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  22. <title>The Elements For Creating a Japanese Garden</title>
  23. <link></link>
  24. <comments></comments>
  25. <pubDate>Fri, 19 May 2023 18:13:13 +0000</pubDate>
  26. <dc:creator>admin</dc:creator>
  27. <category><![CDATA[Gardening]]></category>
  29. <guid isPermaLink="false"></guid>
  30. <description><![CDATA[The Key Elements of a Japanese Garden Japanese gardens are growing in popularity nowadays. This can be attributed to its graceful combination of plants, water and rocks all meticulously arranged to invite a sense of calm and tranquility. If you&#8217;re &#8230; <a href="">Continue reading <span class="meta-nav">&#8594;</span></a>]]></description>
  31. <content:encoded><![CDATA[<div id="article-content">
  32. <p>The Key Elements of a Japanese Garden</p>
  33. <p>Japanese gardens are growing in popularity nowadays. This can be attributed to its graceful combination of plants, water and rocks all meticulously arranged to invite a sense of calm and tranquility. If you&#8217;re looking to build your own Japanese garden at home, here are important principles you should keep in mind:</p>
  34. <p>1. Your stone layout sets the foundation</p>
  35. <p>As Ancient Japanese mythology puts great importance to mountains and stones as the foundation of the earth, the Japanese consider this as one of their most important principles in designing their own zen gardens. They believe that stones form the frame of the garden and if they are properly arranged, the other parts of the garden should automatically arrange itself. If you&#8217;re just in the process of designing your Japanese garden, some ideas include incorporating raked gravel around islands or laying out uniform-sized gray river rocks to create a stream bed.</p>
  36. <p>2. The water serves as the basis of the whole garden composition</p>
  37. <p>Water is considered an essential part of every Japanese garden, as it symbolizes the steady and continuous flow of time. Elements of water in the Japanese garden are evident in their pond installations and thin water strings flowing through rocks, as well as in rocks, gravel and sand where water seems to have run dry to symbolize the passing of time. It might be a good idea to introduce falling water or bamboo fountains in your garden design to complete the Japanese garden flavor.</p>
  38. <p>3. The architecture must help design a path</p>
  39. <p>As the Japanese culture put a lot of significance on life being a path, its gardens are designed to take guests through a carefully designed path. On top of keeping with tradition, the main function of the path in Japanese garden design is the unification of all garden elements. They also put significant importance in designing architecture that complements the path. These are usually made of natural materials such as wood, stone and metal.</p>
  40. <p>Traditional Japanese garden architecture includes pavilions, stone lanterns and wells. You can make your own tea house in the middle of your garden by using bamboo. You can even add your own personal touch to your garden by adding stone water jars or bamboo garden fences to give the impression of lightness and grace.</p>
  41. <p>4. Use plants to create the background</p>
  42. <p>Every Japanese garden is designed in a way that plants always obey the stone layout. So, instead of letting the plants dictate how you want your garden to look, always keep in mind your stone layout in selecting the plants that will soften the lines and create the background. You can select different kinds of garden plants to complement your stone layout from evergreens and conifers to blooming trees and shrubs, all the way to local hardwoods and perennial forest flowers. Don&#8217;t be afraid to prune the trees in order to echo your garden&#8217;s architectural design and create subtle reflections in water.</p>
  43. <p>Apart from the minimalism of Japanese gardens, what most people do not realize with the design is that it attempts to illustrate the unique relationship between man and nature. Man should always improve nature, by showing its essence, and not by pressuring it to its needs. If you only keep this in mind, you&#8217;ll be able to design a Japanese-style garden that not only complies with its aesthetics but also its founding philosophy.</p>
  44. </p></div>
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  49. <item>
  50. <title>Lemon Law and Secret Warranties</title>
  51. <link></link>
  52. <comments></comments>
  53. <pubDate>Fri, 19 May 2023 14:25:46 +0000</pubDate>
  54. <dc:creator>admin</dc:creator>
  55. <category><![CDATA[Law and Issues]]></category>
  57. <guid isPermaLink="false"></guid>
  58. <description><![CDATA[One of the defining attitudes of the American character is full exposure. Love it or hate it, very little remains hidden in the US. We don&#8217;t like secrets at all. Much to the contempt of Europeans, Americans wear their hearts &#8230; <a href="">Continue reading <span class="meta-nav">&#8594;</span></a>]]></description>
  59. <content:encoded><![CDATA[<div id="article-content">
  60. <p>One of the defining attitudes of the American character is full exposure. Love it or hate it, very little remains hidden in the US. We don&#8217;t like secrets at all. Much to the contempt of Europeans, Americans wear their hearts on their sleeves. Because of this we have often been misjudged and thought weak. I could easily write a great deal on how foolish it is to judge us against the fact that we don&#8217;t hide the things we care about.</p>
  61. <p>Another characteristic often misjudged, even within the country itself, is our passion for fair play. We hate a cheater and our laws reflect this hatred. Do we over do this antipathy? Probably, but it&#8217;s better our way than the smug arrogance of the French or the indifference of the German.<br />
  62. Automobile manufacturers cheat. You laugh and say things like, no kidding or what was your first clue? Here&#8217;s the important thing. Nowhere in the world, in no other country does the consumer have so many tools to right wrongs: Does this create a contentious environment? To some extent, it does.  It would be so much better if we lived in that best of all possible worlds where vehicle manufacturers and dealerships accept responsibility for their products and their service.</p>
  63. <p>We demand of our manufacturers that they warrant that their goods are made to a high standard and that they are what the manufacturer advertised. It&#8217;s hard to find a product that doesn&#8217;t have some sort warranty. The administrative parts of federal and state governments are littered with agencies whose charter is to enforce functional and quality standards. As a teacher of the old school, I&#8217;d give them a fair grade, certainly better than any other country on the planet. Even so, a strong body of law has been enacted across the United States that further makes it possible to enforce warranties.</p>
  64. <p>What is a warranty?</p>
  65. <p>1. Law.</p>
  66. <p>a. An assurance by the seller of property that the goods or property are as represented or will be as promised.</p>
  67. <p>b. The insured&#8217;s guarantee that the facts are as stated in reference to an insurance risk or that specified conditions will be fulfilled to keep the contract effective.</p>
  68. <p>2. A guarantee given to the purchaser by a company stating that a product is reliable and free from known defects and that the seller will, without charge, repair or replace defective parts within a given time limit and under certain conditions.</p>
  69. <p>This is pretty straightforward. When you buy a new car it comes with a warranty. The warranty says that if it doesn&#8217;t meet the standards set forth stating that the vehicle is what was promised, the manufacturer or its agents (dealerships) must repair it, and more than that bring it to the condition that existed before the defect(s) occurred.</p>
  70. <p>One of the keys to all warranties is how long they are in force and what exactly do they cover. Obviously manufacturers aren&#8217;t going to warrant a vehicle for the next twenty years. It is quite likely that most vehicles will end their days in the junkyard long before that. You may have heard of the expression, built-in obsolescence. With light bulbs it is obvious that they are designed to fail after a very short period of time.</p>
  71. <p>With automobiles, it is a bit more complex. Materials, manufacturing processes, tolerances of manufactured parts and other quality issues and depending on how well such companies are managed can have a powerful effect on how long any specific make of model of vehicle will last.</p>
  72. <p>An automobile may indeed last twenty years with perfect maintenance, low mileage and careful driving.</p>
  73. <p>Prior to the existence of lemon law it was not unusual for manufacturers to compel the consumer to return the car for repair over and over; sometimes the consumer would take the vehicle back more than twenty times for the same repair. The consumer had no recourse. The playing field was terribly imbalanced.</p>
  74. <p>To this point we have been talking about the warranties that come with each vehicle sold in the US. Warranties vary considerably from maker to maker. There is another category of warranty you will never read about in your vehicle maintenance manual or warranty documents. These are called Secret Warranties. Needless to say, the manufacturers absolutely hate to call them by this name. They have their own names that are sugar-coated, double-speak designed to make that sow&#8217;s ear seem like a silk purse.</p>
  75. <p>Here&#8217;s how it works:</p>
  76. <p>1. The manufacturer does a little product homework, some surveys, focus groups, samples previous product data, and then has a look at what&#8217;s working for the competition. (Yes, manufacturers steal from each other shamelessly)</p>
  77. <p>2. A decision is made to build a new SUV. It doesn&#8217;t matter a tinker&#8217;s damn if this monster sucks gas faster than the North Slope pumps oil. If they think it will sell-read make a profit-they&#8217;ll build it.</p>
  78. <p>3. Production schedules are created and parts began arriving at the assembly plant. These schedules are more important to assembly management than the coming of the tides or assurances that the sun will rise.</p>
  79. <p>4. The designers and engineers get to work. A lot of the tasks are farmed out to assorted parts manufacturers all over the world. Prototypes are made and as much testing as can be squeezed in, takes place. During these tests it is discovered that the turbo charger had a tendency to produce oil sludge. Sometimes as a result the turbo would fail. Occasionally the turbo would freeze, explode and spatter shattered components all over the countryside. (This is a real example.)</p>
  80. <p>5. Enter the risk analysts, the statisticians and the actuaries. These are the fellas who roll the mathematical dice and determine what it will cost to repair these defective turbos or pay off the lawsuits if one of those exploded hunks of metal ends up buried in the driver&#8217;s forehead. Understand this; the manufacturer does not care if this happens. They only care if the balance sheet looks bad. Let them protest all they like, tell us what wonderful and caring people they are, Ford and their Pinto put an end to that paradigm forever. Add to that bit of history the current situation, where manufacturers cause owners with defective cars and trucks unmitigated misery and disillusionment, and you have the average life of a car owner in the US.  So, the stats and risks guys say, not to worry, this problem will only happen to 5.628 vehicles in every 1,000. Most people will roll over when we tell them it&#8217;s their fault and get it replaced at their cost. There are ways to deal with owners who make too much noise.</p>
  81. <p>6. It&#8217;s a nice looking car. The manufacturer spends enough money on advertising to support a medium sized country for a year. They sell lots of them. All is well in the boardroom. Stuffy, essentially useless old men congratulate each other. Unwarranted arrogance is not a nice thing to see.</p>
  82. <p>7. After a few thousand miles, as predicted, the oil in the turbo begins to sludge and wouldn&#8217;t you know 5.628 vehicles in every 1,000 begin to fail. No one said these stats guys couldn&#8217;t do math.</p>
  83. <p>8. As was predicted, some people got their vehicles repaired, some complained only to be told that it was their fault because they used substandard oil. Others, not that many, raised hell, called the BBB, wrote letters to the National Highway Traffic Safety Administration (NHTSA). They told the people at the dealerships that they were full of camel poop and generally got loud and obnoxious.</p>
  84. <p>9. Thus we arrive at the moment of&#8230;wait for the mysterious music&#8230; &#8220;Secret Warranty.&#8221; All of a sudden the service writer goes all decent and helpful. It&#8217;s an amazing thing to see.  It might go something like this. The service writer says, &#8220;You&#8217;ve been a really good customer, Mr. Jones. Let me talk to the manager and see what he can do.&#8221; Still fuming, Mr. Jones snarls assent. The service writer comes back ten minutes later, just before Mr. Jones decides to get really loud. The service writer says confidentially, &#8220;I got the manager to call the District Manager and he has agreed this one time the manufacturer will cover all the costs of your repairs. Isn&#8217;t that wonderful, Mr. Jones?&#8221; Mr. Jones is still highly annoyed but he wants his car fixed, so he lets them do it.</p>
  85. <p>What&#8217;s wrong with all of this? Of the hundred people who have the turbo problem, maybe two won&#8217;t let the dealer/manufacturer screw them into the ground like a tent peg; make them pay for the repairs. Yes, you are right! It is cynical and immoral, and it happens all of the time. There isn&#8217;t one automobile manufacturer that doesn&#8217;t have at least one Secret Warranty in place. Some of them have three or four for different defects.</p>
  86. <p>Why do they do it? It&#8217;s the oldest reason in the world. No, it&#8217;s not sex. It&#8217;s money, of course. Remember, Mr. Jones wrote to NHTSA? If NHTSA gets enough reports of turbos blowing up they can compel the manufacturer to issue a recall. When this happens, accountants and senior management guys squeal like they got their lips caught in a vice. I have done a fair amount of research on recalls and I couldn&#8217;t find one that didn&#8217;t cost the manufacturer at least $5,000,000.00 dollars, and that is definitely on the low side. This is serious corporate pain and this is why there are Secret Warranties. They exist so that manufacturers can avoid recalls.</p>
  87. <p>As a car owner, be very alert when someone at the dealership starts telling you it&#8217;s your fault. Don&#8217;t go into apathy and give in. Fight it. Do research. Find out if a Secret Warranty exists and make them use it. Frankly, for their bad behavior I would much rather that they felt the pain of the recall, but for you the car owner, I would rather you get back on the road in a safe vehicle.</p>
  88. </p></div>
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  94. <title>Top 10 Reasons Behind the Rise of Aerospace Engineering Career</title>
  95. <link></link>
  96. <comments></comments>
  97. <pubDate>Tue, 09 May 2023 17:44:26 +0000</pubDate>
  98. <dc:creator>admin</dc:creator>
  99. <category><![CDATA[Uncategorized]]></category>
  100. <category><![CDATA[Aerospace Defense]]></category>
  102. <guid isPermaLink="false"></guid>
  103. <description><![CDATA[It is a recent buzzing trend that students are opting for more and more challenging career options to suit their qualities, expertise and interests. Aerospace engineering is one such choice. Almost 1 million students are hired across the globe every &#8230; <a href="">Continue reading <span class="meta-nav">&#8594;</span></a>]]></description>
  104. <content:encoded><![CDATA[<p> It is a recent buzzing trend that students are opting for more and more challenging career options to suit their qualities, expertise and interests. Aerospace engineering is one such choice. Almost 1 million students are hired across the globe every year from top aerospace &#8211; aeronautical engineering schools, under several designations and positions in the aerospace industry. The industry provides great perks, lucrative opportunities and career growth in terms of prospects. So if you are wondering the uniqueness of this career beat we have listed all the valid reasons behind this boom. Read on!<br />
  105. 1. Broader scope for study<br />
  106. Aerospace engg. is a vast field which deals with the development and study of aircraft, missiles and spacecraft. Today, in India and many other countries it is considered as a developing sector. Due to budding talents, India has begun offering good scope in this engineering segment.2. Remarkable Achievements<br />
  107. With regards to this engineering, it can be surely ascertained that India has a number of significant achievements under its belt. Right from developing heavy-weight rockets, helicopters and aircraft etc. Indian aerospace engineers have received a great exposure.3. Aerospace &#8211; An Emerging Industry<br />
  108. Owing to its demand and great career prospects, most of the noted and recognized institutes have introduced aerospace engineering degrees. You can find some of the best aerospace engineering colleges in Nashik Maharashtra and other prime metro cities as well.4. Rise in Indian Economic status<br />
  109. The economic policy of Indian government provides a lot of scope to aerospace engineering and caters to its advancement. The growing aerospace and civil aviation sectors are attracting world&#8217;s leading companies like Airbus, Rolls-Royce, Boeing and others to India.5. Growth of overall Aviation Market<br />
  110. One more factor that caused the rise of aerospace engineering in India is the improving commercial aviation market. This growth not only attracted new talent and fresh engineers but also elevated the demand for civil, defense and commercial aircraft.6. Massive boost in FDI<br />
  111. During the year 2015, Govt of India elevated the (FDI) foreign direct investment by 60-70 percent which is why most of the international aircraft companies could set up their base in India, thus creating more career options for the aeronautical engineers7. Growth of Indian Aerospace Agencies<br />
  112. The Indian aerospace research organizations and other international private companies are promising huge developments and a bright future of aerospace engineering. This reform is attracting more and more students to pursue aerospace engineering as a career.8. Great opportunity for Joint Projects<br />
  113. Most of the colleges offering aerospace engineering courses have affiliated with international institutes for advanced learning options and global career prospects for the students. These joint projects within the institutes are proving beneficial to the aspiring engineers9. Advanced Aerospace Products<br />
  114. Industries are working towards advancing the existing products and performing research and develop on new aerospace products by attracting world&#8217;s leading companies in aerospace sectors.10. Improved learning system<br />
  115. Most of the recognized institutes that have introduced aerospace engineering have come a far way in terms of faculty and study process. They are investing more in more in providing the best possible technological facilities to the students and groom them professionally in order to survive the most competitive field of aerospace engineeringAnother most important factor leading to the rise of aerospace careers is the advancements in technologies; the industry is highly driven by the aero and techno masterminds. A lot of research goes into developing spacecrafts and aircraft, which is the most risking and tedious responsibility. The accuracy of the project needs to be maintained and achieved in order to avoid life threatening mishaps like a crash or engine fail. Aerospace engineers play a vital role here in ensuring that the product designed and developed by them is going to function to its best and that no loopholes can be found due to which the risking factors may arise.If you think you have the passion for engines and aircraft machines, this career is definitely for you because without passion and dedication for your career there is no other way to scale up new heights.We are pretty sure these facts gave you a clear insight on the career scope for aerospace engineering and all the possible reasons to pursue this as your career. We wish you good luck with your career choice and the future ahead! </p>
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  120. <item>
  121. <title>EMR and EHR System Implementation Best Practices &#8211; Part 5 &#8211; Case Studies</title>
  122. <link></link>
  123. <comments></comments>
  124. <pubDate>Fri, 05 May 2023 11:42:44 +0000</pubDate>
  125. <dc:creator>admin</dc:creator>
  126. <category><![CDATA[Uncategorized]]></category>
  127. <category><![CDATA[body systems]]></category>
  128. <category><![CDATA[chop suey system of down]]></category>
  129. <category><![CDATA[lonely day system of down]]></category>
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  138. <category><![CDATA[systems not goals]]></category>
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  145. <description><![CDATA[This is the fifth article in a series dedicated to uncovering the best practices for an EMR implementation. The information presented has been developed by the author as part of a research project.EMR ImplementationsAs EMR systems become more prevalent, more &#8230; <a href="">Continue reading <span class="meta-nav">&#8594;</span></a>]]></description>
  146. <content:encoded><![CDATA[<p> This is the fifth article in a series dedicated to uncovering the best practices for an EMR implementation. The information presented has been developed by the author as part of a research project.EMR ImplementationsAs EMR systems become more prevalent, more information is being made regarding the success or failure of the final integrated system. According to Hoffman (2007), systems implemented at the Harbin Clinic based in Rome, Georgia had been delayed due to cultural issues including resistance by the physician staff to adopt the new system. Due to the issues, the implementation has increased from two and a half years to over four years. Harbin Clinic is the largest privately owned multispecialty clinic, has 20 locations and employs 135 physicians. This large implementation had significant support from the executive team, however, they found that a number of specialists within the organization did not like the aggravation of keying information into the system because it was not tailored to them. Implementation obstacles identified were the lack of process mapping due to the large number of specialties, lack of a change management strategy regarding adaptation of specialty processes to the new system. The effect of the obstacles led to the extension of the implementation window while increasing the cost of the overall project by a half a million dollars.Bellevue Family Medicine Association (BFMA) in Bellevue, Washington is a healthcare provider with over 100 patients in daily care. Additionally, they had over 10,000 active patient charts. BFMA implemented a new charting system that took two years. BFMA&#8217;s implementation succeeded due to the flexibility they gave their physicians on entering data into the system. The use of tablet PCs allowed the user to either type or write into the system. BFMA paid particular attention to how people would utilize the system and accounted for those aspects in their planning and implementation (Schock, 2007). BFMA also utilized structured training on the use of the new charting system. Additionally, BFMA leveraged an outside IT firm to implement the technology in order to free up their own resources.Dominican Hospital located in Santa Cruz, California, implemented an electronic charting system called CareConnect. Dominican is part of Catholic Healthcare West. Dominican utilized formal training as well as CareConnect provided technical support. Dominican also leveraged &#8220;super user&#8221; groups to help with subject matter expertise. Despite the training and super users, the rollout impacted the nursing staff significantly. There appeared to be a lack of process analysis to understand how the nursing staff utilized the paper charts to administer medication and care. The end result caused significantly more work for nurses to review and validate patient history. Additionally, system issues such as missing or duplicated data undermined trust in the system by the users (Everitt &#038; Hwang, 2007). The system implemented was not analyzed properly to understand whether it was user capable or not. Lack of user involvement, data integrity and usability were significant factors in this failed implementation.Thomas Jefferson University Hospital (TJUH) in 2001 implemented a computerized provider order entry (CPOE) system. A byproduct goal of the project was the building of lifetime electronic health records (EHR). Over 950 physicians enter information into their CPOE and related systems. TJUH took an overarching approach to addressing the realignment and standardization of processes and procedures across the hospital. TJUH involved users at every level of the organization to help redesign workflows and tailoring the system to the appropriate audiences. Strong backing from hospital executives provided credibility that lead to significant buy-in from hospital staff. TJUH implemented an Interdisciplinary Workflow Group to assess departmental processes and make changes where necessary to ensure that the new processes and systems aligned.TJUH leveraged the use of a pilot to test the new system and processes. The pilot allowed them to evaluate progress and then adopt at a pace they could effectively support. As the pilot became the implementation, TJUH leveraged the experience pilot participants to assist with integration of the other users (McGurkin, Hart, &#038; Millinghausen, 2006). TJUH utilized a number of opportunities to ensure the success of their rollout by heavily integrating the stakeholders into the entire process. The integration and change management strategy contributed to the success of their implementation.Yakima Valley Farm Workers Clinic (YVFWC) is a multispecialty community practice. YVFWC operates 18 clinics in Washington and Oregon. YVFMC purpose for implementing an EMR system was to improve patient care and portability of medical information between the various clinics. Patients would commonly visit multiple clinics depending on where they were located at the time they needed service. Without access to all of a patient&#8217;s records, it became difficult to keep them synchronized. YVFWC decided it was time to implement an EMR system that could be accessed by all sites. TVFWC conducted research to determine the best way to implement their EMR system and discovered that &#8220;big bang&#8221; approaches were to be avoided.They leveraged a pilot approach to ease the transition to the EMR by implementing just one module at time. Doing this, they were able to avoid the frustration that quick change brings on along with the unintended consequence of user resistance and distrust. The pilot approach allowed them to continually refine the implementation tactics and overcome obstacles before the larger organization was affected. TVFWC did run into issues related to the lack of standardized processes from site to site. This led to some resistance at local site. They overcame this deficiency by leveraging a consistent rollout team to help train new and consistent processes in the local sites. Training regimens were utilized before, during and after implementation (Simmons &#038; Tschauner, 2006).Dean Health System (DHS) is located in Madison, Wisconsin. DHS is a multi-specialty healthcare system that provides a network of 60 multi-level ownership clinic that provide a wide range of care in the southern part of the state. DHS deployed an EMR system from EPIC Systems using a a phased approach leveraging a pilot phase to work out issues. Their rationale for the pilot was to gain committed users to help with future expansion. Additionally, DHS leveraged additional tools to help with adoption like speech recognition and integrated transcription services. The combination encouraged greater adoption of the technology (Cordio, 2007).The Newhan Primary Care Trust in East London and Nuffield Orthopedic Centre at Oxford implemented a system from Cerner, a U.S. based company. After the implementation several issues with appointments being mailed out to the incorrect people were found resulting in people missing appointments and people showing up for appointments that did not exist. People working on the project associated the many problems with the speed at which the systems were being implemented. The velocity of the changes being thrown at the medical staff made it difficult to be successful (Collins, 2006). Other implementations related to the same program have also been plagued with issues. The system dubbed &#8220;Choose and Book&#8221; provides electronic patient records and appointment booking services as indicated above. The system is17.3 billion British Pounds over its original budget of 2.7 billion pounds (Wilkinson, 2006). Causes of failures identified in the article include lack of stakeholder involvement, the sheer scale of the project (country wide implementation) and turnover in program management.A case study analyzing two Danish installations of the same EMR system at two different locations illustrates the approach and subsequent successful implementations of the case study locations. The case study covers a cardiothoracic surgery ward and an orthopedic surgery ward at two different Danish hospitals. Both sites adopted the same EMR system. The system is a standard system providing a shared electronic patient record. The implementation of EMR system was organized by a project manager who created several diverse workgroups to develop integration plans. Super users were identified and leveraged to help with the design of new work processes to support the EMR system. Additionally, the super users provided localized support and answers to questions. User training consisted of 6 to 8 hours in general IT and EMR prior to implementation. Super users were provided with more detailed training to assist in supporting the EMR. Management led meetings were leveraged to ensure users were informed about the project. All of techniques identified above contributed to the successful implementation of the EMR system within the two surgery centers (Jensen &#038; Aanestad, 2007).Cayuga Family Medicine in Ithaca, New York, is a small practice consisting of pediatrics and obstetrics employing two physician partners and a nurse practitioner. They implemented an integrated practice management system and electronic chart system when they opened in 2000. The system served primarily to provide electronic versions of the patient chart until one of the partners realized that the software could do more through the use of date entry templates. Once he gained understanding, the physician created a number of electronic forms to facilitate data entry and coding. The effect of this activity provided immediate benefits to improved workflow and data entry. Additional gains in billing were achieved due to the more accurate data (Loehr, 2006). The ultimate improvement in the system utilization came from a small scale version of process engineering and showed that it can work even on a smaller level.Herb Smaltz of the Ohio State University Medical Center (OSUMC) uses a support &#8220;S.W.A.T&#8221; team to help with EMR implementations. When moving to a new EMR system, OSUMC leveraged steering committees designed to address the process and procedure changes necessary to implement the new system. Leveraging support teams pre and post implementation helped support those users that needed help. OSUMC leveraged staff in the selection process to encourage buy-in for the new system (Havenstein, 2007). Also covered in the article was Citizens Memorial Healthcare (CMS) in Bolivar, Missouri. CMS leveraged the support of the company&#8217;s executives along with the IT group working directly with staff and physicians through all phases of the implementation. CMS spent 8 million dollars on their EMR project and have over 95 percent of patients on electronic charts (Havenstein, 2007). The JKL Healthcare system operates three acute care hospitals and five ambulatory locations. JKL also operates a research institute and a 450 employee physician group with 50 local offices and a home care services company. The article focuses on one of the acute care hospitals recently acquired.JKL began their implementation in 2001 to install an EMR system. JKL chose EPIC and had a budget of 35 million dollars. JKL leverage process re-engineering and certification to help facilitate the integration of the new system. JKL made physician certification required in order to refer patients to the hospital. To help compensate for the training required, they waived their professional staff dues as an incentive to participate in the training and continue to refer patients to the hospital. JKL leverage super users to facilitate integration of the systems after staff members received training. The day that JKL went live, they assigned each physician a personal trainer that completed rounds with them. Additionally, super users were stationed at every patient unit to assist with questions or procedures. Ninety percent of the physicians using the system believe it is beneficial and made it easier to do their work (O&#8217;Brien, 2006).Healthcare Partners Medical Group (HCP) located in California moved from an older EMR system to a newer product offered by Allscript Healthcare Solutions, Inc. called Touchworks EHR. HCP operates 38 sites, and four urgent care centers serving half a million patients. The overall project cost 4 million dollars and was scheduled to last 3 years. HCP leveraged a multifunctional team to identify requirements for the new system and break them down into &#8220;must haves&#8221; and &#8220;nice to haves&#8221;. The team was also leveraged to evaluate and select the new software package. Vendor considerations were heavily weighted in selecting the new product. HCP focused on ensuring vendor stability and ability to support such a large implementation. HCP analyzed workflows in order address changes to fit the new system and also completed performance testing to ensure the systems could handle large amounts of data transfers. Training was a critical focus for all the users of the systems and included e-learning, instructor led training and individualized training. HCP adopted the use of super users to help field questions during and post go-live. The rollout of the software was accomplished using a pilot method bringing up each location independently. Prior to each location go-live event, managers conducted dry runs of the implementation to ensure that systems and personnel were ready (Yocum, 2006).A study conducted by Miller and Sim (Miller &#038; Sim, 2004)analyzed survey data provided by 90 respondents regarding their use and perceptions of their EMR installations. It was noted that physician&#8217;s attitudes were of utmost importance in determining the success of an implementation. Those practices that had an &#8220;EMR champion&#8221; were more successful and had higher usage of the EMR systems. In contrast, those practices where there wasn&#8217;t a champion of the technology, the use of the system was minimal. Also noteworthy was that larger practices with more staff tended to be higher users than smaller practices and the authors associated this phenomenon with the ability of the practice to absorb implementation costs with regard to additional personnel needed to integrate the project.The next article(s) will delve into additional reference material and best practices related to EMR Implementations.All references can be found at </p>
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  152. <title>What Every Parent and Educator Should Know About Enriching Young Brains and Minds</title>
  153. <link></link>
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  155. <pubDate>Fri, 05 May 2023 09:40:03 +0000</pubDate>
  156. <dc:creator>admin</dc:creator>
  157. <category><![CDATA[Uncategorized]]></category>
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  173. <description><![CDATA[To learn important lessons for all parents and educators, we interview today Eric Jensen, a former middle school teacher and former adjunct professor for several universities including the University of California, San Diego. Mr. Jensen co-founded the Learning Brain Expo, &#8230; <a href="">Continue reading <span class="meta-nav">&#8594;</span></a>]]></description>
  174. <content:encoded><![CDATA[<p> To learn important lessons for all parents and educators, we interview today Eric Jensen, a former middle school teacher and former adjunct professor for several universities including the University of California, San Diego. Mr. Jensen co-founded the Learning Brain Expo, a conference for educators, and has written 21 books on the brain and learning. His most recent book, Enriching the Brain: How to Maximize Every Learner&#8217;s Potential (Jossey-Bass, 2006), is highly recommended for educators and parents alike.Alvaro Fernandez (AF): Eric, thank you for your time. Can you explain the role that you and your organization play?Eric Jensen (EJ): We act as translators between the neuroscience and education fields, helping to build a Brain-Based Education movement. We launched the first conference that attempted to bridge these two worlds in 1998. The goal of the conference, called Learning Expo, was for teachers to speak to scientists, and, equally important, for scientists to speak to educators.Critics say that neuroscience research can add little to educational practices. What we say is that, whereas it is true that much needs to be clarified, there are already clear implications from brain research that educators should be aware of. For example, four important elements that are often neglected by educators, given the obsessive focus on academic scores, are nutrition, physical exercise, stress management, and overall mental enrichment.AF: Since 1998? How would you characterize the progress so far?EJ: The good news is that today many educators, more than ever, are learning about how the brain works. There is a growing number of academic programs such as Harvard&#8217;s masters program in Mind, Brain, and Education, and peer-reviewed journals such as the Mind, Brain and Education Journal.Still, there are clear areas for improvement. Too many staff developers are weak on the science. I see too many books saying &#8220;brain&#8221; in the title that are not grounded in any brain research. Something I always recommend when shopping for books is to check the References section, making sure the book references specific studies in credible journals from 2000 on.AF: Now, those are mostly awareness-related initiatives. What, if any, are the implications in daily teaching and learning in schools?EJ: You are right, this is still an emerging field. A number of private, independent, forward-thinking public schools and charter schools are implementing specific initiatives, mostly around brain-based teaching strategies, nutrition and exercise. But these are tougher for some public schools, which have limited resources and flexibility. to implement. We also see an growing number of enlightened parents learning about the principles we discuss and applying them at home.AF: Have you seen any impact at the policy level? specifically, what do you think about the current debate about the merits or demerits of No Child Left Behind?EJ: I agree with the move towards accountability. Now, the question is, accountability for what? for creating narrow, specific test scores? or for helping nourish better human beings. I have seen very little policy activity in the US; some in Asian countries such as Singapore and China, that are evaluating how to refine the curriculum for 5-10 year olds. In the US, there was a major push for music enrichment programs, that was somehow misguided, in the late 90s. The problem is that, whereas it is clear that enrichment has an impact, it is tough to measure specifically what type of enrichment, since much of the benefit develops over time. The short term &#8220;stock-market&#8221; mentality that measures student growth over a few weeks or months has to be tempered by long-term measures, too.For example, it seems clear that there are important skills that can be trained, that make for a better and more successful human being &#8211; such as the ability to defer gratification, sequencing, emotional intelligence, improved working memory, vocabulary, and processing skills. However, the type of assessments used today to measure schools&#8217; performance don&#8217;t focus on these. We would need broader assessments to allow educators to focus on those important long-term skills, beyond the immediate pressures.A specific area going from bad to worse is the level of stress in the system, and the lack of resources and knowledge to regulate it.AF: You mention processing skills, as well as other cognitive skills. In your recent column you highlight Scientific Learning&#8217;s computer program that can train auditory processing. What&#8217;s your view on the role of computer-based programs?EJ: It is encouraging to see programs based on extensive research, such as Scientific Learning&#8217;s. I appreciate the value of such programs to tailor individualized interventions to the needs of specific kids. So I believe these programs present a huge potential.Now, we must not confuse what is just one narrow tool with a whole enrichment program. Brain-based education also must take into account other important factors such as nutrition, physical exercise, the arts, stress management, social interactions&#8230;Copyright (c) 2008 SharpBrains </p>
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