Waldo County Waldo County, the well-known real estate developer, worked long hours,

/in /by

MINI-CASE
Waldo County
Waldo County, the well-known real estate developer, worked long hours, and he expected his staff to do the same. So George Chavez was not surprised to receive a call from the boss just as George was about to leave for a long summer’s weekend.

Mr. County’s success had been built on a remarkable instinct for a good site. He would exclaim “Location! Location! Location!” at some point in every planning meeting. Yet finance was not his strong suit. On this occasion he wanted George to go over the figures for a new $90 million outlet mall designed to intercept tourists heading downeast toward Maine. “First thing Monday will do just fine,” he said as he handed George the file. “I’ll be in my house in Bar Harbor if you need me.”

George’s first task was to draw up a summary of the projected revenues and costs. The results are shown in Table 10.8. Note that the mall’s revenues would come from two sources: The company would charge retailers an annual rent for the space they occupied and in addition it would receive 5% of each store’s gross sales.

Construction of the mall was likely to take three years. The construction costs could be depreciated straight-line over 15 years starting in year 3. As in the case of the company’s other developments, the mall would be built to the highest specifications and would not need to be rebuilt until year 17. The land was expected to retain its value, but could not be depreciated for tax purposes.

Construction costs, revenues, operating and maintenance costs, and real estate taxes were all likely to rise in line with inflation, which was forecasted at 2% a year. The company’s tax rate was 35% and the cost of capital was 9% in nominal terms.

George decided first to check that the project made financial sense. He then proposed to look at some of the things that might go wrong. His boss certainly had a nose for a good retail project, but he was not infallible. The Salome project had been a disaster because store sales had turned out to be 40% below forecast. What if that happened here? George wondered just how far sales could fall short of forecast before the project would be underwater.

The post Waldo County Waldo County, the well-known real estate developer, worked long hours, appeared first on Infinitessays.org.

What aspects of the character you chose are readily apparent? What are you most curious about regarding this character that is not directly apparent?

/in /by

Poetry is a language translated by the reader. Discernable sentiments and messages rise to the top as you may consider and reconsider the more obscure or “hidden” meanings surrounding the words on the page. You have the opportunity in this week’s Discussion to deconstruct the complexity of Shange’s work through the exploration of a character from her poem while exploring qualities and styles of poetry.

To prepare for this Discussion:

  • Read and listen to each of the Shange poems linked in this week’s Learning Resources. Listen carefully to the voices and words of the different characters. Choose one of the female characters from the five included poems. For these poems, the characters include: Lady in Yellow, Lady in Orange, Lady in Blue, Lady in Red, and Lady in Purple.
  • What aspects of the character you chose are readily apparent? What are you most curious about regarding this character that is not directly apparent?
  • Consider references to formal and/or non-formal education that you identify in association with the character you chose and/or other characters in these five poems? For example, how does Shange communicate a character’s sense of knowledge of herself or an issue? In what ways do the women educate one another?
  • Review examples of poetry from this course to get a sense of the range of styles of poetry. For example, consider the style of Rita Dove’s poem from Week 4 and review a sample of poems from websites provided in this week’s Optional Resources.

With these thoughts in mind:

By Day 3

Post  a 2- to 3-paragraph description of the character you selected from Shange’s poem, including her emotional and physical self. Explain how this character represents the concepts of expression, perspective, and social change. How is the style of poetry in Shange’s work different from other styles of poetry?

By Day 5

Respond  to at least one of your colleague’s postings in one or more of the following ways:

  • What insights into education does Shange’s work address?
  • Build on the ideas presented by your peer by expanding on or providing a new example of how concepts of expression, perspective, and social change are apparent through the character chosen.

Return to this Discussion in a few days to read the responses to your initial posting. Note what you have learned and/or any insights you have gained as a result of the comments your colleagues made.

Difference between provider organizations, Healing Hands and an academic medical center, in terms of mission, services, organization structure, etc. 

/in /by

Read the scenario that you will use for the Individual Projects in each week of the course. The Centers for Medicare and Medicaid Services (CMS) has taken on a more visible role in health care delivery. Many changes have transpired to improve patient safety along with the implementation of additional quality metrics, and these changes impact reimbursement rates.

Likewise, the Patient Protection and Affordable Care Act has changed the reimbursement fee structure of Medicare and Medicaid reimbursement for health care services.  Other legislation including the HITECH Act and the Medicare Authorization and CHIP Reactivation Act of 2015 (MACRA) all impact how healthcare organizations receive reimbursement and demonstrate use of data to improve quality and delivery of patient care.

Mr. Magone, CEO of Healing Hands Hospital, has asked you to join the “Future of Healing Hands” Task Force, and your first assignment is to work with the Hospital Chief Financial Officer, Mr. Johnson, and provide a summary of the current regulations regarding Medicare reimbursement including how MACRA will impact reimbursement if/when Healing Hands coordinates delivery of services by affiliating with physician practices.

For this assignment, write a 2-3 page report that you will deliver to Mr. Magone on how the new CMS initiatives and regulations will impact the organization’s revenue structure. In your presentation, address the following questions:

 

  • Why did CMS become more involved in the reimbursement component of health care? How does CMS’s involvement impact the reimbursement model for Healing Hands Hospital and other health care organizations?  If CMS reimbursement regulations for Medicare and Medicaid change, does it follow that other insurance providers change their policies on reimbursement?
  • What tools can be implemented to ensure organizations such as Healing Hands Hospital and physician practices are meeting the policies and procedures set forth by CMS?

Identify 3 tools from the CMS Web site that are helpful in meeting the requirements for Medicare reimbursement set forth by CMS.   (2-3 page report not including title page or reference page).

 

 

Scenario

Throughout this course, you will provide information and analysis using a fictitious community hospital, Healing Hands, located in a suburban community about 15 miles outside of a major metropolitan area.  Each week, you will complete specific assignments, and in the final weeks of this course, you will provide a final report detailing your findings.

The following scenario will be utilized throughout this course to assist you in completing each week’s assignment:

Healing Hands Hospital is an acute care community hospital in a suburb 15 miles outside of a large metropolitan city. The hospital, which was founded over 50 years ago, is dedicated to serving the local community consisting of working professionals, families and retired individuals.  It has 320 beds and is comprised of a group of 500 physicians.  The hospital has in-patient services for short-stay acute care patients; an in-patient mental health unit; an ambulatory surgical clinic; and specialized units in cancer, maternal and child services, orthopedics, and cardiac care.  Healing Hands Hospital serves a community of approximately 500,000.

Mr. Jeff Magone, the new Chief Executive Officer of Healing Hands Hospital recognizes that an important trend in healthcare delivery that is linked to reimbursement is accountable care and integrated delivery models.   He has set the goal for the hospital to remain financially viable and increase services and quality of care available to the community served by Healing Hands Hospital.   To accomplish this goal, Mr. Magone realizes that there are several options to consider such as:

  1. Addition of outpatient services including urgent care centers and affiliations with more local physician practices,
  2. Merging with another community hospital in a neighboring suburb, or
  3. Affiliating with one of the two large academic medical centers in the city.

Mr. Magone and the hospital Board of Directors have discussed the options and they realize that some changes need to be made to not only maintain and improve the high quality of patient care for which Healing Hands is recognized but also to ensure future financial stability in the changing healthcare industry.

Mr. Magone and the Healing Hands Hospital Board of Directors have created a “Future of Healing Hands” Task Force, and as a Director of Operations, you have been asked to participate on the Task Force and provide support through research, analysis and reports to the Task Force as they evaluate options to meet the goals outlined by Mr. Magone.  You will work with your supervisor, the Chief Operating Officer, Ms. Woods, as well as the Chief Financial Officer, Mr. Johnson, and provide research and analysis.  Community leaders will also be part of the Task Force providing recommendations and input from the community served by Healing Hands Hospital.  Mr. Magone realizes that developing outpatient services, urgent care clinics, affiliations with medical practices  or merging with an academic medical center will also require upgrades to the electronic health record system (EHRs) and other computer systems.  Therefore you will also work with the hospital’s Chief Information Officer to determine if current systems such as the EHRs and Clinical Decision Support Systems are scalable or need to be replaced.

Mr. Magone has made it clear that patient needs and future financial stability are driving the project. He wants to ensure that Healing Hands Hospital stays current with reimbursement and quality care models and remains financially sound through reimbursement by Medicare and other health insurance plans.  Leadership at Healing Hands also recognizes that strong relations with the community and the Healing Hands staff will be imperative to success.

Throughout this course, you will research and analyze different aspects of the developing strategic plan for this initiative.  Each week, you will build the information needed for the plan, and in the final weeks of this course, you will provide a final report detailing your findings.

Your final report to the Future of Healing Hands Task Force will include the following components :

  • Week 1: Legislative and regulatory requirements for Medicare reimbursement including changes for physician practices related to MACRA
  • Week 2: Difference between provider organizations, Healing Hands and an academic medical center, in terms of mission, services, organization structure, etc.
  • Week 3: Reimbursement models including managed care and changes to Medicare reimbursement models
  • Week 4: Impact of advances in health information technology on operations and reimbursement.
  • Week 5: Complete Final Report of findings from each section (week) to the Task Force with the inclusion of research and analysis of healthcare quality metrics and impact on budget and reimbursement.

Outline the role of communication in changing attitudes and opinions.

/in /by

Chapter 6 The Communication Process

After completing this chapter you should be able to …

■ Identify the key components of the communication process.

■ Outline the role of communication in changing attitudes and opinions.

■ Distinguish the roles media play in school communication.

■ Outline the issues that influence the ability of communication to persuade.

In building a school–community relations program, close attention should be given to the communication process. Although some kind of communication takes place in all walks of life, effective communication doesn’t just happen. It is the result of carefully planning the kind of information that needs to be disseminated, the particular audience that is to be reached, and the choice of tools that are best fitted for the job. The job itself is that of bringing about understanding, gaining acceptance, and stimulating supportive action for ideas or proposals.

Communication is not just telling or hearing something. In the true sense of the word, it means communion or a mutual sharing of ideas and feelings. It comes from the Latin communicare, meaning “to share” or “to make common.” In this setting then, communication is the giving and receiving or sharing of anything. This is accomplished through the use of language, which may be spoken or written, or the use of symbolism, or variations of sound or light, or some other such mode. Usually, the word communication brings to mind the sending or receiving of a letter, a telephone call linking one speaker with one listener, a conversation between friends, the publication of a newspaper, a radio or television broadcast, or an e-mail message.

In any event, communication is a cooperative enterprise requiring the mutual interchange of ideas and information, and out of which understanding develops and action is taken. Communication can also be regarded as a tool for drawing people and their viewpoints closer together, and thus facilitating the quality of the relationship they enjoy. As the sociologist Charles Horton Cooley pointed out more than a century ago, communication is actually “the mechanism through which human relations exist and develop.”1

From this point of view, the nature and importance of the communication process in a school–community relations program will be discussed with reference to the elements of communication, communication and persuasion, mass media techniques, and words.

ELEMENTS OF COMMUNICATION

In communication theory, five elements are identified in the transmission of a message. Figure 6.1 identifies them as the source or sender of information, the message form used by the source (encoder), a channel that carries the message, the decoder who perceives and interprets the common language, and a receiver who reacts to the message after conceptualizing it. This simple pattern of message transmission has just as much application to a complex city newspaper that puts messages into print and sends them to thousands of readers as it does to the encoding, sending, and decoding of a letter from one friend to another.

Source of Information

The source of information may be a person or a group of persons who possess certain ideas, feelings, and needs, as well as a reason for wanting to engage in communication. In selecting the source as the starting place for a message, it should be remembered that the source has been influenced by messages received earlier and by perceptions made in the past. In reality, the source is the human brain—a highly developed internal communication mechanism that is able to combine concepts stored there, and so to create ideas, establish purposes for communication, and decide how a message will be transmitted.

The Message Encoder

The information furnished by the source must be put in message form before being sent to a particular person or audience. Here a number of factors come into play. They are important determinants of message effectiveness and may be summed up briefly as follows:

• Although language is the principal tool in coding a message, there are times when a body movement, a facial gesture, an unusual noise, or some other sign will convey just as much meaning to the receiver of the message.

• Senders must understand their messages themselves before they can make them understood by their receivers.

• To impart information or feelings, the sender and receiver should know not only what the words, phrases, or other signs mean, but both should be able to interpret these elements in the same way.

• Unless a message can be decoded easily and accurately, there is a danger that the receiver’s attention will shift to something else that appears to offer an equal or greater reward for less effort.

• A message is received more readily when it contains one or more cues or suggestions that appeal to the receiver’s needs and interests. Such cues or suggestions become an inducement for decoding and accepting the message.

FIGURE 6.1 A Common Communication Model with Examples of Components.

Source: Edward H. Moore

• Once the source determines what ideas the message should convey, he or she can decide how to express them in a form that will appeal to the receiver.

• The use of symbols in a message makes it possible to compress and simplify complex information. When such symbols as the Red Cross, a school building, or the American flag are used, they stand for concepts that people readily understand and grasp.

• Most encoded messages contain a number of parallel messages. When a message is delivered orally, the words, those that are emphasized, the rate of delivery, the pauses, and the facial expressions are all interpreted along with the content of the message.

From this list it is evident that effective encoding calls for a message form that is appropriate for the particular situation, place, and audience.

The Channel

When a message has been coded, the sender must select a channel that will carry it to the person or audience for whom it is intended. The channel may be a word-of-mouth conversation; an oral presentation on radio or television; a written document in the form of a letter or a memorandum; printed matter such as a newspaper, book, magazine, or brochure; or a combination of words and pictures through the medium of motion pictures, videos, e-mail messages, and the like. These are merely some of the more commonly used channels in message transmission.

At the same time, it is essential that the sender know which of these channels are available in the community, how extensively they are used, and how effective each is in reaching various audiences. One channel, for example, might be better than another for message delivery to a foreign-language-speaking segment of the population, whereas a different one could be used with good results for keeping professional persons in the community informed about critical school problems.

Channels that are selected for message transmission should be free from distracting elements that discourage audience attention, such as printed pages of a leaflet or brochure in which the type is smudgy and hard to read, or poorly reproduced photographs and line drawings in a photojournalism piece, or static noises that punctuate a radio broadcast. Such distractions terminate communication possibilities almost at once.

The Message Decoder

Assuming that the transmission channel is working satisfactorily, the question then arises of whether the decoder is able to decode the message accurately. This means interpreting the sign or the way in which the message is coded. If the message is coded in written English, will the decoder understand the vocabulary? Does his or her background of knowledge and experience enable him or her to comprehend quickly and correctly a reference, for example, to a system of open education, a nongraded curricular arrangement, or a minicourse? Unless the reference kindles the same meaning in the mind of the reader as in the mind of the writer, the attempt at communication may be only partly successful, and it may even be totally unsuccessful.

The matter of interpreting the words of a message is further complicated by the fact that the same words have different meanings for different people. Generally, words have two kinds of meaning: (1) a denotative or dictionary meaning that has more-or-less universal acceptance and (2) a connotative meaning—a meaning that is read into the words because of the reader’s background and experience. For example, the word school denotes a place where children go for an education under the direction of qualified teachers. To some individuals this may connote a place where many happy hours were spent, whereas to others it may connote just the opposite, depending on the individual’s experiences while attending school.

Sometimes the people who are the decoders will not take the time to review the message carefully unless they feel that it relates to things of interest to them or that their efforts will be rewarded in some way. In view of the many messages that confront one daily, the problem of getting an individual to select and decode those about the local school system is difficult. Suppose, for example, that the letter carrier just delivered a brochure about school taxes for the coming year and also a popular magazine that the resident thoroughly enjoys reading. If the size, title, color, format, and so on of the brochure lack appeal, it will probably be set aside in favor of the magazine. However, if the brochure creates curiosity regarding the tax situation, reinforces the individual’s concern over mounting educational costs, or suggests that the recipient stands to gain something, the individual may be motivated sufficiently to examine this particular message.

Furthermore, the decoder is more apt to decode a message that calls for the least amount of effort. A six-page brochure on school guidance services that is made up largely of clear photos with clever captions will attract and hold the receiver’s attention more than one on the same subject that consists of six pages of small print. This example illustrates what is referred to in communication theory as Schramm’s “fraction of selection” theory. The expectation of reward is divided by the effort required. Thus, a person will select a particular communication, in all probability, if it promises more reward or if it seems to require less effort to decode than competing messages.

The Receiver

When the message reaches the receiver, who is usually the decoder, it is expressed in some kind of shorthand—letters, drawings, photographs, tables, sounds, and so on. If this shorthand is something that the receiver has learned in the past, he or she will respond accordingly. His or her responses will indicate the meaning that the shorthand has for him or her. Although these responses are the products of experience, nevertheless they are modified at times by the receiver’s physical and mental state. For example, a picture of an attractive tray of desserts will be more appealing to the hungry receiver than to one who has just finished dinner.

Besides translating the shorthand into meaning, receivers’ responses will determine what they will do about the message. The action they take may be based on things they have learned in the past. The word war in a message, for example, may call forth strong feelings of antagonism against the idea of destroying human life. This type of response may cause people to start encoding a message in reply—one that expresses their reactions. Thus, each person in the communication process may be both an encoder and a decoder. On the other hand, the decoder may regard the message as being unimportant or may decide not to reply to it, with the result that the process stops there. However, most individuals are constantly decoding signs, reading meaning into them, and then sending back their reactions. Graphically, the flow is shown in Figure 6.1.

The return message from the decoder or receiver is known as feedback. It tells the sender or source how his or her message is being interpreted. This occurs almost at once in a face-to-face conversation, where verbal response along with body gestures such as a nod of the head, a facial expression, or eye focusing shows the receiver’s responses. In the light of these responses, the encoder or sender may modify future messages.

The feedback situation is somewhat different when messages are carried through mass communication media such as newspapers, television programs, books, or recordings. It is true that the recipients of these messages are individuals, but these individuals supply little or no direct feedback, and only occasionally will they express reactions through telephone calls, letters, or e-mails to the sender. The type of feedback to the sender is usually in the form of a refusal to do something—subscribers discontinue taking the newspaper, listeners and viewers turn to another station, and consumers stop buying the product. This is an impelling reason why so much consumer research is conducted by business organizations. It is the only way available for finding out what programs are watched on television, or what homemakers like about a particular product, or how readers are reacting to given advertisements.

COMMUNICATION AND PERSUASION

A primary purpose behind the communication process is trying to change attitudes and opinions through the use of persuasive messages. In school–community relations this purpose is frequently referred to as that of trying to bring about informed public consent. The procedures for achieving this involve the preparation and presentation by the school of messages containing information, ideas, or proposals that the public who receives them considers and then decides what action, if any, it is going to take. In a two-way communication flow, the process is reversed, with school personnel analyzing and evaluating suggestions and ideas received from people in the community and subsequently deciding what course of action to follow.

The problem of trying to get individuals to learn new ideas and adopt new behaviors through the use of persuasive messages has been the subject of much research. This research has centered on the stages people go through; the characteristics of the sender, the message, and the receiver; and the results. Some of the findings appear to have practical application in a school–community relations program.

How People Accept or Reject a New Idea, Product, or Innovation

Many studies have been conducted on the adoption or rejection of a new idea, product, or innovation. Known as the diffusion process, this communication theory generated much interest in the 1930–1960 period. Many of the studies are relevant today. The diffusion generalizations in the 1950s have since generated some 4,000 empirical studies.

In the 1950s a group of rural sociologists developed a standard diffusion model with five stages: awareness, interest, evaluation, trial, and adoption.

Awareness—This stage introduces a person to a new idea, practice, or product. Little or nothing is known about it other than general information.

Interest—This is sometimes known as the information stage, in which an individual becomes interested in learning more about the idea, practice, or product. He or she will actively seek additional information.

Evaluation—An individual weighs the merits of the idea, product, or practice and attempts to determine if it is good for him or her.

Trial—The person tries the product, idea, or practice a little.

Adoption—The individual decides that the idea, product, or practice is good enough for full-scale use.

According to Lionberger and to Rogers,2 these stages or phases of the diffusion process do not follow a linear sequence. They are not discrete, nor are they experienced by all people.

Mass media play the leading role in the awareness and interest stages, and friends and neighbors are most influential in the evaluation, trial, and adoption stages. In the first two stages, information flows one way, but in the last three stages two-way communication is dominant where attitude change starts taking place.

Message development and audience analysis also play key roles. Basso, Hines, and FitzGerald writing in PR Writer’s Toolbox: Blueprints for Success identify adoption, continuance, discontinuance, and deterrence as the message types linked to direction of persuasive changes.3 Table 6.1 lists the factors and examples for each.

Everett Rogers renamed the stages: (1) knowledge—the individual learns of the innovation and gains information about it; (2) persuasion—the individual forms a positive or negative attitude toward the innovation; (3) decision—the person makes a choice to adopt or reject the innovation; (4) implementation—the person puts the innovation into use; (5) confirmation—the person seeks reinforcement for the decision already made.4

In a similar marketing model, Topor5 emphasizes that people are influenced more in decision making by face-to-face contact than by mass media. Figure 6.2 shows Topor’s four stages of an audience member’s states of mind when an institution is being marketed.

Awareness—Bringing an institution to the attention of an audience

Comprehension—Developing an understanding of the appeal of an institution

Conviction—Matching individual interests to institution offerings

Commitment—Assisting in the decision process

Like Lionberger’s diffusion process, Topor’s marketing model shows that information flows primarily one way in the first two stages, but in the last two stages two-way communication is dominant, whereby a commitment is made. It would appear, then, from both of these models that for the greatest persuasion to take place, a two-way person-to-person communication process must exist.

TABLE 6.1 Persuasive Efforts Begin with Clear Audience Analysis

Type

Description

Example

Adoption

You attempt to get the reader to adopt an idea or plan.

The PTA urges every resident to get out and vote YES to support two new schools in the district.

Continuance

You want the audience to continue a behavior.

We urge every resident to continue their support and vote YES next Tuesday to support school expansion.

Discontinuance

You want the audience to stop doing something.

Residents need to reverse the failed bond referenda and support a plan to infuse the district with much needed funds.

Deterrence