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My Right Knee article analysis
MY RIGHT KNEE
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My Right Knee
Berwick, (2005) is talking on a personal level towards improvement in patient care. Healthcare system in United States is improving, but it has not reached the level in which the author has satisfaction towards replacement of his right knee. It is difficult to internalize the overall view of the healthcare system since it does not follow the demands of the author that he summarizes using the dimension of “total quality” (Berwick, 2005). Total quality requires the health institutions to provide quality care or its patients and encourage them towards having good life. Many chronic diseases get presented in the hospitals and healthcare providers do not have many regards towards the success of the available treatments. The author is worried about the next visit to the surgeon because only 20% of knee surgeries are successful (Berwick, 2005). In order to seek self relief the authors sets five specifications to cub his terrific treatment.
The author directs the five specifications to the healthcare institutions for the purpose of improving the surgical services. The first specification is “no needless deaths”; the specification insists that surgeons should not go into operations that may result in death of the patient (Berwick, 2005). The author is not ready to give surgeons the licence to kill. The second specification is “no needless pain”; the specification urges the surgeons not to inflict pain or hurt the patient. Surgeons should be of help to the patient. The third specification is “no helplessness”; surgeons should provide choices on the patient. The fourth specification is “no unwanted waiting”; the author advocates for open-access model in all hospitals. The fifth specification is “no waste”; surgeons should not waste materials on raising the cost of treatment for the patients (Berwick, 2005). In overall, the author does not identify any hospital that can manage in providing all the five “total quality” (Berwick, 2005).
References:
Berwick, D. M. (2005). My right knee. Annals of internal medicine, 142(2), 121-125.
Harris County Housing Authority Case Analysis
Harris County Housing Authority: Case Analysis
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Pay Goals
Harris County Housing Authority was meant to be a nonprofit, governmental organization aimed at ensuring community members had proper housing. The pay levels for the organization were not to be very high as that would compromise the core aims of the organization. The nonprofit organization that received funding from the government and private builders, however, paid its executives huge sums of money. At the same time, the organization paid other employees below market requirements by around 8 to 40%. However, the company paid the workers slightly better than other housing agencies. Thus, the company did not meet the market goals despite paying employees better than other housing agencies.
Fairness of Pay levels
Perspective of HCHA Employee
The employees were receiving less than they were worth according to marker standards. Deviations that range from 8 to 40% less than the market standards for a certain qualification are significant. The comparisons serve as a good measure to ensure that the employees at the lower levels receive their expected and rightful pay. On the other hand, the company was offering huge sums of money to those in the executive positions (Eckbo, 2011). This poses as a challenge because the company was meant to offer support services to the community and not to reward the management richly. Some of the salaries that those in top management receive are outrageous and raise questions as to whether the organization is managing the finances it receives from the government appropriately.
Perspective of HUD employee
HUD employees conducted their investigations and came up with reports that the top management employees were receiving high amounts of salaries, as opposed to regular employees. The compensations of the top management were also huge. Executives could receive bonuses that surpassed $80,000. On top of that, the top management also received regular pay rises while the same officials debated on whether regular employees should have their payments increased. The HUD employees felt that it would be best if the housing agencies would have their salaries compared and posted on their website for purposes of uniformity and fairness.
Taxpayer
Taxpayers would have to worry, not because HCHA is not doing its work, but because the company is rewarding executives richly with money that comes from them. The housing agency receives money from the government, which implies that taxpayer money fund the company. Increasing payments for workers would then mean that more of the taxpayers’ money would be going to pay salaries for the organization’s company, which should be a nonprofit organization in any case, rather than to development projects.
Balancing payments
Balancing payment ratios in a company requires consideration of a few factors. How a company’s payment scales compare to those of other companies is essential, especially with the rising scrutiny of payments that executives receive by the government, the community, and the corporate community. However, the most important things to consider while making payment balances are the circumstances of the company and its prospects. The salary of the executives should mirror market capitalization rather than value at risk or operational complexity (Eckbo, 2011). These are some of the considerations that HCHA can use to save the situation. They will ensure that the regular employees receive payments that are comparable to other firms in the industry.
Reference
Eckbo, B. (2011). Handbook of Empirical Corporate Finance: Empirical Corporate Finance. Elsevier, Print.
Harm Reduction Psychotherapy
Harm Reduction Psychotherapy
Introduction
Issues pertaining to substance abuse have elicited some controversial opinions from different quarters. Needless to say, substance abuse has been one of the key problems with which the contemporary world is grappling. While there is general agreement as to this fact, there are controversial opinions as to the manner in which the individuals who are under the spell of substance abuse can be rescued. While numerous techniques exist for solving substance abuse and other harmful behaviors, none has been more controversial than harm reduction psychotherapy. This underlines a framework for solving substance abuse and other harmful behaviors with the sole aim of reducing their damaging consequences without necessitating abstinence as a prerequisite for treatment or a goal (Tatarsky and Marlatt, 117).
Harm reduction comes with a number of benefits.
First, it comes with a compassionate and comprehending view pertaining to the users. In most cases, substance abusers sink into the habit simply because they feel neglected and unwanted. This program, however, by being compassionate, enhances collaboration between professionals and consumers thereby enhancing their effectiveness.
Second, it encompasses a human rights agenda, considering that it caters for individuals who are seemingly marginalized from the larger society and who have in the past been having problems accessing quality care.
In addition, HRP has been extremely effective in reducing hepatitis and HIV infections especially considering that it promotes safe enjoyment of the substances for example through not sharing needles.
Moreover, it reduces the use of substances in public places, in which case the general public would be safer as there would be a decline in the number of used needles that they have to grapple with in the neighborhood.
Fifth, it has been found as effective in reducing deaths from overdose, as well as other early deaths among individuals that use substances as it would also enhance their capacity to abandon the habits.
In addition, it would educate such individuals about the how they can undertake safer injecting, as well as lower the frequency of injecting oneself, in which case they would be reduced risk of overdose or over-damage of avenues of abuse such as nose, mouth, anal area and skin.
HRP recognizes and appreciates the uniqueness of substance abusers, not to mention that it goes ahead to accept other goals other than abstinence as logical or reasonable starting points for treatment, in which case it has been accepted more wholesomely by abusers than conventional techniques.
Moreover, HRP comes as one of the most effective techniques for challenging stigmatization of substance abusers (Tatarsky and Marlatt 120). This means that it does not only target the addicts’ physical wellbeing but also their mental, psychological and emotional aspects that push them to the harmful habits.
In addition, the technique considers the fact that the client has specific strengths and motivations, in which case it seeks to use them to make a positive change at all points (Tatarsky and Marlatt 120). In this case, the strengths, motivations and goals would be used to dictate the therapy’s focus, as well as in determining the techniques that can be used to support the positive change in the patient.
Lastly, harm reduction psychotherapy blends varied therapies including cognitive-behavioral, humanistic, and biological therapies, which, combined with its flexibility allows for its applicability in a broad spectrum of clients (Tatarsky and Marlatt 121).
Nevertheless, recent times have seen an increase in the vice especially among the youths. This may mainly be attributed to varied social changes including the following.
There has been an increase in the number of disrupted families, which results in poor adult care of teens at home.
In addition, working parents have become preoccupied with looking for ways to fend for their families in which case the kids have inadequate adult supervision.
Third, there has been intense migration and urbanization, which have resulted in a breakdown in the range of community support structures that took up the locum parenting roles.
Fourth, there has been an increase in the favorable attitudes towards abuse, or rather a decrease in the unfavorable attitudes to such activities.
Fifth, there has been an increase in the magnitude of responsibilities and strain that individuals have to grapple with right from an early stage in their lives.
Sixth, there has been a decrease in the utility of social norms pertaining to how individuals mingle and interact, with individuals being considerably free in their choice of individuals with whom they interact.
Seventh, there has been the entry of social media, which has eliminated some of the barriers that the societies had with regard to the people with whom the teens interact.
Eighth, the entry of internet means that teens have greater access to substances of every kind by a click of the mouse or button on their phones.
In addition, stricter laws on parentage with regard, especially concerning children rights, have increased the freedom that teens and children have, while reducing the capacity of their parents to discipline them.
Lastly, there has been a decrease in the ages within which people start bearing kids, in which case they have questionable parenting skills. This has been complemented by the increase in the numbers of orphans and the decreased role of social structures.
Works cited
Tatarsky, Andrew and Marlatt, G. Alan. State of the Art in Harm Reduction Psychotherapy: An Emerging Treatment for Substance Misuse. Journal of Clinical Psychology, Vol 68 (2). 117-122, 2010.