Smu 1st Sem Assmnt Questions 2010

Fall 2010 Master of Business Administration- MBA Semester 1 MB0041 – Financial and Management Accounting – 4 Credits (Book ID :B1130) Assignment Set- 1 (60 Marks) Note: Each question carries 10 Marks. Answer all the questions. Q. 1 Explain the Various accounting Concepts and Principles? Q. 2 Pass journal entries for the following transactions 1. Madan commenced business with cash Rs. 70000 2. Purchased goods on credit 14000 3. Withdrew for private use 3000 4. Goods purchased for cash 12000 5. Paid wages 5000 Q. 3 Explain the various types of errors disclosed by Trial Balance? [10 Marks] [10 Marks] 10 Marks] Q. 4 From the following balances extracted from Trial balance, prepare Trading Account. The closing stock at the end of the period is Rs. 56000 Particulars Stock on 1-1-2004 Returns inwards Returns outwards Purchases Debtors Creditors Carriage inwards Carriage outwards Import duty on materials received from abroad Clearing charges Rent of business shop Royalty paid t o extract materialsAmount in Rs. 70700 3000 3000 102000 56000 45000 5000 4000 6000 7000 12000 10000 10 Marks] Fall 2010 Fire insurance on stock Wages paid to workers Office salaries Cash discount Gas, electricity and water Sales 000 8000 10000 1000 4000 250000 Q. 5 Differentiate Financial Accounting and Management accounting? [10 Marks] Q. 6 Following is the Balance Sheet of M/s Srinivas Ltd. You are required to prepare a Fund Flow Statement Particulars Equity Share capital Profit & Loss 14,750 17,000 31,000 15,000 16,500 2006 50,000 2007 65,000 Particulars Cash balances Debtors Investment 25,000 5,000 27,000 nil 80,000 (7000) 2006 10,000 2007 13,000 [10 Marks] Trade Creditors 29,000 Mortgage 10,000 Fixed Assets 50,000 Less: Depreciation (5,250) Short term loans 15,000 Accrued expenses 8,000 7,500 Goodwill 5,000 nilStock Total 1, 26,750 1, 52,000 Total 37,000 1, 26,750 39,000 1, 52,000 Additional Information: 1. Depreciation provided is Rs. 1750. 2. Write off goodwill. 3. Dividend p aid Rs. 3500. Fall 2010 Master of Business Administration- MBA Semester 1 MB0041 – Financial and Management Accounting – 4 Credits (Book ID :B1130) Assignment Set- 2 (60 Marks) Note: Each question carries 10 Marks. Answer all the questions. Q. 1 Explain the tools of Management accounting? Marks] Q. 2 Find the contribution and profit earned if the selling price per unit is Rs. 25, variable cost per unit Rs. 20 and fixed cost Rs. ,05,000 for the output of 80,000 units. [10 Marks] Q. 3 Explain the essential features of budgetary control? Marks] Q. 4 A large retail stores makes 25% of its sales for cash and the balance on 30 days net. Due to faulty collection practice, there have been losses from bad debts to the e xtent [10 [10 of 1 % of credit sales on average in the past.The experience of the store tells that normally 60 % of credit sales are collected in the month following the sale, 25% in the second following month and 14 % in the third following month. Sales in the preceding three months have been January 2007 Rs. 80,000, February Rs. ,00,000 and March Rs. 1,40,000. Sales for the next three months are estimated as April Rs. 1,50,000, May Rs. 1,10,000 and June Rs. 1,00,000. Prepare a schedule of projected cash collection. [10 Marks] Q. 5 A factory works on standard costing system. The standard estimates of material for the manufacture of 1000 units of a commodity are 400 kg at Rs. 2. 50 per kg. When 2000 units of a commodity are manufactured, it is found that 820 kgs of material is consumed at Rs. 2. 60 per kg. Calculate the material variance Marks] Q. 6 The Anchor Company Ltd produces most of its electrical parts in its own plant.The company is at present considering the feasibility of buying a part from an outside supplier for Rs. 4. 5 per part. If this were done, monthly costs would increase by Rs. 1,000 [10 Fall 2010 The part under consideration is manufactured in Department 1 along with numerous other parts. On account of discontinuing the production of this part, Department 1 would have somewhat reduced operations. The average monthly usage production of this part is 20,000 units. The costs of producing this part on per unit basis are as follows. Material Labour (half-hour) Fixed overheads Total costs Rs. 1. 80 2. 40 0. 80 5. 00 [10 Marks]

Are Education Systems Modern as Well as Practical Essay

A willing and able person who cannot find a job is given the title of unemployed. /When person who is willing to do work and also has the ability to do so cannot find a job, they are given the title of unemployed. Willingness to work can come about for a number of reasons such as the desire to escape from poverty or attain a higher standard of living. The problem comes in with the ability of that individual to earn a stipend. With the annual population growth being 1.8% during the last four years, nearly a million workers are being added to the workforce every year. However despite such vast potential at hand, the employment rates are creating an unfavorable environment. Nearly 60% of the population is in the ‘economically productive’ age group and with the alarming fact that the rate of youth unemployment in Pakistan is 8%, higher than the overall unemployment rate of 6% this year. Almost half of the Pakistani workforce is unemployed according to the figures released by the Pakistan Economy Watch. The low growth in labour productivity has not matched the rising labour force and due to the low literacy rate coupled with ongoing economic depression, poverty is constantly growing. Since the scientific revolution and the times of the Age of Enlightenment, our knowledge and the way we are educated has progressed through the advancing scientific methods. In our modern times, colleges give us the option of studying, for example, applied science or theoretical science. Our primary education sector /According to data from the International Labour Organization, the /Our primary and secondary education are to an extent meeting modern standards of education but the problem lies with the Tertiary sector. Unemployment and poverty have affected not only our country but the world. The foundation of the eurozone crisis lies with the 11.8% unemployment rate, up from .1% in only a month. Close to 19million in the 17-nation zone have been affected. The risk of poverty is constantly growing, and has become a global issue. Thoughtfully executed management of (social norms and expectations ) our agricultural sector can prevent the takeover of foreign companies along with the loss of jobs due to mechanization. The modern education as it is seen today consists of learning through the mediums of technology, that being the computer,projectors and the internet. The way I see it, the cramming of facts and dates and rote learning does not benefit our society, instead a practical aspect of learning needs to be taught by the government and private institutions. According to various records, with 50% of our population being women, the number of girl enrolling in middle school is alarming. Science has always fascinated children, but with time the motivation dies down. Reading a textbook surely giving us the knowledge but in the end we learn, give exams and forget. A practical demonstration on the other hand would enable the child to grab the idea better, en-rooting the knowledge permanently in their minds. The government has to not only focus on successfully executing growth-oriented policies but manage our agricultural sector.

CIA operations Essay Example | Topics and Well Written Essays - 250 words

CIA operations - Essay Example Politicians are rightly worried about possible human rights violations, as the CIA is operating in complete impunity, answerable to nobody except the president himself. Congress now wants to see the memorandum which allegedly justified the killing by drone strikes, even including those American citizens who are considered terrorists and living abroad (Shear & Shane, 2013, p. 1). It also coincided with the confirmation hearings for the new nominee for the CIA top post, John O. Brenna, who is considered as the chief architect of targeted killing using pilotless drones. Obama is accused of hypocrisy, who said enhanced interrogation techniques were now stopped, but he is using other means which are equally doubtful, in the legal sense. The said memorandum is really a classified document but Congress wants to see a copy of it, which detailed the justifications of killing an American citizen by his own government; the two reasons are if the target is a senior operative of Al-Qaeda and capt ure is not possible without endangering American soldiers. Israel was caught unprepared during this engagement because its generally cannot agree on a unified strategy if war ever comes. Moreover, the attack occurred during the holies day of Israeli religious festivities, which in that year, also coincided with the Muslim fasting month of Ramadan. The Israelis never thought the Arabs would launch an attack during their own holiest religious day. However, there are several reasons advanced why Israel was caught napping. This includes wrong assumptions made by the Israeli Defense Force (IDF) military intelligence about Egypts strategic plans and real intentions, and so concluded that war is not imminent due these erroneous assumptions. Overall, the Israelis did not think the Arabs were serious about going to war, and thereby ignored all warnings, compounded by the squabble among its generals. human body is a very complex system that is highly evolved over the years.

Principles of Project Management Essay Example | Topics and Well Written Essays - 1000 words

Principles of Project Management - Essay Example According to the research findings, it can, therefore, be said that in a functional organization, staffs from the main organization are the ones that fill the functional positions in a project, for example, the people handling the Finance and Accounting will come from the Finance and Accounting department of the organization. This type provides clear authority and designation but may lack on the specific needs of a project. The second organizational structure, the project based, is done for huge projects involving a large number of people in a longer period of time. Staffs are accumulated and several functional departments are created from within which promotes clear authority and clear focus. The downside is the duplication of functions among the departments for instance that the project may have a Finance department duplicating the central Finance department. Finally, the matrix based upholds expertise and maximization of competencies within an organization. Here, staffs with requi red expertise report on their specific department while doing tasks and reporting on one or several projects that need their skill. The major disadvantage is the indistinct authority that may occur since one person may report to several project managers. Selection of the organizational structure would depend on the capacity of the organization, the project scale and the time allotted for its completion. The model, as shown, depicts specific authority and relationship among the project team members. The Senior Responsible Owner or SRO is the main owner or chair of the project which requires an active participation and not just a figurehead role in representing the project team.

Buddhism Essay Example | Topics and Well Written Essays - 750 words - 9

Buddhism - Essay Example It has also stayed conservative because aboriginalphilosophies of the nations it went to never really influenced it. Conversely, the Mahayana belief bases itself on culture, for instance, the Bon and Tibetan Buddhism. Theravada’s philosophy is straightforward. All worldly phenomena possess three traits, which are transient, impermanent, unsatisfactory and no one owns them. Elements that are compound contain both the material and non-material part. Further, they contain nothing but five compounds such as the material quality and non-material qualities such as consciousness, sensations, mental formatives, and perception (Duiker 225). The Theravada belief has remained intact since inception by the elders who heeded to the customof the abbots of the initial Buddha council. Theravada exhibits no hierarchical authority framework. However, the Sangha respects seniority, and the Pali canon, Sanskrit’s Tripitaka and Pali’s Tipitakaare the authoritative scripture, which contains the entire teachings of the Buddha (Saibaba 122). Based on understanding, it is the best thing to venerate Buddha and obey his teachings devoid of biastowards any tradition. This may prove intricate depending on a person’s culture. However, the pronounced teachers from all civilizations avoid any possible bias. The Theravada routeis captivating because it sticks to the fundaments. It is a live tradition with an uninterruptedancestry, which traces back to the ancient Buddha. Theravada Buddhism is the chief religion in the South East Asian dispensations such as Cambodia, Sri Lanka, Burma, and Thailand. Mahayana Buddhism depicts much of the teachings by Buddha’s,but it is churned with additional philosophical conceptions so that it appears to have a different view and leading to a dissimilarobjective. Both Mahayana and Theravada traditions honor and follow ShakyamuniBuddha. Theravada followers do not venerate the various celestial gods and Buddha as

Philosophy in education Essay Example | Topics and Well Written Essays - 250 words

Philosophy in education - Essay Example t it argues that the same tried and true methods and subject matter should continue to be taught to the next generation of students do the fact that it is both tried and true and has informed the preceding generations. On the other hand, progressivism takes the more â€Å"liberal† approach in positing that individuality, progress, and change are key cornerstones of a truly great education (Labaree 281). Naturally, he progressivists approach to education has been largely informed by many sociological, anthropological, educational, and psychological breakthroughs of the 21st century. If one were to choose to follow a strictly perennialist approach to education, a very formulaic approach would ensue; one that placed a high level of emphasis on utilizing the relevant and historical primary texts that have informed education and thought throughout the centuries. For instance, a class on music would be taught focusing upon classical music theory, the works of Brahms, Bach, and Beethoven, and healthy amount of analysis and discussion of the symphony and the role of chamber groups. In this way, contemporary writings or the introduction of new material, rock n roll, jazz, or even swing music would likely not be included. It is the belief of this particular student that the best approach is thereby the progressivist approach. Due to the fact that our world continues to change at such an alarming rate, focusing solely and single-mindedly upon a strict interpretation of classical texts, and the ways in which knowledge has been inferred for hundreds even thousands of years may not be an appropriate way to better the learning understanding of the pupils involved in the process. Although the progressivists also exhibit some shortcomings, it is the belief of this author that such an approach could better inform the next generation of open minded professionals with regards to the key information they should seek to

Job resume Essay Example | Topics and Well Written Essays - 500 words

Job resume - Essay Example Excellent communication skills, good negotiation skills, passion in travelling, fluency in English and the ability to undertake difficult responsibilities are some of the plus points which made me suitable for this profession. Apart from marketing skills, in my opinion, a marketing professional needs management skills and the ability to work in a team. My diverse experiences in Bobby Brown Cosmetic Shop, Samsung life insurance and Oriental Spoon Restaurant have added more value to my leadership, marketing and management skills. It is difficult to market a product using the same marketing strategy all over the world. Each market has its own identity and characteristics because of the cultural, social, political and economical differences. In other words, custom made marketing strategies are necessary for each market. Korea is one of the rapidly developing economies in the world even amidst tensions with the neighboring countries like North Korea. In United States, FedEx has succeeded in monopolizing the logistics market whereas in Korea same thing cannot be said about FedEx. I have studied many of the marketing strategies of the FedEx in America and I think I can implement those strategies in Korea with a little bit of fine tuning. Currently, FedEx failed to deliver even in-state deliveries on the same day of shipping in Korea (Max). But in United States the case is different. In fact same day delivery of goods made FedEx the number one logistics company in United States. In my opinion, FedEx should try to deliver as much as goods on the same day of shipping in Korea also in order to become the market leader there. I have an extensive 150 days marketing plan for my Korea operations if succeeded in getting a marketing profession in FedEx. If FedEx provides me an opportunity to work in Korea, I will use the initial 30 days for studying the market. Market study is

Coca Cola Marketing Essay Example | Topics and Well Written Essays - 750 words

Coca Cola Marketing - Essay Example While Coca-Cola remains mindful of all its responsibilities, its constant endeavor is to maximize long-term returns to the shareowners. As an organization, Coca-Cola takes due care about people's health and well-being. The company aspires to make a positive difference in people's lives. It also seeks to help them lead active and healthy lifestyles. The company not only supports programs that encourage active living but also plays a leading role in identifying and implementing solutions to combat the issues of obesity. Product Portfolio The company has in its product repertoire more than 3,500 beverages ranging from diet and regular sparkling beverages. Over the years, the company has added still beverages like 100 percent fruit juices and fruit drinks, water, sports and energy drinks in its product portfolio. Teas, coffees, and milk-and soy-based beverages are slowly but surely increasing as a proportion of the total product portfolio of the company. Amongst all its brands, companyâ €™s namesake brand Coca-Cola, popularly known as Coke, remains the company’s most popular and biggest-selling soft drink in history. Along with the Coca-Cola, which is the world’s most valuable brand, the company owns and markets four of the world’s top five nonalcoholic sparkling beverage brands, including Diet Coke, Fanta and Sprite. The Company's product portfolio also features 15 billion dollar brands including Powerade, Minute Maid, Simply and Georgia. One of the most recent successful launches for the company has that been of Coca-Cola Zero. The company, in 2009, sold more than 600 million cases of Coca-Cola Zero globally. The company's beverages are reportedly consumed at a rate of 1.7 billion servings a day. Mission of Coca-Cola Armed with numerous quality beverage brands that anticipate and satisfy people's desires and needs, the Coca Cola Company’s stated mission is to refresh the world, inspire moments of optimism and happiness, to create v alue and make a difference. Positioning of Coca-Cola Coca-Cola has been positioned as a brand that inspires creativity, passion, optimism and fun. Customer Snapshot The vast array of beverages from the stable of Coca-Cola satiates the diverse and ever-changing needs of millions of consumers around the world. The company has its distribution channels in over 200 countries of the world and its products cater to consumers of different demographic profiles and to consumers belonging to different socio-economic classes. Historically the company’s brands catered to the youth only. However with the addition of numerous products, sportspersons, health conscious, adults form consumers of the company. Competitive Analysis and Market Share The decades old competition between Coca-Cola and Pepsi has been referred to as the ‘Cola Wars’. These two beverage behemoths have been arc rivals and have indulged in what may be termed as a ‘brand vs. brand’ battle in all t he markets in which they operate. Globally, Coca-Cola has a slight edge over Pepsi, even though the market share situations may vary in different geographies. In the U.S market Coca-Cola has a market share of close to 43 percent vis-a-vis 30 percent market share of Pepsi. Numerous other players share the rest of the 27 percent market share. Marketing Budget The Coca-Cola Company does not divulge the amount it spends on advertising by country, brand, or media

Proposal for the analytical report Thesis Example | Topics and Well Written Essays - 1000 words

For the analytical report - Thesis Proposal Example Technology has revolutionized business activities especially sales and marketing. I will present a variety of smartphone options that the company’s sales and marketing department can use to ensure the achievement of company’s vision in sales. I will then do a comparison of the options gauging their strengths and weaknesses in relation to the objectives of the company. I will ultimately present my recommendation to the company suggesting the best option that it can settle that is relevant to the same objectives. The company is operating in a highly competitive environment where success involves an integration of many factors .The sales have been dwindling in the past couple of months owing to inadequate networking between the sales staff and the company’s product consumers. The high cost of advertising via the local media (radio and television) has made it virtually impossible to advertise these products adequately. The sales manager noted that the company started losing some of its customers to rival companies. He noted that this was not necessarily due to the competitors having better products but attributed this to the loss of personal touch between the company sales agents and the customers. The company realised that the figures they were getting from revenue sales were way less than the ones projected at the beginning of the financial year. The scope of the options that I chose for the report have features that will help address these concerns and hopefully provide even more ben efits. The company has a goal of further expansion of its network and it’s afraid this would not be possible with poor sales and without an effective system of communication. With this goal in mind, the company would like a recommendation of my report to suggest a good brand of smartphone that it can invest in for use in sales and

Scenario #1 Assignment Example | Topics and Well Written Essays - 1000 words

Scenario #1 - Assignment Example After responding to the patient’s need, the next procedure was for the nurses to relate to the patients pain. Thereafter, effective measures in easing the pain experienced by the patients were to be undertaken by the nurses. Constant monitoring of the patient’s condition and communication with family members could assist in understanding the patient’s condition. Constant monitoring of the patient’s condition in collaboration with health professionals will help in promoting good healthcare for patients (Lemmer, 2009). Documented history of the patient home care is also helpful in improving care since doctors can easily monitor patient condition when he/she is brought to the hospital. Family meeting on the health of the patient assists in toning down the tension and coming up with a common message and feeling towards the health of the patient. In this case, a family meeting would help in appointing a person to collaborate with the nurses and doctors in taking care of the patient. The patient had several signs that caused pain and anguish to the patient while at the same time it led to the death of the patient. The important steps that need to be carried out in managing the patient look into reporting, responding, relating, reasoning and reconstructing. These steps are used in taking care of the pain and managing the patient in the process of providing good healthcare to the patients. In this case, the nurses would have managed the pain suffered by Mrs. H. and then make her comfortable while looking for solutions to each of the symptoms (Lemmer, 2009). The first care step would be to make Mrs. H. comfortable and rehydrate her for the patient to be able to cope with her pain. In this case, stabilizing the patient is quite important for Mrs. H. while at the same time looking for solutions through consultations with doctors and experts. Teaching the family the process of monitoring the

Iphone vs android Essay Example for Free

Iphone vs android Essay Over the years technology has been improving in terms of entertainment, social media, and communication. Today, smart phones are a verification of this improving technology, but how do we decide which one is the better device? IPhone and Android are the latest most powerful operating systems out on the market. There are advantages and disadvantages to both cellular devices, and the ongoing competition will improve the smartphones for years to come. Affordability and durability are the two key factors when it comes to purchasing a smart phone. Apple and Google have gone head to head on competing for the best products. Most people assume that the expensive device has better durability and can be used longer. Price wise the Android phones ranges anywhere from one hundred to three hundred dollars. In contrast, the iPhone price range is between two hundred to six hundred dollars. Most Android users report that they have dropped their phone multiple times and have not had major damage to their phone. On the other hand, iPhone users state that the front screen display can be shattered easily because of the front screen glass like display, and replacing the screen can often cost more than the phone itself. There is a wider range of android phones as they are made by a variety of manufactures. Android gives you the flexibility to choose from many different colors, sizes or distinct features. The iPhone is restricted and limited to one model each year, but recently Apple has now developed two phones with different colors to match your personal preference. Nonetheless, Apple phones have the same features. While these phones are more powerful and fun than any other smartphone, that fun comes with a price. Any smartphone user will recharge their phone almost  every couple of hours. The cellular data network on each phone drains the battery the most, because we use it daily either for social networks or important information for homework. A smartphone without applications is nothing but an ordinary dull phone. The applications are the hub of the operating system. Both the iPhone and Android have app stores which are the Apple App store for iPhone and the Google Play Store for Android. According to recent news, each store now has about 700,000 apps. Many of the apps are free for both stores, but Apple on the other hand has a reputation for being pricey. Its also worth noting that Android is still the second option for big companies developing applications. Many applications exist for both devices. It’s logical that the main focus is on releasing and updating the paid applications before the free ones. Each operating system has voice activated assistants which is an app on the android called S-Voice app and the well-known Siri for the iPhone. Siri is admired and amazingly beneficial to all the iPhone users. The voice activated assistants on each device, is an automated assistant that responds when one speaks to it, as if you were speaking to a person. There is also a free Android app called Robin, which pursues to rival Siri. Both of these devices contain a guided navigation system which help in getting around the local area. Apple Maps which is an app for the iPhone and Google Maps for Android. Google Maps allows the use of Googles Street View; Apple Maps does not. When using the GPS on the iPhone there have been complaints on how the GPS guides them to an unusual location rather than the original destination. The GPS for Android users is accurate and more reliable to use especially when going on road trips. Web Browser on Apple Safari for the iPhone and Google Chrome are both fine choices which work well on a mobile screen and offer touch screen capabilities, zooming in for instance is an example. In comparison the two phones have incredibly fast internet and it is basically like having a computer in your pocket at all times. Adobe Flash is available on the Android, and it aids in website where a user interface is needed and here is where Android has the advantage. A function that many people can’t seem to live without is the ability to text message. Both of these phones contain the ability to text, not just with one’s fingers but by just by talking to the phone’s speaker. This function is beneficial, because instead of a phone call that might take up your time, you can just send a message within  seconds. IPhone and Android phones are currently the latest, in demand phones. Some people wonder what the difference between the two is, or if they are just the same. Technology changes every day and there’s always new and different phones on the market. Ultimately it’s the user’s preference on which device they would like to purchase.

Construction Budget Over Runs and Late Project Completion

Construction Budget Over Runs and Late Project Completion Construction projects are graded very successful if the work is completed within budget and to the deadlines agreed in the specification. However, the sad truth is that not all projects are guilty of being successful. Many projects experience failure due to the uncertainties associated with construction projects which include weather, materials, equipment, money and profitability, disagreements between clients, contractors and sub-contractors, statutory regulations, economic and political issues and functionality and purpose. To prevent these failures from constantly occurring, the types of failures need to be addressed so future construction projects do not fall into the same category of unsuccessful Civil Engineering construction projects. It is clear that some of these failures occur regardless of careful planning due to uncontrollable conditions such as climate change, recession, delayed deliveries etc. Therefore addressing the controllable issues, contractors can incorporate the se problems into their specification. By understanding the issues from previous unsuccessful construction projects and correlating the failures, it will be easy to identify the common errors and try to eliminate them from future projects. The research will be based on unsuccessful construction projects by using data from case studies, books, the internet and journals. The constraints and limitation of this paper will depend highly on the data received and analysed by previous sources and their opinion. The paper will also focus on two main factors, budget over runs and late completion. Examples of Budget Over-runs and Late Completion Projects There are many construction projects which have Budget Overruns and Late Completion. A few examples of budget over-run and late completion projects are: Wembley Stadium Sydney Opera House Tfls Jubilee Line Wembley Stadium The Wembley Stadium was a renovation construction project which required the old stadium to be demolished and rebuilt. The main purpose of the new stadium was to increase the capacity of the stadium, be the new home of English football and also host other sports and national events. The original estimated cost of the stadium was  £757m. This value at completion soared to about  £798m. Multiplex (main contractor) reported about  £45m losses in the construction of the New Wembley Stadium. These losses arose due to factors which include: Weather Sub-contractor walkouts (Cleveland Bridge steel company walkout) Sub-contractor disagreements (trade union of workers walkouts) and Changes in design due to failures. Due to the above factors the completion date of the project was pushed back by about three months. [1, 2] Sydney Opera House The Sydney Opera House was built as a performing arts centre and was designed by Jà ¸rn Utzon. The original estimated cost to build the Opera House was AUS $7m in 1957 and expected to be completed in five years. The project was started in 1959 and the value escalated to a massive AUS $102m and was completed in 1973. Not only did the budget over-run to 15 times the original estimate, but it also took 14 years to complete, which is a very late completion. The main factor which affected this project was insufficient planning during the design stage This led to a series of errors during construction, which effectively caused a domino effect. Hence, increasing the cost and pushing back the completion date [3, 4]. Tfls Jubilee Line The London Underground Jubilee Line extension was to link Stratford and the Docklands to Westminster. This project was planned in 1989 and estimated to cost  £1.2billion. The construction started 1993 and expected to take four years. This however was not the case due to a series of setbacks. There are four major causes for these delays: The project was put on hold for 18 months to find funding The movement of the block signalling system caused delays The location of the O2 Centre (Millennium Dome) had not been established and Due to the collapse of Heathrow Express Tunnel, work was put on hold again. This caused many changes to the original design therefore causing the project to be completed in early 1999, which was a twenty months late completion. The cost also increased to  £3.5billion, an astonishing 70% budget over-run [5]. What Are Budget Over-runs? Budget Overrun can be simply defined as when the final cost of the project exceeds the original estimates [6]. In terms of construction, this means the actual cost of the project at completion minus the original tendered cost during the tendering stage. This therefore creates either a positive value or a negative value. If the value is positive, the project is within budget and has created a profit, if the value is negative, the project has created a loss and is referred to as a Budget Over-run. Why Do Budget Over-runs Occur and What Are The Causes? Budget Over-runs occur constantly in construction projects around the world. The main aim of any business (Construction Company) is to make money, however, it is very common in construction to hear companies reporting losses due to budget over-runs. If the project is completed within the budget specified, it can be graded a success. Therefore this is an ideal factor to use, to rate the success of a project. Budget over-runs occur due to many factors, which are sometimes split into two groups, controllable and extent of damages. The types of budget over-runs are caused by: The cost variations between clients and contractors and sometimes a third party e.g. project manager, consultant etc [7]. Poor estimation during tendering process Disagreements with Trade Union of Workers Climate change Late completion Changes in design etc. This shows that the slightest mistake or changes made could increase the cost of the project dramatically. Research carried out around the world on construction projects has shown that: [8] 9 out of 10 projects over-run Between 50 and 100% over runs were common There was a constant correlation of over-run projects for 70 years in each of the 20 nations and 5 continents surveyed. Average construction project costs are about 33%[9] Another source of research carried out by Jahren, et al [10] predicted that the factors which increased the chances of a budget over-run are: Project size Method of delivery Amount of competition Quality of contract documents and Interpersonal relations There have been predictions published in the User Guide (2005), which outlines the common factors which cause budget overruns. These are: Poor Project Management The project manager/management team is employed to control the entire development to run smoothly and efficiently from start to finish for the project. They may or may not cover the costing depending on the clients preference. If the project management is poor, it will create an effect on the entire project and in the User Guide (2005) it is listed as: Lack of planning and co-ordination Poor communication between members of the project team and the project sponsor Failure to identify problems and institute necessary and timely design and programming changes Lack of control over time and cost inputs Lack of end user involvement. Unexpected Ground Conditions The ground conditions on any construction site are key, if the ground is not tested prior to tendering, the costs could escalate out of control, in order to put it right. This effectively will be the contractors responsibility. Although trial pits and bore holes are used to get an idea of the ground conditions, the true site condition will not be exposed until full excavation. From the time the trial pits and bore holes are carried out to the time of excavation, the ground conditions may have changed. Changes in ground condition may cause a redesign and also cause problems for any machines and materials ordered to site. This therefore should be taken into account as these could increase costs. Shortage of Construction Materials When construction is at its peak development stage in a certain areas, locally ordered materials could be in great demand. Some materials maybe required but cannot keep up with the demand, hence causing delays to the project. These materials might be ordered from other areas of the world, but may cost substantially more as it will need to be shipped in and pushing back the completion date due to delays in material deliveries. Therefore to prevent any shortages occurring this will need to be anticipated and added to the cost to prevent budget overruns. Change in Foreign Exchange Rates If specific materials are unavailable in the local market, it will then need to be imported from overseas. This can cause a problem to the budget if there are dramatic changes in exchange rates. This unexpected exchange rate should be taken into account during costing as it will cause an increase in the budget. Inappropriate and/or Inexperienced Contractors Selection of the right contractor is another key decision. The contractor must be suitable for the project as some projects use a wide range of tenders who price the job. Although, the cheapest tender may be very inviting, it does not guarantee quality. The decision should be made on contractors experience, the contractors successful history of completing jobs on time and within budget and also the most competitive price. Research carried out by Yates et al (2003), the contractors tender which is 15% less than the Engineer, it is very likely there will be a budget over-run. The tenders reputation should also be consider. This could be key as some companies may fall into hardship and bankruptcy. This will delay the project considerably and also increase costs as most contractors tend not to takeover other contractors jobs in case of any problems which could arise during later construction. Natural Disasters/Events These are disasters or events which cause inevitable delays and therefore budget issues to the project. The types of disasters/events which may cause delays and cost implications are wars, riots, earthquakes, landslide, fire, political and economic issues, types of projectile, contamination and many other disasters/events. Underestimations Deliberate cost underestimating occurs in order to gain the job. This will result in the project not being completed and the client having to either increase the budget or retender, hence, causing budget over-runs. Research carried out by Fllyvbjjerg showed that big construction projects were common culprits to underestimation and therefore led to the statement, whatever the cause, almost all large public projects contain initial cost estimating errors that result in the need for increased funding to complete the projects'[8]. The underestimation has been split into four major topics by Fllyvbjjerg: Technical These are known as forecasting errors which are errors requiring changes because of imperfect techniques, honest mistakes, inadequate data, inherited problems in predicting the future and lack of experience on the part of forecasters. In this case, the errors occur between the budgeted estimation and the actual cost of construction. [11] Economical The economical issues are split into two groups, public interest and economic self interest. Public interest is where there are promoters and forecasters who underestimate the cost of the project on purpose to give public officials an incentive to cut costs to save public money. Economical self interest is used to create jobs for Engineers and construction companies and shareholders also get involved to make more money. The fact that shareholders get involved tends to influence the forecasting process and therefore makes an impression on the result. [8] Psychological This is known as appraisal optimism. Promoters and forecasters are held to be overly optimistic about project outcomes in the appraisal phase, when projects are planned and decided. [12] By making the cost seem lower than it should be, will effectively cause the budget to over-run. Political Political explanations interpret cost underestimation in terms of interests and power. The political issue arises on the fact that whether forecasters are intentionally biased to serve the interests of project promoters in getting projects started. This is key in order to start a project quickly, however, there is a legal and moral deception attached this form of underestimation [13]. Change and Variation Orders These are changes to the project and are not part of the outlined work during the agreement of the project. In construction, changes tend to be inevitable and will cause a disruption to the project deadline and also budget. These decisions are therefore discussed prior to any changes being made as it may not suit the client or contractor. Inflation The general definition of inflation in economics is the increase in prices and fall in the purchasing the value of money [14]. This means that if there is an inflation increase, the value of all parts of the project will increase e.g. material costs, machinery hire, wages etc, which in turn increases the budget. To avoid these extra costs, predictions of the market should be checked during the tendering process, by both client and contractors. Acceleration This is where there is a delay but the client demands the project to be completed by the contractor on time, before the completion date or before the agreed extension completion date. Delays Of Completion Time and Payments Delays of completion tend to equal delays of payments, this will cause interest rate repayments to escalate causing the alleged interest trap for both client and contractor. What Are The Overall Effects From Budget Over-runs? It is clear that budget over-runs occur continuously in construction projects around the world. There are many causes for these extra costs which have not been considered during the tendering process. This has caused a bad impression not only on clients but also contractors and end users. The effects on each party is as follows: The client loses faith in the construction industry but in-particular their consultants who are unable to deliver the project on time. This also leads to higher investment being required from the client. The consultants reputation is ruined as they have an inability to control the project budget therefore leaving question marks for winning new projects. Contractors do not make the profits anticipated and failure to complete the jobs leaves their reputation in tatters. The end user will effectively be the one paying the highest price in terms of buying/renting/leasing in order for the shareholders to cover their costs. Overall, its the construction industry that suffers as it causes major headlines in the media for the wrong reasons. Clients will be more cautious before investing in large scale projects which will cause a drop in the construction industry projects due to its feeble reputation. Many construction projects which are accepted by the client will come with a greater risk to the contractor. How To Prevent Future Projects From Budget Over-runs? To prevent future projects from being unsuccessful in terms of budget, the management of costs need to be broken down to show exactly where costs will be greatest and smallest. The estimating, scheduling, accumulating and analyzing costs, and implementing measures to correct construction costing must be adhered to strictly. This will prevent any failures in terms of budget. There is a three step process which can be employed during the planning stage through to the construction stage: Identify the scale of the project (in terms of quality, completion time and budget), Ensure scope is adhered to strictly (in terms of time and budget) Monitor and control the above 2 steps constantly till the completion of the project. A successful project is based on the project manager and contractor working hand in hand to get the greatest efficiency from a project and tend to be based on time, performance and cost. There are many types of key principles and actions which should be followed for a project to be labelled successful and a few are listed below [15]: Good project definition and sound business case, Appropriate choice of project strategy, Strong support for the project and its manager from higher management, Availability of sufficient funds and other resources, Firm control of changes to the authorized project, Technical competence, A sound quality culture throughout the organization, A suitable organization structure, Appropriate regard for the health and safety of everyone connected with the project, Good project communications, Well-motivated staff, Quick and fair resolution of conflict. Risks and uncertainties increase the budget of any project. Therefore, a 10% of the estimated cost contingency plan is usually inputted into many projects to prevent the project from delays and going over budget. Although 10% sounds fairly small, by adding other control systems to the project performance, this value could increase dramatically. However, a good project management costing is more desirable and efficient than a contingency plan. What are Late Completions? In construction projects a late completion is commonly referred to as the time between the actual deadline agreed, to the time the project is completed. This is commonly called a delay in construction and tends to have a major effect on the client, end user, contractor and shareholders. If delays occur in construction projects, the contractor will be subjected to: Additional/Extension time of completion, Immediate termination of contract, Reduced profit or A mixture of the above. This is not always the case, as some delays are not the contractors fault. The other parties involved in the construction stage are, clients, consultants and external influences e.g. suppliers, machinery, mother nature etc. Any delay will create problems between all/some of the parties involved. Why Do Late Completions Occur and What Are The Causes? Delays can be split into three categories, these are: Excusable Delays These are delays which are not caused directly or indirectly by the contractor and in turn the contractor is allowed an extension of time. The excusable delay can also be split into two parts, Excusable With Compensation This is where the contractor is delayed due to the actions of the client, and is given and extension of time and compensated with money for wasted time. An example is if client cannot access the site after the client has approved for the work to start. Excusable Without Compensation This is where the client and contractor cannot be blamed for the delays caused and the contractor is only given an extension of time. An example would be Mother Nature. Non Excusable Delays These are delays caused by the contractor or sub contractor and the contractor is not given any extensions. But the client may get liquidated damages. Concurrent Delays These are delays which occur at the same time. If, and only if two delays or more occur at the same time, then the contractor is entitled to an extension. Delays are caused by the members directly involved in the project and also members indirectly involved in the project. Research was carried out by Odeh and Battaineh (2002) and their finding showed that [17], Client Delays The client caused delays in terms of: Finance and Payments, Constantly Interfering, Indecisive Decisions on Design and Requirements, Very Unrealistic Forced Time Schedule, Minimal Experience of Construction Projects, Minimal Experience of Co-ordination and Communication, Very Poor Employment of Representatives, Inappropriate Feasibility Study. Consultant Delays The consultant causes delays in terms of: Poor Management/Management Team in general, Poor Management of the Contract, Lack of Preparation and Poor Drawings leading to Slow Approval of Drawings, Quality Assurance and Control, Improper Site Investigations and Slow Approval of Tests and Inspections, Poor Consultant Team with Minimal Experience. Contractor Delays The contractor causes delays in terms of: Poor employment of Sub-contractors, Poor Site Management, Inappropriate Construction Methods, Poor Planning including costs, time, budget etc, Terrible Decision Making during Construction, Inadequate Contractor Experience. Material Delays Material cause delays in construction projects in terms of: Overall Quality, Its Demand and Supply, Importing Materials, Inflation Rate of Materials, Late Delivery and Unreliable Suppliers Labour and Equipment Delays Labour and Equipment cause delays in construction projects in terms of: Labour Availability and Productivity, Skilled Labour Availability, Low motivation and morale, Strike Action and Absent Labourers, Equipment Demand and Supply, Frequent Breakdown and Maintenance of Equipment, Improper and Inadequate Equipment. Contract Delays Contract cause delays in construction projects in terms of: Constant Changing of Design, Mistakes and Discrepancies in Contract Documents, Different Party Relationship Breakdowns e.g. disputes, negotiations, breakdown in communication, improper organisation. External Delays External influences cause delays in construction projects in terms of: Climate and Weather Changes, Unexpected Ground Condition Changes, Regular Changes e.g. security codes, I.D.s etc, Complaints and Problems from Neighbours, Inflation of All Materials, War, Riots, and Other Conflicts, Slow Clearance of Site. How To Prevent Future Projects From Late Completions? There are many factors which cause late completions of construction projects. The delays can be caused by direct or indirect actions. Direct actions are delays which can be avoided as these tend to be made by the parties involved. Indirect actions are uncontrollable and therefore by minimising the direct actions, the delay can be kept to a minimum. Research carried out by Nguyen, et al. (2004) on project success factors in large construction projects in Vietnam, Aibinu and Jagboro (2002) on acceleration of site activities and contingency allowances, Koushki, et al. (2005) on what the minimization of time delays and cost overruns would require, and Odeh and Battaineh (2002) on recommendations for improving the situation of construction projects allowed for a table of thirty five methods to be created. These methods would show how to minimise/eliminate delays from construction projects.   Conclusion From the research carried out, it appears that Budget Over-runs and Late Completions are a common aspect of the construction industry. However, it is clear that not all Budget Over-runs and Late Completions are controllable and some are fabricated to seem as over-run and completed late due to the process of tendering. In appears that there is a connection between late completion and budget over-runs hence, these are key factors which need addressing. The most influential effects for over-running and late completion are delays, insufficient finances, loss of reputations and controversial decision making from clients, consultants and shareholders. It is therefore compulsory that all the above measures should be followed, but a few major recommendations must be adhered to in order to make sure the project is always successful. The major recommendations for all parties involved are, Client The client should make sure all finances and payments are available and paid on time, the feasibility study is well planned and accurate as possible, the client should be proactive in decision making and understand what is feasible and what isnt, and the client should recommended a deadline but allow for any anticipated delays. Consultant The consultant should have good people skills, understand the projects objectives and the clients obligations, any misunderstood/discrepancies should be ironed out prior to construction and during the construction stages, this will prevent any major changes required during construction. The management team should be more than adequate and have a good history in the field of the construction project, quality control and assurance procedures should be put in place along with potential disagreement solutions which could arise. Contractor The contractor should tender based on the actual job costs and not the minimum tender in order to gain the contract. The contractor should employ reliable sub-contractors which have a good history in terms of completion and quality, the contractor should have a good management history as well as a good reputation in the type of construction project.

Challenges Faced Rural Healthcare Facilities Health And Social Care Essay

Challenges Faced Rural Healthcare Facilities Health And Social Care Essay Twenty-five percent of the total population in the United States are living in rural areas and compared with urban Americans and healthcare facilities in rural areas generally serve low-income, the elderly, and individuals who are less informed and armed with less knowledge concerning health care prevention measures. Moreover, rural individuals accessing healthcare in rural facilities face barriers to healthcare such as fewer doctors, hospitals and health resources in generation and face difficulty in accessing health services. Statement of the problem   Hospital closures and other market changes have adversely affected rural areas, leaving State and Federal policymakers, and others concerned about access to health care in rural America. Considerable changes in the health care delivery system over the past decade have intensified the need for new approaches to health care in rural areas. Managed care organizations, for example, may not be developed easily in rural areas, partly because of low population density. Research Questions          The primary research question in this study is the question of whether rural health care facilities overcome the ongoing challenges to provide quality medical care to their communities. Rationale of the Research The rationale of this research is based upon the following facts: 1.) Rural Healthcare and Barriers to Accessing Care: Many small rural hospitals have closed, while other health care supply of primary care physicians and other health care provider facilities are in financial straits. Unavailability of resources and transportation problems are barriers to access for rural populations. 2.). The supply of primary care practitioners and other health care providers in rural areas is decreasing. Some are leaving rural areas to join managed care organizations elsewhere. 3.) Barriers to Health Promotion and Disease Prevention. Goals for improving the Nations health over the next decade can be achieved only if rural populations are included in efforts to remove barriers to access and use of clinical preventive services. 4.) Barriers Related to Lack in Health Care Technology. Technologies including telemedicine offer promise of improved access to health care, but their most efficient and effective applications need further evaluation. 5.) Organizational Barriers of Service Provision to Vulnerable Rural Populations: Low population density in rural areas makes it inherently difficult to deliver services that target persons with special health needs. Groups at particular risk include: the elderly; the poor; people with HIV or AIDS; the homeless; mothers, children, and adolescents; racial or ethnic minorities; and persons with disabilities. 6.) Consumer choice and the rural hospital. Factors that drive changes in rural hospitals have a critical effect on consumer choice and access. Significance of the Study This study is significant in that individuals in rural areas are likely to continue to receive less healthcare as well as less effective healthcare if rural healthcare does not gain necessary knowledge, informed by research study as to what should be done to better deliver health care services to those in rural areas. This study is of significance to several groups including patients depending on rural healthcare services, the families of these patients, the rural communities at large and the insurance companies who provide insurance coverage for individuals in rural areas. Methodology The methodology of the proposed research is one of a qualitative nature in which data will be gathered through survey/questionnaires of individuals, physicians and business in the rural community at focus in the research in order to asses whether the needs of the community in terms of healthcare provision are being met. Data analysis will be both qualitative and quantitative in nature. After having administered and compiled data from the survey/questionnaires focus groups will be scheduled to gain further insight into the unmet needs of the community in health care services in needs assessment focus group discussions. Literature Review The California Healthcare Foundation, in its Rural Health Care Delivery: Connecting Communities through Technology report of December 2002 states : Challenges facing rural health care include scarcity of local medical resources and distance between patients, physicians and facilities. (Turisco and Metzger, 2002) Furthermore, it is related in this report that there are insufficient numbers of primary care practitioners in rural areas. (Turisco and Metzger, 2002; paraphrased) In the instance where a patient is forced to travel from home to another area for accessing health care services resulting is a range of difficulties including: (1) time away from work; (2) additional expenses; and (3) the complications of coordinating care in different locales. (Turisco and Metzger, 2002) This increases the chance the patient information will come up missing or incomplete and as well may result in care that is delayed or fragmented. (Turisco and Metzger, 2002) The physicians in rural areas as wel l as other health care providers experience negative impacts due to the low number of health care practitioners in rural areas as well as in the distance factor, which results in limitations on productivity, communication and ongoing education. (Turisco and Metzger, 2002) Research notes that there is more difficulty for the rural providers in communication with other providers of health care. There is much less in the way of opportunities to attend conferences and training due to the requirements of travel, which limits access to medical knowledge and research work. Lower efficiency results due to travel time involved in visiting patients in hospitals and nursing homes as well as in à ¢Ã¢â€š ¬Ã‚ ¦fewer face-to-face visits, and more time on the telephone with other providers and with patients. (Turisco and Metzger, 2002) In a recent report relating to healthcare in rural India stated is that: The number of patients is increasing exponentially each year, putting enormous pressure on healthcare delivery systems worldwide. Hospitals and specialists are concentrated in cities and are inaccessible to the rural poor. (Tata Consultancy Services and Microsoft Corporation, nd) This report relates that several physicians in India along with Tata Consultancy Services (TCS) and the largest IT company in India collaborated in the creation of WebHealthCentre.com which is stated to be: à ¢Ã¢â€š ¬Ã‚ ¦a comprehensive healthcare portal like no other. (Tata Consultancy Services and Microsoft Corporation, nd) Offered are abundant health-related reference material, online medical consultation, online appointment scheduling, and online lab results for physicians. (Tata Consultancy Services and Microsoft Corporation, nd) The WebHealthCentre.com website was stated to have been created with the Microsoft.NET Framework, Micr osoft Windows 2000 Advanced Server, Web services and Microsoft SQL Server 2000. The requirements set out by the physicians in rural areas included: Ease of use by a wide cross section of people; Cutting-edge yet cost-effective technologies; Simple log on by many different users and easy assignment of user rights; Tight security to keep medical records confidential; Structured data capture for future data mining; Scalable to handle millions of users; and Extensible to accommodate audio and video interface. (Tata Consultancy Services and Microsoft Corporation, nd) Benefits resulting from implementation of this healthcare service delivery Network include: Improved access to healthcare; Better use of doctors time; Rapid development, usability; Scalable to millions of patients; and Extensible to new technologies. (Tata Consultancy Services and Microsoft Corporation, nd) Key features of WebHealthCentre.com are stated to include the following: Online, real-time medical consultation with remote healthcare professionals. PC or mobile-phone access to regional directories for hospitals, specialists, blood banks, medical appliance suppliers, and welfare agencies. An online appointment scheduler that enables patients to make appointments with participating physicians. An online lab report tool that helps diagnostic centers automate the process of uploading lab reports to the Web. Access to test results through mobile devices. Online access to electronic health records. Medical image upload services. Online sonogram viewing. A medical student resource center. Healthcare job listings. Online shopping for healthcare supplies. (Tata Consultancy Services and Microsoft Corporation, nd) The Agency for Healthcare Research and Quality (AHRQ) held an expert panel meeting to provide guidance on its new health information technology on July 23-24 2003. The focus of AHRQ is the implementation and evaluation of technologies, which have been shown to be effective in small and rural communities. Secondly, the AHRQ has set its focus upon supporting advancement in the HIT field through implementation and evaluation support for innovation in technologies for use in diverse health care settings. (Expert Panel Meeting: Health Information Technology: Meeting Summary, 2003) The Meeting Summary reports that two general themes emerged from the discussion which are those of: (1) Bringing people together; and (2) Providing technical assistance. (Expert Panel Meeting: Health Information Technology: Meeting Summary, 2003) Activities recommended for achieving their goals are those as follows: Support demonstration projects that involve HIT implementation and will lead to the creation of learning networks comprised of providers from various types of rural health care organizations. Create learning communities that span geography; collect and analyze the outcomes associated with participation. Once factors that facilitate learning communities and HIT implementation have been identified, engage CMS and other purchasers to define an appropriate reimbursement strategy. Incorporate evidence-based primary care guidelines with rural relevance into technological templates. Clinicians are likely to accept clinical guidelines offered by the Federal Government at no cost. Support local capacity development for HIT, including barrier analysis, education and other activities. Provide sustained technical assistance (Expert Panel Meeting: Health Information Technology: Meeting Summary, 2003) Evaluation of the process in rural and small communities includes: (1) scope of the project; (2) goals; (3) critical success factors; and (4) technical assistance. (Expert Panel Meeting: Health Information Technology: Meeting Summary, 2003) Community grants have been focused on the provision of personal digital assistant (PDA) systems in assisting with the decision support role. The initiative is stated to include: (1) development of toolkits; (2) leveraging known tools; (3) developing capacity; and (4) disseminating best practices. (Expert Panel Meeting: Health Information Technology: Meeting Summary, 2003) Ormond, Wallin, and Goldenson report in the work entitled: Supporting the Rural Health Care Safety Net (2000) state: The policy and market-driven changes in the health care sector taking place across country are not confined to metropolitan areas. Rural communities are experiencing changes impelled by many of the same forces that are affecting urban areas. However, due to the demographical differences and other facts existent only in rural life the health care system can be differentiated from those in urban areas in various ways. According to Ormond, Wallin, and Goldenson, it is that difference that highlights the importance of giving consideration explicitly to the impact of competitive forces and public policy developments on rural health care systems and the patients and communities they serve. (2000) The changes that are occurring in the health care sectors are resulting in many providers being threatened in both rural and urban areas however, health care provider failures in a rural area is likely to a much greater impact as compared to health care provider failure in urban areas. Because alternative sources of care in the community or within reasonable proximity are scarce, each provider likely plays a critical part in maintaining access to health care in the community. For this reason, in most rural communities all providers should be considered part of the health care safety net if not directly through their care for vulnerable populations, then indirectly through their contribution to the stability of the communitys health care infrastructure. (Ormond, Wallin, and Goldenson, 2000) The study reported by Ormond, Wallin and Goldenson is based on case studies in rural communities in the states of Alabama, Minnesota, Mississippi, Texas, and Washington selected in representation of à ¢Ã¢â€š ¬Ã‚ ¦a broad range of pressures facing rural providers. (2000) A debate is stated to exist in terms of limited services models for hospitals who fear that more insure d patients or those who are wealthier will be reluctant to use this facilities. Challenges to full-service facilities in rural areas include recruitment and retention of health care professionals and of ensuring the financial viability of local hospitals. (Ormond, Wallin, and Goldenson, 2000) Also related is the fact that health care providers are very reluctant to locate in communities without a hospitalà ¢Ã¢â€š ¬Ã‚ ¦ while simultaneously when there is not a strong physician practice in an area, hospitals find it difficult to attract patients. (Ormond, Wallin, and Goldenson, 2000) Constraints upon a rural hospital of either a full or limited service hospital include its rural location. The population required to support given service, such as a hospital or particular physician practice is spread over a much greater area. Low volume can mean high average costs, a factor that rural health officials feel is not always taken into account in reimbursement. (Ormond, Wallin, and Goldenso n, 2000) Demographical and socioeconomic differences in rural areas places demands upon health care system providers in terms of the need for treatment for more elderly people which are those more likely to have chronic health care needs. (Ormond, Wallin, and Goldenson, 2000) Furthermore, due to the lack of access to mass and major media in rural areas, the individuals residing in these areas are much less likely than those in urban areas to be aware of the availability of health care and public programs. Insurance coverage in rural areas is also a factor because rural areas have higher self-employment than urban areas, and specifically relating to farming operations making it very likely the employer-sponsored insurance in minimal. Of those who are insured in rural areas, it is likely that many of these are under insured with high premiums and low benefits as compared to those insured in urban areas. The social structure of rural communities may make the stigma attached to particip ation in public programs greater, particularly in the case of Medicaid. (Ormond, Wallin, and Goldenson, 2000) The range of services offered in rural hospitals is limited by the size of the area it serves as compared to the population within that area. Many of the hospitals in the study reported by Ormond, Wallin and Goldenson relied on a local primary care physician for core servicesà ¢Ã¢â€š ¬Ã‚ ¦but augmented his or her capabilities by making arrangements with other, nonlocal providers. The core services each hospital offers depend primarily on the capabilities of their physicians. (2000) In order that a hospital be able to support a visiting specialist program it is a requirement that the hospital have the staff that is appropriate and qualified to assist in the various specialties and physicians be able to monitor recovery, as well as the necessary space and equipment for procedures. (Ormond, Wallin, and Goldenson, 2000) The rural hospital is not in the position to provision all the services needed within the community it serves and this makes a requirement of having a referral system of a reliable nature. Stated to be a mainstay of the safety net in rural areas just as is the case in urban areas is the community health center. (Ormond, Wallin, and Goldenson, 2000) Another important provider of care in rural areas is the local health department. Another problem in rural areas is transportation for patients in that in rural areas there is oftentimes no public transportation. Internal strategies reported to be used by rural health care providers are inclusive of: à ¢Ã¢â€š ¬Ã‚ ¦increasing the stock of physicians and other health professionals, tailoring facilities and services to the needs of the community, and expanding, downsizing, or diversifying as needed. (Ormond, Wallin, and Goldenson, 2000) Other stated strategies are inclusive of cooperation among rural providers and developing links with urban providers through mergers, management contracts, and joint projects. (Ormond, Wallin, and Goldenson, 2000) Initiatives have been developed for recruitment of physician s and other health professionals who are familiar with life and medical practice in rural areas. (Ormond, Wallin, and Goldenson, 2000) Those who are recruited for practice in rural areas are likely to remain after recruitment. All five states in this study report that they provide support: à ¢Ã¢â€š ¬Ã‚ ¦for the development of rural health professionals by requiring, facilitating, or funding training opportunities in rural areas so that students become familiar with the particular demands and satisfactions of rural medical practice, or by funding education either through scholarships for aspiring providers from rural areas or through loan forgiveness for providers agreeing to locate in rural areas. (Ormond, Wallin, and Goldenson, 2000) Only the state of Washing is stated by this report to have a formal residency program. Service expansion is reported to be utilized by rural hospitals and clinics for enabling them in meeting a broader range of health care needs in their communities. (Ormond, Wallin, and Goldenson, 2000) Areas of expansion included: (1) the construction or renovation of a physician plant; (2) the addition of new medical services; and (3) diversification beyond traditional acute services. (Ormond, Wallin, and Goldenson, 2000) In fact, growth and expansion as compared to downsizing appeared to be the more common, and seemingly more successful, route. (Ormond, Wallin, and Goldenson, 2000) Expansion is also noted in outpatient services offered by hospitals and clinics. Cooperative efforts among rural providers as these health care providers collaborate in order to ensure the capability of serving their communities will continue is noted in this report stating that cooperation with other rural providers is also a mainstay of rural hospitals strategy to ward off encroachment by urban health care systems. (Ormond, Wallin, and Goldenson, 2000) The work of Rygh and Hjortdahl entitled: Continuous and Integrated Health Care Services in Rural Areas: A Literature Study makes a review of literature that examines possible methods of improving healthcare services in rural areas. Stated by these authors is the fact that: Healthcare providers in rural areas face challenges in providing coherent and integrated services. (Rygh and Hjortdahl, 2007) This study proposes a need for greatly flexibility in traditional professional roles and responsibilities, such as nurse practitioners of community pharmacists managing common conditions. (Rygh and Hjortdahl, 2007) Further stated is that the substitution of health personnel with lay health workers or paraprofessionals often in combination with interdisciplinary teams, is among measures proposed to alleviate staff shortage and overcome cultural barriers. (Rygh and Hjortdahl, 2007) Other findings of this study include that for those working in rural areas called for is flexibility of roles and responsibilities, delegation of tasks, and cultural adjustments by the healthcare practitioners. (Rygh and Hjortdahl, 2007) This study states that rural case management is greatly dependent upon a locally based case manager and that the highest ranked skills for rural case managers are: the ability to be creative in the coordination of resources, multidimensional nursing skills, excellent communication skills, high-caliber computer skills and excellent driving skills. (Rygh and Hjortdahl, 2007) Stated is that: Case management in a rural environment requires a much broader and generalist knowledge base, it covers all levels of prevention and transverses all age groups. Rural case management is a distinct specialty area of practice, with a distinct knowledge base and skills level, and nurses should be prepared at the advanced practice level. (Rygh and Hjortdahl, 2007) This study further relates that evidence exists of the success of: à ¢Ã¢â€š ¬Ã‚ ¦collaboration at the interface betw een primary and secondary sectors may improve access, continuity of care and the quality of service delivery in rural areas. (Rygh and Hjortdahl, 2007) This study defines telemedicine as Medicine practiced at a distance therefore encompassing diagnosis, treatment and medical education. (Rygh and Hjortdahl, 2007) The state of Maine is stated to have a well-functioning telemedicine services system using telemedicine in a broad array of interactive videoconferencing applications, including mental health and psychiatry, diabetes management, primary care, pediatrics, genetics and dermatology. (Rygh and Hjortdahl, 2007) According to this review telemedicine has the potential to be a tool of a valuable nature in achievement of healthcare access in rural areas although the cost-effectiveness of telemedicine has yet to be documented. (Rygh and Hjortdahl, 2007; paraphrased) The work entitled: Providing Hospice and Palliative Care in Rural Frontier Areas states that the National Rural Health Association (NRHA) à ¢Ã¢â€š ¬Ã‚ ¦believes that all Americans are entitled to an equitable level of health and well-being established through health care services, regardless of where they live. An important but often overlooked aspect of health and well-being is assurance of appropriate care and support when people are experiencing chronic, progressive illness and/or approaching the end of their lives. (Providing Hospice and Palliative Care in Rural Frontier Areas, 2005) In order to study this area of service provision the method for defining and assessing needs is stated to be through a needs assessment to include recruitment of a group of members of the community for participation in identifying the needs and creating a method of assessing results. Data is gained from various sources an may include the following: Demographics of the community; disease statistics (county health department and state vital statistics division); List of health care organizations/agencies that provide related services; A definition of unmet or under-met service needs; Identification of the unique characteristics that differentiate palliative care and/or hospice services from other services in the community; Vital statistics, including cause of death, age at death and location of death; Loss data; Community residents satisfaction with current hospice and/or palliative care services, obtained through interviews; and Community members preferences about hospice and palliative care. (Providing Hospice and Palliative Care in Rural Frontier Areas, 2005) Recruitment of individuals in this type study are stated to include: Community residents; Representatives from other community service providers such as a librarian, store owners, chiropractor or dentist; The president of a fraternal organization, the Rotary Club, another service club or the Chamber of Commerce; Pastors or leaders of local faith communities; Someone involved with the local food pantry or other emergency relief organization; An influential local business person such as the feed store owner; A county extension staff person active in community events and volunteer work; Someone who organizes the towns annual parade, festival or other special events; Someone who works on civic clean-up and beautification; and Representatives from other small organizations and entities in each of the countries the provider serves. (Providing Hospice and Palliative Care in Rural Frontier Areas, 2005) This study speaks of the creation of capacity building in expansion of the service provision and in meeting unmet or undermet needs in rural areas. Capacity building strategies include education and training of staff for skills development needed in broadening the services provided. Community education in establishing a broader understanding of what services and opportunities are available for care is also stated to be a strategy for capacity building as service utilization will be increased as well. Capacity building strategies as well are stated to include outreach strategies for development and sustaining partnerships and collaborations as well as in sustaining and supporting growth of expectations related to hospice and palliative care services. (Providing Hospice and Palliative Care in Rural Frontier Areas, 2005; paraphrased) Stated as practical examples of the training and education of staff and the philosophy used by rural providers in the creation and sustaining of program ca pacity are those as follows: Development and adoption of service performance parameters; Education of the board and/or local leaders in national trends such as palliative care, open access, managed care, chronic care management and the nursing shortage; Establishment of an ethics committee comprised of community members, hospital representatives, palliative care and hospice program staff, and church members to review specific ethical considerations/cases and to address projects such as advance care planning and advance directives; Importing best practices in enhancing service definition and outreach; Offering support for local and offsite continuing staff education an subsidies for staff to pursue relevant credentials; Offering support for local and offsite continuing staff education and subsidies for staff to pursue relevant credentials; Appointing full-time or substantially part-time physicians and advanced practice nurses as soon as feasible and involving these individuals in professional and community outreach; Establishment of bridge programs and/or extended palliative home care; Improved/extended utilization of volunteers in meeting caregiving requirements. For hospices, this may include volunteer participation in providing continuous care as allowed by regulations; and As needed, referrals to other organizations. (Providing Hospice and Palliative Care in Rural Frontier Areas, 2005) The work entitled: Planting the Seeds for Improving Rural Health Care relates the Chronic Care Model which portrays the essential involvement of the community, the design and function of the health care system and effective interaction between patients/families and their team of caregivers, producing optimal clinical outcomes. (2005) The following figure labeled figure 1 shows the Chronic Care Model: Figure 1 Chronic Care Model Source: Planting the Seeds for Improving Rural Health Care (2005) Components of this program include the following: Use of a rapid-cycle method for implementing quality improvements; Use of a standard set of changes for teams to implement; Sharing a vision of the ideal system of care developed by clinical experts; Monthly reporting of process and outcome measurements; Three learning sessions; A final national forum during which teams attend sessions with expert faculty to share progress, best practices, and lessons learned. (Planting the Seeds for Improving Rural Health Care, 2005) The work entitled: Practical Tips and Information Resources for Developing Collaborative Relationships Between Rural Community Health Centers (CHCs) and Rural Hospitals asks the question of Why Collaborate? and answers this question by stating that collaboration strengthens community health infrastructure; improves efficiency levels; and provides joint economic advantage. Collaboration is stated to be a process through which parties who see different aspects of a problem can explore constructively their differences and search for (and implement) solutions that go beyond their limited vision of what is possible. (Taylor-Powell, et al., 1998) There are five levels of relationships in building collaborative interorgnaizational relationships around health issues in a rural community which are: (1) networking; (2) cooperating; (3) coordination; (4) coalitions; and (5) collaboration. These five levels of relationships according to purpose, structure and process are shown in the following C ommunity Linkages- Choices and Decisions matrix. Figure 2 Community Linkages Choices and Decisions Source: Practical Tips and Information Resources for Developing Collaborative Relationships Between Rural Community Health Centers (CHCs) and Rural Hospitals (2005) The following are examples of the ways that CHCs and hospital partnerships are able to collaborate. These initiatives may also be used by any rural hospital, CHC or primary care provider: Joint training, recruitment, human resources, and clinical direction; Shared case managers; Working together on disease collaboratives; Shared medical laboratory; Partnership establishment enables organizations in qualifying for funding through grants for which they would not otherwise have been eligible to receive; and Shared electronic patient medical records systems; (Practical Tips and Information Resources for Developing Collaborative Relationships Between Rural Community Health Centers (CHCs) and Rural Hospitals (2005) This study states findings that a number of activities specific to an individual site have the potential for wider replication. Those activities are stated to be as follows: Local foundations can support rural health-related activities; namely physician recruitment and retention. Collaboration of CHCs, hospitals, nursing homes, and assisted care facilities in the same location can serve a large rural area and make efficient use of scarce resources; namely physicians. Affiliation with a large regional hospital can be a positive experience that is supportive of community-based services. Collaboration may be a vehicle for expanding benefits to CHC patients; namely as a result of the collaborative, a hospital utilizes the CHCs sliding fee scale for laboratory services provided to CHC patients. Case management for discharge planning and care coordination between the CHC, home health care agency, and the hospital can improve patient care. Electronic patient medical records systems that integrated the CHC and the hospital medical records are the key to future collaboration and the development of a comprehensive model of a health care system for the rural community. (Practical Tips and Information Resources for Developing Collaborative Relationships Between Rural Community Health Centers (CHCs) and Rural Hospitals (2005) There are important factors identified for organizing a successful collaboration which include: (1)

Department of Education: A waste of taxpayer money or a necessity to ou

The United States Government has fifteen Cabinet level agencies which include topics such as agriculture to foreign affairs however there is one specific agency that spends billions of dollars a year which may or may not be needed. The United States Department of Education is an agency that could be minimized. The United States Department of Education should be minimized and the state and local departments should be in charge of their own education policies. In 1867 the original Department of Education was created to collect information on schools and teaching that would help the states establish effective and competitive school systems. During that time the D.O.E. was called the Office of Education and didn’t have an official place in the Executive Branch. The United States Department of Education (D.O.E.) has been officially around since 1971 when President Jimmy Carter signed into law the creation of the D.O.E. as a Cabinet level agency. Two years later, when President Ronald Reagan took office he planned on abolishing the D.O.E. right away because he believed the federal government was intruding too much and that the state and local governments should control the education (Genovese 164). However, in 1983 the D.O.E. published A Nation at Risk: The Imperative for Education Reform which critiqued America’s public education system. President Reagan was alarmed at this report and decided to retain the D.O.E. because h e saw it as a weakness if our education system was producing citizens not able to contribute positively to our economy (Genovese 165). Since that year, most republican presidential candidates have considered abolishing the D.O.E. until recently. The top contenders for the republican presidential candi... ...011. "DESE Mission." Missouri Department of Elementary and Secondary Education. Government of Missouri. Web. 02 Dec. 2011. "Federal Role in Education." U.S. Department of Education. United States Government. Web. 27 Nov. 2011. "Fiscal Year 2012 Budget Summary and Background Information." FY 2012 Budget Summary: Table of Contents. U.S. Department of Education, 31 Mar. 2011. Web. 27 Nov. 2011. Genovese, Michael A. Encyclopedia of the American Presidency. New York: Facts on File, 2010. Print. NeSA Tests Brochure. Nebraska Department of Education. Web. 1 Dec. 2011. "No Child Left Behind (NCLB)." GreatSchools - Public and Private School Ratings, Reviews and Parent Community. Web. 02 Dec. 2011. "Title I, Part A Program." U.S. Department of Education. United States Government. Web. 01 Dec. 2011. USAJOBS - Job Search. United States Government. Web. 01 Dec. 2011.

Familial DNA Searching Essay -- Genetics

Nowadays, DNA is a crucial component of a crime scene investigation, used to both to identify perpetrators from crime scenes and to determine a suspect’s guilt or innocence (Butler, 2005). The method of constructing a distinctive â€Å"fingerprint† from an individual’s DNA was first described by Alec Jeffreys in 1985. He discovered regions of repetitions of nucleotides inherent in DNA strands that differed from person to person (now known as variable number of tandem repeats, or VNTRs), and developed a technique to adjust the length variation into a definitive identity marker (Butler, 2005). Since then, DNA fingerprinting has been refined to be an indispensible source of evidence, expanded into multiple methods befitting different types of DNA samples. One of the more controversial practices of DNA forensics is familial DNA searching, which takes partial, rather than exact, matches between crime scene DNA and DNA stored in a public database as possible leads for further examination and information about the suspect. Using familial DNA searching for investigative purposes is a reliable and advantageous method to convict criminals. Familial DNA searching works by using the combined DNA index system (CODIS) to compare DNA samples taken from crime scenes to DNA profiles already recorded in the local, state, or national criminal DNA database. There are many indexes in the database; two of the largest are the offender index, a catalogue of DNA profiles from previously convicted felons, and the forensic index, a catalogue of DNA from crime-scenes. A DNA sample is run through the database by CODIS’ matching algorithm that searches the indexes against one another to generate matches according to how often base pairs, or â€Å"markers,† repeat in th... ...of Justice, 1 Sept. 2011. Keiper L. More states use familial DNA as powerful forensic search tool. Reuters [Internet]. 2011 [cited May 16 2012]; N. page. Available from: http://www.reuters.com/article/2011/03/30/us-crime-dna-familial-idUSTRE72T2QS20110330. Riley S. How familial DNA can help crime victims. The Grio [Internet]. 2010 [cited 16 May 2012]; N. page. Available from: http://www.thegrio.com/opinion/how-familial-dna-can-help-crime-victims.php. Singer N. In Fighting Crime, How Wide Should a Genetic Net Reach? The New York Times [Internet]. 2010 [cited 21 May 2012]; N. page. Available from: http://www.nytimes.com/2010/07/25/business/25stream.html?_r=1. Steinhauer J. â€Å"Grim Sleeper† Arrest Fans Debate on DNA Use. The New York Times [Internet]. 2010 [cited 21 May 2012]; N page. Available from: http://www.nytimes.com/2010/07/09/us/09sleeper.html?pagewanted=all.

Reflective Paper

Reflective Paper – Effective Human Resources Management Theresa Tapley BUS 303 Dr. Kevin Righter March 13, 2010 Reflective Paper – Effective Human Resources Management Effective Human Resources Management (HRM) plays a major role in ensuring that an organization will survive and prosper. The HRM facilitates the most effective use of people or employees to achieve organizational and individual goals. The HRM consists of numerous activities which include, equal employment opportunity (EEO) compliance, job analysis, human resource planning, the recruitment, selection, motivation, and orientation of employees, performance evaluation and compensation, the training and development of employees, labor relations, and the safety, health, and wellness of the workforce. Effective human resources management plays a vital role in the success of an organization and is an active participant in charting the strategic course of competitiveness, productiveness, and efficiency. An effective HRM focuses on action rather than on record-keeping, written procedure, or rules. Although the use of rules, records, and policies are incorporated, â€Å"action† is the focus. The HRM emphasizes the solution of employment problems to help achieve organizational objectives and facilitate employees’ development and satisfaction. An effective HRM is, also, people-oriented. Whenever possible, the HRM treats each employee as an individual and offers services and program to meet the individual’s needs. An effective HRM program is concerned with helping an organization achieve its objectives in the future by providing for competent, well-motivated employees. Human resources are incorporated into an organization’s long-term strategic plans to assist with ensuring that future growth needs will be adequately staffed with qualified, trained employees (Ivancewich, 2010, pg 5). EEO and Affirmative Action One external factor that has a powerful influence on my company's HRM unction is the equal employment opportunity and human rights legislation, which has a profound effect on our policies and procedures concerning recruiting, selection, evaluation, and promotion. The U. S. Equal Employment Opportunity Commission (EEOC) is an independent federal agency that enforces laws against workplace discrimination. The EEOC investigates discrimination complaints based on an individual’s race, color, national origin, religion, sex, age, disability and retaliation for reporting and/or opp osing a discriminatory practice. This commission is empowered to file discrimination suits against employers on behalf of alleged victims and to adjudicate claims of discrimination brought against federal agencies. No other regulatory area has as thoroughly affected HRM as the EEO programs have. It has implications for almost every activity in HRM and sets standards for hiring, recruiting, training, terminating, compensating, evaluating, planning, disciplining, and collective bargaining. Employers, to prevent employment discrimination in the workplace or to take remedial action to offset employment discrimination implement EEO programs, (Ivancevich, 2010, pg 65). According to the U. S. Equal Employment Opportunity Commission (EEOC) website, the EEOC is responsible for enforcing federal laws that make it illegal to discriminate against a job applicant or an employee because of the person's race, color, religion, sex (including pregnancy), national origin, age (40 or older), disability or genetic information. The laws also apply to all type of work situations, including hiring, firing, promotions, demotions, harassment, training, wages, and benefits. During the employment selection process, each candidate should be evaluated on their qualification of the job requirements, based on their experience, education, and skill set. Many corporations use testing as an important tool. Rae T. Vann, general counsel of the Equal Employment Advisory Council, a national association of large federal contractors, observed, â€Å"When done properly, testing can be a very important tool in the employment selection process, and we commend the Commission on its efforts to improve the quality and fairness of tests and other job screening methods† (Title VII: Affirmative Action, 2006). I encourage my Clinical Managers to become familiar with the provisions of the EEO standards and guidelines. It is essential that they make every effort to seek counsel from our HR dept when initiating the interview and hiring process, dealing with poor performance, disabilities, demotions, appearance of harassment, and training and re-training. Throughout my five years of administrative management, I have unfortunately had to learn HRM and EEOC laws the hard way, through trial and error. With each mistake that I have made, such as not consulting the HR department before decreasing a dual role employee’s hours so that she could focus on one role due to extremely poor performance, I have learned the proper steps to come to the same conclusion. The decrease in hours caused her to lose her benefits and subsequently she filed an EEOC claim of discrimination and retaliation. Fortunately, due to proper documentation of the corrective actions, developmental action plan and the documented counseling, our HRM has adequate information to refute the claim. Now, I consult my HRM representative with any concerns, questions, or updates related to employee situations. Planning, Recruitment, and Selection Human resources planning are the processes by which management ensures that it has the right personnel, who are capable of completing those tasks that help the organization, reach its objectives. It involves forecasting of human resources needs and the projected matching of individuals with expected vacancies (International Labour Organization, 2010). An effective HR plan, also, provides mechanisms to eliminate any gaps that may exist between supply and demand. HR planning determines the numbers and types of employees to be recruited into the organization or phased out of it (Ivancevich, 2010). The Human Resource Planning Process incorporates strategic planning which will have a direct effect on the organization's profitability. The strategic plan must adapt to environmental circumstances. It must forecast how many and what employees are required for the organizations staffing requirements. Next, it must determine how many and what kind of employees are currently employed with the skills and training necessary for the future needs. Finally, after the HR system has analyzed the supply of and the demand or future workers, these two forecasts are compared to determine what action should be taken. Effective workforce planning is a critical element of effective strategic and operational planning. Workforce planning provides managers with a strategic basis for making human resource decisions. It allows managers to anticipate change ather than being surprised by events, as well as providing strategic methods for addressing present and anticipated workforce issues. The US Department of Health and Human Services states, â€Å"Organizational success depends on having the right employees with the right competencies at the right time. Workforce planning provides managers the means of identifying the competencies needed in the workforce not only in the present but in the future and then selecting and developing that workforce† (US Dept. Health and Human Services, 2010). The HR department for my company has implemented a staffing model tool that projects future, potential, or expected growth versus the actual census, the current staffing and skill set of that staff, and calculates the hiring needs of specific positions within the direct and indirect patient care. Once the future needs are determined, then the hiring process begins. Human Resources Development Training and development are processes that attempt to provide an employee with information, skills, and an understanding of the organization and its goals. Training and development are designed to help a person continue to make positive contributions in the form of good performance and advancement within the organization. A solid orientation program is the first step in developing an employee. It reduces anxiety and fears, reduces start-up costs of a new employee, reduces turnover, saves time for supervisors and co-workers, and develops realistic expectations, positive attitudes toward the employer and job satisfaction. Once will established in a specific position, then the manager and employee must set goals for development and advancement. Management and professional development is designed to reduce obsolescence and to increase employees’ satisfaction and productivity. An important part of development is the evaluation process. Performance management is the process by which executives, managers, and supervisors work to align employee performance with the firm’s goals. An effective performance management process determines and evaluates performance, provides feedback to the employees about their performance, and measures and monitors skill-set (Ivancevich, 2010, pg 251). The company that I work for has an excellent formal performance evaluation process that is very effective in the development the employee and the motivation to succeed. Appraising and managing performance at my workplace starts form the day of hire. Each newly hired direct or indirect patient care must attend a through and intensive training program. After 90 days, from date of hire, the new staff member is evaluated for suitability for the position. The manager will present a written 90-day evaluation to the staff member. This evaluation will result in a successful completion of the introductory period, determine a need for an extension of 30 days to improve and meet expectations, or termination due to being unsuitable for the position (this usually occurs when the staff member continually fails to follow policies and procedures and/or causing patient endangerment). Every manager must complete an annual evaluation for staff members under their direct supervision. The score on the evaluation determine the merit increase and caps set forth by the company. When a staff member is failing to follow policy and procedure, putting patient’s safety in jeopardy, tardiness or excessive absenteeism, insubordination, breaking confidentiality and HIPPA regulations, and etc. the manager will conduct corrective action in the form of documented counseling, written corrective action, final corrective action, 3 day suspension, and/or termination. To make this process more effective and ensure compliance with EEOC and federal and state regulations, both next level supervisor and the HR dept representative must approve all final corrective actions, 3-day suspensions, and terminations. Compensation and Benefits There are several reasons that an employer or corporation will offer benefits and services to their employees. One reason is to keep the organization competitive in recruit and retaining employees. Another reason is to keep a union out or because the union has won this during negotiations. Finally, is the fact that providing benefits and service contributed to increased employee performance and job satisfaction (Ivancevich, 2010, pg358). Federal and state governments mandate three benefits programs offered by private and not-for-profit employers. The three mandated programs are unemployment insurance, social security, and workers’ compensation. In addition to the benefits required by law, many employers provide other kinds of benefits voluntarily, such as, compensation for time not worked, insurance protection, retirement plans, FMLA or medical FMLA, life insurance, short and long-term disability, and various retirement programs and stock ownership plans. Some organizations offer tuition reimbursement and flexible benefits plans. Whenever I am interviewing a candidate for a position, I always spend a portion of the interview discussing and explaining our benefit package. Sometimes our hourly rate is not quite as high as our competitor, but our benefits and employee services usually out ways the difference in compensation. Safety and Health The Human Resource Management team of the dialysis company of which I am employed, works very closely with the National Institute for Occupational Safety and Health (NIOSH) to ensure that the most acceptable and innovative concepts in employee safety and health are used. The NIOSH is the primary federal agency that conducts research on the safety and health of the workplace. The Occupational Safety and Health Act (OSH Act) of 1970, to provide research, information, education, and training in the field of occupational safety and health established it in 1971 (Bradley, 2002). The NIOSH develops and promotes the use of national and state-based surveillance systems to identify, quantify, and track injuries and illnesses. Epidemiological analysis of these databases helps identify unsafe and unhealthy workplace conditions. NIOSH also supports laboratory and field research to further identify, assess, and control occupational hazards and exposures and the diseases and injuries they cause. In addition to identifying risks, the NIOSH develops and evaluates prevention measures such as control technology, personal protective equipment, and work practices. Through research internally within our company and the NIOSH, many improvements and standards have been put into place for water treatment safety and personal protective equipment. We have strong policies and procedures that protect both the employee and the patient from exposure to health or safety hazards. There are several reasons for establishing good occupational safety and health standards. First, on a moral note, an employee should not have to risk injury or death at work, nor should others associated with the work environment. The second is economical in nature. Many governments realize that poor occupational safety and health performance results in cost to the State, through social security payments to the incapacitated, costs for medical treatment, and the loss of the employability of the worker. The employing organizations also sustain costs in the event of an incident at work, such as legal fees, fines, compensatory damages, investigation time, and lost production, lost goodwill from the workforce, customers, and community. Lastly, from a legal standpoint, the occupational safety and health requirements may be reinforced in civil law and/or criminal law. It is a known fact, that without the extra â€Å"encouragement† of potential regulatory action or litigation, many organizations would not act upon their implied moral obligations. During a Frontline interview with assistant secretary of labor for occupational health and safety, John Henshaw, the question was asked, â€Å"How successful do you think OSHA has been at protecting workers in the United States? † Mr. Henshaw replied, â€Å"In the last 30 years, OSHA has made some tremendous strides in reducing injuries, illnesses, and fatalities. In the last six to eight years, injuries have gone steadily down and fatalities have gone down to the point where they are the lowest ever (Frontline, 2002). The dialysis industry is carefully scrutinized to uphold acceptable OSHA safety and health standards. We, also, have internal auditors that simulate inspections to ensure compliance and safe practices. Employee and Labor Relations Labor relations can refer broadly to any dealings between management and workers about employment conditions. Most commonly, however, labor relations refer to dealings between management and a workforce that is already unionized, or has the potential to become unionized. Labor relations are thus crucial to industries like autos and airlines with heavily unionized workforces. In the United States, labor relations were profoundly affected by the National Labor Relations Act passed during the 1930’s, which gave workers the right to form unions and bargain collectively. Labor relations have been drastically affected by the passage of the Taft-Hartley Act, which prohibited the â€Å"closed shop†, as well as, the introduction of right-to-work laws in more than 20 states (Ivancevich, 2010, pgs 477). By the early 21st century, labor relations were less affected by labor unions, to which only 8 percent of private sector workers belonged in 2004, about half of the rate in 1983. The decline reflects the increase in labor relations consultants, who have helped managements avoid unionization (Anonymous, 2010). The presence of a union directly affects most aspects of Human Resources Management, including recruiting, selection, performance evaluation, promotion, compensation, and benefits, among others (Ivancevich, 2010, pg. 34). Unions were once thought of a being for blue-collar factory workers, but now even engineers, nurses, teachers, secretaries, salespersons, college professors, professional football players and even physicians belong to unions. Within my workplace, we have an ongoing informational and educational campaign against the unethical practices of recruitment and enticement for our employees. We offer seminars and counseling in regards to the unionization tactics. While facing declining membership, union officials have turned to highly questionable practice of organizing new members through a process called â€Å"card check†. With card checks, paid union organizers try to persuade workers to sign cards saying that they favor union representation. This persuasion comes in the form of deception, coercion, and harassing visits to worker’s homes. John Ivancevich describes this practice as the â€Å"authorization card† (Ivancevich, 2010, pg. 480). Under current laws, as soon as more than 50 percent of the workers sign a union authorization card, all employees within that organization will be required to participate in the union and pay union dues, even though not a single employee has actually been able to cast a personal, private vote. Often times, individual will sign the cards under intentional or unintentional misunderstandings or to get the organizer to stop harassing them, even though the employee may have no desire to join a union (Anonymous, 2010). Conclusion Human Resources Management is the heart of every organization. It serves as an advocate for each employee, while also protecting the organization from legal repercussions. Whether it is ensuring equal employment opportunity (EEO) compliance, providing job analysis, planning for the future staffing needs and subsequent recruitment and selection of qualified candidates, each of these areas are vital to a well-organized corporation. The HRM is paramount in the motivation, training, and development of employees. Ensuring a positive orientation experience, and concise performance evaluation and compensation will aid in retention and job satisfaction. Finally, the HRM has an extremely important role in labor relations and ensuring the safety, health, and wellness of the workforce. References Anonymous. (2010). When voting isn’t Private. Retrieved on February 26, 2010 from website: http://www. unionfacts. com/articles/cardCheck. cfm Bradley, J. (2002). National Institute for Occupational Safety and Health. Retrieved on 3/1/2010 from website: http://www. cdc. gov/niosh EEOC Office of Legal Counsel staff members (2006). Title VII: Affirmative Action. Retrieved on February 12, 2010 from website: http://www. eeoc. gov/eeoc/foia/letters/2006/vii_affimative_action. html Frontline. (2002). A Dangerous Business. Frontline Interview with John Henshaw. September 30, 2002. Retrieved on 3/2/2010 from website: http://osha. gov International Labour Organization. Retrieved on February 11, 2010 from website: http://wwwilo. org Ivancevich. J. (2010). Human resource management (11th ed. ). Boston: McGraw-Hill. ISBN: 9780073381466. US Department of Health and Human Services. Retrieved on February 10, 2010 from website: http://www. hhs. gov/ohr/workforce/wfpguide. html Reflective Paper Reflective Paper – Effective Human Resources Management Theresa Tapley BUS 303 Dr. Kevin Righter March 13, 2010 Reflective Paper – Effective Human Resources Management Effective Human Resources Management (HRM) plays a major role in ensuring that an organization will survive and prosper. The HRM facilitates the most effective use of people or employees to achieve organizational and individual goals. The HRM consists of numerous activities which include, equal employment opportunity (EEO) compliance, job analysis, human resource planning, the recruitment, selection, motivation, and orientation of employees, performance evaluation and compensation, the training and development of employees, labor relations, and the safety, health, and wellness of the workforce. Effective human resources management plays a vital role in the success of an organization and is an active participant in charting the strategic course of competitiveness, productiveness, and efficiency. An effective HRM focuses on action rather than on record-keeping, written procedure, or rules. Although the use of rules, records, and policies are incorporated, â€Å"action† is the focus. The HRM emphasizes the solution of employment problems to help achieve organizational objectives and facilitate employees’ development and satisfaction. An effective HRM is, also, people-oriented. Whenever possible, the HRM treats each employee as an individual and offers services and program to meet the individual’s needs. An effective HRM program is concerned with helping an organization achieve its objectives in the future by providing for competent, well-motivated employees. Human resources are incorporated into an organization’s long-term strategic plans to assist with ensuring that future growth needs will be adequately staffed with qualified, trained employees (Ivancewich, 2010, pg 5). EEO and Affirmative Action One external factor that has a powerful influence on my company's HRM unction is the equal employment opportunity and human rights legislation, which has a profound effect on our policies and procedures concerning recruiting, selection, evaluation, and promotion. The U. S. Equal Employment Opportunity Commission (EEOC) is an independent federal agency that enforces laws against workplace discrimination. The EEOC investigates discrimination complaints based on an individual’s race, color, national origin, religion, sex, age, disability and retaliation for reporting and/or opp osing a discriminatory practice. This commission is empowered to file discrimination suits against employers on behalf of alleged victims and to adjudicate claims of discrimination brought against federal agencies. No other regulatory area has as thoroughly affected HRM as the EEO programs have. It has implications for almost every activity in HRM and sets standards for hiring, recruiting, training, terminating, compensating, evaluating, planning, disciplining, and collective bargaining. Employers, to prevent employment discrimination in the workplace or to take remedial action to offset employment discrimination implement EEO programs, (Ivancevich, 2010, pg 65). According to the U. S. Equal Employment Opportunity Commission (EEOC) website, the EEOC is responsible for enforcing federal laws that make it illegal to discriminate against a job applicant or an employee because of the person's race, color, religion, sex (including pregnancy), national origin, age (40 or older), disability or genetic information. The laws also apply to all type of work situations, including hiring, firing, promotions, demotions, harassment, training, wages, and benefits. During the employment selection process, each candidate should be evaluated on their qualification of the job requirements, based on their experience, education, and skill set. Many corporations use testing as an important tool. Rae T. Vann, general counsel of the Equal Employment Advisory Council, a national association of large federal contractors, observed, â€Å"When done properly, testing can be a very important tool in the employment selection process, and we commend the Commission on its efforts to improve the quality and fairness of tests and other job screening methods† (Title VII: Affirmative Action, 2006). I encourage my Clinical Managers to become familiar with the provisions of the EEO standards and guidelines. It is essential that they make every effort to seek counsel from our HR dept when initiating the interview and hiring process, dealing with poor performance, disabilities, demotions, appearance of harassment, and training and re-training. Throughout my five years of administrative management, I have unfortunately had to learn HRM and EEOC laws the hard way, through trial and error. With each mistake that I have made, such as not consulting the HR department before decreasing a dual role employee’s hours so that she could focus on one role due to extremely poor performance, I have learned the proper steps to come to the same conclusion. The decrease in hours caused her to lose her benefits and subsequently she filed an EEOC claim of discrimination and retaliation. Fortunately, due to proper documentation of the corrective actions, developmental action plan and the documented counseling, our HRM has adequate information to refute the claim. Now, I consult my HRM representative with any concerns, questions, or updates related to employee situations. Planning, Recruitment, and Selection Human resources planning are the processes by which management ensures that it has the right personnel, who are capable of completing those tasks that help the organization, reach its objectives. It involves forecasting of human resources needs and the projected matching of individuals with expected vacancies (International Labour Organization, 2010). An effective HR plan, also, provides mechanisms to eliminate any gaps that may exist between supply and demand. HR planning determines the numbers and types of employees to be recruited into the organization or phased out of it (Ivancevich, 2010). The Human Resource Planning Process incorporates strategic planning which will have a direct effect on the organization's profitability. The strategic plan must adapt to environmental circumstances. It must forecast how many and what employees are required for the organizations staffing requirements. Next, it must determine how many and what kind of employees are currently employed with the skills and training necessary for the future needs. Finally, after the HR system has analyzed the supply of and the demand or future workers, these two forecasts are compared to determine what action should be taken. Effective workforce planning is a critical element of effective strategic and operational planning. Workforce planning provides managers with a strategic basis for making human resource decisions. It allows managers to anticipate change ather than being surprised by events, as well as providing strategic methods for addressing present and anticipated workforce issues. The US Department of Health and Human Services states, â€Å"Organizational success depends on having the right employees with the right competencies at the right time. Workforce planning provides managers the means of identifying the competencies needed in the workforce not only in the present but in the future and then selecting and developing that workforce† (US Dept. Health and Human Services, 2010). The HR department for my company has implemented a staffing model tool that projects future, potential, or expected growth versus the actual census, the current staffing and skill set of that staff, and calculates the hiring needs of specific positions within the direct and indirect patient care. Once the future needs are determined, then the hiring process begins. Human Resources Development Training and development are processes that attempt to provide an employee with information, skills, and an understanding of the organization and its goals. Training and development are designed to help a person continue to make positive contributions in the form of good performance and advancement within the organization. A solid orientation program is the first step in developing an employee. It reduces anxiety and fears, reduces start-up costs of a new employee, reduces turnover, saves time for supervisors and co-workers, and develops realistic expectations, positive attitudes toward the employer and job satisfaction. Once will established in a specific position, then the manager and employee must set goals for development and advancement. Management and professional development is designed to reduce obsolescence and to increase employees’ satisfaction and productivity. An important part of development is the evaluation process. Performance management is the process by which executives, managers, and supervisors work to align employee performance with the firm’s goals. An effective performance management process determines and evaluates performance, provides feedback to the employees about their performance, and measures and monitors skill-set (Ivancevich, 2010, pg 251). The company that I work for has an excellent formal performance evaluation process that is very effective in the development the employee and the motivation to succeed. Appraising and managing performance at my workplace starts form the day of hire. Each newly hired direct or indirect patient care must attend a through and intensive training program. After 90 days, from date of hire, the new staff member is evaluated for suitability for the position. The manager will present a written 90-day evaluation to the staff member. This evaluation will result in a successful completion of the introductory period, determine a need for an extension of 30 days to improve and meet expectations, or termination due to being unsuitable for the position (this usually occurs when the staff member continually fails to follow policies and procedures and/or causing patient endangerment). Every manager must complete an annual evaluation for staff members under their direct supervision. The score on the evaluation determine the merit increase and caps set forth by the company. When a staff member is failing to follow policy and procedure, putting patient’s safety in jeopardy, tardiness or excessive absenteeism, insubordination, breaking confidentiality and HIPPA regulations, and etc. the manager will conduct corrective action in the form of documented counseling, written corrective action, final corrective action, 3 day suspension, and/or termination. To make this process more effective and ensure compliance with EEOC and federal and state regulations, both next level supervisor and the HR dept representative must approve all final corrective actions, 3-day suspensions, and terminations. Compensation and Benefits There are several reasons that an employer or corporation will offer benefits and services to their employees. One reason is to keep the organization competitive in recruit and retaining employees. Another reason is to keep a union out or because the union has won this during negotiations. Finally, is the fact that providing benefits and service contributed to increased employee performance and job satisfaction (Ivancevich, 2010, pg358). Federal and state governments mandate three benefits programs offered by private and not-for-profit employers. The three mandated programs are unemployment insurance, social security, and workers’ compensation. In addition to the benefits required by law, many employers provide other kinds of benefits voluntarily, such as, compensation for time not worked, insurance protection, retirement plans, FMLA or medical FMLA, life insurance, short and long-term disability, and various retirement programs and stock ownership plans. Some organizations offer tuition reimbursement and flexible benefits plans. Whenever I am interviewing a candidate for a position, I always spend a portion of the interview discussing and explaining our benefit package. Sometimes our hourly rate is not quite as high as our competitor, but our benefits and employee services usually out ways the difference in compensation. Safety and Health The Human Resource Management team of the dialysis company of which I am employed, works very closely with the National Institute for Occupational Safety and Health (NIOSH) to ensure that the most acceptable and innovative concepts in employee safety and health are used. The NIOSH is the primary federal agency that conducts research on the safety and health of the workplace. The Occupational Safety and Health Act (OSH Act) of 1970, to provide research, information, education, and training in the field of occupational safety and health established it in 1971 (Bradley, 2002). The NIOSH develops and promotes the use of national and state-based surveillance systems to identify, quantify, and track injuries and illnesses. Epidemiological analysis of these databases helps identify unsafe and unhealthy workplace conditions. NIOSH also supports laboratory and field research to further identify, assess, and control occupational hazards and exposures and the diseases and injuries they cause. In addition to identifying risks, the NIOSH develops and evaluates prevention measures such as control technology, personal protective equipment, and work practices. Through research internally within our company and the NIOSH, many improvements and standards have been put into place for water treatment safety and personal protective equipment. We have strong policies and procedures that protect both the employee and the patient from exposure to health or safety hazards. There are several reasons for establishing good occupational safety and health standards. First, on a moral note, an employee should not have to risk injury or death at work, nor should others associated with the work environment. The second is economical in nature. Many governments realize that poor occupational safety and health performance results in cost to the State, through social security payments to the incapacitated, costs for medical treatment, and the loss of the employability of the worker. The employing organizations also sustain costs in the event of an incident at work, such as legal fees, fines, compensatory damages, investigation time, and lost production, lost goodwill from the workforce, customers, and community. Lastly, from a legal standpoint, the occupational safety and health requirements may be reinforced in civil law and/or criminal law. It is a known fact, that without the extra â€Å"encouragement† of potential regulatory action or litigation, many organizations would not act upon their implied moral obligations. During a Frontline interview with assistant secretary of labor for occupational health and safety, John Henshaw, the question was asked, â€Å"How successful do you think OSHA has been at protecting workers in the United States? † Mr. Henshaw replied, â€Å"In the last 30 years, OSHA has made some tremendous strides in reducing injuries, illnesses, and fatalities. In the last six to eight years, injuries have gone steadily down and fatalities have gone down to the point where they are the lowest ever (Frontline, 2002). The dialysis industry is carefully scrutinized to uphold acceptable OSHA safety and health standards. We, also, have internal auditors that simulate inspections to ensure compliance and safe practices. Employee and Labor Relations Labor relations can refer broadly to any dealings between management and workers about employment conditions. Most commonly, however, labor relations refer to dealings between management and a workforce that is already unionized, or has the potential to become unionized. Labor relations are thus crucial to industries like autos and airlines with heavily unionized workforces. In the United States, labor relations were profoundly affected by the National Labor Relations Act passed during the 1930’s, which gave workers the right to form unions and bargain collectively. Labor relations have been drastically affected by the passage of the Taft-Hartley Act, which prohibited the â€Å"closed shop†, as well as, the introduction of right-to-work laws in more than 20 states (Ivancevich, 2010, pgs 477). By the early 21st century, labor relations were less affected by labor unions, to which only 8 percent of private sector workers belonged in 2004, about half of the rate in 1983. The decline reflects the increase in labor relations consultants, who have helped managements avoid unionization (Anonymous, 2010). The presence of a union directly affects most aspects of Human Resources Management, including recruiting, selection, performance evaluation, promotion, compensation, and benefits, among others (Ivancevich, 2010, pg. 34). Unions were once thought of a being for blue-collar factory workers, but now even engineers, nurses, teachers, secretaries, salespersons, college professors, professional football players and even physicians belong to unions. Within my workplace, we have an ongoing informational and educational campaign against the unethical practices of recruitment and enticement for our employees. We offer seminars and counseling in regards to the unionization tactics. While facing declining membership, union officials have turned to highly questionable practice of organizing new members through a process called â€Å"card check†. With card checks, paid union organizers try to persuade workers to sign cards saying that they favor union representation. This persuasion comes in the form of deception, coercion, and harassing visits to worker’s homes. John Ivancevich describes this practice as the â€Å"authorization card† (Ivancevich, 2010, pg. 480). Under current laws, as soon as more than 50 percent of the workers sign a union authorization card, all employees within that organization will be required to participate in the union and pay union dues, even though not a single employee has actually been able to cast a personal, private vote. Often times, individual will sign the cards under intentional or unintentional misunderstandings or to get the organizer to stop harassing them, even though the employee may have no desire to join a union (Anonymous, 2010). Conclusion Human Resources Management is the heart of every organization. It serves as an advocate for each employee, while also protecting the organization from legal repercussions. Whether it is ensuring equal employment opportunity (EEO) compliance, providing job analysis, planning for the future staffing needs and subsequent recruitment and selection of qualified candidates, each of these areas are vital to a well-organized corporation. The HRM is paramount in the motivation, training, and development of employees. Ensuring a positive orientation experience, and concise performance evaluation and compensation will aid in retention and job satisfaction. Finally, the HRM has an extremely important role in labor relations and ensuring the safety, health, and wellness of the workforce. References Anonymous. (2010). When voting isn’t Private. Retrieved on February 26, 2010 from website: http://www. unionfacts. com/articles/cardCheck. cfm Bradley, J. (2002). National Institute for Occupational Safety and Health. Retrieved on 3/1/2010 from website: http://www. cdc. gov/niosh EEOC Office of Legal Counsel staff members (2006). Title VII: Affirmative Action. Retrieved on February 12, 2010 from website: http://www. eeoc. gov/eeoc/foia/letters/2006/vii_affimative_action. html Frontline. (2002). A Dangerous Business. Frontline Interview with John Henshaw. September 30, 2002. Retrieved on 3/2/2010 from website: http://osha. gov International Labour Organization. Retrieved on February 11, 2010 from website: http://wwwilo. org Ivancevich. J. (2010). Human resource management (11th ed. ). Boston: McGraw-Hill. ISBN: 9780073381466. US Department of Health and Human Services. Retrieved on February 10, 2010 from website: http://www. hhs. gov/ohr/workforce/wfpguide. html