Pro Tips From Successful Writers! Good Work Habits Make All the Difference

Pro Tips From Successful Writers! Good Work Habits Make All the Difference Pro Tips From Successful Writers! Good Work Habits Make All the Difference   Many people assume that good writers are born that way. A modicum of natural talent is certainly helpful; however, when it comes to long-term writing success, good work habits make all the difference. How many gifted writers are there with half-finished work on their hard drives? The completion of a well-written project requires solid work habits, discipline, and self-knowledge. Luckily, these are not traits; they are skills that can be learned! These pro tips from successful writers will help you see your work through from start to finish. Getting Ready to Write Sometimes, just sitting down to work is the biggest obstacle! Whether it’s challenging yourself with a deadline, setting aside time for writing, or avoiding distractions, writers need to engage self-discipline to create the opportunity to be creative. Deadlines Are Your Friends Deadlines can be a blessing in disguise. They propel you through the more difficult stages of your process, helping that end goal to stay within view. Self-motivated projects are understandably challenging to complete- so create deadlines for yourself. Essay contests and job applications can help provide motivating deadlines for a writer. While some creative writers may find adrenaline to be a helpful motivational tool, with academic or business writing, it is more likely to result in sloppy work. Your arguments will be stronger and your vocabulary richer if you avoid the stress of a rapidly approaching end-date. By getting a head start, you won’t short change the vital editing process, and you won’t be thrown off course if setbacks occur. Limit Distractions Short story writer Nathan Englander advises, â€Å"If you want to get work done, you’ve got to learn to unplug.† When you hit roadblocks in your work, it can feel like a relief to distract yourself by messaging a friend. However, studies prove that productivity skyrockets when personal phones are kept out of sight, or at least switched to â€Å"airplane mode.† For many writers, working at home is the easiest way to avoid noise and distractions. However, if you have children or pets, messy areas might become an additional distraction (and a temptation to procrastinate). It can be hard to focus when surrounded by piles of dirty laundry. Use Your Most Productive Hours The best time to write varies from writer to writer. Often, finding your ideal writing window will depend on how you work best. If you require silence to focus, early morning is a great choice (before anyone has the chance to distract you). Writers Toni Morrison, Ernest Hemingway, and Haruki Murakami famously preferred the early hours for their efforts. One advantage of morning writing is a sense of accomplishment that can carry you throughout the day. You’ve made progress; now you can relax without writing looming all afternoon. Use the time for editing, administrative tasks, or research, and focus on writing during your most fruitful hours. Create Your Optimal Environment Not every writer prefers absolute silence or solitude. The presence of others can also be inspiring and comforting. This helps explain the rise in popularity of co-working spaces, which are popping up all over campuses and urban centers. The library can also be a pleasant respite from the busy atmosphere of a coffee shop. Regardless of where you work, noise-cancelling earphones can help shut out the chatter. Just be sure to pick music that inspires you! Up-tempo instrumental music can keep you from succumbing to boredom and fatigue. Finally: Forget The Rules! It can be challenging to stick to a regular writing routine with the stresses of our daily lives. It’s important not to fret over less-than-ideal circumstances if you can’t change them. As E.B. White put it, â€Å"A writer who waits for ideal conditions under which to work will die without putting a word on paper.† It’s also helpful to remember that even the best writers don’t always feel like sitting down to work. As Henry Miller once said, â€Å"write according to program and not according to mood.† Now That You’ve Started Congratulations: you’re off! These simple techniques will help you stay focused while improving your results. Set Short-Term Goals Short-term goalposts can help you drive towards the finish line. You choose the writing interval, which may vary from project to project. When writing a thesis, for example, it’s easy to feel overwhelmed by such a seemingly monumental task. However, when you break that task up into manageable increments, anything is possible! Just take it one step at a time. Whether it’s a half hour or an hour, all you need to worry about it keeping your head down until the buzzer sounds. Be wary of using your phone as a timer, since this may tempt you to use it as a distraction. Leave Yourself Somewhere to Start If you don’t know where to start the next day, sitting down to write can seem impossibly daunting. One oft-repeated piece of advice is to stop writing for the day (or the session) in the middle of a sentence or paragraph. If you provide yourself with a launching pad, you’ll start work focused and inspired, and you’ll get the satisfaction of â€Å"finishing† something early in the session. If you’re working from an outline, know exactly where you’ll begin the next day before signing off, to fend off that dreaded fear of the blank page. Move Your Body Sometimes, when a section is particularly frustrating, a walk or jog can be just what you need. Exercise can clear your head and get you back on track, refreshed. It’s hard sitting at a desk for hours on end! If you’ve set your timer and worked for your allotted time, use your break period to get moving. A walk around the block, a dip in the pool, or a few jumping jacks can be enough to get you energized. Kurt Vonnegut once reported that he broke up his writing with push-ups and sit-ups to fend off lethargy. Editing And Rewriting This can sometimes seem like the toughest part of writing, but it is one of the most critical steps for doing good work. Neil Gaiman described revision as â€Å"a process of making it look like you knew what you were doing all along.† Get Feedback Go to one or two trusted friends, but don’t go to ten. The further along you are in your career, the more likely you are to have respectful, trusting relationships with other writers. Don’t be afraid to reach out, but avoid the temptation to ask everyone for their â€Å"take† on your work. Too many opinions can be counter-productive, particularly if the views are from individuals with a limited understanding of your topic. If you don’t have anyone you feel comfortable showing your work, or if you’re pressed for time, consulting a professional writing service can be invaluable. Know When To Delete Editing the same passages repeatedly can be time-consuming and frustrating. If your wording isn’t creating the desired effect, or if you’re finding it too difficult to make a succinct point, radical surgery may be required. Delete the problematic passage and start over. If it doesn’t work, you can always revert to an earlier version history; but often the solution will become apparent to you once you have a clean slate. Knowing When To Walk Away Remember: your work will never be perfect. Be satisfied knowing that you did the best you could. If you set yourself up for success with your writing habits, you can avoid fretting over sections that might have improved with more time. No writer has all the time they want, and we do the best with what we have. While you may eventually look back on your work and notice small errors that you missed, that’s simply the nature of the process. Whether you’re writing a thesis, a research paper or a college admissions essay, know that writers all over the world struggle with the same issues you do. While there’s no â€Å"easy† way to write, establishing good writing habits will set you apart from the crowd. For expert editing and writing services, call 1 (800) 573-0840 (toll-free) to speak with a professional paper writer. With offices in Toronto, Calgary and Vancouver, can help make sure great habits result in great writing.

Summary of an article Term Paper Example | Topics and Well Written Essays - 1000 words

Summary of an article - Term Paper Example The criminal procedures over the 17th century to the 20th century treated the Anglo European American better while discriminating other races. Many races suffered xenophobic exclusion and segregation in the American society. The laws encourage the discrimination based on the race by treating the white or Anglo European immigrants as better citizens than the natives. These laws made it impossible for immigrant of other descends to obtain the necessary services that they require, leading to a serious problem in the process especially when handling issues of equity in the population. The failure to address the various issues was spearheaded by the discriminatory laws developed to protect the right of the Anglo European Americans. These laws led to massive discrimination which in Trinidad and Tobago. The perpetrators of the discrimination are referred to as Massa. The role of white supremacy in colonization and slavery is evaluated in relation to social development. Effect of colonizatio n on economy of Trinidad and Tobago The white settlers in Trinidad and Tobago changed allegiance in order to avoid abolition of slavery. The change of allegiance ensured that oppression is maintained and not abolished. The switching of allegiance led to war and changing of hands between the British, French, Dutch and eventually back to the British for Tobago. Trinidad was under Spain even though it had French colonists. The economy of Trinidad was controlled by the few whites with the view of accruing wealth. Several factors were considered in order to increase the oppression. The rights of Indians and African Immigrants were violated. For the Indians, the violation of their contracts was instigated while for Africans, the use of slavery was employed. The labor force of the country was affected greatly through massive immigration and mistreatment. For instance, a job that could be accomplished by one worker was scheduled to be done by three people. For example, the white colonist em ployed the use of human labor for simple stuff such as carrying of cigarettes or even keeping the master company (Williams 724). Such trivial use of human labor to show power illustrated the economic losses associated with the colonist. In addition, the commercial production of one type of product only led to over-dependence on imports. The locals and slaves planted sugar cane for the production of sugar, while they could not get basic food stuff like rice, beans, and milk. The main aim was to cripple the slaves to ensure they do not become financially independent. In order to achieve financial success, the colonist employed free labor from the slaves while also paying the Indians poorly. However, the involvement of the European government by passing laws abolishing slavery led to change of allegiance. In the process, war erupted between the countries further affecting the agricultural economy. The dependence on sugar was viewed as a major challenge to the economy in case of disease outbreak or collapse of the sugar market. The complaint lodged by the British Government was not dealt with and the colonist continued with segregation and discrimination until the rise of civil movement (Williams 727). From a global perspective, slaves and other races learnt of the movement and success of the various civil rights

Answer Questions1. Why do you think gender is an important aspect of Essay

Answer Questions1. Why do you think gender is an important aspect of environment-society relations 2. Imagine that you are - Essay Example Males and females use resources distinctively and possess distinct responsibilities in the community. To maintain efficiency, strategies to conserve the environment should thus pay close concentration to the effect of differences between females and males on availability of resources and probabilities. Several individuals apart from worrying concerning class and race, they are as well concerned about environmental justice research on the responsibility of gender in environmental changes, disaster, and politics, a system generally known as eco-feminist. In a shocking number of instances, females have led complaints against dangerous materials. Women constitute 60%-80% of the membership of conventional environmental institutions; however, they appear even further highly in grassroots institutions handling environmental wellbeing and associated matters. The antitoxins parties of the historic half century have greatly remained ruled by females, as well as great profile scientists such as Rachel Carson, including national activists such as Lois Gibbs and Erin Brockovich. Many people claim this is so since role for the wellbeing and caring for the family customarily falls to females in several traditions, hence they are the first to detect, and act to object environmental hazards that are items of industrialist creation. This rank in the family is nevertheless, not founded on any intrinsic features of females. However, it is a societal situation, which branches, in the contemporary economic scheme. Traditionally, males were taken away from the home surroundings to do salary job, and females were left at the residence and provided the role to offer clothing, food, and different primary essentials for the whole family (Geo 103, Binoy, 2013). Similarly, the views and interests of females in this state have been at instances sadly ignored by professionals. Females always launch first protests concerning what are just later recognized as key environmental disasters. For e xample, in the case of Love Canal, a notorious New York housing development fraught with asthma, urinary tract diseases, and epilepsy that was finally revealed to be placed atop chemical dissipate, female protesters were send away as â€Å"hysterical housewives†. This categorization by the media and by the organizations engaged in dumping was applied to claim that the female protesters had inadequate understanding, professionalism, or lucid judgment. Protesters mainly females, who hold further experiential opinions of what kinds of environmental challenges the community encounters test this scientism. This type of association to the environment means that females always detect subtle reforms in the environment that may be overlooked by huge environmental teams further concerned with matters such as wilderness or biodiversity conservation (Geo 103, Binoy, 2013). A different dimension where gender is evident is in the mining industry. Mining is an old human task, with a ‘ troubled’ past and a challenging association with economic growth. Arguments do not conclude there; mining has as well turned to intensely associated with masculinity. Despite it being naturalized in several ways, masculinity is not the ordinary method of mining; this method of reasoning does not value

Political Obligation Thesis Example | Topics and Well Written Essays - 2000 words

Political Obligation - Thesis Example The basic thesis is that obeying the law enables people to be more free within their actions than not. Rousseau's The Social Contract was a highly influential treatise on hos a society based upon laws should work, and why it does actually work. It is a firm foundation for why people should obey the law. Within this work Rousseau suggests that the individual person gives up certain freedoms in return for the protection of society as regards much larger freedoms. For example, most people try to obey traffic laws such as stopping at a red light. This might be seen as a curtailment of their freedom to drive their car wherever they want whenever they want, but obeying red light laws preserves a much greater freedom: that of surviving your journey. Thus the individual gives up a small right in return for a much greater one. The "contract" that thus ensues between the individual and society is one that is "social" in nature. The individual agrees to obey the laws and the State, in the form of the government, police force, justice system etc. agrees to provide an environment in which people are as safe as possible and free to go about their own business. The social contract can also be understood by a consideration of those societies in which it is not present. Thus in times of anarchy, such as a civil war, individuals are free to "do" virtually whatever they want as law and order has broken down. Does this imply more freedom In a theoretical sense perhaps, but the reality of the situation is that most people are afraid for their lives much of the time. The law of the jungle is no law at all. Does this imply that the modern society, as exemplified by advanced Western countries, with sophisticated justice systems and capitalist economic paradigms are totally favorable One giant of philosophy, Karl Marx, would suggest not. Karl Marx suggested that laws were generally a codified means by which one class (the ruling) keeps everyone else (ie. you and me) in check. Marxists in general recognize that for society to function efficiently, there needs to be social order. However, they believed that in all societies except the Communist one, laws were designed to be of advantage to the wealthy. Thus the famous Marxist dictum that "property is theft". It is interesting to note that even for Marx laws were necessary, as was public obedience to them. It was the nature of those laws that Marx disagreed with, not the fact that they should exist at all. One reason the individual may find for obeying the law is the tendency for "labeling" to occur within society.Labeling theory suggests that the labels we give to individuals effects how they eventually act. Thus if a person comes from a gender or racial group that is perceived to be criminal, then they are more likely to act in a criminal way. The converse is also true - if you come from a supposedly law-abiding group - within American society, white upper class would be an example, then you are less likely to become a criminal. Having a system of theoretically objective laws in place stops such stereotyping as much as is possible. If people obey those laws then labeling is much likely to occur. For example, this author was once stopped in bookstore for acting in a supposedly suspicious manner. While I did not fit the classic profile of a "criminal", I was acting as one in the eyes of store security and so was stopped and eventually searched. In my situation I was labeled as a

Bullwhip Effect In Healthcare Sector

Bullwhip Effect In Healthcare Sector In Supply Chain management, Bullwhip effect has attracted some considerable importance in the FMCG sector in the last 20 years. The phenomenon Bullwhip Effect shows how small changes at the customers end have tremendous impact on the operations back there in the chain. The cause behind this effect is mainly attributed to the increasing demand variability in the supply chain. We consider the number of companies taking part in a single supply chain. Each of the company gets the order from its immediate downstream company to be fulfilled. In Bullwhip effect the orders to the suppliers tend to have a larger variance than sales to the buyer. This demand distortion then gets amplified while propagating upstream. The paper mainly focuses on how the Bullwhip effect the matching of the demand and supply and the main causes leading to this. It also focuses on the PG case study to understand the Bullwhip effect and the steps taken to dampen the bullwhip effect. Further it aims at quantifying the bullwhip effect and reducing its impact on the supply chain. Acknowledgement I am thankful to Mukesh Patel School of Technology Management and Engineering (MPSTME) for giving me this opportunity to understand the Bullwhip Effect and the major causes and the PG case. Furthermore helping us understand the various techniques and procedures for writing a research project. I would also like to express my sincere gratitude to my college mentor Prof. Jinu Kurian for her continuous guidance and support and being available at all times whenever the need may arise. I would also like to thank Prof. Prasad Chakrabarty for his help and support in the project. Table of Contents Introduction The bullwhip effect occurs when the demand order variability in the supply chain is amplified as they moved upstream in a supply chain. Distorted information from single end of a supply chain to the other may lead to tremendous inefficiencies. Companies can effectively deal with the bullwhip effect by thoroughly understanding its underlying causes. Organizational leaders are implementing various innovative strategies that pose new challenges: integrating new information systems defining new organizational inter relationships implementing new incentive and measurement systems. At macroscopic level, Bullwhip Effect generates inefficiencies in production scheduling, sourcing, capacity utilization, distribution and the profit generation. While if we take a look at the operating level it induces additional inventory which is placed inappropriately to maintain the service levels. It also reduces the performance level by decreasing the incoming cash and the potential revenue. It can even dilute any companys competitive strategies. 2 factors have changed the landscape of supply chain management in the last few years significantly. Availability and use of the technology and software applications to allow capture and sharing of information across a supply chain mostly through extranets Increasing indulgence of members of the supply chain in order to move towards to put aside the traditional arms-length relationships amongst each other and in its place move towards closer, partnership-type arrangements. Again, the networks over which these collaborations take place must include the necessary levels of performance, scalability, security and reliability to realise these benefits to their maximum potential. Problem Statement To analyse the Bullwhip Effect in healthcare sector and to find out its causes, consequences and cures. Significance Global competition in the world market today contains many challenges to achieve a degree of predictability in the supply chain and remove the impact of Bullwhip Effect. Researchers have examined the bullwhip effect and some models to reduce it, however a very few research has been done on analysing the Bullwhip Effect in healthcare sector and to find out its causes, consequences and cures quantifying the effect of bullwhip and its Measurement still remains an exigent research path. Research Methods A case-study based approach was employed to conduct the research. Data were gathered primarily through interviews, observations and archival sources. At the hospitals, Interviews were conducted, in person, with doctors, nurses, administrators, and other hospital staff. At the diagnostic laboratory, personal interviews were conducted with the CEO, pathologists and other lab technicians. As far as data gathering is concerned, we decided to employ an informal, minimally structured, non-directive interview approach, enabling to minimize the influence of the assumptions. . Literature Review Fluctuations in demand have a varying graph when we compare from industry to industry. Driven by seasonal demand and business cycles, apparel industry faces major demand adjustments, while the diaper market is subjected to constant demand in the market arena. Due to misjudgement of demands, the big players in the retail market can be subjected to inventory shortages or surpluses. But given the consistency of demand in the diaper market the diaper supply chain should be more efficient and accurate. But it isnt the case. The diaper market even with the reliable demand patterns isnt able to match the demand-production matching. The major cause to this supply chain inefficiency can be subjected to Bullwhip Effect. The term was coined by Procter Gamble who noticed amplification in the information distortion as the information of the order travelled upstream in the supply chain. Bullwhip effect or Whiplash effect can be majorly seen in the forecast driven distribution channels. It indicates a lack of synchronization among the members across the supply chain. Even if there is a small fluctuation in the customer sales, it reflected upstream in an amplified form. Because of this supply patterns does not match the demand patterns resulting in inventory surplus at various stages of the supply chain.C:UsersIndiaDesktopblwhp.jpg As the customer demand would be rarely perfectly stable, businesses should forecast demand in order to match the demands with the production and managing their inventory levels. Some of the major reasons behind bullwhip effect are:- Forecast Errors Overreaction to backlogs Lead time variability No communication and no coordination along the supply chain members Delay in information and material flow Price fluctuations Product promotions Order batching raw material orders from ProcterGamble to its suppliers fluctuated over time. On further noticing it was found that farther down the chain, when sales at retail stores were studied, it was found that the fluctuation which was present, were small. It is reasonable to assume that the consumers of the diapers at the last stage of the supply chain used them at a steady rate. Although consumption at the end product was stable, orders for raw material were highly variable, increasing costs and making it difficult for supply to match demands. Lack of coordination between supply chain members also results if information distortion occurs within the supply chain. Considering the Bullwhip effect PG observed in the diaper supply chain. As a result of the bullwhip effect, orders PG receives from its distributors are much more variable than the demand for the diapers at retailers. The lack of the supply chain coordination between members has an adverse effect on manufacturing cost. It increases the manufacturing cost in the supply chain. PG and its suppliers must satisfy a stream of orders that is even more variable than customer demand. ProcterGamble responded to the increased change by either building excess capacity or by holding excess inventory, both of which increase the manufacturing cost per unit produced. It even increases the replenishment lead time in the supply chain. The increased variability due to bullwhip effect makes scheduling at PG and supplier plants much more difficult as compared to a situation with level demand. There are times when the capacity which is available and inventory cannot supply the orders coming in. This results in higher replenishment lead times in the supply chain from both PG and its suppliers. It even hurts the level of product availability and results in more stock outs in the supply chain. Very high fluctuations in orders make it difficult for PG to supply all distributor and retailer orders on time. This increases the likelihood that retailers will run out of stock, resulting in lost sales for the supply chain. It also leads to an increase in the inventory costs. To handle the increased variability in demand PG has to carry a higher level of inventory than would be required if the supply chain was coordinated. As a result, inventory costs in the supply chain increase. The high levels of inventory also increase the warehousing space required and thus the warehousing cost incurred. It impacts the transportation cost in the supply chain. The transportation requirements over time at PG and its suppliers fluctuate with the orders being filled. As a result of bullwhip effect, transportation requirements fluctuate significantly over time. This raises transportation cost because surplus transportation capacity needs to be maintained to cover high demand periods. It also leads to the increase in labour costs associated with shipping and receiving in the supply chain. Labour requirements for shipping at PG and its suppliers fluctuate with orders. A similar fluctuation occurs for the labour requirements for receiving at distributors and retailers. The various stages have the option of carrying excess labour capacity in response to the fluctuation in orders. Either option increases total labour cost. PG estimated that due to the manual interventions required in their process of ordering, billing and shipment systems, each deal to its customers cost between $35 to $75 to process. Sharing point-of-sale (POS) data across the supply chain can help reduce the bullwhip effect. A primary cause for information distortion is the fact that each level of the supply chain uses orders to forecast the future demand. Given that orders received by different levels vary, forecasts at different levels also vary. If retailers share POS data with other supply chain stages, all supply chain stages can forecast future demand based on customer demand. Sharing of POS data helps reduce information distortion because all stages now respond to the same change in the customer demand. Sharing aggregate Point Of Sale data is sufficient to reduceinformation distortion. PG has convinced many retailers to share demand data. PG in turn shares the data with its suppliers, improving coordination in the supply chain. In a continuous replenishment programs (CRS), the wholesaler or the manufacturer replenishes the inventorey regularly based on Point of sale data. In its simplest form, CRS seeks to allow more accurate production planning of inventories and also matching of supply and demand. Success with continuous replenishment programs is achieved when production planning has become demand-driven on an end-to-end basis throughout the supply chain. . Vendor-managed inventory (VMI) is a family of business models in which the buyer of a product provides certain information to a supplier of that product and the supplier takes full responsibility for maintaining an agreed inventory of the material, usually at the buyers consumption location (usually a store). A third-party logistics provider can also be involved to make sure that the buyer has the required level of inventory by adjusting the demand and supply gaps. PG now employs vendor-managed inventory (VMI) in its supply chain, starting with its supplier, 3M, and its customer, Wal-Mart In VMI, packaged-goods behemoth Procter Gamble (PG) initiated a value pricing scheme for sales to retailers. Value pricing was PG label for everyday low pricing (EDLP), a pricing strategy under which retailers are charged a consistent price rather than a high baseline price punctuated by sporadic, deep discounts. PG had many reasons for converting to EDLP. Its sales force had grown to rely on discounting to drive sales and the use of deep discounts had spiralled out of control, cutting into earnings. Background SMS Hospital, operating in Jaipur, is one of the largest government healthcare providers in Rajasthan. It consists of more than 500 beds and offers healthcare services ranging from a 24 hour accident and emergency service, to acute medical and surgical care, operating theatre suites, intensive care, ocus on cardiac and orthopedics areas and head injury and orthopaedic related trauma and community care. The hospital services more than 40,000 patient admissions and an average length of stay of 3.62 days for all patients. There are10 operating rooms (OR) with state of the art equipment, in-patients have hospital wards, acute cases beyond normal post-operative hospital care have rehabilitation unit for recovery and related ancillary services in the hospital facilities. These rooms are being used for major inpatient procedures. On an average of about 27,000 operations are performed in these rooms in a year. Specialty and staffed with suitably qualified nurses and technicians organizes 500+ beds in the hospital. The Operating Room Management Department (ORMD) is the central division, which faces daily challenges of managing and allocating the staff and equipment so that surgeries can be performed in an efficient, cost effective, and safe manner. The equipment that is owned by the hospital may either be dedicated to a theatre or be shared across theatres. The Operating Room staff is comprised of registered nurses, nursing assistants, scrub technicians and unit secretaries and an Operating Room nurse super vises all these. Equipment to be used for Operating Rooms may either be owned by the hospital or be procured from outside on a loan/hire basis. The Operating Room Management Department is responsible for assignment of theatre suitable for the scheduled surgery and ensuring the availability of staff and equipment when needed. Quality and cost of patient care implications are on overstaffed, undermanned, and unbalanced nursing teams. The hospital has adopted a hybrid strategy to meet its nurse requirements in both wards and Operating Rooms. The hospital has employed a group of permanent, full time nurse staff, which is also, complemented by a bank of casual, part time nurses which are available at short notice. Also, the hospital also has made some arrangements with several private agencies, which are known for providing qualified nurses for short periods to hospitals, on a temporary basis. Fifty % of the hospitals requirements) in the terms of nurse requirements are usually been met by permanent staff, thirty% by part time nurses and twenty% from agency staff. The hospital havent employ any specialist/surgeon, but only has a small group of physicians for overall supervision of the wards. Instead, it has arrangement with a large group of consultant surgeons who hold privileges to avail of the hospital facilities for treatment of their patients. The hospital derives its revenues from the fees charged for the use of its facilities ORs, hospital beds and other services from the patients. In most cases hospital charges are borne by patients medical insurance providers and the hospitals revenue is based on negotiated rates with these firms. Value Chain Figure 1 illustrates a schematic description of SMSs service value chain. As shown in the figure, the multi-stage process begins with the patients consultation with his or her primary care physician. Upon receiving a referral from the general practitioner to visit a medical specialist, the patient will then be assessed by a specialist. This stage does not involve the hospital and may consist of several visits to the doctors office and diagnostic laboratories, deals with the assessment of patients condition and treatment options. A determination of the need for surgery results in the addition of the patient to the doctors list of patients requiring surgery/hospitalization. Typically, specialist doctors have privileges at several hospitals in the area, and the choice of hospital for surgery is determined by a number of factors that include cost, patient preference, case complexity, wait involved, facilities and other services provided by the hospital. Following the choice of hospital, the patient is scheduled for surgery by assigning a slot in one of the doctors theatre sessions at the hospital. It is not uncommon for elective surgeries to be scheduled several weeks to a few months in advance. The schedule for each session along with patient and surgery details is expected to be communicated by the doctors office to the hospital well in advance to enable the hospital to make adequate arrangements. The surgeons operating list is not frozen and is dynamic with additions possible at a later stage (in some cases a few hours in advance) and the hospital is expected to be responsive and be able to provide the requisite support of staff, equipment and supplies. Surgery represents the third stage of the value chain and Saint Marys hospital is responsible for providing required support services. These include staffing the theatres with qualified nurses and technicians, and making available all equipment and supplies needed. The hospital is also responsible for pre-operative care of the patient and getting the patient ready for surgery and for post-operative care. Insufficient capacity and delays in these phases can result in blockage and starving of theatre resulting in underutilization of ORs with consequent adverse impact on hospital costs and efficiency. Post-operative care in hospital wards and in subsequent rehabilitation areas, if necessary represent the fourth and fifth stages before the patient is discharged and exits the hospital system. Constraints on bed capacity in wards can lead to fewer surgeries being scheduled resulting in lower theatre utilization. This is in contrast to the rehabilitation services, where capacity shortage may only lead to patients being off-loaded to other facilities owned by competitors, thereby resulting in loss of potential revenue. Planning and Scheduling at SMS Hospital Planning and scheduling at Saint Marys hospital is similar to other hospitals in Australia with annual theatre plans forming the basis for hospitals activities. The theatre plan involves assignment of theatre sessions to consultant surgeons and essentially defines the demand for hospitals services. A half-day slot is considered the basic unit for this purpose and thus each theatre has a capacity of 10 sessions per week, based on a five day week. As described earlier, surgeons expect hospitals to provide complete flexibility in organizing the activities within their sessions and hence assignment of a theatre session to a surgeon commits the hospital for providing the necessary staff and equipment for operation and post-operative care, and hence the hospital workload is a direct consequence of the theatre plan. In practice, theatre planning at Saint Marys begins three to four months in advance, in September/October for the following year. The plan is developed in consultation with the surgeons and varies little from year to year, except for changes to accommodate vacation periods of surgeons and other planned absences. The plan can be characterized as cyclic with effort to evenly spread out sessions assigned to individual surgeons. Further, to the extent feasible, weekly schedules are adopted. For example, a surgeon with 50 sessions would be assigned one session per week, usually in the same time slot every week (say, Monday morning). One feature of session plan at Saint Marys Hospital that merits special mention relates to the practice of concentration of sessions assigned to particular specialty. As a result, we find, sessions corresponding to different specialties peaking on different days of the week. Such practices are not unique to Saint Marys and are quite common at other hospitals i n Australia. The annual session plan forms the basis for nurse and technician staffing in the hospital. The labor cost of nurses and technicians is perhaps the most significant controllable operating cost at Saint Marys and directly impacts the hospitals financial viability. Staffing plan for nurses in the OR theatres is prepared for each calendar month on a monthly basis, two weeks in advance to conform to regulatory requirements. The initial plan is developed on the basis of the session plan. The nurse schedule is revised and frozen only a day in advance, at which time the requirements are assessed based on surgery lists available in the hospital. Besides adjustments for providing the required number of qualified nurses, the final schedule takes into account deviations from the initial plan (for example, absence due to sickness, or inability to schedule the nurse due to excess overtime on the previous day etc.) At this stage there is only very limited flexibility in respect of permanent, full t ime staff and the nurse scheduler relies on part time staff, supplemented by supply from external agency to meet the requirements. As mentioned earlier, current practices at Saint Marys hospital result in 20-25% of nursing needs being met with agency sources. In monetary terms, the proportion is higher due to higher rates paid for the temporary staff. Nurse staffing in wards is similar and schedules are frozen only a day in advance. Observations Our interviews with doctors/surgeons indicated that in a majority of specialties there is no discernable pattern in the demand for elective surgeries. This is in contrast to illnesses such as flu, hay fever that exhibit pronounced seasonality. Thus, daily demand for elective surgery end customer demand can be reasonably be described as fairly uniform with no seasonality (day of the week, month etc.) and low to moderate variability. Figure 2 describes the pattern of admissions (which corresponds to demand) for orthopaedic surgeries at Saint Marys hospital by day of the week. The figure is based on data for one year and excludes the holiday period (mid-December to mid-January) in Australia during which most doctors avoid scheduling elective surgeries. The data in Figure 2 shows mild seasonality by month (admissions range from a low of 332 to a peak of 512 with mean of 470) and high variability by day of the week. Excluding the weekends, the average daily admissions range from a low of 58 on Fridays to a peak of 123 on Wednesdays. The pattern is similar for other specialties, except for the location of the peak. While in Figure 2 the peak occurs on Wednesdays and Thursdays, for other specialties it might occur on other days of the week. Taken in conjunction with our premise that end customer demand is fairly constant, Figure 2 suggests strongly presence of phenomena similar to the bullwhip effect. In the remainder of this section we discuss briefly the impact of this pattern on hospital performance operational and financial. First, increased variability in the number of surgeries performed directly impacts the demand for post-operative services in the wards. Consequently, on peak days, shortage of beds makes the wards the bottleneck, thereby restricting the number of surgeries and reducing the theatre utilization and hospital throughput, which in turn leads to lower revenues and lower operating profits. While the hospital is a not-for-profit organization, operating profits represent one of the key funding sources for financing investments in equipment and facilities, and lower levels or absence of operating profit can severely restrict the hospitals ability to provide state-of-the-art high quality service. Second, the demand for nursing services both in theatres and wards is directly affected by higher variability and results in higher labor costs. With Saint Marys strategy of meeting the nursing demand with a mix of full time, part time and agency staff, higher variability of demand translates to the need for higher levels of flexibility and larger proportion of casual and agency staff. Higher wage rates for these categories increases operating costs and leads to lower profits. Third, SMSs reliance on flexible (part time and agency) staff affects the hospitals operating performance in more subtle, but significant manner. Higher levels of temporary staff leads to frequent changes in the composition of support staff assigned to each theatre, thereby inhibiting development of cohesive support teams. Consultant surgeons in our interviews mentioned this factor repeatedly as the primary cause of inefficiencies in theatre, requiring more operating time and reduction in efficient use of theatre capacity. The role of cohesive support teams in improving OR efficiencies is well known and has been noted in many other hospital environments. In the absence of such a support team, the surgery list scheduled for each session tends to be shorter (thus reducing hospital revenues). Alternately, with normal list the theatre time will be higher than planned, resulting in overtime and increasing operating costs. In either case, this practice adversely affects hospitals profits. Furthermore, this factor influences the doctors choice of hospital, prompting use of Saint Marys for more complex cases requiring its facilities. For simpler cases, the doctors tend to choose other hospitals with more efficiently organized OR theatres, perhaps with more limited range of services. As the more complex cases typically involve higher costs, this behavior has an adverse impact on Saint Marys finances. Under the Australian system the fees payable (to the hospital and doctor) are based on predetermined rates for each class and do not depend on the case complexity within each class. To summarize, increased variability in the demand for elective surgeries at Saint Marys hospital results in lower efficiencies, higher operating costs and lower revenues leading to lower profits. Thus, the presence of bullwhip effect leads to degradation of performance as in the case of manufactured goods reported in the literature. While this is intuitive and not surprising, it is interesting to note the dynamics are different from those observed in manufacturing higher levels of inventories and shortages. Macintosh HD:Users:vasvigakkhar:Desktop:Screen Shot 2012-12-29 at 2.09.56 AM.png Macintosh HD:Users:vasvigakkhar:Desktop:Screen Shot 2012-12-29 at 2.13.36 AM.png Methods for coping with the Bullwhip Effect The preceding section highlighted the different causes of the bullwhip effect in the healthcare sector and identified strategies to mitigate the detrimental impact of the effect. We briefly summarize the strategies (see Table for a summary): (i) Reducing uncertainty In order to minimize or eliminate bullwhip effect, it is important to reduce uncertainty throughout the service value chain. If information about customer can be centrally managed and if each stage of the service value chain can be provided with latest information in a timely manner, it will help eliminate duplication of effort at different stages and also ensure data consistency across all groups that require that data. It is also critical that dynamic updating of information is performed which will greatly help reduce uncertainty. (ii) Reducing variability There is inherent variability in the customer demand process and any effort that can be taken to minimize this variability will help reduce the overall bullwhip effect. Also, localized practices that lead to increased variability in demand at any of the stages should be eliminated with better coordination. Use of good forecasting methods will also assist the reduction of variability. (iii) Developing strategic partnerships The bullwhip effect can be minimized by developing key strategic partnerships with different links in the service value chain. For example, in case of hospitals, the hospital administration has to forge strategic alliances with medical specialists. These partnerships will change the way in which the information is shared and will help foster better coordination between the two parties. Although this may not fully eliminate bullwhip effect, it will go a long way in reducing the effect. (iv) Realignment of incentives One prime reason for the lack of coordination and meaningful information sharing is that the different entities are evaluated on the basis of different criteria and receive rewards for different activities. The evaluation and reward system should be modified to stress cooperation across stages and so that the planning is performed on system-level objectives and not on division/local level objectives. (v) Improving coordination across stages of service value chain To reduce the bullwhip effect, it is also important to ensure coordination across stages that are facilitated and improved. Summary and Future Research In this paper we have identified and described a phenomenon in healthcare industry that is similar to the bullwhip effect observed in the manufacturing sector which results in amplification of demand variability upstream in the service chain. Not surprisingly, this distortion likewise leads to performance degradation. However, the similarity with the manufacturing sector does not extend much further since the causes and the impact are somewhat different. For example, while bullwhip effect in manufactured goods results in higher levels of inventory and shortages, in hospitals it leads to lower levels of throughput, higher operating costs and longer patient waits. Hence, initiatives and strategies for minimizing the bullwhip effect and its impact require a different approach that addresses directly the root causes. Our study also indicates that the potential for performance improvements is quite significant. While our study focused on hospitals and other allied institutions in the health sector, we conjecture that a similar phenomenon may be present in other service industries. For example, billing practices in consumer utilities (electricity, gas etc) and credit card services with monthly cycles leads to variable unbalanced loads in certain segments. Similarly, scheduling practices in auto repair industry result in some variability amplification. Together this suggests that a more detailed study of the bullwhip phenomenon in services is warranted and may lead to order-of-magnitude performance improvements similar to those realized during the past two decades in the manufactured goods industries.

Jane Austens Sense And Sensibility Essays -- Austen Sense Sensibility

Sense and Sensibility is a book that deals with many of life's circumstances during the eightteen hundreds. Although it was written in the first person it can provide the reader with a detailed perspective on the lifestyle of the upper crust of society. However, in order to get a full sense of appreciation of this lifestyle the elements of the opposite group, the lower class, must be attained. By comparing the differences amongst lifestyles characteristics which differ between individuals of their respective groups can be explained, and more importantly be justified. The Dashwood's are undoubtedly not of the lower crust of society, instead they were of the upper middle class for a number of different reasons. The most obvious which set them apart from the lower class is that they do not need to work to in order to survive. Although they were left on a budget by the senior Mr. Dashwood, they had no inclination to work, nor was there any mention of it during the entire novel. They were content with simply waiting to be married by a financially stable male. The evidence for this statement came from Mrs. Jennings when she said;" (She) Missed no opportunity of projecting weddings among all the young people." This is the same practice that any reasonable female of that era would participate in. The aristocrats of that time would not have imagined that taking a regular job was the way to succeed, and they were right. It was impossible to succeed, however to the people who did work at those time it was not about success, but rather survival. At the time this book was written England was going through a "Boom." The industrial revolut... ...l servant, the expense would be a trifle; mama she was sure would never object."(22) This left the reader perplexed and curious to understand why this would be the case. However, after analyzing the lifestyle of the lower class, and the upper classes, the reader can gain a sense of understanding as to the mindset of the Dashwood family. It is easy to see how someone that has servants and hunters at their feet might not know how to make it on their own, or for themselves. It is easy to get accustomed to a particular lifestyle, especially if it is one you are born into. Although it is not the families fault that they are not accustomed to hard work, but it begs me to ask the question; how does one learn the meaning of hard work if one never works hard? Britain. 2005. History Channel. 2 Feb 2005. http://www.historychannel.com/perl/print_book.pl?ID=210855

On the Sidewalk Bleeding Essay

In the short story â€Å"On the sidewalk bleeding,† by Evan Hunter, the author makes us feel sympathy for the main character by using a variety of techniques such as characterisation, plot structure and language. The story opens with the main character, Andy, who has just been stabbed because he is in a gang. . Unfortunately it is too late to change what had happened and as a result the reader feels immense pity for him when he dies. This short story includes the themes of regret and how gang violence causes loss of identity. Firstly the author makes the reader feel sympathetic towards Andy by using effective techniques to emphasise the agony and the painful phase that Andy is going through. The author says that Andy is in so much pain that no sound comes out of his mouth. The passage says, â€Å"There was no voice in his throat only the bubbling of blood between his lips.† In this quote, alliteration is used with the words â€Å"bubbling of blood.† The author uses this technique to highlight how much pain and terror gangs can create. This is also effective as it creates a gruesome image in the reader’s mind of Andy in his current situation. Therefore we feel sorry for Andy as he cannot even call for help. Another way the author makes us sympathise for Andy is how the author uses the idea of Andy being isolated from the rest of the world. Andy is lying in the alley far from help and he can hear music but nothing or no-one is able to help him. We see this when the writes says, â€Å"He watched the world passing,† and also the quote, â€Å"He could hear the faint noise of music now, from and long, long way off.† These two extracts from the passage illustrate that although Andy is dying the world is still moving and no one cares or even looks at Andy. Also it shows to us that Andy is isolated from society. At this point in the story Andy realises that being in a gang has detached him from the rest of the world and there is no going back. This relates to the theme of regret as Andy starts to regret the choices he made in life. The reader starts to feel even sorrier for Andy as he starts to repent what he has done but he can’t do anything to save himself now as it is to o late. Furthermore, throughout the story the author has created characters which pass by Andy but unfortunately for Andy they don’t help him for different reasons. When the third useless person comes into the alley, Andy is in hope that she will help him but sadly she doesn’t. The story says, â€Å"An old lady stopped at the other end of the alley like a queen.† In this quote the author uses a simile to show us how the old lady was acting and how she considered herself nothing less than a queen. This quote makes us sad as Andy has now had three attempts of surviving but all of them have slipped away just because he is in a gang. This also relates to the theme of how gangs cause loss of identity as if he wasn’t in a gang he would have had at least one chance of surviving out of the three. This again makes the reader sympathise towards Andy. Furthermore feel sorry for Andy by using personifying the jacket and the knife. Andy knows that he is dying and wants to be known as an individual and not a royal. The quote is, â€Å"Had they stabbed him, Andy or had they only stabbed the jacket and the title, and what good was the title if you were dying. † In this personification is used to emphasise that the guardians only stabbed Andy simply because he was a royal and show that the knife had no hatred towards Andy only the jacket and the title. The jacket symbolises the royals and the knife symbolises the guardians to indicate how much hatred is between the two gangs. Similarly this idea is further developed when Andy blames the jacket for him loosing his life. Andy begins to realise that if there was no jacket there wouldn’t have been a rumble in the first place. The short story says, â€Å"The jacket was a stupid meaningless thing, which was robbing him off his life.† The jacket and title has ruined his life and future. The word choice of â€Å"meaningless† shows that where once the title and the jacket was so important to Andy and how he was proud of it, but now the same jacket and title mean nothing to Andy but instead detests them. Also personification is used to make the knife and jacket seem like people. This suggests that objects are more important and this goes back to the theme of when you join a gang you lose your identity. The theme here shows that when you join a gang you are no longer an individual but you are a gang member instead. Finally Andy at the end of the story was ashamed of being called a royal and his new identity. Andy tries to tell the world that he not a royal but only Andy. The reader sees this when the writer says, â€Å"I’m Andy,’ he screamed wordlessly, ‘I’m Andy.’† Reputation of Andy’s name emphasises to us that he wants to be known as Andy and not a royal before he dies. Juxtaposition of â€Å"screamed wordlessly† is used to show that Andy is trying to scream but he only can in his mind as he is in too much pain to speak. By this point Andy is utterly helpless and can’t do anything. We feel pity towards Andy as he can’t even speak his feeling so there is no chance of him surviving. In conclusion the author has used many techniques of writer’s craft such personification and language to make the reader sympathise towards the main character Andy. Although not much action happens in the short story, the author still manages to make us feel sorry for Andy as Andy goes through his life and realises that he has done nothing major in his life expect make stupid mistake of joining a gang which leads him to losing his life.