Analysis of Hospital Quality Management Team

Analysis of Hospital Quality Management Team Contents INTRODUCTION BACKGROUND History Vision Mission Core values MAIN SERVICES AVAILABLE, HOW SERVICES ARE DELIVERED AND TARGET POPULATION ISSUES IDENTIFIED ANALYSIS OF QUALITY MANAGEMENT PROGRAM REFERENCES INTRODUCTION This is an in-depth analysis of quality management program conducted in Villingili hospital. Improving the quality of care management practice is a concern in many countries regardless of differences in definition, organization, and funding of services. Quality assurance involves a commitment to guaranteeing the quality of services, not as an additional element attached to the service, but as part of an ongoing system in which performance is monitored and achievement measured against set standards or benchmarks (Camp, 1989; Crosby, 1979; Oakland, 1993 cited in Clarkson Challis, 2003). First a brief introduction of the hospital will be presented followed by the discussion of various quality related issues that can be identified within the hospital. Followed by this, one quality management effort, which is the indoor environment of the hospital, will be analyzed. Subsequently, recommendations for any other strategies that could be implemented to improve the present situation and to overcome quality issues that are not part of any quality program at present will be elaborated. BACKGROUND History Villingili hospital was first opened as a health center in 21st April 1994. The health center was initially opened as a branch of Male’ Health center. The health center was set up in a four room building provided by Male’ municipality. On 15th April 2002, the government changed the health center to a three story building. On 14th August 2014, the health center was changed to a third grade hospital; same level as an atoll hospital. Vision: strive to provide healthcare services to people of Villingili and to make the community aware regarding health life styles and to provide ideal, quality and acceptable health care service to residents of Villingili. Mission: To provide an uninterrupted health care to residents of Villingili. To diagnose and treat different types of diseases and work towards the prevention of these diseases. To further develop the laboratory services. Core values: no core values are identified by the organization. Even though the Villingili Hospital have a rich history, it was depressing to find that the staff of the hospital was unaware of the vision, mission and core values of the organization. MAIN SERVICES AVAILABLE, HOW SERVICES ARE DELIVERED AND TARGET POPULATION The main services available in this hospital are, consultation services from general practitioners, consultation from specialized practitioners, laboratory services, community health care, vaccination and nursing care services. The target population is the residents of Villingili, whose population is around 17,000 people according to Villingili hospital. Specialized doctors’ consultations are on specific days. Gynecological consultations are done on Sundays and Wednesdays from 08:00am to 04:00pm. Orthopedics consultations are done on Sundays and Mondays at 08:00am to 04:00pm by Orthopeadician Dr. Hussain Faisal. Pediatrician consultations are done on Mondays and Tuesdays at 08:00am to 04:00 pm. All consultants are arranged sent from IGMH. Vaccination and child growth monitoring is done on all working days from 09:00 am to 01:00 pm. All available services are provided within the hospital. Even though they have a community health service unit, home visiting are not done. Services are provided 24 hours throughout the day, and shift duties are done by all consultants, nurses, receptionists, interpreters, ambulance drivers and attendants. Even though specialized consultations are done, it is evident that both the consultants and clients face enormous difficulty to diagnose and treat diseases and conditions as essential and compulsory diagnostic services such as ultra sound scanning and x-ray services are not available in the hospital. ISSUES IDENTIFIED After conducting surveys in the Villingili hospital and interpreting the results, I have identified some issues related to quality of service provided by the facility. Here are the results of the survey conducted in the facility. In the survey questionnaire, a question was used targeting to identify the staff response to patients need and their courteousness. The evaluation will be accurate if we analyze the situation in both directions. According to the hospital officials, clients can consult general practitioners through a walk in OPD. But the consultation for specialized practitioners such as the orthopeadician and gyneacologist, clients have to make appointment prior to consultation. Appointments are issued until the planned slots are filled. From the interviews conducted, we understood that the time delay dissatisfaction usually arose during busy situations where the doctor who is consulting in the OPD have to attend in patients or emergency cases. Some clients also noted that the doctors sometimes goes for break while more than 10 clients are waiting outside. A service provider have to consider suitable timings in order to provide a quality service to the clients. In order to evaluate this, we questioned whether they are satisfied with service timing of the facility, both general and specialized consultations. Among 10 clients, 2 clients (20%) informed that they are not satisfied with the time for specialized consultation while 3 clients (30%) told that they are moderately satisfied and 5 patients (50%) are fully satisfied with the service timing. Figure 1 Even though they get the appointment for specialized consultation and can consult the general practitioner through a walk in OPD, the time taken to consult the doctors vary. To verify the time taken to consult the doctor, we gave time ranges from 0-10 minutes, 20-30 minutes and more than 30 minutes. According to the clients who gave the interviews 5 clients (50%) informed that they had to wait between 0-10 minutes, 3 clients (30%) told that they waited between 20-30 minutes for the consultation and 2 clients (20%) stated that they waited for more than 30 minutes to consult the doctor. These findings are presented below in figure 2. Figure 2 Identification of the client satisfaction and dissatisfaction is crucial in order to upgrade and provide an ideal and acceptable quality service to the clients. In order to identify the overall satisfaction of the clients regarding the time they spent during consultation, we included questions targeting this issue. According to 7 clients, (70%) they are fully satisfied with the time they spent and 3 clients (30%) are not satisfied. These results are shown below in figure 3. According to the information we collected, we found that most clients highlighted that the biggest issue they face is the way the staff communicate with them. Some clients have informed that they were left feeling like a fool during consultations and some staff spoke rudely to them. Few noted they feel that the staff are overburdened with responsibilities and they seem very unenthusiastic. In addition to this, some clients informed that the staff seems to be involved in their personal things while attending the clients who goes to the counter for different things. Communication effectively with patient and family is a cornerstone of providing quality health care (Patient care improvement guide, 2008). The manner in which health care provider communicate information to a patient can be equally important as information being conveyed (Patient care improvement guide, 2008). Patient surveys have demonstrated when communication is lacking, it is palpably felt and can lead to patients feeling increased anxiety, vulnerability and powerlessness (Patient care improvement guide, 2008). Among 10 clients, 5 clients (50%) informed that the staff was poor in areas being respectful, friendly helpful and courteous. Another 3 clients (30%) noted that the staff was fair in this area while the remaining 2 clients (20%) informed that the staff was good in this area. It is depressing to note that not even one client told that the staff was great in this area. The information is shown in a pie chart below in figure 1. Figure 1 The next question was whether the staff explained the procedure and how they answer questions asked by clients. Among 10 clients, 6 clients (60%) informed that the staff was poor in explaining the procedure and answer questions asked by them. Another 3 clients (30%) noted that the staff was fair in this area. The remaining 1 clients (10%) informed that the staff was good in this area. The information is illustrated in figure 2. Figure 2. According to the information collected through survey, it is clear that most clients highlighted that the biggest issue they face is the way the staff communicate with them. Some clients have informed that they were left feeling like a fool during consultations and some staff spoke rudely to them. Few noted they feel that the staff are overburdened with responsibilities and they seem very unenthusiastic. In addition to this, some clients informed that the staff seems to be involved in their personal things while attending the clients who goes to the counter for different things. The issues identified through survey with clients of this facility that, may hinder the quality of service provided are, ineffective communication and unenthusiastic staff. Additionally, by conducting interview with the senior administrative officer of Villingili health center, it is evident that some staff lack knowledge in some areas such as care during emergency situations. Lack of knowledge is due to lack of practice as the institute have less inpatients who needs constant care. Communication effectively with patient and family is a cornerstone of providing quality health care (Patient care improvement guide, 2008). The manner in which health care provider communicate information to a patient can be equally important as information being conveyed (Patient care improvement guide, 2008). Patient surveys have demonstrated when communication is lacking, it is palpably felt and can lead to patients feeling increased anxiety, vulnerability and powerlessness (Patient care improvement guide, 2008). ANALYSIS OF QUALITY MANAGEMENT EFFORT As the Villingili Hospital is being rebuild to accommodate required facilities to function as a hospital, patients’ and staff are facing various difficulties. The major difficulty that most people face is that consultant rooms are situated in the first floor of the building. A person does not have to be elderly to have a difficulty to climb stairs, and because of this arrangement some patients have faced difficulty. It is evident that the changes to the present building is being brought on to provide a quality service to the customers. However, the effect of physical environment on healing process is evident through research. The arrangement of wards, labor rooms, consultant rooms and waiting areas and its physical environment such as ventilation, lighting, and temperature is important aspects to consider to provide a quality hospital environment. From my personal experience, it is clear that the physical environment of hospital is set to ease the staff only and patient prefer ence or perspective is rarely considered. As I have experienced, I have faced immense difficulty when I went for a consultation with high grade fever and wheezing. The consultant’s room air conditioner was set a temperature where it was difficult for me to utter a single word without clattering my teeth. Additionally, I have found that the present physical environment of the Villingili hospital can be considered dangerous for patient especially the elderly and young. The present construction activities and especially the smooth tiles put on the floor of the hospital is a hazard for falls. For this analysis, I will be looking into the extraneous factors of the hospital in order to deliver a quality service. Extraneous factor of hospital The physical work environment often influences (positively or negatively) the mindset of the service providers and their efficiency and capability to innovate in delivering expanded services (). Sometimes the aspects of the consultation rooms can have a negative impact. Such as the consultation room being too cold, hot, dark, noisy or unwelcoming (Moulton, 2007). Distractions in the room include visual distractions (eye catching photographs or art), auditory distractions (sounds from the waiting room or next consultation room) and olfactory distractions (bad odors or body odor of previous patients) (Moulton, 2007). Suboptimal seating arrangement also can be a negative extraneous factor of hospital, such as seats being hard and uncomfortable (Moulton, 2007). In recent years, the effects of the physical environment on the healing process and well-being have proved to be increasingly relevant for patients and their families as well as for healthcare staff (Huisman, Morales, Hool Korts, 2012) Studies have shown that excessive noise, glare and poor air quality can create stress as is evidenced by increased heart and blood pressure and reduced oxygen level in the blood in both adults and babies who are exposed to these environment (Blomkvist, Ericksen, Theorell, Ulrich, Rasmanis, 2005; Hagerman, Rasmanis, Blomkvist, Ulrich, Eriksen, Theorell, 2005;Zahr Traversay 1995 cited in Zborowsky Kreitzer, 2008). A healing environment with appropriate physical aspects contribute to patients’ outcome such as shorter length of stay, reduced stress, increased patients satisfaction and others (Ulrich et al., 2004 cited in Hussain Babalghith, 2014). REFERENCES Clarkson, P., Challis, D. (2003). Quality Assurance Practices in Care Management: A Perspective from the United Kingdom. Care Management Journals, 4, (3), 142-151. Huisman, E. R. C. M., Morales, E., Hool, J. V. Korts, H. S. M. (2012). Healing environment: A review of the impact of physical environmental factors on users. Building and Environment (58), 70–80. Moultan, L. (2007). The Naked Consultation: A Practical Guide to Primary Care Consultation Skill (1st ed). United Kingdom, UK: Radcliffe Publishing. WHO. (2004). Quality Improvement in Primary Health Care; A Practical Guide. WHO regional publication, Eastern Mediterranean Series 26. Zborowsky, T., Kreitzer, M. J. (2008). Creating Optimal Healing Environment in Health Care Setting. Clinical and Health Affairs, 91(3), 35-38. Saushan Rasheed Quality Assurance in Health Care Assignment 2

Nervous Breakdowns :: Nervous Breakdown Mental Collapse Stress

In the middle Ages, it was called melancholia. In the early 1900s, it was known as neurasthenia. From the 1930s to about 1970, it was known as a nervous breakdown. "Nervous breakdown" is a term that the public uses to characterize a range of mental illnesses, but generally it describes the experience of "snapping" under massive pressure, mental collapse or mental and physical exhaustion. Have you ever wondered how you can tell if someone is having a nervous breakdown? Or what causes them or how they're caused? Well, the causes of nervous breakdowns are very similar to panic attacks, ADD, and ADHD. There is always a trigger or catalyst that sparks a nervous breakdown. Breakdowns usually stem from a change in a major life event such as a broken relationship, death of a loved one, a demanding job or financial difficulties On some cases getting nervous breakdowns are genetics, you receive them because a past family member has had one or in simpler words family history. Another sign is Coexisting medical conditions such as vitamin deficiencies or thyroid disorders. Stress, drugs, alcohol and depression are one if the most main causes of nervous breakdowns. You can always treat a breakdown. Sometimes people talk to therapist or someone they trust to discuss their issues and just â€Å"let it all out† instead of breaking down. As for others talking doesn’t always work at times it may tend to worsen the problem, so they take prescribed depression pills. Other treatments are drugs, alternative treatments, surgery, and lifestyle changes. If you feel close to having a nervous breakdown right now you are probably feeling like you have hit rock bottom. Many people who are close to a nervous break down feel a million miles from their real self. Feelings of anger, negativity, exhaustion and anxiety are probably overwhelming you and your ability to pursue a 'normal' life and 'normal' relationships is no doubt proving tough. Obviously the best approach is to prevent the breakdown from occurring in the first place. Recognizing the warning signs of a nervous breakdown and reducing and managing stress levels can often produce excellent results and prevent the total collapse usually associated with a nervous breakdown.

A Comparative Look at Beethoven and Mozart Lives

Beethoven and Mozart are great and famous composers of classical music who share similarities in musical composition and still both exhibit certain differences. Being counted among the list of the most influential composers in the history of music, Wolfgang Mozart and Ludwig Beethoven are artists who have much in common.This paper draws on the views that both of these composers have the same musical foundation having been introduced to music by their fathers. It seeks to explore the similarities as well as differences in the lives of Mozart and Beethoven in the history of music.Mozart and Beethoven are from the same origin and they worked in the same musical genres such as classical and romantic thus exemplifying themselves as very talented musician a as well as prolific composers. However, it is plausible to accept the fundamental truth there are no two people are exactly the same. On this basis, Mozart and Beethoven harbor certain differences that emanate from their different perso nalities and perspectives in music. As a result, it emerges that the age at which they began composing points out clear differences in their composition and musical careers coupled by their musical style.Differences The first notably difference between Mozart and Beethoven lies in their musical style. Brown (23-25) postulates that the overwhelming greater part of the composition of Mozart is not only light but also very aerial and delightful. As such, music critics have attributed that the musical pieces of Mozart aim at general entertainment and extensively apt relaxation which underlies the whole paradigm in which music is composed and performed. On the hand, Beethoven’s music is typical of intensive drama which makes it heavier and typical of a wide range of pith.In light of this, Wallace (105-107) explains that the music of Beethoven exhibits a lot of in-depth passion and dynamism in composition as well as performance. Notably, another important difference that marks the Beethoven and Mozart is their entry age in the field of musical composition. Arguably, Mozart began his musical career at the age of five and grew up composing music for royal people in most cases (Lancaster, 37-39). On the same note, Beethoven is said to have delved into music when he was already a teenager and concentrated a composing music for the public at large.With regard to this difference, both musical artists grew in different circumstances as pertains their introduction to music and thus, their audience became marked by the conditions that characterized their entry in music. With the different audiences, Mozart and Beethoven had to compose music at deferent condition and they addressed different thematic concerns hence marking their greatest difference in their lives and music (Pestelli, 52-54). Significantly, it is prudent to note their difference in notation styles. Mozart continued to produce musical piece that was marked by clear and neat notations.Comparatively, this was greatly different from the notational styles of Beethoven since his composition was marked by sloppy, unclear and somewhat careless notations (Brown, 49-51). Extensively, the style of their music as well as the audience they composed for left them emotionally feeling different. For instance, as Mozart became a happy, easy-going composer and person in life while Beethoven was typical of bad temper and largely became depressive. On this note the life experiences of these two life time composers propelled them to different pedestals.Essentially, Beethoven led a lone life but his due to the question that he composed and performed for the general public he received an honorable burial after his death at the age fifty six. On the other hand, Mozart who specialized in composing for the royalties was buried in unmarked grave in Vienna at the age of thirty six (Lancaster, 87-89). Unlike Mozart, Beethoven had a method of composing which mirrored a situation where he recorded ideals in not ebooks and later used them in building up blocks for his composition.For example, the Ode of Joy, a symphony that was build on the theme of seeds was a concept conceived several years ago Accordingly, it is a reflection of a long gestation period of composition where Beethoven paid supreme attention to minute details in a bid to depict that in the music lies strength of idealism (Wallace, 36-38). This creative process marked the inspirational ability of Beethoven. However, Mozart was radical and was dubbed the Trent Reznor of his lifetime. He succeeded in his spontaneity ability as well as his outspoken nature.With regard to their musical works, Beethoven composed pieces that rapidly diverged from his teacher and peers. Revolution was in air and Beethoven’s symphonies mirrored both political and artistic features. For example, his third symphony was dedicated to Napoleon but later own, Beethoven deleted his name on the title of the Symphony after the realization that Napoleon had already declared himself an emperor (Pestelli, 41-42). The resulting events led to Beethoven to produce shorter symphonies such as his fourth and eighth.In light of this, Beethoven explored new areas in life and extensively wrote string quartets following the influence he got from his teacher Haydin. The works of Beethoven largely bordered personal introspective works that slid into uncharted musicals that still remained intimate. As a result, Brown (45-48) highlights that Beethoven composed various pieces that included several overtures, a mass and opera as well as concertos. He even stretched his base to write for piano with a host of sonatas and concertos for violins.On the other hand, Mozart influenced greatly on the musical development by drawing his works from figures and preludes and extensively employed fugal writing within the larger composition of symphonies. Although this influenced greatly on the development of classical music, it had little connection to his creati vity. Wallace (28-29) argues that the feelings, thoughts and ideologies of Mozart formed the basis of his influence and success in musical composition. As a result, these influence strove Mozart to commit to the depth of musical form and thus position him as a successful romantic composer.In the same vein, both great musicians had extraordinary pieces of music and performed in different era. Mozart belonged to the classical period while Beethoven belonged to the romantic era. As such, Mozart ended up being criticized for composing radical music that endangers the morals of the women since majority of these women were aroused with Mozart music. Beethoven on the other hand Beethoven had the advantage of in paving way for the creation and invention of pianoforte. The greatest music of Beethoven is his symphonies which are still heard in the present time as they were listed to in his time.Compared to Mozart, Beethoven continued to unify contrasting movements using musical continuity. Of ten, his music would have unclear ending, something that made his symphonies a bit longer (Brown, 57-61). Similarities It is worth noting that ideas and differences between Beethoven and Mozart can not suffice to say that either of them was better than the other but the interesting point of focus should be built around the understanding that both of them made major contributions in the world of classical music; contributions which led to the development of music as an art.Arguably, we can draw from their differences to construct a viewpoint of how Mozart and Beethoven are similar. Significantly, considering the fact that both of them were creative and gifted innovators of classical music during the classical and romantic period, both Mozart and Beethoven share a similar characteristic of being musical genius (Pestelli, 12-17). In addition, Brown (65-67) illustrates that Beethoven went at length of achieving the iconic status of musical composer.This factor is equally shared by Mozar t and thus, the iconic status as a composer was a status achieved as a result of ones revolutionary and immense influence on the development of music within the milieu of pivotal points in terms of the classical and the romantic periods. As such, the symphonies of Mozart as well as Beethoven demonstrates the development for music in these eras as the themes portrayed in these symphonies resonate what was entirely used as the European anthem. Moreover, their images are construed within the parameters of musical history.Beethoven, just like Mozart was born into a musical family where the father and grandfather were singers. Although this is not to the same extent, it is plausible to argue both Beethoven and Mozart were musical prodigies who were taught music by their parents at a tender age. Lancaster (121-122) asserts that the education of these two musical composers was courted by musicians such as Neefe; a factor which enabled them to demonstrate their musical talents in areas such as keyboard playing piano and harpsichord.In addition, composers during their eras were employees of the church, state or rich patron who were requested to compose musical works to articulate different occasions that were deemed important within the precincts of religion as well as secular. According to Wallace (23-44) both Beethoven and Mozart exhibited some sense of independence in their creative works. As such, they could set their own agenda in the entire composition.The basis of the set agenda gave these artists the opportunity to express their deepest feelings in life as exemplified by Beethoven who have his three symphonies reflecting the ideals of republicanism, liberty, religious beliefs as well as the aspect of brotherhood in the society. Conclusion From the foregoing discussion, it is evident that Beethoven and Mozart are great and famous composers of classical music but both exhibit certain differences. Being counted among the list of the most influential composers in t he history of music, Wolfgang Mozart and Ludwig Beethoven are artists who have much in common.However, both Mozart and Beethoven harbor certain differences that emanate from their different personalities and perspectives in music. All these similarities and differences fall within the wider framework of their musical careers, experiences and musical styles of composition. Work Cited Brown, P. The Musical Times: Mozart and Beethoven. Cambridge: CUP 2007 Lancaster, E. The Golden Age of Symphony: Mozart and Beethoven. London: Alfred Music Publishing 2000 Pestelli, G. The Age of Mozart and Beethoven. Harvard: HUP 1984 Wallace, R. Classical Equilibrium in Music. Oxford: OUP 2009

Multiple Choice Questions Sample

Multiple Choice Questions Sample 2. it is shifted 4 units UP 3. 16.91 4. 88.53 5. two solutions 6. one solution 8. Quadratic 9. (2,20) and (-3, 0) 10. (-1, 1) and (7, 33) 11. 3.54 12. Reaches a maximum height of 22 feet after 1.00 second. 13. Reaches a maximum height of 372.25 feet after 4.63 seconds. 14. x=2, x= -6 16. -3 and 2 17. -3 and 9 18. 5 m 19. 225/4 20. -11.56, 1.56 21. 7.53, -0.53 22. -7 and 3 23. exponential