Hospital Essay

Hospital Essay.

This report outlines the service delivery process at Al Salam Hospital in Mohandseen focusing on the out-patient clinic along with our evaluation of the service there. We visited the hospital several times and also played the role of patients there. We made reservations and were examined by several doctors (e. g. internal medicine doctor, ear nose and throat, chest and ophthalmology,…etc). We also interviewed one of the doctors (cardiology) for the purpose of gaining more information. We made a survey and interviewed some patients to see their evaluation of the service and how it meets their perception.

Based on our visits and the interview we made we were able to gain enough information to evaluate the offered service and prepare our report. This report was prepared by Ban Faisal, Mariam Riad, Nancy Mustafa and Mohamed Magdi Al Kady. Process Description at Al Salam Hospital: Al Salam Hospital has 2 buildings, the first one is located on the main street, is the hospital itself, for surgeries, patient hospitalization and it has the blood testing lab and x-rays.

The second building which is located on a side street near to the main building is the out-patient clinics.

The first step for being examined in one of the hospital’s Out-Patient Clinics, is to select the desired doctor, according to the specialty and available times. The patient can acquire the needed information through the hospital’s website (http://alsalamhospital. org/reservation. asp), through the telephone or through personal inquiry at the hospital. Reservation Details: The patient should then make a reservation. The reservation can be made either through the telephone or by going directly to the clinics’ reception.

This depends on the doctor, some doctors allow reservation through the telephone and others only allow reservation to be done directly at the out-patient clinic along with payment. If the patient is making his reservation at the clinic, then he can make it on the same day as the desired time or a few days in advance depending on the availability of appointments. There are several payment categories; the patients who pay normally, the ones who have an insurance that gives them a discount (partial or full) and there are members of unions who usually get a partial discount that varies according to the union.

Reservation Process The patients head to the reservation area that is set near the main entrance. There are two windows located one for the normal patients and one for the insured ones. The receptionist begins by asking the patient if this is his/her first visit to the hospital, if it is, the receptionist asks for the patient’s information and a file is created for the patient on the hospital’s computer system. The patient tells the receptionist which doctor and when they want to reserve an appointment.

The receptionist then checks on the computer reservation system if there are any available appointments t the desired time and if not he tell the patient the first available appointment. If the desired appointment is available then in the case of the normal patient, the patient pays and gets a receipt. The patient is given a floor number (where the examination room is on) and is asked to head there and is advised to give the receipt to the nurse who is sitting at a desk on this floor. The nurse then takes the receipt and enters the information in a ledger (the day’s list of patients) she has to organize patients and then gives the patient his number (on a first come first served basis).

She checks the patient’s ID and goes to the archive to find the patient’s medical record. If this was his first visit, she gets a new blank medical form. The medical records are given to the doctor later. If the patient has an insurance or will get a discount the above process is the same the difference is that at the time of payment, the patient presents his/her insurance card (or union membership card) to the receptionist who then checks if he has a contract and with which insurance company and the amount of discount he will get.

The payment is settled according to the discount rate and the receptionist finishes the reservation process and gives the patient three sets of papers to sign along with the normal receipt. The papers are for the insurance company or union (One for the hospital, one for the company and one for the patient). The receptionist keeps one of the signed forms and advises the patients to go to the doctor as previously mentioned. If the doctor cancels his appointments for the day the hospital then calls the patients informing them of this change and gives them another appointment.

If the patient has made his appointment in an earlier day, before his appointment he’ll first head to the nurse on the clinic’s floor to give her his papers and take his number. At the time of the appointment, all patients wait in the waiting area for his/her name to be called by the nurse at the desk that already gave him his number on the day’s list of patients. When the doctor arrives the nurse provides him with the list of patients by their order. She also gives him the medical records of all the patients. After the patient’s name is called he goes into the doctor’s office to be examined and describe his/her complaint.

The doctor checks the patient’s medical record, if there is any, to get a clearer background about his health. After the examination, the doctor can then give the patient a prescription or orders a few tests to be made, and if needed advises the patient to schedule a follow up consult to check on the progress of the treatment or to check the results of the test. The doctor writes everything down in the medical record (the complaint, diagnosis and recommended treatment), the form is given to the nurse to return to the archive at the end of the day.

The number of consults may vary depending on the ability of the doctor to pin point the patient’s illness and the treatments effectiveness. The doctor also has a document where he keeps information about all the patients that he has seen on that day. If tests are required then the hospital offers the lab as a complimentary service to the out-patient clinic. There are two labs one in the outpatient clinic building and one in the hospitals main building. The first step to get the tests done is for the patient to take the papers with the prescribed tests to be registered in the hospitals computer system which is located on the ground floor.

The patient will then get a paper which s/he will then take to the nurses sitting at a window located immediately next to the lab, they will take the paper and then tell the patient to go into the lab to be tested. The patient will then be told when his results will be ready to be picked up. The patient can reserve for a consult the same way s/he reserve for a regular examination. Go to Appendices 1 & 2 for more illustration about the service delivery process at the out-patient clinics.

Evaluation and Analysis of Al Salam Hospital’s Service: Service concept and characteristics: Service Concept The hospital should be able to offer all things a patient can need: out-patient clinics for examinations, emergency rooms, intensive care units, x-rays and labs, .. etc The employees should feel that they are saving lives not just having a normal job. The community should treat the hospital as a crucial facility that they need to help and do what they can to help it operate. The treatment should be as efficient and professional as possible and make the patients feel safe and secure so that they would receive their regular treatments there and recommend it to their families and friends.

The design of the hospital takes into consideration the devices needed, emergency rooms, moving large objects as beds in corridors and elevators. The interior design is suited to a hospital and allocation of rooms and floors takes into account the psychology of patients (i. e. departments with a high death rate like intensive care units and cancer patients should be located away from newly born babies and incubators). The hospital is marketed based on the names of the doctors working there and how successful they are in treatment.

Target Market Segment: AL Salam Hospital is a private hospital focusing on average and above average-income families. This market is not usually price-sensitive when it comes to healthcare services. This community needs a professional hygienic hospital which they trust to be able to go to for regular examinations, consultations, tests and emergencies The most important segment is of those of the older generation because they usually get sick more. However, it is important that the hospital builds it ties of trust with the customers throughout their whole life.

Distinctive Characteristics of the Service at Al-Salam: Simultaneity: It is the fact that services are created and consumed at the same time at the hospital, the patient enters the room, the doctor examines the patient (the customer) and the patient receives this service simultaneously. For example if a patient comes to the hospital and is diagnosed as having a very low blood pressure the doctor will hook the patient to a salt solution IV which will raise the patient’s blood pressure.

Perishability: The service is perishable which means it cannot be stored. If the patient doesn’t come at the reserved time, a lost opportunity has occurred at that time. An hour without patients during a doctor’s shift can be considered as a lost opportunity and the money that the hospital was supposed to make at that time will never be compensated. Faced with variable demand and time-perishable capacity to provide the service, the managers of the hospital used the following techniques: * smoothed demand by using reservations or appointments Allowed patients to wait. * Accepted more patients than the time capacity. Intangibility: Services are ideas and concepts, not products. The patient experiences the service that the doctor offers; he doesn’t touch it or see it. The intangible nature of services presents a problem for customers. When buying a product, the customer is able to see it, feel it, and test its performance before purchase. But for a service, things are different.

The doctor tried to overcome this intangibility feature through making the intangible tangible; trying to stop the pain that the customer feels. He did this through examination and then medication. Another way through which the hospital overcame this intangibility feature was the reliance on reputation and word-of-mouth. Al Salam hospital is very well-known by its good reputation and its customers who are really satisfied with the service delivery system.

This two features encourages people to guarantee that when they go to this hospital, they will be satisfied even though it’s not a product that they can really see and touch. Heterogeneity: The combination of the intangible nature of services and the customer as a participant in the service delivery system results in a variation of the service being offered from one customer to customer next at the same doctor, let’s take a dentist for instance, each customer might have a different kind of pain and thus, needs a unique method of treatment.

On a larger scale each customer needs a certain doctor based on his/her illness. Al Salam hospital offers a variety of doctors with different specializations. Also, there is a cafeteria for patients; that provides a variety of food and drinks to satisfy as much patients as possible. There is cooked food, biscuits, cheese, sandwiches…etc. And as for the drinks there were many kinds of them such as: juice, tea, coffee…etc.

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Hospital Essay

The Flower of Services for Gleneagles Hospital Essay

The Flower of Services for Gleneagles Hospital Essay.

Gleneagles hospital Kuala Lumpur provides clear information about direction to service site on the websites. The address of Gleneagles hospital Kuala Lumpur is No 282 & 286 Jalan Ampang, 50450 Kuala Lumpur. Gleneagles hospital describes the location of the hospital where is located on Embassy Row on the main Jalan Ampang, Kuala Lumpur. The hospital location is central and easily accessible by the inner ring roads of Jalan Tun Razak and Jalan Ampang; the MRR (middle ring road) and AKLEH (Ampang-Kuala Lumpur Elevated Highway) by cars taxis or buses.

Gleneagles Kuala Lumpur is near to Jelatek stop of Putra LRT station, it take less than 5 minutes by taxi to the hospital. The location map provided on the official website of Gleneagles. Gleneagles also provide information of regular visiting hours run from 9am to 10 pm. The visiting hours for Intensive Care (ICU) / Coronary Unit (CCU) / High Dependency Units (HDU) is 9. 00am to 2. 00 pm and 4. 00pm to 8. 00 pm. Gleneagles operates 24 hour daily for accident and emergency on the ground floor of the hospital.

Gleneagles list out the price of executive screening programme such as basic screening for male and female is RM423, comprehensive screening for male and female is RM920, premium plus screening for male is RM1217, premium plus screening for female is RM 1364, etc. Gleneagles also provide information of prices for women wellness programme such as basic gynaecological screening cost RM115, breast screening cost RM192, etc. Gleneagles remind the customer to bring the following items to ensure a smooth admission:

* passport/ identity card health insurance card and written letter of guarantee from health insurance company if the person is covered by insurances * doctor’s referral note, past or present medical records, x-rays, or prior test results (if the person physician has requested them) * Medications that have been prescribed to the person * A copy of your advance directives (if any) Gleneagles give warning to visitors, do not send flower to patient in ICU because ICU is a sterile place and should be kept free from possible contaminant.

Order-taking The patients can book an appointment with Gleneagles through official website of Gleneagles. The patient need to fill in their particulars such as nationality, patient’s name, gender, date of birth, NRIC / Passport number, telephone number, mobile number, fax number, e-mail address, and patient’s current medical conditions / symptoms / diagnosis . The patient also needs to fill in preferred appointment period and time slot either morning or afternoon sessions.

Lastly, Gleneagles require the person who book an appointment answers a question for additional information for Gleneagles and Gleneagles require these information to process the customer request. After complete fill in the details, the customer click submit button, the appointment is successfully book. Billing Gleneagles deliver the bill for individual who do medical services at their hospital. The bill contains information address of Gleneagles, bill number, bill date/time, bill prepared by who, account number, credit term and contact number.

The bill also state clearly about the medical service charge such as charge for bed, CSSD, cath lab, medical record, laboratory, pharmacy, medical/surgery supply, equipment charge, nursing and doctor consultation / procedure charge. Payment The patients can make payment at registration counter when check out from hospital by using credit or debit card. Pre-payment is required for all check-up programs. Gleneagles also accept the cash for the payment and changes will give back to the customer for overpayment.

The patient also can make payment for medical service provided through online to Gleneagles Hospital Kuala Lumpur SDN. BHD. &cross account. For self-paying patients, 1. 5 percent interest will be charged per month is the amount due after 30 days. Gleneagles charge parking fee for the vehicles park inside the hospital. Gleneagles using machine at entry gate for gives the parking ticket to the driver who want parking inside the hospital. Therefore, the visitors and patient parking inside Gleneagles need pay the parking fee by insert cash into machine in order to drive out from the hospital.

The Flower of Services for Gleneagles Hospital Essay

Too Far Ahead of the It Curve? Essay

Too Far Ahead of the It Curve? Essay.

The project has gone far over budget and over schedule. And yet in its final stage, we still face additional cost in new software licensing. In the mean time, we also need the resources in place to launch the new product after years of research and development. We do not have enough cash for both, so the decision here is whether to delay the launch of the new product, or choose to allocate the cash to the project. A solution was suggested by the lead developer that we could bypass the new software licensing cost by connecting to his company’s server.

It is only a temporary solution so we could have enough time to straighten out the cash flow issue. However the dilemma is that is it ethical to do so? If we follow his advice, what are the consequences of such action? Here are some possible courses of actions:

1/Follow the developer’s proposal: The immediate benefit is that it will allow time to solve the cash flow crisis.

However, it is violating the Code of Ethical Principals and Rules of Conduct of CGA Association. The first Rule of Conduct is Responsibilities to Society and according to CEPROC, as members of society, we have the responsibility to safeguard and advance interest of society. Accessing the software through the developer’s server is an unlawful activity under that rule. The cost saving in licensing will not be enough for the possible financial and reputation damages that it will bring if the activity was found out, and we could possibly face lawsuits from Microsoft. That would put the company’s credibility at risk. We also set bad behaviour for our employees. 2/If we do not follow his proposal, we now face the following two alternatives: A – Allocate cash to the IT project: Since the project is already in its final stage, it will finally be up and running.

However, delaying the launch of the new product will certainly impact our reputation. The stake is quite high here because given the mandate of our company is to reduce pesticides; it is very beneficial to bring this product to the market as soon as possible because of the huge benefits that it is bringing to farmers locally and worldwide. Our company reputation and credibility will be increased and this would bring tremendous benefits to company in the long term.

Efforts and resources have already been dedicated to the product for a long time, delaying it might have some negative effects on staff morale. B – Launch the product: The advantage of this choice is that the faster we introduce this product to the market, the more beneficial it will be for all the stakeholders involved such as: farmers, research and development team, and our company credibility. However, delaying the project may incur further cost in renewing old software licenses for the system. In the end, the total cost of the project might outweigh the benefits that it intended to bring. Any decision should follow the two criteria:

1/ As a company and a member of society, we must operate in an ethical and responsible way. Operating ethically will gain trust and credibility. And that will be beneficial to the company in the long run. 2/ The benefits and interests of the organization as a whole should be the basis for any decision. Recommendation:

I would recommend not following the developer’s proposal as doing so would violate ethical rules of conducts. And the best option would be to launch the product instead of pouring more cash into the IT project. As launching the products would be more beneficial to the company as whole. We should also have to sit down and re-evaluate the IT project, to see where it went wrong, and then determine the appropriate action instead of just pouring more cash into it. If you need to discuss the issues further, please do not hesitate to contact me.

Question 3:
EXECUTIMVE SUMMARY

IT tool has become a double-edged sword to Peachtree. It is indispensible and yet the unreliability of it could cause catastrophic consequences. Facing the routine breakdowns, and the increase burden of supporting various legacy systems across all hospitals, the company must decide whether to replace with monoliths – enterprise software, or just pieces of it with SOA approach. The first would create mass standardization. And the latter would allow for selective standardization. Each system has its strengths and weaknesses.

How then could Peachtree decide? Criteria such as, selective standardization, reliability, timing, ease of implementation should be the basis for any selection. The final decision would then have to really take the different aspects of clinical culture of each hospital into account. Given the nature of healthcare mission and Peachtree’s long term business strategy, it is crucial to maintain some form of autonomy especially in the treatment of patients. The recommendation is to go with SOA method since it allows for selective standardization. And that would support business objectives.

CURRENT SITUATION

Peachtree current IT system is barely functioning, it is having routine breakdowns. The reliability of the IT tools is in question. The results of such failures have been causing distress on staffs and threatening the quality of services provided. If the IT problems are not addressed soon, Peachtree’s reputation will be dragged down along with it and that damage will not be easily repaired. Peachtree current IT system is a de-centralized one. Each hospital has its own system that caters to its own special needs and purposes. The strengths of such system are that it will be able to respond to each individual hospital’s needs quickly thanks to the familiarity with the local business practices. Another gain is that it gives doctors some autonomy in decision makings. And this is quite suitable consider how the organization structure of Peachtree was made up (a network of hospitals.)

However, the weaknesses for such systems are that maintenance and support cost are high due to the lack of standardization. As we can see from Peachtree’s situation, the cost of maintenance is eating up a big chunk of the organization’s budget and it will be getting harder to support as the network grows. Therefore, the IT decisions tend to be reactive rather than strategic. This will result in less efficiency for the entire enterprise, thus not adding value to Peachtree as a whole. Peachtree is made of interdisciplinary hospitals.

Their strengths are that patients could have access to all kinds of treatment services. The advantages for such network are that diagnostic and treatment processes could be redesigned so that patients’ treatment journeys could be shortened, and patients’ care could be continued without disruption. Thus making support activities such as records keeping, lab results, pharmacy records synchronized to improve efficiency, and faster care could be provided through the co-operation among hospitals. Together with IT tools, Peachtree could have achieved success with such business model. However, its current IT system is weighing it down and preventing it from achieving the possible synergies.

CRITERIA

The first criterion for any system is the ability to go after selective standardization. The company’s long term strategy is still focusing on preserving hospitals’ flexibility. The strength of Peachtree network is that patients could have access to different staff skilled in different medical background and training. Standardizing everything including the way doctors providing care to patients could really jeopardize the fundamental principles in health care mission. After all, doctors are different because of the ways they provide care.

Timing and reliability are the other two criteria that need to be addressed now. Current system functionality is near failure, which will directly interfere with Peachtree’s mandate of providing consistent and quality of care. Current system also is not working properly. It needs fixing now. The third criterion should be the ease of implementation; the new system should have the least disruption to current systems. Given the complicated organization structure at Peachtree, any changes made should be done gradually and not a complete cutover, otherwise it will bring upon a lot of resistance and cause a lot of disruption in current services.

ALTERNATIVES

Monolith System

The premise of enterprise system is to have standardization in the way business processes are conducted. Enterprise system will have a set of integrated software modules and a central data base. To use the enterprisem software, each hospital must change their old ways of doing things to the way that were built in the software. In other words, everything must follow protocols. As we can see in Peachtree’s situation, all of hospitals’ legacy systems will be replaced: every facility would use a single set of systems and applications; everything is unified and consistent. This will help increasing the efficiency of operation and provide faster information access for decision makings, along with the improvement in management of making decision.

The success and reliability of such system has been proven in other industry and also healthcare. The downside of ERP is that it doesn’t allow for selective standardization. Too much customization might compromise the main benefits of the system and the cost is also much higher. Moreover, Peachtree is also facing a much higher risk because of the scope of the changes. There is no doubt that centralized data will be beneficial to ancillary clinics, health records management, imaging clinics. However, standardizing patient care might not be achievable given the life and death situations of healthcare mission.

Service-oriented-architecture (SOA)

SOA is a set of self-contained modules of business service that could communicate to each other. The basis of SOA applied in Peachtree’s situation is that legacy systems that are still useful could be modified. Program codes could be written so that each hospital information system is grouped into modules that perform distinct services. These modules will then be able to communicate to one another. Because of this, business processes such as patients’ files, pharmacy records, care performance and patients’ outcomes could be centralized by sharing a single business service module. If it is implemented successfully, this method will be much cheaper in the long run than the whole system replacement such as ERP system. The advantage with SOA is that it allows for selective standardization, so the change will be taken in small incremental steps, thus it will be less risky to the whole enterprise. Therefore, less disruption will be created to the current system. This will allow more time to examine whether or not the system is meeting business needs, and provide more time for the company to re-assess strategies.

Another advantage is that SOA could be implemented right away, and that would suit Peachtree quite well consider the urgency of their problems. However, SOA method is quite new, so the efficiency of it has yet to be proven, resulted in the lack of track records. Therefore, becoming one of the first to implement such system could be risky. If SOA’s functionality is not working as intended, it could mean much more money will be wasted than the whole system replacement. Peachtree could then be then left with the problems that are far worse to solve than the initial ones.

Before selecting any information system, according to the case commentary by George C. Halvorson, Peachtree must determine: What is the overall plan of the information system of the organization as a whole? What are the organization’s business priorities and strategies? How could the new system meet those needs? Then the information needs of each hospital could be incorporated into that master plan. The planning process should involve representatives from different hospitals including senior management, users, and representatives from non-medical departments such as accounting and HR. Issues such as cost, time, risk, and scope of the project should be addressed in order to arrive at a unified decision that could benefit everyone.

RECOMMENDATION

Since Peachtree’s long term business strategy is allowing hospitals to have flexibility in the way they offer care and the different purposes of each hospital, the recommendation should be the SOA approach, due to the fact that it allows for selective standardization. Given the indigenous clinical culture that Peachtree has, independence in the way of offering care is greatly valued. Therefore, small scale changes are easier to be implemented and supported than whole scale change and mass standardization. According to Candace, the method could be implemented now on the areas of that need fixing first, and that could address the current crisis, and also limit the risk of functionality failure, making the projects more dependable. The small steps in implementation will also give Peachtree a lot of chances to re-assess priorities according to Randy Heffner in the case commentary.

It won’t meet a lot of resistance compare to the enterprise system, because it allows time for the hospitals to adapt to change and retain some of their identities. Randy Heffner also indicated in his commentary that SOA should be viewed as a methodology instead of a product. And that in terms of helping organization achieving their objectives, integration and flexibility of SOA method has been proven. The individual business service software is already aligning itself to the business’ needs; in a nutshell, the system is already meeting the business’ needs. The technology is only there to support the purpose. After all, the information system is there to support business strategies instead of the other way around.

RISK MANAGEMENT PLAN

Any changes to information system require co-operation among hospitals. Therefore, the immediate challenge is to obtain support of management for a system change from all hospitals. Successful of the project will not be achieved without management involvement and engagement. The planning process should involve key representatives from all departments across all facilities. Representatives from doctors, nurses, and other staff from across facilities should be solicited for input since each hospital has its own unique treatment practices. Then a proper plan with defined objectives and requirements should be developed for the new system.

The next action would be to identify IT issues such as which system software and hardware that need to be replaced or modified? With the implementation of SOA, are there enough skilled IT staff to handle it in house or should it be outsourced? Will the IT staff have enough expertise to support the new system once it is up and running? Or do they need to be re-trained? Once the business service modules have been developed, the question arises as how they will be governed and maintained? We should decide as to what components of the new system should be governed by a central support group? Or is it better to have within each hospital.

These kinds of questions and planning should be left to the IT department to handl. How do we ensure that new processes will be followed? Since given the difference in practices, it is very possible that the change will not be welcomed by staffs. The solution is to have new processes and standards communicated to all employees to ensure compliance, and make sure that people are ready for the change. Training and support should be offered to employees throughout the implementation process. Another thing to look at is to measure whether the SOA is operating as planned. How then quality should be measured? How do we measure the impact of such system on the care of patients? We could use tracking tools to measure things such as reducing wasted steps during the treatment process. Or we could track the reduced medical errors or the cut down in treatment time and trip to various hospitals.

Too Far Ahead of the It Curve? Essay

St Jude’s Research Hospital Essay

St Jude’s Research Hospital Essay.

“Shortly after Hayden’s fifth birthday, he began having headaches and nausea. At first, the doctor thought he had migraines and asked his mother to keep a record of when his head hurt. After only a short period of time, Hayden’s headaches grew more frequent. Then, he began having trouble with the vision in his right eye causing him to see double. It was at this point, his mother knew there was a bigger issue at hand. Hayden was referred to an ophthalmologist for further testing.

When the doctor examined Hayden’s eyes closely, he saw abnormal swelling and immediately ordered a CT scan. The results were upsetting: There was a mass on Hayden’s brain. He underwent surgery to remove the tumor, after which a biopsy revealed more devastating news: Hayden suffered from a type of brain tumor called Medulloblastoma. Hayden’s parents had heard about St. Jude’s Children’s Research Hospital and immediately asked their doctor for a referral.

” Hayden’s story comes from St. Jude’s Research Hospital website.

He’s featured as this month’s “Patient of the Month”. Hayden is an adorable 6 year old boy with a beautiful smile. Other than the fact that he has no hair, you would never know that he’s been through more than most of us will endure in a lifetime. What is Medulloblastoma? It’s a highly malignant primary brain tumor which is most common in children. Re-occurrence of Medulloblastoma is almost always fatal, so fast evasive treatment is critical the first time it’s diagnosed.

There are several sound reasons’ to support the St. Jude’s Research Hospital. I’m going to tell you why you should support St. Jude’s Research Hospital, starting with its humble beginnings as a good deed by a wealthy famous man turning a personal promise into one of the most successful charities in the United States and ending with the impact it’s had on medicine today. A A good deed by a famous, wealthy man doesn’t seem all that remarkable. Hollywood stars do it all the time. But this story is particularly significant. St. Jude’s Research Hospital was founded by television star Danny Thomas.

He worked with the likes of Doris Day and acted in roles on The Dick Van Dyke Show, The Andy Griffith Show and The Mob Squad. His professional career was a resume that spanned several decades. But his most remarkable accomplishment was the foundation of St. Jude’s Research Hospital. Danny Thomas was a devout catholic. Early in his career, while still a struggling actor with a new family he prayed for an answer on how to proceed in his life.

He made a promise to build a shrine in honor of St. Jude, the patron saint of hopeless causes, if he could only proceed with and find success in his career as an entertainer. He never forgot that prayer or that promise. The shrine he built was opened in 1962 in Memphis Tennessee and stands today as a pillar of hope for families of children with cancer around the world. St. Jude’s Research Hospital was founded on the premise that any needy child would be able to receive care regardless of race, religion or the ability to pay, a hospital where no suffering child would be turned away.

Danny Thomas lived until 1991 to witness the miracle his promise to St. Jude created. His children continue to participate and avidly support St. Jude’s Research Hospital today. Without a most sincere prayer of faith during a time of great need, this world could have been in a very different place. B Cone Communications, a public relations and marketing agency puts together an annual list of the top 100 non-profit power brand companies in the US. St. Jude’s Research Hospital ranks #18 on the list with top leaders such as:

1. YMCA 2. United Way 3. American Red Cross This is significant considering St. Jude’s is one hospital accomplishing this. The other charities I mentioned are based all over the country. St. Jude boasts nearly 5 million donors and 1 million volunteers. St. Jude was named for the 6th year in a row as one of the top institutions in the annual “Best Places to Work in Academia” by Scientist Magazine in July 2011. They are one of the best employers as a research and learning hospital.

St. Jude’s Research Hospital follows the Better Business Bureau “Wise Giving Alliance Standards for Charity Accountability”. This means that St. Jude’s Research Hospital fully discloses basic information about their services and their fundraising. There is nothing to hide! You have a right as the consumer and donor to ask those questions and you can find that information. What are the differences between St. Jude’s and other charities? Most charities focus on one key marketing or fundraising area. St. Jude’s target for marketing fundraising is far larger than most charities.

Their target; preschoolers, professionals, 8th graders and 80 year olds, television, radio, local drives, school drives, trike-a-thons, math-a-thons, local, county, state and national events. Some of the big ones that you may be familiar with; the “Dream Home Giveaway”, the “Thanks and Giving Campaign” and the radio-a-thon “Country Cares”. Because of last year’s St. Jude’s NFL event, 18% of American’s said they planned to support St. Jude’s “Thanks and Giving Campaign” during this past holiday season. No opportunity is turned away.

Comparing St. Jude’s Research Hospital with other powerhouse charities such as The Susan G Koman foundation and American Cancer Society here are a few facts to consider: * The CEO for The Susan G Koman Foundation doesn’t make any money – she is the founder and therefore choses to forgo that expense leaving it in the foundation’s budget. The Susan G Koman Foundation is much smaller than St. Jude’s when talking about total revenue. Susan G Koman foundation keeps their general and administrative expenses well below 10% of their annual revenue in order to give back through outreach programs and funding valuable research.

The CEO for the American Cancer Society has an income of almost a million dollars a year. Preventcancer. com reported in 1988 that the American Cancer Society was the world’s wealthiest non-profit institution. Only 26% went to medical research programs and the rest to operating expenses which included about 60% for generous salaries, pensions, executive benefits and overhead. Nationally, less that 16 percent of all money raised is spent on direct services to cancer victims. * The CEO for St. Jude’s Research Hospital has an income that’s less than 200,000 a year.

In 2009, 74% of St. Jude’s revenue went to patient care, research and education, training and community services, 17% to fundraising and only 9 percent to administrative costs. Why do I tell you these numbers? According to the August 2010 Charity Navigator CEO Compensation Study, the average median income for the CEO of a Charity is in the 100,000 to 200,000 dollar annual income range and it is considered healthy to pay income for CEO’s rather than expect free services for a number of reasons. The differences in the percentages of revenue going to research, treatment or administrative expenses tell the real story though.

St. Jude’s uses many powerful connections, they have a “star-studded roster” like many charitable foundations, they’ve made brilliant marketing decisions and created a variety of programs which reach out to a much wider variety of consumers and business’ than other charities of its kind. C Today St. Jude’s Research Hospital is internationally recognized. St. Jude’s is a pioneer in research and treatment of children with cancer and other catastrophic diseases:

1. They are the first and only comprehensive cancer care center devoted only to children funded by the national cancer institute 2. They are the only private cancer center in the US committed to caring for and supporting children with cancer and other catastrophic diseases regardless of the family’s financial or healthcare resources. 3. Ranked as one of the best pediatric cancer hospitals in the country 4. They coordinate several cancer studies and continues to do pediatric cancer research 5. They are also now the leader in sickle cell disease research 6. They play a significant role in the research for influenza. 7. They treat over 5,700 patients per year

St Jude’s Research Hospital Essay

John Q Movie Essay

John Q Movie Essay.

This movie is about John Quincy Archibald (played by Denzel Washington) and his working class family who lived in Chicago. His son is diagnosed with cardiomegaly and he needs a heart transplant.

He realized that his insurance does not cover the medical expenses and he decides to takes matter in his own hands. John and his wife Denise (played by Kimberly Elise) worked in factories, but the money they made was not enough. Denise had her car repossessed and John had to take her to work.

He was working a part time job with no hope for a second job. He tried to get a second job but he was told that he was overqualified. Here we see the principle of equality of fair opportunity and the principle of justice. Their only son, Michael, loved bodybuilding and baseball. One day, he collapsed during the baseball practice. They took their son to the hospital and they were told that their son is very sick and he needed a heart transplant. Here we see the truth telling of the doctors. They were honest with the treatment and the money needed for the treatment, which was $250,000 and the 30% ($75,000) needed as a down payment to put his son on the donor list. John went to work to find out that his health insurance got changed because he was working part time.

There was no veracity involved from the employer. The employer change his PPO to a HMO health insurance coverage without his knowledge and that did not covered the entire hospital bills or the heart transplant. John went to the welfare office to get help but he did not get any because he was working and making $18,900 per year. Here we see the socialist conception of justice. John started to get donations from people, he sold the stuff from the house and he finally raised six thousand dollars. He paid the money to the hospital and he found out that he is $30,000 in debt with the hospital. After paying the hospital the $6,000, his wife called him and told him that Michael will be released that day and it was nothing they could do. Denise was suffering tremendously and nothing could take her pain away. While she was next to Michael, she was seeing children dying one after another. She had no hope anymore. John decided to go and talk to the cardiologist about his son’s situation but nothing could change the doctor’s mind. John got really mad and he put the gun to the doctor’s head and took him hostage.

He entered the emergency room and told everyone that they are taken hostages and he locked the emergency room. He had taken eleven people hostages and he finally told them the reason for his situation. Some people sympathized with him and some not. Here we see the ethical egoism and the harm principle involved in John’s way of thinking. The cops surrounded the hospital and Frank Grimes, a cop, talked to John about his motives and demands. He explained that he wants his son on the donor list, or his son will die. Frank talked to Rebecca Payne, the hospital administrator about the situation. They gather around and decided to lye and say to John that they will put Michael’s name on the donor list. There is no veracity involved and the duty of fidelity does not take place. Michael released some of the hostages after he heard that his son is on the donor list. The television was involved and John’s friend spoke to him on TV. It was an emotional moment.

John had a lot of supporters outside the hospital. Denise called John and told him that their son is on the donor list. John talked to his son and tears were running down on his face. He was suffering enormously. During this emotional phone call, the Chief of Police gave orders to a sniper to enter the hospital’s emergency room to shoot John. The sniper shot John, but not lethal. People saw everything because it was live on TV. The sniper fell down from the ceiling and John bit him up. John tight up the sniper and took him as hostage. After that, he asked for his son to be brought to the emergency room; the cops agreed in exchange for the sniper, then the sniper was released. After his son arrived to the emergency room, John told everyone there that he wants to commit suicide to save his son’s life.

He persuaded Doctor Turner to perform the surgery and he had two of the hostages to witness his last request. The doctor said that something like this is not ethical and he refused in the beginning; then, he accepted it and the principle of respect for autonomy. He knew that if John was committing suicide that was against his oath where he promised the non-maleficence. When he was thinking about saving Michael’s life, that was beneficence. John went to say good-bye to Michael and went to the surgery room. He loaded the gun to shoot himself, but the safety’s gun was on. When he prepared the gun for the second time, his wife came screaming to the emergency room’s door, saying that Michael is saved because a woman who got killed in car accident was a donor.

That woman had the same blood type (B+) as Michael. Before the surgery was done, the hostages were released and one of the hostages pretended to be John so John can assist to his son’s surgery. The transplant surgery was a success and everyone was happy for it. Here we see the act-utilitarianism and rule-utilitarianism embedded together. After surgery, John was arrested. He was found guilty of kidnapping and he got a minimal sentence. John was happy and proud by doing what he did. His son’s “thank you” meant everything to him. He was ready to do the ultimate sacrifice. He was ready to commit suicide in order to save his son. John made history. He got the media’s attention related to the health care system in this country and the problems related to the HMO. Here the ethics of care were neglected.

John Q Movie Essay

Discharge Planning Essay

Discharge Planning Essay.

Discharge planning is a process that aims to improve the coordination of services after discharge from hospital by considering the patient’s needs in the community. It seeks to bridge the gap between hospital and the place to which the patient is discharged, reduce length of stay in hospital, and minimise unplanned readmission to hospital.1

Discharge planning is an established part of hospital care, but the process varies and is not entirely evidenced based. A Cochrane review analysed 11 randomised controlled trials looking at discharge planning in over 5000 patients and failed to show a reduction in mortality among elderly medical patients, lower readmission rates, or a shorter length of hospital stay.

1 However, two trials in the review did report greater satisfaction of patients and carers when discharge planning was used.2 3 The Cochrane review concluded that discharge planning remains important as a small improvement, not detected by the studies performed so far, could still yield highly significant gains in health care with huge resource implications and better use of acute hospital beds.

1 Unfortunately, none of the included trials assessed communication with primary care staff about patient transfer of care. This is an important aspect of discharge planning and another potentially important advantage for patients.

On a patient’s initial contact with health services, discharge planning should be started.4 This is often difficult to achieve when acutely unwell patients are admitted as a thorough social history may not be immediately available without a collateral history from a relative or primary healthcare provider (who may be difficult to contact). Taking a comprehensive social history is often thought to be time consuming but can be obtained quickly through the use of systematic open questions (see the four scenario boxes).

Effective discharge planning requires multidisciplinary team working. This can be difficult to coordinate because of shift work, ward transfers, staff illness, and perhaps poor team communication. To overcome this problem, an adequate handover—oral, written, or electronic—is key. Sometimes disagreements arise in the team about the most appropriate course of action, but this can usually be resolved through the involvement of a more senior member of the medical team.

Clear sensitive communication with the patient and family is pivotal, especially for the patients who experience a considerable new loss of function. Patient confidentiality cannot be neglected, however, and permission needs to be sought from a competent patient before information is divulged to a family. Relatives will sometimes disagree with the patient’s or team’s views about the most appropriate discharge destination.17 Listening to the relatives’ concerns is especially important in these situations as a compromise is often possible; however, it is the competent patient’s wishes that are paramount. Often asking patients and families for their opinion on the best and safest place to stay and then subsequently considering potential difficulties on discharge can yield the best outcome. Serious disputes should involve the consultant responsible for the care of the patient.

Handover to primary care is easily neglected as it may be perceived as low priority compared with treating unwell inpatients. Early completion of the immediate discharge document can prevent pharmacy delays, and vigilance is needed to ensure effective follow-up and handover—such as ensuring that follow-up is booked before discharge, oral information is given at handover of patients to primary care, and immediate discharge letters leave with patients

The patient’s ongoing needs must be considered and provided for before he or she leaves hospital.4 This might entail arranging appropriate follow-up (in primary or secondary care); ensuring appropriate drug treatment (with details of indications, length of course, planned dose changes); noting specific warning signs and symptoms that should prompt immediate medical attention; and ensuring adequate support at home.

A key aim of discharge planning is to provide good continuity of care to ensure good patient outcomes, hence effective handover to primary care. This is most often achieved through the immediate discharge document.13 Limited data are available on discharge documentation, but recent audits have shown that key facts and data such as follow-up arrangements, new diagnoses, and accurate medication lists are often omitted.14 15 16 The Scottish Intercollegiate Guidelines Network (SIGN) has recommended that senior staff should approve every immediate discharge document.13 Box 3 outlines the recommended minimum content for discharge documentation. In complex or unwell patients, contacting the general practitioner, community matron, or specialist nurse before discharge may be necessary to ensure an effective handover. See also the scenario box (Case study part 4).

The Department of Health guidelines suggest that preparation for discharge needs to involve health professionals, family members, social services, and the patient.4

Staff involvement

Increasingly, the process of discharge is coordinated by the discharge coordinator (a new post in health care), who is often recruited from a nursing or social services background. Discharge coordinators provide a single point of contact for all involved in the discharge planning process.4 In some hospitals, however, this planning role may still lie principally with junior members of the medical team or the ward sister. In either case, the consultant in charge of the patient’s care has responsibility for ensuring an appropriately safe and timely discharge or transfer of care to the community.

Discharge planning requires effective multidisciplinary team working, and this is usually facilitated by weekly team meetings—which typically include medical, physiotherapy, occupational therapy, nursing, and social services professionals—to discuss each patient’s progress and the current obstacles to discharge.4 To participate fully in these meetings junior doctors need:

* A good understanding of the medical problems of the patients in their care—including prognosis, ongoing treatments, and investigations that may influence functional outcome

* An ability to communicate these points clearly

* To appreciate the clinical roles of other team members, such as anticipating which patients may require a home visit from an occupational therapist.8

Patient and family involvement

Admission to hospital is a vulnerable time for patients and their families. As a result of illness patients often experience a loss of functional ability and require either a temporary or more prolonged increase in social support.

For most patients the ideal situation is to return to their previous level of function (and their usual accommodation). However, the length of stay in an acute hospital bed is usually fairly short and may not be long enough to allow the full potential recovery of a patient. So in such a case, it must be considered whether a patient might benefit from a period of rehabilitation—either as an inpatient or in the community. Intermediate care—for patients not requiring general hospital resources but with needs outside the traditional scope of primary care—has become a popular model for delivering rehabilitation in the NHS and elsewhere.9

The involvement of patients, carers, and families is crucial to successful and timely discharge planning.4 A survey by the charity Carers UK found that 43% of the 2.3 million carers in the United Kingdom felt inadequately supported when the person returned home.10 11 Topics that carers may want to be discussed before discharge include their role as a carer, the possibility of future respite, finances, and benefits.4

Discharge destinations

A patient who has had an irreversible loss of function may require additional support at home. This could be achieved by increased care services (via social services), compensatory aids or adaptations to the home informed by an occupational therapist’s assessment, community nursing input, or through the patient’s informal care network.

Patients who can no longer manage at home may need long term care in a care home, but this should only be considered after a period of multidisciplinary rehabilitation team assessment and treatment. The process for this is outlined in the national framework for NHS continuing healthcare and NHS-funded nursing care, introduced in 2007.12

Discussing such a proposition with a patient or their family requires great sensitivity, and the decision to discharge to a new residence is one that requires senior input. However, junior doctors often play an important role in collecting information that helps inform decision making, and box 2 gives some useful questions to ask the patient when making this decision; see also the scenario box (Case study part 3).

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Discharge Planning Essay

Cosmetic Surgery Essay

Cosmetic Surgery Essay.

Finally, cosmetic surgery can cause an addiction by society trends and Body Dimorphic Disorder. No one is perfect, and there is no “perfectism” either. People often complain about something on their body. They may think that their noses are shorter than others. Maybe, they think beautiful women should have big eyes. Sometimes, they may wish their lips to be a little bit thicker. However, the truth is people are a product of the love between their mom and dad. They should accept it as a present that their parents gave them.

According to the American Society for Aesthetic Plastic Surgery (ASAPS), “The top five surgical cosmetic procedures in 2007 were: liposuction (456,828 procedures); breast augmentation (399,440 procedures); eyelid surgery (240,763 procedures); abdominoplasty (185,335 procedures); and breast reduction (153,087 procedures) (“Highlights of the ASAPS 2007 Statistics on Cosmetic Surgery”). Based on the fact, most surgeries were done because they felt unsatisfied about their body. They want to change their beauties by using the plastic surgery to be more attractive.

Nowadays, our society is developing so fast that it creates a lot of ways to make people look more beautiful or even younger by using make-up products, skin care or doing exercise to maintain a good and healthy body. That is good enough to make them look better based on what they have. More importantly, even if they do a cosmetic surgery, it does still not guarantee the expected results: The potential exists that the surgery will not produce the “ideal” look the patient was seeking in spite of the surgeon’s best efforts.

Cosmetic surgery is not an exact science, so potential patients need to keep in mind that there is no way to know what the final outcome will look like until the procedure has been performed and the recovery period has passed. (“The Pros And Cons Of Having Cosmetic Surgery”) Therefore, nothing is 100% perfect. Being yourself is accepting the truth, and finding other ways to improve what you are not happy about are the best choices a person should follow. Finally, there is still something more important than appearance.

What would we think if a Miss Universe wins with a low education and without a good heart? Then, the “beauty” exists for a long time or stays in a short time and gone? In another case, in the Vietnamese-American community, everyone knows about Mr Don Chu, singer Ha Phuong’s husband. Although he is not good looking, he is an American billionaire who is managing a billion dollar fund at Wall Street. He is still confident about himself, and people still admire him. Cosmetic surgery requires a lot of time for recovery and has a lot of side effects.

After surgery, patients cannot do normal activities, such as sports or heavy lifting. The healing time can take several months, even forever. It depends on health condition, age, and gender. Sometimes, scars are left on the body that cannot be treated by any other surgeries. Moreover, smoking and alcohol are banned within healing time. If not, it can extend healing time and make the case more complicated. Like other surgeries, plastic surgery may lead the death if the equipment or chemicals used in the surgery are not suitable to that patient, or by bleeding.

Following the death of a former Miss Argentina after complications arising from plastic surgery, questions are being raised about the risks of cosmetic surgery. Solange Magnano, 37, died in hospital, after being transferred from a clinic where she underwent an elective surgery on her buttocks last Wednesday… Magnano is reported to have died from a pulmonary embolism, a blockage of the blood supply to lungs. (“Model’s death highlights plastic surgery risks”) Besides, as with any kind of surgery, it may have side effects.

For example, breast implants makes it hard to read a mammogram which helps the body to prevent breast cell cancer. More important, although liposuction is the most common cosmetic surgery, it is also the most dangerous one. “A report by Dr. Frederick Grazer of Penn State and Dr. Rudolph de Jong of Thomas Jefferson Medical college says that to date, “917 plastic surgeons reported 95 deaths in over 496,000 liposuction surgeries. If you do the math, that comes out to 19 deaths per 100,000 or 1 death in 5,224” (“Liposuction safety report”).

One of the most dangerous side effects is fluid imbalance. During the procedure, the surgeon will put a large amount of fluid inside the body, and some is removed from fat tissue, which causes fluid imbalance. It may cause kidney dysfunctions, heart problem, and too much fluid in the lungs. Cosmetic surgery addiction is one of the most modern addictions, along with internet addiction, shopping addiction, and workholism. According to recent studies, 66 percent of all patients who have a single cosmetic surgery will return to have another.

They return, not because the first surgery failed, but because it succeeded and now the patient wants more. Often, these plastic surgery addicts have a perfect image in mind that they want to attain, whether it is a celebrity that they are trying to emulate, or their ideal picture of what they should look like. (“Plastic Surgery Addiction”) Among the reasons that cause cosmetic surgery addiction are society trends and Body Dimorphic Disorder (BDD). Nowadays, with the development of media and advertising, people accept with cosmetic surgery more easily.

The result is they accept it as a should-have behavior to be beautiful. For example, in their beauty definition, a beautiful girl should have long legs, big breasts, big eyes, or a high nose. Wanting those characteristics compel them to come to a surgeon. Moreover, people with BDD never feel happy even after thousands of cosmetic surgeries. They always see something wrong with their body that must be fixed. Michael Jackson and Jocelyn Wildestein are good examples of this kind of addiction. Michael Jackson had more than ten nose surgeries, according to People Magazine.

He spent over two million dollars for surgery over his career to range from a “handsome” black singer to an “alien with a chimpanzee face” who never stopped to surprise people. Jocelyn Wildestein has a similar story to Michael’s. She spent almost four million dollars on cosmetic surgery over the years. With the nickname “Bride of Wildestein,” nobody can recognize her now compared with that beautiful woman she was in the 1970s. Plastic surgery is not a good solution for anybody. People should face the truth that they are not beautiful instead of hiding themselves by using plastic surgery.

Doing surgery only reflects that they love untrue beauty. There are a lot of ways to improve what they have. For example, if they have a problem with belly fat, they can exercise with a strict nutrition system. If they want a higher nose or bigger eyes, they can put on makeup that still makes them look beautiful without asking a surgeon. Moreover, cosmetic surgery requires a very strict aftercare and causes many kinds of side effects. It takes several months for healing time without any smoking and alcohol during this period. Also no normal activities and heavy lifting are limited.

Additionally, breast implants may reduce the ability to detect breast cancer, and liposuction can cause buildup of fluid in the lungs. Finally, cosmetic surgery is a new kind of addiction in this century. People can get addicted either by society trends or BDD, which makes them never feel happy with their body and never say “No” to cosmetic surgery. Works Cited “Choosing Cosmetic Surgery. ” medicinenet. com. MedicineNet, Inc, n. d. Web. 19 Sept. 2011. Rollins, Gray. “The Pros And Cons Of Having Cosmetic Surgery. ” articlecity. com. N. p. , 3 Mar 2006. Web. 9 Sept. 2011. “Quick Facts: Highlights of the ASAPS 2007 Statistics on Cosmetic Surgery. ” surgery. org. The American Society for Aesthetic Plastic Surgery, n. d. Web. 19 Sept. 2011 Tutton, Mark. “Model’s death highlights plastic surgery risks. ” cnn. com. CNN, 02 Dec. 2009. Web. 19 Sept. 2011. Venuto, Tom. “Liposuction Safety Report… Advice From A Respected Fitness Coach. ” burnthefact. com. Burn The Fat Enterprises, n. d. Web. 19 Sept. 2011. “Plastic Surgery Addiction: Is it dangerous? ” articlesbase. com. ArticlesBase, 31 May 2010. Web. 19 Sept. 2011.

Cosmetic Surgery Essay