RESUMO
The scattering of the acoustic waves generated by a monopolar source propagating through a two-dimensional elliptic vortex, fixed or convected by a uniform flow, is studied by solving the Linearized Euler Equations in Cartesian coordinates using the Discontinuous Galerkin Method. For a fixed vortex position, the number, amplitudes, and angular spreads of the acoustic interference beams resulting from the sound scattering are found to significantly depend on the orientation of the vortex major axis with respect to the direction of the incident waves and on the vortex maximum tangential velocity. In particular, additional interference beams are obtained at large observation angles for a more elliptical vortex. For a convected elliptic vortex, the interference beams are curved as the angle between the incident acoustic wave and the vortex major axis varies when the vortex travels in the downstream direction. As expected, the scattering of the acoustic waves leads to spectral broadening in this case. Moreover, the widths and the frequencies of the lateral lobes obtained in the spectra on both sides of the peak at the source frequency are different for elliptic and round vortices.
RESUMO
BACKGROUND: An improvement initiative begun by nurses at Parkview Episcopal Medical Center (Pueblo, Colo) to develop patient-focused care delivered by multiskilled workers followed a quality improvement methodology. Implementation of the new care delivery system on a model unit--2 South--provided the opportunity to plan, analyze data, and make changes as appropriate. Parkview's indoctrination of the teachings of W. Edwards Deming has helped leaders and staff realize the integral role of training in improvement activities. In his 14 points, Deming emphasizes the importance of employee education and of the employee having a clear understanding of his or her job. The time and money put into up-front education should help ensure the long-term success of this initiative. DEFINING THE CAREPARTNER: Three new multi-skilled positions were developed on 2 South--a Personal CarePartner, a Business CarePartner, and a Clinical CarePartner. By cross-training each of these roles to perform duties formerly done by centralized departments, 2 South was able to cut costs and time while ensuring quality care. TRAINING THE CAREPARTNER: An internally developed training program provided the new CarePartners with up-front education to prepare them to deliver patient-centered care. RESULTS: 2 South has experienced drops in patient falls and medication errors--areas that are often negatively affected when multi-skilled programs are instituted. Patient and physician surveys have shown increased satisfaction with care provided on the unit. The increased efficiency of the model unit has produced these outcomes while cutting costs substantially. LESSONS LEARNED: The interdisciplinary team coordinating the improvement project learned many lessons in the process, including the importance of communication, education, and a sense of humor.
