Police History Essay

Starting In 1829, Sir Robert Peel began developing his theory of policing. These nine principles are as relevant today as they were in the 1800’s. Peel established the Metropolitan Police when he served as Home Secretary of England. Since Sir Robert Peel introduced his principles of policing in the early 1800’s, our country has continued to follow his ideas of effective policing. Community policing is based on Peel’s concept of prevention. According to one of Peel’s principals, the real key for policing is â€Å"The police are the people and the people are the police†. Peel believed that prevention of crime could be accomplished without intruding into the lives of citizens. Sir Robert Peel’s first principle was that, â€Å"The basic mission for which the police exist is to prevent crime and disorder† (Westminster Police Department, 2012) In our diverse society, it is necessary for police to understand the different cultures that make up the communities that they patrol. If police can relate to and understand the different cultures of the community, they will be able to successfully gain public approval. I believe this is important for his second two principals. â€Å"The ability of the police to perform their duties is dependent upon public approval of police actions. † Also, â€Å"Police must secure the willing co-operation of the public in voluntary observance of the law to be able to secure and maintain the respect of the public†. (Westminster Police Department, 2012) Peel also felt strongly about the idea of the use of force as well. In two other principals Peel stated â€Å"The degree of co-operation of the public that can be secured diminishes proportionately to the necessity of the use of physical force† and that â€Å"Police use physical force to the extent necessary to secure observance of the law or to restore order only when the exercise of persuasion, advice, and warning is found to be insufficient. † (Westminster Police Department, 2012) Excessive force has been a public concern and the first sign of community mistrust in the police. It can take years to gain the trust of a community and one incident to lose that trust. By providing adequate training on the use of force and having the public’s trust and respect can ensure that force is only used to the extent necessary. When individuals have little or no respect towards the police, they are most likely to ignore the requests or demands of officers. This can lead to the officer having to use force in order to gain control of a situation. Peel felt that â€Å"The test of police efficiency is the absence of crime and disorder, not the visible evidence of police action in dealing with it. (Westminster Police Department, 2012) When police are faced with dispersing large crowds, it is necessary for the public to have the respect to follow police orders. When individuals lack trust and respect for the police, riots may occur, which can also lead to arrests, serious injuries, and even death. Sir Robert Peel’s principles and Community Policing go hand in hand and share the same concepts and goals in policing. One of the distinct similarities between Peel’s approach and Community Policing is that prevention of crimes is the number one priority. I believe that Peel felt morals played an important role in effective policing. It is important that police officers think things through and have the best interests in mind before making decisions. Peel’s principals â€Å"Police seek and preserve public favour not by catering to public opinion but by constantly demonstrating absolute impartial service to the law†, and â€Å"Police should always direct their action strictly towards their functions and never appear to usurp the powers of the judiciary† (Westminster Police Department, 2012) Are important and should be demonstrated to earn the trust of the people in the long run and to uphold the law. The relationship between the U. S. overnment and police organizations across the United States can be analyzed in several ways. I believe that because the police organizations and the government have a close relationship in several ways. Not only are police organizations expected to follow rules from their own departments, they also must follow standard federal guidelines as well. There are federal, state and, local levels of police organizations. The federal government roles are similar to that of local and state; however there are a few differences. The FBI (Federal Bureau of Investigation) and the Department of Homeland Security are examples. Employees of these organizations are by law, allowed to make an arrest in any county or state. Unlike local or state police organizations, these officers do not provide basic protection services or simple criminal investigations unless the local or state agency cannot control the situation (say for example a serial killer). There are some problems with the way our government controls certain things with the other agencies. For example our government ran U. S. military is being used for domestic law enforcement. Also, the federal government is taking over the training, financing and delegation of local police. This could cause many issues, removing the police from local control may not be the smartest move. The concern is arising that the federalized police have increasingly turned to violent tactics and assaults on people who have not committed any crimes. When issues like this arise, it can cause problems within local or state organizations when it comes to police procedures and the way policing is being done. If the organizations don’t feel as though they are in control, or that their problems or concerns are not being addressed properly, this may affect the quality of law enforcement. It could also cause communication issues and lapses. There is the other possibility, that some people may have the opinion that things are better with more outside control. Policing may have to change in many ways to adapt to the change in control. Conclusion In conclusion I think there can be both pros and cons to the relationship between the U. S. government and the police organizations. I also believe that Sir Robert Peel had a major effect on the policing of his time, our current police procedures, and community policing.

Russian Standard Vodka Case Study Essays

Russian Standard Vodka Case Study Essays Russian Standard Vodka Case Study Paper Russian Standard Vodka Case Study Paper Russian Standard Vodka: Strategies for Global Branding and Expansion into the US Market Case Study By CHEN Mengjie Marguerite Summary Given the success of Russian Standard Vodka in the Russian and European Market, following the global branding vision, expansion strategy for US market needs to be defined. This case study will provide in-depth analysis to focus on evaluating expansion strategies and offering market entry recommendations. 1. Russian Standard 1. 1 Overview Russian Standard was launched by Roust Holdings, a company driven by an unusual mix of quality orientation and Russian pride. In launching the Russian Standard brand, the ambition of Roustam Tariko, founder and main owner of Roust Holdings, was to set a new standard of world-class quality for a new breed of global Russian brands. The first category to which Tariko decided to apply his Russian Standard concept was vodka born in Russia and strongly associated with the country. The next big move was the creation of the Russian Standard Bank, aiming to serve foreign trade companies, small businesses and individual customers, with a main focus on retail banking. Apart from the two mainstream businesses, Roust also launched B2B and B2C e-commerce portal. 1. 2 Visions Tariko had two ambitious goals for Russian Standard brand: (1) to develop a line of original products and services in multiple categories which would meet international quality requirements, and (2) to create a brand that would set new Russian standards and improve the image of Russia both at home and abroad. 1. 3 Brand Identity Tariko’s personal affinity for luxury goods and his ambition to create the first truly premium Russian brand determined to a large extent the identity of Russian Standard. The brand has the mission to re-establish something that will be a standard for Russians. The essence of the brand and the overall brand strategy was born as â€Å"embraced the past, and inspired progress† after brand research. This theme is the main identity and positioning of the brand. 2. Russian Standard Vodka 2. 1 Overview Roustam Tariko introduced Russian Standard in 1998 as the first authentic Russian premium vodka. Russian Standard vodkas are made with only the finest Russian ingredients, uniquely conforming to the formula for vodka established in 1894 by famed Russian scientist Dimitri Mendeleev for Russias Czars. Two years after launch, sales of Russian Standard surpassed all imported premium vodkas on the Russian market. 2. 2 Success Factors The success of Russian Standard can be attributed to its high and consistent product quality, its distinctive premium packaging, its strong distribution and merchandising, and its Russian heritage. 1) True Russian Spirit: There was a clear niche in the Russian market for a premium brand that was genuinely Russian, with a link to Russia’s rich past. No competitors could qualify for this definition. ) Market Uniqueness: Russian Standard vodka was the first domestic brand to create a rich mosaic of imagery (product, packaging, pricing, merchandising, media communications). 3) Strong merchandising skills and relationships with off-trade and on-trade: This allowed Russian Standard to secure privileged shelf space and promotion by supermarkets, and access to the bars of the most prestigious and fashionable clubs and restaurants in Moscow and St Petersbu rg. Encouraged by its rapid success at home, management aimed to make Russian Standard the number one Russian vodka in the world. After launching the brand in 10 European countries, the founder wondered which expansion strategy to follow for Russian Standard vodka to be launched in the US, the biggest premium vodka market in the world. 3. Global Branding Strategies 3. 1 Expansion Strategies Options The management defined three expansion strategies: 1) Directly apply the successful positioning of the brand and marketing mix used for Russia to the US market. 2) Pursue a global branding strategy – one that preserves the key sources of equity of a potentially global brand but also included local market adaptations. ) Use a customized approach to the US market be used to win the key market, regardless of the implications for the brand in other global markets. The following analysis will give a profound basis for choosing the expansion strategy for Russian Standard Vodka. 3. 2 Vodka Markets Analysis – Russian and US [pic] Based on the market analysis, we can find the substantial market potential in US m arket. US market is the biggest premium vodka market and super-premium is growing very fast, and there’s market niche for products with subtle distinctions in taste and heritage to join. The consumer group is more balanced and energetic in US including men and women and targeting young generation. The consumption was in groups and on-premise, which is a different business model from domestic market and a good opportunity for expansion. 3. 3 Criteria for Global Branding Strategies 1) Intended brand meaning of the organization It’s natural for Russia to enjoy such a renaissance in premium vodka production. Russian Standard Vodka is to assure Russia’s place as the birthplace of vodka and to be the world’s first premium Russian vodka made according to the standards of Mendeleev’s 1894 formula to reveal brand authenticity. ) Fundamentals the firm plans to compete on Russian Standard Vodka’s statement is very clear and loud: to be the number one Russian vodka in the world. The first fundamentals will be to keep the true Russian spirit. Russian Standard also have a ambitious goal which is to set new standard for Russia. Russia standard als o need to balance the business portfolio between Vodka and Bank. It’s essential to protect the equity of the brand in Russia. 3) Main benefits to be provided to the customers Russian heritage dream factor: Russian Standard Vodka reflects Russia’s vodka-producing heritage. It’s also a symbol of the essence of Russian’s modern society, Russian vodka premium quality: It’s a brand new premium vodka distilled and bottled exclusively in Russia using only the finest Russian ingredients with a passionate attention to detail and state-of-the-art distilling techniques. 3. 4 Expansion Strategy Decision According to the analysis given above, the second option will be suggested as the most practical strategy for Russian Standard Vodka to enter US market: Pursue a global branding strategy – one that preserves the key sources of equity of a potentially global brand but also included local market adaptations. The first alternative will be very risky given the differences in US market. Market adaptions will be needed to certain extent. The third alternative cannot be chosen in the sense that the management needs to keep the brand image consistent and maintain the brand identity. This approach tends to dilute the brand authenticity. 4. Expansion into US Market Recommendations 4. 1 Target customers The international product manager must know how similar/different potential customers are in the market to serve. The US customers will be younger and more diversified. And they are very cultural sensitive and looking for something different with heritage and taste. The connoisseurs and strivers categories can also be applied to US market since they also appreciate high quality and prestige of the brand. 4. 2 Country of origin Russian Standard Vodka will fit in perfectly with the country of origin concept to win US customers. The Russian origin of vodka has symbolic value associated with the brand. It’s also about attraction by cultural difference. The product can be marketed on the basis of its specific Russian cultural background. It is precisely the difference in culture that makes it desirable. 4. 3 Product / Brand positioning Functionally, the brand shall emphasize the authentic quality from Russia, the purity of vodka, its neutral taste and superior aroma. Emotionally, the brand was meant to serve as a source of Russian identification, belonging and validation. Russian Standard shall also be positioned as a luxury brand to create an aura of prestige for users, to make them believe no other vodka brand in the world could bring such an authentic Russian experience to US consumers. . 4 Market communication Russian Standard Vodka and Russian Standard Bank will be linked together once the communication message is consistent in transferrin the message of Russian Standard offers more than products or services, it provides Russians with a sense of pride and personal freedom. The market communication will be key to keep the real essence of the brand across international markets. The concept could be that it embodie s the true Russian spirit of generosity, and the traditional Russian passion for vodka. In-store marketing, on- and off-premise promotions, local events hosted  / sponsored by Russian Standard Vodka or even television program can be marketing approaches to fit in different purposes. 4. 5 Pricing decisions In Russia, Russian Standard was one of the most expensive brands among locally produced vodkas. The price gap that the brand maintained vis-a-vis standard segment vodkas clearly demonstrated its premium position. The premium positioning of the brand was emphasized to foreigners. In US market, given the fast growing of super-premiums, pricing can target premium and super-premium segments. New product development can also be considered in a latter stage to expand the product portfolio. Conclusion Reeling Russian culture far into the future meant taking a novel look at the treasures of its past. Russia has undergone a true renaissance and Russian Standard has played a pivotal role, providing Russians from all walks of life the opportunity to realize their dreams. Named the number one premium vodka in Russia and ranked one of the fasted growing brands in the world, Russian Standard is well on its way to achieving its long-term vision as the international leader in premium and luxury spirits.

American Civil War - Battle of Hampton Roads

American Civil War - Battle of Hampton Roads The Battle of Hampton Roads was fought March 8-9, 1862, and was part of the American Civil War. Fleets Commanders Union Flag Officer Louis M. GoldsboroughLieutenant John L. Worden1 ironclad, 2 screw frigates, 2 frigates, 1 sloop of war Confederate Flag Officer Franklin Buchanan1 ironclad, 3 gunboats, 2 tenders Background Following the outbreak of the Civil War in April 1860, Confederate forces seized the Norfolk Navy Yard from the US Navy. Prior to evacuating, the Navy burned several ships in the yard including the relatively new steam frigate USS Merrimack. Commissioned in 1856, Merrimack only burned to the waterline and most of its machinery remained intact. With the Union blockade of the Confederacy tightening, Confederate Secretary of the Navy Stephen Mallory began searching for ways in which his small force could challenge the enemy. Ironclads One avenue that Mallory elected to follow was the development of ironclad, armored warships. The first of these, the French La Gloire and British HMS Warrior, had appeared in the last year. Consulting John M. Brooke, John L. Porter, and William P. Williamson, Mallory began pushing the ironclad program forward but found that the South lacked the industrial capacity to build the needed steam engines in a timely manner. Upon learning this, Williamson suggested using the engines and remains of the former Merrimack. Porter soon submitted revised plans to Mallory that based the new ship around Merrimacks powerplant. Approved on July 11, 1861, work soon began at Norfolk on the casemate ironclad CSS Virginia. The interest in ironclad technology was also shared by the Union Navy which placed orders for three experimental ironclads in mid-1861. Key among these was inventor John Ericssons USS Monitor which mounted two guns in a revolving turret. Launched January 30, 1862, Monitor was commissioned in late February with Lieutenant John L. Worden in command. Aware of Confederate ironclad efforts at Norfolk, the new ship departed New York Navy Yard on March 6. CSS Virginia Strikes At Norfolk, work on Virginia continued and the ship was commissioned on February 17, 1862, with Flag Officer Franklin Buchanan in command. Armed with ten heavy guns, Virginia also featured a heavy iron ram on its bow. This was incorporated due to the designers belief that ironclads would be unable to harm each other with gunfire. A distinguished veteran of the US Navy, Buchanan was eager to test the ship and sailed on March 8 to attack Union warships in Hampton Roads despite the fact that workmen were still on board. The tenders CSS Raleigh and Beaufort accompanied Buchanan. Steaming down the Elizabeth River, Virginia found five warships of Flag Officer Louis Goldsboroughs North Atlantic Blockading Squadron anchored in Hampton Roads near the protective guns of Fortress Monroe. Joined by three gunboats from the James River Squadron, Buchanan singled out the sloop of war USS Cumberland (24 guns) and charged forward. Though initially unsure what to make of the strange new ship, Union sailors aboard the frigate USS Congress (44) opened fire as Virginia passed. Returning fire, Buchanans guns inflicted significant damage on Congress. Engaging Cumberland, Virginia pounded the wooden ship as the Union shells bounced off its armor. After crossing Cumberlands bow and raking it with fire, Buchanan rammed it in an effort to save gunpowder. Piercing the Union ships side, part of Virginias ram detached as it was withdrawn. Sinking, Cumberlands crew gallantly fought the ship until the end. Next, Virginia turned its attention to Congress which had grounded in an attempt to close with the Confederate ironclad. Joined by his gunboats, Buchanan engaged the frigate from a distance and compelled it to strike its colors after an hour of fighting. Ordering his tenders forward to receive the ships surrender, Buchanan was angered when Union troops ashore, not understanding the situation, opened fire. Returning fire from Virginias deck with a carbine, he was wounded in the thigh by a Union bullet. In retaliation, Buchanan ordered Congress be shelled with incendiary hot shot. Catching on fire, Congress burned throughout the rest of the day exploded that night. Pressing his attack, Buchanan attempted to move against the steam frigate USS Minnesota (50), but was unable to inflict any damage as the Union ship fled into shallow water and ran aground. Withdrawing due to darkness, Virginia had won a stunning victory, but had taken damage amounting to two guns disabled, its ram lost, several armored plates damaged, and its smoke stack riddled. As temporary repairs were made during the night, command devolved to Lieutenant Catesby ap Roger Jones. In Hampton Roads, the situation of the Union fleet improved dramatically that night with the arrival of Monitor from New York. Taking a defensive position to protect Minnesota and the frigate USS St. Lawrence (44), the ironclad awaited Virginias return. Clash of the Ironclads Returning to Hampton Roads in the morning, Jones anticipated an easy victory and initially ignored the strange-looking Monitor. Moving to engage, the two ships soon opened the first battle between ironclad warships. Pounding each other for over four hours, neither was able to inflict significant damage on the other. Though Monitors heavier guns were able to crack Virginias armor, the Confederates scored a hit on their adversarys pilot house temporarily blinding Worden. Taking command, Lieutenant Samuel D. Greene drew the ship away, leading Jones to believe that he had won. Unable to reach Minnesota, and with his ship damaged, Jones began moving towards Norfolk. At this time, Monitor returned to the fight. Seeing Virginia retreating and with orders to protect Minnesota, Greene elected not to pursue. Aftermath The fighting at Hampton Roads cost the Union navy the loss of USS Cumberland and Congress, as well as 261 killed and 108 wounded. Confederate casualties were 7 killed and 17 wounded. Despite the heavier losses, Hampton Roads proved a strategic victory for the Union as the blockade remained intact. The battle itself signaled the demise of wooden warships and the rise of armored vessels built of iron and steel. Over the next several weeks a standoff ensued as Virginia attempted to engage Monitor on several occasions but was refused as Monitor was under presidential orders to avoid battle unless absolutely required. This was due to President Abraham Lincolns fear that the ship would be lost allowing Virginia to take control of the Chesapeake Bay. On May 11, after Union troops captured Norfolk, the Confederates burned Virginia to prevent its capture. Monitor was lost in a storm off Cape Hatteras on December 31, 1862.

Using Lean Six Sigma to Improve Hospital based, Outpatient Imaging Article

Using Lean Six Sigma to Improve Hospital based, Outpatient Imaging Satisfaction - Article Example Therefore, the paper focuses on improving the service of the imaging department and brings into consideration the expectations of patients regarding the hospital. Unlike any commercial business, where greeting the customer and asking him to pay another visit soon, shall be considered good, such is not the case of the healthcare industry. In order to create an experience in the mind of the patients, service has to be personalized and focused. Previously, the hospital had wrongly focused on the process, procedure, safety and time to deliver the service; however, recent analysis suggested that customer satisfaction is about the consistency in the smooth conduct of the process as well as behavior of the staff. In order to ensure that Methodist achieves its objectives, it has decided to adopt a process that involves six sigma approaches and includes steps that are Define, Measure, Analyze, Improve and Control. Moreover, the customer satisfaction is the function of the service that is delivered to outpatients; therefore, the department has decided to pay special attention to these patients. Furthermore, the hospital uses Press Ganey service to assess its patient’s satisfaction.... The volume modality table seems to confirm the strategy of the hospital as outpatients seems to be the most frequent user of the machinery as compared to others while their share is approximately 50% in the case of Ultrasound, MRI and nuclear medicine. Thus in order to measure the performance in achieving those objectives, a more focused approach was laid down by reviewing the past data of outpatient imaging. The data revealed that the customer’s satisfaction has a very strong correlation with the time that the patient has to wait after being called down to testing area. Thus, based on this finding, a research was conducted that also confirmed the earlier finding. Therefore, the process was redesigned in order to improve efficiency in the system such that the lagging time shall be minimized. This was initiated by forming the workflow of all the four areas involved in the process which includes scheduling, registration, imaging and specific modality. However, more important in this regard was the communication regarding the appointments that were made with the patients since the time can be interpreted in more than one ways, while there used to a background noise that made communication difficult. In this regards, the email system was proposed as the solution to the problem. The most important part is the process of registration which used to take a lot of time due to its complex nature, such was simplified. Further, the outpatient was not being focused upon, as inpatient was being prioritized more over to outpatient regardless of the condition of the patients. To ensure further patient satisfaction, he will be communicated and briefed about the time the tests will start and details related to it. In case, he is late then he can be

Leadership and Organizational Behavior Assignment

Leadership and Organizational Behavior - Assignment Example As such, national labor policies are often translated in corporate policies that regulate human capital with sensitivity to these personal and professional goals of each worker. Business managers must make it as a corporate policy to uphold diversity to recognize the different capacities, competences and skills of these employees. Through that, management can systematize performance to attune these all to corporate goals and objectives. If all workers are nurtured by management to be goal-oriented and to be proficient in their tasks, albeit personal and motivational differences, it is perceived that the corporation would likely earn high achievement level (Hellriegel & Slocum, 2010). This is possible if the company was able to harness the participation of the employees in decision-making and in sharing them incentives as reward for great performance. It’s also helpful for the company if its sensitive to business ethics. This calls for management leadership that can help provid e direction to workers on what is relevant; regulate to boost their efforts and motivation; offering reward to the nature of persistence illustrated by employees; and ability to formulate strategic business plans that is contributory to the goals of the company. AllState Insurance Company, for instance, demonstrated their competence to understand and maximize diversity as how they made it as a policy to maximize it for corporate competitiveness (p. 215). This strategy is helpful for organizational internal development and for external relations with its diverse customers. AllState Company with 36,000 employees, have undertaken the following steps to cultivate competitive advantage using diversity: a. Succession Programming – the company accommodated employees with diverse motivation for professional development and enthusiasm for opportunities. As such, they employed women employees and those which came from other nations, including those who came from ethic communities but w ith high educational attainment. b. Development—All employees of AllState underwent career development training o improve their skills and competence. They can opt for more education or through mentoring, coaching or training (p. 215). c. Measurement- The company also enforce Diversity Index assessment which contain quarterly Leadership Measurement System (QLMS) to ascertain their quality service to their diverse customers; to determine their ethical behaviors at work albeit diverse personalities; and about how they gravitate in the workplace with mutual trust among co-employees and managers (p. 216); d. Accountability and Reward—AllState used the Diversity Index as one of the bases to determine compensation to encourage employees to maintain commitment and their responsibilities to contribute to corporate goals (p. 216). It also affords benefits to proficient workers and incentives through free services (p. 216). 2. Discuss how organizational policies and procedures c an impact organizational ethics. Organizational policies and procedures are essential in the upholding and promotion of organizational ethics of a corporation. Policies are internal regulations made by the company in consonance to corporate codes and labor laws that are imperative in strategically directing the goals and performance

Abuse in the Movie Unleashed Research Paper Example | Topics and Well Written Essays - 1750 words

Abuse in the Movie Unleashed - Research Paper Example The research paper "Abuse in the Movie Unleashed" talks about the abuse within the film "Unleashed" particularly the kind of abuse with the utter disregard of the rights and needs of a fellow human being. The film Danny the Dog also released as Unleashed is a stark and compelling reminder of the segments of society that promote and condone abuse for their own selfish ends, and how victims are treated. These sordid details are often never brought to light as they are shameful to civilized societies, yet they persist in secrecy either with or without the support of corrupt officials and criminals. Fighting to the death is common in Taiwan, Bangkok, Vietnam and many other nations where this illicit sport draws crowds yearning to see one human being inflict punishment on another till he gives up, is maimed for life or worse still, loses his life just to please the organizers, his manager and a bloodthirsty crowd who are looking for cheap thrills but should clearly know better. All such a ctivity is illegal and punishable by Law in all civilized cities of the world. Originally released as Danny the Dog, French director Louis Letterier’s action thriller starring Jet Li in the lead role was his first experiment with the action thriller genre. He was originally interested in music but began his foray into films by studying at the Tisch School of the Arts at New York University. Louis has gone out to direct such action thrillers as the Transporter & Transporter 2, The Hulk, and the Titans.

Cooper Green Hospital Care Plan

Cooper Green Hospital Care Plan The case, Cooper Green Hospital and its Community Care Plan is a very interesting case, which tries to outline the problems that plagued the hospitals growth and the attempts made by the top management of the hospital to enhance its reach to maximum number of poor and undeserved citizens who were in dire need of medical treatment. This mission of CGH made it stand in front of constant scrutiny from country commission. Media and the community challenges about the quality of care provided by CGH limited its ability to attract patients with private insurance. For the first 2 decades the hospital face increasing budget pressures, cost overruns were a common phenomenon. The hospital was understaffed, under stocked and overflow with patients. Some of the major problems faced by the hospital were balancing cost with maximum access to care, managing employee within budget, performance and demand and simplifying procedures and aligning them with policies. The two plans are named as Health first, a traditional fee for service plan and the community care plan , a prepaid membership plan based on family size and income, which would give opportunity to the people to receive quality medical care for at affordable price and with less waiting time. In a scenario where there are constant changes in the US health care system, where managed care was altering how providers interacted with patients funding for care was restricted and many health care systems were using non-physician providers to cut cost, CGH had an opportunity and challenge to attract uninsured patients and outperform its competitors. In the light of all these issues, the question that posed in front of the top management was, is to move ahead with the expansion plans or hold and improve operational efficiency or give up altogether. Key Issues The hospital was understaffed, under stocked and was overflowing with patients. The major problems that plagued the companys growth were as providing affordable good quality medical services to the indigent population of deficient country, streamlining procedures with polices, managing employees and gauging their performances, declining revenue, decreasing enrollments and under utilization, no upgrading enhancement of technologies, indifferent behavior of some employees towards the patients, inability of the infrastructure to cater to the increasing demands of the out patients section, resulting in long waiting hours and frustrated patients. Situation analysis The top management needs to make some critical calls on some top level strategic issues. If these problems are not taken care of then the following could be the repercussion: Negative revenue Dissatisfied patients Thrown away by competition Loss of goodwill and mistrust among people Inability to achieve the mission providing good quality service at affordable price and enhancing access to care. Complete shutdown of the hospital Directional strategies The directional strategies are undertaken by the hospital to improve its position and enhance its reach and ability to serve maximum number of patients starts with the defining of its mission statement vision and goals. Mission statement CGH is committed to serve the residents of Jefferson country with high quality health care regardless of ability to pay (Copper green mercy,). The hospital strike to attract and maintain a dedicated and compassionated staff of professionals who believe in serving the society and seek to continuously improve the services and adapt to need the changing health needs of the communities. (Cooper green mercy,). Vision Statements CGH is the leader to an evitable and just health care system through excellence, quality, compaction and trust. (Copper green mercy,). Value Statements Some of the key value statements for the company are commitment to health and well being of those being served expectation, to achieve the highest level of excellence, understanding the vital importance of advocacy for those being served, imbibing creativity and innovation, recognizing the importance of working with the patients and the community and dedication towards providing high level education to health professionals. Legislative-Political Changes The Medicare program was established in 1965 to insure medical coverage for the aged and disabled. It then expanded to in compass other people entitle to social security or rail road retirement benefits and also people with end stage renal disease. Another provision allowed non covered aged individuals to also benefit from the plan. There are 2 separate programs for Medicare i.e. Part-A :- Hospital insurance (free of charge) Part-B :- supplemental medical insurance (against monthly fee) In 1997 Medicare as a whole covered 38 millions people utilization of Part-A and B was 87% of enrollees. (DeButts, 2010). Title XIX of the social security act of 1965 gave rise to Medicaid as part of the federal state welfare structure to aid Americas poor population. It allowed federal funding for state run programs. In order to provide basic health service including hospitals in patients and out patients service laboratory and X-ray services and physician services. In 1998 Alabama Medicaid program provided benefits to variety of population but the majority were for indigent women and children and elderly persons in nursing home. In 1998 15.3% of Alabamas population was eligible for Medicaid program. The balance budget act of 1997 brought a significant change for the Alabama hospital in the light of ALLKIDS programs. Economic changes Health care cost rose at twice the inflation rate from the mid 1980s to mid 1990s creating a 1 trillion dollars industry that accounted for 14% of the US GDP. By the end of century the health care industry had grown to more than 1.5 trillion dollar or 18% of GDP. In 1995 nearly 3 quarters of American workers were insured by HMO, PPO and POS plans up from only 27% in 1987. (The Economy in,). Social-Demographic changes By the 1990s Jefferson Country has become a diversified economy with industries spanning across various industries like Biotechnology, healthcare, engineering and financial sector. As of 1998, the Birmingham metropolitan statistical areas population was approximately 875,000.Jefferson Country population was approximately 652,000. According to a 1993 survey it was found out that 1/3rd of Jefferson country resident were uninsured. 12 acute care hospitals were located in Birmingham. In 1998 8 out of 12 hospitals reported experienced decline in admission, in patient capacity in the area exceeded demand in order to reposition themselves. (Johnson, 2006). To respond to this and other changes in health care environment many hospitals went in for strategic alliance like the Brook wood Medical Centre, Medical centre East and Lloyd Noland Hospital. The other hospitals spread across the diverse geography of Jefferson are as follows: Princeton Baptist Medical centre. Montclair Baptist Centre Brook wood Medical Centre Cooper Green Hospital Health South Medical Centre Saint Vincents Hospital etc. Technological changes In the 1990s there was an increasing emphasis on outpatient care driven by the need to reduce cost and improve technology that would enable more types of care to be delivered on the outpatient basis. The lack of capital resources with CGH to invest in technology enhancement, new medical renovation led to longer waiting time, patient frustration and declining enrollments. The shortage of examination rooms, clerks, nurses, waiting room space further worsened the patients experience. Sometimes the reason for this frustrated experience was the discourteous and uncompassionate behavior of some of the staffs with the patients. There were some staffs that were very dedicated and loyal and compassionate but some were not interested in their jobs and used to perform below the expected levels and show negative attitude to the patients. The administration made several attempts to improve the employee morale but it was of little use as there remained a core of negative people who demoralized other staff members and angered patients. Competitive Changes In order to provide good quality health care at affordable and fair prices to the poor and needy patients, the hospitals both Non Profit making and profit making should go in for a strong alliance and should complement each others competitive strengths and ensure to pass on the benefits of reduced cost, higher advanced technological developments, better quality health care to the indigent population. (DeButts, 2010) Internal Environment SWOT Strengths: Pool of talented and compassionate staff members who choose to work at Jefferson health systems and believed in its mission and enjoyed serving those in need. Turnover of the staff was pretty low High overall patients satisfaction which averaged about 90%. Patients recorded the most satisfaction with issues related to the health care providers. Many patients expressed their gratitude for the care they received. They often remarked as saying they would have no way of obtaining health care without JHS and God bless CHS. CGS was considered one of the safety net providers across the US because of its mission to provide medical care to the poor. Weakness: Declining revenue of the Hospital Majority of capital was funded and only 6% was operating revenue. With this low operating revenue, operations may become unsustainable in future Hospital was not able to attract patients who are not insured Resources are not adequately utilized Inadequate infrastructure to take care of the growing demand in out patients section. Opportunities: Managed care was dominated form of insurance in US and enrollment was expected to increase Change in the US health care system. Managed care was altering how health care providers interacted with patients, funding for care was being restricted and many health care system were using non physician providers to cut cost. This threw plethora of opportunities in front of CGS. Threats: Vandalism and violence Stiff competition in the health care segment Technological advancements along with insufficient capital Inability to cope up with competition in the light of technological advancements which made diagnosis of multiple problems possible and insufficient capital. Comparative strategies According to a 1993 survey conducted by CGH centre for community care more than 1/3rd of the resident of Jefferson country was uninsured. Many poor people were delayed getting necessary medical care because they had no health insurance. Some 48 thousand residents have been denied care because they lacked health insurances. On average health care was listed as the 6th most important issue. This unexploited segment of uninsured population gave an opportunity to CGH to cater to the demands of segment that top management was able to identify this niche market. In order to serve this niche market CGH and Jefferson country development of health (JCDH) established a working alliance in order to improve continuity of care for the indigent population. JCDH physician staff privileges at CGH. They also explored the idea of more comprehensive alliance but no plans could materialize before 1999. JCDH operated an extensive health care network to service approx 80 thousand people every year. Health care services were available to people at the cost of service based on their ability to pay. Seminars were also sponsored by the health centres on disease eradication and health promotion topics. Recommendations The following actions could be taken in order to resolve the problem faced by the hospital: Developing the infrastructure facility so as to meet the growing demands of the out patients segment, as the hospital was designed to take care of the in patient. Establishing strategic alliances with some of the top profit making hospital. Giving better training and education to the staff so that they can be adequately utilized Offer better discounted bundle price/package to the patients so as to attract the insured patients as well. This will help increase the number of enrollments and increase the patient base. Increasing operational efficiency and reducing waiting time in the clinic. Reducing the dependency on funding and establish more ways to generate operational revenue Investing in technological advancements and providing high quality modern medical facilities to the patients Implementation strategies In order to implement the recommendation the following strategies should be adopted Establish more number of CCP clinics which would take care of in patients demand and reduce the waiting time CGH can go in for a comprehensive alliance with top performing hospitals just like Brook wood Medical Centre, Medical Centre East and Lloyd Noland Hospital formed an alliance in 1995. Aligning with the apex health care institutes to provide high quality training to the staff Involving more non physician providers like registered nurse and practicing physician under the supervision of medical experts. Motivating the staff to work efficiently by addressing their monetary as well as personal requirements Increasing the synchronization among the various departments so as to reduce the waiting time. Giving better offers for both Health First and Community Care Plan to the existing uninsured patients as well as the new insured patients. This will enhance the revenue base and decrease the dependency on funding Attracting investors by means of more aggressive marketing initiatives in order to enhance the popularity of the CCP concept. Marketing Strategies In order to make the CCP success some marketing initiatives were undertaken which did not turn out to be successful A health fare was scheduled at the site of the first CCP clinic before its establishment but because of construction delay the clinic couldnt be operational several months after the fare thereby nullifying the impact of the promotional efforts. The primary approaches to marketing during the first two years were appearances by the top management and staff members at community organization, church groups, schools along with promotional materials placed within the hospital. The intention of all these marketing activities was to educate staff neighboring communities, social services, uninsured people, small businesses and other hospitals in the area regarding CCP and how to access the service. Word of mouth had proven to be the promising and reliable avenue of retaining patients. Due to limited administrated staff no one person was responsible for coordinating the marketing efforts. Before the commencement of the first clinic focus group were used to assess the membership plan but there were no service to assess the patient awareness attitude or understanding about CGH or CCP. Benchmarks for Success In order to ensure the success of the CGH in achieving its goal of providing quality treatment at affordable fees and increase access to care, following strategies/ actions should be adopted / executed: Increasing the revenue base by attracting more patients both insured and uninsured Taking advantage of the niche market of uninsured population Offering better compensation services so that the patients feel that they are getting more for less Educate staff members and train them properly so that the patients waiting time is reduced and patient experience enhanced Go in for strategic alliances with good profit making hospitals to get access to capital and make necessary investments in technology.