Factors of Production free essay sample

To understand how growth can occur, we need to consider the factors of production. Economists observe that in the production of any good, four factors of production are involved. These are 1. Land The physical land, but also comprising all the natural resources on the earth, below the earth or in the atmosphere. There is a distinction between renewable and non-renewable resources. Renewable resources are those that can be used and replaced. For example, water in a lake can be used, but can also be replenished. Non-renewable resources are those that once used cannot be used again. For example, coal and oil. 2. Labour This is the workforce of the country. Each worker has a certain capacity to produce based on inherent characteristics such as intelligence, physical strength and emotional stability, and also acquired skills produced through education and training. 3. Capital This comprises the stock of manufactured tools, machines, and other manmade resources, such as roads and railways, that are used in the production of goods and services. We will write a custom essay sample on Factors of Production or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page 1 4. Enterprise Entrepreneurs are individuals who organise the other factors of production to make goods and services. They also take risks with their own money and the financial capital of others. Growth can occur because one or more of the factors of production can increase. New resources can be discovered; land can be reclaimed; the workforce can be upskilled, so that each worker is capable of producing more per hour of effort; the capital of the country can increase; and the total organisation of the factors of production, through enterprise, can improve. writing a service letter Technological change, as a result of enterprise, can result in better production techniques. Of course, a country can also suffer negative growth; for example, a war may result in the destruction of labour and capital, and may result in land becoming useless for production. 1 It is worth noting that the term â€Å"capital† has many meanings. This is the economists’ use of the term, and should be distinguished from â€Å"capital† in the more popular sense of â€Å"lots of cash†.

Of Mice and Men Quotes

Of Mice and Men Quotes The following Of Mice and Men quotes represent some of the most significant elements of the novel, including the themes of nature, strength, and dreams. Additionally, Steinbecks use of vernacular language and colloquial dialects is evident in many of these passages. A few miles south of Soledad, the Salinas River drops in close to the hillside bank and runs deep and green. The water is warm too, for it has slipped twinkling over the yellow sands in the sunlight before reaching the narrow pool. On one side of the river the golden foothill slopes curve up to the strong and rocky Gabilan Mountains, but on the valley side the water is lined with trees- willows fresh and green with every spring, carrying in their lower leaf junctures the debris of the winter’s flooding; and sycamores with mottled, white, recumbent limbs and branches that arch over the pool. This passage, which serves as the novels opener, establishes from the very beginning the importance of land and nature to the text- specifically, an idealized version of nature. The river runs â€Å"deep and green,† the water is â€Å"warm,† the sands are â€Å"yellow†¦in the sunlight,† the foothills â€Å"golden,† the mountains â€Å"strong,† and the willows â€Å"fresh and green. Each adjective is positive and healthy. Taken together, these descriptions create a romanticized image of the natural world. The passage suggests that the natural world is epic and powerful, the animals and plants living blissfully and peacefully according to their natural rhythms, coming and going as they please, untouched by man’s destructive hand. â€Å"There is a path through the willows and among the sycamores, a path beaten hard by boys coming down from the ranches to swim in the deep pool, and beaten hard by tramps who come wearily down from the highway in the evening to jungle-up near water. In front of the low horizontal limb of a giant sycamore there is an ash pile made by many fires; the limb is worn smooth by men who have sat on it.† Untouched, that is, until the beginning of the second paragraph, when into this scene come â€Å"boys,† and â€Å"tramps,† who wreak all manner of havoc on this natural scene. The path through the willows soon becomes a â€Å"path beaten hard as the men walk all over it, ruining it of its proper tenderness. There is an â€Å"ash pile by many fires,† which suggests more harm to the landscape, both in that it implies the area is well-traveled, as well as because fires are damaging to the ground upon which they burn. Moreover, these frequent visits have â€Å"worn smooth† a tree limb that the men have used as a bench, deforming it. This paragraph introduces the uneasy balance, central to the novel, between an idealized version of the natural world and the actual version in which people live- in other words, the world of mice and the world of men. The more the world of men tries to attain or possess the world of mice, the more they harm it, and consequently the more they lose it. â€Å"That mouse ain’t fresh, Lennie; and besides, you’ve broke it pettin’ it. You get another mouse that’s fresh and I’ll let you keep it a little while.† This statement, made by George to Lennie, reveals Lennie’s gentle nature, as well as his inability to prevent his physical power from bringing destruction upon those smaller than him. Throughout the novel, Lennie is often seen petting soft objects, ranging from a mouse to a rabbit to a womans hair. In this particular passage, nothing of consequence comes of Lennies actions- he is simply touching a dead mouse. However, the moment foreshadows another scene: later in the novel, Lennie attempts to stroke Curleys wifes hair and accidentally breaks her neck in the process. Lennies unintended but inevitable acts of destruction serve as a metaphor for humanitys destructive nature. Despite our best laid plans, the novel suggests, humans cannot help but leave behind a ruinous wake. I seen hundreds of men come by on the road an’ on the ranches, with their bindles on their back an’ that same damn thing in their heads. Hunderds of them. They come, and’ they quit an’ go on; an’ every damn one of ‘em’s got a little piece of land in his head. An’ never a God damn one of ‘em ever gets it. Just like heaven. Ever’body wants a little piece of lan’ I read plenty of books out here. Nobody never gets to heaven, and nobody gets no land. It’s just in their head. They’re all the time talkin’ about it, but it’s just’ in their head.† In this speech, a farmhand named Crooks rejects Lennie’s notion that he and George will one day buy a piece of land and live off of it. Crooks claims that he has heard many people make these sort of claims before, but that none of them have ever come to fruition; rather, he says, â€Å"it’s just in their head.† This statement encapsulates Crooks’ (justified) skepticism about George and Lennie’s plan, as well as a deeper doubt about anyones ability to attain whatever idealized sanctuary they have envisioned for themselves. According to Crooks, â€Å"[n]obody never gets to heaven, and nobody gets no land. Whether the dream is eternal spiritual salvation, or just a few acres to call your own, nobody can actually achieve it.  Ã‚   ‘We’ll have a cow,’ said George. ‘An’ we’ll have maybe a pig an’ chickens†¦an’ down the flat we’ll have a†¦little piece alfalfa- ‘For the rabbits,’ Lennie shouted.‘For the rabbits,’ George repeated.‘And I get to tend the rabbits.’‘An’ you get to tend the rabbits.’Lennie giggled with happiness. â€Å"An’ live on the fatta the lan’.’ This exchange between George and Lennie takes place at the end of the novel. In it, the two characters describe for each other the farm they hope to live on one day. They plan to have rabbits, pigs, cows, chickens, and alfalfa, none of which they currently have access to on the barley farm. The dream of having their own farm is a refrain to which the pair often returns throughout the book. Lennie seems to believe the dream is realistic, even if currently out of reach, but for most of the book, it is unclear whether George shares that belief or simply considers it an idle fantasy that helps him get through the day. By the time this scene occurs, however, George is preparing to kill Lennie, and he clearly knows the farm dream will never become reality. Interestingly, even though they have had this conversation before, only now does George assent when Lennie asks him if they can have rabbits- a recurring symbol throughout the book- on the farm. Given that he is about to shoot Lennie, this juxtaposition implies that, for the characters of Of Mice and Men, the more they hope to attain in the real world, the further from it they must travel.

Role of Music in Computer Games Essay Example | Topics and Well Written Essays - 1000 words

Role of Music in Computer Games - Essay Example Computer or video game music involves the use of soundtracks that accompany the game while it is being played. Early games used YMO melodies and beats. They used simple sounds and there was little distinction between 'noise' and 'music', or 'sound' and 'music'. At the time, little concentration was given to the possibility of incorporating music into games. Numerical developments in storage capacity increased over time. Long ago, the 1983-87 era employed '8-bit' systems, the 1987-1993 era used '16-bit' systems (Donkey Kong Country 2), '32-bit' systems occurred during 1993-2003 and the '64-bit' has been used since 2003-present. More space in the memory has been focused on with more detail being added (images, sounds and music). The first commercially produced games were by Computer Space (Nutting Associates 1971). The first game produced that had a 'musical dimension' was Space Invaders in 1978. It employed the rise and fall of bass notes that looped and sped up when the 'aliens' got nearer –a popular cinematic technique. Super Mario Brothers was the first video game produced in 1985 that went on to achieve worldwide success. The first dynamic use of 8-bit music was in a game’s plot titled Duck Tales in 1989. The first time songs were incorporated into video games was in 2005 in the computer game, ‘Still Alive’ in ‘Portal’. The development of the popularity of games was acknowledged which led to the creation of arcade games. At present, it is reported that video game composers employ advanced tools and instruments to make these exceptionally high quality sound tracks. These soundtracks rival the quality of production and musical sources that are distinctive with films. The central connection that exists between films and videogames is that they both rely heavily on the use of aural cues and visual cues as well to express a sense of constant diegesis or game world. The role played by music in these video games has advanced from once being a mere ringing sound to symphonic orchestral sounds and hip-hop playlists that can be customized. At present, music in computer games has evolved the whole experience one derives from these games when compared to the past. This fact has caused competitors within the game console industry to revolutionize their products. Music is used to express a particular mood when the visuals are accompanied with it. Onekey function among the extensive video game music functions sis that the sound aids in engaging the discernment of a spatial digress by the audience. Diegetic and Extra diegetic music is usually combined with the video game sounds to generate a particular captivating mood. Diegetic music is the kind of music assumed to be perceptible to the characters in the narrative on the screen. Musical cues and sound effects usually impart the objects with even an extra life than they possess when they simply make appearances as figures in motion. Use of music in computer game s makes the illusion portrayed in computer games compelling. Use of music in film Musical cues and sound effects have always been part of film from inception of the film began. Early exhibitions of films were characteristically incorporated the use of a piano. Silent films were complemented by a range of musical instruments such as the solo piano to larger musical instruments depending on the kind of film. Music in films was intended to spark interest in audiences.Originally, films had no music andthis caused audiences to seek other sounds (such as ambient noises) that fulfilledfunctions usually achieved by musical cues.Use of musical cues in film applieshigher influence on the subject of the film than it would have if there was no accompaniment of music.Music divides the emotive content of the filmand considerably impactson the understanding of thetheatrical plot by the audience (Collins, 2008).Music within films influences memoryof the scenes in the film. Through the musical cues, one is able to remember what was

Animation Essay Example | Topics and Well Written Essays - 1500 words

Animation - Essay Example The purpose of this paper is to explore how animation has evolved and changed since the golden age of Disney in the 1930s through to the Pixar films of modern day. To do this, the research will focus particularly on a classic Disney movie (Fantasia) and one of the most popular films released by Pixar (Toy Story). In doing this, some similarities will be uncovered between the two, despite the differences in technology and the vastly different eras in which they were generated and produced. Disney’s Fantasia Fantasia is one of the most influential Disney films, and was released in 1940 (Neuwirth, 2003). The film itself is highly complex for such an early example of animated film, with over 500 characters being present within the story and over 1000 members of staff working on different elements of the production (Neuwirth, 2003). Although related to previous Disney animations (Mickey Mouse and Silly Symphonies), Fantasia is well recognized for having some of the most brightly co lored and intensely lit stills from any other animated movie or short from the period (Lasseter, 1995), perhaps a testament to the developing technology of the time. Color itself is recognized as being one of the most important elements of Fantasia’s success, and Disney requested that each scene be color-coded in a specific way to allow smooth transition between shots. Additionally, artists involved in the picture were encouraged to make 3D models of their characters to understand the movement for a more ‘realistic’ feel, despite the abstract nature of the film (Cavalier, 2011). An important point to note with respect to Fantasia and the early Disney films is that each and every shot in the film was drawn, colored and lit individually; an extremely painstaking process. It is from this starting point that the evolution of animation technology can be considered. Pixar’s Toy Story Like Fantasia, Toy Story is extremely significant in the history of animation. Released in 1995, Toy Story was the first full-length animation to be completely done using computer animation techniques. It also has the credit of being the first film released by Pixar, a hugely successful modern film studio. Toy Story relies on CGI-animation techniques created with PhotoRealistic RenderMan, a Pixar-specific image-rendering application based on the industry standard (Cavalier, 2011). One of the biggest challenges for animating the movie was that the producers wanted the animation to look as realistic as possible, which means a huge attention to detail. In this way, the animation techniques for both Toy Story and Fantasia involve a similar commitment. However, it is worth noting that only 27 animators worked on the production of Toy Story, although over 400 real 3D models were created to allow the animators to study movement and gain a picture of how the characters in the film should move and behave to create the aforementioned realism (Lasseter, 1995). Additional ly, there were challenges involved in creating realistic shadows and lighting, although these could be done to a higher standard than in typical ‘cartoon-style’ animations. Technology & Composition There are 55 years between the release of Disney’s Fantasia and Pixar’s Toy Story, which evidently means that there are a lot of

Movie Funny People Analysis Essay Example | Topics and Well Written Essays - 1750 words

Movie Funny People Analysis - Essay Example The essay "Movie Funny People Analysis" analyzes the movie â€Å"Funny People† released in 2009, analyzes and evaluates the movie in all possible detail. "Funny People" as the title suggests needed some funny people as the front cast and who could have been a better choice than Adam Sandler for ‘Judd Apatow’. Not only Sandler is Apatow’s former roommate, but also without any doubts, Sandler is amongst the few top class actors in the Hollywood today. Experts say that he has it all: style, charisma, talent, skills, personality, hard work, and some great movies under his names. Whatever contribution, he has done to Hollywood is worth remembering for ages. His roles in movies like â€Å"Billy Madison†, â€Å"Big Daddy†, â€Å"Mr. deeds†, â€Å"50 first dates†, â€Å"I know pronounce you Chuck and Larry†, and now â€Å"Funny People† serve as models for the newcomers in the industry to follow. He is also the head of his production house â€Å"Happy Madison Productions†. Sandler’s co-star in this film is Seth Rogen who is also very much an actor, comedian, writer, stand-up comedian, producer, and entrepreneur like Sandler. This Canadian Jewish, 27-year-old man, has impressed critics with his roles in movies like â€Å"The 40-year-old virgin†, â€Å"Knocked up†, â€Å"Pineapple Express† and of course â€Å"Funny People†. He has not won anything for his acting but he has won best writer award Canadian Comedy Award for â€Å"Superbad† in the year 2008. Judd Apatow’s wife Leslie Mann also plays a supporting role in this movie.

E-Health System Advantages and Disadvantages

E-Health System Advantages and Disadvantages Introduction: Information systems designed for specific objectives. Today, lots of information systems are designed to help the health care industry. One of the main systems is Health Information System, which has designed for collecting, storing, managing and providing available patient information important to the healthcare delivery system. One field of health information systems is hospital information system. This system records the patient related data and update the data and make it available for clinical staff for monitoring the patient and diagnosis and also to make treatment decisions by hospital professions. Designing process: Information technology has already changed the ways of services in hospitals, and become one of the important considerations in modern hospitals, but often bad designed IT solutions may have problems to communicate with the staff. The main objective of System Design is to make a technical solution that fulfills the functional demands for the system. There are several challenges to design a good IT system; organizations in any healthcare units can improve the implementation process by using the following five elements: Comprehensive Business Plan: Defines the reason for taking the responsibility for the project and the expected results. Demand administrative Commitment and Leadership: Achieving success needs brave leadership and a full commitment. When the go-forward decision is made, those who responsible for the care of the design process must stand behind the leadership. Set Realistic Expectations: keep away from searching for the extreme solution and trying to carry out all aspects of the system at once. The selection may focus on a sequence of expectations concerning software performance, with fulfilling the clinical goals within a reasonable budget. Secure Operational Ownership of the Project: the supplier has experience; customers have to define their own vision and demands. The timetable of process and method of use among customers could be different in an extreme manner. Lead the Implementation: The pilot site idea allows the supplier, clinical and IT staffs to study procedures, define future state workflows, and develop guidelines and procedures. The absence of any essential element may leads to physician disappointment and less adoption with the system. the system itself also must satisfy following demands: Make connection between care professions and patients and also their relatives. It must be useful to keep the patent data not only for diagnosis but also for prevention and maintaining health. Easy enough to use by clinical staff. IT must have interconnection between other health care systems in other hospitals and care centers. The system must be learnable enough and has no considerable errors in sending and receiving data. Evaluation: The evaluation begins during program development and can be divided into verià ¯Ã‚ ¬Ã‚ cation, validation, assessment of human factors and clinical assessment of clinical effect (Engelbrecht et al. 1995; Ohmann Belenky 1995; Ohmann et al. 1998; see also Van Bemmel Musen 1997)., Verification checks development of the system according to its specià ¯Ã‚ ¬Ã‚ cation and conà ¯Ã‚ ¬Ã‚ rms consistency, completeness and correctness of the system. Validation checks that the system performs the tasks for which it has been designed in the real working environment. Evaluation of human factors is the next phase of system evaluation. Even if a system has been verià ¯Ã‚ ¬Ã‚ ed and validated, it may be so clumsily designed that it cannot be used in real life, because using the system is either too inconvenient or consumes too much time.[3] In this part the main consideration must be how to evaluate the system continuously to make sure that the system is efficient enough as in care delivery or cost. It means that the system should not impact the patient data, because any change in patient data may cause bad diagnosis and incorrect care delivery, and the system must be in budget. One important factor in evaluation is to define correct evaluation goals. Without proper goals the evaluation has no sense. The main purposes of evaluation are user-based evaluation for design feedback, which checks whether users can carry out their jobs through the system or not and makes a feedback to system, and User-based evaluation for metrics . Technology Acceptance: Resistance of hospitals staff arises when they cannot adopt IT applications easily, so challenge in design is to integrate the ICT into their workflow. Staff members may be afraid to learn new technology, or they may be afraid that the system will eliminate their job, so they insist to keep working in traditional paper-base system. Moreover, physicians assign many reasons why they cant adopt ICT systems. Some mention about difficulty, or they are not well enough in typing. There are also interested in making eye contact with patients. Making connection between hospital staff and their colleagues who are currently using ICT systems, will illustrate that the system increase physician-patient relationship and also the system does not eliminate hospital staff jobs however it may cause changes in their workflow. Training criteria: In order to train the staff, system supplier must develop training materials, training plan and also lead the proper training program for staff, i.e. perform annual workshops to improve the computer and IT knowledge of staff continuously. Hospital training department can assist supplier in developing and performing the program and can ensure participation of all users in training sessions. The training department also should perform computerized training programs for both new arrived nurses and physicians to make them ready for the system that hospital is working with. By this process It is likely hospital will have a favorable response in convincing the staff. Advantages and disadvantages with Ehealth system: After implementation an Ehealth system some advantages and disadvantages may identified when comparing the system to paper-based documentation. Ehealth system advantages: reduces staff stress. makes an efficient and accessible patient record. Time saving and reducing indirect works, that leads to more direct care delivery. Causes keeping staff in their possession and attracting them. Ehealth system disadvantages: changes communication processes with staff. training of staff is quite time-consuming. Conclusion: In conclusion, a good Ehealth information system must concentrate on providing information and services to guarantee the best outcome for the patient care. There is a strong demand for employing personnel with health informatics skills to supervise this process and to keep the management part of the hospital in a high standard level because these personnel will play an important role in the system design, system implementation and evaluation of the system. Discussion: References: [1]Development and Evaluation of Information Systems for Shared Homecare(ISABELLA SCANDURRA) [2]acceptance [3]-full text-evaluation [7] J. K. H. Tan, Health Management information Systems; Methods and practical Applications. 2001.

Assessment of Blood Brothers, by Willy Russell :: Blood Brothers Essays

Assessment of Blood Brothers. Paper 1 unit 2 'Blood Brouthers' when we first was told about the play I did not know what it was about, I had heard of it before but I had never seen or read any of the play. Then we were told the basic story of the play and the playwright's history:  · The play was set in the early 1970  · It was written by the playwright Billy Russell  · There have been two different versions of the play scripts that have been written by Billy Russell, one being the original and the other being a modern musical version.  · The story is based on two different types of people in different types of classes and how children cannot see the differences.  · The play is based in Liverpool and at this time (1970's) there was a mixture of the wealthy and working class people.  · Billy Russell has based the play on his upbringing as he was brought up in a working class family in Liverpool  · The story is basically about a working class woman who works for a wealthy woman, the working class woman has 7 children and she finds out she is pregnant again with twins and her husband has just left her so the wealthy woman persuades the working class woman to give her one of the twins. The two twins meet at various points in there life's, they meet as young children and become friends when young adults, when they find out that they are twins they both die because the wealthy women kills them both. To get us to understand the play we read more into it by taking scrip's from the musical and the original, and developing them by using: Brainstorming We brainstormed a lot about the play, what we all knew about it. We also brainstorm about the different themes of the play, money, dreams, friendship and superstition we then linked them to the play. This helped me a lot because I did not know the full play and this helped me understand the themes and how they connected to the play. Still-image In my group we created a few still-images to help use decide each theme and to make use understand it more and were the themes come into the different parts of the play. We also created a caption to go with each still-image so that it helps other groups to understand what each still image is about. Narration We used narration at many different times but that was also because

Leadership Framework

Leadership Academy Leadership Framework A Summary  © 2011 NHS Leadership Academy. All rights reserved. The Leadership Framework is published on behalf of the NHS Leadership Academy by NHS Institute for Innovation and Improvement, Coventry House, University of Warwick Campus, Coventry, CV4 7AL. Publisher: NHS Institute for Innovation and Improvement, Coventry House, University of Warwick Campus, Coventry, CV4 7AL.This publication may be reproduced and circulated free of charge for non-commercial purposes only by and between NHS-funded organisations in England, Scotland, Wales and Northern Ireland staff, and their related networks and officially contracted third parties. This includes the right to reproduce, distribute and transmit this publication in any form and by any means, including e-mail, photocopying, microfilming, and recording. No other use may be made of this publication or any part of it except with the prior written permission and application for which should be in writi ng and addressed to the Director of Leadership (and marked ‘re. ermissions’). Written permission must always be obtained before any part of this publication is stored in a retrieval system of any nature, or electronically. Reproduction and transmission of this publication must be accurate, must not be used in any misleading context and must always be accompanied by this Copyright Notice. Warning: Unauthorised copying, storage, reproduction, adaptation or other use of this publication or any part of it is strictly prohibited. Doing an unauthorised act in relation to a copyright work may give rise to civil liabilities and criminal prosecution. Similar essay: Describe How Own Behaviour Could Impact NegativelyThe Clinical Leadership Competency Framework was created with the agreement of the NHS Institute for Innovation and Improvement and the Academy of Medical Royal Colleges from the Medical Leadership Competency Framework which was created, developed and is owned jointly by the NHS Institute for Innovation and Improvement and the Academy of Medical Royal Colleges. NHS Institute for Innovation and Improvement and Academy of Medical Royal Colleges (2010) Medical Leadership Competency Framework, 3rd edition, Coventry: NHS Institute for Innovation and Improvement. NHS Institute for Innovation and Improvement and Academy of Medical Royal Colleges 2010 The Leadership Framework The Leadership Framework provides a consistent approach to leadership development for staff in health and care irrespective of discipline, role or function, and represents the foundation of leadership behaviour that all staff should aspire to. Fundamental to its development was a desire to build on existing leadership frameworks used by different staff groups and create a single overarching leadership framework for all staff in health and care.In developing the Leadership Framework detailed research and consultation with a wide cross section of staff and stakeholders has been undertaken, including those with a patient perspective and those involved in healthcare outside the NHS such as professional bodies, academics, regulators and policy makers. Those consulted embraced the concept of the Leadership Framework because it affords a common and consistent approach to professional and leadership development, based on shared values and beliefs which are consistent with the principles and values of the NHS Constitution1.The Leadership Framework is based on the concept that leadership is not restricted to people who hold designated leadership roles and where there is a shared responsibility for the success of the organisation, services or c are being delivered. Acts of leadership can come from anyone in the organisation and as a model it emphasises the responsibility of all staff in demonstrating appropriate behaviours, in seeking to contribute to the leadership process and to develop and empower the leadership capacity of colleagues2.This document provides a summary of the seven domains of the Leadership Framework. A full and web based version can be found at www. leadershipacademy. nhs. uk/If Design and structure of the Leadership Framework Delivering services to patients, service users, carers and the public is at the heart of the Leadership Framework. The needs of the people who use services have always been central to healthcare and all staff work hard to improve services for them. However, if we are going to transform services, acting on what really matters to patients and the public is essential and nvolves the active participation of patients, carers, community representatives, community groups and the public i n how services are planned, delivered and evaluated3. The Leadership Framework is comprised of seven domains. Within each domain there are four categories called elements and each of these elements is further divided into four descriptors. These statements describe the leadership behaviours, which are underpinned by the relevant knowledge, skills and attributes all staff should be able to demonstrate.To improve the quality and safety of health and care services, it is essential that staff are competent in each of the five core leadership domains shown at right: demonstrating personal qualities, working with others, managing services, improving services, and setting direction. The two other domains of the Leadership Framework, creating the vision and delivering the strategy, focus more on the role and contribution of individual leaders and particularly those in senior positional roles. 1 Department of Health (2010) The NHS Constitution: the NHS belongs to us all.The NHS Constitution can be accessed via http://www. nhs. uk/choiceintheNHS/Rightsandpledges/NHSConstitution/Pages/Overview. aspx NHS Institute for Innovation and Improvement and Academy of Medical Royal Colleges (2009) Shared Leadership: Underpinning of the MLCF Patient and Public Engagement, Department of Health (2009) Putting Patients at the Heart of Care: The Vision for Patient and Public Engagement in Health and Social Care. www. dh. gov. uk/ppe 2 3 Leadership Framework: A Summary 3 The word ‘patient’ is used throughout the Leadership Framework to enerically cover patients, service users, and all those who receive healthcare. Similarly, the word ‘other’ is used to describe all colleagues from any discipline and organisation, as well as patients, service users, carers and the public. The leadership context The application and opportunity to demonstrate leadership will differ and the context in which competence can be achieved will become more complex and demanding with care er progression. We have therefore used four stages to describe this and to help staff understand their progression and development as a leader.They are: Stage 1 Own practice/immediate team – is about building personal relationships with patients and colleagues, often working as part of a multi-disciplinary team. Staff need to recognise problems and work with others to solve them. The impact of the decisions staff take at this level will be limited in terms of risk. Stage 2 Whole service/across teams – is about building relationships within and across teams, recognising problems and solving them. At this level, staff will need to be more conscious of the risks that their decisions may pose for self and others for a successful outcome.Stage 3 Across services/wider organisation – is about working across teams and departments within the wider organisation. Staff will challenge the appropriateness of solutions to complex problems. The potential risk associated with t heir decisions will have a wider impact on the service. Stage 4 Whole organisation/healthcare system – is about building broader partnerships across and outside traditional organisational boundaries that are sustainable and replicable. At this level leaders will be dealing with multi-faceted problems and coming up with innovative solutions to those problems.They may lead at a national/international level and would be required to participate in whole systems thinking, finding new ways of working and leading transformational change. Their decisions may have significant impact on the reputation of the NHS and outcomes and would be critical to the future of the NHS. 4 Leadership Framework: A Summary Application of the Leadership Framework and supporting tools The Leadership Framework is designed to enable staff to understand their progression as a leader and to support fostering and developing talent.There are many ways it can be applied, for example: †¢ To raise awareness t hat effective leadership is needed across the whole organisation †¢ To underpin a talent management strategy †¢ As part of an existing leadership development programme †¢ To inform the design and commissioning of training and development programmes †¢ To develop individual leadership skills †¢ As part of team development †¢ To enhance existing appraisal systems †¢ To inform an organisation’s recruitment and retention processes.To assist users the full and web based version have a suite of indicators across a variety of work place situations which illustrate the type of activity staff could be demonstrating relevant to each element and stage as well as examples of behaviours if they are not. Supporting tools A self assessment and 360 ° feedback tool support the Leadership Framework; in addition an online development module signposts development opportunities for each of the seven domains.The 360 ° is a powerful tool to help individuals id entify where their leadership strengths and development needs lie. The process includes getting confidential feedback from line managers, peers and direct reports. As a result, it gives an individual an insight into other people’s perceptions of their leadership abilities and behaviour. To assist with integrating the competences into postgraduate curricula and learning experiences, there is the LeAD e-learning resource which is available on the National Learning Management System and through e-Learning for Healthcare (www. -lfh. org. uk/LeAD). The Clinical Leadership Competency Framework and the Medical Leadership Competency Framework are also available to specifically provide staff with clinically based examples in practice and learning and development scenarios across the five core domains shared with the Leadership Framework. A summary version of the Leadership Framework follows, which includes the domains, elements and descriptors. Work-place indicators that demonstrate h e practical application of the framework at the four stages are included as tables in the back of the document. The examples in practice are not included, however these are available in the full document as well as on the website (www. leadershipacademy. nhs. uk/If). Leadership Framework: A Summary 5 1. Demonstrating Personal Qualities Effective leadership requires individuals to draw upon their values, strengths and abilities to deliver high standards of service.To do so, they must demonstrate effectiveness in: †¢ Developing self awareness by being aware of their own values, principles, and assumptions, and by being able to learn from experiences †¢ Managing yourself by organising and managing themselves while taking account of the needs and priorities of others †¢ Continuing personal development by learning through participating in continuing professional development and from experience and feedback †¢ Acting with integrity by behaving in an open, honest and et hical manner. 1. 1 Developing self awareness 1.Recognise and articulate their own value and principles, understanding how these may differ from those of other individuals and groups 2. Identify their own strengths and limitations, the impact of their behaviour on others, and the effect of stress on their own behaviour 3. Identify their own emotions and prejudices and understand how these can affect their judgement and behaviour 4. Obtain, analyse and act on feedback from a variety of sources 1. 2 Managing yourself 1. Manage the impact of their emotions on their behaviour with consideration of the impact on others 2.Are reliable in meeting their responsibilities and commitments to consistently high standards 3. Ensure that their plans and actions are flexible, and take account of the needs and work patterns of others 4. Plan their workload and activities to fulfil work requirements and commitments, without compromising their own health 1. 3 Continuing personal development 1. Actively seek opportunities and challenge for personal learning and development 2. Acknowledge mistakes and treat them as learning opportunities 3. Participate in continuing professional development activities 4.Change their behaviour in the light of feedback and reflection 1. 4 Acting with integrity 1. Uphold personal and professional ethics and values, taking into account the values of the organisation and respecting the culture, beliefs and abilities of individuals 2. Communicate effectively with individuals, appreciating their social, cultural, religious and ethnic backgrounds and their age, gender and abilities 3. Value, respect and promote equality and diversity 4. Take appropriate action if ethics and values are compromised 6 Leadership Framework: A Summary 2. Working with OthersEffective leadership requires individuals to work with others in teams and networks to deliver and improve services. To do so, they must demonstrate effectiveness in: †¢ Developing networks by working in partnership with patients, carers, service users and their representatives, and colleagues within and across systems to deliver and improve services †¢ Building and maintaining relationships by listening, supporting others, gaining trust and showing understanding †¢ Encouraging contribution by creating an environment where others have the opportunity to contribute †¢ Working within teams to deliver and improve services. . 1 Developing networks 1. Identify opportunities where working with patients and colleagues in the clinical setting can bring added benefits 2. Create opportunities to bring individuals and groups together to achieve goals 3. Promote the sharing of information and resources 4. Actively seek the views of others 2. 2 Building and maintaining relationships 1. Listen to others and recognise different perspectives 2. Empathise and take into account the needs and feelings of others 3.Communicate effectively with individuals and groups, and act as a positiv e role model 4. Gain and maintain the trust and support of colleagues 2. 3 Encouraging contribution 1. Provide encouragement, and the opportunity for people to engage in decision-making and to challenge constructively 2. Respect, value and acknowledge the roles, contributions and expertise of others 3. Employ strategies to manage conflict of interests and differences of opinion 4. Keep the focus of contribution on delivering and improving services to patients 2. Working within teams 1. Have a clear sense of their role, responsibilities and purpose within the team 2. Adopt a team approach, acknowledging and appreciating efforts, contributions and compromises 3. Recognise the common purpose of the team and respect team decisions 4. Are willing to lead a team, involving the right people at the right time Leadership Framework: A Summary 7 3. Managing Services Effective leadership requires individuals to focus on the success of the organisation(s) in which they work.To do so, they must b e effective in: †¢ Planning by actively contributing to plans to achieve service goals †¢ Managing resources by knowing what resources are available and using their influence to ensure that resources are used efficiently and safely, and reflect the diversity of needs †¢ Managing people by providing direction, reviewing performance, motivating others, and promoting equality and diversity †¢ Managing performance by holding themselves and others accountable for service outcomes. . 1 Planning 1. Support plans for clinical services that are part of the strategy for the wider healthcare system 2. Gather feedback from patients, service users and colleagues to help develop plans 3. Contribute their expertise to planning processes 4. Appraise options in terms of benefits and risks 3. 2 Managing resources 1. Accurately identify the appropriate type and level of resources required to deliver safe and effective services 2.Ensure services are delivered within allocated resour ces 3. Minimise waste 4. Take action when resources are not being used efficiently and effectively 3. 3 Managing people 1. Provide guidance and direction for others using the skills of team members effectively 2. Review the performance of the team members to ensure that planned services outcomes are met 3. Support team members to develop their roles and responsibilities 4. Support others to provide good patient care and better services 3. Managing performance 1. Analyse information from a range of sources about performance 2. Take action to improve performance 3. Take responsibility for tackling difficult issues 4. Build learning from experience into future plans 8 Leadership Framework: A Summary 4. Improving Services Effective leadership requires individuals to make a real difference to people’s health by delivering high quality services and by developing improvements to services.To do so, they must demonstrate effective in: †¢ Ensuring patient safety by assessing and m anaging risk to patients associated with service developments, balancing economic consideration with the need for patient safety †¢ Critically evaluating by being able to think analytically, conceptually and to identify where services can be improved, working individually or as part of a team †¢ Encouraging improvement and innovation by creating a climate of continuous service improvement †¢ Facilitating transformation by actively contributing to change processes that lead to improving healthcare. 4. 1 Ensuring patient safety 1.Identify and quantify the risk to patients using information from a range of sources 2. Use evidence, both positive and negative, to identify options 3. Use systematic ways of assessing and minimising risk 4. Monitor the effects and outcomes of change 4. 2 Critically evaluating 1. Obtain and act on patient, carer and user feedback and experiences 2. Assess and analyse processes using up-to-date improvement methodologies 3. Identify healthcare i mprovements and create solutions through collaborative working 4. Appraise options, and plan and take action to implement and evaluate improvements 4. 3 Encouraging improvement and innovation 1.Question the status quo 2. Act as a positive role model for innovation 3. Encourage dialogue and debate with a wide range of people 4. Develop creative solutions to transform services and care 4. 4 Facilitating transformation 1. Model the change expected 2. Articulate the need for change and its impact on people and services 3. Promote changes leading to systems redesign 6. Motivate and focus a group to accomplish change Leadership Framework: A Summary 9 5. Setting Direction Effective leadership requires individuals to contribute to the strategy and aspirations of the organisation and act in a manner consistent with its values.To do so, they must demonstrate effective in: †¢ Identifying the contexts for change by being aware of the range of factors to be taken into account †¢ Applyi ng knowledge and evidence by gathering information to produce an evidence-based challenge to systems and processes in order to identify opportunities for service improvements †¢ Making decisions using their values, and the evidence, to make good decisions †¢ Evaluating impact by measuring and evaluating outcomes, taking corrective action where necessary and by being held to account for their decisions. . 1 Identifying the contexts for change 1. Demonstrate awareness of the political, social, technical, economic, organisational and professional environment 2. Understand and interpret relevant legislation and accountability frameworks 3. Anticipate and prepare for the future by scanning for ideas, best practice and emerging trends that will have an impact on health outcomes 4. Develop and communicate aspirations 5. 2 Applying knowledge and evidence 1. Use appropriate methods to gather data and information 2.Carry out analysis against an evidence-based criteria set 3. Use inf ormation to challenge existing practices and processes 4. Influence others to use knowledge and evidence to achieve best practice 5. 3 Making decisions 1. Participate in and contribute to organisational decision-making processes 2. Act in a manner consistent with the values and priorities of their organisation and profession 3. Educate and inform key people who influence and make decisions 4.Contribute a clinical perspective to team, department, system and organisational decisions 5. 4 Evaluating impact 1. Test and evaluate new service options 2. Standardise and promote new approaches 3. Overcome barriers to implementation 4. Formally and informally disseminate good practice 10 Leadership Framework: A Summary 6. Creating the Vision Effective leadership involves creating a compelling vision for the future, and communicating this within and across organisations.This requires individuals to demonstrate effectiveness in: †¢ Developing the vision of the organisation, looking to the future to determine the direction for the organisation †¢ Influencing the vision of the wider healthcare system by working with partners across organisations †¢ Communicating the vision and motivating others to work towards achieving it †¢ Embodying the vision by behaving in ways which are consistent with the vision and values of the organisation. 6. 1 Developing the vision for the organisation 1.Actively engage with colleagues and key influencers, including patients and public, about the future of the organisation 2. Broadly scan and analyse the full range of factors that will impact upon the organisation, to create likely scenarios for its future 3. Create a vision which is bold, innovative and reflects the core values of the NHS 4. Continuously ensures that the organisation’s vision is compatible with future developments within the wider healthcare system. 6. 2 Influencing the vision of the wider healthcare system 1.Seek opportunities to engage in debate abo ut the future of health and care related services 2. Work in partnership with others in the healthcare system to develop a shared vision 3. Negotiate compromises in the interests of better patient services 4. Influence key decision-makers who determine future government policy that impacts on the NHS and its services. 6. 3 Communicating the vision 1. Communicate their ideas and enthusiasm about the future of the organisation and its services confidently and in a way which engages and inspires others 2.Express the vision clearly, unambiguously and vigorously 3. Ensure that stakeholders within and beyond the immediate organisation are aware of the vision and any likely impact it may have on them 4. Take time to build critical support for the vision and ensure it is shared and owned by those who will be communicating it. 6. 4 Embodying the vision 1. Act as a role model, behaving in a manner which reflects the values and principles inherent in the vision 2. Demonstrate confidence, self belief, tenacity and integrity in pursuing the vision 3.Challenge behaviours which are not consistent with the vision 4. Identify symbols, rituals and routines within the organisation which are not consistent with the vision, and replace them with ones that are. Leadership Framework: A Summary 11 7. Delivering the Strategy Effective leadership involves delivering the strategy by developing and agreeing strategic plans that place patient care at the heart of the service, and ensuring that these are translated into achievable operational plans.This requires individuals to demonstrate effectiveness in: †¢ Framing the strategy by identifying strategic options for the organisation and drawing upon a wide range of information, knowledge and experience †¢ Developing the strategy by engaging with colleagues and key stakeholders †¢ Implementing the strategy by organising, managing and assuming the risks of the organisation †¢ Embedding the strategy by ensuring that strate gic plans are achieved and sustained. 7. 1 Framing the strategy 1. Take account of the culture, history and long term underlying issues for the organisation 2.Use sound organisational theory to inform the development of strategy 3. Identify best practice which can be applied to the organisation 4. Identify strategic options which will deliver the organisation’s vision 7. 2 Developing the strategy 1. Engage with key individuals and groups to formulate strategic plans to meet the vision 2. Strive to understand others’ agendas, motivations and drivers in order to develop strategy which is sustainable 3. Create strategic plans which are challenging yet realistic and achievable 4. Identify and mitigate uncertainties and risks associated with strategic choices 7. Implementing the strategy 1. Ensure that strategic plans are translated into workable operational plans, identifying risks, critical success factors and evaluation measures 2. Identify and strengthen organisational capabilities required to deliver the strategy 3. Establish clear accountability for the delivery of all elements of the strategy, hold people to account and expect to be held to account themselves 4. Respond quickly and decisively to developments which require a change in strategy 7. 4 Embedding the strategy 1.Support and inspire others responsible for delivering strategic and operational plans, helping them to overcome obstacles and challenges, and to remain focused 2. Create a consultative organisational culture to support delivery of the strategy and to drive strategic change within the wider healthcare system 3. Establish a climate of transparency and trust where results are discussed openly 4. Monitor and evaluate strategic outcomes, making adjustments to ensure sustainability of the strategy 12 Leadership Framework: A Summary The following tables combine the indicators of behaviours at different leadership stages from each domain section.Please refer to the full domain pages f or the element descriptors. 1. DEMONSTRATING PERSONAL QUALITIES Effective leadership requires individuals to draw upon their values, strengths and abilities to deliver high standards of service. To do so, they must demonstrate effectiveness in demonstrating self awareness, managing themselves, continuing their personal development and acting with integrity. 2 Whole Service/Across Teams 3 Across Services/Wider Organisation Element Appreciates the impact they have on others and the impact others have on them. Routinely seeks feedback and adapts their behaviour appropriately.Reflects on their interactions with a wide and diverse range of individuals and groups from within and beyond their immediate service/organisation. Challenges and refreshes own values, beliefs, leadership styles and approaches. Overtly role models the giving and receiving of feedback. Successfully manages a range of personal and organisational demands and pressures. Demonstrates tenacity and resilience. Overcomes s etbacks where goals cannot be achieved and quickly refocuses. Is visible and accessible to others. Acts as an exemplar for others in managing their continuous personal development.Facilitates the development of a learning culture. 1 Own Practice/Immediate Team 4 Whole Organisation/Wider Healthcare System Uses sophisticated tools and sources to continuously learn about their leadership impact in the wider health and care community and improve their effectiveness as a senior leader. Understands how pressures associated with carrying out a high profile role impact on them and their performance. Remains focused on strategic goals when faced with competing and, at times, conflicting demands arising from differing priorities.Identifies where they need to personally get involved to achieve the most benefit for the organisation and wider healthcare system. Develops through systematically scanning the external environment and exploring leading edge thinking and best practice. Applies learnin g to build and refresh the service. Treats challenge as a positive force for improvement. 1. 1 Developing Self Awareness Reflects on how factors such as own values, prejudices and emotions influence their judgement, behaviour and self belief. Uses feedback from appraisals and other sources to consider personal impact and change behaviour.Understands personal sources of stress. 1. 2 Managing Yourself Plans and manages own time effectively and fulfils work requirements and commitments to a high standard, without compromising own health and wellbeing. Remains calm and focused under pressure. Ensures that own work plans and priorities fit with the needs of others involved in delivering services. Demonstrates flexibility and sensitivity to service requirements and remains assertive in pursuing service goals. Leadership Framework: A Summary Puts self forward for challenging assignments and projects which will develop strengths and address development areas.Acts as a role model for others in demonstrating integrity and inclusiveness in all aspects of their work. Challenges where organisational values are compromised. 1. 3 Continuing Personal Development Takes responsibility for own personal development and seeks opportunities for learning. Strives to put learning into practice. 1. 4 Acting with Integrity Behaves in an open, honest and inclusive manner, upholding personal and organisational ethics and values. Shows respect for the needs of others and promotes equality and diversity.Creates an open, honest and inclusive culture in accordance with clear principles and values. Ensures equity of access to services and creates an environment where people from all backgrounds can excel. Assures standards of integrity are maintained across the service and communicates the importance of always adopting an ethical and inclusive approach. Generic behaviours observed if individual is not yet demonstrating this domain: †¢ Demonstrates behaviours that are counter to core valu es of openness, inclusiveness, honesty and equality †¢ Lacks confidence in own abilities to deliver results Does not understand own emotions or recognise the impact of own behaviour on others †¢ Approaches tasks in a disorganised way and plans are not realistic †¢ Unable to discuss own strengths and development needs and spends little time on development 13 14 2 Whole Service/Across Teams 3 Across Services/Wider Organisation 4 Whole Organisation/Wider Healthcare System Works across boundaries creating networks which facilitate high levels of collaboration within and across organisations and sectors.Builds and maintains sustainable strategic alliances across the system and other sectors. Has high impact when interacting with others at all levels. Uses networks to bring individuals and groups together to share information and resources and to achieve goals. Identifies and builds effective networks with a range of influential stakeholders internal and external to the org anisation. Builds and maintains relationships with a range of individuals involved in delivering the service. Manages sensitivities between individuals and groups.Creates a supportive environment which encourages others to express diverse opinions and engage in decisionmaking. Constructively challenges suggestions and reconciles conflicting views. Helps lead others towards common goals, providing clear objectives and offering appropriate support. Shows awareness of team dynamics and acts to promote effective team working. Appreciates the efforts of others. Integrates the contributions of a diverse range of stakeholders, being open and honest about the extent to which contributions can be acted upon.Builds and nurtures trusting relationships at all levels within and across services and organisational boundaries. Creates systems which encourage contribution throughout the organisation. Invites contribution from different sectors to bring about improvements. Takes on recognised positio nal leadership roles within the organisation. Builds high performing inclusive teams that contribute to productive and efficient health and care services. Promotes autonomy and empowerment and maintains a sense of optimism and confidence. Contributes to and leads senior teams.Enables others to take on leadership responsibilities, building high level leadership capability and capacity from a diverse range of backgrounds. †¢ Does not encourage others to contribute ideas †¢ Does not adopt a collaborative approach 2. WORKING WITH OTHERS Effective leadership requires individuals to work with others in teams and networks to deliver and improve services. This requires them to demonstrate effectiveness in developing networks, building and maintaining relationships, encouraging contribution, and working within teams. Element 1 Own Practice/Immediate Team . 1 Developing Networks Identifies where working and cooperating with others can result in better services. Endeavours to work co llaboratively. 2. 2 Building and Maintaining Relationships Communicates with and listens to others, recognising different perspectives. Empathises and takes into account the needs and feelings of others. Gains and maintains trust and support. 2. 3 Encouraging Contribution Seeks and acknowledges the views and input of others. Shows respect for the contributions and challenges of others. Leadership Framework: A Summary 2. 4 Working within TeamsUnderstands roles, responsibilities and purpose within the team. Adopts a collaborative approach and respects team decisions. Generic behaviours observed if individual is not yet demonstrating this domain: †¢ Fails to network with others and/or allows relationships to deteriorate †¢ Fails to win the support and respect of others 3. MANAGING SERVICES Effective leadership requires individuals to focus on the success of the organisation(s) in which they work. This requires them to be effective in planning, managing resources, managing peo ple and managing performance. Whole Service/Across Teams 3 Across Services/Wider Organisation 4 Whole Organisation/Wider Healthcare System Anticipates the impact of health trends and develops strategic plans that will have a significant impact on the organisation and wider healthcare system. Ensures strategic objectives are translated into operational plans. Strategically manages resources across the organisation and wider healthcare system. Element Works collaboratively to develop business cases and service plans that support organisational objectives, appraising them in terms of benefits and risks.Leads service design and planning processes. Communicates and keeps others informed of strategic and operational plans, progress and outcomes. 1 Own Practice/Immediate Team 3. 1 Planning Contributes ideas to service plans, incorporating feedback from others including a diverse range of patients, service users and colleagues. 3. 2 Managing Resources Understands what resources are availabl e and organises the appropriate type and level of resources required to deliver safe and efficient services. Identifies resource requirements associated with delivering services.Manages resources and takes action to ensure their effective and efficient use. Forecasts resource requirements associated with delivering complex services efficiently and effectively. Manages resources taking into account the impact of national and local policies and constraints. Motivates and coaches individuals and teams to strengthen their performance and assist them with developing their own capabilities and skills. Aligns individual development needs with service goals. Leadership Framework: A Summary Provides others with clear purpose and direction.Helps others in developing their roles and responsibilities. Works with others to set and monitor performance standards, addressing areas where performance objectives are not achieved. †¢ Does not effectively manage and develop people †¢ Fails to identify and address performance issues 3. 3 Managing People Supports others in delivering high quality services and excellence in health and care. Inspires and supports leaders to mobilise diverse teams that are committed to and aligned with organisational values and goals. Engages with and influences senior leaders and key stakeholders to deliver joined up services. . 4 Managing Performance Uses information and data about performance to identify improvements which will strengthen services. Establishes rigorous performance measures. Holds self, individuals and teams to account for achieving performance standards. Challenges when service expectations are not being met and takes corrective action. Promotes an inclusive culture that enables people to perform to their best, ensuring that appropriate performance management systems are in place and that performance data is systematically evaluated and fed into future plans.Generic behaviours observed if individual is not yet demonstratin g this domain: †¢ Disorganised or unstructured approach to planning †¢ Wastes resources or fails to monitor them effectively 15 16 2 Whole Service/Across Teams 3 Across Services/Wider Organisation 4 Whole Organisation/Wider Healthcare System Creates a culture that prioritises the health, safety and security of patients and service users. Delivers assurance that patient safety underpins policies, processes and systems. Reviews practice to improve standards of patient safety and minimise risk.Monitors the impact of service change on patient safety. Develops and maintains audit and risk management systems which will drive service improvement and patient safety. Engages with others to critically evaluate services and create ideas for improvements. Synthesises complex information to identify potential improvements to services. Identifies potential barriers to service improvement. Benchmarks the wider organisation against examples of best practice in healthcare and other sectors . Evaluates options for improving services in line with future advances.Acts as a positive role model for innovation. Encourages dialogue and debate in the development of new ideas with a wide range of people. Challenges colleagues’ thinking to find better and more effective ways of delivering services and quality. Accesses creativity and innovation from relevant individuals and groups. Drives a culture of innovation and improvement. Integrates radical and innovative approaches into strategic plans to make the NHS world class in the provision of healthcare services. Focuses self and others on achieving changes to systems and processes which will lead to improved services.Energises others to drive change that will improve health and care services. Actively manages the change process, drawing on models of effective change management. Recognises and addresses the impact of change on people and services. Inspires others to take bold action and make important advances in how servi ces are delivered. Removes organisational obstacles to change and creates new structures and processes to facilitate transformation. †¢ Maintains the status quo and sticks with traditional outdated ways of doing things †¢ Fails to implement change or implements change for change’s sake 4.IMPROVING SERVICES Effective leadership requires individuals to make a real difference to people’s health by delivering high quality services and by developing improvements to services. This requires them to demonstrate effectiveness in ensuring patient safety, critically evaluating, encouraging improvement and innovation and facilitating transformation. Element 1 Own Practice/Immediate Team 4. 1 Ensuring Patient Safety Puts the safety of patients and service users at the heart of their thinking in delivering and improving services. Takes action to report or rectify shortfalls in patient safety. . 2 Critically Evaluating Uses feedback from patients, carers and service users t o contribute to healthcare improvements. Leadership Framework: A Summary 4. 3 Encouraging Improvement and Innovation Questions established practices which do not add value. Puts forward creative suggestions to improve the quality of service provided. 4. 4 Facilitating Transformation Articulates the need for changes to processes and systems, acknowledging the impact on people and services. Generic behaviours observed if individual is not yet demonstrating this domain: Overlooks the need to put patients at the forefront of their thinking †¢ Does not question/evaluate current processes and practices 5. SETTING DIRECTION Effective leadership requires individuals to contribute to the strategy and aspirations of the organisation and act in a manner consistent with its values. This requires them to demonstrate effectiveness in identifying the contexts for change, applying knowledge and evidence, making decisions, and evaluating impact. 2 Whole Service/Across Teams 3 Across Services/Wi der Organisation 4 Whole Organisation/Wider Healthcare System Synthesises knowledge from a broad range of sources.Identifies future challenges and imperatives that will create the need for change and move the organisation and the wider healthcare system in new directions. Influences the context for change in the best interests of services and service users. Uses knowledge, evidence and experience of national and international developments in health and social care to influence the future development of health and care services. Ensures that corporate decision-making is rigorous and takes account of the full range of factors impinging on the future direction of the organisation and the wider healthcare system.Can operate without all the facts. Takes unpopular decisions when in the best interests of health and care in the long term. Identifies gains which can be applied elsewhere in the organisation and incorporates these into operational/ business plans. Disseminates learning from ch anges which have been introduced. Synthesises learning arising from changes which have been introduced and incorporates these into strategic plans. Shares learning with the wider health and care community. Element Identifies the external and internal drivers of change and communicates the rationale for change to others.Actively seeks to learn about external factors which will impact on services. Interprets the meaning of these for services and incorporates them into service plans and actions. 1 Own Practice/Immediate Team 5. 1 Identifying the Contexts for Change Understands the range of factors which determine why changes are made. 5. 2 Applying Knowledge and Evidence Gathers data and information about aspects of the service, analyses evidence and uses this knowledge to suggest changes that will improve services in the future. Involves key people and groups in making decisions.Actively engages in formal and informal decision-making processes about the future of services. Obtains and analyses information about services and pathways to inform future direction. Supports and encourages others to use knowledge and evidence to inform decisions about the future of services. Understands the complex interdependencies across a range of services. Applies knowledge to set future direction. Leadership Framework: A Summary Evaluates and embeds approaches and working methods which have proved to be effective into the working practices of teams and individuals. 5. 3 Making DecisionsConsults with others and contributes to decisions about the future direction/vision of their service. Remains accountable for making timely decisions in complex situations. Modifies decisions and flexes direction when faced with new information or changing circumstances. 5. 4 Evaluating Impact Assesses the effects of change on service delivery and patient outcomes. Makes recommendations for future improvements. Generic behaviours observed if individual is not yet demonstrating this domain: †¢ Makes poor decisions about the future †¢ Fails to evaluate the impact of previous decisions and actions Unaware of political, social, technical, economic, organisational factors that impact on the future of the service/organisation †¢ Does not use an evidence-base for decision-making 17 18 ELEMENT DESCRIPTORS (see also page 11) 4 Whole Organisation/Wider Healthcare System Actively engages key stakeholders in creating a bold, innovative, shared vision which reflects the future needs and aspirations of the population and the future direction of healthcare. Thinks broadly and aligns the vision to the NHS core values and the values of the wider healthcare system.Actively participates in and leads on debates about the future of health, wellbeing and related services. Manages political interests, balancing tensions between organisational aspirations and the wider environment. Shapes and influences local, regional and national health priorities and agendas. Clearly communicates t he vision in a way that engages and empowers others. Uses enthusiasm and energy to inspire others and encourage joint ownership of the vision. Anticipates and constructively addresses challenge. Consistently displays passion for the vision and demonstrates personal commitment to it through their day-to-day actions.Uses personal credibility to act as a convincing advocate for the vision. †¢ Misses opportunities to communicate and share understanding of the vision with others †¢ Lacks enthusiasm and commitment for driving the vision 6. CREATING THE VISION Those in senior positional leadership roles create a compelling vision for the future, and communicate this within and across organisations. This requires them to demonstrate effectiveness in developing the vision for the organisation, influencing the vision of the wider healthcare system, communicating the vision and embodying the vision.Element 6. 1 Developing the Vision for the Organisation †¢ Actively engage with c olleagues and key influencers, including patients and public, about the future of the organisation †¢ Broadly scan and analyse the full range of factors that will impact upon the organisation, to create likely scenarios for its future †¢ Create a vision which is bold, innovative and reflects the core values of the NHS †¢ Continuously ensures that the organisation’s vision is compatible with future developments within the wider healthcare system . 2 Influencing Vision in the Wider Healthcare System †¢ Seek opportunities to engage in debate about the future of health and care related services †¢ Work in partnership with others in the healthcare system to develop a shared vision †¢ Negotiate compromises in the interests of better patient services †¢ Influence key decision-makers who determine future government policy that impacts on the NHS and its services Leadership Framework: A Summary 6. 3 Communicating the Vision Communicate their ideas an d enthusiasm about the future of the organisation and its services confidently and in a way which engages and inspires others †¢ Express the vision clearly, unambiguously and vigorously †¢ Ensure that stakeholders within and beyond the immediate organisation are aware of the vision and any likely impact it may have on them †¢ Take time to build critical support for the vision and ensure it is shared and owned by those who will be communicating it 6. 4 Embodying the Vision Act as a role model, behaving in a manner which reflects the values and principles inherent in the vision †¢ Demonstrate confidence, self belief, tenacity and integrity in pursuing the vision †¢ Challenge behaviours which are not consistent with the vision †¢ Identify symbols, rituals and routines within the organisation which are not consistent with the vision, and replace them with ones that are Generic behaviours observed if individual is not yet demonstrating this domain: Does not involve others in creating and defining the vision †¢ Does not align their vision with the wider health and care agenda 7. DELIVERING THE STRATEGY Those in senior positional leadership roles deliver the strategic vision by developing and agreeing strategic plans that place patient care at the heart of the service, and ensuring that these are translated into achievable operational plans. This requires them to demonstrate effectiveness in framing the strategy, developing the strategy, implementing the strategy, and embedding the strategy. ElementELEMENT DESCRIPTORS (see also page 12) 4 Whole Organisation/Wider Healthcare System Critically reviews relevant thinking, ideas and best practice and applies whole systems thinking in order to conceptualise a strategy in line with the vision. 7. 1 Framing the Strategy †¢ Take account of the culture, history and long term underlying issues for the organisation †¢ Use sound organisational theory to inform the development of strate gy †¢ Identify best practice which can be applied to the organisation †¢ Identify strategic options which will deliver the organisation’s vision . 2 Developing the Strategy †¢ Engage with key individuals and groups to formulate strategic plans to meet the vision †¢ Strive to understand others’ agendas, motivations and drivers in order to develop strategy which is sustainable †¢ Create strategic plans which are challenging yet realistic and achievable †¢ Identify and mitigate uncertainties and risks associated with strategic choices Integrates the views of a broad range of stakeholders to develop a coherent, joined up and sustainable strategy.Assesses organisational readiness for change. Manages the risks, political sensitivities and environmental uncertainties involved. Leadership Framework: A Summary 7. 3 Implementing the Strategy †¢ Ensure that strategic plans are translated into workable operational plans, identifying risks, critic al success factors and evaluation measures †¢ Identify and strengthen organisational capabilities required to deliver the strategy †¢ Establish clear accountability for the delivery of all elements f the strategy, hold people to account and expect to be held to account themselves †¢ Respond quickly and decisively to developments which require a change in strategy Responds constructively to challenge. Puts systems, structures, processes, resources and plans in place to deliver the strategy. Establishes accountabilities and holds people in local, regional, and national structures to account for jointly delivering strategic and operational plans. Demonstrates flexibility when changes required. 7. 4 Embedding the Strategy Support and inspire others responsible for delivering strategic and operational plans, helping them to overcome obstacles and challenges, and to remain focused †¢ Create a consultative organisational culture to support delivery of the strategy and t o drive strategic change within the wider healthcare system †¢ Establish a climate of transparency and trust where results are discussed openly †¢ Monitor and evaluate strategic outcomes, making adjustments to ensure sustainability of the strategy Enables and supports the conditions and culture needed to sustain changes integral to the successful delivery of the strategy.Keeps momentum alive by reinforcing key messages, monitoring progress and recognising where the strategy has been embraced by others. Evaluates outcomes and uses learnings to adapt strategic and operational plans. Generic behaviours observed if individual is not yet demonstrating this domain: †¢ Absolves oneself of responsibility for holding others to account †¢ Fails to enable an organisational culture that embraces the strategy †¢ Does not align the strategy with local, national and/or wider health care system requirements †¢ Works to develop the strategy in isolation without input or feedback from others 19

Vonage in Trouble with Verizon Communications

Vonage in Trouble with Verizon Communications Free Online Research Papers Vonage Holdings Corporation has been in a lot of trouble as of late. Vonage Holdings Corporation is a company that offers their customers cheap phone calls, by way of the VoIP using the Internet. VoIP stands for Voice over Internet Protocol. It takes a conversation and runs it through an Internet based source, then routes it to the recipient. Vonage promised to provide millions of customers with this service at low cost. Now it is costing Vonage. Verizon Communications’ recent lawsuit against Vonage seems to be taking the largest toll. On April 7, a judge declared that Vonage must cease its services to new customers. This is only if they do not continue to infringe upon Verizon’s patents. In essence, the federal judge has not shut down Vonage for the crime, but still dealing the corporation a heavy blow. Roger Warin, Vonage lawyer, says, Its the difference of cutting off oxygen as opposed to the bullet in the head.† Vonages lawyers argued that Verizons predecessor, Bell Atlantic, always intended to use its patents as a weapon against competitors. Vonage pointed on one occasion to records of meetings from the late 1990s in which Bell Atlantic executives and lawyers said the legal objective for one patent was to define it as broadly as possible so that competitors would be screwed, according to a court transcript. (Ultimately Vonage wasnt found to have infringed that patent.) The judge noted that a lot of us make smart-mouthed remarks from time to time. Most recently, a jury ruled in favor of Verizon on three of the five patents in question, ordering Vonage to pay damages, plus ongoing royalties for any further infringement at a rate of 5.5% of sales. On Friday (April 7, 2007), Judge Hilton rejected Vonages request for a full stay of the ruling, and said the company must lodge an appeal bond of more than $60 million, which would be held in an account pending the outcome. The bond is not affected b y the higher courts stay of Judge Hiltons ruling. Verizon is not the only pain in Vonage’s side. Vonage is strictly a phone service. Its competitors include every phone company that offers land lines, and every mobile carrier. Nowadays, major companies are providing packages to consumers that allow them to receive the internet, cable, and phone service all together. According to In-Stat, a market-research firm, cable companies account for 10.6 million subscribers with Internet phone hook ups (Boles). The problems do not stop here. Big corporations providing phone service have had to charge their customers surcharges thanks to the government. Vonage, not being large or traditional, avoided these government taxes. Then, the government caught on. Now Vonage has to tax just like the big dogs (2006 2). Vonage was once reliable and cheap. It seems as though the service is about to get flipped 180 degrees. Vonage has more problems. Initially, Vonage phone service caught like wildfire. The company then decided to go public via the NYSE. It went public less than a year ago. Since its debut in the NYSE, Vonage’s stock has plummeted by 80%. Vonage and its 2.2 million customers may soon be looking elsewhere. 2.3% of the customers are deactivating service monthly (Boles). The company’s future remains in the balance. Vonage, as it seems, is headed down the dumps. The company exploded with success in the first year it debuted. After about the third year, the government caught on. They began setting regulations and taxing customers. After the government caught on, so did Verizon Communications. Verizon obtains patents that prevent companies like Vonage from providing the services it wants. It makes one wonder how it took three years for Verizon to catch on and file a law suit. Verizon, along with every other phone provider, is prepared to wipe Vonage out of business. As mentioned previously, Vonage’s stock has dropped 80% since going public. This does not reflect the company’s revenue. Rather, it reflects what the everyday investor thinks about Vonage. In other words, investors see Vonage going out of business, and fast. Cable providers realized the business that Vonage was obtaining through Internet phone service. In return, they started to create packages that allow customers to have internet, cable, and phone service from one entity. This cut Vonages customer and profit share in sizeable portions. In conclusion, if the Verizon’s lawsuit does not end up going Vonage’s way, people are going to sell their stock until the stock cannot be sold anymore. Vonage had an amazing product, but failed to obey the necessary laws it takes to run a successful business. Vonage has a good product. Yet, it seems like the best has already come. (2006, June 5). Vonage Facing Trouble: Falling Shares, Possible Lawsuits, and Fierce Competition. Retrieved April 11, 2007 from Web site: associatedcontent.com/article/37273/vonage_facing_trouble_falling_shares.html?page=2 Boles, Corey, Sharma, Amol (2007, April 7). A Blow in Court Adds to Threats Facing Vonage. Retrieved April 11, 2007 from , Web site: http://online.wsj.com/article/SB117587187185562221.html?mod=telecommunications_primary_hs Research Papers on Vonage in Trouble with Verizon CommunicationsNever Been Kicked Out of a Place This NicePETSTEL analysis of IndiaAnalysis of Ebay Expanding into AsiaTwilight of the UAWThe Project Managment Office SystemMarketing of Lifeboy Soap A Unilever ProductUnreasonable Searches and SeizuresCapital PunishmentQuebec and CanadaGenetic Engineering

globalisation and sovereignty essays

globalisation and sovereignty essays Globalization and the National Sovereignty During the 1990s, the globalization emerged as one of the central terms in political conflict and political analysis around the world. In political science, globalization became perhaps the most widely used phrase to characterize the social, economic, and political changes that reconfigured the map of world politics over the decade. The controversies surrounding globalization had a certain pattern, always returning to the relationship between the modern nation-state and the international social, economic, and political context in which it is situated. A close look at any of the debates or conflicts surrounding globalization suggests that they are indicative of important changes going on in the nature and role of the boundaries that both separate states from each other, and the international environment, and regulate the relationships between the states and this environment. Whether the specific issue concerns trade policy, the power of financial markets, or the impact of immigration , most discussions of globalization eventually turn to the question of the role of the state in a new, globally organized social and economic context. In fact, globalization as a process of world economic integration and interdependency is far from being new, and it could be argued that this process has its roots in time immemorial when humanity first found it advantageous to trade surpluses of goods with one another. But what we call globalization- at the very least in the strictest economic sense of this term - is nothing more than a continuum of a genuine and very human historical process. However, it needs to be acknowledged that this latest economic globalization has been much faster, and much more dramatic in its unprecedented power to influence culture on a global scale. So, we can define globalization as the integration of trade, finance, and information that is creating a single ...

Ten Critical Steps for Risk Managers Essay Example | Topics and Well Written Essays - 750 words - 2

Ten Critical Steps for Risk Managers - Essay Example Argentina is one of the Latin American countries which have a high political risks associated with international business. These risks affect the way international business is done between Argentina and the rest of the world.According to World Bank (2001), managing political risk and other forms of risks associated with international business is something that can be very difficult for businesses. However, experts such as Thomas Cook (2012) have provided useful information regarding the ways in which international businesses can address these issues. For a country such as Argentina, the main issue for international business people to understand is the fact that this country is not stable politically. Countries which have not matured democratically such as Argentina have more and higher political risk and it is necessary for businesses to be able to address these risks in a more serious way. The following ten steps as developed by Cook can be used to manage political risk in Argentina . The first issue to for a manager to consider is selecting a risk insurance firm which is suited to the insurance needs of the business. According to Cook (2012), it is absolutely necessary for a manager to know that the underwriters who they choose are conversant in political risks in the country. In this regard, choosing an insurance broker in Argentina will concentrate on looking for an insurance broker who critically understands the political risks in the country not only in theory but also in practice.... In buying insurance, it is always necessary to understand the nature and extent of the risk involved (Cook, 2012). In this regard, it will be increasingly necessary to understand the political risks involved in Argentina and then look for an insurance provider who will guarantee these risks. It will be necessary to look for an insurance provider who clearly understands these risks and who is able to look at the way in which the business can be shielded from this kind of risk. Thirdly, the manager should consider combining risk and covering them with one insurance policy. There are a number of risks associated with doing international business in Argentina and this will require combining risks when buying an insurance policy. In this regard, it will be necessary to understand the various risks which can be combined in order to make sure that the business is well protected. For instance, apart from political risks, there are other non-political risks which must be looked at in this reg ard, instead of having a different policy for each risk; it could be useful to have one umbrella policy which will protect the business from all the risks. Fourth, constant communication about the contract after it has been put in place is also very important. This is because Argentina’s political environment is very volatile and therefore the nature and extent of political risks in Argentina keep changing over time. Fifthly, constant review and update of the insurance contract is necessary because political risks can change with regard to which regime is in power and also depending on seasons such as the electioneering season. With a country which does not have a concrete public policy, the nature of the governance is purely

ABC Hospital Risk Management Plan Essay Example | Topics and Well Written Essays - 1750 words

ABC Hospital Risk Management Plan - Essay Example The risk management plan developed for ABC Hospital is aimed to establish closer connection and collaboration between the departments of the Hospital and the services they provide in order to improve the overall service delivery. In addition, it identifies, investigates and management of accidents, injuries and other events and the process will be directed by the risk manager on managing adverse events occurring with patients, employees and other organizational assets. The risk management plan will affect, persuade and educate staff of the above mentioned departments in order to improve quality of care within the safe environment and protect resources of ABC Hospital. These departments are the Administration, Billing Services, Business Development, Clinical Services, Health Information and Privacy Management, Employee Health, Human Resources, Infection Control, Legal Services, Medical Equipment, Relations with patients, Quality and Improvement of Performance, Safety Management and En vironment of Care and Security Management. Resources needed for Risk management plan implementation will include meetings with staff and initiatives directed toward support of team efforts, training and development of skills necessary for better provision of services. A Quality and Improvement of Performance department will assist with the collection of data for evaluation of what should be improved and what goals should be reached.