Patient Education Sessions Influences Levels Of Satisfaction

Cancer treatments can be extremely frightening and intimidating. Patients receiving treatment require adequate knowledge to help them deal with the treatment. Education sessions and preparation that cancer patients get prior to radiation treatment or CT simulation may influence their satisfaction. In this study, authors seek to explore whether the timing of patient education sessions influences levels of satisfaction in women treated for breast cancer. - The author’s purpose, approach or methods, hypothesis, and major conclusions. Purpose: To explore whether the timing of patient education sessions influences levels of satisfaction in women treated for breast cancer. Methods: Two groups of participants, 350 women total, were surveyed retrospectively via a postal questionnaire. Participants from group 1 received a patient education session following their first radiation therapy treatment. Group 2 received a patient education session on the same day as their computed tomography (CT) simulation appointment. Data were analyzed using descriptive and inferential statistics. Results: No significant difference in the levels of satisfaction was found between the 2 groups. Satisfaction levels were high in both groups across all measures; however, satisfaction levels were lowest when participants were asked how satisfied they were with the information provided about support services. Discussion: The timing of patient education did not significantly influence the level of patientShow MoreRelatedThe Responsibilities of Nurses When Providing Patient Education948 Words   |  4 PagesPatient education is a process of providing patients and their families with information, knowledge and skills that are necessary for the management of their health and illness concerns (Park, 2005). It is the responsibility of nurses to follow the teaching process when providing patient education. They includes assessing the patient educational needs, planning an educational session, implementing the plan, and evaluating the educational process. Obstacles to teaching and learning are those thatRead MoreNurse Knowledge Exchange ( Nke ) At The Bedside During Shift Change1489 Words   |  6 Pagesplays great role while transferring information from one nurse to another nurse. According to studies, nursing reports at the bedside have positive results such as improved communication among n urses and patient, nurse and patient satisfaction, safety, decreased overtime and improve nurse patient relationship etc.(Maxson, Derby, Wrobleski and Foss, 2012; Tan, 2015; Sand-Jecklin, and Sherman, 2014). This paper outlines an implementation plan that describes a current issues that requires change, theRead MoreHealth Promotion Is A Key Element Of The Nurses Role1707 Words   |  7 Pageswell as a state of complete physical, mental and social well being (World Health Organization 2005). Of the many occupations found in the health sector, it is nurses who continually need to interact with a range of individuals. From colleagues to patients and their families, nurses are often thrown in highly stressful situations. Such environment unfortunately makes nurses more susceptible to mental health stress (Bazarko et. al 2013, pg 108). Given this context, the promotion of mental health notRead MoreObserving Group Observation Paper1605 Words   |  7 PagesIn this paper, I discuss my ex perience with observing a group counseling session with the purpose of evaluating it in terms of how it is set up, how it is run, interventions used, culturally sensitivity, and the contribution toward my professional development as a social worker. The group setting plays a critical role in social work outside of the individual session and can be largely beneficial for clients in the forms of therapy, counseling, self-help, and support. By attempting to better understandRead MoreAnalysis Of Nephrology Nursing : Implementation Of Home Dialysis Vs. Institutional Dialysis1400 Words   |  6 PagesNursing: Implementation of Home Dialysis vs. Institutional Dialysis For patients suffering from the implications of kidney disease, nephrology nurses not only provide physical and supportive care, but also act as the patient’s advocate to improve their quality of life. Nephrology nurses advocate for the administration of home hemodialysis and peritoneal dialysis as a means to improve quality of life and level of independence of patients experiencing kidney disease. Nephrology nurses advocate that homeRead MoreMotivation Is Central Of Creativity, Productivity And Happiness1010 Words   |  5 Pagesde-motivated staff is the patients are not receiving adequate care for the severe cases patients and could possibly be detrimental, especially to the weaken immune system of the HIV/AIDS ward patients. If the hospital leaders do not make some changes the hospital will not continue to survive, and could lead to closure. To better understand employee attitudes and motivation, Fredrick Hertberg performed studies to determine which factors in an employee’s work environment caused satisfaction or dissatisfactionRead MoreEating Disorders: Anorexia Nervosa1653 Words   |  7 PagesAnorexia Nervosa Anorexia Nervosa is one of several subtypes descending from feeding and eating disorders. It is a crippling life-threatening condition marked by a patient placing restriction on energy intake relative to needed energy requirements, resulting in a relentless pursuit of low body weight in the context of age, sex, development and physical health. According to American Psychiatric Publishing of diagnostic and statistical manual of mental disorders (DSM-5) â€Å"Anorexia Nervosa, often timesRead MoreBenefits And Retention Strategies For Students1527 Words   |  7 Pagescan be challenging for both instructor and student. Interaction is vital for the online learner, because it aids in the development and understanding of concepts and enhances the earners satisfaction with their studies (Kang Im, 2013), (Olson Benham-Hutchins, 2014). In addition to a higher level of satisfaction with online course work when students interact with their instructors and classmates, outcomes are also higher. Through a meaningful exchange of information, thoughts, and ideas, a significantRead MoreA Reflection On Learning Theories And Assessment Strategies1616 Words   |  7 Pagesis associated with improved retention, improved satisfaction and positive work environment, however needs to be assessed by a mentor (Kennedy et al, 2015). In this order, discussing and planning learning activities related to the care of the acutely ill patient in advanced helped to clarify level of learning needs in relation to the placement. In adjunction to this, understanding the student’s learning style and his personality trait will influence performance and how facilitation of learning shouldRead MoreRetention At My Manager A Common Trend Discussed Was The Issue Of Retention1786 Words   |  8 Pagessupervisors not engaged with floor nurses and day to day activities. Consequences I perceive to be problematic as a result of poor retention rates include: decreased patient satisfaction; decreased continuity of care; increased risk of harm to the patient resulting from inadequately trained individuals; decreased staff satisfaction; decreased morale; increased workload; staffing complications and conflicts; increased overtime hours; increased financial strain on unit budget related to increased demands

The Characters Personalities in Grendel and Beowulf...

The book Grendel, written by John Gardner, and the poem Beowulf, translated by Seamus Heaney, both have very distinct opinions on what role each character plays. The translator of Beowulf and the writer of Grendel follow the idea that everyone has a story. A story is the writer’s perspective on a character’s personality, the way people in the story see and treat the character, and the way it ties the ideas together. There are many examples in these two writings of this concept, but the main instances connect with the lives of Grendel, Beowulf, and Unferth. Our first character, Grendel, is an exceptionally diverse character. It is implied that in both book and poem, Grendel is a blood-thirsty monster. All Grendel does is go through†¦show more content†¦This way of thinking leads Grendel to be the assassin we know him as today. A great character to include in this topic is Unferth. Unferth is a very out of the ordinary individual. In Beowulf, the writer’s perspective on Unferth is a pathetic warrior who couldn’t win even the simplest of fights. When first introduced in the poem Beowulf, it’s hard to feel sympathy for Unferth because he is in verbal conflict with Beowulf, insulting Beowulf. When switching to the outside view in the book Grendel, it becomes apparent that Unferth isn’t just doing this to pick a fight. Grendel has been his arch enemy ever since the twelve year war started. Unferth was embarrassed and infuriated in his first meeting with Grendel when Grendel said â€Å"I’m going to carry you back to Hrothgar, safe and sound† (p.90). The other people in the book think he’s supposed to be the savior of the kingdom, yet he can’t even come close to killing Grendel and when he does attempt to kill Grendel, Grendel just laughs and teases him. Th is idea of embarrassment drives Unferth mad with rage. When Beowulf comes along, he claims that he has done all these heroic and outstanding things. He makes the claim that Grendel is hardly a work out which infuriates Unferth. He has worked so hard to get revenge on Grendel and a warrior came from a distant land and claims to kill him like it is nothing. It is notShow MoreRelatedCulture And Values : The Epic Of Beowulf And Beowulf1260 Words   |  6 PagesAnalyzation of the Beowulf Epic and the Beowulf and Grendel Film The epic tale of Beowulf was written sometime after his death. In other words, a long time ago during the Anglo-Saxon period. Today, directors in Hollywood did not keep from creating their own rendition of this epic poem As a result, plenty of modern interpretations of Beowulf, such as Sturla Gunnarsson’s Beowulf and Grendel, have been released. Naturally, the cultural values that might be reflected in modern Beowulf renditions willRead MoreCompare And Contrast Beowulf And Grendel725 Words   |  3 PagesRogalcheck Honors English 3 10/29/17 Grendel Point of View Essay Both the epic poem Beowulf and the novel Grendel depict the same storyline, but from different point of views. Grendel’s personality tends to be much more evil than he himself depicts in the novel. Since Grendel is the narrator of the novel, the audience only gets to know what the story is like from his point of view, which he stretches the truth on numerous occasions. But, in Beowulf, the poem has a narrator and is in the thirdRead MoreThe Epic Poem, Beowulf - A Jungian Reading of Beowulf Essay774 Words   |  4 PagesA Jungian Reading of Beowulf  Ã‚  Ã‚  Ã‚        Ã‚   The epic poem, Beowulf, depicts the battles and victories of the Anglo-Saxon warrior Beowulf, over man-eating monsters. The noble defender, Beowulf, constantly fought monsters and beasts to rid the land of evil. The most significant of these monsters, Grendel, represents Beowulfs shadow, the Jungian archetype explored in the essay collection, Meeting the Shadow.    The character Grendel portrays the fallen self, which will assert itself violentlyRead MoreSimilarities Of The Story In Beowulf922 Words   |  4 PagesBeowulf was originally an epic poem written by an unknown author that set the tone for future epic literature and created the ideal hero for pieces later to come. But despite its significance, Beowulf has been adapted throughout time and the character and poems image has been changed constantly. One of the best examples showing change to the story is the movie depiction of Beowulf. While there are some similarities that connect the book and story together there are overall more differences that separateRead MoreA Comparison Of Thor And Beowulf728 Words   |  3 Pages Beowulf has delighted and intrigued a wide array of people for centuries. The timeless nature is visible in modern-day extensions of this epic, through heroics and battles of good versus malevolent forces. Beowulf continues to appeal to sophisticated audiences because it tells the story of a great hero prevailing over evil, a timeless theme valued by society and portrayed by his counterparts in modern media, although these new heroes display more complex qualities. Beowulf can be compared to MarvelRead MoreThe Selection And The 2005 Film Beowulf And Grendel1371 Words   |  6 Pages With that said, there is a massive distinction between the concepts and characters of the original text of the selection and the 2005 film Beowulf and Grendel. These differences include how the creators of the selections from the two societies use certain aspects to attract the attention of the audiences during their respected times in history and how the characters are portrayed in each works. In the epic poem of Beowulf it is evident that the religion displayed throughout the text is ChristianityRead MoreCharacter Of Grendel And Beowulf999 Words   |  4 Pagesstory. When most think of Grendel, they picture evil and mayhem. However, this is because of the one sided portrayal provided by the novel Beowulf. By having another piece of writing that identifies the other side to the character that was not addressed, it allows the reader to see a different point of view and connect with the overall story even more; this is especially important in significant parts of the story. Both novels express distinct views on Grendel’s character, most powerfully shown duringRead MoreCompare And Contrast Beowulf And King Arthur901 Words   |  4 Pagespossess influence their own lives and those of the people around them, specifically like the heroes in the epic â€Å"Beowulf† and the novel The Once and Future King. Each trait that Arthur and Beowulf possessed impacted major events in their lives, such as defeating Grendel in â€Å"Beowulf† or removing Excalibur from the stone in The Once and Future King. In both literary pieces, Arthur and Beowulf embark on quests in order to save their people. For both heroes, the effects of their actions differed, as wellRead MoreBeowulf Character Analysis999 Words   |  4 PagesMost teachers emphasize that a well-written character in a story should be deep, believable, and human, with flaws and personality. Then, say that Beowulf, a poem about a man who is as deep as a sheet of paper, is a masterpiece. While the poem Beowulf is one of the most important and influential pieces of literature in the world, Beowulf himself is a poorly written character when compared to characters of today’s standards. Beowulf is originally a Scandinavian story from a period before written recordsRead MoreBeowulf Is A Classic Story Of A Hero1485 Words   |  6 PagesBeowulf is a classic story of a hero. His immense strength allows him to complete impossible deeds, and his honorable personality and strong moral compass means he is focused on helping people, not on winning glory. Beowulf’s strength as a hero beyond physical strength is exemplified by his extreme stubbornness and persistence when faced with a difficult challenge. His battles follow the arc of his character development, from a minor hero to a powerful and loved king with his conquests being so important

System Thinking in Health Care Samples †MyAssignmenthelp.com

Question: Discuss about the System Thinking in Health Care. Answer: In order to deal with complex issues in the public health, system thinking is the best way to investigate this issues. The purpose aims to demonstrate the understanding of how system-thinking concepts can be applied to public health. In this paper, the system approach is compared to the addressing a public health challenge with more traditional biomedical/positivist modelsfor understanding and acting on public health challenges. The essay clearly describes the system thinking. It further presents critical discussion on the differences between systems approaches and other approach. The essay will emphasise on particular public health challenge and drawing on the issues described in the essay, systems perspective will be applied to reflect on intervention approaches that might address the challenge. System thinking in health care is approach towards problems and solution by a way of thinking. In this approach, the dynamic nature of the complex system is appreciated. It appreciates the role of the stakeholders, the implementation of the new policies and actions, even if they generate counterintuitive and unpredictable effects. The positive aspect of system thinking is that it can be applied irrespective of the field of inquiry. The health system comprise of the linear and reductionist approaches. It can be addressed by the system thinking, by testing new ideas in the social systems, through group learning, joint thinking, and shared understanding of the problems (Peters, 2014). System thinking is applied to public health by taking into account the organisational dynamics, pattern of interaction, events, and structure. These are viewed as the components of larger structure. This approach does not react to the event instead; it helps to anticipate to address the challenges emerging in public health. The polices and actions are carefully considered, for its outcome. It is obvious to use system approach owing to the complexity of the public health issues. It involves different concerns to bear, with numerous interacting variables, groups and multiple agencies that need to be accounted for (Swanson et al., 2012). The five basic principles of system thinking are: Purposefulness, composition, connectedness, perspective, and emergence. Purposefulness refers to understanding the purpose of the stakeholders behind the use of your intended product to complete their tasks. The term composition refers to striking balance between contradictory needs and interdependencies. For instance, customization vs standardisation and security vs performance. If a product is delivered in the health care system, then the ecosystem of the product is considered to know the implications of the ecosystem. This refers to the principle of the connectedness. The principle of perspective is used to see the action that caused the results opposite to that intended. Sometimes a product can yield additional capabilities and values. The set of interactions is the emergence (Atun, 2012). Obesity is the significant heath challenge in the present society. According to Brennan et al. (2015) it is the most complex heath challenge of our time. It is the lifestyle disease and is caused by multiple factors such as socioeconomic status, hereditary, educational attainment, diet and many others. There are social and cultural determinants of obesity. The common characteristics in the complex issues are interdependence, heterogeneity, nonlinearity, and self-organisation. It is not possible to use the reductionist search for the causes. If system thinking is used to address obesity, appropriate solution can be identified. It is because in this approach biology is interacting with cultural and social built factors. It means that system thinking omits the aspects of traditional models, which includes relentless search for obesity causes that are specific and isolated. System thinking is justified to address obesity as this epidemic function at multiple levels. At each of this level, there are multiple interactions. Thus, system thinking is the new way of making obesity an issue of everyones business at local level. The national level projects such a work with industry to make food healthier, the campaign called change4life and community interventions like talking to family and individuals directly are the projects that are complemented by system thinking (Mulderrig, 2016). The applications of system thinking to address childhood obesity can take many ways. Firstly, we can cope with the complexities involved in the disease. Secondly, we can skip the aspect of identifying the risk factors of obesity. It is usually the intervention of traditional positivist model. Instead, system thinking tends to understand the intersectoral dynamics and interpersonal dynamics. Thirdly, we can create virtual laboratories, for testing the sustainable interventions and design new ones. Fourthly, system thinking can be applied to generate new hypothesis. It can be used to collect empirical data and identify gaps. Fifthly, integrate multiple disciplines and data sources. Lastly, anticipation of the expected and unexpected results (Brennan et al. 2015). For addressing obesity primary care advocacy involves both physical environment support and social environment support. Under the physical and environmental support, the system thinking approach considers the policies for housing, transportations, food availability, recreation, education, financing and marketing. In the social environment support, the sytem thinking approach considers policies on media, information, individual incentives, industry practices. In this system, thinking approach the family practices and individual behaviour is interlinked to regional urban planning and peer and family networks. Environment is shaped by the individuals. The primary care advocacy involves the physicians and counsellors who advocate patients for promoting healthy lifestyles by social and environmental changes. Thus, it is evident how the system thinking approach is used to address all the interactions involved in different levels at which the obesity epidemic functions (Midgley, 2006). System thinking is different from other traditional biomedical approaches for addressing public health challenges. The traditional model focus on the system decomposed unto the solution components. In most cases, the problem or issue is broken down into small parts or constituents. On the contrary, the system thinking approaches towards solution by taking a broad view of the parameters and the variables involved in fixing long problem (Adam, de Savigny, 2012). Unlike the traditional models, which are too, specific the system thinking can be used in any area such as human resources, environmental, political, and many others in addition to medical. The traditional models are based on the old sayings that can be used t solve the public health issue in one way. Using the system thinking is like integrative thinking where a problem can have many solutions. These are combined to produce the best solution (Atun, 2012). The various health models such as social determinant model of Aboriginal health tend to identify and address the health inequalities in this community. This model is used to identify the impact of spirituality and religion on obesity. It eliminates the factors such as socio economic status and policies contributing to this problem. It does not contain expanded view of the environmental influence on this community. Similarly, the health belief model identifies intervention to obesity based on the understanding that a person will adopt positive lifestyle by perceiving the health benefits (Skinner, Tiro Champion, 2015). This approach mainly focuses on the psychological aspect of the individual. Both of the above models differs from the system thinking approach as they do not focus on bringing a consistent, big picture view to all the stakeholders involved in addressing obesity (Rutter et al., 2017). The social cognitive model of fruits and vegetables consumption to reduce obesity is based on specific domain such as self-efficacy, personal preference and outcome expectancies. Similar the social learning theory to reduce fast food consumption is based on the idea that a child will eat fast food if majority of the people in local area do same. These models are basically the cause and effect thinking. It includes some pitfalls that are overcome by system thinking such as avoiding the independent effects from the casual factors, and one-way causality that is feedback. System thinking avoids the linearity of effects, which are dynamically variable over time. It also avoids the instantaneous effects (Sallis, Owen, Fisher, 2015). Unlike the system thinking approach this are time consuming as they focus on single factors and the intervention is based on just parameter. However, the system thinking approach is similar to the socio-ecological model to some extent (Swanson et al., 2012). Socio-ecological model focus on the broader aspect unlike the above two models. It emphasises on the determinants and linkages among various determinants of obesity. It emphasise on the community, organisational, interpersonal and policy levels. So when this model is used for designing interventions it targets the individuals (ages, sex, psychological factors), interpersonal (social and cultural support, family factors), organisational (policies in schools, work, health care) and community (information, transportation, sedentary) and public policy (policy incentives such as rewards for behaviour). Together these behaviours ensure energy balance. Together it influences the body fat and weight, which in turn influence the risk fact ors of cancer, health costs and others (Ohri-Vachaspati et al., 2015). Public health issue like obesity is complex problem. The system in which this chronic disease is occurring functions at multiple levels. The organisation and the individual actors at each level matters. When the complexity of the individual task is matched with the capacity of the individual and the organisation to respond to a situation, then the system function is optimised. System thinking comes with nonlinear solutions, which completely complements traditional toolbox. This solution-oriented approach compels people to ask different questions. References Adam, T., de Savigny, D. (2012). Systems thinking for strengthening health systems in LMICs: need for a paradigm shift.Health Policy and Planning,27(suppl_4), iv1-iv3. Atun, R. (2012). Health systems, systems thinking and innovation.Health policy and planning,27(suppl 4), iv4-iv8. Brennan, L. K., Sabounchi, N. S., Kemner, A. L., Hovmand, P. (2015). Systems thinking in 49 communities related to healthy eating, active living, and childhood obesity.Journal of Public Health Management and Practice,21, S55-S69. Midgley, G. (2006). Systemic intervention for public health.American journal of public health,96(3), 466-472. Mulderrig, J. (2016). Fat-shaming: Change4Lifes anti-obesity nudgecampaign glosses over social inequalities.Democratic Audit UK. Ohri-Vachaspati, P., DeLia, D., DeWeese, R. S., Crespo, N. C., Todd, M., Yedidia, M. J. (2015). The relative contribution of layers of the Social Ecological Model to childhood obesity.Public health nutrition,18(11), 2055-2066. Peters, D. H. (2014). The application of systems thinking in health: why use systems thinking?.Health Research Policy and Systems,12(1), 51. Rutter, H., Savona, N., Glonti, K., Bibby, J., Cummins, S., Finegood, D. T., ... Petticrew, M. (2017). The need for a complex systems model of evidence for public health.Lancet. Sallis, J. F., Owen, N., Fisher, E. (2015). Ecological models of health behavior.Health behavior: theory, research, and practice. 5th ed. San Francisco: Jossey-Bass, 43-64. Skinner, C. S., Tiro, J., Champion, V. L. (2015). The health belief model.Health behavior: theory, research, and practice. 5th ed. San Francisco (US): Jossey-Bass, 75-94. Swanson, R. C., Cattaneo, A., Bradley, E., Chunharas, S., Atun, R., Abbas, K. M., ... Best, A. (2012). Rethinking health systems strengthening: key systems thinking tools and strategies for transformational change.Health policy and planning,27(suppl_4), iv54-iv61.

Tesco, Focussing on Its Environmental Analysis Essay Example

Tesco, Focussing on Its Environmental Analysis Paper One example of Tests adapting is to accommodate an increased demand for organic products. Technological Factors Technology is a major element which has influenced the development of many of the Tests products. The new technologies benefit both customers and the company: customer satisfaction increases because goods are available, services can become more personalized and shopping more convenient. Tests utilizes these technologies: * Wireless devices * Intelligent scale * Electronic shelf labeling * Self check-out machine * Radio Frequency Identification (REID). The use of Electronic Point of Sale (Eposes) has improved efficiency of distribution and stocking, with needs being communicated almost in real time to the supplier (Finch, 2004). Environmental Factors In 2003, there have been increased pressure on companies and managers to acknowledge their responsibility to society, and act in a way which benefits society overall (Lingered and Hinged, 2003). Grassier and Scott (2004) state that in 2003 government intended to launch a strategy for sustainable consumption and production to cut waste reduce consumption of resources and minimize environmental damage. Collative Factors Various government legislations and policies have direct impact on Testes performance. Most large stores has built their power due to operating efficiency, one-stop shopping. This has impacted on small traditional shops, like butchers and bakers. This creates barrier for new companies wanting to enter the grocery market because its difficult to raise sufficient capital because of large fixed costs and developed supply chains. Other barriers are economies Of scale and differentiation achieved by Tests and USDA through aggressive operational tactics in product development, promotions and good distribution. Bargaining Power of Suppliers Stores like Tests negotiate better promotional prices from suppliers that small chains are unable to do[ Ritz (2005)]. In return, UK suppliers are heartened by the ability of large retailers to source their products from abroad at cheaper deals. Bargaining Power of Customers Decos famous loyalty card Cellular is most successful customer retention strategy that increases profitability of Decos. It helps meet customer needs, customizing service ensure low prices, better choices, constant flow of in- store promotions enables Tests to control and retain customers. We will write a custom essay sample on Tesco, Focussing on Its Environmental Analysis specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Tesco, Focussing on Its Environmental Analysis specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Tesco, Focussing on Its Environmental Analysis specifically for you FOR ONLY $16.38 $13.9/page Hire Writer Threat of Substitutes General substitution reduces demand for a specific product, as there is a threat of consumers switching to the alternatives Porter M. (1980). In this industry this is in the form of product-for-product or substitute. Bargaining Power of Competitors I-J grocery retailers has had to be innovative to maintain and increase market share. For Tests this includes development of different trading methods I. E. E-retailing, in response to changes in consumer behavior. After close evaluation of external analysis of Tests and SOOT analysis in Appendix 1, it is good to consider internal operational effectiveness of Tests to identify Decos critical success factors. Branding and Reputation Companies have to focus on selling brands before the product. Tests has ransomed the basic brand into the specialized brands, through carefully branded packaging and promotion of an every penny counts. Tests has a strong brand image, and is known for good quality, trustworthy goods thats excellent value. Supplier Management Tests does sources goods from overseas manufacturers who are competitive on price and volumes. However Tests have been supporting British jobs and expertise by encouraging large branded suppliers to develop exclusive production facilities. But in recent years the company has realizes the need to look abroad for products not available in ELK, but tried to do it through long- established UK partners. As a major retailer selling diverse product range, they work with many different suppliers around the world, with employees from many different cultures and ethnic groups. Therefore, it is the company policy and companys main approach to have unique relationships with suppliers. ANALYSIS OF RESOURCES, COMPETENCE AND CULTURE SOOT Analysis Tests is aimed at the broad middle mass-market, it has maintained its position through a clear focus, well targeted product offer and excellent record in product innovation. Tests also leads the world in online grocery retailing. The full SOOT analysis of Tests is presented in Appendix 1, summarizing the key issues from the business environment and the strategic capability, including resources of Tests that are most likely to impact on strategy development. Core Competence Superior performance, according to Johnson and Schools (2003), has to be determined by the way in which companys resources are used to create competence in the organizational activities. Core competencies are activities that critically underpin the companys competitive advantage. The goal for Tests management is to focus the attention on competencies that really affect competitive advantage. Core competences framework suggests three factors, which can help to identify core competences: Provide potential access to a wide variety of markets: enables the creation of new products and services. Tests is recognized as the company, providing the most custom used and efficient service, based on a good customer relationship management. Makes a significant contribution delivering a fundamental customer benefit: Tests was the first UK grocer to launch a loyalty card and has been the most effective. Finch (2004) claims that until recently, it was the Only grocer to use the information to mail customers every month. Difficult for competitors to imitate highlights the need for a core competence to be competitively unique. This indicated the importance of product differentiation. Applying this framework to Tests shows that in order to be successful it has to base its business strategy on these capabilities. In the external environment, the level of competition is not completely under the retailers control, however, to compete effectively Tests have to identify its core competences and use them for companys advantage. DECOS STRATEGIC OPTIONS: GENERIC STRATEGIES Generic Strategies developed by Porter help Tests to acknowledge sustainable competitive advantage they should follow. The strategy of cost leadership is where Tests can strive to have the lowest costs and offer its products and services to a broad market at the lowest prices. This strategy is based on Decos ability to control their operating costs so that they are able to price their products competitively and be able to generate high profit margins, therefore having a significant competitive advantage. If Tests uses another strategy of differentiation, than it has to try to offer services and products with unique features that customers value. The last strategy of Ochs can be either a cost leadership or differentiation strategy aimed toward a narrow, focused market. In pursuing a cost leadership strategy Tests focuses on the creation of internal efficiencies that will help them withstand external pressures. CONCLUSION In a rapidly changing business environment with a high competitors pressure Tests have to adopt new strategies or diversified the existing in order to sustain its leading market position. The company must constantly adapt to the fast changing circumstances. Strategy formulation should therefore be regarded as a process of continuous learning, which includes learning about he goals, the effect of possible actions towards these goals and how to implement and execute these actions. APPENDIX 1 . SOOT ANALYSIS: TESTS Source: Minute Report, Denominator Reports, Tests Case Studies Strengths increasing market share: Tests holds a 13% share of the UK retail market. Its multi-format capability means that it will continue to grow share in food, while increasing space contribution from hypermarkets will allow it to drive a higher share in non-food. Decos general growth and ROI show no sign Of abating: In the KICK, Decos late 2002 investment into West-midlands based nonviolence store group T;S was billed as the most aggressive move into the neighborhood market by a big-name retailer so far. The deal has turned Tests into the countrys second biggest convenience store chain after the Co-operative Group, and the company also plans to open up 59 new stores in the UK this year. Tests has grown its non-food division to the extent that its revenues now total 23% of total group earnings. Decos international business segment is growing steadily, and is predicted to contribute nearly a quarter of group profits over the next five years. If geographical spread entities to grow, this will ensure Decos continued regional strength. Insurance: In fiscal 2003 Tests personal Finance reached the milestone Of one million motor insurance policies, making it the fastest growing motor insurance provider ever. The groups instant travel insurance allows Cellular holders to buy their holiday insurance conveniently at the checkout. Pet insurance now has over 330,000 cats and dogs covered, while the life insurance policy followed on from the success of last year, when it was voted The Most Competitive Life Insurance Provider in the Moneybags Awards 2003. Tests online: Tests. Mom is the worlds biggest online supermarket and this year the group had sales of over IEEE million, an increase of 29% on last year. Tests online now operates in over 270 stores around the country, covering 96% of the I-J. With over a million households nationwide having used the companys online services, the company has a strong platform to further develop this revenue stream. Brand value: Profits for Decos operations in Europe, Asia and Ireland increased by 78% during the last fiscal year. The company has a strong brand image, and is associated with good quality, trustworthy goods that represent excellent value. Decos innovative ways of improving the customer shopping experience, as well as its efforts to branch out into finance and insurance have also capitalized on this. UK market leadership reinforced: Since acquiring number one ranking in 1996, Tests has developed a successful multiform strategy that has accelerated its advantage. Its UK sales are now 71 % larger than Sunbursts. Also the Competition Commissions report makes it very difficult for a competitor to challenge its scale and has effectively scupper Wall-Marts chances of stealing I-J leadership. Therefore, Tests is in an enormously strong position n its domestic market. Weaknesses Reliance upon the UK market: Although international business is still growing, and is expected to contribute greater amounts to Decos profits over the next few years, the company is still highly dependent on the UK market (73. % of 2003 revenues). While this isnt a major weakness in the short term, any changes in the UK supermarket industry over the next year for example, like the Morrison group successfully purchasing the Safety chain could alter the balance of UK supermarket power, and affect share. Debt reduction: Tests is not expected to reduce its debt until at least 2006. Tests has a large capital expenditure program mainly due to its huge investment in space for new s tores. Since its expansion is so aggressive, Tests has little free cash for any other operations. Signs point to serial acquisitions: With an enterprise value of EWE billion, Tests clearly has enormous firepower. Also, its product range is vast and almost any acquisition can be justified, particularly in the K. While fill the gap strategy would be useful to the company, as has been the case with the UK convenience market, there is the danger of Tests becoming a serial acquirer, as this tends to reduce earnings visibility and quality. Opportunities Non-food retail: The growth in Decos hypermarket format in the UK means that there are expectations of seeing its 13% share of retail sales climb sharply over the next few years. It can use its footfall and low cost structure together with improved merchandising skills to add another leg to growth. Equally, its growth overseas will further increase earnings and scale, taking Tests onto the virtuous circle of growth. It is estimated that Decos non-food sales will double over the next four years. Worldwide it has sales of E billion in non-food, some 23% of the total. Its aim to be as strong in non-food as we re in food, no longer sounds like the consultancy-speak that it once did, and they are getting there using the basic tenets of value, choice and convenience that have been so successful in food. Around half Of new space opened in the UK last year was for non-food and the result has been to increase its market share from 5% to 6% and its overall share of UK retail sales has increased by 100 basis points to 12. 8%. The companys telecoms venture is the latest stage in its strategy to develop popular retail services. It has repeated its approach in banking, by capitalizing on its brand. Health and beauty: Decos UK health ND beauty ranges continue to grow, and it is currently the fastest growing skincare retailer in the market. The company has a volume market-leading position in both toiletries and healthcare and is number one retailer in the baby goods markets. Across all health and beauty ranges Tests continues to invest in price to deliver the value customers have come to expect and this year invested EWE million on health and beauty pricing alone. The company now has 1 9 stores with opticians and nearly 200 stores with pharmacies. Further international growth: Tests now operates in six countries in Europe in edition to the UK; the Republic of Ireland, Hungary, Czech Republic, Slovakia, Turkey and Poland. It also operates in Asia: in South Korea, Thailand, Malaysia, Japan and Taiwan. Seven years ago, its International sales were IEEE million. Now, they are nearly 10 times larger, at almost E billion, with profits of IEEE million. In the current year, Tests will add 2. 5 million square feet to sales area and could well enter another major market. Growing internationally has forced Tests to become serious about hypermarkets and this has had seriously positive implications for growth in the I-J. Tests has armed a strategic relationship with US supermarket, Safety Inc. To take the tests. Mom home shopping model to the US. Telecoms are the latest stage in its strategy to develop popular retail services. It has repeated its approach in banking, by capitalizing on its brand. In 2004 the company plans to enter the Chinese market, as China is one of the largest economies in the world with tremendous forecast growth and will present many opportunities for Tests. The rats UK structural change co uld spark a price war: The price followers in the UK market are about to become aggressive investors in price, Safety because f new ownership and Ginsburg because of new management. Morrison is reducing Safetys prices by up to 6% and Ginsburg is bound to see lower prices as one of the basic changes necessary to drive its recovery. With both USDA and Tests committed to price leadership, this could result in a step down in industry profitability. Overseas returns could fall: The buy case for Tests is predicated around investment overseas driving higher group returns as each country moves past critical mass. This might not happen, either because of economic conditions, competitor action, or failure in Decos business model. It also could come as a consequence of an aggressive move into a larger market, such as China or Japan. Wall-Mart/USDA challenge: Since the US shopping giant Wall-mart purchased USDA, Decos rank as the top UK supermarket has been threatened. USDA can now compete extremely well on price and range of goods. For the moment, USDA is the third largest supermarket in the KICK, just behind Sunbursts and then Tests. However, USDA closed the gap on Sunbursts in 2003, leaving the company to directly challenge Decos dominance. Tests is well aware of this, and has so far been quick to keep up with price cuts or special offers at USDA.