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Improving the Quality of Healthcare in Hong Kong

 

Choosing ONE of the provided scenarios, analyse the identified health care problem. Apply Ishikawa’s FishBone Analysis, Lewin’s Force Field Analysis and Clinical Governance Strategies within your analysis, in order to improve practice in the given health care area

 

Scenario 1

Retained instruments or other material following surgery. Retained Guidewire

A patient with a cervical cord transverse myelitis was prescribed plasmapheresis as her disease did not respond to pulse steroid therapy. Double lumen catheter insertion was required for plasmapheresis. During catheter insertion, pre procedural checking and TIME OUT were performed. During post procedural checking, the guidewire was not found. However, the box for ‘Guidewire Removed’ was ticked in the post procedural checklist. On the next day, a retained guidewire was noted on the chest x ray. The retained guidewire was removed intact under image guidance 12

The three scenarios used for the assignment question, are based on reports and plans related to health care within Hong Kong.

 

Scenario 2

Death of an inpatient from suicide (including home leave)

A patient with a history of paranoid schizophrenia and multiple hospital admissions was admitted for psychosis. After symptoms improved, rehabilitation and occupational therapy training were arranged for him. At a multidisciplinary recovery meeting two months prior to the incident, he was granted as- needed day leave with staff for rehabilitation activities.

On the day of the event, the patient went on day leave with a family member after an assessment had been completed. Two hours later, the family member informed the ward staff that the patient had jumped from a height at home.

 

Scenario 3

Patient -Food Services. Hygiene and safety

Following an outbreak of salmonella poisoning in a hospital in Hong Kong – three elderly patients died. Following a review, improvements were considered to be needed in the storage and staff handling of patient food.

 

Reports Include –

‘The Annual Report on ‘Sentinel and Serious Untoward Events’ published by the Hong Kong Hospital Authority (Jan 2019)

https://www.ha.org.hk/haho/ho/psrm/T_SESUE1718.pdf (accessed 24.09.2019)

‘The Hospital Authority Annual plan’ (2019-2020)

https://www.ha.org.hk/haho/ho/ap/AP2019-20_Eng1.pdf (accessed 24.09.2019)

  1. ‘The Annual Report on Sentinel and Serious Untoward Events 2017- 2018 published by the Hong Kong Hospital Authority (Jan 2019), identified 22 Sentinel Events and 83 Serious Untoward Events.

Within the ‘Sentinel Events’ there were ten cases of retained instruments or other materials after surgery or interventional procedures, (p46). There were seven cases of inpatient suicide (including home leave), (p52)

  1. Within ‘The Hospital Authority Annual Plan’ 2018-2019, Patient Food Services, specifically hygiene and safety standards were considered to need enhanced surveillance, (p45)

 

The essay should be richly referenced. It is important to read widely, critically appraise the literature and apply to your discussion.

Please DO NOT copy content from the LSM because this does not demonstrate learning and therefore will not gain good marks and might be considered plagiarism 

 

Guidelines for the Essay

 

1. Introduction (300 words)

Signpost the reader by identifying the structure of your essay i.e. explain what you are going to write about. Identify your chosen scenario.

 

2. Main Body (2,500 words)

Select one of the scenarios, address ALL A – E below

 

A. Discuss the meaning and importance of clinical governance and link this discussion to Total Quality Management (TQM) and the 2019 – 2020 HA Annual Plan / Report and Sentinel Events (2019).

 

B. Ishikawa’s FishBone Analysis

Use the ‘Ishikawa’s Fishbone’ diagram to analyse the cause of your chosen scenario.

Then, summarise and critically discuss the key identified causes for the problem and the areas of practice that need to be changed

Discuss the strengths and weaknesses of the tool

(The fishbone diagram must be included. If you cannot draw the fishbone on the computer then draw it by hand and scan the figure into your assignment. Please ensure that work is legible. You can download a ‘fish’ from Google)

 

C. Lewin’s Force Field Analysis.

After identifying areas for change –

Discuss how Lewin’s force field analysis can help staff to change practice.

In relation to your chosen scenario and issues identified in your Fish Bone diagram, critically discuss how Lewin’s Force Field Analysis can help staff to identify the resisters against and forces for, identified changes needed in practice.

Include the diagram to identify the resistors and drivers that will enable change.

(If you cannot draw the Force Field diagram on the computer then draw it by hand and scan the figure into your assignment. You could download a force field analysis diagram from google)

 

D. Clinical Governance strategies.

Select two clinical governance strategies and critically apply to your chosen scenario in order to suggest how the incidence of the problem could be reduced.

Ensure that you apply your chosen Clinical Governance Strategies to the key causes identified in the Fish Bone Analysis and resistors against and forces for change identified in Lewin. Make specific suggestions as to how you may do this.

e.g. More education needed for staff in relation to understanding policy, the use of risk analysis or quality circles in identifying potential problems etc.

 

E. Audit and SMART Standards.

With reference to your chosen Clinical Governance Strategies, discuss AUDIT as a third Strategy. What is the aim of carrying out audit and which method(s) of audit could you use to monitor any affected change.

Discuss the importance of SMART standards and identify one standard for each of the 2 Clinical Governance strategies that you have discussed. (Do not set a standard for Audit)

 

3. Conclusions (200 words)

Summaries the key points discussed in your essay, do not describe the structure.

It is important not to bring any new ideas or literature into the conclusion

 

 

Guidelines for the Essay

 

  1. Discuss the meaning and importance of clinical governance and link this discussion to Total Quality Management and the HA 2019-20 Annual Plan
  2. Select one of the scenarios below (taken from Health Authority annual plan / Sentinel Events Reports)
  3. Use Ishikawa’s fishbone to analyse the causes of the problem in your chosen scenario.
  4. Discuss Lewin’s Force Field Analysis to assist in changing practice
  5. Select and discuss two clinical governance strategies and critically apply to your chosen scenario in order to suggest how the incidence of the problem could be reduced.
  6. Discuss the importance of audit as third strategy to monitor any effected change
  7. With reference to you Clinical Governance Strategies, discuss the importance of SMART standards and identify one standard for each strategy
  8. Conclusion

Introduction
There are many literatures that define the meaning of clinical governance such
as Som (2004), Swage (2004) and Sale (2005). Som (Som, 2004, p.89) emphasized
an integrated approach of inputs, structure, processes and outcomes quality
improvement, with considering staff accountability and environmental culture. Clinical
governance is important as it is an integrated structure that enable an organisation to
improve the quality through Total Quality Management. All aspects of quality are
included so that they can be continuously monitored. Staff are accountable and
customers are engaged (Gottwald and Lansdown, 2014). Sale (2005) suggests
clinical governance is a framework which can be represented as 7 aspects. They
are: quality circles, evidenced based practice, risk management, education and
training, complaints management, integrated care pathways, and audit. Moullin
(Moullin, 2002, p.38) state total quality management is ‘An ongoing process,
requiring commitment from top management and involving everyone in the
organisation, to meet the requirements of service users and other stakeholders while
keeping costs to a minimum’. The Hospital Authority Annual Plan 2018/19 (Hospital
Authority, 2018) emphasizes on planning and implementation to attain five clinical
governance strategic goals. Example highlights are: improve service quality (quality
circles), attract and retain staff (risk management), enhance staff training and
development (education and training). It also emphasizes on it is an ongoing
improvement process (total quality improvement) to meet public requirements with
optimal financial resources, which implies to ensure that quality health care is not
only delivered safely but continuously updated and improved. Besides, Hospital
Authority Annual Report on Sentinel Events is studied and linked to risk
2
management incorporated to other clinical governance aspect such as education
and training, quality circles and audits.
This essay will at first discusses the importance of Clinical Governance. Then it
will analyse the causes of medication error by using Ishikawa fishbone. How the
Lewin’s force field analysis can help to change will also be discussed. The clinical
governance strategies of Education and Training and Risk Management will be
discussed in relation to medication errors and finally Audit will be discussed and
SMART standards identified. Finally, the key points in this essay will be summarised
in the conclusion.
Main body
Administration of medication is one of the daily nursing practice. In fact,
medication errors are a common incidence among the clinical error reports in public
healthcare practice (Gottwald and Lansdown, 2014). In the period from October
2017 to September 2018, there were total 76 untoward medication errors, 7 due to
patient misidentification reported in public hospital in Hong Kong (Hong Kong
Hospital Authority, 2019). In this assignment medication error was chosen to analyse
the possible causes. In order to reduce medication error, this assignment is going to
looking for the causes of this quality problem by using Ishikawa’s fishbone (Ishikawa,
1985).
Ishikawa fishbone (Ishikawa, 1985) is used to analyse the causes of quality
issue. All the possible causes are listed systematically in a fish shape diagram the
cause-effect relationship are displayed graphically. This tool is commonly used in
root cause analysis as well as cause and effect analysis. In case of root cause
analysis, the cause of each fragment of the bone would be discussed in-depth and to
be identified separately (Gottwald and Lansdown, 2014). In order to be more simple
to begin with, the cause and effect analysis is used in this assignment. The diagram
3
illustrates the head is the problem and the bones are the causes. Besides this, the
strengths of this tool also includes being simple to use and clear presentation for
easy read and understand. In contrast, there some limitations that fishbone only
provides an easy approach to identify the key causes but there is no solution is
provided to solve the problem. Also, the fishbone does not prioritise the causes to
solve the problem (Gottwald and Lansdown, 2014).
The following fishbone diagram shows the possible causes of medication
error found in the chosen scenario situation. The fishbone is illustrated in 4Ps: Place,
Policy, People and Procedure. The key causes identified are highlighted in the
diagram.
PLACE PROCEDURES
Busy ——————- Not follow the procedure —
Shortage of staff ——— Not using 3 checks 5 rights—
Distraction ———————-
Medication
errors
Causes of medication by using Ishikawa’s fishbone (Ishikawa, 1985)
Causes of medication error by using Ishikawa’s fishbone (Ishikawa, 1985)
Poor perception in
Counter checking ————– Lack of continuous training —–
Lack of knowledge—- Lack of communication ————–
People
PEOPLE POLICY
Policy
4
In the aspect of the Place. In Scenario 2 the hospital ward the environment
was busy. The busy environment might due to shortage of nursing staff. In recent
years, the problem of global shortage of nurses is becoming more severe that
affecting the quality of care (Chan et al, 2012). Among the public hospitals in Hong
Kong, Nurse-to-patient ratio may be 1 to 13 or even worse (Chan et al, 2012). Also,
any unexpected issues would distract nurse’s attention that making them difficult to
concentrate in checking and calculating drug dosage. The situation may be
deteriorated during visiting hours as the interruptions from patients and their relatives
would increase the workload of nurses.
Secondly, in the aspect of the People, nurses involved in this medication
error were working in a busy ward. The first nurse administered the medication alone
without counterchecking with another nurse against the prescription. Besides, she
just put the drug on bedside without asking the right patient to take the medication
instantly and did not witness the right patient taking the drug. The second nurse
wanted to finish the task of giving medications in hurry by just asking a patient
without checking patient’s identity. Also, it was observed that the second nurse did
not check the medications against prescription. It showed that both nurses had
inadequate basic concept on 3 checks 5 rights as safe administration of medication.
Therefore, one of the causes of this medication error was identified as they had
problem of lack of knowledge in both administration of oral medication as well as
medication safety.
The third aspect is to looking at the Procedure. Both nurses in the chosen
scenario were observed to seek for convenience and did not follow the 3 checks and
5 rights procedural rule. In case of high risk medication, they even did not obey the
guideline of high risk medication. Morphine was belonged to the category of
dangerous drug. In this incidence the two nurses had neglected the procedure rule
by not complying the counter-checking procedure against two qualified nurses.
5
Instead, the second nurse just asked a different patient if those were her drug
without checking patient’s identity against the prescription. Therefore, one of the
causes of this medication error was identified as they did not comply the 3 checks 5
rights procedure.
The fourth aspect would be the Policy. As mentioned, both nurses involved
in this medication error were observed to be lack of awareness or knowledge in the
policy of proper administration of oral medications as well as concept in medication
safety. It indicated that they did not meet the required knowledge standards to
ensure they were capable of delivering quality care. In consideration of cause and
effect relationship, insufficient training led to lack of knowledge to perform high
standard care, which causing poor quality of care issue such as medication error.
Learning implies someone to change in knowledge, skills, attitude as well as
behaviour (Gottwald and Lansdown, 2014). Besides, continuous education and
training could enhance communication to inform staff on any updated drug policies
as well as a warm reminder on medication safety.
After working the Ishikawa’s fishbone to the medication error in the chosen
scenario, it was identified that the main causes linked to the incidence were failure to
comply 3 checks and 5 rights rule, lack of training and busy-ness.

Genetic/Genomic Nursing Assessment

Overview

This assessment requires you to complete a Genetic/Genomic Nursing Assessment using the information found in your text on page 224, Box 8-7.  You DO NOT need to create a family tree.  Rather, write out your assignment in APA format and address the items from the Nursing Assessment box 8-7.

Your paper should include the following information:

      1. Identify three generations of one family (male/female, age, role in the family such as son/daughter, father, mother, grandmother, grandfather).  You may use grandparents, parents, and children.  Be sure to find a family with children.
      2. Brief health history of each family member (for example what health problems has each member encountered in his/her lifetime).  Focus on any/all genetic diseases that may be present or those for which family members may be at risk.
      3. Complete a reproduction history for relevant above identified family members
      4. Describe the ethnic backgrounds of family member
      5. Identify any growth and development variations of each member
      6. State to what extent each family member understands the causes of their health problems
      7. Relate what questions family members may have about potential genetic risks
      8. Describe what nursing intervention strategies the family health nurse should relate to your selected family based on the obtained assessment

Objectives

Analyze family genetic health risks

Points: 40

References

Minimum of four (4) total references: two (2) references from required course materials and two (2) peer-reviewed references. All references must be no older than five years (unless making a specific point using a seminal piece of information)

Peer-reviewed references include references from professional data bases such as PubMed or CINHAL applicable to population and practice area, along with evidence based clinical practice guidelines. Examples of unacceptable references are Wikipedia, UpToDate, Epocrates, Medscape, WebMD, hospital organizations, insurance recommendations, & secondary clinical databases.

Style

Unless otherwise specified, all the written assignment must follow APA 6th edition formatting, citations and references. Click here to download the Microsoft Word APA 6th edition template. Make sure you cross-reference the APA 6th edition book as well before submitting the assignment.

Number of Pages/Words

Unless otherwise specified all papers should have a minimum of 600 words (approximately 2.5 pages) excluding the title and reference pages.

 

This is the class textbook:

Kaakinen, J. R., Coehlo, D. P., Steele, R., & Robinson, M. (2018). Family health care nursing theory, practice, and research. Philadelphia, PA: F.A. Davis Company.

 

Articles:

 

Calzone, K. A., Cashion, A., Feetham, S., Jenkins, J., Prows, C. A., Williams, J. K., & Wung, S. F. (2010). Nurses transforming health care using genetics and genomics. Nursing outlook58(1), 26.

Click here to download the article

Note: Take a look at the references at the end of the Calzone article for more resources

 

Essential Nursing Competencies and Curricula Guidelines for Genetics and Genomics:  Outcome Indicators

Note: Do a google search for this title and you’ll find several sites from which to open about the topic

 

Gallo, A. M., Angst, D. B., & Knafl, K. A. (2009). Disclosure of genetic information within families: How nurses can facilitate family communication. The American journal of nursing109(4), 65.

Click here to download the article

 

Essential genetic and genomic competencies for nurses with graduate degrees. Retrieved from http://www.genome.gov/Pages/Health/HealthCareProvidersInfo/Grad_Gen_Comp.pdf

Click here to download the article

 

National Human Genome Research Institute  (NationalInstituteofHealt

 

Analysis of a major project

Students are required to analyse a significant business project, and apply a range of project management tools and techniques.

 

Students have the choice between basing their analysis on a real business project (if this is available to them), or using the Oil project scenario (below) as the basis for their work.

 

If students prefer to use a real project, then it is expected that all the following tools and techniques are applied:

 

  • Planning (critical path analysis)
  • Resource analysis
  • Risk analysis and management
  • Costing and budgeting
  • Progress tracking and variance analysis (preferably using EVM)

 

For the Oil scenario, a range of specific questions are set out.

 

In either case, students are expected to use Microsoft Project (and Excel) where applicable to develop various analyses, and demonstrate proficiency with the software to a professional level.

 

A formal project report document (created in Microsoft Word) is required from each student.   Guidance as to format, structure, contents etc. will be provided during the module.

 

With respect to the work done with Microsoft Project, do not submit any MS Project files, but instead include screenshots from MS Project within your report document. Guidance will be provided on the best ways to achieve this.

 

Format:  Business report document

 

Word limit:  4,000

Assessment criteria: see grading criteria

 

Oil Engineering

 

The information based upon this invented business organisation is purely fictitious and has been prepared solely for an academic case study.  Any resemblance to companies, structures, roles, events, persons or information included is purely coincidental.

 

It should be noted that no engineering or technical knowledge is required.

 

Background

 

Oil Engineering is a marine and offshore construction company with several decades of experience in the design, manufacture, commissioning and delivery of modules for offshore oil, gas and renewable energy installations.  It operates out of a large fabrication yard on the North East coast of England.

 

The company’s advanced engineering and construction facilities allow them to offer tailor-made solutions that are highly competitive with other companies in this market. Over the years numerous modules have been designed and built for a variety of different oil and gas companies.

 

After some intense competition, Oil has recently won a major contract from Pretoria Oil to build the topsides module for a new offshore production platform for delivery in September 2018. The fixed price of the contract was finalised as being £59.5m.  The Oil bid was based on a detailed design specification provided to all the bidders by Pretoria Oil.

 

Oil are currently very busy with work for other clients and will not be able to start this new project work for Pretoria Oil until 2018.

 

Aware of this, Pretoria Oil, insisted on a penalty clause being inserted into the contract:

Delivery of the completed module must take place no later than Friday 21 September 2018.  For every day (or part day) that the project is late (including weekends), Oil must pay Pretoria Oil liquidated damages of £1 million.

 

A team of engineers working for Pretoria Oil would also be present at the Oil fabrication yard to supervise onshore commissioning – the intensive testing of the entire module before it was transported from the Oil fabrication yard to the offshore location.  Eight weeks was allowed for this work (Task N in Table 1), and if any problems were detected, then delays could occur because Pretoria would be entitled to demand that the faults were rectified on the spot before the module was acceptable to them. Oil were accustomed to working with their clients in this manner.

 

Part 1    Parameters and risks

 

(a)          Discuss the relative importance of the various iron triangle parameters that will need to be managed by the Oil project manager over the course of the project, and how they may inter-relate to each other. (15 marks)

 

(b)          Use the template provided to create a risk register, identify and analyse a maximum of ten risks that Oil would be facing with a large fabrication project of this nature. (10 marks)

 

Part 2    Planning and costs

 

In preparation for the forthcoming work, the Oil project manager created the following data in Table 1:

 

TaskDescriptionDuration (weeks)Predecessor/sFixed costsNumber of engineersNumber of technicians
AFabricate upper deck48.31045
BFabricate cellar deck27.11256
CTurbine generators6A2.5820
DFuel gas systems2B2.8622
EFabricate flare boom4B3.9832
FCooling systems8C4.51218
GSeawater pumping systems12C2.51220
HConnect both decks2C,D3.11046
IInstall flare boom6E,H2.2835
JCoalescer systems4F2.2714
KGas dehydration systems4J2.7710
LWater injection systems6G,H3.1612
MGas compression systems6I3.2614
NOnshore commissioning8K,L,M1.11224

 

Table 1 – project plan

 

The average (fully inclusive) cost of an engineer was estimated to be £59.00 per hour and for a technician £36.00 per hour. The company generally works a standard five day week and eight hour days. The fixed costs for each task are shown in Table 1 are in £m.

 

(a)          Using Microsoft PowerPoint (or any similar graphics package) prepare a network diagram showing the critical path and planned duration of the project. Quantify the float on the non-critical tasks. (10 marks)

 

(b)          Using Microsoft Project (or a similar package) prepare a Gantt chart for the project to a professional standard. Calibrate the timescale in weeks. If the project is scheduled to start on Monday 8 January 2018 determine the planned completion date based on the critical path analysis. (8 marks)

 

(c)           Using the information provided, calculate the projected gross profit for the contract (i.e. revenue – costs) that Oil will be aiming to achieve from this project.  Show your workings clearly. (7 marks)

 

Part 3    Tracking progress and spending

 

The project started on time, and after 16 weeks of work, an intensive review of the project was held on Monday 30 April 2018 at the Oil fabrication yard. The following information was reported by the project team.

 

TaskActual progress to date (%)Total expenditure incurred to date (£m)
A1008.15
B1007.2
C1002.56
D1003.18
E1004.43
F754.29
G351.67
H904.03
I200.78

No other tasks had started yet or incurred any expenditure.

 

Table 2 – actual progress and spending after 16 weeks

 

(a)          Firstly make a copy of the Gantt chart for the project created in part (b).  Using the Gantt chart, determine the planned progress (%) for each task after 16 weeks had elapsed. Assume that progress is achieved on a linear basis for each task. For example if a task is planned over the course of 4 weeks, then if 3 weeks have elapsed planned progress would be 75%. (10 marks)

 

Secondly enter the actual progress values for progress from Table 2 into the Gantt Chart, and using Microsoft Project reschedule the project with effect from the review date. Comment on the outcome from a commercial perspective. (15 marks)

 

Part 4    Predictive outcomes and tactics

 

(a)          Create an Earned Value Analysis table showing ACWP, BCWP and BCWS values for every project task. Using EVA determine an overall planned % figure for the entire project and compare with an overall actual figure for the project. Show all workings in a neat and professional layout. (8 marks)

 

(b)

Lynda.com Tracking progress

Viewing progress

 

 

 

Create a projected completion date for the entire project using the Estimate at Completion (schedule) method derived from the Earned Value Analysis.

 

Create a projected final spend for the entire project using the Estimate at Completion (cost) method derived from the Earned Value Analysis. Show your calculations clearly

 

Compare these values with the original contract value to determine the likely profitability of the contract as it now stands. (8 marks)

 

Soon after the review, a day long meeting was convened to discuss possible tactics to accelerate progress and avoid the prospect of any penalty charges.  In response to urgent demands from the Chief Executive, the project manager had researched some acceleration options for the Directors to consider.

 

 

TaskOption
KThe design of the gas dehydration systems could be simplified leading to a faster installation process. This could save up to 2 weeks but at a cost of £80,000 per week
LAn alternative vendor for the water injection systems could be selected for the project. This could save up to 4 weeks at a cost of £150,000 per week
MThe vendor for the gas compression systems has offered to work over-time in order to accelerate the installation schedule. This option can save up to 3 weeks at a cost of £55,000 per week
NThe Oil team required for onshore commissioning could be asked to work evenings and weekends. This would save up to 3 weeks at a cost of £75,000 per week

 

Table 3 – possible acceleration options

 

(c)           Recommend which of the options should be accepted and which should be declined. Explain and justify your recommendations with reference to the project plan and critical path.  If the recommended options are implemented successfully, analyse the commercial impact on the profitability of the project. (9 marks)

Aggregate Expenditure Model

Macroeconomic Analysis – Aggregate Expenditure Model

Purpose

To assess your ability to undertake a macroeconomic analysis of a selected country.

Overview

Throughout the second half of the course you are asked to analyze a country’s economy through the application and analysis of economic data.

In this week’s assignment you are asked to select a country and apply its GDP data to the expenditure model.

Action Items

  1. Review chapters 11 and 12 in Farnham (2014).
  2. Select a country to analyze (Canada).
  3. Go to The World Factbook. Click on https://www.cia.gov/library/publications/resources/the-world-factbook/.
    • In the upper right dropdown click on “Please select a country to view”
    • Once on your chosen country’s page, click on “Economy” and use the data there to complete the Country Economic Data Worksheet.
    • (Please note specific data requested for this and future assignments appear in red on the Worksheet.)
  4. ​​Using data from the Worksheet, complete the Excel document for your chosen country.
  5. Review Business Brief Guidelinesand Critical Thinking Process.
  6. Write 2-pages business brief describing the results, follow these guidance:
  • Provide relevant background on your country
[Type a quote from the document or the summary of an interesting point. You can position the text box anywhere in the document. Use the Drawing Tools tab to change the formatting of the pull quote text box.]
  • Not history!
  • Current economic situation*, for example, appropriate comparisons might include:
This requires a little research and then critical thinking and synthesis between economic concepts from Chap 11 & 12 and research on current economic situation of country.
  • Size of GDP and place in the world’s GDP
    • g. Top 10%, bottom 10%, middle 50%
    • g. It’s like the size of the GDP of Texas
  • Size of population, but then compare to something
  • Current economic situation
    • Venezuela – can’t feed its people due to . . .
    • Price of oil impacting Saudi Arabia
    • Impact on Russia of International (US/EU) sanctions/embargo
    • Government debt situation in Greece
    • Age of population in Japan
    • Etc, etc
  • Provide economic definition(s) for appropriate economic topics covered in business brief*, e.g.
    • GDP
      • Components of GDP
    • Circular Flow
    • Expenditure approach = Income approach = GDP
    • Marginal Propensities (to Consume, Invest, Import)
    • Multiplier effect
      • Equation 12.20 from textbook
    • Describe the data you entered into the spreadsheet (the green input boxes)*
      • GDP (PPP) $ Values, GDP component percentages
    • Describe the two Scenarios and the resulting forecast for 2017 GDP*
      • What are the $ values? What are the % growth values?  What’s the multiplier value?
      • Why are they different?
    • Describe the multiplier effect * (* = Required)
      • Benefits
      • Limitations

 

 

  • Important to create a cohesive “story” / argument describing your country and the data entered into the spreadsheet and the results of the spreadsheet.

 

Note: We will be using a “proxy variable” approach to estimating the impact of fiscal policy using the GDP data for each country.

Securing Digital Government Services

Project #2: Securing Digital Government Services

For this paper, you will research potential and existing security issues affecting digital government websites. Government websites enable customers to enroll in programs and services, check the status of benefits, and receive information about the federal government’s activities. Your audience for this research report is the Chief Information Officer for a small federal agency who asked for assistance in developing a risk assessment and risk mitigation strategy for the agency’s digital government websites.

Note: this research report is separate from the report you previously prepared about OPEN data and may not reuse information from that report. This paper must address other types of government services. See Table 1 for the list of websites to use in your research.

For this report, you should begin by reviewing three or more specific digital government websites (from the list provided in Table 1) to determine:

  • the types of information provided by the websites
  • the types of services provided by the websites
  • security issues which could impact the delivery of digital government services by the websites

After you have reviewed these websites, review the Federal Cybersecurity Risk Determination Report and Action Plan https://www.whitehouse.gov/wp-content/uploads/2018/05/Cybersecurity-Risk-Determination-Report-FINAL_May-2018-Release.pdf to identify additional sources of risk that the agency must be aware of and should address in its planning. You should also review Executive Order 13800 Strengthening the Cybersecurity of Federal Networks and Critical Infrastructure https://www.whitehouse.gov/presidential-actions/presidential-executive-order-strengthening-cybersecurity-federal-networks-critical-infrastructure/

 

Table 1. List of Digital Government Websites

Base URLs
BENEFITS.GOVCANCER.GOVCONSUMERFINANCE.GOVDATA.GOV
DIGITALGOV.GOVDISASTERASSISTANCE.GOVFOODSAFETY.GOVGRANTS.GOV
HEALTHCARE.GOVHEALTHFINDER.GOVMEDICARE.GOVREADY.GOV
RECREATION.GOVREGULATIONS.GOVRESEARCH.GOVSAFERCAR.GOV
SERVE.GOVSTOPFAKES.GOVUSA.GOVVOLUNTEER.GOV

 

 

Research:

  1. Read / Review the Weekly readings
  2. Research three or more attacks that could compromise the security of a Digital Government Website that uses Web Applications, a Web Server, and a Database Server. Here are some sources to get you started:
    1. Web Applications Architectures and Security (in the Week 3 content module).
    2. Cyber Vandalism — https://www.digitalgov.gov/resources/readiness-recovery-response-social-media-cyber-vandalism-toolkit/
    3. Cybersecurity: Actions needed to address challenges facing federal systems (GAO 15-573T) http://www.gao.gov/assets/670/669810.pdf
  3. Review three or more websites that deliver digital government services (select from those listed in Table 1). What types of information or services are available via these websites? What population do these websites serve (who is in the intended audience for each website)?
  4. As part of your Digital Government websites review, determine the types and sensitivity of information collected, displayed, processed, and stored by the Web applications that implement the Digital Government services.
    1. See http://www.digitalgov.gov/resources/checklist-of-requirements-for-federal-digital-services/ for general security and privacy requirements.
    2. See FIPS 199 for additional guidance on determining the sensitivity level of a Federal IT system. (See the section on public websites.)
  5. Using FIPS 200, the NIST Cybersecurity Framework, and NIST SP 800-53, research the general types of security controls required by IT systems hosting the Digital Government service that you reviewed.
    1. FIPS 200 https://doi.org/10.6028/NIST.FIPS.200
    2. NIST Cybersecurity Framework https://nvlpubs.nist.gov/nistpubs/CSWP/NIST.CSWP.04162018.pdf
    3. NIST SP 800-53 https://nvlpubs.nist.gov/nistpubs/specialpublications/nist.sp.800-53r4.pdf
  6. Find three or more additional sources that provide information about best practice recommendations for ensuring the security of the Web Applications used to deliver Digital Government information and services. These additional sources can include analyst reports and/or news stories about recent attacks/threats, data breaches, cybercrime, cyber terrorism, etc. that impacted the security of digital government services.

 

 

Write:

Write a five- to seven-page summary of your research. At a minimum, your summary must include the following:

  1. An introduction or overview of digital government that provides definitions and addresses the laws, regulations, and policies that require federal agencies to provide information and services via the Web. This introduction should be suitable for an executive audience.
  2. An overview of the information and services provided by the digital government Websites that you reviewed. Answer the following questions:
    1. What types of information or services are available via your selected Websites?
    2. What populations do the websites serve (who is the intended audience)?
    3. What sensitivity level are applicable to each Website (use FIPS 199 criteria).
    4. What security issues did you observe during your review?
  3. A separate section that addresses the architectures and security issues inherent in the use of Web applications when used to deliver the services provided by your selected digital government Website. Include 5 or more examples of security issues and address how these issues contribute to increased risk.
  4. A separate section that includes recommendations for best practices for ensuring Web application security during the design, implementation, and operation of digital government websites. Include five or more best practice recommendations in your recommendations. (Hint: at least one of your recommendations should address use of the NIST Cybersecurity Framework. Another recommendation should address use of NIST SP 800-53 controls for ensuring security and privacy.)
  5. A closing section in which you summarize your research and your recommendations.

 

Submit for Grading

Submit your work in MS Word format (.docx or .doc file) using the Project 2 Assignment in your assignment folder. (Attach the file.)

Additional Information

  1. Consult the grading rubric for specific content and formatting requirements for this assignment.
  2. Your 5- to 7-page paper should be professional in appearance with consistent use of fonts, font sizes, margins, etc. You should use headings and page breaks to organize your paper.
  3. Your paper should use standard terms and definitions for cybersecurity. See Course Content > Course Resources > Cybersecurity Concepts Review for recommended resources.
  4. The CSIA program recommends you follow standard APA formatting since this will give you a document that meets the “professional appearance” requirements. You can find APA formatting guidelines and examples under Content > Course Resources > APA Resources. You can use the provided APA template file (MS Word format) CSIA_Basic_Paper_Template(APA_6ed,DEC2018).docx.
  5. You must include a cover page with the assignment title, your name, and the due date. Your reference list must be a separate page at the end of your file. These pages do not count towards the assignment’s page count.
  6. You should write grammatically correct English in every assignment that you submit for grading. Do not turn in any work without (a) using spell check, (b) using grammar check, (c) verifying that your punctuation is correct, and (d) reviewing your work for correct word usage and correctly structured sentences and paragraphs.
  7. You must credit your sources using in-text citations and reference list entries. Both your citations and your reference list entries must follow a consistent citation style (APA, MLA, etc.).

How can HR make a strategic contribution to this organisation

Research Report (60% of the module mark)

The Chief Executive of your chosen organisation is reviewing the HR function. She/he wants to know what contemporary research says about the contribution HR makes to organisational success. You have been commissioned by the Chief Executive to write a report titled:

How can HR make a strategic contribution to this organisation?

Your brief is:

  • To select three contemporary HR issues (from the nine covered in the module);
  • To review recent research evidence and contemporary practice relating to these Issues;
  • To advise the Chief Executive on whether and how HR can make a strategic contribution to their organisation in relation to these Issues.

Note that you may argue for or against the idea that HR can make a strategic contribution. You are not required to make a case in favour of HR; whatever your stance, your argument must be informed by evidence. See the guidance below on the choice of organisation and the choice of issues for the Research Report.

Format

2,500 words, excluding title page and reference list.

Word processed. One-and-a-half spaced.

The font size should be 12.

Sections:

–           Cover page (from the SurreyLearn site)

–           Title page and contents (not included in the word count)

–           Assignment text (subheadings are permissible, but optional)

–           A reference list in Harvard style on a separate final page(s) (not included in the word count).

You may use or adapt the suggested subheadings below, or you may choose your own structure for the report.

Suggested structure:

Section            Words (approx.)          Notes

Cover page      n/a       IE the standard Cover page for all assignment son your degree

Title page        n/a       With contents list (optional)

Introduction    500      Set out your choice of organisation and three HR issues in the light of the organisation you have chosen

HR Issue 1:     500      Critical review of research evidence and contemporary practice

HR Issue 2      500      Critical review of research evidence and contemporary practice

HR Issue 3      500      Critical review of research evidence and contemporary practice

Recommendations      500      Your research-based advice for the Chief Executive

References      n/a       In Harvard style

2500

–           Text in any headings, diagrams, figures, tables, footnotes and endnotes does count for word count purposes.

–           Suggested word lengths for sections are advisory.

–           Please do not include any appendices. In any case, any material surplus to the maximum word count will not be marked.

 

Preliminary care coordination plan for patient having total knee replacement

The associated best practices for health improvements for patient having total knee replacement

Competency two: collaborate with patients and family to achieve the desired outcomes

Establish mutually agreed upon health goals for a care coordination plan in collaboration with the patient

Competency 3: create a satisfying patient experience identify available community resources for a safe and effective continuum of care

Competency 6: Apply professional, scholarly communication strategies to lead a paient-centered care

Write clearly and concisely in a logically coherent and appropriate form and style

Prepare a preliminary care coordination plan and proceed by identifying the patients three priorities for heath related to a total knee replacement surgery and by investigating the resources available in your community for a safe and effective continuum of care

Identify orthopedic health concerns as the focus of your care coordination plan. Infection, mobility, medication, nutrition.

Identify available community resources for a safe and effective continuum of care. skilled nursing home for rehab, home health nursing after rehab

Cite at least two credible sources within last 5 years from peer-reviewed journals of professional industry publications that support your preliminary plan

Analyze your selected health concern and the associated best practices for health improvement

Consider underlying assumptions and points of uncertainty in your analysis

Extablish mutually agreed-upon health goals for the care coordination plan, in collaboration with the selected individual.

Identify available community resources for a safe and effective continuum of care

Write clearly and concisely in a logically coherent and appropriate form and style

Attainment or proper care and better health outcome is what every patient desires. Inter-professional collaborative practice is one strategy that is believed to improve the health and overall well-being of a patient in any care setting. Defined as the process of working as a team while respecting the expertise of all the team members from various disciplines, inter-professional collaboration promotes effective communication and building of relationships between the patient, her/his family and various healthcare practitioners. As a result, improved patient care, better health outcomes, reduced number of preventable errors, abridged healthcare costs and enhanced relationships amongst the health care experts are evident. The adoption of an inter-professional collaborative practice is vital in providing greater benefits to all the stakeholders involved in the provision of patient care

Different organizations have been engaged in the support and implementation of the inter-professional collaborative practices. The American Association of Colleges of Nursing is one such organization that has release a statement in support of a collaborative approach in the provision of patient care. According to the organization, different disciplines in health care have a purpose of providing quality care to the patient and greater benefits to all the stakeholders. Even though every discipline has its specific focus, working collaboratively with other disciplines assures the attainment of an improved health outcome even in a complex medical issue.

 

Mathematical context knowledge

Discuss teaching early number and place value. Discuss the mathematical context knowledge (MCK) and the pedagogical content knowledge needed to team early number and place value. In doing so, identify some good teaching strategies appropriate tasks and appropriate resources

Assessment 3 should be written in a modified essay format. That means that it should be written in the form of an essay though there is need for subheadings

Aging is associated with many health issues following the depreciation of the functions of the body’s vital organs. The functions of the body’s vital organs tend to be slowed down by the aging process (Fonda & Zeynel, 2017). As a result, the immunity of many older people beyond the age of 65 years has been often low. Also, the older generation is faced with significant changes in their lifestyle due to the reduced immunity and weak nature of the body (Choudhary et al., 2015). This change does not only affect their vigor to work, but also have increased their chances of developing illnesses and conditions associated with poor lifestyles and weak immunity.

Diabetes is one of the conditions that are associated with lifestyle condition. Different forms of diabetes, such as Type 1 and Type 2 diabetes exist and occur in different populations across the world. According to American Diabetes Association (2014). Type 2 diabetes is the most commonly diagnosed form of diabetes and occurs when the body resists the effects of insulin. As a result, the management of blood sugar levels in the body is hampered. The National Standards for Diabetes Self-Management Education and Support define diabetes self-management education as a collaborative and ongoing process intended to facilitate the development of knowledge, skills, and abilities that are required for successful self-management of diabetes. (L. Haas, M. Maryniuk, J. Beck, et al. National standards for diabetes self-management education and support. Type 2 diabetes has no cure, however, the control of the blood sugar in the body can be attained through nutrition, exercising and maintaining a healthy lifestyle.

The occurrence of diabetes has been on the rise in the recent times. According to (Fonda & Zeynel, 2017) about 25% of the older population in America is diagnosed with diabetes every year. The low immunity level and the poor lifestyle conditions observed amongst the elderly contributes increases their risks of developing the condition. Also, the inability of the elderly to manage the situation either through medication or other self-care activities further increase their chances of suffering from the condition (April & Freeland, 2017). Research shows that in old age, the chronic nature of the illness is bound to increase to levels that are devastating. This is because most of the symptoms of diabetes can be perceived to be old-age illnesses causing delays in diagnosis and treatment. Self-care and management of the condition is also a daunting task for the elderly due to their lack of knowledge on best practices. This presented the need for an educative program that aim at enhancing the elderly on self-care activities and the lifestyle changes needed for them to implement to help them manage the condition independently. The proposed project is an educative program focused on improving the health of diabetes patients by enlightening them on the self-care management of the condition. The program will focus on educating the patients on nutrition, exercises and other lifestyle changes suitable for management of diabetes.

Public Policy paper

1) Define public policy issue and why it is important.
2) Review three studies on the topic, and quote each study directly.
3) Based on your analysis of the previous studies, propose a policy solution.

Define public policy issue and why it is important

The public policy in the U.S has faced a lot of changes since Head of State, Donald Trump came to power in January 2017. In his reign, it has been viewed as a threat to employment and security in the nation. This is contrary to what politicians believed in the past citing that it was part of the nation’s heritage even when they disagreed with the various policies that surrounded it. Recently, police makers are greatly divided on the same goals of immigration and the policies that should be put in place to oversee the process.

There is a difference in what the president desires and what is actually being implemented by the administration. The president has advocated for the building of a wall on the southern part of the Mexican border, abolishing legal immigration, banning of refuges from selected Muslim-majority countries and deportation of illegal immigrants. However, the administration has worked to redefine the policies that are associated with the act (Pierce, Bolter and Selee p 1). Some of the steps include adding some extra requirements on who should be prioritized for immigration, greatly reducing the admission of refugees and making the process to acquire a visa slower.

The US has a fragmented political system where the roles of different government institutions overlap (Pierre, p14). The executive, the judiciary and the legislature are all involved in policy making which slows down the process making the ambitions of the ruling party not to be realized(Immigration Council). The three arms of government disagree with some of the proposals forwarded to amend the existing immigration policies. For instance, the courts have stopped some of the initiatives the administration tried to implement terming them as extreme. On the other hand, some local governments have been uncooperative with the state concerning the deportation policy.

Review three studies on the topic, and quote each study directly

Players

Like aforementioned, the United States government has a system where the roles of different government systems overlap. This implies that the three arms of the government- judiciary, executive and legislature are involved in the process of policy making (US Immigration). While the legislature is mostly involved in making the policies, the judiciary and executive especially is involved in its implementation. The administration of Trump has managed to implement some modest policies that have enabled enforcers to reach immigrants that are in interior parts of the country. After just one fiscal year in office, the immigration and customs enforcement extracted 61,000 immigrants from the interior parts of the country – this was a 37% increase compared to the previous year (Pierce, Bolter and Selee p 3). The courts have been on the forefront to throw out proposals that have infringed the law. Some forms of governments within the nation have also been uncooperative to support the deportation proposals forwarded by the administration.

Some other players in the policy making process are foreign governments and human rights activist groups (US Immigration). Foreign governments with the interest of the citizens are interested at how they are treated in foreign countries. Any policies that are harsh on them may be resisted through sanctions and retaliatory policies. Also, human rights activists are interested in the policies that govern immigration. For instance, the intention to target immigrants from Muslim countries was opposed by activists on the basis of equality for all (Immigration Council). Lastly, the other group interested in the policies is people who wish to move to the US permanently. For, instance, with Trump’s attitude, it is unlikely that Muslims would be comfortable moving to the country. Most will be afraid because they are likely to be victimized or even locked out at the airport.

Roles of Players in public policy formulation 

The different players involved in the policy have different roles. First, the legislature is involved in formulating the policies. Some of the roles of the legislature is also to promote the wishes of the president. However, the administration of trump has neglected his rhetoric on media platforms and made policies that are less controversial and modest (Pierce, Bolter and Selee p 2). Some members in of the legislature who are elected use this policy to gain some political relevance. Most of them oppose some of the extreme immigration policies to create a public image for a very diverse American audience. The executive role is to enforce the policy after it has been implemented. The judiciary on the other hand provides checks and balances for the policy and halts any that infringes the law. Human rights activists play the role of a ‘watch dog’ fighting against policies that infringe on human rights. The hardening of the grounds of issuing asylum has faced criticism especially in an era where nations face civil wars and internal conflicts. Another move that has faced resistance from the groups is moving of children of immigrants to foster care institutions when the parents are arrested. This is termed as an infringement on the rights of the children who are supposed to be taken care of by their parents. Foreign governments also play a role of mitigation to ensure that citizens from their countries are taken care of when they move to the US.

Based on your analysis of the previous studies, propose a policy solution

The legislature has an influence on the public policy and it affects how it is implemented or amended. First, it consists of elected politicians who have different interests. Like mentioned earlier, some use it to foster their political ambitions. Some local governments oppose the deportation laws to show that they support affirmative action (Pierce, Bolter and Selee p 14). The move is basically used to build a political image so that they gain support for their parties and themselves. This results in some of the components of the policy being rejected or the state administration facing difficulties in implementing it. The legislature should work in unison with the central government to ensure that the policies are implemented. On the other hand, the administration should include all local governments in creating the policy to avoid a conflict of interest.

Human rights activists have an influence on the public policy too. First, if they reject some components of the policy, it is likely to have a negative effect on the political image of the ruling party both internally and externally. There motive is to create a fair playing ground for all and ensuring that the policy does not infringe on the fundamental human rights. Their cause of action can lead to abolishment of the policy by good will of the administration or through court orders. This can be avoided if human rights activists are involved in the formulation of the policy. This ensures that the required changes are made at an initial stage.

The administration of president Trump has put a lot of emphasis on the public policy like no other government in the history of the United States. This has enabled it to reach immigrants in the interior of the country like no other administration in the history of the nation. They have also faced resistance from different arms and forms of governance frustrating their efforts as a result.

 

 

 

 

Works Cited

“U.S. Public policy.” Council on Foreign Relations, Council on Foreign Relations, www.cfr.org/report/us-immigration-policy.

“How the United States Immigration System Works.” American Immigration Council, 26 Mar. 2019, americanimmigrationcouncil.org/research/how-united-states-immigration-system-works.

Guerlain, Pierre. “US Foreign Policy of Chaos under Trump: the Wrecker and the Puppeteers.” Revue LISA / LISA e-Journal, no. vol. XVI-n°2, 2018, doi:10.4000/lisa.10208.

Pierce, Bolter and Selee Andrew. “U.S Public policy Under Trump: Deep Changes and Lasting Impacts.” The migration Policy Institute. 2018. Print.

 

Creating and Leading Effective Teams

Review the Harvard Business School reprint, Leading Teams. Consider the criteria for successful teams and the factors needed to ensure teams are structured for success.

Create a plan (750-1,000 words) describing the steps necessary to create more successful teams at various levels within your organization. Include the following in the plan:

Define the characteristics and structure of successful teams within your organization. How are independent teams vital to the success of your organization?

  1. What are important factors to consider when leading teams within the various levels of the organization?
  2. What factors are important to consider when leading teams at the executive level?
  3. What aspects are essential in identifying appropriate members for teams and ensuring the teams are successfully launched?
  4. What factors are important to ongoing team dynamics? Describe guidelines to evaluate the function and productivity of teams.
  5. Compassion is a significant attribute of many religions and philosophies, including a Christian worldview, as well as being important for both authentic and servant leadership. As a leader, how would you empower your teams through compassion to honor diversity and support equality for all members as they work toward a common goal?

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

Shan, Keller, and Joseph (2019) contend that one potential reason for the low status of women in modern organizations is the lack of effective negotiation skills. Weak negotiation performance among women have been shown to contribute to women’s lower status in contemporary organizations. With this in mind, Shan, Keller and Joseph (2019) sought to examine how negotiation performance differs between different genders and culture. The scholars conducted an electronic research on major online databases to identify articles on the impact of gender and culture on negotiation skills of both men and women. During the search they focused on GLOBE cultural practices, as well as, Hofstede cultural and Schwartz cultural value orientations to examine the effect of gender on negotiation skills.  In total, Shan, Keller, and Joseph (2019) reviewed 185 articles on gender negotiation skills and performance across 30 societies. Shan, Keller, and Joseph (2019) found that women had inferior performance as compared to men in societies that emphasized agency over communalism. In contrast, societies that emphasized communalism over self-interests, women performed better in negotiations as compared to men. Summarily, the found that women performed better in negotiations than men in societies with higher levels of harmony, lower assertive practices, higher communalism and lower individualism.

The article is quite informative on how negotiation skills and performance differ in different genders in different cultures. While the general notion has been that women are generally poor negotiators, which contributes to their low status in contemporary forms, the study provides first hand evidence that this is not the case, as negotiation skills of the different genders performs different in different cultures. One possible explanation is that cultural values and practices support specific negotiation skills. For example, in cultures with high individualism, men perform better than women when negotiating. This might explain why in individualistic cultures, such as Britain, American and Western worlds, men tend to dominate higher status in organizations. Yet, the article does not explain why despite the higher performance of women in collectivist and communalist society, women do not hold higher status in organizations. While social conditioning does impact negotiation performance, the article does not provide evidence on why despite the differences in negotiation performance does not impact women status in communalist and collectivist societies, as both individualistic and collectivist societies tend to have similar levels of gender inequality. One possible explanation is that there are other factors beyond the cultural values explored in the article that explain power relations in societies with differing cultural values and practices.

The article explores two topic learnt from the course, diversity and culture, and negotiation. By integrating GLOBE cultural practices, and Hofstede cultural values, as well as, Schwartz cultural value orientations, the article is able to integrate diversity and culture into the discussion of gender diversity and status of women in contemporary societies. Further, the authors explore how cultural values and practices determine women status in modern organizations. In the context of negotiations, Shan, Keller, and Joseph (2019) explore the role of culture in negotiation performance, focusing on how cultural values determine how different genders perform during negotiation. Summarily, the article provides evidence on the impact of culture on negotiation performance in different genders. While the article is informative on how cultural practices and values affect gender performance during negotiations, it fails to take into account regional variations in cultural values and practices and how they affect such performance.

 

 

References

Shan, W., Keller, J., & Joseph, D. (2019). Gender Differences in Negotiation Across Cultures Are Men Better Negotiators Everywhere? A Meta Analysis of How Gender Differences in Negotiation Performance Vary Across Cultures. Journal of Organizational Behaviour, 0(0), 1-45.