Recent orders
Confederate Monuments as Symbols of Hate
Name
Institution
Course
Professor
Date of Submission
Confederate Monuments as Symbols of Hate
Are Confederate monuments our heritage or symbols of hate? It is an inquisitive that has attracted attention in the nation and has significantly developed a debate that require legislative action to make the right decision. It is right that the Confederate monuments are vital in maintaining the nation’s history but while at the right place and expressing the right context that will not lead to the deprivation of national cohesion. Most of these statues erected all over the country are no more than political rudiments that to a greater extent amplifies the white supremacy. People have been defending of the act of these confederate monuments being moved, removed as well as being altered into a way that brings out sound expression, which is not ethical regarding the sovereignty in the nation that depicts civil rights to all the citizens. In this discussion, the fact of Confederate monuments being symbols of hate in the state is elaborated into a profound extent with regards to these statues meaning and their origins as well as the influence they can depict in the society.
The fundamental purpose of preserving the Confederate monuments in the United States is not for the nation’s heritage and history but a vibrant reflection of the political itinerary. The vast number of statutes, more than a thousand along the streets of cities like North Carolina, Virginia, New Orleans, and Durham among other states in the United States did not just emerged but were meaningfully put in place (Leib, page 15). The setting up of these numerous statutes were as a result of enormous the efforts of white southerners and some of the northerners to show their political intents. Many were put in place during the era during the fight of the south to resist political rights of the African-American civilians who had actively participated in fighting for the national liberation after the end of slavery. The act of removing these confederate monuments from the nation’s landscape requires the same efforts put in setting them in place. It will be essential as a way of curbing the biased political affairs they depict as a measure of bringing sound change in the country.
Change is inevitable regarding modernization and advancement in the technology and way of living, and the public must accept it to enhance the nation’s growth and development. The Confederate monuments that depict racial undertakings are passed with time and should be removed to eradicate the mentality of racial supremacy in the country as a measure of boosting national unity. Only a few of these statues that underwent the legal process of authorization this making the history of Confederate monuments complicated than what many people think. In following up their history line, they many of these statues were funded, installed and dedicated by ethnic groups such as the United Daughters of Confederacy who claimed to be representatives of sentimentality in the local community (Ferris, page 3). The white supremacists opposed the action of blacks being granted public voting rights and their advocate statutes could not be erected. The southerners and other private supremacists used confederate monuments to take possession of the open space. On freezing these set apart standards in place, the state government has to pass laws of removing and moving these statutes from the publicity.
It is disgusting to find that even some of these confederate monuments were put in place by the use of public funds. For instance, the statutes of Jim Crow knockdown in Durham was significantly funded by the federal money after the Confederate Veterans persuasion with the Durham’s government to allocate some revenue from civilians’ taxation. It is ironical and repulsive to understand that no one considered the African-American views about their taxes being used to install back the Confederate monument as they were the victims of the Jim Crow’s laws that deprived the civil right of blacks to vote. Up to today, the fact remains that many Confederate monuments were put in place after the world war as symbols of liberty, but after the southerners gave the Jim Crow the leadership mandate. At this time, the northerners had given up in fighting for racial justice due to the empowerment by the southerners as well as the act of some people joining supremacist. It is important to acknowledge that the Southern memorials that have been legally installed and inherited are not changing as they do not depict this racial segregation notion. The supremacists did not consider the statutes of the nationalists who fought for equal civil rights in the nation and they significantly favored their inconsiderate monuments.
The first step to take in moving and removing confederate memorial landscape from the public space is first by understanding that today the South America community has made a pace of eradicating racism thus changing its line of history. While on the other side the statutes in the state are the products of white power and supremacy that was not at any stance considerate of other ethnic groups (Webster, page 30). Therefore, the removal of these confederate monuments is justified, and the future ones are designed in a way that is inclusive of all public demands through following of the legal procedure. It is right that there are monuments that are already installed and they significantly signifies national heritage, and it is alright for them remaining in place or being moved to more useful locations.
It has been heard that after the debate of removing, moving as well as altering these memorial landscapes that people are arguing that more monuments regarding the excluded communities such as the African-Americans be put in place to solve the issue. It makes sense, and this can be a practical solution to the complicated matter. However, it comes to impossibility regarding the limited resources in the society as well as the extra cost to be incurred in erected those many memorial structures. Indeed, these historical landscapes are supposed to be found in historical sites such as museums where people can visit know and them as a way of preserving the nation’s history. They should be dismantled entirely from the public space and the right measurements as well as pictures be taken to the museums where brief description should be given (Berman, page 11). With this, if anyone is interested in specific historical information, he or she can visit the museum’s access all the recommended information.
According to the above discussion, Confederate monuments should be removed, moved as well as altered efficiently and taken to the historical sites where anyone can easily access them. The act of erecting them in public landscape leads to spread of ethnicity differences, and this will significantly affect national cohesion. In curbing the roots of racism in the United States, the Confederate memorials must be removed from the public space to prevent its spread to the present and future generation. The monument landscape that will be put in place shortly must be approved under the legal process, and the public opinions are set in consideration to avoid the action of individuals using them as ways of accomplishing own political objectives.
References
Berman, Scott. “Plato, Socrates and the Removal of Confederate Monuments.” (2017).
Ferris, Marcie Cohen. “front porch.” Southern Cultures 23.3 (2017): 1-6.
Leib, Jonathan, and Gerald R. Webster. “On remembering John Winberry and the study of Confederate monuments on the Southern landscape.” southeastern geographer 55.1 (2015): 9-18.
Webster, Gerald R., and Jonathan I. Leib. “Religion, murder, and the Confederate battle flag in South Carolina.” Southeastern geographer 56.1 (2016): 29-37.
Database Management
Database Management
Contents
TOC o “1-3” h z u Introduction PAGEREF _Toc381006546 h 1How Energy auditing Database works PAGEREF _Toc381006547 h 1Entity relationship diagram (ERD) of Persons’ data PAGEREF _Toc381006548 h 3Entity relationship diagram (ERD) Workout sessions PAGEREF _Toc381006549 h 5
Introduction
Today, nearly everyone in across the world would love to store their information in the database to keep track of everyday activities. Organizations are also not left behind in operating their businesses by storing their information on databases. Databases are designed in a way they offer organized mechanisms for storage, managing and retrieving information. The data are stored and organized in different tables by the use of Microsoft Excel or using Structured Query Languages (SQL). Most people have implemented systems that are integrated with databases since they have recognized databases to be the best method of storing and retrieving information that may be of help in the future. For that case, this paper will analyze how energy auditing database can be created and how it will keep track of personal workout history for fitness focused individual using Visio or Entity relationship assistant to create Entity Relationship Diagram (ERD).
How Energy auditing Database works
The database created will keep track of the people personal workout history for fitness focused individual. Each data of persons’ entities and attributes will be entered in the database to keep track of every activity one does, making one entity to be the key identifier of the table of persons created (primary key). When creating the energy auditing database, the three Entity Relationship model are used, such as the entities, attributes and relationships. Entities in this case involve things used to seek information. In this case, there are various entities that includes; the data/information, client, and the exercises done. The attributes tends to be the data collected regarding the entities, and relationship on the other hand, provides the structure that is required for drawing information from multiple entities.
The energy auditing database will work in a way that it will allow a person to feed in the information. The information entered will mainly involve the workout sessions that are tracked over time to help clients in identifying exercises performed at particular sessions. The information entered in the database could also help the clients in calculating their monthly aggregate workout statistics in order to allow individuals to track ones’ personal fitness as well as giving them the ability of spotting trends in weight lifting strength and cardiovascular activities. Database securities will also be enabled to limit the number of people without authentications to view or alter with the data in the system.
Securities in databases have become the main issues in most organization; some people tend to hack the systems to change the information that are already in the database making the database to differ from other sections of departments. It is therefore necessary for the database created to have SQL injections to control hackers from hacking the system, and therefore, the database should be tested to determine whether it is vulnerable to SQL injection attack. The database should allow the auditor to easily add or delete data within the system. The first step is to create tables in Energy auditing database. The first table created is the client table where, the client is able to give the identification Number, his/her FirstName, LastName, Address and the City. The syntax is;
CREATE TABLE Person(P_Id int, (Primary Key)LastName varchar (50),FirstName varchar (50),Address varchar (50), City varchar (50))
Entity relationship diagram (ERD) of Persons’ dataThe ERD diagram allows the client to enter his/her information in the database. The attribute ID_no is the primary key in this case. This ERD is many-to-one given that different clients can only enter one attribute of themselves one at a time. The client can only enter one LastName, FirstName and ID_no, since the database limits the number of datatype in each table. The data entered in the database will also help the client to find information concerning them.
Person
Enters
LastNameFirstNameID No
After the client information is entered into the database, the client is able to create other tables in the database which will be used for storing their information regarding different workouts, type of exercises, Exercise name, sets, duration, weight setting, and units of measurements for every exercise type. The syntax will be;
CREATE TABLE Workoutsessions(ExerciseWeightSetting int,TypeofExercise varcha r(50),ExerciseName varchar (50),ExerciseSets varchar (50), ExerciseDuration varchar (50)
ExerciseUnitsof Measurements varchar (50))
The above data/information will be inserted into persons’ table to match with the data in the table workout sessions. The syntax will be;
USE workoutsessiontableindatabase;
INSERT INTO Persons’
VALUES (“ExerciseWeightSetting”);
INSERT INTO Persons’
VALUES (“TypeofExercise” );
INSERT INTO Persons’
VALUES (“ExerciseName”);
INSERT INTO Persons’
VALUES (“ExerciseSets”);
INSERT INTO Persons’
VALUES (“ExerciseDuration”);
INSERT INTO Persons’
VALUES(“ExerciseUnitsof Measurements “);
Entity relationship diagram (ERD) Workout sessionsThe ERD diagram below shows the relationship between the Person and the workout sessions. Every exercises performed by the clients, data must be recorded, the type of exercise, the name of exercise, and duration of exercise taken by each individual has to be recorded in the database.
Person
Exercise Duration
Type of Exercise
Exercise Name
Enters
ConductinganEnvironmentalAnalysis
Conducting an Environmental Analysis
HSA 599 Health Services Administration Capstone
CONDUCTING AN ENVIRONMENTAL ANALYSIS 2
The scenario for this assignment is that I am an administrator of a hospital and as the administrator I am faced with the challenges of declining reimbursements from insurance providers and increasing demands for patient services due to dramatic changes in the external environment. These changes include those imposed by the Patient Protection and Affordable Care Act. I need to evaluate the position of the organization and conduct and environmental analysis. The purpose of this is to determine the organization’s ability to continue to provide quality care and remain financially solvent in the face of these challenges.
Determine two specific forces in the external environment that will have the most impact on the organization.
The external organization comprises of all the entities that exist outside its boundary but have significant influence on its growth and survival. The most common external reason for declining reimbursements from insurance providers from the external environment that has the most impact on the organization are competition and customers. Competition comprises of related industries with similar products and services, their geographic locations and markets. Competition and traditional competition in health care involves one or more elements such as price, quality, convenience and superior products and services. A key role in competition in health care is the potential to provide a mechanism for reducing health care costs (Rivers & Glover, 2008, p. 630).
However, it has been discovered that competition can not enhance efficiency in the health care industry. Since public and private insurance companies are paying for three-quarters of the health care bills. It has been reported that competition in the United States has become
CONDUCTING AND ENVIRONMENTAL ANALAYSIS 3
Zero-sum-based, this is a situation in which a health care organization is actively engaged in dividing value instead of creating value. This type of competition erodes existing value through unnecessary costs. Zero-based competition in health care is associated with bad strategic choices such as incorrect level of competition, focus on cost reduction, incorrect geographic market, focus on satisfaction surveys, and offers of improper incentives to providers (Rivers & Glover, 2008, p.635).
Zero-sum competition divides value instead of increasing it. It takes the form of cost shifting rather than fundamental cost reduction. Costs are shifted from the payer to the patient, from the health plan to the hospital, from the hospital to the physician, and from the insured to the uninsured and so on. Passing costs around creates no net value, instead gains for one participant comes at the expense of others with added administrative costs (Porter & Teisberg, 2004, para. 9). Another issue with zero-sum competition is that it restricts choice and assess to services instead of making care better and more efficient. As the system is currently structured, health plans make money by refusing to pay for services and by limiting subscribers and physicians’ choices. Many health plans pay a health care organization a set amount per admission for a given condition rather than for a full treatment cycle (Porter & Teisberg, 2004, para. 11).
The Patient Protection and Affordable Care Act (PPACA) has had an affect on competition because physicians are being driven to make other arrangements to practice medicine since the current landscape has caused their practice costs to rise and their reimbursements falling. Seeing costs rise among shrinking revenue, physicians are finding
CONDUCTING AN ENVIRONMENTAL ANALYSIS 4
the prospect of working at a salaried position at a hospital leaving smaller health care organizations which helps with the increasing demands for patient services in this organization (Gottlieb, 2012, para. 21).
Another external factor having an impact on the organization is industry regulations such as the Patient Protection and Affordable Care Act. All health care organizations have to abide by the legal system, new laws and regulations that are constantly being added due to political and social changes. Compliance can result in additional, developing new technology, and additional taxes or legal fees.
With new industry regulations such as the Patient Protection and Affordable Care Act there are ramifications for this organization. One ramification is that health care organizations will have to be careful when billing patients on financial assistance since health care organizations must first limit charges to these patients and then do everything they can to avoid collection actions. Medicare and Medicaid patients account for more than 50% of the care provided by health care organizations. The expansion of these programs and the government’s cost-cutting initiatives are now impacting revenues. The decline in insurance reimbursements has affected this organization since health care organizations receive a bulk of their revenue from Medicaid and Medicare and the Patient Protection and Affordable Care Act has cut reimbursements. The increase demand for services due to the Patient Protection and Affordable Care Act is a result of more individuals now being insured with fewer physicians and now physicians will receive lower reimbursements (Sarath, 2010, para. 1-3).
Another cause of lower reimbursements is that performance is now tied to reimbursements
CONDUCTING AN ENVIRONMENTAL ANALYSIS 5
which took effect on October 1, 2012. Value-Based Purchasing (VBP) is a model where incentives payments are given to hospitals that meet or exceed certain performance benchmarks set by The Centers for Medicare and Medicaid (CMS). In 2013, he clinical measures for the incentive payments have to include certain achievements of quality metrics related to conditions such as heart failure, pneumonia, and hospital-related infections. Also, the bundled reimbursement plan is given to a health care organization for an episode of care beginning three days before admission and ending 30 days after being discharged. This is to lower readmission rates and to correct the inefficiency of the “fee-for-service” model (Sharamitaro, 2011, p.1).
Lastly, new regulations will have an affect of more patients needing care since an estimated 34 million uninsured will enter the health care marketplace. This change will result in changing intake procedures based on severity of care, more efficient use of bed space, and lowering readmission rates (Sharamitaro, 2011, p.2).
Determine two specific internal factors that the organization’s leaders need to consider in preparing for the future of health care and the future of the organization.
In the past 10 years, hospital leaders were focused on restructuring and re-engineering their organizations for greater efficiency. They scrambled to cope with cutbacks in federal funding while trying to minimize the effects on health care quality. Today, the leadership skills set that are being sought have shifted greatly. This does not mean financial awareness and operational ability are no longer needed or important but now the shift in “hot” leadership skills are being fueled by rapid technological advancements as well as demographic changes (Dister, n.d., p.1).
CONDUCTING AN ENVIRONMENTAL ANALYSIS 6
One internal factor that the organizations’ leaders need to consider for the future of the organization is having leaders with the strongest potential to develop broad leadership skills. New leadership skills for the organization to survive will have to include:
High-level technological decision-process leadership skills- Health care leaders will have to manage technological assessment and decision-making at a very rapid pace in order to keep the organization current and competitive. Technology options will be many times greater means new technologies impacting the marketplace faster than ever. Leaders will need to know the highest-level skills in order to ask the right questions to external and internal experts to have the best knowledge to select technologies that will be the best investments for the organization (Dister, n.d., p.1).
Clinical connectivity- Due to the increasing depth of physician involvement in management decision-making today’s non-medical executives will have to connect well with clinical management. These leaders will have to understand far beyond clinical issues and how they are impacted by management. Leaders will have to include physicians’ perspectives and integrate them into decision-making. They will need to have effective contributions from physicians and engage physicians in business decisions (Dister, n.d., p.2).
Leadership of diverse management teams- In order for a health care organization to succeed in developing more diverse management teams, leaders will have to be effective in leading diverse groups and using each member’s expertise to advance the organization for the future. Future leaders will have to look beyond racial, cultural, and gender diversity to prepare and organization for success in the future. The more diverse viewpoints, the more effective the idea generation will be, with better outcomes. It will be critical for success not
CONDUCTING AN ENVIRONMENTAL ANALYSIS 7
only to hire such people, but to listen to them. The most effective healthcare management teams of tomorrow will include members with different professional, expertise, knowledge, and educational backgrounds (Dister, n.d., p.2).
Fostering of innovative thinking and problem-solving- The visionary leader must encourage a culture of innovation in the organization. The culture must begin with the leadership team and flow through the entire organization. The innovative culture needs to encourage formation of proactive solutions, services, and processes. The culture should reward risk taking and entrepreneurial thinking and promote knowledge transfer. The organization needs to review in order to identify innovative processes and future trends (Dister, n.d., p.3).
Another internal(and it can be external as well) factor that the organizations’ leaders need to consider in preparing for the future is the shortage of nurses that is happening and will continue to worsen with more patients having insurance due to the Affordable Care Act.
Hospitals have used a mix of short-term and long-term strategies to deal with the nursing shortage. They have used nurse education, competitive compensation, and temporary staff. Interviews with health care leaders indicate that these activities have helped in reducing the shortage; however, hospitals’ actions have increased costs and raised concerns about their potential impact on patient care. A large degree of doubt exists among hospitals about their ability to meet future nursing needs (May, Bazzoli, & Gerland, 2006, p. 317).
CONDUCTING AN ENVIRONMENTAL ANALYSIS 8
Currently, there is a shortage of more than one million nurses and that number is only to worsen as more people are insured. Short-term solutions to fill immediate vacancies include increasing salaries, using temporary staff, and offering sign-on bonuses. Long-term solutions for creating growth in the nursing workforce include providing financial support for nursing education and changing nurses’ work environment.
The internal impact that this shortage will have that the organizations’ leaders need to consider is the financial cost. High costs has been attributed to the loss of revenue in health care organizations because of the use of temporary nurses, increasing nurse salaries, investment in other recruiting and retention strategies such as nurse education. Efforts that improve nurse retention might result in future cost savings through reduced nurse turnover (May et al., 2006, p. 320).
The shortage of nurses will have an internal impact on access and quality. Health care organizations reported an increase in nurse workloads as a result of nurse shortages, which can affect care if nurses are overburdened. Hospitals that rely on temporary and inexperienced nurses are concerned about the impact on patient care. One hospital executive stated “we have bodies, but we don’t have seasoned bodies” (May et al., 2006, p. 321).
Discuss the impact of both the identified internal and external forces on the organization’s ability to develop a competitive strategy.
CONDUCTING AN ENVIRONMENTAL ANALYSIS 9
One key question that the organization’s leaders will have to address when discussing internal and external forces, competition, and customer satisfaction to remain competitive is “what impact will these factors have on our health care quality and customer satisfaction?”
One impact is that these factors will cause increased competition which forces the organization to use cost-minimization strategies to the detriment of the quality of health care provided. This is in turn lowers patient satisfaction levels. Another impact is that the organization can improve the quality of health care and patient satisfaction through investments in hard and soft technologies in order to cultivate and maintain a viable patient base and stay competitive. The last impact will be that the quality of health care delivery is improved and total costs may decrease without negatively affecting patient satisfaction and still remaining competitive (Rivers & Glover, 2008, p. 639).
Recommend one strategy that involves the organization’s managers in implementing and maintaining the momentum of the strategic plan.
One strategy that involves the organization’s managers in implementing and maintaining the momentum of their strategic plan is to have a plan that focuses on these four criteria:
Patient focused excellence- The focus is on the drivers of customer engagement, patient health status, new markets, and market share. These are key factors in competitiveness and organizational sustainability.
Operational performance improvement and innovation- This plan contributes to the short and longer-term productivity growth and cost containment. It builds operational
CONDUCTING AN ENVIRONMENTAL ANALYSIS 10
capability, including speed, responsiveness, and flexibility. This focus represents an investment in strengthening organizational fitness.
Organizational and personal learning- These are necessary strategic considerations in today’s fast-paced world. Learning and improvements need to be embedded in work processes. The role of strategic planning is to align work systems and learning initiatives with the organization’s strategic direction, ensuring that improvement and learning prepare and reinforce organizational priorities.
Use comparative data- The organization needs to know where it stands in comparison to competitors and to best prices. This leads to a better understanding of the processes and performances of the organization (National Institute of Standards and Technology, 2013, p. 4).
References
Dister, L. (n.d.). The new healthcare leadership culture: key senior leadership traits for the
success of the 21st century hospital. Retrieved July 23, 2014, from http://www.healthleaders media.com/content/137379.pdf
Gottlieb, S. (2012). Healthcare consolidation and competition after ppaca. Retrieved July 23,
2014, from http:/www.aei.org/speech/health/healthcare-reform/ppaca/health-care-consoli-
dation-and-competition-after-ppaca/
May, J.H., Bazzoli, G.J., & Gerland, A.M. (2006). Hospitals’ responses to nurse staffing
shortages. Health Affairs, 25(4), 316-323.
National Institute of Standards and Technology. (2013). Baldrige health care criteria for
performance excellence: category and item commentary. Retrieved July 23, 2014, from
http://www.nist.gov/baldrige/publications/upload/category_and_item_commentary_hc.pdfPorter, M.E., & Teisberg, E.O. (2004). Redefining competition in healthcare. Retrieved July
23, 2014, from http://www.hbr.org/web/extras/insight-center/health-care/redefining- competition-in-health-care
Rivers, P.A., & Glover, S.H. (2008). Health care competition, strategic mission, and patient
satisfaction: research model and propositions. Journal of Health Organization and
Management, 22(6), 627-641.
Sarath, P. (2010). How does the ppaca affect the healthcare sector? Retrieved July 23, 2014,
from http://www.bizmology.hoovers.com/2010/07/06/how-does-the-ppaca-affect-the- healthcare-sector/
Sharamitaro, A. (2011). Healthcare reform: impact on hospitals. Health Capital Topics, 4(1),
1-3.