The readings and videos reviewed this week have been thought provoking - to say the least. In the back of my mind I have silently worried about my family's vulnerability related to an accelerating dependence on the networked world for several years now and have been taking steps to protect us in the event that our digital umbilical cord is severed due to any number of catastrophic events. This week's work has served to exacerbate my anxieties related to personal security and privacy as we slide down this slippery slope of connectedness. That being said, the same technology that makes us so very vulnerable also continues to give us a competitive edge in an increasingly competitive and flatter world. So how do we maintain our economic value as employees by leveraging technology while reducing our vulnerability and risk at the same time? I suggest a "redundancy" lifestyle.
I disagree with Laurie Garrett's view that "individual preparedness" for pandemics, [terrorism, and/or insurrection and revolution] is "irrational." I'm sure there are many who would also consider those of us who seriously consider that these kinds of catastrophic events are probable as "irrational." But the global financial near-meltdown of 2008 clearly demonstrates that individual preparedness for these kinds of predictable catastrophic events is a wise course of action, whereas dependence on government preparedness is absolute folly given their historic track record of "responsible" stewardship.
So what does a "redundancy" lifestyle mean? It means that we should continue to be active members of the global digitally connected community. Understanding technology and learning how to effectively leverage technology makes us professionally and personally more efficient and productive. But we should also all learn how to become digitally invisible. Even though I am technology illiterate from an IT back-end perspective, I am now committed to learn as much as I can about software and hardware solutions that can keep me safe, and have just purchased "Counter Hack Reloaded" to begin this process. A redundant lifestyle means that we should continue to purchase food at our local grocery stores, but we should also consider learning how to garden so we can grow our own as well. It means we should learn to hunt and fish. It means we should consider stockpiling some nonperishable food for emergency. A redundant lifestyle means that (most of us) should stay on the electrical power grid, but we should also consider installing secondary sources for heat including gas auxiliary generators, solar panels and batteries, and/or wood/coal burning stoves. A redundant lifestyle means that we should continue to rely on community water sources, but should also consider digging an auxiliary well or purchasing an emergency water storage system. It means that we shouldn't abandon our banks, but we should spread a diversity of fiscal resources across several financial institutions. It means we should also have immediate access to emergency "hard" currency. A redundant lifestyle means that we should continue to trust our community hospitals and their dedicated clinical personnel, but we should also learn basic diagnostic and first aid skills and have an emergency stockpile of medications to minimize pain, reduce inflammation, and eradicate bacterial infections.
A redundant lifestyle means we should adopt both new and old world pioneer attitudes to survive the coming storm. Fortunately, we have unlimited access to information to learn these old world pioneering skills in our digitally interdependent connected world.
Friday, October 16, 2009
Friday, October 9, 2009
TLT 471 TQ#5 Technology Planning Reflections: What I Have Learned So Far.
It’s all about money. This is what I have been thinking about most recently in my technology planning project. Even if I sell the idea that a comprehensive simulation-based nursing peripheral IV catheter (PIVC) procedure training curriculum will improve nursing practice (which will result in better patient care) it may not matter unless I can confidently predict that the money invested in the project will return more than the dollars invested.
Over the past couple of weeks, I have been laboring to establish the budget that is needed to implement PIVC simulation-based curriculum research. Based on my analysis, I believe that a 14 Month, 4-Phase research program to create and validate a PIVC value-add clinician training will cost $307,450. This budget includes dollars allocated for eLearning pre-work ($50,000), simulation software and hardware ($85,000), clinician advisors/consultants ($32,000), reimbursement for partner hospital clinical staff time ($135,450), and IRB application submission fees ($5,000). During the course of this study we will be training approximately 60 nurses. I worry that a $307,450 budget or a short-term perception of $5,124 per nurse trained might overcome the intuitive “vision” of how this training program could positively impact our business long-term.
Ultimately, the PIVC simulation-based training program (if validated by our research) will be rolled out in multiple ways. The simplest to disseminate/execute will be to offer a new RN graduate 2-day PIVC certification program in a stand-alone simulation education center. Based on my analysis, I believe that the total year-one budget for this program will be $91,926. This budget includes allocated dollars for simulation software and hardware, as well ($34,000), but will also utilize the simulation equipment that is utilized in the aforementioned study, more fully leveraging these capital resources. The budget also includes allocated dollars for a clinical course facilitator ($30,800), and course disposables ($27,126). We believe that we have the capacity to train 154 nurses at this 2-day PIVC certification course in 2010 concurrently with our research project. Thus the total $399,376 proposed budget for both technology-based training initiatives will result in 214 nurses trained in 2010, or $1,866 per participant. Still high from a short-term perspective, but I’m hopeful that the additional nurses trained during the 2-day PIVC certification program in years two and three will reduce the per-participant cost of the course over time. For example, after the initial simulator capital outlay in year one, the cost to continue the 2-day program is just $57,926, or $376.14 per nurse participant.
By spreading the total three year budget of $423,302 over 522 total nurses trained (60 during research and 154 trained during the 2-day course in 2010, 2011 and 2012), average participation costs are further reduced to $810.92. This is a conservatively high number given that 2,400 nurses graduate from 47 nursing schools within 50 miles of Bethlehem annually so our inevitable expansion of the program will further reduce individual participant costs dramatically.
Even though the budget to conduct simulation-based PIVC training is predicted to trend (positively) downward over time, whether or not these better trained nurses will ultimately result in increased IV catheter sales is still a leap of faith. Unfortunately, we won’t know if the dollars invested in this program will return more than the dollars invested until long after we place the bet. So I continue to worry about my ability to sell an ROI vision that doing the right thing for nurses and their patients will positively impact the business bottom line.
Over the past couple of weeks, I have been laboring to establish the budget that is needed to implement PIVC simulation-based curriculum research. Based on my analysis, I believe that a 14 Month, 4-Phase research program to create and validate a PIVC value-add clinician training will cost $307,450. This budget includes dollars allocated for eLearning pre-work ($50,000), simulation software and hardware ($85,000), clinician advisors/consultants ($32,000), reimbursement for partner hospital clinical staff time ($135,450), and IRB application submission fees ($5,000). During the course of this study we will be training approximately 60 nurses. I worry that a $307,450 budget or a short-term perception of $5,124 per nurse trained might overcome the intuitive “vision” of how this training program could positively impact our business long-term.
Ultimately, the PIVC simulation-based training program (if validated by our research) will be rolled out in multiple ways. The simplest to disseminate/execute will be to offer a new RN graduate 2-day PIVC certification program in a stand-alone simulation education center. Based on my analysis, I believe that the total year-one budget for this program will be $91,926. This budget includes allocated dollars for simulation software and hardware, as well ($34,000), but will also utilize the simulation equipment that is utilized in the aforementioned study, more fully leveraging these capital resources. The budget also includes allocated dollars for a clinical course facilitator ($30,800), and course disposables ($27,126). We believe that we have the capacity to train 154 nurses at this 2-day PIVC certification course in 2010 concurrently with our research project. Thus the total $399,376 proposed budget for both technology-based training initiatives will result in 214 nurses trained in 2010, or $1,866 per participant. Still high from a short-term perspective, but I’m hopeful that the additional nurses trained during the 2-day PIVC certification program in years two and three will reduce the per-participant cost of the course over time. For example, after the initial simulator capital outlay in year one, the cost to continue the 2-day program is just $57,926, or $376.14 per nurse participant.
By spreading the total three year budget of $423,302 over 522 total nurses trained (60 during research and 154 trained during the 2-day course in 2010, 2011 and 2012), average participation costs are further reduced to $810.92. This is a conservatively high number given that 2,400 nurses graduate from 47 nursing schools within 50 miles of Bethlehem annually so our inevitable expansion of the program will further reduce individual participant costs dramatically.
Even though the budget to conduct simulation-based PIVC training is predicted to trend (positively) downward over time, whether or not these better trained nurses will ultimately result in increased IV catheter sales is still a leap of faith. Unfortunately, we won’t know if the dollars invested in this program will return more than the dollars invested until long after we place the bet. So I continue to worry about my ability to sell an ROI vision that doing the right thing for nurses and their patients will positively impact the business bottom line.
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