Scientific Management And Its Relevance Today Essay - 7

Scientific Management And Its Relevance Today - Essay Example Those who hold such views think that scientific management was not effective then and cannot be in the present days. This essay argues that Taylor’s scientific management system had its weaknesses, but the weakness can guide research towards making the theory more relevant to the current management realities. Scientific Management and its Relevance Today The result of years of experimentation and research that Taylor and his colleagues conducted in the scientific management theory.  The following four principles anchor the theory: Establishment of a science that would increase production; selection and training of personnel that will improve efficiency and increase production; application of the science established to tasks designed; and building of teamwork between personnel and management to realise the set targets (Cannon, 2009). These principles have continued to inform management practices since the 19th century to the modern days. There are many areas within management , industrial and organizational psychology that scientific management principles are applicable today. Scientific management principles has had the greatest impact in two management subfields of human resource and accounting management. Many organizations have implemented these ideas to cost?accounting and management of personnel (Wren, 2005). Areas were these principles are in operation today includes job design, selection, group processes, job performance criteria, organizational change and development, motivation and incentive systems, worker’s attitude and performance appraisal (Payne, et al. 2006). Examination of some general business practices and techniques is one of the means to prove this (Haden, Humphreys, Cooke & Penland, 2012). According to Wren (2011), studies conducted in recent years have shown that Taylor is the leading contributor to theoretical and practical approaches in management. Management researchers like Heames & Breland (2010) found Taylor at the top in their studies. Bedeian and Wren list Taylor’s book, The Principles of Scientific Management as the number one among the 25 most significant management books since the turn of 20th century. These studies were conducted decades after Taylor made the introduction of scientific management to the world. The result of these studies shows that scientific management principles have become an essential human resource tool for many managers. Application scientific management is apparent, for example, when a customer support representative picks a call under pressure from the 90/10 practice (regulations demanding customer support representatives to pick 90 percentage of calls and assist customers within 10 seconds). This regulation has its roots in scientific management as it is about efficiency and productiveness of personnel. Thus, scientific management is evident in such situations were machine-like accuracy is required for improved profitability (Bell & Martin, 2011). Taylorâ₠¬â„¢s experimentation on time and motion provides guidelines of how long it should take workers to perform a task. Time study reduces wasted motions and set a suitable standard of task performance (Wren, 2011). The study helps in the elimination of motions that do not add value to the organization’s production process. Time and motion sensors also assist employers to make decisions on strategies and techniques needed for efficient specialization.  

Speaker Independent Speech Recognizer Development

Speaker Independent Speech Recognizer Development Chapter 4 Methodology and Implementation This chapter describes the methodology and implementation of the speaker independent speech recognizer for the Sinhala language and the Android mobile application for voice dialing. Mainly there are two phases of the research. First one is to build the speaker independent Sinhala speech recognizer to recognize the digits spoken in Sinhala language. The second phase is to build an android application by integrating the trained speech recognizer. This chapter covers the tools, algorithms, theoretical aspects, the models and the file structures used for the entire research process. 4.1Research phase 1: Build the speaker independent Sinhala speech recognizer for recognizing the digits. In this section the development of the speaker independent Sinhala speech recognizer is described, step by step. It includes the phonetic dictionary, language model, grammar file, acoustic speech database and the trained acoustic model creation. 4.1.1 Data preparation This system is a Sinhala speech recognition voice dial and since there is no such speech database which is done earlier was available, the speech has to be taken from the scratch to develop the system. Data collection The first stage of any speech recognizer is the collection of sound signals. Database should contain a variety of enough speakers recording. The size of the database is compared to the task we handle. For this application only little number of words was considered. This research aims only the written Sinhala vocabulary that can be applied for voice dialing. Altogether twelve words were considered with the ten numbers including two initial calling words â€Å"amatanna† and â€Å"katakaranna†. Here the Database has two parts, the training part and the testing part. Usually about 1/10th of the full speech data is used to the testing part. In this research 3000 speech samples were used for training and 150 speech samples were used for testing. Speech database Before collecting data, a speech database was created. The database was included with the Sinhala speech samples taken from variety of people who were in different age levels. Since there was no such database published anywhere for Sinhala language relevant for voice dialing, speech had to be collected from Sinhala native speakers. Prompt sheet To create the speech database, the first step was to prepare the prompt sheet having a list of sentences for all the recordings. Here it used 100 sentences that are different from each other by generating the numbers randomly. 50 sentences are starting with the word â€Å"amatanna† while the other half is starting with the word â€Å"katakaranna†. The prompt sheet used for this research is given in the Appendix A. Recording The prepared sentences in the prompt sheet were recorded by using thirty (30) native speakers since this is speaker independent application. The speakers were selected according to the age limits and divided them into eight age groups. Four people were selected from each group except one age group. Two females and two males were included into each age group. One group only contained two people with one female and one male. Each speaker was given 100 sentences to speak and altogether 3000 speech samples were recorded for training. The description of speakers such as gender and age can be found in Appendix A. If there was an error in the recording due to the background noise and filler sounds, the speaker was asked to repeat it and got the correct sound signal. Since the proposed system is a discrete system, the speakers have to make a short pause at the start and end of the recording and also between the words when they were uttered. Speech was recorded in a quiet room and the recordi ngs were done at nights by using a condenser recorder microphone. The sounds were recorded under the sampling rate of 44.1 kHz using mono channel and they were saved under *.wav format. Sampling frequency and format of speech audio files Speech recording files were saved in the file format of MS WAV. The â€Å"Praatâ€Å" software was used to convert the 44.1 kHz sampling frequency signals to 16 kHz frequency signals since the frequency should be 16kHz of the training samples. Audio files were recorded in a medium length of 11 seconds. Since there should be a silence in the beginning and the end of the utterance and it should not be exceeded 0.2 seconds, the â€Å"Praat† software was used to edit all 3000 sound signals. 4.1.2 Pronunciation dictionary The pronunciation dictionary was implemented by hand since the number of words used for the voice dialing system is very few. It is used only 12 words from the Sinhala vocabulary. To create the dictionary, the International Phonetic Alphabet for Sinhala Language and the previously created dictionaries by CMU Sphinx were used. But the acoustic phones were taken mostly by studying the different types of databases given by the Carnegie Mellon University’s Sphinx Forum (CMU Sphinx Forum). Two dictionaries were implemented for this system. One is for the speech utterances and the other one is for filler sounds. The filler sounds contain the silences in the beginning, middle and at the end of the speech utterances. The attachment of the two types of dictionaries can be found on the Appendix A. They are referred to as the languagedictionaryand thefiller dictionary. 4.1.3 Creating the grammar file The grammar file also created by hand since the number of words used for the system is very few. The JSGF (JSpeech Grammar Format) format was used to implement the grammar file. The grammar file can be found in Appendix A. 4.1.4 Building the language model Word search is restricted by a language model. It identifies the matching words by comparing the previously recognized words by the model and restricts the matching process by taking off the words that are not possible to be. N-gram language model is the most common language models used nowadays. It is a finite state language model and it contains statistics of word sequences. In search space where restriction is applied, a good accuracy rate can be obtained if the language model is a very successful one. The result is the language model can predict the next word properly. It usually restricts the word search which are included the vocabulary. The language model was built using the cmuclmtk software. First of all the reference text was created and that text (svd.text) can be found in Appendix A. It was written in a specific format. The speech sentences were delimited byandtags. Then the vocabulary file was generated by giving the following command. text2wfreq svd.vocab Then the generated vocabulary file was edited to remove words (numbers and misspellings). When finding misspellings, they were fixed in the input reference text. The generated vocabulary file (svd.vocab) can be found in the Appendix A. Then the ARPA format language model was generated using these commands. text2idngram -vocab svd.vocab -idngram svd.idngram idngram2lm -vocab_type 0 -idngram svd.idngram -vocab svd.vocab –arpa svd.arpa Finally the CMU binary of language model (DMP file) was generated using the command sphinx_lm_convert -i svd.arpa -o svd.lm.DMP The final output containing the language model needed for the training process is svd.lm.dmp file. This is a binary file. 4.1.5Acoustic model Before starting the acoustic model creation, the following file structure was arranged as described by the CMU Sphinx tool kit guide. The name of the speech database is â€Å"svd† (Sinhala Voice Dial). The content of these files is given in Appendix A. svd.dic -Phonetic dictionary svd.phone -Phoneset file svd.lm.DMP -Language model svd.filler -List of fillers svd _train.fileids -List of files for training svd _train.transcription -Transcription for training svd _test.fileids -List of files for testing svd _test.transcription -Transcription for testing All these files were included in to one directory and it was named as â€Å"etc†. The speech samples of wav files were included in to another directory and named it as â€Å"wav†. These two directories were included in to another directory and named it using the name of the database (svd). Before starting the training process, there should be another directory that contains the â€Å"svd† and the required compilation package â€Å"pocketsphinx†, â€Å"sphinxbase† and â€Å"sphinxtrain† directories. All the packages and the â€Å"svd† directory were put into another directory and started the training process. Setting up the training scripts The command prompt terminal is used to run the scripts of the training process. Before starting the process, terminal was changed to the database â€Å"svd† directory and then the following command was run. python ../sphinxtrain/scripts/sphinxtrain –t svd setup This command copied all the required configuration files into etc sub directory of the database directory and prepared the database for training. The two configuration files created were feat.params and sphinx_train.cfg. These two are given in Appendix A. Set up the database These values were filled in at configuration time. The Experiment name, will be used to name model files and log files in the database. $CFG_DB_NAME = svd; $CFG_EXPTNAME = $CFG_DB_NAME; Set up the format of database audio Since the database contains speech utterances with the ‘wav’ format and they were recorded using MSWav, the extension and the type were given accordingly as â€Å"wav† and â€Å"mswav†. $CFG_WAVFILES_DIR = $CFG_BASE_DIR/wav; $CFG_WAVFILE_EXTENSION = wav; $CFG_WAVFILE_TYPE = mswav; # one of nist, mswav, raw Configure Path to files This process was done automatically when having the right file structure in the running directory. The naming of the files must be very accurate. The paths were assigned to the variables used in main training of models. $CFG_DICTIONARY = $CFG_LIST_DIR/$CFG_DB_NAME.dic; $CFG_RAWPHONEFILE = $CFG_LIST_DIR/$CFG_DB_NAME.phone; $CFG_FILLERDICT = $CFG_LIST_DIR/$CFG_DB_NAME.filler; $CFG_LISTOFFILES = $CFG_LIST_DIR/${CFG_DB_NAME}_train.fileids; $CFG_TRANSCRIPTFILE = $CFG_LIST_DIR/${CFG_DB_NAME}_train.transcription; $CFG_FEATPARAMS = $CFG_LIST_DIR/feat.params; Configure model type and model parameters The model type continuous and semi continuous can be used in pocket sphinx. Continuous type is used for continuous speech recognition. Semi continuous is used for discrete speech recognition process. Since this application use discrete speech the semi continuous model training was used. #$CFG_HMM_TYPE = .cont.; # Sphinx 4, Pocketsphinx $CFG_HMM_TYPE = .semi.; # PocketSphinx $CFG_FINAL_NUM_DENSITIES = 8; # Number of tied states (senones) to create in decision-tree clustering $CFG_N_TIED_STATES = 1000; The number of senones used to train the model is indicated in this value. The sound can be chosen accurately if the number of senones is higher. But if we use too much senones, then it may not be able to recognize the unseen sounds. So the Word Error Rate can be very much higher on unseen sounds. The approximate number of senones and number of densities is provided in the table below. Configure sound feature parameters The default parameter used for sound files in Sphinx is a rate of 16 thousand samples per second (16KHz). If this is the case, then the etc/feat.params file will be automatically generated with the recommended values. The Recommended values are: # Feature extraction parameters $CFG_WAVFILE_SRATE = 16000.0; $CFG_NUM_FILT = 40; # For wideband speech its 40, for telephone 8khz reasonable value is 31 $CFG_LO_FILT = 133.3334; # For telephone 8kHz speech value is 200 $CFG_HI_FILT = 6855.4976; # For telephone 8kHz speech value is 3500 Configure decoding parameters The following were properly configured in theetc/sphinx_train.cfg. $DEC_CFG_DICTIONARY = $DEC_CFG_BASE_DIR/etc/$DEC_CFG_DB_NAME.dic; $DEC_CFG_FILLERDICT = $DEC_CFG_BASE_DIR/etc/$DEC_CFG_DB_NAME.filler; $DEC_CFG_LISTOFFILES = $DEC_CFG_BASE_DIR/etc/${DEC_CFG_DB_NAME}_test.fileids; $DEC_CFG_TRANSCRIPTFILE = $DEC_CFG_BASE_DIR/etc/${DEC_CFG_DB_NAME}_test.transcription; $DEC_CFG_RESULT_DIR = $DEC_CFG_BASE_DIR/result; # These variables, used by the decoder, have to be user defined, and # may affect the decoder output $DEC_CFG_LANGUAGEMODEL_DIR = $DEC_CFG_BASE_DIR/etc; $DEC_CFG_LANGUAGEMODEL = $DEC_CFG_LANGUAGEMODEL_DIR/ ${CFG_DB_NAME}.lm.DMP; Training After setting all these paths and parameters in the configuration file as described above, the training was proceeded. To start the training process the following command was run. python ../sphinxtrain/scripts/sphinxtrain run Scripts launched jobs on the machine, and it took few minutes to run. Acoustic Model After the training process, the acoustic model was located in the following path in the directory. Only this folder is needed for the speech recognition tasks. model_parameters/svd.cd_semi_200 We need only that folder for the speech recognition tasks we have to perform. 4.1.6Testing Results 150 speech samples were used as testing data. The aligning results could be obtained after the training process. It was located in the following path in the database directory. results/svd.align 4.1.7Parameters to be optimized Word error rate WER was given as a percentage value. It was calculated according to the following equation Accuracy Accuracy was also given as a percentage. That is the opposite value of the WER. It was calculated using the following equation To obtain an optimal recognition system, the WER should be minimized and the accuracy should be maximized. The parameters of the configuration file were changed time to time and obtained an optimal recognition system where the WER was the minimum with a high accuracy rate. 4.2Research phase 2: Build the voice dialing mobile application. In this section, the implementation of voice dialer for android mobile application is described. The application was developed using the programming language JAVA and it was done using the Eclipse IDE. It was tested in both the emulator and the actual device. The application is able to recognize the spoken digits by any speaker and dial the recognized number. To do this process the trained acoustic model, the pronunciation dictionary, the language model and the grammar files were needed. The speech recognition was performed by using these models in the mobile device itself by using the pocketsphinx library. It is a library written in C language to use for embedded speech recognition devices in Android platform. The step by step implementation and integration of the necessary components were discussed in detail in this section. Resource Files When inputting the resource files to the Android application, they were added in to theassets/directory of the project. Then the physical path was given to make them available for pocketsphinx. After adding them, the Assets directory contained the following resource files. Dictionary svd.dic svd.dic.md5 Grammar digits.gram digits.gram.md5 menu.gram menu.gram.md5 Language model svd.lm.DMP svd.lm.DMP.md5 Acoustic Model feat.params feat.params.md5 mdef mdef.md5 means means.md5 mixture_weights mixture_weights.md5 noisedict noisedict.md5 transition_matrices transition_matrices.md5 variances variances.md5 Assets.lst models/dict/svd.dic models/grammar/digits.gram models/grammar/menu.gram models/hmm/en-us-semi/feat.params models/hmm/en-us-semi/mdef models/hmm/en-us-semi/means models/hmm/en-us-semi/mixture_weights models/hmm/en-us-semi/noisedict models/hmm/en-us-semi/sendump models/hmm/en-us-semi/transition_matrices models/hmm/en-us-semi/variances models/lm/svd.lm.DMP Setup the Recognizer First of all the recognizer should be set up by adding the resource files. The model parameters taken after the training process were added as the HMM in the application. The recognition process was depended mainly on this resource files. Since the grammar files and the language model were added as assets, these two can be used for the recognition process of the application as well as the HMM. The utterances can be recognized from either the grammar files or language model. The whole process is coded using the Java programing language. 4.3Architecture of the developed Speech Recognition System

Processed Food Should or Should not Be Banned from School Meals? Essay

Processed food should be banned from school meals due to increasing health issues in children, increasing academic deficiency and increasing production cost to produce processed foods. There are people who would oppose to this idea due to population growth and an increasing food demand. However, this escalating demand of food is forcing the food industry and other government agencies to resolve the current hunger and lack of resources issues, by hiring processing factories and private companies to manufacture processed foods. The greater part of school age children consume processed foods on a daily basis. The purpose of this study is to examine what are processed foods? What are the associated problems? Also, to determine if processed foods affect students’ health and their academic performance. In addition, what is the position of the Food and Drug Administration (FDA), United States Department of Agriculture (USDA) and food industry in the distribution of processed foods in schools? Also, to determine the outcome of this study, the behavior and health of students along with the governing agencies were analyzed to establish, if processed foods should be banned from schools or just monitored carefully. Discussion of key terms What are processed foods? It is food â€Å"composed of synthetic chemical additives, such as colorings, preservatives, sugar substitutes and trans-fats† (Fitzgerald, 2006, p.72). Fitzgerald reported that by the â€Å"1970s most meats and dairy products that were factory farmed were laced with growth hormones, antibiotics and a range of pesticides† (p.72). Furthermore, food that is frozen, packaged and canned is considered processed food. A brief explanation of the chemical additives in processed food. 1. Pre... ...with over twenty-five years' experience in the book publishing industry. He is an expert in general-interest non-fiction publishing, specializing in topics from business and personal finance to politics, current affairs, history, autobiography, self-help, and personal development. Before founding his company, Weber served as managing director of the Times Business imprint at Random House (1994-1997). This book is a life changing book. It was inspirational, informative and gave you insight about the things we do not know about the food we eat. The documentary was graphic and detailed, informing you of the process from the farm or the fields, to the manufactures, to the labeling and packaging companies. It informed me, about the school lunches, how some of the meals at school are made, to the politics behind it. This book is also a collectible.

Interracial Marriage Essay

Today interracial marriages are happening more and more despite that many disapprove as we become more diverse, both racially and ethnically. In the past, though considered to be taboo interracial marriages are a quickly growing segment of the population. Interracial marriage is a marriage of two individuals each of different races. The focus of this paper is to address interracial marriage increase, effects on children, acceptance and challenges, and my personal views. Interracial marriage is used to describe marriages that take place between people who are from different racial or ethnic groups. Interracial marriage can convey a relationship between a Black and an Asian, a White and a Korean, a Hispanic and an Asian, a White and a Hispanic, a Black and a White, and etc. However, when people talk about race relations, the focus is on Blacks and Whites. 1. Interracial marriages hits a new high 2. Interracial marriages and the effect on children 3. Acceptance of interracial marriage 4. Difficulties and challenges of interracial marriage 5. Views on interracial marriage Interracial Marriages Hits a New High For most of U. S history, in most communities, such unions were taboo. Interracial marriage approval is at a high point in the United States at 86 percent, a Gallup poll indicated. The poll of 1,319 adults found the United States is on the verge of unanimity on the topic of interracial marriage, Gallup reported. Ninety-six percent of African-Americans, who have always been more approving of marriage between blacks’ whites, approve of such unions, while 84 percent of whites approve. The gap of approval ratings between blacks and whites has narrowed considerably. The gap since 1997 has been averaging 13 percentage points. From 1968 to 1994, the average gap was 32 points. When Gallup first asked about interracial marriage in 1958, only 4 percent of those asked approved. Approval of black-white marriages is slightly lower among Southerners, Republicans, conservatives and those in lower education levels. The elderly are the least approving group at 66 percent (UPI. com, 2011). Interracial Marriages and the Effect on Children No matter what ethnic groups are involved, one major result of these marriages are children. Children are far more negative than a lot of adults are today regarding interracial relationships. It’s not that they approve or disapprove; it’s more like they don’t understand. If a child has never been exposed to other races or seen two different races married and living together than their first reaction might be to think its â€Å"weird†. When kids don’t understand something their first reaction is to tease the child with the interracial parents. There are more serious effects of a child being interracial †¦ labeling and racism. Encountering an identity crisis, which group does she/he belong to? Having siblings that can actually pass as white, who may result in receiving privileges that society may deny the child of more color (darker). Acceptance of Interracial Marriage The willingness of people entering into interracial relationships has grown and so does acceptance. There still some that frown upon mixed marriages with the belief that marriage is tough enough without having to deal with the burden racial differences. A report released by the Pew Research Center says that 43 percent of Americans believe that marriage between people of different races has been productive in our society while only 10 percent believe it has changed America for the worse (AFRO. com, 2012). Difficulties and Challenges of Interracial Marriage As an interracial couple you will possibly face extra challenges in your marriage from people outside your marriage. These include antagonistic and unfair treatment from others, suffering rejection from family members or disinheritance, and dealing with prejudices from friends. All of these things combined can push a couple into social segregation. If you or a couple you know is dealing with these kinds of things (even same-race couples do), think about the following: Have confidence in your choice; Deal with your feelings; Stand up for each other and your marriage; Surround yourselves with supportive people. What can cause an interracial marriage to fall apart is the inability of a couple to handle their differences and a failure to talk about stress and prejudice created by others (Marriage Matters, 2009). The problems and issues that used to occur with interracial marriages are no longer as adamant and noticeable. Views on Interracial Marriage Interracial marriages are more common today than ever before and I support it. There are cultural differences, but if anything, I believe that in interracial marriages couples can help each other to grow as a person. Love as no boundaries†¦what difference does the color of your skin make if two people are in love. You can’t help with whom you fall in love with, and people should stop seeing mixed race relationships as a political statement. If people attempt to understand the different beliefs, traditions and values of the diverse groups that make up this world, then they could work together for the good of all. Love has no color! Interracial marriage in the United States has been fully legal in all U. S. states since the 1967 Supreme Court decision that deemed anti-miscegenation laws unconstitutional, with many states choosing to legalize interracial marriage at much earlier dates. The United States has many ethnic and racial groups and interracial marriage is fairly common among most of them (The Full Wiki, n. d. ). In conclusion ethnic groups bring diversity and wealth to a society by introducing their own ideas and customs. Interracial marriages introduce such variety. In a picture-perfect world, everyone should celebrate this. However, the world is not perfect. I think that the more love there is in this world, the better off we all are†¦ regardless of whom it is we love.

A Root Cause Analysis Essay

Healthcare facilities that are accredited by Joint Commission are required after a sentinel event to conduct a root cause analysis (RCA). A root cause analysis is conducted to determine the cause or factors that contributed to the sentinel event. A few things must be asked in the RCA such as who, what, where, why and how in order to identify the cause. After the cause of the sentinel event is determined and a corrective action plan has been put in place a failure mode and effects analysis (FMEA) could be conducted to reduce the likelihood that it should happen again. The scenario A 67 year old male (Mr. B) was brought into the emergency room for pain to left leg and left hip. The injury occurred when the patient had a fall due to him losing his balance after tripping over his dog. The hospital is a 60 bed rural hospital located in Mr. B’s hometown. Mr. B was brought in by his son and neighbor. Upon triage Mr. B was complaining of pain 10/10 on the numerical pain scale and his vitals were found to be stable. Mr. B has a history of impaired glucose tolerance, prostate cancer, and chronic pain which he is on oxycodone. The Patient states he had no known allergies or previous falls. Upon the nursing assessment Nurse J. has noticed that the patient has limited range in motion, his left leg has swelling and appears shortened in comparison to the right. Nurse J. has informed the ED physician which he came to his bedside for evaluation. Upon evaluation the physician decided that Mr. B needed to have a reduction of his left hip, due to the dislocation and will require a conscious sedation. Mr. B requires multiple doses of medication to achieve the desired sedation affect for the reduction. Once the reduction was successful Mr. B is left with son in the room where a full set of vitals were not continuously monitored and goes into respiratory failure which lead to the death of Mr. B. Staffing on this day is the day of the event consisted of a secretary, emergency department physician (Dr. T), and two nurses (one RN and one LPN). A respiratory therapist is in house and available as needed in this six bed ED and sixty bed hospital. Events At 3:30pm- Mr. B was taken to ED for left leg and left hip pain from a fall. Pain is a 10/10 vitals include 120/80 blood pressure (BP), 88 heart rate (HR) and regular, 98.6 temperature, (T), 32 respirations (R), 175 lbs.. At 4:05pm- Mr. B was given Diazepam 5mg IVP which had no affect after 5min. At 4:10pm- Dr. T orders 2mg of hydromorphone to be given to Mr. B. At 4:15pm- Mr. B was given 2mg of hydromorphone IVP. At 4:20pm- Dr. T is not satisfied with level of sedation and orders Mr. B to be given 2mg of hydromorphone, and diazepam 5mg IVP. At 4:25pm- Mr. B appears to be sedated and reduction of his (L) hip takes place. The patient remains sedated and appears to have tolerated the procedure. The procedures concludes at 4:30pm. No distress is noted, patient is placed on monitor for blood pressure to be taken every 5 minutes along with pulse oximeter but no supplemental oxygen or ECG leads (monitors cardiac rhythm and respirations) was placed on patient at this time. At 4:30pm- Nurse J allows Mr. B’s son to remain in the room with him as he is being monitor by blood pressure machine only. Nurse J leaves the room. At 4:35pm- Mr. B vitals are BP 110/62, O2 sat is 92% still no oxygen or ECG leads are on patient at this time. EMS is transporting a patient in respiratory distress, lobby is beginning to get congested. LPN and Nurse J. in the process of discharging 2 patients and are checking in the patient that EMS has transported in. LPN enters Mr. B’s room and resets his alarming monitor that was showing a sat of 85% and restarts the B/P to recycle. LPN does not supply oxygen and does not alert Nurse J at this time. Management is not notified that patient acuity and patient load is increasing. Nurse J is now fully engaged with the emergency care of the respiratory distress patient. At 4:43pm- Mr. B’s son comes out of room and informs the nurse that the monitor is alarming with vitas of B/P 58/80 O2 of 79%. The patient has no palpable pulse and is not breathing. A STAT code is called and the son is taken to the waiting room. The code teams arrives places Mr. B on cardiac monitor where he is in ventricular fibrillation and the team begins resuscitative efforts. CPR is started and the patient is intubated. Mr. B is defibrillated and reversal  agents, vasopressors and IV were started. At 5:13pm- After 30 min of interventions the ECG returns to a normal sinus rhythm with Mr. B’s B/P being 110/70. The patient is completely dependent on the ventilator, his pupils are fixed and dilated and there is no spontaneous movements. The family as asked for the patient to be transferred out to a tertiary facility for further advanced care. Outcome Seven Days later Mr. B has died. The family had requested that life-support be removed after brain death had been determined by EEG’s. This is a sentinel event. Investigation of sentinel event should begin with a Team and method of investigation. Interdisciplinary team included in the RCA should include the Director of Nurses, Nursing Supervisor, Risk management, Nursing Coordinator, and Manager of the department. Once the team is put together the RCA should be started. The team should set up interviews with all staff that was involved and present in the department the day the sentinel event happened. A complete chart review should be conducted by team. The policies on conscious sedation, staffing of department, and standardized work should be reviewed. When the cause is identified a corrective action plan should be conducted. The corrective action plan will allow a series of projects can be put in place to help create or change polices if needed. The new or changed polices should be put into education models to teach to current and new staff as needed. The Root Cause Analysis Causative factors- (why it happened) determined cause Individual’s cause factors Nurse J did not follow procedure for conscious sedation. The patient was not placed on continuous B/P, ECG, and pulse oximeter throughout the procedure. Respiratory Therapist was not informed of the conscious sedation. LPN did not address low o2 saturation of 85% between the 4:35pm-4:43pm. Dr. T did not take in account of the patient’s weight and chronic pain medication use. Nurse J did not question the medication that Dr. T ordered. Team’s cause factors Management was not called and informed of staffing needs and acuity of patients. Back up staff was not called in to help when acuity and patient load had increased. Commination between Nurses and Dr. T were not present when the patient began to decompensate. Management /Organizational cause factors Unsafe Staffing at ED. There was not enough staff present to safely manage emergencies in the ED. RCA Findings: Errors and/or Hazards 1. Per protocol the patient was not hooked up to the proper monitoring equipment at the bedside. The facility procedure police called for continuous B/P ECG, and pulse oximetry during and after procedure until patient meet the discharge criteria. The nurse should have remained with patient during the recovery period. Crash cart with defibrillator was not present during the procedure nor was the proper reversal agents that could reverse the medication given for sedation. 2. Nursing staff communication was very poor. LPN did not notify Nurse J or ED physician when the patient’s o2 saturation dropped down to 85%. Oxygen was not placed on patient when O2 saturation dropped which led to respiratory failure causing the patient to code and eventually led to Mr. B’s death. 3. Communication between ED staff and management lacked when staffing needs increased. Patient safety was put at risk when the patient load and acuity increased in the ED and the staffing did not increase. Staffing shortage caused the nurse and nursing support staff to attend to other patients and leave Mr. B unmonitored which led to respiratory distress due to the patient being over medicated for sedation which led to respiratory failure and eventually led to Mr. B’s death. 4. The ED physician did not request the patient be transferred to the nearest trauma center due to lack of recourse’s in the emergency department. Recommended Corrective Action Plan/Change Theory/Improvement Plan 1. Improved patient safety during conscious sedation: Effective immediately all conscious sedation procedures will be conducted per protocol. Within 10 days the conscious sedation procedure should be evaluated by a committee to ensure the best practices are being used. Within 30 days of this RCA all  staff should be educated on conscious sedation protocol. All nursing staff should use review protocols for conscious sedation before a conscious sedation procedure is to take place. 2. Communication within the department should be evaluated immediately by a group of staff members to find out where the miscommunication failure lies. This could be that the nursing support staff is unaware of the parameters that should be reported to nurse or physician. With 10 days of this RCA a policy on documentation of communication should be put in place to ensure that all nursing staff are documenting the communication of a patients change in status has be reported to physician. Effective immediately all nursing support staff should be educated on parameters that should be reported to nursing staff and physicians. This should be put into a policy along with documentation of communication. 3. Improved patient to nurse ratios: Management should put in place a safe nurse to patient ratio for the emergency room. Communication policy between department and management should be put in place effective immediately to ensure that no other patient should be placed in harm’s way due to staffing shortage. The emergency department should be put on diversion if the patient load and acuity places patients at risk for harm in any manner. A copy of the RCA should be given to management and leadership. Management should share the finding with all emergency department staff. Feedback should be done 30 days after corrective action plan or change theory have been put in place to ensure that everything that has been put in place is effective for the department to improve patient safety. Constant reevaluation of patient safety should be conducted and feedback given to improve patient safety by all providers involved. Management will continue to ensure that all staff follow all protocols to ensure that patient care and safety are not compromised. At a 90 days bench mark after the corrective action plan has been put in place management should revisit the any changes made to protocols and polices to ensure compliance and effectiveness is still in place and reevaluate the process to ensure patient safety. Failure Mode and Effects Analysis (FMEA) A Failure Mode and Effects Analysis is proactive versus the RCA which is reactive. A FMEA assesses a process for risks of failures or adverse effects of a process and prevents them by correcting what is wrong proactively  (Institute for Heathcare Improvement, 2004). A Healthcare facility may use FMEA tools on the Institute for Healthcare Improvement website to evaluate a process in the facility. This tool will calculate a risk priority number (RNP) of a process, evaluate the impact of the process and the changes that are being considered, and tract the improvement over time (Institute for Heathcare Improvement, 2004). PRE-FMEA 1. Step one: Select a process to be evaluated with FMEA. The FMEA for this paper will focus on the conscious sedation protocol. 2. Step Two: Recruit a multidisciplinary team and include a member from every department that may be involved or affected. This team for the conscious sedation protocol should will include. Registered Nurse Physician Management Pharmacist Respiratory therapist A member from Legal Laboratory Tech Emergency Department Tech 3. Step Three: Information needs to be gathered by the team. A list of steps in the process being evaluated should be put together or even an outline of steps would be helpful to the team. All internal and external data, clinical practice guidelines, current policies and procedures, current literature and any other information that may pertain to the process that is being evaluated. For the purpose of this paper we would use data on outcomes of conscious sedation protocols, RCA’s on bad outcomes, clinical practice guidelines and any research documentation that would aid in best practices for conscious sedation. Team meetings should be structured with an agenda. A leader or primary person with extensive knowledge of the FMEA knowledge (Department of Defense Patient Safety Center, 2004) 4. Step Four: The Team should list the failure modes and causes. In each process all failure modes should be listed, and then for each failure mode a list of possible causes should be listed as well. In this scenario we will use this as an example Preparing medication Wrong medication prepared Wrong dose prepared 5. Step Five: A Risk Priority Number (RPN) will be assigned to each failure mode for the likelihood of occurrence, for the likelihood of detection, and for the severity. This step is also known as the three steps FMEA. The RPN is a numerical rating. For this scenario here is an example Likelihood of Occurrence: This will measure the likelihood a failure mode is to occur. The score range will be 1-10 with 1 meaning it is very unlikely to occur and 10 meaning very likely to occur. Example- Wrong medication prepared = 5 Likelihood of Detection: This will measure the likelihood a failure mode is to be detected if it should occur. The score range will be 1-10 with 1 meaning it is very likely to be detected and 10 meaning very unlikely to be detected. Example- Wrong medication prepared = 6 Severity of occurrence: This will measure the severity of the failure mode should it occur. The score range will be 1-10 with 1 meaning no effect and 10 will be death should a failure mode occur. Example- Wrong medication prepared= 9 6. Step Six: The team will evaluate the results. For each failure mode the three scores are multiplied with each other. The failure mode with the highest RPN will be the one that will be evaluated by the team to ensure patient safety. The higher the RPN a failure mode has the higher the potential for harm it may cause. The RPN score can be as high as 1,000 and as low at 3. Example- Wrong Medication Prepared Occurrence- 5 Detection- 6 Severity- 9 5x6x9= overall score =270 7. Step Seven: An improvement plan will be made based on the RPN. Likely to Occur. Have a triple check put in place. Have team attempt to eliminate all possible causes. Example-Have medication scanned when pulled from Pyxis to check providers order. Have patient scanned before medication may be prepared to check providers order. Have patient and medication scanned to ensure correct patient with the correct medication and proper providers order. Unlikely to be detected. Look for warning signs that the error may not be detected. Use data from any previous or prior errors. Severity. Use any data available to determine severity of error. Make available any and all resources to prevent further errors and severity of errors. Final Step- The final step in the FMEA is to plan an observation or test. A plan should be clear of its objections and should have some sort of predictions or outcomes. During the test all data should be documented. In this data collection phase all observations including problems or unexpected issues should be documented and later evaluated. After the test is complete and all data collected the team should meet for analysis of the data. A summary of the analysis should be documented. All changes or modifications to the process will be based on the test and analysis of data conducted. Any and all changes should be communicated to all staff members. These changes may or may not show improvement to the process, this is why constant reevaluation of all process should be conducted and any feedback should be given to leadership for the reevaluation of the process. Nurses play a vital role in health care. Nurses have the most contact with a patient. Nurses carry out any orders and or processes. A nurse is the patient advocate, they are the ones who will advocate for patient safety. Nurses are the advocates who will be looking for evidence base practices to improve patient care and patient safety. Improving quality of care for each patient will improve the outcomes for each patient. References Department of Defense Patient Safety Center. (2004, 12 26). Failure Mode and Effects Analysis. Retrieved from FMEA Info Centre: http://www.fmeainfocentre.com/handbooks/FMEA_Guide_V1.pdf Institute for Heathcare Improvement. (2004). Failure Modes and Effects Analysis (FMEA). Retrieved from Institute for Heathcare Improvement: http://www.ihi.org/resources/Pages/Tools/FailureModesandEffectsAnalysisTool.aspx

Ceo Duality Essays - Corporate Governance, Management, Corporate Law

Ceo Duality Essays - Corporate Governance, Management, Corporate Law Ceo Duality October 22,1999 Term Paper Separating the Board Chairperson and Chief Executive Officer: Pro and Con & Rebecca Hundley I Introduction Numerous reports on corporate governance have emphasised the desirability of increasing the number of outside directors on boards. An equally important and related issue is a growing insistence that the role of chairman and chief executive should be separate, though on this issue there is less unanimity in the U.S. than in other countries. Choosing the right Chief Executive officer is the key task for the board of directors. Pressure on chief executives to perform in ever decreasing time frames makes it essential that the CEO and the Board work closely together. An effective chief Executive will drive company strategy, lead the top team and fulfill shareholder ambitions . A good CEO will transform Board dynamics by keeping an open line of communication, placing a high value on Board input, and promoting the belief that management and the Board is working toward common goals. The average Board size is between eight and nine members. It used to be that Boards were constructed of executives with one or two non-executives; but trends are swiftly driving executives out of the boardroom as even the CEOs familiar role as chairman has been called into question. There has been a notable shift from executive director to non-executive director in the boardroom. The supposed advantages to these changes are to provide greater board independence from management, greater objectivity, and a representation of multiple perspectives. Bosch believes that the fundamental principle underlying this composition is accountability; if you have strong independent directors, a separation of the Chair/ Chief executive role will safeguard accountability . An opinion widely held is that separating the role of chairman from chief executive- would secure a board sufficient power to challenge CEO dominance. Although in many cases that rationale holds true, there are considerable benefits to CEO duality. Researchers have suggested that chairman/chief executive duality is a double-edged sword . While some stockholders are put off by the absence of board control and checks and balances, others are reassured by the presence of unity of command and the absence of potentially acrimonious conflict between strong-minded individuals. Finkelsein and DAveni found that a major factor in divining the success of this duality was the level of CEO informal power. Either perceptual or objective data can be used to measure informal CEO power. Although some researchers have used perceptual measures of power, power is a sensitive subject for many managers. In using perceptual measures, a researcher assumes that social actors are knowledgeable about power within their organizations; informants are willing to divulge what they know about power distributions; and such a questioning process II Advantages of CEO Duality When it comes to insiders versus outsiders on the board, a predominant role for insiders finds support more often, probably because insiders are more familiar with the issues, the technology, and the practice of the firm . Only they who are deeply involved and can make it work add value. It is simply not viable for twice removed outsiders, no matter how expert, to provide anything other than a cursory perspective and maybe act as an eventual deterrent to abuses of executive power. According to organizational theory, this CEO duality can establish strong, unambiguous leadership . By consolidating two of the most prestigious offices in a company stakeholders are often reassured, because it clarifies decision-making authority . An additional problem with nonduality is that it weakens and disrupts CEOs ability to manage the task environments their organization faces. For example, several laboratory studies suggested that the participation of constituencies who review negotiator action lead to less effective and more difficult negotiation processes. As a result, The reasons the positions of chairman and CEO are usually combined is that this provides a single focal point for company leadership(Anderson/Anthony) A powerful and effective CEO creates an image of stability and instills a sense of well being to its employees as well as its shareholders, projecting a clear sense of direction. III Negative aspects of CEO Duality When a companys chief executive officer is also the chairperson of its board, directors often have contrary objectives . Boards of directors are charged with ensuring that Chief Executive Officers

Free Essays on Suicide In Shakespeare

give me a immense feeling of sorrow and pity for Hamlet because it must take a lot of pain and suffering for someone to wish to take his own life. That is not something I fell is right, but I can understand the reason why Hamlet wants to die. Hamlet also expresses that there is nothing left in this world for him to live for. This feelings are not only expressed by Shakespeare through Hamlet, but it I have seen it the world today. For example, in the movie What Dreams May Come the death of a woman’s husband drives her to suicide because of the pain she feels, and she believes that there is nothing left for her to live for. She feels hollow and empty inside and decides the only way to end her pain and the feeling of emptiness is to take her own l... Free Essays on Suicide In Shakespeare Free Essays on Suicide In Shakespeare â€Å"O, that this too too solid flesh would melt, Thaw, and resolve itself into a dew! Or that the Everlasting had not fixed His canon ‘gainst self-slaughter! O God! God! How weary, stale, flat, and unprofitable Seem to me all the uses of this world!† -Hamlet -Act I, Scene 2, page 16 The topic of suicide is a controversial subject that many people choose to avoid, but Shakespeare approached the subject in his play Hamlet. I enjoyed reading how Shakespeare incorporated this subject into his play. He explores it mainly through the character of Hamlet. In the first four lines in the above passage, Hamlet wants to melt away, to disappear, or to exist no longer. He asks why God made suicide a sin because he does not want to cope with the grief of his father dying and his mother remarrying his uncle. The way Shakespeare conveys these feelings into the words of Hamlet are beautiful. He just does not say that I want to die, but uses eloquent words to allow the reader to visualize Hamlet’s thoughts in saying how he wants his flesh to melt, thaw and change to dew. I feel Hamlet’s strong feelings of pain when he asks why God had to make suicide a sin. Shakespeare’s words give me a immense feeling of sorrow and pity for Hamlet because it must ta ke a lot of pain and suffering for someone to wish to take his own life. That is not something I fell is right, but I can understand the reason why Hamlet wants to die. Hamlet also expresses that there is nothing left in this world for him to live for. This feelings are not only expressed by Shakespeare through Hamlet, but it I have seen it the world today. For example, in the movie What Dreams May Come the death of a woman’s husband drives her to suicide because of the pain she feels, and she believes that there is nothing left for her to live for. She feels hollow and empty inside and decides the only way to end her pain and the feeling of emptiness is to take her own l...