Nature And Impact Of Child Abuse And Neglect Essay Example

The following legislation affects Safeguarding children and young people in the UK- The United Nations Convention on the Rights of the child 1989 this includes childrens rights to protection from abuse, the right to express their views and be listened to, and the right to care and services for diabled children or children living away from home. Although different british governments have said that it regards itself bound by the Convention and refers to it in child protection guidance,it has not become part of UK law. Working together to safeguard children 2010 applies to those working in education, health and social services as well as the police and the probation service. It is relevant to those working with children and their families in the statutory, independent and voluntary sectors.

The document covers a summary of the nature and impact of child abuse and neglect, how to operate best practice in child protection procedures,the roles and responsibilities of different agencies and practitioners, the role of local safeguarding children boards,the processes to be followed when there are concerns about a child, the action to be followed when there are concerns about a child,the action to be taken to safeguard and promote the welfare of children experiencing, or at risk of,significant harm,the important principles to be followed when working with children and families, training requirements for effective child protection what to do if youre worried a child is being abused 2003 is a guide for professionals working with children which explains the processes and systems contained in working together to safeguard children.

The protection of children Act 1999 requires childcare organisations not to offers employment involving regular contact with children, either paid or unpaid, to any person listed as unsuitable to work with children on the Deaprtment of Health list and the Department for Education and Employments list 99. The criminal records bureau acts as a central access point for criminal records checks for all those applying to work with children and young people the children act 2004 sections 1-9 created a childrens commisioner for England, placed a duty on local authorities to appoint a Director of childrens services and an elected lead member for childrens services, who is accountable for the delivery of services.

It placed a duty on local authorities and their partners (including the police, health service providers and the youth justice system) to cooperate in promoting the wellbeing of children and young people and to make arrangements to safeguard and promote the welfare of children. The act also revised the legislation on physical punishment by making it an offence to hit a child if it causes mental harm or leaves a lasting mark on the skin

Case: University Health Services: Walk-In Clinic

Kathryn Angel has been hired as assistant director for ambulatory care at Harvard’s University Health Services. By implementing a triage system, she wanted to reorganize the Walk-In Clinic. The staff of the clinic includes 22 physicians, 2 registered nurses and 11 nurse practitioners.

  • Physicians : 40 hours per week, in blocks of three to four hours; in total 150 hours per week available to the Walk-In Clinic 12 hours in Walk-In Clinic
  • 16 hours meeting patients by appointment (including 2 half-hour periods ‘reserve time’) 5 on duty at the UHS infirmary
  • 7 on administrative and other matters
  • Registered nurse: eight-hour shifts, including one hour for lunch, can treat minor ailments without consulting a physician.
  • Nurse practitioner: eight-hour shifts, 45% of their ours are available to treat patients in the Walk-In Clinic Before the triage system

There was a lot of dissatisfaction due to the long waiting time between sign-in and treatment (in average 23 minutes). The image of the clinic was cold, inefficient and impersonal. Patients who requested specific physician had to wait an average of 40 minutes. If a nurse had to refer a patient to a doctor, the patient had to wait an average of 10 minutes to meet the doctor. The bottleneck was that all the nurses had to see all the patients initially, which led to inconsistency, too much variation in treatment and duplicated efforts.

The triage system

When the patient arrives, he/she has to fill in an Ambulatory Visit Form (AVF). A triage coordinator (highly experienced registered nurse) calls for the patient and spent 3 or 4 minutes per patient in a private room to summarize the patient’s problem. Then the triage coordinator determines whether the patient need to see a nurse practitioner or a physician, or whether the patient could handled better in another UHS service. Only if the patients their ailments fall under one of 13 categories, they can be triaged to a nurse practitioner, otherwise a physician’s authorization is required. Expanding these guidelines beyond the 13 ailments would require detailed treatment guides, but this expansion is planned in the near future. As Kathryn Angel, how do you evaluate the introduction of the triage nurses into the process of the Walk-in Clinic. The average total waiting time was more than expected (37.5 minutes, including triage time).

There were two main problems: the triage coordinators are sometimes classifying patients as physician/nurse practitioner to maintain the flow when they feel the practitioners are backed up. So the physician’s share of patients gets increased in overload situations. The mean waiting time to see a physician was much longer (25.2 minutes) than the mean waiting time to see a nurse practitioner (6.7 minutes). 24% of all patients ask to see a specific doctor or nurse. The waiting time for triage is always the same, but patients who asked for a specific provider had to wait an average of 8.6 minutes longer. Two of the five doctors on duty are 100% occupied with ‘walk-in appointments’. So the available MD resources decrease by 40% and fills up the waiting room. People want a practitioner who knows them well, but the aim of the UHS Walk-In Clinic is to provide the best possible care to all their patients, particularly those whose medical needs are almost urgent.

How can the waiting times be improved and the complaints be reduced? First of all, they need to expand the 13 nurse practitioner guidelines and they also have to define further the roles of nurse practitioner and physician.

The UHS always had a philosophy of not trying to tell physicians how to practice medicine, but many patients only want to see their doctor. Furthermore, doctors also encourage their patients to meet them in the Walk-In Clinic, what’s not the purpose of the UHS concept.

Other potential alternatives are:

  • educate the public on the separate purposes and missions of doctor appointments and the Walk-In Clinic
  • ask the triage coordinators to be a little more aggressive (ask if they really need a specific person and suggest alternatives)
  • establish a firm policy of not accepting specific physician requests in the Walk-In Clinic

Panera Bread Company Analysis Answers To Questions

1. What are the primary components of Panera Bread’s value chain?

The primary components of Panera Bread’s value chain are

2. What strategic issues and problems does Panera Bread management need to address?

The strategic issues and problems that Panera Bread management needs to address are to do with their previously discussed strategy. They want to provide premium bakery and café experience, broaden their stores and locations in the states, and make Panera a nationwide brand name. The management at Panera needs to make sure that consumers and stockholders understand that Panera offers superior products.

They need to specially train all chef’s and staff to make sure they accomplish the goal of creating and presenting the best product. They would also benefit from offering seasonal menu items. They need figure out how to make their products still high quality but at a lower cost and balance the lower cost without sacrificing quality. Some of the marketing issues that they should address are developing brand awareness, using marketing strategies to express that Panera Bread serves food for all hours of the day and not just specifically breakfast. They should continue to develop “Panera Warmth” and lastly develop an expert team to decide on the demographics of new locations.

3. What does Panera Bread need to do to strengthen its competitive position and business prospects vis-à-vis other restaurant chain rivals?

In order for Panera Bread to strengthen its competitive position and business prospects vis-à-vis other restaurant chain rivals they need to develop more products for the evening eaters. They did have a few items on their menu for dinner however that is no more. Instead of trying to fix that they just completely got rid of it. I think that a lot of chains offer more when it comes to dinner items and Panera should step it up. I think that if they lowered the price of their food a bit that their product would be more demanding as well.

Panera needs to also create brand awareness. Many people I know have not even stepped foot in a Panera. I think if more of the restaurants also had drive-thru’s the the company would be in a better position as well. Now-a-days people just want to get in and get out and everyone is so busy. Having a drive-thru makes things more convenient and I think that it would attract more customers.

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