...Shouldice Hospital: Operations Assessment [pic] Shouldice Hospital has been devoted to repairing hernias for over half a century. Although the Shouldice system has led to great competitive positioning, the hospital is falling victim to its own success. Demand for Shouldice services is so much higher than its current capacity of 89 beds that it is in a constant state of operations backlog, which grows by 100 patients every 6 months. Thus, Shouldice needs to find a solution to its single most critical question – how to expand the hospital’s capacity while simultaneously maintaining quality control of service delivery. The analysis below is designed to assess the current operations at the hospital, in addition to explaining our recommendation that Shouldice should invest $4MM in a new unit, which will increase bed capacity by 50% and require its surgeons to perform Saturday surgeries. As the financial analysis shows, this change will allow Shouldice to capture unmet demand without compromising its unique system of patient and employee care. Lastly, our recommendation will be also juxtaposed to other options we evaluated as potential solutions, but that neither make financial sense nor solve the current dilemma for the hospital. Hospital Overview Shouldice Hospital is a “focused factory:” a hospital with a specific area of expertise that gives it competitive strength resulting in lower cost, higher quality service for its patients, and better pay for and...
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...AET 535 Interview Presentation on Assessments Learning Team B Dr. Greg Thomas 9/30/13 Donna Romano Name: Paula R. Boblitz Title: Nurse Coordinator at University of Virginia's Neuro-Oncology Department Highest level education - Bachelor's degree in Nursing Organization name - Unversity of Virginia Years of teaching - 30 years Type of learning environment - Within the hospital- hands on What kind of assessments are used? We use different assessments. We verbally ask the students questions as well as we watch them work. Questionairres are sent out to the different departments that they are working in to assess their abilities and their work ethic. They are also giving tests about what they did for the week and what they thought could be better or was good about what they did. They are also asked to asses their teaching and themselves. What information do you want your learner to retain? We are hoping that they retain all that they learn. They will be nurses that will work with patients in sometimes life emergiencies. We want them to know what to do and how to do it. If the patient can be saved, we want them to have the ability to do it. How are assessments changes implemented? Once all the data is compiled and read through we take in account what everyone has said and critiqued. We can make changes immediately once all are in agreement. There are 5 of us that make that decision based on the facts of the tests, the journals and the questionairres...
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...continues to be a struggle at Banner Hospital, so it is important that a new pain management process becomes implemented. If nurses become better educated on pain management and how to asses it, if pain goals are discussed and written on the whiteboards, and if pain assessments are included in hourly rounding, pain would be better controlled and patient satisfaction scores would increase. Change, however, is never easy to implement. Once change begins, monitoring the implementation process is important to evaluate the effectiveness, the quality of the change, and how it will affect staffing. Communication also plays a vital role in the implementing process, as keeping everyone informed and empowered is important in order for change to be successful. The proposed solution to help implement the change would be to hold educational programs about pain management and assessments that each and every medical-surgical unit nurse would need to attend. The educational program will be held three times per week for each shift to complete. The program will be mandatory and each week a certain nursing unit will be assigned until all units/nurses have attended the educational program. The educational program for pain management and assessment will teach nurses about the pain process, how to assess it visually and through communication, and what interventions can be done to help manage it. The educational program will also teach nurses on how to use assessment tools for pain and how to explain...
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...needed and gathered from all those parties and then decide (who should you liaise with here) what is really student’s needs which is related to the subject or program they intend to do. The question is who are they involved in such a process to identify the learners’ needs? Here we’ll discuss some of them: • Learner him/herself: learners are the main source of getting information from them directly, cooperation and the welling to answer questions during the assessments is the key point because simply we want them to speak and explain their own needs and they are the ones who know themselves the best. But do they know their rights and needs? And if yes, are they ready to tell/ share those needs with others? The fact is: It’s not that easy to be open and trust others especially in the beginning of the program, here it comes the role of other parties like: • Teacher or tutor: An experienced or good teacher can identify and discover the learner’s needs going through the initial and diagnostic assessments. Teacher has the advantage of direct relationship with learners all over the period of teachings. • Organisation or teaching provider: is the one who organize the whole teaching process and is the one who gives the definition and then the recognition of needs and consequently to provide the effective recourses that learners need. (give an example of an organisation) • Health centres (general...
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...submit this portfolio with your final assignment. Contents Overall Assessment of Achievement 3 Portfolio Instructions & Your Responsibility 4 Guidance for the Supervising Mentor 6 Who can be your learner during the mentorship course? 7 Key meetings and activities with your Learner 8 Record of your initial meeting with Supervising Mentor 9 Learning Contract 10 Assessment of the eight domains of mentorship 11 1 - Establish effective working relationships 12 2 - Facilitation of learning 13 3 - Assessment and accountability 14 4 - Evaluation of learning 16 5 - Creating an environment for learning 17 6 - Context of practice 19 7 - Evidence-based practice 20 8 - Leadership 21 Record of progress meetings 23 Record of final meeting 24 Future developmental Action Plan 25 Acknowledgements This portfolio was developed by the Supporting and Assessing Learning in Practice Settings module team at City University London, with the kind help of practice facilitators who are the members of the Mentorship Programme Board. The table of key meetings and activities (page 7) is adapted from ‘A guide for mentors when using the record of achievement in practice’ by Practice Education Facilitators Gareth Evans (The London Clinic), Anne Levington (St. Bartholomew’s Hospital), Maggie Maxfield (Newham University Hospital NHS Trust) and Raj Samraj (Newham University Hospital NHS Trust). Overall Assessment of Achievement This must be completed by the named supervising mentor...
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...Interview 1. How is the assessment process made and who is involved in the process? Assessments are made by an individual casemanager and then discussed as a team if the issues of the case become to difficult for the individual CM. 2. Is it important to know the clients past? If it is to what extent and details should be known? Yes, it is always necessary to have some access of the clients past history in order to get the full story of where they are currently. 3. Where does the reassessment information need to go, and what information needs to be obtained? The information is placed on a form in the clients chart, be reassessed at a later date. I worked for a hospital as a casemanager, so the info needed would be, support systems at home, medical diagnosis, prior medical history, short and long term plan for the pt. 4. What kinds of lines or boundries are in place for client meetings? Well, they are really no official boundary lines, you just have to use tact and best judgment when asking discreet question. 5. Do the types of relationships you have with a client determine if the case has a negative or positive outcome, if so what are some of those negative or positive situations that could arise? Most of the relationships you have with the pts are superficial and short term. Your goal as a CM in the hospital is to have the client hospital stay to remain as short as possible to save the hospital money. Your ultimate goal...
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...Clinical Foundations – Semester 2, 2013 Clinical Practice Examination: Systematic approach Student: Student Number: Overall Mark: Systematic Approach to Patient Assessment Examiner : 2nd officer: Concept Area and description of performance criteria Approach to scene The student should describe to the examiner the use of PPE, standard precautions and safety equipment. Focus points Explains the use of standard or additional precautions Describes the use of the following gloves; glasses; clothing helmet reflective vest Explains the type of information being sought in the following areas and provides professional inferences on patient condition number of patients exact location time of day weather time to scene / time to hospital partner & qualifications back-up (level & time away) access and egress enquires about nearest appropriate hospital TO TAL /6 Pre brief The student should describe to the examiner the concepts of a systematic pre brief. /10 Concept Area and description of performance criteria Primary survey The student should discuss and demonstrate the primary survey with the examiner and explain their actions. Focus points Explains the type of information being sought in the following areas and provides professional inferences on Danger Verbalise (Assessment of hazards to self; partner patient; bystander and other emergency services) Introduce self and partner Takes time to observe and comment on patient’s overall presentation...
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...Fall 08 Fall Journal Article Review Kim Watson Chamberlain College of Nursing NR 305 Health Assessment Professor J. Deibel Spring B 2014 Journal Article Review Introduction ‘A guide to taking a patient’s history’ is an article published in the nursing standard Journal, volume 22, issue 13, dated December 5, 2007, written by Hillary Lloyd and Steven Craig. In this article, Lloyd and Craig describe the practice of obtaining a patient history in a systematic way, importance of communication skills, preparing the environment, and explaining why a thorough assessment is indispensible. Summary of Article Obtaining a patient’s history is of utmost importance, for the nurse or healthcare provider, when conducting a patient assessment. It is during this time the patient presents valuable and pertinent information. Also, it is at this time a relationship is evolved between the nurse and patient. Prior to taking the history it is important to prepare the environment. The nurse may come across many varied environments. Such as, patient’s homes, emergency room, clinics, community settings, and different areas of the hospital. Having all needed equipment accessible and area to avoid interruption is important. The environment should support safety for both the patient and nurse. Making sure enough time is allotted to conduct the assessment is stressed. “Not allowing enough time can result in incomplete information, which may adversely affect...
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...Developing a Spiritual Assessment Toolbox A. Wilmer Developing a Spiritual Assessment Toolbox Summary When a client’s spirituality is an active component of his belief system and culture, assessing his quality of life from a mental health perspective would not be complete without an accurate assessment of his spiritual needs (Hodge, 2005). Experts are stating that a holistic approach to counseling incorporates both psychological and spiritual assessments (Hodge, 2005). The accrediting body of hospitals, Joint Commission on Accreditation of Healthcare Organizations (JCAHO), recognizes the importance of spiritual assessments and recommends that health care providers conduct these assessments to understand their clients’ religious beliefs and spiritual habits (Hodge, 2005). David Hodge (2005) presents a review of five qualitative assessment tools for effective analysis of a client’s spiritual and cultural wherewithal. The design of these assessment tools gives a more definitive construction of a client’s worldview for the purposes of integrating spiritual beliefs and attitudes in the therapeutic process and discharge planning (Hodge, 2005). Hodge asserts that this form of assessment allows the healthcare professional to explore a client’s “spiritual strengths that might be used to ameliorate problems or cope with difficulties” (Hodge, 2005, para. 1). The five qualitative assessment tools offered by Hodge (2005) provide a detailed description and comparison of each tool...
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...Disaster assessment and recovery plan Robert Favinger Everest University Disaster assessment and recovery plan A small convenience store recently suffered an unforeseen incident arising from the carelessness of one of its customers. This resulted in a lot of damage in terms of people, building damage, stocks and utilities and a temporary halt to normal business operations (Walzer, 2009). The incident caused a lot of panic among shoppers and personnel causing a stampede towards the other end of the store. Five people were among the injured. Two were shoppers, a cashier, a shelf attendant, and a supervisor. The young child did not suffer any injuries. Emergency services were quickly contacted and the injured were transported to a nearby hospital for treatment. After every one had been safely evacuated from the store, a thorough disaster assessment was conducted. The store’s insurers determined that the store had suffered extensive damage on its front section of about 54% (Insurance Information Institute, 2014). Damage to the rear section which was used as the emergency exit was calculated as 3%. Many products on the display stands were damaged especially glass bottles and jars as well as goods on the pathway leading to the rear exit. Most of the utilities were left intact though computers and accessories at the front entrance were written off. No damage was registered in the frozen foods section, as there was no loss of power. Business recovery was estimated to require...
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...PATIENT ASSESSMENT PROCESS * Scene size-up * Initial assessment * Focused history and physical exam * Detailed physical exam * Ongoing assessment A. SCENE SIZE-UP - how you prepare for a specific situation - includes dispatch information and must be combined with inspection of scene Helps identify: scene hazards, safety concerns, MOI, NOI and number of patients you may have, as well as additional resources BODY SUBSTANCE ISOLATION - Assumes all body fluids present a possible risk for infection Personal Protective Equipment (PPE) - Latex or vinyl gloves, Eye protection, Mask, Gown * Reduces your personal risk for injury or illness SCENE SAFETY Information provided by dispatch may help in determining potential hazards Potential Hazards - Oncoming traffic, Unstable surfaces, Leaking gasoline, Downed electrical lines, Potential for violence, Fire or smoke, Hazardous materials, Other dangers at crash or rescue scenes, Crime scenes Scene Safety 1. Park in a safe area - allows rapid access to your patient and your equipment (infront of the scene) 2. Speak with law enforcement first - ask to accompany you if the victim is a suspect in a crime 3. Do not enter until a professional rescuer has made the scene safe - Carefully evaluate scene & request specific help to manage the scene threats Professional Rescuer: law enforcement, firefighters, utility workers, hazardous materials crew * Remember that hazards do not need to be dramatic situations...
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...Extenuating Circumstances – Student Guidance Frequently Asked Questions Q What are extenuating circumstances? A Extenuating Circumstances are circumstances which • impair your examination performance in assessment or reassessment, or • prevent you from attending for assessment or reassessment, or • prevent you from submitting assessed or reassessed work by the scheduled date Such circumstances rarely occur and would normally be • unforeseeable - in that you could have no prior knowledge of the event concerned, and • unpreventable - in that you could do nothing reasonably in your power to prevent such an event, and • expected to have a serious impact on performance You are expected to make reasonable plans to take into account commonly occurring circumstances (such as transport or computer problems), even those which, on occasion, may have been unforeseeable and unpreventable. (Note: Ongoing extended circumstances are not covered by extenuation procedures. Ongoing medical conditions may be covered by disability procedures) Q What is meant by a serious impact on performance? A Many things may have an impact on our performance – a poor night’s sleep, a minor illness (such as a cough or cold), a minor injury, and financial worries and so on. These will often impact on our performance but would not be expected to have a serious impact and so would not be acceptable as...
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... 2. ASSESSMENT PROCESS, Pgs 5-8 3. TREATMENT OPTIONS, Pgs 9-12. 4. EVALUATION, Pgs 13-16 5. CONCLUSION. Pg 17 6. COPY OF PRESCRIPTION, Pg 18 7. REFERENCE SECTION, Pgs 19-23 8. BIBLIOGRAPHY, Pg 24. INTRODUCTION In the following case study, the author will discuss the issues surrounding a seventy-year-old female with a chronic neuropathic ulcer on the sole of her right foot and the rationale and implications of prescribing in the community setting. The author a (trainee nurse prescriber) will display the need for a robust assessment, exploring all areas of health and well-being in order to achieve a safe outcome. The author will further follow current guidelines and be mentored by a senior nurse prescriber throughout the process. The aim of the case study is to display the implications involved in issuing a nurse prescription if deemed appropriate. With regard to writing a prescription as a qualified practioner, the author will adhere to the guidance within the Nursing and Midwifery Council (NMC 2006a) standards for safe prescribing. To protect this patient’s identity and maintain confidentiality, she will be referred to as Mrs X throughout the case study in accordance with the code of conduct (NMC 2008a). GENERAL BACKGROUND Originally, Mrs X had presented to her General Practioner (GP) with signs and symptoms of infection in her ulcer, which had not responded to systemic antibiotics, therefore admission to hospital was arranged...
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...the Mentorship role I am a band five registered paediatric nurse based on an orthopaedic and spinal surgical ward in a tertiary paediatric hospital. I am currently engaging in completing my training to become a qualified mentor. This reflective account details my experiences assessing, teaching and facilitating the learning of a student during their practice based learning, and how this experience may affect my future practice. Throughout the account, in order to protect the identities of people, trust and clinical setting involved confidentiality will be maintained via the use of pseudonyms or omission of names (Nursing and Midwifery Council (NMC), 2008a). The function of practice based learning is to provide experience, serving an important role in developing the skills of the student in interacting with patients and their families assisting in technical, psychomotor, interpersonal and communication skills (Ali and Panther, 2008). Practice based learning provides an opportunity to link theory and practice, and promotes professional identity development (Fishel and Johnson, 1981). Practice based learning is also crucial in the profession of nursing due to the vocational nature of the work, and necessity of assessing clinical competency and safeguarding the public (Rutowski, 2007). By ensuring specific standards are met with assessment in practice, it effectively ensures that students are fit for practice at point of registration (NMC, 2004). My demonstration of demonstrating...
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...With the hundreds of screening instruments and assessments tools that exist. There is a specific instrument available to help counselors determine whether further assessment is warranted, the nature and extent of a client’s abuse, whether a client has a mental disorder, what types of traumatic experiences a client has had and what they consequences are and treatment related factors that impact their response to interventions. This TIP makes no recommendations of the tools needed for screening and assessment for women.”ncbi.nlm.nih.gov” The purpose of screening is to determine whether a female needs the assessment. The focus of the assessment is to collect the detailed information that is necessary for a treatment plan that will...
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