Phantom Towers: Reconstructing the Normal Essay -- Personal Narrative

Phantom Towers: Reconstructing the Normal Every night before going to bed I used to stare at Manhattan at its best. The tall buildings with the lights on give you the impression of diamonds laid on black velvet. It is such a treat to live on the 26th floor, to not have the suffocating sight of walls and windows obstructing the view. But the scenery has changed drastically since September 11th. White smoke was everywhere. At night the smoke became even more apparent with the shine of the stadium lights at Ground Zero that aided the workers making it through the night. From my window you would not pay attention to the buildings that survived the attack, your eyes could not leave that spot where the fumes and light were glowing. In the same way you see a hurricane from a distance, its dimension, its movement, its strength; in the same way you could see that spot on the tip of Manhattan where light hit the tiny molecules of dust giving an eerie impression of death and spirits. The word "debris" was in the news, in my neighbor's mouths, in the press; but I couldn't think of debris per se, people were scorched to death. The Twin Towers became a crematory of innocents. The souls of the deceased were roaming about before going to the other world, the after-life. No matter the distance, you could see that uncanny cloud even from New Jersey. I stood at my window for hours, hoping to see the black smoke turn to white; a good signal that fire was being extinguished. For a moment, I saw it happening and felt relieved. But the sudden and unexpected surrender of the towers after those agonizing hours filled me with disbelief for I knew I was "witnessing thousands of deaths," as John Updike describes the tragic scene. The follow... ... Professor Gilbert explains, it is what one does with time. I wonder how long this country can live in the fallacy of predictable and understandable normalcy while seeing a world that is neither. Works Cited "Filling the Void." The New York Times Magazine 23 Sept. 2001: 80. Gilbert, Kathleen R. "What is Grief?" 2 Jan. 1997. 9 Dec. 2001. <http://www.indiana.edu/~hperf558/sprng97/unit1.html>. "Kearl's Guide to the Sociology of Death." Kearl's Guide to Sociological Thanatology. 9 Dec. 2001. <http://www.trnity.edu/~mkearl/death.html>. Longaker, Christine. "The Normal Process of Mourning."Spiritual Care Program. 9 Dec. 2001. <http://www.spcare.org/practices/suddendeath/bereavement- processofmourning.html>. Updike, John. Reflection. New Yorker. 24 Sept. 2001. 11 Nov. 2001. <http://www.newyorker.com/THE_TALK_OF_THE_TOWN/?01092ta_talk_wtc>.

Case Analysis of Sutton Health Essay

This network identified that traditional payment processing system had limitations that hindered the effective collecting of revenue. What with the recession, healthcare organizations have seen an increase in the inability to collect debt from the self-pay, the uninsured and underinsured patients. This has caused a lot of struggle when it comes to the organizations to meet the operational margins and the profits. I find there are a number of reasons for the new increase in patient’s debts, the most common are, poor accounting practices, lack of patient information and correct demographics. There is new governance that is designed to provide more coordinated care to said patients (Gleeson,2010). There are five geographic regions that reflects the health care access to the customers of Northern California. Each of the five regions will have governance structure and it will oversee many of the Sutter affiliated medical facilities and also the hospitals. In its effort to increase point of service collections and improve the overall revenue cycle Sutter health took steps to measure performance using a handful of specific primary benchmarks, empowering PFS staff to assume responsibility for every individual account they handle, ensure each registration is analyzed using a rules engine to identify problems before patients leave the registration desk and ensure PFS staff receive appropriate co mprehensive training to excel under the new system† (Souza, McCarty, 2007). Obtaining the correct patient information plays a large part on non-collectable debt because patients are not able to be reached. These limitations were associated with limited access to accurate information by the account representatives, ineffective performance measures and fragmented centers of the service provision. The Sutter Health program developed a system that was comprised of solutions that were geared towards overcoming these limitations. The key problems and issues, is that the United States healthcare system is characterized by huge upkeep from collecting revenue from patients. This situation is brought about by a health care insurance system which entails high deductible pay health plans and as well as higher co-payments plan. (Souza, McCarty, 2007). This situation has been made worse through the large proportion of the population not having healthcare coverage. The traditional health care system has had a hard time meeting their target revenue collection. This is due to several problems that attached along with the traditional payment system. Unlike when dealing with the payments through insurance claims but also dealing with the up-front payments that are required by the hospital for payment of services before the patient could even receive the service (Souza, Mccarty, 2007). So this means that the patient services staff (PFS) has to have complete and accurate information about above said client. This presented a problem for the traditional payment system where much of the customer payment system was processed in the back end. This system also required that the PFS staff ask for money from self-pay patients, but the PFS were not accustomed to this under the traditional system. The PFS staff found it hard to wait for the back end section to process customer information and to provide a breakdown of the patients payment details. So this became a tedious task for hospital accounting departments as well as for patients that had to wait a longer period before receiving services. The inefficiency of the traditional system not only resulted in low quality services, but also in low revenue collections. The system provides such a broad range of health care services, which include acute, sub- acute, home health, long term, outpatient care as well as physician delivery systems. These services are provided through an integrated health care delivery approach that gives the system the ability to deliver a full range of healthcare products and services. rks. Sutter also recognized that the traditional system did not provide a means for analyzing selected data nor did it generate required detailed report on demand. This led to more cost as the hospital had to rely on programmers to generate such reports. The front desk staff also lacked real time information which hindered their ability to serve the client without consulting the back end staff. It also meant that the front desk staff could not monitor the patients progress (Souza, McCarty, 2007). Another challenge was that the PFS members were not empowered enough to be held accountable for each patients accounts they dealt with and it reduced the amount of accountability among the staff. These are some of the key challenges that the Sutter system were meant to address. The solutions that were employed by Sutter Health was an attempt to overcome the challenges stated above. Sutter Health implemented certain changes in the fore mentioned system that would make their operation more efficient. The strategies identified by the Sutter program entailed transferring most of the back end tasking to the front desk; providing accurate and complete information to managers and upfront staff; providing more effective performance evaluation and integrating all data elements within the system (Souza, McCarty, 2007). Allowing front desk staff to handle much of the payment process was deemed to have an effect on the efficiency of the process. Various solutions were employed to ensure that this is achieved. One of these solutions entailed using benchmarks to measure performance by the Patient Service Staff (PFS). Sutter identified a handful of primary benchmarks which included; Unbilled A/R days, Gross A/R days, Major A/R days, Cash Collection,percentage of A/R over 90, 180, 360 days (Souza, McCarty, 2007). This benchmark introduced shorter periods with which staff performances could be evaluated. This move was timely especially when onsidering that the industry has changed and things happen in terms of hours and days but not months. Another solution involved empowering the PFS members to have full responsibility over the accounts they are dealing with. This move was meant to increase a sense of responsibility and accountability as each individual members will be responsible for his or her own account (Souza, McCarty, 2007). This also gave the PFS members more autonomy to act as they saw fit and this improved the speed and efficient of service delivery by these staff members. The program also provided the PFS members with tools, that enabled them to automate their accounts, sort out their accounting using various means and seen their performances based on the achievement of the target. PFS and other accountant representatives were presented with individual dashboards that helped in the tracking of their progress in meeting targets. This also helped in enforcing the benchmarks set by this program. Sutter’s health program also introduced a front end collecting system as means of overcoming the mentioned problems. The pint of access collecting system introduced an opportunity for the health care facilities to reduce claims and denials. Though this system the patient records are analyzed before the patient leaves the registration desk. This enables the front desk staff to identify problems such as bad debt, patient or invalid patient type early enough and take the necessary corrective action. The Sutter health program also embarked on a comprehensive training program that was designed to support the existing PFS members and the registration staff. This gave staff the necessary competence to deal with the tools provided by this system. The training program also eliminated the need to hire formally educated staff to operate the system that would and more than the $10-$20 an hour paid to current registration and PFS staff. For example, registration staff who were not used to asking patients for money were trained in effective communication skills. The training was also designed to introduce autonomy and effectiveness which acted as a motivator to the employee.

Sexual Reproduction - Gametes and Fertilization

Individual organisms come and go, but, to a certain extent, organisms transcend time through producing offspring. Reproduction in animals occurs in two primary ways, through sexual reproduction and through asexual reproduction.  While most animal organisms reproduce by sexual means, some are also capable of reproducing asexually. Advantages and Disadvantages In sexual reproduction, two individuals produce offspring that inherit  genetic characteristics from both parents. Sexual reproduction introduces new gene combinations in a population through genetic recombination.  The influx of new gene combinations allows members of a species to survive adverse or deadly environmental changes and conditions. This is a major advantage that sexually reproducing organisms have over those that reproduce asexually. Sexual reproduction is also advantageous as it is a way to remove harmful gene mutations from a population through recombination. There are some disadvantages to sexual reproduction. Since a male and female of the same species are required to sexually reproduce, a considerable amount of time and energy is often spent in finding the right mate. This is especially important for animals that do not bear many young as the proper mate can increase the chances of survival for the offspring. Another disadvantage is that it takes longer for offspring to grow and develop in sexually reproducing organisms. In mammals, for example, it can take several months for offspring to be born and many more months or years before they become independent. Gametes In animals, sexual reproduction encompasses the fusion of two distinct gametes (sex cells) to form a zygote. Gametes are produced by a type of cell division called meiosis. In humans, gametes are produced in the male and female gonads.  When gametes unite in fertilization, a new individual is formed. Gametes are haploid, containing only one set of chromosomes. For example, human gametes contain 23 chromosomes.  After fertilization, a  zygote is  produced from the union of an egg and sperm. The zygote is diploid,  containing two sets of 23 chromosomes for a total of 46 chromosomes. In the case of animals and higher plant species, the male sex cell  is relatively motile and usually has a flagellum. The female gamete is non-motile and relatively large in comparison to the male gamete. Types of Fertilization There are two mechanisms by which fertilization can take place. The first is external (the eggs are fertilized outside of the body) and  the second is internal (the eggs are fertilized within the female reproductive tract).  In either case, each egg is fertilized by a single sperm to ensure that the correct  chromosome  numbers are preserved.   In external fertilization, gametes are released into the environment (typically water) and are united at random. This type of fertilization is also referred to as spawning. In internal fertilization, gametes are united within the female. In birds and reptiles, the embryo matures outside of the body and is protected by a shell. In most mammals, the embryo matures within the mother. Patterns and Cycles Reproduction is not a continuous activity and is subject to certain patterns and cycles. Oftentimes these patterns and cycles may be linked to environmental conditions which allow organisms to reproduce effectively. For example, many animals have estrous cycles that occur during certain parts of the year so that offspring can typically be born under favorable conditions. Humans, however, do not undergo estrous cycles but menstrual cycles. Likewise, these cycles and patterns are controlled by hormonal cues. Estrous can also be controlled by other seasonal cues such as rainfall. All of these cycles and patterns allow organisms to manage the relative expenditure of energy for reproduction and maximize the chances of survival for the resulting offspring.