The Ethics Surrounding Nuclear Energy Politics Essay

The Ethics Surrounding Nuclear Energy Politics Essay Electricity plays an increasingly important role in our everyday lives. Heating our homes, powering our electronics, and keeping our cities running requires a tremendous amount of electricity. The United States rising demand in electricity paired with their stringent environmental standards have put energy generation efforts in a tight spot. Coal and natural gas energy generation accounted for nearly sixty-eight percent of all electrical transmission in 2012. In contrast, only nineteen percent came from nuclear sources down a third of a percent from 2011 (eia.gov/electricity). I will prove that nuclear generation is a safe, clean, and efficient source of energy with the ethical theories of Kant, Rawls, and Act Utilitarianism and back it up with credible data. A little background is needed on the subject to fully understand the situation. In 1789, Martin Klaproth discovered the element Uranium, lighting the path towards nuclear generation. For 150 years there was no news on the front of nuclear generation. In 1939, Otto Hahn and Fritz Strassman demonstrated that nuclear fission would give off incredible amounts of energy. In the future, it will be shown that this energy could be used in great or terrible ways. By 1941, the MAUD Committee, comprised of a group of respected scientists, published two important summaries. They were titled: Use of Uranium as a Source of Power and Use of Uranium for a Bomb (world-nuclear.org). At the time, a stronger focus was put on the second due to the World War II efforts around the world. In America, interest in the second paper and the creation of the Manhattan Project took place after the events at Pearl Harbor. The Manhattan Project was a government funded project in which scientists took on the task of enrich Uranium into the isotope U-235. In addition to the uses it has for war, it was noted that the isotope could also be used in peaceful ways. In August of 1945, the efforts of the Manhattan Project finally came to fruition. A nuclear bomb was dropped on Hiroshima, Japan. With World War II effectively over, attention was now directed on the first paper published by the MAUD Committee, Use of Uranium as a Power Source. Utilizing the efforts of the Manhattan Project, America would have a head start developing a process of using the heat created by nuclear fission as a source of power. By 1951, the first prototype of a nuclear reactor was revealed (world-nuclear.org). Although this prototype only produced a small amount of electricity, it demonstrated the potential that was there. In 1953, Eisenhower backed this work with his Atoms for Peace program. This program rerouted funding from nuclear weapons to nuclear power (world-nuclear.org). Once into the 1960s, the technology was ready to be used commercially. Some of the nuclear reactors designed by General Electric and Westinghouse were in use until the 1990s (world-nuclear.org). The United States has had a constant sixteen to nineteen percent of electrical generation due to nuclear sources since then. During this time, there has been less of an interest in expanding and building new nuclear power plants. Even though there has been improvements made to the design of power plants, there has been no new demand to expand upon the already in place infrastructure. China has overtaken the United States in nuclear energy with plans to expand its nuclear output six times what it is by 2020 (world-nuclear.org). There are other places around the world investing in nuclear energy, including India, Japan, and South Korea. The question we have to ask ourselves is when the subject of nuclear energy comes up is: Can the research and development of nuclear energy sources be done while maintain an upholding the safety of the people around them? If not, is it then ethically correct to continue even with all the energy it breaks to the numerous communities? I will answer these questions and back it up with the data I have found. I first decided to run these questions through Kants ethical theory. When using the formula of the universal law of nature a generalized maxim can be made: One shall utilize and develop for an energy source if, and only if, it does not harm the people in the surrounding area and it is beneficial to the nation. To defend this maxim, one would have to know how a nuclear power plant affects the area it is utilized. In terms of Act Utilitarianism, nuclear power generation would have to have a greater net benefit to be considered ethical. To determine this, we must first analyze the reliability and safety of nuclear energy. Reliable and safe energy is in high demand nowadays and recently much attention has been put on the environmentally friendliness of the generation of this energy. CO2, or carbon dioxide, emissions have become known as a highly recognized contributor to global warming and have help put the spotlight on safe energy generation. There have only been few noteworthy disasters throughout nuclear powers history. Chernobyl, Three Mile Island, and Fukushima are some of these noteworthy disasters. When mishandled, nuclear power can be incredibly dangerous. In an article written by Head and Hall, compares the risk of radioactive waste or a critical failure of a plant to that of getting struck by lightning. With arduous industry regulation the chance of these failures happening is insignificant. Since the industry is relatively new, it has been more heavily regulated with every failure that occurs. During the Three Mile Island critical failure of 1974, an irregular amount of radioactive gas was released. The generating unit was also effectively destroyed. Contrary to what most people thought, there were no deaths, injuries, or adverse health effects cause by the failure (world-nuclear.org). Although this failure resulted in no adverse effects, it did put pressure on nuclear power in the United States. It is important to analyze the impact on the environment from the CO2 emissions due to nuclear power generation. In 2011, there were nearly 2.3 million-thousand metric tons of carbon dioxide emissions due to electrical generation plants (eia.gov). For every kilowatt hour of electricity produced, there were 9 to 21 grams of carbon dioxide emissions (world-nuclear.org). There are no emissions that come directly from the nuclear plants or reactors, but from indirect sources such as the mining and transportation of Uranium. Emissions created by nuclear power generation are equal to between 1 and 3 percent of the emissions produced by typical coal burning plants. As you can see, it is much cleaner, in that sense, than the forms of power generation we currently rely on. As clean as nuclear power is in terms of emissions, it does encounter some problems when it comes to waste. The treatment and disposal of nuclear waste is another reason why nuclear power has not been fully accepted in the United States. Inaccurate information about nuclear waste is spread by non-governmental organizations, claims Poletti, a professor and power engineer. All cycles in a nuclear fuel life cycle produce radioactive nuclear waste according to the World Nuclear Association, but can be appropriately and safely dealt with if done correctly. There are three types of radioactive waste in a nuclear life cycle: low, intermediate, and high level waste. All forms of waste can be handled with ease, with the exception of high level waste. This type of waste is harder to take care of and requires a great deal of care since it contains used fuel and the other waste products separated from the fuel. To take care of this waste, it is first stored in a reinforced concrete and steel str ucture. These are then placed in a cooling pond. After staying there for five years it is then transported to a multiple barrier geological disposal (world-nuclear.org). One of these sites is typically located in a hollowed out mountain-like structure. These regulations show that waste from all nuclear power plants can be taken care of in a safe manner with little to no risk to the general public and environment. Nuclear waste also accounts for less than one percent of total industrial toxic waste (world-nuclear.org). By analyzing this data, we have found that some aspects of each ethical theory can be satisfied. The other factor we have to consider is if the development of nuclear power facilities should be prioritized over traditional sources of energy generation. Nuclear power was responsible for almost ten percent of the United States total electrical capacity (Existing Capacity by Energy Source, 2011). The supply of electricity generated by nuclear power plants accounted for nearly twenty percent of the total electrical supply (Where Does US Electricity Come From?). The difference here is that for all the energy used, twenty percent of it came from nuclear sources while only ten percent of our potential capacity of electricity is in nuclear form. The reason for this is that nuclear fission is a continuous process. Once begun, it must continue and can be a source of energy that can constantly be drawn from. Seventy percent of our energy capacity is in the form of coal and natural gas. Of that seventy percent, sixty-five percent of it is used. To generate that much power it takes a total of 6,925 coal and natural gas generation units. For nuclear energy source to generate twenty percent of our consumed energy, it takes 104 units. If nuclear energy were to generate as much as coal and natural gas combined, it would take a total of 338 nuclear generation units. It takes far less nuclear plants and reactors to generate the same amount of energy, with a fraction of the emissions (world-nuclear). Many of the nuclear reactors were built in the 1960s and 70s. At this time, many of the generators were generating 250 megawatts. During this time many of the nuclear reactors began to brown out, or improve their technology and efficiency while retiring more units than you are producing. The increase in efficiency can be seen across Asia and Europe. Both Japan and France began replacing many of their nuclear reactors in the early 2000s, with new ones as large as 1,650 megawatts (world-nuclear.org). In the last 50 years, the output of nuclear reactors has increased by nearly 7 times. Many of the reactors in the United States have not been improved upon and continue to operate with a lower output than they should be. The Energy Policy Act, enacted in 2005, presented incentives to the industry for building next-generation nuclear reactors. The technology for nuclear reactors and plants has been advancing ever since it was created. Due to upgrades in technology and a growing demand for energy in the 1980s, the load capacity and output grew tremendously. This can be seen even into today. Research is constantly being done to improve upon this technology. Alternatives to uranium are being researched, a second burning technique to get rid of the nuclear waste is being researched, and much more. An example of this can be seen with Thorium research (world-nuclear.org). I personally believe that the United States should invest more into the development of more nuclear reactors and plants. There is an ample amount of data supporting this claim. It is very safe for the environment and the people surrounding the plant and it is also more efficient and eco-friendly than our current alternatives. The question I ask is: Can the research and development of nuclear energy sources be done while maintain an upholding the safety of the people around them? If not, is it then ethically correct to continue even with all the energy it breaks to the numerous communities? I choose to use the ethical theories of Kant and Act Utilitarianism to help answer these questions. When using Kants theory, like I stated above, I created the maxim: One shall utilize and develop for an energy source if, and only if, it does not harm the people in the surrounding area and it is beneficial to the nation. Defending this maxim is fairly easy. As we found out above, nuclear energy is far less harmful to the Earth and people in the surrounding area since it has much lower CO2 emissions and its waste can be stored in such a way that does no harm. After knowing this information, it is easy to see that one would want to research, develop, and utilize for nuclear energy since it defends the maxim. When using Kants Formula of Humanity, I believe it is fairly easy to defend as well. The Formula of Humanity states that when deciding on whether or not to commit an action that you shall only commit that action if you use people as an ends and not as means to your end. When it comes to this, I assume that the end is getting the energy from the nuclear plants to the nation. In the end, the people are the ones benefitting, and are not being used to achieve your goal. Using Act Utilitarianism, a similar result is produced. We can split each consequence of developing and utilizing nuclear power into the two categories of hedons and miserons. Hedons being for the development and utilization and miserons being against it. For the hedons category, a simple list can be shown: cleaner energy for the nation, more efficient production of energy, minimal harm to the environment, creates jobs for surrounding area, causes less harm to atmosphere than other sources of energy. The miserons category would contain the following: possible failure of nuclear reactor causing harmful material to be spread around surrounding area, creates CO2 emissions. Since the chance of a nuclear reactor failing is fairly minimal and the fact the CO2 emissions caused by nuclear power generation are miniscule compared to the other source of energy generation, I conclude that the development and utilization of nuclear power generation would be the correct action to take. We can see that both theories come to the same conclusion, quite handedly. All the data points to this conclusion as well. I believe that with the outcome of both of these theories that my statement regarding the morality is correct. The development, research, and utilization of nuclear energy sources should be done.

POSITIONING SIX SIGMA WITHIN THE MANAGEMENT ACCOUNTING AGENDA

3.1 IntroductionIn the old chapter, the treatments focused on developments in the constructs of quality direction, come oning from its original limited function of review to its present province as an built-in portion of concern scheme through strategic quality direction ( SQM ) . This chapter traces the parallel historical developments in cost and direction accounting from its traditional cost accounting phase to its current phase that addresses the demands of administrations runing in dynamic and competitory contexts and explores the acceptance of quality issues within the scope of direction accounting. The chapter commences with an overview of the historical developments in accounting that led to be and direction accounting. From this literature, an analytical model is put frontward to: Discuss the major phases taking to the development in cost and direction accounting paying peculiar attending to the direction of quality at each phase ; and Discuss the interface between direction accounting patterns and SS quality enterprise.3.2 Historical DEVELOPMENTS IN ACCOUNTINGIn its earliest signifier, accounting focused chiefly on proper mark maintaining and net income coverage ( Johnson, 1991 ) . Although these two maps continue to play a cardinal function in the accounting systems, accounting patterns have progressed to cover wider concern activities and applications such as the direction of quality enterprises ( IFAC, 1993 ) . Following these developments, Lenhardt and Colton ( 2000: 21 ) , analysed accounting patterns into three types: Historical – uses cost information that has a historical or consequences perspective and whose intent is to enter what has happened in the past. Peoples outside the company who typically use such information, include bankers, shareholders, creditors, bondholders, regulators and taxing governments. Real clip – uses cost information that has a current position and is utile to people and squads doing existent clip determinations about concern procedures. Strategic – uses cost information that has a advanced, strategic position and is utile to those doing pricing and other strategic determinations about the company ‘s hereafter. The 2nd position affecting existent clip patterns and their development is normally referred to as cost and direction accounting patterns. The literature has provided a figure of models to analyze the development of cost and direction accounting. Some of these authors have traced the development from its beginning ( Johnson, 1972 ; Chatfield, 1974 ; Chandler, 1977 ; Johnson and Kaplan, 1987 ) , while others have either looked at the state specific developments ( Bhimani ( 1996 ) and Dugdale and Jones ( 2003 ) for UK developments ; Virtanen et Al. ( 1996 ) for Finnish developments ; Scherrer ( 1996 ) for German developments ) , or the modern strategic direction accounting developments ( Lee, 1987 ; Luft, 1997 ; Srikanthan, 2004 ) . None of this literature has traced the developments at the interface between direction accounting and quality direction. The purpose of this chapter is to utilize an analytical model proposed by International Federation of Accountants ( IFAC ) to discourse the altering function of direction accounting and its interface with alterations in quality direction.3.3 PROPOSED IFAC FRAMEWORKIFAC ( 1998 ) in its Statement on Management Accounting Concepts analysed the development and alteration in direction accounting through the undermentioned four recognizable phases: Phase 1 – Prior to 1950, the focal point was on cost finding and fiscal control, through the usage of budgeting and cost accounting engineerings ; Phase 2 – By 1965, the focal point had shifted to the proviso of information for direction planning and control, through the usage of such engineerings as determination analysis and duty accounting ; Phase 3 – By 1985, attending was focused on the decrease of waste in resources used in concern procedures, through the usage of procedure analysis and cost direction engineerings ; Phase 4 – Beyond the mid-1980 ‘s attending had shifted to the coevals or creative activity of value through the effectual usage of resources, through the usage of engineerings, which examine the drivers of client value, stockholder value and organizational invention ( IFAC, 1998. parity. 7 ) . Harmonizing to IFAC ( 1998. parity. 9 ) , ‘each phase of development represents version to a new set of conditions confronting administrations, by the soaking up, reshaping and add-on to the focal point and engineerings used antecedently ‘ . In Stages 1 and 2 the direction accounting developments focused on traditional proficient activities and the proviso of information ( IFAC, 1998. parities. 17 and 19 ) . During these phases, the information refering quality was non captured in the direction accounting literature ( Yasin et al. , 2005 ) . A critical displacement between Stage 2 and Stages 3 and 4 is the alteration in focal point from information proviso towards resources direction in the signifiers of waste decrease ( Stage 3 ) and value coevals or creative activity ( Stage 4 ) . This displacement promoted the widespread usage of quality oriented concern patterns and schemes ( Yasin et al. , 2005 ) . The subsequent subdivisions will analyze these developments with ment ion to IFAC ‘s four phases of development.3.3.1 Phase 1: Cost finding and fiscal controlBetween 1880 and mid-1920s rapid developments in cost accounting theories and techniques gave a existent drift to the growing of cost accounting. During this period rehearsing comptrollers and industrial applied scientists contributed widely to the development of cost accounting literature ( Littleton, 1933 ; Solomon, 1968 ) . Solomon ( 1968 ) referred to this period as the â€Å" costing Renaissance † . Initially cost accounting information was developed for the intent of merchandise costing and net income finding, but over clip this function evolved to include elements of planning, control and decision-making ( Solomon, 1968 ) . These major developments marked the footing for traditional cost direction accounting patterns ( Johnson and Kaplan, 1987 ) .Merchandise costing and net income findingMerchandise costing and net income finding has long been the map of cost accounting. Garne r ( 1954 ) traced the development of merchandise costing and net income finding to the early ‘domestic ‘ structured system, under which the whole fabrication procedure was wholly under the control of the proprietors. Johnson and Kaplan ( 1987 ) noted that the proprietors of individual activity concerns created new accounting processs to command the end product from internal procedures. This attack was similar to the craftsmen ‘s quality development patterns discussed in the old chapter. In a ‘domestic ‘ structured system, the proprietors devised input cost steps such as stuffs cost and transition costs to enter the ‘price ‘ of end product from internal operations ( Johnson and Kaplan, 1987: 7 ) . Even in the early old ages, the proprietors of centrally controlled individual activity concerns held the sentiment that by efficaciously pull offing the costs of their internal concern procedures greater value could be achieved ( Johnson and Kaplan , 1987 ) . However, restrictions on cost accounting measuring restricted the range for quality cost measurings ( Johnson and Kaplan, 1987 ; Yasin et al. , 2005 ) . With the oncoming of the industrial revolution internal administrative procedures were established to co-ordinate multiple production activities ; runing costs were generated to measure public presentation and luxuriant cost coverage mechanisms were devised, peculiarly for direct labor and stuffs ( Smith, 1995: 7 ) . For illustration, Johnson and Kaplan ( 1987 ) study that the development of an integrated dual entry cost accounting system helped direction supervise the efficiency of internal procedures and employee public presentation and later formed the footing for the development of a public presentation related wagess and incentive strategy. Despite the strong concern for commanding internal costs, quality cost measuring was non considered a portion of the direction accounting map. Alternatively, the implicit in rules of merchandise costing and net income finding provided the way for a broad organizational planning and control function ( Black and Edwards, 1979 ; Johnson and Kapl an, 1987 ) .Planing and controlIn the early 20th century, planning and control tools such as standard costing and discrepancy coverage were introduced as portion of the direction accounting map ( Solomon, 1968 ) . Standard bing formed an built-in portion of production planning, while discrepancy analysis was used for cost control. Solomon ( 1968 ) noted that the first mention to â€Å" direction by exclusion † was founded in Taylor ‘s celebrated paper on â€Å" Shop Management † that was closely linked to early quality control and that Taylor ‘s construct of standard procedures and standard operating clip ( clip and gesture survey ) was used as the footing for the development of standard costing. This demonstrates that the rules of standard costing are derived from Taylor ‘s scientific direction theory and thoughts of quality control discussed in Chapter 2. Therefore, even in the early portion of the 20th century there were indicants of a nexus betwee n alteration direction schemes and direction accounting systems. Another important development in Stage 1 was the development of concern budgeting techniques ( Black and Edwards, 1979 ; Johnson and Kaplan, 1987 ) . Business budgeting was founded on the rules of governmental budgeting processs used in England and US ( Black and Edwards, 1979 ) . In contrast to standard costing, a budgetary control system involves all the maps and sections in an administration. Despite including all maps and sections in the budgeting procedure, quality costs budgeting was non considered as a portion of the direction accounting map.Short-run decision-makingThe concluding development of early cost accounting information was the proviso of cost information for decision-making. Harmonizing to Johnson ( 1981 ) , in the early old ages transition costs were used for the intent of pricing determinations. In ulterior old ages, increased jobs with ‘price repairing ‘ created uncertainties in the back uping historical based cost accounting system ( Solomon, 1968 ) . Academicians observed the deficiency of relevancy of historical costs for future decision-making, which led to the development of a ‘modern ‘ cost accounting system aimed at bettering internal decision-making and control ( Black and Edwards, 1979 ) . The new cost information system emphasised that for effectual determination doing it is of import to separate variable costs from fixed costs, and relevant costs from irrelevant costs. Despite a displacement to a forward looking cost information system, the importance of mensurating quality costs or measuring the success of quality attempts was non mentioned in the direction accounting literature. The categorization of costs into fixed and variable elements had deductions both for bettering the planning and control procedure and short-run decision-making ( Black and Edwards, 1979 ) . Any betterments in public presentation concentrated on commanding the variable elements of entire costs. Consequently, these developments increased the value of cost accounting information in three cardinal positions: 1 ) â€Å" Co-ordination of Operations † , 2 ) Performance Evaluation † and 3 ) â€Å" Decision -Making † ( Black and Edwards, 1979: 16 ) . There was nevertheless, limited sharing of these functions with other concern maps within the administration ( Yasin, et al. , 2005 ) . As such, the issues and challenges of pull offing quality attempts continued to come on without aid from the cost accounting map or profession. Overall, the traditional direction accounting tools and techniques developed in Stage 1 pursued fabrication and organizational aims. IFAC ( 1998. parity. 19 ) referred to this period of the development in direction accounting as a period of â€Å" proficient † activity necessary for the chase of organizational aims. The direction of quality remained the sole sphere of the quality direction staff, fabrication and production technology section forces and merchandise design and technology section forces ( IFAC, 1993. IMAP 5, parity. 29 ) . A closed system position of quality had small interaction with external elements such as providers and clients every bit good as the internal accounting subsystem ( Yasin et al. , 2005 ) . As such quality information was neither captured by the accounting map, nor was it reported to the corporate quality direction entities throughout the administration ( Yasin et al. , 2005 ) . Hence, the direction accounting development in Stage 1 progressed frontward disregarding the developments of quality attempts. Possibly this absence of involvement in quality attempts can be attributed to two primary grounds ( Johnson and Kaplan, 1987 and Johnson, 1992 ) . First, the accounting profession after World War 1 stipulated stiff accounting regulations that prohibited the development of direction control systems for more effectual determination devising. Second, faculty members progressively encouraged the usage of fiscal accounting information for managerial decision-making, which closed the mentality of future directors to wider applications.3.3.2 Phase 2: Passage to direction accountingA displacement from cost accounting to direction accounting, which involved a displacement from pr oficient focussed activities to managerial centred duties, occurred chiefly in the fiftiess. Managerial centred duties relied largely on the proviso of information for more effectual planning and control determinations ; hence it contributed to the accounting information epoch ( IFAC, 1998 ) . Despite this information oriented attack, the accounting information system failed to capture information refering quality ( Yasin et al. , 2005 ) . Alternatively, to guarantee proper answerability in a multi-divisional organizational construction, â€Å" duty Centres † and â€Å" duty accounting † was developed, therefore supplying the drift for direction accounting to be applied to more complex countries like divisional pricing and long term planning and control determinations ( Anthony, 2003 ) .Divisional pricing, long term planning and control determinationsIn mid-1950s, the incorporation of vertically integrated multi-activity houses and multi-divisional construction changed the original map of direction accounting ( Johnson and Kaplan, 1987 ) . For illustration, a new focal point on â€Å" duty accounting † led to the development of transportation pricing policies such as market based pricing and cost plus pricing schemes every bit good as long term planning and control techniques ( Antony, 2003 ) . Johnson and Kaplan ( 1987 ) study that with the development of duty accounting, investing duties shifted from the market to exceed direction who were so accountable for decentralized divisional public presentations. Despite the major restructuring of duties, pull offing quality betterments continued to stay outside the sphere of the direction accounting map. Another development in this phase was capital budgeting techniques. Capital budgeting techniques ab initio focused on accounting steps such as the payback period and return on investing ( ROI ) steps, but with the development of the clip value of money construct, discounted hard currency flow ( DCF ) methods such as NPV and IRR were introduced for measuring long term determinations ( Johnson and Kaplan, 1987 ) . During the same clip, GE Corporations pioneered and promoted the residuary income attack to get the better of some of the failings identified in the ROI step ( Johnson and Kaplan, 1987 ) . Today, these methods continue to play a critical function in the rating of capital outgo activities ( Smith, 1995 ) . The capital budgeting developments coincides with the scientific quality control developments and both had their beginnings in industry. Despite sharing a similar origin, merely capital budgeting developments gained acknowledgment in the direction accounting literature, whil e quality steps remained the concern of the non-accounting map ( Johnson and Kaplan, 1987 ; Morse, 1993 ) . Overall, the direction accounting developments in Stage 2 continued to function the traditional cost accounting maps. Harmonizing to Martin ( 1997 ) , most companies used traditional cost accounting systems along with production control systems, nevertheless, these systems were non decently designed to capture or supervise the public presentation of quality enterprises. Albright and Roth ( 1992 ) add that early quality motion progressed frontward with really small aid from the accounting map. During this period, factory chiefs with proficient expertness carried out traditional quality review and control processs ( Bromwich and Bhimani, 1994 ) . Further, both the direction accounting and quality developments were linked to the plants of non-accounting professionals, like the industrial applied scientists and production applied scientists ( Littleton, 1933 ; Garner, 1954 ; Soloman, 1968 ; Flood, 1993 ) . Even so, quality direction concerns were ignored in the direction accounting liter ature. Johnson and Kaplan ( 1987 ) noted that despite considerable alterations in the nature of administrations and the dimension of international competition, there have been no major publications by practicians or faculty members depicting inventions such as quality enterprises in the direction accounting literature before 1980.3.3.3 Phase 3: Nipponese influence and passage to SMABy 1985, the direction accounting focal point on information proviso ( Stage 2 ) was revised in IFAC Stages 3 and 4, where information became an organizational resource, along with other organizational resources. The cardinal focal point in Stage 3 was the decrease in waste in resources used in concern procedures, through the usage of procedure analysis and cost direction engineerings ( IFAC, 1998. parity. 7 ) . Bromwich and Bhimani ( 1994 ) noted that the direction accounting developments during this period were largely promoted by Nipponese industries that adopted quality as their cardinal competitory t ool. For case, the chase by Nipponese industries of strategic organizational aims, particularly in the country of cost decrease, formed the beginning of a new construct of strategic direction accounting ( SMA ) in the West ( Bromwich and Bhimani, 1994 ) . Further, a new focal point on waste decrease led to the development and the widespread acknowledgment of quality direction in the direction accounting literature ( Bromwich and Bhimani, 1994 ) . The Nipponese administrations who dominated the universe in choice direction during this period, focused on three cardinal developments that changed production methods to run into consumer demands: 1 ) merely in clip stock list system ( JIT ) , 2 ) entire quality control and 3 ) computing machine integrated fabrication ( CIM ) systems ( Johnson and Kaplan 1987 ; Monden and Sakurai, 1989 ) . From a strategic position, these techniques were besides utilised by Nipponese top direction for mark costing exercisings which contributed to be direction through the accent on be aftering cost decreases from the design and development phases to fabrication ( Bromwich and Bhimani, 1994: 176 ) . Over clip, the successful application of these techniques by Nipponese industries triggered a global revolution in fabrication operations which resulted in a new way for best patterns in direction accounting ( Bromwich and Bhimani, 1994 ) . The subsequent subdivisions will supply a brief treatment on the t hree cardinal direction techniques developed by the Japanese.Merely in clip ( JIT ) stock list systemJIT was originally developed at the Toyota car works and has been designed to cut down the degrees of natural stuffs and work in procedure stock lists ( Johnson and Kaplan, 1987 ) . The debut of JIT had significant effects on accounting ( McWatters et al. , 2001 ) as important elements of conventional stuff cost accounting became excess and were replaced by modern techniques, such as back-flush accounting, and a cost benefit attack statement was used to supervise the JIT system ( Drury, 2000 ) . The JIT system provides existent clip information in non-financial footings, and this therefore led to the extended used of non-financial indexs in Japan ( Bromwich and Bhimani, 1994 ) . The quality criterions implemented under JIT focal point on the decrease of non-value adding activities, such as the decrease of stock list storage and retention costs, which are elements closely linked to mo dern quality direction enterprises that besides had important deductions for direction accounting ( Bromwich and Bhimani, 1994 ) .Entire quality controlIn the 1970ss, Nipponese companies adopted entire quality control, a doctrine aimed at zero defects ( Johnson and Kaplan, 1987 ) . In this attack, quality was built into the design phase and merchandises were produced in conformity with the design specification. Harmonizing to Johnson and Kaplan ( 1987 ) companies implementing zero defect plans, worked closely with providers to guarantee defect free points were delivered therefore, extinguishing the demand for incoming review. To measure the success of quality enterprises, quality cost were analysed into conformity ( bar, and assessment costs ) and non-conformance costs ( internal failure and external failure costs ) and these developments were later incorporated in direction accounting text editions ( Drury, 2000 ) .Computer integrated fabrication ( CIM ) systemThe development of ne w direction patterns such as JIT and entire quality control finally led to the increased usage of digital computing machine production engineering that has non gone unnoticed by the direction accounting map ( Johnson and Kaplan, 1987 ) . Harmonizing to Johnson and Kaplan ( 1987 ) , computing machine integrated engineering enabled greater fabricating flexibleness with improved quality and dependability. A decently implemented CIM system should be closely linked with other systems in the administration. For illustration, in an administration, CIM is ab initio linked to the design phase by a system referred to as computing machine assisted design, and this system is so linked to a computing machine aided fabrication system ( McWatters et al. , 2001 ) . The impact of extended fabrication mechanization and engineering has revolutionised the manner administrations operate. These alterations, which were adopted with the purpose of accomplishing entire quality control in the production map, were incorporated as a portion of the direction accounting map ( Bromwich and Bhimani, 1994 ) . Overall, the direction accounting developments from Stage 3 onwards began back uping the direction of strategic quality attempts. During this period, concern administrations found it necessary to broaden their accent from an efficiency-only based orientation to an orientation that integrates efficiency and quality to accomplish organizational effectivity ( Yasin, et al. , 2005: 323 ) . As discussed in Chapter 2, the station World War diminution of American endeavor fight and public presentation were attributed to the failure of direction accounting patterns to accommodate to the demands of the â€Å" new † endeavor that included the planning and control of quality concerns ( Johnson and Kaplan, 1987 ) . Consequently, the National Association of Accountants, now the Institute of Management Accountants, influenced by Nipponese inventions, published a monograph in 1987, that was designed to present comptrollers to quality issues, and this later led to quality direction being offi cially recognised as a important portion of direction accounting map ( Morse et al. , 1987 ) . The IMA besides worked closely with the American Society of Quality to print a volume on quality based cost direction that promoted a customer-oriented attack to direction coverage ( Atkinson et al. , 1994 ; Smith, 1995 ) .3.3.4 Phase 4: Widespread usage of SMA patternsHarmonizing to IFAC ( 1998. parity. 32 ) , direction accounting developments in Stage 4 were largely concern with the effectual usage of organizational resources, and this involved back uping strategic placement, and developing or accommodating the direction schemes necessary for organizational success and endurance. From a strategic point of position, Srikanthan ( 2004 ) notes that SMA techniques gained widespread acknowledgment in the direction accounting literature, as a tool for better resource direction and value coevals. The direction accounting developments during this period were strongly influenced by emerging strat egic direction patterns such as value based direction, and quality direction ( McWatters et al. , 2001 ) . Srikanthan ( 2004 ) adds that many techniques developed during this period focused on turn toing the critical success factors needed for a concern to obtain sustainable competitory advantage in its markets. Hence, the major component that distinguishes SMA from old accounting patterns is the acceptance of advanced schemes that emphasise external organizational factors such as planetary competition ( Ward, 1985 ) .SMA techniquesThe SMA techniques are influenced by both external factors and internal procedures ( Srikanthan, 2004 ) . The former techniques include life rhythm costing, benchmarking, supply concatenation direction and strategic quality direction enterprises. While the latter include value concatenation direction, theory of restraints, procedure direction, activity based direction, and the development of an integrated or balanced public presentation measuring system. In recent old ages, the widespread application of SMA techniques has extended the boundaries of direction accounting patterns across other disciplinary countries ( Bromwich and Bhimani, 1994 ; IFAC, 1998 ) . Hence, Otley ( 2001: 259 ) suggested that research in direction accounting should switch from its accounting beginnings to integrate â€Å" the direction back into direction accounting † . Previous literature besides suggests that most SMA techniques tend to overlap in their applications. For case, life rhythm costing was introduced as a selling scheme, whereby all phases ( planing to marketing ) in providing a merchandise were analysed, and benchmarked with prima rivals utilizing rival analysis ( McWatters et al. , 2001 ) . Similarly, from a quality direction perspective the value concatenation analysis and internal benchmarking procedures helped houses place their degree of public presentation for each concern activity ( Chiang, 2002 ) , while a balanced public presentation measuring system is used to show the nexus between productiveness, quality, and net incomes ( Harrington, 1996 ) . Along this line of statement, Kaplan and Norton ‘s ( 1992 ) balanced scorecard attack has been extremely recommended to measure quality enterprises such as TQM ( Talwar, 1993 ) and SS ( Phadnis, 2003 ) . More late, procedure direction and activity based cost direction have been found to hold a important influence on the success of TQM and SS quality enterprises ( Talwar, 1993 ; Hammer, 2002 ) . Benner and Tushman ( 2003 ) added that procedure direction, which is a derivative of the value concatenation direction attack, has been the focal point of quality direction applications since the 1980s. Similarly, Ishikawa ( 1984 ) Deming ( 1986 ) and Juran ( 1989 ) proposed process direction patterns as a key to the successful deployment of quality direction enterprises. Along this line of treatment, Breyfogle III ( 2003 ) claims that SS may utilize the ABCM system to track the drivers of possible concern procedure betterment chances along the value concatenation. ABCM focuses on analyzing concern procedure activities, with the purpose of seeking chances for cost decrease, which are characteristics attributed to TQM and SS quality enterprises. By analyzing activities along the value concatena tion, ABCM seeks to better the value received by the clients and this finally impacted positively on clients and the net incomes ( Turney, 1992 ; Glad and Becker, 1995 ) . Overall the direction accounting developments in Stage 4 show a close nexus with choice direction enterprises. In the 1880ss, TQM was incorporated into direction accounting literature as a new cost decrease technique that is aimed at extinguishing non-value adding costs in mainly production activities ( McWatter, et al. , 2001 ) . Smith ( 1995 ) claims that TQM provides a vehicle for the accounting map to accomplish control, uninterrupted betterment and maximal efficiency by guaranting that all of the procedures carried out by that map are in control. In 1993, IFAC produced its first statement on quality ( ‘Managing Quality Improvements ‘ ) that recognised that TQM was an built-in portion of direction accounting map in many states. More late, SS ‘s consequence on clients, costs and bottom -line public presentation necessarily necessitate a direction accounting input. For illustration, Breyfogle III ( 2003 ) asserted that SS methodological analysis through techniques like the theory of restraints will do houses to abandon their traditional cost direction accounting steps for more dynamic steps that focus on throughput, stock list and operating disbursals every bit good as promote a information driven determination attack. By using a information driven determination attack, SS interfaces with a figure of direction accounting patterns and this relationship will be examined in the following subdivision.3.4 THE INTERFACE BETWEEN MANAGEMENT ACCOUNTING AND SSThe implicit in foundation of SS methodological analysis is the perceptual experience that the administration is made of procedures and sub-processes/activities that drive concern public presentation, and this attack is demonstrated by the usage of several d irection accounting patterns developed within Stage 4 of the development in direction accounting. The subsequent subdivisions will analyze the literature and discourse the significance of utilizing the following cardinal direction accounting patterns with SS and the function they should play within the SS led DMAIC procedure:3.4.1 Process direction and supply/value concatenation directionProcess direction, like SS enterprises, focal points on the cardinal drivers of concern public presentation foregrounding the mutualities that define, enable or restrain an administration ‘s possible ( IMA, 2000. parity. 16 ) . By following the DMAIC procedure, SS administrations emphasise the flow of concern activities and attempts and their linkage to high executing value concatenation procedure activities ( Hammer, 2002 ) . Hammer ( 2002 ) adds that by positioning SS under the procedure direction umbrella, companies used a structured attack to public presentation betterment that is centred on the disciplined design and careful executing of a company ‘s end-to-end concern procedures, and this attack benefited SS administrations. Other SS authors have voiced similar positions. For case, Swinney ( 2000 ) claims that a decently executed procedure direction coupled with the DMAIC procedure can ensue in enormous additions for administrations. Similarly, Averboukh ( 2002 ) reported positive consequences from deploying procedure direction with SS. Further, procedure direction has besides been recognised as a primary enabler for the execution and direction of an integrated supply concatenation, which is a cardinal characteristic of SS methodological analysis ( Schiegel and Smith, 2005 ) . Dasgupta ( 2003 ) noted that SS methodological analysis adopts supply/value concatenation direction rules to guarantee the effectual and efficient usage of organizational resources. Trent ( 2001 ) argues that providers invited to be portion of the SS value concatenation analysis procedure can actively reexamine client specifications and supply thoughts to the purchasers on stuffs and procedure betterment chances. By making so, houses have been able to salvage resources, and finally monetary value their merchandises more competitively without impacting their client quality ( Trent, 2001 ) . Weigang ( 2005 ) claims that the significance of pull offing non-value adding activities at all organizational degrees and in all concern processes with the cardinal purpose of bettering bottom-line consequences, gained greater acknowledgment merely after the debut of the SS methodological analysis.3.4.2 ABCM and benchmarkingABCM system is recognised as an extension to treat direction pattern. The underlying foundation of ABCM systems is the perceptual experience that activities transform resources driven by the procedure into end products ( Bromwich and Bhimani, 1994 ) and this is a position strongly observed by SS administrations when aiming undertaking betterments. For case Gupta ( 2004 ) and Breyfogle III ( 2003 ) claim that the usage of ABCM for procedure activities offers the added flexibleness of uniting costs with procedure activities to prioritize procedure betterment chances and besides enables SS administrations to quantify the return on investing for procedure alterations. Further, utilizing SS as an illustration, Cokins ( 2003 ) showed that the integrating of ABCM and cost of quality could supply fact based informations fo r administrations to larn, concentrate and take necessary actions. In a recent SS survey, Chiang ( 2002 ) noted that procedure direction in healthcare administrations involved the combined application of activity-based direction and internal benchmarking processs, which he referred to as activity based benchmarking. Chiang added that activity based benchmarking for health care procedures involve three stairss: analyzing procedure flow and placing major activities, taking the appropriate measuring of resource ingestion for benchmarking, placing the best procedure and pattern for benchmarks. The benchmarking technique is frequently used in define, step and analyse stages of SS on the footing of distinguishable comparings like: competitory benchmarking ; strategic benchmarking ; and internal benchmarking ( Harry and Schroeder, 2000 ) . Competitive benchmarking evaluates the house ‘s place within its industry, while strategic benchmarking sets a way for the administration by mention to universe category pattern and internal benchmarking relates to outdo patterns within the administration ( Stroud, 2006 ) .3.4.3 Balanced scorecard ( BSC ) attackBesides benchmarking, SS practicians have repeatedly stressed the importance of holding appropriate measurement systems in topographic point for successful SS enterprises. Gupta ( 2004 ) and Phadnis ( 2003 ) advocate the usage of a balanced scorecard ( BSC ) type of attack for the choice of undertakings, as this will guarantee that the undertaking meets both client and concern demands. Pyzdek ( 2004 ) claims that Kaplan and Nor ton ‘s ( 1992 ) BSC attack helps SS administrations maintain a holistic position by supplying a concise show of public presentation prosodies in four countries that correspond to the major stakeholders. Overall, the reappraisal has shown that SS interfaces with several SMA developments. Despite SS ‘s relationship with direction accounting patterns, SS has received small attending from direction accounting research workers. CIMA ( 2004 ) has late encouraged research workers to set about fieldwork and instance surveies, which demonstrate the linkages between public presentation measuring systems and SS and besides other analytical engineerings that support direction procedures. Therefore, there is a timely demand for researching SS quality enterprises in a direction accounting context, peculiarly given that quality direction forms an built-in portion of the direction accounting map and that direction comptrollers have an of import function to suit the alterations by planing new measurement systems to mensurate and measure concern public presentation ( Lee, 1987 ; Bromwich and Bhimani, 1994 ) .3.5 SUMMARY OF ChapterThis chapter has reviewed the altering function of direction acco unting, and identified that direction accounting ‘s concern with quality issues has come comparatively late in the map ‘s development. Indeed it was non until the eightiess that quality direction techniques, such as TQM, were considered to be an built-in portion of the direction accounting map. The alteration arose from a displacement â€Å" off from information proviso † towards ‘resource direction ‘ schemes which was occasioned by an accent on cost decrease reflecting international competitory force per unit areas from globalization and Nipponese advanced programmes like JIT, TQM, and CIM. A important part to this displacement was the close coaction between IMA and the ASQ that resulted in acknowledgment that formalised quality direction was a important portion of the direction accounting map and this besides promoted a client oriented attack to direction coverage. Subsequently development focused on strategic issues, and these developments coincided with the development of SMA which involved many techniques, such as benchmarking, ABC/M, value concatenation direction, procedure direction, integrated PMSs and the BSC attack, that were an built-in portion of SS and other modern quality enterprises. From a PMS position, the subdivision besides notes that the CIMA among other issues has called on research workers to show the linkage between PMSs and SS. SS ‘s nexus with PMSs and the involvement shown by CIMA on this capable affair fits the demands in research inquiry two that examines the association between PMSs alteration and SS. The reappraisal has besides shown that in the modern position of quality, the most of import part from accounting is a new focal point on uninterrupted procedure betterment enterprises, informations aggregation and measuring. This development fits closely to research inquiry three that explores the function of dire ction comptrollers in SS execution procedure. Given SS ‘s relationship with direction accounting patterns and in peculiar with the PMS, the following chapter will develop the literature on the cardinal research issues associating to SS methodological analysis that have been identified in the current and predating chapter.

Would You Recommend a Friend to Our Hospital

Running head: WOULD YOU RECOMMEND A FRIEND TO OUR HOSPITAL? 1 David M. Dowling Operations Management I Southwestern College 20 January 2011 Week 3 – The Culture & Quality at Arnold Palmer Hospital Running head: WOULD YOU RECOMMENT A FRIEND TO OUR HOSPITAL? 2 Abstract In this paper I will demonstrate the importance of instilling a culture of quality in employees and why it’s essential to establish a concise mission statement, code of ethics, procedures and processes that employees can utilize in order to carry out the hospitals philosophy and mission.I will also show what systems and processes I would set up in a new hospital to achieve a culture of quality in a hospital. The paper will also show some of the processes that the Arnold Palmer Hospital in Orlando, Florida uses to achieve such a high success rate in customer satisfaction. The bottom line of this paper is that it’s easy to claim or make the statement that a hospital provides a quality service. Itâ€⠄¢s another thing to deliver. Learned and established techniques from this text will help an operations manager achieve the desired goal for establishing an environment of quality, excellence and profitability.Running head: WOULD YOU RECOMMEND A FRIEND TO OUR HOSPITAL? 3 INTRODUCTION My Name is Dave Dowling and I am a new employee at the Arnold Palmer Hospital in Orlando, Florida. After graduating from Southwestern College I was looking for a company that I could exercise my new talents as an Operations Management graduate. I was drawn to Arnold Palmer Hospital because of their dynamic structure and their compassion and care for children. First I would like to give you a little background on the Arnold Palmer Hospital and why it is such an appealing place to work. It was founded in 1989, the Arnold Palmer Hospital (A. P. H. is sanctuary of hope and healing for many sick children. It has grown to be one of the largest women’s and children’s hospitals in the United State s. A. P. H. is a top level 1 children’s trauma facility. The hospital provides tangible services such as neonatal and pediatric intensive care services, pediatric oncology and cardiology. It also provides specialized service such as care for high risk pregnancies and maternal intensive care. The hospital is very proud of its new multi building facility that covers 676,000 square feet and houses some of the finest advanced state of the art medical equipment on the market today.This awesome facility houses 2,000 of the most compassionate and dedicated doctors, nurses and administrators found in any hospital in the United States. WOULD YOU RECOMMEND A FRIEND TO OUR HOSPITAL? 4 As part of the management team I was introduced to many of the processes that have been put into place at A. P. H. They have built a culture of quality that is focused on the patient and their family. The mantra at A. P. H. is â€Å"Quality is not just taking care of the patient, but also taking care of t he family†. Why is it important for Arnold Palmer Hospital to get patient assessment of health care quality.Does the patient have the expertise to judge the health care he or she receives? In order to feel the pulse of the hospital and truly be able to assess what services need to be added, deleted or modified. Administrators need to know how patients truly feel about the experience they had at the Arnold Palmer Hospital. A powerful tool that A. P. H. has been using is the comprehensive survey that captures a patient’s honest assessment on their experience. Administrators review the assessments on a daily basis. This tool will allow administrators, doctors, nurses and employees adjust processes to provide patients better services.If patients and families are unhappy about treatment, facilities, parking, finding their way around the hospital, the management and hospital administrators need to know. They need to know on a daily basis. The executive staff level at A. P. H. review assessments as they are loaded into the executive dash board on a daily basis. They look at four quadrants of the hospital operation. Services, Quality, Human Resources and Finances. The results of the survey’s allow corporate officers to move assets, resources , personnel and changes to that functional areas that need the change.The results can help hospitals learn how to treat patients the way they expect to be treated. WOULD YOU RECOMMEND A FRIEND TO OUR HOSPITAL? 5 Addressing the question, Do patients have the expertise to judge the health care he or she receives. According to (Drain, 2010) â€Å"Patients do judge the quality of clinical care they receive. However, they base their judgments on far more than the technical interventions, many of which they are unaware. The sweeping overhaul of the U. S. health care system likely will result in increased patient volumes for hospitals and medical practices.As the nation moves toward value-based purchasing, patient sa tisfaction will become an increasingly important measure of quality. In a 2009 HealthLeaders Media survey, nearly a third of health care executives said that the patient experience was their top priority; another 55% said that it was in their top five. All reported that patient experience would be a priority in five years. In a 2004 study of five clinical conditions, two dimensions of patient-centered care stood out: emotional support and respect for patients’ values, preferences and expressed needs.Simply, put, providing support and involving patients in decision making are associated with better outcomes. Good communication between patients and care providers drives positive patient experiences and compliance, which lead to positive outcomes. Patient satisfaction is not about making patients â€Å"happy†; it is about improving the patient’s experience to facilitate health and medical outcomes. When patients are satisfied, trust is enhanced. When patients trust their physician, they are more likely to disclose information, follow advice and adhere to treatment plans†.It is very difficult to answer this question, regardless if you feel that people have the expertise to judge physicians and hospital on the care they receive or not. One must keep in mind that most people just want to feel that they are receiving the best medical care possible and they want to be informed and feel that they are cared for and have a clear roadmap on what is going on with their treatment. WOULD YOU RECOMMEND A FRIEND TO OUR HOSPITAL? 6 How would you build a culture of quality in an organization such as Arnold Palmer Hospital?As an operations manager I would break down my plan to develop a culture of quality into three categories, management, personnel and facilities. In order to properly take an organization to â€Å"A Culture of Quality† It is important develop a plan at the management level first. The first step is to establish a code of ethics, mission statement and leadership philosophy for management and first line supervisors. Although Arnold Palmer Hospital empowers all employees to make decisions. A foundation of standards needs to be established in writing as a source document for all employees from the top down.This will make it very clear that there is specific behavior that is expected from every employee from the CEO to food service. The next step I would take is to establish a mission for the hospital. The goal is to provide quality health care and make the patient experience as pleasant and comfortable as possible. Establish with every employee that each patient is an individual and must be respected as a person. People and families tend to not be themselves when they are sick. Every employee needs to rise above their own feelings and focus on why they are in the health care business.Establish in the minds of employees that every patient has the right to comprehensive, compassionate family centered health care service. Every patient and family has a right to be heard with the concerns they have about the care they or their family member is receiving. I would establish a patient bill of rights in order to serve as a guideline for employees to follow and understand. Once rules and policy is established I would then implement and put into place the following processes in order to give our employees the means and tools to carry out the desired missions of the hospital board of directors and administrators.WOULD YOU RECOMMEND A FRIEND TO OUR HOSPITAL? 7 The first step is to establish a department that will construct a comprehensive survey the patients can fill out in order to capture what their experience was like at the hospital. I would then have the department establish an executive web site that this department can post reports, flowcharts, checksheets, Scatter Diagrams, cause and effect diagrams and various statistical reports. This will allow leaders at all levels see what patients like and dislike about their experience.This will allow top levels of management properly direct what processes need improvement and change and what assets need to be re-directed to those weak functional areas or processes. In order to ensure that your employees are on board with the hospital philosophy rules and policy must be established to empower employees to make decisions without being promoted to act. And work everyday with the goal of continually striving to improve processes and their specific job duties. I would also establish process improvement teams by department.These are the teams that ensure that data is being captured as problems arise with processes or employees and also reacting to customer surveys and tackle what patients see as a problem. And finally I would establish some type of awards program that would reward employees for making the effort of making our hospital a better place to work and a place the patients feel at ease with getting well. As mentioned in the p rior paragraphs, I would establish a training program that will instill the culture of quality in every employee. Encourage them to own it and live it.To continually strive to improve processes and that there is always room for improvement. I would also instill that communication is key. Ensure that employees understand that keeping customers informed WOULD YOU RECOMMEND A FRIEND TO OUR HOSPITAL? 8 is the number one priority. If you don’t have the answer, you will find someone who has the answer. The facility and equipement is also a very important concern when establishing a culture of quality within your hospital. As an operations manager you must ensure that the hospital has the best quality and up to date state of the art facilities and equipment that you budget will allow.Continually work with doctors, nurses, technicians and staff to ensure that operations is doing everything it can to ensure that processes are properly equipped and that patient rooms, surgical rooms an d all facets of the facility are properly supplied, illuminated, marked, and safe. The bottom line is that you need facilities that are state of the art facilities, processes that provide quality healthcare, programs and measures that capture the patients like and dislike about your hospital. But most of all you need to mentor your employees about all the task that need to be accomplished in order to achieve â€Å"a culture of quality†.Constant analysis and caring employees is what make this happen. What techniques does Arnold Palmer Hospital practice in its drive for quality and continuous improvement? The number one technique that A. P. H. utilizes is their comprehensive surveys. Patient survey capture the customer’s assessment’s of there experience in the hospital. These survey’s will assess customers expectations of the medical services that the hospital is offering. This survey will be in-depth and will ask a wide variety of questions from the qualit y of food, staff, accommodations and medical treatment.The most important question is â€Å"Would you recommend A. P. H. to your friends? † Once the surveys are done they are posted they are posted on the WOULD YOU RECOMMEND A FRIEND TO OUR HOSPITAL? 9 executive Dash Board which allows continuous monitoring of the problems and the measures the hospital staff are taking to correct the problems. It is important for key leadership and senior administrators to review survey each and every day in order to keep their pulse on the climate of the hospital and its patients.The survey asks specific questions such as respect, access, quality of care and medical staff, was the care coordinated, were you given a thorough explanation of your condition and follow on care. This information will assist employee, supervisors and administrators refine processes to improve the quality that is provided to patients. The new measure are pushed down to the individual department levels to ensure chan ges are made were the problems exist. A. P. H. management will also take these assessments and compare the against a national benchmark comparison in order to provide the best health care possible.Data is available on how other hospital might handle a similar issue or chanllenge. As mentioned prior, The A. P. H. executive dashboard is a crucial tool in assessing customers opinions about their experience at A. P. H. In order to truly know were we really stand with customers we must capture extremely accurate information on how our patients and their families fell about the care that we have provided. It doesn’t matter what we think, The only opionion that truly counts is the patients and their family. Another method is benchmarking.Benchmarking in order to ensure that standards are set in order to establish and maintain specific standards in the specific medical services that it will offer its customers. The specific services that they focus on are pediatric and neonatal inten sive care, pediatric oncology, labor and delivery and care for high risk pregnancies. As mentioned prior, the business of caring for people is the business of having highly trained physicians and WOULD YOU RECOMMEND A FRIEND TO OUR HOSPITAL? 10 state of the art equipment. This is your service. If you fail to contiunually update processes and benchmark.You will not survive, patients will simply go to better hospitals. Without benchmarking quality of service could slip causing customer dissatisfaction. Another interesting and unique technique that A. P. H. uses is giving senior leadership cell phone and they can monitor and get directly involved with patients and families if there are significant challenges or patients are unhappy or concerned about the service they are receiving. The senior management has taken call on the most trivial issues. The unique part of this story is they don’t see these small issues as trivial.This is probably why they rank so high nationwide in cust omer satisfaction. The hospital also uses various charts. I will briefly discuss the uses of each. The flow charts & Pareto charts are used to give staff and personnel a quick overview of what is happening in the hospital and nationwide. The Pareto charts also focus on critical items and leave less important issues off. This is a good chart to find out what the major problems are. Benchmarking is critical in showing where opportunities exist for improvement. Develop a fish-bone diagram illustrating the quality variables for a patient who just gave birth at A.P. H. Another tool that can be used by operations managers is cause and affect diagram or fish-bone chart. This can assist department heads such as those who are in charge of a post natal unit in a hospital. This chart can help doctors, pediatricians and pediatric nurses take care of mom and baby in a more efficient manner. It chart will identify potential causes to problems that that may have occurred in the past. Knowing what causes problems will give employees the ability to WOULD YOU RECOMMEND A FRIEND TO OUR HOSPITAL? 11 identify these problems.These charts should be updated as new problems arise and new equipment is introduced to the post labor or neo natal units. Charts like these help us document mistakes and learn from others . Below is a chart I developed to help the nurses and doctors identify potential causes of the most common post natal problems that hinder quality care for mom and baby. Material: Quality rooms designed for post natal patients PATIENTS HAVING TO ENDURE CRAMPED ROOMS COMPLAINTS ABOUT OLD EQUIPMENT AND SUPPLIES Method: Processes & classes to prepare parents to go home SPECIAL DESIGNED ROOMSROOMS THAT ACCOMMODATE MOM & BABY WELL LIGHTED ROOMSBASIC INFANT CARE CLASSE POOR PARENTING SKILLS ACCOMODATIONS FOR LONG TERM STAYSMOMS MEETING MOMS CLASSENO SUPPORT QUALITY MEDICAL SUPPLIESBIG BROTHER BIG SISTER CLASSESKIDS NOT COPINGPARENTAL BREASTFEEDING CLASS NOT UNDERSTANDING EDUCATED P ARENT PREPARED TO TAKE BABY HOME Hospital cant provide care because lack of state of the art equipment NEONATOLOGISTINEXPERIENCEDPEDIATRIC EMERGENCY UNIT PEDIATRIC NURSESLACK OF SPECIAL SKILLSPEDIATRICS INENSIVE CARE UNIT PEDIATRIC SPECIALISTSNICU CANT DEAL WITH NICU UNITSManpower: Quality Doctors, Nurses and specialists Machine: State of the art equipment & Services EMERGENCIESPEDIATRIC INPATIENT UNIT WOULD YOU RECOMMEND A FRIEND TO OUR HOSPITAL? 12 REFERENCES 1. Drain, M. , MA. (2010). How patient satifaction correlates with clinical quality, Retrieved from http://www. pressganey. com/improvinghealthcare /improvingHCBlog/blogPost/10-04-12/How_Patient_Satisfaction_Correlates_With_ Clinical_Quality. aspx

Leaders against Followers in Animal Farm by George Orwell

Published in England on August 17th 1945 and written by Eric Arthur Blair (also known as George Orwell) between 1943 and 1944, Animal Farm is a novella that takes place and has the same ideologies of the Russian Revolution on an imaginary farm. Major characters such as Napoleon and Boxer the Horse play important roles concerning freedom and equality. Napoleon, considered by most to be the leader of Animal Farm is manipulative and selfish; does not care about others, and does not like to be bothered when it comes to gaining full control. Boxer the Horse, on the other hand, is the strongest yet most gullible of all the animals. He believes everything Napoleon tells him and never questions whether he is losing his freedom or not. This novella argues how a farm, just like a country, can transform for the worst with leaders who do not know how to govern it. Just like Karl Marx once said â€Å"The ruling ideas of each age have ever been the ideas of its ruling class.† Like any other leader in the world, Napoleon does not differ. Not all leaders are dictators and not all dictators are leaders. Napoleon, due to his manipulative behavior gains hatred from a lot of people around him who cannot say anything to him due to their fright. By constantly changing the commandments, he creates a tension within Animal Farm making the animals believe that everything he does is done in the right way. An example of change is when he changes the commandment concerning slaughter of another animal. ByShow MoreRelatedAnimal Farm Essay1324 Words   |  6 PagesSlaughterhouse Animal Farm is a beast fable written by George Orwell as an allegory to the Russian Revolution and the rise of communism in Russia, in which, â€Å"All animals are equal, but some animals are more equal than others†(Orwell 134). 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