Read the following case study. Then in a minimum of 200 words answer the following questions. Responses should be logical and substantial.

What were some lessons learned from this case study? Do you think this author should participate in similar projects in the future? Why or why not? Would you have handled the rollout at the second location differently? If so, how?

Device Selection – No other Phase Is More Important: Mobile Nursing Devices

Case Study: Our story began almost 2 years ago. As a consultant, this author participated in a team that completed a device needs assessment for the selection of point-of-care documentation devices for Big Healthcare System (BHS). Our consultant team was engaged because of an unsatisfactory response from an employee to a member of the facility’s board of directors. The question was “How did we arrive at the decision to select these certain machines that you are asking $1.7 million to purchase?”

Our Team defined the following metrics for device selection:

• Device form factor analysis (workstations on wheels [WOWs], tables, other handheld devices)
• Space availability within patient rooms during use and storage
• Provisions for spare machines
• Downtime strategies
• Analysis of various clinician usage and preferences
• Wireless networking capacity and coverage
• Integration with bar coding and scanning technologies
• Electrical outlet availability (location and quantity)
• Reallocation of existing desktop machines for physician usage

In total, this process was completed over the course of eight weeks, and upon presentation to the board of directors, out team literally received a standing ovation. Upon completion of our work, we presented our strategy and success around device selection, and the abstract of this write-up received a national award.

Based on this success, there was great confidence in our processes. In a new opportunity for a similar device selection process as part of a larger project at a Regional Community Hospital (RCH) in the West, we expected to repeat our success. The project was initiated, and RCH built a team of invested, skilled, and knowledgeable clinical and information technology staff. However, the device selection team was scheduled to meet weekly, as opposed to the concentrated “all hands on deck” efforts experienced at BHS. Thus, from the project design stage, the process was changed to be longer in duration at RCH than our process of 8 weeks at BHS. Almost two years later, point-of-care devices were only just being purchased for use by nursing assistants, respiratory care therapists, and some sporadic use in the intensive care unit.

As a result of the slower, comprehensive, and methodical process for device selection, we identified opportunities that would not have been possible in a quicker, more concentrated project. Some of our notable findings are the following:

• The emergence of newer point-of-care technologies (tablets with scanners)
• Postponement of capital expenditures
• Reconciling specific challenges with wireless network coverage and capacity constraints
• Resolution of infection control issues related to device cleaning and storage
• Planning for medication administration and pharmacy delivery process changes
• Configurations of WOWs

This methodical approach created a new challenge to our credibility, especially among the nursing staff. Because significant aspects of point-of-care device selection requires participation from the front-line nursing staff, we engaged the nursing staff early in the selection approval process. Although early involvement provided education and buy-in, it also led to significant delays in acquisition and deployment, which caused frustration among the nursing staff.

HIT or miss: Lessons learned from health information technology Implementations
by |   Publisher: Ahima | Publisher Place: United States | Year: 2013

Revenue Recognition: Understanding the Impact of IFRS 15 - Revenue from Contracts with Customers

Rodney Redding       Brent T. McCallum* Abstract

In May 2014, the International Accounting Standards Board issued International Financial Reporting Standard (hereafter IFRS) 15 “Revenue from Contracts with Customers”. The standard replaces the International Accounting Standards (IAS) 18, “Revenue” and IAS 11, “Construction Contracts.” The accounting guidelines under IFRS 15 will become authoritative in 2018. Some companies may not see significant changes in the amount of revenue recognized. However, in certain industries such as telecom, software development, real estate, and some retailers, the effect on revenue recognition timing may be significant. The purpose of this case is to contrast the accounting for a transaction under the present IAS standard for revenue recognition and the guidance to be implemented in 2018. The case is relevant not only for those majoring in accounting but also for majors such as finance that analyze corporate financial statements. The case requires the performance of a web search to obtain details of the guidelines provided in IFRS 15 and a contrasting of the accounting treatment under IAS 18 with the approach required by the new IFRS 15 for a mobile telecommunications company.

Key Words: Revenue Recognition , IFRS 15, “Revenue from Contracts with Customers”, International Financial Reporting Standard 15, telecommunications revenue recognition, telecoms revenue recognition, revenue recognition timing, five-step process for revenue recognition, guidance changes for revenue recognition, identify the contract with the customer, performance obligations, contract price, transaction price, satisfying the performance obligation.

Introduction

In May of 2014, the International Accounting Standards Board issued International Financial Reporting Standard (hereafter IFRS) 15 “Revenue from Contracts with Customers”. The standard replaces the International Accounting Standards (IAS) “Revenue” and “Construction Contracts” as well as several other interpretations dealing with related issues. The accounting guidelines under IFRS 15 were originally intended to become authoritative in 2017 however, following a recent amendment, this has been extended to 2018. IFRS 15 changes the guidelines for timing and amount of revenue recognition for contracts with customers. For many companies these changes will have little financial impact Companies in the telecoms, software development, real estate, and retail sectors may however be significantly impacted by these changes. The core of IFRS 15 is the new five step process for determining the timing and amount of revenue to be recognized which will now be applied to all revenue from contracts with customers.

What Are The Accountants Doing To Our Revenue? The Company

MoServ is a Middle Eastern North African (MENA) telecommunications company that has been in existence since 2011. The company provides mobile phone service to 16 Middle Eastern and African countries. To attract customers they operate similar to their competition by offering low

cost or sometimes free mobile telephones to customers that sign multiyear service contracts. The company has been able to keep initial construction costs to a minimum by signing an agreement with a competitor to use the competitor’s signal towers on a 10 year lease ending in 2022. MoServ has already begun to acquire land in suitable locations for construction of company owned signal towers. Financing of the tower construction will require the company to acquire external funding through debt issuances in 2021. The Treasurer is concerned about the potential impact of the adoption of IFRS 15 on the trading results for the company for the three years 2018 to 2020. The Treasurer has a finance background and needs to know the impact of the new revenue recognition guidelines on reported income in those two years. He requires guidance on the following issues:

• Will the effect lower reported earnings?
• If so, how much compared to earnings determined using IAS 18, the current guidance for revenue recognition?
• Will the amount of any decrease affect the cost of borrowing or perhaps even restrict access to some debt opportunities?

The treasurer has asked the Controller to assign an accounting staff member to report on the new IFRS 15 guidelines to bring the treasury staff up to date on the changes. He also wants to know how the new standard will affect the revenue recognition arrangements on their 2 year New Soltam contract. This is the company’s highest revenue generating transaction and consists of a two year calling contract with a “free” telephone upon contract signing.

Revenue Transaction

MoServ offers a package similar to many of its competitors. Customers that sign up for a multiyear contract for phone usage are provided a phone for free or at cost significantly below the market value of the mobile phone. MoServ’s main contract (that provides 95% of corporate revenue) is as follows:

2 Year New Soltam Contract with Moserv

Length of contract: 24 months Cancellation policy: Non-cancelable

Monthly fee for mobile service: AED 800 (AED: United Arab Emirates currency) Contract signing bonus: New Soltam 398FX6 sophisticated mobile phone

Other information:

Normal selling price of Soltam mobile phone without contract: AED 1800. A 24 month contract with no free mobile phone is 870 AED per month.

The cost to MoSERV for the Soltam 398FX6 is AED 900 per unit.

Specific Instructions and Questions for the Accounting Staff

1. Access one of the websites of one of the Big Four public accounting firms and obtain the firm’s publication on IFRS 15. You are looking for only an Overview of the guidance. The Treasurer only wants an introduction to the guidance not detailed information. Attach a file to your report with this information or publication for review by the Treasurer.
2. Is the new revenue recognition guidance different under IASB and FASB? Or is this a joint project where the guidance is similar?
3. Indicate the IASB standard that is followed currently by MoServ before the adoption of IFRS 15.
4. Show the accounting for the signing of one contract by a customer under the current IASB authoritative guidance, for revenue recognition. Include the accounting at the time of signing the contract and for the first two months of the contract.
5. What is the effective date for the adoption of IFRS 15?
6. Can MoServ adopt IFRS early?
7. List and discuss the five steps of revenue recognition under IFRS 15 as applied to MoServ’s 2 Year New Soltam contract. Include the accounting journal entries at the time of signing the contract and for the first two months of the contract.
8. Write a brief description of the differences in the revenue and expense recognition under the two IASB standards.

1. Cigarettes/Day	Death Rate/1000/Year due to CHF Males	Death Rate/1000/Year due to CHF Females
   0	0.01	0.008
   1-14	0.27	0.11
   15-24	1.23	1.15
   25+	2.00	1.50

2. Your team would like to calculate the attributable risk or attributable proportion of CHF death rates due to smoking 1-14 and 15-24 cigarettes per day separately for males and females. Do you notice any differences within and between these groups in death rates due to CHF based on the different number of cigarettes smoked per day?
3. What can the team conclude about the death rate due to CHF for males and females separately when zero cigarettes per day are smoked? How do they compare?

   Your quality improvement Team is revisiting the following patient readmissions and would like to predict the number of readmissions based on the number of drugs administered.

Na⁺
159 mEq / liter (Normal = 136-145 mEq / liter)
K⁺       
4.9 mEq / liter (Normal = 3.5-5.0 mEq / liter)
C1^-
100 mEq / liter (Normal = 96-106 mEq / liter)

Will the interstitial fluid increase or decrease the "osmolarity"(concentration) due to the nurse's mistake?Which electrolytes were out of the normal range and in which direction? 

Given your knowledge of osmosis, will the patient’s cells increase or decrease in size? Explain your answer. 

Can you explain why the patient may have edema? 

What is the function of aldosterone and how will the increase in osmolarity affect the blood aldosterone levels? 

Is Mr. Kaunda susceptible to hyponatrenia or hypernatremia? What possible symptoms could Mr. Kaunda develop from his present (osmotic) condition? 

Are there any other normal homeostatic mechanisms that the body has, to control the situation Kaunda faces? How might it react in this situation? 

Please find out the values of a,b,c and d.