Organizational change: implications of culture and leadership in the transformation to a total quality management paradigm

The study was undertaken to investigate organizational readiness for change to a total quality management (TQM) paradigm as the corporate-wide strategy within a long-term care facility. The focus of the study was on leadership values and organizational cultural characteristics that could either accelerate or impede the change process at The Public Hospital. structurally, the ~tudy included 'three distinct components. The first component examined the management philosophy outlined by Deming (1986) and his contemporary Juran (1989) in order to determine what leadership values best support the new Total Quality Management paradigm. Secondly, this information was compared to present leadership values at The Public Hospital with the purpose of identifying opportunities for improvement within the organization's current culture as the hospital moves toward the desired TQM culture. The final component, a roadmap, was developed to reflect the most appropriate direction for organizational change at The Public Hospital.

Management decision-making in nursing

This study developed a new, valid and reliable evaluation instrument to measure the level, type and pattern of management decisions of fifteen nursing students. The management decision score achieved using this instrument was correlated with two psychological determinants of management decision making: creativity and problem-solving ability. The instrument was a written patient management problem in case format, answered by a free form written response. The student responses were classified for type of management decision according to the sub-categories of technical, inter-personal, environmental and unique. Using statistical analysis a significant difference was found in the type of management decisions most frequently selected by the study sample. The students predominantly selected technical type decisions. This preference for one type of management decision may be due to a number of psychological and environmental factors. These factors may program and mold the type of management decisions student nurses make early in their career. Low but positive correlations were found between the total management score and the two psychological tests. This finding supports the authors cited in the literature who state that although creativity augments the type of management decision making, it is not present or encouraged widely in the nursing profession. These factors are worth considering when the profession becomes concerned over ritualization and lack of individuality in patient care. The tool is easy to administer, lends itself to a variety of professional settings and shows promise with further refinement for computer application.

The effects of plants(Typha Latifolia)and root-bed medium on the treatment of domestic sewage within a vertical flow constructed wetland /

The effect that plants {Typha latifolia) as well as root-bed medium physical and chemical characteristics have on the treatment of primary treated domestic wastewater within a vertical flow constructed wetland system was investigated. Five sets of cells, with two cells in each set, were used. Each cell was made of concrete and measured 1 .0 m X 1 .0 m and was 1.3 m deep. Four different root-bed media were tested : Queenston Shale, Fonthill Sand, Niagara Shale and a Michigan Sand. Four of the sets contained plants and a single type of root-bed medium. The influence of plants was tested by operating a Queenston Shale set without plants. Due to budget constraints no replicates were constructed. All of the sets were operated independently and identically for twenty-eight months. Twelve months of data are presented here, collected after 16 months of continuous operation. Root-bed medium type did not influence BOD5 removal. All of the sets consistently met Ontario Ministry of Environment (MOE) requirements (<25 mg/L) for BOD5 throughout the year. The 12 month average BOD5 concentration from all sets with plants was below 2.36 mg/L. All of the sets were within MOE discharge requirements (< 25 mg/L) for suspended solids with set effluent concentrations ranging from 1.53 to 14.80 mg/L. The Queenston Shale and Fonthill Sand media removed the most suspended solids while the Niagara Shale set produced suspended solids. The set containing Fonthill Sand was the only series to meet MOE discharge requirements (< Img/L) for total phosphorus year-round with a twelve month mean effluent concentration of 0.23 mg/L. Year-round all of the root-bed media were well below MOE discharge requirements (< 20mg/L in winter and < 10 mg/L in sumnner) for ammonium. The Queenston Shale and Fonthill Sand sets removed the most total nitrogen. Plants had no effect on total nitrogen removal, but did influence how nitrogen was cycled within the system. Plants increased the removal of suspended solids by 14%, BOD5 by 10% and total phosphorus by 22%. Plants also increased the amount of dissolved oxygen that entered the system. During the plant growing season removal of total phosphorus was better in all sets with plants regardless of media type. The sets containing Queenston Shale and Fonthill Sand media achieved the best results and plants in the Queenston Shale set increased treatment efficiency for every parameter except nitrogen. Vertical flow wetland sewage treatment systems can be designed and built to consistently meet MOE discharge requirements year-round for BOD5, suspended solids, total phosphorus and ammonium. This system Is generally superior to the free water systems and sub-surface horizontal flow systems in cold climate situations.