Qusetion: Comment 1: The scientific management theory was first described by Frederick Taylor in the early nineteen hundreds. Frederick Taylor published The Principles of Scientific Management which described how the application of scientific management applied to workers will greatly improve productivity. Scientific management calls for making tasks that are being performed easier and simplifying the tasks and training the workers on those specific tasks to be performed to the best of their abilities. Taylor stated his published work, "The principal object of management should be to secure the maximum prosperity for the employer, coupled with the maximum prosperity for each employee. The words 'maximum prosperity' are used, in their broad sense, to mean not only large dividends for the company or owner, but the development of every branch of the business to its highest state of excellence, so that the prosperity may be permanent" (Caramela, 2018).

One of the things our hospital is inefficient with is individualizing every single care plan. Our team does good but we have frequent fall outs. Individualized care plans are just that individualized. Not everyone will have the same interventions. The leaders and the education department had meet with many nurses to see how we can make individualized care plans more easier and help the nurses focus more on them. Feedback was provided from all nurses and leaders took that in for the ultimate decision. The leaders took the information back to the chief nursing officer who ultimately made the final decision.

Comment 2: A prominent name in scientific management is Frederick Taylor who in 1914 wrote a book called The Principles of Scientific Management which primarily sought to improve the level of cooperation between management and the labor force so that profits could be maximized but so could the personal development of the workers (Huber, 2014). However, there are faults in this theory with one of them being the worker often feels undervalued (Huber, 2014). One of the most frequently complained about routines in healthcare is the broken algorithm used to determine staff to patient ratios. In our PCU we can have up to acuity 5 patients. Usually I will have 3-4 acuity 3 patients or some combination of acuity 3's and 4's. Our ICU is acuity 5 and above. At most you can only have two level 5's or one level 6 or 7. Level 8-10 are 2-3 nurses per patient and they are reserved for very sick patients such as those on ECMO. It seems the staffing office can never get it right when it comes to the number of nurses we are going to need and we are always either short-staffed or overstaffed. Another routine which seems could with a bit of tuning is the EPIC EMR system. This system has a great idea but there are many short-fallings in a system developed back in 1979. Finally, I would say that a routine in the healthcare field in general which is inefficient mainly is the billing department. I cannot be the only person that has been double billed, told that our insurance doesn't cover something that it does cover, or some other terrifying mistake made. The situation is a problem in many ways and could do with a considerable tune-up. We have several examples of participative decision-making in my workplace and the first starts with every employee my department. We are primarily a democratic department and decisions which would affect the department are usually put to the vote via surveys, emails, and polls. We are also a unionized hospital and therefore have a relatively significant influence on decisions. A second example of participative decision making is the various committees that are comprised of all sorts of staff that seek to analyze, brainstorm, and implement policies and procedures in the hospital that can affect patient care.