Line of Action Game searching techniques

Abstract: Artificial intelligence is the brain behind solving the intelligent games like chess, lines of action, Chinese chess and many other perfection information board games. This paper deals with artificial intelligence techniques like searching and heuristics for the game Lines of Action (LOA). The LOA is a two player game here coins are moved for a particular cluster arrangement which decides the winning in the game.  The general algorithm of LOA is much similar in comparison to Othello, Chinese chess few more board games. The AI techniques for such board games are much sophisticated in nature and the space complexity here is solved by the tree searching and heuristics.     

Keywords:  Lines of Action, Artificial Intelligence,   tree searching, heuristics.

I.                    INTRODUCTION

A line of Action (LOA) is a two-player connection game in which each player attempts to connect all of his/her pieces. It is played on a (8x8 grid) chess board with each player starting with 12 pieces, which to a large amount of possible game states. The solution to the problem is adapting AI techniques which would solve the game problem.

There are huge collection of game based tree searching techniques and the heuristics available for the game development. The choice of tree searching techniques will result in affecting or efficient space complexity where as the heuristics are responsible for the game impact and the intelligent move in the game for winning.

In this paper we discuss the techniques that will allow playing LOA efficiently. The intelligent algorithm here uses a depth searching technique and the combination of central and quad heuristics for the efficiency of the game as explained by Winands (2001).

It is considered that Mona and YL’s (2002) have acquired some success in working the Winand’s theory and techniques. The discussed techniques are unlikely to be in competition with others but we try to bring an idea which might be a basic step for research in future with more sophisticated modifications.

The remaining paper is divided into following sections: section II is about the literature review, evolution and history about the LOA. Section III discusses the methods and the techniques. Section IV is the conclusion to the discussion considering few future enhancement points.

II.                 LITERATURE REVIEW

Background information which aids in understanding the problem of discussing the necessary techniques for playing this game intelligently is provided by this section and offers a Lines of Action history including information about the game and how it’s played. A brief discussion about relevant work is also presented with the discussion on search tree and closing with the comparison of central and quad heuristics.

A.      History  

A line of Action was created by Claude Soucie and first publicized in 1969 by Sid Sackson in his book A Gamut of Games. However, not until the 1990s did its popularity started increasing. In 1997 the first Mind Sports Olympiad was held by the Mind Sports Organization in London’s Royal Festival Hall which included the Lines of Action world championship and continues to host the event annually. With 3 computer contestants the 2000 series of Lines of Action was included in the 5th Computer Olympiad. A line of Action also continues to be included in this annual event.

B.      The Game

Lines of Action belongs to the category of zero-sum game which means that losses and gains between opponents are exactly balanced where there is no hiding of information whatsoever between the opponents.  The games are played on an 8x8 grid which is similar to a standard chessboard. The game begins 24 pieces divided into 12 black and 12 white equally controlled by 2 players.

There are some rules illustrated below:

·         Each 12 black coins are set up at top of the board followed by another 6 in the bottom row while white coins are set up on the left side of board with 6 at top and 6 in the bottom row. The initial setup arrangement is shown in Fig.

·         Turns are alternated between players with black having the first move.

·         Coins can move horizontally, obliquely, or vertically.

·         On a particular line, the total number of pieces is equal to the number of spaces it can move along that line (these are the Lines of Action). Fig shows possible moves along the board. Fig.

·         Same color coins can jump over coins.

·         Capturing a coin is possible by directly landing on them but jumping over opponent pieces is not possible.

·         By connecting all his/her coins vertically, horizontally, and/or oblique into one contiguous unit a player can accomplish a win as shown in Fig.

·         In case of a connected unit established between players, the player having moved wins.

·         The player loses if he is out of moves or cannot move.

Fig: Starting Position

Fig: Possible Position

Fig: Winning Situation

C.     Relevant Work

In 2000 Winands submitted a thesis on LOA the most dedicated and prominent scientist to work exclusively on LOA. In his thesis he has enlighten the detail techniques that give efficient solution of the game of LOA.

D.     Comparison

As mentioned previously e discuss here about the depth-limit search for the indentifying the best possible moves. This is very clear that AI is not only bothered about the current move but it is also conserved about the future moves and the effect of current move on future move which eventually will decide the winning of the game. The simplest techniques are built in consideration with current move and do not care about the future moves. The depth-limit searching technique and the quad heuristics are the best considered techniques for efficient game solution.

III.               METHODS AND TECHNIQUES

A.      Game Tree Searching

The depth search is most commonly considered for large tree which has to be examined in LOA that is, the initial branch is recursively expanded to an immediate next successful node of the current node till the leaf node is reached. As search process progresses at initial levels remaining branches are later considered.  A modified version of this technique is commonly used which is called iterative-deepening search which is a depth search with a depth limit where tree is completely searched up to the given depth limit. The limit increases and new search is started if the search is completed. Hence search process is comprised of several search trees with increasing depth. Iterative deepening search may seem waste as so many nodes are expanded multiple times. But the overhead of this multiple expansion is rather small. To make this concrete for LOA, for b = 30 and d = 4, the number of nodes expanded in a depth search is:

The numbers are total expansions and are iterative

The overhead is about 3.4 %. The higher the branching factor the lower will be the overhead. We see that the branching factor of LOA stays high during the game, so we have a little bit of overhead. But what is the advantage of iterative deepening?

It significantly helps in controlling time that is spent for a move decision as it is hard to predict search times for a fixed depth search, because these differ significantly for specific positions, which is solved by iterative deepening. It is possible to produce a best move after iterations or during iteration by stopping the search.

B.      Heuristics

In 99% of the cases heuristic can be detected that the game is definitely not finished and solution lies in the use of bits.

1)      Central Heuristics

Central Heuristics assign a close and greater value to the coin. It is considered that the center of the board is the best place for arranging the coins with intelligent moves. The centre of the board has the average less distance to all the coins on the board. The central heuristics have assigned values to each block on the board as shown in the figure.

Fig: Assigned values on board

Based on these weights a value could be calculated which decides the position of the coin on the board and denoted which coin is close enough to the center of the board. This calculation is performed by the addition of the values on which the player’s coin is present. The image below shows the example of calculated value.

Fig: Centralized Heuristic with value = 15

Fig: Central Heuristics with value = 10     

The central heuristics works this way.

2)      Quad Heuristics

The first quad heuristics was given by Winands (2001). This generally gives the value of the joint connection of the coins for one player. Here the board is expected to be broken in 81 pieces with 2x2 blocks each and these blocks are called quads. These are quads are given a weighted value considering the number of coins present in each quad. As shown below in the images.

Fig: Quad with 0 coins having Q = 0

Fig: Quad with 1 coin having Q = ¼

Fig: Quad with 2 coins having Q = 0

Fig: Quad with 3 coins having Q = - ¼

Fig: Quad with 4 coins having Q = 0

Fig: Quad with 2 coins having Q = - ½

This uses a weighted value for the calculation of Euler Number which denotes the position of the coins as advantage position. The higher the Euler Number means the higher non connectivity of coins for a player. The example shows below.

 

Fig: Euler Number with White = 4 & Black = 3

Fig: Euler Number with White = 6 & Black = 7

Smaller the Euler number is the greater the advantage for the player. The Euler number 3 is the advantage for the player than the one with Euler number 5. Suppose the Euler number are negative in nature like -3 and -5 in that case the quad heuristics would suggest -3 as best advantage for the player and high chances of winning.

The AI winning strategy is to combine both the heuristic techniques to find the weights and calculate the value based on which the current and future move of the coin is dependent and there is very minimum chance for the computer to lose the game. 

Fig: Combined Heuristics, value = 14

Fig: Individual Contribution

Fig: Combined Heuristics, value = -5

Fig: Individual Contribution

VI. CONCLUSION

The combination of quad and central heuristics will limit the depth of the tree and there shall be no much need for the implementation of whole tree and traverse all the nodes in the tree for optimum searching. The combined technique will create a game tree with a pre determined depth value and reduce the space and time complexity of the game state execution.

REFERENCES

[1] S. Sackson,(1969)A Gamut of Games Random House.

[2] Unknown author. (2011) Mind Sports Olympiad [Online]. Retrieved 08 April 2013.Retrieved from: http://www.boardability.com/home.php

[3] M.Winands,(2000) Analysis and Implementation of Lines of Action, Dept. Computer Science, Maastricht University.

[4] S.B. Gray, (1971, Vol: 20(5), Pp:551–561) Local properties of binary images in two dimensions. Computer Science IEEE Transactions.

[5] Minsky M. (1968) Semantic Information Processing. M.I.T. Press,USA.

[6] Minsky, M. et al (1988) Perceptrons- An Introduction to Computational Geometry. M.I.T. Press,USA.

[7] M.H.M. Winands et al.,( 2001, Vol: 24, Pp: 3-15) The Quad Heuristic in Lines of Action,ICGA

[8] Unknown author. (2002, Nov). Mona and YL’s Lines of Action page [Online]. Retrieved 10 April 2013. Available: http://webdocs.cs.ualberta.ca/ darse/LOA/

Nurses in supporting the psychology of patient

Nurses in supporting the psychology of patient

Abstract

The psychological position of patient is an important aspect during the treatment plan. The treatment plan could be short term and even long term some cases very long term that could be counted in years. Nurses are the major part in balancing the psychological aspects of the patient. There is always a limitation to the care expected and the care provided. Nurses have their main role in keeping the persons spiritual, hopes, optimism, and sexuality during the assessment of their psychology. The qualities of the care that nurses can provide are based on these major factors. The care will in future result into the cured patient with high spirits and could lead a quality file post treatment.   

Introduction

“Ciccarelli & Mayer (2006, p.4) explain that psychology is the study of behavior with scientific outlook considering the mental condition of the patient under the treatment covering the over reactions, actions, under reaction shocks, expressions, eye contact, movements and other signs and signals from any and every patient. The internal covert activity of the mind is exposed by the mental process and the reactions, feelings and thinking process”   

The psychological support is not important for the patient with treatment plans but this is also very much important for the staff dealing with those patients. Sussman and Baldwin (2010, Vol: 40 pp: 18 24) The psychological and emotional requirements in the case on cancer patients are never ending and are most often unmet during the treatment procedure. Nursing staff are capable of providing the psychological and emotional support to the patients in both written and verbal methods. The practice of written information support is generally introduced for the newly diagnosed patients; it is considered that written motivation support will be helpful as primary diagnosis already leaves many questions and instances about the disease.  The newly identified patients lack the capability of retaining the information because they are over loaded with the information. Moody (2003 Vol: 12(21) pp: 1281 1287) States that the written information is more suitable for the cancer patient to re read several times than by giving any verbal information which could be a misinformation also in some cases.  

In cases of Oncology patients nurses play a pivot role in handling their psychology and provide proper care for them in the patient’s best conditions and also in the worst conditions. The journey of an oncology patients starts with normal test visits during the diagnosis nurses and the medical practitioners provide the psychological strength to face the initial diagnostics, nest stage Is the acceptance stage where the patient needs a mental preparation about the disease he/she is going to carry with them through the time they are alive.  The future stages for the oncology patients get more worst in general cases there are few cases those turn out to be positive and curing in both best and worst case scenario the medical practitioner and his associated nursing staff play vital role is keeping the patients’ psychology level in balance. Muriel et al (2009 vol: 60(8) pp:1132 1134)  places a questions while explaining the above scenario that “How effective is the addressing about the psychological consideration and the care given to the general patients”?  

What is meant by psychosocial care?

Hodgkinson (2008, Ch 1, p1 12) is stating that involvement of social, cultural and spiritual support is known as psychology. Nurses here are key aspects in the support of the patients; Ellis, et al. (2006, Chapter 23, p457 474) discusses that nurses are the major part in the treatment life for a patient they build dialogues with patients to understand the goods and the bad about the patients. Nurses help the patients in decision making about the relation maintenance during the treatment duration. The main aspects are building good assessment levels and communication skills with patient for development the rapport between medical staff and the patient under treatment which helps is a good clinical relationship with patient and his family for a better treatment. In few oncology patients the level of disease reached the level of chronic where the patient including his family members are hospitalized for the entire journey of the tragic treatment. Such chronic cases allow the communication and the trust relation between the nurse and the patient stronger with whole family being in communication and part of the assessment. The patient and nurse trusted communication and the relationship with the family are different levels when it comes to hospital based nurses and home based nurses. Watt(2007, Vol. 60(6) pp. 663 672), Botti, and Hunter (2010, vol. 33(2) pp.1 8) explain that nurses take different treatment measures differing from patient to patient as every patient has his own set of treatment plans with respect to physical, mental, based on the symptomatic and so on. Ellise et al. (2006, Chapter 23, p457 474), Carlson and Bultz (2003, vol. 1(8) pp.1 9) suggest that good psychological support has been proving beneficial for the patient in facing and reducing the physical distress and psychological imbalances, this helps in better treatment planning and increase the quality of life. This also helps in better healing positive attitude among the patients I return give less recourses used of hospitals.      

Roland M, et al (2007, vol. 117(6065), p. 6-8) and Dept of Health (2000) The long term considerations (LTCs) management have changed the heath care industry over decade with managing of general practitioners (GPs) and the in hospital practice nurses (PNs) to support the expertise medical staff and the central feature in major countries like USA, UK, EU and Australia  

Książek J,et al(2004, vol.34, pp.1-10) and Bielawska M. D. (2000, Vol. 12-14, pp.36-7) evaluate that 

Considering the entire nursing care should also consider. Nurses should be properly trained considering the conditions of the patients and the measures other than behavioral patters of nurses their major roles is the assist the medical staff along with the patients. Nurses should posses the ability to take timely and safe decisions, monitor the patient records in general and clinical understandings with a detail record maintenance, balancing and supporting the psychological condition of the patient and their family member to avoid confusions and wrong intention. They are expected to cover the fundamental functionalities like provided the clear details about the case to the patient and their family members and also make them understand the treatment procedure considering the condition and category of the patient. It is nurses who take care about the medical records of the patient which is expected to be upto date with adequate information about the institution and the concerned medical staff attending the patient. The needs and conditions are also expected to be charted properly for current and future references.        

The theories on shared decision making and chronic disease managements are suggested that patient self efficiency and activation are crucial and critical and also effective in patient participation care which is well explained by Bodenheimer, Lorig, Holman, & Grumbach (2002, Vol. 288,  pp. 2469-2475) and Lorig, Sobel, Ritter, Laurent, & Hobbs (2001, vol. 4(6), pp. 256-262). In Bandura’s (1977, Vol. 84, pp. 191-215) explanation the self efficiency based social cognitive theory and practical performs few tasks for implementing the self care behavior and analysis. Gill, Robison, & Tinetti, (1997, vol. 12, pp. 757-762).); Hardy & Gill, (2005, vol. 165, pp. 106-112); Mendes de Leon, Seeman, Baker, Richardson, & Tinetti, (1996, vol. 51, S1,pp. 83-S190) all together stand on single point explanation that self efficient and self care contribution will allow the patient have a better quality of life and better motivational levels, reduced depressions, high rate of positive reaction towards treatment, very strong rate of full healing is also possible especially in cases on oncology where it is pre decided that end is very tragic but the self motivation and high spirits with less depression always result towards positive health. In every stage the nurses play the key role for self help and self care with lots of motivations.    

Burr V (2003, 2nded) explains that social psychology among the nurses is going in crisis. The social psychology was actually created after World War 2 where these social skills were expected to serve the British government and the Americans. The call for social skills and social psychology was implemented in medical healthcare industry as part of the political agenda for the political power management in wide areas and applications.  In mid 60’s and around 70’s social psychology was a separate group of psychologist who dealt with the dominant groups and prime healthcare centers by suppressing the patient’s psychological rights. The rational social psychology had prime focus on decontextualizing the nursing staff from the laboratories and research. The psychology then was very much concerned and everything was culturally sensitive about that people say and what they do and the adverse affects of them were always linked with the spiritual aspects.  The analysis of the psychology influenced the modern paradigm and was termed as psychoanalysis, these theories helped in deriving the psychological patterns of the patients, medical staff and also general public which was used to build a vision in advance level beyond the biological body.      

Providing Psychological Care 

Good communication skills plan an important role in providing good psychological treatment and support. This support could be provided in both verbal and non verbal form. The communication skill in case of oncology patients is all about general interaction and boosting their spirits to level of acceptance. The psychological support here is more concentrated on supporting the interaction, convey the empathy, make the patient understand about his disease conditions and the affects related to the curing measures and the treatment plans. Apart from the clinical support to the patient nurses play an important role in supporting the patients to hand with confidence for their responsibilities, rise their motivation to fight the disease with a cheerful smile and accept the pain and move forward in the life until they are alive by providing them respect, social support and setting mutual goals among them and many such activities are carried out as explained by Ritchie (2001, Vol. 24(3), pp. 165 175).

         

Rodin et al (2009a, vol. 68(3), pp. 562 569) explains that the trust relationship between the medical staff and the patient is an important support for the cancer experiencing patients are they are likely to be distressed most of the times. Fallowfield and Jenkins (1999, Vol.  35(11), pp. 1592 1597) suggest that non verbal communication is more affective and is a great deal for the patients who scrutinize their doctors and nurses by the facial expressions like fornuances expressions or demeanour. Rodin et al (2009b, Vol. 16(6), pp.42 49) states that non verbal communication is more indicated from the patients to express their good or bad feeling which is as much as affective than that of verbal communication. Whereas verbal communication is crucial and strong in building the relationship with transmission of information, there is always a change of negotiation and treatment discussions. Zebrack et al (2010, Vol. 18(1), pp. 131 135) the patient nurse relationship can vary based on the age factors, gender which plays a high impact on the building a trusted relationship for skillful communication and support. Nurses play a different tact to deal with patients of different ages and different convincing strategy based on the different age group. There is need to provide evidential information about the age group and available support to every patient.  Every patient other than the disease he has a personal, professional and social life which is outside the hospital and the disease information and treatment may affect the individual’s fertility, job, education, finances and many such in one or the other way. Nurse’s role part here is to make an attempt to provide the required resources which are in reach of the hospital like provision for education, providing updates about the outside social world, providing the intensive care for the critical patients.         

It is the responsibility of the nurse and the medical staff to have a friendly and cheerful environment for the patient to feel comfortable about living there for a period of time as required for his treatment. The initial and the final emotional journey is very much demanding and the patients and their family members mainly rely on the nursing staff and the medical attending for the proper information and support to pass through the tragic journey. Oh and Kim (2010, vol. 37(2), pp.98 104) discuss here that the emotional ups and downs in the oncology patients result in ups and down of their physical health which in return affects the quality of life. The more distressed patient is more prone loose the physical health and the quality of life is on stake. Vodermaier et al (2009, Vol.101 (21), pp.1464 1488) suggest that questionnaires are helpful tools for routine screening of cancer treatment procedure and balance the emotional distress. The screening advantage give equal access to the psychological treatment to identify and over look the substantial proportion in distress management.  Lin and Bauer-Wu (2003, Vol. 44(1), pp.69 80) states that cancer is highly affective and stressful journey which associated with difficulties in emotional ups and downs.      

Conclusion

This document discussion is considering the psychological support for the patients under oncology treatment and the future discussions will be collection of few such short term and long term treatment based. The role of nurses in balancing the psychology of the patients and their family members for facing the treatment difficulties and mentally preparing for any and all the adverse affects of the concerning diseases.

Nurses play very important role in supporting the psychology of the patient and his family in all the positive hope but in the process the psychology of the nurse also affects, in few long term patients nurses also get attached to them like a family and due to the trajectory faced by the patients also affect the psychology of the nurse which is possible in few cases and with soft natured nurses. Here in future part of the discussion we will also consider the measures to be taken for self psychological support for the nurses themselves. 

References: 

1. Sussman, J. and Baldwin, L.M. (2010, Vol: 40 pp: 18 24) the interface of primary and oncology specialty care: From diagnosis through primary treatment. Journal of the National Cancer Institute Monographs.

2. Moody, R. (2003 Vol: 12(21) pp: 1281 1287). Overcoming barriers to delivering information to cancer patients. British Journal of Nursing.

3. Muriel, A., (2009 vol: 60(8) pp: 1132 1134) Management of psychosocial distress by oncologists. Psychiatric Services.

4. Hodgkinson, K. (2008, Ch 1, p1 12). What is the psychosocial impact of cancer. in Hodgkinson, K. and Gilchrist, J. Psychosocial Care of Cancer Patients, Ausmed, Melbourne.

5. Ellis, M., et, al (2006, Chapter 23, p457 474). Psychological Issues in Grundy, M Nursing In Haematological Oncology, , Elsevier, Sydney.

6. Kenny, A., Endacott, R., Botti, M. and Watts, R. (2007, Vol. 60(6) pp. 663 672). Emotional toil: psychosocial care in rural settings for patients with cancer. Journal of Advanced Nursing.

7. Watts, R., Botti, M. and Hunter, M. (2010, vol. 33(2) pp.1 8). Nurses’ perspectives on the care provided to cancer patients. Cancer Nursing.

8. Carlson, L. and Bultz, B. (2003, vol. 1(8) pp.1 9). Benefits of psychosocial oncology care: Improved quality of life and medical cost offset. Health and Quality of Life Outcome

9. Ciccarelli S.K. & Meyer G.E. (2006, p. 4) Psychology. Upper Saddle River, NJ: Pearson Prentice Hall.

10. Roland M, et al (2007, vol. 117(6065), p. 6-8) Care closer to home. Moving care. Health Service Journal.

11. Department of Health: (2000) the NHS Plan London: Department of Health.

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13. Bielawska M. Dokumentacja (2000, Vol. 12-14, pp.36-7)medyczna jako nośnik informacji dla kas chorych. In: Piąta Ogólnopolska Konferencja „Jakość w Opiece Zdrowotnej”, Kraków.

14. Burr V (2003, 2nd ed) Social constructionism.. New York- Routledge.

15. Bodenheimer, T., Lorig, K., Holman, H. & Grumbach, K. (2002, Vol. 288,  pp. 2469-2475). Patient self management of chronic disease in primary care. JAMA.

16. Lorig, K. R., Sobel, D. S., Ritter, P. L., Laurent, D., & Hobbs, M. (2001, vol. 4(6), pp. 256-262). Effect of a self-management program  on patients with chronic disease. Effective Clinical Practice.

17. Bandura, A. (1977, Vol. 84, pp. 191-215). Self-efficacy: Toward a unifying theory of behavior change. Psychological Review.

18. Gill, T. M., Robison, J. T., & Tinetti, M. E. (1997, vol. 12, pp. 757-762). Predictors of recovery in activities of daily living among disabled older persons living in the community. Journal of General Internal Medicine.

19. Hardy, S. E., & Gill, T. M. (2005, vol. 165, pp. 106-112). Factors associated with recovery of independence among newly disabled older persons. Archives of Internal Medicine. 

20. Mendes de Leon, C. F., Seeman, T. E., Baker, D. I., Richardson, E. D., & Tinetti, M. E. (1996, vol. 51, S1,pp. 83-S190). Self-efficacy, physical decline, and change in functioning in community-living elders: A prospective study. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences.

21. Ritchie, M. (2001, Vol. 24(3), pp. 165 175)  Psychosocial nursing care for adolescents with cancer. Issues in Comprehensive Paediatric Nursing. 

22. Rodin, G., Lo, et al  ( 2009a, vol. 68(3), pp. 562 569). Pathways to distress: The multiple determinants of depression, hopelessness, and the desire for hastened death in metastatic cancer patients. Social Science and Medicine.

23. Rodin, G., Zimmerman, C., Mayer, C., Howell, D., Katz, M., Sussman, J., Mackay, J.A. and Brouwers, M. (2009b, Vol. 16(6), pp.42 49) Clinician patient communication: evidence based recommendations to guide practice in cancer. Current Oncology.

24. Fallowfield, L. and Jenkins, V. (1999, Vol.  35(11), pp. 1592 1597). Effective communication skills are the key to good cancer care. European Journal of Cancer.

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SAFETY CULTURES For Health Care Industry

ABSTRACT

Safety culture is a term originally coined by The International Nuclear Safety Advisory Group which was indented to denote the conditional dysfunction and the decision process that led to disaster of Chernobyl nuclear during 1986 illustrated by the group of International Atomic Commission Energy (1986). This concept has been adapted in almost the concept was adapted in almost every applicable areas for identifying the behavioral observation sand patterns in attitudes associated with the healthcare industry ever since then.

INTRODUCTION

Potential performances that are delivered are the more focused areas in healthcare industry in terms of Safety Culture than the outcomes that are general.  These Safety Culture aspects are preconditioned and are set well before consideration of proposed number of tasks at a specific situation which usually vary with true situation elaborated by Reiman T, et al. (2010, vl 19(5), e20). Safety Culture interventions involving improved outcomes and better safety practices are  put forward by the new generation medical institution as discussed by Pronovost P, et al (2005, vol:1 iss:1 p:33–40) and Huang DT, et al (2010 vol: 22(3) ,p: 151–161). 

Castle NG, et al. (2007, vol: 32(1), p: 66–76) and Wagner LM, et al. (2009; vol: 41(2), p:184–192) suggest that in general studies it is usually observed that nursing homes are poorly developed from a safety culture aspect. Nursing homes are still in a pitiful situation for improving their safety cultures.    

According to P. Aspden (2007) Medication Errors (MEs) causing the Adverse Events (AEs) are posing continued challenges when it comes to acute care situations. It was recently stated by WHO that there has been statistical increase in MEs giving an estimate of about 1.5 million patients affected due to MEs in major countries like United States and United Kingdom. P. Aspden (2007) also illustrated that risk factors from ME’s are supported by substantial evidences. “Preventing Medication Errors”  reports discusses that on average annually 5% to 10% of patients who are affected due to MEs end in deaths cases and this rounds to be about 7000 deaths, which is a number covering only United States and increasing in different countries.      

MEDICAL ERRORS 

The main definition of ME is inconsistent, although several attempts are being made on developing international definitions. NCC MERPP (2012) – The National Coordination Council for Medication Error Reporting and Protection discusses that “The Medication Errors are preventable which might cause due to inappropriate medicinal uses and wrong diagnosis in early stages or this may be due to control of health care professionals. These could be related to the lack in practice of healthcare products, systems and procedures.” The range of errors is usually widened due to many factors like miss communication, nomenclature, wrong product labeling, packaging, to wrong monitoring, and usage directions included.   

The fundamental for the process of improving patient care A. Page, Ed (2004)  J. G. Samuels (2010, vol. 40, no. 11, pp. 471-476)  is creation of reliable health organizations. Safe and reliable practice environments M. Stergiou-Kita (2010, vol. 57, no. 2, pp. 76-87)  A.F. Pantoja and J. R. Britton (2011, Vol. 23, no. 3, pp. 309-316) can be established by usage of evidence-based practice guidelines which is need of the time in order to improve patient care but organizational barriers limit/prevent implementation of these guidelines S.D.S Scott et. al. (2008, vol 3. no. 1, article 41) K. Stenger et. al. (2001, vol. 13, no. 2, pp. 319-327).  M.  It was found by Ricart et. al. (2003, vol. 31, no. 1, pp. 32-41) that fear among nurses causing potential harm to the patients rendered to the non adherence to these guidelines. Doherty (2006, vol. 19, no. 1 , pp. 32-41) stated that lack of regular nursing staff educational meetings as a major setback to implementation of safety guidelines in emergency room particularly those involving asthma cases.  Estabrooks et al. (2007, vol. 56, no. 4, pp. s7-s23) stated that there was variability or difference observed between communication pattern characteristics of nurses and their decision making process which again varied in different organizations.  It was observed that a positive perception led to more appropriate use of research finding as opposed to adverse patient outcomes G.G. Cummings et. al. (2010, vol. 10, article 68) S. E. McLean et al. (2006, vol. 5, no. 3, pp. 299-309) L. Harwood (2007, vol. 17, no. 1, pp 22-29).  This perception varied across various disciplines with different healthcare settings and professional ranks D.T. Huang et al. (2007, vol. 35, no. 1, pp. 165-167) J. B. Sexton et al. (2006, vol. 26, no. 8, pp. 463-470). The perception towards safety culture varied at different levels where leaders showed higher level of perception compared to frontline workers and manager and physicians demonstrated higher level of perception compared to staff nurses S. Singer et al. (2007, vol. 42, no. 5, pp. 1999-2021) reviewed that factors like work experience and work position among nurses significantly affected their perception towards safety culture with higher levels observed among those nurses who help more than 10 years of experience.  Kim et al. (2007, vol. 29, no. 7, pp. 827-844) found differences in perception of patient safety culture between staff nurses and managers of healthcare organization.

At nursing unit levels nurses work as charge nurses or non charge nurses . Charge nurses function by shift-by-shift pattern and their duties vary within and across the organization M. Krugman and V. Smith (2003, vol. 33, no. 5, 284-292) L. M. Connely et al. (2003, vol. 12, no. 5, pp. 298-306). Staff nurses that are recently hired provide direct patient care supervised by charge nurses D. S Wilson et. al (2011, vol. 33, no. 6, pp. 805-524) .  In evidence based practice criteria the role of nurses could be charge or non-charge P Wong et al. (2002, vol. 28, no. 7, pp. 363 -372) R. E. Keith et al. (2010, vol. 5, article 99). 

Studies conducted by M. Lisby (2010, vol. 22, no. 6, pp. 507–518) identifies the range of medication error between 19-70% which were performed at various setting of healthcare. The research methodology states that despite increased level of awareness and precautions regarding ME, the high rate of errors still persist in the healthcare industry over past decade.  A considerable amount of technological designs and developments have been put forward for MEs reductions.  L. L. Leape, et al (1995, vol. 274, no. 1, pp. 35–43) draws a result about the MEs based on the situations such as 39% errors occurred during order placing process and 38% during medical administrations process, 12% during transcription process, and overall 11% during medicinal dispensing and process of medication.  Barker.K.N (2002, vol. 162, no. 16, pp. 1897–1903) and the colleagues presented a report showing resulted errors occurring during the fifth dose of medication administration which also included the dysfunction in the timing of administrations, which was nearly 43% as counted and omission of dosage which counted to be 30%, wrong prescription and dose was 17% including external factors that result in 10% of error factor. 

Cooper (2003, vol.37, p: 212–14) states that there are no standard definitions for culture in existence but few very commonly cited definitions that are short and provide intuitive understandings of the culture that are stated by very common statement “is this the way things work here”.  “This is the way work done here” provides a good reflection of safety culture where it is expected by the learning outcome of the teamwork, among the staff, institution members, , open for good and bad communication irrespective of the positions, collecting proper feedbacks from patients as well as from the staff, and non punitive error responses. JCAHO- Joint Commission International Center for Patient Safety has mentioned that it is necessary for an organization to adopt above-mentioned qualities and put them effectively into practice as part of improvement efforts for the goals of national patient safety. The safety goals vary based on the standards  and institutional levels which also include the constraints like care durations, treatment terms, health and behavior, and finally the facilities that are provided by the nursing home or/and the hospitals. Based on the common downfalls , the goals are set also taking into consideration  medication errors, communication factors of the patient, patient, resident, or attendee identifications, the care giver, and lastly but not limited here is  the infections in the healthcare associations.       

PATIENT SAFETY 

The next section is considering the safety culture from patient perspectives. JCAHO has been dealing with broad variety of situations in order to establish the patient safety goals.  A considerable difference has been observed towards safety culture adoption when it comes to nursing homes and general hospitals. First point to consider is the type of patients as they differ in nursing homes and hospitals. All age groups of patients can be accommodated by hospitals considering both short and long term care giving and deciding duration of stay based on the term of the care, high end technology emphasizing with high accreditation value from JCAHO. The nursing homes can be considered as care centers for the old age group with varied long or short term stay and the treatment plan designed.  Nursing homes do not focus much on the JCAHO accreditation and the innovative technology in comparison to the hospitals. Secondary consideration can be given to focus on safety of the patient and implementation of good safety culture which has been an inpatient setting.

The safety culture examination is the first step for developing the understanding capability for the safety of the residents in the nursing homes.  Cooper (2003, vol.37, p: 212–14)  suggest that healthcare organization’s safety cultures are identified as “the most basic constraint to improve the safety for the resident care”. The safety cultures of the patients in the hospitals are the performance indicators of the concerned hospitals and also serve as comparison factor between hospitals and nursing homes.    

SAFETY CULTURE IN CLINICAL RESEARCH 

This section is about the adaption and discussion about the safety culture among the clinicians and the researcher’s perspectives.  Laura M. W., et al (May 2012, vol.38 No.5) and Reiman T, et al (2010, vol 19(5), e20) describe that units of Healthcare are identified as the complex adaptive system (CAS) which involves interdependent organizational levels with multiple involutions. Pronovost P, et al. .( 2005, vol:1 iss:1 p:33–40) and Huang DT, et al. (2010 vol: 22(3) ,p: 151–161) say that it is unpredictable and nonlinear when it comes to complex challenges stating the transforming changes in relationship within the CAS at the same time. Castle NG, et al. (2007, vol: 32(1), p: 66–76), Wagner LM, et al. (2009; vol: 41(2), p: 184–192) and Cooper (2003, vol.37, p: 212–14) specify that echoed challenges in the field of enhancement of quality specified by the leaders who indentify the shortcomings, like limitation in research involvement methods, immature and weak designing evaluation,  and study failure in verbal context. It is a challenge for an individual investigator to nail down entire healthcare system considering the shortcomings since the process is interwoven .  This calls for need of collaborative model that can integrate perspectives at multiple layers and numerous disciplines, which is expected to be helpful at advanced levels of safety culture investigations. It is also expected that this model will improve scientific design and development strategies by facilitating the disseminations.    

It was explained by P. Aspden, (2007), that Trans disciplinary collaborative models are particularly effective and potential as they bring together diverse individual group that are fully functional and integrated with frameworks, methods, and theories in their respective area of expertise combined together to work on the complex problems. The level of collaboration varies from interdisciplinary and multidisciplinary stages where it is expected that numerous individuals work together and are grounded strong enough to their individual roles and ideologies at the same time. D. W. Bates (1999, vol. 159, no. 21, pp. 2553–2560) and L. L. Leape, (1991, vol. 324, no. 6, pp. 377–384) suggest that transdisciplinary effective collaboration are considered for development of the healthcare system according to the recent studies. Wagner LM, et al. (2009; vol: 41(2), p:184–192) and M. Lisby, et al (2010, vol. 22, no. 6, pp. 507–518) describe that Individual’s research intervention particularly involves the healthcare research development considering either any single clinical unit , nursing home or any one hospital. As inefficient approach towards the complexity changes , single researcher’s perspective is inadequate considering occurrences in the healthcare institutional changes under influence of contextual impact in the intervention effectiveness and implementation.         

Castle NG, et al. (2007, vol: 32(1), p: 66–76) and the NCCMERP (2012) explain that stage improvement and advanced scientific research implementation are the massive requirement for addressing complex issues concerning the healthcare industry. In specific a hand-in-hand work coordination between the clinicians and the researchers is expected by adapting the redefined design and development strategy, which will establish a healthy communication relationship for the betterment of the safety cultures in the healthcare organizations.  K. N. Barker, et al (2002, vol. 162, no. 16, pp. 1897–1903) states that at any given situations transdiciplinary models are expected to serve the purpose at the current stage. Moreover sustainable and effective intervention programs will be promoted with the implementation of scientific framework. 

Transdisciplinary multisite investigation site models that involves the movement from individual analysis to group analysis gives an alarm for the interactions in unique way for the clinicians and the researchers. For individual interventions, there are several other tools and models but in case of transdiscipline there are few competencies and models for team performances and building the context for the better tomorrow. 

CONCLUSION AND FUTURE 

The future work of this essay is described as the study of safety culture based on specific survey conducted by exploring the impact of Commission accreditation on the nursing homes on the perception considering the senior and experienced managers in every nursing home.  

Next session focuses on a modified version of the survey for hospital specifically on patient safety culture and response of nursing homes about the administration– HSOPSC survey. The purpose of this research is to mainly identify safety culture issues those concerning nursing homes and view a comparative review by comparing existing available results with the hospitals. This usually involves usage of instruments for purpose of analyzing the existing data from the hospital.      

The last section describes about adaptation of transdisciplinary healthcare model that mainly deals with improvement in research and network which in turn has huge influence on the collaborations conducted for the national improvement studies. 

REFERENCES 

[1] International Nuclear Safety Advisory Group (1986), Summary Report on the Post-Accident Review Meeting on the Chernobyl Accident. Geneva: International Atomic Energy Commission.

[2] Laura M. et al. (May 2012, vol.38 No.5) Relationship between Nursing Home Safety Culture and Joint Commission Accreditation.

[3] Reiman T, et al. (2010, vol 19(5), e20) Multilayered approach to patient safety culture. Qual Saf Health Care. 

[4] Pronovost P, et al.( 2005, vol:1 iss:1 p:33–40) Implementing and validating a comprehensive unit-based safety program. J Patient Saf.

[5]. Huang DT, et al. (2010 vol: 22(3) ,p: 151–161) Intensive care unit safety culture and outcomes: A US multicenter study. Int J Qual Health Care.

[6]. Castle NG, et al. (2007, vol: 32(1), p: 66–76) Nursing home administrators’ opinions of the resident safety culture in nursing homes. Health Care Manage Rev.

[7]. Wagner LM, et al. (2009; vol: 41(2), p:184–192) Nurses’ perceptions of safety culture in long-term care settings. J Nurs Scholarsh.

[8] Cooper JB, (2003, vol.37, p: 212–14) Developing a culture of safety. Biomed Instr Technol.

[9] P. Aspden, (2007). Institute of Medicine, Committee on, and E. Preventing Medication, Preventing Medication Errors, National Academies Press.

[10] D. W. Bates, et al, (1995, vol. 274, no. 1, pp. 29–34) “Incidence of adverse drug events and potential adverse drug events: implications for prevention,” Journal of the American Medical Association.

[11] D. W. Bates, et al. (1993, vol. 8, no. 6, pp. 289 -294) “Incidence and preventability of adverse drug events in hospitalized adults,” Journal of General Internal Medicine.

[12] D. W. Bates, et al., (1999, vol. 159, no. 21, pp. 2553–2560). “Patient risk factors for adverse drug events in hospitalized patients. ADE Prevention Study Group,” Archives of Internal Medicine.

[13] L. L. Leape, (1995, vol. 52, no. 4, pp. 379–382). “Preventing adverse drug events,” American Journal of Health-System Pharmacy.

[14] L. L. Leape, et al.,(1991, vol. 324, no. 6, pp. 377–384) “The nature of adverse events in hospitalized patients. Results of the Harvard Medical Practice Study II,” The New England Journal of Medicine.

[15] M. Lisby, et al. (2010, vol. 22, no. 6, pp. 507–518) “How are medication errors defined? A systematic literature review of definitions and characteristics,” International Journal forQuality in Health Care.

[16] NCCMERP, (2012) National Coordinating Council for Medication Error Reporting and Prevention, About Medication Errors: What is a Medication Error? http://www.nccmerp.org/ aboutMedErrors.html.

[17] J. A. Cafazzo, et al.,( vol. 12, pp. 70–74, 2009) “Human factors perspectives on a systemic approach to ensuring a safer medication delivery process,” Healthcare Quarterly.

 [18] L. L. Leape, et al., (1995, vol. 274, no. 1, pp. 35–43)“Systems analysis of adverse drug events. ADE Prevention Study Group,” Journal of the American Medical Association.

[19] K. N. Barker, et al (2002, vol. 162, no. 16, pp. 1897–1903) “Medication errors observed in 36 health care facilities,” Archives of Internal Medicine.

Customer Relation Management Survey Question

1. As a client are you knowledgeable about this module?
A. Yes as a client i have knowledge about the module
B. No as a client i am not knowledgeable with the module.
C. As a client i cannot trust the knowledge that i have about the module.
D. As a client i am fairly in state of confusion about the module.
Suitable solution here is "a"
The integration of technology and human resources is termed as customer relationship management; this management level is handled by the organization's all the departments from lower client service to the research and development category. This management strategy is adapted by the concerned organization to maintain the healthy relationship between the customer group and the developer/ producer group of the concerned organization.  Adaption of  crm is basically made for the healthy relationship of the customer and to maintain the customer satisfaction in terms of loyalty and long term profits for the organizations

2. Do you know how this module works?
a. Yes.
b. No.
c. Not fully.
d. Not sure.
The solution for this question is option”a“
Working concept of customer relationship management customer relationship management system/module will help your organization mainly through analyzing customer preferences and their purchasing habits since it differs from one customer to another. It will help you to differentiate between valuable and not so valuable customers and help you retain valuable customers and developing cost-effective options for non-valuable customers.

3. Which module would you like to introduce into your organization?
a. Enterprise customer relationship management module.
b. Premium edition customer relationship management module.
c. Free edition customer relationship management module.
The solution for this question is free edition customer relationship management system/module since i am a first time user and other versions are expensive and too complex to understand.
Enterprise customer relationship management system/module is mainly for large organizations where customer-oriented processes are multi-faceted and complex and with less than dozen sales representatives and departments that interact with potential and existing clients.  Those companies maintaining multiple sales and marketing team that are spread across separate business sections. Hence in order to communicate timely client information to stakeholders and to record, consolidate, and centralize the data regarding the actions taken on behalf of these customers to entire business.
Premium edition is mainly when there is business expansion and you need customer relationship management system with advanced functionalities. Most popular premium edition is goldmine premium edition customer relationship management system. This feature particularly supports marketing, sales, and customer service through a very powerful customer relationship management features which include support administration, sales force automation, marketing automation, and relationship management.
Free edition is particularly for those users who are implementing customer relationship management system/module in their organization for the first time, for two users who are unaware of the complexity of customer relationship management system/module and cannot afford high price customer relationship management system.  This edition particularly manages customers, prospects, and sales and keeps track of all activities of customers. Eg . Zoho free edition customer relationship management module.

4. Are you aware of outlook and web based system?
a. Yes.
b. No.
c. Not sure.
d. Unheard.
The solution for this question is option yes.
Web based customer relationship management system/module is basically a customer relationship software which does not require purchasing but everything is controlled by remote host which keeps track of customer, clients, and sales lead tracks.
Outlook customer relationship management system/module is a software, which has to be purchased for maintaining a track of customers, clients, and sales lead. Outlook customer relationship management system/module particularly needs a consultant who is familiar with outlook customer relationship management system/module and keeps track of sales and recognizes entire sales team effectively and quickly.

5. What would be your role in your organization in relation to this system?
a. Organization-based decision.
b. Manager-based decision
c. Employee-based decision.
d. Too early to decide.
Answer is it would be decided by organization after implementation of customer relationship management system/module depending on my abilities to handle customer relationship management.
Roles in customer relationship management system/module basically differ at level of access to information. Where information is completely accessible to sales manager regarding sales representatives under him while sales rep can access only his information.  It is by default set that users are top roles cannot access information shared by their subordinate users however these settings can be changed while users with ceo role can access entire data in their organization and manage it.

6. How do you think this module would impact your organization?
a. Positive impact
b. Negative impact.
c. Not aware of.
d. Need details.
The solution for this question is option “a”
Basic implementation of customer relationship management system/module in an organization does not increase functionality of organization to a great extent but its effective management is the deciding factor.  There are many setbacks to effective implementation of customer relationship management system/module but customer relationship management system/module can result in extremely successful organization if managed effectively.

7. Do you have any ideas of including sales related applications with customer relationship management?
a. Yes
b. No
c. Possible
d. Not aware of
The solution for this question is option “d”
There are many sales related applications that can be integrated with basic customer relationship management system/module like customer reference system, call canter system, sales compensation management scm, and contract management, business intelligence service, web analytics, and collaboration tools.
Customer reference program is basically managed by crp managers who are responsible for gathering information and request for references this in turn helps sales people to gather new clients and prevent overusing of valuable customers. This effectively reduces sales cycle and efforts of sales representatives.
Call center system effectively manages telemarketing activities which is effective for sales follow up and post-sales customer service.
Sales compensation system is particularly effective in managing and avoiding overpayment of commissions, disputes regarding commissions and slow sales rate due to inefficient or distracted sales people.

8. Did you face any troubles while introducing system?
a. Few
b. Very few
c. Many
d. Huge
The solution for this question is option c many
It was very difficult to come in terms with the staff as they preferred the old way of keeping the records, early technical difficulties, most the staff lacked it skills which added to poor training and support, customer relationship management system software did not integrate well with the existing system which reduced its credibility and performance delivery.  Lack of commitment among the staff members and overall capital invested increased.

9. Are you currently satisfied with the system?
a. Yes.
b. No.
The solution for this question is option a.
Though initially implementation of customer relationship management system/module was a great difficulty, the organization has improved in various ways after its implementation in managing sales , customer preferences, and arranging market choices and demand.

10. Do you know the ways of improving your modules?
a. Yes.
b. No.
c. Not sure.
d. Not aware of.
The solution for this question is option b
There are many ways of further improving your customer relationship management. By automation of sales order process and quotation generation, frequent communication among staff through personalized mail-merge templates, integration of data from internal applications to main customer relationship management system/module so that it could be accessed by sales people, provide chatter to the sales people so that issues are addressed quickly and task segregation is rapid to other departments, enhance marketing communication, integrate phone system with incoming caller id provision for better services and mapping applications should be upgraded.  Links to social media like facebook, linkedin , and twitter should be provided as a part of social customer relationship management

10. Does staff of your organization lack it skills?
a. Yes.
b. No.
The solution for this question is option a
They lacked it skills due to which training and support was also poorly perceived by my staff.

11. Do you think it skills are must while introducing the module into your organization?
a. Yes.
b. No
The solution for this question is option yes.
Though customer relationship management system/module should not be perceived as technology –only solution although large parts of it are technology related, it mainly deals with integration of people, processes and technology. Basic ideas of customer relationship management system/module work successfully if core management or staff system operating it is efficient.  It skills can be trained or brought about but basic understanding of implementing customer relationship management system/module is necessary.

12. Describe the size of your organization?
a. Small sized.
b. Medium.
c. Large.
d. Collaboration.
The solution for this question is option a

13. What does your organization mainly deal with?
a. Service goods.
b. Sales and marketing.
c. Advertising.
d. Financial marketing.
The solution for this question is option d.

15. What has been the total duration of your organization?
a. Years.
b. Months.
c. Days.
d. Decades.
The solution for this question is option a.  In 2012 till now.

16. Do you expect any changes after implementation ?
a. Yes
b. No.
c. Unaware.
d. Not sure.
The solution for this question is option a.
You can expect better productivity/profitability, improved tracking of sales, better marketing communication, improved customer relations, and overall improvement of organization.

17. Can you enlist the possible benefits of implementing the system?
a. Good reputation in marketplace.
b. Efficient marketing and sales.
c. Reducing sales cost.
d. Increased valuable customers.
e. All of the above.
Answer is e.

18. Are there any further changes that you would like to consider to your current system?
a. Yes.
b. No.
c. Not sure.
d. Unable to decide.
Answer is b. Further changes would be considered based on success of current customer relationship management system/module.
19. Would you consider  this system after business expansion?
a. Yes.
b. No.
c. Not sure.
d. Cannot tell.
Answer is cannot tell as decision of customer relationship management system/module implementation is not individual based but organization dependent and usually depends on its success rate before the expansion.
20. What is your educational status?
a. Student.
b. Diploma.
c. Degree.
d. Master’s degree.
e. Professional degree.
f. Doctorate.
Answer is e.  I have completed my management education and now handling my own small organization for which i am seeking customer relationship management.
21. What is total turnover/success rate of your organization?
a. Good.
b. High.
c. Excellent.
d. Stupendous.
Answer is a.  Success rate of my organization has been good overall.
22. Would you consider any future tie ups after success of your organization after implementation?
a. No.
b. Yes.
c. Not thought of.
d. Not sure
Answer is c.  Tie ups with organization depends on success rate of initial set up which is highly variant at initial stages of set up.
23. Would you increase your organization strength after implementation of system/module or considering employing much efficient staff?
a. Yes.
b. No.
c. Not sure.
d. Difficult.
Answer is difficult.  Employees in my organization are well aware of the current scenario and conditions in my company and hence need only training regarding customer relationship management system/module or they are well eligible for the employment.

24. Which system/module features attracted you the most?
a. Sales tracking.
b. Better customer relations.
c. Better marketing aspects.
d. Increased profitability.
Answer is b.
25. Do you know someone who has implemented system/module in their organization?
a. Yes.
b. No.
c. Unaware.
d. May be.
Answer is a.  I was referred to your customer relationship management system/module through him who has greatly succeeded in his business venture through implementation of customer relationship management.

















Client to customer relationship management system/module
1. Does a thought process involve in selecting an appropriate system/module for organization?
a. No.
b. Yes.
c. Definitely.
d. Not needed.
Answer is yes.
Customer relationship management system/module that is implemented in your organization should be selected mainly considering the size of your organization as there are different customer relationship management system/module system/modules available for different strength organizations like free edition, enterprise edition and premium edition.
A cost-per-lead values and cost-per-sale values are the factors which are mostly considered since it is easy to determine this way if organization is worth to a business.

2. What are the possible benefits of implementing the system?
a. Enhanced profitability.
b. Better customer relations and satisfaction.
c. Sales tracking.
d. Better customer preferences and prospects.
e. All of the above.
Answer is e all of the above.
3. What are the common mistakes made by the organization that leads to failure of the system?
a. Lack of commitment.
b. Poor communication.
c. No leadership-like role.
d. Lack of knowledge about customer relationship managment.
e. All of the above.
Answer is e.
Lack of commitment: everyone involved in the business should be committed to viewing their operations from customer prospective , failure to do so can lead to breaking of relationships with the customer resulting in customer dissatisfaction and loss of revenue.  Hence customer-focused approach is needed which may require a cultural change.

Poor communication people in organization must be aware of the information that they need and how to utilize that information.  Poor communication can prevent buy-in-order

Weak leadership when a proposed plan is not suitable for the customers it should not be implemented and hence team must be made to work back to find a solution and attempting to get a complete solution in one go is a risky matter.

4. How can be system/module particularly beneficial for me?
a. Staying informed of customer’s world.
b. Measure effectiveness of customer service and delivery.
c. Data security and ease to access and use.
d. All of the above.
Answer is d all of the above.
Basic fundamentals of customer relationship management system/module like data security, access, and ease of use are achieved. Customer relationship management system/module will accentuate the way you work but also take it to next level. Customer relationship management system/module will help you monitor, deliver, and measure your effectiveness, if u deal mainly with customer service and in case of flat organization, immediately know how is obtained. Customer relationship management system/module will help in acquiring knowledge about customer’s world..
5. What are the most basic ways of implementing the system?
a. Collection of information, storage, access, analyze customer behaviour, more effective marketing, and enhanced customer experience.
b. Remote host server like in web based customer relationship management.
c. Outlook customer relationship management.
Answer is a.
Identifying and categorizing customer needs is important prior to identifying information related to them. A centralized customer database which is relational database serves as most effective database to store and manage customer information. This particularly facilities access to the information from same source and ensuring up-to-date information is available to all.  Collected and stored information is made available to the staff in appropriate format. Data mining tools are utilized to analyze data to profile customers and develop sales strategies.
Customer experience is enhanced by understanding their needs , desires, and self perception. Valuable customers are targeted and cost-effective options are adopted for non valuable.
Small group of customers are not profitable but complaints from small group take a huge amount of staff time to address and solve them hence if problems are identified and resolved quickly, much more of the staff time will be save to articulate time for other customers.

6. What are the aspects that system/module mostly focuses on?
a. Sales.
b. Marketing.
c. Customer purchasing habits.
d. Customer prospects and behaviour.
e. Valuable customers.
f. Non valuable customers.
g. Customer relations.
h. All of the above.
Answer is all of the above.
Customer relationship management system/module is a multi-faceted and integrated approach toward enhancing business of an organization.  It cannot direct itself only one aspect for growth of organization. Customer relationship management system/module works from all angles tracking sales trends and sales leads, enhancing marketing communication, tracking valuable customers and providing cost-effective options for non valuable customers.  All these factors contribute to better customer relations.

7. In what way does system/module benefit any business organization?
a. Customer needs and their preferences are identified.
b. Customer retention is increased as focus is on both valuable and non valuable customers.
c. Products and services are re-priced and reconfigured.
d. All of the above.
Answer is d. All of the above.

8. Are there any tools to measure success rate of system?
a. No.
b. Yes.
c. Possible.
d. Depends.
Answer is b.  Marketing campaigns can be effective tools of measuring successful implementation of customer relationship management system/module and sales and service can also be utilized to measure customer satisfaction.
9. Even after implementation of system/module it leads to failure, can you enlist any possible reasons of it.
a. Lack of commitment.
b. Poor communication.
c. No leadership role.
d. Deficient it skills among staff.
e. All of the above.
Answer is e.

10. Enlist the points considered before implementation of system.
a. A customer-oriented or customer-centric approach should be adopted by the dealership staff and management.
b. Areas in organization should be focussed on evaluating customer relationship management system/module products.
c. Integration of technology, process, and people.
d. All of the above.
Answer is d.
11. What are the ways of accessing system/module information?
a. Pc installed in dealership.
b. Maintaining backup information by staff.
c. Copy of customer relationship management system/module data should be made available in case of customer relationship management system/module is vendor hosted.
d. Agreement based access to the customer relationship management system/module information.
e. All of the above.
f. None of the above.
Answer is e.
12. Are there any training courses provided to the staff that could lead to successful implementations.

a. Yes.
b. No.
c. Not needed.
d. Could be considered.

Answer is yes.

13. Are there any particular points to be trained to the staff for better understanding?
a. No.
b. Yes.
c. Definitely.
d. Not required.
Answer is c.  Training is integral part of customer relationship management system/module for its effective implementation.

14. How much time does it take to get benefits of system?

a. Days.
b. Months.
c. Years.
d. Decades.
e. Estimation is difficult.
Answer is e. Difficult to estimate as customer relationship management system/module is an ongoing process and success comes eventually or cannot be expected as soon as implementation of customer relationship management system/module because effective implementation can only result in success of organization..
15. Whose responsibility is it to monitor system/module in an organization?
a. Head.
b. Ceo.
c. Managers.
d. Juniors.
e. All.
Answer is e all as customer relationship management system/module works at different levels but the basic access to information differs at each level.  It involves coordination of marketing professionals and sales representatives.

16. What is the qualification of a person who can handle?
a. Not a criterion.
b. Important criteria.
c. Depends.

Answer is c depends.  Qualification can be negligible but concept of customer relationship management system/module should be well understood and should be efficient in implementing customer relationship management.  In outlook customer relationship management system/module there are special consultants recruited for the purpose of better understanding of customer relationship management system/module who manages sales quickly and effectively.

17. Can you explain system/module in lay man terms?

a. Yes.
b. No.
Answer is yes.
Customer relationship management system/module is basically a customer relationship management which the name itself suggest works towards enhancing customer relations towards a particular organization where it involves tracking of customer needs and preferences, segregation valuable customers from not so valuable and re-pricing and configuring products and services according to their needs.

18. Why should i implement system/module or consider implementing?
a. For better tracking of customer preferences.
b. Improved market reputation and response.
c. Reduce sales cycles.
d. Gain more valuable customers.
e. All of the above.
    Answer is e.
19. Should I suggest system/module to other organization? if so how ? Would that benefit me?
a. Yes.
b. No.
c. May be.
d. Should.
Answer is d.  You should definitely suggest customer relationship management system/module to other organization you know.  This may not particular benefit your organization but customer relationship management is a concept which functions through customer relations.  Success in customer relationship management system/module is interdependent and varying.
20. Are managing contacts important criteria?

a. Yes.
b. No.
c. Not necessary.
d. Can be ignored.
Answer is a.
Managing contacts is an important way for customer reference criteria, maintaining a list of valuable customers and non valuable customers, and re-configuring goods and services for the purpose of non valuable customers.  Most casual way preferred nowadays is excel sheet which should be avoided and a more organized method should be adopted.
21. Can customer relationship management system/module be categorized?
a. Yes.
b. No.
c. Not possible.
Customer relationship management system/module can be categorized into outsourced solutions, off-the-shelf solutions, custom software, managed solutions,
If customer relationship management system/module needs to be implemented quickly in a company that lacks in-house skills necessary to tackle the job then application service providers can provide web-based customer relationship management system/module solutions for your business. It is particularly useful if your company is already into online e-commerce.
Integration of customer relationship management system/module with existing software packages are offered by several companies while cut-down versions of such software may be apt for smaller businesses. It is the cheapest option as investment is mostly into standard software components.  Consultants and software engineers may customize and create customer relationship management system/module for tailored customer relationship management system/module solutions.
This approach is particularly costly depending on software designer quotes.

22. Are there any key components adopted by your system/module ?
a. Yes.
b. No.
c. Very few.
d. Not many
Answer is a.
Management of contacts, territory, content, and opportunities, collaboration of sales through webinars, email campaigns, and through social customer relationship management system/module like facebook, twitter, and linkedin. Using telesales.

23. Are you aware of the system/modules available currently?
a. Yes.
b. No.
c. Not sure.
d. Unaware.
Answer is a.
There are many which are available in the market currently like salesforce.com, Microsoft dynamics Microsoft business contact manager, maximize, sage customer relationship management, saleslogix, goldmine, siebel, pivotal, act!, sugar customer relationship management, oracle, and sap

24. Are there any specific advices to be followed for one who is introducing system/module into his organization?
a. Yes.
b. No.
c. Not needed.
d. Can’t say.
Answer is a
First and foremost thing is considering and analyzing future needs of your organization, secondary thing is clearing up data, and third is to communicate throughout the process and get early buy-in. Ensure staff is effectively it trained to implement customer relationship management system/module and factors like lack of commitment, weak leadership, and poor communication within the organization should be addressed and rectified which can lead to failure of implementation of customer relationship management.

25. Is consolidation an important aspect ?
a. Yes.
b. No.
c. Can’t say.
d. Not sure.
Answer is yes.
Customer enquiries should be responded quickly being aware of their prior needs and preferences. There should be effective use of voice and digital email system, in-person meetings, and other touch points. Personalized interaction is enabled by effective management of services which in turn increases customer loyalty.



26. What are the vendors particular that a client should be aware of?
a. Experience.
b. Demographics of vendor.
c. Firmographics.
d. Both a and c .
e. All of the above.
Answer is d.
Enough experience in the particular field with customer relationship management system/module products, and effective training and support is provided to everyone using the system