Research Articles Base

The National Transport Standards Commission (NTSC)

The National Transport Standards Commission (NTSC), a public law body, is empowered by statute to monitor public transport throughout the UK.  NTSC has the following powers and duties under the statute   1.a duty to consult with bus operators and with the public with a view to preparing reports for government and on the basis of those reports licences are granted. 2.To divide  the country up into regions with each region having a Director who is responsible for the day to day management of the region. 3.To enter into contracts with individual bus companies and to establish a basis for providing grant aid and subsidies to those companies. 4.To ensure that companies provide safe bus services and to this end to phase out buses over 15 years old over a period of 5 years.  Compensation to those operators is to be provided.  The statute states that “any decision of the NTSC on this matter shall be final”  5.To set up a committee to whom complaints about the service can be addressed.   ·         The area of law for examination is Administrative Law or Judicial Review of Executive. Primary Legislation has delegated power to NTSC and defined those powers. The important  legal question regarding public bodies relates  to whether actions taken and decisions made are within the powers delegated by Parliament and conform to the rules of natural justice. ·        Initial research consisted of reading A Carroll[1] and  H Barnett [2] to gain an overview of the topic. ·        Established that relevant case books include (insert) ·        Conducted web search. For an overview of judicial review seeURL[3] and the URL[4] proved useful in that it provided details on The New Rules on Procedural Requirements     Note: 1.There are several relevant text books and case books on the area to be discussed. It is not necessary to research all.  It might be advisable to read a basic text initially ie Butterworths Core Text Series Constitutional and Administrative Law or a text that sets out the major points of law relevant to the topic. It is then appropriate to read a more detailed account. 2.It may also be appropriate to do a general web search to acquire a general overview of the topic.  This wll often depend on the topic to be researched.   Consider the following   (i)                George is the Director of the Midlands region and has been employed for 5 years by NTSC.  It has always been the practice of the Board of NTSC to discuss with him changes to his working practices and problems in relation to his area of responsibility.  Last week he was informed that he was to be relocated to head office and that certain management benefits removed.  Advise George.   ·        This matter relates to the lack of consultation by NTSC ·        Established that procedural propriety, the third ground of challenge laid down by Diplock in Council for Civil Service Union v Minister for the Civil Service [5] includes both the failure to observe procedural rules laid down in statute and a failure to observe the rules of natural justice. Researched procedural ultra vires in statute but confirmed from problem facts given that there is no statutory duty to consult with Directors in these circumstances.. ·        Read the relevant section in A Carroll[6] on the rules of natural justice and in particular “the right to a fair hearing”. Noted the requirements involved to satisfy a fair hearing  and the fact that these will depend on all the circumstances. ·        Read the case of Ridge v Baldwin in Allen and Thompson[7] Noted that the decision was clear that the applicant should have been informed of the grounds on which the Committee proposed to proceed and given him a proper opportunity to present his case. What amounts to fairness will depend on the effect on an individual’s rights.  In George’s case relocation and the loss of certain management benefits may not amount to a substantial loss of rights.  More detail on the exact loss of benefit is needed. ·        Considered the implications of the concept of “legitimate expectation” on George’s position. Read the relevant section in A Carroll and H Barnett. Noted that a legitimate expectation can arise on the basis of past practice or established policy. ·        Researched the case of Council for Civil Service Union v Minister for the Civil Service at Current Legal Information[8]. The House of Lords ruled that were it not for the issue of national security the court would have upheld the appellant’s legitimate expectation to be consulted as the practice of consultation had been established since GCHQ had been formed. ·        Further relevant cases include R v Liverpool Corp., ex parte Liverpool Taxi Fleet Operators Association and R v North and East Devon Health Authority, ex parte Coughlan 1999[9]. In the latter case a promise given to patients that they could live “for life” at a home for the severely disabled raised a legitimate expectation that they would not be transferred elsewhere. ·        In conclusion George may be able to establish a right to  be consulted on the basis of promises made and previous policy.             (ii) The Snail Co. complete the process of registration but discover after 5 months that they have been refused grant aid.  They proceed by way of judicial review to challenge the decision but are told that this is not a public law matter. Advise the Snail Co   ·        The first issue relates to the Public/ Private law divide. ·        Clearly NTSC is a public law body. Read A.Carroll[10]. The established procedure for an action against a public law body is judicial review.The early cases show that ordinary actions taken against public bodies were considered to be an abuse of process. ·        Read the case  of O’Reilly v Mackman1983 in Allen and Thompson[11]. The case confirmed the  consequences of  using  ordinary procedure to challenge the decisions of a public body.  The prisoners were left without a remedy because the time limits for judicial review had passed and they had proceeded by way of writ which was considered to be an abuse of process. ·        Established the need to make a distinction between private and public law issues and the fact that cases can involve public and private law issues.  Read the case of Roy v Kensington and Chelsea and Westminster FPC[12]. Noted that the litigant had private law rights arising from the contractual relationship he had with the FPC, a public law body. ·        And so on.    (iii)  NTSC submit a report which is highly critical of the Northern region.  They neither consult with the operators nor members of the public. Swift Ltd are refused a licence on the basis of the report. Advise Swift Ltd   (iv) NTSC propose the imposition of conditions on all bus companies, one of which is that buses should be painted green. Advise Bill who is one of the operators.    (v) NTSC impose a charge on all companies which register with them.  Furthermore they also to set up a network of garages which operators must use for servicing vehicles.  Advise   (vi) The Antique Co. are told that the buses they run which are 16 years old will be taken immediately out of service. When they propose to challenge the decision of NTSC they are told that the decision is final and cannot be challenged by review   (vii) Members of the Southern region wish to make complaints and suggestions to the committee.  They are told that all matters will be dealt with by the executives of NTSC.  Advise the Southern region operatives.   (viii) GoPublic, a voluntary organisation committed to the improvement of public transport and having several thousand members seeks to challenge a policy decision of NTSC.  They have been advised that they may not have locus standi.  Advise.       [1] Constitutional and Administrative Law 3rd Edition  Chapters 14-[1]1 [2] Constitutional and Administrative Law Chapters 26- 27 [3] http://www.publiclawproject.org.uk/simpleguide.html#11 [4] http://webjcli.ncl.ac.uk/2000/issue5/cornford5.html [5] Civil Service Union v Minister for the Civil Service 1984 AC 374 [6] Constitutional and Administrative Law 3rd Edition  Chapters 14-[6]1   [7] Cases and Materials on Constitutional and Administrative Law. [8] http://www.smlawpub.co.uk [9] Barnett Constitutional and Administrative Law Chapter 27 [10] Chapter 17 Exclusivity. [11] Cases and Materials on Constitutional and Administrative Law 7th Edition [12] Barnett Constitutional and Administrative Law Chapter 26 Credit:ivythesis.typepad.com

The National Transport Standards Commission (NTSC)

The National Transport Standards Commission (NTSC), a public law body, is empowered by statute to monitor public transport throughout the...

Marketing Orientation: The Basis of an Effective Marketing Strategy in UK

Marketing Orientation: The Basis of an Effective Marketing Strategy in UK   Abstract This article addresses the paucity of research into the development of an effective marketing of firms in the UK. The need for UK marketers to balance their external focus on customers and competitors with a complementary internal focus on service processes and employees recognized and the academic discourses on market orientation is reviewed. The contribution of internal marketing, and its associated internal focus, to complement the external focus of market orientation is explored.   Introduction As the cornerstone of both marketing and strategic management, (Greenley, 1995), market orientation has been presented as the implementation of the marketing concept (Kohli and Jaworski, 1990). Despite the broader focus of market orientation in UK on exogenous market factors (e.g., competition, regulation) that affect customer needs and preferences and current as well as future needs of customers (Kohli and Jaworski, 1990), it does not challenge the spirit of the first pillar of the marketing concept, customer focus. This narrow external vision has endured for nearly forty years, despite changes in the service requirements of today s markets and the need for a complementary internal focus. Gummesson (1994) identifies this narrow external vision as a marketing myopia and identifies the need to broaden the management focus of the firm, calling for research examining the importance, costs and contribution of other relationships, including relationships with employees for a more effective marketing orientation. A market orientation is an organization culture in which all employees are committed to the continuous creation of superior value for customers. Being the organization’s culture, a market orientation is necessarily cross-functional and thus radically different from a marketing (single-function) orientation. A market orientation consists of three components customer orientation, competitor orientation, and interfunctional coordination. It is measured as a continuous variable. The greater a business’s market orientation, the greater its ROI, sales growth, new-product success, and customer retention. The market orientation performance relationship is observed in dynamic as well as static analyses. There is no evidence that either market condition or industry type moderates the market orientation performance relationship. A market orientation can best be created by results-driven processes rather than by programmatic change efforts. Top management plays a vital role in creating and maintaining a market orientation. However, a market orientation also requires that the organization’s market units, not the top management, have the ongoing authority for managing customer satisfaction. This paper is split into three main sections. The next section reviews the academic discourse on the concept of market orientation as a tool in effective marketing and examines the relationship between the firm’s employees and its marketing orientation. Marketing orientation is reported to have important consequences for effective marketing.   Market Orientation and Marketing Orientation Market orientation has been proposed as the cornerstone of both marketing effectiveness and strategic management (Greenley, 1995). It is differentiated from marketing orientation y its broader focus. Market orientation, in contrast to marketing orientation, puts the marketing emphasis on customers, competitors, and organizational issues and has been defined empirically and validated as a way of improving business performance. The literature dealing with market orientation, however, shows remarkable inconsistency in defining the concept as either a business philosophy or management behavior. Several studies explore the relationship between marketing orientation and some output measure such as profitability or customer satisfaction, see for example Day and Nedungadi (1994), and Pelham and Wilson, (1996). Perhaps the most significant finding for theorists and practitioners is the consistent evidence that being marketing oriented does improve marketing strategy. This has been found to be true for large firms (Jaworski and Kohli, 1993, Day and Nedungadi 1994) as well as for small firms (Pelham and Wilson, 1996) for product producers, (Narver and Slater 1990), as well as service suppliers (Naidu and Narayana, 1991) and for-profit (Slater and Narver, 1994) as well as for not for profit (Wrenn, La Tour and Calder, 1994). Research on marketing orientation has centered around understanding the construct and examining its relationship to performance (Kumar and Subramanian, 2000). Two important studies sought to define and operationalize market orientation. Based on an extensive review of the literature on sustainable competitive advantage and marketing strategy, Narver and Slater (1990) operationalized market orientation as consisting of three dimensions: customer orientation, competitor orientation, and inter-functional coordination. Using both a literature review and field interviews of managers, Kohli and Jaworski (1990) operationalized the market orientation construct as consisting of three basic components: intelligence generation, intelligence dissemination, and responsiveness. Intelligence generation extends beyond collecting information about customer needs and preferences to include information about the entire task environment confronting an organization. To be market-oriented, an organization has to communicate, disseminate, and often “sell” market intelligence to relevant departments and individuals in the organization. (Kumar, Subramanian, & Yauger, 1998). And finally, the market-oriented organization responds to or acts on the market intelligence gathered and disseminated. The two approaches to defining the market orientation construct are similar in their emphasis on behavioral issues (Greenley, 1995). Both groups of researchers identify the construct as consisting of collecting information about the task environment, disseminating the information to all organizational units, and readying the organization to act on the information to provide value to the customer. Both approaches are similar also in operationalizing the market orientation construct as a multi-dimensional concept, where each dimension measures a different feature of market orientation. Finally, both studies view an organization’s magnitude of market orientation as the sum total of its relative emphasis on the different components of market orientation. It is conceivable that a given magnitude of market orientation may be highly skewed to either customer emphasis or competitor emphasis. The literature on sustainable competitive advantage supports this notion. While some authors (e.g., Peters & Austin, 1985) suggest that customer emphasis is the most important component, others (Jaworski & Kohli, 1993) contend that a high magnitude of market orientation will yield superior performance only when swift managerial responses follow, regardless of the focus.   Marketing Orientation and Effective Marketing in the UK It may be reasonably expected that if managers buy into the marketing orientation philosophy, they would also show a level of consideration for employees. It appears, therefore, that managerial consideration is an important component of marketing orientation and how managers respond to the wants and needs of employees forms one of the dimensions of the construct. Common to all conceptualizations of marketing orientation is the need to collect information about the internal environment. This information also has a broader focus than employees. It involves the generation of internal information, about the current satisfaction of employees with their working conditions and employment activities, the factors that influence satisfaction and the important attributes of job offer that employees consider. There is also an external focus relating to the activities of competitors in the employee market and generating intelligence about employment conditions with firms competing for the same employees. A range of industries seek effective customer contact staff, and competition for employees may be from sectors not normally considered by marketing intelligence. It appears therefore that marketing orientation may be operationalised as an internal marketing orientation in a similar manner to the operationalisation of external marketing as market orientation. At this juncture, it appears that marketing orientation may contribute directly and indirectly to the marketing performance of the firm. The direct impact of marketing orientation on firm performance has been suggested by Pfau et al (1991), as improving service quality; as increasing employee and customer satisfaction and Gummesson (1994), as decreasing staff turnover and reducing training costs. Indirectly market orientation may contribute to the effective marketing strategy of the firm. Analysis Achieving effective marketing involves serious issues and decisions which deserve disciplined consideration. Leading advertising agencies apply a planning process which identifies the critical decision junctures and issues to be addressed at each specific stage of development, working with clients to develop strategy and create marketing communications. A disciplined approach systematically guides the marketing decision maker through the following key decisions: What should my marketing orientation strategy be? Is my product line/service right? The first question is the most critical since the decisions made at this step in the process set the stage for the rest of marketing communications development. Research is especially important at this initial phase since the depth and breadth of information needed for planning strategies includes objectives such as:  Uncovering new opportunities for products and services to meet consumer needs. Identifying those consumers who represent the greatest potential. The key issues to be considered in the creation of the marketing orientation strategy must be approached from two perspectives: internal, in terms of business considerations, and external, in terms of the consumer’s wants and needs. The consumer is the other important source of information in creating the specific dimensions of the marketing communications strategy. Strategic research among relevant consumers helps to address these fundamental questions. It helps the marketer to understand the consumer’s “ABCs” — their attitudes, usage behavior and demographic and lifestyle characteristics. For instance, strategic piece of research for one client uncovered the existence of distinct segments of consumers within the camera market to which it could direct a different camera model. The segments differed significantly according to their attitudes, behavior, and characteristics. For example, within the segment profiles developed, the desire for sophisticated, complex features was a key differentiator between the kinds of people in one segment versus another. Through this product line diversification by segment and the segmented communications effort that accompanied it, the company was able to address each target group with the most relevant product message for them. Ultimately, this strategy helped it to expand the market and strengthen its position as market leader. In this case, companies’ marketing strategy would want to maintain and leverage the distinctive, appealing parts of the brand’s heritage and yet update it as well. With this research, specific visual, non-verbal stimuli were used to help understand how users were perceived and how that imagery related to the target consumers’ perception of themselves and their aspirations. The results confirmed the positive image traits of the brand but also indicated that certain other elements of its personality were not being projected, since the picture of the user and the self-image of its target audience were not in synch. The need for changes such as a more youthful presence was identified and the advertising approach in turn was modified with successful marketplace results. The basic questions marketers face at the final point include: What was the “effect” of the marketing orientation effort on the consumer’s mind in terms of awareness and attitudes toward the brand? What was the effect on consumer behavior in terms of purchase of the brand? Should the campaign continue as is, be refined and refreshed, or be replaced? The primary research tool to measure the effect on consumer attitudes is the tracking study among the target audience. These studies usually compare consumer attitudes at a point prior to a campaign’s launch to a point (or many) after a campaign has been established. Measures used within the tracking vehicle should be developed according to the strategy and objectives defined in the first phase of the process.   Conclusion Recent research has suggested a positive effect of market orientation, the implementation of marketing concept, on business profitability (Jaworski and Kohli, 1993; Slater and Narver, 1994) and salesforce behavior and attitude. Because of its potential effect on business performance, market orientation plays a key role in the formation of business strategy (Day, 1994). A marketing orientation does not only enhances the effectiveness but also reduces management waste by knowing what customers do not require. Employees and assets are two main resources of any organization. A measure of cost efficiency is how much sales, on average, an employee can produce. Another measure is how much sales can be generated from available assets. The association between market orientation and cost efficiency offers a promising opportunity for many service firms. While many marketing managers view a market-oriented campaign as expensive and often question its contribution to profitability, the present study shows that market orientation can actually lower operating costs and increase per employee contribution. Being customer-oriented enables the firm to learn not only what customers desire but also what customers do not need. As many firms are learning to be leaner in the21st century, UK managers may find that marketing orientation can be very useful. One purpose of this article was to explore the new expectations for a marketing orientation in an ever more demanding marketing environment in UK. Today, marketing needs to go beyond the traditional challenges of reflecting a brand’s positioning, communicating product benefits, and building awareness to establishing a Brand Character or a personality for the brand. This will better enable the products to form a bond with its target consumer. Today, marketing strategies are also expected to extend beyond the traditional media into the concept of “integrated marketing communications,” including public relations, sales promotion, and direct marketing efforts. This article also described the vast panorama of research issues that are at the heart of the marketing orientation and effective development process, and many of the research tools available to serve as a guide in making key decisions in this process. This article asserts that for marketing orientation to be effective in UK, marketers must improve its internal capabilities and at the same time be creative in researching and presenting the products to the public. An effective approach to such is the development of market orientation. This shall be the basis of an effective marketing strategy.   References   Day, G. S and Nedungadi, P., (1994), Managerial Representations of Competitive Advantage , Journal of Marketing, 58, (April), 31-44   Day, G. S., (1994), The Capabilities of Market Driven Organizations. Journal of Marketing, 58, (October), 37-52   Greenley, G. E., (1995), Market Orientation and Company Performance: Empirical Evidence from UK Companies. British Journal of Management, 6, 1-13   Gummesson, E., (1994), Using internal marketing to create a new culture. The case of Ericsson quality , Journal of Business and industrial marketing 2, (3), 23 28   Jaworski, B. J. and Kohli, A. K., (1993), Market orientation: antecedents and consequences. Journal of Marketing, 57, (July), 53-70   Kohli, A. K. and Jaworski, B. J., (1990), Market orientation: the construct, research propositions, and managerial implications. Journal of Marketing, 54, (April), 1-18   Kumar, K. and Subramanian, R. (2000) Navigating the External Environment Through a Market Orientation. SAM Advanced Management Journal, Vol. 65.   Kumar, K., Subramaniam, R., & Yauger, C. (1998). Examining the market Orientation Performance Relationship: A Context Specific Study, Journal of Management, 24(2):201-233.   Narver, J. C. and Slater, S. F., (1990), The effect of a market orientation on business profitability. Journal of Marketing, 54, (4), 20-35   Pelham, A. M. and Wilson, D. T., (1996), A longitudinal study of the impact of market structure, firm structure, strategy, and market orientation culture on dimensions of small firm performance , Journal of the Academy of Marketing Science, 24, (1), 27-43   Pelham, A. M., (1997), Mediating influences on the relationship between market orientation and profitability in small industrial firms , Journal of marketing theory and practice, (Summer), 55-76   Pfau, B., Detzel, D. and Geller, A., (1991), Satisfy your internal customers , Journal Of Business Strategy, 12, (6), 9-13   Slater, S. F. and Narver, J. C., (1994), Does competitive environment moderate the market orientation-performance relationship? Journal of MArketing, 58, (Jan), 46-55   Wrenn, B., La Tour, S. A. and Calder, B. J., (1994), Differences in perceptions of hospital marketing orientation between administrators and marketing officers, Hospital and Health Services Administration, 39, (3), 341-358   Credit:ivythesis.typepad.com

Marketing Orientation: The Basis of an Effective Marketing Strategy in UK

Marketing Orientation: The Basis of an Effective Marketing Strategy in UK Abstract This article addresses the paucity of research int...

PROMOTING / DEVELOPING RECOVERY IN MENTAL HEALTH

PROMOTING / DEVELOPING RECOVERY IN MENTAL HEALTH   Introduction               The clinical area where I am working is the neuropsychiatry department, specifically working on brain injury patients. This is the department of the hospital wherein patients with mental disorders that are somewhat related to nervous system diseases are being treated. From the fact alone, that nurses deal with patients that have mental disturbances or disorders, the nurse deals with a very difficult role. Issues such as asking for consent and the confidentiality of patient records is of particular importance.             As a newly qualified nurse on my first job, a preceptorship experience is needed. In my preceptorship experience in the area of mental health, I have learned a lot of things. Specifically, I was dealing with patients recovering from brain injuries. The reason why I chose this topic for preceptorship experience is that injuries to the brain can create very unpleasant experience for both the patients and their families and presents a challenge to nurses. Nurses can help the patients and families through providing care. Survivors of brain injuries face many challenges as they recover from their initial injuries and strive to regain function. At the same time, the family members of the patient face challenges as they adjust to permanent changes in their family roles and functions. It is therefore a challenge for the nurses and other members of the healthcare team to work together to effectively meet both the needs of patients and their families. My experience in the preceptorship focused more on involving the family in the rehabilitation process. Family support is defined as assistance provided by nurses to patient and family. Family support is an intervention that assists the family in realistically assessing the impact of the head injury event on the patient and family. In providing family support, the critical care nurse engages the family so it can expand, contract or stabilize (1996).             The diagnostic and treatment procedures experienced by brain injury patients during life-threatening illness are major sources of distress for the patient and the family. Procedural distress may be defined as unpleasant physical sensations and negative psychological states associated with specific diagnostic or treatment procedures. Physically invasive procedures involve objects such as needles, catheters or probes entering the body. It is believed that procedures that are physically invasive cause more distress than do procedures that do not penetrate the skin or a body orifice (1996). Using a structured critical pathway that addresses the common needs of patients and family members can assist in organizing care and ensuring that important issues are not overlooked (2006).     Main Body   The importance of this chosen theme RECOVERY in the context of national and local mental health policies               Nurses who care for patients with brain injuries face unique challenges, especially when it comes to caring for the patient during recovery. Patient care can be time consuming and complex, with appropriate treatment and rehabilitation varying from patient to patient. Interactions with patients’ families place further demands on nurses’ time and energy. Ineffective communication between anxious family members and healthcare providers has been identified as a major source of stress for both nurses and families ( 2003), as well as a factor in the success or failure of a patient’s recovery.             Contemporary changes in the healthcare setting have created further challenges not only for the nurses but also for the patient recovering from the brain injury. Nursing shortages have led to increased patient care loads, and managed care has led to shorter hospitalizations. The result is that less time is available for healthcare providers to anticipate and meet the needs of those family members assuming caregiver responsibilities. Nurses require specialized training and resources to help families cope with the effects of brain injury upon recovery.             Neuroscience nurses practicing in the community or within rehabilitation programs are well-positioned to assess and comprehensively refer and manage the brain injury survivor upon recovery. It is important to note that there are some negative effects on the patient after the brain injury. Physical changes may include sensory deficits (e.g., visual or heating impairment), diminished coordination and muscle control, fatigue, seizure disorders, and headaches. The physical changes are generally the most easily recognized by others. In addition, typical emotional changes include emotional lability, decreased inhibition, increased anger, depression, frustration, and anxiety. These post- brain injury alterations become most apparent to family members or co-workers. Cognitive changes post- brain injury may create additional rehabilitation needs and include decreased short-term memory, inability to maintain attention/concentration, difficulty with receptive and/or expressive communication, and poor organization/planning. These changes once again are most noticeable to those who have close contact with persons who have brain injury (1990). Pharmacotherapies may be indicated, yet there is no substantive evidence on the most effective drugs. Because primary depression is best treated when pharmacotherapies are combined with strengthening interpersonal relationships, similar strategies should be employed with this population (2000). (1990) described cognitive changes with greater specificity by discussing the pervasive limitations that impaired executive functioning may present. Diminished executive functioning is connected to frontal lobe damage, and simply put, is “an organically based inability to plan, put into action, and carry through with an appropriate course of action.” An unemployed person manifesting executive dysfunction may claim he/she wants to go to work, but has no idea how to initiate, plan, or complete a job search. Additional behaviors related to executive dysfunction include difficulty sequencing events, loss of self-monitoring ability, and inability to analyze social situations and self adjust. When a person demonstrates such behaviors, he/she may have difficulty interacting with others and may be identified as cognitively impaired, unmotivated, and disinterested. Such residuals from diminished executive functioning create pervasive social and vocational problems that the nurse should help address. Once professionals have identified common residuals, brain injury professionals can design services to meet these specialized needs.             Critical evaluation of the rationale for introducing this development and the theoretical framework used   It is well established that irreversible tissue damage following brain trauma is a result of primary and secondary processes. The primary injury occurs at the time of the traumatic event and encompasses mechanical processes such as neuronal shearing, transection and axonal injury. Obviously, these primary events cannot be prevented once the trauma has occurred. However, secondary injury develops over time following the primary traumatic insult. Recent evidence suggests that much of the irreversible damage after brain injury is actually caused by these secondary events initiated at the time of trauma but taking hours to days after the insult to resolve. The time factor involved in the secondary injury process suggests that irreversible brain injury may be prevented or at least attenuated. As such, understanding the role of these secondary mechanisms in the injury process permits the implementation of nursing care practices that may potentially minimize irreversible tissue damage (1999).               Training and inclusion of the family in patient care is a concept that most nurses felt would lessen negative encounters. Approaching care from the perspective of the nurse-family team helped instill a sense of control in family members. It should be pointed out, however, that “not all families want to be involved in care. Some are scared, and some think that the nurses are not doing their job if they ask the family to help. Although family involvement in care is needed, the critical care environment can be intimidating during the early phases of care, so family members must be approached cautiously and individual circumstances carefully assessed when involving them in physical care of the patient.             We nurses also encountered some barriers to effective implementation of the pathway. The shortage of registered nurses necessitates increased patient loads and the use of temporary nursing staff, which could disrupt the continuity of care. To be most effective, the role of coordinator should be assigned to the patient and family educator or someone not involved in direct patient care. There is also emphasis on the need for consistent staff or someone to guide existing staff (2006).             The nurses also recommended that training be provided for all staff members involved in implementation of the critical pathway because it is difficult to maintain continuity of information with staff who had not been involved in the orientation phase of implementation. Because the pathway is an interdisciplinary tool, it has been suggested that all staff, from nursing assistants to physicians, be trained and roles clarified before pathway implementation. When there are multiple physicians, including subspecialists and residents, interacting with the families, information consistency is difficult to maintain. It is also recommended that weekly interdisciplinary team meetings including the families be instituted. These suggestions have been implemented as the program has grown and evolved.             The reason for incorporation of the family in the recovery process is that many family members do not understand the whole situation. In their recent investigation of common misconceptions held by family members of individuals with brain injury,  (1997) found that most family members did not really understand altered states of consciousness. Further, family members believed that personal motivation and hard work were the primary determinants of recovery of function, as opposed to extent and severity of the injury. Such misconceptions can be detrimental to the rehabilitation process and highlight the need for family education.             The family needs to be approached as an integral part of the team in rehabilitation. For this reason, they need to be well informed about all aspects of the patient’s program of care. They also need to be able to share their knowledge of the patient with the professional staff. Within the first week of a patient’s arrival at the facility, the family is scheduled to attend an introductory class that includes an overview of brain injury as well as an overview of the program. Any person identified as assuming a caregiver role with the patient receives a “learning needs and barriers to learning” assessment before attending the class.             More specifically, the integration of the family within the treatment can help a lot in the improvement. Sometimes strong families can provide a solid infrastructure to support and facilitate recovery of the person with brain injury (2002). Normally, the family initially is of minimal help as it manifested shock, disbelief, and are devastated by this event. Consequently, in my experience, the family appeared to be of little help to a brain injury patient’s recovery. However, we the interdisciplinary team educated the family on brain injury, described how daily functioning may be impaired, and learned how to implement simple strategies to enhance his time management skills, memory, spatial orientation, and social interactions.             However, the effectiveness of psychotherapies and support groups has been understudied. Studies indicate tremendous problems with social support, social isolation, and belonging. Strengthening social support and assisting the survivor to feel valued and connected to a group or person is imperative in rehabilitation. Educating support persons about the importance of their role in assisting the survivor maintain interpersonal relationships and appreciate the changes in ability and temperament is truly a challenge and not to be accomplished in a single session. Long-term follow-up for comprehensive management of the survivors and their support system is required (2000).   Implementation process, highlighting issues encountered and their resolution   The goal of a clinical pathway is to create a user-friendly tool for nurses that would meet both their needs and those of families. Neuroscience nurses involved in the trial implementation of the pathway can offer insights into the complexities of delivering holistic, structured care to patients and families. The opportunity to approach family care from a structured perspective can offer the nurses insights about their past feelings toward family care. A critical pathway designed and implemented to help nurses identify family needs during the acute and postacute phases of brain injury and to provide a structured approach to applying nursing interventions to address family needs was used during my preceptorship. The critical pathway presents a structured approach to family care from admission through discharge. Specific interventions, developed from the professional literature (2002), are indicated throughout phases of care: Phase 1 – admission, Phase 2 – acute critical care and hemodynamic stabilization, Phase 3 – acute critical care/mobility and weaning, and Phase 4 – postacute care/prerehabilitation or predischarge. The critical pathway addresses six aspects of family care adapted from the Brain Injury Family Intervention (BIFI) program ( 2002). Although the BIFI program was designed to focus primarily on rehabilitative care, the six interventions were constructed to meet the needs identified most frequently in Kreutzer, et al., by brain injury families across the continuum of care. Typical brain injury rehabilitation phases include acute medical services, acute rehabilitation services, and post-acute rehabilitation services. These phases target preserving life, increasing post- brain injury physical and daily functioning, and facilitating successful community reintegration, respectively. The ideal goal has been to provide necessary comprehensive rehabilitation services to assist with the successful reintegration of each person with brain injury into all areas of life. The increasing numbers of persons surviving brain injury have stimulated rehabilitation professionals (neuropsychologists, psychologists, and rehabilitation counselors) to more closely examine this population and deliver more comprehensive rehabilitation services. Physical, cognitive and emotional deficits serve as obstacles to community integration and vocational success for adults with brain injury (2001).             Post acute rehabilitation services may be appropriate and may be provided in many ways. The person may be afforded to continue with multidisciplinary rehabilitation services on an outpatient basis. This is desirable when the person is medically stable, is making progress, and the team collectively agrees more progress can be made. Also, referral to the state/federal mental support system to facilitate successful return to work or independent living services may be appropriate. Perhaps referral to innovative community based rehabilitation programs within many parts of the UK designed to facilitate community reintegration of persons with brain injury (2001) are possibilities. It should be emphasized that emergency medical treatment and the state/federal support system are accessible to most persons in the UK. The bulk of acute and post acute brain injury rehabilitation services are available on a limited basis, depending on one’s financial resources. Services are provided to achieve an overriding goal of functional independence. More specifically, comprehensive service provision is directed toward productive employment and independent living outcomes (2002). Chronological rehabilitation for recovery milestones important to the person’s overall recovery are noted. In one patient, one month after rehabilitation started, the patient gained and reported slight cognitive awareness of his current situation, diminished his aggressiveness, and expressed his needs verbally. This cognitive awareness was the beginning of ongoing improvements. Six weeks into rehabilitation this person is able to successfully participate in a family outing further encouraging the family to stay involved with his rehabilitation. However, at this time he was still under 24 hour supervision. After two months in the recovery process, the patient’s daily supervision was reduced to 16 hours (no supervision while sleeping). Furthermore, three months into his rehabilitation he only requires eight hours. During these times he is making small gains in his memory, daily routines, and social interactions from a combination of his therapeutic meetings (averaging three days a week) and family assistance. The therapeutic meetings focus on cognitive rehabilitation strategy to enhance his attention, memory, language skills, and personal awareness.             Fourth months into his rehabilitation and many changes have occured. Continued progress from the complementary professional and family involvement is observed. During the fifth month, the professionals work on preparing this person and his family for termination of the recovery program. Preparation for termination was completed and rehabilitaion interventions for this brain injury patient ended after six months. Many gains were made including the eradication of behavioral problems, but slight amnesia, impaired executive functioning, and limitations with independent completion of Activities of Daily Living. At termination, this person was referred to a protected education facility where he continued working on his social skills and independence.             When a patient does not show improvement that warrants continued inpatient rehabilitation, a family may decide to care for the injured family member at home. Even with the education they have received, the family takes on an overwhelming, 24-hour-a-day job that is both physically and emotionally draining (1999). Some temporary home health services may be available, but previous experience suggests that these services often do not have the expertise needed to work with this special population. Also, without a way to monitor and evaluate the ongoing status of the patient, family members may attach significant meaning to a patient response that is not truly indicative of a change in the patient’s neurological status. Moreover, important changes may go unnoticed and rehabilitation opportunities may be delayed or never recognized (2002). Additionally, an educational module can also be developed to train the nursing staff members participating in the implementation of the critical pathway. This approach was chosen because of the number of individuals who needed training and the difficulty of bringing them together. Each participant could complete the module individually at his or her own convenience. In addition the module served as a resource for information throughout the implementation period. The module included topics derived from the literature review, such as the concept of family-centered care, typical emotional responses of families following severe brain injury, research findings related to family needs, and use of the critical pathway to meet family needs. These topics were the most pertinent to families and those trying to address their needs (2006).             Evaluation of own role in the process of managing this development, lessons learned and areas for further development I have learned from my preceptorship that nursing strategies to structure the patient and family’s environment consist of organizing the patient’s immediate environment and providing for the physical comfort of the family. Critical care or trauma units are crowded with unfamiliar noise and technology. Resources provided in the critical care environment are a clear benefit to the patient. However, the environment may place additional demands on the family of a head injury patient. For example, equipment sense of crowding for the patient and family. People providing care and physically close to critically ill patients are usually strangers while those who are emotionally closest are kept physically distant by restricted visiting hours and the assembly of bedside equipment, tubes, wires, catheters and lines (1996).             As nurses, the nursing strategies are to structure the patient’s environment minimizing the amount of equipment. Interventions include those actions that enhance and respect the patient’s and family’s personal space and need to control the immediate environment. The family doesn’t know what to expect from the critical care environment. To facilitate environmental structuring, discuss items such as equipment and scheduling with the family.             Comfort measures that optimize family member’s participation in the care of the critically ill patient are found in an environment that is as pleasurable and attractive as possible. Comfort measures include couches large enough for a family member to recline and telephones near critical care. The family can designate a family member as the primary person responsible for communicating information about the patient’s condition to other family members. This will alleviate the nurse receiving telephone calls from other family members (1996). Nurses can expand their concept of the             patient with brain injury as an individual in a bed to that of a member of a family. It is important for the nurse to assess the needs of families of head injury patients during the crisis period. It is during the early phase of the crisis that the family can experience feelings of hopelessness. The ultimate outcome of a family’s attained and maintained hope is dependent upon the nurse developing successful hopeful interventions. By applying hopeful strategies to families, the nurse increases the family’s sense of hope in the present and the future. The nurse obtains information about the family’s past experience with critical illness, the family’s need for information and family readiness and/or ability to cognitively process information. Once this information has been obtained, the nurse can develop informational strategies. Informational strategies include providing information about the family’s loved one, explaining procedural distress from invasive procedures and/or treatments, providing instructional materials and establishing family meetings or rounds.   Conclusion               Nurses working with brain injured patients at the neuropsychiatry department face varied challenges from other nurses working with people who are mentally stable. For one, care for brain injured patients is very different and requires great effort and dedication. The care should include not only health care professionals but most especially the family of the brain injured patient. There are many ways by which the nurse can include the family in the care of the brain injured patient and the nurse should see to it that she performs these duties and not miss one of them for no matter how small it could be, such negligence can have a profound effect on the brain injured patient. Not only that, this could also affect the credibility of the nurse.   Credit:ivythesis.typepad.com

PROMOTING / DEVELOPING RECOVERY IN MENTAL HEALTH

PROMOTING / DEVELOPING RECOVERY IN MENTAL HEALTH Introduction The clinical area where I am working is the neuropsychi...

An individual report based on strategy dynamics theory

Contents Page 1.      Reflection on the Beefeater Simulation 1.1.  Nature of resources 1.2.  Management of resources 2.      The strategy dynamics approach 2.1.  Strategic Issues 2.2.  Internationalization of strategy 2.3.  Development of new strategy 2.4.  The hospitality sector References                                           Reflection on the Beefeater Simulation Nature of resources Often the transition phase is managed by two parallel structures one that keeps the operation going and one that oversees changes impacting the technical, financial, or people ends of the business. When more than one initiative is required, a change strategy called a multiple project integration process can be used to provide for coordination and integration to minimize the chaos and competition for attention and resources. A good communication and participation plan can hold the whole thing together and aid employee involvement and commitment. Transformation usually results from radical marketplace or environmental changes coupled with the organization’s inability to handle current and future requirements using its existing mindset, resources, skills, structures, and practices. The pain of the mismatch between the organization and the needs of its environment creates a wake-up call for the leaders of the organization ( 2000).   If the leaders don’t hear or heed the call and the organization doesn’t change to meet the new demands, the organization will struggle, decline, and ultimately die. To survive, the leaders in one way or another must act on the wake-up call and begin the process of transforming to a new way of being and operating. Over time, the organization begins to experience difficulties in any number of areas: stagnation, equipment failure, productivity drops, and loss of control of costs and information. Threats from competition, inadequate resources and skills, market loss, or new demands from the environment add to its difficulties. It moves into a period of struggle between internally and externally driven chaos, and attempts to maintain some semblance of order and control. Because of their attachment to the old success record, executives usually continue to deny, explain away, or overlook the series of wake-up calls for needed change, which get louder, more painful, and more costly as time goes by. The fact that specific resources are available is useless until they are utilized. In order for an enterprise to operate effectively in successfully discharging its tasks, it is necessary to know the value in action of its resources ( 2000).   Even if the measures are very fair or are perceived as fair, even if everyone can win, a performance-driven system still encourages people and teams to accumulate resources. In particular, such a system of competition encourages the accumulation of those resources that are important to success and most difficult to locate and acquire. To the extent that measures are linked to rewards or punishments, organizations will seek the resources they need to do well by these measures. If measures are to motivate improved performance, those managing the performance-driven system will have to make sure that key resources are available to all. They will have to ensure that no individuals or teams can gain an unfair advantage by monopolizing control of some essential but limited resources ( 2000). The Beefeater simulation helped in determining the importance of resources to organizations and it showed the effect of resources to organizational actions. Resource management             Historically managers focused on the desires of traditional users or commercial interests in the various renewable resources, in part, because they showed the greatest concern about resource management. The focus on understanding consumptive users reflected popular philosophies of the time, emphasizing conservation and management for wise use or the production of commodities from the resource. The environmental movement and its emphasis on non consumptive and ecosystem-function benefits from the natural resource base has been a relatively recent phenomenon, preceded by decades of effort by hunters, anglers, other outdoor recreationists, commercial fishing and forest industry interests (1996). The combination of ecological, political, economic and socio cultural factors that influence the management process can be conceptualized as the particular context or environment in which natural resource management is conducted. The concept of a management environment draws together these four domains of influence on natural resource management, which must be considered in management decision making regardless of the specific contextual attributes involved. The ecological component of the management environment sets the limits or boundaries on potential resource productivity and use. The ecological component includes the ecosystem within which the flora and fauna of interest exist (1996).   The economic component of the management environment includes all the processes of the marketplace and non market forces that influence valuation of natural resources. Economics has long been an important consideration in natural resource policy. The political component includes three aspects: established laws and codes, policies of various government agencies, and the values of government employees who enforce or interpret laws and policies in their daily work as resource managers. The first aspect usually consists of concrete, legislative statutes and administrative codes that grant agencies the responsibility and authorization for management of the public’s natural resources. The second aspect includes the branches of government that interact with a natural resource agency and have important influences on management decisions. The third aspect is poorly defined because the biases of government officials are dynamic and often undocumented (1996).   The socio cultural component of the management environment includes traditions, values, norms, religions, and philosophies of various segments of the public, specific constituencies, and resource managers themselves. These represent the complex socio cultural milieu within which management is conducted. This component provides the primary motivation for natural resource management to occur. Management takes place because the end products are believed to have value to all or part of society (1996). The Beefeater simulation provided insight on how management of resources can be done. It provided information on what are the different weaknesses of the company’s resource management. It provided insights on how the management of resources can be a success. The strategy dynamics approach Strategic issues External analysis pinpoints major opportunities and threats posed by the environment. It analyzes those external factors the community or public sector jurisdiction cannot control but which nevertheless affect its ability to achieve strategic objectives. Internal analysis provides an objective understanding of the controllable factors in the public sector jurisdiction’s internal environment, identifying those with the greatest long-term impact on a community’s or organization’s position ( 1991). The objective of this analysis is to identify the organizations or community’s major strengths and weaknesses with respect to its overall mission or relative to each of the strategic issues it faces. The usefulness of the internal analysis depends on objectivity and completeness and identifies strengths and weaknesses of the organization as it attempts to implement strategic plans, goals and objectives, and its overall mission. Organizations need to be aware of what is happening in their environment that might affect them. In other words, they should continually survey and monitor the outside as well as the inside of the organization. This is especially true during the strategic planning process ( 1991).   Five separate but overlapping environments should be monitored. These include the macro environment, the government environment, the competitive environment, the citizen environment, and the organization’s internal environment. These areas should be surveyed in depth. Environmental scanning will also identify a variety of factors, both internal and external to the organization. In fact, one of the benefits of strategic planning is that an organization will gain a better understanding of how environmental scanning should be done and be able to manage more effectively as a result.  Factors to be considered as part of the macro environmental scanning process include social factors such as demographics, financial factors such as interest rates, and political factors such as increasing government deregulation, changing federalism and state government’s trends, and regulations ( 1991).               Among the factors to be considered as part of the government environment are the number and locations of other governments, the degree of federal and state government presence, the typical services being provided, and the marketing strategies of other competitive local governments. The competitive-environmental scan includes consideration of general competitor profiles, market segmentation patterns, research and development, and others ( 1991).The combination of environmental assessment and forecasting, and the strength and weakness evaluations is often referred to in the strategic planning process as the situation audit or the environmental scan. The basic purpose of the environmental scan is to assess the environment within which strategic planning will be conducted and to develop a set of strategic issues ( 1991). The strategies formulated by businesses will always be under certain issues. These issues helps a company determine which strategy is the best one for them to consider to use.  Internationalizing strategies Four broad types of internationalization strategy that can be identified in the businesses include domestic, exporting, international, and global strategy dimensions. Understandably, the internationalization dimension played a very minor role in defining domestic strategies. Instead, overall strategic behavior was dominated by competitive positioning. Little emphasis was placed on international investment, political, or integration sub strategies. When compared with strictly domestic businesses, exporting businesses relied much more heavily on international sales in accounting for total business revenues ( 1990).  Furthermore, businesses were commonly committed to increasing international sales levels through eventual foreign direct investment, typically in terms of overseas sales/distribution centers. Exporting businesses placed considerable attention on international external integration and international political activities. Integration with the international external environment was achieved largely through developing expansive international information networks and establishing licensing agreements based principally on manufacturing technology ( 1990).   With increased levels of international activity, businesses became more fully exposed to divergent international business environments. This exposure had a dramatic influence on strategic behavior, as businesses found themselves stretched to balance global competitive pressures with organizational capabilities that remain dominated by domestic concerns. International investments were contingent on market opportunities for introducing the particular technology ( 1990).  Minimizing costs played a relatively minor role in determining the location of overseas operations. Also, rather than trying to influence their political environments proactively, international strategies seemed to be much more reactive. A high propensity existed either to enter independently only those foreign markets that provided attractive political environments or to avoid political entanglements entirely by seeking local partners to assist in product assembly and distribution. Of the four internationalization strategy types identified, the global strategy type demonstrated the highest commitment to international activities. This commitment was directed by tight head office control over all international activities ( 1990).   International investment location decisions were determined on the basis of potential comparative advantage. Value activities were frequently spread across national boundaries leading to huge scale economies. Production-sharing alliances were used frequently. Worldwide distribution networks were established to move the business’s internationally standardized products. Distribution often involved the sharing of outlets with sister businesses within the same corporate organization (1990).   Strategies should not only be based on changes in the local environment. The strategy of any company is affected by the different changes in the international environment. Strategies need to be globally competitive and well adjusted to the demands of the environment for it to be a success and for it to help the company in achieving its goal. Development of a new strategy Because any new arrangement is likely to decrease some valued benefits of past associations, and outcomes of new activities are often uneven, the period of affirming a new strategy continues to be unstable. Interaction among those in the middle of the organization will also bring conflicting interests and concerns to the attention of top executives, which can be an important impetus for developing new strategy. The true second order change will be more likely if people across the organization gain ownership in the new strategy by putting together pieces of it for themselves (, , . & , . 2000). New assignments also divert attention to new issues. These factors, in conjunction with social norms about fair trial, help generate a honeymoon period following formal adoption of a new strategy. In the formal model, the affirmation of the new strategy is assumed to be accompanied by a reduction in stress, such situations out of the old strategy (, ,  & ,  2000). In any industry changing a strategy is a must especially if the company has difficulty in surviving in the environment. Companies should have the appropriate tools and procedures that will help them determine whether their strategies are appropriate.   The hospitality industry Cursory inspection of the accommodation sector might suggest that a few large chains dominate the market, giving the impression of an oligopolistic structure. However, the service hospitality sector within holiday tourism is mostly fragmented in many small units where location and the spatial distribution of accommodation are important factors determining the degree of competition. Furthermore, the wide range and quality of accommodation, its multi-product nature and seasonal variations in demand, introduce an additional dimension into the operation of the market. These aspects of the accommodation sector are considered at some length in tourism texts, of which those are good examples ( &  1997).Accordingly, different forms of structure perfect competition, monopolistic competition, oligopoly and even monopoly might, as argued below, reflect the conditions of different elements of the sector, ranging from the serviced to the un-serviced self-catering segments. Notwithstanding its complicated structure, some fundamental economic factors characterize the accommodation sector. It is subject to fixed capacity with all its attendant problems in the face of periodicity, perish ability and seasonality. Allied to this, particularly in larger units offering a wide range of services, high fixed costs drive operators to attain high occupancy rates through such devices as product differentiation and market segmentation ( &  1997).   These characteristics tend to involve elements of both natural monopoly and oligopoly. For example, some hotels concentrate on the luxury segment while others serve a budget clientele. Many seek flexibility by targeting the business market during the working week and the leisure sector at weekends. In holiday resorts, the needs of different groups can be met over the year, for instance catering for skiers in winter and walkers in the summer, as occurs in Austria, France and Switzerland ( &  1997). Despite these attempts to exploit market potential, in the early 1990s hoteliers who bought at the peak of the property boom in the UK were put under extreme pressure as they had made an over-priced purchase which could not be serviced by revenue. Large corporate-run hotels, mainly serving business travelers, tend to cluster in or around large urban areas, airports and on land transport routes. Holiday hotels are more likely to be independent and more widely dispersed, although clustering still occurs, such as in resorts or locations which are principal tourist attractions. In this sense the accommodation sector is akin to monopolistic competition in the retail market ( &  1997).  The accommodation sector can be a source of a profitable business. This sector provides lodging to tourists and other kinds of clients in different countries.   Franchising in the hotel/motel industry has been used extensively. Hotels have used franchising to satisfy the retailing of services to meet the challenges of intangibility, perish ability, inseparability, and variability. Labor intensity and quality control are other challenges that franchising has successfully addressed. Fluctuating demand caused by seasonal variations is another facet of the market structure of the hotel industry. To meet this challenge, several ski resorts in appropriate locations have opened their facilities to tour groups during the summer months ( &  1995). Moreover, hotels have offered weekend rates and discounts to special groups during the off-season. In general, hotel and motel organizations tend to be small, with more than half accounting for no more than three units. Nonetheless, like the rest of the retail industry, large organizations are steadily increasing their market share. This concentration of large organizations has developed partly because of inter organizational communication systems, franchised networks, and corporate vertical systems ( &  1995).    A strong and clear hotel image can increase consumer confidence in its lodging and service accommodations. Because the way in which consumers perceive a hotel can influence their reaction to its offerings, management is very concerned with the development of hotel image. Perception of a hotel image is derived not only from functional attributes of price and convenience but also from the influence of architecture, interior design, colors, and advertising ( &  1995). The competition on the hotel industry is based on the desire of each hotel owners and managers to provide the best service to clients. Companies in the hospitality sector that face a tough competition has to make sure that its strategy can overcome the threats by the competitors. One approach that can assist in strategy change is the strategy dynamics approach. The strategy dynamics approach provides a deeper understanding of how strategy works for an organization. It shows what aspects of a strategy needs to be strengthened for it to be effective and for it to provide benefit to the hospitality company. The strategy dynamic approach provides assistance in how important is strategic planning. It determines the different steps taken in strategic planning and how it fits the situation in the hospitality industry. Through strategy dynamic approach proper means of undergoing strategy planning can be made. References Credit:ivythesis.typepad.com

An individual report based on strategy dynamics theory

Contents Page 1. Reflection on the Beefeater Simulation 1.1. Nature of resources 1.2. Management of resources 2. The s...