Aircraft Icing Essay Example for Free

Aircraft Icing Essay Ice and aircrafts are never a good combination. Ice, which can accumulate on any part of the aircraft, is most dangerous when it accumulates on the wings or similar airfoils. These icing encounters cause many fatalities a year, fatalities that could be prevented if pilots use the strategies and tactics that are at their disposal to avoid icing dangers. In flight icing is always a concern and should be treated with an expedited response, however, proper avoidance of icing conditions begins on the ground during preflight. This safety report will discuss the many types of icing and their effects on flight. Along with the effects of icing on an aircraft, this report will examine the procedures to follow when reacting to these icing conditions. This report will include accident data as reported by the National Transportation Safety Board (NTSB) and more importantly the research and technologies developed to help reduce icing-related aviation accidents. Aircraft Icing Aircraft Icing What are the Causes and Possible Solutions? Icing is a definite weather hazard to aircraft. Icing refers to any deposit or coating of ice on an aircraft. Two types of icing are critical in the operation of aircraft: induction icing and structural icing. Another important form of structural icing may affect the runway or other resources used by aircraft. A runway covered with even a thin film of ice can cause loss of directional control and make braking efforts completely ineffective while the craft is on the ground (Roy, Steuernagle, Wright, 2008). In flight, including the takeoff, the threat of ice hazard is increased. Icing Causes:  Common sense tells us that winter time brings on icing conditions, however, ice is present, or potentially present, somewhere in the atmosphere at all times, no matter what the season. The secret is the freezing level of altitude, which may be around 15,000 feet during the summer and perhaps as low as 1,000 feet above ground level (AGL) on those â€Å"warm† winter days (Lester, 2004). Carburetor icing: When the temperature and dew point are close, you can be certain that water vapor is condensing within the carburetor of an aircraft reciprocating engine, and, if the engine is run at low speed, the condensation is turning into ice. This is why some engine manufacturers recommend that carburetor heat be applied when the throttle is retarded for prolonged descent and prior to landing (Gleim, 2003). Accident summaries contain many cases of unexplained power loss. Many of these aircraft accidents can be attributed to carburetor ice. Once carburetor ice is suspected –at the first sign of engine roughness Aircraft Icing or power loss- apply full carburetor heat (Gleim, 2003). After carburetor heat is applied the engine may run rougher as the ice melts away but the rpm will return to their normal setting. There are many cases of loss of engine power as a result of carburetor icing which forces a landing. The following accident report summary describes a similar carburetor icing situation: A 106-hour Skyhawk pilot reported that the engine began to run rough and lost power as the airplane climbed through 9,000 feet means sea level (MSL). She then switched fuel tanks and moved the mixture to full rich, but the engine continued to lose power. Carburetor heat was not used at any time. A forced landing was subsequently made in a field, where the airplane collided with a utility pole and landed in a ditch. An examination of the engine revealed no evidence of mechanical failure or malfunction. An icing probability chart revealed that the reported weather conditions in the area were favorable for the formation of moderate carburetor icing at cruise power. The Cessna 172M owner’s manual notes that a gradual loss in rpm and eventual engine roughness may result from the formation of carburetor ice and prescribes the use of carburetor heat to clear the ice. (Civil Aviation Authority, 2006). Structural Icing: The previous report refers to induction icing within the engine, but other forms of icing attach to the exterior of the aircraft called â€Å"structural icing†. Airframe or structural icing refers to the accumulation of ice on the exterior of the aircraft during flight through Aircraft Icing clouds or liquid precipitation when the skin temperature of the aircraft is equal to, or less than 0 deg C (Lester, 2004). Types of Structural Icing: Structural icing takes on many forms depending on the size of the moisture that comes in contact with the aircraft. The types of structural ice are clear, rime and a combination of the two. The primary concern over even the slightest amount of structural ice is the loss of aerodynamic efficiency. The increase in drag caused by the additional ice also causes an increase in stall speed, instability and a decrease in lift (Roy, K. S, 2008). The type of ice that forms on the aircraft primarily depends on the size of the water droplets. Clear ice forms when the drops are large and the droplets impacting an airplane freeze slowly, spreading over the aircraft components gradually forming a smooth sheet of solid ice (Lester, 2004). Clear ice is the most dangerous form of structural icing because it is heavy and hard; it adheres strongly to the aircraft surface greatly disrupting airflow. Clear ice will normally form while flying through cumuliform clouds and through freezing rain (Lester, 2004). Rime ice is the most common icing type and forms while flying through stratified clouds and freezing drizzle (Lester, 2004). It forms when water droplets freeze on impact, trapping air between the small frozen drops, giving the ice a milky white appearance. Mixed ice has characteristics of both types making it a combination of rime and clear ice. Aircraft Icing The following NTSB summary describes the dangers of inadvertently encountering ice and the effect it will have on the ability of the aircraft to maintain lift and stability: CE 182. One serious and one minor injury. Pilot received a weather briefing approximately one hour prior to flight during which â€Å"A chance of light icing† was forecast. Approximately 30 minutes after takeoff, while at 6,000 feet, a small amount of ice began to form on the strut in the light rain. Although the aircraft was then cleared to climb above the cloud layer, heavy icing began to accumulate. The aircraft could not climb above 7,300 MSL and a 300 – 400 feet per minutes (f. p. m). descent developed. The aircraft was cleared to an alternate airport via radar vectors. Over the runway at about 50 feet above ground level (AGL), the aircraft uncontrollably veered to the left and struck the ground hard, collapsing the nose gear. A witness stated that there was ? inch of ice on the fuselage and an inch on the belly. The aircraft was also loaded approximately 200 pounds over gross weight. NTSB cited the probable causes as icing, improper weather evaluation, and deteriorated aircraft performance. (Watson, 2007) Pilots need to avoid ice especially if their aircraft are not approved for flight into icing. The aircraft in the NTSB report summary above was not approved for flight into icing conditions. Although ice forecast retrieved via weather briefings are in some cases inaccurate the pilot needs to have an escape route should icing be encountered. Accident data as reported by the NTSB is most useful when it brings about the development of technologies that help reduce icing-related aviation accidents. Aircraft fall into two categories, those approved for flight into icing and those that are not. Aircraft equipped with ice protection system allow them to keep ice from accumulating Aircraft Icing on the wing structures while in flight. The evolution of aircraft has provided advanced and useful technologies that have made our aircraft safer in less favorable atmospheric conditions. Icing protection systems: The types of icing protection systems are pneumatic deicing boots, thermal devices, and electro-mechanical systems (Burrows, 2002). The pneumatic deicing boot is a rubber tube attached to the leading edge of an aircraft wing. When ice is encountered during flight, portions of the rubber device inflate breaking off the ice (Burrows, 2002). Pneumatic deicing boots are used on propeller driven aircraft and jets. Thermal systems use electricity to heat protected surfaces of equipped aircraft. Thermal deicing systems have a more advanced function than deicing boots in that it prevents ice from forming on the heated protected surfaces. The electric heaters can be used as de-icers or anti-icers (Burrows, 2002). The newest technological advance in de-icing is called electromechanical de-icing, the system use a type of mechanical actuator that physically knocks the accumulated ice off the flight surfaces. The technology works in conjunction with previously developed ice detection systems and is triggered automatically once sensors detect ice. First, an electro-thermal strip heats the wing’s leading edge to just above freezing, melting the ice. Then other electro-thermal systems heat the leading edge enough to evaporate moisture on contact, preventing it from escaping and refreezing elsewhere as â€Å"runback† ice. The water flows downstream and eventually freezes where Aircraft Icing the aircraft is less sensitive to airflow disruptions. That’s where [the deicers] hit it. † An electrical current is sent through one set of coils at a time, and as the current loops through the coil, it flows in one direction and then the opposite, inducing a magnetic field. Jolted with electrical energy pulses that last . 0005 second, the coils deliver impact accelerations of over 10,000 Gs to the airfoil skin once a minute, shedding ice as thin as . 06 inch.  Despite the high G-load, the impact amplitude—the amount of movement of the aircraft skin—is only about . 025 inch. The skin accelerates so rapidly, though, that ice de-bonds as if hit with a hammer (Smithsonian Air and Space). Conclusion Ice and aircrafts are a dangerous combination when pilots don’t utilize weather services to determine freezing levels. When a pilot doesn’t understand when to deploy his ice protection system or doesn’t do a proper preflight including weather briefings, icing encounters become a reality. Many fatalities a year could be prevented if pilots use available resources to avoid icing dangers.

English literature Essay Example for Free

English literature Essay For Locke, all knowledge comes exclusively through experience. He argues that at birth the mind is a tabula rasa, or blank slate, that humans fill with ideas as they experience the world through the five senses. Locke defines knowledge as the connection and agreement, or disagreement and repugnancy, of the ideas humans form. From this definition it follows that our knowledge does not extend beyond the scope of human ideas. In fact, it would mean that our knowledge is even narrower than this description implies, because the connection between most simple human ideas is unknown. Because ideas are limited by experience, and we cannot possibly experience everything that exists in the world, our knowledge is further compromised. However, Locke asserts that though our knowledge is necessarily limited in these ways, we can still be certain of some things. For example, we have an intuitive and immediate knowledge of our own existence, even if we are ignorant of the metaphysical essence of our souls. We also have a demonstrative knowledge of God’s existence, though our understanding cannot fully comprehend who or what he is. We know other things through sensation. We know that our ideas correspond to external realities because the mind cannot invent such things without experience. A blind man, for example, would not be able to form a concept of colour. Therefore, those of us who have sight can reason that since we do perceive colours, they must exist.

Vibrating Sample Magnetometer (VSM)

Vibrating Sample Magnetometer (VSM) Robert Konstandelos Operation A sample is made to oscillate using a vibrational unit extended on a rod. The sample is placed between two electromagnetic pieces which are used as the applied field for this this experiment. With the sample oscillating induces a voltage between the search coils which creates a signal to determine the magnetic properties of the sample. Reference coils are used to create a reference signal such that noise generated from the signal can be filtered using a lock-in amplifier [1]. Because the signal and the reference signal are directly related through its voltage and amplitude means that precise measurements can be recorded using a voltmeter. Calibration methods are important to determine the relation between the voltages induced by the magnetic field and the sample and their magnetic properties. Calibrating the applied field is done by increasing the voltage in steps measuring the field until reaching a maximum. The system is calibrated using a nickel standard normally as a number of vo lts per unit of magnetic moment. Many materials such as types of barium ferrite or alnico materials can be placed inside to determine properties. These properties include remanence, coercivity, intrinsic coercivity and operating points once the system has been calibrated. Advantages and Disadvantages in terms of experimental facets The key advantage is the precision and accuracy of VSMs. Taking measurements at a range of angles once detection arrangements for the coils have been devised can be done. The advantage of sample vibration perpendicularly to the applied field can be found once the detection coils have been arranged appropriately. This means that there is the ability to test the sample at different angles. The positioning of the coils are done in a way to reduce the effects of sample position variation and external field variation- essentially deep into the applied field shown in figure 1. Disadvantages are that they are not well suited for determining the magnetisation loop or the hysteresis curve due to the demagnetising effects of the sample. Another problem is that, particularly for the VSM used in the third year laboratory is that temperature dependence cannot be controlled. Figure 1. A schematic layout of the VSM 2. B-H Hysteresis Loop Tracer Operation The B-H hysteresis loop tracer is essentially two coils, one with a sample and the other which is empty for comparison. The insertion of a sample into the pickup coils causes a voltage proportional to the rate of change of the vector field to occur across the difference amplifier. After passing through an integrator, a voltage proportional to the intrinsic induction is passed to the Y-amp of the oscilloscope. This voltage combined with an X-voltage representing the magnetising field generated from the solenoid without the sample results in the generation of a hysteresis loop on the oscilloscope. Calibration is through a balance and phase adjustment to establish a trace on the oscilloscope. They are done to make sure that the magnetising field is linear and that every vector corresponds to the applied field. Measurements for the magnetic properties can then be made. Advantages and disadvantages in terms of experimental facets The coils have the ability to heat the sample such that temperature variance can be observed in the way that the material behaves when influenced by a magnetic field. On the other hand, this could cause overheating of the system which could result in a failure. Using a BH-looper can give the user a more improved visualisation compared to a VSM of the way a material behaves. The values plotted on the scope are only proportional to the absolute values, therefore display yields qualitative not quantitative information about a material magnetic properties. The precision is generally low compared to a VSM. Because a hysteresis loop is viewed using an oscilloscope means that observations of whether the material is a soft or hard magnetic material. And this is why it is used in quality control testing industries like the control of ferromagnetic oxides in a magnetic tape factory. Figure 2. A schematic layout of a BH loop tracer [2]. 3(I) Difference between concepts of Vector Field B, Magnetisation M and the magnetising field H The vector field B represents the magnetic induction. Magnetisation M is the magnetic moment per unit volume of a solid. Magnetising H field is the magnetic field strength. These three quantities are related by the equation. With ÃŽ ¼0 being the permittivity of free space. To show the difference between these quantities, hysteresis loops for a magnetic material shown in figure 4 are used. One of the key differences shown is that the magnetisation saturates whereas the B field increases at a constant rate for certain values for H. The magnetisation is generated by the spin and the orbital angular momentum of electrons in the solid. H is generated outside the material by electrical currents[3]. Therefore, from the equation above, the B field is the combination of H and M which shows the difference between the quantities with the inclusion of the permittivity of free space. A way to show the difference between the 3 parameters is through the representation of a bar magnet in a magnetic field shown in figure 3. Unfortunately, due to the age of the diagram, the labels are a bit old. Hence the ‘True’ field denotes the vector field B and the Applied field represents the magnetisation M. However, the arrows represent the direction and strength of each parameter. It is clear from figure 3 that the Magnetisation is much stronger than the demagnetising field. Figure 3 An example of a magnet being demagnetised in an applied field From figure 4, the two sketches representing of B and M against H can give an understanding of other magnetic properties of the material. The curve on the left can show the saturation of the magnetic material as well as the remanence Mr the remaining magnetisation after the applied field has been turned off. The right hand diagram can show the remanent induction Br and the saturation point of the applied field. In terms of the difference between the parameters, M, B and H, they yield different properties of the material in question. Figure 4 Hysteresis loops showing (a) M and (b) B field against H 3(II) The difference between the susceptibility and relative permeability The relative permeability ÃŽ ¼r and susceptibility χ are very closely related as shown by the equation below: The relative permeability represents a characterisation of magnetic materials. Paramagnetic or diamagnetic materials have permeabilities close to the permeability of free space. However for ferromagnetic materials, the permeability is large in comparison. It represents a multiplication factor. For example, the use of an iron core with a relative permeability is 200 times greater than just an air coil used. So this is a measure of the actual magnetic field within a ferromagnetic material. Susceptibility is a measure to an extent to which a material may be magnetised in a magnetic field. It represents a ratio of how much a material is magnetised compared to the applied field on that material [4]. So the susceptibility specifies how much the relative permeability differs from one as shown in the equation above. References [1] Foner S 1959 Versatile and Sensitive Vibrating-Sample Magnetometer* Rev. Sci. Instrum. 30 548–57 [2] Howling D H 1956 Simple 60-cps Hysteresis Loop Tracer for Magnetic Materials of High or Low Permeability Rev. Sci. Instrum. 27 952 [3] Jiles D 1990 Introduction to Magnetism and Magnetic Materials (Chapman and Hall) [4] Magnetic Susceptibilty http://www.britannica.com/EBchecked/topic/357313/magnetic-susceptibility

Berghaus’ Case Study :: Business Management Studies

Berghaus’ Case Study 1) Berghaus is very successful business having an annual growth rate of 25%. This indicates that there is an increasing demand for their products. They also have an export ratio of 50% meaning that their distribution rates are very good. Last year alone their per-tax profits were  £750,000 and a large amount of this money can, most probably, will be reinvested into the company for further development. Also, its pre-tax profits in 1991 were  £750,000 which is obviously not a small amount, Berghaus clearly mean business. By the sound of it, that number is only expected to increase in the years to come. It has an export ratio of 1988-9 of more than 50%, which is the vast majority, within the whole of Europe, meaning that its export increased by a great deal during those years specifically, and we assume it still increases in other years too, although maybe not as much as between 1988-9. 2) In the context of Berghaus, market differences mean many things. Berghaus currently conduct sales through large number of countries, from Germany through the United Kingdom and Switzerland, and as a result Berghaus have found out that the world cannot be treated as though as one market. Each country has its own customer preferences and may have certain social attitudes to a certain type of clothing, and these are known as market differences. Due to this Berghaus has to develop a certain product for a specific country and then modify that product or completely reconstruct it for another country. This as a result means higher costs are involved in research and development and also different advertising methods would have to be implemented. This market difference has meant Berghaus have had to operate quickly and efficiently to design, produce and distribute the product across all the parts of the world, beating all opposition and this is obviously very difficult for Berghaus. 3) There are many different reasons for the success of Berghaus, and these can be mainly divided into four parts, Production, Finance, Marketing and Management. Production is simply the fundamental part of the company, without it no product would exist to sell. Designing new products is what makes people want a certain product and Berghaus have strategically produced a wide range of products meaning that they will be able to successfully cover the different fields in the market. This means that they have more areas for money coming; by having more units and product innovation is an essential key t their success. Production has also been economised by the introduction automated production with continual processes. This allows an easy and flexible method to

Persuasive Essay: England Must Stop Illegal Immigrants :: Papers Agains Immigration Essays UK England

If we, as a country don’t decrease the amount of immigrants in this country the population will be overrun by a lot of people who shouldn’t be here. I say a lot of people because a large number of immigrants have valid reasons for living in England. One of the main issues with illegal immigrants is that they work for a very small amount of money. They are doing the same quality job as your average tradesman but for a huge amount less. This means that most citizens are choosing to employ these less expensive workers. If all the illegal immigrants are doing the work, all tradesmen who have worked hard for there money for so long and become skilled at their profession will lose there jobs and become penniless. Most of these honest workers have built families and unfortunately if they are not getting employed for work they will not be able to provide and feed their families. An enormous amount of old war veterans have been denied council houses because of the rising amount of asylum seekers who are claiming asylum, these people all have to be given houses and are in large numbers so they take up huge estates of houses. These old people who once fought for this country deserve a house a lot more than these people who are entering the country illegally. A high percentage of illegal immigrants in this country apply for benefits and do not go out and find there selves jobs. They receive their money from all the hard working citizens that are paying taxes out of the money that they have worked extremely hard to earn. They just sit at home and get everything paid for them by the â€Å"social†. What is even worse is when they receive there benefits and also they get income from doing little jobs. They commit benefit fraud which is illegal. There are a minority of immigrants that support terrorist views; these people are plainly trouble makers.

Guatemala and Spanish Cultures Essay -- essays research papers

  Ã‚  Ã‚  Ã‚  Ã‚  Guatemala has more people than any other Central American country, with an estimated population of 11,980,000 it is home to many different cultures. The population can be divided into two groups; Indians and people of mixed Spanish and Indian ancestry. But in Guatemala, being called an Indian or a non-Indian does not depend entirely on a person's ancestry. It is basically a matter of how people live and of how they categorize themselves. For example, a Guatemalan is considered an Indian if he or she speaks an Indian language, wears Indian clothing, and lives in a community where the people follow the Indian ways of life. The Indians think of themselves more as part of their community than of their country. They pay little attention to affairs outside the community. Indians make up about 45 percent of the population of Guatemala. Most of them are extremely poor and uneducated. Spanish is the official languages spoken in Guatemala, but there are 20 other Indian lan guages that are spoken as well. Guatemala's fifth constitution was adopted in 1956. The army seized the government again in 1963, and a sixth constitution went into effect in 1966. Elections were held that year, and civilian government was restored under President Julio Cesar Mendez Montenegro. But the country remained troubled. Secret political extremist groups both rightist and leftist made terror raids. Guatemalan political leaders, the U.S. ambassador, and others were killed during the raids.   Ã‚  Ã‚  Ã‚  Ã‚  The movie "El Norte" tells the story of how two siblings (Enrique and Rosita) lose all of their family to military raids in Mexico. When seems to be next to impossible to survive in Mexico, the two decide to flee to the North (America) which they feel ca be there stepping stone to opportunities and freedom. After a difficult journey the finally arrive in America. As illegal immigrants they had to find immediate work and the had to learn to adjust to American cultures, for instance Rosita did not know how to use a washer and dryer so she did it as if she were still in Mexico. While both of them worked hours of hard labor daily, Enrique is offered a job in Chicago that could guarantee him the right to a green card, but in order to take the job he would have to leave Rosita behind. Meanwhile, Rosita becomes very ill from being exposed to rats during their journey to America. At the last minute Enr... ... and get a green card instead of sticking with her. When they got to the United States they were exposed to American cultures that were not like there own. Enrique was introduced to a characteristic of the American society when Macte tried to tell Enrique to leave his sister behind and leap toward the future and leave the past behind him, which is a mentality that most Americans have (Paz 65). As mentioned earlier when Rosita was working she did not know how to use the washer and dryer which seems to be a simple task for Americans but it was unfamiliar to Rosita and she ended up laying the clothes outside. Many North American cultures are taken for granted until we see someone who is not used to simple things such as washing clothes with a machine. Earlier in the movie we saw Rosita washing clothes by hand it was almost as if the movie repeated itself but just showed the same task in a different environment which really stressed the difference in cultures. Work Cited Connor, Walker., Heath Shirley B., and Paz Octavio. Who Are the Mexican-Americans?: A note on Comparability. Washington D.C.: The Urban Press, 1985 "Guatemala" Encyclopedia Britanica. Vol 5. 1996, 536-37

Quality Improvement Plan Essay

Executive Summary Chattanooga Cares is a privately owned, not-for-profit HIV/AIDS clinic located in downtown Chattanooga. Owned and operated by Dr. Jay Sizemore, it was founded in December 2003 to provide medical needs for the underserved HIV positive patients in Chattanooga, Tennessee and 22 surrounding counties. Although its staff is small, consisting of a full-time work force of less than 30, they serve their community by offering AIDS testing, counseling, HIV treatment plans, and assistance with employment, housing, transportation, and childcare. Chattanooga Cares has one very important goal – reducing the levels of sickness in HIV/ AIDS patients. Therefore, the management team has designed a Quality Improvement Plan to tackle this goal. This aspiration has two components; the first concerns itself with the education of the community, and the second revolves around reducing the levels of sickness in already affected patients. Implementation begins with education of the staff in areas of HIV/AIDS protection, treatment, and counseling. Outreach programs, taught by the staff, will be offered to guide the community in AIDS awareness. Data collection tools such as patient tracking system and disease specific flow charts will be utilized to scrutinize the effectiveness of the program. The plan-do-study-act approach to collecting data, monitoring, evaluating, and adjusting will be used to ensure that constant changes can be made to reach our goals. Chattanooga Cares will use competitive benchmarking to determine if their levels of sickness are in line with other clinics in the area. Finally, each person will compile his set of data and report to the management team for evaluation of the plan. The team will use the information collected to make adjustments going forward. This collaboration will be completed on a monthly, quarterly, and annually basis. Chattanooga Cares Quality Improvement Plan Quality improvement cannot be implemented without setting the performance standards needed to determine how improvement can succeed. Chattanooga Cares, a non-profit HIV/AIDS clinic, bases its quality improvement plan around the consumers of their services. Chattanooga Cares is a privately-owned AIDS and sexually transmitted disease clinic in downtown Chattanooga, Tennessee. It consists of a small staff of medical personnel, counselors, administrative staff, and volunteers. The staff offers HIV/AIDS testing, medical treatment plans, counseling, life coaching, and economic assistance through various housing, childcare, and financial institutions. The clinic derives its funding from government grants and community fund-raising events. Chattanooga Cares (2013) mission statement is, â€Å"Our focus is AIDS: education, prevention and support for all people affected by HIV† (About Us). Since the patient, and the patient’s network of friends and family, are the central elements in Chattanooga Cares’ mission statement, the role of the patient is integral in quality improvement plans. There are few goals that do not involve the client. Although the clinic is privately-owned, it proudly displays its goals to the public. Because of its grant status, the treatment center must supply statistical information to the governmental agencies that provide the grants. All this information is readily available to the clients that consume their services. Goals and Objectives Some of the quality improvement goals of Chattanooga Cares are reducing the number of new patients infected by AIDS each year; lowering the economic hardships on their clients; maximizing efficiency and cost effectiveness within the office; and increasing training and education of staff. The clients play a major role in what performance standards are chosen. A few of the quality indicators that consumers use in regard to Chattanooga Cares are health outcomes and length of survival rates, screening and treatment frequencies, and satisfaction evaluations. Using feedback from stakeholders effects the way in which future services are conducted and funding is attained. In order to begin a quality improvement plan, certain quality performance standards need to be determined to measure the levels of improvement. Performance standards concern themselves within a health care organization. Palmer (1997) suggests that clinicians must set performance  standards on their individual practices and offer feedback to health care authorities. Two examples of these standards are defining the rate of re-admittance after completing a procedure and setting a limit for number of patients seen daily. Once the standards are determined and goals are set, compilation of everything is developed into the quality improvement plan. The quality improvement plan is the all-encompassing strategy while the performance standards are the steps needed to achieve it. Scope, Description, and Quality Improvement Activities The first part of the improvement goal of Chattanooga Cares is one of reducing the current levels of HIV/AIDS in the 23 counties the organization serves (â€Å"Chattanooga Cares†, 2013). By reducing the number of people affected by the disease, the overall health status of the community will improve and the economic effect on the health care system will be positive. Since 65% of current patients (â€Å"Chattanooga Cares†, 2013) cannot currently obtain health insurance due to their health status, a decline in the infected population will mean less public monies are needed to support the health care of the indigent population infected by the AIDS disease. The best outcome of reaching this goal is a suppression of the AIDS infected population. Education in the community improves the knowledge base of the community as they learn the risk factors of AIDS contraction and hopefully use that wisdom to make wiser choices in sexual partners and intravenous drug usage. Through careful management of current patients’ progress, the team at Chattanooga Cares can evaluate and adjust the health regimen and assure that proper techniques and medication are being used. Data Collection Tools The main goal of Chattanooga Cares revolves around reducing the level of sickness in patients. The data needed are tracking patient progress through the treatment process, and current information of HIV/AIDS manifestation and control. Following patient progress is achieved through the usage of a reminder tracking system. As soon as a new patient is entered into the electronic medical records of the clinic, a tracking system immediately forms to trace the medical journey of the client (Hashim, Prinsloo, & Mirza, 2013). The system sends out emails, automated phone messages, or  texts to patients reminding them of doctor and counseling appointments. It prompts the case manager to contact the patient personally and ask them questions about their general health, response to medication, mental state, and other factors such as housing, employment, and childcare status. By entering information into the tracking system, adjustments can be made to assure that the patient does not degrade in physical and mental health status. This tool can help prolong the lifespan of the patient and help them get better. Over long periods of time, as a patient has developed an effective health regimen, the system stills tracks their progress and reminds the case manager to touch base from time to time. The strengths of this system are that a patient does not drop out of the program and their health status is continually monitored and improved upon. The weakness is that the ongoing information must be entered into the system to be effective; if the staff is too busy or forgets to follow up, then the health of the patient may be compromised. The measurement and display of this tool could be shown through weekly reports which show the number of patients whose contact reminders have not been completed. The last data tool used to track current information on HIV/AIDS is a disease specific flow sheet (Hashim, Prinsloo, & Mirza, 2013). This chart contains information on the steps needed to test and treat people affected by HIV/AIDS. It allows clinicians to follow a prescribed course of medication and counseling for patients and permits changes in the course of health management. The benefits of using this flow chart is that treatment is spelled out for virtually every type of AIDS related illnesses and gives doctors a reference to follow. The only detriment is that the clinic must make sure to have current flow sheets which show new drugs and regimens for patients. If the clinicians are using outdated materials, then best practices are not being put to use. Quality Improvement Processes and Methodology The plan-do-study-act (PDSA) approach to quality improvements is one of small cyclical changes between processes and outcomes. It focuses on making little changes instead of large, broad strokes that can sometimes be too large to tackle at one time. Hughes stated (2008) that the purpose of PDSA is one that tries to â€Å"establish a functional or causal relationship between changes in processes (specifically behaviors and capabilities) and  outcomes† (p. 33 Chapter 44). The PDSA cycle begins by defining the disposition and extent of the issue, what modifications can and should be made, a strategy for a specific change, who should be participating, what should be gauged to comprehend the effect of change, and where the stratagem will be directed. Change is executed and data and materials are collected. The results are studied and clarified by using key measurements that show the levels of success or failure. New steps are developed based on the results and the process begins again (Hughes, 2008). This approach to quality improvement is positive in that allows extensive problems to be disentangled at a rate not overwhelming to those involved. Because PDSA is readily achievable and results are easy to decipher, almost instant gratification can occur. This makes a monumental task easier to tackle – much like eating the proverbial elephant one bite at a time. The drawbacks to this approach are that it is reactive and relies on people to accept constant change in their facility that can result in change fatigue (Hughes, 2008). To achieve the QI goal, the clinic must review continually the data retrieved from the tracking system of patients’ progress through the treatment process. Therefore, the methodology chosen for Chattanooga Cares’ QI plan is PDSA. Because this system focuses on small, continual changes, it will be helpful in staying on track. Another reason for this choice is that the clinic is small and is used to a frantic pace, therefore change is commonly accepted and a part of the norm. Comparative Databases, Benchmarks, and Professional Practice Standards  Hughes (2008) describes benchmarks in health care as â€Å"the continual and collaborative discipline of measuring and comparing the results of key work processes with those of the best performers in evaluating organizational performance† (p. 38, Chapter 44). Competitive benchmarking can be used to compare Chattanooga Cares’ levels of sickness to other organizations offering the same services (Kay, 2007). By using reports from other HIV/AIDS clinics, Chattanooga Cares can compare their levels of sickness to the patients serviced by other treatment centers. Authority, Structure, and Organization The authority structure of Chattanooga Cares is straightforward and simple. Because it is privately owned, there is no board of directors. Instead, Dr. Jay Sizemore, the physician who owns and runs the clinic is the head of the organization (â€Å"www.chattanoogacares.org/†, 2013). Five other positions comprised of a registered nurse, a medical assistant, an LPN, a patient health coordinator, and an office manager, finish out the authoritative staff at the clinic. Although the doctor leads the team, the other five mentioned have equal standing in decision-making and quality improvement implementation. QI issues are discussed within the confines of these six people and all decisions are handed down from them. Each holds their own position within the organization, however, out of necessity, all of them work interchangeably within other people’s job duties. Communication Because of the intimate nature of Chattanooga Cares, quality plans are shared among all the staff. If a particular strategy involves essentially one person’s performance, that person will hold most of the responsibility for implementing, measuring, and ultimately, evaluating the effective of the plan. For instance, one goal is to improve the levels of sickness in the HIV/AIDS patients the clinic serves (â€Å"www.chattanoogacares.org/†, 2013). A tool for implementing and measuring this is a patient tracking system that follows a patient’s progress through the system. The person responsible for this quality improvement device would be the case manager for that patient. This person would monitor the tracking system, collect data through reports, assemble data for team review, evaluate the effectiveness of the QI plan, and ultimately, apply needed improvements. Each person is responsible for his part(s) in any given QI plan as well as gathering data and reporting such data to the team. Education All medical staff must be board certified and all case managers must have a background in social work and be at a minimum a licensed LPN. All education and prevention staff must be state certified in HIV/AIDS testing and prevention counseling (â€Å"www.chattanoogacares.org/†, 2013). Annual training and certification is required by all employed and volunteer  staff to meet conditions of state and federal grant programs. To implement the patient tracking system quality improvement plan, each person working with patients will be included in the introductory training of the software program and be introduced to the goals of the QI plan. This will be communicated by the person overseeing the process, most likely the case manager. Because staffing at the clinic is minimal, this training can take place efficiently, with little loss of productive medical time with patients. The process will be covered from the initial contact with a patient and will continue as long as the patient wished to be under the clinic’s health care plan. Therefore, it is ultimately the responsibility of the entire staff and not just the case manager, to ensure that current information is uploaded to the tracking system, and that prompts by the system are met in a timely manner. Annual Evaluation The evaluation of the QI plan for improving sickness levels in patients’ is done on monthly, quarterly, and annually bases. Because continual evaluation is needed for the plan to succeed, data must be collected before it becomes overwhelming in numbers. If this plan was left entirely to an annual evaluation, it would take weeks, if not months, to assemble, evaluate, and implement changes. The factors gauged are made of up several items – reports showing the follow-up times of patients, data indicating how many patients did not receive required contact during the time period, and the time frames of between the system prompts and response intervals. When complied, this data shows the breakdown in interaction and allows the team to make changes to ensure that patients do not lack in communication between themselves and the clinic. Monitoring the data on a weekly, if not daily basis, allows the QI plan to be more effective by making changes using the PDSA approach. References Hashim, M. J., Prinsloo, A., & Mirza, D. M. (2013, Spring). Quality Improvement Tools for Chronic Disease Care – More Effective Processes are Less Likely to be Implemented in Developing Countries. International Journal of Health Care Quality Assurance, 26(1), 14-19. DOI:10.1108/09526861311288604 Hughes, R. G. (2008). Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville, MD: Agency for Healthcare Research and Quality. Retrieved from: http://www.ncbi.nlm.nih.gov/books/NBK2682/ Kay, J. F. (2007, February). Health Care Benchmarking. The Hong Kong Medical Diary, 12(2), 22-7. Retrieved from: http://www.fmshk.org/database/articles/06mbdrflkay.pdf Palmer, H. R. (1997, October). Using Clinical Performance Measures to Drive Quality Improvement. Total Quality Management, 8(5), 305-11. Retrieved from http://search.proquest.com.ezproxy.apollolibrary.com/docview/219816031 www.chattanoogacares.com (2013). Retrieved on September 3, 2013 from: http://www.chattanoogacares.org/about-us.html