SICK Score Study Research

SICK Score Study Research Sarah Mohammad Iqbal Chagani This project is pilot study of the clinical student’s preceptor ERC approval research named as â€Å"SICK score study† Introduction to the problem and topic Triaging pediatric patients is a difficult and challenging task as under-triaging could lead to sentinel events and medical errors. Since pediatric patients are more susceptible and less expressive than adult; they deteriorate quickly and many of their signs and symptoms could go either unnoticed or non-prioritized. The increased influx of pediatric patients in ED and changing trends of trained staffing could result in patients being under-triaged or missed resulting in misallocation of limited resources of ED. Numerous scores have been initiated to calculate the severity of illness in children, but all scores have either been introduced in ICU or critical care units. Since Emergency Department serves as the first door to the hospital, it should also have a scoring system so that patients could be sorted accordingly and care is not compromised. WHO has introduced ETAT guidelines for pediatric triage in emergency department but it could only be implemented after proper training and education of staff. A sign of Inflammation in sick children (SICK) score, created by Thompson, has been implemented in ED and is calculated using baseline vital signs and 4 important assessment questions. Since easy to calculate it can be implemented in ED without any specific training as vital signs are taken at the triage and the remaining parameters are verbally assessed but not documented. With this project, if significant sick score could be introduced, children triage could be made efficient and effective. Assessment phase Measurement of vital signs is a routine practice in all triage scales utilized in different hospitals for children visiting emergency department. On previous occasions, it has been seen that a lot of under triaging and over triaging has occurred resulting in missed priority levels of children and patients either being missed or not diagnosed appropriately. On two occasions, oncology pediatric patients were under-triaged resulting in sentinel events of mortality of those children in ED. It is not only important to monitor vital signs at triage but triage staff should be able to calculate severity score so that appropriate allocation of patients could take place. Currently, this hospital utilizes ESI priority system to allocate patients in ED, however, it would be interesting to observe the relationship of SICK score with the outcome of patients and compare it to the Priority levels. Vital signs play a very important role in triaging and disposition decision making of pediatric patients. Respiratory rate, color, nasal flaring all are indicators of pediatric clinical condition, however, pulse oximetry is a non- invasive technique of ruling out the severity of illness in pediatric patients. In a study, pulse oximetry measures were taken to identify the change in treatment plan and decision making of physicians. For 305 patients with Sao2 values less than 95%, the clinicians ordered 81 additional diagnostic tests for 62 patients (20%) and 39 additional treatments for 33 children (11%), and changed or added diagnoses for 25 children (8.2%) (Mower, Sachs, Niscklin, Baraff, 1997). Of this same group, clinicians admitted 50 (68%) children after rechecking the oxygen saturation, whereas 23 children were discharged without having their pulse oximetry rechecked (Mower, Sachs, Niscklin, Baraff, 1997). Furthermore, mortality levels could also be predicted with the vital signs and conscious levels of pediatric patients. Among 1133 patients, abnormality in heart rate and respiratory rates had no effect on the mortality of patients but mortality increased as the age of pediatric patients decreased with Odds ratio being 5.2, 15.4, 42.6, 57.0 and 98.3 (Kumar, Thomas, Singhal, Puliyel Sreenivas, 2003).Unlike heart rate and respiratory rate, abnormal blood pressure, oxygen saturation and conscious levels were found to have a significant (p-value Abnormal vital signs have also been found to have a significant relationship with serious and life threatening infections in pediatric patients. Children with serious infection as compared to minor infection had significantly higher temperature >39C (p,0.001), tachycardia (p,0.001), tachypnea (p = 0.002), oxygen saturations (94% (p2 seconds (p39uC (p = 0.004), tachycardia (p2 seconds (p = 0.001) when compared with minor infection (Thompson, Coad, Harnden, Mayon, Perera Mant, 2009). Planning Phase Purpose The aim of this project is to redesign the triage policy for paediatric patients and all those paediatric patients with higher score will be prioritize earlier for proper disposition and early management, so as to further improve the patient satisfaction and morbidity/mortality outcome. Objectives To predict the disease severity with SICK Score To find association of each independent variable and SICK score with the outcome variable Variables Dependant Variable Outcome of patient Admit Discharge Independent Variable SICK Score Heart Rate Respiratory Rate Temperature Oxygen saturation Systolic BP Capillary Refill Conscious Level Seizures Activity Gender Triage Category Approval and Plan Permissions were taken from ED Clinical Manager and ED Head Nurse to introduce the data collection forms (already approved by ERC AKUH) on the main counter to be attached in the file of all pediatric entries. The Unit Receptionists were informed by Manager and HN regarding the forms and reinforcement was provided by clinical student. E-mails were sent to the rotating PGME pediatric residents and pediatric ED faculty members regarding a brief of the study and requesting for filling of forms. A box was introduced in the pediatric area near the working desk of doctors for collection of data forms. Since the study was already funded by an international agency, therefore, the photocopies of the forms were done by the preceptor as per the need identified by the clinical student. Implementation phase The collected data was entered in SPSS software and codes were given to the categorical data. The sick scores were calculated using software provided by the preceptor. The total forms collected during the three week time was 185 forms but only 100 were included as the remaining had missing information (Diagram 1) The descriptive statistics of the variables revealed mean SICK score of 1.89 and a standard deviation of 0.98with the range between 0.00 – 5.10. Other variable statistics are defined in Table 1. Table 1 As displayed in Table 2, discharge patients accounted for 61% of the population and admission were 39%. It could also be noted that 38% patients lie in the age range 1-5 years and minimum percentage of 6% could be seen in the age range Table 2 On calculating the odds ratio (Table 3), it was found that SICK score had higher odds of 2.123 of patients being admitted to the hospital. Along with this, capillary refill also has higher odds of 2.46 to predict the admission outcome of patient. Table 3 Surprisingly, triage category and conscious levels were found to have no effect on the odds of outcome – indicating either discrepancies in the assessment tool of the study or the training of the triage staff. Consciousness plays a very important role in decision making of the patient but the results of this study are directing towards consciousness level having no effect on the odds of the outcome – which could be an error of the assessment tool. Though the model was 71.7% accurate in predicting the outcome of patient but the results are also implying towards comparing the assessment tool used in the Indian SICK score study and the tool used in this project. Evaluation This project has identified the importance of calculating SICK score in identifying the level of severity of illness in pediatric patients for appropriate triaging and allocation in emergency department. It also indicates that other than the baseline vital signs capillary refill should also be initiated at the triage as on an individual level it has higher odds of determining the outcome of patients. But the results also suggest few errors either in the tool formulated or the triage staff training which needs to corrected before the final study is initiated. Missing values was also a major problem as a lot of forms and patient data had to be removed as the forms were not being filled completely. Recommendation would include comparing the sick score with another simpler scoring system like TOPR and also identifying the relationship between SICK score and the mortality of pediatric patients. References Mower, W. R., Sachs, C., Nicklin, E. L., Baraff, L. J. (1997). Pulse Oximetry as a fifth Pediatric vital sign. Pediatrics. 99(5). 681 – 686. Thompson, M., Coad, N., Harnden, A., Mayon, R., Perera, R., Mant, D. (2009). How well do vital signs identify children with serious infection in pediatric emergency care. Archives of disabled children. 94. 888 – 893. Kumar, N., Thomas, N., Singhal, D., Puliyel, J. M., Sreenivas, V. (2003). Triage score for severity of illness. Indian Pediatrics. 40. 204-210. Retrieved from http://indianpediatrics.net/mar2003/mar-204-210.htm Gupta1 MA, Chakrabarty A, Halstead R, Sahni M, Rangasami J, Puliyel A. et. al. Validation of Signs of Inflammation in Children that Kill (SICK) score for immediate non-invasive assessment of severity of illness. Italian Journal of Pediatrics 2010, 36:35 Bhal S, Tygai V, Kumar N, Sreenivas V, Puliyel JM: Signs of Inflammation in Children that can Kill (SICK score): Preliminary prospective validation of a new non-invasive measure of severity of illness. J Postgrad Med 2006, 52:102-5. Data collection form MR # Age à ¢- ¡ Age bands à ¢- ¡ à ¢- ¡ 1- à ¢- ¡ 12 à ¢- ¡ 60 to à ¢- ¡ >120 months Gender à ¢- ¡ Maleà ¢- ¡ Female Triage Time Triage category (ESI) SICK SCORE Heart rate à ¢- ¡ Respiratory rate à ¢- ¡ Temperature à ¢- ¡ Oxygen saturation à ¢- ¡ Systolic blood pressure à ¢- ¡ CRT à ¢- ¡ ≠¥3 seconds à ¢- ¡ Conscious level à ¢- ¡ Aà ¢- ¡ V à ¢- ¡ P à ¢- ¡ U Seizures à ¢- ¡ Absentà ¢- ¡ Present Outcome à ¢- ¡ Admità ¢- ¡ Dischargeà ¢- ¡ Died Mode of admission à ¢- ¡ Wardà ¢- ¡ PICUà ¢- ¡ NICU

High School and Girls Education Unit Essay

1. INTRODUCTION South Africa has a high-cost, low-performance education system that does not compare favorably with education systems in other African countries, or in similar developing economies. There is a multitude of well-publicised problems, including a shortage of teachers, under qualified teachers and poor teacher performance. In the classroom, this results in poor learner standards and results, a lack of classroom discipline and is exacerbated by insufficient resources and inadequate infrastructure. On a government level, difficulties have been caused by a failure of appropriate inspection and monitoring, and confusion caused by changing curricula without proper communication and training. All this has lead to massive demoralisation and disillusionment among teachers and a negative and worsening perception of the teaching profession. Majority of learners in South Africa are bi- or multi-lingual, and attends school in a language that is not their first language. 2. INEQUALITIES FACING EDUCATION IN SOUTH AFRICA 2.1 Educational inequalities amongst blacks Amongst blacks, educational inequality largely follows the lines of income: more affluent Households are better able to support their children through school, implying increasing stratification within black society. Children from the top two black deciles progress Considerably better through the school system than their poorer counterparts and only at age15 start falling behind whites. Private resources were a major factor determining differential black educational outcomes under apartheid. Pupils in Better-off Black households do better in their education, and we find no parallel for Whites. That the education of Blacks but not Whites is constrained by financial resources is further supported by the fact that many Blacks who are not in school (but not Whites). Furthermore, greater recent access to formerly white schools for more affluent blacks may have accentuated qualitative educational differentials amongst blacks. Data from the 1996 census show mean earnings of full-time employed black workers for whom the educational level of a parent is known, children of the head of household still resident in the household to be substantially higher where the household head has at least matriculated. But is this perhaps solely due to more educated parents having more educated11 children, to differential attainment. In some way the better education of the parent translates into higher earnings for children even Compared to other young workers who also have matriculated, but where the parent had less education. However, it is not clear whether this measures the quality of education, or some other non-observed aspect of human capital transmitted from parents to children. Such premier does decline, though, to about 9% in cases where the children have graduated. 2.2 CHALLENGES FACING FEMALES Over the years girls education has been given a high level of priority at the highest level. It has been boosted by initiatives, such as free education for girls, President’s Empowerment for Girls Education, just to name but a few. However, despite all these incentives, girls education in the country is still faced with a series of challenges. The challenges facing girl’s education include; âž ¢ early marriages âž ¢ teenage pregnancy âž ¢ poverty âž ¢ peer pressure âž ¢ low adult literacy As a result of these factors, it has become very difficult to retain the girl-student in school, especially in the rural areas. Our stand here is that girls must be allowed to finish their education to the highest level, before marrying them off. Parents should be encouraged to desist from such practices as it’s not in the interest of the girl child, female students must also be serious and do away with engaging with men until they complete their schooling. The most common saying among the local people, especially at the provincial areas, is that girl’s education is not important this mentality must be changed and people must understand that education is the key to development. The performance of girls in schools concerning because it is disheartening to know that despite numerous opportunities available to them, the performance of girls in school is not the least impressive. Something urgent must be done sooner rather than later, quality must not be compromised in our education system. The Ministry of Basic and Secondary Education had set up girls education unit and introduced lots of initiatives towards addressing these challenges. Principal, among the initiatives, was the Sponsorship Trust Fund for Girls which was launched in 1999, to support the enrolment, retention and performance of girls in Upper Basic and Senior Secondary Schools in the Upper and Central River Regions. 2.3 Quality differentials in education One should not forget, though, that the quality of education still varies considerably. This is again not unique to South Africa. In some Latin American countries, the poor receive an inferior quality of schooling, with the result that individuals from the lower deciles receive a primary education whose quality is 35 percent lower than that. Although the old dividing lines of race have blurred in education, with many black pupils now attending formerly white schools, shows that most black pupils were still in schools which were predominantly black. About 5% of the pupils in mainly white schools were black, whilst in mixed schools 40% were black, but there is great quality diversity in mainly black schools, and as a group most formerly black schools still perform much worse than white schools, as reflected in matric pass rates. Judging by the high matriculation failure rates, lenient promotion policies in black schools may cause educational attainment at levels below matriculation to give an inflated impression of educational standards reached, as reflected in cognitive levels mastered. 3. CHALLENGES FACING PRIMARY SCHOOLS South Africa spends a bigger share of its gross domestic product on education than any other country in Africa. Primary schooling is compulsory for children aged 7 to 15 while an integrated approach to early childhood development aims to give all children between birth and school-going age the best start in life. A No-Fee Schools policy has abolished school fees in the poorest primary schools across the country, helping to attract poor, orphaned, disabled and vulnerable children to school, yet performance levels are lower than in many other countries in the region. High levels of school attendance, gender parity in both primary and secondary education and pro-poor school policies are achievements that contrast with the poor quality of education. Many children experience a broken journey through school, interrupted by irregular attendance, absent teachers, teenage pregnancy and school-related abuse and violence. Most public schools do not have running water; some do not have libraries and computers. There is limited provision for preschool and special education, the Department of Basic Education has devised strategies to improve learner achievements by 2014. One of these is the Annual National Assessment, intended to provide regular and credible data on learner achievement and inform decision making in the education system. The assessment in 2011 involved numeracy and literacy tests among six million foundation phase which is grade 1 to 3 and intermediate phase grades (4 to 6) learners at government schools. The findings revealed that the quality of teaching is poor, leading to low performance. The percentage of learners reaching a ‘partially achieved’ level of performance varied from 30 per cent to 47 per cent, depending on the grade and subject considered. Those attaining the ‘achieved’ level of performance varied from 12 per cent to 31 per cent. UNICEF supports government capacity to improve programme planning and results-based management while implementing innovative interventions to improve the quality of teaching and learning in schools. UNICEF also works to strengthen gender-sensitive life skills-based education for adolescent girls and boys in and out of school, with a focus on the prevention of gender-based violence, HIV and teenage pregnancy. The programme also pays particular attention to early childhood and the development of strategies for children’s equitable participation in quality ECD services. 4. SOCIAL FACTORS AFFECTING EDUCATION The biggest factor is parents, if parent’s place a high value on education and help their children do well and encourage them to push themselves and learn then it does not really matter how wealthy the neighborhood is. A school located in a lower income area will most likely have lower test scores than a school located in upper-middle class area; also our media as a whole in this country is among the factors does not really encourage higher education or even being smart as values. Even in movies where characters go to college, it is portrayed as a place to party, not to learn. Good parenting in early age of any child, like trying to get them early, and recognition of pictures of dogs, cats, pigs or other animals. Books at home are invaluable to further their education, early reading always enhances a child’s ability to grasp opportunities to progressing a fuller understanding of a subject. Parents who include their children in discussions and opinions are fitting them for communication with others at an early stage. 5. ECONOMIC FACTORS AFFECTING EDUCATION Money can be a factor in access to educational opportunities. In a perfect world, the amount of money in your bank account would have nothing to do with the quality of education to which you have access. But of course, this is not a perfect world. Truth is, despite various different initiatives to create more and better educational opportunities for the financially strapped, there remain many economic factors related to education on all levels. 5.1 PUBLIC SCHOOL DISTRICTS AND HOUSING The best public schools are often located in the most expensive districts for homebuyers. When you are a child, you think all schools are the same and where you live has nothing to do with the quality of education you will receive. That is not the case, and it is the reason why many homebuyers and young families in the housing market say their number one priority is finding a home in a good school district. With so many families looking for good public schooling, the best districts are also often the priciest. 6. CONCLUSION Despite the lasting influence of apartheid, educational access is no longer a major problem in South Africa, as more than 90% of children of all race groups remain at school until attaining matric or reaching age 16. The racial gaps in educational attainment (years of education completed) have also been substantially reduced over the past decades. However, there are severe problems with the quality of education of a large part of the South African school system, as reflected in cognitive tests of numeracy and literacy and also shown by matriculation results. The deficient performance of particularly mainly black schools is a source of concern, as this shows that reduced earnings inequality may well be more difficult than rising educational attainment at lower school levels would indicate. Only limited scope remains for additional resource outlays to redress this malfunctioning of the major part of the school system. Moreover, the evidence shows that more resources is not the solution to bad educational performance, as some of the worst performing schools are well-resourced, whilst some schools perform excellently with limited resources. 7. REFERENCE Bellew, R. & King, E.M. promoting girls and women’s education: lessons from the past. Case, Anne & Deaton, Angus. 1999. School inputs and educational outcomes in South Africa. Quarterly Journal of Economics 114(3): 1047-1084 [WEB:] http://www.google.com [WEB:] http://mg.co.za/article/2012-07-29,world bank education; the only way to reverse inequality in SA

Opre 6371 Case 5-2

6Case 5-2: Rondot Automotive Name: Lovee Sachdeva, Bin Wen, Matthew Miles, Ryan Buxbaum ,Yuguang Wang, Shaoying Lu. Group: 3 Date: 2/22/2013 ————————————————- Situation: * Glenn Northcott is the purchasing planner at Rondot Automobile in Jackson, Mississippi. The company is a wholly owned subsidiary of Rondot Worldwide, a leading global designer and manufacturer of electrical and electronic components. Note: You are Glenn) * Responsible for evaluation the outsourcing opportunity * Meet with Terry Gibson and purchasing manager to decide whether or not to take actions on outsourcing * Glenn had been approached by Greven E-Coating willing to provide electro coating services to Rondot Automobile * Goals of decision making: Reducing the total costs while maintaining and minimizing the risks from any changes made * Considerable global competition under severe cost pressure * Cust omer’s price reduction pressure expectancies from global competition * Total Sales and employment at the Jackson plant had steadily declined * Company is under significant pressure on cost reduction. The company’s current priority is to reduce operation costs * Rondot is a wholly owned subsidiary of Rondot Worldwide, a leading global designer and manufacturer of electrical and electronic components. Rondot Automotive operated 85 plants in 25 countries. The purchasing organization at Rondot automotive had a hybrid structure and the Jackson plant’s purchasing department consisted of four people, including two buyers, a planner (Glen) and Terry Gibson. * Schedule with the purchasing manager, Terry Gibson, and the plant manager, Dick Taylor in one week, and both of them are under significant pressure to reduce costs at Jackson plant. * Greven E-Coating outsourcing opportunity * Greven E-Coating Company uses a system whereby a DC electrical charge is applied to a met al part immersed in a bath of oppositely charged paint particles. * Considered more cost efficient compared to traditional wet paint systems * Samples provided from Greven E-Coating Company Tests results: 5/6 of families of housings could be converted to e-coaring using Greven at a cost of 15 cents each * Parts for five of the six represents 60% of the Jackson Plant’s volume * Failure because of different methods of adhesion of a magnet to the housing. Hot –bond adhesion process fits e-coating while cold-bond adhesion process does not fit e-coating system Current situation: * Total sales and employment at the Jackson plant had steadily declined over the past five years. * The number of employees at the plant had dropped from 1450 to 600 and plant management was under pressure to lower costs and regain market share. * Glenn has the option to do outsourcing on cleaning and painting work to Greven E-Coating. Glenn needs to come up with an ideal recommendation on how to re duce the cost and propose that to Terry Gibson and Dick Taylor. * The cleaning and wet painting had been installed 17 years prior and undergone a number of upgrades, and the current painting method costs 25 cents for each housing. (There are six parts in a housing family) BASIC ISSUES 1. Company to take decision on insourcing or outsourcing 2. Higher costs related to painting & cleaning 3. Lack of advanced technology to compete in cost reduction for a lower price 4. A decision to make, once made, is often difficult to reserve. If Rondot Automobile decides to make agreements on e-coating system, The plant needs to convert 100% hot-bond adhesion system 5.Total cost of converting 40% of cold-bond adhesion system to the total cost savings: Long-Term estimation, not short term 6. Whether the use of e-coating will lead to sole source dependency: Is the e-coating system a common painting method in market? 7. The durability of e-coating VS. of traditional coating system 8. Cost benefits ana lysis on the process 9. Inexperienced decision making on outsourcing opportunity Tasks: * What does Richard Kaplan do? Richard needs to clarify and calculate the total cost savings and the cost of converting from cold-bond adhesion to hot-bond adhesion * 25 Cents * 6 = $1. 50 * 15 Cents * 6 = $0. 90 * Does the difference $0. 60 can cover the conversion from traditional wet coating system to e-coating system? The durability and re-paint rate is also needed to consider: If the wet-coating system has durability of 10 years while e-coating repaint rate is 8 years, The total cost of conversion from traditional wet-coating system to e-coating system will increase significantly * What are alternatives? * Negotiate with Greven E-Coating for a lower costs * Conduct a careful research on both advantages and disadvantages of E-coating system * Search for more options in potential sources and substitute items other than traditional wet-painting and e-coating * The challenge of maintaining long- term technological and economic viability for the possible 100% hot-bond adhesion system * The revision of policy of supplier selection Criteria of standardization and policies regarding the choosing of suppliers * An understanding of the market conditions in order to set appropriate expectations for the price provided from Greven E- Coating * Analyze data collected for cost and technical information * Identify the root causes of sales decline. If the sales revenue can be improved, the company can maintain the current painting process to avoid future external risks * * Determine that is the cold-bond adhesion system a necessary facility for the particular family to manufacture any specified electrical and electronic components * Dose this outsourcing plan fit the business goals and objectives? * What does the company’s top management think about the Jackson plant’s outsourcing plan? * Which level of management makes a final decision on outsourcing? Talk to manufacturin g manager and clarify more information about cold-bond adhesion * Talk to the manager in the family that uses cold-bond adhesion system. Clarify the reason why the family of housing choose to use cold-bond adhesion * Identify and estimate total cost to uninstall and setup the new bond system if the method of adhering a magnet to the housing is not mandatory SUGGESTED QUESTIONS FOR DISCUSSION; 1. How to make analysis of the cost of switching current painting process versus the cost of setting up a painting process? What kinds of training should be provided due to the new standards of temperature, air and etc? 2. If the result of outsourcing is rejected, is the subcontracting an alternative for the company?What are the benefits and risks of using reverse auctions for specialized OEM parts? 3. What risk management and contractual steps are necessary before moving company owned tooling to a new supplier? 4. What are the benefits and risks of outsourcing? Actions: * Determination of deta iled function & mandatory of Cold-Bond Adhesion system * Meet with both Manufacturing manager and the family manager in Jackson Plant. * Determine the total costs of uninstallation the current cold-bond adhesion system and the installation of hot-bond adhesion system * Total Cost Savings calculation * Identify the cost savings potential after the modification. With the newly modified standards, communicate with Greven E-Coating and analyze the decision based on the feedbacks from the supplier. * Determine whether the total cost savings can cover the conversion cost from cold-bond adhesion system to hot-bond system * Estimate the future necessity and future technological tendency of replacing traditional wet paint to E-Coating. If the company is going to replace the traditional wet painting in the future anyway, the cost of conversion can be ignored. * Talk with Betty McKinley again and determine the detailed cost of holding two more weeks of inventory * Make agreements on price and quantity, meanwhile negotiate the term of warranty and quality assurance with Greven E-Coating Results: If accept outsourcing opportunity * Cost savings:25-15-3=7 cents on each housing * Add another two weeks worth of inventory * Lower labor and material costs * Product price reductions i. e. ability to offer reduced price to customers. * Become more competitive and there will be a gradual increase in the profit and market share. * If not accepting outsourcing opportunity (i. e.. using the earlier system ) * No savings- no price reductions * Reduce risk for investment * Extra cost in upgrading the system * Spending on more labor in this operation which results in additional costs * May result in lower operating time * Extra time for testing upgraded system. If total cost savings is greater than the costs of uninstallation of Cold-bond adhesion + Installation of hot-bond adhesion + extra inventory carrying costs: * Prepare the agreements and contract documentation on outsourcing deci sion with Greven E-Coating * The contract content with Greven E-Coating tends to be short-term to avoid sole-source dependency situation. Reach out lower priced suppliers while maintain the quality assurance * If total cost savings is equal to or less than the costs of uninstallation of Cold-bond adhesion + Installation of hot-bond adhesion + extra inventory carrying costs: * Determine the importance of common tendency of using E-coating for other manufacturing companies.If the E-coating is not mandatory in the future market, reject the outsourcing plan to avoid extra possible risks * Find out other alternative ways to reduce total costs, such as reduction of labor costs, manufacturing overhead or the replacement of cost-efficient equipment or facilities Priorities: * Maintain cost reduction at the Jackson plant. * Increase sales volume and high market share. * Ensure a successful outsourcing decision. * Maintain company’s reputation-image for reliability. Conclusion: The pai nting process should be outsourced in order to achieve significant cost savings. Ensure supplier selection process is properly done, forecast and mitigate against outsourcing inherent risks and ensure quality standard is met at all times. These will help in achieving a successful outsourcing agreement.

The Minimum Wage Is Not The Best Policy Essay - 1213 Words

When the costs of labor increase, there is a deadweight loss of employment associated with this reduction in hiring (quantity demand), which reflected in the loss for employers (consumer) and job seekers (producers). In 48 years, from 1968 to 2016, the U.S GDP has rapidly, and steadily increased to 361.5 percent from 4.62 trillion dollars to 16.7 trillion dollars. Relating this statistic to the federal minimum wage, in 1968, the federal minimum wage is 1.60 dollars per hour, if the federal minimum wage should increase by GDP grown rate, it will be 5.79 per hour today. When adjusted by inflating rate, it should be 11.11 dollars per hour for the same purchasing power. Indexing the minimum wage to inflation is not the best policy to help the low-wage worker. For example, suppose the Congress in 1938, at the height of the Great Depression, when established the first federal minimum wage as part of the Fair Labor Standards Act (FLSA) authorized its indexing to inflation thereafter, just a s President Obama asked for in his final State of the Union address, the minimum wage of .25 dollars per hour in 1938 is worth 4.29 dollar in 2016, compared to the current federal minimum wage of 7.25 dollars per hour (BLS CPI Inflation Calculator. So what is a fair minimum wage after all and would it fix poverty with a new increase in minimum wage? Regardless of race, status, age, or where one may live, Americans are the people, not the statistics. We the American people are facing vital andShow MoreRelatedMiimum Wage and Power to the People1746 Words   |  7 PagesThree – Power to the people The third and final alternative minimum wage is to allow the local people in the community vote on a living wage. 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Consequently, by the 1990sRead MoreThe Debate of Increasing Miniumum Wage713 Words   |  3 Pagesdecades, the minimum wage has been on going topic that the economists and the policy makers has been debating on. Indeed, It is still an open issue and the policy makers still debating on increasing it. The first Country that passed the minimum wage policy was New Zealand in 1984, and a lot country followed. President Roosevelt passed the first minimum wage in 1938, the minimum wage was 0.25 when the Roosevelt passed, and it has been increased as the living expense went up. The minimum wage is measuredRead MoreMinimum Wage And Its Effect On Employment839 Words   |  4 Pagesso, the minimum wage in the United States (U.S.) have been a topic of interest for many parties. On one side, the parties that oppose an increase in the minimum wage believe that an increase will spark an epidemic of high unemployment rates. On the other sid e, the parties are asking for an increase in the minimum wage for many other reasons, including help lower the poverty levels, afford health insurance and higher education among other needs. Throughout the U.S., the inequality of wages and compensationRead MoreThe Impact Of National Minimum Wage On South Africa s Income Inequality Essay1525 Words   |  7 PagesThe impact national minimum wage would have on South Africa’s income inequality should it be implemented. South Africa is still considered one of the countries which still consist of high income inequality. Economists argue that inequality is the most unavoidable part of the economic development and that it continues to increase in developing countries due to economic growth (Keeton, 2014). Inequality is a problem in countries such as South Africa, because it shifts the attention from bigger andRead MoreDoes the Minimum Wage Increase the Standard of Living for Low-Income People?1391 Words   |  6 PagesThe United States has maintained a minimum wage which was enacted since 1938. At the present time there is much political debate in regarding to increase the minimum wage to levels at the federal level, state, and local levels of government across this country. There are various theories regarding the minimum wage. Some believe it would circulate money into the economy faster which would negate and negative effects on employment, or even improve unemployment rates. Others point to the ec onomic theoryRead More Do Minimum Wage Laws Increase Unemployment? Essay1188 Words   |  5 Pagescurrent minimum wage, as set by federal law, is less than $15 per hour. Is this enough for any person to provide for themselves and their family? Laborers earning the minimum wage dont seem to think so and are wanting an increase in the required minimum wage so they will be paid more by their employers. The Bureau of Labor Statistics reported in 2015 that 3.6 million workers earned below or at the minimum wage (Minimum Wage Workers). At first it sounds wonderful for minimum wage workers to