree. When using ecree, you should use CHROME as your browser. As posted: “Please note that ecree works best in Firefox and Chrome. Please do not use Internet Explorer or mobile devices when using ecree.”]
BACKGROUND FOR THE PAPER: After the Civil War, the United States had to recover from war, handle western expansion, and grapple with very new economic forms. However, its greatest issues would revolve around the legacies of slavery and increasing diversity in the decades after the Civil War. In the South, former slaves now had freedom and new opportunities but, despite the Reconstruction period, faced old prejudices and rapidly forming new barriers. Immigrants from Europe and Asia came in large numbers but then faced political and social restrictions. Women continued to seek rights. Yet, on the whole, America became increasingly diverse by the 1920s. Consider developments, policies, and laws in that period from 1865 to the 1920s. Examine the statement below and drawing from provided sources, present a paper with specific examples and arguments to demonstrate the validity of your position.
Topic and Thesis Statement—in which you can take a pro or con position:
· Political policies and movements in the period from 1865 to the 1920s generally promoted diversity and “the melting pot” despite the strong prejudices of a few. (or you can take the position that they did not). Use specific examples of policies or movements from different decades to support your position.
After giving general consideration to your readings so far and any general research, select one of the positions above as your position—your thesis. (Sometimes after doing more thorough research, you might choose the reverse position. This happens with critical thinking and inquiry. Your final paper might end up taking a different position than you originally envisioned.) Organize your paper as follows with the four parts below (see TIPS sheet and TEMPLATE also), handling these issues:
1. The position you choose —or something close to it—will be the thesis statement in your opening paragraph. [usually this is one paragraph with thesis statement being the last sentence of the paragraph.]
2. To support your position, use thre.
Assignment 1 Why are the originalraw data not readily us.docxdeanmtaylor1545
Assignment 1
:
Why are the original/raw data not readily usable by analytics tasks? What are the main data preprocessing steps? List and explain their importance in analytics.
Refer to Chapter 3 in the attached textbook:
Sharda, R., Delen, D., Turban, E. (2020). Analytics, Data Science, & Artificial Intelligence: Systems for Decision Support 11E.
ISBN: 978-0-13-519201-6.
Discuss the process that generates the power of AI and discuss the differences between machine learning and deep learning.
Requirement:
****Separate document for each assignment.****
Minimum 300-350 words. Cover sheet, abstract, graphs, and references does not count.
Add references separately for each assignment question.
Double Spaced and APA 7th Edition Format
No plagiarized content please! Attach a plagiarized report.
Check for spelling and grammar mistakes!
$5 max. Please bid if you agree.
Assignment 2
:
What are the privacy issues with data mining? Do you think they are substantiated?
Refer to Chapter 4
in the attached textbook:
Sharda, R., Delen, D., Turban, E. (2020). Analytics, Data Science, & Artificial Intelligence: Systems for Decision Support 11E.
ISBN: 978-0-13-519201-6.
Requirement:
****Separate document for each assignment.****
Minimum 300-350 words. Cover sheet, abstract, graphs, and references does not count.
Add references separately for each assignment question.
Double Spaced and APA 7th Edition Format
No plagiarized content please! Attach a plagiarized report.
Check for spelling and grammar mistakes!
$5 max. Please bid if you agree.
.
Assignment 1 Refer to the attached document and complete the .docxdeanmtaylor1545
Assignment 1
:
Refer to the attached document and complete the following sections from the document (highlighted in yellow):
Policy 1.1
Policy Statement Section Overview
Policy 1.2
Policy Statements Contents
Requirement:
·
****Separate word document for each assignment****
· Minimum 300-350 words. Cover sheets, abstracts, graphs, and references do not count.
·
Add references separately for each assignment question.
·
Strictly follow APA style. Length – 2 to 3 paragraphs.
·
Sources: 2 References to Support your answer
· No plagiarized content please! Attach a plagiarized report.
· Check for spelling and grammar mistakes!
· $5 max. Please bid if you agree.
.
Assignment 1
:
Remote Access Method Evaluation
Learning Objectives and Outcomes
Ø
Explore and assess different remote access solutions.
Assignment Requirements
Discuss which of the two remote access solutions
, virtual private networks (VPNs) or hypertext transport protocol secure (HTTPS),
you will rate as the best.
You need to make a choice between the two remote access solutions based on the following features:
Ø Identification, authentication, and authorization
Ø Cost, scalability, reliability, and interoperability
Requirement:
·
****Separate word document for each assignment****
· Minimum 300-350 words. Cover sheet, abstract, graphs, and references do not count.
·
Add reference separately for each assignment question.
·
Strictly follow APA style. Length – 2 to 3 paragraphs.
·
Sources: 2 References to Support your answer
· No plagiarized content please! Attach a plagiarized report.
· Check for spelling and grammar mistakes!
· $5 max. Please bid if you agree.
Assignment 2
:
Discuss techniques for combining multiple anomaly detection techniques to improve the identification of anomalous objects. Consider both supervised and unsupervised cases.
Requirement:
·
****Separate word document for each assignment****
· Minimum 300-350 words. Cover sheet, abstract, graphs, and references do not count.
·
Add reference separately for each assignment question.
·
Strictly follow APA style. Length – 2 to 3 paragraphs.
·
Sources: 2 References to Support your answer
· No plagiarized content please! Attach a plagiarized report.
· Check for spelling and grammar mistakes!
· $5 max. Please bid if you agree.
Assignment 3
:
Refer to the attached “Term Paper for ITS632(1)” for assignment.
Requirements
:
·
****Separate word document for each assignment****
· Minimum 6 pages. Cover sheet, abstract, graphs, and references do not count.
·
Add reference separately for each assignment question.
·
Strictly follow APA style.
·
Sources: 3-5 References
· No plagiarized content please! Attach a plagiarized report.
· Check for spelling and grammar mistakes!
· $30 max. Please bid if you agree.
.
Assignment 1 Inmates Rights and Special CircumstancesCriteria.docxdeanmtaylor1545
Assignment 1: Inmates Rights and Special Circumstances
Criteria
Unacceptable
Below 60% F
Meets Minimum Expectations
60-69% D
Fair
70-79% C
Proficient
80-89% B
Exemplary
90-100% A
1. Analyze the legal mechanisms in which an inmate can challenge his or her confinement. Support or refute the cost of such challenges to the state and / or federal government. Provide a rationale for your response.
Weight: 30%
Did not submit or incompletely analyzed the legal mechanisms in which an inmate can challenge his or her confinement. Did not submit or incompletely supported or refuted the cost of such challenges to the state and / or federal government. Did not submit or incompletely provided a rationale for your response.
Insufficiently analyzed the legal mechanisms in which an inmate can challenge his or her confinement. Insufficiently supported or refuted the cost of such challenges to the state and / or federal government. Insufficiently provided a rationale for your response.
Partially analyzed the legal mechanisms in which an inmate can challenge his or her confinement. Partially supported or refuted the cost of such challenges to the state and / or federal government. Partially provided a rationale for your response.
Satisfactorily analyzed the legal mechanisms in which an inmate can challenge his or her confinement. Satisfactorily supported or refuted the cost of such challenges to the state and / or federal government. Satisfactorily provided a rationale for your response.
Thoroughly analyzed the legal mechanisms in which an inmate can challenge his or her confinement. Thoroughly supported or refuted the cost of such challenges to the state and / or federal government. Thoroughly provided a rationale for your response.
2. Examine the four (4) management issues that arise as a result of inmates with special needs. Prepare one (1) recommendation for each management issue that effectively neutralizes each concern. Provide a rationale for your response.
Weight: 30%
Did not submit or incompletely examined the four (4) management issues that arise as a result of inmates with special needs. Did not submit or incompletely prepared one (1) recommendation for each management issue that effectively neutralizes each concern. Did not submit or incompletely provided a rationale for your response.
Insufficiently examined the four (4) management issues that arise as a result of inmates with special needs. Insufficiently prepared one (1) recommendation for each management issue that effectively neutralizes each concern. Â Insufficiently provided a rationale for your response.
Partially examined the four (4) management issues that arise as a result of inmates with special needs. Partially prepared one (1) recommendation for each management issue that effectively neutralizes each concern. Partially provided a rationale for your response.
Satisfactorily examined the four (4) management issues that arise as a result of inmates with special needs. Satisfactorily prepare.
Assignment 1 Go back through the business press (Fortune, The Ec.docxdeanmtaylor1545
Assignment 1
Go back through the business press (Fortune, The Economist, BusinessWeek, and so forth and any other LIRN- based articles) and find at least three articles related to either downsizing, implementation of a new technology, or a merger or acquisition. In a minimum of four (4) pages in 7th edition APA formatted paper:
What were the key frontline experiences listed in relation to your chosen change?
How do they relate to those listed in Chapter 4?
Did you identify new ones confronting change managers?
How would you prioritize these experiences?
Do any stand out as “deal breakers”? Why?
What new insights into implementing this type of change emerge from this?
Assignment 2
PA2 requires you to identify a current change in an organization with which you are familiar and evaluate a current public issue about which “something must be done.” In relation to the change issue, think about what sense-making changes might need to be enacted and how you would go about doing this. Assess this in terms of the eight (8) elements of the sense-making framework suggested by Helms Mills and as set out in Table 9.7:
Identity construction
Social sense-making
Extracted cues
Ongoing sense-making
Retrospection
Plausibility
Enactment
Projection
Which ones did you believe you might have the most/least control over and why?
What implications does this have for adopting a sense-making approach to organizational change?
minimum of
four (4) pages document for each assignment
.
Assignment 1 Discussion—Environmental FactorsIn this assignment, .docxdeanmtaylor1545
Assignment 1: Discussion—Environmental Factors
In this assignment, you will have a chance to discuss a topic that brings personality theory together with social psychology. Dealing with unhealthy groups like gangs or cults is an important issue in social psychology. However, you cannot fully address this issue if you do not first understand personality development and how one’s personality affects the choices that are made. Specifically, you will look at Skinner’s behavioral perspective on personality development and discuss how that theory can play a role in this issue of unhealthy groups.
Bob is an adolescent who grew up in a gang-infested part of a large city. His parents provided little supervision while he was growing up and left Bob mostly on his own. He developed friendships with several kids in his neighborhood who were involved in gangs, and eventually joined a gang himself. Now crime and gang activities are a way of life for Bob. These have become his way to identify with his peer group and to support himself.
It is relatively easy to see that Bob’s environment has played a large role in his current lifestyle. This coincides with Skinner’s concept of environment being the sole determinant of how personality develops. Skinner believed that if you change someone’s environment and the reinforcements in that environment, you can change their behavior.
Use the Internet, Argosy University library resources, and your textbook to research Skinner’s concept of the environment and answer the following questions:
If you were to create an environment for Bob to change his behavior from that of a gang member to a respectable and law-abiding citizen, what types of environmental changes and positive reinforcements would you suggest and why?
What are some interventions that are used in the field currently? Are there any evidence-based programs that use these environmental and reinforcement interventions?
Write your initial response in 2–3 paragraphs. Apply APA standards to citation of sources.
By
Saturday, March 1, 2014
, post your response to the appropriate
Discussion Area
. Through
Wednesday, March 5, 2014
, review and comment on at least two peers’ responses.
.
Assignment 1 1. Using a Microsoft Word document, please post one.docxdeanmtaylor1545
Assignment 1
1. Using a Microsoft Word document, please post one federal and one state statute utilizing standard legal notation and a hyperlink to each statute.
2. In the same document, please post one federal and one state case using standard legal notation and a hyperlink to each case.
Assignment 2
A. Social media platforms such as Facebook, Twitter, and even Tiktok have become very powerful and influential. Please give your thoughts on whether governments should regulate the content of content on these media. Minimum 250 words.
B. Respond to two classmates' postings. Minimum 100 words per posting.
.
Assignment 1 Dealing with Diversity in America from Reconstructi.docxdeanmtaylor1545
Assignment 1:
Dealing with Diversity in America from Reconstruction through the 1920s
Due Week 3 and worth 120 points
After the Civil War, the United States had to recover from war, handle western expansion, and grapple with very new economic forms. However, its greatest issues would revolve around the legacies of slavery and increasing diversity in the decades after the Civil War. In the South, former slaves now had freedom and new opportunities but, despite the Reconstruction period, faced old prejudices and rapidly forming new barriers. Immigrants from Europe and Asia came in large numbers but then faced political and social restrictions. Women continued to seek rights. Yet, on the whole, America became increasingly diverse by the 1920s. Consider developments, policies, and laws in that period from 1865 to the 1920s. Examine the statement below and drawing from provided sources, present a paper with specific examples and arguments to demonstrate the validity of your position.
Statement—in which you can take a pro or con position:
Political policies and movements in the period from 1865 to the 1920s generally promoted diversity and “the melting pot” despite the strong prejudices of a few. (or you can take the position that they did not). Use specific examples of policies or movements from different decades to support your position.
After giving general consideration to your readings so far and any general research, select one of the positions above as your position—your thesis. (Sometimes after doing more thorough research, you might choose the reverse position. This happens with critical thinking and inquiry. Your final paper might end up taking a different position than you originally envisioned.) Organize your paper as follows, handling these issues:
The position you choose —or something close to it—will be the thesis statement in your opening paragraph.
To support your position, use three (3) specific examples from different decades between 1865 and 1930. You may narrowly focus on race or gender or immigrant status, or you may use examples relevant to all categories.
Explain why the opposing view is weak in comparison to yours.
Consider your life today: In what way does the history you have shown shape or impact issues in your workplace or desired profession?
Length: The paper should be 500-to-750 words in length.
Research and References: You must use a
MINIMUM of three sources
; the Schultz textbook must be one of them. Your other two sources should be drawn from the list provided below. This is guided research, not open-ended Googling.
Source list for Assignment 1:
Some sources are “primary” sources from the time period being studied. Some sources below can be accessed via direct link or through the primary sources links on Blackboard. Each week has a different list of primary sources. For others, they are accessible through the permalink to the source in our online library: Sources below having
libdatab.
Assignment 1 Due Monday 92319 By using linear and nonlinear .docxdeanmtaylor1545
This document provides guidance for counselors on an upcoming assignment due September 23rd. It instructs counselors to listen both linearly and nonlinearly during client assessments to build a strong therapeutic alliance and identify client needs, resources, strengths and gaps in their stories. Counselors are advised to consider both the conscious and unconscious parts of client stories, including recognizing potential adverse childhood experiences and how that might inform the assessment, guide goal development, and affect client readiness to change.
Assignment 1This assignment is due in Module 8. There are many v.docxdeanmtaylor1545
Assignment 1
This assignment is due in Module 8. There are many variations on WebQuests. Please make sure you follow these instructions and not those listed in the textbook. Although, reading the texts and learning another variation will only benefit you in the future. This assignment is worth 100 points.
1. Find a good website in which you can use for the exercise. If you want your students to learn more about zoo animals, then maybe you should locate your local zoo website and use it as a source. Make sure you choose a site that is age appropriate for your students. And please identify which grade and subject level you have chosen in the title.
2. After deciding on a website, create the student instructions for this exercise. Make sure to incorporate aesthetic value (picture). The instructions are very important because you do want your students to be excited about the activity.
3. You will ask the students 10 questions about the site and its information. Be sure the website is clear in its direction and easily navigated so the students can find the information. Create the questions and type them into a Word document with lines for students to use to fill in their answers.
4. After you finish your WebQuest, make sure you include a sheet with the answers to the questions.
5. Save the document as a .doc, .docx, or pdf and submit it via the assignment drop box by clicking on the title of the assignment.
Submission: To submit, choose the Assignment 4: WebQuest link above and use the file attachment feature to browse for and upload your completed document. Remember to choose Submit to complete the submission.
Grading: This assignment is worth 100 points toward your final grade and will be graded using the Webquest Rubric. Please use it as a guide toward successful completion of this assignment.
Assignment 2
This assignment is due in Module 9. The objective of this lesson is to utilize the Internet to help clarify/expand upon your teaching, while creating a field trip environment for your students.
There are times when you will not have the funding to take your class on an actual field trip. With the help of technology, you can now visit various sites without leaving the room. For assignment 4, you are going to plan a virtual field trip for your classroom. Think about the grade level, subject area, possible topics for the curriculum that you teach, and appropriate online communication. You must create an original, virtual field trip. You cannot use someone else's field trip. Remember, you can utilize various software (PowerPoint, Prezi, etc.) to create this field trip, but be careful, it is not a lesson with technology assisted software. The students have to feel like they are truly at the location of the field trip looking at the exhibit, animal, statue, and so forth. There should be no words on the slides because it is not a classroom lesson, it is a field trip.
You will be the tour guide, and everything you plan to say as the guide shoul.
Assignment 1TextbookInformation Systems for Business and Beyond.docxdeanmtaylor1545
Assignment 1
Textbook:Information Systems for Business and Beyond
Please answer the following
From Chapter 1 – Answer Study questions 1-5 and Exercise 3
From Chapter 2 – Answer Study questions 1-10 and Exercise 2 (should be a Power point presentation)
All the above questions should be submitted in one Word document, except for the PowerPoint presentation (Chapter 2 - Exercise 2).
Please understand that Plagiarism will not be tolerated and will result in a zero grade.
Submission Requirements
Font: Times New Roman, size 12, double-space
Citation Style: APA
References: Please use citations and references where appropriate
No Plagiarism
Chapter 1: What Is an
Information System?
Learning Objectives
Upon successful completion of this chapter, you will be
able to:
• define what an information system is by identifying
its major components;
• describe the basic history of information systems;
and
• describe the basic argument behind the article
“Does IT Matter?” by Nicholas Carr.
Introduction
Welcome to the world of information systems, a world that seems to
change almost daily. Over the past few decades information systems
have progressed to being virtually everywhere, even to the point
where you may not realize its existence in many of your daily
activities. Stop and consider how you interface with various
components in information systems every day through different
Chapter 1: What Is an Information
System? | 9
electronic devices. Smartphones, laptop, and personal computers
connect us constantly to a variety of systems including messaging,
banking, online retailing, and academic resources, just to name a
few examples. Information systems are at the center of virtually
every organization, providing users with almost unlimited
resources.
Have you ever considered why businesses invest in technology?
Some purchase computer hardware and software because everyone
else has computers. Some even invest in the same hardware and
software as their business friends even though different technology
might be more appropriate for them. Finally, some businesses do
sufficient research before deciding what best fits their needs. As
you read through this book be sure to evaluate the contents of each
chapter based on how you might someday apply what you have
learned to strengthen the position of the business you work for, or
maybe even your own business. Wise decisions can result in stability
and growth for your future enterprise.
Information systems surround you almost every day. Wi-fi
networks on your university campus, database search services in
the learning resource center, and printers in computer labs are
good examples. Every time you go shopping you are interacting
with an information system that manages inventory and sales. Even
driving to school or work results in an interaction with the
transportation information system, impacting traffic lights,
cameras, etc. V.
ASSIGNMENT 1TASK FORCE COMMITTEE REPORTISSUE AND SOLUTI.docxdeanmtaylor1545
The document provides instructions for an assignment to analyze an organizational issue and propose solutions as the leader of a task force committee. Students are asked to: 1) Describe the selected organization and issue affecting productivity; 2) Analyze how the current corporate culture contributed to the issue; 3) Identify areas of weakness in the organization; 4) Propose modifications to practices and solutions to resolve the issue; and 5) Prepare a one-page executive summary of recommendations. The assignment aims to expose students to modern organizational challenges and develop solutions reflecting their learning.
Assignment 1Select one of these three philosophers (Rousseau, Lo.docxdeanmtaylor1545
This document contains instructions for 5 separate assignments related to ethics, diversity, and organizational culture. Assignment 1 asks students to analyze differences between ideas of philosophers like Rousseau, Locke and Hobbes and modern democracies. Assignment 2 involves responding to inappropriate workplace comments and discussing ethical and legal implications. Assignment 3 has students analyze alternatives and implications related to a case study on discrimination. Assignment 4 examines organizational culture and inclusion at Sherwood Manufacturing. Assignment 5 is researching diversity at different organizations and comparing their cultures.
Assignment 1Scenario 1You are developing a Windows auditing pl.docxdeanmtaylor1545
Assignment 1
Scenario 1
You are developing a Windows auditing plan and need to determine which log files to capture and review. You are considering log files that record access to sensitive resources. You know that auditing too many events for too many objects can cause computers to run more slowly and consume more disk space to store the audit log file entries.
Answer the following question(s): (2 References)
If computer performance and disk space were not a concern, what is another reason for not tracking audit information for all events?
Scenario 2
Assume you are a security professional. You are determining which of the following backup strategies will provide the best protection against data loss, whether from disk failure or natural disaster:
· Daily full server backups with hourly incremental backups
· Redundant array of independent disks (RAID) with periodic full backups
· Replicated databases and folders on high-availability alternate servers
Answer the following question(s): (2 References)
Which backup strategy would you adopt? Why?
Assignment 1 Submission Requirements
Format: Microsoft Word (or compatible)
Font: Arial, size 12, double-space
Citation Style: APA
Length: At least 350 words for each question
References: At least 2 credible scholarly references for each question
No plagiarism
Assignment 2: Security Audit Procedure Guide
Scenario
Always Fresh wants to ensure its computers comply with a standard security baseline and are regularly scanned for vulnerabilities. You choose to use the Microsoft Security Compliance Toolkit to assess the basic security for all of your Windows computers and use OpenVAS to perform vulnerability scans.
Tasks
Develop a procedure guide to ensure that a computer adheres to a standard security baseline and has no known vulnerabilities.
For each application, fill in details for the following general steps:
1. Acquire and install the application.
2. Scan computers.
3. Review scan results.
4. Identify issues you need to address.
5. Document the steps to address each issue.
Assignment 2 Submission Requirements
Format: Microsoft Word (or compatible)
Font: Arial, size 12, double-space
Citation Style: APA
Length: At least 3 pages
References: At least 4 credible scholarly references
No plagiarism
Assignment 3: System Restoration Procedure Guide
Scenario
One of the security improvements at Always Fresh is setting up a system recovery procedure for each type of computer. These procedures will guide administrators in recovering a failed computer to a condition as near to the point of failure as possible. The goal is to minimize both downtime and data loss.
You have already implemented the following backup strategies for workstation computers:
· All desktop workstations were originally installed from a single image for Always Fresh standard workstations. The base image is updated with all patches and new software installed on live workstations.
· Desktop workstation computers execute a cloud backup eve.
Assignment 1Research by finding an article or case study discus.docxdeanmtaylor1545
A
ssignment 1:
Research by finding an article or case study discussing ONE of the following laws or legal issues as it relates to computer forensics:
1) Electronic Communications Privacy Act (ECPA)
2) Cable Communications Privacy Act (CCOA)
3) Privacy Protection Act (PPA)
4) USA Patriot Act of 2001
5) Search and seizure requirements of the Fourth Amendment
6) Legal right to search the computer media
7) Legal right to remove the computer media from the scene
8) Availability of privileged material on the computer media for examination
Using at least 500 words - summarize the the article you have chosen. You will be graded on Content/Subject Knowledge, Critical Thinking Skills, Organization of Ideas, and Writing Conventions.
.
Assignment 1Positioning Statement and MottoUse the pro.docxdeanmtaylor1545
Assignment 1
Positioning Statement and Motto
Use the provided information, as well as your own research, to assess one (1) of the stated brands (Alfa Romeo Hewlett Packard, Subway, or Sony) by completing the questions below. At the end of the worksheet, be sure to develop a new positioning statement and motto for the brand you selected. Submit the completed template in the Week 4 assignment submission link.
Name:
Professor’s Name:
Course Title:
Date:
Company/Brand Selected (Alfa Romeo Hewlett Packard, Subway, or Sony):
1. Target Customers/Users
Who are the target customers for the company/brand? Make sure you tell why you selected each item that you did. (NOTE: DO NOT say “ANY, ALL, EVERYONE” you cannot target everyone, you must be specific)
Age Bracket: [Insert response]
Gender: [Insert response]
Income Bracket: [Insert response]
Education Level: [Insert response]
Lifestyle: [Insert response]
Psychographics (Interest, Hobbies, Past-times): [Insert response]
Values (What the customer values overall in life): [Insert response]
Other items you would segment up on: [Insert response]
How does the company currently reach its customers/users? What methods and media does the company use to currently reach the customers/users? What methods and media should the company use to currently reach the customers/users?
[Insert response]
What would grab the customers/users’ attention? Why do you think this will capture their attention?
[Insert response]
What do these target customers’ value from the business and its products? Why do you think they value these items?
[Insert response]
2. Competitors
Who are the brand’s competitors? Provide at least 3 competitors and tell why you selected each competitor.
Competitor 1: [Insert response]
Competitor 2: [Insert response]
Competitor 3: [Insert response]
What product category does the brand fit into? Why have you placed this brand into the product category that you did?
[Insert response]
What frame of reference (frame of mind) will customers use in making a choice to use/purchase this brand/service? What other brands/companies might customers compare this brand to (other than the top three identified above)?
[Insert response]
3. USP (Unique Selling Proposition) Creation
What is the brand’s uniqueness? Why do you think this is a key uniqueness for this business?
[Insert response]
What is the competitive advantage of the brand? How is it different from other competing brands? Why do you consider this a competitive advantage?
[Insert response]
What attributes or benefits does the brand have that dominate competitors? Why do you think they dominate?
[Insert response]
How is this brand/company better than its competitors? What is the brand’s USP (Unique Selling Proposition? Why have you decided upon this USP?
Unique Selling Proposition: [Insert response]
Defense of USP: [Insert response]
4. Positioning Statement & Motto
Develop a new positioning statement and motto for the brand you selected. Below is an.
ASSIGNMENT 1Hearing Versus ListeningDescribe how you le.docxdeanmtaylor1545
ASSIGNMENT 1:
Hearing Versus Listening
Describe how you learned how to listen! Please use between 300-500 words to make a complete description of this learned behavior. Did you learn to listen properly? Do you still listen the same way that you were taught as a child? Why or why not?
“Doctor Aunt”
by Eden, Janine and Jim.
CC-BY
.
A mother takes her four-year-old to the pediatrician reporting she’s worried about the girl’s hearing. The doctor runs through a battery of tests, checks in the girl’s ears to be sure everything looks good, and makes notes in the child’s folder. Then, she takes the mother by the arm. They move together to the far end of the room, behind the girl. The doctor whispers in a low voice to the concerned parent: “Everything looks fine. But, she’s been through a lot of tests today. You might want to take her for ice cream after this as a reward.” The daughter jerks her head around, a huge grin on her face, “Oh, please, Mommy! I love ice cream!” The doctor, speaking now at a regular volume, reports, “As I said, I don’t think there’s any problem with her hearing, but she may not always be choosing to listen.”
Hearing
is something most everyone does without even trying. It is a physiological response to sound waves moving through the air at up to 760 miles per hour. First, we receive the sound in our ears. The wave of sound causes our eardrums to vibrate, which engages our brain to begin processing. The sound is then transformed into nerve impulses so that we can perceive the sound in our brains. Our auditory cortex recognizes a sound has been heard and begins to process the sound by matching it to previously encountered sounds in a process known as
auditory association
.
[1]
Hearing has kept our species alive for centuries. When you are asleep but wake in a panic having heard a noise downstairs, an age-old self-preservation response is kicking in. You were asleep. You weren’t listening for the noise—unless perhaps you are a parent of a teenager out past curfew—but you hear it. Hearing is unintentional, whereas
listening
(by contrast) requires you to pay conscious attention. Our bodies hear, but we need to employ intentional effort to actually listen.
“Hearing Mechanics”
by Zina Deretsky. Public domain.
We regularly engage in several different types of listening. When we are tuning our attention to a song we like, or a poetry reading, or actors in a play, or sitcom antics on television, we are listening for pleasure, also known as
appreciative listening
. When we are listening to a friend or family member, building our relationship with another through offering support and showing empathy for her feelings in the situation she is discussing, we are engaged in
relational listening
. Therapists, counselors, and conflict mediators are trained in another level known as
empathetic or therapeutic listening
. When we are at a political event, attending a debate, or enduring a salesperson touting the benefits of vario.
assignment 1
Essay: Nuclear Proliferation
The proliferation of nuclear weapons is closely monitored by the international community. While the international community formally recognizes only five nuclear powers - the United States, Russia, China, France, and the United Kingdom - it is widely acknowledged that at least four others (India, Israel, North Korea, and Pakistan) currently possess nuclear weapons and one other (Iran) is attempting to develop nuclear weapons capabilities.
Describe the current international regime governing the development of nuclear weapons, including the major agreements and treaties controlling nuclear technology. Explain why the international community generally seeks to prevent the proliferation of nuclear weapons. (500-750 words)
assignment 2
World military spending is nearly $2 trillion every year. If you could redirect these funds, how would you use them? Would such uses be better or worse for the states involved? Do you think there is a realistic chance of redirecting military spending in the way you suggest? (150 words minimum)
assignment 3
Human Rights: A Hollow Promise to the World?
( one paragraph )
.
Leveraging Generative AI to Drive Nonprofit InnovationTechSoup
In this webinar, participants learned how to utilize Generative AI to streamline operations and elevate member engagement. Amazon Web Service experts provided a customer specific use cases and dived into low/no-code tools that are quick and easy to deploy through Amazon Web Service (AWS.)
it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.
Gender and Mental Health - Counselling and Family Therapy Applications and In...PsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Beyond Degrees - Empowering the Workforce in the Context of Skills-First.pptxEduSkills OECD
Iván Bornacelly, Policy Analyst at the OECD Centre for Skills, OECD, presents at the webinar 'Tackling job market gaps with a skills-first approach' on 12 June 2024
Philippine Edukasyong Pantahanan at Pangkabuhayan (EPP) CurriculumMJDuyan
(𝐓𝐋𝐄 𝟏𝟎𝟎) (𝐋𝐞𝐬𝐬𝐨𝐧 𝟏)-𝐏𝐫𝐞𝐥𝐢𝐦𝐬
𝐃𝐢𝐬𝐜𝐮𝐬𝐬 𝐭𝐡𝐞 𝐄𝐏𝐏 𝐂𝐮𝐫𝐫𝐢𝐜𝐮𝐥𝐮𝐦 𝐢𝐧 𝐭𝐡𝐞 𝐏𝐡𝐢𝐥𝐢𝐩𝐩𝐢𝐧𝐞𝐬:
- Understand the goals and objectives of the Edukasyong Pantahanan at Pangkabuhayan (EPP) curriculum, recognizing its importance in fostering practical life skills and values among students. Students will also be able to identify the key components and subjects covered, such as agriculture, home economics, industrial arts, and information and communication technology.
𝐄𝐱𝐩𝐥𝐚𝐢𝐧 𝐭𝐡𝐞 𝐍𝐚𝐭𝐮𝐫𝐞 𝐚𝐧𝐝 𝐒𝐜𝐨𝐩𝐞 𝐨𝐟 𝐚𝐧 𝐄𝐧𝐭𝐫𝐞𝐩𝐫𝐞𝐧𝐞𝐮𝐫:
-Define entrepreneurship, distinguishing it from general business activities by emphasizing its focus on innovation, risk-taking, and value creation. Students will describe the characteristics and traits of successful entrepreneurs, including their roles and responsibilities, and discuss the broader economic and social impacts of entrepreneurial activities on both local and global scales.
हिंदी वर्णमाला पीपीटी, hindi alphabet PPT presentation, hindi varnamala PPT, Hindi Varnamala pdf, हिंदी स्वर, हिंदी व्यंजन, sikhiye hindi varnmala, dr. mulla adam ali, hindi language and literature, hindi alphabet with drawing, hindi alphabet pdf, hindi varnamala for childrens, hindi language, hindi varnamala practice for kids, https://www.drmullaadamali.com
Chapter wise All Notes of First year Basic Civil Engineering.pptxDenish Jangid
Chapter wise All Notes of First year Basic Civil Engineering
Syllabus
Chapter-1
Introduction to objective, scope and outcome the subject
Chapter 2
Introduction: Scope and Specialization of Civil Engineering, Role of civil Engineer in Society, Impact of infrastructural development on economy of country.
Chapter 3
Surveying: Object Principles & Types of Surveying; Site Plans, Plans & Maps; Scales & Unit of different Measurements.
Linear Measurements: Instruments used. Linear Measurement by Tape, Ranging out Survey Lines and overcoming Obstructions; Measurements on sloping ground; Tape corrections, conventional symbols. Angular Measurements: Instruments used; Introduction to Compass Surveying, Bearings and Longitude & Latitude of a Line, Introduction to total station.
Levelling: Instrument used Object of levelling, Methods of levelling in brief, and Contour maps.
Chapter 4
Buildings: Selection of site for Buildings, Layout of Building Plan, Types of buildings, Plinth area, carpet area, floor space index, Introduction to building byelaws, concept of sun light & ventilation. Components of Buildings & their functions, Basic concept of R.C.C., Introduction to types of foundation
Chapter 5
Transportation: Introduction to Transportation Engineering; Traffic and Road Safety: Types and Characteristics of Various Modes of Transportation; Various Road Traffic Signs, Causes of Accidents and Road Safety Measures.
Chapter 6
Environmental Engineering: Environmental Pollution, Environmental Acts and Regulations, Functional Concepts of Ecology, Basics of Species, Biodiversity, Ecosystem, Hydrological Cycle; Chemical Cycles: Carbon, Nitrogen & Phosphorus; Energy Flow in Ecosystems.
Water Pollution: Water Quality standards, Introduction to Treatment & Disposal of Waste Water. Reuse and Saving of Water, Rain Water Harvesting. Solid Waste Management: Classification of Solid Waste, Collection, Transportation and Disposal of Solid. Recycling of Solid Waste: Energy Recovery, Sanitary Landfill, On-Site Sanitation. Air & Noise Pollution: Primary and Secondary air pollutants, Harmful effects of Air Pollution, Control of Air Pollution. . Noise Pollution Harmful Effects of noise pollution, control of noise pollution, Global warming & Climate Change, Ozone depletion, Greenhouse effect
Text Books:
1. Palancharmy, Basic Civil Engineering, McGraw Hill publishers.
2. Satheesh Gopi, Basic Civil Engineering, Pearson Publishers.
3. Ketki Rangwala Dalal, Essentials of Civil Engineering, Charotar Publishing House.
4. BCP, Surveying volume 1
Strategies for Effective Upskilling is a presentation by Chinwendu Peace in a Your Skill Boost Masterclass organisation by the Excellence Foundation for South Sudan on 08th and 09th June 2024 from 1 PM to 3 PM on each day.
1. Summary Needs Statement
Demographics:
· Age-27
· Sex-Females
· Family available-Yes
· Family involvement-Yes
· Social network-Yes
· Income-Yes
· Housing-Yes
· Working-Yes
Presenting Problem – What brought person to agency?
Medical Status - Summary of what is known from assessment
· The physical disability or illness the client reports
low self-esteem issues
· Medical issues identified whether treated or not treated
· What specific ways it effects the client’s social and
occupational functioning and activities of daily living.
· Perceived overall health status:
· Medications
Intellectual & Mental Health Status - Summary of what is
known from assessment
· Mental functioning:
· Describe the client’s mental functioning.
The client’s functioning habits are up and down. Our goal is to
have the client in a safe environment, we want to client to feel
comfortable at all times.
· Has Mental health diagnosis been completed - results
· Cognitive functioning:
· Ability to think and reason?
· Able to participate and make decisions?
Yes the client is able to participate in the program with no
issues and also at their work place. The decision making has
gotten a lot better from where we started.
2. Social & Environmental Factors - Summary of what is known
from assessment
· Open to outside help?
The client has been very open to outside help. The client’s close
cousin has been willing to help more and more and they also
have seen a big improvement in the past few weeks. I can see
where the client loves to see when people of the family cares, it
help them relax and get through the week.
· Impairment prohibits functioning?
· Supportive work environment?
· Social support:
· Neighbors? Friends? Community?
· Family support:
· What support, or help can be expected?
· Ethnic/religious affiliation:
· Membership? Help or hindrance?
Functional Status – Summary of what is known from
assessment.
Specific Needs to be addressed in the care or treatment plan
An intraorganizational model for
developing and spreading quality
improvement innovations
Katherine C. Kellogg
Lindsay A. Gainer
Adrienne S. Allen
Tatum O"Sullivan
Sara J. Singer
3. Background: Recent policy reforms encourage quality
improvement (QI) innovations in primary care, but
practitioners lack clear guidance regarding spread inside
organizations.
Purpose: We designed this study to identify how large
organizations can facilitate intraorganizational spread of
QI innovations.
Methodology/Approach: We conducted ethnographic
observation and interviews in a large, multispecialty,
community-based medical group that implemented three QI
innovations across 10 primary care sites using a new
method for intraorganizational process development and spread.
We compared quantitative outcomes achieved
through the group_s traditional versus new method, created a
process model describing the steps in the new
method, and identified barriers and facilitators at each step.
Findings: The medical group achieved substantial improvement
using its new method of intraorganizational process
development and spread of QI innovations: standard work for
rooming and depression screening, vaccine error
rates and order compliance, and Pap smear error rates. Our
model details nine critical steps for successful
intraorganizational process development (set priorities, assess
the current state, develop the new process, and measure
and refine) and spread (develop support, disseminate
information, facilitate peer-to-peer training, reinforce, and
learn and adapt). Our results highlight the importance of
utilizing preexisting organizational structures such as
Key words: implementation, patient-centered medical home
(PCMH), primary care, quality improvement, spread
Katherine C. Kellogg, MBA, PhD, is Professor of Work and
Organization Studies, MIT Sloan School of Management,
Cambridge,
Massachusetts. E-mail: [email protected]
4. Lindsay A. Gainer, RN, MSN, is Executive Director of Clinical
Services and Innovation, North Shore Physicians Group,
Peabody, Massachusetts.
AdrienneS.Allen,MD,MPH,
isMedicalDirectorofQuality,Safety,andPopulationManagement,N
orthShorePhysiciansGroup,Peabody,Massachusetts.
Tatum O"Sullivan, RN, MHSA, CPHRM, is Director,
Ambulatory Risk and Patient Safety, North Shore Physicians
Group, Peabody, Massachusetts.
Sara J. Singer, MBA, PhD, is Professor of Healthcare
Management and Policy, Harvard T.H. Chan School of Public
Health, Boston, Massachusetts.
The authors have disclosed that they have no significant
relationship with, or financial interest in, any commercial
companies pertaining to this article.
Supplemental digital content is available for this article. Direct
URL citations appear in the printed text and are provided in the
HTML and PDF
versions of this article on the journal_s Web site
(www.hcmrjournal.com).
This is an open-access article distributed under the terms of the
Creative Commons Attribution-Non Commercial License 4.0
(CCBY-NC-ND),
where it is permissible to download, share, remix, transform,
and buildup the work provided it is properly cited. The work
cannot be used
commercially without permission from the journal.
DOI: 10.1097/HMR.0000000000000122
Health Care Manage Rev, 2017, 42(4), 292Y302
Copyright B 2017 The Authors. Published by Wolters Kluwer
Health, Inc.
6. safety improvement in primary care and at the intersection of
ambulatory and inpatient care include most notably patient-
centered medical homes (PCMHs; Rosenthal, 2008).
To achieve the promise of PCMHs to provide better
coordinated, safer, more timely, and appropriate care for
patients, ambulatory settings must redesign and improve
care processes. As in complex health systems more gener-
ally, ambulatory safety has been stymied by the inability of
health care organizations to spread promising innovations
(Gandhi & Lee, 2010; Wynia & Classen, 2011).
This study aimed to contribute to knowledge about
developing and spreading quality improvement (QI) inno-
vations across sites inside large health care organizations.
To do so, we compared one organization_s traditional method
of intraorganizational process development and spreadVin
whichQIstaffsolicitedimprovementideasfromstaffmembers
from multiple disciplines, developed new processes based on
them, and spread these processes through site level pre-
sentationsandemailsVtoitsnewmethodVinwhich QI staff
took staff, providers, and patients representing all disci-
plines from one practice site offline for 1Y5 days to generate
and refine improvement ideas and then spread the new
processes using formal Bprocess advocate[ positions in each
site for each role. We use comparative data on the traditional
method (less successful) versus new method (more success-
ful) to develop a conceptual model for intraorganizational
process development and spread of QI innovations and to
describe barriers and facilitators that influence each step.
Conceptual Framework
As in prior research, we define innovation as Bnovel be-
haviors, routines, and ways of working geared toward im-
proving health outcomes, administrative efficiency, cost
7. effectiveness, or users_ experience and that are imple-
mented by planned and coordinated actions[ (Greenhalgh,
Robert, Macfarlane, Bate, & Kyriakidou, 2004). To have
significant impact on an organization, new processes must
be developed and implemented locally and then spread
more broadly. New process development refers to the
method by which improvement teams carry out projects to
analyze suboptimal processes and propose their redesign
(Harrison et al., 2016). Spread is the process of facilitating
the adoption of an innovation across multiple units, con-
ditions, or types of patients (Parry, Carson-Stevens, Luff,
McPherson, & Goldmann, 2013).
Considerable research consolidates lessons about inno-
vation development, implementation, and spread. This re-
search includes process models that specify the steps through
which innovations are developed, implemented locally, and
spread broadly; determinant frameworks that explain the
factors that influence these processes; and evaluation frame-
works for measuring new process development and spread
efforts (Nilsen, 2015).
Plan-Do-Study-Act (PDSA, popularized by Edward
Deming as Plan-Do-Check-Act) is perhaps the iconic
model for new process development and local implemen-
tation, providing a structure for the iterative application of
scientific methods for testing small changes to improve
quality in systems (Taylor et al., 2014). In simple terms,
enacting a PDSA cycle requires planning a process includ-
ing establishing criteria upon which to measure its achieve-
ment, doing or executing the plan, studying actual compared
to expected result, and acting on the findings by adopting
successful changes and repeating the process with iterative
cycles. LEAN is another model for new process development
and local implementation in which LEAN experts coach
9. curs (Bradley et al., 2012; Damschroder et al., 2009;
Kaplan, Provost, Froehle, & Margolis, 2012; Kitson et al.,
2008; Milat, Bauman, & Redman, 2015; Nolan et al., 2007;
Parker, Wubbenhorst, Young, Desai, & Charns, 1999;
Pronovost, Berenholtz, & Needham, 2008). In their book
on spread, Sutton and Rao (2014) distill numerous lessons
derived from multiple industries: Spread requires trade-offs
between cloning an original model and encouraging local
variation, stoking emotions as well as providing a rational
argument to provoke action, Brelentless restlessness[ in
pursuit of constant innovation, muddling through inevita-
ble messiness that comes with spread, and cascading new
practices through individuals and their social networks.
Research suggests that rigorous evaluation and moni-
toring of defined goals and milestones promote spread ef-
fectiveness. One example of an evaluation framework for
implementation isPARiHS (PromotingAction on Research
ImplementationinHealthServices;Kitsonetal.,2008),which
was designed as a practical and conceptual heuristic for re-
searchers and practitioners to measure elements of evidence
and context and then determine approaches to facilitation.
Although plentiful, most prior research addresses spread
of evidence-based practices across organizations, rather
than the development and spread of QI innovations inside
an organization with multiple sites. Prior frameworks have
also been criticized for providing only Blimited Fhow-to_
support,[ for being Btoo generic to provide sufficient detail
for guiding an implementation process,[ and for not iden-
tifying or systematically structuring information about
barriers and facilitators (Nilsen, 2015). Indeed, in their
comprehensive review of innovation spread in service
organizations, Greenhalgh and colleagues (2004) call for
multimethod, detailed, process-oriented research that
illuminates the features that account for program success
10. in a specific context. This article addresses these gaps by
codifying one organization_s improvement journey based
on ethnographic, interview, and clinical evaluation data.
The result is the intraorganizational process development
and spread of QI innovations model. Like the PDSA,
Framework for Spread, and AIDED models, it is a process
modelVone that is designed to guide both development and
spread of new practices (PDSA and Framework for Spread
address one but not the other) inside an organization rather
than to scale up innovations across countries (as in AIDED).
The distinguishing characteristic of our model is that it pro-
vides a detailed guide for facilitating new process develop-
ment and spread across sites within an organization.
Methods
We used multiple methods to understand how a large,
multispecialty, community-based medical group, the North
Shore Physicians Group (NSPG), implemented a new
method for process development and spread across 10 pri-
mary care practice sites. Specifically, we combined an eth-
nographic approach and interviews with key informants
with quantitative outcomes comparing the organization_s
use of their new method of process development and spread,
which was informed by Virginia Mason and Hartford
Medical Group approaches, versus their traditional method
for two QI innovations related to standard work for rooming
and depression screening, and vaccine error rates and order
compliance. We also compared the organization_s use of no
method versus their new method of new process develop-
ment and spread for a third QI innovation related to Pap
smear error rates. Since September 2013, NSPG has used
this new method of development and spread to imple-
ment 15 workflow process innovations. We chose to focus
on these three processes because they each have the po-
12. service coordinators (PSRs) (at least four at each of the
10 practice sites), and central administrators. Interview
responses were typed in real time.
The ethnographer asked questions to understand how
respondents experienced the implementation of the tra-
ditional versus new method of process development and
spread and what they saw as barriers to and facilitators
of the new method. The ethnographer analyzed the data
by engaging in multiple readings of the field and inter-
view notes and coding based on themes emerging from the
data (performed in ATLAS.ti qualitative software) regard-
ing work activities and regarding facilitators and barriers
to developing and spreading processes using the new
method. When formal data collection had finished, she
presented her analysis for review by NSPG staff mem-
bers to ensure that these interpretations represented their
experiences.
Quantitative Process Outcomes
For each of the three new processes, we identified and mon-
itored quantitative process outcomes over time. We eval-
uated the significance of an improvement in outcomes using
the new method versus traditional method of spread with a
standard one-tailed z test.
We evaluated spread of the standard rooming process
in 2013 and 2014 by conducting two types of review:
process audits and retrospective chart review. First, we
audited adherence to standard work, including depres-
sion screening, in the summer of 2013, after the use of
the traditional method of spread, and in 2014, after the
use of the new method of spread. An auditor posed as a
patient and tracked each completed step of the rooming
process. Retrospective chart reviews of depression screening
13. documentation involved two reviewers who examined the
patient flow sheet for evidence of the Patient Health
Questionnaire two-question screen (PHQ-2). For each
primary care physician and nurse practitioner, we randomly
selected one full day in June 2013 and June 2014 and
calculated the percentage of patients seen that day who had
been screened for depression, excluding patients under 18
and no-shows from the denominator.
We used two measures to assess the spread of a new
vaccine administration process: self-reported immuniza-
tion errors and retrospective chart review. NSPG tracks
immunization errors if a patient receives an incorrect vac-
cine, additional doses, incorrect dosage, expired vaccine, or
incorrect vaccine administration. We measured vaccine
error rates by comparing error rates during the use of the
traditional method (October 2012 to June 2014, 21 months)
to error rates during the use of the new method (July 2014
to August 2015, 14 months). To measure vaccine order
compliance, we performed a retrospective chart review for
vaccine order compliance in November 2013, after the use
of the traditional method of spread, and in December 2014,
after the use of the new method of spread. We reviewed
charts for a signed provider order for the vaccine for up to
3 patients per provider, 9Y23 patients per practice in
November 2013, and 15Y35 patients per practice in
December 2014, which estimates suggested would suffice
for revealing significant differences.
In contrast to the two previous examples where NSPG
spread a new process using the traditional method and
then the new method, there was no standardized process
for Pap smear labeling a priori. We measured labeling error
rates by comparing error rates reported by the laboratory
completing the test during the use of no method (October
14. 2012 to April 2014, 18 months) to error rates during the use
of the new method (May 2014 to August 2015, 16 months).
Examples of Pap smear labeling errors include unlabeled
specimen sent to the lab, label on the specimen did not
match the patient information on the accompanying req-
uisition, label on the specimen was for the incorrect patient,
and transcription errors on the label including incorrect date
of birth.
Findings
Results From Quantitative Analysis of
Process Changes
Table 1 details that, regarding standard rooming, 64% of
rooming steps were completed in 2013 with the traditional
method compared to 80% of rooming steps completed in
2014 with the new method, a 16 percentage point increase
(z score = 7.42, p G .01). There was also an increase in
depression screening with the use of the new method, with
a mean improvement of 20 percentage points from 2013 to
2014 (z score = 9.2, p G .01). Regarding vaccine adminis-
tration, 60% of the charts included physician orders for
vaccines in 2013 with the traditional method compared to
96% in 2014 with the new method, a 36 percentage point
increase (z score = 8.81, p G .01). There was also a decrease
of vaccine error rate with the use of the new method, with a
mean decrease of 0.03 percentage points (z score = j1.65,
p G .05). Regarding Pap smear labeling, there was a decrease
in Pap smear labeling errors with the use of the new method
versus no method of intraorganizational process develop-
ment and spread. There was a Pap smear labeling error
rate of 0.83% before implementing the new process com-
pared to a 0.18% error rate after implementing the pro-
cess using the new method, a decrease in 0.65 percentage
points (z score = j3.81, p G .01).
16. accountable care organization (ACO) requirements as well
as organizational priorities beyond QI. By including an
assessment of the environmental context, our model en-
sures that new workflows will meet not only the needs of
local teams but also the needs of the broader organization.
Perhaps because setting priorities takes into account the
needs of the broader organization, one barrier to this step is
that prioritized new processes do not always match the top
priorities for providers and staff at local sites. They reported
feeling overloaded and wanted more input into the setting
of priorities. We found that a key facilitator of setting
priorities was joint prioritization of improvement work with
other organizational initiatives in which providers and staff
members at the local sites were being asked to participate.
In BAssess Current State,[ Improvement Specialists not
only perform sophisticated analyses with LEAN tools such
as value stream mapping and takt time but also take into
account the voice of the customer. By including an as-
sessment of the voice of the customer, our model ensures
that new workflows will meet the needs of local teams and
the broader organization. The sophisticated analyses used
in assessing the current state require gathering data about
waste and defects through direct observation of staff doing
their day-to-day work. One barrier to this step is that, even if
the organization has a culture of improvement, there is still a
hierarchy in primary care. Lower-level staff expressed concern
about being observed. Having someone do this observation
Table 1
Outcomes for traditional versus new method of
intraorganizational process development and spread
Traditional method New method Difference in percentage
17. pointsa
Adherence to standard work for roomingb 64% (n = 630) 80% (n
= 1,029) 16%***
Depression screening rates 15% (n = 806) 35% (n = 744)
20%***
Vaccine order compliance 60% (n = 169) 96% (n = 222)
36%***
Vaccine error rates 0.06% (n = 27,125) 0.03% (n = 24,611)
j0.03%**
Pap smear error rates 0.83% (n = 4,554) 0.18% (n = 3,288)
j0.65%***
**p G .05. ***p G .01.
aAll outcomes compare performance achieved with traditional
versus new method of intraorganizational process development
and spread except
Pap smear error rates, which compare performance achieved
with no method versus the new method of process development
and spread.
bEstimations for both the traditional and new method are made
based on data for 7 of 10 sites, because three sites were not
measured in 2013 under
the traditional method. If we include these three sites in the new
method calculation, adherence to standard work under the new
method is 80%,
n = 1,470, p G .01. Difference in sample size for traditional and
new method is due to difference in number of people audited
per site. Fewer people
per site were audited in 2013 to assess the traditional method
than in 2014 to assess the new method.
Figure 1
Intraorganizational model of process
development and spread
19. Site Manager: BWe_ve got the
process improvement people
telling us things and the
operations people telling us
thingsIIt_s helpful to have a
calendar that puts everything
together in one place so there
aren_t too many requests at once.[
Y Organizational priorities
Gather needs of users in each role
Y Provider needs
Y Staff needs (Brock in the shoe[)
Y Patient needs (access, quality,
safety)
Assess current
state
Assess existing workflow Staff fear of evaluation Observations
done by a trusted
staff memberY Direct observation Medical Assistant: BWhen
they did
the new process for standard
rooming, they timed us and
followed us so they could do things
like spaghetti maps. It_s
uncomfortable and tough to have
someone following you around
when you are trying to workI
You have people watching every
move you make, and you worry,
FAm I doing something wrong?_[
Improvement Specialist:
20. B[Improvement Specialist] started
out working as a float [PSR] in
many of the sites before he moved
to our office. Because many of the
staff know him personally, they
trust him, and feel comfortable
when he is the one following
them around with a stopwatch.[
Y Use of LEAN tools (e.g., value
stream map)
Y Analysis of defect rates
Y Analysis of the voice of the
customer
Set targets for workflow
improvement
Develop new
process
Gather new workflow ideas Local site staffing shortfall
during event
Participation by outside expert
Y Gather ideas from the people
who do the work
Y Solicit information from the
field on current standard
workflows in other
organizations
Engage in offline workflow
process improvement
21. Y Pull staff from each role
involved in the workflow
offline for an RPIW or
Kaizen event
Carry out workflow change
on a small scale
Y Execute the planned
change on a small scale
Site Manager: BIt_s a lot of pressure
on the other staff when you do a
RPIW. In our last RPIW, providers,
PSRs, MAs, and I were pulled
offline for an entire week.[
Improvement Specialist: BIt_s
helpful to have an outsider
participate in the event who
has some relevant experience
from elsewhere. For our Pap
smear labeling Kaizen event,
we invited an MA from one
of women"s health practices
because that practice does a
lot of Paps and has already
done a lot of thinking about
their processI.That was also
one less person we needed to
pull offline from the practice.[
Y Document problems and
unexpected observations
22. Measure and
refine
Study Difficult to cut off failed ideas
immediately
Close communication between
improvement specialists and
site level process owners
Y Analyze data and compare data
to targets at 30, 60, 90 days Site Medical Director: BFor the
new
patient intake RPIW, we figured
out relatively soon that the medical
records weren_t very useful but we
felt like we had to keep tracking
them down because we were
trying to hit that measure. So that
felt a little too formal.[
Site Manager: BWe were meeting
on a regular basis with
[Improvement Specialist], and
she helped us decide when we
could cut parts of the process
that weren_t working.[
Act
Y ContinuePDSAstorefineprocess
over 30 days in one practice
Document
Y Create materials to document
new standard workflow. At
24. Y Cultivate support among
staff members holding
formal leadership positions
by presenting at the
monthly meeting of Site
Medical Directors
Doctor: BI learn about new standard
work within day to day work. So,
the other day, a patient needed a
vaccine, and the MA said, FThere
is a new process that I learned
about._ It would be helpful if, when
something new was rolled out, I
was alerted a little more directly
about itIIt would be good to get
an FYI: why we are doing it and
here is what all of the MAs will
be doing.[
Doctor: BBuy-in at the
beginning is very strong
point for us. We_ve got a
monthly meeting, and it_s
well attendedIThey take
us through the presentation
(explaining how the new
process has been developed
and tested). When it_s
presentedthatway,weknow
that we_ve had an intact
team try it ahead of time.
When I worked at a different
site,ifsomethingwasthrown
at me, I had no idea if it
had already been tried.[
25. Y Facilitate knowledge sharing
and technology transfer by
presenting at the monthly
meeting of Site Managers
Y Provide organization-wide
training to continue to build
culture of change
Disseminate
information
Introduce the new process to
lead users using formal
process advocate positions
and formal communication
channels
Confusing standard work documents Simplification of standard
work training materials
Y Appoint an MA and a PSR
process advocate for each site
Y ‘‘Train the trainers’’ by
presenting to process
advocates at the monthly
MA/PSR Council Meeting
Y Translate the new standard work
for the process advocates by
developing a computer-based
learning module
Site Manager: BThe standard work
26. they write outVI know it_s a
simplified tool and is supposed
to be straightforwardVbut a
lot of staff will read through
it, will go back and question
it multiple times, and still
won_t understand itIFor
standard rooming, there are
32 steps and it is kind of all
over the place compared to
how you will really room
somebody. It_s not laid out in
the best way.[
Improvement Specialist: BWe
simplified the training
documents and standardized
the Healthstream module
to include the Bwhy,[ the
opportunities for
improvement, the process
flow, the key improvements,
results, and lessons learned.[
Facilitate
peer-to-peer
training
Appoint process advocates
from each site to spread the
innovation to their peers in
the same formal position at
their site
No protected time to train Site manager support for
training
27. Y Site Manager meets with site
process advocates to discuss
new standard work
PSR Process Advocate: BThe problem
I have is finding the time to sit
with each person. I am supposed
to sit with them, give them a little
lesson. Even if everyone has
watched the Healthstream, I can_t
be taking phone calls and also
going around to check in with
people. When I leave my desk,
someone has to cover.[
PSR Process Advocate: B[Site
Manager] has been very
supportive of it and helping
me find the time. After the
last PSR Council meeting, I
spoke to [Site Manager]
and she carved out an hour
TuesdayYFriday from
2Y3 pm. She put that aside
for me to be off of the
phone to train [the other
PSRs at my practice site].[
Y Process advocates train peers
in the same position at their site
Y Improvement Specialists
distribute computer-based
learning module to all
employees via Healthstream to
29. both ameliorated the staffing shortfall at the focal site and
allowed for participation by a staff member who had specific
expertise in the process being improved.
Finally, in BMeasure and Refine,[ Improvement Spe-
cialists and site level process owners use not only rapid cycle
improvement but also data analysis in a structured way at
30, 60, and 90 days. A key barrier in this step is the formality
of the 30-, 60-, 90-day remeasurement requirement. Time
and energy were sometimes wasted because the formal re-
quirement made it difficult to change parts of the new
process that were immediately seen to be ineffective. A
facilitator for this step was for Improvement Specialists and
Table 2
Intraorganizational model of process development and spread:
Steps, barriers, and facilitators,
Continued
Process step Activities Key barrier Key facilitator
Reinforce Reinforce use of new
workflows
Overload Site manager redistribution
of existing work
Y Process advocates perform
competency checks of peers at
their sites at 30Y60Y90 days
Site Manager: B[The MAs and PSRs]
are under pressure to get a lot
done, and it_s coming fast and
furious. It_s really hard to find the
30. time to understand and do all of
the new standard work.[
Site Medical Director: BMAs
and PSRs take the brunt of
the changes. They need to
know that some of their
work will be redistributed, if
necessary. The Site Manager
does continuous ongoing
work redistribution as we
introduce new standard work.
We do our best to level load.[
Y Improvement Specialists
round out to all sites to audit
adherence to new standard
workflow
Learn and
adapt
Solicit feedback and adapt
new processes
Perceived rigidity of standard work Strong relationship between
site managers and
improvement specialistsY Improvement Specialists
discuss spread of new standard
workflows and solicit feedback
at monthly meetings of the
MA/PSR Council, the Site
Medical Directors, the Site
Managers, the Headquarters
Staff Members, and the
31. Quality Council
Doctor: BThe sense is that it_s done.
We can_t say, FCan we change it?_
No. It is coming down from above as
opposed to a collaborative approach.
We get our orders and are under
pressure to make sure certain things
are rolled out in a certain way.[
Site Manager: BBecause I_m
involvedwithQualityCouncil,
most of the time, I can answer
whatever questions [the
providers or staff] have. And
if I have a question I can
always email [Head of
QI]IIn terms of the details
ofthe process, you can say to
whoever developed it,
FWe_re only doing 80% of it
because of this reason._ And
that_s fine. Or, I_ll say, FI_m
running into this and I think
we can handle it this way._[
Y Top managers solicit
feedback during Senior
Rounding to the sites
Note. PCMH = patient-centered medical home; RPIW = Rapid
Process Improvement Workshop; MA = medical assistant; PSR
= patient service
coordinator.
A Model for Developing and Spreading QI Innovations 299
33. monthly meeting and rolling out that process at their sites.
In addition, the use of MA and PSR process advocates as a
key means of spread sometimes resulted in providers at the
sites not hearing about a new process until they were
midsession and their MA or PSR informed them of it. Key
facilitators for this step were creating timelines for rollout
that took into account the preexisting meeting schedule for
organizational leaders and introducing new processes at
well-attended site level provider meetings.
In BDisseminate Information,[ process owners intro-
duce the new process into lead users_ daily routines by
appointing lead users to formal positions with responsi-
bility for spread (who we call Bprocess advocates[). Within
an organization, there are already shared norms and com-
mon daily workflows for organization members in particular
roles, so there is less of a need for translation and integration
activities directed at lead users than has been shown in
other models of spread such as the AIDED model. Instead,
the key activities associated with this step are to formally
appoint process advocates for each site, train them at a
monthly process advocate meeting, and develop a computer-
based learning module to help process advocates incorporate
the new process into their existing workflows. One barrier
to disseminating information is that MA and PSR process
advocates may not fully understand the new process after it
is introduced to them. Process advocates sometimes found
the new standard work documents to be confusing. Dissem-
inating information was facilitated by simplifying the training
materials to highlight each step by role and by incorporating
lessons learned into computer-based learning modules.
In BFacilitate Peer-to-Peer Training,[ process managers
spread the new process using a peer network composed of
organization members who share their same organizational
34. role and using the authority of Site Managers who manage
the day-to-day work of the process advocates and the target
users. The key activities in this step involve ensuring that
the Site Managers give the process advocates protected
time to train their peers and give the target users protected
time to complete the computer-based learning module. It is
also key that the Improvement Specialists provide trouble-
shooting help to Site Managers and users who need it. A
key barrier to facilitating peer-to-peer training is overloaded
process advocates; process advocates need to have time to
help staff struggling with particular aspects of a new process.
A key facilitator of peer-to-peer training was gaining the
buy-in of the Site Manager so that he or she took the time
upfront to talk to the process advocates and understand the
process in-depth in order to help make any necessary modifi-
cations before the process advocates started their training.
Our model includes two final stepsVBReinforce[ and
BLearn and Adapt[ across the organization. Because, within
an organization, there are structures such as formal perfor-
mance management processes and formal communication
structures, our model uses these to reinforce the new process
in an ongoing way, to solicit feedback to continue to adapt
the new process to user needs across the organization, and
to drive further improvement. The key activities in this step
include process advocates performing competency checks
of their peers, and Improvement Specialists auditing ad-
herence to new processes and soliciting feedback within the
preexisting communication structures of monthly staff
meetings. One of the barriers to learning and adapting new
processes is that some staff may perceive that the new
processes are set in stone and that Improvement Specialists
are not amenable to feedback. A key facilitator was a strong
relationship between the Site Manager and the Improve-
ment Specialists; this empowered the Site Manager to make
changes to standard work and to explain to the Improve-
36. cess development and local implementation, and the
AIDED model addresses development, local implementa-
tion, and spread (Bradley et al., 2012; Curry et al., 2013;
Pérez-Escamilla et al., 2012). AIDED_s first two stepsV
assess the landscape and innovate to fit user receptivityV
are new process development steps. Their second three
stepsVdevelop support, engage user groups, and devolve
efforts for spreading innovationVare spread steps. Also,
like in other models of process development and spread, we
found that the adoption of an innovation by individuals in
an organization is more likely if key individuals in their
social networks act as champions for the innovation (e.g.,
Markham, 1998; Meyer & Goes, 1988).
However, our model is unique in that it addresses process
development and spread across sites within an organization.
It also extends existing process models. Specifically, our
model extends PDSA_s process development model by
encouraging broad environmental assessment to ensure that
the new process meets the needs of the broader organization,
sophisticated analysis, and systematic long-term follow-up
components that increase the likelihood of implementing
new workflows efficiently and effectively across an organi-
zation. Also, our model extends AIDED by addressing new
process development and spread within an organization
rather than within and across countries; process steps in our
model leverage preexisting organizational structures, such
as communication channels, standardized roles, common
workflows, and performance measurement systems.
Our study also extends prior models in that, whereas
other studies have shown the importance of innovation
champions, our study provides empirical evidence of how
to harness the energy of a particular kind of championV
process advocatesVfor the spread of new processes. Process
advocates are working staff members in each practice site
37. (e.g., MAs and patient service representatives) who are
formally appointed to serve in this role, are trained in each
new process, and offer one-on-one training to peers. We
describe in detail the position of process advocates and how
this position can be enabled and enhanced. Process ad-
vocates lead by example by always performing the new
process, supporting colleagues_ use of the new process by
answering their questions, and relaying feedback to their
managers regarding any implementation problems.
Yet, although formally appointed process advocates
are a very effective mechanism for spreading new processes
inside an organization, we found that there are several po-
tential barriers to their use: lack of understanding of new
processes on the part of process advocates, lack of protected
time for process advocates to train their peers, and problems
inherent in new processes that arise during training. We
found facilitators to address each of these barriers to spread
by process advocates, including simplification of standard
work documents, support of site managers for protected
time to train, and Improvement Specialist_s help with trou-
bleshooting new processes.
Our findings should be considered in light of limitations
inherent in the study design. First, the study used a pre/post
design, and without a control group, we cannot establish a
cause-and-effect relationship between the use of the new
method and the change in outcomes. Although we attribute
the improvement entirely to the change of method, it is pos-
sible that some of the improvement could also be related to
changes beyond the change of method, for example, if prac-
tices were being held to new levels of accountability either by
regulators or payors. Second, the study of a single organization
limits the generalizability of the findings. There was a high
level of support for QI innovation in this organization, so this
organization may have experienced fewer implementation
39. organizations attempting to implement reforms to redesign
primary care may fail to do it. Our research demonstrates,
however, that successful spread inside organizations is pos-
sible and sustainable. Only by successfully spreading QI
innovations can we achieve the promise of improved safety
in ambulatory settings.
The Appendix comparing our intraogranizational model
to the PDSA and AIDED models (Appendix A, Supple-
mental Digital Content 1, http://links.lww.com/HCMR/
A14) can be viewed online.
Acknowledgment
The authors acknowledge financial support from the MIT
Sloan School of Management.
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44. Project Evaluation
What have I learned
Introduction
This paper will critique the assessment, care plan, Service
arrangement process, Monitoring, and reassessment provided to
a specific consumer.
It will accomplish this:
by identifying and describing each specific component of care
management
the skills used in that component to facilitate services for the
identified consumer
describe the resources available in the target area of the
consumer.
Care management
Describe and discuss each of the 7 components of the Care
Management Process separately: Intake, Assessment, Care
planning, Arranging for services, monitoring, Reassessment and
recording. Be specific !
Intake
How was consumer processed and assigned to the individual
care manager
Assessment
Information collected
Critique
45. Skills utilized
Critique
Care planning
What was the specific care plan developed
Critique of specific care plan developed
Arranging for services
How does agency arrange for services
Critique the arranging for services process
Monitoring
How d0es your agency monitor the process – describe the
process
Critique of your monitoring process
Reassessment
Identify the reassessment process utilized by your agency
Critique the reassessment process utilized by your agency
Recording
Describe the recording process used by your agency
Critique the recording process used by your agency
Community resources
Resources identified for your client from the target resources
available
Critique the availability of resources in your area by type and
amount