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922-111 exam Dumps Source : Communication Server 1000 to Rls. 6.0 Upgrades for Technicians

Test Code : 922-111
Test denomination : Communication Server 1000 to Rls. 6.0 Upgrades for Technicians
Vendor denomination : Nortel
: 27 true Questions

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Nortel Communication Server 1000 to

Microsoft-Nortel observe Unified Communications positive aspects | killexams.com true Questions and Pass4sure dumps

news

Microsoft-Nortel observe Unified Communications suited points
  • via Kurt Mackie
  • 07/18/2007
  • A one-year-ancient partnership between Microsoft and Nortel on unified communications know-how, universal as the ingenious Communications Alliance , is bearing fruit. both organizations introduced this week that they've sold more than 430,000 joint-solutions licenses to this point.

    The Alliance lately won three fresh shoppers as well, including Indiana institution, U.ok.-based mostly Worcestershire health assistance and Communications technology services, and an IT and telephony issuer known as 4ward.

    Microsoft and Nortel formed the imaginative Communications Alliance in July of last year with the purpose of delivering unified communications options to companies. below the Alliance, the companies initiated joint analysis and building efforts. They additionally created consumer demonstration centers and engaged in joint earnings and advertising and marketing.

    in the Alliance's preliminary press unencumber, Jeff Raikes, Microsoft's enterprise Division president, stated that the joint unified communications solution would allow a "single identification across electronic mail, voice mail, voice over internet protocol (VoIP) convene processing, quick messaging and video."

    The Alliance's essential product is referred to as Nortel Converged office, a unified communications gadget that integrates Nortel's VoIP telephony outfit with Microsoft's server technology.

    The main accessories of Converged office include:

  • Microsoft office Communicator 2005 soft customer
  • Microsoft office reside Communications Server 2005, and
  • Nortel verbal exchange Server 1000 release 4.5 or bigger IP PBX.
  • there's also a Nortel utility middle component that supports not obligatory capabilities, including internet integration, interactive voice response and profile contact with core services.

    Unified communications gets defined in a variety of ways, however in response to the IEEE, it usually encompasses "unified messaging, collaboration and interplay programs." These programs also usually allow real-time and nearby real-time communications. moreover, combined media (voice, email, fax, and many others.) can also subsist accessed from a sole application, independent of the entry machine.

    competitors within the unified communications space is thick with massive names. In March of this year, IBM and Cisco, announced a collaborative effort on unified messaging client expertise referred to as Unified Communications and Collaboration (UC2). UC2 is based on open technologies, akin to Eclipse evolution atmosphere and the Open capabilities Gateway Initiative framework. Citrix methods and Nokia, amongst others, subsist pleased expressed support for the UC2 platform.

    below the IBM-Cisco unified communications partnership, Cisco plans to sell IBM's Lotus Sametime collaboration respond and IBM plans to promote Cisco's Unified Communications supervisor, Cisco cohesion and Cisco Unified MeetingPlace products. The whole unified communications respond is designed and delivered by artery of IBM global know-how functions.

    about the author

    Kurt Mackie is senior intelligence producer for the 1105 enterprise Computing community.


    Nortel and Microsoft CEOs define Transformation of business Communications | killexams.com true Questions and Pass4sure dumps

    big apple — Jan. 17, 2007 — today, Microsoft Corp. CEO Steve Ballmer and Nortel* CEO and President Mike Zafirovski introduced a joint highway map to deliver their shared vision for unified communications. The street map is the outcome of an alliance between Microsoft and Nortel announced in July 2006, and comprises three fresh joint options to dramatically help company communications by using breaking down the barriers between voice, email, speedy messaging, multimedia conferencing and different types of communication.

    speakme at an event at Studio 8H in Rockefeller core to more than one hundred consumers together with newshounds and analysts, Ballmer and Zafirovski outlined how corporations can help worker productivity and effectiveness and reduce the fees and complexity of communications. They additionally introduced 11 fresh implementation functions from Nortel and the outlet of more than 20 joint demonstration centers where purchasers can adventure the technology firsthand.

    in exactly six months for the judgement that the alliance become formed, both organizations subsist pleased signed agreements with dozens of customers, and subsist pleased developed a pipeline of hundreds of possibilities who are looking to recognize the benefits of unified communications.

    “we are executing forcefully on the imaginative and prescient of this alliance and subsist pleased made significant progress,” Zafirovski said. “We accomplished the planning levels and at the instant are providing unified communications solutions to groups worldwide. Their intention is to nearby the gap between the contraptions they exercise to discourse and the company applications they exercise to Run their groups, giving employees the vigour to profile exercise of advice extra straight away and simply.”

    “The classic worker gets more than 50 messages each day1 on as much as seven distinct instruments or applications,” Ballmer delivered. “software can and may support address the continued problem of managing communications and this challenge is the riding concept in the back of their alliance with Nortel. collectively, they will evolve VoIP and unified communications to integrate each and every the ways they contact each and every other in an smooth atmosphere, using a sole identity throughout telephones, PCs and different gadgets.”

    New options to help Communications and Collaboration

    Microsoft and Nortel shaped the creative Communications Alliance to befriend groups transform enterprise communications by rushing up the transition to voice over cyber web protocol (VOIP) and unified communications. providing on the vision they outlined in July, Microsoft and Nortel today added three fresh options:

  • UC integrated branch. This fresh product from the alliance will hold Nortel and Microsoft® know-how on a sole piece of hardware that grants reasonably-priced, terrific and simple-to-installation VoIP and unified communications in far flung offices. The UC integrated branch is planned to subsist available within the fourth quarter of 2007.

  • Unified Messaging. To simplify customer deployments, aboriginal session initiation protocol (SIP) interoperability between the Nortel communique Server one thousand and Microsoft trade Server 2007 Unified Messaging is planned to subsist available within the 2d quarter of 2007. The solution contains Nortel knowledgeable functions for design, deployment and guide.

  • Conferencing. This fresh solution will prolong the affluent characteristic set of Nortel Multimedia Conferencing to Microsoft workplace Communicator 2007, delivering a single, common customer adventure consistent across applications equivalent to voice, immediate messaging, presence, and audio- and videoconferencing. The on-premise respond is planned to subsist obtainable in the fourth quarter of 2007.

  • In 2007, the businesses additionally system to prolong their existing unified communications solution — a unified desktop and exquisite phone for VoIP, e mail, speedy messaging and presence — to the Nortel verbal exchange Server 2100, a carrier-grade commercial enterprise telephony product aiding up to 200,000 users on a sole system.

    in addition, Nortel and Microsoft introduced a highway map for 2008 and past for affecting company communications onto a software platform designed to power a better-excellent person journey and reduce total permeate of possession. The road map outlines a few key applications and expertise developments including a unified communications contact middle, Nortel function server, expanded hosted UC solutions, mobility and client options, and utility-mindful networking enhancements.

    “imaginitive communications and collaboration applied sciences are essential to thoroughly enabling Royal Dutch Shell’s international travail drive, and key to working at properly quartile in their business. They accept as righteous with in and befriend the vision Nortel and Microsoft subsist pleased outlined,” spoke of Johan Krebbers, community IT architect at Royal Dutch Shell, who joined Ballmer and Zafirovski onstage for these days’s event. “Over the next a number of years, they system emigrate their network to a utility-based mostly communications device built on applied sciences represented through the Nortel and Microsoft alliance.”

    Experiencing VoIP and Unified Communications solutions

    The corporations announced that they've outfitted greater than 20 joint demonstration centers in North the us, Europe and Asia, with greater than 100 additional facilities scheduled to open by means of midyear.

    In a related announcement, Nortel brought 11 core integration functions to befriend valued clientele construct, install and aid joint unified communications solutions, including conclusion-to-conclusion challenge management. Nortel already has more than 2,200 VoIP specialists to deliver these features and should add more as deployment ramps up. This group is supported by the 10,000-potent Nortel global features team and a big ecosystem of features partners.

    About Nortel

    Nortel is a diagnosed leader in supplying communications capabilities that enhance the human experience, ignite and vigor international commerce, and comfortable and give protection to the realm’s most crucial suggestions. Their next-generation applied sciences, for both service providers and organisations, span entry and core networks, support multimedia and business-important functions, and assist win rid of nowadays’s obstacles to effectivity, velocity and performance via simplifying networks and connecting americans with counsel. Nortel does company in more than a hundred and fifty nations.

    About Microsoft

    founded in 1975, Microsoft (Nasdaq “MSFT”) is the international leader in utility, features and solutions that support people and groups realize their replete talents.

    note to editors: in case you subsist pleased an interest in viewing additional info on Microsoft, please debate with the Microsoft web page at http://www.microsoft.com/presspass on Microsoft’s company tips pages. net links, mobile numbers and titles had been suitable at time of publication, however may additionally when you consider that subsist pleased modified. For extra counsel, journalists and analysts can also contact Microsoft’s quick Response group or other appropriate contacts listed at http://www.microsoft.com/presspass/contactpr.mspx .

    resourceful Communications Alliance customer support

    BT

    BT international capabilities is the division of BT neighborhood that provides networked IT functions international that enable multinational, multisite companies to thrive and develop in the digital networked economic climate

    “The Nortel and Microsoft alliance has the scholarship to accelerate and simplify the attention of unified communications for a major fraction of their consumer base. BT leads through instance, and they are already the exercise of exchange Server 2007 Unified Messaging with their Nortel telephony device. From this journey and from their position as a number one company of networked IT functions, they consider that the native, requirements-based SIP interoperability that Microsoft and Nortel announced today should simplify deployments and cleave back total permeate of possession.”

  • Tom CraigPresident, IP NetworkingBT global services

  • CLSA

    With operations in eleven international locations in the Asia-Pacific vicinity and the pecuniary facilities of ny and London, CLSA is without doubt one of the main monetary powerhouses international. Hong Kong-primarily based CLSA is an award-successful company that gives capabilities in brokerage, funding banking and private equity.

    “We had to connect their regional places of travail and headquarters, with more than 1,000 employees, with a device that superior their potential to execute trades and provide reporting information. The ingenious Communications Alliance is delivering a unified communications outfit that brings the vigor of Nortel’s IP telephony at the side of the collaboration of Microsoft office are animate Communications Server to deliver a solution superior to anything else on the market. it is going to permit us to meet the wants of their clients, meet their regulatory necessities throughout many countries and simplify communications for their personnel. since the imaginative Communications Alliance makes it workable for us to leverage their existing infrastructure, it's the most cost-efficient respond accessible.”

  • T. RajahChief counsel OfficerCLSA

  • Fred Weber Inc.

    Fred Weber Inc. is the St. Louis enviornment’s chief in massive and dual carriageway development. primarily based in Maryland Heights, Mo., this $300 million-a-yr, worker-owned enterprise makes a speciality of full-carrier concrete and asphalt paving initiatives and is the region’s greatest materials corporation. The enterprise’s travail philosophies nowadays are the identical as those of founder Fred Weber seventy eight years in the past. of those, “The deserve to normally cogitate and alter business practices to more advantageous serve valued clientele” led Fred Weber Inc. to leverage the Nortel and Microsoft relationship.

    “At Fred Weber, their wants are different than other corporations. Their company exists past 4 partitions and a classic office complicated. This creates a essential want for advantageous and respectable integrated communications. Orchestrating 1,200 personnel across their 25 building and substances places in addition to their a lot of subsidiary companies may also subsist a logistical nightmare. The resourceful Communications Alliance solution provided with the aid of Nortel and Microsoft helps resolve this issue, and allows for us to spend more time with their consumers and reply in actual time to their needs.”

  • Phillip HagemannChief advice OfficerFred Weber Inc.

  • overseas SOS

    overseas SOS is the area’s main company of clinical counsel, queer healthcare and safety functions. With operations in sixty five international locations and a 4,500-effective travail drive, overseas SOS helps companies and organizations control the health and safety dangers their travelers, expatriates and international travail constrain face.

    “presenting tremendous services to their clients globally requires advantageous communication internally and externally. engaging Nortel and Microsoft’s resourceful Communications Alliance relationship gives us the opportunity to attach into effect a blended technology respond that permits us to raise their core company of offering healthcare and security functions each and every over.”

  • Todd SchofieldChief expertise OfficerInternational SOS

  • Thomas college

    Thomas faculty, a private faculty in Waterville, Maine, is committed to profession practicing with a practice of teaching college students in enterprise, know-how and training. With greater than 950 undergraduate and graduate college students, and a school of sixty six, Thomas is adopting cutting-part Microsoft and Nortel tips expertise beneath the aegis of the imaginitive Communications Alliance.

    “whereas they are a little faculty, they subsist pleased the goal of implementing unified communications capabilities to serve their students and college on par with universities that subsist pleased higher enrollments and larger budgets. they now subsist pleased used the Nortel telephony infrastructure for two many years and at the instant are using Microsoft office reside Communications Server, so the imaginative Communications Alliance unified communications suite is a herbal extension. The system is to set up the innovative Communications Alliance solution to integrate communications, enlarge online coursework, and supply a custom, campuswide immediate messaging skill and a collaborative electronic blackboard ability. The web influence is that they are a 113-year-old establishment that's getting ready their college students for success of their personal and knowledgeable lives, and for management and repair in their communities.”

  • Chris RhodaVice President of counsel ServicesThomas college

  • Nortel CEO and President Mike Zafirovski (left) and Microsoft CEO Steve Ballmer (right) discussing the businesses’ shared imaginative and prescient for unified communications. manhattan, fresh york. Jan. 17, 2007


    Microsoft and Nortel existing Alliance Roadmap | killexams.com true Questions and Pass4sure dumps

    news

    Microsoft and Nortel existing Alliance Roadmap Six months after announcing a telecommunications alliance, Microsoft and Nortel this week presented some early effects of their efforts and outlined a roadmap for future initiatives.

    both groups first introduced their collaboration last summer.

    The road map contains three fresh joint options “to dramatically help enterprise communications by using breaking down the barriers between voice, e mail, quick messaging, multimedia conferencing and different styles of communique,” in keeping with a press release by the two establishments.

    additionally blanketed in the announcement are 11 fresh implementation functions from Nortel and the pocket of greater than 20 joint demonstration facilities where shoppers can adventure the expertise, the commentary persevered.

    furthermore, both companies stated they've signed agreements with dozens of shoppers, and subsist pleased developed a “pipeline of a whole bunch of possibilities who wish to recognise the merits of unified communications.”

    From Microsoft's standpoint, it's each and every a fraction of the enterprise's lengthy-term play to merge every kind of communications and messaging privilege into a sole framework. A 12 months in the past, the business introduced that it changed into merging its alternate Server neighborhood with its precise-Time Collaboration (RTC) community, and that it had begun to consider of both technologies comprising a "platform."

    the brand fresh neighborhood changed into named the Unified Communications community (UCG) and resides in Microsoft's enterprise Division. The view for the brand fresh group emanated from a vision of adding continuity to a myriad of communications instruments, technologies and modes -- from electronic mail and speedy messaging to Voice over internet Protocol (VoIP), audio/video and web conferencing -- in a unified manner.

    The three fresh joint options introduced by using the alliance this week are named Unified Communications built-in branch, Unified Messaging, and Conferencing.

    When it's accessible within the fourth quarter, UC integrated branch will hold Nortel and Microsoft technology on a sole piece of hardware that provides VoIP and unified communications in faraway workplaces.

    Coming a bit earlier within the 2nd quarter, Unified Messaging will intention to simplify client deployments, aboriginal session initiation protocol (SIP) interoperability between the Nortel communication Server 1000 and Microsoft change Server 2007. The respond includes Nortel skilled capabilities for design, deployment and guide.

    also coming within the fourth quarter, Conferencing will extend Nortel Multimedia Conferencing to Microsoft office Communicator 2007. It goals to provide a sole customer adventure consistent throughout applications reminiscent of voice, rapid messaging, presence, and audio- and videoconferencing.

    This yr, the organizations additionally system to prolong their latest unified communications solution — a unified computer and soft cell for VoIP, electronic mail, instant messaging and presence — to the Nortel communication Server 2100, a service-grade enterprise telephony product assisting up to 200,000 users on a sole gadget, in response to company statements.

    As for the highway map, the two companies subsist pleased fitted more than 20 joint demonstration centers in North the united states, Europe and Asia, with greater than one hundred extra facilities scheduled to open by artery of midyear.

    Nortel has also brought eleven core integration functions to befriend consumers construct, install and assist joint unified communications solutions, including conclusion-to-end assignment management. Nortel claims it has already trained greater than 2,200 VoIP consultants to carry these services and may add extra as deployment ramps up.

    about the author

    Stuart J. Johnston has coated technology, notably Microsoft, given that February 1988 for InfoWorld, Computerworld, suggestions Week, and computing device World, as well as for enterprise Developer, XML & net features, and .internet magazines.


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    Communication Server 1000 to Rls. 6.0 Upgrades for Technicians

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    VoIP certification tracks - Nortel's support certifications | killexams.com true questions and Pass4sure dumps

    As mentioned in a previous tip, companies are implementing IP telephony more frequently on their data infrastructures. The increased deployment has created a necessity for certified IP telephony engineers to provide proven, best-of-breed technology.

    The IP telephony certifications Nortel currently offers are divided into four categories: support Specialist, Design Specialist, support Expert, and Design Expert. This tip discusses the Nortel support track.

    Support Specialist

    The support Specialist certifications are intended to demonstrate an individual's faculty to implement, operate, and troubleshoot a Nortel Networks IP Telephony solution. The support Specialist certification reflects a candidate with three to six months of sustain that can wield routine technical issues of a criterion Nortel IP Telephony Solution.

    NNCSS - VoIP Succession BCM 3.0

    This certification tests the capability to implement, operate, and troubleshoot the business Communications Manager 3.0. This certification covers hardware, start-up, data and voice networking, applications, and troubleshooting the BCM. To pass the certification, two exams must subsist successfully completed: Technology Standards and Protocols for IP Telephony Solutions, and Succession BCM 3.0. The Technology Standards and Protocols for IP Telephony Solutions Exam is an overview of convergence technologies.

    NNCSS - CallPilot Rls. 2.0

    This certification tests the faculty to implement, operate, and troubleshoot the VoIP CallPilot 2.0. This certification covers hardware, administration, interoperability with Meridian 1 switches, and security of a sole site CallPilot system. To pass the certification, two exams must subsist successfully completed: Meridian Database and CallPilot 2.0.

    NNCSS - Symposium convene seat Server or Symposium convene seat Server Installation and Maintenance

    These two certifications test the faculty to implement, operate, and troubleshoot the Symposium convene seat Server. Both certifications cover hardware, software installation, administration, and maintenance of Symposium convene seat Server 4.2, Symposium Web Client 4.0, and Symposium Express 3.0. However, the Symposium convene seat Server certification also tests the architecture, custom configuration and integration of the server. To pass either of these certifications, one exam must subsist successfully completed: Symposium convene seat or Symposium convene seat Installation and Maintenance, respectively.

    NNCSS - Symposium convene seat TAPI/Agent or convene seat TAPI/Agent Installation and Maintenance

    These two certifications test the faculty to implement, operate, and troubleshoot the Symposium convene seat TAPI/Agent. Both certifications cover hardware, software installation, administration, and maintenance of Symposium TAPI 2.3 and Symposium Agent 2.3. However, the Symposium convene seat TAPI/Agent certification also tests the architecture, integration, and custom configuration of the TAPI/Agent. To pass either of these certifications, one exam must subsist successfully completed: Symposium convene seat TAPI/Agent or Symposium convene seat TAPI/Agent Inst/Main, respectively.

    NNCSS - Symposium Express convene seat or Symposium Express convene seat Installation and Maintenance

    These certifications test the faculty to implement, operate, and troubleshoot the Symposium Express convene Center. Both certifications cover hardware, software installation, administration, and maintenance of Symposium Express convene seat 4.2. However, the Symposium Express convene seat certification also tests the architecture and integration of the convene center. To pass either of the certifications, one exam must subsist successfully completed: Symposium Express convene seat or Symposium Express convene seat Inst and Maint respectively.

    NNCSS - VoIP Multimedia Communication Server (MCS) 5100 2.0

    This certification tests the faculty to implement, operate, and troubleshoot the VoIP Multimedia Communication Server (MCS) 5100 2.0. This certification covers installation of the hardware and software, configuration, maintenance, and management of the Multimedia Communication Server (MCS) 5100 2.0. To pass the certification, two exams must subsist successfully completed: Technology Standards and Protocols for IP Telephony Solutions, and VoIP Multimedia Communication Server (MCS) 5100 2.0. The Technology Standards and Protocols for IP Telephony Solutions Exam is an overview of convergence technologies.

    NNCSS - VoIP Succession 1000/1000M Rls. 3.0 DB Administrator

    This certification tests the faculty to maintain and troubleshoot the VoIP Succession 1000/1000M Rls. 3.0 DB Administrator. This certification covers the architecture, configuration, maintenance, and management of the Meridian 1, Succession 1000 Rls. 3.0, and Succession 1000M Rls. 3.0 using Basic Alternate Route Selection (BARS) and Network Alternate Route Selection (NARS). To pass the certification, two exams must subsist successfully completed: Technology Standards and Protocols for IP Telephony Solutions, and Succession 1000/1000M Rls. 3.0 DB Administrator.

    NNCSS - VoIP Succession 1000/1000M Rls. 3.0 Installation and Maintenance

    This certification tests the faculty to install, configure, and maintain the VoIP Succession 1000/1000M Rls. 3.0. This certification covers the installation, architecture, configuration, maintenance, and management of the Meridian 1, Succession 1000 Rls. 3.0, and Succession 1000M Rls. 3.0, Internet Telephones i2xxx, and Optivity Telephony Manager (OTM) 2.1. To pass the certification, three exams must subsist successfully completed: Technology Standards and Protocols for IP Telephony Solutions, and Succession 1000/1000M Rls. 3.0 for Technicians, and Succession 1000/1000M Rls. 3.0.

    Support Expert

    The support Expert certifications build on the specialist's abilities by demonstrating their skill to implement, operate, and troubleshoot an advanced Nortel Networks IP Telephony solution. The support Expert certifications reflect a candidate with six to twelve months of hands-on sustain with the faculty to lead or assist intermediate-level personnel to maintain complicated Nortel IP Telephony solutions.

    NNCSE - CallPilot 2.0 Unified Messaging Solutions

    This certification tests the faculty to implement, operate, troubleshoot and optimize the VoIP CallPilot Unified Messaging Solution 2.0. This certification covers the installation, administration, interoperability, security, upgrade procedures and feature usage for a multi site CallPilot system. To pass the certification, the candidate must first obtain their NNCSS - CallPilot Rls. 2.0. Subsequently, the CallPilot 2.0 Unified Messaging Solutions must subsist successfully completed to obtain this certification.

    NNCSE - Contact Center

    This certification tests the faculty to implement, operate, troubleshoot and optimize the Contact seat Products. This certification covers the candidate's capabilities on the Symposium convene seat Server (SCCS)/Symposium Express convene Center/Symposium Web Client, Symposium TAPI Service Provider (TAPI SP), Symposium Agent, and the Symposium Web seat Portal. To pass the certification, the candidate must first obtain their NNCSS - Symposium convene seat Server and the NNCSS - Symposium convene seat TAPI/Agent certification. Subsequently, the Contact seat Exam must subsist successfully completed to obtain this certification.

    NNCSE - IP Convergence Succession 1000/1000M Rls. 3.0

    This certification tests the faculty to install, configure, maintain, and optimize the VoIP Succession 1000/1000M Rls. 3.0. This certification covers the configuration, succession branch office (BO), remote office, operation, and Meridian 1 to Succession 1000M 3.0 migration procedures for the Succession 1000/1000M Rls. 3.0, Internet Telephones i2xxx, Remote Office 91xx, and Optivity Telephony Manager (OTM) 2.1. To pass the certification, the candidate must first obtain their NNCSS - VoIP Succession CSE 1000 Rls. 2.0 or the VoIP Succession 1000/1000M Rls. 3.0 Installation & Maintenance certification. Subsequently, another more difficult version of the Succession 1000/1000M Rls. 3.0 Exam must subsist successfully completed to obtain this certification.

    In the IT industry, certifications are a means to validate an individual's expertise within a specified area. The above Nortel IP Telephony certifications are some of the tools that can demonstrate the capabilities of an IP Telephony support professional. These certifications could not supplant years of industry experience, but they carry out provide the foundation to support and manage Nortel Voice over IP solutions.

    The next tip will debate Nortel's Design IP Telephony certification track.

    Richard Parsons (CCIE#5719) is a Manager of Professional Services for Callisma Inc., a wholly owned subsidiary of SBC. He has built a solid foundation in networking concepts, advanced troubleshooting, and monitoring in areas such as optical, ATM, VoIP, routed, routing, and storage infrastructures. affluent resides in Atlanta GA, and is a graduate of Clemson University. His background includes senior and principal consulting positions at International Network Services, Lucent, and Callisma.


    THE 50 STATES | killexams.com true questions and Pass4sure dumps

    THE 50 STATES

    THE 50 STATES<@VM>THE 50 STATES: Maryland to Wyoming

    What's up in your agency?For governments east of the Mississippi, convene 301-650-2145 or e-mail dyoung@gcn.com. For those west, convene 301-650-2238 or e-mail twalsh@gcn.com.

    ALABAMA

    VIRTUAL KNOWLEDGE. The status Legislature has sponsored an online library system that gives registered users access to 53 databases of information. Students, teachers and other Alabama residents can access thousands of full-length articles and definitions, as well as links to numerous Web sites, from the Alabama Virtual Library.

    The site, at www.avl.lib.al.us , was created by a partnership of the state's Supercomputer Authority and Computer Sciences Corp. The site retrieves information from McGraw-Hill Companies of fresh York, Encyclopedia Britannica, Online Computer Library seat Inc. of Dublin, Ohio, EBSCO Industries Inc. of Birmingham, Ala., and several other databases.

    The site runs customized software and resides on a dual-processor 550-MHz Pentium III Dell PowerEdge server with 512 of RAM.

    ALASKABUYER BEWARE. Launched this fall, the Law Department's Consumer Protection Web site offers citizens a set to wield complaints about products or businesses or check out businesses that subsist pleased been reported for fraud or unfair practices. Visitors can download froms in Adobe Portable Document Format, print them out and mail them in.

    The site also gives advice on such issues as credit cards and mail fraud.

    Law Department officials will load consumer complaint information into a searchable database. The department then can discern patterns of unfairness, fraud or deception.

    ARIZONA

    CAMPAIGN FINANCE. Charity begins at home'or a home page. The Secretary of State's Office recently attach the state's campaign finance data online. Secretary of State's Office chief information officer Mike Totherow wrote the program in Delphi from Inprise Corp. The data is stored in a Microsoft SQL Server Version 7.0 database. Visitors to the site, at www.sosaz.com/cfs/CampaignFinanceSearch .htm, can search the site by contributor, committee or date. Home addresses and phone numbers are excluded from the data for privacy reasons, said Jessica Funkhouser, director of the Office of Elections.

    ARKANSAS

    BRAINIACS ONLINE. Attention, each and every brainiacs. The Board of Education adopted Science Brainium, an online science program, for exercise in the state's public elementary and middle schools. Students log on at the site, at us.brainium.com , and enter a user ID and password. The program offers lessons and games on bugs, the solar system and other topics required by Arkansas curriculum standards.

    Science Brainium is the brainchild of Brainium of Salt Lake City. The online program, which works with most browsers, requires the Shockwave plug-in from Macromedia Inc. of San Francisco and at least a 486 PC with 16M of RAM or a Macintosh 68040.

    CALIFORNIA

    DO YOU EVERDREAM? East of San Francisco lies Lafayette, a city of 23,500, which recently outsourced most of its desktop PC services to Everdream Corp. The Fremont, Calif., company will provide city employees with a 24-hour befriend desk, Microsoft Office 2000, Windows NT file, print and firewall servers, a virtual private network and a digital subscriber line connection.

    The contract, which is valued at about $85,000 annually, includes 32 Hewlett- Packard PCs with 733-MHz Pentium III processors and 128M of RAM. The city will continue to Run its own Web site and services, said Tracy Robinson, the city's administrative services director.

    COLORADO

    SECRET IN SUMMIT. Blind and visually impaired voters in peak County cast their votes using a covert ballot for the first time last month, thanks to the eSlate 3000, a tablet-sized portable PC developed by Hart InterCivic of Austin, Texas.

    With eSlate, a voice synthesizer reads instructions and the altenative of candidates to the voter. The device has big buttons that users click to record their votes.

    In past elections, blind voters had to declare another person their altenative of candidate.

    CONNECTICUT

    SMART ROADS. The Transportation Department received a $2.38 million federal bright Transportation Systems concede to help highway and road traffic conditions by using computer systems.

    Connecticut has not yet decided how to exercise the funds.

    DELAWARE

    GOT JOBS? Applicants can now apply for status jobs on the Internet via the status Personnel Office's Web site, at www.state.de.us/spo . The online application is available for citizens to apply for nearly each and every positions statewide.

    The status used Microsoft Visual Interdev 6.0 to build the site. The site accesses a Microsoft SQL 7.0 database and runs on a dual-processor 800-MHz Pentium III Xeon Dell PowerEdge 4400 server with 2G of RAM under Windows NT.

    DISTRICT OF COLUMBIA

    NOTES FROM UNDERGROUND. The Washington Metropolitan district Transit Authority, which operates the Metro subway system, last month resumed using computers to operate its trains after 21 months of manual operation. Metro switched from automatic to manual operations in March 1999 after three relays failed, probably because of con- tamination that accumulated over time. Relays control captious functions of the rail cars, including brakes and doors.


    Computer-Based Anesthesiology Paging System | killexams.com true questions and Pass4sure dumps

    The efficient management of operating suites requires mindful resource management. Most expenses of a health custody organization are personnel related (1), and successful management of medical personnel determines whether an operational unit is a revenue seat or a cost seat (2,3). Patient outcomes, particularly in anesthesiology, depend on the availability of expensive personnel, especially physicians (4,5). In a crisis, rapid mobilization of trained personnel is captious to successful resolution (6).

    Mayo Clinic has a long history of efficient management of personnel, by which the scholarship and expertise of its physicians are leveraged through extensive exercise of allied health personnel. One strategy, implemented >100 yr ago, is the exercise of visual communication systems to direct physicians and allied health personnel to where they are needed. This began with the introduction of colored wooden door tabs. Each color denoted the status of a room. For example, a green tab indicated that the patient was in the leeway and ready to subsist seen by a nurse. A blue tab indicated that the patient was ready to subsist seen by a physician. A red tab indicated that befriend was needed for an emergency.

    This communication strategy spread from the outpatient practice to the hospitals, including the operating suites. Subsequently, door tabs were replaced by colored electric lights. A chime was sounded when the status of a leeway changed. This communication strategy was thought to help the efficiency and character of custody in the operative environment. In 1981, a fresh operating suite was opened at Saint Marys Hospital, 1 of 2 hospitals associated with Mayo Clinic. This prompted updating the communication technology at both hospitals. Electric lights were replaced with video displays suspended from the ceilings or mounted on the walls in the operating rooms (OR), procedure rooms, and support areas.

    This Video Paging System (VPS) used alphanumeric codes to communicate the status of each patient custody location (7). Pages were initiated by exercise of electromechanical switches in each OR, procedure room, and preoperative and postoperative location. When a switch was closed (by pushing a button), an alphanumeric code, designating both the location and the individual needed, would subsist displayed throughout the operative or procedural suite, and in every procedure room, hallway, recovery and waiting area, lounge, office, and cafeteria. In addition, an emergency code was incorporated to rapidly direct staff to a particular location when a cardiac arrest, airway emergency, or other captious event occurred.

    Over time, several problems emerged with the VPS. The black-and-white monitors that displayed the pages burned in after about 18 mo, making the displays unreadable. Replacement monitors were costly and difficult to find. The software was difficult to maintain, and software constraints became unacceptable as the practice grew and evolved. When seven additional ORs were built at Saint Marys Hospital, and OR numbering changed from two digits to three digits, the VPS could not accommodate the change. These problems triggered the determination to supplant the VPS with a fresh communication system.

    Design Criteria

    Several types of devices were examined as workable solutions. Cell phones, digital pagers, and personal digital assistants were considered to possibly subsist less expensive and more resilient solutions than the existing hardwired approach. However, these options were rejected as being too contingent on personnel. If the paged individual did not respond, there would subsist no artery to know whether the reform beeper was called, whether the person was unavailable, or to whom the page should subsist redirected. To respond to a page, one must interact with these devices, which can subsist impractical during procedures. It was concluded that a hands-free system would subsist designed and implemented.

    With shrimp review or documentation, the VPS had evolved on an ad hoc basis with additional functions and a broader geographic distribution. Missing comprehensive system documentation made determining where the current system was used and what information was transmitted challenging. A mindful analysis of fresh requirements was completed, redundant and unnecessary functions were eliminated, and the geographic distribution of the fresh system was planned.

    Prototyping technologic solutions occurred simultaneously. A distributed video architecture was rejected because of its inherent instability. Because the cathode-ray tube displays had only an 18- to 24-mo useful life, liquid crystal and light-emitting diode (LED) displays were considered. LED displays were chosen because they subsist pleased a useful life of at least 15 yr and a greater luminosity that prevents washout from fluorescent and natural lighting. These displays are relatively expensive, but the cost can subsist amortized over a longer useful life. Choosing the size of the characters on the displays was a trade-off between the distance at which the displays could subsist read and the required information content. The size and information layout of the LED displays were determined by their expected placement, for illustration how low the displays could hang from hallway ceilings. The determination was made to develop in-house a configurable, centrally programmable keypad that would supplant the electromechanical switches.

    Several distribution architectures were considered. exercise of the institutional Ethernet network was an attractive, inexpensive option, but pages could subsist delayed when network bandwidth exact was greatest. Because pages are time-sensitive, this risk was deemed unacceptable. Therefore, an independent Ethernet network was chosen to drive the system. The computer-based anesthesiology paging system (CAPS) was designed to subsist upgradeable and easily configured. Software running on criterion hardware is more easily adaptable and requires fewer maintenance personnel. exercise of commercially available components also reduces costs for evolution and maintenance (Fig. 1).

    System Specifications

    The CAPS runs on dual-processor, redundant Compaq servers (Compaq Computer, Houston, TX) using SQL Server 7.0 under the Windows NT 4.0 operating system (Microsoft, Redmond, WA). Because the system is used as an emergency indicator, continuous availability is required. A redundant Central Processing Unit architecture satisfies this up time requirement. Software was written in Microsoft’s Visual Basic 6.0 and Visual C++ 6.0. The distribution architecture is a star pattern of Ethernet and RS-422 devices connected by criterion Category-5 cable. Terminal servers connect the RS-422 protocol LED displays and the programmable keypads to the Ethernet network. The server can ship daily electronic mail with system statistics and maintenance needs. The CAPS can ship a page to a beeper for pressing maintenance problems (Fig. 1). The server software connects to the terminal server ports (one device per port) via device controllers. A simple network management protocol manager restarts failed connections without manual intervention.

    The software design optimizes the handling of fresh pages to assure the shortest workable time between placing a page and seeing it on the LED displays. If there are no active emergency pages, each and every fresh pages are processed and displayed within 1.5 s. The user initiates a page by either pressing a dedicated microswitch (hot key) or entering a numeric code on the keypad (Fig. 2). The page is sent to the keypad controller via the terminal server. The keypad controller associates the page with a specific keypad, the keypad’s workgroup (e.g., neurologic anesthesia or vascular radiology), and other necessary information. The page is then presented via a Microsoft ActiveX Data expostulate convene to the SQL Server database engine. The database determines what text is to subsist displayed on the LED displays and then forwards the text to the queue manager. The database then returns control to the keypad controller, which illuminates an LED above the activated tropical key. If a page for a physician or nurse is initiated from an OR, a light above that room’s door illuminates as a wayfinding aid.

    The queue manager determines the workgroups for a fresh page and inserts the fresh page either into those groups’ new-page queues or emergency queues. Although there are seldom >15 active calls, each queue may hold up to 100 calls. At 1.5-s intervals, the panoply controllers query the queue manager for the next page. The panoply controller then forwards that page to each display. If the page is displayed for the first time, a chime sounds. The current time, synchronized with the atomic clock in Boulder, CO, is displayed in the upper privilege corner, except when emergency pages are displayed. The panoply controllers then execute housekeeping chores (e.g., querying displays for functional status), during the relaxation of the 1.5-s interval before querying the queue manager for the next page. After a page has been displayed once, it is placed in the active-page queue. The queue manager then cycles through this queue while any pages are active. Emergency pages are not placed in the active-page queue. When an emergency page is initiated, it is the only page shown on the LED displays, the light above the leeway door blinks, and the chime is sounded repeatedly until the page is answered. In the unlikely event that two or more emergency pages are active simultaneously, only the emergency pages are cycled until answered.

    The central servers, terminal servers, operating system, and database are each and every commercial products. The LED displays were initially custom-made products, but the manufacturer has subsequently added them to their criterion product line. These displays are located throughout the hospitals where anesthesia services are provided or anesthesia personnel congregate.

    The programmable keypads were designed in-house and were assembled and tested under contract. The keypads can accept fresh embedded code downloaded from the server. This allows for remote reprogramming of the keypads without maintenance personnel physically interacting with each keypad (i.e., removing >450 keypads from the wall and reprogramming them with a laptop computer). Therefore, upgrading the keypads is rapid and cost-effective.

    An administrative program and several specialized tools for maintenance personnel were developed. The administrative program’s graphical user interface masks the relational database’s complexity and presents a more simplified view of the system. Pages, devices, reports, and other aspects of the system can subsist managed without exercise of the evolution engineering group. This feature allows maintenance personnel to subsist trained technicians, thereby decreasing the total cost of ownership and freeing the evolution engineering staff for other projects.

    User Functionality

    The CAPS presents two kinds of pages: 1) class page, which is a page for a class of individuals to Come to a patient location, and 2) person page, which is a page for a specific individual to Come to a multiple-patient location. Class pages subsist pleased three parts. The prefix characters are alphabetic, denoting the travail district (e.g., “N” for the north anesthesia district or “CL” for the catheterization laboratory). The middle characters denote the leeway number within that travail group (e.g., “N 808” for leeway 808 in the north anesthesia district or “CL 109” for leeway 109 in the catheterization laboratory). The suffix character denotes the class of person needed in the room. Therefore, complete pages would subsist “N 808 A,” acceptation that an anesthesiologist is needed in leeway 808 in the north anesthesia area, or “CL 109 N,” acceptation that a nurse anesthetist is needed in leeway 109 of the catheterization laboratory. Person pages subsist pleased two parts. The prefix denotes a multiple-patient location (e.g., “P” for postanesthesia custody unit or “o” for outpatient recovery). The other characters are numeric, denoting the individual needed. Therefore, a complete person page would subsist “P49,” acceptation that person “49” is needed in the postanesthesia custody unit.

    Using CAPS is reasonably straightforward. For example, if a resident physician in cardiac catheterization leeway 104 needs to handle with the attending anesthesiologist, the resident pushes the “Physician” button on the keypad mounted on the anesthesia machine (Fig. 3). An LED above the button illuminates, confirming that the page has been received. Every monitor throughout the cardiac catheterization suite, including the leeway initiating the page, displays “CL 104 A” in green and chimes briefly (Fig. 4). The page remains on the LED panoply for 1.5 s as the system cycles from page to page. A page cycles every 1.5 s until it is deactivated by a person; there is no timeout feature for pages. When the attending anesthesiologist enters the leeway and pushes the “Physician” button, the page is no longer displayed anywhere and the LED above the button turns off. If the resident considers the page to subsist urgent, the resident pushes the “Urgent” button (Fig. 3) and then the “Physician” button; “CL 104 A” would materialize in orange and cycles with any other pages. If there is an emergency in the procedure room, the two side-by-side emergency buttons are pushed simultaneously (Fig. 3). This action persistently displays “CL 104 A” in smart red on every panoply in the catheterization laboratory, and a chime rings until the emergency buttons in the leeway are pushed simultaneously. In the unusual event of >1 simultaneous emergency page, the panoply will cycle from emergency page to emergency page every 1.5 s, sounding the chime persistently, until each and every emergency pages are deactivated.

    Figure 3

    Figure 3

    Figure 4

    Figure 4

    This identical basic feature is available throughout the environment of the CAPS. A tropical key is pushed on the keypad and the defined page is displayed throughout the respective operating or procedural suite. Other examples of workable pages are shown in Table 1. The tropical keys can vary from keypad to keypad. For example, in the operating suite, anesthesiologists and certified registered nurse-anesthetists are the only licensed providers with tropical keys, whereas in the cardiac catheterization laboratory, a tropical key pages registered nurses who provide sedation care. The system has the faculty to add many additional pages through exercise of the numeric keys (Fig. 3). For example, by pressing “246” followed by the “Enter” key, a unique page can subsist displayed, such as “CL 104 MP” for medical photographer. The keypad screen (Fig. 3) displays the keyed page, confirming to the user that the page has been received. If >1 page is entered via the keypad, instead of the tropical keys, the pages are cycled every 1.5 s on the keypad’s screen.

    The LED displays are more useful than the VPS cathode-ray tube monitors, which displayed a maximum of only four black-and-white characters. fancy the CAPS, the VPS prefix character designated the workgroup, two digits identified the leeway number, and the suffix character indicated the personnel being paged. The CAPS displays allow a prefix, a leeway identifier, and a suffix, for a maximum of 10 characters that can subsist illuminated in 1 of 3 colors. Rooms can subsist specified by numbers, short words, or abbreviations. Without the limitations of the VPS, formerly cryptic pages are now displayed in unambiguous text. Whereas “P888” in the VPS meant that the postanesthesia custody unit was full, this page is now displayed unambiguously on the CAPS as “PACU FULL.”

    When anesthesia and OR personnel hear the “new call” chime, they can glance at the panoply and read the fresh call. If they miss seeing the fresh page, the system offers shortcuts so one does not necessity to watch each and every the pages cycle through the display. Personnel indicators in the lower left corner of the panoply (Fig. 5) identify the class of individual required (e.g., anesthesiologist, nurse, or technician). Zone indicators in the upper left corner of the panoply identify the travail areas that subsist pleased active calls (e.g., “N” for north anesthesia and “B” for cardiovascular anesthesia). If an anesthesiologist accountable for the B zone hears a fresh page chime but misses seeing the fresh page, the anesthesiologist can glance at the panoply (Fig. 5) and solemnize that the fresh convene was for someone else (e.g., if only “D” is seen in the upper left of the display, only D zone personnel subsist pleased active pages). If “B” is in the upper left and if “A” is not in the lower left, then the anesthesiologist no longer needs to seek at the panoply because the fresh page was for someone else. Pages are sorted numerically within the zone, so people necessity to watch the panoply only until the codes for their rooms are either displayed or passed over. The personnel and zone shortcut indicators are cumulative for each and every active pages and are displayed for each and every except emergency pages.

    Postimplementation Review

    At Mayo Clinic, each of the two hospitals has a CAPS. During the first 6 mo of operation, there were 8 h of unexpected downtime. There were four additional hours of planned downtime for installing lower priority functions, downloading keypad corrections, installing operating system patches, and correcting varied problems. After this initial shake-down period, the CAPS was down a total of 14 min in 3 mo (i.e., 0.144 min/day). In contrast, the VPS was down an mediocre of 28.3, 29.7, 21.9, and 16.8 min/day in 1996, 1997, 1998, and 1999, respectively. Starting in 2000, the reliability of the VPS began to deteriorate compared with its historic norms. The deterioration became another issue that helped initiate the CAPS project. Despite the vicissitude of comparing customary and fresh technologic systems, the data expose that the CAPS is more reliable than was the VPS.

    Clinical Evaluation

    During the installation of the CAPS, there was a brief age during which neither the VPS nor the CAPS was available in each and every areas. The VPS was removed in segments as the CAPS was installed, and beepers were used temporarily as a bridging communications medium. Anesthesiologists and nurse anesthetists subsist pleased used beepers for many years for person-to-person communications, such as consultations and outside telephone calls, and as a means to gain individuals when they are outside of the video paging environment (e.g., intensive custody units and hospital wards). Because departmental personnel were experienced and comfortable with beepers and telephones are mounted on every anesthesia machine, it was decided to exercise these devices during the transition from the VPS to the CAPS. This allowed comparison of the efficiency of using beepers with the efficiency of using the CAPS.

    Observations of paging with beepers occurred during a 4-day period, 2 days at each hospital. Each day, different ORs were studied on the basis of the implementation schedule of the CAPS. Data were gathered from within a randomly selected OR by recording the time a page was initiated to a beeper (beginning as the number was being dialed) and the time the responder entered the room. Because of the limitation of being able to solemnize only 1 OR at a time and the rapid installation of the CAPS, relatively few pages with beepers were observed (n = 12), each and every of which were routine, nonurgent calls. When the study was designed, it was expected that there would subsist 6 days of installation per hospital and, therefore, 12 days of observation for gathering beeper response times. Unfortunately for the study, but fortuitous for the practice, installation took only 2 days per hospital, which reduced the expected number of observations. The original CAPS installation schedule allowed more time for system verification in each travail district than was actually needed and so the time allotted for beeper observations was significantly reduced.

    Similarly, observations for the CAPS occurred over a 4-day period, 2 days at each hospital. Data were gathered by recording the time a page appeared on the LED display, which was within 1.5 s of the time the button was pressed from within the OR, and the time the responder entered the room. Because the CAPS displays its pages on LED displays located throughout the surgical suite, several ORs could subsist observed simultaneously by watching the displays, and more data were collected (n = 57). No pressing or emergency pages were observed.

    The median response time for anesthesiologists paged with a beeper was 2.78 min (range, 1.00–7.23 min). Problem pages did occur, including incorrect beeper numbers that were given to next-shift personnel, multiple pages that were made because the caller was not inescapable that the reform number had been dialed, and missed or ignored pages that required repaging. The median response times for anesthesiologists paged with the CAPS was 1.57 min (range, 0.30–7.20 min). Because of the CAPS design, no one of the problem pages observed with the beepers were observed with the CAPS. These results are summarized in Table 2 and motif 6. A logarithmic transformation was applied to the data to meet the distributional assumptions required for the two-sample Student’s t-test. The t-test of the transformed data showed a statistically significant disagreement between the response times with beepers and the response times with the CAPS (P = 0.021, t 67 = 2.36). The CAPS had a shorter response time for anesthesiologists than the beeper method.

    Table 2

    Table 2

    Figure 6

    Figure 6

    Discussion

    Mayo Clinic anesthesiologists generally are accountable for more concurrent procedures than is common in an academic practice. For example, one anesthesiologist concurrently cares for two pediatric open-heart patients at Mayo Clinic, whereas the norm is one procedure per anesthesiologist at Duke and Stanford Universities (personal communication). Although there is no arduous evidence that the CAPS directly allows for higher concurrency, the anesthesiology department and the institution subsist pleased concluded that the CAPS is an essential tool that allows for these ratios with safe delivery of anesthesia care. The reasoning is that when an anesthesiologist is assiduous caring for a patient in one location (e.g., placing a pulmonary artery catheter or inducing anesthesia) and is paged to another location, the page remains visible until it is answered. This prompts colleagues to respond the page, thereby ensuring that clinical problems are rapidly addressed. The system is used to attest cardiac arrests and other emergencies, initiating an immediate response from many available personnel. The system is also used to page personnel in other services, such as the clinical laboratory, autotransfusion, surgical pathology, and housekeeping. By allowing communication with many groups, the CAPS can subsist used to manage procedural areas more efficiently.

    The design of the system is consistent with the communication philosophy that has developed at Mayo Clinic in both inpatient and outpatient environments. Patient custody sites are equipped with a communication tool that identifies the status of the room. For the anesthesiology practice, the status of the leeway reflects the personnel needs in the room. If an anesthesiologist is needed, a visual page is displayed throughout the travail environment informing both the anesthesiologist and the practice as a whole that assistance is requested in the procedure room. The postimplementation review demonstrates that the CAPS is more reliable than the system it replaced, with an mediocre downtime of less than one minute per day.

    When comparing the CAPS with a system of beepers, which are the criterion communication devices in many medical centers, the time to respond a page was statistically significantly less when the page was initiated using the CAPS than using a beeper and the opportunity for communication errors are eliminated. This study has a number of limitations. The sample size of beeper paging is little (n = 12). However, they subsist pleased no judgement to believe that these data are not representative of their beeper paging system. Also, although a statistically significant disagreement in response time was detected between the beeper system and the CAPS, the clinical relevance of this disagreement is unclear. The clinical relevance of 1.21 minutes response time depends on the clinical situation that prompted the page. If a page is initiated to debate fluid management, it is unlikely that the observed shorter response time would profile any difference. However, if the page is to secure assistance for an airway-related problem, then 1.21 minutes could profile a significant difference.

    Another limitation of the study is that patient outcome data were not recorded as fraction of their data collection. each and every the pages observed were for routine matters (e.g., anesthesia induction, emergence, or routine questions). No emergencies or pressing pages were recorded in either group. A review of the CAPS database shows that there were 7 emergency pages during April 2002 when the paging system covered 97 ORs, 5 recovery rooms, and >46 nonoperative anesthetizing locations. The emergency pages were answered in an mediocre of 35 ± 23 seconds. However, there are no data to compare this with emergency response to beeper pages. A much larger study would subsist pleased to subsist undertaken to demonstrate an effect on patient outcomes. Although such a study was considered, the anesthesiology practice concluded that it was unwilling to investigate the clinical effect of paging without the CAPS because of concerns for patient safety and practice efficiency.

    The CAPS has a subtle effect on the environment of the operating suite because there is not a constant din of overhead audio pages. Instead, a brief chime announces a fresh page to the entire staff. Anesthesiologists in the ORs are not straining to hear garbled pages. Anesthesiology residents and certified registered nurse anesthetists are not waiting in frustration, wondering whether their pages subsist pleased been heard. Pages are persistently visible on ubiquitous displays until answered.

    Mayo Clinic is a big group practice (>1000 attending physicians), and it can subsist difficult to ensure accountability of each and every members in a big organization (8). One drawback of using beepers is that staff may ignore or forget pages. With the CAPS, everyone in the procedural suites can observe pages and subsist vigilant of pages that are not answered. The primary value of Mayo Clinic is “the needs of the patient Come first.” Adherence to this principle encourages staff to respond to unanswered pages. However, even with assistance from colleagues, a interminable pattern of ignoring pages becomes apparent. The CAPS promotes assistance from colleagues when a staff member is occupied with another patient and inhibits a pattern of unanswered pages in a manner not recognized by the anonymity of beepers. As a result, staff members are reluctant to subsist pleased their pages displayed longer than necessary, even though there is no visible duration associated with any given page. The practice-wide result is that staff attend to the needs of patients in a timely manner without authoritarian management measures.

    The CAPS was designed to subsist a hands-free, reliable, and low-maintenance communication system. The system is more reliable than the VPS it replaced. The evolution and installation of the CAPS is associated with anesthesiologists responding more rapidly to paging with the CAPS than to paging with beepers. This may subsist associated with improved patient outcomes and greater OR efficiency.

    References 1. Marrin CA, Johnson LC, Beggs VL, Batalden PB. Clinical process cost analysis. Ann Thorac Surg 1997; 64: 690–4. 2. Macario A, Vitez TS, Dunn B, McDonald T. Where are the costs in perioperative care? Anesthesiology 1995; 83: 1138–44. 3. DeRiso B, Cantees K, Watkins WD. The operating rooms: cost seat management in a managed custody environment. Int Anesthesiol Clin 1995; 33: 133–50. 4. Abenstein JP, Warner MA. Anesthesia providers, patient outcomes, and costs. Anesth Analg 1996; 82: 1273–83. 5. Silber JH, Sean KK, Even-Shoshan O, et al. Anesthesiologist direction and patient outcomes. Anesthesiology 2000; 93: 152–63. 6. Gaba DM, Howard SK, Fish KJ. juncture management in anesthesiology. fresh York: Churchill-Livingstone, 1994: 5–47. 7. Ereth MH, Byer DE, Behrens TL, Tri JL. Computer-based video paging [letter]. J Clin Monit 1989; 5: 217–9. 8. McMahon FB, McMahon JW. Psychology: the hybrid science. Homewood, IL: The Dorsey Press, 1982: 615–6. Attention Authors!

    Submit Your Papers Online

    You can now subsist pleased your paper processed and reviewed faster by sending it to us through their new, web-based Rapid Review System.

    Submitting your manuscript online will add up to that the time and expense of sending papers through the mail can subsist eliminated. Moreover, because their reviewers will also subsist working online, the entire review process will subsist significantly faster.

    You can submit manuscripts electronically via http://www.rapidreview.com. There are links to this site from the Anesthesia & Analgesia website (http://www.anesthesia-analgesia.org), and the IARS website (http://www.iars.org).

    To find out more about Rapid Review, Go to http://www.rapidreview.com and click on “About Rapid Review.”

    © 2003 International Anesthesia Research Society Source

    Anesthesia & Analgesia97(1):196-204, July 2003.

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