This article illustrates the successful application of principles established by the American Hospital Association (AHA) to foster hospital transformations (). We examined a small community hospital's successful transition from one emergency care center (ECC) physician group to another and the methods by which significant improvements in outcomes were achieved. The foundation of this transformation included a generative governance style at the board level, a shared governance model at the employee level, a renewed sense of employee and physician engagement, and a sense of individual accountability. Outcomes included improved communication, a more unified vision throughout the ECC (which led to improved efficiency and accountability among staff), improved metrics, and a positive impact on the community's perception of care. Press Ganey scores and ECC operational metrics demonstrated significant increases in patient satisfaction and decreases in wait times for seven operational metrics. These data serve as a proxy for the transformation's success. Structured interviews revealed an increase in employee satisfaction associated with the transition. The positive outcomes demonstrate the importance of the AHA-articulated governance principles. The AHA recommendations for a superior value-based care model closely align with the methods illustrated through Bristol Hospital's successful transformation. Other institutions can apply the lessons from this case study to drive positive change and improve patient care.
Simple constraints analysis, as taught to most aerospace engineering students gives little guidance as to exactly which design point should be selected. There is a recent body of work that attempts to solve this for initial designs, without having to fully size the new aircraft concept. The best of these focuses on maximizing a ‘Range Parameter’ which leads to minimizing gross weight for transport aircraft. However, this is not guaranteed to maximize the value of the new design. This paper presents a corresponding surplus value parameter which is designed to provide just that capability. Furthermore, it shows that in at least some cases the resulting optimum design point will shift from that suggested by the range parameter.
: This paper demonstrated of power quality problems associated with the wind turbine based distributed generation systems and how the FACTS device such as UPFC play an important role in power quality improvement of Distributed Generation System. The purpose of the paper is to derive and analyze a reactive power control strategy of UPFC dedicated for DFIG mitigation. The FACT device Unified Power Flow Controller (UPFC) is connected with load bus. Matlab/simulink is used for the work. Paper demonstrated the simulation results for with and without UPFC for Grid connected distributed generation system.
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