Project Management and Leadership in Construction Company

Project Management and Leadership in Construction Company Management There are several key elements that contribute to the success of any organization good management, inspirational leadership, proper service-orientation, and economic stability. Today, little emphasis is placed on the study of an organization’s infrastructure, function, and employees’ behaviors as they relate to successful accomplishment of the organization’s goals. Rather, these concepts are typically taken at face value and accepted for what they are. Employees work and accomplish at a minimum what needs to be done. Within the last century or so studies relating to behavior in organizations began to increasingly emerge resulting in the theoretical framework of this field. The three most notable facets of this framework includes: scientific management, human relations movement and bureaucracy. (Greenberg and Baron, p.12-14). This paper will provide brief information on the theoretical framework of an organization’s structures which in turn will provide an overview of types of management/leadership styles, an assessment of the New York City Department of Design and Construction’s (NYCDDC) style of management, and my personal management preference. According to Greenberg and Baron, one of the earliest pioneers in the study of behavior in organizations, Frederick Winslow Taylor, an engineer, sought ways to change the ineptitudes of employees. His research, the concept of scientific management, â€Å"not only identified ways to design manual labor jobs more efficiently, but also emphasized carefully selecting and training people to perform them.† The second facet of the theoretical framework, the human relations movement, was founded by Elton W. Mayo, an organizational scientist and consultant. The human relations movement â€Å"emphasized the social conditions existing in organizationsthe way employees are treated by management and the relationships they have with each other – influence job performance.† Bureaucracy, the third facet, was initiated by Max Weber, a sociologist. This form of organization is governed by a â€Å"set of applied rules that keep higher-ranking organization officials in charge of lower-ranking workers, who fulfill the duties assigned to them.† (Greenberg and Baron, p.12-14) Today, at least one form of the theoretical framework can be found in any existing organization, and, each form comes with a different type of management leadership style within the organization. So then, what is management? Management, as defined by the Merriam-Webster Online Dictionary as, â€Å"the conducting or supervising of something (as a business or people).† Management) Managers are endowed with the power to lead their organization. They must share that power in conjunction with other leaders in other parts of the organization and wield that power successfully over a designated staff within the organizational hierarchy. Since no one individual is gifted with precise knowledge on every topic, managers must: possess their own particular area of expertise, have an understanding of general organizational psychology, consistently offer creative thinking and innovative views on current issues facing the organization at different levels and guide (supervise) and motivate their team effectively along a predetermined path that will meet their corporate goals in order to insure the success of the entire organization. But not all managers supervise their staff in the same way. The different management leadership styles are noted in the Every Manager’s Desk Reference by Penguin Group, Inc. Some of the styles include: â€Å"dictatorship, the ‘almost’ democracy, the partnership and the transformational leadership.† According to the Every Manager’s Desk Reference In a dictatorship, managers, tend to keep decision- making powers and most critical knowledge to themselves. In the ‘almost’ democracy, the leader â€Å"strives to make sure the group is well informed and participating in the direction of the team as a whole.† In a partnership, the lines between the leader and the members of the group are blurred. The leader â€Å"becomes just one of the group.† And, in the case of the transformational leader, the leader â€Å"goes beyond trying to keep individuals and team performing at the status quohe/she is .one who has the power to bring about change in team members and the organization as a whole. (Penguin Group, Inc., p. 309-312) The theoretical framework and management style employed by an organization determines whether or not it is effectively leading its staff, enhancing and improving the morale and the overall work environment; and, thereby increasing productivity and output quality by employees. Based on some of the characteristics listed by Greenberg and Baron, which includes, â€Å"Formal rules and regulations; Division of Labor; Hierarchical structure; Authority structure, etc†¦Ã¢â‚¬  (Greenberg and Baron, p.14), the theoretical framework employed by the NYCDDC is that of a bureaucracy and a â€Å"directive leadership† style of management. Under a directive leadership, the managers â€Å"give specific guidance to their subordinates.† However, there are limitations associated with the directive leadership style of management because it can be â€Å"redundant, less effective and can reduce a worker’s satisfactions.† (12 Manage Premium, 2009) Additionally, adherence to the agency’s policies and procedures are a strict requirement. There is also a partnership style that applies within the NYCDDC’s various divisions/units. It is essential for all units of the agency to work cohesively together to ensure the agency’s mission, goals and objective of safe, successful, and expeditious completion of projects are met. The day to day management of any organization is one of the most essential factors that will either result in the success of that organization or to its eventual demise. In support of the above statement, Chris Lauer, in his book, â€Å"The Management Gurus,† states, â€Å"Who you are determines what you see and the way you see it†¦and who you are determines how you see others.† (Lauer, p 8) Although, the agency employs the directive leadership method, the style of management most applicable to my personality is, â€Å"the ‘almost’ democracy.† My work ethic parallels the basic characteristics of this style. I encourage â€Å"participation from all team members and welcome their opinions in setting new goals, procedures and direction for the unit.† (Penguin Group, Inc., p.310-311) This form of management creates a trusting environment between management and staff because it welcomes and encourages communication of staff views and ideas. All viable ideas are openly considered. With this style, any given team is motivated to do what is best for the team and for the organization as a whole while displaying adaptability and openness to ideas from peers. This style of management declares that an open line of communication is imperative to the successful relationship between management and staff, but, notes that management is still the leader and must have the final say on any matter without being necessarily obligated to explain its decisions. An assessment of my work ethic corroborate that I utilize â€Å"the almost democratic† style of management when managing my group. My overall personality characteristics reflect openness. I freely admit to not being knowledgeable in every topic. I welcome, encourage and respect the views of others. I can explain decisions I make without hesitation should they come into question. But, I have no difficultly asserting my role as the manager of my group. Overall, I believe that a strong work ethic, two-way communications, an innate trust and a shared common goal to succeed are key principles for positive group dynamics. I also strongly acknowledge individual success and outstanding performances as well as the shared success of the group. I believe that when the manager shares his/her success with the whole team the relationship between management and staff is strengthened and enhanced. The almost democratic style of management has its drawbacks. The line between management and staff can be precarious at times. For example, the staff can develop several creative ideas and suggestions concerning how to improve and increase employee morale. Although some suggestions can and will be taken into consideration and possibly utilized, a contributing member of the team might feel slighted if his or her idea is not adopted. That employee might possibly be offended by the final decision made by management which might result in that employee feeling less motivated. In conclusion, the theoretical framework of management I have outlined acknowledges the three organizational structures: scientific management or division of labor; human relations movement or people oriented; and, the bureaucratic method where managerial emphasis is placed on policies and procedures to run the organization. Along with these facets an array of management styles have been established and employed by managers throughout time. While the NYCDDC employs the bureaucratic management framework and the directive leadership and partnership styles of management, I follow the same organizational framework, but utilize the â€Å"almost democratic† style of management. However, I also, acknowledge that no manager can agree to use only one style of management at all times. Different situations, different groups of people and different tasks require different management styles at any given time. Deviation from the norm will be necessary for success to be accomplished. But, overall, a manager who tends to stay true to what works best for them and his/her subordinates will be viewed as consistent and reliable. My intentions are, whenever possible, to stay true to myself and my staff. The Organization As defined by Jerald Greenberg and Robert Baron in their book, â€Å"Behavior in Organizations,† an organization is â€Å"a structured social system consisting of groups and individuals working together to meet some agreed-upon objectives.† (Greenberg Baron, p.5) However, an organization is much more complex than what this simplistic definition seems to imply. Because it is a society of persons working together, the internal management of the individual steps necessary to attain the overall goals of the organization and the abilities of the managers and specialized workers are intrinsically linked together in order to determine the success or failure of that organization. The essence of any organization lies within its infrastructure. History The New York City Department of Design and Construction (NYCDDC) was established in 1996, with the objective of providing â€Å"design and construction expertise to over 20 City agencies.† (10th Anniversary Magazine Supplement, DDC, 1996, p.1) When originally established and this practice continues to date, the agency is a cultivated agency with the majority of its employees coming from two sister city agencies: the New York City Department of Transportation (NYCDOT) and the New York City Department of Environmental Protection. (NYCDEP) The NYC Department of Transportation (NYCDOT): City agency responsible for any work related to bridges and roadways, including the rehabilitation and reconstruction of them. The NYC Department of Environmental Protection (NYCDEP): City agency responsible for any work related to water mains, storm and sanitary sewers, including the rehabilitation and reconstruction of them. The relationship among these three agencies is that the NYCDDC is the managing agency for the NYCDOT and NYCDEP projects dealing with â€Å"design and construction related to roadways, sewers, water mains, correctional and court facilities; cultural institutions; libraries; and other public building, facilities and structures†¦Ã¢â‚¬  (DDC, 2006, p.ii) Management Philosophy/Style The New York City Department of Design and Construction (NYCDDC) employs over 1,200 employees in numerous professions, including architects, engineers, estimators, project managers, communications and community outreach, auditors and outside consultants. The scope of responsibilities of the 1,200 plus employees is divided into two groups: Design and Construction; the Design Staff covers all five boroughs while the Construction Staff is divided into divisions: Infrastructure and Structure Divisions. The Infrastructure and Structure Divisions’ staff are divided into New York City’s five boroughs: Brooklyn, Bronx, Queens, Staten Island and Manhattan. Although, there is an overall leadership team for the agency, each borough consists of a borough director that administers the day to day operations of his/her respective borough. Although some materials covered in this paper are reflective on the NYCDDC as a whole entity, but, the primary focus will be on the Infrastructure Division. The NYCDDC headquarters is located in Queens at 30-30 Thomson Avenue, Long Island City, New York, 11101, where it currently occupies four floors – the 1st, 3rd, 4th, and 5th floors. While there is an overall bureaucratic management structure that governs the agency and because of the physical structure of the agency, various management philosophies are employed at the headquarters location and the satellite or borough offices. Yet these different, but cohesive, philosophies are essential for the successful governance of the agency. For example, there is a directive leadership that governs the overall agency structure, but, also evident is a partnership amongst units such as the Design and the Office of Community Outreach and Notification Units. Directive leadership is the overall management style of the NYCDDC. Direction and management decisions come from the top and trickle down the organizational chart from management to key supervisory staff. This is internally the same for each unit within the agency and is based on the policies and procedures that must be followed. For example: each borough has a chain of command that is headed by the Borough Director. He/she directs his/her immediate staff (Deputy Borough Director and Borough level staff) on agency philosophy, key initiatives, changes or additions to current policy as well as what to do and how to perform their duties/tasks. These directives are then passed on to the Engineers-In-Charge, then onto the project support staff. The Borough Director oversees all projects in his/her borough and provides the consent/approval for most day to day operations. In addition, the borough director also has a chain of command that must be followed. Certain decisions/approvals have to be reviewed by subordinates as they travel up his/her chain of command: Assistant Commissioner, Associate Commissioner, Deputy Commissioner, and Commissioner. The numbers of approvals that are required from the members of the hierarchy depend on the scope of the issue. The Office of Community Outreach and Notification’s (OCON) staff are comprised of the Director, Deputy Director, Citywide Construction Liaisons, Community Board and Small Business Service Liaisons, Executive Assistant and Graphic Artist. They work in tandem with each of the Borough Office’s Staff – Director, Deputy Directory, Engineers-In-Charge, Resident Engineers, Project Liaisons, and Office Management. This direct partnership between the two entities facilitates the exchange of information necessary to keep all individual projects moving forward. This partnership also helps to address and eliminate any and all complaints and concerns of the affected communities where the work will be or is being performed. Mission The New York City Department of Design and Construction’s (NYCDDC) mission, â€Å"To Deliver The City’s Construction Project In A Safe, Expeditious, And Cost-Effective Manner While Maintaining The Highest Degree Of Architectural Engineering, And Construction Quality.†(DDC, 2006, p.i) With such an overreaching and specific mission statement, all of the organization’s personnel must strive on a daily basis to meet the fundamental goals and objectives set forth by the agency. Goals A goal is defined define as, â€Å"the end toward which effort is directed.† (Goal. 2009) The goals of the NYCDDC are, to build and upgrade the infrastructure and public spaces provided by local government in order to ensure the health, safety as well as the economy of the City of New York. Objectives Objectives are defined as, â€Å"something that ones efforts or actions are intended to attain or accomplish; purpose; goal; target.† (Houghton Mifflin Company, 1995) The objectives of the NYCDDC are, to continue to achieve and maintain excellence in design and construction while adhering to safety and quality standards. The NYCDDC achieves its goals and objectives by continually recruiting and employing highly trained and certified professionals of all disciplines including engineering, architecture, construction management and administration. (DDC, 2006, p.ii) Internal Systems: Strengths and Weaknesses For any organization to succeed it is equally important to provide excellent goods and services to its clients while reviewing and addressing elements its internal infrastructure-the strength and weaknesses of the organization and its personnel. Human Resources: Paid and Unpaid The New York City Department of Design and Construction (NYCDDC) currently staffs approximately 1,200 plus paid employees providing skills needed to execute the daily requirements of projects in the design and construction phases in a timely and efficient manner. In addition to its full-time paid personnel, the agency also offers both paid and unpaid summer internships to students in all areas of the agency’s current working environment. General consensus among workers is they are underpaid and overworked. Employees of NYC agencies are hired under a particular title that comes with an associated salary range. The same rule of thumb applies when employed by the NYCDDC. An employee’s salary is based on the range to which that title has a minimum and maximum amount; if through an employee’s tenure that he or she max out at the range and still in the position hired then he or she will remain at that salary until their unions get involved. The City’s employee unions attempt to compensate its members with percentage and cost of living raises as contracts are renegotiated. Merit raises are sometimes awarded, although, they are few and far in-between. There are occasions when employees are asked to perform tasks beyond their normal required duties. In these cases grievances are usually filed in order to be compensated for out of title work. Additionally, employees of NYC agencies enjoy good job security as it is rare that city workers are removed from their positions. Interns at the NYCDDC experience a cross section of the daily tasks performed at the agency. These internships can often result in promoting the desire of a potential engineer or architect, or changing the focus to a completely different specialty or field. Committees and/or Boards The New York City Department of Design and Construction (NYCDDC) perform its duties under a chain-of-command organizational chart that clearly delineates the units, ranking of officials and the required approval process. Figure I illustrate the overall chain of command for the agency’s various units and Figure II illustrates the overall chain-of-command for the NYCDDC Infrastructure Division’s OCON unit. (See Appendix for the NYCDDC’s Organizational Charts). The NYCDDC’s strength lies in the vested time in developing and maintaining its infrastructure so that the agency could meet its goals and requirements without confusion or question of direct authority. However, the agency’s weakness is noted when at times, even in a structured environment, that things can be overlooked or tasks mistakenly believed to be the responsibilities of another department. Formal And Informal Groups Several formal groups exist at the New York City Department of Design and Construction (NYCDDC) which enhances the overall environment of the agency. These groups include Design and Construction Procurement Services or the Agency Chief Contracting Officer (ACCO). This group is responsible for â€Å"ensuring that the NYCDDC procures goods, services and construction in conformance with City regulations.† (DDC, 2006. p.31) The Project Review Service Unit consists of the agency’s architects and engineers who provide the creativity and oversight of a project in the design stages. The Office of Sustainable Design unit â€Å"identifies and implements cost-effective ways to promote greater environmental responsibility in building design.† (DDC, 2006. p.31) The Research and Development Unit studies â€Å"innovative technologies, construction materials, methodologies and management strategies to improve the design and construction of buildings and infrastructure in New York City.† (DDC, 2006, p.31) The Performance Metrics is when the NYCDDC utilizes the â€Å"Key Performance Indicator (KPI) program† to process the â€Å"Inter-related databases that maintain information about the agency’s projects, contracts, payments and support functions, as well as a multi-level reporting system which extracts data on critical processes in the agency’s operating divisions and presents it in an easy-to-read, yet comprehensive format.† (DDC, 2006, p.31) The Quality Assurance and Construction Safety Unit oversees that safety procedure are adhered to in every aspect of the project for all of the agency’s projects. The Geographical Information Services works with and utilizes the Geographic Information System (GIS). This system allows the agency to clearly oversee the project dimensions of all projects locations on an electronic map and allows the agency to appropriate coordinate their work with other entities. The Technical Supports group works prior to the onset of construction. They conduct investigations, monitor and provide information on â€Å"asbestos, lead, and other environmental contaminants†¦provide research, analyses and survey preparation for property-line, damage and acquisition, new buildings and all roadway, water and sewer projects.† (DDC, 2006, p.31) The Percent for Art Unit works with the NYC Department of Cultural Affairs to integrate arts into a project scope. And, the Peer Review program promotes and enables review and open discussion from the agency’s staff on design issues. (DDC, 2006, p.31) Informal Groups Whether at the New York City Department of Design and Construction (NYCDDC) headquarter office or at the borough office level, the agency encourages frequent informal group discussions. Among the groups are the lunch groups who meet on a daily basis to discuss socio-political-economical issues and the ethnic groups that celebrate religious and national milestones, etc. The strength of the NYCDDC lies both in its employees and in the groups listed above. The presence of both the formal and informal groups enhances, strengthens and excites the overall agency culture. The experience of attending these groups helps to encourage and educate all staff members to address the myriad of concerns the agency faces and promotes cultural diversity; this ensures that each employee feels welcome and accepted as part of his/her work environment. This acceptance helps to alleviate employee stress. As with any organization with such a varied cross-section of personnel, the weaknesses lies in conflicts of many kinds that can occur especially when employees allow personal issues to overrule their professionalism. Therefore, for that organization to be successful it must rely heavily on each individual staff member pulling his/her weight and performing to the best of his/her ability. Material Resources The New York City Department of Design and Construction (NYCDDC) provide an array of free public information materials for the communities they serve and educational materials for its employees. Prior to the onset and for the duration of most projects, the NYCDDC-Office of Community Outreach and Notification (OCON) releases several public information printed resource materials including: Start-Up Advisory Notice which provides essential project information distributed to all affected parties prior to the onset of any project; Project Brochure is the medium used to provide a detailed overview of the project; Bi-Monthly Newsletters provides an update on the project status Work Operation Notices provides all affected parties with work operations that may affect their daily routines including water shut-offs and so forth; Bus Cards are handouts that provides information to affected bus rides if a bus route will be affected because of a project and so forth. The education materials are designed to provide NYCDDC employees with essential information. Some materials include: Employees Manual which Provides employees with all the essential rules for being a successful employee of the agency; the Design Consultant Guide provides vital information including the goals and objectives on the design phases for all of the agency structures projects; the Design Construction Excellence: How the City is Improving its Capital Program is a publication that provides a review and explains the policy changes that were implemented and provides information of design and construction projects. The NYCDDC is a proactive agency that provides the community and its employees with an array of vital information and assistance. This sensitivity illustrates how important the agency values its image and credibility. A major concern is that the information provided to the user is easily accessible, comprehensive and understood by all. A weakness that applies is a manual should be applicable and understanding to all the agency’s personnel rather than a selected group. Constraints Due to its configuration, the New York City Department of Design and Construction (NYCDDC) have both structural and human constraints. Structural. The NYCDDC currently occupies by means of rental, four floors at its current location and has five respective borough offices. This is a costly endeavor for the agency because it has occupancy is five borough offices rather than one. Human (Political, Relationships) The NYCDDC currently employees over 1,200 employees in its overall structure. There are some noted political affiliations; for example, the agency’s Commissioner is appointed by the Mayor of the City of New York. More of than not, if an employee can assist in any means to find advance the career of a friend, associate, acquaintance, then that employee will assist in what means he or she can. There are often scheduling conflicts when planning meetings. These conflicts lead to delays in actions that may need to be taken thus inhibiting the progression of an issue. Additionally, because of the locations of most of the borough offices, traffic and parking are major issues. Because of the five borough offices, more often than not, relationships are formed through emails and telephones. Therefore, personal contact with coworkers is being eradicated at a hasty pace. Relationship To External Systems Collaborative Agreement with Outside Agencies on City/ Local State and Federal Levels. The New York City Department of Design and Construction (NYCDDC) has and maintain collaborative relationships with many municipal entities. These collaborations are essential to the daily operation of the agency’s work flow and for the successful completion of projects. The NYCDDC receives funding from these entities based on the client agency’s annual budget allowances and its specific objectives to be achieved. Accurate accounting is kept of how the monies are spent. There are times when an overrun will occur and additional funds are necessary for the completion of a project; an under-run also can occur when funds remain after the completion of a project. The municipalities, the NYCDDC collaborates which includes: the NYC Comptroller keeps count of all finances and provides oversight to ensure the proper ethical procedures are being adhered to. The Borough Presidents and the NYC Council are entities that collaborate with the agency’s project management on issues dealing with land and zoning matters or if these entities funded any project within their borough or district. The Client Agencies include several external agencies that work with the NYCDDC; these external agencies includes the twenty plus NYC agency clients including: Departments of Children’s Services, Environmental Protection, Parks and Recreation, Transportation and so forth; NYS Office of Court Administration; Office of the Chief Medical Examiner; New York, Queens and Brooklyn Public Libraries, and so forth where the NYCDDC manages the projects from the initial steps in design to the final stages in construction for the projects set forth by these agencies. The Mayor’s Office of Management and Budget provides the NYCDDC with services ensuring all finance related issues dealing with a project are dealt with properly and without conflicts. The NYCDOB is the city agency that provides the NYCDDC with any/all necessary and applicable permits for some projects to occur. The Mayor’s Office of Contract Services ensures that any project bidding operation is done in a fair manner with an open competition amongst contractors providing the opportunity for no conflicts of interest to happen. The NYCDDC collaborates with the fifty-nine NYC Community Boards to hold public meetings with their constituents when a project is being planned for their community. At these meetings, residents’ are given a presentation about the project and its impact on the community. An open forum follows so that concerns and opinions are addressed. The Utilities companies gas, electric, cable and telephone services is a very vital relationship. Clear, proactive cooperation ensures the progression of the project and limits the opportunity for problems surrounding limiting/eliminating services to their constituents. The NYCDDC’s OCON Unit is a proactive unit that reaches out to affected communities, ameliorates problems and concerns and addresses all public inquiries. The NYDDC collaborates with the NYC Art Commission to bring approved public arts to the appropriate projects. (DDC, 2006, p.29) The history, management philosophy, mission, internal and external systems all play vital roles in the structure of any organization. These entities must interact, have a directional flow and coexist with each other for the day to day operations of the organization to proceed smoothly. Since there are times when conflicts arise, it is imperative that such issues be dealt with properly and in an appropriate manner. For example, failure to hire the appropriate personnel can and will lead to the decrease in the services the agency aims to provide to its clients; hence, a decrease in the credibility of not only the employees but the reputation of the agency. The NYCDDC has a proven reputation for providing excellent goods and services to its clients. Its leadership role in implementing new facets of technologies and its innovative thinking when applying new management models into the agency’s overall infrastructure clearly enhance its ability to accomplish its mission statement. The Target Service Area For any business or organization to succeed in providing the professional services it offers, it first must assess, analyze and fully understand the service area(s) and the target audience(s) it hopes to provide its services to. The New York City Department of Design and Construction (NYCDDC) services the five boroughs of New York City by â€Å"building and upgrading the City’s infrastructure and public spaces.† (

Periodic Performance Review Essay

DEFINITION: A periodic performance review (PPR) is a self-assessment of standards all of which are applicable to a health care organization. The Joint Commission of Healthcare Organization conducts triennial surveys of health care organizations. The PPR involves an annual assessment of an organization’s performance. The PPR show the organizations performance in relationship to the standards set forth by the Joint Commission. The standards are measured by elements of performance. Some elements of performance require a simple response of yes or no while others require multiple possible responses (e.g., compliant, partial, and noncompliant). The PPR helps determines and organizations readiness for an accreditation audit PURPOSE OF PERIODIC PERFORMANCE REVIEW An integral component in the Joint Commissions accreditation process, PPR promotes continuous standard compliance through ongoing internal monitoring. Beginning in January 2006, the Joint Commission expects organizations to conduct annual self-assessment against applicable Joint Commission standards, develop plans of action to address identified areas of non-compliance and identify measures of success in the identified problem areas to validate resolution. At the mid-cycle point, the organization is expected to share information with the Joint Commission. The staff at the Joint Commission will work with the organization to refine its plan of action to assure that the corrective efforts are on target. To address concerns about the potential discoverability of PPR information, particularly where it is shared with the Joint Commission, the Joint Commission has established three options to the full PPR, for accredited-health care organizations: Option One: The organization performs the full self-assessment, develops the plan of action and measures of success (MOS), but does not submit PPR data to the Joint Commission. At the time of the complete on-site survey, the organization provides its MOS to  the Joint Commission surveyor team for assessment. Option Two: The organization remains accountable for conducting a full self-assessment and developing plans of action and applicable MOS, but does not submit PPR data to the Joint Commission. The organization undergoes an on-site survey, which will be approximately one-third the length of a typical full on-site survey. The organization receives a report of the survey activities. Option Three: The organization remains accountable for conducting a full self-assessment and developing plans of action and applicable MOS, but does not submit PPR data to the Joint Commission. The organization undergoes an on-site survey, as in Option Two, but no written documentation or written report of the survey is provided to the organization. Nightingale Community Hospital is completing a PPR to assess the readiness of the hospital for an upcoming accreditation by the Joint Commission. This analysis will include: 1. The current compliance status of the hospital. 2. Trends evident in the case study that may cause the organization to not be in compliance with regards of patient care as set forth by the Joint Commission. 3. A review of staffing of the hospital’s patient care unit with regards of the performance improvement standard by doing the following: a. An analysis of the data to determine the staffing patterns of the patient care unit. b. A plan to develop a staffing plan to minimize the number of falls in the patient care unit. CURRENT COMPLIANCE STATUS In reviewing the data of Nightingale Community hospital, there are a number of compliance standards the hospital will need to address to remain in compliance with the Joint Commission standards which fall into several broad accreditation functions 1) Environmental Care – the environment of care is made up of several areas in terms of patient care including the he building or space, including how it is arranged and the special features that protect patients, visitors, and staff, equipment used to support patient care or to safely operate the building or space, and people, including those who work within the hospital, patients, and anyone else who  enters the environment, all of whom have a role in minimizing risks. The self-assessment noted deficiencies with interim life safety measures (ILSM) which refers to the health and safety measures that are put in place to protect the safety of patients, visitors, and staff who work in the hospital. Environmental factors that include signs and pathways to an egress point, fire protection systems including smoke detectors (specifically noted in the self-assessment), fire suppression, fire extinguishers and fire alarm systems, smoke barriers, emergency evacuation plans, in additi on to many other items that contribute to the well-being and safety of occupants in the hospital or healthcare facility. 2) Nursing leadership – this specific deficiency noted out of compliance showed inconsistencies in nurses documentation and timeliness which affected morale 3) Record of Care – this compliance standard refers to all the data and information gathered about a patient from the moment he or she enters the hospital to the moment of discharge or transfer. The particular deficiency noted is verbal orders are not authenticated within 48 hours. This particular problem is noted under on several floors within the hospital 4) Life Safety – A particularly critical standard in terms of patient care that is crucial in terms of patient and staff safety. The self-assessment noted clutter in hallways and carts in the hallways as noted in the observations during the PPR rounds. 5) Information Management – this patient care standards refers to the whether the hospital has a written policy regarding the privacy, security and integrity of health information. The deficiency noted prohibited abbreviations found in nursing notes and or physician orders as noted in the chart review conducted the PPR rounds 6) Medication Management – this is an important component in palliative treatment of many diseases and conditions. To minimize harm, the hospital needs to develop an effective and safe medication system. The hospital deficiencies with this standard was noted in the staff interviews where it was shown nurses did not follow range order policy or could explain how this is executed. It was also noted the syringes were found unlabeled in the OR and Cath labs. 7) Provision of Care, Treatment and Services (PC) – these standards revolves around assessing patient needs and planning, providing and coordinating treatment and services. Several deficiencies noted in audit included day of procedure reassessment inconsistencies and absence of documented plan of  anesthesia 8) Universal Protocol – Hospitals are charged with developing guidelines for the implementation of the universal protocol for the prevention of wrong site, wrong procedure and wrong person surgery. There were several sentinel events noted in the self-assessment which appear to demonstrate an absence of a guideline for this crucial standard. A sentinel event is an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof. These events included lung biopsy side unmarked and a knee arthroscopy site not marked. 9) National Patient Safety Goals – The National Patient Safety Goals (NPSGs) have become a critical method by which the Joint Commission promotes and enforces major changes in patient safety in thousands of participating health care organizations around the world. The criteria used for determining the value of these goals, and required revisions to them, are based on the merit of their impact, cost, and effectiveness. Two findings noted in the observation during the PPR included unlabeled basins and pre-labeled syringes. 10) Medical Staff – The organized medical staff and the governing body collaborate in a well-functioning relationship, reflecting clearly recognized roles, responsibilities, and accountabilities, to enhance the quality and safety of care, treatment, and services provided to patients. This collaborative relationship is critical to providing safe, high quality care in the hospital. To meet this standard and to remain in compliance, the Joint Commission (JCAHO) requires accredited hospitals to examine and evaluate performance data for all practitioners with privileges on an ongoing basis as part of their Ongoing Professional Practice Evaluation (OPPE) initiative. It was noted in the interviews with the medical staff the OPPE process does not meet standards. CURRENT TRENDS IMPACTING COMPLIANCE In preparation for the audit, the self-assessment analysis included a review of current trends that may cause the organization to not be in compliance. Several major trends noted in the case study include Fire Drill History ( Environment of Care) – the data shows that the fire drills were not routinely performed in Nightingale Community Hospital that requires one drill per shift per quarter. There was an average of three drills per quarter with no consistent methodology for conducting the drills per shift  or floor. This environment of care standards observation as noted above in the previous section indicated smoke wall penetrations which could have been discovered in there were routine fire drills. Moderate Sedation Monthly Audit (Provision of Care, Treatment and Services) – Moderate sedation provides a minimally reduced level of consciousness in which the patient retains the ability to independently and continuously maintain an airway and respond appropriately to p hysical stimulation or verbal command. The data showed in the Endoscopy Department a lack of pre-sedation ASA (American Society of Anesthesiology) and no documentation plan of anesthesia noted in endoscopy. The data shows that in pre-procedure, during procedure, and post-procedure no documentation was consistently recorded. The trends show the first quarter had a high of 100% and low of 75% and a fourth quarter high of 100% and low 79%. Pain Assessment Audit (Provision of Care, Treatment and Services) – Pain assessment is diagnostic tool to measure the pain level of a patient before administration of a medication and following administration. The goal is assess the patient’s pain relief and thus the effectiveness of the therapy. The data shows that pain assessment and reassessment is consistently missing in the Emergency Department(ED). The data shows a trend of this occurring with a range of 65% to 82%. The data shows the other departments listed have a higher a level of compliance. 3E shows a range of 90% to 97%, whereas the Post-anesthesia care unit (PACU) shows a higher range of 95% to 99%. PI (Patient Injury) Data Falls 4E (Life Safety) – Falls in 4E were highly prevalent. The target goal for falls with injury is 0.62 per 1000 patient days. Several months (January, February, April, July, and November) experienced 0 falls. In contrast, the other months experienced rates varying from 1.72 to 5.6. Data suggest trends show a marked increase over the last 7 months as compared to the first five months of the year that the data was collected. The target goal for all falls is set at 3.21. This number was achieved in five months, with 2 months (January and August) experiencing 0 falls. The data for falls overall in 4E appears to conflict with the data shown for fall with injury. The data shows no falls for the month of August, however, August also reports 4.5 falls with injury. Also, the month of October shows 4.1 total falls vs. 4.37 falls with injury. This brings to mind the reporting of the data, which has to be in error. PI (Patient Injury) Data falls For the Entire Hospital (Life  Safety) – Overall, the hospitals falls and falls with injury are lower than that of 4E. That being said, trends show there is a rise in both categories over the course of the year. In total falls there were peak months in March and September showing 5.1 and 4.9 respectively. In falls with injury, three month April thru June showed no injury related falls. Overall, the falls with injury are below the target as a mean total for the year. That being said, data clearly shows a trend towards increase of falls with injury. Prohibited Abbreviations (Information Management) – The Joint Commission has sent forth a list of prohibited abbreviations that should not be used by healthcare organizations. This list includes but is not limited to medical terminology, disease states, units of measurement, and drug dosage forms. The use of abbreviations can lead to a misinterpretation of meaning which could use lead to an adverse event. The audit monitored the abbreviations â€Å"cc† and â€Å"qd† because they are the most frequently used prohibited abbreviations. Cubic centimeters are a measurement of volume and are abbreviated†cc†. It is the cubic amount required to hold 1 milliliter of water. If poorly written it can be misread as â€Å"U† for units, ml should be used instead of cc. The term qd† means once daily. However, it is often misinterpreted for â€Å"qid† which means four times daily or â€Å"qod† which means every other day. The word daily should be written out. Aggregate data for the audit included the ICU, Telemetry and floors 3E and 4E. These abbreviations should never be used. The data suggest a high prevalence of the u se of these abbreviations. The abbreviation â€Å"cc† was used far more frequently than â€Å"qd†. The monthly range for its use was 20 to 47 times monthly according to the data. By contrast the monthly range for the abbreviation â€Å"qd† was 10 to 25. The data suggest a steady trend in the use of prohibited abbreviations. Staffing Effectiveness (Nursing Leadership) – Effective staffing by definition is the competency, number, and skill set of staff in its relation to patient care and treatment. The data used by the hospital to measure effectiveness utilizes key indicators from clinical/service screenings and human resource screenings. This data is then analyzed to look at ways to access and improve staff effectiveness on a continuous basis. Clinical indicators include patient falls, patent falls with injuries, ulcer prevalence, and ventilator associated pneumonia (VAP). Human resource indicators include nursing care hours and overtime. The  care areas associated with this data were ICU (intensive care unit), 3E and 4E. The data suggests no trends in relationship to nursing hours and falls and nosocomial ulcers in 3E. In ICU, data shows a decrease in falls from previous year from 4.1 to 1.9 per 1000 patients. Of the 1.9, which represents seven falls, five occurred in the first quarter of FY09. VAP increased from 2.2 per 1000 ventilator days to 3.0 for current year. Trends show a decrease in falls however an increase in VAP. Trends also show a decrease in nursing care hours. In 4E, there was an increase in patient falls and nosocomial pressure ulcers. Falls increased to 4.37 per 1000 patient days as compared to 1.47 per 1000 the previous year. Trends shows there appears to be relationship with falls and nursing care hours which shows an increase. There was also a slight increase in nosocomial ulcers during the period which appears to be a relational trend. Verbal Orders Authenticated Within 48 Hours (Record of Care) – Data indicates a trend showing a decrease in verbal order authentication during the year collected. Quarterly averages show: Q1-84%, Q2-87%, Q3-73%, and Q4-81%. The first half year average is 85.5% as compared to second half year average of 77%. PERFORMANCE IMPROVEMENT STANDARD: STAFFING A) STAFFING PATTERNS – DATA In analyzing the data, 3E (Oncology) maintained a relative consistent range of hours in nursing care over the course of the year. Peak nursing hours were used in the month of October which corresponded with the lowest amount of fall prevalence. However, the second month with the highest amount of nursing care hours had the highest amount of fall prevalence. There is also a linear trend showing an increase in falls over the course of the year. Data shows a decrease in nosocomial ulcers over the same time period. Prevention of falls and nosocomial ulcers are a focus point of this unit due to patient population. Several staff members attended the NICHE program. The name stands for Nurses Improving Care for Health system Elders and is designed to improve recognition of age-related changes and increase nurses’ sensitivity. Nursing staff members who attended program shared knowledge with their colleagues and changes were implemented to improve patient care and outcomes. Changes included nurses prompting patients every two hours to  void while awake to decrease urgency which could lead to falling or incontinence which could lead to pressure ulcers. The unit’s nosocomial ulcers decreased from 2.76% in FY08 to 1.23% in FY09. The units’ year end falls average was 5.45 compared to previous years 5.57. The linear trend which shows an increase in falls over the course of the most current year indicates that more training is needed. 4E experienced an increase in nosocomial ulcers and falls during the past year. The relational trend in nursing hours shows an increase through the year. The trend towards ulcers also shows an increase in through the year. However, the peak month for nosocomial ulcers shows occurred during the month that the third fewest nursing hours were used. This does not indicate a relational trend. The number of falls in 4E increased sharply in the year compared with the previous year. The current year showed an increase average to 4.37 as compared to the previous year’s average of 1.47. The peak month occurred in December showing an ever increasing trend. The nursing hours increased over the course of year. Data appears to suggest a relational trend with nursing care hours and patient falls. ICU showed an increase in falls from 1.9 from the previous year’s average of 0.41. Five of the seven falls that occurred happened in the first quarter of FY09. There appears to be no correlation between nursing care hours and patient falls. VAP (ventilator associated pneumonia) increased from 2.2 per 1000 ventilator days to 3.0. This number indicates two infections versus one infection during the respective fiscal years. There appears to be no relational correlation with VAP and nursing hours. Due to the increase in VAP, the following actions were implemented that included: * VAP bundle implementation including sedation vacation * Mouth care protocol * Daily rounds with the intensivist B) STAFFING PLAN – MINIMIZE FALLS Based on the data, an initial conclusion can be drawn the number of falls decreased in 3E based on nursing staff after attending the NICHE Program and sharing information learned with colleagues the increase of falls prevalence through the year suggests more training is necessary. The other units could also benefit from more training conducted on a monthly basis with the  desired outcome to reinforce policy and to impact future accreditation reviews. Inpatient working conditions have deteriorated in some facilities because hospitals have not kept up with the rising demand for nurses. This situation has motivated some state legislatures to enact or consider regulatory measures to assure adequate staffing. These regulatory measures assign some minimum level of staffing that all hospitals must meet regardless of the types and severity of patients. The number of nurses is not always a mitigating factor in the reduction of patient falls. However, there are a number of variables which should be factored in reviewing the falls such as fatigue from mandatory overtime with patient care and time consuming but necessary administrative tasks such updating patient records and documenting physician and other medical orders etc. Model Staffing Patterns — In researching, various staffing models several require acute care hospitals maintain minimum nurse-to-patient staffing ratios. Required ratios vary by unit, ranging from 1:1 in operating rooms to 1:6 on psychiatric units. Most state legislation also requires that hospitals maintain a patient acuity classification system to guide additional staffing when necessary, assign certain nursing functions only to licensed registered nurses, determine the competency of and provide appropriate orientation to nurses before assigning them to patient care, and keep records of staffing levels. The Joint Commission recommends all nursing units be supervised by a registered nurse. Nursing Staffing Plan Based on Type of Care — Another factor for consideration is the knowledge, skills and ability of the individual nurse. The safety and quality of patient care is directly related to the size and experience of the nursing workforce, Such as thoroughness in documentation, following protocol, and work pace. A comprehensive staffing pattern will have to take this into account in terms of reviewing the effectiveness of the individual nurses to reduce the occurrence of incidents. The chief nurse must monitor the performance of the nursing staff on a continuing and ongoing basis.

Steps in Making Business reports

The importance of the report determines the kind of effort called for: – the amount of research – the length of the report – time spent in writing it to the importance of the subject – use of the report It is important that your readers to be identified, so that the style, format, and the tone of the report may be determined. Tone refers to the total emotional and intellectual effect of a passage of writing. Since tone reflects to feelings, the business report writer must take care that he does not cloud his purpose in writing the report with his emotions. The reader of the report must also be sensitive to the tone of the report. The following generalizations about tone may be considered in writing the report: 1. Reports that travel upward, especially to top management, generally, are written in a more formal tone than those that travel laterally or downward. 2. Reports circulates outside the company are usually more formal in tone than those kept within t he â€Å"family' for internal use. 3.Be generous with headings because report. 2. Words used must be simple 3. Sentences and paragraphs must be short 4. Coherence – provides transitional words between sentences and paragraphs which are expressed as therefore, yet, however, in addition to 5. Margins should be consistent throughout the report, and double spaced for easier reading 6. Illustrations (maps, tables, graphs, drawings, diagrams) give a clear presentation of data especially if any figures are used. After the first draft has been written and edit the report for mechanical errors or errors of facts.Are words correctly spelled? Do ideas relate to one another? Is the right word used? Here are a few examples to show how proper editing results in clarity and conciseness: Original: Sales for the month of July were, by and large, higher than they were for a similar period last year, but the difference is not appreciably so, at least to the extent where one might now consider sitting on â€Å"his success† so to speak. As a matter of fact, the increase was only approximates 4. 5% over last year's sales which were Just average for the industry.Edited: Sales for the month of July were approximated only 4. 5 percent higher than in the similar period last year. Although this is an improvement, it is not impressive and one should make every effort o increase this figure in the future. Original: The business executive has many duties to carry through in business nowadays. He is often called upon to make decisions involving the expenditure of funds, future corporate and movement of human resources. He must also attend many kinds of meetings which are professional in nature and scope.Moreover, he has counseling duties to his subordinates. And on some occasions he must serve as the company's representative to community groups. These are only few of the many tasks hat the modern business executive is expected to carry through. Edited: Today's modern business executive has many duties to perform. Some of these are: 1 . Decision making for the expenditure of funds, for corporate planning, and for the movement of personnel. 2. Attendance in professional meetings. 3. Counseling of subordinates. 4. Serving as the company representative to community groups.

Intro to Greek Life 12 Benefits and Advantages

Sororities and fraternities are an integral part of non-academic life on many university campuses. Since the founding of Phi Beta Kappa, the first fraternity, at William Mary College in 1776, these student clubs or social communities have been named after letters of the Greek alphabet—and the system of fraternities and sororities as a whole has been dubbed, simply, Greek life. Going off to college means so many new experiences—and one of those is the introduction to  Greek  life. As a parent, you hear about the houses, rush, hazing, and parties, and many potential concerns about fraternities and sororities. But theres a lot to Greek life. Heres the lowdown on the benefits and advantages of fraternity or sorority life, including a few youve probably never thought about—and one youll hope you never need: Housing: Depending on the college, Greek life can be not only an enormous part of campus social life but a primary housing source too. Freshman housing is not guaranteed at every university, so at the University of Washington in Seattle, for example, rush begins before classes even start. Many freshmen move directly into their Greek houses, not the dorms. (That said, not every Greek system is residential—some by choice, others because of city zoning regulations. Some sororities and fraternities maintain a house for social purposes, but all or nearly all their members live out, i.e., in the dorms or off-campus.)A ready-made social life: College can be a daunting proposition for a shy freshman, but Greek life provides an entire cadre of new friends and a full social calendar. Its not all toga parties either. There are philanthropic events, small-scale mixers and academic dinners with members favorite professors.Lifelong friends: A dormitorys population changes dramatically every fall. Students are usually grouped by class - in a freshman dorm or on a freshman wing - and their R.A. may be the only upperclassman within reach. Greek members, by contrast, live with nearly the same people for all four years, with a slight ebb and flow as seniors graduate and new pledges enter. Theyre mentored and led through the thickets of university bureaucracies by their older sorority sisters or fraternity brothers, and those close friendships tend to last a lifetime. Moreover, once theyre out of college, they maintain close ties with their Greek houses - and sister organizations across the country - via social networks.Study buddies: Theres no work involved in forming a congenial study group. A Greek house brims with instant study buddies and exam cram support. That said, your childs experience will vary depending on his academic priorities and his and his friends willingness to go to the library or another quiet location if the frat gets too boisterous.Academic boosts: De spite what you see on the silver screen, many sororities and fraternities take their members academic rankings very seriously. They may hold their own academic awards dinners, host professors at special dinners, and even post A-graded papers and exams on a Were so proud bulletin board. Some have rules about minimum GPAs as well. Again, your childs experience may vary. (See above.)Leadership: Greek houses are run by student councils, which offer members many opportunities to develop leadership skills. These councils usually consist of a president, a house manager or treasurer, and leadership roles in public outreach, philanthropy, social event planning, and member discipline.Business connections: Those lifelong friendships and their extended alumni social network become an incredibly helpful business network for members. Kappa Alpha Theta, for example, uses an online message board, dubbed the BettiesList, where members post news about job openings or internships at their companies, a partment rentals and offers of help in every major city across the United States.Philanthropic interests: Virtually every Greek house has a designated charity, for which they host fundraisers and awareness events. For many students, philanthropic work provides an important balance in a life filled with academic stress—or too much socializing. It can also be the start of a lifelong interest in a specific cause, court-appointed special advocates for abused and neglected children, for example, or the Childrens Miracle Network of childrens hospitals.Social skills: Despite the late 20th centurys mocking of certain social niceties, social skills are a critically important factor in the business world. Many Greek houses actually run etiquette classes for their members, and its not just folklore either. It includes lessons on setting guests at ease and building connections through small talk, whether its with nervous prospective members during rush or industry recruiters and CEOs at frat-hosted business dinners. The idea, of course, is that small talk leads to big talk—and small talk, which is all about establishing common ground, is an art form. Members also learn to host and organize a variety of events, such as mixers, awards ceremonies, and massive charity golf tournaments. The events range in size, with anywhere from 20 to 2,000 people. And they teach them how to dress, not only for toga parties but for business interviews.A limitless wardrobe: If your daughter doesnt have the perfect gown for the formal, a buddy does. There are, after all, 50 or more closets under a single sorority roof and everyones prom and homecoming dresses find new life in a sorority. (So do their Halloween costumes.)Food and housing costs: Depending on the campus, Greek life can be less expensive than the dorm alternative, even when you factor in social dues. And the food is nearly always better. Its prepared, after all, by a chef who faces his or her diners every single dayà ¢â‚¬â€not a central kitchen catering to tens of thousands.Aid in desperate need: Heres one you wont want to think about, but when everything comes crashing down at home—theres a death in the family or a grievous injury—its the sorority house thats going to get your child safely home with everything she needs. Its her 50 sorority sisters who will deal with the paramedics on the phone, book the plane ticket, pack the necessary luggage including, if necessary, mourning clothes from their own closets, and provide steady emotional support. Theyll tuck wads of emergency cash in her pockets, and drive her to the airport or all the way home. And theyll be there to pick up the pieces afterward too. Its a perk you hope youll never need, but its good to know that an incredible support network is there.