HR Strategy of Brunazzi Sports Systems Research Paper

HR Strategy of Brunazzi Sports Systems - Research Paper Example Brunazzi Sports Systems, as core brand of Bendicco, aims to expand their manufacturing and engineering excellence worldwide by opening new development centers and manufacturing facilities abroad. The suggested location for this new venture in China. As China is a constantly growing economy, with labor cost less than other countries, therefore, setting up plants in China would help the organization reduce cost from various aspects. Furthermore, it would also allow Brunazzi Sports System to gain a competitive edge in the market of high-performance exhaust systems because, at present, a number of international organizations are looking to set up their business operations in China. In order to fulfill the expansion plans, adequate strategic resourcing, reward management strategies, performance management subfield and training, and development strategies need to be devised for the next five years. Therefore, due to the dynamic nature of the work environment and market Brunazzi Sports Syst ems to strategically resource its employees so that it not only proves to be cost-effective but also bring success to the organization. Furthermore, a proper reward management system known as the total reward will be devised in which the employees will be given compensations and benefits for the services they render to the organization. The total reward system would include both financial and non-financial rewards that would not only benefit the employees but it would also build a healthier psychological contract and a more appealing Brunazzi brand. Another significant aspect of the strategic human resource plan is the performance management of the employees. This will include the appraisal of the employee's overall performance in accordance with the organization’s performance  standards. Any discrepancies between both will result in the issue being properly addressed.

Evidence-based practice in nursing Research Paper

Evidence-based practice in nursing - Research Paper Example The motivators for evidence-based practice in nursing, also called evidence-based nursing (EBN), come from political, professional and societal factors (McSherry et al., 2006 cited in Scott & McSherry, 2009, p.1085). This paper explores the pros and cons of evidence-based practice in nursing. It analyzes the concepts of clinical expertise, patient preferences, and caring in the context of evidence-based nursing. It also examines the impact of these practices on the art of nursing as a practice. Pros and Cons of Evidence-Based Practice in Nursing Evidence-based practices, when applied to nursing, can enhance patient outcomes by improving clinical decisions (Scott & McSherry, 2009, p.1087). Evidence-based practice is a combination of patient values and clinical conditions with the best research evidence in clinical decision making (Brown et al., 2010, p.1945). Patient preferences are also used in making decisions. The processes of evidence-based practices concern practical steps that m aximize the best evidence. Evidence-based practice starts with asking an answerable question in a specific clinical situation, collecting the best relevant evidence, critically evaluating the evidence, and using the evidence in consideration of patient preferences in clinical decision-making (Brown et al., 2010, p.1945). The systematic approach in finding and evaluating the best evidence is critical to producing quality patient results (Scott & McSherry, 2009, p.1087)... its framework (when and if it is defined and mandated by organizations) and actual implementation (Rolfe, Segrott, & Jordan, 2008; Scott & McSherry, 2009). McKenna (2010) argued that evidence-based practices create confusion, because of the delimiting definition of evidence. Rolfe, Segrott, and Jordan (2008) studied nurses’ understanding and interpretation of evidence-based practice (EBP). Findings showed that tensions and contradictions in nurses’ understanding of evidence-based practice were prevalent. National and local guidelines, nurses’ own experiences and patients’ preferences continue to dominate the practice of nursing for their sampling. Brown et al. (2010) noted from their studies that personal and management barriers hinder the implementation of evidence-based practices. Evidence-based practice in nursing reduces the importance of soft approaches to nursing practice (McKenna, 2010). Paley (2006) examined the well-known concepts of expertise and clinical judgment, which evidence-based practice tend to undermine. For him, evidence-based practice should not overlook the value and role of clinical judgment in making quality patient decisions. He stressed: â€Å"†¦clinical expertise is interpreted as that which is required in order to integrate the research evidence with professional experience, context, circumstances, patient preferences, various holistic considerations, and so on†¦Ã¢â‚¬  (p.87). Kitson (1997) suggested that evidence-based practices cannot be simply transferred directly to individual components of health care (i.e. nursing and midwifery) and merely translating evidence-based management as evidence-based practices in nursing may be inaccurate without changing some elements that underlie the conceptual framework of evidence-based practices

Howard Zinn Essay Example for Free

Howard Zinn Essay Howard Zinn was born on December 7 19922 in Brooklyn New York. Zinn was raised in a working-class family in Brooklyn, and flew bombing missions for the United States in World War 2, which experience he uses to shape his opposition to war. Howard Zinn is one of the most respected historians, the author of various books and plays, and a passionate activist for radical change. A clear statement of his nature is his autobiography You Cant Be Neutral on a Moving Train. He is perhaps best known for A Peoples History of the United Sates, which presents American history through the eyes of those outside of the political and economic establishment, like the Native Americans, slaves, women, blacks, etc. In his essay Violence and Human Nature Howard Zinn points that; even if humans are capable of violent behavior, it is social conditions that harness that cruelty. He warns us to steer clear of the widespread notion that humans are biologically predisposed to violence and warfare. Mr. Zinn starts off by using an arsenal of famous thinkers, pointing out their pessimistic views and believes on human behavior. Views based on no concrete evidence that we humans are born with this trait called violence. Zinn starts off using Machiavellis positive view in the The Prince that humans tend to be bad. Zinn add great minds such as Einstein and Freud and their correspondence to illustrate their own views on the subject, and their conclusions that humans are violent by nature. Other scholars are also thrown in to support this traditional view of human nature being evil. The writer goes on with the idea that scientific evidence doesnt proves it, and that is the notion that humans are in nature prone to violence. Howard picks on some scientific fields to show as that there is no evidence of human instinct for the kind of aggressive hostility that characterizes war. He turns to sociobiology, where the Harvard professor E.O Wilson in his book On Human nature answers with a yes on the question Are human beings innately aggressive? and finds his evidence not in his field but as Freud did in History. Wilson goes on to describe that humans are born with such a trait as violence, that we own it to our genes. Zinn counter attacks this with the following, Stephen Jay Gould a colleague of Wilson and a expert in evolution categorically just replies when asked that there no evidence for  such a statement by Wilson. Zinn is starting to show us an interesting pattern, a blueprint that clearly show us that every explanation from those important people look to root their selves with evidence found only in History. Zinn invites us to illustrate why History is being picked as the field from where those people can pull their evidence of Human violence. Its easily proven when you choose humans to be evil, you just need to pick your example, and history is flooded with it. Zinn shows us that there is a down side of it picking on history, because it depends on which historical events you examine to be in your favor. Its dangerous and very biased to follow this trail. Zinn goes on to convince us that our concentration get deflected by the real cause of violence and war. Zinn uses the 1986 international conference of scientists in Spain to express their conclusion on the question of human nature and violent aggression, to lure as to the very point of the whole essay that society has the power to harness this violent instinct in humans, and not our biological makeup. To further straighten his observation, Zinn uses the well-known Milgram experiment. In sum, carefully controlled experiments demonstrate that we follow others more often than we might like to think. However, it also seems to true that we dont always conform. We are more likely to conform when authority figures are close by, and are more likely to express our individuality and dissent when the consequences of our actions are more apparent. Also from the area of anthropology Zinn uses the two tribes of The Forest People and The Mountain People from the studies of Colin Turnbull, to show us what an impact can an out side disturbance have on one tribe, which brought out a violent behavior in them. But the second tribe uninterrupted continued on a gentle and peaceful life. Howard decided to turn our attention from all does academic studies to the war itself. He gives himself as an example to explain war. Zinn argues that he and his fellow soldiers killed as a result of a set of experiences that  brought them to the front lines of war, not because they felt an instinctual compel to do so. He doesnt view the soldiers willingness to go to war as genuine to their human nature but is rather triggered by existing social conditions. This is what is expected from you, the pressure of people around him to do his duty. Zinn recalls being brought up to trust that the nations political leaders would make just and fair choices, and that the world was divided into good and bad countries, his own country being one of the good. He also recalls being trained not to question orders and being reminded that there was no reason to question those orders since they all stemmed from good political leaders and you should obey those people. Ones in the war and having such obedience, produced in him by his society, a soldier easily demonstrates the power of culture in extreme ways, like for example the My Lai Massacre. Where a detachment of units annihilated a whole village consisted only by elderly people, women and children. Zinn decides to show us that in the aftermath of the massacre, GIs as in the case of Charles Hutto said that he did what he was told to do. But we see that also a helicopter offices decides to save as much people as he can from the village below, Howard suggests that men are disposed to war under certain setting. Society should come to turns to this power which it holds over people harnessing this violent instinct and avoid doing so at all costs.

Cystic Fibrosis Newborn Screening

Cystic Fibrosis Newborn Screening Cystic fibrosis is a common autosomal recessive genetic disorder1. This means that to have cystic fibrosis, a person must have inherited a defective gene from each of his or her parents2. This gene is located on chromosome seven2. Absence or mutation in this particular gene results in worse performance or absence of the Cystic Fibrosis Transmembrane Conductance Regulator2. This is most commonly found in Europe, North America, and Australia1. This gene manages anion transport and mucociliary clearance in the airways1. With the failure of this function, the results are mucus retention and chronic infection in the lungs1. Nowadays, modern technology provides aid for patients with their diseases and gives them a longer and more active life. Newborn screening for cystic fibrosis is a modern technological advance which is designed to detect early signs of cystic fibrosis. Several methods under the name of the Newborn Screening are used to detect whether a newborn has cystic fibrosis or not1. These methods include immunoreactive trypsinogen (IRT) testing combined with DNA mutation analysis and the sweat chloride test1. IRT stands for Immunoreactive Trypsinogen Test. The procedure of this test is a chemical reaction. Trypsinogen is made from the pancreas, and it normally transmits to the intestines where it is activated to a form of an enzyme called trypsin. In a patient who has cystic fibrosis, the thick mucus covers the pancreatic ducts1. Therefore, trypsinogen wont reach the intestines, and the amount of trypsinogen goes up. This test runs with a blood sample, and if the results come out with a normal level of trypsinogen, then this test is reliable, but if there is a high level of trypsinogen, then more tests need to be run to find out whether the patient has cystic fibrosis or not. A sweat chloride test is the amount of chloride in patients sweat. In a patient that has Cystic Fibrosis, the sweat chloride test will result in significantly higher levels of chloride in sweat than a person that does not have cystic fibrosis due to the restricted movement of chloride. The gene mutation test is a DNA sequencing test to locate a defective gene in the chromosome. There are many different types of mutations that can cause a deficiency in the production of the CFTR protein. More than 2000 CFTR variants have been discovered1. About 15% of the identified gene variants are not associated with CF1. CFTR mutations can be classified into six classes according to their effects on protein function1. Classification is helpful because it relates to the molecular and cellular processes in gene translation and protein processing and has some useful clinical relations1. Class I, II, and III mutations are associated with no residual CFTR function and patients with these mutations on average have a severe phenotype, whereas individuals with class IV, V, and VI mutations have some residual function of CFTR protein and have a mild lung phenotype and pancreatic deficiency1. Today, different laboratories use a wide variety of panels depending on the patients need, like t he twenty-three panel or panel of seventy. The following is an example of a molecular CF test. Lab Corporation of America published a procedure for a Cystic Fibrosis molecular diagnostic3; The coding sequence of CFTR is amplified by polymerase chain reaction and each PCR product (amplicon) then sequenced bi-directionally, using Sanger sequencing methodology. CFTR Chr7(q31,2) Nucleotide Change Amino Acid Change Consequencing Zygosity Relation to Cystic Fibrosis c.1327G>T p.Asp443Tyr missense mutation homozygous recessive, associated 1. Prof J Stuart Elbom, Cystic Fibrosis, Lancet, 19-25 November 2016, Volume 388, Issue 10059, page 2519-2531 2. The Clinical and Functional Translation of CFTR(CFTR2) at Copyright 2011 US CF Foundation, John Hopkins University The Hospital for Sick Children; available at https://cftr2.org. 3. Corporation of America Published Documents   2014   available @ http://oneworld.labcorp.com/Billing/TestMaster/Resource Center/Sample Reports/C-4/Cystic Fibrosis (CF) CFTR 252763.pdf

Leadership and Management in Changing Context of Healthcare

Leadership and Management in Changing Context of Healthcare INTRODUCTION The National Health Service (NHS) Trusts face a range of challenges arising from a national approach to the modernisation of services as laid out in the NHS Plan. (DOH, 2000) The NHS Plan recognises that the NHS is capable of providing more effective and accessible care by the rationalisation of service delivery through merged organisations. Mergers illustrate the focus on organisational restructuring as the key lever for change as indicated by the ninety nine health care provider mergers in England between 1996 and 2001. (Fulop, Protsopsaltis, King, Allen, Hutchings, and Normand, 2004) However, in many cases, mergers have unexpected consequences and drawbacks including problems in integrating staff, services, systems and working practices, clashing organisational cultures and poor leadership capacity. This essay considers leadership and management in the context of a problematic merger of services from two hospitals onto one site. The essay focuses on the change management process within one department to highlight key leadership, team, and cultural issues that negatively affected the newly merged department. The microcosm of the department mirrors similar occurrences across the two merged hospitals. The essay concludes with a comment on the organisational consequences if a macro intervention is not implemented. Confidentiality has been preserved by anonymising the identity of the hospitals and departments concerned. BACKGROUND This essay explores a recent change process involving the creation of a psychiatric liaison team based in a NHS hospital Accident and Emergency Department. (A E) in January 2004. The change occurred because of the merger of two hospitals that resulted in a number of structural changes, including the amalgamation of a traditionally split emergency service into a one site A E department. The liaison team replaced the existing deliberate self-harm service which had operated in the one hospital for two decades. The new liaison team consisted of eight newly appointed G-grade mental health nurses, a team leader, and a consultant psychiatrist who had both previously worked in the deliberate self-harm service. The hours of operation initially were 08:00 to 22:00 and there were two nurses on duty on early and late shifts. During a four week induction period, the team participated in team building and training exercises and developed into a cohesive, effective group. The team created clear key performance indicators specific to the psychiatric liaison team, established an action plan to achieve the set objectives, and planned to carry out six-monthly reviews. The team developed a shared vision to provide high quality, person centred care to the A E department without breaching government’s four hour targets (DOH, 2001). The team leader’s leadership style was democratic, and she fostered collaboration and involvement within the team (Walton, 1999). The team members considered her an expert in the field, and respected her for it. In July 2004, the service manager attended a monthly team meeting. At the meeting she was informed that a major change was expected to the hours of operation. The service would be extended to a 24-hour service starting in September 2004. In order for the liaison team to cover a 24-hour roster there was initially be a reduction in the number of nurses on duty, however, more staff would be recruited if necessary after a six month service review. An exact date for the review was not given. The change had not been communicated as part of the strategy for the greater merger. The Department of Health (DOH) modernisation agenda for the NHS, (DOH, 2002) sets out to modernise services in the NHS, and introduced a three star rating scale against which each NHS Trust’s performance is compared against benchmark standards. Funding in turn is dependant on the star rating achieved. One such standard relates to delays in A E departments, and stipulates that mental health patients should have 24 hour access to services, and that patients should be assessed and treated within four hours of arrival. (DOH, 2001) The underlying rationale for the change was therefore that the psychiatric liaison service had to provide a 24-hour service in order for the hospital to comply with the benchmark. Management of the merged hospitals did not consider staff shortages or how the four hour target might affect the quality of service provision, particularly when staff are under constant pressure to discharge patients before they exceed the benchmark standard. (RCP, 2004) In th e service described above, reaching the necessary 98 % four hour target proved impossible, because the staff numbers did not match the requirements of the service. The service was therefore to be expanded without additional staff, implying not only changes in hours and shifts, but also changes in work patterns. The team members reacted negatively to how the change process was introduced. Concerns were expressed about the reduction in staff numbers and questions were raised as to how the staff would be able to cope. The sense of security and continuity were put at risk. (Walton, 1999) The service manager was not available to address the concerns due to an increased scope of responsibility because of the merger that was beyond her normal remit. Lack of two way communication between the manager and the employees meant that the manager lost a valuable opportunity to resolve the negative reactions, and laid the foundation for resistance to change (Johnson, Scholes, and Whittington, 2005). Within a month of the announcement, the team leader had resigned. A new team leader was appointed and was tasked to lead the team through the change. The team started gradually becoming fragmented, staff sickness rates soared, and morale plummeted. The situation reached a crisis point by December 2005, by which time two more staff members had resigned. The majority of staff had taken sick leave, and the psychiatric liaison service was left uncovered for several days. A number of mental health patients in A E waited for hours, sometimes all night, to be seen by a mental health professional. The A E department laid a formal complaint about the liaison team’s performance. In March 2005, following discussion with a union representative, the team took out a grievance against the team leader. The key issues of concern were the way the change process had been introduced, lack of two-way communication and the team leader’s unsuitable task-oriented, directive leadership style. The team leader was suspended and the Trust commenced a lengthy investigation into the change process. The investigation continues to date. ANALYSIS Cameron and Green (2004) suggest McKinsey’s 7S model as a diagnostic tool to identify interconnected and related aspects of organisational change. The model is problem rather than solution focussed, and hence useful for pointing out retrospectively why change did not work. The weakness of the model is that it does not explicit identify drivers from the external environment and accordingly key forces have been described by way of explanation. According to Burke and Litwin (1992), the external environment is any outside condition or situation that influences the performance of the organisation. Systems, Staff and Strategy Systems refer to standardised policies and mechanisms that facilitate work, primarily manifested in the organisations reward systems, management information systems, and in such control systems as performance appraisal, goal and budget development, and human resource allocation. (Burke and Litwin, 1992) Systems are the mechanisms through which strategy is achieved. Strategy is how the organisation intends to achieve a purpose over an extended time scale. Johnson, Scholes, and Whittington (2005) link it directly to environment (industry structure), organisational structure, and corporate culture. Leaders are the executives and managers providing overall organisational direction and serving as behavioural role models for all employees. (Burke and Litwin, 1992) The systems that the service had in place to support the staff prior to the merger had functioned efficiently. The psychiatric liaison team had monthly team meetings, weekly ward rounds and supervision, and twice daily handovers to ensure high quality service. Teams in this context mean â€Å"a group who share a common health goal and common objectives, determined by community needs, to the achievement of which each member of the team contributes, in accordance with his or her competencies and skill and in co-ordination with the functions of others.† (WHO, 1984) Under the previous team leader’s management, the team had achieved a mature and productive level of performance that fell within Tuckman’s model of team development of a performing team. (Mullins, 2002) The leader demonstrated characteristics of an effective team leader (e.g. good communication) and ensured that the team members’ views were passed on to the management. (Marquis and Huston, 2003) The team also developed team specific performance indicators to fit the Trust’s strategy, such as the goal to provide high quality care within four hours of service users presenting to the A E department. However, the new management of the merged hospitals did not take into account that the reduction in staff numbers would make it difficult for staff to find time to attend ward rounds and to supervise care. Lack of supervision had a negative impact on the quality of care provided, and staff shortages meant that the team did not reach the four-hour targets in A E department. The change process indicated a lack of sincere stakeholder consultation which would have alleviated the crisis in the department. (Iles and Sutherland, 2001) Structure and Style Structure is the arrangement of functions and people into specific areas and levels of responsibility, decision-making authority, communication, and relationships to assure effective implementation of the organisations mission and strategy. (Burke and Litwin, 1992) The NHS Leadership Qualities Framework (DOH, 2002, p34) suggests â€Å"leading change through people† with â€Å"effective and strategic influencing† is essential in a merger environment. This is supported by Johnson, Scholes and Whittington (2005) who suggest that strategic, transformational leadership is a key element within an organisation staffed by professionals and that a collaborative style is required to achieve transformational, lasting change. However, the new team leader’s leadership style was autocratic and the team members were no longer consulted about matters concerning it, which was inappropriate in team nursing approach associated with collaborative patient centric care. Marquis and Huston (2003) suggest that a democratic leadership style works best with a mature experienced team with shared responsibility and accountability. The change in leadership style meant that the team felt disempowered and uninvolved in decision making which did not allow ownership of the change process to emerge. Furthermore, the flow of information to the team slowed down and the team’s concerns about the change did not reach top management implying that communication channels in the new organisational structure were not functioning efficiently. Management style equally affects culture. Johnson, Scholes and Whittington (2005) state that culture is the â€Å"taken for granted† assumptions that are accepted by an organisation or team. These work routines are not explicit, but are essential for effective performance. Ignoring these as the new team leader did, reduces motivation and performance, and stiffens resistance to change. Skills Skills are the distinctive capabilities of key people. (Cameron and Green, 2003) The nature of the team membership implied a range of key skills interdependent on the other for effective performance. A problem area in the skills portfolio was information technology skills. The Trust managing the merged hospitals had introduced a Trust wide electronic patient record system in accordance with NHS requirements. (DOH, 2003) This was implemented simultaneously with the decision to extend the working hours. The change aimed to improve the service user experience by allowing staff a 24-hour access to service user’s care and crisis plans. (DOH, 2003) The staff shortage meant that team members did not receive appropriate training on the system and the use of the electronic patient record system became a source of frustration and confusion. Lack of computer skills contributed to staff’s frustration and negative attitudes with the change process. Superordinate goals Superordinate goals are the longer term vision of the organisation and the shared values and guiding principles that that shape the future of the organisation and motivation achievement of strategy. (Cameron and Green, 2003) The team’s superordinate goals were initially created during the four-week team building period and aligned with those of the larger organisation. The team’s vision was to provide high quality, service user centred care. The team also considered change as a natural part of organisational development. However, the team became increasingly resistant to change when it felt that the organisation did not really care about its employees, their concerns, and the ultimate reason for the organisation’s purpose, being the patient. DISCUSSION OF CHANGE PROCESS Change management is art of influencing people and organisations in a desired direction to achieve an agreed future state to the benefit of that organisation and its stakeholders. (Cameron and Green, 2003) A number of models can be used to model a change management process. A popular model is Kurt Lewin’s forcefield analysis. A forcefield analysis is a useful tool to understand the driving and resisting forces in a change situation as a basis for change management. This technique identifies forces that might work for the change process, and forces that are against the change. Lewin’s model suggests that once these conflicting forces are identified, it becomes easier to build on forces that work for the change and reduce forces that are against the change (Cameron and Green, 2003). The difficulty is the assessment of strength or duration of a force, partlicularly when the human dimension is considered. The key resisting force in the change process was a lack of staff and poor leadership. The change process under discussion was largely motivated by external factors. However, due to poor project planning, Trust management failed to consider the internal factors that had a major impact on the change. In particular, the management failed to involve the necessary stakeholders at a local level to increase ownership of the change thus failed to consider the human dimension (Walton, 1999 and DOH, 2004). The new team leader’s autocratic leadership style did not fit the requirements of the task, or the culture of the team and thus sowed the seeds of resistance to change. (Hogg and Vaughan, 2002). The poorly managed change process became costly to the Trust due to the loss of human resources, reduced staff morale and lowered the credibility of the management. The change left the psychiatric liaison team feeling betrayed, and individual team members traumatised. As the change process progressed, it became evident that a thorough analysis of current resources and various dimensions of organisational change had not been carried out (Johnson, Scholes and Whittington, 2005). The management had not prepared a clear plan for launching and executing the change at a local level. The NHS Modernisation Agency Improvement Leaders’ Guide (DOH, 2004) stresses the importance of taking into consideration the human aspect when planning a change project. Similarly, Walton (1999) argues that change initiatives should be thought through and planned as far as possible taking into account the psychological bonds that staff form with their work groups and their organisation as a whole. It follows then that no precautions had been taken to address resistance to change. Johnson, Scholes and Whittington, (2005) state that there should be a clear communication plan to state how information about the change project will be communicated inside and outside the organisation. The team members were not given an opportunity to challenge and test the change proposal, or clarify what aspects of the change they could or could not influence. (Walton, 1995) Fulop, Protsopsaltis et al, (2004) suggest that change project should be presented as an opportunity to improve the quality of performance and that clinicians should should be involved on a consultative basis. Team members were aware of the consequences of extending the hours of operation without increasing the resources, however, there were no systems in place to communicate these views to the Trust management, a key aspect of the change process. The lack of key stakeholder involvement in the change meant that the management did not have access to the psychiatric liaison team’s valuable experience on the immediate and wider implications of cutting down resources. (Henderson, 2002) The team members felt that their concerns about the lack of resources had not been taken seriously, and this inevitably led to a feeling that the Trust did not care about it’s employees or their views. Strong emotions such as anger and frustration were expressed by the team members. The lack of formal communication channels, meant that the team members took them out on each other. Johnson, Scholes and Whittington, (2005) confirm that at times of change, rumours, gossip and storytelling increases in importance and that team members engage in countercommunication, thus unconsiously spreading distrust, suspicion and negativity which leads to lowered staff morale and job satisfaction. Although the rationale for change was clear to everyone, the change was executed at such short notice that the team members did not have time to develop strategies to deal with it. The NHS Improvement Leaders Guide to Managing the Human Dimension of Change (DOH, 2004) suggests that clinicians go through phases of shock, denial, anger, betrayal, conformance and understanding before they finally develop comitment to the change. The team members were left in a state of shock after the service manager’s initial announcement of the impending change in July 2004 and then moved into a state of denial. The general opinion was that the management would sooner or later realise that the change could not be executed without increasing the resources and accordingly delayed the change process until more staff would be employed. When there was no indication of this in the weeks that followed, the team members became demotivated. The team failed to move on to the next stages in their reaction s to change, and commitment to the change process did not develop. The team leader’s task-oriented leadership style did not suit the context of the change process, and partly contributed to it’s failing. Cameron and Green (2003) suggest that leadership will be most effective when the leader’s leadership style, the subordinates’ preferred leadership style and the requirements of the task fit together. A directive leadership style therefore is ineffective if the subordinates’ preferred leadership style is democratic, even though the task is well defined within tight parameters. In addition, Hogg and Vaughan (2002) argued that the most effective leaders are those who are able to combine task and socio-emotional leadership styles, and organise team members to work towards achieving goals at the same time promoting harmonious relationships. The new team leader paid no attention to the team culture and failed to communicate to management about the impending issue. Johnson, Scholes and Whittington (2005) suggest that power is a key element in a change process. Power is the ability of individuals to persuade or coerce others into following a course of action. The new team leader’s source of power was based on his hierarchal position in the Trust rather than on expertise or knowledge as shown by the previous team leader. The team members did not consider that the new team leader possessed appropriate expertise or personal characteristics. The team leader exercised coercion which was met with resistance by the team and for this reason the team members lacked respect for him. He was seen as an executor of decisions made by the management. The new team leader appeared to be more concerned about a successful completion of the change, was target driven and lacked sensitivity to employees feelings and concerns. The team leader used his positional power in a negative way, filtered information and gave the management a distorted view of how the staff were coping with the change process. The relationship between the team leader and the staff members eventually deteriorated to a point where communication broke down. Two staff members went on a long term sick leave, and two other staff members resigned. Following a meeting with a union representative in March 2005 the team members, including those who had resigned, made a decision to take grievance out against the teamleader. The key issues brought up in the meeting were the way the change had been introduced, poor project management and the team leader’s autocratic management style (Walton, 1999). CONCLUSION In conclusion, lack of stakeholder involvement, poor project planning and the teamleader’s unsuitable leadership style lead to the psychiatric liaison team becomimg fragmented, and resistant to change. No systems were put in place to ensure two-way communication with the employees. Lack of communication reduced the staff’s commitment to, and ownership of the change, and lead to a lower quality service provision and increased long waits in A E. The poorly managed change process became costly to the Trust due to loss of trained human resources, staff morale and credibility of the management. Similar incidents occurred in other areas of the hospital indicating that the change processes associated with the merger had created organisational wide problems that were indicative of failure at a top management and strategic level. Strategic leadership is a key element of the change process. A successful merger will only be achieved with consistent communication and the establishment of a vision that percolates throughout an organisation as a basis for effective change to realise the stated benefits of all stakeholders. References Brooks, I. (2002) The Role of Ritualistic Ceremonial in Removing Barriers between Subcultures in the NHS. Journal of Advanced Nursing. Volume 38, 4. Burke, W. W. and Litwin, G H. (1992) A Causal Model of Organisational Performance and Change. Journal of Management. Volume 18, 3. Cameron, E. and Green, M. (2004) Making Sense of Change Management. Kogan Page. Carr, D. K., Hard, K. J. and Trahant, W. J. 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Celebrities and their Tibet Essay -- Expository Tibet Essays

Celebrities and their Tibet Tibet has long been a mystical land, a place that not many have known about. However this has changed. The celebrities have come out in force in making Tibet the center of attention. Even now, most people don't know more about Tibet than its location, somewhere in Asia. So, while the popular support of the struggle of the Tibetans has become well known due to the involvement of celebrities spreading the word, has it really helped the cause or simply let people know what is going on there? Even more importantly, is the information that the celebrities are passing on always correct? Before any of these questions can be answered though, one must first know the origin of the conflicts between the two regions as well as the history of the Free Tibetan Movement. As said above, Tibet used to be a place that not many people knew about. This made it much easier for the Chinese government to come in and take control of the people and the land without much protest from the outside world. In fact even if other countries, like bordering India, had known, not much would have been done. This is because no nation had ever recognized Tibet as an independent country. Rather, it was the events that followed which caused the uproar. According to defected citizens of Tibet that traveled to India and then dispersed throughout the world, the Chinese started a form of spiritual cleansing. Monks and spiritual leaders that would not follow their ground rules were detained, captured or killed. The lama's of the Tibetan people were either taken as political prisoners or exiled. However, there are also those that said that some of this never happened. "'The first troops had appeared in the city in September, 1951.' The ... ...Collins. 1969. Connolly, Paul. "Tale of Two Cities." The Times. Newspaper Source. 2/23/2002 Dolker, Sonam. "So Far from Home." Time for Kids. Issue 11(1997): page 4. 3/27/02. Ewing, Alice. "How The Tibet Movement Can Backfire on America." --- Chinese American Forum. Issue 2(2001): page 22. 3/28/02. Free Tibet Campaign. 3/31/02. http://www.freetibet.org/menu.htm. Fricke, David. "Lama-palooza." Rolling Stone. Issue 774(1997): page 105. 3/28/02. Kim, Albert. "Lookin' Tibet." Entertainment Weekly. Issue 416(1998): page 15. 3/28/02 McQueen, Dane. "Discos or the Dalai Lama: what does Tibet want?" YPA. 3/31/02. --- http://www.ypa.org/issues/previous/tibet.html. Snellgrove, David, and Hugh Richardson. A Cultural History of Tibet. New York: --- Praeger. 1968. Trebay, Guy. "And Then Tibet." Village Voice. Issue 3(1998): page 26. 3/27/02.

Substance Abuse in the Workplace Essay -- Illegal Drugs Alcohol Addict

Substance Abuse in the Workplace Substance abuse in the workplace is one of the top concerns in the United States today. â€Å"Studies show that 73 percent of drug users are employed, costing American businesses billions of dollars annually in lost production and staffing costs (Walsh).† â€Å"Due to higher employment rates and rising substance abuse, the chances that your organization employs one of these 8.1 million workers is greater today than it has been in the past several years (Walsh).† Studies also reveal that employees who abuse drugs have a tremendously harmful effect on the workplace. They are more likely to have extended absences from work, show up late, be involved in workplace accidents, and file workers compensation claims. Substance abuse includes anything from drug use, such as cocaine and heroin, to alcohol abuse. Before I start to discuss the various ways to get control of substance abuse I would like to give you a small background of the impact of substance abuse on the world today. The department of labor has gathered some of the following information and statistics to show the world how it is being affected: †¢Substance abuse in the workplace costs are estimated at $100 billion dollars annually. †¢Alcoholism causes 500 million lost work days each year. †¢Drug-using employees at GM average 40 days of sick leave each year compared to 4.5 days for non-users. †¢In Ohio substance abuse treatment has shown significant improvements: - 91% decrease in absenteeism. - 88% decrease in problems with supervisors. - 93% decrease in mistakes in work. - 97% decrease in on-the-job injuries. Page 2 As you can see substance abuse is a very ser... ... the warning signs and implement a policy to attack the problem. Most likely it is going on right under your nose and you do not even know it. Take the time to step back and help your employees, the people that really make a difference to your company. You never know it might save you money. Bibliography: Works Cited Campbell, Reginald L. Substance Abuse in the Workplace. New York: Mcgraw Hill, 1990. Harris, Michael. Human Resource Managment: A practical Approach. New York: Dryden Press, 1997. Largent, Richard J. Preventing Substance Abuse in the Workplace. Boston: Houghton Mifflin Company, 1996. Loomis, Loyd. Drug Testing: A Workplace Guide to Designing Practical Policies. Chicago: BNA Plus, 1990. Walsh, Michael J. Drug and Alcohol Abuse in the Workplace. New York: Target Investment Inc., 1996.