A lean elvek alkalmazása az egészségügyi folyamatok fejlesztésében = Applying lean principles in healthcare process development

A fejlett társadalmak egészségügyi szolgáltató rendszerei napjainkban kettős kihívással néznek szembe: miközben a társadalom a szolgáltatási színvonal emelkedését, a hibák számának a csökkenését várja el, addig a költségvetési terhek miatt a költségcsökkentés is feltétlenül szükséges. Ez a kihívás nagyságában összevethető azzal, amellyel az USA autóipara nézett szembe az 1970-es évektől. A megoldást az autóipar esetében a konkurens „lean” menedzsment elvek és eszközök megértése és alkalmazása jelentette. A tanulmány arra keresi a választ, hogy vajon lehetséges-e ennek a megoldásnak az alkalmazása az egészségügy esetében is. A cikk az egészségügy problémájának bemutatása után tárgyalja a lean menedzsment kialakulását és hogy milyen módon került köztudatba. A tanulmány második felében a szakirodalomban fellelhető, a témával kapcsolatos tapasztalatokat foglalja össze, majd levonja a következtetéseket. = In developed societies healthcare service systems are facing double challenge; society expects service level to rise and the number of mistakes to drop, but at the same time, because of the overloaded budgets, cutting cost is also absolutely necessary. This challenge compares to the one the US automotive industry was facing in the 1970-s. In case of the automotive industry the solution was the comprehension and application of the principles and the tools of lean management. This study aims to answer the question whether it is possible to apply this solution also in the case of the healthcare system. The article first introduces the problems in the healthcare system, than describes the formation of lean management concept and its wide spread. The second half of the study summarizes the available knowledge in the literature and drives conclusions.

A tudásmenedzsment és az IT audit kapcsolódási pontjai - a tudásmenedzsment-rendszerek auditja (Connection points of knowledge management and IT audit – audit of knowledge management systems)

A cikkben a szerzők megvizsgálják a tudásmenedzsment komplex rendszerfejlesztési projektekben és az informatikai auditban játszott szerepét. Fő céljuk, hogy a tudásmenedzsment-rendszerek fejlesztéséhez kapcsolódó audit támogatására értékelési modellt készítsenek. Cikkükben megvizsgálják a tudásmenedzsmentnek az IT-auditban játszott általános szerepét, az auditban érintett tudásvagyon védelmének kérdését, a tudásmenedzsment-folyamatok szerepét a rendszerfejlesztésben (auditszempontból), a kontrollok implementálását, valamint a tudásmenedzsment és az IT-audittal kapcsolatos szabványok, módszertanok kapcsolatát. Az eredmények illusztrálására egy az Európai Unió 7. keretprogramjából finanszírozott nemzetközi projekt (GUIDE, IST–2003–507498) szolgál. ________________ Authors investigate the role of knowledge management in complex system development projects and IT audit. The primary goal is to provide an evaluation framework for an assessment of the development of special knowledge management solutions. On the other hand IT audit itself is a knowledge-dependent activity. The paper analyses the role of knowledge management in IT audit in general, the protection of knowledge assets during an audit, the role of knowledge management processes during system development (from audit point of view) and in the implementation of controls, the relationship of knowledge management with audit standards. Authors investigate the specialities of KM developments from audit point of view (particularly important aspects of audit, specific control objectives) A case study, based on experiences gained from GUIDE project (IST-2003-507498 funded by the European Commission’s 6th Framework Programme) illustrates the findings.

Szervezetek közötti együttműködés a fenntartható fejlődés szolgálatában (Cooperation among the organisations in service of the sustainable development)

A vállalatok egyre gyakrabban alakítanak ki olyan kapcsolatokat, melyek célja az egymással, illetve más típusú szervezetekkel (pl. kormányzati vagy civil szervezetekkel) különféle célok érdekében megvalósuló együttműködés. Ezen együttműködési formák egy része kedvező hatással van a vállalatok környezeti, illetve társadalmi teljesítményére is, és ezáltal – a szűken vett profitérdekeken túl – elősegíti a fenntartható fejlődés társadalmi céljának megvalósítását is. Jelen cikk célja, hogy bemutassa a vállalati szférára jellemző együttműködési formákat magyarázó legfontosabb szervezetelméleti megközelítéseket, majd ezek tükrében ismertesse a fenntartható fejlődés ügyét is elősegítő együttműködési kapcsolatok korszerű megnyilvánulási formáit. _________ Corporations more and more often engage in relationships, which aim at cooperation with each other and other types of organisations (e.g. governmental or nongovernmental organisations). Some of these collaborative efforts have a positive impact on the environmental and social performance of participating organisations and thus – apart from their positive impact on profitability – also foster the implementation of sustainable economic and social development. The objective of this article is to introduce the most important organisational theories, which give an explanation of the cooperative efforts of the corporate sector and, using this as a basis, to provide an overview of the most up-to-date forms of cooperation, which enhance our chances in the direction of a sustainable future.

A karcsú (lean) elvek alkalmazásának tapasztalatai az egészségügyi folyamatok fejlesztésében (Experiences of the adaptation of lean management in the development of healthcare processes)

Az elmúlt néhány évben a külföldi sajtóban és szakmai publikációkban egyre többször jelenik meg a „lean egészségügy”, azaz a karcsú menedzsment alkalmazása az egészségügyben mint téma. Habár az ez irányú kutatások még nemzetközi szinten is csak legfeljebb a hajnalukon tartanak, Magyarországon még szinte teljes a sötétség. Ennek a cikknek az a célja, hogy egyrészről felhívja a kutatók, de még inkább a egészségügyi dolgozók, menedzserek figyelmét erre a menedzsmenteszközre és filozófiára, mely új lehetőségeket kínál, másrészről, hogy áttekintést adjon a területen végzett nemzetközi kutatások eredményeiről. A tanulmány ennek megfelelően alapvetően két részre bontható. Az első felében az egészségügyi szolgáltatások helyzetének rövid jellemzése után a karcsú menedzsment alapjait és az egészségügyi szolgáltatásokban való alkalmazásának eszményét mutatja be. A második fele ugyanakkor 16 esettanulmány elemzésén keresztül bemutatja, hogy meddig jutott a világ a „lean egészségügy” ideájának megvalósításában. _______ In the past few years “Lean Healthcare” – the adaptation of lean management into healthcare settings – turns up as a topic often and often in foreign press and the in the professional publications. Although researches at international level in this field are at best at their dawning, in Hungary the darkness is almost complete. This article aims at one side to draw researchers’ and even more healthcare employees’ and managers’ attention to this management tool and philosophy, which offers new possibilities. From the other side to provide an overview of the results of the researches conducted in this field. Reflecting this doubled aim the study is divided into two major sections. In the first part the situation of the health care providers is shortly described followed by the introduction of the basics of the lean management and the idea of applying it into healthcare services. While the second part of the study shows how far the World reached in realizing the idea of “Lean Healthcare” by analyzing 16 cases.

Civil service reform trends in public personnel management: Experiences from the Commonwealth of the Bahamas

This study has explored the potential for implementing a merit-based public personnel system in The Bahamas, a former British colony in The Commonwealth Caribbean. Specifically, the study evaluated the use of merit-based public personnel management practices in areas of recruitment, selection, promotion, training and employee development and performance evaluation. Driving forces and barriers which impact merit system successes and failures as well as strategies for institutionalizing merit system practices are identified. Finally the study attempted to apply the developmental model created by Klingner (1996) to describe the stage of public personnel management in The Bahamas. The data for the study was collected through in-depth interviews with expert observers. ^

Alternative service organizations: Funding environment, strategies, and patterns of adaptation

This study explored the strategies that community-based, consumer-focused advocacy, alternative service organizations (ASOs), implemented to adapt to the changes in the nonprofit funding environment (Oliver & McShane, 1979; Perlmutter, 1988a, 1994). It is not clear as to the extent to which current funding trends have influenced ASOs as little empirical research has been conducted in this area (Magnus, 2001; Marquez, 2003; Powell, 1986). ^ This study used a qualitative research design to investigate strategies implemented by these organizations to adapt to changes such as decreasing government, foundation, and corporate funding and an increasing number of nonprofit organizations. More than 20 community informants helped to identify, locate, and provide information about ASOs. Semi-structured interviews were conducted with a sample of 30 ASO executive directors from diverse organizations in Miami-bade and Broward Counties, in South Florida. ^ Data analysis was facilitated by the use of ATLAS.ti, version 5, a qualitative data analysis computer software program designed for grounded theory research. This process generated five major themes: Funding Environment; Internal Structure; Strategies for Survival; Sustainability; and Committing to the Cause, Mission, and Vision. ^ The results indicate that ASOs are struggling to survive financially by cutting programs, decreasing staff, and limiting service to consumers. They are also exploring ways to develop fundraising strategies; for example, increasing the number of proposals written for grants, focusing on fund development, and establishing for-profit ventures. Even organizations that state that they are currently financially stable are concerned about their financial vulnerability. There is little flexibility or cushioning to adjust to "funding jolts." The fear of losing current funding levels and being placed in a tenuous financial situation is a constant concern for these ASOs. ^ Further data collected from the self-administered Funding Checklist and demographic forms were coded and analyzed using Statistical Package for the Social Sciences (SPSS). Descriptive information and frequencies generated findings regarding the revenue, staff compliment, use of volunteers and fundraising consultants, and fundraising practices. The study proposes a model of funding relationships and presents implications for social work practice, and policy, along with recommendations for future research. ^

Development of an odor management plan for industrial stationary sources in an urban environment: A case study for Broward County, Florida

Objectionable odors remain at the top of air pollution complaints in urban areas such as Broward County that is subject to increasing residential and industrial developments. The odor complaints in Broward County escalated by 150 percent for the 2001 to 2004 period although the population increased by only 6 percent. It is estimated that in 2010 the population will increase to 2.5 million. Relying solely on enforcing the local odor ordinance is evidently not sufficient to manage the escalating odor complaint trends. An alternate approach similar to odor management plans (OMPs) that are successful in managing major malodor sources such as animal farms is required. ^ This study aims to develop and determine the feasibility of implementing a comprehensive odor management plan (COMP) for the entire Broward County. Unlike existing OMPs for single sources where the receptors (i.e. the complainants) are located beyond the boundary of the source, the COMP addresses a complex model of multiple sources and receptors coexisting within the boundary of the entire county. Each receptor is potentially subjected to malodor emissions from multiple sources within the county. Also, the quantity and quality of the source/receptor variables are continuously changing. ^ The results of this study show that it is feasible to develop a COMP that adopts a systematic procedure to: (1) Generate maps of existing odor complaint areas and malodor sources, (2) Identify potential odor sources (target sources) responsible for existing odor complaints, (3) Identify possible odor control strategies for target sources, (4) Determine the criteria for implementing odor control strategies, (5) Develop an odor complaint response protocol, and (6) Conduct odor impact analyses for new sources to prevent future odor related issues. Geographic Information System (GIS) is used to identify existing complaint areas. A COMP software that incorporates existing United States Environmental Protection Agency (EPA) air dispersion software is developed to determine the target sources, predict the likelihood of new complaints, and conduct odor impact analysis. The odor response protocol requires pre-planning field investigations and conducting surveys to optimize the local agency available resources while protecting the citizen's welfare, as required by the Clean Air Act. ^

Realization of Differentiated Quality of Service for Wideband Code Division Multiple Access Core Network

The development of 3G (the 3rd generation telecommunication) value-added services brings higher requirements of Quality of Service (QoS). Wideband Code Division Multiple Access (WCDMA) is one of three 3G standards, and enhancement of QoS for WCDMA Core Network (CN) becomes more and more important for users and carriers. The dissertation focuses on enhancement of QoS for WCDMA CN. The purpose is to realize the DiffServ (Differentiated Services) model of QoS for WCDMA CN. Based on the parallelism characteristic of Network Processors (NPs), the NP programming model is classified as Pool of Threads (POTs) and Hyper Task Chaining (HTC). In this study, an integrated programming model that combines both of the two models was designed. This model has highly efficient and flexible features, and also solves the problems of sharing conflicts and packet ordering. We used this model as the programming model to realize DiffServ QoS for WCDMA CN. ^ The realization mechanism of the DiffServ model mainly consists of buffer management, packet scheduling and packet classification algorithms based on NPs. First, we proposed an adaptive buffer management algorithm called Packet Adaptive Fair Dropping (PAFD), which takes into consideration of both fairness and throughput, and has smooth service curves. Then, an improved packet scheduling algorithm called Priority-based Weighted Fair Queuing (PWFQ) was introduced to ensure the fairness of packet scheduling and reduce queue time of data packets. At the same time, the delay and jitter are also maintained in a small range. Thirdly, a multi-dimensional packet classification algorithm called Classification Based on Network Processors (CBNPs) was designed. It effectively reduces the memory access and storage space, and provides less time and space complexity. ^ Lastly, an integrated hardware and software system of the DiffServ model of QoS for WCDMA CN was proposed. It was implemented on the NP IXP2400. According to the corresponding experiment results, the proposed system significantly enhanced QoS for WCDMA CN. It extensively improves consistent response time, display distortion and sound image synchronization, and thus increases network efficiency and saves network resource.^

Challenge to Managers: Changing Hotel Work from a Secondary Choice to career Development

In his discussion - Challenge To Managers: Changing Hotel Work from a Secondary Choice to Career Development - by Leonidas Chitiris, Lecturer in Management, Piraeus Graduate School of Industrial Studies, Athens, Greece, Chitiris marginally alludes at the outset: “Surveys and interviews with hotel employees in Greece with regard to why individuals work for hotels and to what extent their rationale to join the hotel industry affects hotel productivity revealed that the choice to work in hotels is a secondary preference and reflects the opportunity structure in the economy at any given time and the greater the number of those who work in hotels when there are no other employment opportunities, the less likely the chances for overall improved performance. Given the increase in the proportion of unskilled, unmotivated workers, the level of hotel productivity consequently decreases! The author interprets the findings in terms of the economic and employment conditions in the Greek hotel industry. To enhance the rationale of his thesis statement, Chitiris offers with citation: “Research on initial entry into the labor force has shown that new employees reflect idealized expectations and are frequently not very satisfied with their jobs and roles in the work settings.” Chitiris advances the thought even further by saying: “Research on job satisfaction, motivation, and production purports that management can initiate policies that develop job satisfaction and may improve productivity.” The author outlines components within the general category of the hotel industry to label and quantify exactly why there may be a lag between employee expectations and the delivery of a superior level of service. Please keep in mind that the information for this essay is underpinned by the hotel industry in Greece, exclusively. Demographic information is provided. One example of the many factors parsed in this hotel service discussion is the employee/guest relationship. “The quality of service in hotels is affected to a great extent by the number of guests a hotel employee has to serve,” Chitiris offers. Additionally, Chitiris’ characterization of the typical hotel employee in Greece is not flattering, but it is an informed and representative view of that lodging labor pool. The description in and of itself begs to explain at least some of why the hotel industry in Greece suffers a consequently diminished capacity of superior service. Ill equipped, under-educated, over-worked, and under-paid are how Chitiris describes most employees in the Hellenist hospitality field. Survey based studies, and formulaic indices are used to measure variables related to productivity; the results may be inconclusive industry wide, but are interesting nonetheless. Also, an appealing table gauges the reasons why hotel workers actually employ themselves in the lodging industry. Chirtiris finds that salary expectations do not rate all that high on the motivational chart and are only marginal when related to productivity. In closing, Chirtiris presents a 5-phase development plan hotels should look to in improving performance and productivity at their respective properties.

Food service Contracts That Win: Essentials in the Development of a Food service Agreement

The authors provide tips for institutions wanting to place a contract for operation of their food service and for companies and/or individuals in the business of managing food service operations for a fee.

The Food Service Industry Environment: Market Volatility Analysis

In their dialogue entitled - The Food Service Industry Environment: Market Volatility Analysis - by Alex F. De Noble, Assistant Professor of Management, San Diego State University and Michael D. Olsen, Associate Professor and Director, Division of Hotel, Restaurant & Institutional Management at Virginia Polytechnic Institute and State University, De Noble and Olson preface the discussion by saying: “Hospitality executives, as a whole, do not believe they exist in a volatile environment and spend little time or effort in assessing how current and future activity in the environment will affect their success or failure. The authors highlight potential differences that may exist between executives' perceptions and objective indicators of environmental volatility within the hospitality industry and suggest that executives change these perceptions by incorporating the assumption of a much more dynamic environment into their future strategic planning efforts. Objective, empirical evidence of the dynamic nature of the hospitality environment is presented and compared to several studies pertaining to environmental perceptions of the industry.” That weighty thesis statement presumes that hospitality executives/managers do not fully comprehend the environment in which they operate. The authors provide a contrast, which conventional wisdom would seem to support and satisfy. “Broadly speaking, the operating environment of an organization is represented by its task domain,” say the authors. “This task domain consists of such elements as a firm's customers, suppliers, competitors, and regulatory groups.” These are dynamic actors and the underpinnings of change, say the authors by way of citation. “The most difficult aspect for management in this regard tends to be the development of a proper definition of the environment of their particular firm. Being able to precisely define who the customers, competitors, suppliers, and regulatory groups are within the environment of the firm is no easy task, yet is imperative if proper planning is to occur,” De Noble and Olson further contribute to support their thesis statement. The article is bloated, and that’s not necessarily a bad thing, with tables both survey and empirically driven, to illustrate market volatility. One such table is the Bates and Eldredge outline; Table-6 in the article. “This comprehensive outline…should prove to be useful to most executives in expanding their perception of the environment of their firm,” say De Noble and Olson. “It is, however, only a suggested outline,” they advise. “…risk should be incorporated into every investment decision, especially in a volatile environment,” say the authors. De Noble and Olson close with an intriguing formula to gauge volatility in an environment.

Toward A Better Understanding of the Evolution of Hotel Development: A Discussion of Product-specific Lodging Demand

In his essay - Toward a Better Understanding of the Evolution of Hotel Development: A Discussion of Product-Specific Lodging Demand - by John A. Carnella, Consultant, Laventhol & Horwath, cpas, New York, Carnella initially describes his piece by stating: “The diversified hotel product in the united states lodging market has Resulted in latent room-night demand, or supply-driven demand resulting from the introduction of a lodging product which caters to a specific set of hotel patrons. The subject has become significant as the lodging market has moved toward segmentation with regard to guest room offerings. The author proposes that latent demand is a tangible, measurable phenomenon best understood in light of the history of the guest room product from its infancy to its present state.” The article opens with an ephemeral depiction of hotel development in the United States, both pre’ and post World War II. To put it succinctly, the author wants you to know that the advent of the inter-state highway system changed the complexion of the hotel industry in the U.S. “Two essential ingredients were necessary for the next phase of hotel development in this country. First was the establishment of the magnificently intricate infrastructure which facilitated motor vehicle transportation in and around the then 48 states of the nation,” says Carnella. “The second event…was the introduction of affordable highway travel. Carnella goes on to say that the next – big thing – in hotel evolution was the introduction of affordable air travel. “With the airways filled with potential lodging guests, developers moved next to erect a new genre of hotel, the airport hotel,” Carnella advances his picture. Growth progressed with the arrival of the suburban hotel concept, which wasn’t fueled by developments in transportation, but by changes in people’s living habits, i.e. suburban affiliations as opposed to urban and city population aggregates. The author explores the distinctions between full-service and limited service lodging operations. “The market of interest with consideration to the extended-stay facility is one dominated by corporate office parks,” Carnella proceeds. These evolutional states speak to latent demand, and even further to segmentation of the market. “Latent demand… is a product-generated phenomenon in which the number of potential hotel guests increases as the direct result of the introduction of a new lodging facility,” Carnella brings his unique insight to the table with regard to the specialization process. The demand is already there; just waiting to be tapped. In closing, “…there must be a consideration of the unique attributes of a lodging facility relative to its ability to attract guests to a subject market, just as there must be an examination of the property's ability to draw guests from within the subject market,” Carnella proposes.

A Customer's Expectation and Perception of Hotel Service Quality in Cyprus

In recent years, hotels in Cyprus have encountered difficult economic times due to increasing customer demands and strong internal industry development competition. The hospitality industry’s main concern globally is to serve its customer S needs and desires, most of which are addressed through personal services. Hence, the hotel businesses that are able to provide quality services to its ever-demanding customers in a warm and efficient manner are those businesses which will be more likely to obtain a long term competitive advantage over their rivals. Ironically, the quality of services frequently cannot fully appreciated until something goes wrong, and then, the poor quality of services can have long lasting lingering effects on the customer base and, hence, often is translated into a loss of business. Nevertheless, since the issue of delivery of hospitality services always involves people, this issue must center around the management of the human resource factor, and in particular, on the way which interacts with itself and with guests, as service encounters. In the eyes of guests, hospitality businesses will be viewed successful or failure, depending on [he cumulative impact of the service encounters they have experienced on a personal level. Finally, since hotels are offering intangible and perishable personal service encounters, managing these services must be a paramount concern of any hotel business. As a preliminary exercise, visualize when you have last visited a hotel, or a restaurant, and then, ask yourself these questions: What did you feel about the quality of the experience? Was it a memorable one, which you would recommend it to others, or there were certain things, which could have made the difference? Thus, the way personalized services are provided can make the deference in attracting arid retaining long-term customers

The early development and pilot -testing of a case management intervention with victims of stalking: An evaluation study

This study evaluated the early development and pilot-testing of Project IMPACT, a case management intervention for victims of stalking. The Design and Development framework (Rothman & Thomas, 1994) was used as a guide for program development and evaluation. Nine research questions examined the processes and outcomes associated with program implementation. ^ The sample included all 36 clients who participated in Project IMPACT between February of 2000 and June of 2001, as well as the victim advocates who provided them with services. Quantitative and qualitative data were drawn from client case files, participant observation field notes and interview transcriptions. Quantitative data were entered into three databases where: (1) clients were the units of analysis (n = 36), (2) services were the units of analysis (n = 1146), and (3) goals were the units of analysis (n = 149). These data were analyzed using descriptive statistics, Pearson's Chi-square, Spearman's Rho, Phi, Cramer's V, Wilcoxon's Matched Pairs Signed-Ranked Test and McNemar's Test Statistic. Qualitative data were reduced via open, axial and selective coding methods. Grounded theory and case study frameworks were utilized to analyze these data. ^ Results showed that most clients noted an improved sense of well-being and safety, although residual symptoms of trauma remained for numerous individuals. Stalkers appeared to respond to criminal and civil justice-based interventions by reducing violent and threatening behaviors; however, covert behaviors continued. The study produced findings that provided preliminary support for the use of several intervention components including support services, psycho-education, safety planning, and boundary spanning. The psycho-education and safety planning in particular seemed to help clients cognitively reframe their perceptions of the stalking experience and gain a sense of increased safety and well-being. A 65% level of satisfactory goal achievement was observed overall, although goals involving justice-based organizations were associated with lower achievement. High service usage was related to low-income clients and those lacking in social support. Numerous inconsistencies in program implementation were found to be associated with the skills and experiences of victim advocates. Thus, recommendations were made to further refine, develop and evaluate the intervention. ^

It takes an institution's village to retain a student: A comprehensive look at two early warning system undergraduate retention programs and administrators' perceptions of students' experiences and the retention services they provide students in the early warning system retention programs

Institutions have implemented many campus interventions to address student persistence/retention, one of which is Early Warning Systems (EWS). However, few research studies show evidence of interventions that incorporate noncognitive factors/skills, and psychotherapy/psycho-educational processes in the EWS. A qualitative study (phenomenological interview and document analysis) of EWS at both a public and private 4-year Florida university was conducted to explore EWS through the eyes of the administrators of the ways administrators make sense of students' experiences and the services they provide and do not provide to assist students. Administrators' understanding of noncognitive factors and the executive skills subset and their contribution to retention and the executive skills development of at-risk students were also explored. Hossler and Bean's multiple retention lenses theory/paradigms and Perez's retention strategies were used to guide the study. Six administrators from each institution who oversee and/or assist with EWS for first time in college undergraduate students considered academically at-risk for attrition were interviewed. Among numerous findings, at Institution X: EWS was infrequently identified as a service, EWS training was not conducted, numerous cognitive and noncognitive issues/deficits were identified for students, and services/critical departments such as EWS did not work together to share students' information to benefit students. Assessment measures were used to identify students' issues/deficits; however, they were not used to assess, track, and monitor students' issues/deficits. Additionally, the institution's EWS did address students' executive skills function beyond time management and organizational skills, but did not address students' psychotherapy/psycho-educational processes. Among numerous findings, at Institution Y: EWS was frequently identified as a service, EWS training was not conducted, numerous cognitive and noncognitive issues/deficits were identified for students, and services/critical departments such as EWS worked together to share students' information to benefit students. Assessment measures were used to identify, track, and monitor students' issues/deficits; however, they were not used to assess students' issues/deficits. Additionally, the institution's EWS addressed students' executive skills function beyond time management and organizational skills, and psychotherapy/psycho-educational processes. Based on the findings, Perez's retention strategies were not utilized in EWS at Institution X, yet were collectively utilized in EWS at Institution Y, to achieve Hossler and Bean's retention paradigms. Future research could be designed to test the link between engaging in the specific promising activities identified in this research (one-to-one coaching, participation in student success workshops, academic contracts, and tutoring) and student success (e.g., higher GPA, retention). Further, because this research uncovered some concern with how to best handle students with physical and psychological disabilities, future research could link these same promising strategies for improving student performance for example among ADHD students or those with clinical depression.