Why Hospital Improvement Efforts Fail: A View From the Front Line.

In the 21st century, healthcare executives are facing changes of unprecedented magnitude in virtually every area, affecting their ability to compete. That hindrance brings with it a greater need for rapid and effective organizational change and improvement. Yet changes in the U.S. healthcare delivery system have historically been criticized as slow and less than effective in responding to the changes necessary for rapid performance improvement. To that end, the purpose of this applied research study was to help healthcare executives better understand the barriers to effective organizational change and improvement from the perspective of frontline leaders. Focus groups were conducted with 167 frontline leaders from four community hospitals to explore why hospital change efforts fail. Participants representing 11 different functional areas, including all facets of hospital operations, were asked to identify the primary causes of failure of a recent change initiative at their hospital. A content analysis of the focus group data identified 10 primary barriers to successful hospital change, some of which are ineffective implementation planning and overly aggressive timelines, failure to create project buy-in and ownership, ineffective leadership and lack of trust in upper management, unrealistic improvement plans, and communication breakdowns. Leadership lessons and recommendations based on the research findings are provided

Features of stratospheric aerosol lidar observations at Mauna Loa, 1974 - 1985

Lidar observations of the stratospheric aerosol over Mauna Loa were begun in the fall of 1974 and have continued to the present. An analysis of these observations has yielded interesting features of the stratospheric aerosol profile that change according to perturbed (from volcanic activity) and quiescent conditions. In the Mauna Loa lidar record there are two major perturbations that are contrasted, Fuego and El Chichon. The variations in relative aerosol cloud thickness, altitude of the maximum concentration and nonsymmetry are compared for the quiescent and perturbed time periods. Also, a climatology of annual average aerosol profiles is descrbied. A brief description will be given of procedures used to validate the lidar optical thickness information

Progressivism and the Mission Field: Church of the Brethren Women Missionaries in Shanxi, China, 1908-1951

This thesis examines the attitudes and activities of Church of the Brethren women missionaries in Shanxi, China, between 1908 and 1951, focusing on evangelism, \u27woman\u27s work\u27 programs, education, and relief work. This thesis presents the mission field as an expression of changing gender roles in the Church of the Brethren. In sum, Brethren women missionaries in Shanxi embodied both conservative and progressive ideologies and ultimately moved in a progressive direction, seeking growth, flexibility, and accommodation in their mission endeavor. The expansion of the Church of the Brethren mission field and the denomination\u27s geographic and cultural boundaries has implications for the evolution and continued existence of distinctive faith communities in the United States

The Partimento Tradition in the Shadow of Enlightenment Thought

This presentation investigates the relationship between partimento pedagogy and Rameau’s music theories as influenced by Enlightenment thought. Current research on partimento has revealed its importance in Neapolitan music schools of the eighteenth and nineteenth centuries. Along with counterpoint, partimento was a core subject in the study of composition in the Neapolitan schools; however, as pedagogy and theory began to be influenced by Enlightenment ideals such as the scientific method or a preference for clear systemization, the partimento tradition began to wane. In this presentation, I examine Rameau’s music theory as an example of Enlightenment thought in music, juxtaposing the central ideals of Rameau’s music theory with the ideals of partimento pedagogy and suggesting that Enlightenment thought hastened the decline of partimento study. Both the method of partimento pedagogy and Rameau’s theory of the fundamental bass stemmed in part from the practice of thoroughbass, and both were viewed as effective ways to teach musicians composition and improvisation. However, Rameau’s theory sought to improve on existing pedagogies by condensing eclectic rules and extended study into a few fundamental principles—an example of Enlightenment thought applied to music theory. In the light of Rameau’s understandable, widely applicable theory of harmony based on Enlightenment assumptions, the long years of practice-based partimento study under a maestro gradually became obsolete. The research methodology of this presentation consists of historical research from primary and secondary sources

The Partimento Tradition in the Shadow of Enlightenment Thought

How did Enlightenment ideals influence seventeenth-century music theory and composition pedagogy? This article investigates the relationship between partimento pedagogy and Rameau’s music theories as influenced by Enlightenment thought. Current research on partimento has revealed its importance in Neapolitan music schools of the eighteenth and nineteenth centuries. Along with counterpoint, partimento was a core subject in the study of composition in the Neapolitan schools; however, as pedagogy and theory began to be influenced by Enlightenment ideals such as the scientific method or a preference for clear systemization, the partimento tradition began to wane. Juxtaposing the Enlightenment ideals of Rameau’s music theory with the ideals of partimento pedagogy, the author suggests that Enlightenment thought hastened the decline of partimento study. Both the method of partimento pedagogy and Rameau’s theory of the fundamental bass stemmed in part from the practice of thoroughbass, and both were viewed as effective ways to teach musicians composition and improvisation. However, Rameau’s theory sought to improve on existing pedagogies by condensing eclectic rules and extended study into a few fundamental principles—an example of Enlightenment thought applied to music theory. In the light of Rameau’s understandable, widely applicable theory of harmony based on Enlightenment assumptions, the long years of practice-based partimento study under a maestro gradually became obsolete

Could we be coyotes

who howl all night behind the house, whose ancestors mated with wolves

Analyzing motivation and sense of belonging belonging in CS1 review sessions

The Computer Science Department at James Madison University has a Teaching Assistant program which aims to help students succeed in early-level Computer Science courses. Part of this program is a review session, the Fourth Hour, which provides students extra help on the concepts taught each week in class. Historically, attendance at this review session has been low. Because of this, the study aimed to increase attendance by motivating students through interventions, primarily offering quiz retakes to students who attended. Additionally, this study looked at the reported sense of belonging for participants who attended. We made three conclusions from survey data we collected. First, giving students incentives in the form of quiz retakes notably increased attendance. Second, students who did not attend the Fourth Hour had a greater sense of belonging, likely because many of them were not struggling. Third, the primary reason students reported not attending is that they did not see value in attending, possibly because they have a greater sense of belonging than students who attended

Understanding Leadership Skills of Hospice Executives

The healthcare industry is a rapidly changing environment requiring leaders to possess a high level , of leadership skills. leaders in the hospice industry have experienced the same level of change, but over the brief span of 25 years.With the aging of hospice executives and the dynamic environment of the hospice industry, the need for strong leadership is more important than ever. This research study reports on the perceived leadership skills of hospice executives and is a replication of an earlier study (longenecker, 2006). All study participants were executives of organizations that participated in clinical and operational benchmarking activities at the national level. The study evaluated leadership skills using transformational leadership theory as the conceptual model by which leadership skills were measured. The results of the study identified that the participants perceived they displayed an ideal use of skills based on transformational leadership theory