Exploring a Work of Art Essay Example | Topics and Well Written Essays - 2500 words

Exploring a Work of Art - Essay Example The subject, color, style, and theme successfully depict the main tenets common during the Romantic Age. A formalist analysis of the work may lead to a better understanding of the work and the message being conveyed by the artist. In addition, some research on what other people have to say about the work will help attain a complete analysis. Background of the Author Caspar David Friedrich was a German painter born to a poor family in 1774 in Greifswald, Germany. Despite poverty, the artist attended formal art study with artist Johann Gottfried Quistorp, who conducted art lessons mostly outdoors. This training and exposure to outdoor life helped Friedrich to master the local color and environment thus helped the artist master the art of landscape. According to Vaughan (65), Friedrich’s paintings, which generally reveal Romantic Age ideas, make him â€Å"one of the most important artists† during his time. â€Å"The Monk by the Sea,† an oil on canvass by Caspar Davi d Friedrich in 1809. Analysis of Form A formalist analysis of the color, space, line and texture could lead to discovering the artist’s overall craftsmanship. Color can be considered the most important element in the painting because it is through color that the artist achieves meaning. Notably, contrast is applied with the use of white against the dark green background and the black suit of the monk. This contrast reflects the theme of confusion but considering that the white takes a larger space than the dark colors, taken by the white color, the theme of good versus evil may be implied as darkness may be associated with evil (Guerin 34). Minimalism, a characteristic of Romantic art, is applied with the minimal use of colors. Through minimalism, the artist achieves focus and emotionality. Adding in several colors would have made the painting look less gloomy, hence distorting the message. Importantly, Friedrich used dark green instead of blue for the sea. This may be a litt le questionable considering the usual color of the sea. Nevertheless, the dark emerald green color implies the depth and mystery of the sea. It could also mean unusualness in the life of the monk. Depicting the sea with great darkness, Friedrich made it a point to limit this part to at least one-eighths of the canvass. This allows the other images, such as the sky, the land, and the monk to take form, while it allows the purpose of showing the location of the monk at the same time. Specifically, the center clouds where a rich combination of colors is applied, capture the motion of light breaking into the darkness and at the same time the darkness eating up the light. Such drama found in nature suggests some Romantic thoughts that could likewise draw out sentimentality from the audience. Space is also another important element. The whole image can be divided horizontally into three different parts, namely, the sky, the sea, and the land. The great expanse of the sky, which covers at least â€Å"five-sixths of the canvass† (Web Gallery of Art, n.d.), attracts attention considering the light it sheds on the whole image. Through devoting much space to the sky, the artist achieves artistic drama, which is very typical of the Romantic Movement. On the issue of emphasis, Friedrich attains emphasis with the proper use of space as he allows a larger part of the canvass to be plain. If he made the figure of the

Short Stories Essay Lamb to the Slaughter Essay Example for Free

Short Stories Essay Lamb to the Slaughter Essay Most murder mysteries often have a motive to prompt an investigation, and most classic murder mysteries include a detective to solve the case. Murder mysteries obviously also include a murder, may it be spectacular, cold blooded or accidental. There is also a murderer and a victim and a weapon of some description.. However, not all murder mysteries involve an alibi which in my opinion, adds to the suspense of the story. The main focus of a murder mystery is the location of the story or where it is set. There may be many different locations in a murder story, however there must be one main location for the story to be effective. Lamb to the Slaughter was written by Roald Dahl who is infamous for his enthralling stories, most of which are directed at a younger audience. It was first published in 1954. In Lamb to the Slaughter, the use of modern language automatically gives the impression that it is written in the present day. Roald Dahl is much more famous for his stories which are directed at a younger audience, however Lamb to the Slaughter is directed at an older audience ranging from GCSE students to adults. In his style of writing, Roald Dahl always writes about ordinary people who get involved in difficult situations to make his stories more suspenseful. The other short story, which I will be investigating, is The Speckled Band. The Speckled Band was written by Sir Arthur Conan Doyle and it was first published in 1892. Sir Arthur Conan Doyle is infamous for writing The Sherlock Holmes Adventures and The Speckled Band is just one story of many and The Speckled Band is written in speech of the time when it was first published much like Lamb to the Slaughter. Much more formal English language was used when compared to Lamb to the Slaughter. The main characters in The Speckled Band are Holmes and Watson and you could tell that they were well educated just by analysing how they spoke. Sir Arthur Conan Doyles creation has had worldwide success and has also been made into a Television series. The stories prove so popular because of the way Sir Arthur Conan Doyle wrote the stories. He was very descriptive and gave the reader a real atmosphere of what it must be like to be in Sherlock Holmes Land. The setting also enhances the suspense and the atmosphere of the stories which is also another successful formula, which proves the Sherlock Holmes Stories to be  so popular. Sherlock Holmes is probably thee most famous detective in the world now and it is all thanks to the creation of Sir Arthur Conan Doyle. Lamb to the Slaughter and The Speckled Band are both murder stories however they both deal with different types of murders. However in both stories there is a focus on animals that being the snake in The Speckled Band and the Leg Of Lamb in Lamb to the Slaughter. The Speckled Band is the longer, more sophisticated story of the pair and deals with exotic animals. This may be a personal theme of Sir Arthur Conan Doyle. While the Lamb to the Slaughter murder is brutally simple, but in this case the murder is so good the murderess gets off. In the Speckled Band we want the detective to solve the murder to tell us how it was done, while in the Lamb to the Slaughter we know how the murder was committed, and we read on to see if she gets away with it. We also have two different styles as one of them was written in the 19th Century and the other in the 20th Century. The Speckled Band starts with the reader being introduced to how many cases Dr Holmes and Watson have solved and also what sort of cases these were. These cases were not ordinary cases, they were all difficult; strange, but none-commonplace, so any normal cases were shunned. The first sentence is also very long; taking up eight lines, so the reader can get background all in one go, without having to refer back to anywhere. The story is retrospect, as the plot of the story has already been started. We are introduced to the case and Dr Holmes; by Dr Watson, the faithful companion to Holmes. The entire first paragraph is devoted to describing the case of Dr Grimesby Roylott of Stoke Moran The first mention we get of Holmes is when at the beginning of the second paragraph he wakes Watson up, which we find unusual as, we are told he is a late riser. At the bottom of the next page we get our first archaism of the story. These are old style words or phrases that are now no longer in use, the one we get here is intimate friend, in this sentence he is referring to Dr Watson, and now most people no longer say male friends are intimate. We also get the feeling that Holmes has collected a considerable amount of money for his efforts on the seventy odd cases he has solved. This is shown by the fact he is only a bachelor; but he still manages to have a maid, and  he also drinks coffee which is an expensive drink; as in 1883 coffee was a recent import and so only for the upper classes. He is also respectful and a gentlemen and cares a lot for people, You must not fear, he said leaning forward and patting her arm. We then come across defray which is another archaism and means to make good or repay. We also find that Holmes finds his work rewarding, as when Miss Stoner says she cant pay yet, Holmes lets her pay when she can. The narrative then told by Miss Stoner goes on to say she was a step daughter to one of the oldest Saxon families in England, this family has fallen apart as has the Saxons. Being old as well would mean they were honourable. The estate had stretched to Berkshire and Hampshire, which are both rich a reas. The Dr Grimesby Roylott went to Calcutta, which was the jewel in the crown, of the British Empire, and soon got a prison sentence for beating a native butler to death, but as he was white, he did not get a death sentence. This shows us that he had a huge temper and was strong enough to kill someone with a beating. While in the Indies he married Mrs Stoner who had ?1000 a year, which would be given to him while her daughters resided with him. So when she died shortly after they returned to England near Crewe in a railway accident, they moved in with Dr Grimesby Roylott back to his roots at Stoke Moran. While they lived with him the ?1000 a year saw to all their needs. Until Doctor Grimesby Roylott changed and started throwing fits of anger, and as he was a man of immense strength he often got into brawls. It was said to be part hereditary and part from living in the tropics for so long. He had even thrown the local blacksmith over a bridge, so if he could do that to a blacksmith, normal people had no chance. He also allowed gypsies onto his land, and would disappear off with them for weeks at a time. He also had a cheetah and a baboon roaming his land, showing that he could not leave India behind. Her sister met a half-pay Major of Marines at her aunts house, and if she were to marry him Dr Grimesby Roylott would have to pay ?250 a year of his ?1000. A half pay soldier is a private soldier who already has enough money to live, and doesnt need paying; he is an amateur soldier. On the day of the murder the weather had been bad and full of forbidding, offering perhaps some pathetic fallacy of the awful deed done that night. Then from the story being quiet and conversational it very quickly turns into a scene of action and murder. The last words of her sister were very confusing, and so puzzled everyone;  which added mystery and cynicism. The next main event was when Percy Armitage asks for her hand in marriage. When this happens she is told to move to the room where her sister had died. From this point onwards the reader is very neutral, as they talk of what to do, and in a classic Sherlock Holmes way he talks of what to do and when to do it, but it will all happen because of logic. The next page is just Dr Holmes summing up and analysing all that he has been told. Dr Grimesby Roylott then burst through the door and starts shouting and threatening Holmes, he is never phased by any of this and responds quietly and politely to the raging shouts directed at him. We then see the great detective start on his quest; he shows he is also well aquatinted with firearms as he tells Watson to get an Eleys No2. So they then set off on the journey to Stoke Moran, when reached the story tells of the darkness surrounding Stoke Moran, and the Great House and its owner. During this part of the story, Watson asks Holmes questions on behalf of the reader, and so the reader gets all the information that Watson gets. Sherlock Holmes then goes through the whole process of trying to solve the mystery of how the murderer got into the house room, but it is without success, so it is still a mystery to Watson, the reader and probably Holmes. It is obvious though over the next few pages that Holmes begins to understand how the murder was committed. It is also shown that he begins to dislike Dr Grimesby Roylott increasingly, as he understands more about the murder and how it was committed. We then get the plan of Sherlock Holmes to show us how the murder was committed. The plan works perfectly, but with one fatal part for Dr Grimesby Roylott. The doctor is bitten by the murder weapon, the evil doctor dies dressed even in death in an eastern style. After this we are brought up to date by Dr Watson as he finishes writing the narrative. The start of the Lamb to the Slaughter differs from the Speckled Band because it is in the pas-tense. It builds up a picture. It also shows that it is in the 20th century as it has a Thermos bucket. We are then introduced straight away with no description a character who is Mary Maloney, who is six months with a child; and so an unlikely murderer. Where as in the Speckled Band we are introduced to Holmes after a page of description of his background; and  he is the story. The story style is more immediate and straightforward, and in the Speckled Band we have Dr Watson as a filter to help us. We get description of movement over the next paragraphs. This helps us to assess the mood in the house, and the tension between the two people. We also get to know the characters, and their routines, where as in the Speckled band we know who the main characters are and what they do, while out of no where we are told that Mr Maloney is a policeman with no build up to it all. We are also told that the couple have a conversation that lasts only about four or five minutes. We are not told what happened in this conversation, so we are forced to make our own opinion, of what he said to her, while in the Speckled Band we are given every detail. We are then made to make up our own mind about this and the next part of the story, when she walks across the room, she couldnt even feel her feet touching the floor. This shows she is walking on an autopilot, she may have pre-meditated the murder. She then goes downstairs to get the leg of lamb. We are told all this in the Lamb to the slaughter, but in the Speckled Band we dont know what the murder weapon is, but we do know that it is pre-meditated. We are then told that Mrs Maloney goes out to the shops to get an alibi, that she was happy and chirpy and not looking or acting like someone who had just committed murder, she puts on the face of a expectant mother and a very happy wife. She does this perfectly and gets th e alibi needed for later in the story. So when she gets back to the house she does not need to act to cry or feel sorrow at the death of her husband because she really loved him, and was probably sorry for killing him. The stories do also differ as, one person calls all the moves of the investigation, and the other has a team of people working all working together to try and solve the murder, when the single investigator solves the crime and the group of detectives fail. We then get a long drawn out conversation between the policemen, which is all-ironic. As they talk about the murder weapon, they are describing the joint that they are eating. Towards the end Mary gets referred less and less as a person and more as an object; this shows her identity as a murderer is disappearing. Both of the murders are perfectly planned and carried out, but the one has a detective, which we need to solve the case, and the other is a case of will the murderer be caught?

The Hierarchy Of Strategic Intent Marketing Essay

The Hierarchy Of Strategic Intent Marketing Essay Strategic analysis, strategic choice and strategy application are the three parts of the Strategic Management. Strategic choice is anxious with decisions about the companys future and the way it needs to reply to the impacts and influences identified in strategic analysis. The choice becomes an indolent exercise if the strategy is not correctly implemented. These three divisions, so, form a closed loop in which the tail and the head are often vague. TASK1 Understanding the process of strategic planning: Explain strategic contexts and terminology missions, visions, objectives, goals, and core competencies: STRATEGIC INTENT: Strategic analysis, strategic choice and strategy application are the three parts of the Strategic Management. Strategic optimal is concerned with decisions about the organizations prospect and the way it needs to respond to the effects and impacts identified in strategic analysis. Choice becomes an indolent exercise if the strategy is not properly applied. These three divisions, consequently, form a closed loop in which the tail and the head are often indistinguishable. THE HIERARCHY OF STRATEGIC INTENT: I will discuss these parameters as a ladder of strategic intent. The ladder of strategic intent includes the following elements. A broad vision of what the organization should be. The organizations mission The strategic objectives   and specific goals to be pursued relentlessly The plans that are developed to accomplish the intentions of management in a concrete way. The fundamentals of the hierarchy specify the devout intentions, lofty ideals and clear-cut ideas that serve to unify the energy and forces scattered throughout an business. They are beginning points for any formal planning process, but they also provide the sense of direction necessary to assure that incremental behavior culminates in overall progress. Strategic intent is said to have expressed effectively when individuals believe fervently in their products and industry and when they are absorbed totally on their firms ability to outdo its competitors. VISION: Vision is what keeps the business moving forward. Vision is the motivator in an business. It needs to be meaningful with a long term viewpoint so that it can motivate individuals even when the business is facing discouraging odds. Vision has been defined in numerous dissimilar ways. Kotter defines it as a description of somethings (an organization, corporate culture, a business, a technology, an activity) in the future. El-Namaki reflects it as a mental perception of the kind of environment an separate, or an organization, aims to create within a broad time prospect and the underlying conditions for the actualization of this insight. Miller and Dess view it simply as the category of intentions that are broad, all inclusive, and forward thinking. The communal strand of thought evident in these definitions and several others available in strategic management literature narrates to vision being future ambitions that lead to an inspiration to be the best in ones field of action. CHARACTERISTICS OF VISION: Vision is industrialized through sharing across an organization: Famous stories of successful vision include visions that have been extensively shared across entire organizations. Of course, an individual leader, often a founder has a powerful influence on the others. Techniques of convincing the others about vision: The leaders by working hard along with others persuade the others in the organizations rather than merely delivering speeches. Change Agents: Leaders must recognize the complexity of changing an outmoded vision to reflect new realities. Organizations must redefine themselves through efficient visions of the future through new purposes and strategies. THE ADVANTAGES OF HAVING A VISION: Parikh and Neubauer point out that numerous advantages accumulating to a business having a vision. Here is what they say: Good visions are inspiring and exhilarating. Visions represent a discontinuity, a step function and a jump ahead so that the company knows what it is to be. Good visions help in the creation of a common identity and a shared sense of purpose. Good visions are competitive, original and unique. They make sagacity in the marketplace as they are practical. Good visions foster risk-taking and experimentation. Good visions foster long-term thinking. Good visions represent integrity; they are truly genuine and can be used for the benefit of people. VISION STATEMENT: When you initiate the process of strategic planning, visioning comes first. Martin Luther King, Jr. said, I have a dream, and what followed was a vision that altered a nation. That famous speech is a dramatic example of the power that can be produced by a convincing vision of the future. A vision is a guide to applying strategy. Visions remain about feelings, beliefs, feelings and pictures. A vision statement responses the query, What will success look like? pursuiting of this advent of success is what inspires individuals to work collectively. It is an significant obligation for building a strong foundation. When all the staffs are committed to the companys visions and goals, best choices on business decisions are more likely. CREATING A SHARED VISION: Most managers, now-a-days, talk about a communal vision, meaning that individuals from across the business have a common mental image and a equally supported set of ambitions that serve to unite their efforts. MISSION: A mission was earlier careful as the scope of the industry activities a secure pursues. The definition of mission has slowly expanded to represent a concept that exemplifies the purpose behind the existence of an organization. Business mission can be defined as the important, unique purpose that sets a business apart from other companies of its type and identifies the scope of its operations in product and market term. CHARACTERISTICS OF A MISSION: A mission statement includes the basic business purpose and the reason for its being by rendering some valuable functions for the society. An effective mission statement should possess the following physiognomies. Feasible: The mission should be accurate and achievable. For example, Tesco professed its mission as to encourage saving among customers by selling their product cheep. Precise: A mission statement should not be fine or too comprehensive. Clear: A mission statement should lead to action. O2 mission of connecting people leads it to a variety of service with varied tariff structure so as to cater to the preferences of mobile phone users. Motivating: The mission should be motivating for the employees to be inspired for action. For example Royal mail mission is to expectations of the customer with dedication, devotion and enthusiasm. So customer service has develop a value and it is inspirational and motivating the postal employees. Distinctive: A mission statement will indicate the major components of the strategy to be adopted. The mission should be unique. When Microsoft defines its mission as to be a world class competitor it creates a unique place in the minds of individuals personal computer users. Indicates major components of strategy: The mission statement of Shell Bp emphasizes petroleum refining, marketing and transportation with international standards and modern technology. It indicates that Shell Bp is going to adopt diversification strategy in future. The mission delivers way to insiders and strangers on what the company stands for. It is the supervisory star for any copany. MISSION STATEMENTS: Vision is the critical focal point and beginning to high presentation. But clearly a vision alone wont make it happen. Even the most exciting vision will remain only a dream unless it is followed up with the striving, building, and improving. RESEARCH OF VISION AND MISSION STATEMENTS: In a competitive economy ambitious by the cruel logic of markets, a business with a determined management can transform a business much more quickly and much more efficiently than in the past. Clearly enunciating your strategic intent is the key. Vision and Mission hold an business together. OBJECTIVES: An objective designates the result that the business expects to achieve in the long run. It is an end result, the end point, somewhat that you aim for and try to reach. It is a desired result towards which behavior is directed in a business. CHARACTERISTICS OF OBJECTIVES: Objectives have the following structures: Objects Form a Hierarchy: In many organizations objects are structured in a hierarchy of importance. There are objectives within the objectives. Objectives Form a Network: Objectives interlock in a network fashion. They interrelated and interdependent. The concept of network of objectives implies that once objectives are established for every department and every individual in a business, these subsidiary objectives should contribute to meet the objectives of the total business. Multiplicity of Objectives: Organizations pursue multifarious objectives. At every level in the hierarchy, goals are likely to be manifold. Long and Short-range Purposes: organizational objects are usually related to time. Long-range objects extending over five or more years are the ultimate or dream objectives for the business GOALS: They are stated in precise terms as quantitatively as possible. The emphasis on goals is on measurement of progress toward the attainment of objectives. Goals have the following structures they: 1. Are resulting from objects, 2. Offer a normal for measuring presentation, 3. Are articulated in concrete terms, 4. Are time-bound and work-oriented. Advantages and Disadvantages: It helps organizations do to satisfy a particular need of the society or to fulfill a particular deficiency in the society. There is always a deadline which sometimes is never meant by organizations. Review the issues involved in strategic planning: Businesses that succeed do so by creating and keeping customers. They do this by providing better value for the customer than the competition. Marketing management constantly has to assess which customers they are trying to reach and how they can design products and services that provide better value (competitive advantage). The main problem with this process is that the environment in which businesses operate is constantly changing. So a business must adapt to reflect changes in the environment and make decisions about how to change the marketing mix in order to succeed. This process of adapting and decision-making is known as marketing planning. Where does marketing planning fit in with the overall strategic planning of a business? Strategic planning is concerned about the overall direction of the business. It is concerned with marketing, of course. But it also involves decision-making about production and operations, finance, human resource management and other business issues. The objective of a strategic plan is to set the direction of a business and create its shape so that the products and services it provides meet the overall business objectives. Marketing has a key role to play in strategic planning, because it is the job of marketing management to understand and manage the links between the business and the environment. Sometimes this is quite a straightforward task. For example, in many small businesses there is only one geographical market and a limited number of products (perhaps only one product!). However, consider the challenge faced by marketing management in a multinational business, with hundreds of business units located around the globe, producing a wide range of products. How can such management keep control of marketing decision-making in such a complex situation? This calls for well-organized marketing planning. What are the key issues that should be addressed in strategic and marketing planning? The following questions lie at the heart of any marketing and strategic planning process: à ¢Ã¢â€š ¬Ã‚ ¢ Where are we now? à ¢Ã¢â€š ¬Ã‚ ¢ How did we get there? à ¢Ã¢â€š ¬Ã‚ ¢ Where are we heading? à ¢Ã¢â€š ¬Ã‚ ¢ Where would we like to be? à ¢Ã¢â€š ¬Ã‚ ¢ How do we get there? à ¢Ã¢â€š ¬Ã‚ ¢ Are we on course? Why is marketing planning essential? Businesses operate in hostile and increasingly complex environment. The ability of a business to achieve profitable sales is impacted by dozens of environmental factors, many of which are interconnected. It makes sense to try to bring some order to this chaos by understanding the commercial environment and bringing some strategic sense to the process of marketing products and services. A marketing plan is useful to many people in a business. It can help to: à ¢Ã¢â€š ¬Ã‚ ¢ Identify sources of competitive advantage à ¢Ã¢â€š ¬Ã‚ ¢ Gain commitment to a strategy à ¢Ã¢â€š ¬Ã‚ ¢ Get resources needed to invest in and build the business à ¢Ã¢â€š ¬Ã‚ ¢ Inform stakeholders in the business à ¢Ã¢â€š ¬Ã‚ ¢ Set objectives and strategies à ¢Ã¢â€š ¬Ã‚ ¢ Measure performance Advantages and Disadvantages: Market planning delivers a means for actively involving personnel from all areas of the business in the management of the company and this participation improves the quality of the plans, with the participation of the staffs it enhances their overall understanding of the companys objectives and goal. One of the disadvantages is costly to implement. Explain different planning techniques: Planning is a critical business responsibility that is often overlooked, particularly by smaller companies with limited time and personnel resources. However, the reason for this oversight is often the result of managements lack of planning techniques. Learning useful planning methods and factors eliminates this knowledge gap. Business planning is just as critical as having a map when traveling to an unfamiliar location. Without it you may never reach your destination. Primary Planning Types Business planning types come in various flavors depending on the company size and industry. However, there are three basic plans that apply to all businesses, large or small. Business, strategic and marketing plans are important to every for-profit and nonprofit organization. Understanding the goals and components of each offers businesses the tools to create effective plans using the most basic or sophisticated techniques. Business Plans Typically used for starting up or financing a company, business plans are the cornerstone of the planning function. Components of a business plan include an executive summary, market analysis, product/service descriptions and financial/operations projections for a minimum of three to five years. In start-up situations that need initial financing, creators should paint a vivid, yet conservative, picture of the founders and the rationale for believing the business will succeed. When seeking growth-financing, management should highlight past company performance and carefully project the impact of the new funding on improving net income. Always include debt service, which is the amount needed to repay the new loan, in income and expense projections. Strategic Plan Strategic plans should be created by business owners and/or senior management only. Unlike business plans, which are based on historical data and future projections, strategic plans are more conceptual. These plans should include defining your organizational goals, identifying your available options to achieve your objectives and considering new short-term opportunities you believe will exist to improve your businesss results. You may want to incorporate specific industry trends into your planned strategy. Strategic plans are not long-term creations, but should address taking advantage of available opportunities in the next 12 to 24 months. Marketing Plans All the fabulous business and strategic plans ever devised will fail if you dont market and sell your product or service. A solid marketing plan will help you achieve gross income and sales goals. A SWOT (strengths, weaknesses, opportunities, and threats) analysis is an effective technique for creating a winning marketing plan. SWOT is also useful in strategic plan creation as a foundation technique. You can also combine a SWOT analysis with the four Ps product, price, publicity, and place of effective marketing. Even if you have invented the better mousetrap, you need a superior marketing plan to get results. These techniques will give you the ammunition you need. SWOT analysis and marketing A vital part of the planning process is looking at the existing position of an industry and trying to decide how factors external to the business may affect the business. An organization can perform a SWOT analysis as a way of deciding which marketing plan to use.   The organization performs an audit on the internal and external nature of the company looking at the current and future situation.   An audit is a review of all the company s activities. Internal Explanation Strategy Implications Strengths Reviews the business current strengths such as a good brand or strong sales performance Can develop the strengths, perhaps in the way they promote the product, or wish to develop new products (Tesco have used their strong brand name to launch several products) Weaknesses Reviews the business current weaknesses such poor response times to requests for information or late deliveries Can implement strategies to eradicate these weaknesses e.g. more resources put into a better warehousing system for the dispatch of goods. External Opportunities Reviews the business future opportunities e.g. new technology making it easier to manufacturer certain goods or new markets abroad Can use strategies to take advantage of the potential opportunities e.g. developing new products to meet the potential increased demand Threats Reviews the business future threats, mostly from increased competition from other firms or from changes in the economic situation. Can employ strategies to ward off these problems, e.g. setting lower prices or increasing promotion Rational about the use of a SWOT analysis in measuring the influence of marketing to a business strategy; Possible strengths in marketing might be: Specialist marketing expertise An innovative product or service The location of the business convenient for customers The reputation of the brand perhaps it is trusted or recognized as the highest quality Likely weaknesses in marketing could include: Lack of a clear product differentiation compared with competing products Weak distribution compared with competitors Inadequate online presence Potential marketing opportunities could include: The use of technology to develop new products Growing demand from overseas markets (e.g. China India) The use of social media like Facebook and Twitter to reach new customers A list of likely marketing threats might include: Competitors introducing better products at lower prices Changes in the economic environment which encourage customers to be less loyal to established brands Changes in customer tastes and fashions Universal Techniques To make business planning come alive and succeed there are three simple practices that must be always be employed. First, set realistic, measurable goals. Second, understand and communicate with your customer base. Third, attract and retain the best employees your company can afford. Without these three components, your business planning, however sophisticated, risks failure on a massive scale. Using these three simple techniques, your business plans should deliver the results you want. SPACE, PIMS. PIMS data can be described as a guide to help management describe the business a business situation and opportunity relative to the offerings of its competitors in two-dimensional space. TASK 2 BE ABLE TO FORMULATE A NEW STRATEGY Produce an organizational audit for a given organization Tesco Marketing Audit: The marketing audit is a fundamental part of the marketing planning process. It is conducted not only at the beginning of the process but also during and after the process completion. Marketing audit not only consider its own plan but also considers internal and external factor that affects marketing planning. Some important tools used by marketing audit are SWOT for internal and external environment where as PESTLE and Five Forces Analysis which focus only on the external environment. It can be viewed as an umbrella that covers efforts to assess customer needs and wants and to understand community patterns. The external environment is reviewed at micro and macro level. Definition: The marketing Audit has been defined by Phillip Kotler strategic market auditing (1977) as a comprehensive, systematic, independent and periodic examination activities and resources in order to determine problem areas and opportunities and to recommend a plan of action. As per the definition: Marketing Audit is Comprehensive, systematic, independent and periodic features. In simple word marketing audit is the complete review of the environment that includes both internal and external environments of any organization. The marketing audit follows the following areas as components of marketing audit:  · Environmental Audit which includes Macro Environmental Audit and Micro Environmental Audit.  · Marketing Strategy Audit  · Marketing Organization Audit  · Marketing System Audit  · Marketing Productivity Audit  · Marketing Function Audit Processes and techniques used for auditing the marketing auditing environment follows simple three steps are: a) Agreement on objectives, scope and approach: Marketing auditor must prepare for the marketing audit by holding discussion with the CEO and the executive staff and briefly reviewing some financial and marketing data. Often objectives are discussed in the meeting such as determine how the market views the company and its competitors, recommending a pricing policy, determining sale activity. The audit would cover the marketing operations of the company as a whole. b) Data collection: More time is spent on the gathering data. More auditors are involved when the project is large. Auditor has to spent time in deciding what question to be asked, who will be interviewed and so on so forth. Daily reports of the interviews are to be written up and reviewed. c) Report preparation and presentation: When the data gathering is over, auditor prepares notes for a visual and verbal presentation to the company officer. Techniques used for auditing the marketing environments are as follows. 1) SWOT Analysis: It is one of the most important tools of marketing audit. It helps a lot of help to the marketers and is used at the beginning of the marketing audit process. It has advantages as well as drawbacks. Some of the drawbacks are subjective and cannot be relied too much. Therefore it should be used as a guide in the marketing planning and not as a prescription to the process. 2) PESTLE Analysis: Various factors of the marketing is analyzed by PEST analysis that effects upon the marketing process. An organization that is carrying the analysis needs to study the environmental factors that are internal and external. 3) Five Force Analyses: This is an analysis that helps the marketers to have a clear picture of competitors for the market. This analysis has some similarities with PEST analysis. In this analysis the marketer goes through five areas of concerns. Analyze and evaluate the external environment of the organization by using PEST framework, Porters Five Forces model and Product life cycle. Companys profile: Tesco runs more than 2300 supermarkets and convenience stores in the UK, Ireland, Central Europe and Asia. It is operating in almost areas such as gasoline retail (Tesco Express) small urban stores (Tesco Metro) hypermarkets (Tesco Extra) and Financial service (Tesco Personal Finance). It covers up to 35% stake in US grocery. It is the leading online grocery store and is now expanding its business with a TV channel and a retail based education institution. A) A PEST Analysis of the industry was then undertaken to examine the local, national and global influence of political, economic, social and technological factors to understand opportunities and threats well. An assumption was made that most of these ( political, economic, social, legal and environmental ) factors would, to some extent apply to the retail industry in Sweden: Political: Following the European Integration and Free Trade Agreements, the market has opened British Companies to invest in Eastern European. It has 60 stores in Hungary. Lidl is fighting hard to maintain its market share with an aggressive pricing strategy against Tesco. Economic: Retail industry is fairly recession proof and also very sensitive to interest rate. Because of September 11 events, the world economy have suffered heavily, stocks were plummeting and prices are low all time. However the world economy is up after the September 11th attack. Consumers are optimistic and retail industry is once again boosting. Social: There are changes in consumer taste and lifestyle present both opportunities and threats for the retail industry. There are alternative Sweden national retailers which poses additional threats to the Tesco while entering in the Sweden market industry. Technical: Introduction of online shopping via internet is now a common place in retailing. IT system undertakes a paperless operation, the management and administration of the company which are monitored by the secured severs, it provides a flexible base for running the business. Sweden is at the forefront of technologically developed with national companies like Ericsson, hence Tesco gets an advantage of developed logistics and distribution channels already in place. One other tool that will be used in these areas is Porter Five Forces. This model can be used to good analytic effect alongside other models such as the SWOT and PEST analysis tools. Five Forces analyses five important in the determination of competitive power and these are:  · Buyers power:  · Suppliers power:  · Rivalry among competitors:  · Threat of new entrants:  · Threat of substitute product Problems faced by Tesco can be explained by Porters five forces including of the threat of substitutes from other supermarkets, buyer power, supplier power and the power of customer. Buyer power also decides the prices in the market. If products are expensive in Tesco then they will purchase from Sainsbury. This mean market is disciplined which make the pricing is disciplined as well. This in turn stops them to destroy the market in a profit war. Supplier power is an important part of this model. Supplier power is wielded by suppliers demanding that retailers should pay them certain price for their goods supplied. There is always a threat of substitution, although Tesco tries to ensure brand image and quality by having the best value for the products. Tesco acknowledges the fact that there have always been threats from the competitors and new entrants into the markets and therefore always plan to improve upon developments in its stores. Carry out an environmental audit for a given organization: PESTLE (Political, Economic, Social, Technological, Ecological, Legal and Environment) Among the above PESTLE analysis Political, Economic, social and Technological factors are implemented as a technique for the auditing of the marketing environment. Political/ legal:- An environment of marketing at any nation is affected due to the political reasons. There should be the management of change once there is a change in the political condition and situation. The system of nation keeps on changing if there is a lack of stability in politics and the organization should change the marketing strategies as per the changing environment so that the organization can exist in the changing environment. Economic:- Economics plays a vital role in the marketing environment audit. A country with weak economy cannot compete in the international market. To be successful in the marketing there should be a sound financial transaction of an organization. Some of the components of economic factors for environmental audit are: Interest rates, Business cycles, Investment policies. There should be good investment policies for the investment by the nation so that the interest of the investor in investment increases which helps to raise financial stability in the nation. Social and cultural:- Social and cultural refer to the tradition and costumes or belief of people living in a particular geographical region. Social value and norms sometimes becomes the barrier to the marketing environment. There is vast different in the culture and tradition of eastern and western societies as a result of it the culture of eastern may not be suitable for western and vice versa. The marketing depends upon the culture and tradition of any geographical area. S Technological:- In this competitive age technological changes plays a vital role in the marketing. All the developed countries have been successful due to the drastic changes in the technology and their capacity to cope with changing technology. Different technologies can be used for the auditing of the marketing environment. SWOT analysis:- SWOT analysis includes strength, weaknesses, opportunity and threats for an organization. Strength and opportunities are the positive aspect of an organization whereas weaknesses and threats are negative. Similarly strengths and weaknesses are internal environment whereas opportunity and threats are external. Low cost of production and sales, good information about the market and sound finance of the organization are the strengths and lack of communication and low quality of goods are the weaknesses. Similarly lack of competition and expansion of the market is the opportunities whereas control from pressure groups, lack of political and system stability are the threats for any organization. PORTERS five forces model:- It consists of five main points that are listed below: Bargaining power of the customers: It is found in the open or the competitive market where the customer has the advantage over the suppliers or the sellers. A consumer has the choice of quality and the rate and if the supplier fa

School Psychologist :: essays research papers

The purpose of this informative interview was to develop a better understating of certain aspects of the School Psychologist that are of interest to me. My interviewee for the Psy 600 interview assignment was Elsie, a school psychologist intern for the Board of Education. I have conducted this interview over the phone. In preparation for the interview, I picked the questions from professor’s guidelines, that I felt important for helping to persuade myself to go into school psychologist field.   Ã‚  Ã‚  Ã‚  Ã‚  Before becoming a school psychologist, Elsie has been involved in general education for 7 years and in special education for 6 years. While working with special education population, she has developed a strong interest in learning to identify the main cause of behavioral and emotional problems in children. Therefore, she learned that the School Psychologist professional training would enable her to explore her career in area of special education.   Ã‚  Ã‚  Ã‚  Ã‚  Elsie’s favorite part of the job is the evaluation process that involves the: assessments and other psychological testing. The most important part of the assessment is identifying the problems associated with learning and behavior. Elsie said that the assessments are something like a â€Å"detective work,† but of course nature of work, is different. Elsie’s least favorable part of the job is the enormous amount of administrative paperwork to be completed and submitted to the principal and other administrative staff.   Ã‚  Ã‚  Ã‚  Ã‚  Elise also mentioned the importance of the School Based Support Team within the school system. The SBST consists of: education evaluator, social worker, and a school psychologist. However, when the education evaluators were discontinued from the school system, the SBST became a IEP team. The IEP team consists of. Social Worker and School Psychologist. The advantage of being part of the team is to make the evaluation process easier. When asked about the preferable counseling interventions, Elsie said that there was no one size fits all interventions and it must be based on individual needs of every student. One of the crucial elements of evaluation process, from Elise’s experience, is a class observation.

Medical Home Practice-Based Care Coordination

Medical Home Practice-Based Care Coordination: A Workbook By: Jeanne W. McAllister Elizabeth Presler W. Carl Cooley Center for Medical Home Improvement (CMHI) Crotched Mountain Foundation & Rehabilitation Center; Greenfield, New Hampshire Beyond the Medical Home: Cultivating Communities of Support for Children/Youth with Special Health Care Needs Funded by: H02MC02613-01-00 United States Maternal and Child Health Bureau, Integrated Services for CSHCN, HRSA June 2007Workbook Contents This workbook includes the tools and supports needed for a primary care practice to develop their capacity to offer a pediatric care coordination service; particularly for children with special health care needs. The health care team, determined to develop such an explicit service, makes an assessment of current care coordination practice and frames their improvement efforts to achieve proactive comprehensive practice-based care coordination.Tools included in this resource are: a definition of care coordi nation in the medical home, a care coordination position description, a framework for care coordination services including structures and processes, strategies for the protection of devoted staff time, and a logical sequence of care coordination improvement ideas offered in the context of the Model for Improvement (Langley, 1996). Each tool can be used as is or it can be customized in a manner which best fits your practice environment and the strategic plans your organization holds for medical home improvement activities.Table of Contents Medical Home Practice Based Care Coordination Medical Home Care Coordination A Definition & A Vision Is It Medical Home Care Coordination? A Checklist Medical Home (Practice Based) Care Coordination – Position Description – A Worksheet A Medical Home (MH) Care Coordination Framework – Framework – Worksheet Time Protection Tips & Strategies †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 3 †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦5 †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 6 †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦7 †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦8 †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦9 †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 10 †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 11Care Coordination Development: The Model for Improvement †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦12 Care Coordination Aim Statement †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦13 Care Coordination Outcomes †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦14 Plan Do Stud y Act (PDSA) Worksheet & Examples †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦15 1) Care Coordination Role/System †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦16 2) Care Coordination – Needs Assessment †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦18 3) Comprehensive Care Planning †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦20 Medical Summary, Action & Emergency Plans 4) Transition to Adult Care & Services †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦22 5) Community Outreach & Resources †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦24 Appendices A.Websites and References †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. †¦.. 26 2 Medical Home – Practice-Based Care Coordination This workbook is designed to suppor t practice-based quality improvement teams in their efforts to build comprehensive primary care â€Å"medical homes†. The focus is specifically upon the professional role development for the provision of practice-based care coordination. The ideal care scenario is one where the staff within the medical home is proactively prepared to support the central care giving role of families.The role of care coordination discussed within this workbook is one designed in the service of children/youth with special health care needs (CYSHCN). It is acknowledged that care coordinators in different environments will apply their skills and efforts toward the care of all children as well as adults with special needs or chronic health conditions; you should find the structures and processes offered within suitably applicable.Workbook Goals and Objectives: Goal: To put forth a practice-based medical home care coordination framework from which practices can select and suitably customize. Content s include a medical home care coordination checklist, definition, position description, model framework with structures and processes, and strategies for effective and successful care coordination development and implementation. Objectives: 1) Define practice-based care coordination for children with special health care needs in a medical home ) Select and appropriately modify a position description that fits each unique medical home improvement team environment 3) Use a care coordination model framework to fit the role well within each practice environment 4) Draw from a list of time protection and resource allocation strategies those with the best fit for the practice environment and related improvements 5) Develop tests of change (PDSA – plan, do, study, act) for the incremental development of a comprehensive care coordination service model to include: care services, assessment of needs, care planning, transition support, and community outreach with resource linkages.It is established in the literature that the medical home is meant to be a centralizing resource for children and families, particularly for CYSHCN (AAP Medical Home Advisory Committee, 2002) Evidence is building that care coordination is essential to a medical home (Antonelli, 2004). It has been suggested that you cannot be a strong medical home without the capacity to link families with a designated care coordinator; this is the ideal.The policy statement issued by the American Academy of Pediatrics on Care Coordination (CC) describes CC as complex, time consuming, even frustrating but as key to effective management of complex issues in a medical home; and states that a designated care coordinator is necessary to facilitate optimal outcomes and prevent confusion. Care coordination takes resources and time. Practices need to be reimbursed for this labor intensive role (AAP Committee on Children with Disabilities, 1999).Horst, Werner, and Werner (2000) state that in all types of systems, care coordination is an essential element to ensure quality and continuity of care for CSHCN and their families. In a 10 point strategy to 3 achieve transformational change within health care for all, issued by the Commonwealth Fund, care coordination is cited as one of ten key components to organize care and information around the patient (Davis, K. 2005). Ideal care coordination provides timely access to services, continuity of care, family support, strengths-based rather than deficit-based thinking and advocacy.This is very time consuming, whether accomplished by parents or by parent professional partnerships (Presler, 1998). At the front lines of care, in the medical home Antonelli (2004) states that without the ability to support care coordination at the level of the medical home, barriers to achieve the Healthy People 2010 objectives remain. In the Future of Children (2005) the author claims that care coordination requires (at the very least) adequate personnel and time and i s often limited in primary care by lack of the very time and resources necessary.This is substantiated by the AAP Periodic Survey of Fellows #44, (2000), by a national Family Voices Survey (2000) with parents reporting their physicians have the skill for coordination but are difficult to access and have minimal time available for care coordination activity/implementation. Similarly a survey of state Title V Directors and their perception of barriers to care coordination in the medical home includes: time, reimbursement, lack of physicians, lack of skill/training, and limited cultural effectiveness.Successful medical homes result when partnerships with families offer fully implemented practice-based care coordination. Proactive care coordination and care planning are fundamentally essential for improved care quality, access to services and resources, health and function of children and youth, and quality of life as well as improved systems of care. No medical home will achieve optima l comprehensive, coordinated and compassionate care without dedicated time and resources to develop, implement, and evaluate a complement of care coordination activities.Such an investment is favorable in terms of cost and benefit for children/youth and families, primary care practices and their broader health care systems. In summary, care coordination: Is accomplished everyday by families with and for their children and youth, but Support is desirable, feasible and beneficial coming from the medical home Requires critical funding and protected time Requires tested tools and strategies (some are included in this workbook, others have been developed and continue to evolve) Is a defining characteristic (element) of a fully implemented and comprehensive medical home Medical Home Care Coordination – A Definition The literature offers several definitions of care coordination but most have been written for application across varied health care environments such as hospitals, speci alty based centers, community & home health agencies. Few definitions focus exclusively on the distinctions found within the primary care medical home for the role of practice-based care coordinator.The focus of the Center for Medical Home Improvement is on the primary care practice with the provision of team-based care coordination, delivered from the centralizing resource of a primary care medical home with physician leadership and by experienced nurses, social workers, and/or comparable professionals. Care CoordinationPractice-based care coordination within the medical home is a direct, family/youth-centered, team oriented, outcomes focused process designed to: Facilitate the provision of comprehensive health promotion and chronic condition care; Ensure a locus of ongoing, proactive, planned care activities; Build and use effective communication strategies among family, the medical home, schools, specialists, and community professionals and community connections; and Help improve , measure, monitor and sustain quality outcomes (clinical, functional, satisfaction and cost (McAllister, et al, 2007)A Vision for Practice Based Care Coordination Children, youth, and families have seamless access to their team, enhanced by they availability of a designated care coordinator who facilitates a team approach to family-centered care coordination services. (McAllister, et al, 2007) 5 CC CHECKLIST Is It Medical Home Care Coordination? Checklist – how are you doing? What elements are in place, which require some additional attention? NO / PARTIALLY/ YES 1) Families know who their care coordinator is and how to access him or her (or their backup)? ) Values of family-centeredness are known to the medical home team and drive the development and provision of care coordination? 3) A medical home care coordination position description is established; roles/activities are clearly articulated and care coordination training and education is available? 4) Administrative lead ership helps to develop/support a care coordination service system; protected time allows for CC role development? 5) CYSHCN identification and assessment of child/family needs/unmet needs are completed; care planning is a core CC/medical home response? ) Education and counseling are offered as an essential part of medical home care coordination? 7) Care coordination includes comprehensive resource information, referrals, and cross agency/organization communication? 8) Child/family advocacy is a part of care coordination 9) Families are asked for feedback about their experiences with health services/care coordination? 10) Medical home system improvements are implemented simultaneously with the development of care coordination (care coordinator contributes to this quality improvement process)? 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 1 2 2 3 3 1 2 3 1 2 3 Total score: _________/ out of 30. Notes: 6 Medical Home (Practice Based) Care Coordination – Position Description The care coor dinator works within the context of a primary care medical home, from a team approach, and in continuous partnership with families and physicians to promote: timely access to needed care, comprehension and continuity of care, and the enhancement of child and family well being.Care Coordination Qualifications: The care coordinator shall have: Bachelor’s preparation as a nurse, social worker, or the equivalent with appropriate past experience in health care Three years relevant experience, or the equivalent, in community based pediatrics or primary care, particularly in the care and service of vulnerable populations such as children/youth with special health care needs (CYSHCN) Essential leadership, advocacy, communication, education and counseling, and resource research skills Core philosophy or values consistent with a family-centered approach to care Culturally effective capabilities demonstrating a sensitivity and responsiveness to varying cultural characteristics and belie fs Medical Home Care Coordination Responsibilities The care coordinator will: 1) Demonstrate and apply knowledge of the philosophy/ principles of comprehensive, community based, family-centered, developmentally appropriate, culturally sensitive care coordination services 2) Facilitate family access to medical home providers, staff and resources 3) Assist with or promote the identification of patients in the practice with special health care needs (such as CYSHCN); add to registry and use to plan and monitor care 4) Assess child/patient and family needs and unmet needs, strengths and assets 5) Initiate family contacts; create ongoing processes for families to determine and request the level of care coordination support they desire for their child/youth or family member at any given point in time 6) Build care relationships among family and team; support the primary care-giving role of the family 7) Develop care plan with family/youth/team (emergency plan, medical summary and action p lan as appropriate) 8) Carry out care plans, evaluate effectiveness, monitor in a timely way and effect changes as needed; use age appropriate transition timetables for interventions within care plans 9) Serve as the contact point, advocate and informational resource for family and community partners / payers 10) Research, find, and link resources, services and supports with/for the family 11) Educate, ounsel, and support; provide developmentally appropriate anticipatory guidance; in a crisis, intervene or facilitate referrals appropriately 12) Cultivate and support primary care & subspecialty co-management with timely communication, inquiry, follow up and integration of information into the care plan 13) Coordinate inter-organizationally among family, medical home, and involved agencies; facilitate â€Å"wrap around† meetings or team conferences and attend community/school meetings with family as needed and prudent; offer outreach to the community related to the population o f CYSHCN 14) Serve as a medical home quality improvement team member; help to measure quality and to identify, test, refine and implement practice improvements 15) Coordinate efforts to gain family/youth feedback regarding their experiences of health care (focus groups, surveys, other means); participate in interventions which address family/youth articulated needs 7 Position Description WorksheetMedical Home (Practice Based) Care Coordination Position Description Responsibilities Worksheet – Customize for Your Practice Care Coordination in a Medical Home – The Care Coordinator will: 1) Demonstrate and apply knowledge of the philosophy/ principles of 2) 3) comprehensive, community based, family-centered, developmentally appropriate, culturally sensitive care coordination services Facilitate family access to medical home providers, staff and resources Assist with or promote the identification of those with special health care needs (such as CYSHCN); add them to the regi stry and use it to plan and monitor care Assess child/patient and family needs/unmet needs, strengths and assets Initiate family contacts; create ongoing processes for families to determine and request the level of care coordination support they desire for their child, youth or family member at any given point in time Build care relationships among family and team; support the primary care giving role of the family Develop care plan with family/youth/team (emergency plan, medical summary and action plan as appropriate) Carry out care plans, evaluate effectiveness, monitor in a timely way and make changes as needed; use age appropriate transition imetables for interventions within care plans Serve as contact point, advocate and informational resource for family and community partners/payers Research find, and link resources, services and supports with/for the family Educate, counsel, and support; provide developmentally appropriate anticipatory guidance; in a crisis, intervene or fac ilitate referrals appropriately Cultivate and support primary care & subspecialty co-management with timely communication, inquiry, follow-up and integration of information into the care plan Coordinate interorganizationally among family, the medical home, and involved agencies; facilitate â€Å"wrap around† meetings or team conferences and attend community/school meetings with family as needed and prudent; offer outreach to the community related to the population of CYSHCN Serve as a medical home quality improvement team member; help to measure quality and to identify, test, refine and implement practice improvements Coordinate efforts to gain family feedback regarding their experience with health care(focus groups, surveys, other means); participate in interventions that address family/youth articulated needs Accept Reject 4) 5) 6) 7) 8) 9) 10) 11) 12) 13) 14) 15) *** Add additional key responsibilities here (use additional paper): 8 A Medical Home (MH), Team Based, Care Co ordination (CC) Framework Fundamental Tools Structures Medical Home Interventions Access to Medical Home, Health Care and Other Resources Identify and register the CYSHCN opulation Establish with families effective means for medical home/office access Provide accessible office contract for family and community agencies Catalog resources to link families to appropriate educational, information and referral sources Promote and â€Å"market† practice-based care coordination to families and others (e. g. brochures, posters, outreach efforts) Establish alliances with community partners Facilitate practice & family linkages with agencies (e. g. family support, schools, early intervention, home care, day care &agencies offering respite, housing, & transportation) Align transition support activities with schools & other groups Collaborate to improve systems of care for CYSHCN (families, payers, provides, and agencies) Community Connections Fundamental Processes Proactive Care Plannin g Medical Home Interventions Help to maintain health and wellness & prevent secondary disease complications Maximize outcomes (e. g. lleviation of the burden of illness, effective communication across organizations, enrollment in needed services, and school attendance/success) Listen, counsel, educate, & foster family skill building Screen for unmet family needs Develop written care plans; implement, monitor and update regularly Plan for future transition needs; incorporate into plan of care Facilitate subspecialty referrals, communication & help family integrate recommendations of specialists Link family, staff to educational/financial resources †¢ †¢ †¢ †¢ Establish alliances with community partners Facilitate practice & family linkages with agencies (e. g. family support, schools, early intervention, home care, day care & agencies offering respite, housing, & transportation) Align transition support activities with schools & other groups Collaborate with famil ies, payers, providers and community agencies to improve systems of care for CYSHCN Improving and Sustaining Quality 9 Framework Worksheet A Medical Home (MH) Care Coordination Framework – WORKSHEET Fundamental Structures Access to Medical Home, Health Care and Other Resources Who? How? Medical Home InterventionsIdentify and register the CYSHCN population Establish with families effective means for medical home/office access Provide accessible office contract for family and community agencies Catalog resources to link families to appropriate educational, information and referral sources Promote and â€Å"market† practice-based care coordination to families and others (e. g. brochures, posters, outreach efforts) Establish alliances with community partners Facilitate practice & family linkages with agencies (e. g. family support, schools, early intervention, home care, day care &agencies offering respite, housing, & transportation) Align transition support activities wit h schools & other groups Collaborate to improve systems of care for CYSHCN (families, payers, provides, and agencies) Community Connections Fundamental Processes Proactive Care Planning Medical Home InterventionsHelp to maintain health and wellness & prevent secondary disease complications Maximize outcomes (e. g. alleviation of the burden of illness, effective communication across organizations, enrollment in needed services, and school attendance/success) Listen, counsel, educate, & foster family skill building Screen for unmet family needs Develop written care plans; implement, monitor and update regularly Plan for future transition needs; incorporate into plan of care Facilitate subspecialty referrals, communication & help family integrate recommendations of specialists Link family, staff to educational/financial resources †¢ †¢ †¢ †¢ Establish alliances with community partners Facilitate practice & family linkages with agencies (e. g. amily support, schools, early intervention, home care, day care & agencies offering respite, housing, & transportation) Align transition support activities with schools & other groups Collaborate with families, payers, providers and community agencies to improve systems of care for CYSHCN Who? How? Improving and Sustaining Quality 10 Time Protection Tips & Strategies The statement (on page 4) that no medical home will achieve optimal comprehensive, coordinated and compassionate care without dedicated time and resources to develop, implement, and evaluate a complement of care coordination activities warrants a few tips about how to achieve such dedicated time.Ideas for the successful implementation of practice based care coordination include administratively supported techniques and the resulting implemented care coordination (systematic) processes. Consider the following suggestions for time protection and use them to craft your own strategic approaches. Administrative Strategies for Achieving Some  "Think† and Implementation Time Personnel – proactively allocate a block of dedicated time. This includes the number of hours, days and time blocks or hours and how those hours will be prepared for, spent and accounted for. (This can be done as a trial or test of change) You may need a private place, an office, or even a â€Å"my care coordination development hat is on today† sign!Clear activities – Use the position description and the CC framework on page 9 to select the focus and logical progression of this role development and how time will be spent Determine how you will document and/or account for this time Team based care coordination – determine how you will allow for the development of care coordinator – family partnership. Could there be a designated clinic time for specific group of CYSHCN, or a special condition focused approach with a care coordination protocol? Some practices have held what is referred to as a DIGMA (drop in grou p medical appointments) for a group of families with children with similar conditions. A DIGMA can take on many forms such as family education, community resource connections, or even time for care coordination introduction and development with the opportunity to meet, greet and complete care plans.Approaches Helpful to Building Time into Your System Use your population identification system to determine who needs care coordination Use the development of your CC role to establish systematized screening assessments and resulting care planning and monitoring Hold medical home related staff meetings; offer education regarding CYSHCN and gain buy-in and staff understanding for the value of providing care coordination Engage families who can educate staff about the complexity of their child’s needs Create a reporting line to senior leaders from the Care Coordinator so that CC development is built into their role expectation Develop the capacity for care coordination â€Å"roundsà ¢â‚¬  by discussing direct CC efforts around individual children and youth with staff; gaining the input of colleagues will help you with staff education and their buy in to the medical home and practice-based care coordination approach; all will then learn about complex health and community based needs and resources Maximizing Reimbursement for Care Coordination: Ensuring affordability and sustainability by: Developing smart legitimate up-coding; Tracking CC data (service/outcome) to negotiate new payment opportunities Prepare for the use of new codes (care plan oversight) Become aware of and access Title V supports 11 Care Coordination Development: 1) The Model for Improvement 2) Care Coordination Aim Statement 3) Plan Do Study Act (PDSA) cycles or â€Å"tests of change†Model for Improvement Questions 1) What are we trying to accomplish? Medical Home Improvement Responses Medical Home – Care Coordination 2) How will we know that a change is an improvement? Measures – Medical Home Index, Medical Home Family Index & Survey, Other 3) What changes can we make that will result in an improvement? Good ideas – ready for use (e. g. CC definition, job description, framework & activities, PDSA examples 12 2) Care Coordination Aim Statement A good aim statement includes the following elements: Population – CYSHCN Timeframe – by when Intent – what/why Stretch goals – e. g. identify 100% CSHCN Example: Overarching Aim – Care CoordinationBetween Learning Session 2 and spring of 2006 we will customize and use a model of medical home care coordination for children/youth with special health care needs so that a position description and framework of activities are explicit, with time protected and accounted for and ~ 75% (goal) of children, youth and families report that they: Know who their care coordinator is Know they are receiving care coordination Participate in decisions about the level of care coordination needed Are satisfied with their access to care, care coordination, and resources (most of the time) For Veterans – Advanced Care Coordination Aim Goals Youth and families report that: A transition timetable is shared among family, practice and community professionals They have coordinated support getting their child’s needs met within the community and from sub-specialists 13 Thinking Through Some Measurement Ideas – For Practice-Based Care Coordination – PDSA Cycles Care Coordination Outcomes Family satisfaction decrease in worry and frustration (CMHI survey tools) increased sense of partnership with professionals (CMHI survey tools) improved satisfaction with team communication (CMHI survey tools)Staff satisfaction improved communication and coordination of care improved efficiency of care elevated challenge and professional role Improved child/youth outcomes Decrease in ER visits, hospitalizations, & school absences (family, plan report) Increase in a ccess to needed resources (CMHI survey tools) Enhanced self-management skills (CMHI survey tools) Improved systems outcomes decreased duplication decreased fragmentation improved communication and coordination (CMHI Medical Home Index) 14 PDSA Worksheet PDSA Team: Aim: CMHI Plan-Do-Study-Act Worksheet PLAN: Objective: (Including details (who, what, where, when) What additional information will you need to take action? What do you predict will happen?How will you know your change is an improvement? DO: Was the plan carried out? What was observed that was not part of the plan? STUDY: What happened? Is this what you predicted? What new knowledge was gained? ACT: As a result, list next actions: Are there organizational forces that will help or hinder efforts? Objectives for next test of change: 15 CMHI Plan-Do-Study-Act (PDSA) Worksheet PDSA Example Team: #1 Care Coordination Role/System Aim: Use from page 13 or create own PLAN: Objective: (Including details (who, what, where, when) We will develop and test a clearly defined system of care coordination (CC) services using strategies that fit our practice environment.This will include the use of a: 1) clear CC definition, 2) CC position description and 3) CC framework with an outline of activities. CC role, contact and access information will be explicit for families. {Our test of change will include dedicated time for the CC to share plans with staff and implement CC PDSA cycles (see examples in following pages). We will feed back lessons learned to our Medical Home Improvement team for guidance and direction. What additional information will you need to take action? Knowledge of and securing the availability of senior leader support with designation of one (or more) staff members to provide CC leadership What do you predict will happen?There will be false starts with â€Å"tyranny of the urgent† keeping us from our task; our will, ideas and execution will overcome this in the end. How will you know your ch ange is an improvement? Staff/families begin to ask for care coordination / CC activities (e. g. care plan); selected outcome measures improve (see page 14) DO: Was the plan carried out? What was observed that was not part of the plan? STUDY: What happened? Is this what you predicted? What new knowledge was gained? ACT: As a result, list next actions: Are there organizational forces that will help or hinder efforts? Objectives for next test of change: 16 PDSA Worksheet PDSA Team: Aim:CMHI Plan-Do-Study-Act Worksheet PLAN: Objective: (Including details (who, what, where, when) What additional information will you need to take action? What do you predict will happen? How will you know your change is an improvement? DO: Was the plan carried out? What was observed that was not part of the plan? STUDY: What happened? Is this what you predicted? What new knowledge was gained? ACT: As a result, list next actions: Are there organizational forces that will help or hinder efforts? Objectives for next test of change: 17 CMHI Plan-Do-Study-Act Worksheet PDSA Example Team: #2 Care Coordination Needs Assessment Aim: Use from page 13 or create own PLAN:Objective: (Including details (who, what, where, when) With MH lead physician review pending CYSHCN visits; select 3 CYSHCN who will benefit from an assessment for care coordination. By â€Å"a week from next Tuesday† complete an assessment (e. g. parent/youth screening tool in appendices behind page 26) either before the office visit or by pre-visit phone call. Begin care planning process with child/youth and family What additional information will you need to take action? Listing of pending CYSHCN visits from the CYSHCN list or â€Å"registry† What do you predict will happen? Some false starts finding the right CYSHCN and with timing; we will succeed if persistent over slightly longer time span How will you know your change is an improvement?Follow up with 3 families in 2 weeks to determine if pre-visit assessm ent and follow-up planning are helpful and what needs to be added/improved; review value with lead physician as well. DO: Was the plan carried out? What was observed that was not part of the plan? STUDY: What happened? Is this what you predicted? What new knowledge was gained? ACT: As a result, list next actions: Are there organizational forces that will help or hinder efforts? Objectives for next test of change: 18 PDSA Worksheet PDSA Team: Aim: CMHI Plan-Do-Study-Act Worksheet PLAN: Objective: (Including details (who, what, where, when) What additional information will you need to take action? What do you predict will happen?How will you know your change is an improvement? DO: Was the plan carried out? What was observed that was not part of the plan? STUDY: What happened? Is this what you predicted? What new knowledge was gained? ACT: As a result, list next actions: Are there organizational forces that will help or hinder efforts? Objectives for next test of change: 19 CMHI Plan-D o-Study-Act Worksheet PDSA Example #3 Comprehensive Care Planning Team: Aim: Use from page 13 or create own PLAN: Objective: (Including details (who, what, where, when) 1) Develop/choose care plan medical summary and use with 5 identified CYSHCN/week. 2) Add an emergency plan if warranted. ) Study provider and family feedback and integrate to improve the plan and the process for plan use. Create immediate action plan for how to meet resource, educational and other needs of CYSHCN/patient and family 4) Use lessons learned to share, engage, educate and spread medical home to staff. What additional information will you need to take action? Sample care plans to choose from using team priorities; identified CYSHCN with pending visit to initiate plan with. Also identify educational needs of staff /families. What do you predict will happen? Will start slow, 1-2 per week and pick up speed to reach 5. Value will result in better preservation of care coordinator time to complete plans, thus i ncreased use of CC and team process.Ultimately, we may schedule comprehensive care planning â€Å"rounds† with team/staff; review 3-5 CYSHCN/patients who are receiving this care coordination. Use rounds to review successes, challenges, needs of child/family with staff and address questions. How will you know your change is an improvement? Review with families for benefit, follow up in 4-6 weeks; review also with staff DO: Was the plan carried out? What was observed that was not part of the plan? STUDY: What happened? Is this what you predicted? What new knowledge was gained? ACT: As a result, list next actions: Are there organizational forces that will help or hinder efforts? Objectives for next test of change: 20 PDSA Worksheet PDSA Team: Aim: CMHI Plan-Do-Study-Act Worksheet PLAN:Objective: (Including details (who, what, where, when) What additional information will you need to take action? What do you predict will happen? How will you know your change is an improvement? DO : Was the plan carried out? What was observed that was not part of the plan? STUDY: What happened? Is this what you predicted? What new knowledge was gained? ACT: As a result, list next actions: Are there organizational forces that will help or hinder efforts? Objectives for next test of change: 21 CMHI Plan-Do-Study-Act Worksheet PDSA Example #4 Transition to Adult Care & Services; Up-coding to maximize reimbursement Team: Aim: Use from page 13 or create own PLAN:Objective: Have MD & Care Coordinator jointly see (2) YSHCN & family for transition visit; use a transition assessment (timetable) checklist to guide the visit and align activities with community partners. Bill for visit – document nature of complexity Details (who, what, where, when) CC Schedules 2 YSHCN for transition care plan visit next week, with family permission informs/communicates with key community partners about assets & needs. Codes for â€Å"99214† for 60 minute visit with established patient and document extent and complexity of the visit What additional information will we need to take action? – Extract from list of CYSHCN youth over 14 due for visit; communicate with family and learn community partners – Clarify with senior leaders ability to track reimbursement results for these visits What do we predict will happen? (E. g.May take time to match YSHCN with open slots; will need to follow up with payers for denials and use documentation to justify activities). How will you know your change is an improvement? Review with family staff; community partners. Select other ongoing measures (p14) DO: Was the plan carried out? What was observed that was not part of the plan? STUDY: What happened? Is this what you predicted? What new knowledge was gained? ACT: As a result, list next actions: Are there organizational forces that will help or hinder efforts? Objectives for next test of change: 22 PDSA Worksheet PDSA Team: Aim: CMHI Plan-Do-Study-Act Worksheet PLAN: Obj ective: (Including details (who, what, where, when) What additional information will you need to take action? What do you predict will happen?How will you know your change is an improvement? DO: Was the plan carried out? What was observed that was not part of the plan? STUDY: What happened? Is this what you predicted? What new knowledge was gained? ACT: As a result, list next actions: Are there organizational forces that will help or hinder efforts? Objectives for next test of change: 23 CMHI Plan-Do-Study-Act Worksheet PDSA Example #5 Community Outreach / Resources Team: Aim: Use from page 13 or create own PLAN: Objective: (Including details (who, what, where, when) Plan for care continuity across the: medical home, school, and community agencies with 4 families and children/youth over the next four weeks.Use a selected communication strategy (fax back, email, NCR paper, electronic forum, other) to centralize key information with strengths, goals, care plans, access information, an d releases fostering cross organizational communication; the CC performs as a â€Å"hub of the wheel function† in these activities. What additional information will you need to take action? Identification of children/youth and families in need of transition and/or community-based coordination; identification of key community partners; consensus on communication strategy What do you predict will happen? Territorial barriers will crop up and family will need to be front and central to the process.How will you know your change is an improvement? Review with family and agencies whether there has been improved care communication, also consider other systematized outcome measures (see page 14). DO: Was the plan carried out? What was observed that was not part of the plan? STUDY: What happened? Is this what you predicted? What new knowledge was gained? ACT: As a result, list next actions: Are there organizational forces that will help or hinder efforts? Objectives for next test of c hange: 24 PDSA Worksheet PDSA Team: Aim: CMHI Plan-Do-Study-Act Worksheet PLAN: Objective: (Including details (who, what, where, when) What additional information will you need to take action?What do you predict will happen? How will you know your change is an improvement? DO: Was the plan carried out? What was observed that was not part of the plan? STUDY: What happened? Is this what you predicted? What new knowledge was gained? ACT: As a result, list next actions: Are there organizational forces that will help or hinder efforts? Objectives for next test of change: 25 Appendices A. Key Websites for Care Coordination Tools 1) Center for Medical Home Improvement (CMHI): www. medicalhomeimprovement. org 2) National Center for Medical Home Initiatives (AAP) www. medicalhomeinfo. org 3) Utah Medical Home Portal www. medhomeportal. orgReferences 1) McAllister, J. W. , Cooley, W. C, Presler, E. Practice-Based Care Coordination: A Medical Home Essential. Pediatrics, Volume 120, Number 3, S eptember 2007, e1e11. 2) American Academy of Pediatrics, Medical Home Initiatives for Children with Special Health Care Needs Project Advisory Committee. The medical home. Pediatrics, 2002; 110:184-186. 3) American Academy of Pediatrics, Committee on Children with Disabilities. Care Coordination: Integrating Health and Related Systems of Care for Children with Special Health Care Needs, Pediatrics, 1999, Vol. 104:978-981. 4) American Academy of Pediatrics, Division of Health Policy Research.Periodic Survey of Fellows #44. Health Services for Children with and without Special Needs: The Medical Home Concept Executive Summary. Elk Grove Village, Illinois: American Academy of Pediatrics; 2000. Available at: www. aap. org/research/ps44aexs. htm. Accessed April, 2005. 5) Antonelli, R. , Antonelli, D. , Providing a Medical Home: The Cost of Care Coordination: Services in a Community-Based, General Pediatric Practice. Pediatrics (Supplement) 2004; Vol. 113: 1522-1528 6) Cooley, W. C. and M cAllister, J. W. Building Medical Homes: Improvement Strategies in Primary Care for Children with Special Health Care Needs. Pediatrics (Supplement) 2004; 113: 1499-1506. ) Davis, K. , Transformation Change: A Ten Point Strategy to Achieve Better Health Care for All. The Commonwealth Fund. Accessed at www. cmwf. org April 13, 2005. 8) Family Voices. What Do Families Say About Health Care for Children with Special Health Care Needs in California: Your Voice Counts. Boston, MA: Family Voices at the Federation for Children with Special Health Care Needs; 2000. 9) Future of Children, Health Insurance for Children; Care of children with Special Health Care Needs. Key Indicators of Program Quality. Available at www. futureofchildren. org/information2827/Accessed April 13, 2005. 10) Horst, , Werner, R. , & Werner, C. 2000) Case management for children and families Journal of Child and Family Nursing, 3, 5-14. 11) Langley, G. J. , et al. The Improvement Guide: A Practical Approach to Enhanc ing Organizational Performance. Jossey-Bass, San Francisco, 1996. 12) Lindeke, L. L. , Leonard, B. J. , Presler, B, Garwick, A, Family-centered Care Coordination for Children with Special Health Care Needs across Settings. Journal of Pediatric Health Care, Vol. 16, No. 6, November/December, 2002, 290-297 ** 13) Presler, B. (1998, March/April) Care Coordination for Children with Special Health Care Needs. Orthopedic Nursing, (Supplement), 45-51. 26 CMHI Center for Medical Home Improvement (CMHI) Crotched Mountain Foundation Greenfield, New Hampshire 2007 27

More Hyphenation of Phrasal Adjectives

More Hyphenation of Phrasal Adjectives More Hyphenation of Phrasal Adjectives More Hyphenation of Phrasal Adjectives By Mark Nichol Three types of phrasal adjectives are treated according to the same basic rules, as shown in the following (erroneous) examples, which are discussed and revised below each sentence. First, a definition: A phrasal adjective is a phrase consisting of two or more words that, when combined, constitute a single expression of modification of a noun. Phrasal adjectives are usually hyphenated when they precede a noun but left open when they follow one. 1. Embracing change is the only viable alternative to becoming a victim of the never ending cycle and escalating speed of innovation. The words never and ending team up to serve as a synonym for endless. Because they precede cycle, they are hyphenated to communicate their interrelationship as modifying elements: â€Å"Embracing change is the only viable alternative to becoming a victim of the never-ending cycle and escalating speed of innovation.† 2. The researchers highlighted the follow the herd mentality the students exhibited. A phrasal adjective can also consist of more than two words, as in this verb-article-noun idiom, which modifies mentality: â€Å"The researchers highlighted the follow-the-herd mentality the students exhibited.† 3. For New York Stock Exchange-listed organizations, the audit committee charter must include the committee’s duties and responsibilities. When a proper noun consisting of more than one word is linked with another word to form a phrasal adjective, an en dash is employed as a â€Å"superhyphen† to indicate that despite the number of words in the phrasal adjective, it consists of only two elements- the proper noun and the adjective listed: â€Å"For New York Stock Exchange–listed organizations, the audit committee charter must include the committee’s duties and responsibilities.† The original treatment mistakenly implies that the phrasal adjective is Exchange-listed, and that the three preceding words are unrelated, and the alternative â€Å"For New-York-Stock-Exchange-listed† is unwieldy and suggests that the elements of the proper noun are discrete. However, a better solution is to relax the sentence as shown here: â€Å"For organizations listed on the New York Stock Exchange, the audit committee charter must include the committee’s duties and responsibilities.† Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Grammar category, check our popular posts, or choose a related post below:30 Religious Terms You Should KnowDoes "Mr" Take a Period?The Difference Between "Shade" and "Shadow"