Local Government In The Malaysian Context Information Technology Essay

Local Government In The Malaysian Context Information Technology Essay Customer satisfaction is a key issue for all organizations in both public and private sectors. This is a highly important challenge as service standards today relies on excellent service quality delivery and high customer satisfaction levels. All employees have a role in determining the degree of satisfaction experienced by their customers. In the public sector, due to increased levels of information dissemination, governments are expected to be more sensitive to the demands and needs of the peoples and societies they serve. Many public sector organisations are undergoing reforms in order to provide better, faster and even wider range of services to the people. The customer has a prominent place in these reforms. In recent history, much has been written on the subject of customer satisfaction, but comparatively little regarding customer satisfaction in the public sector. This is despite the issue of customer satisfaction in public services has been growing in importance, particularly in Malaysia due to the perception of deteriorating levels of satisfaction as perceived by most quarters of the public. In the past ten years with the explosive growth of broadband internet penetration levels in the country, public agencies have been increasingly placed in the spotlight for their shortcomings as larger segments of the public are made aware of the lack of satisfaction encountered by others. In most countries including Malaysia, local government has the most direct impact on the resources in the economy as they are most involved in the implementation of national and state government policies. The range of activities involving the local government sector is primarily labour intensive. There are therefore a number of reasons for the need of this research particularly in the Malaysian environment. Firstly, local government has a monopoly on the provision of most of their services, and do not have forces of competition and profit driving efficiency and effectiveness in meeting customers needs (Caruana, Ramaseshan, Ewing 1998). Members of the public who are unhappy with the local authority administering their premises or property are not able to change to another local authority or opt out of receiving services from that authority (and thus not paying taxes due) without moving to another area administered by another local authority. Secondly, demand for government services is on an increasing uptrend due to increased expectations by the people. More and more people expect the government to assist them in resolving various issues encountered. Such issues includes the provision or maintenance (or lack of provision or maintenance) of infrastructure and services. Thirdly , due to increasing pressure on governments as a service provider for an increasing range of services, local government has to set up and maintain competence in many aspects of performance. An instance of this can be seen with the advent of information technology (IT). Many local authorities responded by setting up an IT department which was put in charge of computerising operations. Hence local government organisations will be perceived to be competent, knowledgeable, courteous and reliable if and when their employees possess competencies to allow effective execution of their prescribed duties. This study will be undertaken with the objective of investigating the impact of employee competencies as perceived by customer satisfaction in the services provided by Majlis Bandaraya Alor Setar (MBAS) or Alor Setar City Council. Additionally, this study will also evaluate the relationship between employee competencies and perceived customer satisfaction. It is important to undertake this research at this time particularly at MBAS because it is now in transition to move towards a new stage of increased employee competencies in the new era of internet-enabled services. 1.1 Local government in the Malaysian Context Local authorities in Malaysia are governed primarily by various national and state legislative provisions. At the national level, the Local Government Act of 1976 is the primary legislation that specifies the functions and responsibilities of local government bodies in Peninsular Malaysia. These functions and responsibilities not only include mandatory functions but also discretionary functions too. These functions include solid waste management, street maintenance and activities pertaining to public health. Examples of discretionary functions include development and infrastructure functions like providing amenities, recreational parks, housing and regulating certain aspects of commercial activities such as licensing. According to a report by the United Nations Economic and Social Commission for Asia and the Pacific (2001), provisions of the Local Government Act 1976 grants local authorities in Malaysia the following roles in their respective jurisdictions or areas: Local planning authority Licensing authority Manage to impose certain kinds of taxes Take in charge housing, building and commercial construction (markets, hawker stalls and many others) Manage to perform urban planning, landscaping and management functions Manage public transport systems Manage to plan and provide public utilities. Source: United Nations Economic and Social Commission for Asia and the Pacific (2001). http://www.unescap.org/huset/lgstudy/country/malaysia/malaysia.html As can be see above, local authorities in Malaysia have a wide range of functions and responsibilities which has significant impact in the environment which they operate in. It is highly important for available competencies to be studied and further developed in order to improve the delivery of services to the people (their customers). The fact that the Malaysian government is aggressively pursuing economic growth can be seen with the introduction of the New Economic Model (NEM) initiative and 10th Malaysia Plan by Prime Minister Datuk Seri Najib Tun Razak recently. As part of these initiatives, local authorities will play important roles in the further development of the country. As of July 2010, there are 147 local authorities in Malaysia as summarized in Table . Table Local Authorities in Malaysia Local Authorities Total City Councils 12 Municipal Councils 39 District Councils 96 Total 147 Source: Ministry of Housing and Local Government. http://jkt.kpkt.gov.my/en/main.php?Content=vertsectionsSubVertSectionID=59VertSectionID=43CurLocation=43IID= 1.2 The Background of Majlis Bandaraya Alor Setar (MBAS) MBAS is one of the local authorities in Peninsular Malaysia. At its inception in 1735, MBAS was established as a sanitation board when the city was founded by Sultan Muhammad Jiwa Zainal Adilin Muazzam Shah. The city of Alor Setar and the local authority body which oversaw it has grown in size and functions since then. MBAS is the local authority entrusted with providing services for the governance and development of Alor Setar. It is the only local authority in the state of Kedah with city council status which was awarded by the federal government on 31 December 2003. This upgrade of status came after Alor Setar officially became a city on 22 August 2002. From the Population, Household Living Quarters Malaysia 2009 publication by the Department of Statistics, we find that the district of Kota Setar (which includes Alor Setar) has a population of 429,900 people. Source: 1. Majlis Bandaraya Alor Setar. http://www.mbas.gov.my/web/guest/background 2. Department of Statistic, Malaysia. http://www.statistics.gov.my/ccount12/click.php?id=294 According to the Local Government Department of the Ministry of Housing and Local Government, a city council should meet the following criteria: Area under jurisdiction includes the administrative centre of the state Population above 500,000 Fiscally sustainable with annual revenues exceeding RM100 million capable of sustaining a balanced budget Provision of high level of services Sustainable development with an emphasis on tackling urban issues like squatters, illegal factory operation, security, housing for low-income groups and environmental conservation Achieves stable city classification under Malaysia Urban Indicator Network System (MURNInet) Availability of industrial centres, financial institutions, cultural centres, sports and recreational facilities and educational institutions Complete infrastructure provision and public utilities inclusive of public transportation facilities, traffic management system, efficient road network and ICT services, public areas which are disabled-friendly; and Recognition as a city either at national or international level in certain areas Source: Ministry of Housing and Local Government. http://jkt.kpkt.gov.my/en/main.php?Content=vertsectionsSubVertSectionID=65VertSectionID=43CurLocation=43IID=Page=1 The current mayor of Alor Setar is Dato Khazali Din. He has been in office since 1 December 2008. Besides the mayor, there are also 14 local councillors who are appointed by the State Government under provisions in the Local Government Act 1976 to administer MBAS. It employs approximately 250 employees ranked from Head of Departments to labourers. There are nine major departments and divisions in MBAS as follows: Treasury Development planning Engineering Assessment and Property management Management services Municipal services and Health Community development Law Buildings Source: Majlis Bandaraya Alor Setar. http://www.mbas.gov.my/web/guest/jabatandanbahagian The main objectives of MBAS are as follows: Provide a comfortable living for the community of Alor Setar city from the aspects of services, planning and development; Transform the employees of MBAS to an efficient, clean, trustworthy and disciplined workforce; Increase and diversify the sources of revenue so that MBAS will become a financially strong institution; Management system which is of quality, dynamic and innovative; and Develop a caring society environment among the workforce through the provision of welfare, health and safety schemes Source: Majlis Bandaraya Alor Setar. http://www.mbas.gov.my/web/guest/objective Throughout its 275 years of existence from a sanitation board up to the current incarnation as a city council, MBAS has been contributing a strategic role in the delivery of local government services in Alor Setar. Its official mission statement is to provide the highest level of services based on the latest technology. The primary functions of MBAS as a local authority includes development and operational functions such as solid waste management, cleaning of public areas and amenities, traffic system design and street maintenance, landscaping and beautification works, provision of shared public facilities and amenities like sports and recreation areas and infrastructure works. The most important secondary function of MBAS is to regulate business and commercial activities by means of licensing provisions. An example of the usage of these regulatory powers can be seen in the recent controversy regarding sports betting. While the federal government had approved a sports betting license to Ascot Sports Sdn Bhd, the state governments led by Pakatan Rakyat (PR) had declined to issue licenses for premises to be used for sports betting activities. This was done by instructing the various local authorities in PR-controlled states not to issue premise and other business licenses for sports betting activities to Ascot Sports Sdn Bhd. This effectively ensured that Ascot Sports will not be able to operate sports betting activities in those states. Source: The Star, June 2010 http://thestar.com.my/news/story.asp?sec=nationfile=/2010/6/7/nation/20100607155524 Other secondary functions of MBAS include the promotion of commercial and tourism activities and health and safety regulations of the community. This is done through the provision of infrastructure like roads and public facilities like parks, recreational areas, museums and the like. In terms of health and safety regulations, a commonly seen example would be the enforcement of laws against aedes mosquito breeding areas and building inspections and renovation regulations to ensure that such work is done within acceptable limits and meets minimum safety standards. 1.3 Background of the study There are many opinions with regards to the issue on how to manage service quality and delivery. In terms of service-based businesses, while the basis is similar to that of manufacturing-based businesses, the challenges posed are quite different. This is mainly due to the different attributes of both businesses. In manufacturing businesses, typically a product is made to certain specifications. The outcome of the process to create and manufacture a particular product should produce very little variation. This contrasts with service businesses whereby the outcome of services provided by the business can be significantly different due to the interaction between the business and its customers in the process. There are variations in expectation, expertise and material inputs from one customer to the next. Because of this, the outcomes of the process as perceived by customers can vary significantly even when businesses try to control for as many variables as possible. In terms of the public sector and civil service in Malaysia, the government has set up a number of agencies and undertook various measures to improve performance and service quality delivery. Some of these agencies and measures along with a brief history are mentioned below. One of the earliest attempts in post-independence Malaya to formalise and standardise training procedures for Public Services Department (PSD) employees is the setting up of the National Institute of Public Administration (INTAN). It was set up in September 1959 as the Staff Training Centre in Port Dickson, Negeri Sembilan. The centre provided training in administrative areas such as financial, land, office management and local government administration. The Staff Training Centre became INTAN in June 1972 and now has a mission to develop human resources in the public sector though the provision of quality training programmes. Source: National Institute of Public Administration, Malaysia. http://www.intanbk.intan.my/i-portal/en/about-intan/intan-in-brief.html The Malaysian Administrative Modernisation and Management Planning Unit (MAMPU) was initially created as the Development Administrative Unit (DAU) in 1966. The DAU was created based on a report by Prof. John D. Montgomery dan Milton J. Esma in Development Administrative in Malaysia which called for steps to improve professionalism in the public service by providing training and conducting educational programmes for all levels of the civil service. DAU was responsible to spearhead improvements in the civil service. In 1972, DAU was merged with the Implementation, Coordination and Evaluation Unit (ICEU) to form the Implementation, Coordination and Development Administration Unit (ICDAU). MAMPU was set up in 1977 as a new agency which took over the responsibilities of modernising and human resources planning from the ICDAU. Source: 1. Malaysian Administrative Modernization and Management Planning Unit, Prime Ministers Department. http://www.mampu.gov.my/mampu/sejarah1 2. Implementation Coordination Unit, Prime Ministers Department. http://www.icu.gov.my/icuV9/pg/indexV9.php?pg=prof The Public Complaints Bureau (PCB) under the Prime Ministers Department was mooted by former Prime Minister Tun Abdul Razak. It started operations on 2 August 1971 and is the leading organisation in Malaysia for the management and monitoring of public complaints regarding government departments and agencies (Suddle, 2009). Source: Suddle, 2009. Report on Study Tour of PUBLIC COMPLAINTS BUREAU MALAYSIA. http://www.asianombudsman.com/ORC/RETAreports/FTO_report.pdf Probably the most well known effort by the government to improve the civil service by reducing instances of corruption would be the Malaysian Anti-Corruption Commission (MACC) which was mooted by former Prime Minister Tun Abdullah Ahmad Badawi which officially commenced operations on 1 January 2009. The history of MACC began as an agency when the National Bureau of Investigation was set up in 1973 to consolidate corruption and other special cases which were being handled by different teams in the police, Prime Ministers Department and the Law Ministry. The name was then changed to the Anti-Corruption Agency in 1982 to reflect its role as the main agency in Malaysia in the fight against corruption. Source: Malaysian Anti-Corruption Commission. http://www.sprm.gov.my/ To improve civil service performance, former Prime Minister Tun Abdullah Ahmad Badawi in January 2005 had suggested various means on reinventing the civil service in Malaysian. According to him, to safeguard the image of civil service, public sector employees must be creative, inventive, fluid, consultative and free of corrupt practices. He addressed this issue to 3000 decision makers in public sector, ministers and chief executive officers of government-linked companies in order to have a free flow of ideas between top-level officers and their subordinates for the betterment of the service. He said civil servant must be able to think out of the box and make strategic adjustments so that they could act speedily when faced with adversity. On free flow of ideas within the service, department heads must be willing to acknowledge good suggestions which were given by their subordinates. Civil servants should be encouraged to provide feedback on approaches undertaken and these responses mu st be taken seriously by decision makers who should also institute changes whenever necessary. Source: The Star, January 2005 In February 2005, Tun Abdullah Ahmad Badawi reminded the civil service to increase emphasis on integrity, accountability and high work ethics in its efforts to improve efficiency in serving the people and the business community to safeguard the image of the public sector in order to enjoy the support and confidence of the people. Source: The Star, February 2005 The Special Taskforce to Facilitate Business (PEMUDAH) was established on 7 February 2007 under the Prime Ministers Department. Mooted by former Prime Minister Tun Abdullah Ahmad Badawi, the terms of reference for the objectives and operations of PEMUDAH is as follows: To review the status of the public services delivery system in terms of processes, procedures, legislation and human resource towards introducing improvements; To study best practices in the private sector that can be adopted by the public sector; To coordinate programs across public sector agencies towards enhancing Malaysias competitiveness; To monitor the implementation of policies, strategies and procedures aimed towards improving the efficiency and effectiveness of the public delivery system; and To take appropriate action in addressing issues raised during Cabinet meetings regarding the public delivery system. Source: PEMUDAH Secretariat Office, Ministry of International Trade and Industry. http://www.pemudah.gov.my/297 On 13 April 2007, the government introduced the concept of One Stop Centre (OSC) for local government agencies under the Ministry of Housing and Local Government. According to Chief Secretary to the Government, Tan Sri Mohd Sidek Hassan, the OSC was set up based on the concept of No Wrong Door whereby it will be a single point of entry which allows customers to obtain various services from multiple agencies using an integrated method. OSC will coordinate all stages from documentation submission until a decision is reached and provided to the customer. Source: The Office of Chief Secretary to the Government. About One Stop Centre. http://www.pmo.gov.my/ksn/?frontpage/speech/detail/1470 Within half a year of assuming office, Prime Minister Najib Tun Razak had mooted and established the Performance Management Delivery Unit (PEMANDU) on 16 September 2009. A unit under the Prime Ministers Department, its main role and objective is to oversee the implementation and assess the progress of the government transformation programme (GTP) and to facilitate and support the delivery of both National Key Result Areas (NKRAs) and Ministry Key Result Areas (MKRAs) of the various ministries and government agencies. Source: Performance Management Delivery Unit, Prime Ministers Department. http://www.transformation.gov.my/index.php?option=com_contentview=articleid=205Itemid=144lang=en On 1 January 2010, the MBAS Complaints Portal was launched as an online application to allow the public to lodge complaints to the local authority. The portal accepts submissions both online and though Short Message Service (SMS). The public can then follow up on complaints lodged though the portal. The portal also provides a forum for the council to receive feedback from the public. Source: MBAS Complaints Portal. About Complaints Portal. http://aduan.mbas.gov.my:2000/aduan/news.php 1.4 Research Problem Many business organisations these days would no doubt agree that the environments in which they do their businesses is becoming more and more complex and more challenging to understand due to rapid pace of change. There have been many studies which concluded that no business can be successful without taking the needs of their customers into serious consideration. There are several factors which have played significant roles which has changed the impact customers have on businesses. One of them would be the rise of consumerism in the 20th century. Rapid economic expansion due to the agricultural and industrial revolutions along with explosive population growth has rapidly increased the number of consumers in the market. Prior to this, only a small percentage of the population had sufficient disposable incomes to make an impact outside of their local societies. Due to rapid economic growth, more and more people earned enough to start having significant levels of disposable income which could be used for discretionary purchases. New inventions and improvements allowed businesses to transport goods faster and cheaper allowing more people to have increasing choices in the goods and services available to them. The services industry started being recognised as an arm of the economy in its own right and in more advanced economies, is more important t han manufacturing and trading industries. Customers now have more choices and could demand more from businesses. Any business which does not respond adequately to the rapidly changing business environments may face overwhelming challenges and can even go out of business. As a local authority and a government body, while it is very difficult for MBAS to go out of business per se, it is still a service organisation that provides multiple services to the people. MBAS cannot deny the expectations of its customers because their customers are taxpayers and voters. As a government body, it receives all income from public sources (i.e. taxpayers) and if they are not happy, they will show their displeasure during elections and effect changes through the government. We can thus surmise that employees in service organisations play an important role in ensuring that customers have a positive first impression. If customers are not provided with a level of service which they expect, this will lead to dissatisfaction and as a consequence, the number of complaints will increase. According to MBAS Public Relations Section, the authority receives on average 29 complaints per day sent by the public through various channels namely the MBAS Complains Portal, telephone, m ail and fax. In order to reduce dissatisfaction with its services and thus the number of complaints, it is necessary for MBAS to increase the quality of services it provides. It is highly important for them to plan, coordinate and then implement a comprehensive program to promote and disseminate the mindset of service quality excellence among employees in the organisation. It is imperative for MBAS to improve its services because its customers (the public) expect to interact with competent employees who are able to display high levels of professionalism and provide equally high levels of service quality whether in terms of explanation or physical services provided. Local authorities play an important role in the growth of both in the state they are located in and their own jurisdiction. You can go to virtually any part of Alor Setar and the name of the local authority administrating the city can be clearly seen. This has an effect of ensuring that services (or in contrast, the lack of services) provided by MBAS is always in the public eye. For example, a pedestrian bridge along Jalan Alor Setar-Sungai Petani at Batu 3, Tandop which has been in a state of disrepair for some time caused a scare when a large metal piece measuring 3 x 24 metres and a banner celebrating the Sultans recent birthdaye road isrepair for some time caused a scare when piecen of S is always in the public eye. t services or fell on the road underneath the bridge. While no vehicles or people were hurt in the incident, there has been several earlier incidents of smaller pieces of metal falling off the bridge. A road user claimed that he had informed MBAS about the earlier inc idents but thus far no action has been taken. A few questions had arose from the incident namely why the local authority did not take any action upon receiving complains about the bridge earlier? While there may be a lack of allocation at this time to repair the bridge, perhaps if MBAS had more competent staff, perhaps any loose metal pieces could have been removed and the bridge temporarily closed while awaiting allocation to fully repair the bridge. This would have helped to ensure no untoward incident happens. http://www.sinarharian.com.my/bterkini/4941.asp Landscaping and beautification activities of public areas and amenities are one of the local authorities primary functions. It was reported recently that the Taman PKNK football field has not been properly maintained for several months. This had made the field unusable due to the tall grass which has now became homes to poisonous snakes and other animals. According to the news report, MBAS follows a schedule whereby grass will be cut on fields located in residential areas every 21 days. The questions that are being asked is what had caused the oversight in maintaining the field? The oversight was not noticed by the council despite multiple 21 days cycles having passed. Could it be due to incompetence of MBAS employees that lead to the oversight in providing the required service? Employees should be more innovative and creative in overcoming obstacles faced when providing such services. http://www.sinarharian.com.my/utr/content/story5181294.asp The attitudes and procedures of MBAS once again came into question when a conflict occurred between the council and Chinese associations over what was felt as a new requirement to pay two different license fees for mahjong activities. The council had issued a letter on 7 July 2010 requesting payment for licensing fee but the associations had already paid a licensing fee to the Kota Setar district office for their mahjong activities. According to them, that is the only license they have always paid to conduct their activities. It was later clarified by Alor Setar Mayor Datuk Khazali Din that the license paid to the district office was to conduct mahjong activities but a separate license for the premises was also required to be paid to the council but was not enforced earlier. The questions raised in this incident relates to why if there were indeed such rules, it was not informed or explained to the Chinese associations earlier to prevent the misunderstanding from occurring in the fir st place. http://thestar.com.my/news/story.asp?file=/2010/7/18/nation/6689157sec=nation As the mahjong activities has been going on for some time, the point now is that the attitude of the council and lack of tack in approaching the matter had caused the disruption of legitimate activities of other people. The approach used to approach the Chinese associations regarding the licensing issue reveals the inflexibility of the council. MBAS could have used more gentle approaches when approaching the associations and prevent the misunderstanding from occurring in the first place like giving them a suitable grace period rather than threatening immediate fines and legal action for non-compliance with its demands. MBAS will be categorised as a quality service provider if its employees have initiative, accountability, motivation and work as a team to accomplish their tasks or projects. Perhaps if the council had employees with the correct competencies in place, the various incidents mentioned above would not have happened? MBAS has to provide sufficient skills, ability, and the correct knowledge and resources to their employees and place them at the right positions. At the same time, the council should also adopt new forms of work organisation such as work teams, management delayering, job sharing, reengineering and downsizing redundant employees. In this context, MBAS should not only improve business performance but must also focus itself on making the necessary management changes related to combination of factors such as employee competencies, new computing and communications technologies and measure the productivity of service staff and knowledge workers. There is precious little studies in the past to measure perceived service quality in MBAS. As a service provider, MBAS is expected to be more competent and innovative. Given the situation that the council now finds itself in, service quality will be an undoubtedly interesting area to study. 1.5 Research Objectives The objective of this study is to determine if service quality at MBAS is driven by employee competencies. To be more specific, we want to: Identify employee competencies which is important for MBAS to improve customer satisfaction; Examine customer satisfaction as perceived by the public at MBAS; and Investigate the relationship of employee competencies in relation to perceived customer satisfaction in MBAS. 1.6 Research Question This study was motivated by our determination to answer the following questions: What are the competencies that employees at MBAS should have? What is customer satisfaction as perceived by the public? What are the relationships between employee competencies and perceived customer satisfaction? 1.7 Definition of Terms Local Government Employee A worker who is employed to provide services to a company on a regular basic in exchange for compensation and who does not provide these services as part of an independent or self-employed business. Competencies A cluster of related knowledge, skills and attitudes that affects a major part of role or responsibility that correlates with performance on the job, that can be against well accepted standards, and that can be improved via training (Competencies Workgroup, September 2002). Service Service can be defined as any primary com

Hello? - Original Writing :: Papers

Hello? - Original Writing The women slid into the luxurious crumpled white leather sofa and let the tide of cushions envelop her. Bathed in the subtle light she sat, gazing mindlessly into her TV. Inside the spacious living room, the large mirror hung majestically over the ornate stone fireplace and the traditional rug from South Africa was stretched out on the glossy, wooden floor; well positioned ornaments were placed around the room, giving it soul and life. And a soothing snug sound from the grandfather clock floated around the room. Warm-hearted pictures of friends, family and of her husband gave the room a familiar character. The TV flickered and fuzzed and a smart, well spoken, serious looking newsreader began with the bad news as usual, but this time, it was much more significant. The women immediately sat up, with an uneasy look spreading over her face. She leaned forward and listened carefully to the incoming news report. The man strode forward through the bushes, as he passed he brushed aside the leaves and felt the soft squelch of mud under his boots. As he reached the path the gravel crunched, and ground as the stones gnashed together. Catching a stone from the new red brick wall it shattered into fragments. The light from the street lamp glinted off his watch which he quickly covered up, stopping on his way to scratch his thick, dark, grainy stubble; he made his way to the house. The last rays of light had fallen and now the dark had completely covered the ground. The eeriness crept in, and like some unsure sign, it made itself known but not visible. There was something there, and she could feel it. She walked to the front door looking left, then looking right as she took each step, and with every glance she expected to see something she did not want to. Her keys jostled and echoed in the high ceiling hallway and with her slightly quivering hands she found it hard to place the key in the lock, but just as the

Electronic Medical Records Essay

Electronic Medical Records (EMR) are becoming more widely used across the healthcare spectrum. One of the reasons for their popularity is the potential that is presented for increasing the quality of care delivered to patients by decreasing handwriting interpretation errors, reducing medication administration errors and eliminating lost charts. Time management is a crucial skill to have as a nurse. It allows for a smooth workflow which translates into quality patient care. Much time can be wasted not only by the nurse signing off illegible handwritten orders, but also by the other nurses that have to help interpret the handwriting. The EMR requires the physician to enter orders electronically, thereby eliminating handwritten orders. Electronic orders are more precise and more accurately followed (Sokol, 2006). Fewer errors make it to the patient, reducing unnecessary tests and increasing the quality of care that patients are receiving. Electronic medication administration records (MAR) are useful in displaying medications due at specific times. Not only is it possible to sort the medications due at one time, the MAR will also alert the nurse to potential drug interactions. Late medications will be displayed in red to be easily seen. If bar coding is implemented, medication errors can be reduced by a range of 60%-97% (Hunter, 2011). A lost chart can be very frustrating while trying to deliver seamless care to a patient. Paper charts are easily misplaced. Since there is only one, if a single provider is using it, no one else of the medical team can view the chart. The EMR can be viewed from any computer with secure internet access or on a handheld device. When the internet is down, a downtime view only access is available. Nursing Involvement Nurses are known as patient advocates. In advocating for their patients, nurses strive for what is best in their patient’s care. Since nurses will be using the EMR most frequently, it is imperative that they are part of the selection and implementation on an EMR. A nurse, on the EMR team, will represent all nursing. Nurses will be accessing the EMR through their shift several times and will become familiar with the layout and workflow and will be able to provide insight into what would work best to ensure quality of care. There is a saying that you don’t know what you don’t know. A nurse knows what she will need and is the best to supply this information. While researching which EMR would be the best for a facility, a nurse can provide information on time saving workflows between systems. Nurses must also be trained as super users to provide a seamless change from paper charting to electronic charting and provide support to fellow nursing staff. A nurse on the EMR team will be able to deliver new information in a way that other nurses are more receptive to. Handheld Devices If nurses were to use handheld devices in delivery of patient care, there would be a noticeable savings of time as well as more accurate charting. Nursing personnel carrying a handheld device would have immediate access to their patients chart to notice new orders, lab results, or medication admission records. The need to review the paper chart repeatedly throughout the day would be eliminated along with the long search that commences every time you have to look for the paper chart. This could add several minutes to a nurse’s time at the bedside, improving patient satisfaction. When vital signs are taken, written on a slip of paper and then transcribed into the paper chart, there are many opportunities for error and delay. Numbers can be transposed, written incorrectly or the wrong patient’s information could go into a chart. With the immediate availability of a handheld device, the information from the vital signs monitor would have the ability to interface into the patient’s chart virtually eliminating late charting and errors. Security Standards The Health Insurance Portability and Accountability Act (HIPAA) was initiated in 1996 as a standard for protecting individually identifiable health information (U. S. Department of Health and Human Services). HIPAA requires that all information, either written or electronically, that falls under the criteria is protected from unauthorized viewers. An EMR carries more stringent HIPAA guidelines than a paper chart due to the risks associated with computer based files and there are a few key steps that must be taken to ensure compliance with this act. Access control: each user will have a unique user name and password that must not be shared. Firewall protection must be used on the internet server the hospital utilizes to prevent hackers from obtaining access to protected information. If users are authorized to access patient information from home, there must be a secure server used (Arevalo, 2007). Storage: Data must be encrypted to enhance the security while information is being stored and while it is transferred. Encryption entails protection of files and data that is only viewable to authorized users. Compliance of these regulations should be audited on a regular basis with any violation being swiftly remedied (Medical Records, 2013). Healthcare Costs Purchasing an EMR can cost hundreds of thousands of dollars. In order to justify such a large purchase, one must examine the potential ways that money can be saved while using an EMR. After spending hours training users and with a little practice, nurse’s workflows will improve and less time will be wasted. A chart will not have to be searched for, double or triple charting is eliminated by using handheld devices for immediate charting. The quality assurance team will be able to run reports on compliance of core measures and be able to recommend changes to nursing personnel to implement. Fewer medication errors will be made by using the electronic MAR. Most importantly, these time and money saving factors will enhance patient safety. With fewer paper charts to store, valuable space can be remodeled into patient care areas that offer services not previously offered due to space issues (Power, 2013). This will increase revenue for the facility. Comparison Epic offers a computerized management system that is utilized by everyone in the healthcare setting including, nurses, nurse aids, physicians, dietary, radiology, emergency department and the business office. Each department will have a unique look and functionality to their program. There is no need to use multiple systems to gather information on a patient. It can be used in medium size ambulatory settings such as a clinic as well as in a hospital setting for either inpatients or outpatients. With all departments having access to the same information on a patient, errors will be reduced in delivery of patient care. The chance for entering erroneous lab results or miss- documentation will also be reduced with department specific workflows. Not only will this result in better patient care, but also in a nurse’s ability to delivery effective, efficient, quality care without delay. In addition, all physician order entry is electronic, every time. Order sets can be customized for each prescriber, saving time and hassle while maintaining meaningful use and following core measures. For added security, the system can be set to automatically sign a user out after a specified length of time of non-use. And while all of the patient’s information is available to each user, audit trails are left enhancing patient security. Epic has pre-loaded patient teaching materials available as well as the option to custom make information. After visit summaries are easily printed upon discharge and an electronic copy is permanently attached to the chart. Patient would benefit from a facility the uses the Epic system by having access to MyChart. MyChart is a portal of access between a patient and their provider for communication as well as a portable computerized health record. IF a patient were to access care from a facility that does not utilize the Epic system, that patient would have access to MyChart and would then be able to provide critical information that would enhance their care. Another computerized management system available is one from Cerner. This system can be used in all settings in a hospital including nursing. For medication administration, Cerner has available barcode identification of medication to help nursing staff complete their five rights verification prior to administration. It also allows charting at the bedside to enhance accuracy either through a handheld device or a stationary computer. All order entry by physicians is done on the computer allowing the providers to follow built in prompts for allergy information and adverse drug interactions as well as prompts that will aid in the order of care protocols to enhance patient care. Cerner also has a portal designed for patient to have access to their records no matter where they are as well as tracking information for health goals a patient and their provider have established. The portal allows progress tracking and provides information on steps that can be used to help the patient reach their goals. This gives patients more responsibility for their health while providing the incentive needed. Nursing care will be escalated similarly to the way it would be in Epic. Patient information is easily accessible through intuitive workflows allowing nursing staff to make responsible decisions regarding patient care. My recommendation for a computerized management system would be the one available from Cerner. It is the most user friendly for staff including nursing and offers intensive training and yearly upgrades. The different departments systems appear to work together seamlessly resulting in increased savings of time and money (Cerner, 2013).

Analysis Of Gwen Harwood s The Violets - 1450 Words

Poetic techniques displayed through the ideas, poetic features and style of the poet, reveal concepts which transcend time and place. In Gwen Harwood’s poem â€Å"the violets† her ability to interweave past and present emphasises the importance of memory in preserving ones journey though the universal experiences of growth, maturity and mortality. Similarly the poem â€Å"Mother who gave me life† demonstrates the memory of motherhood as a timeless quintessential part of the human condition. And lastly In Harwood’s â€Å"father and Child†, the connection between the father and son/daughter highlights that transformation throughout childhood is inevitable. Through the content and the language, the ways in which human experiences reveal concepts which†¦show more content†¦To reinforce the childish simplicity and ignorance of time loss, Harwood personifies time as a thief. The use of monosyllabic language â€Å"the thing I could not grasp or name’, emphasises adolescent ignorance and the obliviousness towards youth, a precious finite commodity of life, seen through, â€Å"that, while I slept, had stolen from me†. TS - By drawing upon common experiences, Harwood conveys the resonate message of the quintessential connection between experience through the persona’s gratitude towards her parents, through the power of memory. Points This notion is particularly evident in the realisation of the persona â€Å"years cannot move nor deaths disorienting scale distort those lamp lit presences† reiterating the immortality of memory as a constant, surpassing the boundaries of time and places we go. Thus, it is evident that deeply personal moments of one’s past are made significant by the bittersweet nature of life and the inevitability of death which are a part of the human condition. This also reflects the inevitability of growth from innocence to maturation. TS - In the poem, â€Å"Mother who gave me Life†, Harwood explores the memory of motherhood as a quintessential part of being human. Points The individual experience is demonstrated by Harwood though her personal tone of