L

2010
Lim Uy, Sandra Sharlene D. P.

MD MBA 090064

HR Management

[ANALYSIS OF THE
KYTHE
FOUNDATION]
Table of Contents

Background....................................................................................................................3
Scope...........................................................................................................................4
SWOT ANALYSIS...........................................................................................................4
Strengths......................................................................................................................4
Weaknesses.................................................................................................................8
Opportunities................................................................................................................9
Threats.......................................................................................................................11
Analysis Matrix............................................................................................................12
Value Discipline............................................................................................................12
Generic Strategies........................................................................................................13
Operational Excellence...............................................................................................13
Product Leadership.....................................................................................................14
Customer Intimacy......................................................................................................14
The 7S Model................................................................................................................15
Strategy......................................................................................................................15
Structure.....................................................................................................................15
Systems......................................................................................................................17
Skills...........................................................................................................................17
Staff............................................................................................................................17
Style............................................................................................................................18
Shared Values............................................................................................................18
Strategy Map and the Balanced Scorecard................................................................18
Recommendations.......................................................................................................22
Underlying Points........................................................................................................22
Points for Development...............................................................................................23
References....................................................................................................................25

Background
2
Kythe was formed in 1992 by two psychology graduates of Ateneo de Manila

University, Maria Fatima Garcia-Lorenzo and Icar Castro, to provide

psychosocial support for pediatric cancer patients. Today, Kythe is considered as

one of the non-stock, non-profit organizations based in Manila. Their mission is to

implement and integrate the Child Life Program (CLP) in their affiliate hospitals

and institutions. Through education and research, the organization aims to

increase awareness of the said program in the health care industry. Currently,

there are nine affiliated hospitals all over the country that are working with Kythe

for the implementation of CLP in their institutions. Kythe envisions an

improvememtn in the quality of life for pediatrics patients by uplifting their spirits

and strengthening hope in these patients and their families.

The Child Life Program (CLP) aims to minimize the psychological trauma

experienced by pediatric patients and their families by addressing their

psychosocial needs. The said patients, who are afflicted with chronic diseases

like cancer, are assisted in coping with the stress and anxiety brought about by

the whole hospital experience. Consequently, CLP could help promote a child’s

normal growth and development and at the same time make sure that the

family’s living pattern is still within normal. With CLP, the patients are not the only

ones who could benefit from the program; at the same time, the family and the

health care providers also enjoy some of the benefits. The parents of the patients

are given emotional support in order for them to be emotionally sound about the

condition of their child. Doctors, on the other hand, are trained in order to step

3
into their patients’ perspective of the experience. The possible interventions

provided by CLP includes psychosocial need assessment of the patient and the

family, education regarding the illness, preparation for and assistance during

medical procedures, therapeutic play, and hospice care. In the end, everyone

benefits from this program—the patient, the family and the health care providers.

Kythe Foundation attempts to institutionalize CLP in each of their hospital

affiliates in order to seek an improved quality of life for their pediatric patients by

uplifting their spirits and providing a spark of hope to their family.

Based on Kythe’s assessment, a successful CLP includes:

1. Approval from the medical director and hospital management,

2. Department heads’ awareness of the program,

3. A “Child Life Champion” in the hospital,

4. Training and education for medical staff and doctors about CLP,

5. Involvement of the community as volunteers,

6. Two full-time salaried Child Life Coordinators, and

7. A Child Life Center.

4
The ultimate goal of Kythe is to be able to assist hospitals in making CLP an

integral part of all services of the hospital.

Scope

Kythe is most identified with its Childlife program which it spearheaded in the

country. The paper will then be limited to the program for which the organization

is most known for, which it focuses on, and which people use it interchangeably

with.

SWOT Analysis

Strengths

There is good coordination among the Child life coordinators who are

assigned to each affiliated hospital and the board of trustees. The board and

everyone involved in Kythe are informed of the occurrences in each of the

hospitals through regular reports made by the Childlife coordinators assigned to

5
each affiliated hospital. Toys that do not get used in one hospital may also be

transferred to other institutions so that their utilization may be maximized.

The Childlife coordinators are trained by the Childlife specialists who were

trained and certified in the United States. The training of Childlife specialists

only happen in America and they have to take an exam to get certified. There are

currently only two Childlife specialists in the country, one of them is the founder

of Kythe, Mrs. Fatima Garcia.

The organization generally has a good relationship with their partner

hospitals. The hospitals that enforce the program have most of the items

needed for a successful Childlife program. Some of these items like the play

areas and the Kythe offices and other facilities are provided by the hospital while

others like the toys and books are provided by the organization. Soe hospitals

like POC and UST have Childlife parties every month to celebrate the children

making it through one more month fighting their diseases or in rehabilitation.

These are done inside or outside the hospital. Outside the hospital only

outpatient children are allowed to attend the parties. They also have annual

summer camps fro which all children, members and volunteers are required to

attend.

Childlife coordinators committed to the program. The Childlife coordinators

do not work for free. They are social workers who do not get paid as much as

they would have should they have worked in other countries. In other countries,

social workers are not mere employees who see to it that the underprivileged are

given discounts and the charity that the hospital or their organization can

6
 accommodate; they are people who get paid much more and are given more

respect. In foreign countries, once there has been a patient, there is

automatically assigned to the social worker not the patient who goes looking for

the social orker. Furthermore, they can get paid much more outside of the

Philippines for doing the same job of dealing with harassed family members,

crying children, etc.

Table 1. Assessment of Childlife Affiliated Hospitals

UST Tarlac PSH Davao AFP QMMC NCH POC NKTI
Provincial Ceb Medical
Hospital u Center

Awareness of Limited ü ü ü ü O ü Limited Limited

Child Life
Program
Acceptance of Limited ü ü ü ü O ü Limited Limited
Child Life
Program
Organic full O O O O ü O ü Part O
time Child Life time
Coordinator
Funded by the
Hospital (after
the grant)
CLP as part of ü ü ü ü ü Limited Limited O ü
multi-
disciplinary
treatment
(referrals/ case
management/
progress
report)
Hospital Multi- O ü ü ü O O O Limited O
Disciplinary
Team involved
in planning of
Child Life
activities
Hospital Multi- O ü ü ü O O O Limited O
Disciplinary
Team involved
7
in
implementation
of Child Life
activities
Child Life Play O ü O ü ü ü ü ü O
Area
Note: BMC (Bicol Medical Center) is the newest hospital affiliated with Kythe. No Assessment has been
done for this hospital.This hospital and those outside Metro Manila is not included in the assessment.

Weaknesses

Some of the Childlife coordinators do not work full time at the hospital they

were assigned to. Some of the coordinators may be giving half baked services

because they can concern themselves with other activities. Some of them teach

like ate Julie reyes who is assigned to the UST charity wards, go into sales, etc in

an effort to earn extra income for their families.

Not all members of the affiliated hospitals are aware of the existence and/

or the advocacy of Kythe and the CLP. From the interviews conducted by my

group in ASMIP, we found out that only those who are in contact with the children

themselves are aware of the program and its advocacies. Many of the newly

appointed doctors have no idea of the existence of the program.

The program has no feedback mechanism. Apart from the happy smiles that

the program achieves, they have no data through which the success of the

program can be measured. There are no evaluations for the activities held by

Kythe as part of the Childlife Program nor are there evaluations for the Childlife

coordinators. The organization should not rely on word of mouth alone to tell

whether they have been a success or not. Everything, even evaluations should

have some amount of paperwork that can measure performance.

8
Change in leadership in Kythe has resulted in lack of coordination with the

hospital. The director of Kythe, Mrs. Girlie Lorenzo is not currently being as

active as she was on the years preceding this one because of the election (her

husband ran for a position in their province). She was not able to visit the

hospitals and therefore wasn’t as in tune as she was prior to 2010. This was also

the reason why they were not able to present the current agenda of the

organization and the program to the hospital administrators and why even the

coordinators have no end goal towards which all of them would be working for.

Opportunities

Kythe has proper financing from external organizations. Pfeizer is the major

sponsor of Kythe in advocating CLP. It has helped in developin the Childlife

Centers in the different hospitals that support Kythe. Childlife parties can also be

sponsored by specified individuals or group. Japan Airlines and Toshiba

Philippines have also provided monetary donations to fun the organization’s

program.

Kythe has multiple avenues through which people can help. A person an

volunteer to do playroom or bedside activites, ie play with the kids or read them

books. Kythe can also become the beneficiary for an event that the volunteer is

having, be it a birthday, a charity, etc. Third, the individual can donate money to

help fund the hospital requirements of the cancer patients involved with Kythe.

This can be done in person, bank payments or online through the Kythe website.

The volunteer can also donate toys and books to contribute to the Kythe play

areas in the different hospitals. Lastly, a person can be what Kythe calls P100

9
miracle Worker which involves donating only 100 pesos every month for a year.

Again, this can be done through bank payments and online at the website. The

full list of donors for each hospital can also be found in the Kythe website.

Kythe’s broadening service would encompass not just the patients and

their families but those who deliver the health service as well. The current

plan of the organization is to cater to the needs of the health professionals so

that they may be able to deliver the quality of care that the patients need. They

have already established their program for the children and their parents so the

focus will shift to the doctors, nurses and the institution. They plan to invite these

change leaders in the hospital to workshops and seminars that would help them

to manage whatever it is that they feel hinder them from doing their job or from

giving their full efforts into their jobs. (This was what our ASMIP paper was

about- to find out what the change leaders needed and make a training needs

assessment from the gathers information)

Kythe can also expand its program to encompass more public hospital as

well as include private institutions. Kythe plans to include more public

hospitals in its roster of affiliated institutions. They will be celebrating their 20th

anniversary in the year 2012 and their goal for that year is to have 20 affiliated

hospitals all over the Philippines.

Institutionalizing Kythe to the Affiliated hospital. Tone of their goals,

therefore is to he organizers of the organization are well aware that they task is

merely to help the hospitals develop programs for the children themselves. They

are also aware that they have no monopoly over the Childlife program, a fact that

10
few hospitals and people are aware of. They want the program to e adapted by

the hospital, and hopes that by targeting the change leaders of the institutions,

there will come a day when the hospital itself is taking charge of the program and

the coordinators will be employees not of Kythe, but of the hospitals. They hope

to pass the torch to the hospitals so to speak.

Threats

Kythe has no control over the affiliated hospital. The organization is also only

limited to what the hospital they are affiliated with allows them to do. Therefore, if

they want to take the children out to summer camps or to the Childlife parties,

they may do so only after the hospital administration had given its approval.

Moreover, should the hospital choose to take away certain priveleges, they may

do so. This is what happened in UST where the Kythe office was moved to an

office was shunted to a room that was about the size of a cubicle and their

playroom was taken away or in NKTI where the playroom was moved to a

corridor next to the fire exit instead of being a proper room.

CLP is not exclusive to the organization. Kythe has no monopoly over the

program that they advocate and although they want the advocacy to spread,

there is always that slim chance that other organizations who may adapt he

program may not have fine tuned it as much as Kythe, so much so that they may

not do a very good job of program implementation and therefore, they might

unravel all that Kythe has worked for in establishing the said program and sin

CLP is so recognizable as a Kythe program, other organizations who muck it up

may undoubtedly also tarnish the reputation of Kythe.

11
 Analysis Matrix:
Strengths Weaknesses
Opportunities The strengths of Kythe can be utilized Some of the weaknesses of Kythe can
in order to garner and achieve the be filled in by the opportunities. For
opportunities. This can be done by example, the institutionalization of the
proper communications that would program. The program will become
highlight their strengths in order to internal to the hospital so there will be
encourage and entice people who can full time workers who will take care of
open doors for the organization that the well being of their customers. This
can help them with achieving their will also help in the increased
opportunities awareness and support from the
members of the hospital, and have
systems in place that will monitor the
processes as well as feedback
mechanisms for the program.

Threats The program has been associated The weaknesses and the threats to the
with Kythe that the two have become program can become disheartening to
interchangeable in the minds of those the organization, However, there are
who are aware of it, so that Kythe is always strategies to minimize the
the more established organization that dangers that these two factors may
is handling CLP therefore the threat is cause:
not that great that other new entrants - The continuous innovation of the
will affect them. program can help to decrease
Furthermore, there is always room in the threats and weaknesses
our society to help the - Having systems in place such as
underprivileged. a more defined structure and/ or
The strength could also increase the code of internal procedures can
awareness of the institutions and their help ease the burden of
members about the program to gain miscommunications and the lack
support of feedback mechanisms

Value Discipline:

Since its conception, the value discipline of Kythe had always been to ease the

child into his illness, his new settings as well as the treatments that will be

undergone. It is to see to the child’s as well as the parent’s comfort especially

these underprivileged cancer patients that will have a prolonged stay in the

12
hospital. Now however, it is broadening the scope of its value discipline to

include an increase the quality of service and the health care delivery system of

the Philippine public hospitals. It is therefore probable that there are two

categories of customers that Kythe caters to: the patient and family as well as the

health care institution and its members.

To achieve its value discipline the organization uses generic strategies and

because there were two customers identified it is important to note how each

value discipline affects each category of customers before noting which strategy

is most employed by the company

Generic Strategies:

Operational Excellence focuses on low price and hassle free service.

For the patients and their relatives this is evident in that the service provided is

free and is made by trained professionals. The professionals also help by

preparing the patient and the family on what will happen with regard to the

treatment and its course to give them knowledge and alleviate their anxiety over

the treatment.

For the health care institution this is may be observed in that the service is free

and the treatment course and performance would go on smoothly, because the

Childlife coordinator is present to calm the child down and the child already

understands what is to come so he is calmer while being treated.

The service is hassle free because knowing the schedule of the coordinator, they

are usually there when the treatment is given and they are easily contacted by

13
the health care professional as well as their peers ( social workers) should hey

be needed by either customer.

Product leadership centers on products that continue to be innovative so that it

remains to be the best. The product of the organization is the service provided by

their coordinators to the hospital as well as the patients.

In the part of the patients, this service is to see to their comforts and to give them

some fun and hope despite their cancers. They are innovative because they give

Childlife parties as much as once a month as in the case of the Philippine

Orthopedic Center, that makes the children and their parents happy. They also

provide avenues for the volunteers to help or to donate, by riding the wave of

technology so that the philanthropists may donate through their website or

through personal communications. They also hold summer camps. These are

innovative because cancer patients are typically handled with such care and the

children’s lives filled with an endless myriad of treatments and schedules that

they find it difficult to have more fun with their life or be comfortable in their new

surroundings.

On the other hand, they continue to innovate their program so that it may also

reach the doctors and nurses of the hospitals which is what they aim to do this

year in partnership with the Ateneo School of Management to create a seminar

series or workshop that would cater to the members of the healthcare delivery

system.

Customer intimacy refers to the close relationship that is formed between the

supplier, Kythe and the customers, their patients and the care givers to achieve

14
optimum results. The coordinators are the living proof of customer intimacy.

Watching their easy interaction with the children and their parents it was easy to

see that they tend to rely on the organization for support.

The organization currently has no formal programs to cater to the service

providers. However, the coordinators have relationships with those doctors to

whom they have close contact with while helping to take care of the patients.

The generic strategies of the organization and subsequently the organization are

customer intimacy and product leadership this is especially seen in how they are

dealing with their customers, the patients and the current innovations that will

help them establish customer intimacy with the doctors, nurse, labs, etc.

The 7S Model

Strategy determines the vision, goals, and objectives of the organization that

would give the organization their edge over the competition. (for the strategies of

the Kythe please see the generic strategies section)

Structure determines the hierarchy in the organization. (See below) The

structure of Kythe is vertical. These structures are hierarchical, with graduating

levels of responsibility and power in one direction and diminishing levels of

autonomy and authority in the others.

15
 Executive
Executive director:
director:
Maria
Maria Fatima
Fatima Garcia-
Garcia- Lorenzo
Lorenzo

President:
President:
Dr.
Dr. Kelly
Kelly Salvador
Salvador

Vice
Vice President:
President:
Eddy
Eddy Jose
Jose Manzanares
Manzanares

Secretary/
Secretary/ Treasurer:
Treasurer:
Minnie
Minnie LuLu Fong
Fong

Trustee:
Trustee: Trustee:
Trustee: Trustee:
Trustee: Trustee:
Trustee:
Rey
Rey Gerrardo
Gerrardo Bacarro
Bacarro Chiqui
Chiqui Escarreal-
Escarreal- Go
Go Cathy
Cathy Babao
Babao Guballa
Guballa Fr.
Fr. Ted
Ted Gonzales,
Gonzales, SJ
SJ

Child
Child Life
Life Projects
Projects Officer:
Officer:
Cynthia
Cynthia Manzanares
Manzanares

Child
Child Life
Life Specialists:
Specialists: Dianne
Dianne
Jimenex,
Jimenex, Nerissa
Nerissa Sumpaico
Sumpaico

Childlife
Childlife Coordinators
Coordinators
Quirino
Quirino Memorial
Memorial Medical
Medical Center:
Center: Maria
Maria Fatima
Fatima Garcia-Lorenzo
Garcia-Lorenzo
Armed
Armed Forces
Forces of
of the
the Philippines:
Philippines: Aida
Aida Calagui,
Calagui, RM
RM
Davao
Davao Medical
Medical Center:
Center: Crissa
Crissa Maria
Maria Nacionales,
Nacionales, MA,
MA, Shiena
Shiena Payno
Payno
National
National Children's
Children's Hospital:
Hospital: Maryan
Maryan I.I. Sanchez,
Sanchez, RM
RM
National
National Kidney
Kidney and
and Transplant
Transplant Institute:
Institute: Dianne
Dianne U.
U. Jimenez
Jimenez
Philippine
Philippine Orthopedic
Orthopedic Center:
Center: Evelyn
Evelyn Muniz
Muniz
Tarlac
Tarlac Provincial
Provincial Hospital:
Hospital: April
April Anne
Anne A.A. Palomo,
Palomo, Cherry
Cherry Anne
Anne O.
O. Umblas
Umblas
University
University of
of Sto.
Sto. Tomas:
Tomas: Juliet
Juliet P.
P. Reyes,
Reyes, RSW
RSW

This means that there is only one point of authority that everyone has to follow.

The board of the organization would make decisions and these would be

16
followed and implemented by the Childlife coordinators. Therefore, the decision

to include the health professionals would increase the work load of the

coordinators; they have no choice but to follow.

Systems refer to the processes that are involved in getting the job done. Every

day the coordinators would make their rounds, much like a doctor through the

charity wards of the hospitals to check on the patients and their families and to

spend time with them. They also open and watch over the children in the play

area and are called to assist in certain procedures especially when the children

are expected to act up. They are also there during celebrate life parties, summer

camps, etc. Another one of their duties is to send regular reports to the officers of

the organization to keep them in tune with what is going on with the organization.

Skills are the capabilities of the employees that are reflective of the organization.

The coordinators are the ones who are in regular close contact with the patients.

They are social workers who know how to manage the stress experienced by the

patients and their families. They also empathize with the customers and have a

lot of patience with them. They know accounting and the operations of the

hospital to be able to provide feedback about the program and how the materials

such as books and toys are being utilized. They are flexible to the needs of their

patients and their customers. All these reflect the thrust of Kythe that looks out

for the safety, comfort and well being of their customers.

Staff refers to all activities that are related to the employees including,

recruitment, promotions, training and development. The recruited coordinators

are those who are involved with social work or have training that will improve the

17
patient wwelfare like nurses, like ate Evelyn in POC. The promotions are done

according to the amount of training that the coordinators get. First, they are

trained by the child Life Specialists, after which they can take the exam in the

United States to become Childlife Specialists themselves.

Style is the approach of the management and the work culture that would reflect

how the company or organization will be perceived externally. The organization

has a formal structure but their interactions with each other are very informal.

They are perceived as what they are which is a non profit organization that

specializes in the care for children with cancer. Because they interact with

children, they have a light camaraderie what is easily observed by the outsider.

Shared values refer to the guiding principles of the organization that fo beyond

the objectives that they have set for themselves. The shared value of all Kythe

officers, members and volunteers is the alleviation of the anxiety of pediatric

patients and their families through the promotion of optimum growth,

development and helping Kythe’s kids cope with challenge of hospitalization.

Every one of them is working towards this goal. This is the driving force of the

organization that makes the hard work and the palnning worthwhile to see that

the children are being taken cared of.

Strategy Map and the Balanced Scorecard

The balanced scorecard aims at “balancing” shareholder objectives with

customer and operational objectives. It is part of the strategy map which is a

diagram explicitly describing how an organization creates value by connecting

18
strategic objectives in cause-and-effect relationship to each other in the four

Balanced Scorecard perspectives.

19
 Stakeholders
Clients/ customers
Investors,
funders, donors
Employees
Areas of
Operations
Objectives
Measurement systems to t evaluate
evaluate
objectives
Strategies to achieve the
objectives
Tactics to achieve objectives
Formal evaluation process

Outcomes/ Core competencies

Results and Internal
Financial returns Vision processes
Policy and To achieve our
development vision, what do we
Health/ well being Values need to excel at?
Community safety
Objectives
Objectives
Measurement systems to t evaluate
evaluate
Measurement systems to t evaluate
evaluate
objectives
objectives
Strategies to achieve the
Strategies to achieve the
objectives
objectives
Tactics to achieve objectives
Tactics to achieve objectives
Formal evaluation process
Formal evaluation process

Learning growth and

Change
Improvements
and sustenance

Objectives
Measurement systems to t evaluate
evaluate
objectives
Strategies to achieve the
objectives
Tactics to achieve objectives
Formal evaluation process

20
Balanced Objectives Measurement Target
Scorecard
Perspective
Stakeholders Attract and retain # of children who are still 100% pediatric cancer
more patients active participants in the patients in the charity
program regardless of wards of the hospital
remission

Attract and retain # of organizations and 20- 30% increase in

funding sources and members of the private sources of funding and
volunteers sector who donate and volunteers
volunteer to the organization

Attract and retain # of hospitals who are 20 affiliated hospitals in

support from health affiliated with the 2012
professionals and organization
institutions
# of health professionals who 20% increase in awareness
recommend the program to and support from doctors
their patients
Core Fast turnover of # of patients a doctor and 50% increase in turnover
Competencies patients during child life coordinator can rate
and Internal treatment treat and help in a given shift
Processes
Learning Develop necessary Readiness for the job 10 % improvement in
growth and skills readiness of the personnel
Change
Develop good Availability of information 100%
support systems systems

Job performance Awareness of the VMO and 100%

aligned with goals of goals of the organization
the organization
Outcomes Profitability and Profits 20-30% increase in profits
More funding

More patients # of patient who are 20- 30% increase members

availing of treatment members of the organization
30- 50% increase in
More patients % of patients who live survivors
getting well from
cancer
100% factors associated
More support from Capabilities and activities with a successful CLP
the institutions allowed to the organization
Recommendations
21
Underlying Points

1. Importance of communication and relationships. CLP shows that

communication is the most frequently-used tool in circumventing any

major crises as a result of the difficulties experienced by the doctors,

patients and the Childlife coordinators. The flow of information allows for a

cooperative manner of solving problems. In the interest of CLP,

furthermore, these communication lines and relationships can be taken

advantage of in pushing for the visibility and support that the program

needs.

a. There is unrecognized importance of knowledge and information

sharing. Apart from the fact that some respondents have hardly

heard of CLP in their hospital, it appears that the crucial role that

knowledge and information plays is insufficiently taken into account.

2. Vague idea of support. Frequently cited as the hospital’s and health

provider’s means of assisting the respondents is its provision of “support.”

The problem is that this support is not properly characterized, and is most

often thought of only as money and resources and the treatment flowing

from top management to the different departments. It doesn’t take into

account the emotional and psychosocial support given to the important

stakeholders.

3. CLP is caring for the patients’ well-being. The respondents recognize the

importance of holistic care—of attending to the needs of the patients

outside medicines and treatment. However, it also appears that most of

22
 them are resigned to the fact that medical practitioners are incapable of

this practice. As a result, heavy reliance on a child life

coordinator/volunteer is observed.

Points for Development

1. Capitalizing on communication and relationships. As an effective problem-

solving technique, communication and personal relationships must be

cultivated more deliberately as a skill rather than happenstance. Those

involved need to be pro-active in taking advantage of these relationships

to develop better solutions, rather than just thinking of communication as

“reporting problems to management.” Focus can be on the following

things:

a. Institutionalizing feedback mechanisms to gauge the performance

of CLP in the institution

b. Fostering interpersonal relationships

c. Building skills in advocacy and enlisting support of potential

sponsors as well as supporters within the institution.

2. The vague idea of support has to be given more dimensions. The

stakeholders have to be more aware of the other important aspects of

support that lie outside the realm of funding and equipment and

medications for treatment.

3. Reintroduction of CLP as a program. There is a need to clarify the nature

of CLP, which in most cases is mistaken for Kythe Foundation itself. In

23
conjunction with the development of communication skills, this can ensure

the correctness of the content with which leaders advocate the program.

24
References

1. Child Life Council, Incorporated. (1998-2010). Child Life Council.

Retrieved May 2010, from http://www.childlife.org/

2. Kythe Incorporated. (2009). Kythe Foundation. Retrieved May 2010, from

http://www.kythe.org

3. Miller, J.A. & Osinski, D.M. (1996). Training Needs Assessment. Retrieved

May 2010, from:

http://www.ispi.org/pdf/suggestedReading/Miller_Osinski.pdf

4. Personal Communication with Mrs. Fatima Garcia- Lorenzo

25