Impact of Poor Services on Healthcare Organization

Impact of Poor Services on Healthcare Organization Assessment 4 Issue 1: Effect of Poor services On Reputation of Kindly Residential Care Rest Home Generally, the reputation of an institution, particularly elderly care facilities, is very essential in order to make known to concerned clients and their families how firm the institution is in offering quality health care services. In order for an institution live up to their reputation or even exceed the expectation of the clients and be more competent than other neighboring competitors, series of quality improvement measures are then conducted all year round. The first step or approach in quality improvement is to be able to identify certain factors that have a potential or a likelihood of contributing to the rise and fall of an institution’s reputation. Patient safety Safety for the client is always considered the highest priority and is the topmost factor to consider. Issues such as shortfalls, injury, elderly abuse and the like are indicators that help measure the quality of service rendered by the institution. If and when complaints in relation to these issues start skyrocketing, that is when measures for legislative amendments are called for. When the safety of a resident is at risk in an institution that is reputed to have substandard services and management, the said institution will be subjected to disciplinary action set by the Ministry of Health. Management The essential component of a healthy institution is quality satisfaction derived from both the staff and, most importantly, the customer or client. And the driving force of an institution is the operational team or the management. Any quality of service rendered by the staff and level of client satisfaction would greatly reflect on the management’s performance. Poor management over staff, facility and its services would lose the trust of its staff as well as its clients. Quality assurance The quest for an institution’s outstanding reputation doesn’t happen only once. Over periods of time, a series of audits, surveys, investigations, studies and statistics are continuously conducted to ensure that an institution lives up to its reputation. Quality assurance is there to make sure that the institution still served its purpose. At some point, certain issues within the institution have been overlooked and what has been known to be reported to responsible parties doesn’t seem to reflect the raw evidence that may arise from poor quality assurance. This would then lead people to think otherwise about entrusting themselves with the institution. On Accountability of Private Sectors and Public Sectors Private sectors are at an advantage when it comes to accountability. The public sector accounts more than the private sector, since most legislations and policies governing private institutions are stipulated by the public sector. When poor services are noted from the public sector, consumers or clients tend to rely more on the private sectors due to their extensive services and features. Because the government has minimal or little involvement over private sectors over quality improvement measures, the private sector may have the opportunity to expand the boundaries of their services in order to improve better client outcomes. There is no formal organizational structure compared to the public sector. Therefore, in the event that poor services may arise from Kindly Residential Care Rest Home, it may turn to be more of a challenge in order to gain competency in the health care industry. Stakeholders They are the persons who have a â€Å"stake ‘’ in any organization. They may be called: Internal Stakeholders in the Kindly Residential Care Rest Home, the Internal Stakeholders are the Owners or the Healthcare Providers, the carers, the nurses, and all who work for the well- being of the elderly especially those persons with dementia. The External Stakeholders include the Government and Non- government organizations which contribute their time, treasure and talent to help the Residential Care Rest Homes deliver quality service. â€Å"Quality of Care’’ is a difficult concept to measure particularly within the context of residential aged care, which involves lifestyle issues as much as health issues. One example is the Australian Accreditation Standards having been credited with contributing to improve care. Though they represent only minimum standards of quality, they do not focus on clinical outcomes. Individual facilities might only be assessed against these standards every 3 years; and within these years, much scope for quality variations may go unnoticed. Hence, collecting and analyzing comprehensive clinical data from aged care facility residents constitutes an essential step in the process of monitoring quality environment. Ways to Improve The USA has introduced and continued to refine, a compulsory technioque of assessment within its nursing homes aimed at monitoring quality of care and clinical outcomes. There is a Minimum Data Set/ Resident Assessment Instrument which is a system of forms to be completed at certain intervals to meet a number of purposes such as care planning, case mix funding and quality monitoring. This uses Quality Indicators as a means of implementing quality assurance and improvement within residential aged care. Residential facilities had been subsidized by the Commonwealth Government since 1962, but funding was not regulated. Initiatives relevant to residential care have included a standardized system of assessment (Resident Classification Scales) to determine resident care needs and a formal system of Accreditation to ensure quality service delivery. Because quality of care is a multi – dimensional concept, no single area of assessment can provide an accurate indication of quality. Thus, an effective assessment should contain as many items considered relevant to quality care. Hughes et. al suggested that quality measures should be integrated into routine clinical practice. The Australian Society for Geriatric Medicine described the Residential Classifications Scales as the â€Å"antithesis of a funding system that generates incentives for quality health outcomes.’’ Government –appointed bodies responsible for assessing residential care facilities compliance with standards improved quality of care within residential care facilities. Aged Care Standards and Accreditation Agency was introduced in 1998 that compels residential aged care facilities to seek accreditation for funding. Clark and Bowling (32) suggested that quality of life in residential care could be ascertained by looking at measurable indicators such as general health, functional status, mental health, comfort, emotional wellbeing, privacy, choice and autonomy. When considering quality assessment for residential aged care facilities, indicators of quality should encompass areas of clinical care directly related to residents’ physical health, as well as quality of life and lifestyle-related issues such as activities and family involvement. Issue 2: Quality Management Theories Pareto Analysis This is a simple methodology by which prioritization of potential changes through determining the problems that can be addressed and resolved through making necessary changes. Through this technique, the organization can make prioritization according to the individual alteration that could improve the scenario. This quality management tool utilizes the Pareto Principle or the 80:20 rules. This rule utilizes the concept of 20 percent cause that could produce to 80 percent outcome. The Kindly Residential Care Rest Home will use the following approach while taking into consideration the principles of Pareto Analysis to achieve the best practice in healthcare services of the said organization. Problem Identification and List it First, the problems and potential threats are listed down. In this step, possible inputs from clients and members of the Kindly Residential Care Rest Home (KRCRH), and conduct surveys to identify the existing problems in the organization. The root cause of problems are identified In this stage, methods are utilized that warrants the team to identify the root causes of threats and problems. Score Problems In the third step, the organization prioritizes the problems according to its severity or effect on the healthcare practices of KRCRH. Problems are grouped according to their root cause. The identified problems are put in to a group according to their root causes. Add up Scores In this step, scores are added up and identify which of the group has the highest and lowest score. Through this, prioritization is according to scores are done. Take Action In the final step, KRCRH will take actions in addressing the highest priority according to the group or problem that got the highest score. William Edwards Deming Dr. William Edwards Deming proposed the plan-do-check-act, also known as PDCA. It is a four step methodology by which used by the organization to control and improve the services and product of an organization. Kindly Residential Care Rest Home will also make use of this kind strategy to improve the healthcare services of the healthcare organization. The end result of this would be a high quality of services by the facility to the residents and staff of the organization. The following are the Steps of PDCA that the facility will make use: PLAN Objectives and processes are established which are necessary to deliver the outcome in to the expected results. The KRCRH will have a clear view of their target and their goals in achieving their proposed target in this initial phase. DO The plans from the initial phase are implemented in the second step. Data collection is also vital in this phase because the data collected will be used in the later stage of the process. CHECK The KRCRH will do evaluation of the data gathered during the DO stage. These will be charted and analyzed by the facility to identify which needs to improved and which are well in the health care services of the KRCRH facility. ACT Corrective actions are done in phase. The differences between the actual and planned results are analyzed and the root causes are determined. The corrective actions are implemented to achieve the planned outcome of the KRCRH. Issue 3: Quality Management Tools Total Quality Management Behind success of Kindly Residential Care Rest Home are the people who are hand in hand managing an organization, determined to make change for rendering the best of its healthcare services. Through years that Kindly Residential Care Rest Home offers quality of care to its residents and proves its Excellency by garnering prestigious awards, positive feedback and unending trust from stakeholders, family and community its success does not end instead continuity of more complete, comprehensive and structural way of management by enhancement of strategies to improve the quality of services is their big secret towards success or the so called â€Å"total quality management†. Kindly Residential Care Rest Home utilizes total quality management to ensure that giving the quality of care for their residents will not be compromised which can lead to poor health outcomes and downfall of the organization due to improper management. Using the total quality management Kindly Residential Care Rest Home first identify the problem and plan what to do. Second is to implement the solution then evaluate or check if it resolves the problem. And lastly integrate the solution if it works upon further evaluation. As a result Kindly Residential Care Rest Home identified the following problems and able to resolve and improve its quality of service. Falls Risk – most of the common problem that arises among the elderly due to physical restriction like inability to walk or unsteady gait, mental incapacity, side effect of a drug, and in relation to disease condition like poor vision, etc. To prevent this happen solutions are the following: use of sensor mat, call bell, mattress, assistive devices (walker and gutter) , side rails (as necessary and with GP`s order) UTI outbreak – another problem that is commonly and easily acquired by elderly due to low intake of water and poor hygiene. To address this problem the following should be implemented like hand washing, proper hygiene, use of PPE, hand sanitizer to each room and even corridor, health education or information dissemination (mass production of pamphlets regarding UTI prevention), infection control, and proper waste disposal. Patient satisfaction – one of the most important thing to be prioritize because patients are the ones who receives care and they should be satisfied or even exceed the expectation of the services being rendered to them. To be able to improve the quality of care makes the patient satisfied and happy the following are being implemented to have quarterly auditing of services rendered, quality assurance, suggestion box or feedback forms. Incompetent staff – to give a quality of care means to have enough knowledge and skills to handle the patients and assist them according to their needs. Incompetent staff is another problem identified that contribute in poor healthcare delivery service and patient`s injury. For example clinical error, and negative feedback. To address this problem the following are being implemented like comprehensive recruitment and selection, trainings and seminars, disciplinary action, continuous evaluation and staff appraisal. Lean Management Lean Management is all about encouraging everyone in the facilities from the top management down to the staff to be involved in helping to participate in the improvement of quality care, and reducing errors. First, you have to identify the problem and acknowledge that the problem exists and why it is a problem, willingness to change and you can now find ways on how to solve that problem. In Kindly Residential Rest home we value our residents, respect our residents and continue to provide quality of care. We have to understand the voice of our clients, where they coming from, and made sure to meet their needs and put into action. The most important thing in lean for healthcare organization is that the errors and mistakes are being corrected nor improve, the amount of time taken is being valued, productivity increases, and so it is easy for the staff to work easier by eliminating those waste that can provide good quality of care and productivity of the staff. Here are some of the common Errors: Clinical Communication – In electronic patient record, if there is any laboratory test results needed instead of waiting for a week wherein referral needed from the attending physician of the patient and then sending back the result from the physician, the system is being made to remove any unnecessary stages instead laboratory people sends electronic results so he can access right away and evaluate the result. So, it saves time and effort of the patient from travelling. Waiting time/ Getting Appointment – Appointment System is an agreement to meet with the physician at a specific time and day and it is used also to control the demand and the problem is on the mismatch on the capacity of the patients and the physician. In order to avoid this problem the system must be monitored or may provide different type of consultation to accommodate everyone. In result, the patient is being examined on the day she wanted to be seen, less stressed for the staff. Overproducing – spending so much time on something that is not important for the patient Defects – wasted time and effort for the inspection of something that has been already done or inspected In KRRH we value our residents the most, we have to eliminate those wastes and focus to what is important to our client and be able to maintain the quality of work and our commitment to our profession and to the residents as well. Issue 4: Continuous Improvement System It is important to maintain a continuous improvement system for delivery of service to geriatrics. Quality management is one way to improve the system and it is composed of costumer focused organization, leadership, involvement of people, process approach, system approach to management, continual improvement, decision making, and mutually beneficial supplier relationships. In order to perform quality improvement an organization must consists of team that has a deep understanding of an area that requires enhancement. Organization like the Kindly Residential Rest Home is determined to continue finding solutions for the present problems as well in the future that may arise. By continuous improvement of the system there will be a positive result that will lead to a better healthcare service it will ensure the high standard of care that is cost effective and accessible to all. Organization must be sensitive to the needs of the patients and therefore must understand and ensure that there will be a plan of action to meet those needs. This is the result when an organization is costumer focused. Secondly is the Leadership, this is the action of leading a group of people and the leader should know how to unite people that will be involved in achieving the organization’s goals. Thirdly, is the involvement of the people in the organization at any level must do their part in their full capabilities in order to have a successful outcome that can be used for the benefit of the organization. Continuous improvement is necessary because there is no permanent in this world, even the facility in some point changes. Given an example is the technology; people depend on computers and this help in many ways like documentation, auditing and research. Many facilities depend on computer and internet because they make the job easier and efficient. Trainings and seminars a re also another way of improving the system. Developing and enhancing the skills of employees will lead to better healthcare delivery. A well knowledgeable and trained staffs has so much to offer that will benefit not only the clients but also the organization. They will be more confident as well as an important member of the facility. The residents will be satisfied with the care that they are getting from the healthcare providers and as the result they intend to stay longer. The facility will gain a good reputation and the business will be successful. This will attract more people to invest in the health care industry. By frequent assessment and analysis of the problem or changes there will be an ideal plan of action. Continuous improvement in an organization is part of duties and responsibilities of management. To achieve highest performance and success adapting to changes is essential. There is no such thing as constant especially when it comes in dealing with lives of people. Different approaches must be applied depending on the person’s character, behaviour or needs.

Chapter Essay

What do you think are the prime advantages and disadvantages of National City Corporation’s virtual tryouts? The advantages of using virtual tryouts are competitive edge against other companies. Allows them to pick candidates better suited for their work environment, allows candidates the knowledge that they are applying for a company that is at the cutting edge of technology and they want to move forward with the times. Unfortunately there are also disadvantages associated with virtual tryouts. Employers may grab the interest of candidates, however if real day to day activities at work do not contain some of the aspects that the virtual test had, then employees will get uninterested and quit. 2. Do you think there would be any EEO concerns regarding this system? I don’t think there would be any EEO issues with this system, otherwise it would not be offered in the market. However I do believe that this new system â€Å"Virtual Tryouts† is not necessarily right for all hiring aspects for every type of position/ company. There are aspects of a perfect employee to company match that a computer test cannot guarantee. Example, you can have a candidate that gets great results in the virtual tryouts given the situation that they are told to address, yet in the real day to day situation of the position they do not do very well, and vice-versa. 3. Would you suggest the company tailor its system for different types of candidates? Yes, I recommend that the company tailor its system for the different types of positions and the different types of candidates required to fill those positions. Chapter 8 Case Study Appraising Employees at the San Diego Zoo. 1. Do you think the San Diego Zoo’s old appraisal system needed to be changed? I think it needed to be changed because before they weren’t taking it seriously and it was a low priority to them. Now with the new system the employees will get raises depending on their performance which in turn will ncrease company performance. 2. What do you think are the pros and cons of using a Web-based appraisal system? The pros of using a web-based appraisal system is that it is convenient because a large group of people can be rated in less time and it will control personal bias. The cons of using a web-based appraisal system is that it gives too little attention to the overall performance of workers and in person interviews are more effective in rewarding or po inting out deficiencies in workers. 3. How do you think the new appraisal system will affect employees and the types of employees who work at the zoo? The new appraisal system will affect employees positively for those employees that are looking to grow with the company and be a part of the growth. When an employee is given targets and goals to reach, then they know what they are working towards and they are aware that if they reach the targets and goals there is a gain for them at the end. With this set, you will get employees that are willing to do the work and the time to get a job done right.

Fermentaion

Dilution is achieved by controlling the flow of process water from the dilution tank TUB 1201 into the mixer GAL. 1230. Process water flow rate is controlled to achieve the desired density of the mixed solution. The now diluted C-molasses solution flows into the vapor condensate EAI 1204, where it is preheated by the condensing hot water vapor from the flash tank TUB 1203. The solution is preheated to about 75 to ICC. The preheated solution flows into the hydrothermal GAL. 1231 where the temperature s increased to between 85 to ICC, using the 7 – lobar saturated steam as a heating medium.The then heated solution enters the cyclone IF 210. The cyclone is responsible for removing solid purities that may be present in the concentrated C- molasses. The discharge valve on the cyclone will open periodically to dislodge the cyclone. The diluted, heated and now ‘cleaned' C-molasses then flows into the intermediate/ Buffer Tank TUB 1202. The tank is equipped with a level indicato r control that controls the flow out of this tank maintaining a desired level set point. The stream is then pumped out into the second hydro heater GLOBAL where the temperature is increased to between 121 to ICC, using the 7 – lobar saturated steam.The hydro heater GAL. 1232 is equipped with highly delicate temperature indicator controller; this temperature control is a Critical Control Point. When the temperature drops below ICC, the sterilizer will go into recirculation and will stop feeding forward to the sterile tanks. This is designed to prevent Coli and C. Botulism to enter the sterile tanks. These are harmful micro-organisms that are not suitable to fermentation and human consumption. The heated solution then flows through the retention coils and into flash tank TUB 1203. The flow through the retention coils is controlled at a backslappers of kappa.The coils are interchangeable since there are two coils, one online and the other on standby. The flash tank is kept under vacuum – 35 to -kappa by using the vacuum system. The flash tank TUB 1203 is protected from over-pressuring by pressure relief valve installed into the vacuum system. The vapor leaving the flash tank is condensed by incoming diluted C-molasses in EAI 1240 and forming condensate that flows to the inch separator vessel. This separator easel separates liquid from vapor and also forms a barometric seal into the seal pot. L.DEVELOP DIAGNOSTIC TOOL FOR THE EFFICIENT OPERATION OF THE PLANT/ SECTION OF PLANT UNDER CONSIDERATION. The diagnostic tool for the efficient operation is a system developed for better and safe way of operating a system. These processes include daily maintenance to ensure that a system is performing at its best. There a programs that is designed for each operation of the plant to maintain stability and safety operation through monitoring. There are alarms installed in the plant to alarm operators of deviation from normal operation of the plant.Deviations can b e of process out of specification and danger alarms of hazards in the plant. At Anchor Yeast Durban the company has a dedicated and well developed system of monitoring deviation throughout the plant operation for the efficient operation. There are DOCS and software such as Aurora. Aurora is used for daily operation maintenance and keeping records of the plant operation. Without these systems the plant will be a danger to employees and the surrounding environment. These tools assist in managing and implementing efficient ways of operation of the plant.With the tools it is possible to determine and strategies the optimal peak operation for the plant in the next hour of operation and for the 24 hour of operation. They provide demand response strategy for emergency situations, such as extreme unwanted condition of the plant operation. With these the company always adheres to maintains high standard of delivery to its customers, through meeting schedule timing for the production and safe ty and cost efficient way of saving energy. Fault Tree Analysis is a broadly used deductive method for the efficient operation of the plant in designs and daily operations to minimize costF. HAZARD AND OPERABILITY STUDY (HAZARD) OF THE PROCESS OR PART OF THE PROCESS UNDER CONSIDERATION. Hazard and Operability study is the method in which a multi – discipline team performs a systematic study of a process to identify hazard and problems which prevents efficient operation. The technique is applied to new plant development and existing Operations for better and safe Operation. The method is also applied to continuous and batch process. The study provides opportunities to engineers to let their imaginations go free and think of all possible ways in which a hazard or operating problems might arise.Engineers have to ask themselves the following questions when performing HAZED study: What can go wrong? This is the first and most important stage in any hazard study, is to identify the most important things that can go wrong and produce accidents or operating problems. What will be the consequences? Engineers need to know the consequences to employees, members of the public (community), plant and profits, now and in the long term. How can it be prevented? – Safeguard Engineers need to administer controls that will prevent accidents from occurring, or make them less probable and protect people from the consequences.What should be done? – Solution At this stage engineers weigh their options to resolving the accidents, by comparing the risk (that is, the probability times the consequences) with generally accepted codes and standards or with other risk around them. Is it worth the cost? Engineers should compare the cost of prevention with the cost of the accident to see if the remedy (solution) is reasonably practical or they should look for a cheaper but efficient solution. Prevention At this point engineers have come up with a solution but before comm encing to put the solution in motion they should assess their solution, I. Perhaps their method of prevention has disadvantages and better methods of prevention should be suggested. Figure 1: Hazed Procedure [Figure 2. 1, Peg. 9: Hazed and Hazard Identifying and Assessing Process Industry Hazards, Tremor Klutz 3rd Edition] P. PROBLEM SOLUTION TO A CUSTOMER REQUEST (TECHNICAL REPORT) Unhappy customers are bad news for the company and the business. It takes one unhappy customer to steer away prospective customers away from the company. Unhappy customers have their reasons. Some customers have unrealistic expectations and some they Just don't feel well with the business.We must be hones some customers complaint are legitimate and realistic and we as the suppliers we must attend to their complainants with honesty and integrity to build on good customer relationship. Whatever the cause, unhappy customers are our hope for future business and we want them happy again for the business. Cust omer may not always be right but he or she will always be the customer we want and need. So we need to take care of our customer and take control of their complaints and them to our own advantage. There are seven (7) steps in resolving customer complaint which eave proven to work well. . Listen Intently: Listen to customer and do not interrupt while telling you a complaint. They need to tell their story and feel that they have been heard. 2. Thank Them: Thank the customer for bring the problem to your attention. You cannot resolve a problem that you do not have full details about or solve it on assumptions. 3. Apologies: Sincerely convey to your customer and apology. This is not the time to make Justification and making excuses. You apologies, that's it. 4. Seek the Best Solution: Determine what the customer is seeking as a solution, Ask the customer. Reach Agreement: Seek to agree to the solution that will resolve the problem to their satisfaction. 6. Take Quick Action: Act on the problem with a sense of urgency. Customer will respond positively to your focus on helping them immediately. 7. Follow Up: Follow up to make sure that the customer is completely satisfied. TYPICAL CUSTOMER REQUEST AND SOLUTION At anchor yeast we have customers all over the country and across the border. Customer happiness is very valuable to the company and any complaint is attended with urgency and caution.As one of largest yeast making company in South African, e are always under pressure to deliver on time and meet our customer wants and needs, and still performing to our utmost in producing high quality yeast. There are trucks coming in the plant to collect cream yeast and deliver to customers. One of the company that we always work with very closely is Anchor Yeast Johannesburg were most of the cream yeast produced at Anchor Yeast Durban is transported to, for further applications. There are Unitarians coming on daily basis to collect the product.Delays are very stressing the r elationship between the two companies. The Unitarians ruckus come from Johannesburg Debug) with molasses to Durban Anchor Yeast. The molasses is a raw material that is used to make yeast. When the trucks come on site they first have to go to the company's weighbridge before being offloaded. After being weighed the truck is offloaded either Tank offloading point or at the HTML offloading point. Offloading of the truck takes three (3) hours maximum then truck goes back to be weighed. After the truck has been weighed, it goes to the CHIP (Clean In Place) point to be Caped.Coping is a process where the truck is being clean using chlorinated water and Caustic. This process takes one hour (1 her). After the CHIP the truck is ready to be loaded with cream yeast. The loading process takes one hour (1 her). Then after that the truck is ready to go back to Judder with the product. Customer Complaint: Unitarians tankers are taking to long at Anchor Yeast Durban to turn around back to Anchor Ju dder. Possible causes of delays: At Anchor Yeast Durban there are three companies that come on site to deliver molasses.The Subs Hertz Borders Trucks (GHB) and Gridiron Terminal Trucks and local delivery trucks that that transports cream yeast to Durban based customers ND other customers across the country. When the Unitarians trucks from Judder comes onsite to deliver molasses there are always trucks waiting, loading or offloading molasses. There are only two offloading points at the company. Unitarians have to wait for other trucks which came before to finish offloading and loading. The trucks can sometimes wait for over three hours depending on the number of trucks offloading. Sometimes production of cream yeast is very slow.That means every time the trucks arrives onsite to collect cream yeast, they wait because not enough cream yeast has been produced. The company having to aware of the complaint from the Anchor Yeast Johannesburg, the company came with solutions to the complai nt. There was a spreadsheet that was made to record the times the Unitarians come onsite and time finished to offload the truck. The spreadsheet included also the time it took to load a truck. With regard to running low on cream yeast there was a production time table set for everyday that how much needs to be produced and how much will be transported to Judder on daily basis.The number of other truck companies bring molasses was reduced to avoid Unitarians trucks to wait for other trucks to finish. It was also suggested that Unitarians trucks given first priority when comes to offloading. This meant when Unitarians is onsite and there is a truck waiting to be offloaded, the Unitarians truck will offload before the truck to avoid delays. The plant efficiency was increased and more of product was produced and made available for the Unitarians to transport. The implement solution has been running fro couple months now and been evaluated. The solution has been found to be working well and keeping the customer happy.Thought at the beginning the other companies were not happy with Unitarians having o bypass their trucks, but after some negotiations the other companies have come to accept the terms.

Julius Caesars Rise to Power in the Roman Republic

By the time of the First Triumvirate, the republican form of government in Rome was already on its way to monarchy. Before you get to the three men involved in the triumvirate, you need to know about some of the events and people that led to it: During the era of the late Republic, Rome suffered through a reign of terror. Terrors tool was a new one, the proscription list, by which large numbers of important, wealthy people, and often senators, were killed; their property, confiscated. Sulla, Roman dictator at the time, instigated this carnage: Sulla now busied himself with slaughter, and murders without number or limit filled the city. Many, too, were killed to gratify private hatreds, although they had no relations with Sulla, but he gave his consent in order to gratify his adherents. At last one of the younger men, Caius Metellus, made bold to ask Sulla in the senate what end there was to be of these evils, and how far he would proceed before they might expect such doings to cease. We do not ask thee, he said, to free from punishment those whom thou hast determined to slay, but to free from suspense those whom thou hast determined to save.Although when we think of dictators we think of men and women who want enduring power, a Roman dictator was: A legal officialDuly nominated by the SenateTo handle a major problem,With a fixed, limited term. Sulla had been dictator for longer than the normal period, so what his plans were, as far as hanging onto the office of dictator went, were unknown. It was a surprise when he resigned from the position of a Roman dictator in 79 B.C. Sulla died a year later. The confidence which he reposed in his good genius... emboldened him... and though he had been the author of such great changes and revolutions of State, to lay down his authority....Sullas reign drained the Senate of power. The damage had been done to the republican system of government. Violence and uncertainty allowed a new political alliance to arise. Beginning of the Triumvirate Between the death of Sulla and the beginning of the 1st Triumvirate in 59 B.C., 2 of the wealthiest and most powerful remaining Romans, Gnaeus Pompeius Magnus (106-48 B.C.) and Marcus Licinius Crassus (112-53 B.C.), grew increasingly hostile to each other. This wasnt simply a private concern since each man was backed by factions and soldiers. To avert civil war, Julius Caesar, whose reputation was growing because of his military successes, suggested a 3-way partnership. This unofficial alliance is known to us as the 1st triumvirate, but at the time was referred to as an amicitia friendship or factio (whence, our faction). They divvied up the Roman provinces to suit themselves. Crassus, the capable financier, would receive Syria; Pompey, the renowned general, Spain; Caesar, who would soon show himself to be a skilled politician as well as a military leader, Cisalpine and Transalpine Gaul and Illyricum. Caesar and Pompey helped cement their relationship by Pompeys marriage to Caesars daughter Julia. End of the Triumvirate Julia, the wife of Pompey and daughter of Julius Caesar, died in 54, passively breaking the personal alliance between Caesar and Pompey. (Erich Gruen, author of The Last Generation of the Roman Republic argues against the significance of the death of Caesars daughter and many other accepted details of Caesars relations with the Senate.) The triumvirate further degenerated in 53 B.C., when a Parthian army attacked the Roman army at the Carrhae and killed Crassus. Meanwhile, Caesars power grew while in Gaul. Laws were altered to suit his needs. Some senators, notably Cato and Cicero, were alarmed by the weakening legal fabric. Rome had once created the office of tribune to give the plebeians power against the patricians. Among other powers, the tribunes person was sacrosanct (they couldnt be harmed physically) and he could impose a veto on anyone, including his fellow tribune. Caesar had both tribunes on his side when some members of the senate accused him of treason. The tribunes imposed their vetoes. But then the senate majority ignored the vetoes and roughed up the tribunes. They ordered Caesar, now charged with treason, to return to Rome, but without his army. Julius Caesar returned to Rome with his army. Regardless of the legitimacy of the original treason charge, the tribunes had vetoed, and the disregard for the law involved in violating the tribunes sacrosanctity, the moment Caesar stepped across the Rubicon river, he had, in legal fact, committed treason. Caesar could either be convicted of treason or fight the Roman forces sent to meet him, which Caesars former co-leader, Pompey, led. Pompey had the initial advantage, but even so, Julius Caesar won at Pharsalus in 48 B.C. After his defeat, Pompey fled, first to Mytilene, and then to Egypt, where he expected safety, but instead met his own death. Julius Caesar Rules Alone Caesar next spent a few years in Egypt and Asia before returning to Rome, where he began a platform of reform. Julius Caesar granted citizenship to many colonials, thus widening his base of support.Caesar granted pay to Proconsuls to remove corruption and gain allegiance from them.Caesar established a network of spies.Caesar instituted a policy of land reform designed to take power away from the wealthy.Caesar reduced the powers of the Senate so as to make it an advisory council only. At the same time, Julius Caesar was appointed dictator for life (in perpetuity) and assumed the title of imperator, general (a title given ​to a victorious general by his soldiers), and pater patriae father of his country, a title Cicero had received for suppressing the Catilinarian Conspiracy. Although Rome had long abhorred a monarchy, the title of rex king was offered him. When the autocratic Caesar rejected it at the Lupercalia, there were grave doubts about his sincerity. People may have feared he would soon become king. Caesar even dared to put his likeness on coins, a place suitable for the image of a god. In an effort to save the Republic -- although some think there were more personal reasons -- 60 of the senators conspired to murder him. On the Ides of March, in 44 B.C., the senators stabbed Gaius Julius Caesar 60 times, beside a statue of his former co-leader Pompey. Sources (www.herodotuswebsite.co.uk/roman/essays/1stTriumvirate.htm) How and why did the so-called First Triumvirate come into being? Suzanne Cross: [web.mac.com/heraklia/Caesar/gaul_to_rubicon/index.html]Gaul to the Rubicon The Rise of Julius Caesar www.republic.k12.mo.us/highschool/teachers/tstephen/ 07/13/98