Nurse-Legislators

There are several nurses who hold positions as state or federal legislators. One of the American nurse-legislators is California’s Representative Lois Capps, who has served in Congress since 1998 to the present (Library of Congress, 2014). Lois was a nurse before becoming a legislator in 1998. Nurse-legislators have a crucial role of influencing changes in laws, regulations and policies governing the healthcare system (Abood, 2007). They operate beyond their nursing practice settings and assume the role of advocates for improved healthcare delivery. They achieve this through influencing health policy implementation, vetoing the proposals of others and initiation of policy proposals (Abood, 2007). Nurse-legislators are in a better position to advocate for important issues in healthcare delivery.

Lois Capps has sponsored several bills relating to healthcare. One of them is the Registered Nurse Safe Staffing Act of 2013 which aims to ensure adequate nurse staffing to reduce fatigue and improve patient care (Library of Congress, 2014). Another bill is the HIV Organ Policy Equity (HOPE) law which allows for organ transplant between patients suffering from HIV. She has also sponsored the Planning Actively for Cancer Treatment Act (PACT) which will improve how Medicare patients suffering from cancer receive care (Library of Congress, 2014). Nurse-legislators such as Louis Capps have a better understanding of the challenges facing healthcare. Therefore, they propose bills that are tailored to address those challenges and improve health care. They have valuable experience from the healthcare industry that enables them to advocate for healthcare improvement.

In retrospect, nurse-legislators play an important role because they are directly involved in shaping healthcare policies. They are in a unique and influential position to change the healthcare delivery system for the better.

References

Abood, S. (2007). Influencing health care in the legislative arena. Online Journal of Issues in Nursing, 12(1).

Library of Congress (2014). Representative Lois Capps. Retrieved 23 February 2014 from http://beta.congress.gov/member/loiscapps/1471?q={%22sponsorship%22%3A%22Sponsored+Legislation%22}&page=2

 

 

 

Mandatory Continuing Nursing Education

Mandatory continuing education refers to the ongoing nursing professional development courses aimed at ensuring that nurses remain updated with changes in practice, competent to offer relevant care and maintain their certification (Gallagher, 2007). Continuing nursing education is supported by ANA’s code of ethics and scope and standards of practice.

The purpose of ANA’s scope and standards of practice is to improve the nurses’ understanding of professional expectations in delivery of their services so that they can adhere to the established guidelines. This enables them to be accountable to legal and regulatory bodies and also improve the care provided to patients. Within ANA’s scope and standards of practice, continuing education is seen as a learning experience in which the attitudes, skills and knowledge of nurses are augmented, leading to the enrichment of their contributions to healthcare as well as the achievement of their career goals (American Nurses Credentialing Center (ANCC), 2012). Continuing education is one of the standards of professional development which enables nurses to enhance their practice, maintain competence and achieve career goals. One of the advantages of mandatory continuing nursing education in relation to the scope and standards of practice is that it ensures that nurses are trained properly in their responsibilities so that they can practice within the set guidelines. It also helps in mitigating liabilities such as errors in their practice (Gallagher, 2007). Moreover, it enables them to comply with regulations and be accountable to the relevant authorities. It also serves to assure the public that they are in good hands since the nurses are informed about their standards of practice (Skees, 2010). However, mandatory continuing education goes against the principles of adult learning since they are supposed to engage in learning voluntarily (Gallagher, 2007). Moreover, the public may get a false sense of security since continuing education may not necessarily translate to improved practice.

The purpose of the ANA code of ethics is to guide nurses as they perform their responsibilities to ensure that they adhere to the profession’s ethical obligations and nursing care quality. One of the provisions of the ANA code of ethics states that nurses have the responsibility of maintaining competence and ensuring the continuation of professional and personal growth. Therefore, continuing education enables nurses to achieve professional growth through knowledge development (ANCC, 2012). This promotes competence in the nurses’ professional practice. One of the advantages of mandatory continuing education in relation to the code of ethics is that it ensures that nurses keep up with the changes such as technology, emerging diseases, medical breakthroughs and innovations in healthcare. Nurses are able to remain competent if they are up to date with the latest developments in healthcare. This enables them to serve patients better (Gallagher, 2007). Furthermore, mandatory continuing education enables nurses to improve patient outcomes. Mandatory continuing education also enables nurses to demonstrate professionalism in their ever-changing practice (Skees, 2010). Moreover, it promotes networking among nurses and this enables them to share knowledge and experiences, which may result in improved practice. However, mandatory continuing education does not always lead to competency as nurses may not improve on their practice after undergoing the process (Gallagher, 2007). It also consumes time that could have been spent caring for patients. Moreover, it may be difficult since it is expensive and the curriculum may be inflexible.

Regardless of its cons, mandatory continuing nursing education should be encouraged. This is because it keeps the nurses informed of new development in healthcare thus leading to improved patient care and better outcomes. Such education also is able to acquaint nurses with the changing legal environment of their practices so that, during their practices, they can adhere to expected legal and ethical obligations.

 

References

American Nurses Credentialing Center (ANCC). (2012). The Value of Accreditation for Continuing Nursing Education: Quality Education Contributing to Quality Outcomes. Silver Spring, MD: American Nurses Credentialing Center.

Gallagher, L. (2007). Continuing education in nursing: a concept analysis. Nurse Education Today, 27(5), 466-473.

Skees, J. (2010). Continuing education: a bridge to excellence in critical care nursing. Critical Care Nursing Quarterly, 33(2), 104-116.

 

Legislative Worksheet (SBAR Format) –

How a Bill Becomes a Law

 

SITUATION: IS THIS SOMETHING THAN CAN BE LEGISLATED?

• Identify the problem/concern: There are continued cases of fatal accidents, especially involving school buses, occurring in our community every day. A close study has found out that, such vehicles do not have seat belts installed in them, and that presence of seat belts reduces the magnitude of the accidents.
• State your proposal/idea: I firmly propose passing into law a bill requiring that, all vehicles have seat belts installed at least in the front seats.

BACKGROUND: DO YOUR RESEARCH

• Include studies, reports, personal experience, or anecdotal stories related to your proposal: I have been working with the emergency room of at local hospital in Texas for a while. Although, I have handled various cases of fatal accidents, the one I handled recently was quite horrible considering that it involved young children. These two children were injured when their school bus driver applied brakes suddenly to avoid collision with another vehicle. It is quite evident that the children could not have been injured if they had belted up, but unfortunately, the school bus had no seat belts installed. Indeed, research has it that, seatbelts help reduce such fatalities by a significant magnitude (Dissanayake & Parikh, 2011; “North Dakota Seat Belt Defense,” 2011; Daly, 2013). Further, in my investigation, I found out that such avoidable humanly accidental causes are just a trend in Texas especially the community I serve as a nurse. I am confidently aware that, recently, the Texas legislature failed to pass a bill requiring seat belt installation in all vehicles. However, all of us are aware that the Congress passed the Federal Aid Highway Act of 1973 that requires installation in all vehicles to avoid “social and economic losses incurred by auto accidents” (“North Dakota Seat Belt Defense,” 2011, p. 146). As such, it is my firm stand that, to avoid such accidental losses especially to our schoolchildren, the legislature should pass the bill requiring all vehicles to have seat belts installed at least in the fronts seats.
• Has there been similar legislation introduced and/or passed in other states? If so, include it: Some states already have the seat belt law in place. For instance, Georgia, Minnesota, and South highly embrace the seat belt law, even referring to it in court on cases involving vehicle accidents (Daly, 2013; “North Dakota Seat Belt Defense,” 2011).

ASSESSMENT: FINANCES AND STAKEHOLDERS

• Identify financial impact if any: Pushing such a bill into law will have various financial implications. Notably, the defendants will not have to bear costs that could have been avoided if the plaintiff belted up (Daly, 2013). Additionally, a great deal of social and economic losses could accrue due to reduced accidents of the avoidable humanly causes (“North Dakota Seat Belt Defense,” 2011). Ideally, the financial implications of passing the bill into law are in light of positive outcomes.
• Identify stakeholder groups that would support this bill: Various stakeholder groups support this bill. Specifically, the Parents and Teachers’ Association of the school whose students were injured has great interest. I have also collected over 2, 000 signatures of registered voters from my district who are in support of this bill. Therefore, I do not have doubts concerning the support of this bill.
• Identify people/groups that would oppose this bill: I know some individuals and or groups will oppose this bill. Notably, the vehicle owners may go on rampage considering the costs that they will incur in the seatbelt installation. Others may also argue that the bill only addresses one cause of accidents. What I can tell such a people is that the financial implications of seat belt installations are quite cheap, and that other laws have already addressed other causes of accidents as drinking and driving, and over speeding.

RECOMMENDATION

• Make an appointment with your legislator to discuss your proposal: I am hereby seeking an appointment with you, as my legislature representative, to discuss an urgent matter relating to a bill requiring that, all vehicles be installed with seat belts. This is to address the avoidable humanly causes of accidents that cause losses to many people, including schoolchildren, in our own district.

References

Daly, J. E. (2013). Seat-belt defense in Georgia. Mercer Law Review, 65, 20-40.

Dissanayake, S., & Parikh, A. (2011). Self-reported behavior, perceptions, and attitudes of drivers regarding seat belt use: Descriptive study. Advances in Transportation Studies: International Journal, 5-16. DOI 10.4399/97888548465861

North Dakota’s Seat Belt Defense (2011). North Dakota’s Seat Belt Defense: Time for North Dakota to statutorily adopt the doctrine of avoidable consequences. North Dakota Law Review, 87, 139-165.

 

 

 

CMS Reimbursement Rules

The Centers for Medicare and Medicaid Services (CMS) stopped the reimbursements of complications which occur during patient hospitalization as from 2008 (McNair, Luft & Bindman, 2009). These complications are referred to as never events. The never events are preventable errors affecting hospitalized patients and they mostly occur due to negligence or failure to adhere to the set guidelines (Stone et al., 2010). Initially, the physician’s reimbursement model was fee-for-service. This involved paying them for their services and focusing on quantity instead of the quality of care and its outcomes. Reports indicated that medical errors were prevalent and they were costing the healthcare system a substantial amount of money every year (Stone et al., 2010). Because of the fee-for-service model, physicians were not keen to adhere to the set guidelines in order to avoid errors since they were paid based on quantity (McNair et al., 2009).

In order to reduce never events, a pay-for-performance reimbursement model was proposed whereby physicians would be paid depending on the outcomes of their treatments. As a result, CMS changed its reimbursement policy and stopped reimbursing hospitals for a number of preventable errors, referred to as never events (Stone et al., 2010). Examples of never events include falls, wrong-site surgeries, bedsores, wrong blood transfusions and infections resulting from catheters and surgeries. Hospitals are expected to bear the costs of never events and this is expected to compel them to adopt preventative measures to avoid the occurrence of these events (McNair et al., 2009). Hospitals are also expected to report on the satisfaction and experiences of their patients. These rules will ensure that patients in inpatient facilities will have better experiences and outcomes as hospitals will focus more on providing quality care to reduce medical errors instead of emphasizing on quantity (Stone et al., 2010).

References

McNair, P. D., Luft, H. S., & Bindman, A. B. (2009). Medicare’s policy not to pay for treating hospital-acquired conditions: the impact. Health Affairs, 28(5), 1485-1493.

Stone, P. W., Glied, S. A., McNair, P. D., Matthes, N., Cohen, B., Landers, T. F., & Larson, E. L. (2010). CMS changes in reimbursement for HAIs: setting a research agenda. Medical Care, 48(5), 433-439.

 

Role of nurses

In the past, the role of nurses was taking care of the patients among the general operations on healthcare centers. Currently, the roles of nurses have advance following the complications of sicknesses in addition to the increasing number of patients in the society with respect to the high growing rate of sicknesses. These changes are advancing the nurses knowledge to meet the current modern standards of health care as well as aiding in research activities. As addressed by Allen (2001), the current roles include addressing of health care policies, publishing research activities and also enhancing the mobile healthcare activities. Prior to the modern roles, nurses are expected to play a role in determining the course of patient care. This is coordinated through their advanced education which acquits them with appropriate knowledge of addressing the course of patient as supported by Lang (2011).

Evidence-based practice plays a role in health care through application of the knowledge acquired in nurse education. Since the traditional care is not eluded in today’s roles, the continued interaction with patients as well as their families offers a clear understanding of the patient’s previous conditions, which in return offers the nurses clarity of any complications to be addressed during the patient care (Drach-Zahavy, 2009). The history of nursing being culturally wise is still relevant today. This aspect has to be maintained considering that the nurses stay with patients for longer hours compared to the doctors. Being culturally wise enables the nurses to listen and understand patients, an aspect which improves the quality of care in the health centers as supported by Sewell (2008).

 

 

Reference

Allen, D. (2001). The changing shape of nursing practice the role of nurses in the hospital division of labor. New York: Routledge.

Drach-Zahavy, A. (2009). Patient-centered care and nurses’ health: the role of nurses’ caring orientation. Journal of Advanced Nursing, 65(7), 1463-1474.

Lang, L. (2011). IOM Report Urges Expanding Role of Nurses. Gastroenterology, 140(1), 5.

Sewell, E. A. (2008). Journaling as a Mechanism to Facilitate Graduate Nurses’ Role Transition. Journal for Nurses in Staff Development (JNSD), 24(2), 49-52.

Special Policy and Private Security

Article 1, Section 14 of the Ohio constitution protects the United States’ people from unreasonable searches and seizers. This is the Fourth Amendment in the United States constitution which prevents violation of public privacy by the government officials. For the private individual who broke into the suspect’s home, the law does not convict him from having undertaken the search with or without a warrant. Therefore, the private individual did not require a warrant for the search but for any state government official, a search warrant is a must since failure to have it would lead to violation of the fourth amendment. In relevance to the ‘Silver platter doctrine’ which requires the court to deny any evidence seized by the federal agents without the search warrant, it directs the court to accept similar evidence if seized by the private agent with or without a search warrant.

On considering the state action, it refers to the government officials’ involvement in any search or seize by either directly acting or instructing what to be is to be done. In the FBI case of requesting a private individual for assistance, the law allows for coordination between private and government agents in public protection, where the government official does not instruct the operation. The state action was therefore not involved in the search but only requested for assistance which is not violation of the fourth amendment of the public rights. In this case, the suspect should be prosecuted with the evidence provided since the state only received the documents but was not involved in the breaking and the search of the evidence documents presented by the private individual. Private agents are not bounded by law in performing their duties without a warrant and therefore, most sectors have turned to hiring the private agents for security and other obligations previously undertaken by the government officials.

The Role of Accounting on Business and Our Society

Question One:

Financial statements are formal records of a company’s financial activities. The records are written reports that measure the performance, liquidity, and financial strength of an entity. They reflect or represent the business transactions’ and events’ financial effects on the company. There are four main types of financial statements (Weygandt, Kimmel, & Kieso, 2009). The first is the statement of financial position, also called the balance sheet. This statement shows an entity’s financial position at a certain period. Its main elements are assets, equity, and liabilities.  Assets are things a business controls or owns while liabilities are things that the company owes to people and institutions. Equity is what the company owes to the owners. The income statement is also referred to as the profit and loss account and reports the entity’s financial performance in relation to the net profit and loss in a certain date. It is comprised of the income, expense, and depreciation (Weygandt, Kimmel, & Kieso, 2009). Cash Flow statement, on the other hand, presents the movement in bank and cash balances in a specified period. It is classified into operating activities, investing activities, and financing activities. The fourth statement is the statement of changes in equity (statement of retained earnings) presents the movement of equity of owners in a certain period. Its components are the income statement, issued share capital, dividend payments, recognized losses or gains, and effects on changes in accounting policy (Weygandt, Kimmel, & Kieso, 2009). In my opinion, the most effective in reporting the financial health of the business is the statement of financial position as it measures the performance, liquidity, and financial strength of an entity.

Question Two:

Accountants have roles similar to certified public accountants. One of the major roles played by an accountant is financial data management. This involves the gathering and maintenance of financial information as it concerns an organization. It is the duty of an accountant to ensure that financial records are maintained in conformity to legal and accepted policies and procedures (Larson, Kalagnanam, & Jensen, 2005). Accountants are also involved in giving analysis and advice. They use financial data to help in making critical company decisions. Accountants are involved in the preparation of financial reports, which are used by important company stakeholders such as customers, suppliers, or even investors in making decisions. The reports are made using accounting systems and computer programs. Another role of accountants and which is very important even for the legal institutions is to ensure compliance. These include adhering to legal rules and procedures, meeting deadlines, and tax and audit compliance (Larson, Kalagnanam, & Jensen, 2005). Another role is to ensure external business affiliations as they must work with people from the management, internal auditing, public, and government accounting industries.

Question Three:

If I would create my own business, it would be in the service industry. Service business deals with the sale of intangible goods while merchandise business sells tangible products. There are differences in the charts of accounts of both businesses. The differences are in the format of financial statements and the recognition of revenue (Larson, Kalagnanam, & Jensen, 2005). Merchandising businesses generally collect their payments from clients when client takes the goods from the store. On the other hand, service businesses recognize revenue when the entity carries out the service for the client. In many cases, the entity bills the client on a future or later date to request payment. Merchandise businesses recognize revenue on the time of sale. The formats of the income statements differ between the two types of companies. For the service industry, operating expenses are deducted from the revenues in order to get the net income. For merchandise companies, the cost of merchandising is deducted from the revenue to get the gross profit (Larson, Kalagnanam, & Jensen, 2005). After this is done, operating expenses are then deducted to get the net income.

Question Four:

Automating the accounting process in my business is important. It refers to an approach of maintaining current accounting records using accounting software. It allows for easy accounting process in conformity with the accounting standards and procedures in operation. Automated accounting systems saves a lot of time when compared to traditional methods.  There are a number of internal controls that can be used to prevent or detect theft or fraud (Weygandt, Kimmel, & Kieso, 2009). One of the internal controls that will be used in the business is to use a system of checks and balances in order to ensure that no one has authority or control over all components of financial transactions. Another internal control is to limit the use of agency credit cards and confirm all accounts and credit cards’ charges, which is meant to ensure that they are all business-related (Weygandt, Kimmel, & Kieso, 2009). The preparation of fiscal procedures and policies in writing and obtaining the approval of the Board of directors is an important control in preventing theft or fraud.

 

 

 

References

Larson, K. D., Kalagnanam, S. S., & Jensen, T. (2005). Fundamental accounting principles. Toronto: McGraw-Hill Ryerson.

Weygandt, J. J., Kimmel, P. D., & Kieso, D. E. (2009). Accounting principles. New York: Wiley.

Americans with Disability Act

The HR department is charged with ensuring that the right people are identified and adequately trained so that they can effectively and efficiently execute the mandates for various job positions being advertised. The law obligates HR departments to give equal opportunities to all people regardless of their gender, race, disability, religion and ethnicity. Therefore, when vacancies occur, then HR departments must advertise for the positions in a manner that does not discriminate against a group of people; for example use of a media like newspapers where blind people will not be informed.

The Americans with Disability Act (ADA) is a piece of legislation that is meant to protect persons that are regarded as being disable in one aspect or another from discrimination. Such disability encompasses physical or mental impairment that substantially limits one or more major life activities of an individual where such a record exists or where the disability is apparent. The act envisages persons who have physiological disorders or conditions, organic brain syndrome, specific learning disability, mental retardation, anatomical loss that affects major systems of the body and cosmetic disfigurement that is affects normal muscle tone, height or weight range (Vierling, 2004).

This law requires employers to make reasonable accommodations for persons with disabilities that would be helpful in assisting them to comfortably carry out their duties. The act however obligates employers to make these adjustments to the point where they do not cause undue hardships (Acemoglu & Angrist, 2001). The law may require an employer to analyze the job to ensure that upon reasonable adjustments, a person with disability can comfortably do it. Such persons must be qualified for the jobs advertised and can do them with minimum adjustments. The work environment must also be considered to ensure that disabled persons can operate in it with minimum adjustments and that the benefits and privileges that are enjoyed by persons without disability can still be applicable to those with disabilities.

The law requires that sustainable limits of job performance be reasonably determined. Disabled persons might not be able to perform certain job tasks for an extended period of time or sustain the energy required for the tasks. Here undue hardships are considered so as to not discriminate against people with disabilities on criteria that are not reasonable. The law requires that reasonable accommodations be done in order to assist people with disabilities which may warrant a review of the tasks in a group of people so that they are reorganized in a manner that will allow the able-bodied to perform those tasks that the disabled may not without exerting undue pressure on them (Schall, 1998). The specific tasks of a certain job will determine the staffing mix. This may be followed by a comprehensive method of performance appraisal and rearrangement of all accompanying rewards, benefits and privileges to ensure that there is fairness and equality in distribution.

The ADA is a good piece of legislation that employers must embrace even beyond the parameters encompassed therein. This means that the employment should be wholesome to the person with disability to the extent that it allows for independent living, full participation, equal opportunities and self-sufficiency which all reflect an improved quality of life. Therefore, there must be a delicate mix of the person with disability, the workplace and the society at large.

 

 

References

Acemoglu, D. & Angrist, J.D. (2001). Consequences of Employment Protection? The Case of the Americans with Disabilities Act. Journal of Political Economy, 109, 915–957.

Schall, C.M. (1998). The Americans with Disabilities Act—Are We Keeping Our Promise? An Analysis of the Effect of the ADA on the Employment of Persons with Disabilities. Journal of Vocational Rehabilitation, 10(3), 191–203.

Vierling, L.E. (2004). Proving disability remains difficult. The Case Manager, 15(1), 25–29.

Risk Management

 

Introduction

Risk management in nursing encompasses many challenges that face the patients and medical fraternity, which can be either external or internal. Internal risk includes delayed communications, varying capacities among others. External risks entail competition, prices, medicine supplies, and distance from the hospitals. Nursing profession may encounter failures that may affect the hospital financially and possibly harm the patients (Sodhi, 2012). Therefore, for efficient in the nursing profession there has to be a safeguarding of the supply chains of medical needs to reduce losses and increase efficiency in treatment of patients. War and terrorism hinder the supply chains of medicine and this discourages any trading among businesses (Slack, Jones and Johnston, 2013). War situations present a situation where hospitals are looted, a case to consider is Sudan, where the fighting factions loot hospitals and kill the sick. Thus insecurity comes in as a risk. Therefore, hospitals have to be well equipped to cater for the patients in their care.  In addition, political problems in a country, fire incidences are also potential areas that can affect hospitals operations. The risk of being infected by disease is very potent in nursing. This demands that the nurse take care not to come in contact with the fluids from the patients specially when carrying out treatment or administering drugs to the patient. . This paper will review how St. Mary’s hospital and how it has addressed some of the supply chain risks medical supplies. In addition, the paper will provide three cases where similar approaches have been used to mitigate supply chain risks.

Risk Management Issue at St. Mary’s

Risk management entails the use of protective measures against risks associated with activities being carried out by an organization (Slack, Jones and Johnston, 2013). These risks emanate from the nature of business being undertaken by a firm. Risk management is a management function that is critical in discovering the level of uncertainties that a business and its operations are prone to in any given situation. In addition, risk management helps in determining the solutions needed to alleviate or lessen the negative impacts and increase the positive impacts (Slack, Jones and Johnston, 2013). Therefore, the activities geared towards lessening risks and the negative impact they may have becomes dominant in carrying out risk management. This ensures that the project is profitable to the community and the cost of keeping out the risk is manageable to the Hospital (Slack, Jones and Johnston, 2013). The challenge of supply chain disruptions is real for St Mary’s hospital.  Timely supply of needed medicines and equipment for administering treatment is crucial for the effective running of the hospital. This ensures that patients are treated on time and those in critical conditions are catered for as quickly as possible. The availability of medical supplies determines the patient’s fate especially those who are in critical condition is critical for St. Mary’s Hospital because it is a competitive tool that ensures products reach the market at the right time. Any delays will mean products will reach the hospital late, which creates serious and dangerous situations that risk the lives of the patients (Slack, Jones and Johnston, 2013).

Managing Global Suppliers to Mitigate Risks

The improvement of supply chain issues revolves around the areas that the hospital is trying to make some changes (Slack, Jones and Johnston, 2013). The hospital has come up with various methods that it used in getting supplies. Medical supplies are procured from the suppliers who need to be informed on time before supply is made. The sooner the suppliers are informed the better. They act on the demand and make sure that the hospital receives the supplies as soon as possible.  Hospitals mostly deal with the same products and thus it is common to find that they have the same needs. There is much competition in the hospitals since they have to demand for the same products and since there are many hospitals some may end up with a shortage in supplies especially those that are located in remote areas. This becomes a risk in itself (Slack, Jones and Johnston, 2013). One profound effects of globalization is the shift of production to transitional economies, which has led to a decrease in associated costs. Despite such benefits, risks of inconsistencies in quality of products, culture, political risks, as well as disruptions in the supply chain are some of the issues that the hospital has to deal with urgently.

The hospital has taken several initiatives to address these supply chain risks such as buying from global suppliers and seeking partnerships with new suppliers. Shifting to new suppliers makes sure that the hospital gets supplies at the right time, thus minimising cases of delays in administering treatment to their patients (Seifert and Isaksson, 2013). In addition, new suppliers help St. Mary’s Hospital diversify supply chain risks. The increase in efficiency in the supply chain ensures that the hospital meets its demands on medicine and implements needed to function on day to day basis. Knowing the suppliers and keeping them makes the hospital have the needed supplies for its operations (Seifert and Isaksson, 2013).

Another benefit for choosing other suppliers is that St. Mary’s Hospital deal with the community in regard to treating normal ailments and a bit of surgery. As noted above, the Hospital competes with several other hospitals in getting supplies for its operations. Therefore, St. Mary’s Hospital should not waste more time dealing with other hospitals. Therefore, to be competitive in upcoming markets, St. Mary’s Hospital must enhance its capacity issues urgently. This will only be made possible by having several suppliers that will ease capacity constraints so that St. Mary’s Hospital can shift more focus and be efficient in dealing with various maladies (Seifert and Isaksson, 2013). Therefore, seeking additional suppliers is critical for St. Mary’s Hospital because it will give the Hospital more control over its supply chain at a time when increasing demand for medical is at a high.

In today’s nursing profession, efficiency of operations is of paramount importance. However, the exchange of data within the Hospital and other players in the supply chain is not an easy task as it is accompanied by costly programming within departments (Sodhi, 2009). Implementing a uniform knowledge management platform is critical in helping St. Mary’s Hospital transfer and share relevant information and knowledge with other partners in the supply chain. The supply chain of the hospital includes other players like dispensaries, clinics and pharmacies.

The adoption of knowledge management practices and principles  at St. Mary’s Hospital as well as the subsequent automation using collaborative knowledge portals has helped St. Mary’s Hospital achieve a more cost-effective , efficient and competitive supply chain (Seifert and Isaksson, 2013). However, the implementation of knowledge management at St. Mary’s Hospital is not free of challenges. Therefore, proper guidelines for the full implementation and adoption of Knowledge management should be addressed.

The application of knowledge management tools has also been used by others companies to deal with supply chain risks. One such Hospital is Malmo University Hospitals health facility that suffered delays occasioned by fire in one of the suppliers’ facilities. Numerous theories are critical in the supply chain operations of St Joseph’s health Facility. Malmo University Hospitals integrated its S&OP and the collaborative planning, forecasting, and replenishment (CPFR) model to share market intelligent with the other hospitals in order to get more information and manage the supply chain process  (Kato, 2013). In addition, the business continuity management model (BCM) ensures Malmo University Hospital can deal with a situation in a way that minimizes risks (Jansson and Norrman 2003). The Hospital understands the challenges of fire outbreak in the supply chain (slack, J. and Johnston 2013) as it happened in the Albuquerque accident. Using the BCM approach, the Hospital will be in a position to ensure continuity of business operations as it deals with the risk at hand. There are also other areas that can help Malmo University Hospital in identifying risks that can affect its supply chain. Political instability in a company affects the supplies of medicine to the hospital and this causes delayed treatment which can be can have catastrophic results.  Risk mapping will help the Hospital identify and quantify the probability of risk in a given country (slack, Jones and Johnston 2013). This can be done by using fault tree analysis (FTA) or the event tree analysis (ETA), which are used to research factors and causes that lead to accidental events (Jansson and Norrman 2009).

The current supply-chain risk management approach is based on feedback-loops between the various players in the supply chain. The process includes identification, assessment, treatment, and monitoring of risks using FTA and ETA (Nilson & Mattias, 2013). These processes ensure minimal disruptions in the supply chain.

Other companies that have put in mechanism to deal with supply chain risks include Maryland Health facility. The company, like St. Mary’s Hospital and Malmo University Hospital, face the threat of supply chain disruptions from various sources, including natural disasters, political upheaval, fires, and supplier inefficiencies among other factors. The active strategy embraced by these companies is similar to what St. Mary’s Hospital has done. They have backup suppliers spread across the globe (Sodhi, 2012).

Conclusion

The challenge of an effective supply chain is real for St. Mary’s Hospital. Poor working conditions and supply disruptions can lead to poor performance in dealing with their patients. For instance, the competition posed by rivals hospitals and other health facilities can put St. Mary’s Hospital’s operations at a high risk. To overcome these problems, St. Mary’s Hospital has taken measure to diversify its supply network. Some difficulties in the implementation of knowledge management might include lack of capacity by partners within the supply chain. This strategy is not unique to St. Mary’s Hospital Inc. as other companies such as Malmo University Hospital and Maryland Health facility have also taken similar initiatives to mitigate against supply chain disruptions.

 

 

References

Nilsson J. and Mattias S. (2013). Mapping of the supply chains to Malmö University Hospital in connection to risks and risk management. Lund. Sweden.

 

Seifert, W. R. and Isaksson, H. D., (2013). The Perks and Pitfalls of Knowledge Diffusion in the Supply Chain. Retrieved from http://www.imd.org/research/challenges/TC079-13-knowledge-diffusion-in-supply-chain-seifert-isaksson.cfm

Slack, N, Jones, B. A., and Johnston, R. (2013). Operations management, London: Pearson Education Limited.

Sodhi, M. M. S., & Tang, C. S. (2012). Managing supply chain risk. New York: Springer.

 

 

 

 

 

 

 

The mind of South Africa

The writer, Allister Sparks talks about the complicated culture of the then apartheid South Africa, a country that is living in the claws of inequality and unfair treatment among the layers of its society. Allister (1990) takes us through the mind of the Afrikaner people and how their twisted way of thinking has brought forth a segregated society in South Africa. The Afrikaner settlers (a minority group in South Africa that is composed of the descendants’ of the Dutch settlers, German and other Boer tribes and speaks the Afrikaan) imposes a classification of individuals based on the color of skin and the race. The minority whites’ make the indigenous black population live like foreigners in their own country making them carry badges and passes as second-class citizens. The interesting part about this is that the inequality is legally justified.

The life of an Afrikaner male is as simplistic as it is complicated. This means that, an Afrikaner man will find it easy to live within the confines that the society allows him (which is much more compared to the other races) while at the same time, the segregation that exists within his rule limits to a great degree his ability to choose. The “freedom” that the Afrikaner male seems to enjoy is actually as limited as it is for the African, although it is self-imposed for the former.

The relationship between the Afrikaner male and the other races is in the worst form. This is clearly shown by the classification of people; where African indigenous population has been reduced to second-class citizens while the white minority enjoys all the privileges. The democracy smokescreen that they have put in place is actually a lie that is aimed at consolidating their control over the blacks with limited resistance. The brutal nature of the Afrikaner is seen in the bloody conflicts beginning in the early eighties to late eighties where thousands of Africans were killed in the crackdown against activism.

The gender relationship depends on the people with whom the Afrikaner male is interacting with. For fellow Afrikaner women, the relationship was cordial and followed the normal courtship and friendship procedures. On the other hand, the interaction with the native African population was prohibited within the social circles, and it was seen as a form of deviance on his part. In the event there was contact, the Afrikaner took the dominant place and the “other” perceived the relationship as a duty not a choice.

According to Allister Sparks, apartheid created a negative personality in almost all Afrikaner population because they lived in fear of domination by the black populations. Therefore, they saw apartheid as a necessity for their survival. This led them to become brutes in the aim of consolidating their hold on the South African resources. As Allister (1990) argues, the Afrikaner mentality where they cannot respect the people who are ready to forgive after such inhuman treatment is in itself self-defeating and greatly flawed. The doctrine of supremacy, which was instilled in the minds of Afrikaner people is much more self destructive and morally weak.

Apartheid helped the Afrikaner population remain in power throughout the struggle. It made infiltration almost impossible for the black population and security after the collapse of their rule. Apartheid made it possible for the white populations acquire the status of gods by having many things at their disposal and free labor almost close to slavery.

 

 

References

Sparks, A. H. (1990). The mind of South Africa. London: Heinemann.