The Nhs Quality Standards Health And Social Care Essay

The Nhs Quality Standards Health And Social Care Essay The Quality Standards for Health and Social Care set out the standards that people can expect from Health and Personal Social Services (HPSS). In developing these standards, this report aims to discuss the quality of services and to improve the health and social wellbeing of the people of UK. (Department of Health, Social Services and Public Safety, March 2006). At the heart of these standards are key service user and carer values including dignity, respect, independence, rights, choice and safety. The recent NHS Next Stage Review (England, 2008) outlined a number of initiatives designed to improve the measurement and monitoring of quality within the NHS. In the other UK countries, despite a reduced focus on market mechanisms to incentivise quality, data which helps others understand the patient experience and the quality of care delivered by the multidisciplinary team still remains an important theme. (RCN position statement, Publication no: 003 535, 2010). The measurement and communication of health and social care quality therefore requires assessment of key and consensual variables that reflect the breadth and complexity of health care. Engaging with multiple stakeholders to identify core elements of health and social care quality is essential to this process (See Figure 1) (Soane DM and Silber JH 2003). Figure-1 Health Care Environment Setting System Regulation. What is Quality? The quality of technical care consists in the application of medical science and technology in a way that maximizes its benefits to health without correspondingly increasing its risks. The degree of quality is, therefore, the extent to which the care provided is expected to achieve the most favourable balance of risks and benefits (Avedis Donabedian, M.D., 1980). As matter of fact, one cannot assure of guarantee quality only increase the probability that care good, or better because quality cant be guaranteed, many my-self included have criticized the term assurance. (A.Donabedian R. Bashshur, 2003). Quality is an umbrella for continuous staff and organization development using new methods, an equal emphasis on specification and measurement as an attitudes and relationships. It also building on good practices as well as introducing new procedure raising satisfaction at the same time reducing costs and increasing productivity. (J.Ovretveit, 1992). Definition of quality is different from many others according to Maxwell (1984), accessibility, relevance to need, equity, social acceptability, efficiency and effectiveness. But here is something missed which is central to the quality which is customers responsiveness and what customers want. Fully meeting customer requirements or the totality of futures and characteristics stated of implied needs (BSI, 1990). The most comprehensive and perhaps the simplest definition of quality is that used by advocates of total quality management doing the right thing right, right away.(Quality Assurance Project, Lori DiPrete Brown, 2010). Quality is proper performance (according to standards) of interventions that are known to be safe, that are affordable to the society in question, and that have the ability to produce an impact on mortality, morbidity, disability, and malnutrition. -M.I. Roemer and C. Montoya Aguilar, WHO, 1988 According to Roemer, M.I., (1998) the most comprehensive and conceivably the simplest definition of quality is that used by advocates of total quality management: .Doing the right thing right, right away. Quality frame Work: As health and social care quality is, by necessity, a multi-factorial and broad ranging concept, the definition, measurement and communication of quality in health and social care should involve multiple stakeholders. (RCN position statement, 2010). In health care, quality assurance has been meant to apply predominantly, or even exclusively to health and social care practitioner (A.Donabedian, 2003). However discrepant views between the different stakeholders, ranging from service users (the public, patients and carers) to service providers (nurses, allied health professionals and clinicians) and commissioners of health and social care, exist with regards to the definition and prioritisation of quality issues (Leatherman and Sutherland, 2008, Campbell et al., 2002). Many authorities and organisations in the UK and elsewhere have chosen to adopt an off the shelf performance improvement model or tool in order to help them manage strategically and deliver against the national modernisat ion agenda. (Review of Performance Improvement Models and Tools, 2006). These are the Investor in People, ISO9001:2000 quality system and Practical Quality Assurance System for Small Organisations (PQASSO) etc. On the other hand there are many other approaches and tools available on the market and the choice which to use can be a difficult one. Investor in People: Over 34,000 UK organisations are recognised as Investors in People employing around 27% of the UK workforce. Investors in People provide a straightforward, proven framework for delivering business improvement through people. 73% of Captains of Industry working with recognised Investors in People organisations believe that working with the framework leads to increased productivity.  79% of employers recognised with the Investors in People Standard say it helps all types of organisations adapt to change and growth'(Ipsos Mori Tracking study 2008). Figure: The Investors in People Standard There are three principles of Investor in People to which an organisations key indicators and to work towards have donate to and It is the reflects of business planning cycle (plan, do, review) for following and implement in their own planning cycle structure it obvious for organisations .The structure is based on three main principles: Plan -development to improve the performance of the organisation. Do -to improve the performance of the organisation they take necessary step/action. Review assess the impact of its investment in people on the performance of the organisation. Organisations perform better when their employees have clear goals and are supported by human resource (HR) practices Investors in People recognised organisations have greater human capital flexibility. This denotes to alter their behaviour, to cope with changing workplace circumstances or practices in practice are employees in Investors in People organisations are more capable. Including doing poles apart jobs and acclimatizing to new ways of working with the Investors in People Standard has a positive contact on novelty of a greater willingness to gain new skills. People acknowledgment is more expected to have high levels of service and product innovation effectual communication has a straight and positive result on profitability of Organisations that have Investors. By the learning to have a positive effect on communication inside an organisation and therefore a collision on profitability, assessed by profit margin and profit per employee is shown for Investors in People standing. (Institute for Employment Studies, 2008). The whole process is driven by your needs as a customer. Investors in People specialist will establish with organisational priorities and goals are at the start and then identify the most relevant parts of the framework for your organisation and its particular needs. Through the assessment process Investors in People specialist will provide feedback and advice on the areas of achievement and where there is room for development and Continual support which is personal, practical and flexible in the form of visits, online tools such as the business improvement tool IIP Interactive. Relationship with the Investors in People specialist is enhanced and their input is even more consultative (IIP, 2010). ISO9001:2000 quality system: ISO 9001:2000 is the global standard and come up for quality management systems. The standard mainly focuses on the management of processes and documentation work in order to meet customers needs and expectations. The standard originated in the UK in 1976 as BS 5750. It later evolved to ISO9001 and was revised in 2000 to ISO9001:2000. The nature and reduced documentation requirements of the latest edition of the standard have significantly increased its applicability to the public sector. (ISO: 9000, 2010) The technical committee (TC) 176 developed a series of international standards for quality systems, which were first published in 1987. The standards (ISO 9000.9001, and 9004) were intended to be advisory and were developed for use in two-party contractual situation and internal auditing. However with their adoption by the European community (EC) and a worldwide emphasis on quality and economic competitiveness, the standards have become universally accepted (Besterfield, D. H. 2007). ISO 9001:2000 Quality management systems (QMS)- requirements in the standard used for registration by demonstrating conformity of the QMS to customers, regulatory, and the organizations own requirements (Besterfield, D. H. 2007). The mark is a public demonstration that the organisations quality system has been assessed and is internationally recognised. Once an organisation has gained ISO9001:2000 status it will be visited at regular intervals each year to ensure the standard is maintained. Practical Quality Assurance System for Small Organisations (PQASSO): Practical Quality Assurance System for Small Organisations (PQASSO) is an off-the-shelf quality assurance system. It was first developed in 1997, which offers a practical step-by-step and designed specifically for use within voluntary and community sector organisations to improve the way organization runs and to help them to improve the quality of their services (PQASSO 3rd edition 2008). It provides a stage approach to working out what an organisation is doing well and what could be improved and approach to implementing 3 qualities through levels of achievement'(Proveandimprove 2010). Practical Quality Assurance System for Small Organisations (PQASSO) is a quality assurance system that was produced by the Charities Evaluation Service (CES) specifically for small and medium sized voluntary and community sector organisations (PMMI 2006). It aims to help organisations to set priorities for the future to improve their performance. Charities Evaluation Services (CES) has also designed a CD-ROM to complement the work pack and make the self-assessment process more manageable. PQASSO covers twelve standard quality areas, which organisations should address in order to operate efficiently and achieve good results. The twelve areas are: Planning for quality Governance 3. Management 4. User-centred service 5. Staff and volunteers 6. Training and development 7. Managing money 8. Managing resources 9. Managing activities 10. Networking and partnerships 11. Monitoring and evaluation 12. Results Practical Quality Assurance System for Small Organisations (PQASSO) is currently a self assessment tool although the CES are looking at building peer review into the approach. The system is very flexible and is designed to be worked through over a period of time anything from 12 months to several years. Its focuses strongly outcomes, and helps you to measure the differences to any organization and users that come about by planning and implementing improvements. Organization also can choose to work towards the externally assessed PQASSO quality mark. Especially any small or medium-sized organisation without any paid members of staff or organisations with one or two members of staff can use Quality First. The PQASSO quality mark validates an organizations progress made through self assessment, and it will be cost between  £1,055 to  £1,200 depending on the size of your organization [Islington Voluntary Action Council (IVAC), 2010]. It is a good starting point for organisations tha t are unfamiliar with quality tools. According to Paton (2003), suggests that organizations which allow plenty of time to engage properly in the PQASSO process are more likely to gain significant organisational benefits. However research conducted by Aston Business School (2004) advises funders of the critical importance of allowing and encouraging VCOs to make informed choices about quality systems. Health and Social care Quality standard in UK: In the UK governments White Paper A First class service: Quality in the NHS clinical governance is defined as a framework through which NHS organizations are accountable for continuously improving the quality of their services safeguarding high standards of care by creating an environment in which excellence in clinical care flourish (DoH, 1998). There are numerous concepts and theories associated with ever-increasing base of knowledge on the subject of quality assurance, so much so that it was difficult to choose which to develop. There are many definitions of the term quality assurance written by people who have researched the subject thoroughly (Diana N.T. Sale 2000). Quality assurance is the measurement of the actual level of the service provided plus the efforts to modify when necessary the provision of these service in the light of the results of the measurement (Williamson, 1979). In Britain, the 1990 government NHS reform put quality on the agenda for the first time (DoH 1989). A standard is a level of quality against which performance can be measured. It can be described as essential- the absolute minimum to ensure safe and effective practice, or developmental, designed to encourage and support a move to better practice. The Quality Standards for Health and Social Care, which is contained in this document, is classed as essential. Given the rapidly changing environment in which the HPSS operates, it is important that standards do not become outdated or serve to stifle innovation. To prevent this, standards need to be regularly reviewed and updated. It will be the Departments responsibility, drawing on the best evidence available, including advice, reports and/or information from the Regulation and Quality Improvement Authority (RQIA), to keep the quality standards under consideration, with a formal review being completed by the end of 2008. In recent years under the rubric of total quality management it has become popular to include in the idea of quality assurance almost every function or activity a health care organization (A.Donabedian, 2003). It is reasonable to say that the quality of the environment of health care, including the managerial activities in it, have an influence of the quality of care- either directly, by influencing the performance of practitioner or indirectly, by influencing the convenience, comfort, or safety patients(Berwick, D.M., 1989). Conclusion: Some believe that quality in health care is too abstract and nebulous a concept to precisely defined or objectively measured and one cannot assure or guarantee quality. One only increases probability that will be good or better (A.Donabedian, 2003). Quality cannot be guaranteed, many, included myself, it criticized the term assurance. It suggested alternatives have been improvement or, better still continuous improvement, terms meant to remind us that no given level of quality can be fully satisfactory; one should always try to do even better, progressing to ever higher level of goodness (Berwick, D. 1989). Quality if care is the responsibility of everyone involved in health care and it has never been more important than it is today. Setting and monitoring standards of care and quality assurance are separate issues, although they are sometimes discussed as though they are same (Diana N.T. Sale 2000 p.34-38). Standard must be evidence based and dynamic always moving, always changing to ensure or improve the quality of patient care rather than just a paper exercise.

Misrepresentation of Mental Illnesses :: essays research papers

Misrepresentation of Mental Illnesses by Television Media   Ã‚  Ã‚  Ã‚  Ã‚   To eliminate the partial representation of mental illnesses, television media needs to focus on all sides of this illness. The media needs to show that attention deficit hyperactive disorder (ADHD) is a legitimate disorder with effective treatments. At least one in four families in the U.S. is affected by mental illnesses. Unfortunately there is no cure for this range of illnesses, which have been around for thousands of years. Of the American adult population, 5.4 percent have a serious mental illness. These health conditions are characterized by alterations in thinking, mood, behavior, or some combination of these. They are also associated with distress and sometimes impaired functioning. In 1990 the total cost of mental health services in the U.S. was $148 billion. According to a new report by the Mental Health Foundation, one in five children suffer from a mental health problem. Attention deficit hyperactive disorder is a mental illness that is diagnosed mainly in young children and doesn’t always disappear in adulthood.† All we know is that this genetic, inherited condition [ADHD] is not due to brain damage at all but rather a variation in how the brain functions.† Attention-Deficit/ Hyperactivity Disorde r (ADHD) includes symptoms and characteristics that can be placed in one of three categories: inattention, hyperactivity and impulsivity. These characteristics commonly leave a person with ADHD with lack of attention span, easily distracted, fidgety, struggling to stay seated, having trouble engaging in calm activities, impatient, and talking excessively or out of turn. A new study by researchers says that hyperactive children have behavioral differences due to under active parts of their brain, a biological malfunction, rather than due to way they were brought up. This was revealed by a magnetic scanning device that allowed researchers to look at the brains of children diagnosed with ADHD. These studies and statistics reinforce the claim that mental illnesses are not invented simply to justify drugging of children and a disease that needs be educated to the public for better understanding. Rather, ADHD is an illness that affects many people throughout their lives. This topic is oft en misunderstood by the public. The media and medical community need to educate the positive side of this controversy and not just show the opposing view, which often times misrepresented by the media.   Ã‚  Ã‚  Ã‚  Ã‚  According to the current President of Attention Deficit Disorder Association (ADDA), the medication prescribed by a doctor cannot lead to drug abuse and addiction.

Book Report †Sway: The Irresistible Pull of Irrational Behavior Essay

The book, Sway: The Irresistible Pull of Irrational Behavior, by Ori Brafman and his brother, Rom Brafman dives into the way that we make decisions. Why do humans make the horrible decisions we do when logic would tell us to act otherwise? There are several psychological influences that sway our decision-making ability according to the Brafman brothers. The authors look at several different factors, with a lot of fascinating and logic-breaking examples. This book will help you understand the decisions you make. In many circumstances times when logic would dictate that we take a certain action, we take the opposite. To illustrate, just ask yourself why you have stayed so long in a doomed relationship? Why was it so hard to sell a stock that has lost much of its value†¦or to sell your house if it will be for less than you paid for it? In their book, Sway, Ori and Rom Brafman explore our decision making process and what influences our behavior. Hence, the subtitle, The Pull of Irra tional Behavior is used. Sway opens with a convincing example — the historic KLM flight where the pilot made a seemingly irrational decision that cost the lives of 584 people in 1977, the largest airline disaster in history. The authors make the argument that because the pilot was so focused on getting to his final destination after being diverted; he was swayed into making a wholly irrational decision, which ended in tragedy. How was he swayed specifically? Well, the book revisits the KLM disaster a few times to flesh out the underlying irrational decisions likely being made by the pilot. The book is filled with such examples, such as people who have bid as much as $200 for a $20 bill. Why? Why would anyone pay more than the face value of a $20 bill? Well, the authors have the answers.Here I will describe all the major sways listed in the book. I will also give an example of the sway and why it affects people so harshly.1. We overreact to potential losses. Humans tend to focus more on the short-term consequences rather than the longer-term effects. This is illustrated well by AOL’s Internet options. For a while, AOL gave consumers access to the web through a pay as you go method. Customers would pay for every minute they used the Internet. Then, when AOL introduced a flat monthly fee, customers began signing up for that plan in masses. Customers wanted to make sure they avoided the perceived  losses from the pay as you go method, when in the long run; most users were losing money with the flat rate. 2. Loss averse. The more meaningful a loss is, the more loss averse we become, meaning we don’t want to give up our hold on the loss (even when it’s economically, emotionally or otherwise beneficial to do so). The best example of loss aversion is in the stock market. Inexperienced traders have the hardest time selling a plummeting stock. Say you invest in a stock for $10 a share and in a week the price rises to $20. Now it would be great to sell then. But then the next day the stock drops to $17 a share. For whatever reason, humans perceive this $3 difference as a loss, instead of a $7 gain (you invested at $10 and could sell at $17). So, the investor says, once it gets back to $20 I will sell. Then it drops to $15, then $12, then $6, and before you know it, you have lost money, when you could have gaine d $7 a share!3. Commitment. When we are committed to a relationship, decision, or position in our lives, it can be very difficult for us to see the better, healthier alternatives available. The best example of this in the book is the $20 dollar bill auction. Harvard Business School Professor Max Bazerman conducts this auction on the first day of his class. There are only two rules to the auction; first, bids are to be made in $1 increments. The second rule is a little trickier; the winner of the auction gets the $20, but the runner up still has to honor their bid, while receiving nothing. When the bidding gets closer and closer to $20 the students realize what is about to occur. The two people left in the bidding war both do not want to walk away with nothing, therefore instead of accepting defeat and losing $19 in the auction, somebody will bid $21. The students continue bidding, ignoring all rationality and drive the price upwards. Bazerman states that it once made its way up to $204. 4. Value attribution. Humans have a tendency to place certain qualities upon someone or something based on its perceived value rather than objective data. If we see something labeled a certain way, we’ll take that label at face value. The authors have two amusing examples of value attribution at work — a world-famous violinist is mistaken for a street musician in the subway and a SoBe energy drink that is only as valuable in helping improve your memory as you think it is. In the SoBe energy drinks case, the authors cite a study that measured test results after consumption of the energy drink. The subjects were put into three  categories. Those that had no SoBe, those that were told the powers of SoBe and then bought it at full price, and those that were also told the powers of SoBe but then received it at a discounted price. After taking a test, the results were measured to see if there was a pattern within the groups. The results showed that those who drank the SoBe at full price had better test scores than those who had no SoBe at all. But before we run to buy all the energy drinks we can afford, the group who drank the cheap SoBe performed far worse than those who drank no SoBe at all. When things are discounted off of their regular price, people tend to give the product or service a reduced value attribution. In other words, when we get a discount on something, we tend to unconsciously value it less than if we had paid full price.5. Diagnosis Bias. Humans have a propensity to label people, ideas or things based on our initial opinions of them. This includes our inab ility to reconsider those initial value judgments once we’ve made them. Again, the authors bring this sway to life with their examples of how players perform directly in relationship to their NBA draft pick number, amongst many others. A single word or label can color our entire perception of a person, closing off avenues of shared experience and seeing people for who they really are. Once a person is given a label (and even directly, a diagnosis), it’s hard for people to see people in a way that isn’t biased by that label. The authors also note that hiring interviews are actually a terrible way to identify possible employees. Turns out â€Å"first date† style interviews are completely unscientific and at the end of the day, quite horrible at helping managers choose a good employee.6. Fairness. People want and expect fairness in all of their dealings with other people, companies and organizations. It is vitally important for people to feel they have a voice. People want to be listened to and heard, even if nothing changes. Talking through our reasons for a price or our position in an argument or debate, explaining how we arrived at it, and communicating what we feel is the fair thing to do makes other people feel like we’ve treated them more fairly and reasonably. The authors cite a study done which pair’s strangers and offers up a chance at winning cash. The strangers are placed in separate rooms and told that they will never meet the other person, even after the study is over. Then the instructions are given to the first subject. They are told that there is $10 dollars to be split between them and the partner. They  have been chosen as the person to divide the money however they see fit. The catch is that the other person must agree to the offer. If the person does not agree, both partners will walk away with nothing. The same speech is given to the second pa rticipant except with minor changes letting them know that the other person will be splitting the money and that they have the power to say yes or no to the deal. The study showed that all splits of 50/50 were accepted and almost all of the uneven splits were denied. Even though people were offered some money, they chose to deny it because they saw it as â€Å"unfair†. People did not seem to realize that they were in a fortunate position just to be offered any money at all.7. Altruistically or Selfishly. Humans approach everything from one of these two viewpoints, but usually not both at the same time. When the two centers of the brain (altruism and pleasure) compete, pleasure usually wins. When the pleasure, self-interested perspective is operating, unexpected behavior or effects can occur. Essentially, a person cannot act in their own interest while looking out for others, because your desires to look out for number 1 will always win. This portion of the book also speaks on the most relevant portion to our class. It speaks on how rewards can damage someone’s work ethic when it is believe that they will actually help. It’s not that rewards for specific tasks or behavior are bad, it’s the possibility of a reward dangled ahead of time that can potentially result in destructive, unintended effects. It’s okay to reward someone after the fact, but don’t always create the possibility of the reward ahead of time. And know that money defeats/negates altruism.8. Groups. Groups can have profound effects on our ability to reason rationally. A study was done on individuals and their ability to ignore wrong information. Subjects were placed in a room with several other people and the task was given to all subjects; identify which two lines were the same lengths. Then, on the screen 4 lines would appear, two of which were the same length. The study made it very obvious too; no rulers were needed, for the lines were glaringly different. The catch was that only one person in the room was an actual subject, all other people were paid actors told to identify the wrong line. When the researchers asked the group which lines matched, all the actors would give the same incorrect answer, and the effects were powerful. 75% of the subjects incorrectly identified the lines because they did not want to go against the group. Then a second round began  and one actor was told to give the correct answer, or at least an answer different than the group. In almost all cases, the subject spat in the face of the actors and correctly identified the lines. The lesson to be learned here is that dissent is invaluable – you need a dissenter, even if you don’t agree with the specific dissent itself. Dissenters open up discussion and allow individuals to express their views. I highly recommend this book. It was nearly impossible for me to put down and only took me about a day to read. I think very economically and logically (or at least I would like to believe), so the book spoke to my every thought. The book offers a few solutions in the epilogue; solutions that help individuals think more rationally. However the solutions are very trivial. Suggestions such as â€Å"take a deep breathe and evaluate the situation† are recommended. The problem with these solutions is that the situations don’t allow for deep breaths! That is why irrational behavior takes place in the first place. Overall, the book was a great read and a valuable lesson.

The Haunted House (1859) by Charles Dickens

The Haunted House (1859) by Charles Dickens is actually a compilation work, with contributions from Hesba  Stretton, George Augustus Sala, Adelaide Anne Procter,  Ã¢â‚¬â€¹Wilkie Collins, and Elizabeth Gaskell.  Each writer, including Dickens, writes one â€Å"chapter† of the tale.  The premise is that a group of people has come to a well-known haunted house to stay for a period of time, experience whatever supernatural elements might be there to experience, then regroup at the end of their stay to share their stories.  Each author represents a specific person within the tale and, while the genre is supposed to be that of the ghost story, most of the individual pieces fall flat of that.  The conclusion, too, is saccharine and unnecessary—it reminds the reader that, though we came for ghost stories, what we leave with is  a mirthful  Christmas story. The Guests Because this is a compilation of separate short stories, one would not expect much character growth and development (short stories are, after all, more about the theme/event/plot than they are about the characters).  Still, because they were interconnected via the primary story (a group of folks coming together to the same house), there could have been at least a bit of time spent developing those guests, so as to better understand the stories they ultimately told.  Gaskell’s story, being the longest, did allow for some characterization and what was done, was done well.  The characters remain generally flat throughout, but they are recognizable characters—a mother who would act like a mother, a father who acts like a father, etc.  Still, when coming to this collection, it cannot be for its interesting characters because they just are not very interesting (and this could be even more acceptable if the stories themselves were thrilling ghost stories because then t here is something else to entertain and occupy the reader, but †¦).   The Authors Dickens, Gaskell, and Collins are clearly the masters here, but in my opinion Dickens was in fact outshone by the other two in this one.  Dickens’s portions read too much like someone trying to write a thriller but not quite knowing how (it felt like someone mimicking  Edgar Allan Poe—getting the general mechanics right, but not quite being Poe).  Gaskell’s piece is the longest, and her narrative brilliance—use of dialect in particular—are clear.  Collins has the best paced and most appropriately toned prose.  Salas’s writing seemed pompous, arrogant, and long-winded; it was funny, at times, but a bit too self-serving.  The inclusion of Procter’s verse added a nice element to the overall scheme, and a nice break from the various competing proses.  The verse itself was haunting and reminded me quite a bit of the pace and scheme of Poe’s â€Å"The Raven.†Ã‚  Stretton’s short piece was perhaps the most e njoyable, because it was so well-written and more intricately layered than the rest.   Dickens himself was reportedly underwhelmed and disappointed by his peers’ contributions to this serial  Christmas tale.  His hope was that each of the authors would put into print a certain fear or terror particular to each of them, as Dickens’s story did.  The â€Å"haunting,† then, would be something personal and, while not necessarily supernatural, could still be understandably frightening.  Like Dickens, the reader may be disappointed with the end-result of this ambition. For Dickens, the fear was in revisiting his impoverished youth, the death of his father and the dread of never escaping the â€Å"ghost of [his] own childhood.†Ã‚  Gaskell’s story revolved around betrayal by blood—the loss of a child and lover to the darker elements of humanity, which is understandably frightening in its way.  Sala’s story was a dream within a dream within a dream, but while the dream could have been unnerving, there seemed little that was truly frightening about it, supernatural or otherwise.  Wilkie Collins’s story is the one in this compilation which could actually be considered a â€Å"suspense† or â€Å"thriller† story.  Hesba Stretton’s story, too, while not necessarily scary, is romantic, somewhat suspenseful, and well-accomplished overall.   When considering the group of tales in this compilation, it is Stretton’s which leaves me wanting to read more of her work.  Ultimately, though it is called The Haunted House, this compilation of ghost stories is not really a ‘Halloween’-type read.  If one reads this collection as a study of these individual writers, their thoughts, and what they considered haunting, then it is quite interesting.  But as a ghost story, it is no extraordinary achievement,  possibly because Dickens (and presumably the other writers) was a skeptic and found the popular interest in the supernatural rather silly.