مقایسه محتوای طرح تکریم در مقایسه با اصول و مبانی مشتری‌مداری

چکیده: (۶۰۷۷ مشاهده) مقدمه: اصل مشتری‌مداری در نظریه‌های نوین مدیریت به عنوان یکی از جهت گیری‌های اصلی سازمان‌های امروزی تلقی می‌شود، زیرا در عمل با جلب رضایت مشتریان درون و برون سازمان، کارآیی خود را در راستای بهره‌وری سازمانی به اثبات رسانده است. طرح تکریم نیز به عنوان یکی از برنامه‌های تحول اداری کشور، با محور قرار دادن جلب رضایت ارباب‌رجوع در این راستا به اجراء در آمده است. هدف از انجام این پژوهش، بررسی محتوای طرح تکریم در مقایسه با اصول و مبانی مشتری‌مداری است. روش بررسی: در این مقاله که به روش مروری و با استفاده ازمنابع کتابخانه‌ای و اینترنت و ثبت و آنالیز تجربیات عینی، مستقیم و گسترده نویسنندگان در سازمان‌های دولتی تهیه؛و سعی شده است علاوه بر بیان اهداف طرح تکریم و معرفی آن به عنوان یک راهکار مشتری‌مدار در راستای برنامه‌های تحول اداری کشور، اهمیت جلب رضایت مشتریان داخلی سازمان (کارکنان) و توانمندسازی و انگیزش آنها به عنوان پیش شرط اجرای این طرح بررسی شده و میزان تطابق این طرح با اصول و مبانی مشتری‌مداری مورد بحث و بررسی قرار گیرد. به دلیل تازه‌گی، ضرورت اجرا و گستردگی این طرح در سطح کشور، انجام این پژوهش‌هایی در این زمینه بسیار ضروری به نظر می‌رسد. مروری بر مطالعات: عمده مطالعات انجام شده نشان داده اند که بیشترین مشکلات نظام اداری کشور در بخش نیروی انسانی است که اهم آن نداشتن انگیزه، عدم تامین اقتصادی و نیازها؛ وجود محافظه کاری وروابط کار نامطلوب است. در بخش سیستم‌ها و روش‌ها نیز کم توجهی به مشتری گرایی و مدیریت کیفیت ذکر شده است. توجه به مشتری‌مداری به عنوان راهکار مشترک تمام پژوهش‌های مذکور مطرح گردیده است. در مصوبه طرح تکریم تامین منافع ارباب‌رجوع بر منافع مؤسسه و ارائه دهندگان خدمت ترجیح داده شده است، که این کم توجهی موفقیت سازمان را در این راستا به چالش کشیده است . نتیجه‌گیری: طرح تکریم به عنوان یک راهکار مشتری‌مدار در راستای ایجاد تحول اداری کشور، باید با توانمندسازی، حمایت همه‌جانبه وانگیزش ارائه دهندگان خدمات از طریق اعمال مدیریت علمی و کارآمد، مشتریان داخلی رادر اولویت توجه قرار داده تا از طریق جلب رضایت آنها، بهبود مستمر کیفیت خدمات تحقق یافته و رضایت مشتریان خارجی سازمان نیز جلب شود

Kann die Verknüpfung von CSR-Maßnahmen und Sportsponsoring zur Optimierung der Unternehmenskommunikation beitragen?

kein Abstract vorhande

Colonic Metastasis from Carcinoma of the Breast that Mimicks a Primary Intestinal Cancer

Although the lung, liver, or bones are the most common location for distant metastases in breast cancer patients, metastases to the intestinal tract are very rarely recognized in the clinic. We will present an unusual case of colonic metastasis from a carcinoma of the breast that mimics a primary intestinal cancer, along with a through review of English language medical literature. Despite the fact that isolated gastrointestinal (GI) metastases are very rare and much less common than benign disease processes or second primaries of the intestinal tract in patients with a history of breast cancer, metastatic disease should be given consideration whenever a patient experiences GI symptoms

(In)dependência funcional na dependente relação de homens tetraplégicos com seus (in)substituíveis pais/cuidadores

Objetivou-se identificar elementos da classificação internacional de funcionalidade, incapacidade e saúde, aplicáveis ao cuidado domiciliar de homens adultos tetraplégicos, com vistas à redução da dependência de ajuda de seus pais para as atividades da vida diária, e o autocuidado. Os dados foram coletados de junho de 2004 a março de 2005, a partir de entrevista semi-estruturada, realizada com 8 adultos acometidos de lesão medular alta, e com experiência de usuários do cuidado domiciliar. Optou-se pela análise de conteúdo, a partir das categorias de significados pautadas nos seguintes resultados: suporte familiar: segurança para as funções corporais do incapacitado; tecnologia assistiva: inventividades para promoção da qualidade do cuidado; medos, futuro incerto e perda dos pais: limiares e fragilidades humanas; e ganhos funcionais: respostas objetivas das funções corporais. Conclui-se que o apoio da família e, em especial, a presença dos pais, são fundamentais para enfrentar as limitações e reagir na busca de equilíbrio na deficiência, incapacidade, desvantagem e saúde dessa clientela, preparando-a para o alcance de gradativos ganhos funcionais e independência para atividades cotidianas e autocuidado.El estudio tuvo como objetivo identificar elementos de la clasificación internacional de funcionalidad, incapacidad y salud, aplicables al cuidado domiciliario de hombres adultos cuadripléjicos, con el fin de reducir la dependencia de la ayuda de sus padres en las actividades de la vida diaria y el autocuidado. Los datos fueron reunidos entre junio de 2004 y marzo de 2005, sobre la base de una entrevista semiestructurada efectuada a 8 adultos que sufrían de lesión medular alta y que recibían normalmente cuidado domiciliario. Se optó por el sistema de análisis de contenidos a partir de las categorías de significados pautados en los siguientes resultados: apoyo familiar: seguridad para las funciones corporales del discapacitado; tecnología de apoyo: soporte tecnológico para optimizar la calidad de los cuidados; miedos; futuro incierto y pérdida de los padres: los umbrales y las fragilidades humanas; y ganancias funcionales: respuestas objetivas de las funciones corporales. Se concluyó en que el apoyo familiar y, en particular, la presencia de los padres, son fundamentales para enfrentar las limitaciones y reaccionar en la búsqueda de equilibrios en la deficiencia, incapacidad, desventajas y salud de tales pacientes, preparándolos para alcanzar en forma gradual mejoras funcionales e independencia para realizar actividades diarias y ocuparse del autocuidado.The objective of this study was to identify elements of the international classification of functioning, disability and health, applicable to quadriplegic men's home care, to reduce the dependence on their parents' help for activities of daily living and self-care. Data were collected from June 2004 to March 2005. Semi-structured interviews were performed with eight adults with high spinal cord lesions who were being cared for at home . Content analysis was performed based on the categories of meaning extrapolated and the following themes were discovered : family support: safety for the corporal functions of the disabled; supporting technology: inventiveness to promote quality care; fears, uncertain future and parents' loss: thresholds and human fragilities; and functional gains: objective response of body functions. In conclusion, family support, and especially the presence of parents, is fundamental to facing limitations and to reacting in the search for balance with the deficiency, disability, disadvantage and health of that population, preparing them to achieve gradual functional gain and independence for daily activities and self-care

United States Acculturation and Cancer Patients' End-of-Life Care

Background: Culture shapes how people understand illness and death, but few studies examine whether acculturation influences patients' end-of-life treatment preferences and medical care. Methods and Findings: In this multi-site, prospective, longitudinal cohort study of terminally-ill cancer patients and their caregivers (n = 171 dyads), trained interviewers administered the United States Acculturation Scale (USAS). The USAS is a 19-item scale developed to assess the degree of "Americanization" in first generation or non-US born caregivers of terminally-ill cancer patients. We evaluated the internal consistency, concurrent, criterion, and content validity of the USAS. We also examined whether caregivers' USAS scores predicted patients' communication, treatment preferences, and end-of-life medical care in multivariable models that corrected for significant confounding influences (e.g. education, country of origin, English proficiency). The USAS measure was internally consistent (Cronbach α = 0.98); and significantly associated with US birthplace (r = 0.66, P<0.0001). USAS scores were predictive of patients' preferences for prognostic information (AOR = 1.31, 95% CI:1.00-1.72), but not comfort asking physicians' questions about care (AOR 1.23, 95% CI:0.87-1.73). They predicted patients' preferences for feeding tubes (AOR = 0.68, 95% CI:0.49-0.99) and wish to avoid dying in an intensive care unit (AOR = 1.36, 95% CI:1.05-1.76). Scores indicating greater acculturation were also associated with increased odds of patient participation in clinical trials (AOR = 2.20, 95% CI:1.28-3.78), compared with lower USAS scores, and greater odds of patients receiving chemotherapy (AOR = 1.59, 95% CI:1.20-2.12). Conclusion: The USAS is a reliable and valid measure of "Americanization" associated with advanced cancer patients' end-of-life preferences and care. USAS scores indicating greater caregiver acculturation were associated with increased odds of patient participation in cancer treatment (chemotherapy, clinical trials) compared with lower scores. Future studies should examine the effects of acculturation on end-of-life care to identify patient and provider factors that explain these effects and targets for future interventions to improve care (e.g., by designing more culturally-competent health education materials). © 2013 Wright et al

Integration of oncology and palliative care : a Lancet Oncology Commission

Full integration of oncology and palliative care relies on the specific knowledge and skills of two modes of care: the tumour-directed approach, the main focus of which is on treating the disease; and the host-directed approach, which focuses on the patient with the disease. This Commission addresses how to combine these two paradigms to achieve the best outcome of patient care. Randomised clinical trials on integration of oncology and palliative care point to health gains: improved survival and symptom control, less anxiety and depression, reduced use of futile chemotherapy at the end of life, improved family satisfaction and quality of life, and improved use of health-care resources. Early delivery of patient-directed care by specialist palliative care teams alongside tumour-directed treatment promotes patient-centred care. Systematic assessment and use of patient-reported outcomes and active patient involvement in the decisions about cancer care result in better symptom control, improved physical and mental health, and better use of health-care resources. The absence of international agreements on the content and standards of the organisation, education, and research of palliative care in oncology are major barriers to successful integration. Other barriers include the common misconception that palliative care is end-of-life care only, stigmatisation of death and dying, and insufficient infrastructure and funding. The absence of established priorities might also hinder integration more widely. This Commission proposes the use of standardised care pathways and multidisciplinary teams to promote integration of oncology and palliative care, and calls for changes at the system level to coordinate the activities of professionals, and for the development and implementation of new and improved education programmes, with the overall goal of improving patient care. Integration raises new research questions, all of which contribute to improved clinical care. When and how should palliative care be delivered? What is the optimal model for integrated care? What is the biological and clinical effect of living with advanced cancer for years after diagnosis? Successful integration must challenge the dualistic perspective of either the tumour or the host, and instead focus on a merged approach that places the patient's perspective at the centre. To succeed, integration must be anchored by management and policy makers at all levels of health care, followed by adequate resource allocation, a willingness to prioritise goals and needs, and sustained enthusiasm to help generate support for better integration. This integrated model must be reflected in international and national cancer plans, and be followed by developments of new care models, education and research programmes, all of which should be adapted to the specific cultural contexts within which they are situated. Patient-centred care should be an integrated part of oncology care independent of patient prognosis and treatment intention. To achieve this goal it must be based on changes in professional cultures and priorities in health care