What D&D Character Are You?

I Am A: Lawful Neutral Elf Ranger Druid


Alignment:
Lawful Neutral characters believe in the triumph of law and order above all else. It does not matter whether the leader is for good or evil; the leader will be followed, because the order they provide is the most important thing.


Race:
Elves are the eldest of all races, although they are generally a bit smaller than humans. They are generally well-cultured, artistic, easy-going, and because of their long lives, unconcerned with day-to-day activities that other races frequently concern themselves with. Elves are, effectively, immortal, although they can be killed. After a thousand years or so, they simply pass on to the next plane of existance.


Primary Class:
Rangers are the defenders of nature and the elements. They are in tune with the Earth, and work to keep it safe and healthy.


Secondary Class:
Druids are a special variety of Cleric who serves the Earth, and can call upon the power in the earth to accomplish their goals. They tend to be somewhat fanatical about defending natural settings.


Deity:
Silvanus is the True Neutral god of nature. He is also known as the Patron of Druids. His followers believe in the perfect balance of nature, and believe that nature's bounty is preferable to any other 'civilizing' method. They wear leather or metallic scale mail, constructed of leaf-shaped scales. Silvanus's symbol is an oak leaf.


Find out What D&D Character Are You?, courtesy ofNeppyMan (e-mail)

Speaking of the Hawks...

This article raises the question of a WR cut, either of Engram or Robinson, to free up cap space for another experienced linebacker. Peter Bouleware would certainly be a great addition, and the personal ties are there. We need real linebacker help, immediately.

The drawback of losing Robinson is his potential, which has so far been wasted. He still has the speed, he's still young, and he's been physically healthy. If he can get beyond his personal problems, start catching passes and show up on time to team meetings, he could be amazing. He has a contract year coming up; maybe that will motivate him into the next level. After all the time and energy Holmgren has invested, one hopes the payoff is coming this year. In my heart of hearts I think it's time to stop throwing good money after bad and let him loose. Maybe he'll take the dropped passes with him.

Bobby Engram, in contrast, is what he is. He's a stable slot receiver. He'll never be great, but he's good, dependable, and a great guy for a team's third slot on the chart.

All this instability at linebacker and wide receiver is making me nervous. Again I'm a little annoyed that they drafted a center (Chris Spenser) with their first round pick.

My Birthday

I had a birthday today, and it's been a good one. I tricked people into coming to brunch by telling them it was a Memorial Day Brunch. Heh. Actually I did mention it to most of them. It was really just an excuse to invite people over. We have a good house for entertaining, and we were due.

The coolest girlfriend in the world got me season tickets to the Seahawks. Whoopee!

Somalia warlords clash in Baidoa

Rival Somali warlords have clashed in Baidoa, killing at least 15 people over plans to relocate the government - now based in Kenya - to the city.

Game maker Ubisoft fights back

I hope Ubisoft can hang on. I think the competition between these game designers is a good thing, and Ubisoft makes good stuff.

Live Journal

Live Journal irritates me because I have to log in every time I want to read entries from my friends list. As a result, I read those less often. I've never felt comfortable with the LJ interface. I always feel like I'm fumbling through menus, trying to find what I want.

I'm very fickle that way. A little annoyance keeps me away unless some other force compels me to trudge on.

blog as second memory

Just this week I used my blog to track and confirm a correction in a sports article about Trent Dilfer. The article mentioned that he'd been acquired by the Browns 'via free agency,' when in fact he'd been traded for a 4th round pick.

While I would love to have a deeper, more regular readership, writing this blog for others won't keep me going. What keeps it going is writing and documenting what interests me. Happily, I'm finding this useful in the real world, in real time.

I've also looked back to remind me of Xbox game titles. I only wish the contents system and search engine was more useful and accurate.

Cormac McCarthy!

Has a new novel coming out on July 19th!

Star Wars Quiz

Dolphins: Williams contacts NFL about reinstatement

I don't care about the Dolphins, and I don't really care about Ricky Williams, but this story is too good to miss. I'm sure he needs the cash. If he's smart he'll come back for a year or two, stay clean, save his money, then retire forever. In the mean time, he needs to avoid knocking up any more girlfriends, otherwise he'll never have the cash to retire.

Unlike Garcia, Dilfer bonds with Browns

Jamal Lewis coping well during prison term

Lewis is doing exactly the right thing. He's making the most of having nothing but time; he's preparing for his time back in the world.

I'm sure it's easier to keep your head on straight when you have an NFL career waiting for you upon release. His situation is very different from other men in his situation. Men doing time for drug charges who have nothing to return to except for poverty.

Strategies for Better Patient Flow and Cycle Time

SUGGESTED READING
Mastering Patient Flow to Increase Efficiency and Earnings. Woodcock EW. Englewood, Colo: Medical Group Management Association; 2000.
Lean Thinking: Banish Waste and Create Wealth in Your Corporation. Womack JP, Jones DT. New York, NY: Simon and Schuster; 1996.
The Machine That Changed the World: The Story of Lean Production. Womack JP, Jones DT, Roos D. New York, NY: Harper Perennial; 1991.
The Goal: A Process of Ongoing Improvement. Goldratt EM, Cox J. Great Barrington, Mass: North River Press; 1985.

Narcotics Activity

I've been witnessing probably narcotics activity in my neighborhood. I left a message on the Narcotics department line today.

I plan on keeping an eye on license numbers and descriptions of individuals.

I've already witnessed my neighbor handing cash to someone out in front of a nearby minimart.

I've had enough, and I'm getting involved. Don't worry, I plan on being discreet. I don't mind making my presence known, but only if there's some gain (testifying at a trial, for example). Until then, I'd rather they didn't know I existed, or at least not that I see what they're up to.

Summary of work projects

Since our JCAHO inspection, I've been trying to build a team to help me sort out our closet of medical supplies. Over a year ago, two clinic areas were merged, and all of their supply carts were jammed together. As a result, there have been large redundancies, askew par levels, and other inefficiences.

Since I have no formal medical training, and don't personally use any of the supplies, I wanted direct nursing input on the ideal layout of the supply carts. I spent a good deal time and effort managing schedules, soliciting help, and generally trying to put this together. In the end, one nurse pledged two hours and a second said she'd stop by and at least help with her insight.

On the day when it was finally to come together (Wednesday), something came up at home, so I had to do some scurrying around and had to leave the plumber (I had reason to believe she was trustworthy, but still, it's discomforting to leave a stranger alone in one's home) alone in our house in order to get to work for kick-off. I didn't want to leave the nurses waiting, and after all this time, I couldn't just reschedule.

I was then stood up and wound up 'pulling a Kendra' and doing it all essentially by myself. If I'd known it was going to work out that way, I could have done it six weeks ago. Times like these, I have great sympathy for George W's approach to the Iraqi invasion. Consensus building does not work (I joke! Mostly.)

There are a few things I need to remember to do soon. I'll need the updated list to do it right.

More table paper
move those top shelf syringes over with the other syringes
adjust otoscope specula pars - no way do we need that many of all those sizes
follow up on the derm biopsy kits
follow up on the blue cover thing for derm
add small masks
write an alphabetical catalog

I also want to get rid of another cart. We have a few empty drawers, and a few high pars; I believe we can merge the smaller cart into the others. Alternately, I could switch out a large cart for a smaller one.

Belief in sex-mad demon tests nerves

The story behind new Xbox design

Mogadishu warlords merge militias

Feedback

I gotta read that Managing Change book. Here's some feedback from yesterday's trial. I don't accept that shifting one room would have been a huge problem. In this case it would have increased the walking some, but not much. In fact, the other available rooms were closer to the waiting and patient arrival area.

Everybody thinks they're special.

While I think it could work for most clinics it will not work for general surgery when we have 4-5 surgeons in clinic.
It is to difficult for us to have to track down the rooms when we are trying to get between 25-30 pts seen in the first hour. While the attending is seeing one pt the resident will be seeing the other pt in the other room so that the flow runs smoothly and we get pts seen. Yesterday someone did use one of the rooms and it was okay because we had another room to use seen as how Surgeon X was out, but had he
been in clinic this would have been a huge problem.
PCC
X

Core and flex rooms

Assign # of rooms per zone instead of specific rooms, especially for afternoon.

Allow clinics to opt out?

What does success look like?

Separate bins for each zone

Color-coded cards (flags are coming)

Supply Survey

A few days ago I used surveymonkey.com to create and distribute a survey among nurses about what supplies they use on a regular basis.

Since I used the free version I couldn't use the web site to do much crunching. I invited 30 people to take the survey, 9 responded. I suppose that from a market research perspective, that's a good percentage, but I was hoping for more. We have a total of 15 different clinics who use this space, so I got less than one response per service.

Any item used 'frequently' by any respondent will continue to be stocked in exam rooms.

'Sometimes' is defined as 1-3 times per week. That's pretty often, so I'm inclined to stock those items in exam rooms as well. At a minimum they need to be readily available. I also need to factor in how many (or what percentage) use them that often.

The surveymonkey report generates a number per item. As I set it up, the lower the number, the more frequently the item is used.

I should probably send the survey to physicians as well.

Ghost Recon: Island whatever

Good game. Only 8 missions (as advertised), the difficulty between missions varies wildly, and I found the final mission a bit anticlimactic. Maybe it seemed easy because I'm that damned good. Probably not considering how much trouble the first mission and a couple of the others gave me.

Now I need to decide what to play next: Full Spectrum Warrior (which sells for cheap nowdays), the Lord of the Rings RPG I've already purchased, that strategy game I listed before that I'd probably have to order, or something else entirely.

Exerpts from XBox 360 article

Xbox 360 looks nothing like its bulky, black predecessor. It's sleek and white, and it can stand on one end like a book or lie flat like a DVD player. Its 20-gigabyte hard drive and three powerful processors will enable high-definition graphics and surround sound, making games seem more like movies.

Microsoft says Xbox 360 will arrive in North American stores around Thanksgiving and in Europe and Japan by year's end. Analysts said several months of lead time could help the new Xbox close in on the market-leading PlayStation, but they're waiting to see what Sony rolls out before making any bold predictions.

Microsoft has said gamers can expect 200 new Xbox titles by the end of the year, but hasn't said how many will be designed for Xbox 360 and whether the new machine will play games designed for the old model.

Many Xbox 360 features are designed for non-gamers: watching movies, playing music, viewing slide shows or holding video chats. It has three USB ports to connect digital cameras, music players and other devices.

While current Xbox owners need to buy an attachment to play DVDs, Xbox 360 supports DVD playback out of the box.

And the specs directly from Microsoft: http://www.xbox.com/en-US/xbox360/factsheet.htm and http://www.xbox.com/en-us/xbox360/peripheralsfactsheet.htm

106Miles Blog

106Miles Blog

Flex Rooms, 1.1

I ordered color flags so the room cards can be actually color coded. This will make it easier to find a room close to one's conference room. I have a zone system in place, but I only have a black and white printer. Writing the word 'red' on a card isn't really that helpful.

I'm up to my 11th rule. I'm afraid it's getting a little wordy. They'll need to be revised soon anyway. They were written quickly with little or no organization.

We'll take tomorrow off, and probably Monday. We'll likely try again next Tuesday and maybe Friday. I want to try all the days once before trying any one day a second time.

I've received more positive feedback from floats. They love it. The good vets are dealing with it, mostly with mixed reviews. The stingy ones don't like it at all, but they hate all change, so I'm not too worried about their opinions.

Post Experiment Debrief

The day is winding down, no one quit, no one was fired, there were no tears (that I saw), and no one took a swing, so all things considered I feel good about our experiment.

A lot of people like the system quite a bit; the positive feedback came primarily from the floats, who are accustomed to a little chaos, don't feel at home and are happy to have a system to help them.

Some problems: One clinic wound up with the same number of rooms, but spread out. Physicians and PCC's had to walk twice as far as they normally do. In this space, PCC's already walk too much, so this is significant.

There was no plan for the transition between morning clinics and afternoon. It worked because it had to, and because I was there to nudge things along. I need to come up with something better.

There were gaps in education. Some folks didn't quite get the cards, others didn't know where some of the rooms were. I'm not too concerned about this, but it does illustrate how I need to adjust my instructions.

I don't know if it's an actual problem, or just perceived: there was lots of chaos during peak hours. That is to be expected, but I was hoping to reduce peak hour chaos. I don't know if that happened.

One person is thinking like a hobbit. She has a good situation and she wants to keep it that way. She doesn't realize that people are dying (not literally) around the corner. Or if she does realize it, she feels bad, but doesn't feel compelled to get involved. She doesn't understand that their problem is our problem.

We're trying at least one more day. After tomorrow I'll take a break and see what we can improve.

I don't know if we reduced the low level muda, which is the whole goal. It probably would have been a good idea to come up with some metrics for this experiment. I wonder if there's a way to get the results of the family experience survey from today's appointments. After all, that is the whole point.

Transition

We're trying my experiment today.

I forgot to plan for a transition between morning and afternoon clinics.

The transition should happen pretty much right now.

It's not a problem with cards that stay in the same places. When a clinic keeps a room, or a flex room that stays flex, that's all okay.

The handoffs are imperfect.

Somali warlords 'to merge forces'

The most powerful warlords in Somalia's capital, Mogadishu, have agreed to set up a united force, which they say will restore security to the lawless city.

However, our correspondent says that, for the moment, the gunmen are likely to remain loyal to the warlords, rather than President Abdullahi Yusuf, who has little support in Mogadishu.

It's ON

We're trying my idea tomorrow. I spoke with all the affected PCC's and they're all willing to give it a try. Naturally some are more excited than others. It's a medium to light day over all, so it's perfect to try a new system.

I laminated cards, I wrote up rules, it's a little like what I imagine game design to be like.

Luckily, my boss is away and has given us carte blanc to fix the room availability situation. Otherwise it might take weeks to trial something.

Another idea

I had another idea to help solve my exam room challenge.

I could assign every service with a group of core rooms on a daily basis, and make another group of rooms 'flex' exam rooms. When a service has used all of their normal rooms, they can use a flex room if they have a patient. Flex rooms can only be used when all of the non flex rooms are already in use.

This would take little or no maintenance, unlike my two other plans. A self sustaining system could be set up easily enough. This could also be combined with my daily assignment system. In a sense, it's a hybrid of my other two ideas.

I could start by assigning every service with one room per scheduled provider. That includes social workers, nutritionists and nurses. All other rooms are flex. Tickets for flex rooms can be kept at the front desk and need to be returned when those rooms are no longer in use.

There is some vulnerability to gamesmanship since the power to claim rooms is decentralized during the day. PCC's might 'forget' to return flex room tickets, PCC's may room families immediately rather than letting them linger in the waiting area (this is not necessarily bad, considering our waiting room situation.)

This system reminds me of the JLA and Avengers structures through the years: a small core who access reservists depending on the situation. Heck, it's similar to the military's structure, not to mention police and fire departments across the country. The biggest difference, of course is that in my case, it's a resource and in the others it's personnel.

The best thing about this, is that we could start immediately. I don't need a Pathways report or electronic white board to make it work. It also doesn't require adding a substantial responsibility to any one job, and isn't dependant on any one person to make it work (once it gets rolling).

Most doctors can't track information on patient care

Vicious gangs spark bitter debate

Gang members who claim affiliation with MS-13 have been connected to crimes in the Seattle and King County area, said Gabriel Morales, a consultant on gangs to several local law enforcement agencies.

The group first began appearing in some South Seattle neighborhoods about five years ago, with graffiti appearing everywhere from South Park to neighborhoods in North Seattle.

But gang crimes in general are not the problem in Seattle and King County that they are in other metropolitan areas, police officials said.

The King County Sheriff's Office reported 194 gang-related incidents last year, down from 392 incidents the year before. Sgt. John Urquhart said the category is broad and includes crimes as minor as tagging to more serious crimes, including murders. The department eliminated its gang unit several years ago, he said.

Exam Room Assignments Back Up Plan

If the Patient Traffic Control scheme doesn't fly, I'm also preparing a system wherein rooms are assigned daily. I've learned a lot about what reports are available and I can manipulate them quickly to get pretty good data without much effort. I can export a report from the scheduling system, then delete the fluff, crunch the numbers in a simple way, and work out ratios of allocation.

To really make it work though, I need reports that tell me how many visits are schedule in the am and in the pm. I haven't heard back from the report writing folks.

The Pinochio Theory

Steven Shaviro has a great, smart blog. Most recently he's started his Buffy the Vampire Slayer analysis. It's good reading for fans of post modernism and/or Buffy.

I took two classes with him at the University of Washington several years ago. One was a intro to film studies course, the other was on Critical Theory. I've also seen him in my comics shop. He has since moved to another city.

I wanna be the Human Torch

Last month I took and posted a "Which Marvel Hero are You" quiz. Apparently I'm the Human Torch from the Fantastic Four. I didn't think twice about it, until a few days ago.

The question to myself was, which comic book character's life would I really like to live? Spider-Man works too hard. He holds a day job, has family commitments, and spends all night fighting evil. Captain America has no fun and has no real powers. Tony Stark is a business tycoon and an alcoholic.

Reed Richards has a pretty good deal. He has plenty of time to pursue his interests, he is financially secure (quite wealthy in fact), his powers are fun he is popular and doesn't worry about a secret identity. He does, however, have a wicked arch nemesis in Dr. Doom. This is a legitimate concern, because Doom is formidable and dangerous. Reed always has to look over his shoulder, always has to improve, always has to beat Doom.

That's when I remembered the Human Torch. Johnny Storm has all the benefits of Reed Richards (wealth, no day job and no identity) without the drawbacks (no arch nemesis or guilt over turning Ben into the Thing), and with better powers.

I wanna be the Human Torch.

Army to Get Energy-Converting Sheeting

Everything I needed to learn I learned in the Army.

I often with that the hospital culture resembled military culture. In the Army, leaders listened to input when appropriate, stopped discusion when appropriate, made plans, gave orders, inspected the results, gave feedback and that was that.

Leaders can inspect soldiers, make sure standareds are being met, reprimand them when standards weren't met. In the military, you are expected to show up on time. Everyone is expected to be on time, from Generals to privates, for the most part, everyone is on time.

Soldiers are expected to suck it up when the going gets rough. Leaders are expected to take care of their soldiers.

Task, conditions, standards

Team members are expected to watch out for one another. Mandatory means mandatory.

Process improvement thoughts

This probably won't make sense to anyone but me:

Medium goal: Identify an ideal number of total Whale 7 Visits. Instead of comparing room assignments to actual visits, compare room assignments to ideal number of visits, especially while visits are below the ideal number.

Short goal: Get a Pathways report that shows total Visits, by service, for specific time ranges. Specifically 7am – 12:30pm & 12:30 pm - 4:30pm. Data outside these sets are irrelevant and skew the results.

Blast strikes Somali PM's rally

A blast has killed at least eight people and injured 30 at a rally in a football stadium in Somalia's capital being addressed by the prime minister.

The explosion went off as Ali Mohammed Ghedi began his speech. He later told the BBC that a security guard had accidentally set off a grenade.

Mr Ghedi, on his first Mogadishu visit since being appointed, is negotiating his government's return from exile.

Somalia has had no functioning central authority since 1991.

Mogadishu is considered to be an especially dangerous location for the government to be based in.

'Not deterred'

The BBC's Mohammed Olad Hassan in Mogadishu says that several thousand Somalis, who had gone to welcome the prime minister, waving flags and chanting pro-government slogans, fled from the stadium in panic.

Revelation! 666 is not the number of the beast (it's a devilish 616)

Exile leader reappears with strange tale

Me vs Evangelists

Today I found Ordering your Private World in one of my exam rooms. On the surface it looks like a normal everyday self help book. However, the promo material on the back leads off with "The Scriptures, the experiences of the great saints..." That's a worrisome beginning. Then I noticed it is categorized as "Christian Living." Yep, the evangelists have struck again and slipped propaganda into the hospital.

I wonder how long this book has been in there? I need to do more frequent exam room walk throughs.

Ebay virginity

I've listed an item for auction on ebay for the first time. I've made plenty of purchases, but never sold anything.

I hope I make money.

http://cgi.ebay.com/ws/eBayISAPI.dll?ViewItem&category=62053&item=8189386443&rd=1&ssPageName=WDVW