Implementing a Lean Process

I focused on keeping my work area/desk clear of garbage and waste. I sorted everything and put things neatly away in drawers got rid of anything that I did not need. I put things in drawers according to subject and of importance. I put a little garbage can on the side of my desk so that I can throw out any unnecessary things. I feel like I can keep my desk free of waste even if I can't keep it completely organized all of the time. 

5S Process

Post a record of a 5S process that you have completed. Post a before and after picture. Also, post a short narrative of how you addressed each of the 8s's of the 5S process.

I chose to do my 5S process on cleaning my room in my apartment because I could barely get to my desk after clothes had built up on the floor.  

Before:

After:

Sorting (Seiri):
 Seiri is about eliminating all unnecessary things, keeping only essential items.  I cleaned out my desk and got rid of any papers or post it notes that I didn't need anymore. It actually saved me a lot of space afterwards.

Straightening or setting in order/ Stabilize (Seiton):
  Seiton is about there being a place for everything and everything being in that place. I organized all of my clothes and shoes.  I hung up the shirts according to color and then hung up the nice pants.  My casual pants were folded and put in the hang up shelves according to color. I did the same with my shoes.  Other things were put into the correct drawers and sections in my closet.

Sweeping or shining or cleanliness/systematic cleaning (Seiso):
 Seiso is about a clean workspace and keeping it clean and organized. I decided to clean out my desk and organize everything so that it was organized so that I could find stuff easier.  Each drawer contains a different group of things so that I know what will be in each.

Standardizing (Seiketsu):
  Seiketsu is about standardizing which is what I did with cleaning otu each drawer of my desk and nightstand.

Sustaining the discipline or self-discipline (Shitsuke)
  Shitsuke is about maintaining these standards.  I made a promise to myself that every night after practice I will pick up any clothing or anything that is on my floor or bed and put it in the correct spot.

Criteria for Evaluation

Post the final criteria and the process you will use to evaluate and rank the members of your team related to the final project.

• Participation
• researching topics
• adding to the conversation
• asking questions
• attendance in group meetings and class
• Contributions
• quality effort
• Tasks accomplished
• follow the timeline established by the group
• Professionalism
• Communication

COPD Project

Post your Team's project Title, Issue, and Action Plan. 

COPD

Finding/designing a medical device or treatment to help with COPD 

We broke up tasks for each member to find information and then meet with Dr. Ruth the first week of November to go over the information found.

Shoshana:

·         Pathogenesis of COPD

Mitch:

·         Reversibility or ways to slow the progression of COPD

·         When is O2 needed

Kallie:

·         Primary causes of COPD

·         Impact on patients quality of life

·         Common patient complaints related to COPD

Whitney:

·          What helps with the disease (treatments, drugs)

·         What exacerbates the disease

Kevin K:

·         Pathophysiology of COPD

Kevin O:

·         What happens to the lungs and surrounding organs

·         What is happening to the Alveoli on an anationical  and cellular level

Matt:

·         What part of the lungs are affected and how does this differ in different patients

Jennifer:

·         Incidence and Prevalence

·         What organ systems are involved

Danielle:

·         What is happing to the bronchi on an anationical and cellular level

·         What part of the disease makes the patients feel ill

Ethical Question

• Is it ethical for a physician to accept Wild tickets from a pharmaceutical rep to take her family to the game?

• Provide an argument for this based on the current ethical fabric of society and what is accepted in the organizations involved. 

 I would say that this depends on the situation itself. If it were me, I would look closely at the motives of the pharmaceutical rep and the way in which the tickets were offered and decide from there. Most likely the tickets are given to be an incentive or a bribe for you to help them sell their product, which is evident. I probably wouldn't accept the tickets, but I think it could be ethically acceptable if you can judge the product they are selling without that "gift" persuading you.

General Ethics

Post an ethical code/ statement for your career field of interest that has been developed by a professional organization in your field.
Post this code/statement for the following countries: USA, India, China, Thailand, Saudi Arabia, and Israel.

USA

I. A physician shall be dedicated to providing competent medical care, with compassion and respect for human dignity and rights.
II. A physician shall uphold the standards of professionalism, be honest in all professional interactions, and strive to report physicians deficient in character or competence, or engaging in fraud or deception, to appropriate entities.
III. A physician shall respect the law and also recognize a responsibility to seek changes in those requirements which are contrary to the best interests of the patient.
IV. A physician shall respect the rights of patients, colleagues, and other health professionals, and shall safeguard patient confidences and privacy within the constraints of the law.
V. A physician shall continue to study, apply, and advance scientific knowledge, maintain a commitment to medical education, make relevant information available to patients, colleagues, and the public, obtain consultation, and use the talents of other health professionals when indicated.
VI. A physician shall, in the provision of appropriate patient care, except in emergencies, be free to choose whom to serve, with whom to associate, and the environment in which to provide medical care.
VII. A physician shall recognize a responsibility to participate in activities contributing to the improvement of the community and the betterment of public health.
VIII. A physician shall, while caring for a patient, regard responsibility to the patient as paramount.
IX. A physician shall support access to medical care for all people.

INDIA

A. Declaration: Each applicant, at the time of making an application for registration under the provisions of the Act, shall be provided a copy of the declaration and shall submit a duly signed Declaration as provided in Appendix 1. The applicant shall also certify that he/she had read and agreed to abide by the same.

B. Duties and responsibilities of the Physician in general:?

1.1 Character of Physician (Doctors with qualification of MBBS or MBBS with post graduate degree/ diploma or with equivalent qualification in any medical discipline):

1.1.1 A physician shall uphold the dignity and honour of his profession.

1.1.2 The prime object of the medical profession is to render service to humanity; reward or financial gain is a subordinate consideration. Who- so-ever chooses his profession, assumes the obligation to conduct himself in accordance with its ideals. A physician should be an upright man, instructed in the art of healings. He shall keep himself pure in character and be diligent in caring for the sick; he should be modest, sober, patient, prompt in discharging his duty without anxiety; conducting himself with propriety in his profession and in all the actions of his life.

1.1.3 No person other than a doctor having qualification recognised by Medical Council of India and registered with Medical Council of India/State Medical Council(s) is allowed to practice Modern system of Medicine or Surgery. A person obtaining qualification in any other system of Medicine is not allowed to practice Modern system of Medicine in any form.

1.2 Maintaining good medical practice:

1.2.1 The Principal objective of the medical profession is to render service to humanity with full respect for the dignity of profession and man. Physicians should merit the confidence of patients entrusted to their care, rendering to each a full measure of service and devotion. Physicians should try continuously to improve medical knowledge and skills and should make available to their patients and colleagues the benefits of their professional attainments. The physician should practice methods of healing founded on scientific basis and should not associate professionally with anyone who violates this principle. The honoured ideals of the medical profession imply that the responsibilities of the physician extend not only to individuals but also to society.

1.2.2 Membership in Medical Society: For the advancement of his profession, a physician should affiliate with associations and societies of allopathic medical professions and involve actively in the functioning of such bodies.

1.2.3 A Physician should participate in professsional meetings as part of Continuing Medical Education programmes, for at least 30 hours every five years, organized by reputed professional academic bodies or any other authorized organsiations. The compliance of this requirement shall be informed regularly to Medical Council of India or the State Medical Councils as the case may be.

Maintenance of medical records:

1.3.1 Every physician shall maintain the medical records pertaining to his / her indoor patients for a period of 3 years from the date of commencement of the treatment in a standard proforma laid down by the Medical Council of India and attached as Appendix 3.

1.3.2. If any request is made for medical records either by the patients / authorised attendant or legal authorities involved, the same may be duly acknowledged and documents shall be issued within the period of 72 hours.

1.3.3 A Registered medical practitioner shall maintain a Register of Medical Certificates giving full details of certificates issued. When issuing a medical certificate he / she shall always enter the identification marks of the patient and keep a copy of the certificate. He / She shall not omit to record the signature and/or thumbmark, address and at least one identification mark of the patient on the medical certificates or report. The medical certificate shall be prepared as in Appendix 2.

1.3.4 Efforts shall be made to computerize medical records for quick retrieval.

1.4 Display of registration numbers:

1.4.1 Every physician shall display the registration number accorded to him by the State Medical Council / Medical Council of India in his clinic and in all his prescriptions, certificates, money receipts given to his patients.

1.4.2 Physicians shall display as suffix to their names only recognized medical degrees or such certificates/diplomas and memberships/honours which confer professional knowledge or recognizes any exemplary qualification/achievements.

1.5 Use of Generic names of drugs: Every physician should, as far as possible, prescribe drugs with generic names and he / she shall ensure that there is a rational prescription and use of drugs.

1.6 Highest Quality Assurance in patient care: Every physician should aid in safeguarding the profession against admission to it of those who are deficient in moral character or education. Physician shall not employ in connection with his professional practice any attendant who is neither registered nor enlisted under the Medical Acts in force and shall not permit such persons to attend, treat or perform operations upon patients wherever professional discretion or skill is required.

1.7 Exposure of Unethical Conduct: A Physician should expose, without fear or favour, incompetent or corrupt, dishonest or unethical conduct on the part of members of the profession.

1.8 Payment of Professional Services: The physician, engaged in the practice of medicine shall give priority to the interests of patients. The personal financial interests of a physician should not conflict with the medical interests of patients. A physician should announce his fees before rendering service and not after the operation or treatment is under way. Remuneration received for such services should be in the form and amount specifically announced to the patient at the time the service is rendered. It is unethical to enter into a contract of "no cure no payment". Physician rendering service on behalf of the state shall refrain from anticipating or accepting any consideration.

1.9 Evasion of Legal Restrictions: The physician shall observe the laws of the country in regulating the practice of medicine and shall also not assist others to evade such laws. He should be cooperative in observance and enforcement of sanitary laws and regulations in the interest of public health. A physician should observe the provisions of the State Acts like Drugs and Cosmetics Act, 1940; Pharmacy Act, 1948; Narcotic Drugs and Psychotropic substances Act, 1985; Medical Termination of Pregnancy Act, 1971; Transplantation of Human Organ Act, 1994; Mental Health Act, 1987; Environmental Protection Act, 1986; Pre–natal Sex Determination Test Act, 1994; Drugs and Magic Remedies (Objectionable Advertisement) Act, 1954; Persons with Disabilities (Equal Opportunities and Full Participation) Act, 1995 and Bio-Medical Waste (Management and Handling) Rules, 1998 and such other Acts, Rules, Regulations made by the Central/State Governments or local Administrative Bodies or any other relevant Act relating to the protection and promotion of public health. 

 

CHINA

Even if the country's physicians subscribed to the Hippocratic oath, the ancient moral dictum that guides Western medical workers, they would have to violate it. In China, doctors serve the all-powerful state, and when a professional code of conduct conflicts with the Party line, the latter often holds sway. Today, only half of China's medical schools offer ethics courses. When such classes are provided, they suggest that thorny issues can always be resolved by adhering to government policy and that individuals' health and welfare come second. 

THAILAND

 

Good Standard of practice and care:

Make the care of your patient your first concern;

•Treat every patient politely and considerately;

•Respect patients' dignity and privacy;

•Listen to patients and respect their views;

•Give patients information in a way they can understand;

•Respect the rights of patients to be fully involved in decisions about their care;

•Keep your professional knowledge and skills up to date;

•Recognize the limits of your professional competence;

•Be honest and trustworthy;

•Respect and protect confidential information;

•Make sure that your personal beliefs do not prejudice your patients' care;

•Act quickly to protect patients from risk if you have good reason to believe that you or a colleague may not be fit to practice;

•Avoid abusing your position as a doctor; and

•Work with colleagues in the ways that best serve patients' interests.  

 

SAUDI ARABIA 

There are no real written ethical standards used or respected by all physicians. It depends largely on religious beliefs. 

ISRAELI

The ethics or physicians are dependent on the religious beliefs.

Diversity

Talk about what diversity means to you. And explain how valuing and championing diversity will help you in your career.
Post the diversity statements from 5 companies or organizations in your field of interest, comment how they are similar and/or different. How do each of these fit with your own diversity values?

To me diversity is just variety. There is a variety of different people throughout our daily lives. Diversity can extend to more than just race, religion, or age.  Being a fan of biology, diversity among animals and plants is a necessity. They need genetic variations so that one disease doesn't wipe them out in one shot. Diversity is what makes a person unique.  I want to be a doctor so valuing diversity will hep me see my patients as individuals and yet not discriminating against them or my coworkers. In some ways, valuing diversity could help me figure out what is wrong with a certain patient and being able to help my patients I will get paid for doing my job and get the gratification of helping someone.


1. Sacred Heart
The primary purpose of Sacred Heart Hospital is to provide a structure and the means whereby the Hospital Sisters of the Third Order of St. Francis can continue their apostolic mission to serve the sick, the aged, the poor and the terminally ill without regard to race, color, creed or national origin. The primary concern of Sacred Heart Hospital and the Hospital Sisters is the patient's well-being—spiritual, physical, psychological and social.
2. Mayo Clinic
Mayo Clinic staff value and promote diversity. Diversity refers to all the characteristics that distinguish individuals or groups from one another. It includes distinctions based on race, color, creed, religion, gender, age, national origin, marital status, sexual orientation, disability, veteran's status, or status with regard to public assistance.
The goal of Mayo Clinic staff is to create a caring service environment where individual differences are valued, allowing individuals to achieve and contribute to their fullest potential. Benefits of embracing this goal include:

• Diversity of viewpoints and perspectives in concepts, initiatives and decision making
• Greater innovations and creativity
• A broad pool of qualified employees, enabling recruitment and retention of the best talent

An environment that nurtures and supports the fullest contributions of each individual is essential to success in patient care, education and research. Creating and sustaining this climate are the responsibilities of each individual who provides care, directly or indirectly, or learns at Mayo Clinic.
3. Nationwide Children's Hospital

At Nationwide Children’s Hospital, diversity isn’t simply a word used to describe the varied faces you meet in our halls. Diversity describes what we believe in. Our hospital has made a promise to not only acknowledge, but foster and celebrate the diversity of our patients, families, visitors, staff and physicians. Why? Because being an inclusive and welcoming organization makes us better suited to take care of those who need our help the most.

We provide the best care when we understand how our patient’s unique experiences inform their views, and how they expect and deserve to receive treatment. In our day-to-day operations, we strive to shape an environment that lets our patients, families and employees know that they are understood, respected and supported when they are at Nationwide Children’s. Because who they are matters, and always will.
Learn about Nationwide Children's "Who's Who" honorees

Diversity Council

The Nationwide Children's Hospital Diversity Council was established to identify a long-range plan for diversity improvements at Children's, and to lead and support diversity initiatives.
Nationwide Children’s Diversity Council Mission Statement – The Diversity Council will support/lead the hospital’s efforts in celebrating the value of our differences through all aspects of Nationwide Children’s culture.
Nationwide Children’s Diversity Council Vision Statement – The Diversity Council’s vision is to insure and continually advocate for an environment that is inviting, welcoming and supportive of patients, parents, staff and physicians of diverse backgrounds. We will create an atmosphere where the value of diversity is utilized to the fullest by embracing the backgrounds, talents and contributions of all groups reflective of our community who help us achieve the Nationwide Children’s mission.
4. University of Maryland medical center

The University of Maryland Medical System and its affiliated hospitals and health care facilities are equal opportunity employers and proud supporters of an environment of diversity.
5.  Bayshore Community Hospital
We strive to create an environment in which the uniqueness of each person is valued, and where everyone is treated with dignity and respect without regard to race, gender, age, national origin, ethnic background, disability, religion, culture, or sexual orientation.

Even though some of these are shorter than others, they are all pretty much saying that they will treat everyone equally no matter how unique. They respect diversity.  It fits with my diversity values because I believe that everyone deserves equal treatment and would give equal treatment to my patients. there is nothing wrong with being unique.

Carbon Dioxide Paper Evaluation

2. Reflect on the strengths and weaknesses of the criteria established. Were these good criteria, or should there have been different criteria established?

•  The criteria that the class made was legitimate references and a good scientific method. The strengths are that they were a bit broad and were hard to stay focused on them.  The strengths of these are that it doesn't incorporate any content of the paper.

3. Reflect on the strengths and the weaknesses of the presentations as a whole. Consider the "yes" and the "no" groups as a whole.

•  The yes groups looked more at the method of science to justify that the paper was credible, but then I noticed most groups through in some data that contradicted the yes argument.  The no groups picked apart the paper decently as well as the graphs. They focused a little too much on graphs and not enough on the paper itself.

4. Reflect on the group management of your group. what went well, what did not?

•  The management of the group was good and worked nicely.  We each did research on the paper and the references separately and then came together as a group to discuss our findings within that research. What didn't work well is finding times that our group could meet to get everyone there.

5. Reflect on the personal "ethic" you felt in your group. Did you believe in your position? Were you arguing against your beliefs?

• I was arguing that this paper was legitimate, but I didn't believe in that position at all.  I helped my group along in this presentation even though it was against what I believed because it was assigned to us no matter what we believed. 

6. Did the class make the correct decision when considering the broader impacts of the global warming/climate change debate? why?

• I think the class made the right decision that the paper is not legitimate. The "no" groups made stronger arguments than the "yes" ones.  The arguments that the "yes" groups made could be counter-argued but the "no" groups seemed to have more solid arguments. 
  

7. Explain the statement, "what we do in the US, soon will not matter." Provide evidence to justify this statement.

•  The US used to be a powerful country and the actions of this country could affect the world.  Other countries such as China are growing rapidly and will soon take over that view. India and China have populations that are increasing well beyond ours and that means they use more resources.  What the US does will no longer matter to as great of an extent as China or India.

8. Explain this statement, "what we do as individuals matters.' Provide evidence to justify this statement.

• For something to happen it takes at least one individual to do something.  To make a difference in anything at least one individual needs to step up and do something. Sometimes it takes just one person to do something but even if it is a large group, it still means that as individuals they joined that group.
  

Specific Ethical Question

My interest lies within the medical field. The ethical question I am focusing on is about In vitro. This is a process in which egg cells are fertilized by sperm outside of the body.  Eggs are removed from the woman’s ovaries and then adding sperm to fertilize them. Once fertilized, the egg gets transferred into that woman’s uterus. 1. Is it ethical to do In vitro to help with infertility?

2. It is ethical to do In vitro

                In vitro helps couples/individuals who are infertile have a chance at their own genetic child. If there is a technology giving them that opportunity, why not use it? This technology also helps women who cannot carry a baby full term or even a little bit of the time with the use of a surrogate.  It can be the embryo from that couple but inserted into a surrogate to make a healthy baby possible.  In vitro can also be used to prevent diseases and birth defects in babies. Embryos can be sorted out and healthy ones can be singled out from the ones that will produce a birth defect or disease.  The other embryos will be frozen or exposed of.  Embryos may be destroyed in In vitro but they don’t always survive during natural conception either because some embryos fail to implant in the uterine wall and then never become a baby. 

It is not ethical to do In vitro

                This process goes against religion and the beliefs of the religions. It is a “technical action” rather than an “act of conjugal union”.  It is seen as unnatural because In vitro is done in a lab with a third party instead of a couple doing it themselves naturally. It is like playing God by creating life that wouldn’t normally exist. This also doesn’t limit to just couples but single women with an unknown donor’s sperm to fertilize her eggs, and same sex couples using what they have and an unknown to get an embryo.  The doctors can fertilize eggs and then sort out embryos that are preferred, which could lead to designer babies.  The parents could choose exactly what traits and what gender their child is, which also goes against religious beliefs and takes the individuality out of the individual if parents can just select for what they want.  Those embryos that are not used are killed and those embryos could have become a person if it was used.

3. I believe In vitro is ethical to do. If I was told that I was infertile and I wanted a baby with my genetic material, I would consider In vitro. Most of the time, it isn’t someone’s fault if they are infertile, so why shouldn’t they have a chance to have their own child?

4. http://www.lifeissues.net/writers/oma/oma_01invitro.html

http://www.guardian.co.uk/commentisfree/2009/jan/14/vitro-fertlization-ivf-ethics

http://www.gfmer.ch/PGC_RH_2005/pdf/Ethics_IVF.pdf

http://web.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=787dfd47-b5f5-4b67-bde3-104f64fba10e%40sessionmgr10&vid=8&hid=12

http://www.americanpregnancy.org/infertility/ivf.html

My PDP

Mission

• Work toward a career that I'm interested in and challenges me, while keeping my values.

Values

• Staying close to my family and friends
• Morals
• helping people
• Challenge
• Change
• Education/ knowledge
• Respect

Goals

• Career
• Maintain a high GPA (now)
• Internship (this summer or next)
• Graduate from Stout (1or 2 yrs)
• Take MCAT (1 or 2 yrs)
• Get into military med school (2 or 3 yrs)
• Complete military med school (7 or 8 yrs)
• Finances
• keep a summer job until med school (now)
• shop for unnecessary things less than once every 2 months (now)
• Physical/Body
• Work hard and get in shape in track (now)
• Stay active and keep my hobbies (always)
• Personal
• stay close with family (always)
• visit family at least once every month (now)
• maintain friendships (always)
• moose hunting in Alaska with dad (before 10 yrs)
• shooting competition (before 2 yrs)

Criteria

Some criteria for a scientific paper would be:

• Are the sources credible? 
• Was the author clear and concise in their writing? 
• Does the author state what the focus of the paper is?
• Can the data be reproduced? Or has it been done in a previous study?

Penny weights

What would a penny weigh picked up from the sidewalk?

What would a 1908 penny weigh?

What would a 1793 penny weigh?

 The group I was in looked at what year the penny was made and what shape it is in to determine how much the penny from the sidewalk would weigh.  We looked into the difference between the mass of a new penny and the weight, because there is a difference. From that we found that a 1908 penny weighed .00686lbs or had a mass of 3.11g.  We also found the weight of the 1793 penny, which was .02972lbs or the mass was 13.48g. We went into detail about the pennies and their composition changes throughout the years and the changes in mass. Briefly, we talked about how tarnishing/ corrosion can affect the weight of the penny too.  

I think my group did a good job of distinguishing the difference between weight and mass of pennies.  As with most of the other groups, we should have focused more on the questions and less on the history of the penny.  We should have only had one presenter that was good at speaking instead of trying to get everyone to speak, since some people aren't the best at being loud and getting the information across. 

Professional Development Plan

Professional Development Plan

A plan you develop to accomplish your goals.  "Proactive Plan"

• Mission: This is what you want to accomplish/ your goals.  This can include personal and professional goals that you may have. 
• Values: Things that you value in your life and things that mean the most to you. 
• Timeline: This gives a time frame in which you plan to achieve certain aspects of your plan.  Should be reasonable. 
• Strategy: This is how you are going to accomplish the goals you want to accomplish. This may include getting help from people and things you need to look into.