Introduction Many diseases, including diabetes, are a result of unhealthy nutrition and lifestyle. These medical conditions affect millions of people in the United States, and older people in rural areas of the country are in a risk group for such diseases. Food and Life is a nutrition program that combines...
Health literacy is a growing concern among healthcare professionals, and the provided presentation helps to appreciate the importance of the subject. Indeed, in clinical practice, there are many barriers that care providers face in order to deliver high-quality, patient-centered care. According to the presentation, 36% of adult Americans are identified...
The importance of interprofessional practice is hard to overstate in current conditions since it has been closely connected to improved patient outcomes. However, the role of nurse practitioners (NPs) in interdisciplinary teams remains unclear since it is perceived to be somewhere between a physician and a nurse. The present paper...
Introduction The PICOT question on which the project is based is, “In pregnant African American women (P), will an educational program (I) compared to no education (C) increase the rate of breastfeeding (O) over three months (T)?” The essay will discuss the strengths and barriers to the successful implementation of...
Introduction At the present, the healthcare system is facing many new challenges that require interdisciplinary solutions. It appears that without automating certain processes and making data-drive decisions, the system can stagger, depriving many people of medical help. As of now, the connectivity between health providers is insufficient, which leads to...
The leadership skills in the nursing practice are vitally significant for accomplishing the mandatory tasks. These include the education of the patients, obtaining the time management skills, and patient care that is carried out by the appropriate health care provider. However, the ability to lead might also have a harmful...
Subjective Findings and Questions In this case study, Sally is a 45-year-old female patient with a chief complaint of a headache that has been lasting during the last 30 days. The main subjective findings of the condition include a generalized and bilateral headache that is localized around the neck and...
Introduction The whole world and almost all industries of production, entertainment, and services introduce computer technology to increase the pace and quality of customer service. The healthcare sector is no exception, and many medical organizations replace paper medical records with their electronic analogs. This method of storing patient information provides...
Hypertension, or high blood pressure, is a considerable bother for the US healthcare system due to high prevalence and morbidity and mortality implications. However, the US Preventative Service Task Force (USPSTF, 2019b) concludes that there is not enough evidence to suggest screening for primary hypertension in adolescents due to the...
The article by McCabe, McCann, and Brady (2017) titled Computer and mobile technology interventions for self‐management in chronic obstructive pulmonary disease provide a systematic review of studies focused on managing chronic obstructive pulmonary disease (COPD) in the adult population. The research aimed at comparing the outcomes of interventions delivered by...
A key area of medical care for children is the active monitoring of children’s health and the implementation of comprehensive preventive measures. The medical needs of children with disabilities should be taken into account. These actions require the involvement of a large number of medical workers, and, accordingly, funds and...
Introduction The research question for this part of the study is, whether there is any relationship between the PM size and the health of Sun Coast staff? The statistical analysis aims to investigate whether the smaller size increases employees’ health safety. For this purpose, the hypothesizes are: H01: There is...
Therapeutic adherence is assumed as one of the critical factors that influence the success of the treatment. Patients’ therapeutic adherence depends on several factors, such as patient-centered, disease-related, or therapy-oriented issues. The exploration of the factors that affect the adherence to antihypertensive treatment among Afro-Caribbean in South Florida is the...
The performance of athletes depends on various factors, including their physical and mental states, the level of their preparedness, their ability to concentrate and learn. It is important to pay sufficient attention to all these aspects as well as have a clear understanding of the exact ways they affect people’s...
An article by Abbas, Ali, Khan, and Khan (2016) titled Personalized healthcare cloud services for disease risk assessment and wellness management using social media provides a prototype framework, which can be used to assess risk factors among all types of population, including youth and younger adults. The framework proposes to...
Introduction Innovation becomes an integral part of all spheres of human activity as it helps to achieve higher performance levels and better outcomes. These advantages are critical for the healthcare sector as its primary goal is to promote the health of the nation and improve the quality of people’s lives....
Introduction The Doctor of Nursing Practice (DNP) empowers nurses to become skilled providers of evidence-based, high-quality, and personalized care. It guides them to develop and apply superior leadership models that can eventually transform clinical practice. This paper gives a personal reflection of my performance and realization of the outlined outcomes...
Introduction Social determinants of health are various conditions that affect human well-being and that are not related to individual attributes of people. These factors are not the same for different countries and regions but are shaped by income distribution, access to health services and information, local and global politics, and...
Florida’s law concerning general medical care does not differ considerably from state laws. According to the Florida Patient’s Bill of Rights and Responsibilities, health care providers are to respect the rights of patients; however, patients are also expected to respect the rights and regulations of healthcare facilities (Florida Statutes, 2019b)....
Evidence-based practice (EBP) and research are the two essential components of the nursing profession that promote quality in a professional setting and identify excellence in the service delivery process. To better understand their roles and contribution, nurses should be able to distinguish between these components. While EBP aims to translate...
Mental health illness is a potentially sensitive topic; hence, it is susceptible to factors affecting the reliability and validity of patient self-report. In this case, David appears to be anxious and withdrawn; thus, he will need considerable support in discussing his current problem(s). Therefore, there are specific communication techniques that...
Early adolescence is a period of remarkable transformations of the body on all levels. Body image is greatly influenced by hormonal and neurodevelopmental changes, which lead to the rapid growth of cognitive and intellectual capacities and the development of secondary sexual characteristics (World Health Organization, n.d.). Moreover, environmental factors (for...
Depression in adolescents is a significant concern for the US healthcare system. According to Mousavi, Shojaee, Shahidi, Cui, and Kutcher (2019), the condition is characterized by increased irritability, depressed mood, loss of interest and appetite, sense of hopelessness, and psychomotor retardation. Adolescents with low self-esteem, a history of substance abuse,...
Introduction Healthcare professionals should exhibit desirable values and traits that can make it easier for them to achieve their aims. The wellbeing of nurses and caregivers is something essential if they are to transform the health outcomes of their patients. More often than not, challenges, abuses, and disagreements tend to...
One of the most crucial indicators of any country’s state of the art is its healthcare policy and related legislation regulating the mentioned sphere. Citizens’ health might be a vital aspect of national harmony within a state. Hence, when people need treatment, they should be provided with high-quality medical services,...
Introduction While conducting research and developing strategies for improving clinical practices is essential, one must understand the challenges that arise when implementing the findings. A clinical environment that operates following evidence-based practices promotes continuous improvements in patient outcomes. However, this result can only be achieved by establishing a proper culture...
One can think of the situation when the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) results have shown to be below 50%. Such a case is very realistic and indeed occurs from time to time in institutions of healthcare. To deal with such a situation and raise the...
A nurse-led EBP intervention inevitably has to interact with healthcare systems at a local level. The majority of nurses do not have the pull and the resources to solicit a large-scale intervention. At the same time, any EBP must first be generated at the local level. The purpose of this...
Changes occur gradually, so the results are not always immediately noticeable. The situation can become complicated if the participants have different ideas about the proposed changes, methods, and strategies for achieving them. The same is valid for nursing practice, as the nurses are the primary agents in delivering care and...
Abstract Depression, anxiety, and personality disorders are associated with a set of hereditarily determined temperamental traits of a high order, that is, a tendency to search for novelty, avoid harm and depend on rewards. Each of them is associated with a specific neurobiological system such as dopaminergic, serotonergic, and noradrenergic....
Abstract When finishing an educational program, it is essential to stop and think where one is. That is, what has been already achieved and what is to be next. The current paper, explains my concerns in psychology, describes the career goals, analyzes what is needed to achieve them. This assignment...
The present paper is a Collaborative Learning Community Business Plan created for the American Heart Association and Hypertension (AHA). According to Topfer (2011), “Planning is one of the most important parts of running a business, no matter whether it is a large multinational corporation trying to plan an expansion or...
Introduction The purpose of the healthcare sector is to maximise the experiences and medical outcomes of the targeted population. The Australian government has implemented a powerful structure that ensures that majority of the citizens receive timely, reliable and affordable medical care. This goal has been achieved due to the presence...
Implementing new technology is a laborious endeavor for the executive staff of healthcare facilities. Annette Brown, Director of Nursing Informatics in Eisenhower Health, has experience leading the transition process from paper charting to electronic health record (EHR) system provided McKesson in 2008 and then to EPIC in 2017. Eisenhower Health...
Telehealth technology can change the strategies that hospitals use to deliver care to their patients. The introduction of video- and Internet-based devices provides many benefits to people who cannot access treatment in traditional ways. For example, many individuals live in areas without hospitals and have to spend significant time and...
Introduction Out of a variety of spheres in which scholars perform research, applied analysis occupies an important place. In 1968, Baer, Wolf, and Risley identified seven dimensions of applied behavior analysis (ABA). Baer et al. (1968) argued that there was more to the difference between basic and applied research than...
Abstract Florence Nightingale’s model of nursing is based on accentuating the role of the environment in affecting patients’ health outcomes. The purpose of this paper is to investigate Nightingale’s theory and assess its contribution to nursing and application in a modern healthcare context. The analysis of the model indicates its...
Drug-to-drug interactions (DDIs) cause significant patient problems while treating comorbid conditions. Even though these problems are often predictable and preventable, a systematic approach is needed to avoid adverse drug events (ADEs). A clinical database can become an efficient solution for addressing the problem of DDIs. The present paper offers a...
Introduction Exclusive breastfeeding is among the highly recommended practices associated with the proper and timely development of infants since antibodies in breast milk help newborn babies to develop immunity to common infections and viruses. Because of its health benefits, exclusive breastfeeding is promoted among expecting and new mothers in different...
The idea of physician-assisted suicide or euthanasia raises a number and disputes and disagreements in regards to whether a person or their immediate family members should have the right to choose medically aided death. As it stands, current clinical practice, ethical, and legal practices leave decisions regarding medically assisted death...
The proposed title of the research is The impact of creating shared value (CSV) on hotels’ and restaurants’ performance. The study will identify the effect of CSV as a part of the management process on the performance of hotels and restaurants. The primary suggestion and the thesis statement of the...
Health care system has a complicated structure with many stakeholders that have different and sometimes competing views on healthcare administration. The health care costs are increasing due to various factors pushing health care system stakeholders to search for strategies to improve cost-efficiency. The government and insurance companies advocate the concept...
Health care system in the United States is in need of reformation since it has some obvious flaws. The primary goal of change in healthcare is to improve patient outcomes while improving cost efficiency. However, researchers and stakeholders differ in opinions which elements of the system need reformation the most....
Healthcare policies are becoming more and more debated nowadays, as this topic is one of the top 3 concerns. A healthcare policy represents a set of methods and rules aimed at shaping health delivery. Such a system covers many long-term issues concerning financing health programs, public health, chronic and mental...
Problem Statement and Proposed Solution The ultimate goal of healthcare is to provide quality care based on a patient’s needs and recent evidence. The quality of care depends upon many factors, including the level of staffing among frontline care providers. According to Martsolf et al. (2016), nurse staffing level positively...
Introduction Endocrine, metabolic, and hematological conditions can significantly affect people’s lifestyle and health. In the case study, an 82-year-old female comes into the office with complaints of dizziness, fatigue, weakness, and dyspnea that increases after physical activity. The patient’s previous medical history includes hyperlipidemia, atrial fibrillation, and hypertension. Her medications...
Introduction Lung cancer is one of the leading causes of mortality and morbidity in the United States. Annually, it claims more lives than breast, ovarian, prostate, and colon cancers combined, which underscores its high prevalence rates. Smoking tobacco is the most important predisposing factor for lung cancer. Therefore, quitting smoking...
Health care professionals experience different ethical dilemmas and challenges that can affect their aims. Caregivers, physicians, and clinicians who are aware of such issues can find it easier to implement evidence-based measures to overcome them. This paper gives a detailed analysis and description of the responses gained after interviewing a...
Introduction The modern healthcare sector faces a significant problem that limits its further evolution and prevents it from performing the central task, which is the provision of care to all people who might need it. This issue is a too high price for the majority of available treatment plans or...
Public management theories and health care are the two subjects that have been interconnected from the start, with the rise and fall of particular paradigms mirroring across both spheres of academic discourse in equal measure. For the majority of the 20th century, health care in the US was considered to...
Although the US healthcare system is often regarded as exemplary in the world, it is rather cost-ineffective and characterized by a lack of equity. Medical error is one of the major factors that have an adverse impact on American health care. Makary and Daniel (2016) note that medical error is...
Introduction The reviewed article entitled “Mindfulness and Compassion-Oriented Practices at Work Reduce Distress and Enhance Self-Care of Palliative Care Teams: A Mixed-Method Evaluation of an “On the Job” Program” was written by Orellana-Rios et al. (2018). This pilot study examined the efficiency of an intervention aimed at reducing distress, enhancing...
Introduction Globalization is strongly influencing the economy of the US, and the technology market is a key player. Organizations in developed nations have influenced globalization by channeling their services and products to the developing world and emerging markets. Moreover, upcoming markets are taking their services to developed nations, which has...
Introduction The Independence Medical Center currently applies an Electronic Health Record (EHR) system that does not allow physicians and other medical professionals to collect and analyze patient data efficiently, which is reflected in the inadequate workflow and the need to avoid some processes outlined in the EHR. This proposal aims...
Introduction The Oncology Nursing Society (ONS) is a professional nursing organization dedicated to promoting excellence in oncology nursing in the U.S. and globally. They work with researchers, health care professionals, and legislators, to improve cancer prevention, diagnosis, and treatment (Oncology Nursing Society [ONS], 2019a). As a part of their policy...
Introduction The main two issues with Medicare are manifested in the fact that it is vulnerable and adjusted for an ever-growing older population. This means that there will be an increased number of people with chronic conditions, which require inpatient services, outpatient options, and prescription drugs or medications. As an...
Introduction Diabetes is one of the key chronic diseases that seriously affect the health of populations, along with obesity and cardiovascular dysfunctions. In Australia, the rates of people diagnosed with diabetes mellitus increase, which creates the need to properly understand its pathophysiology and potential steps to assist patients. This paper...
Type 1 Diabetes There are two types of diabetes, namely, type 1 and type 2. Type 1 diabetes is an autoimmune condition that occurs when antibodies start attacking the pancreas (Leslie & Grant, 2018). This condition often begins in childhood. It is mainly caused by genetic predisposition and faulty beta...
Introduction Diabetes is a severe health concern both in the US and globally, and due to this reason, it is necessary to examine the specific aspects of this condition. There are two distinct types of diabetes, which differ in manifestations and prognosis. This paper aims to investigate type 1 and...
It is considered that high costs of care primarily stem from it being largely uncoordinated. In turn, the growing prevalence of chronic diseases increases the expenses incurred to deliver healthcare services to patients. Health information technology (IT) is expected to enable an organization to coordinate care better and reduce healthcare...
A quality director is the first position that I was a CEO need to identify after management commitment has been achieved. Since this job is an authoritative one, only experienced candidates with relevant hospital backgrounds in patient safety, quality, or performance improvement should be considered. The level of education should...
Introduction Nursing science has advanced extensively over the past few decades due to the introduction of innovative technologies, the creation of new theories, and the identification of other tools that allow improving patient outcomes. Among the key changes, the shift toward quality combined with sustainability should be deemed as the...
Introduction Type 1 diabetes is an autoimmune disease that affects the pancreas, causing disruptions in the production of insulin. As a result, patients with this autoimmune condition have high blood glucose and other metabolic issues, which can have a severe impact on health. Like most other autoimmune diseases, type 1...
Introduction According to multiple sources, neuroblastoma is one of the most common childhood tumors (Zaoutis & Chiang, 2017). In the majority of cases, this form of cancer is diagnosed before the child reaches the age of five (until the formation of the sympathetic ganglia). The complexity of the disease lies...
Summary, Conclusions, and Recommendations This DPI project is concerned with the exploration of the impact of the educational intervention aimed at decreasing BMI by reducing caloric intake and enhancing physical activity among Hispanic elementary-school children with obesity. The prevalence of this disorder and its comorbidity among US children is still...
Data Analysis and Results Childhood obesity affects approximately 20% of American children and adolescents, although various projects and policies are developed to reduce the rate of affected people (Hales et al., 2017). It has been found that children gain dietary habits observing their parents’ behaviors, so parents play a major...
Introduction Healthcare data reporting (DR) is a crucial component of modern healthcare since it grants publicity to information about patient outcomes and other statistics concerning hospitals’ efficiency. Eisenhower Health Center, Desert Regional Medical Center, and John F. Kennedy Memorial Hospital provide data about its structure, care process, and patient outcomes...
The improvement of the quality of healthcare service is one of the priorities for nursing researchers and practitioners. The US healthcare system is characterized by considerable impairments that lead to people’s death, their health deterioration, the country’s financial losses, and the emergence of numerous issues related to public health. For...
Introduction Informatics in the modern healthcare system is the mechanism that makes it possible to simplify the mode of operation of both junior and senior medical personnel. Various innovative systems that are designed to store, systematize, and transform certain information contribute to speeding up many procedures, for instance, control over...
Introduction Quality is a top priority of all organizations operating in the modern world, and healthcare facilities are no exception. The administration of Avicenna’s Center, a local medical center, acknowledges the need to improve the quality of services provided in several departments, including their cardiovascular surgery department. The medical staff...
Health Care Entity The Twin Mountains Medical Center (TMMC) is a private healthcare entity that has been operating in New York City since 1962. The hospital belongs to a nonprofit system that provides a variety of healthcare services to the local community. The TMMC facility has 300 beds and is...
Introduction The Australian health system had undergone and continues to experience rapid change and innovation. It is part of the social governance of the country with an objective to enhance public health. Health policy is the primary focus of the political agenda as significant challenges remain. The report will investigate...
Introduction Manufacturing and healthcare may seem similar since they both aim at constant improvement. However, these two areas differ in the matter that healthcare focuses on people and their needs rather than on the product. Two contrasting trends of standardization and customization develop simultaneously due to the complex nature of...
Healthcare specialists have a huge variety of tasks, including evaluating patients’ conditions, monitoring treatment outcomes, and helping clients deal with their health issues. However, to guarantee further improvement in patients’ health and facilitate home health agencies’ work, thorough planning after a hospital discharge is required. Problem Statement The absence of...
Introducing the principles of quality performance into the healthcare environment is critical for managing patients’ needs and preventing medical errors from occurring in the clinical context. A set of Key Performance Indicators (KPIs) will have to be developed to evaluate the quality of delivered services (Al-Shdaifat, 2015). The areas of...
Introduction Project management requires one to assess all prospective issues and difficulties that can arise throughout the course of operations to ensure successful achievement of goals. In addition, quality assurance plans allow the project manager to ensure that activities meet the highest standards of quality. The Risk Matrix will outline...
Introduction Team management and development are vital for Behavioral Health (BH) UM because the project targets people’s mental health and requires input from professionals experienced in medicine who can provide sufficient support to the participants. Criteria that can be used to evaluate this plan are its applicability to the vision...
Introduction Quality is one of the basic priorities of healthcare centers that try to ensure the best patient outcomes. It has been acknowledged that quality is not confined to addressing specific health issues and conducting a set of clinical procedures. Patient satisfaction, readmission rates, and the cost-effectiveness of the provided...
Introduction This paper presents an analysis of the role of advanced practice nurses in the management of end-of-life care. It discusses the aspects associated with end-of-life care and the decision-making process. The paper suggests the approach that can be used while communicating with the patient’s family and addresses the appropriateness...
The role of nursing practitioners has grown considerably as these healthcare professionals have been empowered to provide a wide range of services to patients and make diverse decisions. Nurse leaders can now address numerous issues and improve the quality of delivered care. Handoffs and associated quality of care can be...
The issue of food accessibility in developing countries is one of the acutest questions discussed by scholars, governmental organizations, and businesses around the world. The problem of food insecurity as the result of a chain of economic, social, political, and environmental factors imposes hunger threat and is even aggravated by...
Mrs Kapoor is a 67-year-old British Asian lady who was diagnosed with colorectal cancer 2 years ago, and has undergone surgery (with stoma formation) followed by chemotherapy, which has helped to control the disease. Her most recent scans indicate that the cancer has recurred, and has spread. The treatment options...
Paper Review: Purple Group The interest in interoperability and its features are explained in detail, and one can understand that interoperability has many potential benefits for the healthcare industry. However, there exists a lack of information about standardization – an essential requirement not only for separate programs but for the...
Introduction Organizational planning in the health care area is a regular process, which affects the efficiency and economic reasonability of the relevant institutions. I would like to emphasize that appropriate organizational planning requires the identification of a management system to be applied subsequently. The management system provides guidance on aspects...
The problem of medical errors has been persistent in the nursing and healthcare setting for a while, causing numerous negative outcomes and endangering the lives of many patients. Medical errors occur at several levels and lead to injuries, traumas, nosocomial infections, and other consequences that affect patients negatively. However, from...
Change Theory In order to promote change in the TMMC context, one should deploy Kurt Lewin’s change theory (LCT) as one of the most common frameworks in nursing. Specifically, the proposed theoretical approach implies the use of three stages (freezing, moving, and unfreezing). The identified approach is deemed as particularly...
Introduction Many people that pay attention to their nutrition know about antioxidants. Antioxidants are known as compounds that defend individuals’ bodies from harmful molecules found in foods and environments. This report will provide information about the aspects of antioxidants and the foods that contain them. Moreover, the significance of such...
E-cigarettes gained prominence in 2003, and they have been marketed as an alternative means of quitting smoking. The current debate is on whether e-cigarettes should be allowed or banned in public spaces. With proponents and opponents of this topic taking hard stances based on their convictions, there is a need...
The Division of Family and Children Services (DFCS) of Georgia is responsible for providing support and assistance for children in need living in the state while following the legal norms and standards. It is important to analyze an ethical situation related to the DFCS’s activities according to the ETHIC Decision-Making...
Introduction The urgency of the modification of the U.S. healthcare legislation was caused by a number of concerns and shortcomings of the then existing regulations. According to Ogundipe et al. (2015), “rising costs of health care coupled with lack of access to health insurance affected many Americans” (p. 51). A...
Introduction The characteristics of different approaches to addressing health care policies for citizens vary across countries. Braithwaite et al. (2017) state that the Commonwealth Fund determines promising practices that contribute to creating a high-performing healthcare system in the United States. A comparative analysis based upon its report might provide a...
Patient outcomes are a critical focus of most quality improvement initiatives in the United States healthcare sector. Enhancing patient outcomes requires a comprehensive effort of policymakers and care providers, including nurses. Hospital readmission is among the key patient outcomes to be targeted in the United States because it has a...
As infectious diseases are a significant concern in the United States, it is vital to enhance patients’ awareness of the significance of prevention and testing. This report presents a case study that features a female patient concerned about white vaginal discharge. The paper presents the primary diagnosis, as well as...
One of the most useful models for quality improvement initiatives in healthcare is PDSA (plan-do-study-act). The necessary four steps give nurses an ability to collect and analyze information and turn it into practical knowledge and a strategy that can be implemented in the unit and the organization (Agency for Healthcare...
Interprofessional Team Negotiations The issue to be negotiated revolved around the best nursing care model to use in our team. The interests that influenced me included empathy, teamwork, justice, and integrity. My colleague wanted us to embrace the power of a primary nursing care delivery model. However, I preferred a...
Pain management in a geriatric nursing unit is a measure that significantly affects the overall performance indicators of the hospital. Thus, it is vital to address new ways in which patients’ satisfaction may be improved. The scenario’s details reveal some information about the unit’s activities on their path to quality...
Abortion signifies the intended termination of pregnancy before birth. It has resulted in divergent views with the pro-choice movement supporting abortion and pro-life activists criticizing it. The pro-choice movement affirms that pregnant women should be given a right to either bear a child or terminate its life before term (Sedgh...
Technology has played a pivotal role in improving the delivery of health services, as well as patient outcomes. Electronic health records system is one such technology that has had a considerable impact on the way hospitals and nursing homes manage the data of their patients. Electronic health records refer to...
Today’s healthcare systems are dynamic: technology has played a significant role in both education and practice. The nursing field is among the many areas that have integrated technology into education and practice to keep up with the ever-increasing pace of current trends. Therefore, nurses at the baccalaureate level are equipped...
Resistance and Solutions Resistance Medical technologies are presently empowering many practitioners to identify their patients’ health needs and provide exemplary services to them. Such information systems support clinical decision-making and ensure that patients incur reduced costs. However, the use of health informatics and technologies is something that continues to encounter...
Introduction Human embryonic stem cells (hESCs) hold an enormous amount of potential to unlock many mysteries of the human body, as well as treat or prevent illnesses. Yet, despite the potential benefits of studying this issue, there is strong opposition to it. The primary argument against hESC research is that...
Quality management in hospitals is crucial to achieving better patient outcomes. In neonatal and pediatric intensive care, high-quality services can also help to save patients’ lives. Quality, costs, and deliverables are the key indicators of performance that can be applied in this environment. Managers have a unique role in Gemba...