Online Technologies: Opportunities for Charities

Online Technologies: Opportunities for Charities Information Technology and developments in non profit organisations:  How online technologies offer new opportunities for growth to the charity organisations Table of Contents (Jump to) Chapter 1 Introduction 1.1 Introduction 1.2 Aims and Objectives 1.3 Overview Chapter 2 Literature Review 2.1 Introduction 2.2 Charities Chapter 1 Introduction 1.1 Introduction As Sergeant and Jay (2004, p.2) have commented, the concept of charity and their mission of raising funds to help the poor and needy has been around for centuries. However, both the numbers and complexities of charity organisations have multiplied significantly over recent decades. Sargeant and Tofallis (2000) confirmed reports from the NCVO that in the UK as of 1998, the number of NGO’s exceeded half a million, of which 40% could be designated as Charity based organisations., This group was then reported to have a collective estimated turnover of approaching  £20 billion. Both of these statistics will have grown dramatically over the past decade. The main mission of charities is to deliver practical and constructive assistance to those in need; providing information on issues such as health problems and disability or promoting the message for fairer laws. These missions can be related to human activity, preservation of the natural world environment and its wildlife or seeking justice for those that are oppressed. However, currently charities have to face up to a number of obstacles in effectively performing the task for which they have been set up, most of which arise in two particular areas. Firstly, with the increasing growth of needy causes, there is a rise in the number of charitable organisations emerging to address these issues, increasing the competition for funds proportionately. Secondly, there is little doubt from the level of research that has been undertaken, that the charity giver is becoming increasingly discerning about the impact of their donations. This concerns centres around the desire to ensure that the gi ft has the maximum impact. Therefore, it is important to the donor that the minimum amount of that gift is used for the charity’s internal administrative purposes. Despite the fact that the â€Å"mission† of a charity has in the past often been deemed more important than â€Å"economic intentions† (Hussey and Perrin 2003, p.200), the current climate within this sector is requiring them to become more efficient if they wish to sustain the objectives of their cause. This means that thy have to look for ways in which they can improve the effectiveness and the efficiency of their operations. In this regard, although somewhat belatedly when compared with the move by commercial corporations, the charity sector is increasingly studying the benefits of using information technology processes as a means of achieving the efficiencies that are required. However, as Hackler and Saxton (2007), although some charities are incorporating information within their organisations, the extent, areas of the business covered and effectiveness of these developments has not yet been perfected in a significant number of cases. In fact, in some it is considered that with some charities it can be reducing efficiency. Indeed the research conducted by Sargeant and Tofallis (2000) concluded that â€Å"the performance of many charities would appear to fall well short of the efficient frontier with no immediately obvious explanation forthcoming for why this might be so.† Indeed, they could also find no pattern to the causes of these failures either. It is the issue of information technology in particular its effective and efficient use in charity organisations that inspired this research project. Of specific interest is the intention to assess the impact that this technology has upon the duel targets of increasing financial efficiency and improving the delivery of the main services and missions of the charity. 1.2 Aims and Objectives As stated previously, the aim of this research is to identify the ways in which information technologies can be used to improve the efficiencies of charity operations. In this regard it is intended to focus the research upon the usage of IT in the online environment. Thus the research question or hypothesis that has been set for this study is as follows: â€Å"Online information technology processes can offer charities opportunities for growth and expansion in terms of the revenue and message and mission generating areas of their operations.† To assist with the achievement of this goal the research will use the following framework of objectives: Growth and maximisation of revenue It is intended to determine the extent to which a charity can make use of the IT opportunities available using the Internet to grow its revenue base and the methods by which this can be achieved. Cost reduction and efficiency Using the same premise as that included within the previous objective it is also the intention of this paper to address the issue of the appropriate IT methods that can be employed for increasing the efficiency of the charity organisation in terms of cost control and reduction where appropriate. Mission and programmes Bearing in mind the unique purpose of the charity format, which is that it has a mission to serve a specific cause, the research will also be ensure that, in addition to the financial objectives outlined above, the information processes examined are compatible with the enhancing of the message that charities need to communicate. This will be applied to both the potential and recipient of their services. The research itself will use a mixture of data to address the research question. This will include reference to the extensive range of financial statements which are available from individual charity websites or the Charities Commission (2008) online resources, although only a sample of these reports will be utilised. To address the issues and concerns of the individual charities more directly, individual interviews will be conducted with a number of representatives from this sector. 1.3 Overview The management and presentation of the research paper has followed a logical format. Chapter two presents a review of existing literature that is available and that relates to the issues being addressed by the researcher. This includes publications and comments by academics, professional observers and other interested stakeholders. Following this critical review, in chapter three it is intended to concentrate upon the methodology that has been applied to this project. It will provide an overview of the available methods and the reasons for the method that has been adopted in this instance. Chapter four provides the in-depth results of the research findings, both that which has been gathered from primary and secondary resources and these will be analysed and discussed in more detail in chapter five. Finally, the research project will reach a conclusion in chapter six and, where considered feasible and appropriate, the researcher’s recommendations will be presented and explained . Included at the end of this study, although separated from the main body of the study, will be additional information. This will include a biography of the various resources that have been referred to or used to assist with the development of the project. In addition, in attached appendices, information that is considered of further value in understanding the issues raised and the examinations undertaken, including the transcripts of interviews, have also been included. Chapter 2 Literature Review 2.1  Introduction To assess the issues of the charity use of online information technology, it is important to perform a critical review the existing literature that is available relating to various elements. In this case that will include providing a brief understanding of the charity environment. In addition, it will include a review of the information technology processes and their advantages as well as the areas where charities have been found to have deficiencies either in the usage of these technologies or the extent to which they have availed themselves of the technology itself. The chapter has been sectioned in a manner that appropriately addresses these areas. 2.2  Charities As many academics have observed, in comparison with commercial organisations, the charity is a complex organisation, not least because of its structure and mode of operations (Wenham et al 2004, Hussey and Perrin 2003 and James 1983). There are even different to the other types of non-profit organisations referred to by Hackler and Saxton (2007), such as those that are often form for regulating the decisions and objectives of various parts of nation and international political policies. An example of these would be the various organisations that have been set up in the UK to deal with the reduction of carbon emissions such as The Carbon Trust. The differences attributable to the charity organisation can be observed in many areas of the operation. For a start one of the main intentions that is needed for the organisation to qualify as a charity is for it to have a non-profit making objective (Hurray and Perrin 2003). Secondly, its mission that in the corporate sense would be classed as strategic objective is directed to the service of the external stakeholder or user (Hussey and Perrin 2003). In other words, where the purpose of the commercial organisation is to achieve financial success that will enable it to return additional value to the shareholders and potential investor, the charity’s financial aim is to utilise its funds specifically for the benefit of those whose demands and needs it is intending to address. Often, because of the break-even requirement, the charity will take on projects that are of no immediate benefit, but will have the effect of helping them to subsidise other, more highly valued activities (James 1983, p.351). Another difference in organisational processes is that the charity revenues generating activities relies heavily upon the volunteer donor (Wenham et al 2004), therefore making it difficult to predict. In addition, this places constraints upon administrative expenditure in areas such as computers and other modern equipment (Sargeanr and Jay 2004). Furthermore, because of the purpose of the charity and the need to concentrate its expenditure upon projects that are determined within its mission statement, together with the fact that funds may be limited, many charities are heavily reliant upon the efforts of voluntary employees. Many of these employees might have limited knowledge of the operational processes that are required for an efficient organisation, which can be a disadvantage (Galaskiewicz et al 2006, p.338). This is especially true if there is a sizable organisation to manage. Irrespective of these differences, to remain true to its mission statement and stated aims, every charity still has to create a strategy that allows it to address three specific operational procedures. These are the maximisation of incoming funds, minimising administrative costs to ensure the recipients of its objectives, in terms of projects and services, receive the maximum benefit and effective marketing, which is designed to attract donors and service users (Wenham et al 2004). Therefore, it is important for the charity to be organised in terms of its mission, which means having the right strategies in place (Hussey and Perrin 2003, p.215 and 218) and assessing their appropriateness. As Hackler and Saxton (2007) acknowledge, it is in these areas that the use of information technology can be considered. All charities have to be registered with the Charities Commission (2008) irrespective of their size. An integral part if this registration is the need to provide regular financial statements which Holistic Nurse Prescribing: A Case Study Holistic Nurse Prescribing: A Case Study Introduction 1 the patient and their presenting symptoms. Mr Pickles presents an interesting, complex and therapeutically challenging problem. In essence he is a gentleman with multisystem pathology who presents with an almost incidental finding which he was clearly reluctant to discuss. It is a common finding amongst experienced healthcare professionals that in any consultation it is the last 30 seconds which is the most important. As the patient stands up to go, there is the just while Im here moment when they can bring up an issue that really troubles them and may not be the real presented reason for the consultation. In this essay we shall discuss the various aspects of this situation and the measures we can take to try to help him. (Parker and Lawton 2003) 2.a holistic assessment of the pt, including any relevant medical social and psychological issues. If we start with the initial presenting symptom under discussion the impotence it is easier to work backwards from that to discuss the possible pathophysiology that can be relevant. Impotence is said to occur whenever the male fails to get an erection when it is required. This, in itself is neither unusual nor necessarily pathological. It becomes a significant symptom when the male repeatedly fails to get an erection that is sufficient for intercourse. It is quite possible to get full spontaneous erections and yet still be impotent. This is one of the major diagnostic features that distinguishes the psychogenic impotence from the purely physical. (Ackerman MD, Carey MP. 1995) There are a number of obvious physical causes of erectile dysfunction that are relevant to Mr Pickles (see on), but equally there are a number of possible psychogenic causes that may be either primary factors or possibly secondary contributory factors in the aetiology of his problems. The fact that he has recently undergone major cardiac surgery is a very relevant factor. Patients will frequently suffer from a major change in body perception when they have come to a close realisation of their own mortality. If we add to this the fact that, as the major breadwinner in the family, it is likely that Mr Pickles would have felt a major blow to his self-esteem when he was made redundant from a responsible high esteem job and forced to become a taxi driver with long working hours. This is quite apart from the anxiety and fatigue that such a job would engender.(Beck J. 1995) It is possible that the medication that Mr Pickles is taking may have a bearing on his erectile dysfunction as the male erection is dependent on the hydrostatic pressure of the blood for its maintenance. Any medication that reduces the average blood pressure, will effectively reduce the capacity to acquire and maintain an erection. In addition to this the adrenergic beta-blocker group will also selectively block the sympathetic pathways that are vital to the neurovascular control of the mechanisms of erection. Pathophysiology of diabetes and impotence Both of these topics are huge subjects, so in this essay we will restrict out considerations to those aspects which are relevant to Mr Pickles and his problems. We know that Diabetes Mellitus affects about 2% of the UK population with a specifically higher incidence in both the Asian and Afro-Caribbean communities(Nathan 1998). There is also a marked genetic component in the development of Diabetes Mellitus. Mr Pickles has Type II diabetes mellitus which is associated with a number of factors including a high BMI and increasing age. At 56 yrs. old he is currently at the peak incidence age for Type II diabetes mellitus (Gregg et al. 2003). Diabetes Mellitus is known to be associated with a number of complications. The prevalence and incidence of the complications, in general, tends to increase with the length of time that the patient has been diabetic. There is also an independent variable for complications that is directly proportional to the degree of control (as measured by the HbA1 levels). In general terms, the better the control the lower the incidence of complications (Kissebah et al. 1999) As far as Mr Pickles is concerned, there are two major complications of Type II diabetes mellitus that are directly linked with impotence and they are cardio-(macro)vascular disease and neuropathy. (Wagner et al. 1998) We can deduce that Mr Pickles has macrovascular disease by virtue of the fact that he his recovering from a CABG. And this may well be a very relevant factor in his erectile dysfunction but also there is the question of neuropathy which typically occurs in about 2.4% of the general population, but this figure rises to above 8% in the diabetic patient over the age of 60 yrs. ( Hughes 2002) Impotence tends to occur, in varying degrees, in about 10-15% of men under 40 yrs. Its incidence increases with age to the extent that 40% of men at the age of 40 yrs report a degree of impotence and this prevalence rises to 70% at the age of 70 yrs. (Gregoire 1999). If we add to this basic clinical picture the fact that there are other factors such as hypertension, smoking, cardiac neurosis, loss of self-confidence, depression and iatrogenic causes (medication etc.) all of which may well be relevant to Mr Pickles, then it can be seen that there are a plethora of potential causes of his erectile dysfunction. (Barnes, DE. 2004) Both of the first two causes (hypertension and smoking) are independent risk factors for impotence, quite apart for the fact that they are also risk factors for the development of the macrovascular complications of Diabetes Mellitus (Bowering 2001) Mr Pickles diabetic state has been recently well controlled (HbA1 of 6.5%). This is important as the incidence of development of diabetic complications is reduced by between 34-76% (depending on the particular study) for every 10% reduction in the average HbA1 reading. (Bowering 2001). In addition to all of these considerations, atherosclerosis is also a major complication of Type II diabetes mellitus, which, presumably is relevant to Mr Pickles because of his CABG, and this may be a major factor in the development of his erectile dysfunction. Management plan 3.a plan/strategy based on critical understanding of physiological and pharmaceutical issues. Any management plan must firstly be based on an accurate diagnosis. At this point in time we do not have this luxury. As we have discussed, there are anyone of a huge number of possibilities in the aetiology of Mr Pickles erectile dysfunction problem. When confronted with a problem such as this, any experienced healthcare professional may reasonably chose to manage the problem by making a rational judgement of the probabilities of any one particular cause being relevant. Implicit in such a management strategy is the fact that there are some causes that my be correctable (iatrogenic, psychological, and life style related) and there are some that may not (macrovascular damage, neuropathy and atherosclerosis). It is reasonable, in such circumstances, to discuss the situation openly with Mr Pickles and discuss with him the various treatment options. Patient empowerment and education is a vital strategy to adopt in circumstances such as this as Mr Pickles is far more likely to comply and respond if he understands the rationale behind the treatment plan.(Howe and Anderson 2003) We would suggest that an appropriate strategy would be to initially tackle the situation on two fronts. The psychological aspects of the erectile dysfunction are probably best discussed with an experienced psychologist or councillor who has expertise in this particular area. This is important because there is a considerable skill in eliciting the relevant factors from the patient. Many patients are reticent about talking openly about their imitate sexual details and there has to be a careful build up of trust and empathy on both sides. Factors such as good eye contact and a non-judgemental body stance are essential on the part of the healthcare professional if the optimal result is to be obtained Not only can the issues that are relevant be explored, but also any one of a number of psychological treatment techniques can be employed. This is a matter of considerable clinical judgement and skill and therefore probably best done by an experienced healthcare professional in that area. The pharmaceutical area can also be addressed as Atenolol is clearly not the best anti hypertensive to use as, not only will it reduce the blood pressure (which it clearly is important to do) but it also produces a counter productive beta-blockade which will not help the erectile dysfunction problem. The difficulty is that, after the CABG, Atenolol does have a degree of action on the suppression of ectopic electrophysiological foci in the myocardium which is a recognised complication of the procedure. It also is thought to have a cardioprotective effect post-myocardial infarction. It is probably a good idea to change his anti-hypertensive medication, but in the circumstances, it is probably better to seek the advice of the surgical team who performed the CABG. before making the transition. The question of Viagra has been raised by Mr Pickles. This is not as straight forward as it might initially appear. Viagra has been shown to work well in these circumstances. It has the downside that it allows sexual intercourse which is associated with increased peaks of blood pressure. As Mr Pickles is still in the postoperative recovery phase (16 weeks) it would again be sensible to consult with the surgical team as to their advice on the issue. The other problem with Viagra is that if it transpires that the long term aetiology is actually psychological rather than purely physical, then the prescription of Viagra will often breed a feeling of psychological dependence which may firstly be both inappropriate and unnecessary and secondly, very hard to break. It is probably therefore inappropriate to consider such options at this stage in the management. 4.legal and professional accountability should be discussed. The legal and professional issues are largely covered in the making of a management plan. In any area of professional competence, the best defence against criticism or censure, is the fact that a healthcare professional works from a rational evidence-based plan. It is for this reason that we have set out the rational and reasoning for the plan that we have chosen to adopt. It is actually quite permissible (legally) for a healthcare professional to be wrong on any given issue, as long as they have come to a reasoned and rational decision based on the facts that were placed before them. And behaved in a way that the majority of their professional colleagues believe is reasonable in the circumstances. It is, of course, central to these considerations, that all actions are carefully and fully recorded in the patients notes Prescribing decisions 5.a critical discussion of influences on prescribing decisions. The area of prescribing for Mr Pickles is clearly important. To some extent, we have covered the reasoning behind the change of prescription earlier in this essay. There is a common misconception amongst many members of the public (and indeed many of the less experienced healthcare professionals) that the solution to every problem comes in the form of tablets on a prescription. The whole area of patient empowerment and education is often filled with issues of lifestyle change, healthy living, self care and positive thinking which can frequently be more effective that simply giving the patient a prescription. (Boule NG et al. 2001) In the context of the NHS, it is a common observation that sometimes a prescription is given because it is the most expedient short-term measure in a given situation, (Dawes RM et al. 1974), however, time invested in an explanation to a patient as to why other measures might be equally as important is rarely time wasted., (Corrigan B. 1974) Future management 6.consider your future prescribing activity based on experience gained from this case study. In any professional area of activity, the author likes to use the mechanism of reflective practice to allow a critical assessment of a past course of action to modify future actions when faced with a similar situation. (Gibbs, G 1988) On careful reflection of this case, I believe that I may have acted rather rashly in stopping the Atenolol as a first choice. On reflection, I believe that the Atenolol did need to be changed for any one of a number of other anti-hypertensive agents but I feel that, in retrospect, I would have been wiser to take advice from the surgical team before I made that decision. Further reflection and discussion with other healthcare professionals (Marks-Moran Rose 1996), suggested that another appropriate course of action would have been to stop the antihypertensive medication altogether for a short period. This is on the grounds that his hypertension was not severe and was hitherto well controlled. If the erectile dysfunction was simply a reflection of the fact that the medication was holding his blood pressure down to a level where erection could not easily occur, a few days off the medication may allow a transient increase in his blood pressure to the point that erection could occur. As long as one was careful to monitor his blood pressure to ensure that it did not rise too far, I have been advised that this would represent a reasonable therapeutic trial to establish whether the underlying causes were mainly physical or physiological.(Wagner G et al 1998). On the face of it, this does seem reasonable but I believe that I would have to take further advice before I was fully comfortable with that decision. It follows from what has already been discussed, that I also feel that I may have been too quick to consider the pharmacological interventions before making a complete holistic assessment of the patient. There are clearly a number of lifestyle adjustments that may be relevant here such as weight loss and increasing exercise and looking for a new focus in life (to minimise any element of depression) which would be comparatively easy to achieve with appropriate empowerment and education of the patient. (Funnell R et al 2004) All in all, this is not a straight forward case. There are many elements which require careful and considered assessment. I believe that it is one of those cases that helps to point out that although there is a huge emphasis to be placed on modern scientific understanding and application of medical principles, there is also a very large element of human understanding and caring that is so very important to the successful management of patients such as Mr Pickles (Waterlow J. 1998) References Ackerman MD, Carey MP. 1995 Psychologys role in the assessment of erectile dysfunction: historical precedents, current knowledge and methods. 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