Abstract This paper examines the practice of "ambulance chasing" to determine whether it is a service or a disservice to victims of a disaster. The author considers the issue from the perspective of three philosophical models used for determining the ethical course of action, including the teleological approach, the deontological approach and the relativist approach. The paper then concludes that the decision to limit severely or disallow ambulance chasing seems to be the most ethical decision and explains the reasoning behind this conclusion.
Table of Contents
Introduction
Fact Gathering
Ambulance Chasing is a Global Problem
Making Cases
Determining the Ethical Issue
Principles on Which to Base Ethical Decisions
The Relativist Approach
The Deontological Approach
The Teleological Approach
Alternatives Based on the Relativist Approach
Alternatives Based on the Deontological Approach
Alternatives Based on a Teleological Approach
Consequences
The Decision
From the Paper "Deontology demands a good and a bad element. It is difficult to delineate either of these absolutely in the case of ambulance chasing; it is easy in such cases as murder. To force application of this test in the case of ambulance chasing results in an artificially rigid interpretation of right and wrong, and it does so, moreover, before the facts in any given case are known. In the case of the train derailment in California, it is clear that the suicidal man who left his truck on the tracks was acting unethically. However, beyond that, there is no clarity."
Abstract This paper evaluates the London Ambulance service and its CAD (Computer Aided Dispatch) project with reference to five stages of project management, linking the theories prescribed and the actual practice. Suggestions and solutions are offered at all stages. The paper includes diagrams.Table of Contents
Abstract
Introduction
Overview of London Ambulance Service
Brief Overview of the Subject
Defining the LAS CAD Project
Creating the Project Strategy
Detailed Planning of LAS CAD Project
Base Design
Cost and Schedule
Contract Terms and Conditions
Development of CAD Project
Implementation and Control of LAS CAD
System Problems
Change Management
HR and Training
Cultural Issues
Review and Learning
Ideal Project Management Solutions for LAS CAD and Conclusion
Appendix I : Cause and Effect Diagram
Appendix II : Problem and Cause Analysis
List of References
Bibliography
From the Paper "Thus the implementation process actually required certain changes to be made within the workplace, but those areas of change were not focused on properly. Some of the important changes, as spotted by Sommerville (2004) in his case study, are: Re-configuring the control room, using only system proposed resource allocators and separate allocators for different call sources. These changes would have paved theway for an efficient implementation, but the changes were not well communicated and hence the new practices seem to have come as a surprise to most of the staff. The PMBOK guide (2000), when discussing communications planning, states: "Communication planning involves determining the information and communications needs of the stake holders: who needs what information, when they will need it, how it will be given to them and by whom"(p.119)."
Abstract The paper details the kinds of injuries or incidents responded to by helicopter and explains who the members of the ambulance team are. The paper looks at the relationship between the pilot and the medical team and goes on to relate that most flights are actually rapid transfer flights from one medical care facility to another. The paper also discusses the professionalism of pilots who must follow relatively strict safety guidelines and have the discretion to abort missions before and during their occurrence according to the safety of the aircraft and the crew and not on the dire need of the patient.
From the Paper "Flying ambulances are a modern reality and they are characteristic of a growing emergency medical team that attempts to respond as quickly as possible to trauma, injury and disease from a very broad base. Medical air rescue missions have been part of the military in nearly every nation that has a standing army since WWII, with the utilization of helicopter medical transport beginning in Korea. (Glastris, 1986, p. 19) Helicopters are particularly adept at reaching victims in need of rapid transport to medical facilities as they generally have more limited needs (though there are some) for landing and takeoff with regard to space, clearance as agility and speed are on their side as compared to other forms of air and ground transport."
Abstract This paper is written in the form of a case study, discussing the issue of discrimination towards people with HIV and AIDS. It discusses the ambulance service avoiding gay houses and the implications of this as a violation of the sex and AIDS discrimination ordinance. The paper discusses the ramifications for a social worker who knows the issue and her ethical responsibilities in this case.
From the Paper "In this case, Jody is faced with competing ethical values. On the one hand, by his profession and by common social standards he has to fight AIDS discrimination without any consideration of the authority or the social stature of the culpable persons.[NASW] This would involve taking legal actions and publicizing the wrongful behavior of the city council president and the ambulance drivers. Since the ambulance drivers in this case are in flagrant violation of the code of ethics attached to their profession they do not merit any consideration or leniency."
Abstract The paper provides an overview of the concepts of knowledge management supported by empirical research and literature. The paper includes a brief description or overview of the London Ambulance Incident for critical appraisal. The paper discusses the suggestion of Frances Han that there are fundamental business reasons an organization may adopt a process approach and achieve success through knowledge management.
Outline:
Introduction
Brief Review of Knowledge Management Within The Organization
Critical Analysis of The London Ambulance Case
The Failure of the Computer-Aided Dispatch (CAD) System
When Knowledge Sharing Fails
Model for Knowledge Sharing
Knowledge Management and Knowledge Sharing
Knowledge Sharing and Innovation
Conclusions
From the Paper "Fournie (2002) notes that expectation failure typically occurs when individuals fail to consider the exiting "organizational, political and social environment" in which a system is operating, in this case the CAD system adopted by the London Ambulance Department. Even a "technically perfect system" according to Fournie (2002) will fail when organizational, political and social factors are not streamlined within the organizations. The London Ambulance failure is an example of a system failing not solely based on technical reasons or errors in programming but rather because little effort was given knowledge sharing and training with respect to use of the system. As Fournie (2002) notes, individuals using the system had to learn not only a new system but also had to operate in a new environment where they were unfamiliar about the rules and regulations necessary to operate efficiently and in a streamlined process within this environment (Fournie, 2002; Randell, 1993). Contributing to these problems included use of assistants rather than controllers to handle key events and the varying points of views held by multiple stakeholders within the organization regarding use of the system; additionally lack of a "communication mechanism" to "take these points of view into account" also ultimately led to the failure of the CAD system to achieve it's goals (Fournie, 2002)."
Abstract This paper examines Ernest Hemingway's novel "A Farewell to Arms", based on Hemingway's memories of driving an ambulance during World War I. Many of Hemingway's novels are semi-autobiographical and the character of Frederic Henry is in fact modelled on himself and part of the story on his relationship with his wife. It shows that while this is a novel of memory, it is also a novel of self-discovery, structured to show the self-exploration and self-discovery of Frederic who's character changes from the beginning of the novel to the end. It analyzes how the title of the novel has a dual meaning, for by the end of the novel the Frederic Henry will have been tested by arms, meaning the tools of war and he will have been held by the arms of his wife. He says farewell to both, to the war as he deserts and to his wife because she dies.
From the Paper "It is, of course, through his relationship with Catherine that his ability to care is brought forth most clearly so that it becomes a part of his overt personality. Catherine, for her part, is drawn to Frederic precisely because he is not deceptive, whether that is because he does not care enough or not. Catherine "defines herself as someone living life as fully as she can" (Hays 62), and "her love and devotion convert Frederic Henry from a selfish, uncaring individual to one who loves, who shares, and who serves others" (Hays 62). The relationship mirrors the one Hemingway himself had with Agnes, as noted, and he uses the story in the novel as a metaphor for his reality."
Tags: frederic, henry, war, lieutenant, wife, family, death, memory, relationship
This paper discusses the national provider of ambulance services, American Medical Response: Formation, acquisitions, finances, strategy, management, control, structure, resources and leadership.
3,825 words (approx. 15.3 pages), 7 sources, 1994, $ 135.95
From the Paper "American Medical Response was formed in February 1992 with the strategic objective of becoming the leading national provider of ambulance services. It set out to achieve this position through acquisition, not by establishing new provider organizations. In August 1992, the company went public and acquired four ambulance service providers. The company has continued its acquisition policy since that time, with a total of seven providers having been acquired through September 1993..
The company now provides emergency prehospital medical care and ambulance services to patients in response to 911 emergency medical calls, and provides nonemergency ambulance service to patients during transfer to and from health care facilities and residences. It also provides nonmedical transport services to ... "
Abstract This paper covers numerous ways that wireless technology can simplify health care. It shows that both doctors and patients can benefit from its use in hospitals and ambulances. It not only makes communication within medical facilities easier and faster, but more efficient as well. Patient convenience is increased, while physician stress is reduced. The paper shows that its use is also a cost-effective solution, requiring very little effort to install. An overall improvement to health care could be achieved through the use of wireless technology in the medical field.
From the Paper "Accuracy is also increased by the use of wireless networks. According to Samuel Greengard, hospitals that have adopted wireless networks have reduced errors by as much as fifty percent. Less errors, means less chance for malpractice suits and better quality of care for the patient. Hospitals are often among the last to adapt new technologies because they work in a high-risk field were errors could cost someone's life. But since this technology has been around long enough to prove its reliability, more hospitals should make the move to adopt this technology."
Abstract This paper provides a case study of young African man who was brought into A&E by the ambulance crew. The main theory that underpins the whole assessment process is the Roper- Logan-Tierney Model by Roper et al (1996), popularly known as the Roper's model, which emphasises the interaction between biological, psychological and social factors as influences on human behaviour and therefore, on health.
Outline
Background and Context of the Patient
The Assessment Process
The History of the Presenting Problem
Nursing Management Priorities
Conclusion
From the Paper "The history of the presenting problem was collected from the statements and the documentation of the paramedics as well as by directly asking the patient. In many cases the patient was asked to confirm the details. This was good as the patient was actively included in the process. The paramedic said that they had been called to the patient's address as the patient was a having a progressive headache and that it was so bad that he could not function in any way, let alone, drive to the A&E department."
Abstract This document is a design proposal created according to the requirements of the system requirements specification document for an emergency dispatching system for the State of Victoria. The design proposal details how the system will log incoming calls to police, fire, ambulance and state emergency services, send dispatching requests to various services, monitor resource allocation and status and provide complete auditing facilities. The paper is written largely in point form and has many graphics.
Table of Contents:
1. Overall Description of the Proposed Design
1.1. Incident Calls and Information Gathering
1.2. Resource Allocation
1.3. Communication With Emergency Units
1.4. Auditing System
1.5. Conclusion
2. Constraints
3. Functional Requirements
3.1 Requirement - Incoming Call Screen
3.2 Requirement - Timer Initiation and Ending
3.3 Requirement - Dispatch Unit Screen
3.4 Requirement - Submit Incident Report to Auditing Subsystem
3.5 Requirement - Secure Access to System
3.6 Requirement - Description of Incident
3.7 Requirement - Cancel Incident Response
3.8 Requirement - Search and View Incident Log Records
3.9 Requirement - Issue Monthly Summary Report of Operations
3.10 Requirement - Status of Mobile Unit
3.11 Requirement - Communications
3.12 Requirement - Restore Unit to Operational Status
3.13 Requirement - Estimated Cost of Incident
3.14 Requirement - Interface to First Aid Databases
3.15 Requirement - Advise Hospital of Organ Donors
8. Structure Diagram
4. Data Flow Diagrams (DFDs)
4.1 Context Diagram
4.2 Diagram 0
4.3 Diagram 1
4.4 Diagram 1
4.5 Diagram 1
4.5 Diagram 1
5. Screen Designs
5.1 Incoming Call Screen
5. 2 Dispatch Screen
6. Hardware Requirements
7. Data Migration
8. Estimates
9. Estimated Costs and Benefits of the New System
9.1 Hardware and Software Costs
9.2 Labour/Manpower Costs
9.3 Tangible Benefits of the New System
9.4 Intangible Benefits of the New System
10. Test Plan
From the Paper "The new system is composed of 4 sub-systems which provide a complete and accurate response to emergency incidents, both in the field and in the no less important realm of auditing. The auditing system is of prime importance to the Victorian Government as by law it must assess the Emergency Services to ascertain if they are functioning in an efficient manner and at a suitable level."
Tags: allocation, auditing, design, information, resource, response, system
Abstract This paper examines the rise of air medical and evacuation services in northern and remote areas of Canada after the 1920s, noting the continuing need for air ambulance services for Canadians living beyond road or rail networks. The paper points out that a great array of popular history material has been published in the last thirty years or so attesting to the romantic lives of bush pilots who indeed were often self-styled persons to occupy their own boundless milieu. The paper adds that a study of the many female bush pilots provides an intriguing aside on the women's history emphasis of the last decades that can lend an impression of women's domesticity that was by no means general. The paper concludes that, today, bush pilots retain their particular glamour, being well-equipped and trained with every benefit of modern communications and navigation, and still risking unusual, even ridiculous situations.
Outline:
Introduction
A Twentieth-Century Progression
Medical Services in Northern Canada
Saskatchewan
Training of Pilots and Medical Staff
Concluding Discussion
From the Paper "With socialized medicine as a federal Canadian addition, outpost infirmaries and hospitals were incorporated into local communities but some memoirs refer to occasional doctors who carried on in remote service, radioing instructions to particular flying companies or pilots; instructions arrived via Royal Canadian Air Force stations, too, in a continuing range of services that has by no means subsided with the advent of tele-medicine. Nursing were sometimes found in contract posts who might be better described today as physician's assistants in their obstetrical and orthopedic skills, not a few of them turning to surgery where there was no doctor and air evacuation impossible in time to save lives. (Larmour 1988) The international profession of nursing took considerable interest in the post-World War II decades in what Canadian provinces and territories were beginning to pioneer in nursing stations, infirmaries, public information on when to bring patients to radio dispatch centres and all else done and learned by practitioners in the course of northern or Arctic service. (Waller 1964, King 1968, Smith 1972)"
Tags: health, care, aviation, history, air, force, women
Abstract The paper discusses how in "A Farewell to Arms," Ernest Hemingway chronicles the life of Frederic Henry, an American serving as an ambulance driver in the Italian Army during World War I. The paper examines how Hemingway contrasts the death and despair of war with the loving relationship between Henry and an English nurse. The paper explains that this relationship, although an escape from the despondency of battle, actually culminates in more pain and misery, thus highlighting how despair is inevitable in war.
From the Paper "In his partially autobiographical novel, A Farewell to Arms, Ernest Hemingway chronicles the life of Frederic Henry, an American serving as an ambulance driver in the Italian Army during World War I. Hemingway conveys the idea of insensibility shared by Henry and the other soldiers and army personnel as they take pleasure in unscrupulous living and overt excess. Symbolic in nature, their unrestrained behavior discloses the sense of hopelessness felt among the soldiers as they realize the futility of war. Amid the tumultuous events taking place on the battlefield, Hemingway contrasts the death and despair with the loving relationship between Henry and an English nurse, Catherine Barkley. This relationship appears to be an escape from the despondency so prevalent on the frontlines of battle. However, Henry and Catherine's relationship culminates in more pain and misery as Hemingway weaves a tale that illuminates the insensate horror and devastation born out of war."
Abstract This paper defines nosocomial pneumonia as the development of a fever, leukocytosis, purulent sputum, and new or changes to lung infiltrates on chest x-ray within 72 hours of hospitalization. The paper explains that post-operative nosocomial pneumonia is very preventable but that frequent complications can be costly and life-threatening. The paper addresses areas of improvement for the prevention of nonsocomial pneumonia, such as research, which has shown that careful pre-operative screening can identify patients who are especially at risk for developing post-surgical pneumonia. The paper also describes evidence, which shows that use of an incentive spirometer, early ambulation after surgery as well as the use of coughing & deep breathing exercises is associated with positive post-surgical health outcomes. Tables that illustrate the data are included with the paper.
Table of Contents:
Area in Need of Improvement
Evidence-Based Plan
- Table 1. Odds Ratios of Common Post-operative Pulmonary Complications
Implementation Plan for this Process Improvement
- Table 2. Pneumonia Risk Identification
- Table 3. How to Score Patients Using the Pneumonia Risk Identification Protocol
Business Case to Support Evidenced-Based Plan
- Table 4. Cost of Current Practices
- Table 5. Cost of Implementing PRIP
- Table 6. Cost-Benefit Analysis
Conclusion
From the Paper "Currently Medicare has identified eight conditions that will no longer be reimbursed if a patient develops them during an inpatient stay. Those conditions are object left in patient during surgery, air embolism, blood incompatibility, catheter-associated urinary tract infection, pressure ulcer, vascular-catheter associated infection, mediastinitis after coronary-artery bypass grafting, and fall from bed [4]. Rosenthal wrote in October of 2007 that these eight conditions were identified after meeting several criteria including that the condition "could reasonably have been prevented through the application of evidence-based guidelines". Currently post-surgical pneumonia is not one the eight identified conditions, but as the number of Medicare participants increases and funds are strained, this preventable and costly condition could easily become next on Medicare's list of non-reimbursable conditions."
Tags: nursing, incentive spirometer use, surgical Pneumonia, business case analysis, preventative health
