Quality Management in Health Care System in Nigeria A Case Study of Isalu Hospitals Limited, Ogba, Lagos free essay sample

INTRODUCTION In this age, hospital services have gone beyond the conventional way of doctors sitting in their clinics, reading newspapers or engaging in other vain discussions hoping that patients would patronise their healthcare services. Various private hospitals have carved out a niche for themselves using relationship management, customer relations and hospital marketing techniques to expand their business. Although the prime aim of hospital/healthcare establishments is to save lives, the truth is that private healthcare services are profit-driven as owners have to cater for various expenses and overheads to keep the business moving. Those who run healthcare business grapple with regular payment of staff salary, procurement of new medical equipment, maintenance of computers and buildings, payment of electricity bills, procurement and fuelling of power generators, maintenance of official vehicles, communication expenses, staff seminars and printing of receipts, appointment cards and medical report sheets. Just like a good product, a good hospital service sells itself. We will write a custom essay sample on Quality Management in Health Care System in Nigeria: A Case Study of Isalu Hospitals Limited, Ogba, Lagos or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page This comes mostly through testimonials from people who have practically experienced the service(s). But a good product or service cannot, by itself, propagate its services to the users. Certain machinery should be put in place to achieve this end. Although medical bodies such as Nigeria Medical Association strictly prohibits hospital advertising, the dynamic nature of medical business, not only in Nigeria but globally, has made it mandatory for Health Maintenance Organisations (HMOs) to place their advertisements on the pages of newspapers, over the radio/television and on the Internet under the guise of health insurance, since insurance does not forbid advertising its services to various target groups. Good customer care/ relationship management matters in healthcare business because keeping the existing clients—that is, the patients—seems easier than getting the new ones, as satisfied clients will do a lot of our testimonial appeals for us to the new prospects. Some people will use our service on the recommendation of a friend or sibling. This is because patient who feels good experiencing our medical service is most likely to stay with the healthcare and make recommendations to others about us. In these days of sophisticated and well educated customers, patients look beyond coming to the hospital and being attended to in the â€Å"usual manner†. They want to experience an informal contact (tactile communication); they want the doctor to tell them what they don’t know in medicine because many of them have already googled their internet to know about their ailments before consultation; they want to feel like they are in their homes; they want to feel that they are in safe hands and they want to be healed by the words of mouth of the doctors in charge, nurses on duty as well as all other contact points— i. . the staff—in the hospital. Hospitals therefore establish mutual relationship with several HMOs as well as corporate companies (on retainership) and families or private patients to garner more companies on their clientele. STAGES OF COMPANY DEVELOPMENT Various business organisations launch their products/services into the market to claim some mar ket share. Right from the time a product or service is newly introduced, there is always scramble among companies that offer similar services or produce parity products to have some comfortable share of the market to their advantage. In order to achieve this, most producers or service companies have good positioning of their USP. Some hospitals have ATM where patients can easily withdraw money to settle their medical bills without any stress of going to the bank. Some have supermarkets where people on appointment can take some bread with drink before taking their drugs or injections. Others have immaculate environment befitting of a healthcare. Each of these is a strength, a unique selling point (USP) for their medical business. (a)Pioneering stage— This refers to when services are new to the prospective clients. They are only being introduced. Concepts are created. Proposals are developed and companies, HMOs as well as individuals are being convinced to use such medical services. Many companies die at this stage and never make it to the competitive stage. (b)Competitive stage— Most service companies or products remain at this stage throughout their life cycle. Here market acceptance has been met by a service company as certain percentage of the market share has been claimed. Many hospitals especially private ones can be categorised under this stage. The more quality medical service they provide, the more competitive and recommendable they become. c)Retentive Stage—This is the highest point a product or service company can achieve. Although not all products or service companies get to this stage, it is not impossible for any healthcare establishment to get there in Lagos State for instance. It is not always easy to get to the top and retaining it is more tasking. At this stage, the superiority of a company ser vice over all service providers will be established, making it command more clients and greater market share . DEFINITION OF TERMS For the purpose of exposition, I will like to define the following words—quality, management and healthcare respectively. Quality In the estimation of Longman Dictionary of Contemporary English, 2005 edition, the word quality is defined as how good or bad something is. It goes further†¦something that is typical of one thing and makes it different from other things, for example size, colour etc this may be a unique way of doing things. We may settle for this last definition of the word quality by the same lexicon: a high standard. Management Management can be defined as the activity of controlling and organising the work being carried out in an oganisation. The word ‘management’ also means the people who are in charge of a company. According to Kreitner (1980), management is a â€Å"problem-solving process of effectively achieving organisational objectives through the efficient use of scarce resources in a changing environment†. The universally accepted functions of management are planning, organising, staffing, directing and controlling, according to Onifade (1999). Healthcare Simply put, healthcare refers to the service of providing medical care to different categories of people. By classification, there are primary and secondary healthcare systems. Primary healthcare refers to the patient’s first contact for health care. It deals with general health problems which are mostly handled by GPs. They are hospitals dealing with health problems such as malaria and other basic illnesses and accidents while secondary healthcare system is a branch of healthcare that deals with specialised and more technical areas such as paediatrics, surgery, gynaecology, ophthalmology and many others. A healthcare provider can therefore be defined as a hospital where medical care is provided in various forms: laboratory investigation/diagnosis, clinical analysis, medical check-up, edical advice, surgery, blood transfusion, admission and so forth. Quality management in healthcare should be seen as a problem-solving process. How qualitative are the processes in our hospitals today? Are they of high standard or otherwise? The problem-solving process in any hospital environment cuts across all the contact points of the system—right from the gatemen through the customer service executives, the nurses, the laboratory scienti sts, the pharmacists to the consulting room. This chain does not exclude the maintenance officers, the cleaners, administrative staff, the kitchen executives, the security men and all others that have one role or the other to play in the process of caring and live-saving. Quality management in healthcare will be examined in the following key areas viz: ? Information management ?Patient management ?Staff management ?Relationship management ?Human Resource Management. ?Corporate Social Responsibility Information management: This bothers on how organisational messages are communicated in our hospitals, vertically or horizontally? Are messages well relayed to their proper destinations? How do heads of departments in the healthcare system manage hospital information at their disposal? Do we maintain the professional secrecy in the job? Many of us are aware of doctor-patient confidentiality for instance. The laboratory scientist has a lot of information at his disposal. Does he shield the information from the third party? Does he label accurately his specimen to avoid mix-up of laboratory results to the patients? Are our nurses used to discussing such information casually? Do people divulge the hospital’s classified information to the outsiders? These are heart-throbbing questions practitioners in healthcare should examine deeply from time to time. Telephone reception in hospital environment is another vital area where many hospital owners do not take seriously. Many nurses and other administrative healthcare workers lack telephone etiquette. In hospital environment, telephone reception should exceptionally be handled with courtesies and empathy because all patients calling the hospital lines, whether through the ntercom or hotlines, day or night are not doing so in vain or for pleasure. Many patients on admission are distressed and need urgent attention. The ringing of an emergency bell should serve as a saving grace to the in-patients. Some patient is in pains and wants to know if he should continue his dosage or come over to the clinic—this has to be confirmed from the doctor almost immediately because the patient is waiting on the pho ne. Some patient will call to know when doctor A, B or C will be on duty because she has confidence in their treatment and prescriptions. An enrollee will want to know if he has been delisted by his HMO or whether his brother-in-law can come with his card and be treated on fee for service. We must not wait for the third ring before springing into action. This will prove us as real life-savers. The manner and approach by which a hospital staff attends to any of these patients in terms of the information they need will, to a large extent, depict the quality of service available in such a healthcare. Patient management: How do we manage our patients? Do we value one patient over another because of their differing backgrounds? Do we give them the required attention needed at all times? For how long do we delay them especially when they are distressed or in pains? As healthcare practitioners, do we give them due recognition as soon as they enter our facility? Whether an HMO, retainership or private patient, all patients must be accorded courtesies, recognition, sympathy and attention. Are the nurses giving them the total nursing care most hospitals/HMOs promised on the pages of their profiles, tracts or website? Do hospitals design and administer questionnaires on patients’ satisfaction/dissatisfaction of their medical services so as to improve on various areas? Areas such as drug efficacy, hospital hygiene, doctor’s competence, nurses’ attitude and laboratory test results should be appraised by healthcare management as feedbacks from the patients. However, the best way to get feedback from patients is through interpersonal discussions and interview. By this, the healthcare practitioner can read beyond verbal discussions. This will help them improve on areas of deficiencies and at the same time know their strength. At times, in some hospitals, nurses are fond of passing the buck as to who will take the vital signs for a patient who is in pains or who will clean the medical pack. This attitude gives a negative impression of our ladies(men too work as nurses! ) clad in immaculate white to save lives. A patient is ethically and professionally protected on any medical information relating to them. Healthcare professionals especially doctors should protect their patients in this relationship because it is the right of the latter. Common observations have revealed that hospital practitioners like nurses and laboratory scientists in some instances are fond of discussing the confidential document or medical status of patients openly with colleagues to the hearing of other patients or even outsiders. Apart from the fact that this practice is unethical, it shows a betrayal of trust on the part of these supposed ‘professionals’ who are expected to be guardians of patients’ confidential information. Patients with some pain should not be further unleashed with psychological pains through careless gist by healthcare staff during/after working hours. Some health workers would gossip in their OPD that so-so patient is XYZ, whereas a large percentage of people who visit hospitals these days are well aware that a patient whose card is marked XYZ is HIV positive. Although dynamic hospitals are finding alternative terms as tags on their patients’ files, doctor’s reports or medical examination forms, all allied workers to the doctors in the healthcare should be well sensitised on the trauma such patients go through when their ailment is divulged to strangers without their consent. Another area of patient management in the healthcare is prescription and administration of drugs. This area largely constitutes the output of doctors’ diagnosis/treatment. Patients will always accuse the providers of prescribing or dishing out ineffective drugs. The doctors on their part blame this on the economic system/proliferation of fake drugs since they are not the manufacturers of these drugs. Healthcare practitioners such as doctors and pharmacists should collaborate with NHIS, NMA and Pharmacists Association to tackle the problem of drug fakery in the country while each healthcare establishment should source their drugs from registered pharmaceutical companies such as Fidson, Evans, Reals, Emzor, Beecham or Pfizer for instance. This will make them achieve desired results in treatment of their patients. Oftentimes, patients never complete their drug dosage as prescribed by doctors. Sadly, they expect good result. But what we are told in medicine is that if a patient fails to complete the last two of a 4-4-2 anti-malarial drug at a specified time, for instance, such patient has to start all over again or take a complete dosage of another anti-malarial on doctor’s prescription. Patients should be oriented, by doctors, on dangers of not completing their drugs. Staff management: If you smile at a mirror, amazingly, it smiles back at you. This basically concerns the management of a healthcare whether government-owned or private. How do we manage our staff? Do we pay them as at when due? Do we express that a staff is more important than the other? Do we value viable ideas/proposals from members of staff or jettison them into the trash bin? An organised healthcare should realize that a tree does not make a forest. It should make all its members of staff work as team. For example, players in a football team cannot afford to play in disarray and achieve fruitful result. So is the practice in the theatre, in the labour and even during emergency. The combination of the efforts of the nurses, domestic staff, doctors and the laboratory scientist yield the desired result of life-saving. Members of staff in the healthcare should be team-players to achieve the high professional standard in our society. A hungry man, they say, is an angry man. Since the living of healthcare workers too largely depends on their salary, all stake-holders in the health sector should realize that prompt payment of workers’ salaries amounts to saving their (workers’)own lives too. Since they are the engine room of an organisation, they must be considered by the management of individual organisation as most important. Their sweat, their energy, their ideas and commitment to various responsibilities assigned to them will—in the long run—make the organisation achieve its objectives. The good treatment of the internal publics by the management always reflects on the output of the business. Private hospitals should encourage research, paper presentations among staff and sponsor them for seminars so that they impact this for more efficiency in their healthcare establishments. Relationship management: Good interpersonal relationship in any organisation is the key to achieving success and growth. If certain colleagues are not in good talking terms, there can never be a quality management—problem solving process—in that organisation, especially in the healthcare where workers’ primary business is to save lives. Therefore, there should be good relationship between the staff and the top management; between the customer service and the nursing departments; between the domestic and the administrative department and so forth. All the departments of our hospitals or other healthcares like HMOs should be able to work as a team. As a former relationship manager in the healthcare, I had always got back to various departments/units on feedbacks from our clients to achieve this purpose. All forms of biases should be cancelled and a third party should always mediate between two conflicting groups or individuals. Quality management in our hospitals requires the concerted efforts of all people involved. Below is a sample questionnaire of Isalu Hospitals Limited, Ogba, Lagos on service evaluation: - Hospital Service Evaluation fig 1. Poor Satisfactory Good Excellent Caring attitude of doctors Nurses’ competence Neatness of our hospital environment Communication/listening skills Infrastructure: A/C, TV, Computers Performance of housekeepers Can you recommend our hospital to your family member/friend? Yes No Other comments†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. The above questionnaire was administered on 100 patients using Isalu Hospitals, Lagos in June 2009 and the following were the responses received. In all, 82 of the respondents said they could recommend the hospital(in terms of its ser vices) to their family and friends while 18 were indifferent. 70 of them rated doctors’ performance as good, 21 as satisfactory and 9 as excellent. 65 of the respondents said the nurses’ performance was satisfactory, 25 said it was good and 10 said it was excellent. Under communication skills, 30 of the respondents ticked satisfactory, 33 ticked good and 37 excellent respectively. Also, 25% of the respondents ticked satisfactory, 35% ticked good while 40% ticked excellent under hygiene. On other comments,65 of the patient respondents said the hospital’s bill was high, 20% said the hospital needed a bigger space while 15% were indifferent. The data can be vividly represented in fig. 1A, fig. 1B and fig. 1C respectively: fig. 1A fig 1B Fig 1C Basically there are two categories of people working in Isalu Hospitals. These are what I coin as: (a)Professional healthcare practitioners (b)Professionals in healthcare practice PROFESSIONAL HEALTHCARE PRACTITIONERS These are people who have received education and training in hospital-related courses such as medicine, nursing, pharmacy, laboratory science and so forth. They are our doctors, nurses, pharmacists, laboratory scientists/technicians etc PROFESSIONALS IN HEALTHCARE PRACTICE All healthcare workers coming from backgrounds different from medicine and other allied courses are referred to as professionals in healthcare. These professionals are recruited from areas like Accounting, Banking and Finance, Business Administration, Marketing, Personnel Management, Economics, Mass Communication etc to be part of the problem-solving process in the hospital environment. Isalu Hospitals, like other healthcare organisation, is segmented into sundry departments based on the two categories mentioned above. Though some jobs are more professional oriented than others in this hospital, the jobs of the two categories are inextricably intertwined to achieve the desired objective, which is high standard. In order to continue to achieve professional excellence in our healthcare system, through human capital development, members of staff should undergo periodic training relevant to their background and job description. Human Resource Management: The most valued assets of any organisation are the people who may make or mar the quality management in such an establishment. Otherwise known as Human Capital Management (HCM), Human Resource Management is the strategic function of managing an establishment’s most valued assets—the staff of such an organisation. The human resources department of any organisation is charged with not only employing but training, developing, directing and managing various talents in the workforce and as well putting in place development process in the organisation. The department responsible for recruiting the workforce in the healthcare, be it private or government-owned, should be competent enough to hire the right people. Both professional practitioners and other professionals in the profession should comprise this department. This will give room for people of right attitude, coupled with academic merits, to harness the system. Corporate Social Responsibility: Both private and government healthcare should be socially responsible to their immediate society. Isalu Hospitals for instance, publishes and distributes tracts that treat different topics in medicine. As part of its social responsibility, between 2008 and 2009 alone, more than N1m was expended on some portions of Wempco Road by the management of the hospitals not only to ease the traffic congestion but to alleviate motorcycle accidents on the sharp bend of the road to the hospital from Agidingbi Road. CONCLUSION AND RECOMMENDATIONS Since the primary aim of establishment of healthcare institutions in Nigeria and elsewhere in the world is to save lives as well as care for people in pains and sicknesses, owners and administrators of hospitals and HMO’s should ensure quality management in this respect. National Health Insurance Scheme (HNIS) which constitutes the compass between the primary/secondary providers and the HMO’s should not renege on its efforts to separate the grain from the chaff in healthcare industry in Nigeria to ensure quality healthcare standard we deserve. In January 2010, the NHIS suspended further accreditation of Health Maintenance Organisations (HMO’s) and Healthcare Providers (HCP’s) for one year, justifying, inter alia, that â€Å"Only 816 of the 3, 012 accredited primary healthcare providers have 500 lives (patients/enrollees) and above† and there was the need â€Å" to strengthen the scheme and improve quality of healthcare services delivery through re-accreditation processes† The Governing Council of the NHIS further stated in the advertorial that â€Å"( i) Only twenty-seven (27) of the sixty-one (61) HMOs operating under NHIS formal sector programme have lives (ii) Reports of re-accreditation exercises show that HMOs have not made sufficient progress in folding in Organised Private Sector (OPS) and other tiers of government into the scheme†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. (iv) The need to shift focus to re-accreditation processes of HMOs with the view to improving access to quality hea lthcare. † The National Health Insurance Scheme should be further encouraged by the Federal Ministry of Health in making the quality management realistic. To achieve quality management in both government and rivate healthcare in Nigeria, only competent healthcare practitioners and other professionals who are ready for the challenges of the job should be employed and continually trained. It is also high time all the healthcare administrators as well as practitioners valued the sanctity of human lives. There should be a way of instituting a health security system where people’s lives will be guaranteed first—whether in times of accident, serious illness or delivery—whenever they are rushed into the hospitals in Nigeria. This may be through the HMOs or government hospitals. Hundreds of thousands of Nigerians have lost their lives because there was nobody to make financial deposit on their behalf for doctors to commence treatment. The social security gesture in the health sector should start from the government, perhaps through some allocation of some sort from the yearly budgets to the government hospitals in the first instance. Other registered healthcare with the government and the NHIS should be considered. GLOSSARY OF TERMS OPD: The out-patient department of a hospital where patients wait to be attended to by a nurse or doctor. It is a large room where people also wait to see the in-patients—hospital reception. HMO: Also known as Health Insurance, Health Maintenance Organisation (HMO) is responsible for insuring people’s health through a payment called capitation. GP: General Practitioner (GP) is a doctor who has been trained in general medicine. IN-PATIENTS: Patients who are on admission in a hospital because they need special attention by the doctor. PAEDIATRICS: A branch of medicine that deals with care and treatment of children. A paediatrician is a specialist who diagnoses and treats children of their illnesses. SURGERY: A branch of medicine concerned with treatment of diseases, deformities, and injuries through operations on patients. GYNAECOLOGY: A branch of medicine that deals with diseases and fertility especially in women. A gynaecologist is a specialist in this area. OPHTHALMOLOGY: A specialisation in medicine concerned with the function, care as well as the disorders which affects the eyes. An ophthalmologist is a specialist that treats eye disorders. ENROLLEE: A patient who has registered with an HMO to receive medical care from a provider (hospital). TOTAL NURSING CARE: The kind of care that requires all the attention of the nurses to the patients during illness, accident and recovery. PROVIDER: A hospital that provides medical service to enrollees especially under HMO DOCTOR-PATIENT CONFIDENTIALITY: Professional secrecy in medical profession where patients enjoy confidentiality in matters relating to their health. It is unethical of a doctor and other health practitioners to divulge such information without the patient’s consent. VITAL SIGNS: The basic signs and symptoms of illness taken by nurses to assist doctors in diagnosis. They are routine checks including the temperature, pulse, blood pressure, blood/urine analysis and physical examination to evaluate organ function. FEE FOR SERVICE: A medical fee charged on an enrollee who has enjoyed medical service in a healthcare where they are not covered or registered under an HMO. Bibliography 1) Katib, I. K. (2008) Corporate Identity: Telephone Reception for Isalu Hospitals Limited A customer service presentation. 2) Katib, I. K. (2009) Isalu Hospitals: Beyond the Competitive Stage, A Paper Presentation at Isalu Hospitals Limited, Ogba, Lagos. 3) Katib, I. K. (2010) Telephone Paradigm for Crescent University: A Practical Approach, A Paper Presented at A One-Day Seminar, Facilitated by Public Relations Unit, Crescent University, Abeokuta. 4) Katib, I. K. (2010) Listening to your USP, A newspaper article published by Crescent Voice, Accreditation Special, June 2010, page 6. 5) Kreitner, R. (1980) Management: A Problem-solving Process, USA: Houghton Mufflin Company 6) Microsoft ® Encarta ® Encyclopedia 2002.  © 1993-2001 Microsoft Corporation. 7) Oketola, D. (2009) Growing Business through Effective Talent Management, Adapted from The Punch Friday June 19, 2009. ) Onifade, A. (1999) Effect of Change and Time Management on Attainment of Organisational Goals, Adapted from The Polymath, 1999 Edition. 9) Osho, S. (1999) Political Public Relations and National Stability, Jedidiah Publishers, Abeokuta, Nigeria 10)Osunbiyi, B. (1999) Advertising Spiral, from Advertising: Principles and Practice, Gbenga Gbesan Publications, Abeokuta, Ogun State 11)Summers, D. (2005) Longman Dictionary of Contemporary English, Pearson Education Limited, Essex England. 12)Widdowson, H. (2006) Oxford Advanced Learner’s Dictionary, Seventh Edition.

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Most immigrants from Europe lived on the East Coast in cities that quickly became crowded and poor, and fighting was a functional skill to learn while living in the ghetto neighborhoods (Reiss, 1980). Boxing became a social ladder for ethnic groups since one group seemed to dominate until another group became better. Whoever were better boxers at the time were viewed as the tougher race. In the 1800’s and early 1900’s the Irish held most of the Heavyweight Championship titles, with boxers like John L. Sullivan, Jack Kilrain and Gene Tunney (Sowell, 1983). In the 1920’s and 30’s Jews began to have success in the ring, with 1913 being the only year in since the start of the century that there was no Jewish champion. In the two decade span they held 18 titles (Moore, 2011a). These champions were important to the Jewish in proving their worth to the country and countering the discrimination that the Nazis in Germany were trying to spread. Boxing for European ethnic minorities served as a way to prove their race’s toughness, and prizefighting was a way to leave the poor ghettos and make a decent life for themselves. Italians were slower than other groups in their involvement with sports. Between 1899 and 1924 about 4 million immigrated to the United States and settled in the crowded East Coast cities (Reiss, 1980). The Progressive movement was gaining popularity at the time, but because of their past in Italy, many Italians mistrusted governments telling them what to do and what their children should do (Moore, 2011a). However, 2nd generation Italian-American children were given opportunities to play sports through the creation of the Public School Athletic League. In 1905 historian Camillo Cianfarra tracked the Italian youth development in sports and observed: â€Å"In our public elementary school competitions, our children are not inferior to the children of other nationalities, in the lists of gymnastic [track and field] winners the Italian names appear quite frequently as they appear in the rosters of teams involved in inter-high school competition† (Reiss, 1980). Baseball soon became a popular sport with the Italians, and they became very successful with the sport. By the time of the Depression, Italians were becoming a majority in the Major Leagues (Moore, 2011a). Italians success in baseball gave them social mobility, but they were also still discriminated against. Some of the best players in the league in the 1930’s were Joe DiMaggio, Tony Lazzeri, Frank Crosetti and Ernie Lombardi (Baldassaro, 2005). Joe DiMaggio helped Italians gain more exposure and respect when he became the best player in the league and an American celebrity (Moore, 2011a). Blacks in the United States had similar involvement as the Europeans with ports and social mobility, although they faced much more discrimination and rejection than the other minorities. Blacks used sports as a main way to try and prove their equality to the rest of the country. They viewed successful black athletes as heroes and passionately supported them, and used them as a more subtle channel to showcase their fight against the discrimination and hate that they faced daily. Boxing featured several black champions and was a popular sport, just like it was with the European minorities. One of the earliest black champions was Peter Jackson, an Australian who won the Heavyweight Championship over there in 1886. He traveled to America in 1988 to fight John L. Sullivan, who held the Heavyweight Title, but Sullivan refused to fight him because he was black. Besides that setback, he was considered one of the best boxers of the time, and blacks loved him because he was a respectable man and proved black equality with his victories. Frederick Douglass at the time said, â€Å"Peter is doing a great deal with his fist to solve the Negro question† (Moore, 2011b). He was also respected within the white community because he never bragged or belittled an opponent (Moore, 2011b). People around the country of any race looked up to him as a role model. Although Peter Jackson helped gain some respect for blacks in white America, it wasn’t until Joe Louis that Americans found a black athlete that was embraced as an American hero. Louis was born in Alabama in 1914 as the son a sharecropper and great grandson of a slave. His family moved to Detroit in 1924 where he soon took up boxing. After ten years of hard work he won the Golden Gloves as a light heavyweight and his career took off from there. One of his biggest victories was against former heavyweight champion Primo Carnera in front of a crowd of 62,000 at Yankee Stadium (Official Site, n. d. ). Louis’s symbol as an American hero though didn’t fully happen until he avenged his loss against German champion Max Schmeling with a first-round knockout in 1938, during the time of the Nazi’s dominance in Europe. It was this victory that caused the American people to see him not as just another black fighter, but as an American hero. It helped to counter the impression of successful black athletes that Jack Johnson, the previous black heavyweight champion, had left, and in a way almost transcended his race (Schwartz, n. d. ). â€Å"What my father did was enable white America to think of him as an American, not as a black,† said his son, Joe Louis Jr. â€Å"By winning, he became America’s first black hero† (Schwartz, n. d. ). In the 1960’s, black athletes used the world’s biggest sporting stage to fight racism and show their protest against the discrimination that they were still facing. In October 1967 the Olympic Project for Human Rights was established by sociologist Harry Edwards and others, mainly athletes. The goal of the organization was to protest segregation and racism in sport and society. A boycott of the 1968 Mexico City Olympics was suggested but never happened, yet several members still used the Games as an opportunity for the organization. Many on the US Track and Field team wore black socks as support of the black community, or badges of the OPHR (Henderson, n. d. ). The most famous act of protest however was from sprinters Tommie Smith and John Carlos, who finished 1st and 3rd in the 200m final. On the medal podium, they each raised a fist while wearing a black glove. The act led to the International Olympic Committee president, Avery Brundage, suspending them from the rest of the competition and forcing them to leave (Moore, 1991). Although the protest had negative consequences for the sprinters, it was another key moment in sports that showed how the black community rallied around its athletes and used sports as a way to come together and fight for civil rights. Sports and competition were important in minorities efforts to advance in 20th century America through vertical mobility, although the reasons were different for each race. Europeans struggled with adjusting to a new country and culture, and sports helped serve as a way to assimilate more with the American culture and be accepted. Because of the large numbers of immigrants in the late 1800‘s and early 1900‘s, most lived in poor, crowded urban areas. Being successful in sports meant a chance to become professional, leave behind poverty, and make a life for yourself. It was essentially the â€Å"American Dream. † Sports had a slightly different meaning for black Americans. The United States was still a country of discrimination and oppression, and black society used their successful athletes to empower and unite them. Through heroes like Joe Louis, they fought against the discrimination and tried to prove their equality to whites. Both minorities in the 20th century viewed sports as a key tool in their struggle for acceptance in American society.

Internet Taxation †A Dual Issue For Both Sides :: Tax Taxes Internet Web Research Papers

Internet Taxation – A Dual Issue For Both Sides Internet Taxation is a hot button issue that has hit all sides of the spectrum in heated debates since the late nineteen nineties. This is an issue that covers many grounds. The common misconception is that Internet taxation is simply the taxing of purchases bought on the Internet either through consumer-to-consumer e-commerce or business-to-consumer e-commerce. But, while this does remain one of the issues, the most worrisome to those behind the scenes is the second half of this complex issue - the use of the Internet in lieu of a telephone line. Both of these issues could affect consumers & businesses alike, but in different ways. Some of these ways can be temporarily damaging to local economies, but it is mostly harmless and blown up to make people believe otherwise. The first thing most think of when they hear Internet taxation is the words â€Å"like a sales tax.† But it actually is much more complicated than just a simple tax on goods sold. Many politicians have long felt that the sales tax laws are damaging to some economies, confusing to locals & travelers alike, long outdated, & generally much too hard to follow, but they weren’t sure of what an internet tax could do to help this. To alleviate the burden & answer these imposing questions the Internet Tax Freedom Act (ITFA) passed in 1998 created what has become to be known as the e-Commerce Commission, formerly known as the Advisory Commission On Electronic Commerce (CAGW). This commission was supposed to attack many issues that policy makers had asked them to address. These issues included such things as: whether the existing state and local sales and use tax system is compatible with an electronic commerce environment; if electronic commerce should be taxed at all, consideri ng the difficulty of taxing such commerce; whether or not imposing or collecting tax on electronic commerce will undermine the sales and use tax base and create inequalities between sales of equivalent goods and services depending on the form or mode of delivery; whether the multiplicity of and inconsistency among existing state and local use tax laws creates an undue burden on sellers and purchasers in an electronic commerce environment, and, if so, whether it is possible to create greater consistency in state and local sales and use tax laws to facilitate application and administration of

Hewlett Packard Spying Scandal Essay

Corporate misconduct, (or people’s misconduct so to speak) is an issue that has been dominating headline news in the American business world in recent years. Theodore Roosevelt, one time U.S. president was probably right when he said, â€Å"To educate a person in mind but not in morals is to educate a menace to society† (Platt, 1989). The American society has continued to suffer from corporate scandals, despite the fact that people are now better educated because behind each scandal and crisis is a possible lack of morals in the â€Å"educated people† running those corporations (Low et al, 2006). It should be noted that unethical behavior is not a new phenomenon in US business nor it is an issue of the US alone. Research Questions and Objectives The year 2002 witnessed the collapse of giants like Enron, Tyco, Arthur Anderson, WorldCom and less known cases like Morgan Stanley, Dupont and Prudential Financial amongst others all involved in one form of scandal or the other.   Such widespread corporate misbehaviors have left many people (including this writer) to wonder where things are going wrong. Should blame be placed on perceived weaknesses of legislation and accounting standards? Or is it that education is not producing the type of business graduates needed to prevent such scandals? (Low et al).  Ã‚   Do the misdeeds simply involve a few â€Å"bad apples†: a smattering of corporations that make the rest of American business look bad? Or is the problem much broader than that? Further, if it is a widespread issue, what needs to be done? (Clement R. May 2006). Such are the kind of questions this study is out to seek answers to in light of the Hewlett Packard Spying scandal of 2006. Conceptual Framework This section explains what the literature on business ethics suggests for achieving ethical behavior in an organization. It is hoped that this will lay a foundation for the analysis of the recent corporate misdeed of Hewlett Packard. Business Ethics: Business ethics, Black J. (2002) is the branch of ethics that studies what standards businesses should observe in their dealings over and above compliance with the letter of the law. This covers questions such as fair dealing with their labour force, customers, suppliers, and competitors, and the impact of their activities on public health, the environment, and animal welfare. If a good reputation helps to gain and retain business, ethical conduct need not necessarily conflict with profit, but there are bound to be cases where it does. Particularly difficult questions of business ethics arise in multinational firms, where practices such as gifts to officials, which are essential to doing business at all in some countries, are regarded as criminal in others. Previous research works on business ethics have pointed out some measures that can be taken within an organization to help foster a culture of ethical behavior. Many of these studies highlight the role that top management commitment plays in developing an ethical organizational culture. Weaver, Trevino and Cochran (1999) found that the commitment of top management is essential for ethical decision making to be integrated into a firm’s culture; in other words, management’s decisions and actions in promoting the program are more effective than making sure that the program addresses a long list of ethical issues. Trevino and Brown (2004) found that top executives must manage ethical conduct proactively by means of explicit ethical leadership and conscious management of the organization’s culture. To this end, they suggest that top managers should study the cultures of their organizations to see what ethical messages are being sent. The researchers also assert that executives should communicate the importance of ethics, reward ethical behavior, and model that behavior themselves. Holmes et al (2002) found that employees are more likely to engage in ethical behavior if top management is firm in its expectations of ethical behavior of all employees, including themselves (p. 97) while Harrington (1997) concluded that, to achieve ethical behavior, top management needs to gain social consensus through changes in organization culture and by encouraging employees to live up to their responsibilities. What constitutes â€Å"unethical† behavior? It is important to determine the types of corporate behavior to consider unethical, and to decide on the time period over which the data on that behavior should be gathered. Some types of behavior may seem unethical to certain individuals but not to others (Clement R, 2006).   He however identifies three conditions that seem to signal unethical behavior: – A plea of guilty by a firm to charges of misconduct; – by courts or government agencies against a firm as solid evidence of corporate misconduct, even if the firm is still appealing the ruling. – agreement by a firm to settle charges, often by paying a fine or agreeing to other restrictions on company behavior even if the firm is not required to admit guilt. The Hewlett Packard (HP) spying scandal Origins In a Newsweek report by Kaplan D, (2006), the confrontation at Hewlett-Packard started innocently enough in January 2006 when online technology site CNET published an article about the long-term strategy at HP and other information that could only come from a director quoting an anonymous HP source. HP’s chairwoman, Patricia Dunn, fed up with the ongoing leaks told another director she wanted know whom it was. According to an internal HP e-mail, Dun then took the extra ordinary step of authorizing a team of independent electronic-security experts to spy on the January 2006 communications of other 10 directors – not the records of calls (or emails) from HP itself, but the records of phone calls made from personal accounts. That meant calls from directors’ home and their private cell phones were intercepted. Dunn acted without informing the rest of the board and this caused a boardroom fury at the world’s largest technology company. In a related story by Sakuma P. (2007), the HP boardroom-spying scheme erupted into a national scandal , September 2006, after the company disclosed that detectives it hired obtained the private phone records of directors, employees and 9 journalists in an effort to ferret out the source of media leaks. The scandal also introduced the world to â€Å"pretexting,† a shady tactic in which detectives used other people’s Social Security numbers to fool telephone companies into divulging detailed call logs. In an interview with Newsweek, Dunn said she didn’t know that the investigation would reach such heights. Consequences In two separate press releases, HP announced a number of moves that was an outcome of 2 days of teleconferences among the board. – Patricia Dunn was to step down as chairwoman. – CEO Mark Hurd will replace her. – George Keyworth, the longest serving director and one who leaked information to a CNET reporter that led to HP’s investigation was to resign immediately. – Richard Hackborn, who served on the board since 1992 would become â€Å"lead independent director†. – A criminal investigation against Patricia Dunn, Kevin Hunsaker, HP’s former ethics chief who allegedly directed the probe, and 3 private investigators was started on 4 counts: use of false or fraudulent pretenses to obtain confidential information from a public utility; unauthorized access to computer data; identity theft; and conspiracy to commit each of those crimes. Each charge carried a fine of up to 10,000 dollars and 3 years in prison. How and Why HP successfully overcame this scandal Testifying before a congressional in September 2006, Dunn said she was repeatedly reassured by HP’s lawyers about the legality of its detectives’ subterfuge. In a Business Week report, November 2006, a state judge Cunningham in California dropped the above charges against ex-Hewlett-Packard Chair Patricia Dunn after she pleaded guilty. The court however did not accept the pleas of the other three defendants and offered to dismiss the charges against them if they met two conditions – by Sept. 12   2006, they must serve 96 hours of community service and complete any court-filed restitution requests made by victims. In a related story by CNN’s Katy Byron, (September, 2006), the court dismissed Dunn’s charge because of her cancer battle, according to the attorney general’s office. The dismissal came â€Å"not because she’s innocent but because she is sick,† attorney general’s spokesman Barankin told CNN. Dunn had breast cancer in 2000 and melanoma in 2002 and was diagnosed with ovarian cancer in 2004 and is still battling it. She also underwent extensive surgery last year after doctors discovered a malignant tumor in her liver. In a CNBC news report (september 2006) Hewlett Packard agreed to pay $14.5 million to settle the lawsuit brought by California Attorney General Bill Lockyer, whose office accused the company of unfair business practices in its attempts to unmask the source of boardroom leaks. HP also implemented changes to its corporate governance policies to ensure that future internal investigations are conducted legally. There was no finding of liability against HP. The settlement includes an injunction and agreement that the California Attorney General will not pursue civil claims against HP or against its current and former directors, officers and employees. The vast majority of the settlement — $13.5 million — will fund state and local investigations into privacy rights and intellectual property violations, Lockyer said in a statement. The personal efforts of new HP chairman and CEO, Mark Hurd also contributed greatly to HP’s successfull exit from the scandal. He says â€Å"We are pleased to settle this matter with the Attorney General and are committed to ensuring that HP regains its standing as a global leader in corporate ethics and responsibility†. The company shareholders rejected a proposal that would have given investors the right to nominate directors to HP’s board. About 39 percent of HP shares entitled to vote at the company’s annual shareholder meeting favored the measure, which was supported by funds including Calpers, the largest U.S. pension fund, and the California State Teachers’ Retirement System, the No. 3 fund. The above factors culminated in a slight stock price increase of HP in September 2006 despite the fact that September 2006 was a rocky month for the company. Its stock actually rose a bit that month, ending at $36.69. It has since climbed to nearly $40 as HP continues to perform strongly in the PC and printer markets. HP today has regained its leading position as the worlds number one technology company. The Role of Business Ethics in this Success The conceptual framework of this study laid some guidelines on how to identify when a company behavior should be considered ethical or not. In the context of the widely publicized Hewlett Packard spying scandal discussed above, there is no plea of guilt by the firm nor by Patricia Dunn and the other defendents to charges of misconduct, we haven’t seen a ruling against either the Carlifornia court that handled the case nor the Securities and Exchange Commissions against HP for unethical behavior. However, HP agreed to settle charges of $14.5 million to close the case and save the goodwill of the Silicon Valley icon. The payment, by ethical standards could be considered a fine, which is an evidence of unethical behavior, by a firm. HP’s intention, perhaps, as we have seen was to save the company’s image and probably in compliance with a court injunction or lawyer’s advice. Taking a look at HP’s Standards of Business Conduct, (SBC) , we find that it embodies the fundamental principles that govern   ethical and legal obligations to HP. They pertain not only to conduct within the company but also to conduct involving HP’s customers, channel partners, suppliers and competitors. (www.hp.com). As a business, remaining profitable and viable is a must for Hewlett Packard though this is not the only concern for the company. HP seeks uncompromising integrity through what each individual can contribute — to its customers, co-workers, company and communities. HP’s business success is dependent on trusting relationships. Its reputation is founded on the personal integrity of the company’s personnel and its dedication to the principles of: (www.hp.com) – Honesty in communicating within the company and with its business partners, suppliers and customers, while at the same time protecting the company’s confidential information and trade secrets. – Excellence in its products and services, by striving to provide high-quality products and services to its customers – Responsibility for its words and actions – Compassion in its relationships with employees and the communities affected by company business – Citizenship in observance of all the laws of any country in which the company does business, respect for environmental concerns and service to the community by improving and enriching community life. – Fairness to our fellow employees, stakeholders, business partners, customers and suppliers through adherence to all applicable laws, regulations and policies, and a high standard of behavior. – Respect for fellow employees, stakeholders, business partners, customers and suppliers while showing willingness to solicit their opinions and value their feedback. Conclusion From the above, we can say that Dunn’s investigation into the leak was simply in compliance with the first principle (Honesty) of the company’s code of ethics. Her intentions were clear from the outset – to probe into an alleged boardroom leak while at the same time respecting the principles of respect and fairness (last two principles) in the investigation. That in itself shouldn’t have been a scandal. It is the methods of the investigation – pretexting that raised controversy and finally erupted into a scandal. Patricia Dunn was able to prove before congress and the courts that such an act was carried out without her knowledge, though she acknowledged that an investigation was going on, which in itself complied with company ethics.