Salmon Nation: Chapter Summaries and Reflections

Salmon Nation

Introduction/Chapter 1: Recalling Celilo

This chapter, written by Elizabeth Woddy, focused on the history of salmon in the northwest. Celilo falls was an important a remarkable sight of the past.  It was a place where gigantic salmon thrived, and which Native Americans lived off of and worshiped. Celilo means “echo of falling water” or “sound of water upon rock”. In 1957 the Dalles Dam was constructed, which flooded the falls and dramatically altered the habitat for the salmon in the Columbia River. This chapter stresses the importance of the salmon on communities and how their downfall would be a catastrophe. The map diagram of California is informative about the relationship between salmon and population density: areas surrounding the salmon runs were more densely populated.

It was great to learn about the salmon from the perspective of someone who has found such a significant importance in them. The salmon were a huge part of the lives of the Wyampum tribe, which I found to be really fascinating. The way that she discussed the building of the dam made it seem like a horrific tragedy, which is a different perspective than I often hear. This chapter got me excited about reading this book. The short and easy to read chapters with pictures is like a huge breath of fresh air in comparison to my normal reading for classes.

           

Chapter 2: Muddied Waters, Muddled Thinking

This chapter is dedicated to how human actions affect the rivers and the salmon. What I believe the main point that they were trying to get across is that “Everything that happens to flowing water, from the ridgetop to rivulet to the river itself, affects the health of the salmon”. When the early settlers migrated to the west coast, some showed regard to how they might harm nature but many others did not. Logging, cattle grazing, the constructions of roads, dams, the canning of fish, and various other activities of the settlers had devastating effects on the salmon population. When it was realized how these things were putting the salmon and steelhead populations in danger, humans thought that they would find a way to save the fish without stopping their ways. Fisheries were originally were thought to be the supreme way of breeding fish in comparison to nature, because “so much less goes to waste”. Biologists finally realized that this was wrong; fisheries are actually harmful to the wild fish population. Our dependence on the things that are harmful to the fish and rivers has made it difficult to create change.

This chapter brought some questions to my mind: Have humans finally realized that it’s not a good idea to mess with nature? Will we stop harming the bodies of water in time to save the endangered species? I think that it is absolutely absurd how naïve we are when it comes to protecting nature. People need to realize that nature has its ways of maintaining it’s delicate balances, and that it is best if we do not interfere. I found it interesting to read about the detail of exactly how we are harming the salmon and their habit, and how we did so unintentionally throughout the years. I have gained a deeper understanding of the problems we have created in relations to salmon, and it has deepened my resentment of the way we humans treat nature so poorly. I found the information on logging to be the most interesting and infuriating part of the chapter.

Chapter 3: Ghost Town

Many communities, such as the example of the canning town Namu given in this short essay, have been dependent on the salmon. Many changes in technology (i.e. fishing vessels and dams) have caused communities such as Namu to be abandoned. The salmon shortages are due to humans not treating the rivers or salmon respectfully. Many species of salmon and steelhead have become extinct from this, which has not only altered ecosystems but also human communities. Lawsuits, violence, and a verity of conflicts have arisen from the problems concerning the low numbers of fish. Many fisheries have been created in attempt to rectify the problems, particularly in lower British Columbia. These fisheries have tried to replace the wild fish with farmed fish, but the farmed fish have only made the situations worse. Before all the upswing of dams and other harmful things, the salmon gave communities so much that we had stronger reasons to protect them.

I think the most important thing that was said in the article was that “one could not design a better creature to base culture than the salmon”. They are such hardworking and amazing animals, that many communities have indeed based their culture off of them. The destruction of salmon species and habitat has ruined these communities. I agree with this article that we should not have huge fishing vessels and high-tech equipment to catch salmon. These things are expensive for fisherman, and it just makes catching salmon a competition among fishermen. If there weren’t so many hatchery fish flooding the market, then fishermen could make just as much money catching a smaller amount of wild fish, and everyone would be better off. Like you said Professor Hunt, maybe someone should just go blow up the fisheries with bombs.

Portfolio: The Six Species of Salmon Nation

Salmon live not just in the stream, but also in watersheds, which are areas that flow into a particular stream. Chinook, Chum, Coho, Pink, and Sockeye salmon, along with sea-going steelhead and cutthroat trout, live in the North American west coast. Chinook numbers are increasing in Alaska, but are not doing very well in many other regions. There are high numbers of Chum, but lots of them are hatchery. The Coho are threatened in Oregon and California, but doing fine beside that. Pink are dong fine everywhere, for the most part. Sockeye, the beautiful red salmon, have a threatened run in Washington and are endangered on the Snake river, but otherwise are doing fine and doing very well in Alaska. Steelhead populations are declining from California to the Puget Sound.

I found the map diagrams in this section to be both informative and visually stimulating. To me it does not seem like a coincidence that the more north you go, the fewer species are endangered/threatened. I think that this primarily because there are less people around to ruin their habit. I like how this chapter gave me the opportunity to compare the different species in both how they look and the locations that they are/aren’t thriving.

Chapter 4: Keep the Gift Moving

            This chapter is the personal story of a man who worked as a commercial fisherman. In this novel-like chapter he shares his feelings, experiences, and knowledge about commercial fishing. There are several types of commercial fishing nets and techniques, some of which are somewhat similar to what the Native Americans used. It doesn’t make sense that fishermen buy such big and expensive equipment, because they will just need to catch greater amounts of fish to pay off their debt. Commercial fishing can be very dangerous and also takes the spiritual aspect out of fishing. The salmon, which are so important to us and are other living creatures, are simply treated as if they are nothing but product to sell for money.

My favorite quote in this chapter is “ By denying ourselves the perception of our relation to the creatures dying on deck, we were in some essential way denying ourselves wholeness of being”. I think that the chapter really accurately explains how the ways of commercial fishing has become so bad and how they should be in some ways reverted to those of earlier generations. Being a fisherman in today’s world is a difficult and unstable career. I think that needs to be changed, even if that means the government giving aid to fishermen. I found the diagram that explained all the different types of fishing rigs to be interesting. I enjoyed this story and think I learned valuable information from it, but I’m afraid that a lot of it was bias and too personal to believe without skepticism.  

           

Chapter 5: Toward a New Salmon Economy

            This chapter focuses on the good things that have been happening to salmon. People have been creating better habitat for them. Some people have even started sustainably and beneficially farming wild salmon in areas of need. Watershed and restoration groups have been created along California, Washington, Oregon, and British Columbia. These groups are focusing on all different types of projects in attempt to assist the salmon populations. We have been learning to live in a more sustainable way with nature and salmon. Positive effects are being seen from these efforts, and there is hope for the salmon. People should not blame one another for the depletion of salmon, but should work together and to try to rectify it.

            This was a good reflection and conclusion to Salmon Nation. It gave me an overall sense of understanding of the problems and possible solutions regarding salmon. I feel like I have gained a new appreciation for salmon from reading this book and this chapter toped it off. I now know how very important salmon are to different communities and what amazing creatures they are. I see a light at the end of the tunnel full of darkness, salmon will live on. Overall, I have learned more about salmon by reading this book than I ever thought that I would know about them. Salmon Nation was a great introduction to my knowledge about them.

Article Summary and Reflection: America’s Living Oceans: Charting a Course for Sea Change

America’s Living Oceans: Charting a Course for Sea Change

The article America’s Living Oceans was written by the Pew Oceans Commission in May of 2003. The article starts by pointing out how important the oceans are and how dependent we, and all living things, are upon them. It then goes into detail about how poorly we have been treating them, and the problems that this is causing.  It briefly speaks of the “hodgepodge of ocean laws and programs that do not provide unified, clearly stated goals and measurable objectives”, what successes and failures they have had, and how they are not as effective as they were thirty years ago. They strongly believe that change must occur in order for future generation to be able to enjoy the benefits of a healthy ocean, which is a main objective of their organization. They have traveled along the coastal regions to determine the problems and try to find solutions. They have also come up with a list of objectives to help the ocean and a list of recommendations to meet these goals.

This was an interesting and well-written article that I think should be read by many people. I learned a lot from reading it, including the existence of the Pew Oceans Commission and their objectives. From what they said, I think that they are doing very important work, and deserve the full support the US government and people. One thing that I think could be improved upon is in their objectives to rescue the ocean. I thought that their objective list was incomplete and that much could be added to it, along with their recommendations to meet these objectives. The fact that I found most interesting in this article was the dependence of the economy on the ocean’s health. Before the beginning of this class I have never thought about how the ocean’s health affects anything other than the fish and the amount of litter on the beach. This article has given me a stronger understanding of ocean related problems and regulations.

HIV, AIDS and Tuberculosis

Lauren Berg

SOC 420

First Midterm

4/18/12

HIV, AIDS and Tuberculosis

            The global inequality of acquired immune deficiency syndrome and tuberculosis infections is astonishing. Most of the people who are infected with these diseases have been infected because of an economic disadvantage. Those in poverty are also the most in need of treatment for their illnesses, but are unlikely to have access to it. Most developed nations give little regard towards the people in the world who are becoming infected, not getting treated, infecting others, and dying. The global north, prescription drug companies, and medical professionals need to step up and help put an end to the expansive inequalities surrounding these infectious diseases. However important money and treatments are to putting an end to the epidemics, they will not successfully end the epidemics unless they are accompanied with social understanding of the problems and the dynamics of the societies. 

            HIV/AIDS is most typically seen in large cities, areas with large numbers of prostitutes, areas of pronounced drug usage, and is especially prevalent in poor parts of the world. HIV, which is primarily spread through sexual intercourse, has prevalence rates directly related to the sexual habits of societies. After it infects a city, it then will typically spread into the surrounding rural areas. It has affected nearly every region of the world, killing people everywhere it goes.

            Contrary to the theories that have originated throughout the years about the origin of tuberculosis, such as it is “triggered by voodoo practices” or that it is “brought from the US homosexual population”, the origin remains unknown (Farmer 2001). Tuberculosis is a very contagious disease, in which bacteria are spread through coughing. Most people who live in economically deprived countries, such as Haiti, are exposed to it. If the individual who is exposed is generally healthy, they will most likely develop immunity without the symptoms of the disease. If a healthy person does contract the disease, it will be curable. People who already have compromised immune systems have a much more difficult time fighting it off. People with AIDS will get very ill if they contract tuberculosis, usually suffering from pulmonary complications and weight loss. Tuberculosis is very difficult to cure in a person who has AIDS, and it is often fatal.

            Treatment for HIV, AIDS, and tuberculosis exists, but not for everyone. Medical care for the poor is not easy to come by. For example in Haiti in the eighties the “nationwide physician-to-population ratio was 18 physicians to 100,000 inhabitants, compared to 250 physicians per 100,000 in the United States” (Farmer 2001). On top of the difficulty finding any medical care, the treatment cocktails for HIV/AIDS are very expensive and a vast quantity of people cannot afford them. Those who cannot afford them will die, often leaving behind families and orphans. Some of those who do have access to HIV/AIDS or tuberculosis treatments run into other complications. The long term use of drugs for these diseases have caused the development of new strains of the infections that are resistant to the drugs commonly used to treat them. Drug-resistant strains of tuberculosis must be identified quickly and then treated with a newer drug, if the patient is to live through the illness. Resistance to HIV/AIDS drugs is very common, which is one of the reasons that make the drugs so expensive. HIV/AIDS requires about three different cocktails of drugs that patient must rotate approximately every six months to keep them effective.   

            The substantial inequality associated with HIV, AIDS, and tuberculosis is unacceptable. Every person should be educated about these infections, and every infected person should have quality treatment available to them. More effort should be taken into understanding the needs of patients in impoverished regions and making sure that their needs are meet. With a through understanding of the infections and the societies that they impact the most, I foresee the possibility of escaping these epidemics.

Migrant Labor and Sexually Transmitted Diseases: AIDS in Africa

Lauren Berg

SOC 420

First Midterm

4/17/12

AIDS in Africa

            Charles Hunt’s research, Migrant Labor and Sexually Transmitted Diseases: AIDS in Africa, used historical materialist epidemiology and the dependency theory to analyze the HIV/AIDS epidemic of Africa. It explains how the epidemiology of the “AIDS belt” is a product of the labor systems that were implemented during colonialism. The conclusions drawn about AIDS in Uganda are relevant throughout the AIDS belt and disprove other theories regarding the origin and behaviors of disease.

            The AIDS patterns in Africa are related but distinct from those of developed countries. Similar to Africa, in the United States HIV spread through an already vulnerable population. There was a high prevalence of sexually transmitted infections and little use of protection in the US homosexual population prior to the onset of the AIDS epidemic. These factors increased their susceptibility to HIV contraction and caused the homosexual population to be the initial route of the infection into the larger population. During the US epidemic a substantial number of homosexual men, bisexual men, and drug users were infected. These trends caused different patterns of US infections than those in Africa. The US and Europe had a 16:1 ratio of HIV seropositive males to females, whereas Africa had a 1:1 ratio (Hunt 1989).  Another distinctive factor between AIDS in Africa and in developed countries is the secondary diseases that often appear alongside AIDS. Many of the secondary AIDS infections in Africa are worse than those of the US and Europe.

            The labor systems that were encumbered upon Uganda during its colonial period caused the separation of many families. Women and children were left in labor reserves in which their primary duties consisted of providing food for the family. The men migrated to labor concentration sites in which they worked for low wages. This separation of families caused a proliferation in sexual partners, especially in the labor concentration sites. Many women who were prostitutes in the labor concentrations sites had STIs, which were thus spread throughout the labor concentration sites. When men and prostitutes became ill, it was common for them to return to their family, which caused a spread of STIs to the labor reserves. Once HIV/AIDS appeared in the cities, it spread with ease through the already vulnerable populations that had a great number of sexual partners and preexisting STIs. AIDS spread first through the labor concentrations sites and then to the labor reserves, constructing the pattern of AIDS in Uganda.

             South Africa had a similar but more developed labor system than Uganda and the other countries in the AIDS belt. At the time that the AIDS in Africa research was conducted however, South Africa did not have a high prevalence rate of HIV/AIDS. This did not fit the pattern of high infection rates throughout the other countries with this labor system. Hunt hypothesized that this is a result of the stricter familial separation and the later formation of the labor system in South Africa, and that it was only a matter of time before the epidemic would spread to the country. This hypothesis was correct; In 2003 South Africa had an estimated prevalence of 5.3 million people living with HIV/AIDS, which is the highest in the world (KFF 2005).

            It was the world’s core economies push for greater profit that caused the patterns of the HIV/AIDS in the Africa. As Karl Marx wrote, “the drive for profit is a boundless thirst that chases the capitalist over the whole surface of the globe in search for not only low-cost labor but also inexpensive raw materials” (Ferrante 2011). The westernized world, with an obsession for profit and little concern for the wellbeing of laborers, created these disease ridden labor systems.  As the world system theory explains, colonization and exploitation are key elements in how the global economy came to be, however tragic it is. Globalization and global interdependence will keep most of Africa below the poverty line and prevent many from receiving proper HIV/AIDS treatments. The current dynamics of the world’s political economies will continue to cause enormous inequality and suffering in Africa for many years to come.

Works Cited:

Kaiser family foundation (KFF). (2005, Oct). Retrieved from http://www.kff.org/hivaids/upload/7365.pdf

Ferrante, J., & Caldeira, C. (2010). Seeing sociology, an introduction. (pp. 370-374). Wadsworth Pub Co.

PeaceHealth Business Research

BA 101 Introduction to Business

PeaceHealth Business Researchers

Final Paper

Prepared By:

Emily Laing

Patricia Wells

Lauren Berg

March 10^th, 2012

TABLE OF CONTENTS

Introduction

Part 1: Business in a Changing World Chapters 1, 2 & 3 Lauren Berg

Part 2: Starting and Growing a Business Chapters 4 & 5 Patricia Wells

Part 3: Managing for Quality and Competitiveness Chapters 6, 7 & 8 Emily Laing

Part 4: Creating the Human Resource Advantage Chapters 9 & 10 Emily Laing

Part 5: Marketing: Developing Relationships Chapters 11, 12 & 13 Lauren Berg

Part 6: Financing the Enterprise Chapters 14, 15 & 16 Patricia Wells

Summary

Bibliography

Appendix

Introduction

            PeaceHealth is a large nonprofit corporation that provides healthcare within Washington, Oregon, and Alaska. Because it is a nonprofit corporation, it focuses on providing it’s healthcare services rather than earning a profit. It all started in 1890 when two members of the Sisters of St. Joseph of Peace left their convent in New Jersey to build a hospital in the small logging town of Fairhaven, Washington. The hospital started through donations with a mission to help those with physical aliments through Jesus Christ. Their use of a mission without a formal business strategy proved to be sufficient in the early years of the business, but as the business grew they reinforced their mission with a full business strategy. By 1916 the business had expanded to five hospitals in Washington, Alaska and British Columbia. It expanded to Oregon in 1936, and today has a total of seven hospitals. The sisters in charge of the hospitals decided to form a separate framework in the early 1970s. This change was implemented in order to more successfully meet the challenges their business faced with contemporary healthcare and also to partner with other professionals. They were granted status as a Private Pontifical Juridic Person in 1997, which grants them certain legislative rights. Today PeaceHealth is a striving business comprised of 9,600 employees, 1,133 hospital beds plus 46 long-term beds, and has net revenue of $824 million.

Business in a Changing World

Lauren Berg

            PeaceHealth dominates the healthcare market in several regions. In the Eugene/Springfield area it is the largest healthcare provider and offers the most verity of services, including everything from heart transplants to mental health counseling. Although it dominates the healthcare field in the area and has enough clients to sustain its self, it still does have competitors. PeaceHealth’s competitors include McKenzie Willamette hospital of Springfield, private medical businesses throughout the area, and larger hospitals that clients travel to. Although still surviving, McKenzie Willamette has experienced less business since the opening of PeaceHealth’s RiverBend hospital in 2008. They even started a lawsuit against PeaceHealth claiming that they were attempting a monopoly, but did not win.

            Many clients complain about the high prices that PeaceHealth charges for its services. PeaceHealth is not alone with this complaint; almost all hospitals and medical providers receive the same complaints. The high prices that medical providers charge are the result of combination of factors. Medical professionals must be highly skilled and go through many years of schooling; because of this they require high pay for their services. Another reason for the high cost of healthcare is the monopolistic competition of the health related services. Another reason for the high prices is the governmental regulations and laws regarding healthcare and health insurance. Also, many professionals who work at PeaceHealth don’t actually work for them directly, but are hired through a subcontractor, which is a large factor on the cost of their services. For example, the physicians who work in the Emergency Department at PeaceHealth are employed by a for-profit business called Eugene Emergency Physicians (EEP). Prices also must remain high to help pay off PeaceHealth’s debt that has acuminated throughout the years. One more reason for the high price of healthcare is the never-ceasing demand for their services; people will always continue to get sick or injured and seek assistance. Even though PeaceHealth is a nonprofit organization, their prices remain high and not everyone can afford their services, especially during the economic contractions.

            PeaceHealth has pride in its business ethics and social responsibility. It’s mission is to “carry on the healing mission of Jesus Christ by promoting personal and community health, relieving pain and suffering, and treating each person in a loving and caring way”. PeaceHealth’s core values are respect, stewardship, collaboration, and social justice. They believe in providing the most “exceptional medicine and compassionate care” that they can, and they expect their employees to comply with these core values. Although they take great strides to help their patients, some may argue that they are unethical in other ways, such as how they generate a large amount of waste or how they charge high prices for their services.

            Misuse of company resources, like in most businesses, is a problem at PeaceHealth. Some employees take home supplies, ranging from pens to expensive medical supplies, which puts a financial burden on the organization. Another problem that PeaceHealth faces is misuse of on-the-clock time, which puts an even greater financial burden on the company. PeaceHealth also occasionally has to deal with abusive and intimidation behavior, conflicts of interest, and behavior that is not fair or honest. PeaceHealth deals with these issues in several ways, including the implication of greater supervision. Managers and supervisors at PeaceHealth are expected to comply with the businesses mission and core values when reprimanding employees. If the behavior is not too extreme, the employee will usually receive at least one warning before termination.

            I recommend that PeaceHealth make strides to have health insurance available to more of the population. This would increase their customer base and bring in more profits to the company. One example of a region that provides good healthcare options to people who cannot afford insurance is the PeaceHealth Siuslaw Region. This program, called Bridge, helps pay medical bills for people depending on their financial circumstances. Bridge receives their funding’s through donations. With this, many patients from different areas come to Florence for their healthcare. Since PeaceHealth is a “system wide” corporation I would expect each region to have the same program. I believe, because PeaceHealth is a nonprofit and that healthcare should be a human right, they should work on lowering their prices. Overall in this case analysis we will discuss how the business started, the nature of their management, how they motivate their employees, along with their marketing and financial strategies.

Starting and Growing a Business

Patricia Wells

            When you or someone you care about enters a PeaceHealth facility as a patient you are probably not concerned about the legal formation of the corporation status.  However, for a case analysis it is a starting point to understand how the corporation began. A corporation is a legal entity created by a state in order to keep many of the rights, duties and powers of a person protected from its business. So basically rather than a person entering into a contract it is the corporation and the individual person is legally protected.

To become an incorporated business a person or group of people must file legal documents called articles of incorporation with the secretary of state in which they would like to do business.  A corporation can file articles of incorporation in as many states as they would like to operate businesses.  A corporation must elect a board of directors to oversea and manage the corporation. Members of PeaceHealth’s board of directors embrace a leadership style that reflects their mission and values of the Catholic health care system. The board of directors leads in every aspect of their work and overseas the responsibilities of the corporation. When filing the articles of in of incorporation the corporation must provide the state with the information listed below:

1.     Name and address of corporation

2.     Objectives of the corporation

3.     Classes of stock and the number of shares

4.     Expected life of the corporation

5.     Financial capital

6.     Provisions of transferring stock or shares

7.     Provisions of regulation of internal corporate affairs

8.     Address of the business office registered with the state

9.     Names and addresses of the initial board of directors

10.  Names and address of the incorporators

         PeaceHealth is registered with the State of Oregon as a foreign nonprofit corporation. The fact that it is a foreign entity means that the original articles of incorporation were filed in another state other than Oregon. In PeaceHealth’s case the articles of incorporation were filed in Washington State in July of 1976 under another name of “Sisters of St. Joseph of PeaceHealth and Hospital Services”. The corporations name changed to PeaceHealth in October 1994. PeaceHealth also has 22 assumed business names registered in the State of Oregon. Assumed business names are separate business that work under the larger corporation. PeaceHealth operates many small businesses in order to make an effort to make their businesses more flexible, resourceful, and innovative. There can also be demographic reasons to operate many smaller businesses through assumed business names so that they can meet more people’s needs in different regions of the state. Also the technology advances in the medical field has increased the opportunities for PeaceHealth to serve the community with new medical services.  Sometimes large corporations think small in order to meet the growing needs of the state in which they operate their corporation.

         There are some differences in non-profit and for profit corporations. The non-profit corporations focus on providing a service rather than earning a profit.  It doesn’t mean that they do not need to make a lot of money to operate the corporation.  PeaceHealth earns millions of dollars so that it can meet all of their expenses and provide a service to those who cannot afford to pay for their medical expenses.

PeaceHealth success may have something to do with the fact that they consider ethics and social responsibility to their corporation.  They have a great since of compassion to the community that they serve. The also have strong morals and ethics that are the backbone of their corporation. 

Managing for Quality and Competiveness

Emily Laing

Management at PeaceHealth is very important and plays a key role on how the company is operated today. Management is considered “Leadership” at PeaceHealth and is based on their day-to-day mission, values, ethics and desired culture. To carry on their mission PeaceHealth’s management strives for great organization, teamwork and good communication. The services PeaceHealth provides has good inputs and great outputs to make sure, “every patient will receive safe, evidence-based, compassionate care; every time, every touch.”

            PeaceHealth’s management has many areas for this non-profit organization. PeaceHealth involves top management, which includes their President, CEO and Vice Presidents. Middle management involves department managers, and first-line management, which involves their supervisors and office managers. The reason why there are so many types of management is because this structure makes it easier to coordinate the use of the organization’s resources. These three types of management not only help with the organizations resources but with the structure of how each department is set up and makes it easier on employees when they need to come to management for a problem or situation.  Leadership at PeaceHealth is based off a model. This leadership model expresses the view that the role of leaders is to serve and inspire rather than simply motivate. This model reflects PeaceHealth’s mission, values, ethics and desired culture. PeaceHealth’s desired culture includes the values, attitudes, beliefs and behaviors that are the essence of the organization. PeaceHealth’s organizational culture has a strong impact on day-to-day work because it achieves their main goal. PeaceHealth’s main goal is making sure patients are taken care of and are satisfied.  

            Teamwork is used everyday at PeaceHealth. Every department uses teamwork in order to accomplish their goals. With teamwork comes good communication. Each department is required to have meetings and have audits to make sure there is always room for improvement. To improve work at PeaceHealth or make-work more efficient management makes sure to approach problems as opportunities for innovation.

            PeaceHealth has a great example of the transformation process which inputs are converted into outputs. The labor, money, materials and energy at PeaceHealth are converted into pleased patients who received satisfactory healthcare. Management makes sure that this goal is met. If this goal is taking to long to meet PeaceHealth’s management will go to Lean thinking. What is Lean thinking? Lean thinking is the dynamic, knowledge-driven and customer-focused process through which waste is eliminated and the goal of created value is achieved. This is a great example of quality control and total quality management at PeaceHealth because it is insuring that the patients are pleased and satisfied with their healthcare. PeaceHealth management does not only commit to one department but all areas of the organization to make sure everyone is improving patient satisfaction.

            PeaceHealth has established great management. By establishing this PeaceHealth has a reflected their mission, values, ethic and desired culture. It is important for the organization to have satisfied patients because this means the healing mission is complete. PeaceHealth continuously learns and improves not only just in management but also as individuals, as teams and as an organization.

            I recommend that PeaceHealth management should work on improving their customer relations. One way they could work on this would be to give their employees consistent schedules that are appropriate in length. This will make employees more satisfied and help with showing and improving on compassionate care towards patients. PeaceHealth should evaluate their administration to ensure that it is functioning as well as it can.  If PeaceHealth implements these changes the corporation will be more profitable and better functioning. I feel PeaceHealth has done a wonderful job on sticking to their mission and core values. They make sure every patient gets the care that they need through the healing mission of Jesus Christ. With being an employee at PeaceHealth, I really appreciate that no patient leaves without the care and medical attention they need.

Creating the Human Resource Advantage

Emily Laing

The Human Resource Department at PeaceHealth makes up the workforce and diversity of this non-profit organization and is responsible for motivating their employees. Historically and today’s day and age everyone that works at PeaceHealth is considered a Caregiver. The Human Resource Department at PeaceHealth is to make sure every employee feels as a part of the caregiving team regardless of role or title. Human Resources follow their leadership model at PeaceHealth, which is deeply rooted in their identity as a Catholic healthcare system, their mission, values and ethics. Human Resources have embraced the model by committing to growing and developing their own leadership skills. This model expresses the view to serve and inspire rather than to just simply motivate. Throughout the years at this non-profit organization and great management there has been no employee outrage or strikes. Patients are generally happy and employees stay with the organization for many years.

            A great way of motivating employees and increasing productivity is by giving the employees extrinsic rewards, which are benefits the employees receive from the organization. PeaceHealth offers employees health benefits including dental and vision, as well as employee assistance program and referral service, life insurance, disability coverage, pre-tax flexible spending accounts, paid time off, paid leaves of absence, tax deferred account plan, retirement plan, and transportation benefits. PeaceHealth also offers a 457(b) savings plan, educational assistance program, training and development, fitness facilities, alternate/flexible work schedules and telecommuting, employee referral bonuses, relocation assistance and lastly childcare assistance. Benefits and incentives give employees intrinsic rewards with gratitude that they have done a great job. With that PeaceHealth does not have much of a turnover.

            With such great benefits, incentives and many opportunities, PeaceHealth attracts a substantial amount of internal and external employment. Human Resources and senior executives make a promise to engage caregivers in orientation and get them motivated to work for the organization and become successful. Once they give the orientation, employees are trained and developed into a great caregiver to ensure their corporations promise is fulfilled. PeaceHealth holds this promise in the highest regard to make sure it is delivered consistently and with every interaction. PeaceHealth states, “What is our promise? Our promise is”…

·            What everyone in the organization delivers on.

·            It is the unique approach to what we do.

·            It drives what we want to be known for.

·            It is the everyday shortcut to our brand experience.

·            It sums up who we are in a few words.

·            It is the driver for our actions, decisions and messages.

·            It is authentic, believable, differentiating, enduring, relevant and true.

With this promise caregivers are able to achieve their goals through patient care.

            PeaceHealth has done a phenomenal job with treating employees well and making sure every employee is motivated and has a sense of job security. Job security is an important key factor due to the economy today.  PeaceHealth offers many opportunities for employees to excel and do better not only for the patients, but also for themselves. Providing as many benefits and incentives that they have, has kept PeaceHealth growing and succeeding employment wise. Human Resources helps foster the pursuit of knowledge and skills among all those who serve in order to provide quality healthcare. Without such good leadership PeaceHealth would not be where they are at today. With this, I feel PeaceHealth does not have much to work on with their leadership skills.

Marketing: Developing Relationships

Lauren Berg

PeaceHealth is a chain of hospitals that provide healthcare to communities. The main product that they market is of course their healthcare services. They advertise in a variety of ways, including billboards along highways, sponsoring events, giving away products that have their logo, hosting health presentations, and hosting banquets for practitioners and other important people to the business. They also frequently receive publicity on news stations, radio, the Internet, and newspapers. PeaceHealth has several strategies to creating and maintaining both customer relationships and business relationships.

Maintaining a positive view to the public is crucial for the business, and they take the steps necessary to keep their public reputation. Because they are a large business, they receive a substantial amount of publicity. PeaceHealth receives publicity when it undergoes a significant change in business strategy, hospital development, when they have severe malpractice of physicians, when a large lawsuit occurs, and many other occasions. They also can receive positive publicity occasionally. PeaceHealth won the Eugene Area Chamber of Commerce “Best Business of the Year Award” because of its focus on running sustainability with regard to finances as well as the environment. They also were picked because of their charity care and their support to local organizations. PeaceHealth, the largest employer in Lane County, makes a noticeable impact on the community with its good business ethics. This has helped it gain a better reputation and overcome competition.

PeaceHealth has a strong marketing mix that has given it the completive edge to be successful for many years. The business offers better dimensions of their service than do other companies. Their business mix, which includes their appealing business ethics, has a greater variety and perhaps greater quality of services than their competitors offer. The hospital has a large number of specialists who perform technical medical and psychiatric services. They also have advanced medical technology to help them perform better. They have a set standard on how clients are treated and in some sectors of the hospital they try to build a trusting relationship between the client and the caregiver. This marketing mix gives the business a stronger competitive edge.

Technology provides PeaceHealth with many important tools for communication and efficiency throughout the corporation. Almost every employee uses email for numerous purposes, some of which include: developing and achieving business plans, developing and maintaining business relationships, notifying employees about important news, scheduling shifts, and communicating information about patients. PeaceHealth also uses digital communication to administer much of its financial, legal, and human resources. Many other forms of technology are used at PeaceHealth, some of which have been mandated by the government. The government has been imposing upon hospitals throughout the country and instructing them to become more reliant on technology. One example of this is the digitalization of doctors’ notes. Although disliked by many of it’s users, the system of digitalizing notes provides many benefits: there is no longer any struggles to read patient files, notes and files are less likely to be lost, the information can more easily be transferred to a different department or hospital, and the electronic note taking devise also provides doctors with important medical information that they may have not known for each specific patient. PeaceHealth is also doing well through their interpreter services. They use web cameras to facilitate interpretation with interpreters from different areas. When new products are introduced to the PeaceHealth system, including most of their technological products, they are often tested for quality at one hospital before the other hospitals start using them.

            PeaceHealth has been implementing their advertisement and technological strategies perfectly. They have a strong marketing system which, which has given the business a great advantage over the market. Their technology advancements have given the company greater efficiency, profit, and customer satisfaction. With new technological advances I foresee PeaceHealth making even greater strides towards becoming an excellent business.

Financing the Enterprise

Patricia Wells

         The financial records for PeaceHealth as you can imagine are not easy to access so my case analysis is going to be based on the year 2009.  The Register Guard interviewed Sister Monica Heeran was CEO of PeaceHealth, one of her comments was, "No money, No mission”. PeaceHealth may be a nonprofit corporation, but just like any business, it needs to take in more money than it spends. Over the years, PeaceHealth has been very successful in managing its finances and investments so that it is able to stay in business.  But the year 2009 may be the worst on record for PeaceHealth. According to a financial statement filed with the state of Oregon PeaceHealth lost $63.2 million on its operations for the fiscal year that ended June 30, 2009. 

PeaceHealth is doing much better financially since 2009 due to aggressive cut backs in all areas of their hospitals. The Oregon hospitals had two rounds of budget cuts and were able to trim their budget by $175 million. They did this by cutting and freezing wages and eliminating more than 100 full-time jobs.  PeaceHealth also listened to more than 1,000 employee’s suggestions that led to $2 million in savings. The economy slowly improved in the first quarter of the new fiscal year and surgeries were up 18 percent, representing people who postponed surgeries because of the recession now felt confident enough to schedule their surgeries.  Also Hospital admissions were up 4 percent. 

Here is a breakdown of PeaceHealth's two Sacred Heart hospitals in lane country that show RiverBend actually made a profit in fiscal 2009 of $2.2 million, while University District posted a net loss of $9.3 million. PeaceHealth's annual expenses for operating both RiverBend and University District totaled $518 million for the latest fiscal year. PeaceHealth had over 4,214 employees who are paid more than $50,000 a year in fiscal year. That was up 25 percent from just two years earlier, when the organization had 3,364 employees paid more than $50,000 a year. Salaries for top doctors and executives are a major expense. PeaceHealth's five top-paid doctors collectively were paid $4.3 million in fiscal 2008, according to the IRS filing. Three were based in Lane County, and two in Bellingham, Washington. 

Even with its loss in fiscal 2009, the PeaceHealth system does have a big financial bank account built up over the years. PeaceHealth's cash and investments totaled $258 million that is down from $386 million in 2008.  Below is a financial statement for 2009.



PeaceHealth FINANCES, FISCAL 2009 

Operating revenue: $1.37 billion 

Operating expenses: $1.43 billion 

Operating loss: $63.2 million 

Investment loss: $34.7 million 

Total loss: $97.9 million 

Source: PeaceHealth consolidated financial statements 

Article by Urban Institute

By Robert Berenson and Stephen Zuckerman

How will Health Care Reform affect the Hospitals?   For the nonprofit hospitals like PeaceHealth there may not be as many changes that will affect the hospital.  One analysis results from an Urban Institute micro-simulation model suggests that 30 million newly insured Americans would generate $40 billion in new revenues for hospitals.  This would be very good for PeaceHealth’s future one area that will be changed is how Medicare and Medicaid will be paying the hospitals.  This change could be positive or negative depending on how it is implemented.  An Independent Payment Advisory Board will recommend policies to reduce Medicare spending in the future so that it does not exceed a target growth rate.

         There will be new requirements based on whether or not a nonprofit hospital provides the kind of community benefits needed to maintain their nonprofit status and the coverage expansion that will take place with the new Health Care Reform.   The new reform imposes laws that will require nonprofit hospitals to conduct community needs assessments every three years and to adopt an implementation strategy to meet the needs of the community.  The new reform also contains a number of provisions that guide hospitals’ adoption and application of financial assistance policies, including limiting charges to uninsured patients.

PeaceHealth’s general reputation has been excellent for many years and after doing research about the Washington based corporation I have found that Oregon has benefited a great deal.  PeaceHealth has provided hospitals and medical offices that have allowed our community to be cared for as well as provide jobs for so many in Oregon.  In my opinion, PeaceHealth has a mission to serve everyone who needs medical attention regardless if they can afford to pay for it.  PeaceHealth has maintained strong through our recent economic recession.  Also PeaceHealth does a great job to sustain our economy and environment and I feel it would be a great place to work for many years to come.

Summary

            PeaceHealth, founded in 1890, is a strong and competitive business that will continue to prosper for many more years to come. Sr. Andrea Nenzel, CSJP, PeaceHealth Board Chair states that, “PeaceHealth—the legacy of the Sisters—continues this spirit of collaboration and stewardship in fulfilling its mission today. This is the Spirit of PeaceHealth”. As discussed in our case analysis, PeaceHealth has shown excellent decision-making to meet their goals. They have shown strong points in their management, caregiving, motivation and technological development. PeaceHealth has been continuously growing and developing into a stronger business, and has become a leader in local healthcare.

            PeaceHealth is dedicated to providing “exceptional medicine and compassionate care” to many Northwest communities. They continuously pursue additional knowledge, skills, abilities, and experience. With the corporation going system wide, PeaceHealth seeks to learn, develop and grow substantially both professionally and personally. With many benefits and incentives PeaceHealth has made it an enjoyable environment not only for the patients but also for the employees.  

Bibliography

Sharamitaro, A. (2011). Retrieved from http://www.healthcapital.com/hcc/newsletter/1_11/aca.pdf

Mckenzie Willamette hospital vs. peacehealth. Retrieved from http://mhgm.com/cases/McKenzie-Willamette-Hospital-v-PeaceHealth

The spirit of peacehealth. Retrieved from http://www.peacehealth.org/Documents/spirit-of-peacehealth.pdf

http://www.peacehealth.org

http://myhr.peacehealth.org

Berg, Brian, G. MD. (2012, February 10). Personal Interview. About PeaceHealth.

Christie, T. Peacehealth may move jobs. The Register-Guard. Retrieved from http://special.registerguard.com/csp/cms/sites/web/news/cityregion/24820888-41/peacehealth-services-center-shared-memo.csp

PeaceHealth Consolidated Financial Statements

Stephen, Z., & Berensen, R. (July 2012). Time Analysis of Immediate Health Policy Issues.

http://www.crossroads.com  

Appendix

Part I. Business in a Changing World

Chapter 1-3

·   What does it mean that PeaceHealth is a nonprofit?

·   Is PeaceHealth part of competition, pure competition, monopolistic completion, an oligopoly, or a monopoly?

·   In what ways is PeaceHealth ethical or unethical?

Part II. Starting and Growing a Business

Chapter 4-5

·   What are the main differences between for profit and non-profit?  Why would a medical corporation what to be non-profit?

·   Does the government treat non-profit corporations differently?

·   How do non-profits fund their operations?

·   What type of corporation is PeaceHealth?

·   Do non-profits have officers or board of directors?

·   What are the officers and board of director’s responsibilities?

·   What is an ABN and how many do PeaceHealth own and operate?

·   Explain why many large corporations try to think small?  Does PeaceHealth?

·   What demographic, technological, and economic trends affect PeaceHealth

·   What are the advantages of being a nonprofit business?

Part III. Managing For Quality and Competitiveness

Chapter 6-8

·   Why is management important at PeaceHealth?

·   Out of Planning, Organizing, Directing and Controlling, which activities does Peacehealth’s managers/management perform and or carry out everyday?

·   What is PeaceHealth’s Mission Statement?

·   At PeaceHealth is there Top Management, Middle Management and First-Line Management? How do these types of management help the organization?

·   There are other areas of management at PeaceHealth including finance, production and operations, human resources, marketing and administration. What areas are crucial for PeaceHealth to have?

·   Leadership is important to have. What type of leadership does PeaceHealth’s management have, not only towards their employees but also towards the way patients are taken care of?

·   What is PeaceHealth’s organizational culture; PeaceHealth shared values, beliefs, traditions, philosophies, rules and role model for behavior. Does this culture have a strong impact on day-to-day work and why?

·   How does departmentalization affect PeaceHealth? Explain how it helps or does not help the organization?

·   Is PeaceHealth’s management wide or narrow? Why?

·   Is PeaceHealth more of a line structure or line-and-staff structure?

·   At PeaceHealth do the employees work as a group or as a team?

·   How important is it at PeaceHealth to have good communication? What does PeaceHealth do to have better communication?

·   Does PeaceHealth use formal or informal communication?

·   What is PeaceHealth’s transformation process? Does this process make the patients happy?

·   At PeaceHealth are they analyzing work processes to find/address problems as soon as they occur? What programs does PeaceHealth have to help with analyzing the work processes?

·   How does managing quality work at PeaceHealth satisfy the patients?

·   Does total quality management play a big role at PeaceHealth and why?

Part IV. Creating the Human Resource Advantage

Chapter 9-10

·   How and why is motivation the key to success at PeaceHealth?

·   At PeaceHealth what is the extrinsic rewards and the intrinsic rewards? Do these rewards help motivate employees?

·   What theory or theories best fit PeaceHealth, Maslow’s Hierarchy of Needs, Hezberg’s Two-Factor Theory, McGregor’s Theory X and Theory Y, Equity Theory or Expectation Theory?

·   Is there good use of job rotation at PeaceHealth? Does this help with boredom?

·   Does PeaceHealth offer job enrichment programs?

·   Has PeaceHealth ever experienced any problems with picketing, strikes, or boycotts?

·   If they have had employees strike, did they hire strikebreakers?

·   Do the fees they charge have effect the number of clients they receive?

·   How diverse is their staff? Are affirmative action programs a big factor in the amount of diversity at PeaceHealth?

·   What type of orientation do new hires have?

·   Has PeaceHealth ever experienced any problems with picketing, strikes, or boycotts?

·   If they have had employees strike, did they hire strikebreakers?

·   Do the fees they charge have effect the number of clients they receive?

·   How diverse is their staff? Are affirmative action programs a big factor in the amount of diversity at PeaceHealth?

·   What type of orientation do new hires have?

Part V. Marketing: Developing Relationships

Chapter 11-13

·   What are the main things that PeaceHealth sells, apart from general medical care?

·   Does the price of their services reflect its value properly? Should they charge more or less?

·   To what extent does PeaceHealth use the marketing concept? Do some departments and locations work to satisfy the clients more than others?

·   It seams to me that, because of their dominance over the area and the never-ending demand for healthcare, PeaceHealth probably does not have to have much of a market strategy for their services. Is this true, and if not in which ways do they market?

·   When they want to try a new product or system, do they try it first just at one location?

·   Do they sell any tangible products, and if so would they be classified as convenience products, shopping products, or specialty products?

·   Who do they buy their business products from and how do they go about doing so?

·   Does PeaceHealth advertise and what type of advertising do they use?

·   To what extent do the non-administrative employees of PeaceHealth use digital technology to conduct business? Would it be financially beneficial for them to update their systems to more advanced technology in some sectors?

·   What could PeaceHealth add to their website to gain greater customer satisfaction or increase number of clients?

·   Does PeaceHealth administer its financial, legal, and human resources through digital communication?

·   Does PeaceHealth have adequate systems to protect the confidential information of clients that is stored in computers or on the Internet?

Part VI. Financing the Enterprise

Chapter 14-16

·   How large is PeaceHealth accounting department?

·   Does PeaceHealth have an in house CPA or do they hire an outside CPA?

·   What accounting cycle does PeaceHealth use on Page 444?

·   Does PeaceHealth have to provide all their financial records to the public because they are nonprofit?

·   What financial ratios does PeaceHealth use to help assess the financial health of the organization?

·   Can PeaceHealth charge interest to patients with outstanding medical bills?

·   What types of loans do PeaceHealth qualify for and can they sell bonds to fund their business?

·   How has PeaceHealth done during our current recession?

·   How does PeaceHealth balance sustainability with performance during a difficult financial time?