No abstract

This paper is an experience report from my time working at CampusSoft in the UK. The focus is on their experiences using Agile in a multi-site software development environment, spread across the UK, Romania and India. We will start by looking at the motivations behind outsourcing some of their work to India and why the relationship with their partners in India led them to try using an Agile approach. We will then look at some of the approaches which were important for them to be Agile and the challenges that they faced, such as communication, working practices and culture.

The goal of this study will be to examine how Edger Dale's Cone of Experience is employed to positively impact student learning in a foundational leadership course. To accomplish this we will examine student projects in a foundational leadership course at Purdue in which students interactively evaluate leadership by creating surveys, summarizing the results and developing a leadership guidebook with practical recommendations. In addition, the authors will survey students who have completed this project and measure student achievement of learning outcomes as defined as what the student should know and realistically be able to do by the end of the course. This approach will focus on a selfassessment survey to gather in-depth understanding of learning and the reasons that student learning occurred as a result application of Edger Dale's Cone of Experience. The results will be the why and how of learning and retention, not just what. This method will produce information only on this particular course but general conclusions about the application of student projects in any course or discipline will be inferred. Our study will show that in the foundational leadership course effective learning was achieved by applying strategies at the bottom of the pyramid using direct, purposeful learning experiences that simulates "doing the real thing," and represents reality or the closest things to real, everyday life.

Purpose of Study: The study's purpose was to identify hospital programs, organizational characteristics, and levels of nursing involvement in hospital programs that contribute significantly to reductions in readmission rates and reimbursement penalties for hospital systems in upstate New York. Primary Practice Setting: Hospitals located in upstate New York. Methodology and Sample: No sampling technique was employed because the cohort included hospitals located in upstate New York. Hospitals in upstate New York were selected ( N = 94), representing 53 counties ranging between metropolitan and rural status. Using an ex post facto design within the framework of the ecological and synergy models, organizational characteristics of hospital systems and educational levels of nursing involvement in hospital programs were analyzed and coded. Independent-samples t tests, analysis of variance, and Pearson correlation tests were conducted. Results: Organizational programs that reduce various hospital readmission rates and reimbursement penalties for hospitals in upstate New York are (1) certified home health agencies; (2) telehealth; (3) house calls; (4) advanced practice nurses on care management interdisciplinary discharge teams; and (4) increasing the number of hospital readmission reduction programs (HRRPs) utilized. Implications for Case Management Practice: Hospitals should: Encourage and provide support for their case management departments to increase utilization of certified home health agencies, telehealth, and house calls, which contribute to reductions in readmission rates and decreased reimbursement penalties.Incorporate advanced practice nurses into case management teams for improvement in the excess readmission ratio for pneumonia.Continue to support government and hospital policies that increase resources for evidence-based HRRP initiatives and that improve Medicare reimbursement formulas.

Nurse practitioners as well as all nurses need to assess their values, be knowledgeable of Lesbian, Gay, Bisexual, Transgender, and Queer issues and current guidelines of care, and communicate with clients and their families in such a way as to create trusting and safe environments, free from barriers for quality healthcare. Nursing literature supports reflective practice as a means of reducing bias, as well as improving patient-provider trust and quality care. Understanding the primary care needs of specific populations is necessary to fulfill the nursing code of ethics.