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Sample records for quality improvement initiative

  1. Implementing quality/productivity improvement initiatives in an engineering environment

    Ruda, R. R.

    1985-01-01

    Quality/Productivity Improvement (QPI) initiatives in the engineering environment at McDonnell Douglas-Houston include several different, distinct activities, each having its own application, yet all targeted toward one common goal - making continuous improvement a way of life. The chief executive and the next two levels of management demonstrate their commitment to QPI with hands-on involvement in several activities. Each is a member of a QPI Council which consists of six panels - Participative Management, Communications, Training, Performance/Productivity, Human Resources Management and Strategic Management. In addition, each manager conducts Workplace Visits and Bosstalks, to enhance communications with employees and to provide a forum for the identification of problems - both real and perceived. Quality Circles and Project Teams are well established within McConnel Douglas as useful and desirable employee involvement teams. The continued growth of voluntary membership in the circles program is strong evidence of the employee interest and management support that have developed within the organization.

  2. Improving the quality of language services delivery: findings from a hospital quality improvement initiative.

    Regenstein, Marsha; Huang, Jenny; West, Cathy; Trott, Jennifer; Mead, Holly; Andres, Ellie

    2012-01-01

    Over 24 million individuals in the United States speak English "less than very well" and are considered limited English proficient (LEP). Due to challenges inherent in patient-provider interactions with LEP patients, LEP individuals are at risk for a wide array of negative health consequences. Evidence suggests that having an interpreter present to facilitate interactions between LEP patients and health professionals can mitigate many of these disparities. This article presents the results and lessons learned from Speaking Together: National Language Services Network, a quality improvement (QI) collaborative of the Robert Wood Johnson Foundation to improve the quality of language services (LS) in hospitals. Using five LS performance metrics, hospitals were able to demonstrate that meaningful improvement was possible through targeted QI efforts. By the end of the collaborative, each of the hospitals demonstrated improvement by more than five percentage points on at least one of the five recorded quality metrics. Lessons learned from this work, such as the helpful use of quality metrics to track performance, and the engagement of physician champions and executive leadership to promote improvement can be utilized in hospitals across the country because they seek to improve care for LEP patients. PMID:23552202

  3. Total Quality Project Initiatives and Fabrication Improvements at ENUSA Factory

    ENUSA is committed to maximize fuel reliability through different improvement programs to cover fabrication processes, inspection techniques benchmarking with different partners and total quality projects. All these programs focus on reliability of product trough three main concepts: quality as a priority, continuous improvement and personnel involvement in their work. This brief paper describes the Cero defects program, which goal is to obtain a factor of 10 improvement and approach the value of 1/1.000.000 or 1 ppm. A task force was formed to review all aspects relating to fuel rod hermeticity (component suppliers methods, welding techniques, end plugs design, tubes certifications, etc.). Another Best Practices Task Force was formed to review all aspects of pellets manufacturing. Recommendations are then summarized

  4. Improving inpatient postnatal services: midwives views and perspectives of engagement in a quality improvement initiative

    Wray Julie

    2011-11-01

    Full Text Available Abstract Background Despite major policy initiatives in the United Kingdom to enhance women's experiences of maternity care, improving in-patient postnatal care remains a low priority, although it is an aspect of care consistently rated as poor by women. As part of a systems and process approach to improving care at one maternity unit in the South of England, the views and perspectives of midwives responsible for implementing change were sought. Methods A Continuous Quality Improvement (CQI approach was adopted to support a systems and process change to in-patient care and care on transfer home in a large district general hospital with around 6000 births a year. The CQI approach included an initial assessment to identify where revisions to routine systems and processes were required, developing, implementing and evaluating revisions to the content and documentation of care in hospital and on transfer home, and training workshops for midwives and other maternity staff responsible for implementing changes. To assess midwifery views of the quality improvement process and their engagement with this, questionnaires were sent to those who had participated at the outset. Results Questionnaires were received from 68 (46% of the estimated 149 midwives eligible to complete the questionnaire. All midwives were aware of the revisions introduced, and two-thirds felt these were more appropriate to meet the women's physical and emotional health, information and support needs. Some midwives considered that the introduction of new maternal postnatal records increased their workload, mainly as a consequence of colleagues not completing documentation as required. Conclusions This was the first UK study to undertake a review of in-patient postnatal services. Involvement of midwives at the outset was essential to the success of the initiative. Midwives play a lead role in the planning and organisation of in-patient postnatal care and it was important to obtain their feedback on whether revisions were pragmatic and achieved anticipated improvements in care quality. Their initial involvement ensured priority areas for change were identified and implemented. Their subsequent feedback highlighted further important areas to address as part of CQI to ensure best quality care continues to be implemented. Our findings could support other maternity service organisations to optimise in-patient postnatal services.

  5. Quality initiatives: improving patient flow for a bone densitometry practice: results from a Mayo Clinic radiology quality initiative.

    Aakre, Kenneth T; Valley, Timothy B; O'Connor, Michael K

    2010-03-01

    Lean Six Sigma process improvement methodologies have been used in manufacturing for some time. However, Lean Six Sigma process improvement methodologies also are applicable to radiology as a way to identify opportunities for improvement in patient care delivery settings. A multidisciplinary team of physicians and staff conducted a 100-day quality improvement project with the guidance of a quality advisor. By using the framework of DMAIC (define, measure, analyze, improve, and control), time studies were performed for all aspects of patient and technologist involvement. From these studies, value stream maps for the current state and for the future were developed, and tests of change were implemented. Comprehensive value stream maps showed that before implementation of process changes, an average time of 20.95 minutes was required for completion of a bone densitometry study. Two process changes (ie, tests of change) were undertaken. First, the location for completion of a patient assessment form was moved from inside the imaging room to the waiting area, enabling patients to complete the form while waiting for the technologist. Second, the patient was instructed to sit in a waiting area immediately outside the imaging rooms, rather than in the main reception area, which is far removed from the imaging area. Realignment of these process steps, with reduced technologist travel distances, resulted in a 3-minute average decrease in the patient cycle time. This represented a 15% reduction in the initial patient cycle time with no change in staff or costs. Radiology process improvement projects can yield positive results despite small incremental changes. PMID:20067999

  6. The Physician Quality Improvement Initiative: Engaging Physicians in Quality Improvement, Patient Safety, Accountability and their Provision of High-Quality Patient Care.

    Wentlandt, Kirsten; Degendorfer, Niki; Clarke, Cathy; Panet, Hayley; Worthington, Jim; McLean, Richard F; Chan, Charlie K N

    2016-01-01

    University Health Network has been working to become a high-reliability organization, with a focus on safe, quality patient care. In response, the Medical Affairs Department has implemented several strategic initiatives to drive accountability, quality improvement and engagement with our physician population. One of these initiatives, the Physician Quality Improvement Initiative (PQII) is a physician-led project designed to provide active medical staff, in collaboration with their physician department chiefs, a comprehensive approach to focused and practical quality improvement in their practice. In this document, we outline the project, including its implementation strategy, logic model and outcomes, and provide discussion on how it fits into UHN's global strategy to provide safe, quality patient care. PMID:27009706

  7. Preventing Heel Pressure Ulcers: Sustained Quality Improvement Initiative in a Canadian Acute Care Facility.

    Hanna-Bull, Debbie

    2016-01-01

    The setting for this quality improvement initiative designed to reduce the prevalence of facility-acquired heel pressure ulcers was a regional, acute-care, 490-bed facility in Ontario, Canada, responsible for dialysis, vascular, and orthopedic surgery. An interdisciplinary skin and wound care team designed an evidence-based quality improvement initiative based on a systematic literature review and standardization of heel offloading methods. The prevalence of heel pressure ulcers was measured at baseline (immediately prior to implementation of initiative) and at 1 and 4 years following implementation. The prevalence of facility-acquired heel pressure ulcers was 5.8% when measured before project implementation. It was 4.2% at 1 year following implementation and 1.6% when measured at the end of the 4-year initiative. Outcomes demonstrate that the initiative resulted in a continuous and sustained reduction in facility-acquired heel pressure ulcer incidence over a 4-year period. PMID:26473635

  8. Selecting quality management and improvement initiatives: case studies of industries in Thailand

    Thawesaengskulthai, Natcha

    2007-01-01

    Many organisations invest a considerable amount of capital and resources, implementing new techniques to improve their operating performance. Many approaches and techniques are available. New fashionable methods tend to displace older approaches, which may still have value. An effective strategy for selecting and implementing improvement initiatives is an important issue to ensure stakeholder satisfaction. This research aims to investigate quality management and continuous improvement practi...

  9. Florida Initiative for Quality Cancer Care: Improvements on Colorectal Cancer Quality of Care Indicators during a 3-Year Interval

    Siegel, Erin M; Jacobsen, Paul B; Lee, Ji-Hyun; Malafa, Mokenge; Fulp, William; Fletcher, Michelle; Smith, Jesusa Corazon R; Brown, Richard; Levine, Richard; Cartwright, Thomas; Abesada-Terk, Guillermo; Kim, George; Alemany, Carlos; Faig, Douglas; Sharp, Philip; Markham, Merry-Jennifer; Shibata, David

    2015-01-01

    BACKGROUND The quality of cancer care has become a national priority; however, there are few ongoing efforts to assist medical oncology practices in identifying areas for improvement. The Florida Initiative for Quality Cancer Care is a consortium of 11 medical oncology practices that evaluates the quality of cancer care across Florida. Within this practice-based system of self-assessment, we determined adherence to colorectal cancer quality of care indicators (QCIs) in 2006, disseminated results to each practice and reassessed adherence in 2009. The current report focuses on evaluating the direction and magnitude of change in adherence to QCIs for colorectal cancer patients between the 2 assessments. STUDY DESIGN Medical records were reviewed for all colorectal cancer patients seen by a medical oncologist in 2006 (n = 489) and 2009 (n = 511) at 10 participating practices. Thirty-five indicators were evaluated individually and changes in QCI adherence over time and by site were examined. RESULTS Significant improvements were noted from 2006 to 2009, with large gains in surgical/pathological QCIs (eg, documenting rectal radial margin status, lymphovascular invasion, and the review of ?12 lymph nodes) and medical oncology QCIs (documenting planned treatment regimen and providing recommended neoadjuvant regimens). Documentation of perineural invasion and radial margins significantly improved; however, adherence remained low (47% and 71%, respectively). There was significant variability in adherence for some QCIs across institutions at follow-up. CONCLUSIONS The Florida Initiative for Quality Cancer Care practices conducted self-directed quality-improvement efforts during a 3-year interval and overall adherence to QCIs improved. However, adherence remained low for several indicators, suggesting that organized improvement efforts might be needed for QCIs that remained consistently low over time. Findings demonstrate how efforts such as the Florida Initiative for Quality Cancer Care are useful for evaluating and improving the quality of cancer care at a regional level. PMID:24275073

  10. Reducing Unnecessary Portable Pelvic Radiographs in Trauma Patients: A Resident-Driven Quality Improvement Initiative.

    Langer, Jessica M; Tsai, Emily B; Luhar, Aarti; McWilliams, Justin; Motamedi, Kambiz

    2015-09-01

    Quality improvement is increasingly important in the changing health care climate. We aim to establish a methodology and identify critical factors leading to successful implementation of a resident-led radiology quality improvement intervention at the institutional level. Under guidance of faculty mentors, the first-year radiology residents developed a quality improvement initiative to decrease unnecessary STAT pelvic radiographs (PXRs) in hemodynamically stable trauma patients who would additionally receive STAT pelvic CT scans. Development and implementation of this initiative required multiple steps, including: establishing resident and faculty leadership, gathering evidence from published literature, cultivating multidisciplinary support, and developing and implementing an institution-wide ordering algorithm. A visual aid and brief questionnaire were distributed to clinicians for use during treatment of trauma cases to ensure sustainability of the initiative. At multiple time points, pre- and post-intervention, residents performed a retrospective chart review to evaluate changes in imaging-ordering trends for trauma patients. Chart review showed a decline in the number of PXRs for hemodynamically stable trauma patients, as recommended in the ordering algorithm: 78% of trauma patients received both a PXR and a pelvic CT scan in the first 24 hours of the initiative, compared with 26% at 1 month; 24% at 6 months; and 18% at 10 to 12 months postintervention. The resident-led radiology quality improvement initiative created a shift in ordering culture at an institutional level. Development and implementation of this algorithm exemplified the impact of a multidisciplinary collaborative effort involving multiple departments and multiple levels of the medical hierarchy. PMID:25868670

  11. Evolution and Initial Experience of a Statewide Care Transitions Quality Improvement Collaborative: Preventing Avoidable Readmissions Together.

    Axon, R Neal; Cole, Laura; Moonan, Aunyika; Foster, Richard; Cawley, Patrick; Long, Laura; Turley, Christine B

    2016-02-01

    Increasing scrutiny of hospital readmission rates has spurred a wide variety of quality improvement initiatives. The Preventing Avoidable Readmissions Together (PART) initiative is a statewide quality improvement learning collaborative organized by stakeholder organizations in South Carolina. This descriptive report focused on initial interventions with hospitals. Eligible participants included all acute care hospitals plus home health organizations, nursing facilities, hospices, and other health care organizations. Measures were degree of statewide participation, curricular engagement, adoption of evidence-based improvement strategies, and readmission rate changes. Fifty-nine of 64 (92%) acute care hospitals and 9 of 10 (90%) hospital systems participated in collaborative events. Curricular engagement included: webinars and coaching calls (49/59, 83%), statewide in-person meetings (35/59, 59%), regional in-person meetings (44/59, 75%), and individualized consultations (46/59, 78%). Among 34 (58%) participating hospitals completing a survey at the completion of Year 1, respondents indicated complete implementation of multidisciplinary rounding (58%), post-discharge telephone calls (58%), and teach-back (32%), and implementation in process of high-quality transition records (52%), improved discharge summaries (45%), and timely follow-up appointments (39%). A higher proportion of hospitals had significant decreases (?10% relative change) in all-cause readmission rates for acute myocardial infarction (55.6% vs. 30.4%, P=0.01), heart failure (54.2% vs. 31.7%, P=0.09), and chronic obstructive pulmonary disease (41.7% vs. 33.3%, P=0.83) between 2011-2013 compared to earlier (2009-2011) trends. Focus on reducing readmissions is driving numerous, sometimes competing, quality improvement initiatives. PART successfully engaged the majority of acute care facilities in one state to harmonize and accelerate adoption of evidence-based care transitions strategies. (Population Health Management 2016;19:4-10). PMID:26102592

  12. Science Teacher Education in Australia: Initiatives and Challenges to Improve the Quality of Teaching

    Treagust, David F.; Won, Mihye; Petersen, Jacinta; Wynne, Georgie

    2015-02-01

    In this article, we describe how teachers in the Australian school system are educated to teach science and the different qualifications that teachers need to enter the profession. The latest comparisons of Australian students in international science assessments have brought about various accountability measures to improve the quality of science teachers at all levels. We discuss the issues and implications of government initiatives in preservice and early career teacher education programs, such as the implementation of national science curriculum, the stricter entry requirements to teacher education programs, an alternative pathway to teaching and the measure of effectiveness of teacher education programs. The politicized discussion and initiatives to improve the quality of science teacher education in Australia are still unfolding as we write in 2014.

  13. Linking Community Hospital Initiatives With Osteopathic Medical Students' Quality Improvement Training: A Pilot Program.

    Brannan, Grace D; Russ, Ronald; Winemiller, Terry R; Mast, Eric

    2016-01-01

    Quality improvement (QI) continues to be a health care challenge, and the literature indicates that osteopathic medical students need more training. To qualify for portions of managed care reimbursement, hospitals are required to meet measures intended to improve quality of care and patient satisfaction, which may be challenging for small community hospitals with limited resources. Because osteopathic medical training is grounded on community hospital experiences, an opportunity exists to align the outcomes needs of hospitals and QI training needs of students. In this pilot program, 3 sponsoring hospitals recruited and mentored 1 osteopathic medical student each through a QI project. A mentor at each hospital identified a project that was important to the hospital's patient care QI goals. This pilot program provided osteopathic medical students with hands-on QI training, created opportunities for interprofessional collaboration, and contributed to hospital initiatives to improve patient outcomes. PMID:26745562

  14. Implementing an organization-wide quality improvement initiative: insights from project leads, managers, and frontline nurses.

    Jeffs, Lianne P; Lo, Joyce; Beswick, Susan; Campbell, Heather

    2013-01-01

    With the movement to advance quality care and improve health care outcomes, organizations have increasingly implemented quality improvement (QI) initiatives to meet these requirements. Key to implementation success is the multilevel involvement of frontline clinicians and leadership. To explore the perceptions and experiences of frontline nurses, project leads, and managers associated with an organization-wide initiative aimed at engaging nurses in quality improvement work. To address the aims of this study, a qualitative research approach was used. Two focus groups were conducted with a total of 13 nurse participants, and individual interviews were done with 10 managers and 6 project leads. Emergent themes from the interview data included the following: improving care in a networked approach; driving QI and having a sense of pride; and overcoming challenges. Specifically, our findings elucidate the value of communities of practice and ongoing mentorship for nurses as key strategies to acquire and apply QI knowledge to a QI project on their respective units. Key challenges emerged including workload and time constraints, as well as resistance to change from staff. Our study findings suggest that leaders need to provide learning opportunities and protected time for frontline nurses to participate in QI projects. PMID:23744468

  15. The Maryland Resilience Breakthrough Series Collaborative: A Quality Improvement Initiative for Children's Mental Health Services Providers.

    Backer, Penina M; Kiser, Laurel J; Gillham, Jane E; Smith, Joan

    2015-08-01

    The Maryland Resilience Breakthrough Series Collaborative (BSC), a recent quality improvement initiative for children's mental health services providers, is aimed at bridging the gap between resilience theory and mental health service practices. Six provider teams across the state attended resilience training sessions and incrementally implemented practice improvements at their agencies. Group discussions and surveys administered to teams before and after the BSC indicate that the BSC facilitated breakthrough changes in the areas of resilience-enhanced assessment and treatment practices, as well as family and community resilience. This column presents quantitative and anecdotal outcomes and makes recommendations for the provider community. PMID:25930048

  16. Initial results from the Auto/Oil Air Quality Improvement Research Program

    The Auto/Air Quality Improvement Research Program (AQIRP), a cooperative effort by the three major US auto companies and fourteen oil companies, is the most comprehensive research effort ever undertaken to develop data on the air quality effects of the use of various motor fuels in various automotive systems and the relative cost-effectiveness of various fuel/vehicle combinations. Phase 1 of the Program, at a cost of about $15 million, is examining emissions and air quality impacts from current and older vehicles using reformulated gasolines with widely different values of aromatics content, olefin content, oxygenate content and type, sulfur content, vapor pressure (RVP) and 90% distillation temperature. Emissions from Flexible and Variable Fuel vehicles using methanol/gasoline mixtures are also being examined. A second phase with a $25 million budget over three years has also been approved. Initial findings for the Phase 1 study and Phase 2 plans are presented

  17. Paediatric early warning scores on a children's ward: a quality improvement initiative.

    Ennis, Linda

    2014-09-09

    The aim of this quality improvement initiative was to incorporate a paediatric early warning score (PEWS) and track and trigger system in the routine care of children in an acute general children\\'s ward at a regional hospital in the Republic of Ireland. In the absence of a nationally recommended specific PEWS strategy, a local plan was developed. The experience of structuring and implementing the PEWS and track and trigger system is presented in this article. Data from the first year of use were collected to evaluate the clinical utility and effectiveness of this system. In the busy acute children\\'s service, the PEWS initiative was found to benefit processes of early detection, prompt referral and timely, appropriate management of children at potential risk of clinical deterioration. Nursing staff were empowered and supported to communicate concerns immediately and to seek rapid medical review, according to an agreed PEWS escalation plan. Outcomes were significantly improved.

  18. QUALITY IMPROVEMENT INITIATIVES FOR SUPPORT FUNCTIONS IN AN INDUSTRY: TWO CASES

    Shirshendu Roy

    2011-09-01

    Full Text Available The concept of quality improvement in industry has originated from the involvement of inspector which has become the most important part of manufacturing process or development activity. Over years, this initiative is migrated to various support functions of the industry. In this paper, emphasis has been given particularly in the areas related to support functions where improvement project s can be effectively done and hence organization wide impact is assessed. Two case studies are presented here in this context. The first study shows how smaller change in content structure and delivery met hod can drastically improve the training feedback and the second one demonstrates minimizing lead time to recruitment with a cost-effective process modification.

  19. Integrating risk management data in quality improvement initiatives within an academic neurosurgery department.

    McLaughlin, Nancy; Garrett, Matthew C; Emami, Leila; Foss, Sarah K; Klohn, Johanna L; Martin, Neil A

    2016-01-01

    OBJECT While malpractice litigation has had many negative impacts on health care delivery systems, information extracted from lawsuits could potentially guide toward venues to improve care. The authors present a comprehensive review of lawsuits within a tertiary academic neurosurgical department and report institutional and departmental strategies to mitigate liability by integrating risk management data with quality improvement initiatives. METHODS The Comprehensive Risk Intelligence Tool database was interrogated to extract claims/suits abstracts concerning neurosurgical cases that were closed from January 2008 to December 2012. Variables included demographics of the claimant, type of procedure performed (if any), claim description, insured information, case outcome, clinical summary, contributing factors and subfactors, amount incurred for indemnity and expenses, and independent expert opinion in regard to whether the standard of care was met. RESULTS During the study period, the Department of Neurosurgery received the most lawsuits of all surgical specialties (30 of 172), leading to a total incurred payment of $4,949,867. Of these lawsuits, 21 involved spinal pathologies and 9 cranial pathologies. The largest group of suits was from patients with challenging medical conditions who underwent uneventful surgeries and postoperative courses but filed lawsuits when they did not see the benefits for which they were hoping; 85% of these claims were withdrawn by the plaintiffs. The most commonly cited contributing factors included clinical judgment (20 of 30), technical skill (19 of 30), and communication (6 of 30). CONCLUSIONS While all medical and surgical subspecialties must deal with the issue of malpractice and liability, neurosurgery is most affected both in terms of the number of suits filed as well as monetary amounts awarded. To use the suits as learning tools for the faculty and residents and minimize the associated costs, quality initiatives addressing the most frequent contributing factors should be instituted in care redesign strategies, enabling strategic alignment of quality improvement and risk management efforts. PMID:26230469

  20. Responses of Aboriginal and Torres Strait Islander Primary Health-Care Services to Continuous Quality Improvement Initiatives

    Larkins, Sarah; Woods, Cindy E.; Matthews, Veronica; Sandra C Thompson; Schierhout, Gill; Mitropoulos, Maxwell; Patrao, Tania; Panzera, Annette; Bailie, Ross Stewart

    2016-01-01

    Background Indigenous primary health-care (PHC) services participating in continuous quality improvement (CQI) cycles show varying patterns of performance over time. Understanding this variation is essential to scaling up and sustaining quality improvement initiatives. The aim of this study is to examine trends in quality of care for services participating in the ABCD National Research Partnership and describe patterns of change over time and examine health service characteristics associat...

  1. Tracking and sustaining improvement initiatives: leveraging quality dashboards to lead change in a neurosurgical department.

    McLaughlin, Nancy; Afsar-Manesh, Nasim; Ragland, Victoria; Buxey, Farzad; Martin, Neil A

    2014-03-01

    Increasingly, hospitals and physicians are becoming acquainted with business intelligence strategies and tools to improve quality of care. In 2007, the University of California Los Angeles (UCLA) Department of Neurosurgery created a quality dashboard to help manage process measures and outcomes and ultimately to enhance clinical performance and patient care. At that time, the dashboard was in a platform that required data to be entered manually. It was then reviewed monthly to allow the department to make informed decisions. In 2009, the department leadership worked with the UCLA Medical Center to align mutual quality-improvement priorities. The content of the dashboard was redesigned to include 3 areas of priorities: quality and safety, patient satisfaction, and efficiency and use. Throughout time, the neurosurgery quality dashboard has been recognized for its clarity and its success in helping management direct improvement strategies and monitor impact. We describe the creation and design of the neurosurgery quality dashboard at UCLA, summarize the evolution of its assembly process, and illustrate how it can be used as a powerful tool of improvement and change. The potential challenges and future directions of this business intelligence tool are also discussed. PMID:24335812

  2. Nursing Home Quality Initiative

    U.S. Department of Health & Human Services — This Nursing Home Quality Initiative (NHQI) website provides consumer and provider information regarding the quality of care in nursing homes. NHQI discusses...

  3. Costs and financing of improvements in the quality of maternal health services through the Bamako Initiative in Nigeria.

    Ogunbekun, I; Adeyi, O; Wouters, A; Morrow, R H

    1996-12-01

    This paper reports on a study to assess the quality of maternal health care in public health facilities in Nigeria and to identify the resource implications of making the necessary quality improvements. Drawing upon unifying themes from quality assurance, basic microeconomics and the Bamako Initiative, locally defined norms were used to estimate resource requirements for improving the quality of maternal health care. Wide gaps existed between what is required (the norm) and what was available in terms of fixed and variable resources required for the delivery of maternal health services in public facilities implementing the Bamako Initiative in the Local Government Areas studied. Given such constraints, it was highly unlikely that technically acceptable standards of care could be met without additional resource inputs to meet the norm. This is part of the cost of doing business and merits serious policy dialogue. Revenue generation from health services was poor and appeared to be more related to inadequate supply of essential drugs and consumables than to the use of uneconomic fee scales. It is likely that user fees will be necessary to supplement scarce government budgets, especially to fund the most critical variable inputs associated with quality improvements. However, any user fee system, especially one that raises fees to patients, will have to be accompanied by immediate and visible quality improvements. Without such quality improvements, cost recovery will result in even lower utilization and attempts to generate new revenues are unlikely to succeed. PMID:10164194

  4. Reducing inappropriate hypnotic prescribing using a quality improvement initiative in a rural practice

    Togher, Fiona; Tilling, Michelle; Bee, David; Siriwardena, A Niroshan

    2010-01-01

    Context This improvement project was set in a single general practice in rural Lincolnshire, East Midlands, UK. All doctors and practice staff were actively engaged in reducing inappropriate long term prescribing of hypnotic drugs in the practice population as part of a Quality Improvement Collaborative (QIC). Problem Hypnotic drugs are only licensed for short term use but inappropriate long-term prescribing of hypnotics is common. Evidence from previous studies shows that hypnotic...

  5. Science Teacher Education in Australia: Initiatives and Challenges to Improve the Quality of Teaching

    Treagust, David F.; Won, Mihye; Petersen, Jacinta; Wynne, Georgie

    2015-01-01

    In this article, we describe how teachers in the Australian school system are educated to teach science and the different qualifications that teachers need to enter the profession. The latest comparisons of Australian students in international science assessments have brought about various accountability measures to improve the quality of science…

  6. A quality improvement initiative project to evaluate a newborn hearing screening program in a Baby-Friendly Hospital Initiative setting

    Stacey R. Lim

    2015-02-01

    Full Text Available Hearing loss present from birth can have a detrimental impact on later language and educational outcomes. Newborn hearing screening has allowed early identification and intervention of hearing loss, giving children the opportunity to develop age-appropriate language skills. The aim of this quality initiative study was to evaluate the quality of the newborn hearing screening program in the context of a newly implemented Baby-Friendly Hospital Initiative Program at Summa Health System Akron City Hospital. The goals were (1 to determine whether screening environment (mother’s room vs. nursery affected screening results, (2 to identify challenges and positive outcomes encountered by the audiologists, and (3 to ensure that Pass/Refer rates met state standards. A Quest Technologies sound level meter (Model 1800; St. Paul, MN, USA was used to measure noise levels in the nursery rooms where newborns were tested. The length of screening time was determined using a calibrated SP® Traceable® (ISO 17025 stopwatch (McGraw Park, IL, USA. Pass/Refer rates and observed challenges and benefits were noted. All well-baby infants born in the month of February 2013 (n = 101 were included, and Pass/Refer results were compared to those in years 2008-2012.Noise levels in the mother’s room did not appear to negatively affect the Pass/Refer rates. Some challenges were present, including interruptions and louder environmental noise. This protocol was considered appropriate for assessing a hearing screening program in a Baby-Friendly Hospital Initiative (BFHI setting.Benefits of performing hearing screening in the mother’s room included test transparency for parents and the ability to immediately discuss the results. Results obtained in the mother’s room were comparable to past results obtained in the nursery. Noise levels in the screening rooms and challenges should be noted, to ensure accuracy of screening results.

  7. Practice policy and quality initiatives: using lean principles to improve screening mammography workflow.

    Shah, Carla J; Sullivan, Julie R; Gonyo, Mary Beth; Wadhwa, Anubha; DuBois, Melissa S

    2013-01-01

    The "lean" approach is a quality improvement method that focuses on maximizing activities that are valued by the customer and eliminating waste that impedes efficiency in the workplace. The unique philosophy of the lean approach encourages all members of the team to be directly involved in identifying areas of waste and generating solutions to eliminate them. When the breast imaging section at the authors' institution became part of a multispecialty breast care center, the result was escalating examination volumes, more complex cases, and overall increased demand on radiologists' time. After several unsuccessful attempts to improve the efficiency of the section, including evaluation by outside consultants, the decision was made to embark on a comprehensive quality improvement program using the lean approach. A team of radiologists, technologists, file room personnel, information technology (IT) representatives, and administrators from the breast imaging section met twice a month to learn about lean principles and how to apply them to screening mammography workflows. Sources of inefficiency (waste) were identified, and potential solutions were generated. Multiple trials were performed to test these solutions. Throughout the process, all team members were engaged in identifying the problems, suggesting solutions, and implementing change. Most of the tested solutions were successful and resulted in decreased patient wait times, improved efficiency for the technologists and radiologists, faster report turnaround, and advances in IT. In addition, staff members were introduced to the lean philosophy and became actively involved in improving their workplace, resulting in a more cohesive section. PMID:23813321

  8. Pittsburgh Regional Healthcare Initiative puts new spin on improving healthcare quality.

    2002-11-01

    For nearly 4 years, the Pittsburgh Regional Healthcare Initiative (PRHI) has been working to improve the way healthcare is delivered in southwestern Pennsylvania by combining the voices and resources of hospitals, providers, the business community, insurers, health plans, and federal agencies. As one example of borrowing from business, the PRHI has created a new learning and management system, called Perfecting Patient Care, which is based on the Toyota Production System model and is now being used successfully in hospitals. PMID:12497771

  9. Physician attitude toward depression care interventions: Implications for implementation of quality improvement initiatives

    Chanin Johann C

    2008-09-01

    Full Text Available Abstract Background Few individuals with depression treated in the primary care setting receive care consistent with clinical treatment guidelines. Interventions based on the chronic care model (CCM have been promoted to address barriers and improve the quality of care. A current understanding of barriers to depression care and an awareness of whether physicians believe interventions effectively address those barriers is needed to enhance the success of future implementation. Methods We conducted semi-structured interviews with 23 primary care physicians across the US regarding their experience treating patients with depression, barriers to care, and commonly promoted CCM-based interventions. Themes were identified from interview transcripts using a grounded theory approach. Results Six barriers emerged from the interviews: difficulty diagnosing depression, patient resistance, fragmented mental health system, insurance coverage, lack of expertise, and competing demands and other responsibilities as a primary care provider. A number of interventions were seen as helpful in addressing these barriers including care managers, mental health integration, and education while others received mixed reviews. Mental health consultation models received the least endorsement. Two systems-related barriers, the fragmented mental health system and insurance coverage limitations, appeared incompletely addressed by the interventions. Conclusion CCM-based interventions, which include care managers, mental health integration, and patient education, are most likely to be implemented successfully because they effectively address several important barriers to care and are endorsed by physicians. Practices considering the adoption of interventions that received less support should educate physicians about the benefit of the interventions and attend to physician concerns prior to implementation. A focus on interventions that address systems-related barriers is needed to overcome all barriers to care.

  10. Quality Improvement Initiative Reduces Serious Safety Events in Pediatric Hospital Patients

    ... common among older adults and varies across regions Perceptions of quality and safety decline as the size ... 100 leaders, physicians, and staff to get their opinions. Interventions included error prevention simulation training and the ...

  11. Six Sigma within Construction Context : As a Quality Initiative, Performance Indicator/Improver, Management strategy

    Muharrem Firat, Yilmaz

    2012-01-01

    Six Sigma was developed in 1980s in manufacturing industry and became popular as a process improvement method. However, the adoption of this concept is new in construction industry and the aim of this study is to evaluate Six Sigma as a process improvement method within construction context. This thesis includes Literature Review and three interviews. Literature Review had discussed process improvement methods used in construction industry and analyzed the basic features and principles of Six...

  12. Quality initiatives: lean approach to improving performance and efficiency in a radiology department.

    Kruskal, Jonathan B; Reedy, Allen; Pascal, Laurie; Rosen, Max P; Boiselle, Phillip M

    2012-01-01

    Many hospital radiology departments are adopting "lean" methods developed in automobile manufacturing to improve operational efficiency, eliminate waste, and optimize the value of their services. The lean approach, which emphasizes process analysis, has particular relevance to radiology departments, which depend on a smooth flow of patients and uninterrupted equipment function for efficient operation. However, the application of lean methods to isolated problems is not likely to improve overall efficiency or to produce a sustained improvement. Instead, the authors recommend a gradual but continuous and comprehensive "lean transformation" of work philosophy and workplace culture. Fundamental principles that must consistently be put into action to achieve such a transformation include equal involvement of and equal respect for all staff members, elimination of waste, standardization of work processes, improvement of flow in all processes, use of visual cues to communicate and inform, and use of specific tools to perform targeted data collection and analysis and to implement and guide change. Many categories of lean tools are available to facilitate these tasks: value stream mapping for visualizing the current state of a process and identifying activities that add no value; root cause analysis for determining the fundamental cause of a problem; team charters for planning, guiding, and communicating about change in a specific process; management dashboards for monitoring real-time developments; and a balanced scorecard for strategic oversight and planning in the areas of finance, customer service, internal operations, and staff development. PMID:22323617

  13. Quality initiatives: Key performance indicators for measuring and improving radiology department performance.

    Abujudeh, Hani H; Kaewlai, Rathachai; Asfaw, Benjamin A; Thrall, James H

    2010-05-01

    Key performance indicators (KPIs) are financial and nonfinancial measures that are used to define and evaluate the success of an organization. KPIs differ, depending on the nature of the organization and the organizational strategy; they are devised to help evaluate the progress of an organization toward achieving its long-term goals and fulfilling its vision. In healthcare organizations, performance assessment is especially critical for the development of best practices that can lead to improved outcomes in patient care, and KPIs have been incorporated into many healthcare management systems. In the future, radiology-specific KPIs such as those in use at the authors' institution may help provide a framework for measuring performance in radiology practice. PMID:20219841

  14. The preclinical data forum network: A new ECNP initiative to improve data quality and robustness for (preclinical) neuroscience.

    Steckler, Thomas; Brose, Katja; Haas, Magali; Kas, Martien J; Koustova, Elena; Bespalov, Anton

    2015-10-01

    Current limitations impeding on data reproducibility are often poor statistical design, underpowered studies, lack of robust data, lack of methodological detail, biased reporting and lack of open data sharing, coupled with wrong research incentives. To improve data reproducibility, robustness and quality for brain disease research, a Preclinical Data Forum Network was formed under the umbrella of the European College of Neuropsychopharmacology (ECNP). The goal of this network, members of which met for the first time in October 2014, is to establish a forum to collaborate in precompetitive space, to exchange and develop best practices, and to bring together the members from academia, pharmaceutical industry, publishers, journal editors, funding organizations, public/private partnerships and non-profit advocacy organizations. To address the most pertinent issues identified by the Network, it was decided to establish a data sharing platform that allows open exchange of information in the area of preclinical neuroscience and to develop an educational scientific program. It is also planned to reach out to other organizations to align initiatives to enhance efficiency, and to initiate activities to improve the clinical relevance of preclinical data. Those Network activities should contribute to scientific rigor and lead to robust and relevant translational data. Here we provide a synopsis of the proceedings from the inaugural meeting. PMID:26073278

  15. The Strengthening Families Initiative and Child Care Quality Improvement: How Strengthening Families Influenced Change in Child Care Programs in One State

    Douglass, Anne; Klerman, Lorraine

    2012-01-01

    Research Findings: This study investigated how the Strengthening Families through Early Care and Education initiative in Illinois (SFI) influenced change in 4 child care programs. Findings indicate that SFI influenced quality improvements through 4 primary pathways: (a) Learning Networks, (b) the quality of training, (c) the engagement of program…

  16. Management strategies to effect change in intensive care units: lessons from the world of business. Part I. Targeting quality improvement initiatives.

    Gershengorn, Hayley B; Kocher, Robert; Factor, Phillip

    2014-02-01

    The business community has developed strategies to ensure the quality of the goods or services they produce and to improve the management of multidisciplinary work teams. With modification, many of these techniques can be imported into intensive care units (ICUs) to improve clinical operations and patient safety. In Part I of a three-part ATS Seminar series, we argue for adopting business management strategies in ICUs and set forth strategies for targeting selected quality improvement initiatives. These tools are relevant to health care today as focus is placed on limiting low-value care and measuring, reporting, and improving quality. In the ICU, the complexity of illness and the need to standardize processes make these tools even more appealing. Herein, we highlight four techniques to help prioritize initiatives. First, the "80/20 rule" mandates focus on the few (20%) interventions likely to drive the majority (80%) of improvement. Second, benchmarking--a process of comparison with peer units or institutions--is essential to identifying areas of strength and weakness. Third, root cause analyses, in which structured retrospective reviews of negative events are performed, can be used to identify and fix systems errors. Finally, failure mode and effects analysis--a process aimed at prospectively identifying potential sources of error--allows for systems fixes to be instituted in advance to prevent negative outcomes. These techniques originated in fields other than health care, yet adoption has and can help ICU managers prioritize issues for quality improvement. PMID:24575997

  17. Implementation and evaluation of a multisite drug usage evaluation program across Australian hospitals - a quality improvement initiative

    Robertson Marion B

    2011-08-01

    Full Text Available Abstract Background With the use of medicines being a broad and extensive part of health management, mechanisms to ensure quality use of medicines are essential. Drug usage evaluation (DUE is an evidence-based quality improvement methodology, designed to improve the quality, safety and cost-effectiveness of drug use. The purpose of this paper is to describe a national DUE methodology used to improve health care delivery across the continuum through multi-faceted intervention involving audit and feedback, academic detailing and system change, and a qualitative assessment of the methodology, as illustrated by the Acute Postoperative Pain Management (APOP project. Methods An established methodology, consisting of a baseline audit of inpatient medical records, structured patient interviews and general practitioner surveys, followed by an educational intervention and follow-up audit, is used. Australian hospitals, including private, public, metropolitan and regional, are invited to participate on a voluntary basis. De-identified data collected by hospitals are collated and evaluated nationally to provide descriptive comparative analyses. Hospitals benchmark their practices against state and national results to facilitate change. The educational intervention consists of academic detailing, group education, audit and feedback, point-of-prescribing prompts and system changes. A repeat data collection is undertaken to assess changes in practice. An online qualitative survey was undertaken to evaluate the APOP program. Qualitative assessment of hospitals' perceptions of the effectiveness of the overall DUE methodology and changes in procedure/prescribing/policy/clinical practice which resulted from participation were elicited. Results 62 hospitals participated in the APOP project. Among 23 respondents to the evaluation survey, 18 (78% reported improvements in the documentation of pain scores at their hospital. 15 (65% strongly agreed or agreed that participation in APOP directly resulted in increased prescribing of multimodal analgesia for pain relief in postoperative patients. Conclusions This national DUE program has facilitated the engagement and participation of a number of acute health care facilities to address issues relating to quality use of medicine. This approach has been perceived to be effective in helping them achieve improvements in patient care.

  18. Improving health-related quality of life through an evidence-based obesity reduction program: the Healthy Weights Initiative

    Lemstra ME

    2016-03-01

    Full Text Available Mark E Lemstra,1 Marla R Rogers,21Alliance Health, Moose Jaw, 2Department of Physical Medicine and Rehabilitation, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada Abstract: When evaluating any health intervention, it is critical to include the impact of the intervention on health-related quality of life (HRQL. Among those who are obese, HRQL is often lower than the general population and even more when considering obesity-related comorbidities and bodily pain. The objectives of this paper were to determine the impact of a multidisciplinary, community-based obesity reduction program on HRQL and to determine the independent risk factors for lack of improvement from baseline to follow-up. HRQL was measured using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36 at baseline and follow-up (24 weeks. To date, 84.5% of those who completed the program had improvements in their overall SF-36 score. Significant increases in the mean scores on eight dimensions of health were also observed. Lack of improvement was independently affected by smoking status (odds ratio 3.75; 95% confidence interval 1.44–9.78; P=0.007 and not having a buddy to attend the program (odds ratio 3.70; 95% confidence interval 1.28–10.68; P=0.015. Obesity reduction programs that target increasing exercise, improving diet, and cognitive behavioral therapy can positively impact HRQL in obese adults. Social support has a strong role to play in improving outcomes. Keywords: obesity, health-related quality of life, social- support, SF-36, Canada

  19. Improving health-related quality of life through an evidence-based obesity reduction program: the Healthy Weights Initiative.

    Lemstra, Mark E; Rogers, Marla R

    2016-01-01

    When evaluating any health intervention, it is critical to include the impact of the intervention on health-related quality of life (HRQL). Among those who are obese, HRQL is often lower than the general population and even more when considering obesity-related comorbidities and bodily pain. The objectives of this paper were to determine the impact of a multidisciplinary, community-based obesity reduction program on HRQL and to determine the independent risk factors for lack of improvement from baseline to follow-up. HRQL was measured using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) at baseline and follow-up (24 weeks). To date, 84.5% of those who completed the program had improvements in their overall SF-36 score. Significant increases in the mean scores on eight dimensions of health were also observed. Lack of improvement was independently affected by smoking status (odds ratio 3.75; 95% confidence interval 1.44-9.78; P=0.007) and not having a buddy to attend the program (odds ratio 3.70; 95% confidence interval 1.28-10.68; P=0.015). Obesity reduction programs that target increasing exercise, improving diet, and cognitive behavioral therapy can positively impact HRQL in obese adults. Social support has a strong role to play in improving outcomes. PMID:27022273

  20. Improving health-related quality of life through an evidence-based obesity reduction program: the Healthy Weights Initiative

    Lemstra, Mark E; Rogers, Marla R

    2016-01-01

    When evaluating any health intervention, it is critical to include the impact of the intervention on health-related quality of life (HRQL). Among those who are obese, HRQL is often lower than the general population and even more when considering obesity-related comorbidities and bodily pain. The objectives of this paper were to determine the impact of a multidisciplinary, community-based obesity reduction program on HRQL and to determine the independent risk factors for lack of improvement from baseline to follow-up. HRQL was measured using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) at baseline and follow-up (24 weeks). To date, 84.5% of those who completed the program had improvements in their overall SF-36 score. Significant increases in the mean scores on eight dimensions of health were also observed. Lack of improvement was independently affected by smoking status (odds ratio 3.75; 95% confidence interval 1.44–9.78; P=0.007) and not having a buddy to attend the program (odds ratio 3.70; 95% confidence interval 1.28–10.68; P=0.015). Obesity reduction programs that target increasing exercise, improving diet, and cognitive behavioral therapy can positively impact HRQL in obese adults. Social support has a strong role to play in improving outcomes. PMID:27022273

  1. Industrial Training and Quality Initiatives.

    Sandelands, Eric, Ed.; And Others

    1994-01-01

    Twelve articles on total quality management (TQM) cover the following: corporate transformation; systemic barriers to quality improvement; Japan's experience; avoiding costly mistakes; the experience of Land-Rover, Hewlett Packard, and Britain's Royal Mail; unleashing the potential of people; and a profile of a senior TQM practitioner. (SK)

  2. Use of CAHPS® patient experience survey data as part of a patient-centered medical home quality improvement initiative

    Quigley DD

    2015-07-01

    Full Text Available Denise D Quigley,1 Peter J Mendel,1 Zachary S Predmore,2 Alex Y Chen,3 Ron D Hays41RAND Corporation, Santa Monica, CA, 2RAND Corporation, Boston, MA, 3AltaMed Health Services Corporation, 4Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles, CA, USAObjective: To describe how practice leaders used Consumer Assessment of Healthcare Providers and Systems (CAHPS® Clinician and Group (CG-CAHPS data in transitioning toward a patient-centered medical home (PCMH.Study design: Interviews conducted at 14 primary care practices within a large urban Federally Qualified Health Center in California.Participants: Thirty-eight interviews were conducted with lead physicians (n=13, site clinic administrators (n=13, nurse supervisors (n=10, and executive leadership (n=2.Results: Seven themes were identified on how practice leaders used CG-CAHPS data for PCMH transformation. CAHPS® was used: 1 for quality improvement (QI and focusing changes for PCMH transformation; 2 to maintain focus on patient experience; 3 alongside other data; 4 for monitoring site-level trends and changes; 5 to identify, analyze, and monitor areas for improvement; 6 for provider-level performance monitoring and individual coaching within a transparent environment of accountability; and 7 for PCMH transformation, but changes to instrument length, reading level, and the wording of specific items were suggested.Conclusion: Practice leaders used CG-CAHPS data to implement QI, develop a shared vision, and coach providers and staff on performance. They described how CAHPS® helped to improve the patient experience in the PCMH model, including access to routine and urgent care, wait times, provider spending enough time and listening carefully, and courteousness of staff. Regular reporting, reviewing, and discussing of patient-experience data alongside other clinical quality and productivity measures at multilevels of the organization was critical in maximizing the use of CAHPS® data as PCMH changes were made. In sum, this study found that a system-wide accountability and data-monitoring structure relying on a standardized and actionable patient-experience survey, such as CG-CAHPS, is key to supporting the continuous QI needed for moving beyond formal PCMH recognition to maximizing primary care medical home transformation.Keywords: PCMH, performance improvement, accountability, CAHPS®

  3. Delivery of maternal health care in Indigenous primary care services: baseline data for an ongoing quality improvement initiative

    Kwedza Ru K

    2011-03-01

    Full Text Available Abstract Background Australia's Aboriginal and Torres Strait Islander (Indigenous populations have disproportionately high rates of adverse perinatal outcomes relative to other Australians. Poorer access to good quality maternal health care is a key driver of this disparity. The aim of this study was to describe patterns of delivery of maternity care and service gaps in primary care services in Australian Indigenous communities. Methods We undertook a cross-sectional baseline audit for a quality improvement intervention. Medical records of 535 women from 34 Indigenous community health centres in five regions (Top End of Northern Territory 13, Central Australia 2, Far West New South Wales 6, Western Australia 9, and North Queensland 4 were audited. The main outcome measures included: adherence to recommended protocols and procedures in the antenatal and postnatal periods including: clinical, laboratory and ultrasound investigations; screening for gestational diabetes and Group B Streptococcus; brief intervention/advice on health-related behaviours and risks; and follow up of identified health problems. Results The proportion of women presenting for their first antenatal visit in the first trimester ranged from 34% to 49% between regions; consequently, documentation of care early in pregnancy was poor. Overall, documentation of routine antenatal investigations and brief interventions/advice regarding health behaviours varied, and generally indicated that these services were underutilised. For example, 46% of known smokers received smoking cessation advice/counselling; 52% of all women received antenatal education and 51% had investigation for gestational diabetes. Overall, there was relatively good documentation of follow up of identified problems related to hypertension or diabetes, with over 70% of identified women being referred to a GP/Obstetrician. Conclusion Participating services had both strengths and weaknesses in the delivery of maternal health care. Increasing access to evidence-based screening and health information (most notably around smoking cessation were consistently identified as opportunities for improvement across services.

  4. End-Stage Renal Disease (ESRD) Quality Initiative

    U.S. Department of Health & Human Services — The End Stage Renal Disease (ESRD) Quality Initiative promotes ongoing CMS strategies to improve the quality of care provided to ESRD patients. This initiative...

  5. End-Stage Renal Disease (ESRD) Quality Initiative

    U.S. Department of Health & Human Services The End Stage Renal Disease (ESRD) Quality Initiative promotes ongoing CMS strategies to improve the quality of care provided to ESRD patients. This initiative...

  6. SQIMSO: Quality Improvement for Small Software Organizations

    Rabih Zeineddine; Nashat Mansour

    2005-01-01

    Software quality improvement process remains incomplete if it is not initiated and conducted through a wide improvement program that considers process quality improvement, product quality improvement and evolution of human resources. But, small software organizations are not capable of bearing the cost of establishing software process improvement programs. In this work, we propose a new software quality improvement model for small organizations, SQIMSO, based on three ...

  7. IMPROVING CONCEPTUAL DESIGN QUALITY

    Bush, Stuart; Robotham, Antony John

    This paper will consider how Quality Function Deployment (QFD) and Design for Manufacture and Assembly (DFMA) processes can be used to improve the design quality of products at the concept stage. We appreciate that both QFD and DFMA are techniques that have been used for some time by mature product...... continuous improvement of their products. However, we consider that if novice designers are able to successfully utilise design tools like QFD and DFMA and achieve improvements in design quality, then SME’s have no excuses for ignoring the benefits they could bring to their own product development activity....... quality is maintained in design project work. The projects described have been carried out with products manufactured by small to medium sized enterprises (SME's), where we have found significant opportunities for product improvement. The quantitative nature of DFMA analysis results allows the novice...

  8. Improving health-related quality of life through an evidence-based obesity reduction program: the Healthy Weights Initiative

    Lemstra ME; Rogers MR

    2016-01-01

    Mark E Lemstra,1 Marla R Rogers,21Alliance Health, Moose Jaw, 2Department of Physical Medicine and Rehabilitation, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada Abstract: When evaluating any health intervention, it is critical to include the impact of the intervention on health-related quality of life (HRQL). Among those who are obese, HRQL is often lower than the general population and even more when considering obesity-related comorbidities and bodily pain. The obj...

  9. Delivery of maternal health care in Indigenous primary care services: baseline data for an ongoing quality improvement initiative

    Kwedza Ru K; Liddle Helen E; O'Donoghue Lynette; Cox Rhonda J; Kennedy Catherine M; Dowden Michelle C; Si Damin; Bailie Ross S; Rumbold Alice R; Thompson Sandra C; Burke Hugh P; Brown Alex DH; Weeramanthri Tarun; Connors Christine M

    2011-01-01

    Abstract Background Australia's Aboriginal and Torres Strait Islander (Indigenous) populations have disproportionately high rates of adverse perinatal outcomes relative to other Australians. Poorer access to good quality maternal health care is a key driver of this disparity. The aim of this study was to describe patterns of delivery of maternity care and service gaps in primary care services in Australian Indigenous communities. Methods We undertook a cross-sectional baseline audit for a qua...

  10. Preliminary report of improved sleep quality in patients with dry eye disease after initiation of topical therapy

    Ayaki M; Toda I; Tachi N; Negishi K; Tsubota K

    2016-01-01

    Masahiko Ayaki,1 Ikuko Toda,2 Naoko Tachi,3 Kazuno Negishi,1 Kazuo Tsubota11Department of Ophthalmology, Keio University School of Medicine, 2Department of Ophthalmology, Mimamiaoyama Eye Clinic, Tokyo, 3Eye Center, Shinseikai Toyama Hospital, Imizu, JapanPurpose: Dry eye disease (DED) is potentially associated with sleep and mood disorders. This study evaluated sleep quality in patients with DED using a questionnaire-based survey before and after topical eyedrop treatment. The effective...

  11. Does an increase in compression force really improve visual image quality in mammography? – An initial investigation

    Objective: Literature speculates that visual image quality (IQ) and compression force levels may be directly related. This small study investigates whether a relationship exists between compression force levels and visual IQ. Method: To investigate how visual IQ varies with different levels of compression force, 39 clients were selected over a 6 year screening period that had received markedly different amounts of compression force on each of their three sequential screens. Images for the 3 screening episodes for all women were scored visually using 3 different IQ scales. Results: Correlation coefficients between the 3 IQ scales were positive and high (0.82, 0.9 and 0.85). For the scales, the IQ scores their correlation does not vary significantly, even though different compression levels had been applied. Kappa IQ scale 1: 0.92, 0.89, 0.89. ANOVA IQ scale 2: p = 0.98, p = 0.55, p = 0.56. ICC IQ scale 3: 0.97, 0.93, 0.91. Conclusion: For the 39 clients there is no difference in visual IQ when different amounts of compression are applied. We believe that further work should be conducted into compression force and image quality as ‘higher levels’ of compression force may not be justified in the attainment of suitable visual image quality

  12. Explaining the success or failure of quality improvement initiatives in long-term care organizations from a dynamic perspective.

    Etheridge, Francis; Couturier, Yves; Denis, Jean-Louis; Tremblay, Lucie; Tannenbaum, Cara

    2014-09-01

    The purpose of this study was to better understand why change initiatives succeed or fail in long-term care organizations. Four case studies from Québec, Canada were contrasted retrospectively. A constipation and restraints program succeeded, while an incontinence and falls program failed. Successful programs were distinguished by the use of a change strategy that combined "let-it happen," "help-it happen," and "make-it happen" interventions to create senses of urgency, solidarity, intensity, and accumulation. These four active ingredients of the successful change strategies propelled their respective change processes forward to completion. This paper provides concrete examples of successful and unsuccessful combinations of "let-it happen," "help-it happen," and "make-it happen" change management interventions. Change managers (CM) can draw upon these examples to best tailor and energize change management strategies in their own organizations. PMID:24652889

  13. Health Insurance Marketplace Quality Initiatives

    U.S. Department of Health & Human Services — The Affordable Care Act requires the U.S. Department of Health and Human Services (HHS) to develop quality data collection and reporting tools such as a Quality...

  14. Hospital Quality Initiative - Outcome Measures

    U.S. Department of Health & Human Services — In the interest of promoting high-quality, patient-centered care and accountability, the Centers for Medicare and Medicaid Services (CMS) and Hospital Quality...

  15. Hospital Quality Initiative - Outcome Measures

    U.S. Department of Health & Human Services In the interest of promoting high-quality, patient-centered care and accountability, the Centers for Medicare and Medicaid Services (CMS) and Hospital Quality...

  16. How to Begin a Quality Improvement Project.

    Silver, Samuel A; Harel, Ziv; McQuillan, Rory; Weizman, Adam V; Thomas, Alison; Chertow, Glenn M; Nesrallah, Gihad; Bell, Chaim M; Chan, Christopher T

    2016-05-01

    Quality improvement involves a combined effort among health care staff and stakeholders to diagnose and treat problems in the health care system. However, health care professionals often lack training in quality improvement methods, which makes it challenging to participate in improvement efforts. This article familiarizes health care professionals with how to begin a quality improvement project. The initial steps involve forming an improvement team that possesses expertise in the quality of care problem, leadership, and change management. Stakeholder mapping and analysis are useful tools at this stage, and these are reviewed to help identify individuals who might have a vested interest in the project. Physician engagement is a particularly important component of project success, and the knowledge that patients/caregivers can offer as members of a quality improvement team should not be overlooked. After a team is formed, an improvement framework helps to organize the scientific process of system change. Common quality improvement frameworks include Six Sigma, Lean, and the Model for Improvement. These models are contrasted, with a focus on the Model for Improvement, because it is widely used and applicable to a variety of quality of care problems without advanced training. It involves three steps: setting aims to focus improvement, choosing a balanced set of measures to determine if improvement occurs, and testing new ideas to change the current process. These new ideas are evaluated using Plan-Do-Study-Act cycles, where knowledge is gained by testing changes and reflecting on their effect. To show the real world utility of the quality improvement methods discussed, they are applied to a hypothetical quality improvement initiative that aims to promote home dialysis (home hemodialysis and peritoneal dialysis). This provides an example that kidney health care professionals can use to begin their own quality improvement projects. PMID:27016497

  17. Improving the quality of initial management of self harm and suicide patients in A+E at the James Paget Hospital

    Cracknell, Ben

    2015-01-01

    Our objective was to improve the initial management and documentation of suicide risk assessment in the notes of patients attending A+E with a suicide attempt or self harm. An initial audit was carried out in 2012 looking at the notes of 50 patients who attended the James Paget Hospital accident and emergency (A+E) department following a suicide attempt or self harm episode. Compliance to the NICE guidelines on the initial management of self harm was assessed and was found to be low in certai...

  18. Quality Improvement by Qualified Managers

    Dr. Nasser Fegh-hi Farahmand

    2013-01-01

    The aim of the study was to study about the impact of quality improvement strategy on creating a sustainable competitive advantage in the qualified managers. The current study was based on empirical approach. A random sample of quality improvement was drawn from seven organizations. A self administrated questionnaire was employed to collect the required data. A number of hypotheses were formulated for this purpose. This article attempts to explain the quality improvement by qualified managers...

  19. Quality Improvement by Qualified Managers

    Dr. Nasser Fegh-hi Farahmand

    2013-01-01

    Full Text Available The aim of the study was to study about the impact of quality improvement strategy on creating a sustainable competitive advantage in the qualified managers. The current study was based on empirical approach. A random sample of quality improvement was drawn from seven organizations. A self administrated questionnaire was employed to collect the required data. A number of hypotheses were formulated for this purpose. This article attempts to explain the quality improvement by qualified managers by patterns of thinking. The importance of strategic, long-term policy and quality improvement is very clear to planners. Quality managers like to follow a similar and routine quality behavioral pattern. This paper reviews organizational quality improvement and quality measurement literature. For organizations to be quality improvement strategy, they had to improve their working environment and delegate their employees more authorities by qualified managers. However, this study concluded that the performance of the organization is highly affected by its quality improvement strategy and qualified manager's creativity.

  20. Improving the Multilayer Perceptron Learning by Using a Method to Calculate the Initial Weights with the Similarity Quality Measure Based on Fuzzy Sets and Particle Swarms

    Lenniet Coello

    2015-01-01

    Full Text Available The most widely used neural network model is Multilayer Perceptron (MLP, in which training of the connection weights is normally completed by a Back Propagation learning algorithm. G ood initial values of weights bear a fast convergence and a better generalization capability even with simple gradient - based error minimization techniques. This work presen ts a method to calculate the initial weights in order to train the Multilayer Perceptron Model. The method named PSO+RST+FUZZY is based on the similarity quality measure proposed within the framework of the extended Rough Set Theory that employs fuzzy sets to characterize the domain of similarity thresholds. Sensitivity of BP to initial weights with PSO+RST+FUZZY was studied experimentally, showing better performance than other methods used to calculate feature weights .

  1. Enhancing quality improvement team effectiveness.

    Mosel, D; Shamp, M J

    1993-01-01

    Quality improvement teams are different from other work groups in their purpose, leadership, membership, training, procedures, and dynamics. To have effective quality improvement teams, health care organizations must focus on six key process variables, with particular attention to group dynamics. Quality improvement teams progress through the "traditional" stages of team development--forming, storming, norming, and performing--with a "special stage" of closing. Within each stage, there are two core dimensions--team process ("relationship" issues) and the project itself ("task" issues)--and critical tasks that need to be performed by the Quality Council, team members, team leader, and the facilitator. PMID:10130709

  2. Validity and usefulness of members reports of implementation progress in a quality improvement initiative: findings from the Team Check-up Tool (TCT

    Marsteller Jill A

    2011-10-01

    Full Text Available Abstract Background Team-based interventions are effective for improving safety and quality of healthcare. However, contextual factors, such as team functioning, leadership, and organizational support, can vary significantly across teams and affect the level of implementation success. Yet, the science for measuring context is immature. The goal of this study is to validate measures from a short instrument tailored to track dynamic context and progress for a team-based quality improvement (QI intervention. Methods Design: Secondary cross-sectional and longitudinal analysis of data from a clustered randomized controlled trial (RCT of a team-based quality improvement intervention to reduce central line-associated bloodstream infection (CLABSI rates in intensive care units (ICUs. Setting: Forty-six ICUs located within 35 faith-based, not-for-profit community hospitals across 12 states in the U.S. Population: Team members participating in an ICU-based QI intervention. Measures: The primary measure is the Team Check-up Tool (TCT, an original instrument that assesses context and progress of a team-based QI intervention. The TCT is administered monthly. Validation measures include CLABSI rate, Team Functioning Survey (TFS and Practice Environment Scale (PES from the Nursing Work Index. Analysis: Temporal stability, responsiveness and validity of the TCT. Results We found evidence supporting the temporal stability, construct validity, and responsiveness of TCT measures of intervention activities, perceived group-level behaviors, and barriers to team progress. Conclusions The TCT demonstrates good measurement reliability, validity, and responsiveness. By having more validated measures on implementation context, researchers can more readily conduct rigorous studies to identify contextual variables linked to key intervention and patient outcomes and strengthen the evidence base on successful spread of efficacious team-based interventions. QI teams participating in an intervention should also find data from a validated tool useful for identifying opportunities to improve their own implementation.

  3. Improving soybean seed quality

    Both the meal and oil fractions of soybeans may be genetically improved, either by mutagenesis or by genetic engineering. There are a number of mutant lines of soybeans containing a low raffinosaccharide meal, which can be used for animal feed, with an improved total metabolizable energy content. Mutant lines with an improved fatty acid profile of the oil include high oleic and high stearic soybeans. Cloning of the mutant genes facilitates the integration of these traits into high yielding elite lines by providing molecular markers. Cloned genes may also be reintroduced into soybeans to create transgenic lines with improved meal and oil traits, such as seeds with an increased lysine content and stable soybean oils with a very low content of polyunsaturated fatty acids. The design of transgene constructs has been assisted by using soybean somatic embryos in suspension culture as a model system for soybean seed transformation. This system has allowed selection of those genes and promoters that are the most effective way of achieving the desired phenotypes in soybeans. Experiments with constructs containing fatty acid biosynthesis genes in somatic embryos have also led to the conclusion that, in soybeans, gene-transgene sense suppression is a more effective way of silencing endogenous genes than antisense. Sense suppression of genes encoding microsomal, fatty acid omega-6 desaturates has resulted in soybean lines with over 80% oleic acid in their seed oil, and this trait is stable over at least three generations. (author). 12 refs, 2 figs

  4. NETWORKS AND QUALITY IMPROVEMENT

    Miodrag Hadžistević

    2009-12-01

    Full Text Available Tools used in the past to analyze business value creation, such as value chain and process models, are simply too slow, inadequate, or inappropriate to address this new level of business complexity. In stead of that, company has to find way to create quality management system in a multi-layered supply chain. The problem can be solved by networking in the cluster. Cluster can be known as a competitive cooperation in the purpose to gain higher level of competitiveness and success. Bat there is another problem: Organization of the production process in a company is extremely complex process itself, and when we transfer it to the cluster level, we get a complex task which is difficult to solve. For that purpose, this paper analyses the conditions and possibilities that would enable those structures to adapt to changes in the surroundings - flexibility and management adequacy of production and organizational structures - by creating network value system.

  5. Hanford Tanks Initiative quality assurance implementation plan

    Hanford Tanks Initiative (HTI) Quality Assurance Implementation Plan for Nuclear Facilities defines the controls for the products and activities developed by HTI. Project Hanford Management Contract (PHMC) Quality Assurance Program Description (QAPD)(HNF-PRO599) is the document that defines the quality requirements for Nuclear Facilities. The QAPD provides direction for compliance to 10 CFR 830.120 Nuclear Safety Management, Quality Assurance Requirements. Hanford Tanks Initiative (HTI) is a five-year activity resulting from the technical and financial partnership of the US Department of Energy's Office of Waste Management (EM-30), and Office of Science and Technology Development (EM-50). HTI will develop and demonstrate technologies and processes for characterization and retrieval of single shell tank waste. Activities and products associated with HTI consist of engineering, construction, procurement, closure, retrieval, characterization, and safety and licensing

  6. Hanford Tanks Initiative quality assurance implementation plan

    Huston, J.J.

    1998-06-23

    Hanford Tanks Initiative (HTI) Quality Assurance Implementation Plan for Nuclear Facilities defines the controls for the products and activities developed by HTI. Project Hanford Management Contract (PHMC) Quality Assurance Program Description (QAPD)(HNF-PRO599) is the document that defines the quality requirements for Nuclear Facilities. The QAPD provides direction for compliance to 10 CFR 830.120 Nuclear Safety Management, Quality Assurance Requirements. Hanford Tanks Initiative (HTI) is a five-year activity resulting from the technical and financial partnership of the US Department of Energy`s Office of Waste Management (EM-30), and Office of Science and Technology Development (EM-50). HTI will develop and demonstrate technologies and processes for characterization and retrieval of single shell tank waste. Activities and products associated with HTI consist of engineering, construction, procurement, closure, retrieval, characterization, and safety and licensing.

  7. Mexico City Air Quality Research Initiative

    The Mexico City Air Quality Research Initiative is one project that is examining the complex relationship between air pollution, economic growth, societal values, and air quality policies. This paper describes the programs that are being used to fulfill the three tasks of the project: air pollution modeling and simulation, air pollution monitoring, and strategic evaluation. The two lead institutions for this project are the Mexican Petroleum Institute and Los Alamos National Laboratory

  8. Power Quality Improvement Using UPQC

    K. Kalaipriya; S. Jayachitra

    2014-01-01

    This paper presents the power quality improvement using UPQC. UPQC consists of series inverter, shunt inverter and capacitance. Every inverter connected with pulse generator for switching on. UPQC is especially obtained to resolve different kind of power quality drawback like reactive power compensation, voltage interruption and harmonics. DVR is connected in series to deliver the active and reactive power to distribution network. DC-link capacitors stay high as a result of th...

  9. IMPROVING QUALITY MANAGEMENT IN PANIFICATION

    Cornelia Petroman; Calin Popovici; Ioan Petroman

    2010-01-01

    Consumers of panification products (as well as consumers of any other type of product or service) are concerned about the quality of the products they purchase. Implementing the quality management system in the food industry is not compulsory, but it can bring about numerous, palpable benefits, particularly in reducing the amount of acryl amide. It is a modern system allowing the management analysis aiming at checking and reaching the goals to define new objectives, and the continuous improve...

  10. IMPROVING QUALITY MANAGEMENT IN PANIFICATION

    Cornelia Petroman

    2010-12-01

    Full Text Available Consumers of panification products (as well as consumers of any other type of product or service are concerned about the quality of the products they purchase. Implementing the quality management system in the food industry is not compulsory, but it can bring about numerous, palpable benefits, particularly in reducing the amount of acryl amide. It is a modern system allowing the management analysis aiming at checking and reaching the goals to define new objectives, and the continuous improvement of the quality of processes and products.

  11. Alzheimer's Association Quality Care Campaign and professional training initiatives: improving hands-on care for people with dementia in the U.S.A.

    Gould, Elizabeth; Reed, Peter

    2009-04-01

    In the U.S.A., direct care workers and licensed practical nurses are the professionals who provide the most hands-on care to people with dementia in nursing homes and residential care facilities--yet they do not receive adequate training in dementia care. Dementia care training needs to be universal with all disciplines at all levels of care. Even though there is variability on recommended hours and content, most studies emphasize the importance of dementia care training as a distinct component of required training for any professional or paraprofessional working in long-term care. In 2005, the Alzheimer's Association launched its Quality Care Campaign to improve dementia care through state and federal advocacy; consumer education and empowerment; and staff training. This paper describes the effectiveness of Alzheimer's Association training as measured by knowledge gained and providers' intention to change their behavior immediately after attending the training.Overall, findings indicated that the participants responded positively to evidence-based training in dementia care that emphasized the importance of (i) leadership, (ii) team communication and collaboration, (iii) support and empowerment of direct care staff, (iv) awareness and practice of specific dementia care issues, (v) resident and family involvement in care, and (vi) professional self-care. PMID:19288968

  12. Quality Improvement Practices and Trends

    Dahlgaard, Jens J.; Hartz, Ove; Edgeman, Rick L.

    1998-01-01

    The following article, "Quality Improvement Practices and Trends in Denmark," is the first in a series of papers arranged for and co-authored by Dr. Rick L. Edgeman. Rick is a member of QE's Editorial Board and is on sabbatical from Colorado State University. During the year, Rick and his family...... visiting professor, as well as key individuals from various industries. In addition to the above activities, Rick will be working with the European Foundation for Quality Management on their "European Master's Programme in Total Quality Management." That program involves a consortium of European...... universities. Rick has begun the process of developing a comparable consortium of American universities for the same purpose-- an activity which is cosponsored by the Education Division of the American Society for Quality (ASQ)....

  13. Improving quality and consistency of dissertation assessment

    Pathirage, C. P.; Amaratunga, Dilanthi; Haigh, Richard

    2005-01-01

    During the last decade, there has been increasing calls for Higher Education to improve standards, increase the quality of assessment, and for greater accountability of lecturers. It is recognised that consistency in assessment is even more important where assessment is through one large piece of work, such as a dissertation, and where the assessment outcome will have a significant impact on the final grade of students. In this context, this paper outlines the initial literatur...

  14. Improving care at cystic fibrosis centers through quality improvement.

    Kraynack, Nathan C; McBride, John T

    2009-10-01

    Quality improvement (QI) using a clinical microsystems approach provides cystic fibrosis (CF) centers the opportunity to make a significant positive impact on the health of their patients. The availability of center-specific outcomes data and the support of the Cystic Fibrosis Foundation are important advantages for these quality improvement efforts. This article illustrates how the clinical microsystems methodology can improve care delivery and outcomes by describing the gradual application of quality improvement principles over the past 5 years by the CF team at the Lewis Walker Cystic Fibrosis Center at Akron Children's Hospital in Akron, Ohio. Using the example of a project to improve the pulmonary function of the pediatric patients at our center as a framework, we describe the QI process from the initial team-building phase, through the assessment of care processes, standardization of care, and developing a culture of continuous improvement. We outline how enthusiastic commitment from physician leadership, clinical managers and central administration, the availability of coaches, and an appreciation of the importance of measurement, patient involvement, communication, and standardization are critical components for successful process improvement. PMID:19760542

  15. The Improvement of Services Quality

    Cristian-Ştefan Craciun

    2013-01-01

    Full Text Available In the last decades, there was a strong national and international tendency to increase the services role in the economic social life. The technical progress, the enhancing social division of labor and the increase of demand both from the population and entrepreneurs led to the services development and diversification. Due to the recent radical changes in all economic, political and social fields, the economic agents’ goal to gain a rapid and substantial profit was gradually replaced by the fierce struggle for quality domination among competitors. Therefore, there is an increasing need to find more effective ways to improve the services quality, such as training and motivating the staff and implementing a quality management system.

  16. Accountability for Quality: One State's Experience in Improving Practice

    Hooks, Laura McDonald; Scott-Little, Catherine; Marshall, Betty Jo; Brown, Glyn

    2006-01-01

    South Carolina recently implemented a new initiative to improve the quality of pre- kindergarten and kindergarten classrooms in primary schools. This article describes the initiative and examines evidence that such an effort can have a positive effect on early childhood program quality. Data from both classroom observations using the ECERS-R…

  17. Power Quality Improvement Using UPQC

    K. Kalaipriya

    2014-05-01

    Full Text Available This paper presents the power quality improvement using UPQC. UPQC consists of series inverter, shunt inverter and capacitance. Every inverter connected with pulse generator for switching on. UPQC is especially obtained to resolve different kind of power quality drawback like reactive power compensation, voltage interruption and harmonics. DVR is connected in series to deliver the active and reactive power to distribution network. DC-link capacitors stay high as a result of the DVR needs a minimum amount of DC-link voltage to compensate sag. So, DC link voltage is connected with PV module to reduce the cost. Design of UPQC device with multi-bus system obtained using MATLAB/SIMULINK and simulation results are mentioned to support the developed conception.

  18. Assessment of on-road emissions of four Euro V diesel and CNG waste collection trucks for supporting air-quality improvement initiatives in the city of Milan

    This paper summarizes the results of an extensive experimental study aiming to evaluate the performance and pollutant emissions of diesel and CNG waste collection trucks under realistic and controlled operating conditions in order to support a fleet renewal initiative in the city of Milan. Four vehicles (1 diesel and 3 CNG) were tested in two phases using a portable emission measurement system. The first phase included real world operation in the city of Milan while the second involved controlled conditions in a closed track. Emissions recorded from the diesel truck were on average 2.4 kg/km for CO2, 0.21 g/km for HC, 7.4 g/km for CO, 32.3 g/km for NOx and 46.4 mg/km for PM. For the CNG the values were 3.6 kg/km for CO2, 2.19 g/km for HC, 15.8 g/km for CO, 4.38 g/km for NOx and 11.4 mg/km for PM. CNG vehicles presented an important advantage with regards to NOx and PM emissions but lack the efficiency of their diesel counterparts when it comes to CO, HC and particularly greenhouse gas emissions. This tradeoff needs to be carefully analyzed prior to deciding if a fleet should be shifted towards either technology. In addition it was shown that existing emission factors, used in Europe for environmental assessment studies, reflect well the operation for CNG but were not so accurate when it came to the diesel engine truck particularly for CO2 and NOx. With regard to NOx, it was also shown that the limits imposed by current emission standards are not necessarily reflected in real world operation, under which the diesel vehicle presented almost 4 times higher emissions. Regarding CO2, appropriate use of PEMS data and vehicle information allows for accurate emission monitoring through computer simulation. - Highlights: ► Investigated diesel and CNG Euro V waste collection vehicles for municipal use ► NOx-GhG emission trade-off should be considered prior to fleet renewal initiatives. ► NOx and CO emissions exceeded the emission standard values over realistic conditions. ► Current emission factors reflect adequately CNG but need update for diesel trucks. ► Simulation successfully used for CO2 monitoring, opens path for regulatory initiatives

  19. Trading emissions improve air quality

    While admitting sharply contrasting views exist, James M. Lents of the South Coast Air Quality Management District in southern California sees emissions trading open-quotes as a lifesaver for our troubled planet.close quotes He explains: open-quotes If political support for the environment is to be maintained, we must seek the most economical and flexible means of pursuing cleanup. At present, market incentives and emissions trading represent our best hope.close quotes Lents is putting his money where his pen is. The air quality management district he heads plans to use market incentives, including emissions trading, to reduce air pollution in the notoriously dirty southern California area. When the system goes into operation in 1994, he estimates it will save southern California businesses more than $400 million a year in compliance costs, while also making major improvements in the region's air quality. If the idea works there, why won't it work elsewhere, even on a global scale, Lents asks? He believes it will. But open-quotes the ultimate success of emissions-trading programs, whether regional, national, or international in scope, lies in the proof that they're actually achieving reductions in harmful emissions,close quotes he emphasizes. open-quotes These reductions must be real and verifiable to satisfy the Clean Air Act and a skeptical public.close quotes

  20. Using Quality Function Deployment to Improve Reference Services Quality

    Pao-Long Chang; Pao-Nuan Hsieh

    1996-01-01

    Much research has been conducted regarding how reference librarians can evaluate and improve the quality of the answers they provide to users' inquiries. There has been considerably less discussion, however, concerning how to improve the quality of the delivery of those answers, and to upgrade the overall quality of reference services as a whole. Suggestions for improving the quality of service contained within the business literature may be applied to improve library services as well. In thi...

  1. San Francisco Bay Water Quality Improvement Fund

    U.S. Environmental Protection Agency — The San Francisco Bay Water Quality Improvement Fund is a competitive grant program that is helping implement TMDLs to improve water quality, protect wetlands, and...

  2. Defining quality improvement in public health.

    Riley, William J; Moran, John W; Corso, Liza C; Beitsch, Leslie M; Bialek, Ronald; Cofsky, Abbey

    2010-01-01

    Many industries commonly use quality improvement (QI) techniques to improve service delivery and process performance. Yet, there has been scarce application of these proven methods to public health settings and the public health field has not developed a set of shared principles or a common definition for quality improvement. This article discusses a definition of quality improvement in public health and describes a continuum of quality improvement applications for public health departments. Quality improvement is a distinct management process and set of tools and techniques that are coordinated to ensure that departments consistently meet the health needs of their communities. PMID:20009636

  3. Quality improvement practices and trends in Denmark

    Dahlgaard, Jens Jørn; Hartz, Ove; Edgeman, Rick L.

    awareness of quality improvement practices and trends in various European nations, with particular emphasis on western Europe and Scandinavia. Herein the recent history of quality improvement in Denmark is explored and the quality improvement efforts in two Danish companies are chronicled. It is hoped that...

  4. Improvement of nuclear filter quality

    'Full-text:' The investigation was aimed at development of method and methodology of improvement of nuclear filter quality. Nuclear filters are used to manufacture high quality articles used to clean potable water from germ dredge, blood plasmaphoresis, clarification and microbiological stabilization of medical preparations, air and gas secondary cleaning from aerosols and germs. The basis of nuclear filter manufacture process is discriminatory etching of the charged particle-destructed polymer, which depends on destruction degree and destructed channel diameter. During irradiation some areas are destructed in some film regions as a result of ion treatment; during physico-chemical treatment (ultra-violet irradiation, etching in NaOH solution) that follows these areas allow obtain pores with cylindrical form. To ensure pore uniform distribution throughout the irradiated film, it is necessary to locate irradiated material surface perpendicularly to the incident ion beam and correlate polymer material velocity and bombarding charged particle flow density. Milor films was irradiated using the cyclotron P7 (-120) by eight argon charged ions with the energy of 1,0-1,1 MeV/ nucleon. Milor films with the thickness of 10 and width of 320mm were irradiated. During irradiation film motion was normal to the charged particle beam. Film velocity during irradiation was changing in the range of 1,5 m/min 15 m/min depending on charged particle flow density. Research done showed that pore number in the film is directly proportional to charged particle flow density and inversely proportional to film broach velocity. Using the obtained results the method and methodology of pore uniform distribution throughout the film were developed, which allows manufacture high quality nuclear filters. We had no cases when ions were passing through the film at small distances one from another or when dispersion of pore size and form can arise as a result of single channels joining channels next to them during consecutive film physico-chemical treatment. (author)

  5. Improvement of nuclear filter quality

    Komov, A.; Pirogov, N.; Mamontov, A. [Tomsk Polytechnic Univ., Nuclear Physics Inst., Tomsk (Russian Federation)

    2004-07-01

    'Full-text:' The investigation was aimed at development of method and methodology of improvement of nuclear filter quality. Nuclear filters are used to manufacture high quality articles used to clean potable water from germ dredge, blood plasmaphoresis, clarification and microbiological stabilization of medical preparations, air and gas secondary cleaning from aerosols and germs. The basis of nuclear filter manufacture process is discriminatory etching of the charged particle-destructed polymer, which depends on destruction degree and destructed channel diameter. During irradiation some areas are destructed in some film regions as a result of ion treatment; during physico-chemical treatment (ultra-violet irradiation, etching in NaOH solution) that follows these areas allow obtain pores with cylindrical form. To ensure pore uniform distribution throughout the irradiated film, it is necessary to locate irradiated material surface perpendicularly to the incident ion beam and correlate polymer material velocity and bombarding charged particle flow density. Milor films was irradiated using the cyclotron P7 (-120) by eight argon charged ions with the energy of 1,0-1,1 MeV/ nucleon. Milor films with the thickness of 10 and width of 320mm were irradiated. During irradiation film motion was normal to the charged particle beam. Film velocity during irradiation was changing in the range of 1,5 m/min 15 m/min depending on charged particle flow density. Research done showed that pore number in the film is directly proportional to charged particle flow density and inversely proportional to film broach velocity. Using the obtained results the method and methodology of pore uniform distribution throughout the film were developed, which allows manufacture high quality nuclear filters. We had no cases when ions were passing through the film at small distances one from another or when dispersion of pore size and form can arise as a result of single channels joining channels next to them during consecutive film physico-chemical treatment. (author)

  6. HCFA's health care quality improvement program: the medical informatics challenge.

    Grant, J B; Hayes, R P; Pates, R D; Elward, K S; Ballard, D J

    1996-01-01

    The peer-review organizations (PROs) were created by Congress in 1984 to monitor the cost and quality of care received by Medicare beneficiaries. In order to do this, the Health Care Financing Administration (HCFA) contracted with the PROs through a series of contracts referred to as "Scopes of Work." Under the Fourth Scope of Work, the HCFA initiated the Health Care Quality Improvement Program (HCQIP) in 1990, as an application of the principles of continuous quality improvement. Since then,...

  7. Analyzing and Improving Data Quality

    Buccella, Agustina; Cechich, Alejandra; Domingo, Gonzalo

    2008-01-01

    Data quality is a research area strongly investigated during the 90’s. However, few companies in Argentina apply data quality methodologies or tools during the analysis, design or implementation phases of software development process. Developers generally use techniques to design systems such as UML without considering mechanisms for future data quality problems. In this work we propose a methodology in which the data quality is an essential part of the whole software development process. Ear...

  8. Quality and Profitability improvement by Technical Audit

    Prof. Srivastava S. B.; Dr. Mishra R. C.

    2009-01-01

    This paper is aimed for finding the Quality and Profitability Improvement by Technical Audit, through a case study and further establishing the relationship between the product quality, profitability and technical audit. Quality audit generates the report of non conformance which basically represents the deviation from committed quality of products, or in short, it may be called as postmortem of product quality. By virtue of quality audit, the commitment, implementation and follow up for prod...

  9. Total quality drives nuclear plant improvements

    Total quality (TQ) at Carolina Power and Light (CP and L) is fulfilling a 1985 vision of Sherwood H. Smith, Jr., CP and L's chairman, president, and chief executive officer. The TQ concept has provided a way for employees to align their creative energies toward meeting the business needs of the company. Throughout CP and L, TQ has been recognized as the vehicle for reducing operating costs and improving customer satisfaction. Within the nuclear organization, application of the TQ process has helped to improve communications, resolve challenges, and provide more consistent work practices among CP and L's three nuclear plants. Total quality was introduced from the top down, with initial benefits coming from team interactions. Senior management at CP and L defined the corporate expectations and outlined the training requirements for implementing TQ. Management staffs at each organizational level became steering committees for TQ team activities within their departments. Teams of employees most knowledgeable about a given work area were empowered to solve problems or overcome obstacles related to that work area. Employees learned to become better team players and to appreciate the quality of decisions reached through group consensus. Now, formalized methods that started TQ are becoming part of the day-to-day work ethic

  10. Strategy to Support Improvement of Healthcare Quality.

    Ing. Andrea Zejdlova

    2013-01-01

    Full Text Available One of the latest market-based solutions to the rising costs and quality gaps in health care is pay for performance. Pay for performance is the use of financial incentives to promote the delivery of designated standards of care. It is an emerging movement in health insurance (initially in Britain and United States. Providers under this arrangement are rewarded for meeting pre-established targets for delivery of healthcare services. This is a fundamental change from fee for service payment.Also known as "P4P" or value-based purchasing, this payment model rewards physicians, hospitals, medical groups, and other healthcare providers for meeting certain performance measures for quality and efficiency. Disincentives, such as eliminating payments for negative consequences of care (medical errors or increased costs, have also been proposed. In the developed nations, the rapidly aging population and rising health care costs have recently brought P4P to the forefront of health policy discussions. Pilot studies underway in several large healthcare systems have shown modest improvements in specific outcomes and increased efficiency, but no cost savings due to added administrative requirements. Statements by professional medical societies generally support incentive programs to increase the quality of health care, but express concern with the validity of quality indicators, patient and physician autonomy and privacy, and increased administrative burdens. This article serves as an introduction to pay for performance. We discuss the goals and structure of pay for performance plans and their limitations and potential consequences in the health care area.

  11. Initial Survey Instructions for Spring Water Monitoring : Quality

    US Fish and Wildlife Service, Department of the Interior — Initial survey instructions for 1.04 spring water monitoring quality and 1.06 management unit water monitoring quality at Fish Springs National Wildlife Refuge....

  12. Improving Health and Quality of Life

    ... CFS) Share Compartir Improving Health and Quality of Life On this Page Cognitive Behavioral Therapy (CBT) Support ... their ability to function and their quality of life. Doctors may refer some of their CFS patients ...

  13. Voltage Quality Improvement Using Solar Photovoltaic Systems

    Denisa Galzina

    2015-06-01

    This paper briefly shows the methods of power quality improvement, and then the results of on-site power quality measurements in the grid before and after the connection of the solar photovoltaic system.

  14. African Primary Care Research: Quality improvement cycles

    Claire van Deventer; Bob Mash

    2014-01-01

    Abstract Improving the quality of clinical care and translating evidence into clinical practice is commonly a focus of primary care research. This article is part of a series on primary care research and outlines an approach to performing a quality improvement cycle as part of a research assignment at a Masters level. The article aims to help researchers design their quality improvement cycle and write their research project proposal.

  15. African primary care research: Quality improvement cycles

    Claire Van Deventer

    2014-01-01

    Full Text Available Improving the quality of clinical care and translating evidence into clinical practice is commonly a focus of primary care research. This article is part of a series on primary care research and outlines an approach to performing a quality improvement cycle as part of a research assignment at a Masters level. The article aims to help researchers design their quality improvement cycle and write their research project proposal.

  16. Quality improvement within nonprofit social service providers

    Neubeck, Truls

    2016-01-01

    As a relatively new phenomenon in 2009, Swedish nonprofit social service providers proposed quality improvement as a way to reduce mistakes, use resources more effectively and meet the needs and expectations of clients in a better way. Although similar experiences have been studied in health care, the transfer of quality improvement to nonprofit social services gives a possibility for more knowledge on what enables, and constrains, systematic quality improvement in this specific context. This...

  17. Teaching Quality Improvement Through a Book Club

    Benjamin Doolittle; Jaideep Talwalkar

    2015-01-01

    Introduction: Quality Improvement projects are an important part of residency education in the United States and are required for accreditation by the Accreditation Council for Graduate Medical Education. Participation in standard chart-based quality improvement had failed to generate excitement among residents in our program. The objective of our innovation was to inspire interest in quality improvement among our residents. Methods: Our residency program instituted a book discussion gro...

  18. Does Audit Improve the Quality of Care?

    Areti Tsaloglidou

    2009-01-01

    BACKGROUND: The quality of health care and quality assurance are concepts which have been established for many years. Audit nowadays is adopted as a means of developing high quality care.AIM: This study aims to identify the perspectives of audit in practice and its relationship to quality assessment and assurance, quality improvement, and clinical effectiveness.METHODS: There were used the databases Medline and Cinahl to identify studies related to clinical audit. These databases were searche...

  19. CONTRIBUTION TO THE IMPROVEMENT OF PRODUCTS QUALITY IN BAKING INDUSTRY

    Aleksandar Marić

    2009-09-01

    Full Text Available Food industry occupies special place in the processing industry, especially when we talk on the manufacturing of bakery products. Variable products quality on the market initiated the authors of this study to make an attempt, using comparative analysis of methods for quality control that are at most applied in bakery plants and other "convenient" methods to indicate the shortcomings and to argue convenience of using of methods that would improve testing of the quality. That approach could create a base for designing of model of quality improvement the baking industry.

  20. CONTRIBUTION TO THE IMPROVEMENT OF PRODUCTS QUALITY IN BAKING INDUSTRY

    Aleksandar Marić; Slavko Arsovski; Jasna Mastilović

    2009-01-01

    Food industry occupies special place in the processing industry, especially when we talk on the manufacturing of bakery products. Variable products quality on the market initiated the authors of this study to make an attempt, using comparative analysis of methods for quality control that are at most applied in bakery plants and other "convenient" methods to indicate the shortcomings and to argue convenience of using of methods that would improve testing of the quality. That approach could cre...

  1. MEASURES TO IMPROVE WATER QUALITY

    L. SÂMBOTIN; S. MOISA; DANA SÂMBOTIN; ANA MARIANA DINCU; Ilie, C.

    2010-01-01

    The main measures to prevent pollution of surface water -rivers, streams, lakes - consist of domestic and industrial wastewaterwhich, if untreated reach the emissary, it could degrade water quality, making it even unusable.

  2. Power Quality Improvement Using DVR

    BENACHAIBA, C.; B. Ferdi

    2009-01-01

    Voltage sags and swells in the medium and low voltage distribution grid are considered to be the most frequent type of power quality problems based on recent power quality studies. Their impact on sensitive loads is severe. The impact ranges from load disruptions to substantial economic losses up to millions of dollars. Different solutions have been developed to protect sensitive loads against such disturbances but the DVR is considered to be the most efficient and effective solution. Its app...

  3. Methods for evaluation of small scale quality improvement projects

    Harvey, G; Wensing, M

    2003-01-01

    ?? Evaluation is an integral component of quality improvement and there is much to be learned from the evaluation of small scale quality improvement initiatives at a local level. This type of evaluation is useful for a number of different reasons including monitoring the impact of local projects, identifying and dealing with issues as they arise within a project, comparing local projects to draw lessons, and collecting more detailed information as part of a bigger evaluation project. Focused ...

  4. [Quality assurance and quality improvement. Personal experiences and intentions].

    Roche, B G; Sommer, C

    1995-01-01

    In may 1994 we were selected by the surgical Swiss association to make a study about quality in USA. During our travel we visited 3 types of institutions: Hospitals, National Institute of standard and Technology, Industry, Johnson & Johnson. We appreciate to compare 2 types of quality programs: Quality Assurance (QA) and Continuous Quality Improvement (CQI). In traditional healthcare circles, QA is the process established to meet external regulatory requirements and to assure that patient care is consistent with established standards. In a modern quality terms, QA outside of healthcare means designing a product or service, as well as controlling its production, so well that quality is inevitable. The ideas of W. Edward Deming is that there is never improvement just by inspection. He developed a theory based on 14 principles. A productive work is accomplished through processes. Understanding the variability of processes is a key to improve quality. Quality management sees each person in an organisation as part of one or more processes. The job of every worker is to receive the work of others, add value to that work, and supply it to the next person in the process. This is called the triple role the workers as customer, processor, and supplier. The main source of quality defects is problems in the process. The old assumption is that quality fails when people do the right thing wrong; the new assumption is that, more often, quality failures arise when people do the wrong think right. Exhortation, incentives and discipline of workers are unlikely to improve quality. If quality is failing when people do their jobs as designed, then exhorting them to do better is managerial nonsense. Modern quality theory is customer focused. Customers are identified internally and externally. The modern approach to quality is thoroughly grounded in scientific and statistical thinking. Like in medicine, the symptom is a defect in quality. The therapist of process must perform diagnostic test, formulate hypotheses of cause, test those hypotheses, apply remedies, and assess the effect of remedies. Total employee involvement is critical. A power comes from enabling all employees to become involved in quality improvement. A great advantage of CQI is the prevention orientation of the concept. The CQI permeated a collegial approach, people learn how to work together to improve. CQI is a time consuming procedure. During our travel we learned the definition of quality as the customer satisfaction. To build a CQI concept in employed time but all employed are involved in quality improvement. Applying CQI we could be able to refuse Quality control programs. PMID:8581805

  5. Status of quality initiatives, Part II.

    Combes, J R; Scanlan, G F; Priselac, T M

    2001-01-01

    Speaking at the first national Summit on Medical Errors and Patient Safety Research last September, former American Hospital Association Chairman Gordon Sprenger called for plugging the research holes in several areas to improve patient safety. He identified critical areas where more research to improve patient safety would be helpful: changing the culture of health care, learning from other high-risk fields, studying the value of current safety practices, examining safety in nonhospital setting, closing the gaps between knowledge and practice, creating early warning systems, and looking at the human factors. Specifically, Sprenger raised the following questions to explore: What are the critical factors that make for a more open learning environment? What regulatory and legislative changes are necessary to create a nonpunitive, blameless environment? What has worked to improve safety in other fields? What is transferable to health care? Which of the current safety practices work well and how can they be improved? Which don't? How can systems solutions that prevent errors be adapted for settings outside of the hospital that are smaller and have less organizational structure? How can accepted standards of care and appropriate use of new technologies to improve care be better shared? Are they properly used? How can we make better use of precursor events to predict the occurrence of medical error? How can we involve patients in identifying potential errors? How can we advance our understanding of why humans err? PMID:11372517

  6. Electronic health records improve clinical note quality

    Burke, Harry B; SESSUMS, LAURA L; Hoang, Albert; Becher, Dorothy A; Fontelo, Paul; Liu, Fang; Stephens, Mark; Pangaro, Louis N; O'Malley, Patrick G; Baxi, Nancy S; Bunt, Christopher W; Capaldi, Vincent F; Chen, Julie M; Cooper, Barbara A; Djuric, David A

    2014-01-01

    Background and objective The clinical note documents the clinician's information collection, problem assessment, clinical management, and its used for administrative purposes. Electronic health records (EHRs) are being implemented in clinical practices throughout the USA yet it is not known whether they improve the quality of clinical notes. The goal in this study was to determine if EHRs improve the quality of outpatient clinical notes.

  7. Nationwide quality improvement in lung cancer care

    Jakobsen, Erik Winther; Green, Anders; Oesterlind, Kell; Rasmussen, Torben Riis; Iachina, Maria; Palshof, Torben

    2013-01-01

    To improve prognosis and quality of lung cancer care the Danish Lung Cancer Group has developed a strategy consisting of national clinical guidelines and a clinical quality and research database. The first edition of our guidelines was published in 1998 and our national lung cancer registry was...... opened for registrations in 2000. This article describes methods and results obtained by multidisciplinary collaboration and illustrates how quality of lung cancer care can be improved by establishing and monitoring result and process indicators....

  8. Techniques to improve technological and sanitary quality

    David, C.; Celette, F.; Abecassis, J; Carcea, M.; Dubois, D.; Friedel, J.K.; Hellou, G.; Jeuffroy, M.-H.; Mäder, P.; I. K. Thomsen

    2012-01-01

    Agronomical ways for better quality and safety Choice of cultivar is an efficient way to obtain higher grain quality. Intercropping legumes (grain or forage) improves weed competition and N availability for wheat crop or succeeding crop. Green manure can be an effective alternative to farmyard manure. Fertilization with readily available nitrogen improves yield and quality when water is available. Reduced tillage affects soil fertility and wheat yield but has little effects on grain qualit...

  9. Practical Approaches to Quality Improvement for Radiologists.

    Kelly, Aine Marie; Cronin, Paul

    2015-10-01

    Continuous quality improvement is a fundamental attribute of high-performing health care systems. Quality improvement is an essential component of health care, with the current emphasis on adding value. It is also a regulatory requirement, with reimbursements increasingly being linked to practice performance metrics. Practice quality improvement efforts must be demonstrated for credentialing purposes and for certification of radiologists in practice. Continuous quality improvement must occur for radiologists to remain competitive in an increasingly diverse health care market. This review provides an introduction to the main approaches available to undertake practice quality improvement, which will be useful for busy radiologists. Quality improvement plays multiple roles in radiology services, including ensuring and improving patient safety, providing a framework for implementing and improving processes to increase efficiency and reduce waste, analyzing and depicting performance data, monitoring performance and implementing change, enabling personnel assessment and development through continued education, and optimizing customer service and patient outcomes. The quality improvement approaches and underlying principles overlap, which is not surprising given that they all align with good patient care. The application of these principles to radiology practices not only benefits patients but also enhances practice performance through promotion of teamwork and achievement of goals. PMID:26466176

  10. How to Sustain Change and Support Continuous Quality Improvement.

    Silver, Samuel A; McQuillan, Rory; Harel, Ziv; Weizman, Adam V; Thomas, Alison; Nesrallah, Gihad; Bell, Chaim M; Chan, Christopher T; Chertow, Glenn M

    2016-05-01

    To achieve sustainable change, quality improvement initiatives must become the new way of working rather than something added on to routine clinical care. However, most organizational change is not maintained. In this next article in this Moving Points in Nephrology feature on quality improvement, we provide health care professionals with strategies to sustain and support quality improvement. Threats to sustainability may be identified both at the beginning of a project and when it is ready for implementation. The National Health Service Sustainability Model is reviewed as one example to help identify issues that affect long-term success of quality improvement projects. Tools to help sustain improvement include process control boards, performance boards, standard work, and improvement huddles. Process control and performance boards are methods to communicate improvement results to staff and leadership. Standard work is a written or visual outline of current best practices for a task and provides a framework to ensure that changes that have improved patient care are consistently and reliably applied to every patient encounter. Improvement huddles are short, regular meetings among staff to anticipate problems, review performance, and support a culture of improvement. Many of these tools rely on principles of visual management, which are systems transparent and simple so that every staff member can rapidly distinguish normal from abnormal working conditions. Even when quality improvement methods are properly applied, the success of a project still depends on contextual factors. Context refers to aspects of the local setting in which the project operates. Context affects resources, leadership support, data infrastructure, team motivation, and team performance. For these reasons, the same project may thrive in a supportive context and fail in a different context. To demonstrate the practical applications of these quality improvement principles, these principles are applied to a hypothetical quality improvement initiative that aims to promote home dialysis (home hemodialysis and peritoneal dialysis). PMID:27016498

  11. Narrative methods in quality improvement research.

    Greenhalgh, T; Russell, J; Swinglehurst, D

    2005-12-01

    This paper reviews and critiques the different approaches to the use of narrative in quality improvement research. The defining characteristics of narrative are chronology (unfolding over time); emplotment (the literary juxtaposing of actions and events in an implicitly causal sequence); trouble (that is, harm or the risk of harm); and embeddedness (the personal story nests within a particular social, historical and organisational context). Stories are about purposeful action unfolding in the face of trouble and, as such, have much to offer quality improvement researchers. But the quality improvement report (a story about efforts to implement change), which is common, must be distinguished carefully from narrative based quality improvement research (focused systematic enquiry that uses narrative methods to generate new knowledge), which is currently none. We distinguish four approaches to the use of narrative in quality improvement research--narrative interview; naturalistic story gathering; organisational case study; and collective sense-making--and offer a rationale, describe how data can be collected and analysed, and discuss the strengths and limitations of each using examples from the quality improvement literature. Narrative research raises epistemological questions about the nature of narrative truth (characterised by sense-making and emotional impact rather than scientific objectivity), which has implications for how rigour should be defined (and how it might be achieved) in this type of research. We offer some provisional guidance for distinguishing high quality narrative research in a quality improvement setting from other forms of narrative account such as report, anecdote, and journalism. PMID:16326792

  12. An Integrated Care Initiative to Improve Patient Outcome in Schizophrenia

    Mayer-Amberg, Norbert; Woltmann, Rainer; Walther, Stefanie

    2016-01-01

    The optimal treatment of schizophrenia patients requires integration of medical and psychosocial inputs. In Germany, various health-care service providers and institutions are involved in the treatment process. Early and continuous treatment is important but often not possible because of the fragmented medical care system in Germany. The Integrated Care Initiative Schizophrenia has implemented a networked care concept in the German federal state of Lower Saxony that integrates various stakeholders of the health care system. In this initiative, office-based psychiatrists, specialized nursing staff, psychologists, social workers, hospitals, psychiatric institutional outpatients departments, and other community-based mental health services work together in an interdisciplinary approach. Much emphasis is placed on psychoeducation. Additional efforts cover socio-therapy, visiting care, and family support. During the period from October 2010 (start of the initiative) to December 2012, first experiences and results of quality indicators were collected of 713 registered patients and summarized in a quality monitoring report. In addition, standardized patient interviews were conducted, and duration of hospital days was recorded in 2013. By the end of 2012, patients had been enrolled for an average of 18.7?months. The overall patient satisfaction measured in a patient survey in June 2013 was high and the duration of hospital days measured in a prepost analysis in July 2013 was reduced by 44%. Two years earlier than planned, the insurance fund will continue the successfully implemented Integrated Care Initiative and adopt it in the regular care setting. This initiative can serve as a learning case for how to set up and measure integrated care systems that may improve outcomes for patients suffering from schizophrenia. PMID:26779043

  13. Approaching the Practice Quality Improvement Project in Interventional Radiology.

    Reis, Stephen P; White, Benjamin; Sutphin, Patrick D; Pillai, Anil K; Kalva, Sanjeeva P; Toomay, Seth M

    2015-12-01

    An important component of maintenance of certification and quality improvement in radiology is the practice quality improvement (PQI) project. In this article, the authors describe several methodologies for initiating and completing PQI projects. Furthermore, the authors illustrate several tools that are vital in compiling, analyzing, and presenting data in an easily understandable and reproducible manner. Last, they describe two PQI projects performed in an interventional radiology division that have successfully improved the quality of care for patients. Using the DMAIC (define, measure, analyze, improve, control) quality improvement framework, interventional radiology throughput has been increased, to lessen mediport wait times from 43 to 8 days, and mediport infection rates have decreased from more than 2% to less than 0.4%. PMID:26337461

  14. Power Quality Improvement Using DVR

    C. Benachaiba

    2009-01-01

    Full Text Available Voltage sags and swells in the medium and low voltage distribution grid are considered to be the most frequent type of power quality problems based on recent power quality studies. Their impact on sensitive loads is severe. The impact ranges from load disruptions to substantial economic losses up to millions of dollars. Different solutions have been developed to protect sensitive loads against such disturbances but the DVR is considered to be the most efficient and effective solution. Its appeal includes lower cost, smaller size and its dynamic response to the disturbance. This research described DVR principles and voltage restoration methods for balanced and/or unbalanced voltage sags and swells in a distribution system. Simulation results were presented to illustrate and understand the performances of DVR under voltage sags/swells conditions.

  15. IUPQC Simulations for Power Quality Improvement

    S. Rajeev

    2014-04-01

    Full Text Available Power quality determines the fitness of electrical power to consumer devices. Synchronization of the voltage frequency and phase allows electrical systems to function in their intended manner without significant loss of performance or life. The term is used to describe electric power that drives an electrical load and the load's ability to function properly. Without the proper power, an electrical device (or load may malfunction, fail prematurely or not operate at all. There are many ways in which electric power can be of poor quality and many more causes of such poor quality power. This paper proposes a new connection for a unified power quality conditioner (UPQC to improve the power quality of two feeders in a distribution system. This paper illustrates how UPQC can improve the power quality by mitigating all these PQ disturbances. The proposed configuration of the UPQC is developed and verified for various Power Quality disturbances by simulating the model using MATLAB/Simulation

  16. Using information systems to measure and improve quality.

    Bates, D W; Pappius, E; Kuperman, G J; Sittig, D; Burstin, H; Fairchild, D; Brennan, T A; Teich, J M

    1999-01-01

    Information systems (IS) are increasingly important for measuring and improving quality. In this paper, we describe our integrated delivery system's plan for and experiences with measuring and improving quality using IS. Our belief is that for quality measurement to be practical, it must be integrated with the routine provision of care and whenever possible should be done using IS. Thus, at one hospital, we now perform almost all quality measurement using IS. We are also building a clinical data warehouse, which will serve as a repository for quality information across the network. However, IS are not only useful for measuring care, but also represent powerful tools for improving care using decision support. Specific areas in which we have already seen significant benefit include reducing the unnecessary use of laboratory testing, reporting important abnormalities to key providers rapidly, prevention and detection of adverse drug events, initiatives to change prescribing patterns to reduce drug costs and making critical pathways available to providers. Our next major effort will be introduce computerized guidelines on a more widespread basis, which will be challenging. However, the advent of managed care in the US has produced strong incentives to provide high quality care at low cost and our perspective is that only with better IS than exist today will this be possible without compromising quality. Such systems make feasible implementation of quality measurement, care improvement and cost reduction initiatives on a scale which could not previously be considered. PMID:10193881

  17. The impact of leadership qualities on quality management improvement

    Radoslaw Wolniak

    2011-12-01

    Full Text Available Currently, the importance of leadership is considered more and more often in quality management. The need of an appropriate leader has been already emphasized in ISO 9000 standards, in TQM philosophy as well as in different models of improvement which are used in the methodologies of prizing quality. Yet, it is in the concept of TQL where the attitude based on the need of leadership in an organization has achieved its best-developed, full shape. On the basis of the conducted studies, the following publication presents the analysis of the dependence between leadership qualities of managers and the improvement of quality management. There has been an attempt to define the qualities, which a manager being responsible for quality management, should have.

  18. The impact of leadership qualities on quality management improvement

    Ph. D. Radoslaw Wolniak

    2011-05-01

    Full Text Available Currently, the importance of leadership is considered more and more often in quality management. The need of an appropriate leader has been already emphasized in ISO 9000 standards, in TQM philosophy as well as in different models of improvement which are used in the methodologies of prizing quality. Yet, it is in the concept of TQL where the attitude based on the need of leadership in an organization has achieved its best-developed, full shape. On the basis of the conducted studies, the following publication presents the analysis of the dependence between leadership qualities of managers and the improvement of quality management. There has been an attempt to define the qualities, which a manager being responsible for quality management, should have.

  19. Quality improvement through multiple response optimization

    The performance of a product is often evaluated by several quality characteristics. Optimizing the manufacturing process with respect to only one quality characteristic will not always lead to the optimum values for other characteristics. Hence, it would be desirable to improve the overall quality of a product by improving quality characteristics, which are considered to be important. The problem consists of optimizing several responses using multiple objective decision making approach and design of experiments. A case study will be discussed to show the application of the proposal method

  20. Venture Capital Initiative: Ohio's School Improvement Effort.

    Yoo, Soonhwa; Loadman, William E.

    In 1994 the Ohio State Legislature established Venture Capital to support school restructuring. The Venture Capital school initiative is a concept borrowed from the business community in which the corporate entity provides risk capital to parts of the organization to stimulate creative ideas and to provide opportunities for local entities to try

  1. Quality improvement and accountability in the Danish health care system.

    Mainz, Jan; Kristensen, Solvejg; Bartels, Paul

    2015-12-01

    Denmark has unique opportunities for quality measurement and benchmarking since Denmark has well-developed health registries and unique patient identifier that allow all registries to include patient-level data and combine data into sophisticated quality performance monitoring. Over decades, Denmark has developed and implemented national quality and patient safety initiatives in the healthcare system in terms of national clinical guidelines, performance and outcome measurement integrated in clinical databases for important diseases and clinical conditions, measurement of patient experiences, reporting of adverse events, national handling of patient complaints, national accreditation and public disclosure of all data on the quality of care. Over the years, Denmark has worked up a progressive and transparent just culture in quality management; the different actors at the different levels of the healthcare system are mutually attentive and responsive in a coordinated effort for quality of the healthcare services. At national, regional, local and hospital level, it is mandatory to participate in the quality initiatives and to use data and results for quality management, quality improvement, transparency in health care and accountability. To further develop the Danish governance model, it is important to expand the model to the primary care sector. Furthermore, a national quality health programme 2015-18 recently launched by the government supports a new development in health care focusing upon delivering high-quality health care-high quality is defined by results of value to the patients. PMID:26443814

  2. Power theories for improved power quality

    Pasko, Marian

    2012-01-01

    Power quality describes a set of parameters of electric power and the load’s ability to function properly under specific conditions. It is estimated that problems relating to power quality costs the European industry hundreds of billions of Euros annually. In contrast, financing for the prevention of these problems amount to fragments of these costs. Power Theories for Improved Power Quality addresses this imbalance by presenting and assessing a range of methods and problems related to improving the quality of electric power supply. Focusing particularly on active compensators and the DSP based control algorithms, Power Theories for Improved Power Quality introduces the fundamental problems of electrical power. This introduction is followed by chapters which discuss: •‘Power theories’ including their historical development and application to practical problems, •operational principles of active compensator’s DSP control based algorithms using examples and results from laboratory research, and •t...

  3. Improving the coverage of the PMTCT programme through a participatory quality improvement intervention in South Africa

    Chopra Mickey; Doherty Tanya; Nsibande Duduzile; Mngoma Dudu

    2009-01-01

    Abstract Background Despite several years of implementation, prevention of mother-to-child transmission (PMTCT) programmes in many resource poor settings are failing to reach the majority of HIV positive women. We report on a data driven participatory quality improvement intervention implemented in a high HIV prevalence district in South Africa. Methods A participatory quality improvement intervention was implemented consisting of an initial assessment undertaken by a team of district supervi...

  4. Voltage Quality Improvement Using Solar Photovoltaic System

    Galzina, Denisa

    2015-01-01

    Solar power and wind are the most promising distributed energy sources. The photovoltaic system has attracted significant attention in recent years. Although their benefits are numerous, they are known to create power quality issues, because of the power electronic converters they use. This paper investigates if there is a possibility to improve power quality only by connecting a solar photovoltaic system to the grid, and then gives results of on-site power quality measurements in the grid be...

  5. Water Quality Improvement Using Renewable Energies

    Mocanu Catalina Raluca

    2014-06-01

    Full Text Available To reduce the negative effects of eutrophication processes in water bodies it is necessary to improve water quality by ensuring the necessary oxygen concentration. The paper proposes a new innovative solution for the improvement of lake water quality. The premises for the implementation of the experimental floating platform which will aerate the lake waters will be presented. To give a specific view over the oxygen dispersion into the lake, numerical simulations in CFD software will be presented in different cases.

  6. Quality and Profitability improvement by Technical Audit

    Prof. Srivastava S. B.

    2009-10-01

    Full Text Available This paper is aimed for finding the Quality and Profitability Improvement by Technical Audit, through a case study and further establishing the relationship between the product quality, profitability and technical audit. Quality audit generates the report of non conformance which basically represents the deviation from committed quality of products, or in short, it may be called as postmortem of product quality. By virtue of quality audit, the commitment, implementation and follow up for product quality are aligned. This delivers a good quality of product to the customers and thus the customer is benefited. In industries, Quality Inspectors are giving their decision for quality of product in two categories, "ACCEPTED" or "REJECTED". The accepted products are coming to the customers and the rejected products become the burden / problem to the manufacturers.If accepted product quantity is within the “NORMS”, no one cares regarding the rejected product quantities, what so ever. When the rejected product quantity increases beyond the “NORMS”, the analysis process starts to find out the reasons of rejections. Sometimes, it becomes too late to search out the reasons of rejections and survival of the industry becomes a problem. By technical audit and audit report implementation such type of conditions can be avoided and controlled.Basically, Quality is the function of Man, Machine, Materials, Methods, Movement, Manufacturing Processes, Monitoring and Management (8 M’s. If the technicality of 8 M’s is corrected by Technical Audit, the product quality will improve automatically and the profitability of the organization will improve. In short it can be solicited that if 8 M’s are all right, the product quality and profitability will automatically be set right. This may become an important aspect in the scenario of Indian Industries. The findings are supported by a case study of a Process Plant (Slag Dryer of a reputed Indian Industry.

  7. Improving Indicators in a Brazilian Hospital Through Quality-Improvement Programs Based on STS Database Reports

    Pedro Gabriel Melo de Barros e Silva

    2015-12-01

    Full Text Available ABSTRACT OBJECTIVE: To report the initial changes after quality-improvement programs based on STS-database in a Brazilian hospital. METHODS: Since 2011 a Brazilian hospital has joined STS-Database and in 2012 multifaceted actions based on STS reports were implemented aiming reductions in the time of mechanical ventilation and in the intensive care stay and also improvements in evidence-based perioperative therapies among patients who underwent coronary artery bypass graft surgeries. RESULTS: All the 947 patients submitted to coronary artery bypass graft surgeries from July 2011 to June 2014 were analyzed and there was an improvement in all the three target endpoints after the implementation of the quality-improvement program but the reduction in time on mechanical ventilation was not statistically significant after adjusting for prognostic characteristics. CONCLUSION: The initial experience with STS registry in a Brazilian hospital was associated with improvement in most of targeted quality-indicators.

  8. EXFOR: Improving the quality of international databases

    The NEA Data Bank is an international centre of reference for basic nuclear tools used for the analysis and prediction of phenomena in nuclear energy applications. The Data Bank collects, compiles, disseminates and contributes to improving computer codes and associated data. In the area of nuclear data, the Data Bank works in close co-operation with other data centres that contribute to the worldwide compilation of experimental nuclear reaction data in the EXFOR database. EXFOR contains basic nuclear data on low- to medium-energy experiments for incident neutron, photon and various charged particle induced reactions on a wide range of nuclei and compounds. Today, with more than 150 000 data sets from more than 20 000 experiments performed since 1935, EXFOR is by far the most important and complete experimental nuclear reaction database. It is widely used to further improve nuclear reaction models and evaluated nuclear data libraries. The Data Bank supervises the development of the Joint Evaluated Fission and Fusion (JEFF) file, which is one of the major evaluated nuclear data libraries used in the field of nuclear science and technology. As part of its mission, the Data Bank works to maintain the highest level of quality in its databases. One method that was proposed to check the mutual consistency of experimental data in EXFOR is to test for outlier measurements more than a few standard deviations from the mean value as, in principle, several measurements of the same reaction quantity should form a continuous distribution. More recently, another method was developed to cross-check evaluated and experimental data in databases in order to detect aberrant values. It was noted that there is no evidence, on the basis of numerical comparisons only, that outliers represent 'bad' data. The fact that such data deviate significantly from other data of the same reaction may, however, be helpful to nuclear data evaluators who focus on one or a few isotopes and may wish to discard such data after a thorough analysis. The Data Bank also organised a comprehensive review of cross-section data. An efficient review system and associated strategy were developed to systematically compare more than 10 000 cross-section data sets from EXFOR with the corresponding values in the main evaluated nuclear data libraries, including JEFF. The review initially covered all neutron-induced threshold and activation reactions such as (n,n'), (n,2n), (n,p) and (n,?). The resulting statistical information showed various interesting trends in the data, including a list of suspicious data sets for which the cross-section values deviate greatly from the major evaluated nuclear data libraries and/or other measurements. The original publications associated with these data have also been systematically checked. This work confirmed that most of the experimental data were compiled correctly in the EXFOR database, and it identified a few compilation mistakes that have since been corrected. A second part of the review devoted to the (n,?) cross-section is underway. This part of the review is challenging because of the large fluctuations of data in the resonance region that make the comparison more difficult. If successful, the review could be completed with other non-threshold cross-sections such as (n,f), (n,tot) and (n,n). All of these initiatives have been very useful to maintain the highest level of quality in the EXFOR database. In addition, future development versions of the JEFF library can be automatically benchmarked against other evaluated libraries and against a more reliable experimental database. Such work will contribute to improving the quality of evaluated nuclear data for the benefit of all users. (author)

  9. Improvement in spring wheat quality in pakistan

    Forty-four spring wheat varieties released since 1933 to the farmers were tested for quality improvement using canonical variate analysis. Crude protein increased by 6.95% from 1933 to 1996. Ash content and flour yield declined by 9.55% and 5.51%, respectively. Mixograph development time increased since 1933 and was maximum during 1965-1980. As far as baking quality is concerned, total chapati scores of modern cultivars were 8.97% higher than that of cultivars grown since 1933. The average spread ratio and overall cookie scores increased almost 5.53% and 4.44%, respectively from 1933 to 1996. It was interesting to note that overall cookie scores were maximum during 1981-1990 while total chapati scores were minimum during this period. Various segments of wheat processing and data used for canonical variate analysis to study improvement in quality traits from 1933 to 1996 indicated that in different scenarios substantial progress has been made in breeding wheat varieties, with improvement in chapati and cookie quality as well as nutritionally. The epoch (1991-1996) containing the modern varieties showed a substantial improvement in lysine content than the epoch containing the oldest wheat varieties. Similarly amino acid score was also found 4.26% higher than the varieties released during 1933-1964. Though improvement was of lesser magnitude but sufficient which ultimately contributed towards the nutritional needs of Pakistani population. However care should be taken to maintain the current levels of various wheat quality characteristics and to make improvement in lysine, which will be appreciable for export quality wheat. This will be ultimately helpful to earn handsome foreign exchange by exporting surplus wheat. These informations will be useful for the researchers working in the field of quality improvement. (author)

  10. EDUCATIONAL POLICIES AND INITIATIVES FOR IMPROVED PERFORMANCE

    Flavia, CAIA

    2015-03-01

    Full Text Available According to Gartner estimates, due to increased variety, speed and data volume, by 2015 there will be a global demand of 4.4 million professionals for real-time analysis of data from sources with different structures, but only one third of the demand will be met. The purpose of this research is to identify possible solutions for improved academic results in the IT domain, considering the time management policies, the content and the student motivations, as well as the business strategy tendencies. These proposals are targeted toward meeting the IT specialists demand. The research is composed of two parts: the first explores the Romanian IT labour market characteristics, while the second investigates the academic education policies that can help mitigate deficiencies and attain higher performance. The deficiencies are identified through a series of statistical research and analysis based on national level databases, adopting a quantitative approach. The policies proposed are supported by a flow model developed considering the students' activity, motivation, traits and results, measured and analysed quantitatively.

  11. Building Perinatal Case Manager Capacity Using Quality Improvement.

    Fitzgerald, Elaine

    2015-01-01

    Improving breastfeeding rates among Black women is a potential strategy to address disparities in health outcomes that disproportionately impact Black women and children. This quality improvement (QI) initiative aimed to improve perinatal case manager knowledge and self-efficacy to promote breastfeeding among Black, low-income women who use services through Boston Healthy Start Initiative. QI methodology was used to develop and test a two-part strategy for perinatal case managers to promote and support breastfeeding. A positive change was observed in infant feeding knowledge and case manager self-efficacy to promote breastfeeding. Among the 24 mothers participating in this QI initiative, 100% initiated and continued breastfeeding at 1 week postpartum, and 92% were breastfeeding at 2 weeks postpartum. PMID:26937160

  12. The DSN Asset Management/Maintenance Improvement Initiative

    Wackley, J.; Dundics, D.

    2011-11-01

    This article describes the Asset Management/Maintenance Improvement (AMMI) initiative: the first focused Deep Space Network (DSN) initiative intended to improve the efficiency and efficacy of maintenance, support improvement in equipment reliability, and provide metrics for use in understanding equipment reliability and the use of maintenance resources. The initiative has resulted in the introduction of many new processes and procedures including the global use of a computerized maintenance management system (CMMS) and Reliability-Centered Maintenance (RCM) concepts. The work performed as part of the AMMI initiative represents significant changes to the DSN maintenance culture that has been in place for over 40 years.

  13. Informatics Resources to Support Health Care Quality Improvement in the Veterans Health Administration

    Hynes, Denise M.; Perrin, Ruth A.; Rappaport, Steven; Stevens, Joanne M; Demakis, John G.

    2004-01-01

    Information systems are increasingly important for measuring and improving health care quality. A number of integrated health care delivery systems use advanced information systems and integrated decision support to carry out quality assurance activities, but none as large as the Veterans Health Administration (VHA). The VHA's Quality Enhancement Research Initiative (QUERI) is a large-scale, multidisciplinary quality improvement initiative designed to ensure excellence in all areas where VHA ...

  14. Quality assessment and improvements in pathology practice

    Kuijpers, C.C.H.J.

    2016-01-01

    Every patient has the right to receive optimal quality health care. With regard to pathology practice, a small (interpretational) difference can have major impact for the patient, because prognosis and treatment selection are often based on the pathology report. Unfortunately, it is inevitable that errors may and do ultimately arise, and it is the task of all involved to minimize the error rate. In this thesis, we aimed to assess and improve the quality of several important aspects of pat...

  15. Improving Power Quality in AC Supply Grids

    Piotr Fabijański

    2015-01-01

    This paper describes a digital and actual model of the UPQC (Unified Power Quality Conditioner) integrated system for power quality improvement. The UPQC’s design and its connection to an AC supply grid, 1-phase and 3-phase alike, provide effective compensation of unwanted interferences in the waveforms of load supply voltages and non-linear load currents. This article presents an overview of topologies and control strategies. The study of the UPQC confirmed its positive impact on the powe...

  16. ISO certification pays off in quality improvement

    This paper reports that by obtaining and maintaining International Standards Organization (ISO) 9001 certification, a company can improve its quality control system, cut waste, and motivate its employees. In so doing it improves its competitive position in both international and domestic markets. The success of a number of countries (notably Japan) in the world markets has focused the attention of the industrialized countries on improving quality levels and striving for a unified, worldwide quality standard. This has been particularly true in Europe; with several countries competing in a single market, a common quality standard has been a highly desirable goal for decades. One of the first multinational quality standards evolved in the European Community, which is estimated to become a single market with a gross national product of $4.5 trillion by 1992. As a consequence, in 1987 the International Standards Organization created ISO 9000, a single standard to ensure uniform quality in products and services offered with this growing market. U.S. petroleum and natural gas companies must recognize and implement the ISO 9000 standards or possibly lose international markets. If the present worldwide trend towards ISO 9000 continues (and there is no reason to believe that it will not), the standards will be just as important in the domestic market

  17. Basic quality tools in continuous improvement process

    Soković, Mirko; Jovanović, Jelena; Krivokapić, Zdravko; Vujović, Aleksandar

    2015-01-01

    If organizations wish to achieve continuous quality improvement they need to use appropriate selection of quality tools and techniques. In this paper a review of possibilities of the systematic use of seven basic quality tools (7QC tools) is presented. It is shown that 7QC tools can be used in all process phases, from the beginning of a product development up to management of a production process and delivery. It is further shown how to involve 7QC tools in some phases of continuous improveme...

  18. Does Audit Improve the Quality of Care?

    Areti Tsaloglidou

    2009-01-01

    Full Text Available BACKGROUND: The quality of health care and quality assurance are concepts which have been established for many years. Audit nowadays is adopted as a means of developing high quality care.AIM: This study aims to identify the perspectives of audit in practice and its relationship to quality assessment and assurance, quality improvement, and clinical effectiveness.METHODS: There were used the databases Medline and Cinahl to identify studies related to clinical audit. These databases were searched up to May 2009.DISCUSSION: Audit is used as a tool to assure and assess the quality of patient health care. It is also an educational tool as it creates a lot of opportunities for professionals to think about practice and to learn from the experience of others.CONCLUSIONS: Although that audit is a powerfull and useful tool to improve and evaluate the quality of health care, on the other hand there are many barriers that make its use difficult in everyday practice.

  19. Trans-disciplinary community groups: an initiative for improving healthcare.

    Sideras, James Demetri

    2016-02-01

    Purpose - In the context of budget constraints and the current quality crisis facing UK healthcare, the purpose of this paper is to examine the use of trans-disciplinary community groups (TCG) - an innovative and inexpensive initiative for improving patient care. Design/methodology/approach - Using an action research study, TCG was implemented within a private healthcare firm for vulnerable adults. Qualitative data were gathered over 12 months from 33 participants using depth interviews and focus groups. Findings - TCG led to improved patient activities and increased patient decision-making and confidence in self-advocacy. Key prerequisites were top management commitment, democratic leadership and employee empowerment. However, staff nurses resisted TCG because they were inclined to using managerial control and their own independent clinical judgements. Research limitations/implications - Whilst the findings from this study should not be generalized across all healthcare sectors, its results could be replicated in contexts where there is wide commitment to TCG and where managers adopt a democratic style of leadership. Researchers could take this study further by exploring the applicability of TCG in public healthcare organizations or other multi-disciplinary service contexts. Practical implications - The findings of this research paper provide policy makers and healthcare managers with practical insights on TCG and the factors that are likely to obstruct and facilitate its implementation. Originality/value - Adopting TCG could enable healthcare managers to ameliorate their services with little or no extra cost, which is especially important in a budget constraint context and the current quality crisis facing UK healthcare. PMID:26771062

  20. A Model to Improve Service Quality

    Chun-Wu Yeh; Avus Hou; Chin-Chun Huang; Li-Ching Huang; Kuo-Lung Wu

    2013-01-01

    Improving service quality is a very important task in management. Importance Satisfaction models (I-S model) can identify the service items for improvement but not determine whether the items can really enhance the customer satisfaction. Additionally, Kano model can find the service items enhancing the customer satisfaction but not measure the actual feelings of customers. The present study integrates both abovementioned models to identify the service items...

  1. Successful integration of ergonomics into continuous improvement initiatives.

    Monroe, Kimberly; Fick, Faye; Joshi, Madina

    2012-01-01

    Process improvement initiatives are receiving renewed attention by large corporations as they attempt to reduce manufacturing costs and stay competitive in the global marketplace. These initiatives include 5S, Six Sigma, and Lean. These programs often take up a large amount of available time and budget resources. More often than not, existing ergonomics processes are considered separate initiatives by upper management and struggle to gain a seat at the table. To effectively maintain their programs, ergonomics program managers need to overcome those obstacles and demonstrate how ergonomics initiatives are a natural fit with continuous improvement philosophies. PMID:22316947

  2. Teaching Quality Improvement Through a Book Club

    Benjamin Doolittle

    2015-12-01

    Full Text Available Introduction: Quality Improvement projects are an important part of residency education in the United States and are required for accreditation by the Accreditation Council for Graduate Medical Education. Participation in standard chart-based quality improvement had failed to generate excitement among residents in our program. The objective of our innovation was to inspire interest in quality improvement among our residents. Methods: Our residency program instituted a book discussion group. Attendance and participation of attendees was recorded, and residents were sent a follow-up survey one month after the activity to gauge their impressions. Results: Out of 16 residents in the program, 12 attended the discussion group, and all attendees participated in the discussion. The follow-up survey revealed that 10/11 (91% of respondents had read at least part of the book and 11/11 (100% wanted to have another book discussion group in the upcoming year. Conclusion: We believe that the use of a book discussion group can be a novel, inspiring strategy to teach quality improvement in a residency program.

  3. Fostering Quality Improvement in EHDI Programs

    Bradham, Tamala S.; Hoffman, Jeff; Houston, K. Todd; Guignard, Gayla Hutsell

    2011-01-01

    State coordinators of early hearing detection and intervention (EHDI) programs completed a strengths, weaknesses, opportunities, and threats, or SWOT, analysis that consisted of 12 evaluative areas of EHDI programs. For the quality improvement area, a total of 218 items were listed by 47 EHDI coordinators, and themes were identified in each…

  4. Fostering Quality Improvement in EHDI Programs

    Bradham, Tamala S.; Hoffman, Jeff; Houston, K. Todd; Guignard, Gayla Hutsell

    2011-01-01

    State coordinators of early hearing detection and intervention (EHDI) programs completed a strengths, weaknesses, opportunities, and threats, or SWOT, analysis that consisted of 12 evaluative areas of EHDI programs. For the quality improvement area, a total of 218 items were listed by 47 EHDI coordinators, and themes were identified in each

  5. Early Development of Entrepreneurial Qualities: the Role of Initial Education

    Isobel van der Kuip; Ingrid Verheul

    2003-01-01

    This study attempts to create a better understanding of the role of entrepreneurship education in developing entrepreneurial qualities. Theory and practice are confronted. The paper discusses the extent to which entrepreneurship can be taught, and the way in which it should be taught. The focus is on the phase of initial education.

  6. Project Hanford management contract quality improvement project management plan; TOPICAL

    On July 13, 1998, the U.S. Department of Energy, Richland Operations Office (DOE-RL) Manager transmitted a letter to Fluor Daniel Hanford, Inc. (FDH) describing several DOE-RL identified failed opportunities for FDH to improve the Quality Assurance (QA) Program and its implementation. In addition, DOE-RL identified specific Quality Program performance deficiencies. FDH was requested to establish a periodic reporting mechanism for the corrective action program. In a July 17, 1998 response to DOE-RL, FDH agreed with the DOE concerns and committed to perform a comprehensive review of the Project Hanford Management Contract (PHMC) QA Program during July and August, 1998. As a result, the Project Hanford Management Contract Quality Improvement Plan (QIP) (FDH-3508) was issued on October 21, 1998. The plan identified corrective actions based upon the results of an in-depth Quality Program Assessment. Immediately following the scheduled October 22, 1998, DOE Office of Enforcement and Investigation (EH-10) Enforcement Conference, FDH initiated efforts to effectively implement the QIP corrective actions. A Quality Improvement Project (QI Project) leadership team was assembled to prepare a Project Management Plan for this project. The management plan was specifically designed to engage a core team and the support of representatives from FDH and the major subcontractors (MSCs) to implement the QIP initiatives; identify, correct, and provide feedback as to the root cause for deficiency; and close out the corrective actions. The QI Project will manage and communicate progress of the process

  7. Engaging Clinical Nurses in Quality Improvement Projects.

    Moore, Susan; Stichler, Jaynelle F

    2015-10-01

    Clinical nurses have the knowledge and expertise required to provide efficient and proficient patient care. Time and knowledge deficits can prevent nurses from developing and implementing quality improvement or evidence-based practice projects. This article reviews a process for professional development of clinical nurses that helped them to define, implement, and analyze quality improvement or evidence-based practice projects. The purpose of this project was to educate advanced clinical nurses to manage a change project from inception to completion, using the Six Sigma DMAIC (Define, Measure, Analyze, Improve, Control) Change Acceleration Process as a framework. One-to-one mentoring and didactic in-services advanced the knowledge, appreciation, and practice of advanced practice clinicians who completed multiple change projects. The projects facilitated clinical practice changes, with improved patient outcomes; a unit cultural shift, with appreciation of quality improvement and evidence-based projects; and engagement with colleagues. Project outcomes were displayed in poster presentations at a hospital exposition for knowledge dissemination. PMID:26430867

  8. The European initiative for quality management in lung cancer care

    Blum, Torsten G; Rich, Anna; Baldwin, David; Beckett, Paul; De Ruysscher, Dirk; Faivre-Finn, Corinne; Gaga, Mina; Gamarra, Fernando; Grigoriu, Bogdan; Hansen, Niels C G; Hubbard, Richard; Huber, Rudolf Maria; Jakobsen, Erik; Jovanovic, Dragana; Konsoulova, Assia; Kollmeier, Jens; Massard, Gilbert; McPhelim, John; Meert, Anne-Pascale; Milroy, Robert; Paesmans, Marianne; Peake, Mick; Putora, Paul-Martin; Scherpereel, Arnaud; Schönfeld, Nicolas; Sitter, Helmut; Skaug, Knut; Spiro, Stephen; Strand, Trond-Eirik; Taright, Samya; Thomas, Michael; van Schil, Paul E; Vansteenkiste, Johan F; Wiewrodt, Rainer; Sculier, Jean-Paul

    2014-01-01

    . The Task Force undertook four projects: 1) a narrative literature search on quality management of lung cancer; 2) a survey of national and local infrastructure for lung cancer care in Europe; 3) a benchmarking project on the quality of (inter)national lung cancer guidelines in Europe; and 4) a...... feasibility study of prospective data collection in a pan-European setting. There is little peer-reviewed literature on quality management in lung cancer care. The survey revealed important differences in the infrastructure of lung cancer care in Europe. The European guidelines that were assessed displayed...... among countries. The European Initiative for Quality Management in Lung Cancer Care has provided the first comprehensive snapshot of lung cancer care in Europe....

  9. Pediatric CT quality management and improvement program

    Larson, David B.; Chan, Frandics P.; Newman, Beverley; Fleischmann, Dominik [Stanford University School of Medicine, Department of Radiology, Stanford, CA (United States); Molvin, Lior Z. [Stanford Hospital and Clinics, Stanford, CA (United States); Wang, Jia [Stanford University, Environmental Health and Safety, Stanford, CA (United States)

    2014-10-15

    Modern CT is a powerful yet increasingly complex technology that continues to rapidly evolve; optimal clinical implementation as well as appropriate quality management and improvement in CT are challenging but attainable. This article outlines the organizational structure on which a CT quality management and improvement program can be built, followed by a discussion of common as well as pediatric-specific challenges. Organizational elements of a CT quality management and improvement program include the formulation of clear objectives; definition of the roles and responsibilities of key personnel; implementation of a technologist training, coaching and feedback program; and use of an efficient and accurate monitoring system. Key personnel and roles include a radiologist as the CT director, a qualified CT medical physicist, as well as technologists with specific responsibilities and adequate time dedicated to operation management, CT protocol management and CT technologist education. Common challenges in managing a clinical CT operation are related to the complexity of newly introduced technology, of training and communication and of performance monitoring. Challenges specific to pediatric patients include the importance of including patient size in protocol and dose considerations, a lower tolerance for error in these patients, and a smaller sample size from which to learn and improve. (orig.)

  10. Pediatric CT quality management and improvement program

    Modern CT is a powerful yet increasingly complex technology that continues to rapidly evolve; optimal clinical implementation as well as appropriate quality management and improvement in CT are challenging but attainable. This article outlines the organizational structure on which a CT quality management and improvement program can be built, followed by a discussion of common as well as pediatric-specific challenges. Organizational elements of a CT quality management and improvement program include the formulation of clear objectives; definition of the roles and responsibilities of key personnel; implementation of a technologist training, coaching and feedback program; and use of an efficient and accurate monitoring system. Key personnel and roles include a radiologist as the CT director, a qualified CT medical physicist, as well as technologists with specific responsibilities and adequate time dedicated to operation management, CT protocol management and CT technologist education. Common challenges in managing a clinical CT operation are related to the complexity of newly introduced technology, of training and communication and of performance monitoring. Challenges specific to pediatric patients include the importance of including patient size in protocol and dose considerations, a lower tolerance for error in these patients, and a smaller sample size from which to learn and improve. (orig.)

  11. IMPROVING THE QUALITY OF MECHANIZED OPERATIONS

    Maslov G. G.

    2015-03-01

    Full Text Available The article presents analysis of the problem of increasing the quality of the implementation of mechanized operations to harvest crops and seed dressing chemicals. The quality of grain harvesting combine harvesters was considered for the new modern harvesters in terms of crop losses, grain crushing and microdamages. The quality of seed treatment is considered on the basis of the ejection slot-spraying nozzles at ultra low seed coming down with a conical distribution surface, ending rounded shape logisticians. The problem of improving the quality of the grain harvest is mainly due to its losses for the combine and injury. By the way, the amount of grain crushing almost half its losses determines the percentage of the combine. The greatest fragmentation occurs in the threshing and separating device (LSG combines with a hammer drums and several times lower - in the axial rotor LSG. At last there is a big advantage - high performance combines that preference when replacing obsolete machines with a hammer apparatus. Quality depends on the etching uniformity of distribution of atomized liquid droplets and completeness of etching. The proposed new flowsheet Dressers fixed flow distribution and ejection-slotted spray solution of the working fluid has significant advantages: reliable processing of seeds, completeness (not less than 97% and uniformity (98% of dressing material. Optimal duty cycle flow of seeds created by a fixed cone with an angle of 45 degrees, the spatial arrangement of ejection nozzles relative to the flow of processed seeds provide good quality of work

  12. Improving quality and operational reliability through organizational change

    Heiska, Otto

    2015-01-01

    This thesis is based on an organizational change project initiated by Lufthansa Cargo management and Swissport Cargo Services management in late autumn 2014. The idea of the project was to improve the quality and operational reliability of an outsourced Lufthansa Cargo dedicated service unit. The unit operating under Swissport Cargo Services in Helsinki airport was to be restructured and redeveloped to better suit the changed operational environment. The purpose of this thesis is to prese...

  13. Improving wind power quality with energy storage

    Rasmussen, Claus Nygaard

    2009-01-01

    The results of simulation of the influence of energy storage on wind power quality are presented. Simulations are done using a mathematical model of energy storage. Results show the relation between storage power and energy, and the obtained increase in minimum available power from the combinatio...... probability. The amount of storage capacity necessary for significant wind power quality improvement in a given period is found to be 20 to 40% of the energy produced in that period. The necessary power is found to be 80 to 100% of the average power of the period.......The results of simulation of the influence of energy storage on wind power quality are presented. Simulations are done using a mathematical model of energy storage. Results show the relation between storage power and energy, and the obtained increase in minimum available power from the combination...

  14. Improvements to the construction of binary black hole initial data

    Ossokine, Serguei; Pfeiffer, Harald P; Boyle, Michael; Szilágyi, Béla

    2015-01-01

    Construction of binary black hole initial data is a prerequisite for numerical evolutions of binary black holes. This paper reports improvements to the binary black hole initial data solver in the Spectral Einstein Code, to allow robust construction of initial data for mass-ratio above 10:1, and for dimensionless black hole spins above 0.9, while improving efficiency for lower mass-ratios and spins. We implement a more flexible domain decomposition, adaptive mesh refinement and an updated method for choosing free parameters. We also introduce a new method to control and eliminate residual linear momentum in initial data for precessing systems, and demonstrate that it eliminates gravitational mode mixing during the evolution. Finally, the new code is applied to construct initial data for hyperbolic scattering and for binaries with very small separation.

  15. Improving quality of care through improved audit and feedback

    Hysong Sylvia J

    2012-05-01

    Full Text Available Abstract Background The Department of Veterans Affairs (VA has led the industry in measuring facility performance as a critical element in improving quality of care, investing substantial resources to develop and maintain valid and cost-effective measures. The External Peer Review Program (EPRP of the VA is the official data source for monitoring facility performance, used to prioritize the quality areas needing most attention. Facility performance measurement has significantly improved preventive and chronic care, as well as overall quality; however, much variability still exists in levels of performance across measures and facilities. Audit and feedback (A&F, an important component of effective performance measurement, can help reduce this variability and improve overall performance. Previous research suggests that VA Medical Centers (VAMCs with high EPRP performance scores tend to use EPRP data as a feedback source. However, the manner in which EPRP data are used as a feedback source by individual providers as well as service line, facility, and network leadership is not well understood. An in-depth understanding of mental models, strategies, and specific feedback process characteristics adopted by high-performing facilities is thus urgently needed. This research compares how leaders of high, low, and moderately performing VAMCs use clinical performance data from the EPRP as a feedback tool to maintain and improve quality of care. Methods We will conduct a qualitative, grounded theory analysis of up to 64 interviews using a novel method of sampling primary care, facility, and Veterans Integrated Service Network (VISN leadership at high-, moderate-, and low-performing facilities. We will analyze interviews for evidence of cross-facility differences in perceptions of performance data usefulness and strategies for disseminating performance data evaluating performance, with particular attention to timeliness, individualization, and punitiveness of feedback delivery. Discussion Most research examining feedback to improve provider and facility performance lacks a detailed understanding of the elements of effective feedback. This research will highlight the elements most commonly used at high-performing facilities and identify additional features of their successful feedback strategies not previously identified. Armed with this information, practices can implement more effective A&F interventions to improve quality of care.

  16. Frameworks for Change: Four Recurrent Themes for Quality in Early Childhood Curriculum Initiatives

    Burgess, Jennifer; Fleet, Alma

    2009-01-01

    This paper reports on the first phase of a case study that investigated how early childhood teachers experience organisational change. As one of three levels of quality improvement, State government-funded curriculum initiatives were developed with an aim to promote change. Three curriculum documents, one each focusing on literacy, pedagogy and…

  17. Improving quality of service in the internet

    Flckiger, Franois

    2000-01-01

    The Internet transport technology was designed to be robust, resilient to link or node outages, and with no single point of failure. The resulting connectionless system supports what is called a "best effort datagram delivery service", the perfo rmance of which is often greatly unpredictable. To improve the predictability of IP-based networks, several Quality of Service technologies have been designed over the past decade. The first one, RSVP, based on reservation of resources, is operational but has several major deficiencies, such as scalability difficulties. However, associated to other more recent technologies -RSVP aggregation, Diffserv and MPLS- the combination may result into an appropriate solution for improving Quality of Service guarant ees in a scalable way. This article presents the state of the art on the field in an accurate, yet pedagogical style.

  18. A Model to Improve the Quality Products

    Hasan GOKKAYA

    2010-08-01

    Full Text Available The topic of this paper is to present a solution who can improve product qualityfollowing the idea: “Unlike people who have verbal skills, machines use "sign language"to communicate what hurts or what has invaded their system’. Recognizing the "signs"or symptoms that the machine conveys is a required skill for those who work withmachines and are responsible for their care and feeding. The acoustic behavior of technical products is predominantly defined in the design stage, although the acoustic characteristics of machine structures can be analyze and give a solution for the actual products and create a new generation of products. The paper describes the steps intechnological process for a product and the solution who will reduce the costs with the non-quality of product and improve the management quality.

  19. Riding The Waves Of Quality Improvement

    Slaghuis, Sarah

    2016-01-01

    markdownabstractIncreasingly, sustainability and spread have become part and parcel of organizational strategy in health care. This applies in particular to organizations in the long-term care sector, which faces an increasing care demand, ageing population and labor shortage. Unfortunately, sustainability and spread of quality improvement have been understudied. Given the dominance of project-based evaluation research, deeper insight in the dynamics and interplay between care organizations, ...

  20. Narrative methods in quality improvement research

    Greenhalgh, T.; Russell, J.; Swinglehurst, D.

    2005-01-01

    

 This paper reviews and critiques the different approaches to the use of narrative in quality improvement research. The defining characteristics of narrative are chronology (unfolding over time); emplotment (the literary juxtaposing of actions and events in an implicitly causal sequence); trouble (that is, harm or the risk of harm); and embeddedness (the personal story nests within a particular social, historical and organisational context). Stories are about purposeful action unfolding in ...

  1. Using commitment to improve environmental quality

    Lokhorst, Anne Marike

    2009-01-01

    The making of commitments is often used as an intervention aimed at increasing pro-environmental behavior. Research shows that when people commit to changing their environmental behaviors, they tend to adhere to their commitments. In this dissertation it is investigated whether commitment making is effective in improving agricultural nature conservation and with that, environmental quality of farm lands. Furthermore, a conceptual review is offered, as well as an experimental investigation of ...

  2. Goal hierarchy: Improving asset data quality by improving motivation

    Many have recognized the need for high quality data on assets and the problems in obtaining them, particularly when there is a need for human observation and manual recording. Yet very few have looked at the role of the data collectors themselves in the data quality process. This paper argues that there are benefits to more fully understanding the psychological factors that lay behind data collection and we use goal hierarchy theory to understand these factors. Given the myriad of potential reasons for poor-quality data it has previously proven difficult to identify and successfully deploy employee-driven interventions; however, the goal hierarchy approach looks at all of the goals that an individual has in their life and the connections between them. For instance, does collecting data relate to whether or not they get a promotion? Stay safe? Get a new job? and so on. By eliciting these goals and their connections we can identify commonalities across different groups, sites or organizations that can influence the quality of data collection. Thus, rather than assuming what the data collectors want, a goal hierarchy approach determines that empirically. Practically, this supports the development of customized interventions that will be much more effective and sustainable than previous efforts. - Highlights: → We need to consider psychological aspects of data collectors to improve data quality. → We show how goal hierarchy theory furthers understanding. → Looks at the multiple goals of each individual to determine their behavior.

  3. Applying PPM to ERP Maintenance and Continuous Improvement Initiatives

    El-Tal, Nada Maria; Fonnesbæk, Majbrit; Kræmmergaard, Pernille

    prioritize and select maintenance and continuous improvement initiatives. This is done by reviewing the existing literature in the fields of PPM from R&D literature and then by reviewing the existing literature about maintenance and improvement initiatives in the ERP literature, after which the two are...... compared and discussed using three case-studies. The paper contributes with a discussion on how PPM from R&D can be applied to maintenance and continuous improvement initiatives in the second wave of ERP. The paper ends with arguing that emphasis needs to be given to this field, since a conscious and......Enterprise Resource Planning Systems (ERP) has been implemented in many companies during the last decade and has gained an increasing significance. For many companies it means that the focus is no longer on how to implement the ERP system, but rather on how to maintain and improve the system to...

  4. Multichannel DBS halftoning for improved texture quality

    Slavuj, Radovan; Pedersen, Marius

    2015-01-01

    The paper aims to develop a method for multichannel halftoning based on the Direct Binary Search (DBS) algorithm. We integrate specifics and benefits of multichannel printing into the halftoning method in order to further improve texture quality of DBS and to create halftoning that would suit for multichannel printing. Originally, multichannel printing is developed for an extended color gamut, at the same time additional channels can help to improve individual and combined texture of color halftoning. It does so in a similar manner to the introduction of the light colors (diluted inks) in printing. Namely, if one observes Red, Green and Blue inks as the light version of the M+Y, C+Y, C+M combinations, the visibility of the unwanted halftoning textures can be reduced. Analogy can be extent to any number of ink combinations, or Neugebauer Primaries (NPs) as the alternative building blocks. The extended variability of printing spatially distributed NPs could provide many practical solution and improvements in color accuracy, image quality, and could enable spectral printing. This could be done by selection of NPs per dot area location based on the constraint of the desired reproduction. Replacement with brighter NP at the location could induce a color difference where a tradeoff between image quality and color accuracy is created. With multichannel enabled DBS haftoning, we are able to reduce visibility of the textures, to provide better rendering of transitions, especially in mid and dark tones.

  5. Improving energy audit process and report outcomes through planning initiatives

    Sprau Coulter, Tabitha L.

    Energy audits and energy models are an important aspect of the retrofit design process, as they provide project teams with an opportunity to evaluate a facilities current building systems' and energy performance. The information collected during an energy audit is typically used to develop an energy model and an energy audit report that are both used to assist in making decisions about the design and implementation of energy conservation measures in a facility. The current lack of energy auditing standards results in a high degree of variability in energy audit outcomes depending on the individual performing the audit. The research presented is based on the conviction that performing an energy audit and producing a value adding energy model for retrofit buildings can benefit from a revised approach. The research was divided into four phases, with the initial three phases consisting of: 1.) process mapping activity - aimed at reducing variability in the energy auditing and energy modeling process. 2.) survey analysis -- To examine the misalignment between how industry members use the top energy modeling tools compared to their intended use as defined by software representatives. 3.) sensitivity analysis -- analysis of the affect key energy modeling inputs are having on energy modeling analysis results. The initial three phases helped define the need for an improved energy audit approach that better aligns data collection with facility owners' needs and priorities. The initial three phases also assisted in the development of a multi-criteria decision support tool that incorporates a House of Quality approach to guide a pre-audit planning activity. For the fourth and final research phase explored the impacts and evaluation methods of a pre-audit planning activity using two comparative energy audits as case studies. In each case, an energy audit professionals was asked to complete an audit using their traditional methods along with an audit which involved them first participating in a pre-audit planning activity that aligned the owner's priorities with the data collection. A comparative analysis was then used to evaluate the effects of the pre-audit planning activity in developing a more strategic method for collecting data and representing findings in an energy audit report to a facility owner. The case studies demonstrated that pre-audit planning has the potential to improve the efficiency of an energy audit process through reductions in transition time waste. The cases also demonstrated the value of audit report designs that are perceived by owners to be project specific vs. generic. The research demonstrated the ability to influence and alter an auditors' behavior through participating in a pre-audit planning activity. It also shows the potential benefits of using the House of Quality as a method of aligning data collection with owner's goals and priorities to develop reports that have increased value.

  6. Air quality management in Canada: The smog control initiative

    This paper focuses on a Canadian program called the open-quotes Management Plan for Nitrogen Oxides (NOX) and Volatile Organic Compounds (VOCs).close quotes This program was developed by the Canadian Council of Ministers of the Environment (CCME), a forum composed of the 10 provincial ministers of the environment and their federal counterpart. Other air pollution control initiatives that have taken place in Canada are also reviewed in this paper to give a broader perspective of air quality management in Canada

  7. Genetic improvement potential for biomass quality and quantity

    Rockwood, D.L.

    1984-01-01

    A biomass yield strategy will have a strong emphasis on genetic improvement of biomass quality and quantity. Plant characteristics to be favoured in biomass species differ from those stressed in traditional agriculture. Species selection, assuming that minimum quality criteria are met, is the initial phase of an improvement program and will largely be determined by quantity factors. Genetic bases within chosen species should then be developed and manipulated according to appropriate established breeding methods. Long-term gain potential through conventional practices is high and is enhanced by new technology for the propagation and creating genetic diversity. Genetic improvement efforts with biomass species in the Southern United States, with emphasis on Florida, are summarized as examples. 18 references.

  8. Increased Mercury Bioaccumulation Follows Water Quality Improvement

    Changes in physical and chemical characteristics of aquatic habitats made to reduce or eliminate ecological risks can sometimes have unforeseen consequences. Environmental management activities on the U.S. Dept. of Energy reservation in Oak Ridge, Tennessee,have succeeded in improving water quality in streams impacted by discharges fi-om industrial facilities and waste disposal sites. The diversity and abundance of pollution-sensitive components of the benthic macroinvertebrate communities of three streams improved after new waste treatment systems or remedial actions reduced inputs of various toxic chemicals. Two of the streams were known to be mercury-contaminated from historical spills and waste disposal practices. Waterborne mercury concentrations in the third were typical of uncontaminated systems. In each case, concentrations of mercury in fish, or the apparent biological availability of mercury increased over the period during which ecological metrics indicated improved water quality. In the system where waterborne mercury concentrations were at background levels, increased mercury bioaccumulation was probably a result of reduced aqueous selenium concentrations; however, the mechanisms for increased mercury accumulation in the other two streams remain under investigation. In each of the three systems, reduced inputs of metals and inorganic anions was followed by improvements in the health of aquatic invertebrate communities. However, this reduction in risk to aquatic invertebrates was accompanied by increased risk to humans and piscivorous wildlife related to increased mercury concentrations in fish

  9. Improving Quality of Care in Peptic Ulcer Bleeding

    Rosenstock, Steffen Jais; Møller, Morten H; Larsson, Heidi; Johnsen, Søren P; Madsen, Anders H; Bendix, Jørgen; Adamsen, Sven; Jensen, Anders G; Zimmermann-Nielsen, Erik; Nielsen, Ann-Sophie; Kallehave, Finn; Oxholm, Dorthe; Skarbye, Mona; Jølving, Line R; Schaffalitzky de Muckadell, Ove B.; Thomsen, RW; Jørgensen, Henrik Stig

    2013-01-01

    OBJECTIVES:The treatment of peptic ulcer bleeding (PUB) is complex, and mortality remains high. We present results from a nationwide initiative to monitor and improve the quality of care (QOC) in PUB.METHODS:All Danish hospitals treating PUB patients between 2004 and 2011 prospectively registered......, of which one-quarter were in-hospital bleeders. Preadmission use of anticoagulants, multiple coexisting diseases, and the American Society of Anesthesiologists scores increased between 2004 and 2011. Considerable improvements were observed for most QOC indicators over time. Endoscopic treatment was...... disease.Am J Gastroenterol advance online publication, 4 June 2013; doi:10.1038/ajg.2013.162....

  10. Building a national data repository to measure and improve health center quality.

    Shin, Peter; Jones, Emily; Jacobs, Feygele; Tuckson, Reed

    2010-01-01

    Community health centers provide access to high-quality care for underserved populations and have a history of success with quality improvement initiatives, due to their mission and data reporting requirements. Investments in the health center infrastructure can bolster efforts to create a Nationwide Health Information Network to better utilize the available data. Aggregation, stratification by health center type, and use of patient-level quality data enable the development of quality measures that can be used to target health center resources and further improve quality. Health centers are fertile testing grounds for strategies to utilize data and performance measures to fuel quality improvements. PMID:20838110

  11. Improving the quality of care for patients with hypertension in Moshupa District, Botswana: Quality improvement cycle

    Cathy Kande

    2014-01-01

    Full Text Available Background: Although there are no prevalence studies on hypertension in Botswana, this condition is thought to be common and the quality of care to be poor.Aim: The aim of this project was to assess and improve the quality of primary care forhypertension.Setting: Moshupa clinic and catchment area, Botswana.Methods: Quality improvement cycle.Results: Two hundred participants were included in the audit. Sixty-eight per cent were women with a mean age of 55 years. In the baseline audit none of the target standards were met. During the re-audit six months later, six out of nine structural target standards, five out of 11 process target standards and one out of two outcome target standards were achieved. Statistically-significant improvement in performance (p < 0.05 was shown in 10 criteria although the target standard was not always met. In the re-audit, the target of achieving blood pressure control (< 140/90 in 70% of patients was achieved.Conclusion: The quality of care for hypertension was suboptimal in our setting. Simple interventions were designed and implemented to improve the quality of care. These interventions led to significant improvement in structural and process criteria. A corresponding significant improvement in the control of blood pressure was also seen.

  12. Improving wind power quality with energy storage

    Rasmussen, Claus Nygaard

    2009-01-01

    The results of simulation of the influence of energy storage on wind power quality are presented. Simulations are done using a mathematical model of energy storage. Results show the relation between storage power and energy, and the obtained increase in minimum available power from the combination...... of wind and storage. The introduction of storage enables smoothening of wind power on a timescale proportional to the storage energy. Storage does not provide availability of wind power at all times, but allows for a certain fraction of average power in a given timeframe to be available with high...... probability. The amount of storage capacity necessary for significant wind power quality improvement in a given period is found to be 20 to 40% of the energy produced in that period. The necessary power is found to be 80 to 100% of the average power of the period....

  13. Quality assurance in the treatment of colorectal cancer: the EURECCA initiative.

    Breugom, A J; Boelens, P G; van den Broek, C B M; Cervantes, A; Van Cutsem, E; Schmoll, H J; Valentini, V; van de Velde, C J H

    2014-08-01

    Colorectal cancer is one of the most common cancers in Europe. Over the past few decades, important advances have been made in screening, staging and treatment of colorectal cancer. However, considerable variation between and within European countries remains, which implies that further improvements are possible. The most important remaining question now is: when are we, health care professionals, delivering the best available care to patients with colon or rectal cancer? Currently, quality assurance is a major issue in colorectal cancer care and quality assurance awareness is developing in almost all disciplines involved in the treatment of colorectal cancer patients. Quality assurance has shown to be effective in clinical trials. For example, standardisation and quality control were introduced in the Dutch TME trial and led to marked improvements of local control and survival in rectal cancer patients. Besides, audit structures can also be very effective in monitoring cancer management and national audits showed to further improve outcome in colorectal cancer patients. To reduce the differences between European countries, an international, multidisciplinary, outcome-based quality improvement programme, European Registration of Cancer Care (EURECCA), has been initiated. In the near future, the EURECCA dataset will perform research on subgroups as elderly patients or patients with comorbidities, which are often excluded from trials. For optimal colorectal cancer care, quality assurance in guideline formation and in multidisciplinary team management is also of great importance. The aim of this review was to create greater awareness and to give an overview of quality assurance in the management of colorectal cancer. PMID:24671742

  14. Improvements in geomagnetic observatory data quality

    Reda, Jan; Fouassier, Danielle; Isac, Anca; Linthe, Hans-Joachim; Matzka, Jrgen; Turbitt, Christopher William

    Geomagnetic observatory practice and instrumentation has evolved significantly over the past 150 years. Evolution continues to be driven by advances in technology and by the need of the data user community for higher-resolution, lower noise data in near-real time. Additionally, collaboration...... current state of observatory instrumentation and methods, citing some of the general problems in the complex operation of geomagnetic observatories. It further gives an overview of recent improvements of observatory data quality based on presentation during 11th IAGA Assembly at Sopron and INTERMAGNET...

  15. Mexico City Air Quality Research Initiative; Volume 5, Strategic evaluation

    NONE

    1994-03-01

    Members of the Task HI (Strategic Evaluation) team were responsible for the development of a methodology to evaluate policies designed to alleviate air pollution in Mexico City. This methodology utilizes information from various reports that examined ways to reduce pollutant emissions, results from models that calculate the improvement in air quality due to a reduction in pollutant emissions, and the opinions of experts as to the requirements and trade-offs that are involved in developing a program to address the air pollution problem in Mexico City. The methodology combines these data to produce comparisons between different approaches to improving Mexico City`s air quality. These comparisons take into account not only objective factors such as the air quality improvement or cost of the different approaches, but also subjective factors such as public acceptance or political attractiveness of the different approaches. The end result of the process is a ranking of the different approaches and, more importantly, the process provides insights into the implications of implementing a particular approach or policy.

  16. Proceedings of the upwind downwind air quality conference 2004 : a practical conference on improving air quality

    This conference provided a forum for policy makers, environmental managers, urban designers and citizens to discuss current air quality issues. It provided information on urban sprawl and the resulting human health impacts. Many presentations described efforts that are currently underway to improve local air quality through smart growth initiatives, new urban design approaches, successful airshed management and planning legislation. The roles that industry, community groups and governments play in achieving air quality improvements were also highlighted. The mitigation efforts relate to both natural areas and industrial corridors and involve reducing waste, consuming less energy, changing our modes of transportation, and wise land use in urban areas. Sixteen presentations were indexed separately for inclusion in this database. refs., tabs., figs

  17. Biospecimen Reporting for Improved Study Quality (BRISQ)

    National Cancer Institute; Jewell, Ph.D., Scott D.; Seijo, M.S., Edward; Kelly, Ph.D., Andrea; Somiari, Ph.D., Stella; B.Chir., M.B.; McShane, Ph.D., Lisa M.; Clark, M.D., Douglas; Greenspan, M.D., Renata; Hayes, M.D., Daniel F.; Hainaut, Ph.D., M.S., Pierre; Kim, Paula; Mansfield, Ph.D., Elizabeth; Potapova, Ph.D., Olga; Riegman, Ph.D., Peter; Rubinstein, Ph.D., Yaffa; Weier, Ph.D., Heinz-Ulrich; Zhu, Ph.D., Claire; Moore, Ph.D., Helen M.; Vaught, Ph.D., Jim; Watson, Peter

    2010-09-02

    Human biospecimens are subjected to collection, processing, and storage that can significantly alter their molecular composition and consistency. These biospecimen preanalytical factors, in turn, influence experimental outcomes and the ability to reproduce scientific results. Currently, the extent and type of information specific to the biospecimen preanalytical conditions reported in scientific publications and regulatory submissions varies widely. To improve the quality of research that uses human tissues, it is crucial that information on the handling of biospecimens be reported in a thorough, accurate, and standardized manner. The Biospecimen Reporting for Improved Study Quality (BRISQ) recommendations outlined herein are intended to apply to any study in which human biospecimens are used. The purpose of reporting these details is to supply others, from researchers to regulators, with more consistent and standardized information to better evaluate, interpret, compare, and reproduce the experimental results. The BRISQ guidelines are proposed as an important and timely resource tool to strengthen communication and publications on biospecimen-related research and to help reassure patient contributors and the advocacy community that their contributions are valued and respected.

  18. Biospecimen Reporting for Improved Study Quality

    Moore, Ph.D., Helen M.; Kelly, Ph.D., Andrea B.; Jewell, Ph.D., Scott D.; McShane, Ph.D., Lisa M.; Clark, M.D., Douglas P.; Greenspan, M.D., Renata; Hayes, M.D., Daniel F.; Hainaut, Ph.D., Pierre; Kim, Paula; Mansfield, Ph.D., Elizabeth A.; Potapova, Ph.D., Olga; Riegman, Ph.D., Peter; Rubinstein, Ph.D., Yaffa; Seijo, M.S., Edward; Somiari, Ph.D., Stella; Chir., B; Weier, Ph.D., Heinz-Ulrich; Zhu, Ph.D., Claire; Vaught, Ph.D., Jim; Watson,M.B., Peter

    2010-12-27

    Human biospecimens are subjected to collection, processing, and storage that can significantly alter their molecular composition and consistency. These biospecimen preanalytical factors, in turn, influence experimental outcomes and the ability to reproduce scientific results. Currently, the extent and type of information specific to the biospecimen preanalytical conditions reported in scientific publications and regulatory submissions varies widely. To improve the quality of research that uses human tissues, it is crucial that information on the handling of biospecimens be reported in a thorough, accurate, and standardized manner. The Biospecimen Reporting for Improved Study Quality (BRISQ) recommendations outlined herein are intended to apply to any study in which human biospecimens are used. The purpose of reporting these details is to supply others, from researchers to regulators, with more consistent and standardized information to better evaluate, interpret, compare, and reproduce the experimental results. The BRISQ guidelines are proposed as an important and timely resource tool to strengthen communication and publications on biospecimen-related research and to help reassure patient contributors and the advocacy community that their contributions are valued and respected.

  19. Biospecimen Reporting for Improved Study Quality (BRISQ)

    Moore, Ph.D., Helen M.; Kelly Ph.D., Andrea; Jewell Ph.D., Scott D.; McShane Ph.D., Lisa M.; Clark M.D., Douglas P.; Greenspan M.D., Renata; Hayes M.D., Daniel F.; Hainaut Ph.D.,, Pierre; Kim, Paula; Mansfield Ph.D., Elizabeth; Potapova Ph.D., Olga; Riegman Ph.D., Peter; Rubinstein Ph.D., Yaffa; Seijo M.S., Edward; Somiari Ph.D., Stella; Watson M.B., Peter; Weier Ph.D., Heinz-Ulrich; Zhu Ph.D., Claire; Vaught Ph.D., Jim

    2011-04-26

    Human biospecimens are subject to a number of different collection, processing, and storage factors that can significantly alter their molecular composition and consistency. These biospecimen preanalytical factors, in turn, influence experimental outcomes and the ability to reproduce scientific results. Currently, the extent and type of information specific to the biospecimen preanalytical conditions reported in scientific publications and regulatory submissions varies widely. To improve the quality of research utilizing human tissues it is critical that information regarding the handling of biospecimens be reported in a thorough, accurate, and standardized manner. The Biospecimen Reporting for Improved Study Quality (BRISQ) recommendations outlined herein are intended to apply to any study in which human biospecimens are used. The purpose of reporting these details is to supply others, from researchers to regulators, with more consistent and standardized information to better evaluate, interpret, compare, and reproduce the experimental results. The BRISQ guidelines are proposed as an important and timely resource tool to strengthen communication and publications around biospecimen-related research and help reassure patient contributors and the advocacy community that the contributions are valued and respected.

  20. Research of Quality Improvement and Quality Innovation Based on Knowledge Fermenting Model

    Jin Wang; Jinsheng He; Jiansheng Tang

    2009-01-01

    Quality improvement and quality innovation are the important approach to enhance competitive force for enterprises. Quality improvement is a process of knowledge innovation in nature which must be actualized by organizational learning.This article starts from the relations among quality improvement, quality innovation and the ability of organizational learning, analyzes the knowledge moving rule in the interior process of quality improvement and innovation and expatiates on the creation, deve...

  1. Quality of life among HIV-infected patients in Brazil after initiation of treatment

    Lorenza Nogueira Campos

    2009-01-01

    Full Text Available INTRODUCTION: Despite improvement in clinical treatment for HIV-infected patients, the impact of antiretroviral therapy on the overall quality of life has become a major concern. OBJECTIVE: To identify factors associated with increased levels of self-reported quality of life among HIV-infected patients after four months of antiretroviral therapy. METHODS: Patients were recruited at two public health referral centers for AIDS, Belo Horizonte, Brazil, for a prospective adherence study. Patients were interviewed before initiating treatment (baseline and after one and four months. Quality of life was assessed using a psychometric instrument, and factors associated with good/very good quality of life four months after the initiation of antiretroviral therapy were assessed using a cross-sectional approach. Logistic regression was used for analysis. RESULTS: Overall quality of life was classified as 'very good/good' by 66.4% of the participants four months after initiating treatment, while 33.6% classified it as 'neither poor nor good/poor/very poor'. Logistic regression indicated that >8 years of education, none/mild symptoms of anxiety and depression, no antiretroviral switch, lower number of adverse reactions and better quality of life at baseline were independently associated with good/very good quality of life over four months of treatment. CONCLUSIONS: Our results highlight the importance of modifiable factors such as psychiatric symptoms and treatment-related variables that may contribute to a better quality of life among patients initiating treatment. Considering that poor quality of life is related to non-adherence to antiretroviral therapy, careful clinical monitoring of these factors may contribute to ensuring the long-term effectiveness of antiretroviral regimens.

  2. Quality improvement capacity: a survey of hospital quality managers.

    Gagliardi, A R; Majewski, C; Victor, J C; Baker, G R

    2010-02-01

    Background Skilled managers are an important component of quality improvement (QI) infrastructure, but there has been little evaluation of QI infrastructure, which is needed to guide enhancement of this capacity. Methods Quality managers at 97 acute care hospitals in Ontario, Canada, were surveyed by mail to describe how their roles were integrated with QI performance objectives. Binary and scaled responses were analysed quantitatively, and open-ended responses were analysed thematically. Results The response rate was 79.4%. Many QI managers were new to their role and had no support staff despite responsibility for multiple portfolios. Respondents thought that QI objectives should be less reactive to hospital executives or boards, adverse events or demands from government and accreditation bodies, and recommended that dedicated QI managers proactively apply explicit strategic plans and engage executives and clinicians. Findings were consistent regardless of rank, staffing or hospital type. Those with master's training and greater experience were more involved in strategic planning, data analysis and communication. Conclusions QI is not well resourced in most acute care hospitals in Ontario. To develop QI capacity, investment and QI training may be required. Research should empirically establish objective performance measures of QI capacity to guide investment and evaluation. PMID:20172879

  3. Improving the coverage of the PMTCT programme through a participatory quality improvement intervention in South Africa

    Chopra Mickey

    2009-11-01

    Full Text Available Abstract Background Despite several years of implementation, prevention of mother-to-child transmission (PMTCT programmes in many resource poor settings are failing to reach the majority of HIV positive women. We report on a data driven participatory quality improvement intervention implemented in a high HIV prevalence district in South Africa. Methods A participatory quality improvement intervention was implemented consisting of an initial assessment undertaken by a team of district supervisors, workshops to assess results, identify weaknesses and set improvement targets and continuous monitoring to support changes. Results The assessment highlighted weaknesses in training and supervision. Routine data revealed poor coverage of all programme indicators except HIV testing. Monthly support to all facilities took place including an orientation to the PMTCT protocol, review of local data and identification of bottlenecks to optimal coverage using a continuous quality improvement approach. One year following the intervention large improvements in programme indicators were observed. Coverage of CD4 testing increased from 40 to 97%, uptake of maternal nevirapine from 57 to 96%, uptake of infant nevirapine from 15 to 68% and six week PCR testing from 24 to 68%. Conclusion It is estimated that these improvements in coverage could avert 580 new infant infections per year in this district. This relatively simple participatory assessment and intervention process has enabled programme managers to use a data driven approach to improve the coverage of this important programme.

  4. Quality management initiatives at Carolina Power and Light Company

    At Carolina Power and Light Company nuclear quality assurance functions are performed including quality control of site work processes, surveillance of site activities, corporate auditing and quality assurance engineering. In addition, an independent section performs technical evaluations, field observation activities, and safety system assessments. In 1989, the Company's management chartered a team of experienced nuclear managers to help identify opportunities and specific means to improve the Company's self-assessment processes. The team also visited or surveyed approximately 20 other utilities, INPO, NRC's Regional and Central headquarters in order to identify the best practices in the U.S. nuclear industry to self-assessment. The major conclusions drawn by the Company from this review activity are presented. As a result, a number of specific changes have been implemented at the Company, both organizationally and functionally, e.g. the Corporate Quality Assurance audit programme was refocused to introduce performance-based techniques and philosophy. Some of the changes are briefly described. (Z.S.)

  5. Quality Improvement using Data Mining in Manufacturing Processes

    He, Shu-guang; He, Zhen; Wang, G. Alan; Li

    2009-01-01

    In a competitive global market, manufacturing enterprises must stay agile when making quality improvement decisions. The development of IT and other related technologies makes the collection of quality related data easy and cost-effective. However, it is still an open question on how to leverage the large amount of quality data to improve manufacturing quality. This chapter has approached the problem of quality improvement in manufacturing processes using data mining techniques. Firstly, we p...

  6. San Francisco Bay Water Quality Improvement Fund 2015

    U.S. Environmental Protection Agency The San Francisco Bay Water Quality Improvement Fund is a competitive grant program that is helping implement TMDLs to improve water quality, protect wetlands, and...

  7. Promoting a quality of service culture in health care: review of a Scottish initiative.

    Curry, A C; Keogh, W; Hogg, G M

    1997-05-01

    This paper is a review of a quality of service initiative which was carried out as a PICKUP Quality Project within the Scottish Health Service. This Quality Initiative took place between 1989 and 1990: before the emergence of The Patient's Charter. The aim of the review was to provide answers to a number of important questions which examined the perceptions of staff who took part in the Quality of Service initiative, identified parts of the process which were in need of substantial revision, and reported on the reactions of participants to the overall process. The methodology employed involved questionnaires and interview techniques. A number of problems were identified and, after examination, these were taken to indicate learning pointers for the future. It was evident that good quality of service training can be delivered, but only if it is clearly and appropriately tailored to the audience. It is also of fundamental importance to be familiar with the environment in which the organization is operating. In this instance, as is often the case for health care, there were considerable financial limitations in force at the time. These limitations heightened the general business sensitivity and showed that carrying through quality of service improvements involved the demonstration of commitment and the provision of resources. PMID:10168962

  8. PROCESS VARIABILITY REDUCTION THROUGH STATISTICAL PROCESS CONTROL FOR QUALITY IMPROVEMENT

    B.P. Mahesh; M.S. Prabhuswamy

    2010-01-01

    Quality has become one of the most important customer decision factors in the selection among the competing product and services. Consequently, understanding and improving quality is a key factor leading to business success, growth and an enhanced competitive position. Hence quality improvement program should be an integral part of the overall business strategy. According to TQM, the effective way to improve the Quality of the product or service is to improve the process used to build the pro...

  9. Doctor Who? A Quality Improvement Project to Assess and Improve Patients' Knowledge of Their Inpatient Physicians.

    Broderick-Forsgren, Kathleen; Hunter, Wynn G; Schulteis, Ryan D; Liu, Wen-Wei; Boggan, Joel C; Sharma, Poonam; Thomas, Steven; Zaas, Aimee; Bae, Jonathan

    2016-05-01

    Background Patient-physician communication is an integral part of high-quality patient care and an expectation of the Clinical Learning Environment Review program. Objective This quality improvement initiative evaluated the impact of an educational audit and feedback intervention on the frequency of use of 2 tools-business cards and white boards-to improve provider identification. Methods This before-after study utilized patient surveys to determine the ability of those patients to name and recognize their physicians. The before phase began in July 2013. From September 2013 to May 2014, physicians received education on business card and white board use. Results We surveyed 378 patients. Our intervention improved white board utilization (72.2% postintervention versus 54.5% preintervention, P business card use (44.4% versus 33.7%, P = .07), but did not improve physician recognition. Only 20.3% (14 of 69) of patients could name their physician without use of the business card or white board. Data from all study phases showed the use of both tools improved patients' ability to name physicians (OR = 1.72 and OR = 2.12, respectively; OR = 3.68 for both; P business cards and white boards, alone or combined, improved name recognition, suggesting better use of these tools may increase identification. Future initiatives should target other barriers to usage of these types of tools. PMID:27168887

  10. Oversight on the borderline: Quality improvement and pragmatic research.

    Finkelstein, Jonathan A; Brickman, Andrew L; Capron, Alexander; Ford, Daniel E; Gombosev, Adrijana; Greene, Sarah M; Iafrate, R Peter; Kolaczkowski, Laura; Pallin, Sarah C; Pletcher, Mark J; Staman, Karen L; Vazquez, Miguel A; Sugarman, Jeremy

    2015-10-01

    Pragmatic research that compares interventions to improve the organization and delivery of health care may overlap, in both goals and methods, with quality improvement activities. When activities have attributes of both research and quality improvement, confusion often arises about what ethical oversight is, or should be, required. For routine quality improvement, in which the delivery of health care is modified in minor ways that create only minimal risks, oversight by local clinical or administrative leaders utilizing institutional policies may be sufficient. However, additional consideration should be given to activities that go beyond routine, local quality improvement to first determine whether such non-routine activities constitute research or quality improvement and, in either case, to ensure that independent oversight will occur. This should promote rigor, transparency, and protection of patients' and clinicians' rights, well-being, and privacy in all such activities. Specifically, we recommend that (1) health care organizations should have systematic policies and processes for designating activities as routine quality improvement, non-routine quality improvement, or quality improvement research and determining what oversight each will receive. (2) Health care organizations should have formal and explicit oversight processes for non-routine quality improvement activities that may include input from institutional quality improvement experts, health services researchers, administrators, clinicians, patient representatives, and those experienced in the ethics review of health care activities. (3) Quality improvement research requires review by an institutional review board; for such review to be effective, institutional review boards should develop particular expertise in assessing quality improvement research. (4) Stakeholders should be included in the review of non-routine quality improvement and quality improvement-related research proposals. Only by doing so will we optimally leverage both pragmatic research on health care delivery and local implementation through quality improvement as complementary activities for improving health. PMID:26374685

  11. Priorities of Higher Education Quality Improvement: Student and Teacher Attitude

    Savickiene, Izabela

    2006-01-01

    Higher education quality improvement is a constant and continuous university activity and its implementation should be given a priority. This article analyses the most important tasks set at three Lithuanian universities seeking to improve higher education quality: the improvement of higher education quality assurance system, teacher professional…

  12. Making quality improvement stick and stay: Two lines of insurance.

    Weaver, Lynda; Bossé, Isabelle; Sinclair, Dionne; Blais, Bernard; Pereira, José

    2016-01-01

    This article examines issues related to sustaining Quality Improvement (QI) initiatives in a Canadian subacute care hospital and recommends strategies to address them. The authors define two levels of sustainability, the QI project and the corporate/organizational and how they influence a LEADS (Lead Self, Engage Others, Achieve Results, Develop Coalition and System Transformation) culture. The authors then reflect on the differing factors for QI sustainability and present them under five essential categories of accountability, education, communication, monitoring and reporting, and structure and processes. PMID:26656388

  13. Foliage Plants for Improving Indoor Air Quality

    Wolverton, B. C.

    1988-01-01

    NASA's research with foliage houseplants during the past 10 years has produced a new concept in indoor air quality improvement. This new and exciting technology is quite simple. Both plant leaves and roots are utilized in removing trace levels of toxic vapors from inside tightly sealed buildings. Low levels of chemicals such as carbon monoxide and formaldehyde can be removed from indoor environments by plant leaves alone, while higher concentrations of numerous toxic chemicals can be removed by filtering indoor air through the plant roots surrounded by activated carbon. The activated carbon absorbs large quantities of the toxic chemicals and retains them until the plant roots and associated microorganisms degrade and assimilate these chemicals.

  14. Improving smoked herring quality by gamma irradiation

    Smoked herring which is a highly purchasable product in Egypt, was exposed to different gamma irradiation doses (1.5,3.0 and 5.0 kGy) and stored at environmental temperature (12± 2 deg C) until spoilage of the control. Microbiological, chemical and sensory analyses were performed throughout storage to monitor the quality attributes. It is worthy to mention that irradiation reduced the population of bacteria and the effect was more pronounced at the highest dose used (5.0 kGy). At the same time 1.5 kGy completely eliminated staphylococcus aureus (coagulase + ve) and coliforms. By chemical analysis, there was significant decrease in average moisture content by different gamma irradiation doses and storage. Although the average thiobarbituric acid reactive substances (TBARS) increased slightly by γ-irradiation, this increase was highly significant by storage . At the same time there was a significant (p< 0.05)decrease in the average trimethylamine (TMA) value of all irradiated samples compared with unirradiated control, this value increased significantly by storage. interestingly, the average histamine value decreased significantly in all irradiated samples. The sensory analysis revealed a highly significant difference in the average acceptability scores between different irradiation doses used and also by storage. Therefore it could be concluded that the quality of smoked herring during storage at environmental temperature (12 ± 2 deg C) could be improved by using 5.0 kGy γ -irradiation

  15. MKK3 deletion improves mitochondrial quality.

    Srivastava, Anup; McGinniss, John; Wong, Yao; Shinn, Amanda S; Lam, TuKiet T; Lee, Patty J; Mannam, Praveen

    2015-10-01

    Sepsis, a severe response to infection, leads to excessive inflammation and is the major cause of mortality in intensive care units. Mitochondria have been shown to influence the outcome of septic injury. We have previously shown that MAP kinase kinase 3 (MKK3)(-/-) mice are resistant to septic injury and MKK3(-/-) macrophages have improved mitochondrial function. In this study we examined processes that lead to improved mitochondrial quality in MKK3(-/-) mouse embryonic fibroblasts (MEFs) and specifically the role of mitophagy in mitochondrial health. MKK3(-/-) MEFs had lower inflammatory cytokine release and oxidant production after lipopolysaccharide (LPS) stimulation, confirming our earlier observations. MKK3(-/-) MEFs had better mitochondrial function as measured by mitochondrial membrane potential (MMP) and ATP, even after LPS treatment. We observed higher mitophagy in MKK3(-/-) MEFs compared to wild type (WT). Transmission electron microscopy studies showed longer and larger mitochondria in MKK3(-/-) MEFs, indicative of healthier mitochondria. We performed a SILAC (stable isotope labeling by/with amino acids in cell culture) study to assess differences in mitochondrial proteome between WT and MKK3(-/-) MEFs and observed increased expression of tricarboxylic acid (TCA) cycle enzymes and respiratory complex subunits. Further, inhibition of mitophagy by Mdivi1 led to loss in MMP and increased cytokine secretion after LPS treatment in MKK3(-/-) MEFs. In conclusion, this study demonstrates that MKK3 influences mitochondrial quality by affecting the expression of mitochondrial proteins, including TCA cycle enzymes, and mitophagy, which consequently regulates the inflammatory response. Based on our results, MKK3 could be a potential therapeutic target for inflammatory diseases like sepsis. PMID:26119780

  16. The PBRN Initiative: Transforming New Technologies to Improve Patient Care

    Curro, F.A.; Vena, D.; Naftolin, F; Terracio, L.; Thompson, V.P.

    2012-01-01

    The NIDCR-supported Practice-based Research Network initiative presents dentistry with an unprecedented opportunity by providing a pathway for modifying and advancing the profession. It encourages practitioner participation in the transfer of science into practice for the improvement of patient care. PBRNs vary in infrastructure and design, and sustaining themselves in the long term may involve clinical trial validation by regulatory agencies. This paper discusses the PBRN concept in general ...

  17. Gibberellin inhibitors improve embryogenic tissue initiation in conifers.

    Pullman, Gerald S; Mein, J; Johnson, S; Zhang, Y

    2005-02-01

    Somatic embryogenesis (SE), the most promising technology to multiply high-value coniferous trees from advanced breeding and genetic engineering programs, is expected to play an important role in increasing productivity, sustainability, and uniformity of future forests in the United States. For commercial use, SE technology must work with a variety of genetically diverse trees. Initiation in loblolly pine (LP; Pinus taeda L.), our main focus species, is often recalcitrant for desirable genotypes. Initiation of LP, slash pine (SP; Pinus elliottii), Douglas-fir (DF; Pseudotsuga menziesii), and Norway spruce (NS; Picea abies) were improved through the use of paclobutrazol, a gibberellin synthesis inhibitor. Paclobutrazol was effective at concentrations ranging from 0.25 mg/l to 3.0 mg/l (0.85-10.2 microM) and optimal in LP at 1.0 mg/l. Using control media (no paclobutrazol) and 0.33-1.0 mg/l paclobutrazol, initiation percentages in LP, SP, DF, and NS were improved from 37.7% to 44.2% (across experiments), 19.3% to 28.5%, 16.9% to 23.7%, and 38.8% to 48.5%, respectively. Other gibberellin inhibitors such as flurprimidol, chlormequat-Cl, and daminozide also caused statistically significant increases in LP initiation when added to the medium at concentrations of 0.34, 10.0, and 1.0 microM, respectively. No detrimental effects on subsequent embryo development were observed when 29 new initiations from medium without GA inhibitor and 28 new initiations from medium containing paclobutrazol were tracked through culture capture, liquid culture establishment, cotyledonary embryo development, and germination. PMID:15688237

  18. Design, implementation, and initial results from a water-quality monitoring network for Atlanta, Georgia, USA

    Horowitz, A.J.; Elrick, K.A.; Smith, J.J.

    2005-01-01

    In cooperation with the City of Atlanta, Georgia, the US Geological Survey has designed and implemented a water-quantity and quality monitoring network that measures a variety of biological and chemical constituents in water and suspended sediment. The network consists of 20 long-term monitoring sites and is intended to assess water-quality trends in response to planned infrastructural improvements. Initial results from the network indicate that nonpoint-source contributions may be more significant than point-source contributions for selected sediment associated trace elements and nutrients. There also are indications of short-term discontinuous point-source contributions of these same constituents during baseflow.

  19. Quality improvement in large healthcare organizations.

    Höög, Elisabet; Lysholm, Jack; Garvare, Rickard; Weinehall, Lars; Nyström, Monica Elisabeth

    2016-03-21

    Purpose - The purpose of this paper is to investigate the obstacles and challenges associated with organizational monitoring and follow-up (M & F) processes related to health care quality improvement (QI) and development. Design/methodology/approach - A longitudinal case study of a large health care organization during a system-wide QI intervention. Content analysis was conducted of repeated interviews with key actors and archival data collected over a period of four years. Findings - The demand for improved M & F strategies, and what and how to monitor were described by the respondents. Obstacles and challenges for achieving M & F strategies that enables system-wide and coherent development were found in three areas: monitoring, processing, and feedback and communication. Also overarching challenges were found. Practical implications - A model of important aspects of M & F systems is presented that can be used for analysis and planning and contribute to shared cognition of such systems. Approaches for systematic analysis and follow-up of identified problems have to be developed and fully incorporated in the organization's measurement systems. A systematic M & F needs analytic and process-oriented competence, and this study highlights the potential in an organizational function with capacity and mandate for such tasks. Originality/value - Most health care systems are flooded with a vast amount of registers, records, and measurements. A key issue is how such data can be processed and refined to reflect the needs and the development process of the health care system and how rich data can be used for improvement purposes. This study presents key organizational actor's view on important factors to consider when building a coherent organizational M & F strategy. PMID:26964854

  20. Strategy, Structure and Quality Service: Developing School Wide Quality Improvement.

    Murgatroyd, Stephen

    1991-01-01

    Builds on earlier contributions to the literature on educational leadership and total quality management in education. Introduces two new tools--the service guarantee and the House of Quality, placing them in the context of strategic marketing, structural change, and other total quality management methods. (19 references) (MLH)

  1. PROCESS VARIABILITY REDUCTION THROUGH STATISTICAL PROCESS CONTROL FOR QUALITY IMPROVEMENT

    B.P. Mahesh

    2010-09-01

    Full Text Available Quality has become one of the most important customer decision factors in the selection among the competing product and services. Consequently, understanding and improving quality is a key factor leading to business success, growth and an enhanced competitive position. Hence quality improvement program should be an integral part of the overall business strategy. According to TQM, the effective way to improve the Quality of the product or service is to improve the process used to build the product. Hence, TQM focuses on process, rather than results as the results are driven by the processes. Many techniques are available for quality improvement. Statistical Process Control (SPC is one such TQM technique which is widely accepted for analyzing quality problems and improving the performance of the production process. This article illustrates the step by step procedure adopted at a soap manufacturing company to improve the Quality by reducing process variability using Statistical Process Control.

  2. Continuous quality improvement of colorectal cancer screening

    Mariusz Madalinski

    2013-01-01

    Full Text Available Quality assurance is a key issue in colorectal cancer screening, because effective screening is able to improve primary prevention of the cancer. The quality measure may be described in terms: how well the screening test tells who truly has a disease (sensitivity and who truly does not have a disease (specificity. This paper raises concerns about identification of the optimal screening test for colorectal cancer. Colonoscopy vs flexible sigmoidoscopy in colorectal cancer screening has been a source of ongoing debate. A multicentre randomised controlled trial comparing flexible sigmoidoscopy with usual care showed that flexible sigmoidoscopy screening is able to diminish the incidence of distal and proximal colorectal cancer, and also mortality related to the distal colorectal cancer. However, colonoscopy provides a more complete examination and remains the more sensitive exam than flexible sigmoidoscopy. Moreover, colonoscopy with polypectomy significantly reduces colorectal cancer incidence and colorectal cancer-related mortality in the general population. The article considers the relative merits of both methods and stresses an ethical aspect of patients involvement in decision-making. Patients should be informed not only about tests tolerability and risk of endoscopy complications, but also that different screening tests for bowel cancer have different strength to exclude colonic cancer and polyps. The authorities calculate effectiveness and costs of the screening tests, but patients may not be interested in statistics regarding flexible sigmoidoscopy screening and from an ethical point of view, they have the right to chose colonoscopy, which is able to exclude a cancer and precancerous lesions in the whole large bowel.

  3. Quality procedure management for improved nuclear safety

    Emergency Operating Procedures and Accident Management Procedures are the next step in the computerization of NPP control rooms. Different improvements are presently conceivable for this operator aid tool, and research activities are in development. Undergoing activities regard especially formal aspects of knowledge representation, Human-Machine interface and procedure life cycle management. These aspects have been investigated deeply by Ansaldo, and partially incorporated in the DIAM prototype. Nuclear Power Plant Procedures can be seen from essentially two viewpoints: the process and the information management. From the first point of view, it is important to supply the knowledge apt to solve problems connected with the control of the process, from the second one the focus of attention is on the knowledge representation, its structure, elicitation and maintenance, and formal quality assurance. These two aspects of procedure representation can be considered and solved separately. In particular, methodological, formal and management issues require long and tedious activities, that in most cases constitute a great barrier for procedures development and upgrade. To solve these problems, Ansaldo is developing DIAM, a wide integrated tool for procedure management to support in procedure writing, updating, usage, and documentation. One of the most challenging features of DIAM is AUTO-LAY, a CASE sub-tool that, in a complete automatical way, structures parts or complete flow diagram. This is the feature that is partial present in some other CASE products, that, anyway, do not allow complex graph handling and isomorphism between video and paper representation. AUTO-LAY has the unique prerogative to draw graphs of any complexity to section them in pages, and to automatically compose a document. This has been recognized in the literature as the most important a second-generation CASE improvement. (Author) 9 Figs., 5 Refs

  4. IMPROVEMENT OF POWER QUALITY OF A DISTRIBUTED GENERATION POWER SYSTEM

    Aruna Garipelly

    2012-01-01

    The aim of this work is to improve the power quality for Distributed Generation (DG) with power storage system. Power quality is the combination of voltage quality and current quality. Power quality is the set of limits of electrical properties that allows electrical systems to function in their intended manner without significant loss of performance or life. The electrical power quality is more concerned issue. The main problems are stationery and transient distortions in the line voltage su...

  5. Nonformal Education in Improving Quality of Life of Underprivileged Children

    Abdullah Al Mamun

    2013-02-01

    Full Text Available This study explores the role of Non-formal Primary Education (NFPE in improving the quality of the life of underprivileged children in Bangladesh considering their economic, health, environmental issues and life skills. It uses a mixed method approach of research where three NGOs which run NFPE programs were selected purposefully. Data were derived from six NGO officers, nine teachers, ninety students and eighteen guardians by using two sets of questionnaires for NGO officers and teachers, an interview schedule for guardians and 9 focus group discussions with the students. The findings show that there is no income generating program initiated by the organizations for the learners along with education. So, the scope of their income has reduced. But their daily life behavior and skills have improved. Besides, their awareness on health and environmental issues have increased. The findings lead to some recommendations which will give insights to policy makers and professionals engaged in this field.

  6. Human performance in an operational event - how to improve it? An initiative in a French NPP

    In the case of the Saint-Laurent-des-Eaux French nuclear power station, the author comments the elements and principles of human factor policy which have been implemented, the organizational implications of this implementation (building up of an internal human factors network), and briefly evokes studies and initiatives aimed at improving the quality of operation from a general point of view and through projects aiming at analyzing and at a valorisation of human reliability in activities dealing with reactor operation. He also comments the perception and appropriation of quality in the different departments

  7. Laboratory system strengthening and quality improvement in Ethiopia

    Tilahun M. Hiwotu

    2014-09-01

    Full Text Available Background: In 2010, a National Laboratory Strategic Plan was set forth in Ethiopia to strengthen laboratory quality systems and set the stage for laboratory accreditation. As a result, the Strengthening Laboratory Management Toward Accreditation (SLMTA programme was initiated in 45 Ethiopian laboratories.Objectives: This article discusses the implementation of the programme, the findings from the evaluation process and key challenges.Methods: The 45 laboratories were divided into two consecutive cohorts and staff from each laboratory participated in SLMTA training and improvement projects. The average amount of supportive supervision conducted in the laboratories was 68 hours for cohort I and two hoursfor cohort II. Baseline and exit audits were conducted in 44 of the laboratories and percent compliance was determined using a checklist with scores divided into zero- to five-star ratinglevels.Results: Improvements, ranging from < 1 to 51 percentage points, were noted in 42 laboratories, whilst decreases were recorded in two. The average scores at the baseline and exit audits were 40% and 58% for cohort I (p < 0.01; and 42% and 53% for cohort II (p < 0.01,respectively. The p-value for difference between cohorts was 0.07. At the exit audit, 61% ofthe first and 48% of the second cohort laboratories achieved an increase in star rating. Poor awareness, lack of harmonisation with other facility activities and the absence of a quality manual were challenges identified.Conclusion: Improvements resulting from SLMTA implementation are encouraging. Continuous advocacy at all levels of the health system is needed to ensure involvement of stakeholders and integration with other improvement initiatives and routine activities.

  8. Nursing Leader Collaboration to Drive Quality Improvement and Implementation Science.

    Ryan, Rosemary W; Harris, Karen K; Mattox, Lisa; Singh, Olivine; Camp, Melanie; Shirey, Maria R

    2015-01-01

    Nursing leadership opportunities to improve quality and align resources in health care exist. An estimated 18% of United States gross domestic product is spent on health care delivery systems that produce poor outcomes. The purpose of this article was to describe how quality improvement and implementation science initiatives enhance outcomes using nursing leadership strategies that play an integral role in aligning key colleagues to drive the collaborative process. A critical appraisal of the literature was conducted, which supports the importance of evidenced-based practice improvement, collaborative change process, and professional role of nursing leadership. Limited evidence exists related to practice strategies for nursing leaders to implement sustainable change at the unit level for successful alignment of resources. Strategies based on Rogers' Diffusion of Innovation Theory are recommended to address the gap in the literature. The strategies aim to increase meaningful knowledge or the "why," create a tipping point, and implement sustainable change starting with the end in mind. Nurse leaders are a central component for driving alignment and implementing change at the unit level. Uses of the described evidenced-based strategies have implications for nursing practice, education, and scholarship. PMID:26049600

  9. Effect of a quality improvement programme on leadership, innovation and use of quality improvement methods in general practice

    Togher, Fiona; Siriwardena, A. Niroshan; Flynn, John; Dewey, Michael

    2011-01-01

    Introduction Market mechanisms and pay-for-performance have failed to deliver continuing improvements in UK clinical care. Leadership and innovation are currently seen as essential to maintain and improve clinical quality but little is known about the relationship between these and the extent to which quality improvement (QI) methods are used in general practice. This study aimed to investigate the effect of quality improvement training on leadership behaviour, culture of innovation and a...

  10. DEVELOPING WEED SUPPRESSIVE SOILS THROUGH IMPROVED SOIL QUALITY MANAGEMENT

    Sustainable agriculture is based in part on efficient management of soil microorganisms for improving soil quality. However, identification of biological indicators of soil quality for predicting weed suppression in soils has received little attention. We investigated differences in soil microbial ...

  11. Enhancing K-means Clustering Algorithm with Improved Initial Center

    Srinivasa.T.M

    2010-05-01

    Full Text Available Cluster analysis is one of the primary data analysis methods and k-means is one of the most well known popular clustering algorithms. The k-means algorithm is one of the frequently used clustering methodin data mining, due to its performance in clustering massive data sets. The final clustering result of the kmeans clustering algorithm greatly depends upon the correctness of the initial centroids, which are selected randomly. The original k-means algorithm converges tolocal minimum, not the global optimum. Many improvements were already proposed to improve the performance of the k-means, but most of these require additional inputs like threshold values for the number ofdata points in a set. In this paper a new method is proposed for finding the better initial centroids and to provide an efficient way of assigning the data points to suitable clusters with reduced time complexity. According to our experimental results, the proposed algorithm has the more accuracy with less computational timecomparatively original k-means clustering algorithm.

  12. Designing a quality improvement intervention: a systematic approach

    Bokhoven, M.A. van; Kok, G; van der Weijden, T.

    2003-01-01

    

 Most quality improvement or change management interventions are currently designed intuitively and their results are often disappointing. While improving the effectiveness of interventions requires systematic development, no specific methodology for composing intervention strategies and programmes is available. This paper describes the methodology of systematically designing quality of care improvement interventions, including problem analysis, intervention design and pretests. Several the...

  13. Good air quality in offices improves productivity

    Fanger, Povl Ole

    2000-01-01

    Three recent independent studies have documented that the quality of indoor air has a significant and positive influence or? the productivity of office workers. A combined analysis of the results of the three studies shows a significant relationship between productivity and perceived indoor air...... quality. The impact on productivity justifies a much higher indoor air quality than the minimum levels prescribed in present standards and guidelines. One way of providing air of high quality for people to breathe, without involving excessive ventilation rates and energy use, is to provide "personalized...

  14. Good air quality in offices improves productivity

    Fanger, Povl Ole

    2000-01-01

    Three recent independent studies have documented that the quality of indoor air has a significant and positive influence on the productivity of office workers. A combined analysis of the results of the three studies shows a significant relationship between productivity and perceived indoor air...... quality. The impact on productivity justifies a much higher indoor air quality than the minimum levels prescribed in present standards and guidelines. One way of providing air of high quality for people to breathe, without involving excessive ventilation rates and energy use, is to provide "personalized...

  15. Developing the protocol for the evaluation of the health foundation's 'engaging with quality initiative' – an emergent approach

    Scoggins Amanda

    2008-10-01

    Full Text Available Abstract In 2004 a UK charity, The Health Foundation, established the 'Engaging with Quality Initiative' to explore and evaluate the benefits of engaging clinicians in quality improvement in healthcare. Eight projects run by professional bodies or specialist societies were commissioned in various areas of acute care. A developmental approach to the initiative was adopted, accompanied by a two level evaluation: eight project self-evaluations and a related external evaluation. This paper describes how the protocol for the external evaluation was developed. The challenges faced included large variation between and within the projects (in approach, scope and context, and in understanding of quality improvement, the need to support the project teams in their self-evaluations while retaining a necessary objectivity, and the difficulty of evaluating the moving target created by the developmental approach adopted in the initiative. An initial period to develop the evaluation protocol proved invaluable in helping us to explore these issues.

  16. Aspects of improving the organization directed to the quality

    M. Dudek-Burlikowska

    2010-01-01

    Purpose: A new approach for organization connected with system approach, process approach, quality improvement has been presented.Design/methodology/approach: The possibility of estimation of organization quality is connected with system approach and improvement in organization. Interdependence of quality rules and quality methods in management processes has been taken into account.Findings: At the present time the enterprises should manage and control all its activities in systematic way. Su...

  17. AGRICULTURAL PRICE, QUANTITY, AND WELFARE EFFECTS OF AIR QUALITY IMPROVEMENTS

    Ribaudo, Marc; Shortle, James S.

    1986-01-01

    The failure to allow for significant crop quality effects in a partial-equilibrium model can lead to misleading inferences about the price, output and welfare implications of air quality improvements. It has been observed that air pollutants such as ozone, sulphur dioxide, and nitrogen dioxide affect the yield and quality of many crops. The economic benefit from improving air quality in crop producing regions has been measured using a partial-equilibrium approach which accounts only for suppl...

  18. QUALITY IMPROVEMENT MODEL AT THE MANUFACTURING PROCESS PREPARATION LEVEL

    Dusko Pavletic; Mirko Sokovic

    2009-01-01

    The paper expresses base for an operational quality improvement model at the manufacturing process preparation level. A numerous appropriate related quality assurance and improvement methods and tools are identified. Main manufacturing process principles are investigated in order to scrutinize one general model of manufacturing process and to define a manufacturing process preparation level. Development and introduction of the operational quality improvement model is based on a research condu...

  19. How To Improve Software Quality Assurance In Developing Countries

    Ali Javed

    2012-04-01

    Full Text Available Quality is an important factor in software industry. Software quality depends upon the customer satisfaction which can be achieved through applying standards. In this era achieving quality software is very important because of the high customer demands. Developed countries are excelling in software industry and improving day by day. Meanwhile developing countries like Pakistan are struggling with software quality and cannot maintain reputation in International Market. Software Quality lacks due tomany reasons. This paper will address the problems for lacking interest in improving the software quality by higher authorities and software assurance team. We have provided solution to the addressed problems also.

  20. Clinical performance feedback and quality improvement opportunities for perioperative physicians

    Kaye AD

    2014-05-01

    Full Text Available Alan David Kaye,1 Olutoyin J Okanlawon,2 Richard D Urman21Department of Anesthesiology, Louisiana State University School of Medicine, New Orleans, LA, 2Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston MA, USAAbstract: Clinical performance feedback is an important component of the ongoing development and education of health care practitioners. For physicians, feedback about their clinical practice and outcomes is central to developing both confidence and competence at all stages of their medical careers. Cultural and financial infrastructures need to be in place, and the concept of feedback needs to be readily embraced and encouraged by clinical leadership and other stakeholders. The "buy-in" includes the expectation and view that feedback occurs on a routine basis, and those engaged in the process are both encouraged to participate and held accountable. Feedback must be part of an overarching quality improvement and physician education agenda; it is not meant to be an isolated, fragmented initiative that is typically undermined by lack of resources or systemic barriers to gaining improvement within programs. Effective feedback should be an integral part of clinical practice. Anesthesiologists and other perioperative physicians are identifying specialty-specific indicators that can be used when creating a broader quality improvement agenda. Placing a more immediate formal feedback strategy that focuses on goal-oriented behavior is rapidly becoming a mainstay. Physicians may use their individual feedback reports for reflection and designing personal development plans as lifelong learners and leaders in improving patient care.Keywords: physician education, outcomes measurement, performance improvement, anesthesiology

  1. Informatics Resources to Support Health Care Quality Improvement in the Veterans Health Administration

    Hynes, Denise M.; Perrin, Ruth A.; Rappaport, Steven; Stevens, Joanne M.; Demakis, John G.

    2004-01-01

    Information systems are increasingly important for measuring and improving health care quality. A number of integrated health care delivery systems use advanced information systems and integrated decision support to carry out quality assurance activities, but none as large as the Veterans Health Administration (VHA). The VHA's Quality Enhancement Research Initiative (QUERI) is a large-scale, multidisciplinary quality improvement initiative designed to ensure excellence in all areas where VHA provides health care services, including inpatient, outpatient, and long-term care settings. In this paper, we describe the role of information systems in the VHA QUERI process, highlight the major information systems critical to this quality improvement process, and discuss issues associated with the use of these systems. PMID:15187063

  2. Nuclear Regulatory Commission initiative for technical specification improvement

    From early 1982 through 1984, the NRC, with industry's attention, engaged in several initiatives and studies to improve technical specifications. These activities resulted in the February 1987 interim Commission Policy Statement on Technical Specifications Improvements. The policy statement focused on the purpose of technical specifications to identify features that are of controlling importance to safety and to establish on them conditions to assure safe operation that cannot be changed without prior commission approval. The NRC reviewed industry's-represented by the Nuclear Management Resources Council, the four nuclear steam supply system owners' groups, and several of their member utilities-application of the interim policy statement's criteria to standard technical specifications (STSs). As a result, a split was established in May 1988: ∼40% of the current limiting condition for operations (LCO) and surveillance requirements were identified as candidates for relocation to other documents such as the final safety analysis report (FSAR), programs, or procedures. The new STSs are to be living documents. As the NRC and industry continue to gain experience, additional improvements are to be made to the STSs. The guidance of the final policy statement is to be used to screen future generic items for inclusion in technical specifications

  3. Quality Tools for Professional Higher Education Review and Improvement

    Dahl Jørgensen, Malene; Sparre Kristensen, Regitze; Wipf, Alexandre; Delplace, Stefan; PHExcel Consortium

    2014-01-01

    The report is the project’s first outcome, and provides an overview of quality tools, quality models and quality labels, currently in use in (professional) higher education. It is followed by a gap analysis as regards the Standards and Guidelines for quality assurance in the European Higher Education Area (ESG), and the identified characteristics of PHE. The report is structured as follows: Chapter I presents the background of the PHExcel initiative and introduces the preliminary HAPHE defini...

  4. The Osteoarthritis Initiative (OAI) magnetic resonance imaging quality assurance update

    Schneider, E.; NessAiver, M.

    2012-01-01

    Objective Longitudinal quantitative evaluation of cartilage disease requires reproducible measurements over time. We report 8 years of quality assurance (QA) metrics for quantitative magnetic resonance (MR) knee analyses from the Osteoarthritis Initiative (OAI) and show the impact of MR system, phantom, and acquisition protocol changes. Method Key 3 T MR QA metrics, including signal-to-noise, signal uniformity, T2 relaxation times, and geometric distortion, were quantified monthly on two different phantoms using an automated program. Results Over 8 years, phantom measurements showed root-mean-square coefficient-of-variation reproducibility of <0.25% (190.0 mm diameter) and <0.20% (148.0 mm length), resulting in spherical volume reproducibility of <0.35%. T2 relaxation time reproducibility varied from 1.5% to 5.3%; seasonal fluctuations were observed at two sites. All other QA goals were met except: slice thicknesses were consistently larger than nominal on turbo spin echo images; knee coil signal uniformity and signal level varied significantly over time. Conclusions The longitudinal variations for a spherical volume should have minimal impact on the accuracy and reproducibility of cartilage volume and thickness measurements as they are an order of magnitude smaller than reported for either unpaired or paired (repositioning and reanalysis) precision errors. This stability should enable direct comparison of baseline and follow-up images. Cross-comparison of the geometric results from all four OAI sites reveal that the MR systems do not statistically differ and enable results to be pooled. MR QA results identified similar technical issues as previously published. Geometric accuracy stability should have the greatest impact on quantitative analysis of longitudinal change in cartilage volume and thickness precision. PMID:23092792

  5. Improving the quality of head and neck cancer care.

    Weber, Randal S

    2007-12-01

    The 2001 report by the Institute of Medicine (IOM) titled Crossing the Quality Chasm: A New Health System for the 21st Century highlighted the gap that exists between what we know to be effective, beneficial care and the care that is often delivered to an individual patient.(1) In the report, the IOM stated, "Between the health care we have and the care we could have lies not just a gap, but a chasm."(1)((p1)) The report, signifying a national initiative to improve the quality of care in the United States, articulated the following 6 aims for a new health care system: (1) to increase the safety of health care by avoiding injuries to patients through care intended to help them; (2) to provide effective services based on scientific knowledge and to avoid services of no proven benefit; (3) to deliver individualized treatment respectful of and responsive to the patient's preferences, needs, and values; (4) to deliver timely care by reducing wait times and harmful delays; (5) to increase efficiency by not wasting equipment, supplies, ideas, and energy; and (6) to deliver care that is equitable and does not vary by personal characteristics, patient sex, ethnicity, geography, and social economic status. The IOM also recognized a need to optimize quality cancer care in the United States. PMID:18086958

  6. Changing hospital care: evaluation of a multi-layered organisational development and quality improvement programme

    Dückers, M.L.A.

    2009-01-01

    In the last decades many different policy changes have been initiated in the Dutch hospital sector to optimise health care delivery: national agenda-setting, increased competition and transparency, a new system of hospital reimbursement based on diagnosis-treatment-combinations, intensified monitoring of quality, and a multi-layered organisational development programme based on quality improvement collaboratives – the multi-level quality collaborative (MQC). The focus of this dissertation is ...

  7. Danish initiatives to improve the safety of meat products

    Wegener, Henrik Caspar

    2010-01-01

    Campylobacter, and to a lesser extent Yersinia, Escherichia coli O157 and Listeria. Danish initiatives to improve the safety of meat products have focused on the entire production chain from the farm to the consumer, with a special emphasis on the pre-harvest stage of production. The control of bacterial...... pathogens which are resistant to antibiotics has been a new area of attention in the recent decade, and recently, the increasing globalization of the domestic food supply has called for a complete rethinking of the national food safety strategies. The implementations of a ‘‘case-by-case” risk assessment...... system, as well as increased international collaboration on surveillance, are both elements in this new strategy....

  8. Productivity quality improvement at UNC Geotech

    The program to improve productivity is presented in a series of view graphs. Key elements of the program are: CEO leadership and commitment; measurable improvements; specific annual goals; system for sharing benefits of improvements; practical training for employees; and intent to institutionalize

  9. Improving the accuracy of template-based predictions by mixing and matching between initial models

    Guerquin Michal

    2008-05-01

    Full Text Available Abstract Background Comparative modeling is a technique to predict the three dimensional structure of a given protein sequence based primarily on its alignment to one or more proteins with experimentally determined structures. A major bottleneck of current comparative modeling methods is the lack of methods to accurately refine a starting initial model so that it approaches the resolution of the corresponding experimental structure. We investigate the effectiveness of a graph-theoretic clique finding approach to solve this problem. Results Our method takes into account the information presented in multiple templates/alignments at the three-dimensional level by mixing and matching regions between different initial comparative models. This method enables us to obtain an optimized conformation ensemble representing the best combination of secondary structures, resulting in the refined models of higher quality. In addition, the process of mixing and matching accumulates near-native conformations, resulting in discriminating the native-like conformation in a more effective manner. In the seventh Critical Assessment of Structure Prediction (CASP7 experiment, the refined models produced are more accurate than the starting initial models. Conclusion This novel approach can be applied without any manual intervention to improve the quality of comparative predictions where multiple template/alignment combinations are available for modeling, producing conformational models of higher quality than the starting initial predictions.

  10. Assessment literacy to improve assessment quality

    Joosten-ten Brinke, Desirée

    2013-01-01

    Assessment is an important determinant for the quality of the learning processes and it is more than constructing a test and present it to the students. In this part of the course, we will discuss the quality of assessment on different levels during the assessment cycle from design and development to analyses and evaluation. How to design a valid and reliable assessment with objective, efficient and relevant items that suits the requirements of a balanced assessment programme and the assessme...

  11. Zero tolerance for failure. An AREVA initiative to improve reliability

    Significant improvements in fuel reliability have been realized over the past 2 decades, but total elimination of failures has remained elusive. Driving reliability to higher levels requires a philosophy that does not accept that even infrequent and isolated failures are inevitable - it was on this foundation that Areva's Zero Tolerance for Failure (ZTF) initiative was established. This is not in itself either a program or project, but a fundamental shift in the way of thinking about work according to the following four principles: - Failures are avoidable, - Zero failures are our goal, - We will respond rapidly to any failure, - We succeed when we fix failures in a way that precludes recurrence. The shift to a ZTF philosophy is a broad change in corporate culture that expands the concept of failure far beyond cases where fuel rod cladding integrity is breached. While this paper specifically illustrates the ways in which ZTF has shaped the company's response to enhancing fuel rod reliability, ZTF extends to any failures of fuel products to deliver expected levels of performance, manufacturing processes to meet specifications and high first-pass acceptance criteria, and beyond to error-free performance of engineering analyses and cycle design and licensing services. Application of ZTF to enhancing fuel reliability deploys efforts in the areas of manufacturing, human factors, design, R and D, processes and product strategy. In order to achieve the necessary improvements, a number of important actions have been initiated across regions and facilities. In addition to these global scale projects and measures, each region contributes by adopting measures which are relevant to its particular activities and market needs. (orig.)

  12. Beyond clinical engagement:a pragmatic model for quality improvement interventions, aligning clinical and managerial priorities

    Pannick, Samuel; Sevdalis, Nick; Athanasiou, Thanos

    2015-01-01

    Despite taking advantage of established learning from other industries, quality improvement initiatives in healthcare may struggle to outperform secular trends. The reasons for this are rarely explored in detail, and are often attributed merely to difficulties in engaging clinicians in quality improvement work. In a narrative review of the literature, we argue that this focus on clinicians, at the relative expense of managerial staff, has proven counterproductive. Clinical engagement is not a...

  13. Improving Quality Higher Education in Nigeria: The Roles of Stakeholders

    Romina Ifeoma Asiyai

    2014-01-01

    This paper discusses the roles of stakeholders in improving quality of university education in Nigeria. Internal and external stakeholders are identified and the various roles they could play in improving the quality of university education are discussed.  The paper contends that continuous and holistic improvement in university education system requires the collaborative efforts of various stakeholders both internal and external. Collaboration will help to trigger improvement in university e...

  14. 40 CFR Appendix B to Part 132 - Great Lakes Water Quality Initiative

    2010-07-01

    ... 40 Protection of Environment 21 2010-07-01 2010-07-01 false Great Lakes Water Quality Initiative B... WATER QUALITY GUIDANCE FOR THE GREAT LAKES SYSTEM Pt. 132, App. B Appendix B to Part 132—Great Lakes Water Quality Initiative Methodology for Deriving Bioaccumulation Factors Great Lakes States and...

  15. Improvement in the textural qualities of irradiated legumes

    The potential for use of gamma radiation processing to improve texture, hydration and cooking quality of pulses, particularly red gram, has been examined. The textural changes in irradiated pulses in terms of softening is measured by a texturometer, Radiation (1 Mrad) processing of pulses resulted in reduction of cooking time varying from 8 to 39%, red gram showing the maximum reduction. Initial higher hydration rate on soaking and cooking, stabilized on prolonged cooking and resulted in better and uniform texture of irradiated red gram. In the uncooked, irradiated (1 Mrad) sample, destruction of riboflavin was negligible, whereas thiamine and niacin showed about 7% loss. However, the vitamins were retained better in the samples irradiated and then cooked, compared to the corresponding control ones. (F.J.)

  16. Initiatives for the improvement of continuous management training

    Jon Landeta

    2015-03-01

    Full Text Available Purpose. This work aims to present, from the company viewpoint, a structured account of management proposals and practices directed toward improving the intensity and effectiveness of continuous management training (CMT. Design/methodology/approach. The article takes as its main theoretical referents the Theory of Human Capital, the Resource-Based Vision and the contributions made via the new institutional economy with regard to the problems of information asymmetry between companies, employees and training providers and completes the proposals that derive from this theoretical approach. To do this, experience-based contributions are collected from a selection of company training and HR managers from twelve Basque companies characterised by their strong investment in management training. The methodology used was qualitative and obtained by different qualitative techniques: Focus Groups, Nominal Groups and the Delphi Method, which make up the so-called Hybrid Delphi. Findings and implications. The proposals are aimed at the main agents in training activity: training providers, associations and public agents engaged in management training and, particularly, companies themselves. The initiatives seek above all to increase training market transparency, to improve mutual commitments between companies and managers, and to link training and development with culture and strategic management, so that firms make optimal investment in management training. Originality/value. The methodology used is original, and the contributions are consistent with the theory, have a proven practical utility, and are presented in a hierarchy, which facilitates decision making.

  17. Quality improvement – rival or ally of practice development?

    Gavin Lavery

    2016-05-01

    Full Text Available The majority of nurses, doctors, allied health professionals and other healthcare staff possess a strong desire to provide the best possible care and experience for their patients. Unfortunately, this sometimes falls short of what was planned or intended (Institute of Medicine, 2001, p 23. The gap between care intended and care delivered can be explained by problems with systems and processes and/or people and culture. The narrowing of this gap is the focus of many strategies, methodologies and approaches. Practice development is described as ‘an activity focused on developing people and practice for the ultimate purpose of achieving high-quality person-centred care’ and a ‘methodology that aims to achieve effective workplace cultures that are person-centred’ (Shaw, 2012; Manley et al., 2014. Practice development undoubtedly has a strong focus on people and culture and the potential to change processes and systems. Another approach, widely referred to as quality improvement, aims to improve safety, effectiveness and person-centredness in healthcare using principles proven effective in other industries such as manufacturing – notably car manufacturing (Toyota, oil production, nuclear power and aviation. The fundamental principles of quality improvement for healthcare include making care reliable (every patient receiving care as intended every time, using well-designed processes and reducing variation (agreeing a consistent way to provide care. At first glance this may appear to be an approach suited only to systems and processes. However, better processes, designed by those who use them, resulting in fewer errors and less re-working or working around problems, can reduce stress on staff, offer greater job satisfaction with improved morale and free up time to provide person-centred care. In his report, A Promise to Learn – a Commitment to Act (2013, p 24, Professor Don Berwick says: ‘Mastery of quality and patient safety sciences and practices should be part of initial preparation and lifelong education of all health care professionals including managers and executives. The NHS should become a learning organisation. Its leaders should create and support the capability for learning, and therefore change, at scale, within the NHS.’

  18. Improving Data Quality in Intelligent Transportation Systems

    Megler, V. M.; Tufte, Kristin; Maier, David

    2016-01-01

    Intelligent Transportation Systems (ITS) use data and information technology to improve the operation of our transportation network. ITS contributes to sustainable development by using technology to make the transportation system more efficient; improving our environment by reducing emissions, reducing the need for new construction and improving our daily lives through reduced congestion. A key component of ITS is traveler information. The Oregon Department of Transportation (ODOT) recently i...

  19. Quality improvement needed in quality improvement randomised trials: systematic review of interventions to improve care in diabetes

    Ivers, Noah M; Andrea C. Tricco; Taljaard, Monica; Halperin, Ilana; Turner, Lucy; Moher, David; Grimshaw, Jeremy M.

    2013-01-01

    Objective Despite the increasing numbers of published trials of quality improvement (QI) interventions in diabetes, little is known about the risk of bias in this literature. Design Secondary analysis of a systematic review. Data sources Medline, the Cochrane Effective Practice and Organisation of Care (EPOC) database (from inception to July 2010) and references of included studies. Eligibility criteria Randomised trials assessing 11 predefined QI strategies or financial incentives targeting ...

  20. International Accreditations as Drivers of Business School Quality Improvement

    Bryant, Michael

    2013-01-01

    Business schools are under pressure to implement continuous improvement and quality assurance processes to remain competitive in a globalized higher education market. Drivers for quality improvement include external, environmental pressures, regulatory bodies such as governments, and, increasingly, voluntary accreditation agencies such as AACSB…

  1. Technical report for effective estimation and improvement of quality system

    This technical report provides the methods on how to improve the Quality System, in R and D part. This report applies on the quality assurance(QA) programmes of the design, fabrication in nuclear projects. The organization having overall responsibility for the nuclear power item design, preservation, fabrication shall be described in this report in each stage of improvement of QA systems

  2. Nationwide quality improvement of cholecystectomy: results from a national database

    Harboe, Kirstine M; Bardram, Linda

    2011-01-01

    To evaluate whether quality improvements in the performance of cholecystectomy have been achieved in Denmark since 2006, after revision of the Danish National Guidelines for treatment of gallstones.......To evaluate whether quality improvements in the performance of cholecystectomy have been achieved in Denmark since 2006, after revision of the Danish National Guidelines for treatment of gallstones....

  3. Sleep Quality Improvement During Cognitive Behavioral Therapy for Anxiety Disorders.

    Ramsawh, Holly J; Bomyea, Jessica; Stein, Murray B; Cissell, Shadha H; Lang, Ariel J

    2016-01-01

    Despite the ubiquity of sleep complaints among individuals with anxiety disorders, few prior studies have examined whether sleep quality improves during anxiety treatment. The current study examined pre- to posttreatment sleep quality improvement during cognitive behavioral therapy (CBT) for panic disorder (PD; [Formula: see text]) or generalized anxiety disorder (GAD; [Formula: see text]). Among sleep quality indices, only global sleep quality and sleep latency improved significantly (but modestly) during CBT. Sleep quality improvement was greater for treatment responders, but did not vary by diagnosis. Additionally, poor baseline sleep quality was independently associated with worse anxiety treatment outcome, as measured by higher intolerance of uncertainty. Additional intervention targeting sleep prior to or during CBT for anxiety may be beneficial for poor sleepers. PMID:26244485

  4. The role of health information technology in quality improvement in pediatrics.

    Zuckerman, Alan E

    2009-08-01

    Health information technology (HIT) will play an important role in most efforts to improve the quality of pediatric medicine, as evident from the range of investigations and projects discussed in this volume. Clement McDonald identified the importance of using information technology as an integral component of quality initiatives early in the development of electronic medical records (EMR). The role of HIT in quality improvement is not limited to tools integrated into EMR, but that remains an important strategy. Today, much attention is focused on interoperability of clinical systems that integrate and share data from multiple sources. There are also additional freestanding quality-improvement tools that can be used without an EMR. This article explores the many roles of HIT in quality improvement from several perspectives. PMID:19660638

  5. Reviewing the quality of care: Priorities for improvement

    Roberts, James S.

    1987-01-01

    Rapid and substantial change in our health care system has prompted careful analysis of the quality of health care and the effectiveness of the methods used to review and improve quality. Although welcome, those applying this scrutiny must recognize that improvement in the quality of health care will take the concerted and cooperative efforts of health policymakers, health care practitioners, health care organizations, consumers of care, purchasers of care, and those organizations that define...

  6. Implementing continuous quality improvement at the facility level.

    VanValkenburgh, D A

    2001-04-01

    Continuous Quality Improvement (CQI) is a disciplined approach to problem solving. The 4 basic building blocks of the program include; leadership, planning, quality control, and quality improvement. It is customer focused, data driven, and empowers the employees to meet the needs of their patients. Management teams that successfully adopt the underlying philosophic tenets of the program and provide adequate resources for training and implementation may realize such benefits as improved clinical outcomes, increased patient and staff satisfaction, increased staff productivity, fewer adverse events, enhanced cost effectiveness, and an improvement in overall organizational performance. PMID:11349250

  7. Improving the quality of clinical coding: a comprehensive audit model

    Hamid Moghaddasi; Reza Rabiei; Nasrin Sadeghi

    2014-01-01

    Introduction: The review of medical records with the aim of assessing the quality of codes has long been conducted in different countries. Auditing medical coding, as an instructive approach, could help to review the quality of codes objectively using defined attributes, and this in turn would lead to improvement of the quality of codes. Method: The current study aimed to present a model for auditing the quality of clinical codes. The audit model was formed after reviewing other a...

  8. Physical Activity Improves Quality of Life

    ... to Control Stress Four Ways to Deal With Stress Quit Smoking Quitting Smoking Why Quit Smoking? Smoking: Do you ... under control Helps in the battle to quit smoking Improves blood cholesterol levels ... Releases tension Promotes enthusiasm and optimism Counters anxiety ...

  9. Improving initial polyp candidate extraction for CT colonography

    Reducing the number of false positives (FPs) as much as possible is a challenging task for computer-aided detection (CAD) of colonic polyps. As part of a typical CAD pipeline, an accurate and robust process for segmenting initial polyp candidates (IPCs) will significantly benefit the successive FP reduction procedures, such as feature-based classification of false and true positives (TPs). In this study, we introduce an improved scheme for segmenting IPCs. It consists of two main components. One is geodesic distance-based merging, which merges suspicious patches (SPs) for IPCs. Based on the merged SPs, another component, called convex dilation, grows each SP beyond the inner surface of the colon wall to form a volume of interest (VOI) for that IPC, so that the inner border of the VOI beyond the colon inner surface could be segmented as convex, as expected. The IPC segmentation strategy was evaluated using a database of 50 patient studies, which include 100 scans at supine and prone positions with 84 polyps and masses sized from 6 to 35 mm. The presented IPC segmentation strategy (or VOI extraction method) demonstrated improvements, in terms of having no undesirably merged true polyp and providing more helpful mean and variance of the image intensities rooted from the extracted VOI for classification of the TPs and FPs, over two other VOI extraction methods (i.e. the conventional method of Nappi and Yoshida (2003 Med. Phys. 30 1592-601) and our previous method (Zhu et al 2009 Cancer Manag. Res. 1 1-13). At a by-polyp sensitivity of 0.90, these three methods generated the FP rate (number of FPs per scan) of 4.78 (new method), 6.37 (Nappi) and 7.01 (Zhu) respectively.

  10. IUPQC Simulations for Power Quality Improvement

    S. Rajeev

    2014-01-01

    Power quality determines the fitness of electrical power to consumer devices. Synchronization of the voltage frequency and phase allows electrical systems to function in their intended manner without significant loss of performance or life. The term is used to describe electric power that drives an electrical load and the load's ability to function properly. Without the proper power, an electrical device (or load) may malfunction, fail prematurely or not operat...

  11. Improvement of cassava quality through mutation breeding

    Ghana has not been able to take advantage of the high-yielding cassava varieties developed by the International Institute of Tropical Agriculture (IITA) because these varieties generally do not have the desired cooking quality. The major emphasis of this project therefore is to use mutations to produce varieties with the desired starch characteristics while maintaining the disease-resistance and high-yielding characteristics of the IITA varieties. 1 ref., 4 tabs

  12. Improving the quality of care for children in health systems.

    Homer, C. J.; Kleinman, L C; Goldman, D A

    1998-01-01

    OBJECTIVE: To summarize the state of the art in quality improvement, review its application to care for children, and define the information that will be needed so that care for children can be further improved. PRINCIPAL FINDINGS: Health services for children exhibit numerous deficiencies in quality of care. The deficiencies cross all major domains of pediatric care--preventive services, acute care, and chronic care--and provide the opportunity for creative application of improvement strateg...

  13. Improving quality of tuberculosis care in India.

    Pai, Madhukar; Satyanarayana, Srinath; Hopewell, Phil

    2014-01-01

    In India, the quality of care that tuberculosis (TB) patients receive varies considerably and is often not in accordance with the national and international standards. In this article, we provide an overview of the third (latest) edition of the International Standards of Tuberculosis Care (ISTC). These standards are supported by the existing World Health Organization guidelines and policy statements pertaining to TB care and have been endorsed by a number of international organizations. We call upon all health care providers in the country to practice TB care that is consistent with these standards, as well as the upcoming Standards for TB Care in India (STCI). PMID:24640340

  14. Systematic Quality Improvement in Medicine: Everyone Can Do It

    Mark L. Zeidel

    2011-07-01

    Full Text Available In this brief review, written from the perspective of a physician-leader who has fostered the development of comprehensive quality improvement efforts at two academic medical centers, I review the need for improvement, some conceptual barriers that must be overcome, the goals of a comprehensive quality improvement (QI effort, some of the results we have obtained, and some observations on how to develop a culture of continuous improvement in an academic medical center. The mandate for quality improvement is clear; current healthcare is wasteful and error-prone, leading to excessive morbidity and mortality and unsustainably high costs. Successful quality improvement requires the abandonment of two paradigms: the craft model of medical practice and the notion that many forms of harm to patients are not preventable. I will describe how dramatic improvement has been achieved in reducing, by up to 10-fold, rates of central line infections, ventilator-associated pneumonias, peritonitis in peritoneal dialysis patients, and mortality due to cardiac arrest in hospital. I will describe as well how these methods can improve access to out-patient clinics dramatically and enhance the reliability and safety of hand-offs between covering physicians. To develop and maintain systematic quality improvement in all phases of medical care we must articulate a culture in which: everyone working at the medical center makes improvements every day; front-line staff, who know best how the work is done, are empowered to improve the processes of care; and multidisciplinary teams create the protocols that reduce variation that is due to physician preference, leaving only the variation required by the individual needs of patients. I will review as well the crucial elements of education of trainees and faculty members needed to guide and sustain a culture of quality. Finally, I will add some observations on how oversight boards and medical center leaders can help create systematic quality improvement in their medical centers.

  15. [Try to improve journal quality by improving standards and editing process].

    Zheng, Jia-wei

    2005-04-01

    The quality of medical journals depends on several factors involving 3 groups of people with their independent but relevant roles: the authors, the reviewers and the editors. Peer review and editing is the key factor to improve the quality of medical publications and journals. Shanghai Journal of Stomatology (SJS) has been regarded as a leading journal for publishing high-quality work in the field of stomatology in China. In October 2003, it was accepted by the National Library of Medicine, USA, to be indexed and included in Index Medicus and MEDLINE. To further improve the journal's overall quality, the Editorial Agency led by Professor Zheng Jia-wei has made great efforts to formulate its essential requirements in paper style, bilingual abstract writing and statistical analysis for the manuscripts submitted for possible publication. Strict independent peer review system has been adopted to assess the quality of the manuscripts received since it was founded in 1992. The reviewer is required to address detailed aspects of the paper under review and to resend his or her opinion on the paper. The editorial management is a crucial part of the publishing process. The editors begin action with the receipt of the manuscript, direct the various steps of evaluation, correction and re-submission, until a decision is made to accept or reject the paper at the regular meeting of Decision Making Group on Manuscripts of SJS led by the Editor-in-Chief. Once a paper is accepted and carefully revised, the editors will make necessary text and layout editing. Due consideration is given to the statistical, bilingual and ethical aspects as well as to the overall uniformity of the terminology, nomenclatures and style throughout the volume as a whole in the promotion of standards. The journal has not been cited by Science Citation Index (SCI) till now, further steps should be taken to make this journal better known throughout the World, to improve the quality of the publications and reduce the delay between the initial receipt and the final publication of manuscripts. PMID:15886825

  16. The myADHDportal.com Improvement Program: An innovative quality improvement intervention for improving the quality of ADHD care among community-based pediatricians

    Epstein, Jeffery N.; Langberg, Joshua M.; Lichtenstein, Philip K.; Kolb, Rebecca; Simon, John O

    2013-01-01

    Though the American Academy of Pediatrics has developed and disseminated clear evidence-based guidelines for ADHD care, community-based pediatricians often have difficulty implementing these guidelines. New strategies are needed to improve the quality of care received by children with ADHD and to improve utilization of the AAP consensus guidelines by pediatricians. An evidence-based quality improvement intervention has been developed that effectively improves the quality of ADHD care delivere...

  17. Continuous Quality Improvement: Implementation and Sustainability

    Yella, Gilbert Ncheh; Atem, Tongwa Ivo

    2007-01-01

    As the philosophy of doing business shift from sell what you can produce to produce what you can sell so do the customers’ specification continuously become a vital tool during product development process, hence increasing the volatility of the business environment. The objective of this thesis is to thoroughly review literature to be supported by cases why most companies fail in sustaining improvement programs then map out a pathway that will leads to successful implementation. A series of r...

  18. Improving Software Quality through Program Analysis

    In this paper, we present the Program Analysis Framework (PAF) to analyze the software architecture and software modularity of large software packages using techniques in Aspect Mining. The basic idea about PAF is to record the call relationships information among the important elements firstly and then use the different analysis algorithms to find the crosscutting concerns which could destroy the modularity of the software from this recording information. We evaluate our framework through analyzing DATE, the ALICE Data-Acquisition (DAQ) software which handles the data flow from the detector electronics to the permanent storage archiving. The analysis results prove the effectiveness and efficiency of our framework. PAF has pinpointed a number of possible optimizations which could be applied and help maximizing the software quality. PAF could also be used for the analysis of other projects written in C language.

  19. Improvement of power quality using distributed generation

    Moreno-Munoz, A.; Lopez-Rodriguez, M.A.; Flores-Arias, J.M.; Bellido-Outerino, F.J. [Universidad de Cordoba, Departamento A.C., Electronica y T.E., Escuela Politecnica Superior, Campus de Rabanales, E-14071 Cordoba (Spain); de-la-Rosa, J.J.G. [Universidad de Cadiz, Area de Electronica, Dpto. ISA, TE y Electronica, Escuela Politecnica Superior Avda, Ramon Puyol, S/N, E-11202-Algeciras-Cadiz (Spain); Ruiz-de-Adana, M. [Universidad de Cordoba, Departamento de Quimica Fisica y Termodinamica Aplicada, Campus de Rabanales, E-14071 Cordoba (Spain)

    2010-12-15

    This paper addresses how Distributed Generation (DG), particularly when configured in Combined Heat and Power (CHP) mode, can become a powerful reliability solution in highlight automated factories, especially when integrated with complimentary Power Quality (PQ) measures. The paper presents results from the PQ audit conducted at a highly automated plant over last year. It was found that the main problems for the equipment installed were voltage sags. Among all categories of electrical disturbances, the voltage sag (dip) and momentary interruption are the nemeses of the automated industrial process. The paper analyzes the capabilities of modern electronic power supplies and the convenience of embedded solution. Finally it is addressed the role of the DG/CHP on the reliability of digital factories. (author)

  20. Quality Improvement of an Acid Treated Fuel Oil

    Elizabeth Jumoke ETERIGHO

    2008-06-01

    Full Text Available The work on the quality improvement of fuel oil using acid treatment was carried out. The improvement of the fuel oil was done using sulphuric acid to remove contaminants. Sulphuric acid at different concentrations were mixed with the oil and kept at 45°C for four hours in the agitator vessel to allow reaction to take place. Acidic sludge was then drained off from the agitator and the oil was neutralized with sodium hydroxide. Centrifugation operation was used to extract the sulphonate dispersed in the oil. The treated and untreated oils were characterized for various properties and the results showed that the viscosity, total sulphur of fuel oil decreased from 6.0 to before 5.0 cst after acid treatment and 2.57 to 1.2225% w/w respectively while the flash point increased from 248 to 264°F. The water and sediment content increased from trace before to 0.6 after treatment. In addition, the calorific value increased from initial value of 44,368 to 44,805 and 44,715 kJ/kg at 50% and 75% conc. H2SO4 while decreasing with 85% and 90% conc. H2SO4. However, both carbon residue and ash content decreases with an increase in acid concentration.

  1. Achieving faster quality improvement through the 24-hour team.

    Carboneau, C E

    1999-01-01

    This article describes how Great Plains Regional Medical Center (GPRMC) in North Platte, NE, changed its quality improvement (QI) methodology and its mind-set toward team time management to accelerate its improvement efforts. The "24-hour road map" and the improved FOCUS-PDSA methodology, coupled with strong leadership, make up the team time management element that has been missing from healthcare quality improvement but is critically needed to accelerate the process. At GPRMC, a major criterion for success is now a 6-month-or-less improvement cycle for cross-functional teams to complete their QI efforts. The lessons learned at GPRMC can help others in healthcare improve quality, lower costs, and do both more quickly. PMID:10558058

  2. Process safety improvement--quality and target zero.

    Van Scyoc, Karl

    2008-11-15

    Process safety practitioners have adopted quality management principles in design of process safety management systems with positive effect, yet achieving safety objectives sometimes remain a distant target. Companies regularly apply tools and methods which have roots in quality and productivity improvement. The "plan, do, check, act" improvement loop, statistical analysis of incidents (non-conformities), and performance trending popularized by Dr. Deming are now commonly used in the context of process safety. Significant advancements in HSE performance are reported after applying methods viewed as fundamental for quality management. In pursuit of continual process safety improvement, the paper examines various quality improvement methods, and explores how methods intended for product quality can be additionally applied to continual improvement of process safety. Methods such as Kaizen, Poke yoke, and TRIZ, while long established for quality improvement, are quite unfamiliar in the process safety arena. These methods are discussed for application in improving both process safety leadership and field work team performance. Practical ways to advance process safety, based on the methods, are given. PMID:18374483

  3. Process safety improvement-Quality and target zero

    Van Scyoc, Karl [Det Norske Veritas (U.S.A.) Inc., DNV Energy Solutions, 16340 Park Ten Place, Suite 100, Houston, TX 77084 (United States)], E-mail: karl.van.scyoc@dnv.com

    2008-11-15

    Process safety practitioners have adopted quality management principles in design of process safety management systems with positive effect, yet achieving safety objectives sometimes remain a distant target. Companies regularly apply tools and methods which have roots in quality and productivity improvement. The 'plan, do, check, act' improvement loop, statistical analysis of incidents (non-conformities), and performance trending popularized by Dr. Deming are now commonly used in the context of process safety. Significant advancements in HSE performance are reported after applying methods viewed as fundamental for quality management. In pursuit of continual process safety improvement, the paper examines various quality improvement methods, and explores how methods intended for product quality can be additionally applied to continual improvement of process safety. Methods such as Kaizen, Poke yoke, and TRIZ, while long established for quality improvement, are quite unfamiliar in the process safety arena. These methods are discussed for application in improving both process safety leadership and field work team performance. Practical ways to advance process safety, based on the methods, are given.

  4. Process safety improvement-Quality and target zero

    Process safety practitioners have adopted quality management principles in design of process safety management systems with positive effect, yet achieving safety objectives sometimes remain a distant target. Companies regularly apply tools and methods which have roots in quality and productivity improvement. The 'plan, do, check, act' improvement loop, statistical analysis of incidents (non-conformities), and performance trending popularized by Dr. Deming are now commonly used in the context of process safety. Significant advancements in HSE performance are reported after applying methods viewed as fundamental for quality management. In pursuit of continual process safety improvement, the paper examines various quality improvement methods, and explores how methods intended for product quality can be additionally applied to continual improvement of process safety. Methods such as Kaizen, Poke yoke, and TRIZ, while long established for quality improvement, are quite unfamiliar in the process safety arena. These methods are discussed for application in improving both process safety leadership and field work team performance. Practical ways to advance process safety, based on the methods, are given

  5. Improve strategic supplier performance using DMAIC to develop a Quality Improvement Plan

    Jardim, Kevin P.

    Supplier performance that meets the requirements of the customer has long plagued quality professionals. Despite the vast efforts by organizations to improve supplier performance, little has been done to standardize the plan to improve performance. This project presents a guideline and problem-solving strategy using a Define, Measure, Analyze, Improve, and Control (DMAIC) structured tool that will assist in the management and improvement of supplier performance. An analysis of benchmarked Quality Improvement Plans indicated that this topic needs more focus on how to accomplish improved supplier performance. This project is part of a growing body of supplier continuous improvement efforts. With the input of Zodiac Aerospace quality professionals this project's results provide a solution to Quality Improvement Plans and show objective evidence of its benefits. This project contributes to the future research on similar topics.

  6. Manufacturing R&D Initiative Lowers Costs and Boosts Quality

    None

    2015-06-30

    Fact sheet that provides an overview of DOE's Manufacturing R&D Initiative, which supports projects aimed at developing better-performing, lower-cost solid-state lighting while encouraging engineering and manufacturing in the United States.

  7. Improving Quality of Life and Depression After Stroke Through Telerehabilitation

    Linder, Susan M.; Rosenfeldt, Anson B; Bay, R. Curtis; Sahu, Komal; Wolf, Steven L; Alberts, Jay L.

    2015-01-01

    Robot-assisted interventions and home exercise programs administered using a telerehabilitation model may be valuable components of programs to improve quality of life and depression in people after stroke.

  8. Software Quality Improvement in the OMC Team

    Maier, Viktor

    Physicists use self-written software as a tool to fulfill their tasks and often the developed software is used for several years or even decades. If a software product lives for a long time, it has to be changed and adapted to external influences. This implies that the source code has to be read, understood and modified. The same applies to the software of the Optics Measurements and Corrections (OMC) team at CERN. Their task is to track, analyze and correct the beams in the LHC and other accelerators. To solve this task, they revert to a self-written software base with more than 150,000 physical lines of code. The base is subject to continuous changes as well. Their software does its job and is effective, but runs regrettably not efficient because some parts of the source code are in a bad shape and has a low quality. The implementation could be faster and more memory efficient. In addition it is difficult to read and understand the code. Source code files and functions are too big and identifiers do not rev...

  9. Leadership – The Key Element in Improving Quality Management

    Iveta Paulová

    2011-10-01

    Full Text Available The present contribution is processed partial results of the survey application of leadership as one of the fundamental principles of quality management in organizations in the Slovak Republic. This survey was conducted in the research project VEGA No. 1/0229/08 Perspectives of quality management development in coherence with requirements of Slovak republic market. Results from the survey were the basis for proposals to improve the quality management in Slovak industrial organizations

  10. Understanding Why Quality Initiatives Succeed or Fail: A Sociotechnical Systems Perspective.

    Wiegmann, Douglas A

    2016-01-01

    Efforts to implement quality improvements in surgery are notoriously problematic. One needs to look no farther than recent attempts to implement checklists, team training, and surgical briefings. These interventions have been empirically shown to improve team communication and performance. Yet numerous barriers to implementation have limited their broad adoption and use. Apparently, knowing the remedy (intervention) does not translate into knowing how to administer (implement) it. Or in surgical terms, knowing "what" procedure needs to be performed does not necessarily mean that one knows "how" to perform it. Surgeons serve a vital leadership role in driving quality and patient safety initiatives in the operating room. Achieving success requires both an in-depth understanding of the intervention and the complex dynamics of the elements involved in the implementation process. To aid in this endeavor, the present article describes a Model for Understanding System Transitions Associated with the Implementation of New Goals (MUSTAING). The model highlights important variables associated with implementation success. It also provides a tool for diagnosing why certain interventions may not have worked as intended so that improvements in the implementation process can be made. Finally, the model offers a general framework for guiding future implementation or "how to" research. PMID:26079907

  11. The business case for health-care quality improvement.

    Swensen, Stephen J; Dilling, James A; Mc Carty, Patrick M; Bolton, Jeffrey W; Harper, Charles M

    2013-03-01

    The business case for health-care quality improvement is presented. We contend that investment in process improvement is aligned with patients' interests, the organization's reputation, and the engagement of their workforce. Four groups benefit directly from quality improvement: patients, providers, insurers, and employers. There is ample opportunity, even in today's predominantly pay-for-volume (that is, evolving toward value-based purchasing) insurance system, for providers to deliver care that is in the best interest of the patient while improving their financial performance. PMID:23429226

  12. Improving Indoor Air Quality in St. Cloud Schools.

    Forer, Mike; Haus, El

    2000-01-01

    Describes how the St. Cloud Area School District (Minnesota), using Tools for Schools provided by the U.S. Environmental Protection Agency, managed the improvement of their school building indoor air quality (IAQ). The district goals of the IAQ Management Committee and the policy elements used to maintain high classroom air quality are…

  13. Quality Rating and Improvement Systems and Children's Cognitive Development

    Jeon, Lieny; Buettner, Cynthia K.

    2015-01-01

    Background: Providing enriched learning environments is important to stimulating children's development in early childhood. Early child-care policymakers in many states in the US have adopted Quality Rating and Improvement Systems (QRIS) as a way to verify quality of child care and to support children's school readiness. Objective: The purpose of…

  14. Quality Rating and Improvement Systems and Children's Cognitive Development

    Jeon, Lieny; Buettner, Cynthia K.

    2015-01-01

    Background: Providing enriched learning environments is important to stimulating children's development in early childhood. Early child-care policymakers in many states in the US have adopted Quality Rating and Improvement Systems (QRIS) as a way to verify quality of child care and to support children's school readiness. Objective: The purpose of

  15. Using Deming To Improve Quality in Colleges and Universities.

    Cornesky, Robert A.; And Others

    Of all the people known for stressing quality in industry, W. Edwards Deming is the pioneer. He stresses statistical process control (SPC) and a 14-point process for managers to improve quality and productivity. His approach is humanistic and treats people as intelligent human beings who want to do a good job. Twelve administrators in a university

  16. Combating the 'Sick Building Syndrome' by Improving Indoor Air Quality

    Pongchai Nimcharoenwon; Graham Miller

    2012-01-01

    Research indicates that many of symptoms attributed to the Sick Building Syndrome in air-conditioned office buildings are a result of considerably reduced negative ions in the internal atmosphere and that replacing the depleted negative ions can improve indoor air quality. This paper describes a method used to develop a formula (DOF-NIL formula) for calculating the amount of negative ions to be added to air-conditioned buildings, to improve air quality. The formula enables estimates to be mad...

  17. Participatory Patterns in an International Air Quality Monitoring Initiative

    Sîrbu, Alina; Becker, Martin; CAMINITI, SAVERIO; De Baets, Bernard; Elen, Bart; Francis, Louise; Gravino, Pietro; Hotho, Andreas; Ingarra, Stefano; Loreto, Vittorio; Molino, Andreas; Mueller, Juergen; Peters, Jan; Ricchiuti, Ferdinando; Saracino, Fabio

    2015-01-01

    The issue of sustainability is at the top of the political and societal agenda, being considered of extreme importance and urgency. Human individual action impacts the environment both locally (e.g., local air/water quality, noise disturbance) and globally (e.g., climate change, resource use). Urban environments represent a crucial example, with an increasing realization that the most effective way of producing a change is involving the citizens themselves in monitoring campaigns (a citizen s...

  18. Data quality objectives for the initial fuel conditioning examinations

    The Data Quality Objectives (DQOs) were established for the response of the first group of fuel samples shipped from the K West Basin to the Hanford 327 Building hot cells for examinations to the proposed Path Forward conditioning process. Controlled temperature and atmosphere furnace testing testing will establish performance parameters using the conditioning process (drying, sludge drying, hydride decomposition passivation) proposed by the Independent Technical Assessment (ITA) Team as the baseline

  19. Use of the CRABEL Score for improving surgical case-note quality.

    Ho, M.Y.; Anderson, A.R.; Nijjar, A.; Thomas, C; Goenka, A.; Hossain, J.; Curley, P. J.

    2005-01-01

    INTRODUCTION: Quality assurance of medical record keeping in general surgery is facilitated by use of the CRABEL Score. Critical appraisal and constant feedback to staff plays an important part in improving case-note quality. MATERIALS AND METHODS: For each case-note audit, a house officer reviewed two sets of case notes for each of six consultant surgeons. Scores were awarded according to initial clerking, subsequent entries, consent, and discharge summary. Overall scores were derived by sub...

  20. Accounting for quality: on the relationship between accounting and quality improvement in healthcare

    Pflueger, Dane

    2015-01-01

    Background Accounting-that is, standardized measurement, public reporting, performance evaluation and managerial control-is commonly seen to provide the core infrastructure for quality improvement in healthcare. Yet, accounting successfully for quality has been a problematic endeavor, often producing dysfunctional effects. This has raised questions about the appropriate role for accounting in achieving quality improvement. This paper contributes to this debate by contrasting the specific way ...

  1. Crossing the quality chasm: lessons from health care quality improvement efforts in England

    Madhok, Rajan

    2002-01-01

    The second report from the US Institute of Medicine Crossing the Quality Chasm, highlighted the deficiencies in health care quality in the USA, analyzed the contributory factors, and proposed 13 recommendations for improvements. Clearly, the challenges are enormous. Can anything be learned from the experiences of other countries? This article describes the author's experiences of health care quality improvement efforts in the National Health Service in England and their implications for the U...

  2. A quality function deployment application for improving good and service quality in fast food restaurants

    KARPUZ, Utku; TESTİK, Murat Caner; PAKDİL, Fatma

    2012-01-01

    Quality Function Deployment (QFD) is based on the philosophy of developing goods and services to satisfy customer requirements and it transforms the voice of customers to technical requirements. QFD, used as an efficient tool for quality improvement for a long time, is implemented at a fast food restaurants in this study. The main purpose of the study is to illustrate, through a case study, how to utilize QFD in improving good and service quality in fast food restaurants. To determine custome...

  3. The QIBB Quality Initiative of the Vocational Training System in Austria

    Paechter, Manuela

    2009-01-01

    The QIBB quality initiative was specifically developed for the vocational training system in Austria. The quality system is distinctive in that it includes both objectives and survey instruments designed to address the specific concerns of vocational training. There are general quality concepts and instruments that are common to all schools and…

  4. Expression Marker-Based Strategy to Improve Beef Quality

    Cassar-Malek, Isabelle; Picard, Brigitte

    2016-01-01

    For beef cattle research, a main objective is to control concomitantly the development of muscles and the qualities of beef cuts. Beef quality is a complex phenotype that is only detectable after slaughter and is highly variable. The beef industry is in need of tools to estimate beef quality of live cattle or online in abattoirs, with specific attention towards sensory attributes (tenderness, juiciness, flavour, and colour). Identification of relevant genetic and genomic markers is ongoing, especially for tenderness—a top priority quality attribute. In this paper, we describe the steps of an expression marker-based strategy to improve beef sensory quality, from the discovery of biomarkers that identify consistent beef and the biological functions governing beef tenderness to the integration of the knowledge into detection tests for desirable animals. These tools should soon be available for the management of sensory quality in the beef production chain for meeting market's demands and assuring good quality standards. PMID:27066527

  5. Assessment of foodservice quality and identification of improvement strategies using hospital foodservice quality model

    Kim, Kyungjoo; Kim, Minyoung; Lee, Kyung-Eun

    2010-01-01

    The purposes of this study were to assess hospital foodservice quality and to identify causes of quality problems and improvement strategies. Based on the review of literature, hospital foodservice quality was defined and the Hospital Foodservice Quality model was presented. The study was conducted in two steps. In Step 1, nutritional standards specified on diet manuals and nutrients of planned menus, served meals, and consumed meals for regular, diabetic, and low-sodium diets were assessed i...

  6. Improved initial guess for minimum energy path calculations

    Smidstrup, Søren; Stokbro, Kurt; Jónsson, Hannes

    2014-01-01

    A method is presented for generating a good initial guess of a transition path between given initial and final states of a system without evaluation of the energy. An objective function surface is constructed using an interpolation of pairwise distances at each discretization point along the path and the nudged elastic band method then used to find an optimal path on this image dependent pair potential (IDPP) surface. This provides an initial path for the more computationally intensive calculations of the true minimum energy path using some method of choice for evaluating the energy and atomic forces, for example by ab initio or density functional theory. The optimal path on the IDPP surface is significantly closer to the true minimum energy path than a linear interpolation of the Cartesian coordinates and, therefore, reduces the number of iterations needed to reach convergence and averts divergence in the electronic structure calculations when atoms are brought too close to each other in the initial path. Th...

  7. Improvement of a Harvester Based, Multispectral, Seed Cotton Fiber Quality Sensor

    A multispectral sensor for in-situ seed cotton fiber quality measurement was developed and tested at Texas A&M University. Results of initial testing of the sensor using machine harvested seed cotton have shown promise. Improvements have been made to the system and the measurement method to meet t...

  8. Improving the Quality of Electric Energy to Electric Arc Furnace

    Adrian-Ioan Toma

    2011-10-01

    Full Text Available This paper presents a study of power quality problems created by an electric arc furnace (EAF with eccentric bottom tap (EBT at power system. The analysis have been done to EAF of 100 t capacity used for steel melting. Experimental results show this EAF is substantial source of electric disturbances, such as voltage fluctuations, flicker, harmonics, and unbalance between phases. Improvement of the quality of electric energy at EAF imposes a careful technical and economical analysis. Of all possible solutions for improvement of the power quality for an EAF (passive filter, STATCOM or SVC, SVC is the ideal solution.

  9. ????????? ???? ???????? ????????????: ??????????? ?????????????????? // Initial registration of real estate: areas of improvement

    Gutsalenko, L.V.; Yaremchuk, N.F.

    2013-01-01

    ? ?????? ???????? ??????? ??????? ????????????? ?????????????????? ?????????? ????? ???????? ???????? ???????, ??????? ??????????? ????????????? ???? ????????? ?????????? ????????? ? ??????????? ?????????. The paper describes the scientific approaches need to improve primary accounting of fixed assets, proposals distinguishing forms of primary documents of movable and immovable property.

  10. Galantamine improves sleep quality in patients with dementia.

    Naharci, Mehmet Ilkin; Ozturk, Ahmet; Yasar, Halit; Cintosun, Umit; Kocak, Necmettin; Bozoglu, Ergun; Tasci, Ilker; Doruk, Huseyin

    2015-12-01

    The purpose of the study was to evaluate the influences of cholinesterase inhibitors on sleep pattern and sleep disturbance. A total of 87 mild to moderate stage dementia patients who were not on cholinesterase enzyme inhibitor and memantine treatment were included in the study. The dementia patients were treated with donepezil, galantamine or rivastigmine, depending on the preference of the clinician. Fifty-five dementia patients (63.2 %) completed the study. Twenty-three elderly subjects, who had normal cognitive functions, were included in the study as the control group. The Pittsburgh Sleep Quality Index was used for evaluating the sleep quality at the beginning and at the final assessment. The improvement in sleep quality was better with regard to changes in Pittsburgh Sleep Quality Index scores with galantamine treatment compared to the donepezil and the control groups. A significant decrease in Pittsburgh Sleep Quality Index scores was detected in the galantamine group after treatment. Although statistically not significant, rivastigmine decreased and donepezil increased the Pittsburgh Sleep Quality Index scores after treatment. Dementia patients who had a poor sleep quality (n: 36), the rate of improvement in sleep disturbance was 81.8 % in the galantamine group, 75 % in the rivastigmine, and 50 % in the donepezil group. Galantamine may be the first choice of cholinesterase inhibitor in mild to moderate dementia patients in terms of improving sleep quality. PMID:25777522

  11. Hospital value-based purchasing (VBP) program: measurement of quality and enforcement of quality improvement.

    Szablowski, Katarzyna M

    2014-01-01

    VBP program is a novel medicare payment estimatin tool used to encourage clinical care quality improvement as well as improvement of patient experience as a customer of a health care system. The program utilizes well established tools of measuring clinical care quality and patient satisfaction such as the hospital IQR program and HCAHPS survey to estimate Medicare payments and encourage hospitals to continuosly improve the level of care they provide. PMID:24600783

  12. Improvement of Initiating Events Analsis in Low-Power and Shutdown PSA for Korea Standard Nuclear Power Plant

    Park, Jin Jee; Jang, Seung Chul; Lim, Ho Gon

    2005-04-15

    In this study, we have improved the methodology of the initiating event identification for the KSNP LPSD PSA to complement the deficiency obtained from Review of KSNP LPSD PSA Mode based on ANS LPSD PSA Standard. To improve the quality of initiating event analysis, we integrated three systematic approachs for this purpose such as Master Logic Diagram, the empirical approach using domestic and international operating experience and the engineering approach. And we have identified 22 initiation events finally. We could got a basis and satisfied a structured, systematic process for initiating event identification demanded in ANS LPSD PSA Standard. But the sufficient completeness of initiating event analysis for LPSD PSA, the domestic low power and shutdown operating experience for overhaul and un-planed outages analysis is also needed.

  13. Model for improvement - Part Two: Measurement and feedback for quality improvement efforts.

    Randolph, Greg; Esporas, Megan; Provost, Lloyd; Massie, Sara; Bundy, David G

    2009-08-01

    Measurement and feedback are fundamental to quality improvement. There is a knowledge gap among health care professionals in knowing how to measure the impact of their quality improvement projects and how to use these data to improve care. This article presents a pragmatic approach to measurement and feedback for quality improvement efforts in local health care settings, such as hospitals or clinical practices. The authors include evidence-based strategies from health care and other industries, augmented with practical examples from the authors' collective years of experience designing measurement and feedback strategies. PMID:19660627

  14. Applying GRA and QFD to Improve Library Service Quality

    Chen, Yen-Ting; Chou, Tsung-Yu

    2011-01-01

    This paper applied Grey Relational Analysis (GRA) to Quality Function Deployment (QFD) to identify service improvement techniques for an academic library. First, reader needs and their importance, and satisfaction degrees were examined via questionnaires. Second, the service improvement techniques for satisfying the reader needs were developed by

  15. Studying and improving blast furnace cast iron quality

    ?. ?. Balgabekov; D. K. Issin; Kimanov, B. M.; Issagulov, A. Z.; Zholdubayeva, Zh. D.; ?. Z. Akashev; B. D. Issin

    2014-01-01

    In the article there are presented the results of studies to improve the quality of blast furnace cast iron. It was established that using fire clay suspension for increasing the mould covering heat conductivity improves significantly pig iron salable condition and filtration refining method decreases iron contamination by nonmetallic inclusions by 50 70 %.

  16. Improving Quality Of Spectrum Measurement By Event - Event Coincidence Technique

    To improve the quality of measurement data for the research levels density and gamma strength function in intermediate energy region below the neutron binding energy (Bn), a new method was developed at the Dalat Nuclear Research Institute. This method improve the ratio of the count of peak per compton background more times. This results are evaluated, compared with other methods. (author)

  17. Applying GRA and QFD to Improve Library Service Quality

    Chen, Yen-Ting; Chou, Tsung-Yu

    2011-01-01

    This paper applied Grey Relational Analysis (GRA) to Quality Function Deployment (QFD) to identify service improvement techniques for an academic library. First, reader needs and their importance, and satisfaction degrees were examined via questionnaires. Second, the service improvement techniques for satisfying the reader needs were developed by…

  18. Lean management systems: creating a culture of continuous quality improvement.

    Clark, David M; Silvester, Kate; Knowles, Simon

    2013-08-01

    This is the first in a series of articles describing the application of Lean management systems to Laboratory Medicine. Lean is the term used to describe a principle-based continuous quality improvement (CQI) management system based on the Toyota production system (TPS) that has been evolving for over 70 years. Its origins go back much further and are heavily influenced by the work of W Edwards Deming and the scientific method that forms the basis of most quality management systems. Lean has two fundamental elements--a systematic approach to process improvement by removing waste in order to maximise value for the end-user of the service and a commitment to respect, challenge and develop the people who work within the service to create a culture of continuous improvement. Lean principles have been applied to a growing number of Healthcare systems throughout the world to improve the quality and cost-effectiveness of services for patients and a number of laboratories from all the pathology disciplines have used Lean to shorten turnaround times, improve quality (reduce errors) and improve productivity. Increasingly, models used to plan and implement large scale change in healthcare systems, including the National Health Service (NHS) change model, have evidence-based improvement methodologies (such as Lean CQI) as a core component. Consequently, a working knowledge of improvement methodology will be a core skill for Pathologists involved in leadership and management. PMID:23757036

  19. CHAMBER: A Regional Performance Improvement CME Initiative for Breast Cancer Health Care Providers.

    Sutton, Linda M; Geradts, Joseph; Hamilton, Erika P; Havlin, Kathleen A; Kimmick, Gretchen G; Marcom, P Kelly; Spector, Neil L; Watson, Melanie; Rabin, Daniel U; Bruno, Theodore O; Noe, Amanda; Miller, Stacy; Subramaniam, Chitra; Layton, Sherry; Grichnik, Katherine

    2015-08-01

    CHAMBER was a regional educational initiative for providers of care to patients with HER2+ breast cancer. The study goals were to (1) enhance testing for HER2/neu overexpression in patients with invasive breast cancer; (2) increase the appropriate use of targeted therapy for patients with HER2+ breast cancer; and (3) enhance patients' coping ability. This Performance Improvement Continuing Medical Education (PI-CME) initiative included clinical practice assessment, educational activities, and reassessment. Chart review revealed a high rate of HER2 testing (98%) before and after education. Targeted therapy for patients with HER2+ breast cancer declined after the program (from 96% to 61%), perhaps attributable to an increase in awareness of medical reasons to avoid use of targeted therapy. Assessment for patients' emotional coping ability increased after education (from 55% to 76%; P=.01). Rates of testing for HER2 amplification and assessment of emotional well-being after education were consistent with ASCO Quality Oncology Practice Initiative benchmark values. Documentation of actions to address emotional problems remained an area for improvement. PMID:26285246

  20. Improved initial guess for minimum energy path calculations

    A method is presented for generating a good initial guess of a transition path between given initial and final states of a system without evaluation of the energy. An objective function surface is constructed using an interpolation of pairwise distances at each discretization point along the path and the nudged elastic band method then used to find an optimal path on this image dependent pair potential (IDPP) surface. This provides an initial path for the more computationally intensive calculations of a minimum energy path on an energy surface obtained, for example, by ab initio or density functional theory. The optimal path on the IDPP surface is significantly closer to a minimum energy path than a linear interpolation of the Cartesian coordinates and, therefore, reduces the number of iterations needed to reach convergence and averts divergence in the electronic structure calculations when atoms are brought too close to each other in the initial path. The method is illustrated with three examples: (1) rotation of a methyl group in an ethane molecule, (2) an exchange of atoms in an island on a crystal surface, and (3) an exchange of two Si-atoms in amorphous silicon. In all three cases, the computational effort in finding the minimum energy path with DFT was reduced by a factor ranging from 50% to an order of magnitude by using an IDPP path as the initial path. The time required for parallel computations was reduced even more because of load imbalance when linear interpolation of Cartesian coordinates was used

  1. Improved initial guess for minimum energy path calculations

    Smidstrup, Søren [QuantumWise A/S, Lersø Parkallé 107, DK-2100 Copenhagen (Denmark); Science Institute and Faculty of Physical Sciences, University of Iceland VR-III, 107 Reykjavík (Iceland); Pedersen, Andreas [Science Institute and Faculty of Physical Sciences, University of Iceland VR-III, 107 Reykjavík (Iceland); Integrated Systems Laboratory, ETH Zurich, 8092 Zurich (Switzerland); Stokbro, Kurt [QuantumWise A/S, Lersø Parkallé 107, DK-2100 Copenhagen (Denmark); Jónsson, Hannes, E-mail: hj@hi.is [Science Institute and Faculty of Physical Sciences, University of Iceland VR-III, 107 Reykjavík (Iceland); Department of Applied Physics, Aalto University, Espoo, FI-00076 (Finland)

    2014-06-07

    A method is presented for generating a good initial guess of a transition path between given initial and final states of a system without evaluation of the energy. An objective function surface is constructed using an interpolation of pairwise distances at each discretization point along the path and the nudged elastic band method then used to find an optimal path on this image dependent pair potential (IDPP) surface. This provides an initial path for the more computationally intensive calculations of a minimum energy path on an energy surface obtained, for example, by ab initio or density functional theory. The optimal path on the IDPP surface is significantly closer to a minimum energy path than a linear interpolation of the Cartesian coordinates and, therefore, reduces the number of iterations needed to reach convergence and averts divergence in the electronic structure calculations when atoms are brought too close to each other in the initial path. The method is illustrated with three examples: (1) rotation of a methyl group in an ethane molecule, (2) an exchange of atoms in an island on a crystal surface, and (3) an exchange of two Si-atoms in amorphous silicon. In all three cases, the computational effort in finding the minimum energy path with DFT was reduced by a factor ranging from 50% to an order of magnitude by using an IDPP path as the initial path. The time required for parallel computations was reduced even more because of load imbalance when linear interpolation of Cartesian coordinates was used.

  2. Design and Simulation of STATCOM to Improve Power Quality

    Md. Nazrul Islam

    2013-07-01

    Full Text Available The performance of power systems decreases with the size, the loading and the complexity of the networks. This is related to problems with load flow, power oscillations and voltage quality. Such problems are even deepened by the changing situations resulting from deregulation of the electrical power markets, where contractual power flows do no more follow the initial design criteria of the existing network configuration. Additional problems can arise in case of large system interconnections, especially when the connecting AC links are weak. FACTS devices, however, provide the necessary features to avoid technical problems in the power systems and they increase the transmission efficiency. This paper presents a study on the design of a shunt connected FACTS device (STATCOM and investigates the application of this device to control voltage dynamics and to damp out the oscillation in electric power system. STATCOM is one of the key shunt controllers in flexible alternating current transmission system (FACTS to control the transmission line voltage and can be used to enhance the load ability of transmission line and extend the voltage stability margin. In this paper, the proposed shunt controller based on the voltage source converter topology as it is conventionally realized by VSC that can generate controllable current directly at its output terminal. The performance and behavior of this shunt controller is tested in 3-machine 9-bus system as well as the performance is compared in the test system with and without STATCOM at three cases in MATLAB/Simulink. Simulation results prove that the modeled shunt controller is capable to improve the Power quality significantly.

  3. The software improvement process - tools and rules to encourage quality

    The Applications section of the CERN accelerator controls group has decided to apply a systematic approach to quality assurance (QA), the 'Software Improvement Process' - SIP. This process focuses on three areas: the development process itself, suitable QA tools, and how to practically encourage developers to do QA. For each stage of the development process we have agreed on the recommended activities and deliverables, and identified tools to automate and support the task. For example we do more code reviews. As peer reviews are resource intensive, we only do them for complex parts of a product. As a complement, we are using static code checking tools, like FindBugs and Checkstyle. We also encourage unit testing and have agreed on a minimum level of test coverage recommended for all products, measured using Clover. Each of these tools is well integrated with our IDE (Eclipse) and give instant feedback to the developer about the quality of their code. The major challenges of SIP have been to 1) agree on common standards and configurations, for example common code formatting and Javadoc documentation guidelines, and 2) how to encourage the developers to do QA. To address the second point, we have successfully implemented 'SIP days', i.e. one day dedicated to QA work to which the whole group of developers participates, and 'Top/Flop' lists, clearly indicating the best and worst products with regards to SIP guidelines and standards, for example test coverage. This paper presents the SIP initiative in more detail, summarizing our experience since two years and our future plans. (authors)

  4. Participatory Patterns in an International Air Quality Monitoring Initiative

    Sîrbu, Alina; Caminiti, Saverio; De Baets, Bernard; Elen, Bart; Francis, Louise; Gravino, Pietro; Hotho, Andreas; Ingarra, Stefano; Loreto, Vittorio; Molino, Andrea; Mueller, Juergen; Peters, Jan; Ricchiuti, Ferdinando; Saracino, Fabio; Servedio, Vito D P; Stumme, Gerd; Theunis, Jan; Tria, Francesca; Bossche, Joris Van den

    2015-01-01

    The issue of sustainability is at the top of the political and societal agenda, being considered of extreme importance and urgency. Human individual action impacts the environment both locally (e.g., local air/water quality, noise disturbance) and globally (e.g., climate change, resource use). Urban environments represent a crucial example, with an increasing realization that the most effective way of producing a change is involving the citizens themselves in monitoring campaigns (a citizen science bottom-up approach). This is possible by developing novel technologies and IT infrastructures enabling large citizen participation. Here, in the wider framework of one of the first such projects, we show results from an international competition where citizens were involved in mobile air pollution monitoring using low cost sensing devices, combined with a web-based game to monitor perceived levels of pollution. Measures of shift in perceptions over the course of the campaign are provided, together with insights int...

  5. The ReACH Collaborative--improving quality home care.

    Boyce, Patricia Simino; Pace, Karen B; Lauder, Bonnie; Solomon, Debra A

    2007-08-01

    Research on quality of care has shown that vigorous leadership, clear goals, and compatible incentive systems are critical factors in influencing successful change (Institute of Medicine, 2001). Quality improvement is a complex process, and clinical quality improvement applications are more likely to be effective in organizations that are ready for change and have strong leaders, who are committed to creating and reinforcing a work environment that supports quality goals (Shortell, 1998). Key leadership roles include providing clear and sustained direction, articulating a coherent set of values and incentives to guide group and individual activities, aligning and integrating improvement efforts into organizational priorities, obtaining or freeing up resources to implement improvement activities, and creating a culture of "continuous improvement" that encourages and rewards the pursuit and achievement of shared quality aims (Institute of Medicine, 2001, 70-71). In summary, home health care is a significant and growing sector of the health care system that provides care to millions of vulnerable patients. There seems little doubt that home health agencies want to focus on quality of care issues and provide optimal care to home-based patients. Furthermore, there is a growing awareness of the value for adapting innovative, effective models for improving the culture of home care practice. This awareness stems from the notion that some agencies see quality improvement activities as a way for them to distinguish themselves not only to regulators and customers, but also to meet the cultural and transformational needs to remain viable in a constantly evolving and competitive health care industry. PMID:17966307

  6. Integration Quality Function Deployment and Analytic Hierarchy Process Methods to Improve Service Quality

    Shun-Hsing Chen

    2015-01-01

    Full Text Available Customer needs regarding product and service quality are rising. Because of the economic recession, the food and beverage industry faces strong competition. Customer needs can be satisfied only by understanding their needs. Therefore, this study uses Quality Function Deployment (QFD and the Analytic Hierarchy Process (AHP to clarify customer needs and to explore the most effective options to improve service quality in the vegetarian foods industry. This study primary objective included: (1 Prioritizing customer needs to vegetarian food providers according to the level of importance and (2 Prioritizing technology quality for improving products and services as a reference for vegetarian food providers.

  7. Improving the data quality of Advanced LIGO based on early engineering run results

    Nuttall, L. K.; Massinger, T. J; Areeda, J.; Betzwieser, J.; Dwyer, S.; Effler, A.; Fisher, R. P.; Fritschel, P.; Kissel, J. S.; Lundgren, A. P.; Macleod, D. M.; Martynov, D.; McIver, J.; Mullavey, A.; Sigg, D.

    2015-01-01

    The Advanced Laser Interferometer Gravitational-wave Observatory (LIGO) detectors have completed their initial upgrade phase and will enter the first observing run in late 2015, with detector sensitivity expected to improve in future runs. Through the combined efforts of on-site commissioners and the Detector Characterization group of the LIGO Scientific Collaboration, interferometer performance, in terms of data quality, at both LIGO observatories has vastly improved from the start of commis...

  8. Quality improvement 101 for surgeons: Navigating the alphabet soup.

    Santore, Matthew T; Islam, Saleem

    2015-12-01

    It is a fundamental value of the surgical profession to improve care for its patients. In the last 100 years, the principles of prospective quality improvement have started to work their way into the traditional method of retrospective case review in morbidity and mortality conference. This article summarizes the history of "improvement science" and its intersection with the field of surgery. It attempts to clarify the principles and jargon that may be new or confusing to surgeons with a different vocabulary and experience. This is done to bring the significant power and resources of improvement science to the traditional efforts to improve surgical care. PMID:26653158

  9. Continuous quality improvement in the ambulatory endoscopy center.

    Johanson, John F

    2002-04-01

    What does quality assessment have to do with the practicing gastroenterologist? Why should one spend the time and effort to incorporate CQI activities into an already busy practice? First and foremost, quality improvement should directly benefit the patient by ensuring that they receive the highest quality of care possible. For example, comparing endoscopic use or outcomes, such as procedure success or complications, with national standards or other endoscopists in the same community may identify physicians who could benefit from additional training. Similar analyses may likewise identify outstanding physicians who might serve as resources for other physicians. Surveys of patient satisfaction may reveal deficiencies, which might be unknown to a physician who is otherwise technically excellent; deficiencies that would never have been uncovered by traditional measures of quality. Second, applying the techniques of CQI to study one's own practice can provide a competitive edge when vying for managed care or corporate contracts. In this regard, CQI can be used to document physician or practice performance through tracking of endoscopic use, procedure success and complication rates, and patient satisfaction. Finally, the rising concern among various patient advocacy groups has led to an increased emphasis on quality improvement, and in most cases it is a required activity as part of the accreditation process. Steps to quality improvement There is more to quality improvement than simply selecting and implementing a performance improvement plan. A number of steps have been suggested to achieve fundamental improvement in the quality of medical care [3]. The first is to use outcomes management for improvement rather than for judgment. One of the major criticisms of QA is that it will be used to judge physicians providing care. It is feared that CQI will be used to identify poor performers who will then be punished. This strategy leads to fear and inhibits an honest pursuit of improvement. Second, learning must be viewed as a process. A quality improvement plan that is successful in one setting may not be as favorable in another situation. Clinicians must be able to focus on their individual situations and adapt what others have implemented to their own practice. Third, the most important aspect of the quality improvement is the implementation step. It matters little if elegant studies of endoscopic complications or patient satisfaction are completed if the information is not used to improve the delivery of health care to every single patient. The delivery of medical care continues to evolve. Resources are becoming increasingly scarce and the progressive rise of health care expenditures suggests a need for control. In this zeal for cost constraint, quality must not be sacrificed. This new-found attention to quality must be extended to the level of the individual practitioner to ensure that individual patients' interests are protected and the best possible care is delivered regardless of the economic implications. As providers of health care, endoscopists need to take an active role in these efforts both in understanding and implementing the techniques of quality assessment into their practices. If physicians are not actively involved in data collection and measurement to improve the quality and value of their own work, someone else will undoubtedly assume this role. PMID:12180166

  10. Quality Open Access market and other initiatives: a comparative analysis

    Danielle van Gerestein

    2015-05-01

    Full Text Available Recently academic publishing has entered in a new era, namely that of open access publishing. This has resulted in the appearance of numerous new open access journals. Scholars who want to publish their work today have endless publishing possibilities to choose from, but who is able to tell them which journal is reliable? This used to be the job of librarians, but with approximately 17000 journals they are no longer able to keep up. For this reason several websites and services have started to gather information about open access journals in order to make an overview of reliable and unreliable journals. One of these services is called Quality Open Access Market (QOAM. In this article six other services (Directory of Open Access Journals, JournalReviewer, SciRev, Journalysis, Journalguide, PRE-val and Eigenfactor will be compared to QOAM in order to find out which service offers the best results. QOAM is taken as a starting point here because the research presented in this article was commissioned by them (namely: Saskia de Vries and Leo Waaijers in order to find out what value they can actually add.

  11. Data quality objectives for the initial K West fuel examinations

    The Data Quality Objectives (DQOs) were established for the examinations of the first group of fuel samples shipped from the K West Basin to the Hanford 327 Building hot cells for examinations to support the Path Forward recommended to solve the safety and environmental concerns associated with the deteriorating fuel in the K Basins. A separate DQO will be prepared for each future shipment of samples to the hot cells. The material stored in the K West Basin must ultimately be removed from the basin and placed in a stable storage configuration until it can be disposed of in a repository. The condition of the fuel in the closed canisters is a major uncertainty for any of the proposed actions. The major question to answer is what are the conditions of the materials in the closed canisters? The data to be gathered during the canister opening, handling, transport, associated hot cell handling, and examinations will also support decisions related to the Path Forward primarily in areas of transportation and the Multi-Canister Overpack (MCO) design

  12. Improving the quality of clinical coding: a comprehensive audit model

    Hamid Moghaddasi

    2014-04-01

    Full Text Available Introduction: The review of medical records with the aim of assessing the quality of codes has long been conducted in different countries. Auditing medical coding, as an instructive approach, could help to review the quality of codes objectively using defined attributes, and this in turn would lead to improvement of the quality of codes. Method: The current study aimed to present a model for auditing the quality of clinical codes. The audit model was formed after reviewing other audit models, considering their strengths and weaknesses. A clear definition was presented for each quality attribute and more detailed criteria were then set for assessing the quality of codes. Results: The audit tool (based on the quality attributes included legibility, relevancy, completeness, accuracy, definition and timeliness; led to development of an audit model for assessing the quality of medical coding. Delphi technique was then used to reassure the validity of the model. Conclusion: The inclusive audit model designed could provide a reliable and valid basis for assessing the quality of codes considering more quality attributes and their clear definition. The inter-observer check suggested in the method of auditing is of particular importance to reassure the reliability of coding.

  13. Total Quality Management Continuous Improvement: Is the Philosophy a Reality?

    Walsh, Aidan; Hughes, Helen; Maddox, Daniel P.

    2002-01-01

    Responses from 72 Irish companies identified 51 using total quality management (TQM); second-survey responses from 28 of the latter showed that 57% of TQM initiatives were successful or very successful; most have a good understanding of comprehensive TQM and value long-term over short-term results. Benefits were experienced throughout…

  14. Internal Resources to Improve the Quality of Higher Education

    Tatyana V. Zak

    2016-03-01

    Full Text Available The article deals with the situation in the Russian higher education system. The factors affecting the improvement of the quality of higher education are analyzed. The emphasis is on mass universities. The main obstacles to improving the quality of education in these institutions are the Institute of collective reputation and the high costs of the struggle for improving the quality of education.The necessity of focusing on the actuation of the internal resources to improve the quality associated with the change in the educational process: giving students the right to choose the timing exams and training period at university. The implementation of the proposed measures will reduce the opportunity costs associated with quality improvement activities. The proposed change in the organization of the learning process opens the possibility to estimate the activity of universities in terms of medium-term implementation of educational programs. The use of this indicator will not only combine the two different targets of universities, but also to minimize the costs of opportunistic behavior of teachers and management.

  15. Enhancing K-means Clustering Algorithm with Improved Initial Center

    Srinivasa.T.M; Srinivasa Rao Pathakota; Madhu Yedla

    2010-01-01

    Cluster analysis is one of the primary data analysis methods and k-means is one of the most well known popular clustering algorithms. The k-means algorithm is one of the frequently used clustering methodin data mining, due to its performance in clustering massive data sets. The final clustering result of the kmeans clustering algorithm greatly depends upon the correctness of the initial centroids, which are selected randomly. The original k-means algorithm converges tolocal minimum, not the g...

  16. An Integrated Care Initiative to Improve Patient Outcome in Schizophrenia

    Mayer-Amberg, Norbert; Woltmann, Rainer; Walther, Stefanie

    2016-01-01

    The optimal treatment of schizophrenia patients requires integration of medical and psychosocial inputs. In Germany, various health-care service providers and institutions are involved in the treatment process. Early and continuous treatment is important but often not possible because of the fragmented medical care system in Germany. The Integrated Care Initiative Schizophrenia has implemented a networked care concept in the German federal state of Lower Saxony that integrates various stakeho...

  17. X-ray scatter correction method for dedicated breast computed tomography: improvements and initial patient testing

    Ramamurthy, Senthil; D'Orsi, Carl J.; Sechopoulos, Ioannis

    2016-02-01

    A previously proposed x-ray scatter correction method for dedicated breast computed tomography was further developed and implemented so as to allow for initial patient testing. The method involves the acquisition of a complete second set of breast CT projections covering 360° with a perforated tungsten plate in the path of the x-ray beam. To make patient testing feasible, a wirelessly controlled electronic positioner for the tungsten plate was designed and added to a breast CT system. Other improvements to the algorithm were implemented, including automated exclusion of non-valid primary estimate points and the use of a different approximation method to estimate the full scatter signal. To evaluate the effectiveness of the algorithm, evaluation of the resulting image quality was performed with a breast phantom and with nine patient images. The improvements in the algorithm resulted in the avoidance of introduction of artifacts, especially at the object borders, which was an issue in the previous implementation in some cases. Both contrast, in terms of signal difference and signal difference-to-noise ratio were improved with the proposed method, as opposed to with the correction algorithm incorporated in the system, which does not recover contrast. Patient image evaluation also showed enhanced contrast, better cupping correction, and more consistent voxel values for the different tissues. The algorithm also reduces artifacts present in reconstructions of non-regularly shaped breasts. With the implemented hardware and software improvements, the proposed method can be reliably used during patient breast CT imaging, resulting in improvement of image quality, no introduction of artifacts, and in some cases reduction of artifacts already present. The impact of the algorithm on actual clinical performance for detection, diagnosis and other clinical tasks in breast imaging remains to be evaluated.

  18. Nuclear regulatory commission initiative for technical specification improvement

    In February 1987, the US Nuclear Regulatory Commission (NRC) issued its interim Policy Statement on Technical Specifications Improvement for Nuclear Power Reactors. The Commission issued the statement after studying the issue for several years. During that time, the industry had conducted a similar study. The policy statement focuses on the purposes of technical specifications: (1) to identify features that are of controlling importance to safety; and (2) to establish conditions that assure safe operation of those features (conditions that cannot be changed without previous NRC approval). The primary implementation goal of the policy statement is to develop new technical specifications that will improve the safety of nuclear plants with a package of features which, taken together, allow the NRC to conclude that the new standard technical specifications (STS) improve safety

  19. Improvement of cassava cooking quality through mutation breeding

    Many high-yielding cassava varieties do not have the desired cooking quality. The objective of this project was to induce mutations to produce varieties with improved cooking quality while maintaining the disease-resistance and high-yielding characteristics. A cassava mutant (ISU-W) was obtained after irradiation of a variety from IITA with gamma rays and selection. Cuttings of the mutant were grown for 12 months in a field trial and investigated for tuber yield and cooking quality. Pest and disease incidence were monitored during the entire growth period. The results showed that the mutant retained the high-yield and disease resistant characters of the parent, and had improved cooking quality based on increased smoothness, mealiness and elasticity of the flour. (author). 7 refs, 5 tabs

  20. Development of improvement initiatives in an ICT department.

    Golo, Hagan Dennis; Popov, Dimitar

    2014-01-01

    [ABSTRACT] The main goal of this thesis is to study processes in an ICT department of Barcelona Airport and propose some solutions for improvement based on data collected and analyzed. The improvement follows the concept of Lean Six Sigma (LSS) and ITIL framework. The main outcome of this thesis will be to optimize the incidents resolution times. It has been noticed that, too much time elapses from the time an incident is opened and the time an incident is closed. Even though in several insta...

  1. Product manufacturing, quality, and reliability initiatives to maintain a competitive advantage and meet customer expectations in the semiconductor industry

    Capps, Gregory

    Semiconductor products are manufactured and consumed across the world. The semiconductor industry is constantly striving to manufacture products with greater performance, improved efficiency, less energy consumption, smaller feature sizes, thinner gate oxides, and faster speeds. Customers have pushed towards zero defects and require a more reliable, higher quality product than ever before. Manufacturers are required to improve yields, reduce operating costs, and increase revenue to maintain a competitive advantage. Opportunities exist for integrated circuit (IC) customers and manufacturers to work together and independently to reduce costs, eliminate waste, reduce defects, reduce warranty returns, and improve quality. This project focuses on electrical over-stress (EOS) and re-test okay (RTOK), two top failure return mechanisms, which both make great defect reduction opportunities in customer-manufacturer relationship. Proactive continuous improvement initiatives and methodologies are addressed with emphasis on product life cycle, manufacturing processes, test, statistical process control (SPC), industry best practices, customer education, and customer-manufacturer interaction.

  2. Accelerating the spread of laboratory quality improvement efforts in Botswana

    Kelebeletse O. Mokobela

    2014-09-01

    Full Text Available Background: In 2002, the Ministry of Health (MoH of Botswana began its journey toward laboratory accreditation in an effort to enhance the quality of laboratory services. Aftera difficult start, the MoH recognised the need for a more practical and sustainable method for change that could be implemented nationally; they therefore adopted the Strengthening Laboratory Management Toward Accreditation (SLMTA programme.Objective: This study describes the spread of laboratory quality improvement efforts in Botswana.Methods: Eight laboratories were enrolled into the SLMTA programme in 2010, which included a series of workshops and improvement projects conducted over nine months. Four of these laboratories received supplementary training and focused mentorship from the Botswana Bureau of Standards (BOBS. Laboratory performance was measured at baseline and exit using the World Health Organization Regional Office for Africa’s StepwiseLaboratory Quality Improvement Process Towards Accreditation (SLIPTA checklist. One laboratory did not receive an exit audit and was thus excluded from the analysis.Results: An 18 percentage-point improvement was observed when comparing the median baseline score (53% to the median exit score (71% for the seven laboratories. Laboratories that received additional training and mentorship from BOBS improved 21 percentage points, whilst non-BOBS-mentored laboratories improved eight percentage points. Hospital management buy-in and strong laboratory staff camaraderie were found to be essential forthe positive changes observed.Conclusion: SLMTA facilitated improvements in laboratory quality management systems,yielding immediate and measurable results. This study suggests that pairing the SLMTA programme with additional training and mentorship activities may lead to further increases in laboratory performance; and that SLMTA is a practical approach to extending quality improvement to MOH laboratories.

  3. Measuring and improving quality of care in surgical oncology

    Wouters, Michael Wilhelmus Jacobus Maria

    2013-01-01

    This thesis shows that quality of care in surgical oncology varies by provider and is partly based on differences in procedural volume and other attributes of hospitals. Especially for low-volume high-risk surgical procedures concentration of services in hospitals with better outcomes (outcome-based referral) can lead to dramatic improvement in short- as well as long-term outcomes. Casemix- and reliability adjustments are essential in the evaluation of quality of care. In addit...

  4. Interventions to improve water quality for preventing diarrhoea

    Clasen, Thomas F; Kelly T. Alexander; Sinclair, David; Boisson, Sophie; Peletz, Rachel; Chang, Howard H.; Majorin, Fiona; Cairncross, Sandy

    2015-01-01

    Background Diarrhoea is a major cause of death and disease, especially among young children in low-income countries. In these settings, many infectious agents associated with diarrhoea are spread through water contaminated with faeces. In remote and low-income settings, source-based water quality improvement includes providing protected groundwater (springs, wells, and bore holes), or harvested rainwater as an alternative to surface sources (rivers and lakes). Point-of-use water quality impro...

  5. Improving the Quality of Electric Energy to Electric Arc Furnace

    Adrian-Ioan Toma; Andrei Romanescu

    2011-01-01

    This paper presents a study of power quality problems created by an electric arc furnace (EAF) with eccentric bottom tap (EBT) at power system. The analysis have been done to EAF of 100 t capacity used for steel melting. Experimental results show this EAF is substantial source of electric disturbances, such as voltage fluctuations, flicker, harmonics, and unbalance between phases. Improvement of the quality of electric energy at EAF imposes a careful technical and economical...

  6. Quality improvement process pilot project at Gallagher station

    A Quality Improvement Process was piloted at Gallagher station in 1990 to address issues of two Electric System Strategy Group (ESSG) goals. Darrell McElravy headed a group to address quality, productivity and prove and Judy Rushing headed a group to address innovation and recognition. These groups combined when a process was identified that could address both issues. The process was designed for PSI Energy by Business Incentives and is an incentive-based quality improvement process that seeks employee involvement to identify inhibitors t performance and to establish a method to eliminate the problem. Performance goals were also established that help focus efforts to improve performance and reward employees for their efforts

  7. ELECTRICAL SAFETY IMPROVEMENT PROJECT A COMPLEX WIDE TEAMING INITIATIVE

    GRAY BJ

    2007-11-26

    This paper describes the results of a year-long project, sponsored by the Energy Facility Contractors Group (EFCOG) and designed to improve overall electrical safety performance throughout Department of Energy (DOE)-owned sites and laboratories. As evidenced by focused metrics, the Project was successful primarily due to the joint commitment of contractor and DOE electrical safety experts, as well as significant support from DOE and contractor senior management. The effort was managed by an assigned project manager, using classical project-management principles that included execution of key deliverables and regular status reports to the Project sponsor. At the conclusion of the Project, the DOE not only realized measurable improvement in the safety of their workers, but also had access to valuable resources that will enable them to do the following: evaluate and improve electrical safety programs; analyze and trend electrical safety events; increase electrical safety awareness for both electrical and non-electrical workers; and participate in ongoing processes dedicated to continued improvement.

  8. Quality evaluation of initial formation in the third year of medical course.

    Berto Delis Conde Fernández

    2011-09-01

    Full Text Available The priority given by Cuba to the accreditation of initial formation in medical course encourages the introduction of procedures for self assessment. With the objective to contribute to quality management in initial formation of this course by means of the implementation of a self assessment institutional system applicable to the University Hospital, a quasi experiemental investigation was made in “Camilo Cienfuegos” Provincial Hospital, Sancti Spiritus during the period 2005-2010. Different instruments were applied for obtaining the initial information and were determined quality indicators, methods and evaluation procedures, from which it was designed and validated a methodology for the self assessment process, including its quality standard. The results of measurements and the analysis of quality tendency were presented. It concludes highlighting the contribution achieved due to the development of a quality culture and evaluation, orientation towards the continuous perfectioning and organizational change.

  9. Groundwater Quality Assessment Based on Improved Water Quality Index in Pengyang County, Ningxia, Northwest China

    Li Pei-Yue; Qian Hui; Wu Jian-Hua

    2010-01-01

    The aim of this work is to assess the groundwater quality in Pengyang County based on an improved water quality index. An information entropy method was introduced to assign weight to each parameter. For calculating WQI and assess the groundwater quality, total 74 groundwater samples were collected and all these samples subjected to comprehensive physicochemical analysis. Each of the groundwater samples was analyzed for 26 parameters and for computing WQI 14 parameters were chosen including c...

  10. Integration Quality Function Deployment and Analytic Hierarchy Process Methods to Improve Service Quality

    Shun-Hsing Chen; Fei-Yun Chen; Tsu-Ming Yeh

    2015-01-01

    Customer needs regarding product and service quality are rising. Because of the economic recession, the food and beverage industry faces strong competition. Customer needs can be satisfied only by understanding their needs. Therefore, this study uses Quality Function Deployment (QFD) and the Analytic Hierarchy Process (AHP) to clarify customer needs and to explore the most effective options to improve service quality in the vegetarian foods industry. This study primary objective included: (1)...

  11. Model-driven approach to data collection and reporting for quality improvement.

    Curcin, Vasa; Woodcock, Thomas; Poots, Alan J; Majeed, Azeem; Bell, Derek

    2014-12-01

    Continuous data collection and analysis have been shown essential to achieving improvement in healthcare. However, the data required for local improvement initiatives are often not readily available from hospital Electronic Health Record (EHR) systems or not routinely collected. Furthermore, improvement teams are often restricted in time and funding thus requiring inexpensive and rapid tools to support their work. Hence, the informatics challenge in healthcare local improvement initiatives consists of providing a mechanism for rapid modelling of the local domain by non-informatics experts, including performance metric definitions, and grounded in established improvement techniques. We investigate the feasibility of a model-driven software approach to address this challenge, whereby an improvement model designed by a team is used to automatically generate required electronic data collection instruments and reporting tools. To that goal, we have designed a generic Improvement Data Model (IDM) to capture the data items and quality measures relevant to the project, and constructed Web Improvement Support in Healthcare (WISH), a prototype tool that takes user-generated IDM models and creates a data schema, data collection web interfaces, and a set of live reports, based on Statistical Process Control (SPC) for use by improvement teams. The software has been successfully used in over 50 improvement projects, with more than 700 users. We present in detail the experiences of one of those initiatives, Chronic Obstructive Pulmonary Disease project in Northwest London hospitals. The specific challenges of improvement in healthcare are analysed and the benefits and limitations of the approach are discussed. PMID:24874182

  12. A new quality assessment and improvement system for print media

    Liu, Mohan; Konya, Iuliu; Nandzik, Jan; Flores-Herr, Nicolas; Eickeler, Stefan; Ndjiki-Nya, Patrick

    2012-12-01

    Print media collections of considerable size are held by cultural heritage organizations and will soon be subject to digitization activities. However, technical content quality management in digitization workflows strongly relies on human monitoring. This heavy human intervention is cost intensive and time consuming, which makes automization mandatory. In this article, a new automatic quality assessment and improvement system is proposed. The digitized source image and color reference target are extracted from the raw digitized images by an automatic segmentation process. The target is evaluated by a reference-based algorithm. No-reference quality metrics are applied to the source image. Experimental results are provided to illustrate the performance of the proposed system. We show that it features a good performance in the extraction as well as in the quality assessment step compared to the state-of-the-art. The impact of efficient and dedicated quality assessors on the optimization step is extensively documented.

  13. An Initiative to Improve Clozapine Prescribing in New York State.

    Carruthers, Jay; Radigan, Marleen; Erlich, Matthew D; Gu, Gyojeong; Wang, Rui; Frimpong, Eric Y; Essock, Susan M; Olfson, Mark; Castillo, Enrico G; Miller, Gregory A; Sederer, Lloyd I; Stroup, T Scott

    2016-04-01

    Clozapine remains the only medication approved for treatment-resistant schizophrenia. But underuse is the norm. In 2010, the New York State Office of Mental Health began a multifaceted initiative to promote the evidence-based use of clozapine. From 2009 to 2013, in the absence of a well-funded pharmaceutical marketing campaign, the proportion of new clozapine trials among all new outpatient antipsychotic trials increased 40% among adult New York Medicaid recipients with a diagnosis of schizophrenia. The largest gains occurred in state-operated clinics. New York's experience demonstrates the feasibility of making clozapine more accessible to patients who stand to benefit most. PMID:26725299

  14. Using measures to guide the continuous improvement journey: a partnership between quality assurance and toxicology.

    Gentry, P E; Sites, D L

    1994-03-01

    It has been said that you cannot improve what you cannot measure. At Eli Lilly and Company, measurement is one of the five pillars of Total Quality. Quality Assurance and Toxicology have partnered in the use of measures to drive improvements in both areas. Quality Assurance and Toxicology have embarked on a journey in Total Quality to achieve customer satisfaction and drive continuous improvement. Measurement in the research and development world has traditionally not been well received. Contrary to popular belief, we have found that many processes can be measured in the research and development environment. Measurement is critical to the continuous improvement of processes because improvements are made using data. In Quality Assurance and Toxicology, the initial measures were put in place to gather baseline data. As we learned from our measures, we customized them to align with all of our processes. This article describes the journey of measuring Quality Assurance and Toxicology, including highlights of implementation strategies and lessons learned along the way. PMID:7804620

  15. Measuring quality of care for colorectal cancer care: comprehensive feedback driving quality improvement

    Kolfschoten, Nicoline Elisabeth

    2015-01-01

    Data from clinical audits such as the Dutch Surgical Colorectal Audit, can be used for valid and meaningful feedback information, which may support improvement of quality of care. First, we showed that the continuous feedback cycle of clinical auditing has an autonomous, positive effect on the quality of surgical care. Second, we describe how data from clinical audits can be used to monitor and improve national practice and performance in colorectal cancer care, especially for high-risk patie...

  16. [Telecommunication--a medium for improving prenatal diagnosis and gynecologic ultrasound diagnosis? Initial experiences].

    Sohn, C; Beldermann, F; Wallwiener, D; Lepold, H; Bastert, G

    1997-01-01

    To establish the requirements for real-time transfer of an ultrasound examination via telecommunication network the following tests were performed: The ultrasound data were transferred from the video out of an ultrasound system to a basis terminal of the German Telekom. Simultaneously, an external video camera filmed the positioning and movements of the ultrasound transducer, and the verbal comments were recorded. These informations were transmitted to Karlsruhe and London, where they were rerouted to the examination room in Heidelberg. Here the informations were received on a Telecom reception unit/terminal and compared directly with the initial signal. The quality was sufficient if the moving ultrasound images and the camera image of the transducer as well as the oral comment were transmitted over 2 parallel ISDN lines. The delay to a real-time transmission of the examination process is only in the range of milliseconds. If only one ISDN line is used, the image quality is unsatisfactory, three parallel lines do not bring significant improvement of image quality. Telemedicine seems a new possibility to bring the knowledge of specialized centers to the practicing gynaecologists thus avoiding unnecessary referrals. Still unanswered, however, are the problem of liability, data protection and costs. PMID:9206924

  17. Active power line conditioners for improving electric power quality

    Grady, M. [Texas Univ., Austin, TX (United States); Binas, G. [Public Service Electric and Gas Co., Newark, NJ (United States). Research and Development Dept.

    1992-12-31

    New power electronic circuits, called active power line conditioners, (APLCs) were discussed. They have great potential for improving power quality by injecting equal but opposite distortion into a power system. APLCs can counteract distortion, transients, and short-duration variations in power. They differ from conventional power line conditioners because they improve power quality on the power system side rather than on the load side. Although APLCs are only laboratory prototypes, single phase and three phase units are being developed worldwide. 2 refs., 1 tab., 6 figs.

  18. A systems thinking approach to the sustainability of quality improvement programmes

    D.J., van Dyk; L., Pretorius.

    2014-01-01

    Full Text Available The challenge for organisations to continually provide the best return on investment for their shareholders has become increasingly difficult through globalisation of the market place. There are many responses a company could make to these challenges - for example, new product development, increased [...] market capitalisation, cost reduction initiatives, and quality management. This last response focuses on, but is not restricted to, customer satisfaction, continuous improvement, and environmental impact. Continuous improvement addresses waste in the business design and manufacturing processes, which could lead to improved profit margins. The sustainability of quality improvement programmes remains a challenge. Causality can be studied, using Six Sigma tools, to relate cause and effect. But these tools do not always allow the user to study and understand feedback from other factors, such as soft human issues, in the improvement process system, typically referred to as 'feedback causality'. System dynamics may improve this understanding. Quality improvement programmes in the heavy engineering manufacturing environment are not researched to the same degree as those in the automotive manufacturing environment. The purpose of this paper is to share results from research into the sustainability of quality improvement programmes, and the development of an appropriate system dynamics model, using qualitative case study data gathered and coded in a heavy engineering manufacturing environment.

  19. A Systems Thinking Approach To The Sustainability Of Quality Improvement Programmes

    Van Dyk, Dirk Johannes

    2014-05-01

    Full Text Available The challenge for organisations to continually provide the best return on investment for their shareholders has become increasingly difficult through globalisation of the market place. There are many responses a company could make to these challenges for example, new product development, increased market capitalisation, cost reduction initiatives, and quality management. This last response focuses on, but is not restricted to, customer satisfaction, continuous improvement, and environmental impact. Continuous improvement addresses waste in the business design and manufacturing processes, which could lead to improved profit margins. The sustainability of quality improvement programmes remains a challenge. Causality can be studied, using Six Sigma tools, to relate cause and effect. But these tools do not always allow the user to study and understand feedback from other factors, such as soft human issues, in the improvement process system, typically referred to as feedback causality. System dynamics may improve this understanding. Quality improvement programmes in the heavy engineering manufacturing environment are not researched to the same degree as those in the automotive manufacturing environment. The purpose of this paper is to share results from research into the sustainability of quality improvement programmes, and the development of an appropriate system dynamics model, using qualitative case study data gathered and coded in a heavy engineering manufacturing environment.

  20. Scaffolding Company Initiative to Improve Psychosocial Work Environment of Workers

    Forsberg, Johanna; Waltersson, Helena; Aulin, Radhlinah

    2015-01-01

    identity through work gives a necessary context for a meaningful life. Work pace control, autonomy, learning new skills, or participation in company decision making are specific psychological factors included in the job control dimension. On the other hand, high absenteeism and poor health are symptoms used to associate with poor psychosocial working environment. This industry paper presents the effort of a scaffolding company to improve the psychosocial work environment in their organisation...

  1. Quality improvement in breast cancer project: compliance with antiresorptive agents and changing patterns of drug use.

    Borden, Charles P; Shapiro, Charles L; Ramirez, Maria Teresa; Kotur, Linda; Farrar, William

    2014-02-01

    The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute participated in NCCN's Quality Improvement in Breast Cancer initiative. The Opportunities for Improvement (OFI) team elected to improve concordance with the NCCN Clinical Practice Guidelines in Oncology for Breast Cancer recommendation that all patients diagnosed with skeletal metastases receive bisphosphonates. Assembling a multidisciplinary team of clinicians, researchers, and administrative stakeholders, the OFI team followed Six Sigma's approach to problem-solving known as DMAIC (define, measure, analyze, improve, and control). Baseline concordance was 79%, which was below the recommended target range. Initial analysis quickly revealed that 5 cases were concordant, resulting in a new baseline of 89%. The key root cause identified for the remaining gap was lack of documentation. The solution included education regarding documentation for existing staff, in addition to hard-wiring the material into new physician orientation, discussion of all patients with bone disease at tumor board meetings, and improved consistency with use of the new electronic medical record system. After implementation, the reported concordance was 92%, and the lack of documentation problem decreased from 11% in the baseline study to 6%. The team concluded that use of the NCCN Oncology Outcomes Database as an opportunity for clinical quality improvement initiatives not only is possible but also should be an essential element of any clinical program looking to continuously improve. PMID:24614050

  2. An Initial Look at the Quality of Life of Malaysian Families That Include Children with Disabilities

    Clark, M.; Brown, R.; Karrapaya, R.

    2012-01-01

    Background: While there is a growing body of literature in the quality of life of families that include children with disabilities, the majority of research has been conducted in western countries. The present study provides an initial exploration of the quality of life of Malaysian families that include children with developmental/intellectual…

  3. Improving Initial Conditions for Cosmological $N$-Body Simulations

    Garrison, Lehman H; Ferrer, Douglas; Metchnik, Marc V; Pinto, Philip A

    2016-01-01

    In cosmological $N$-body simulations, the representation of dark matter as discrete "macroparticles" suppresses the growth of structure. This effect occurs even on scales many times larger than the particle spacing; for example, modes above $k_{\\rm Nyquist}/4$ inherit a 1 to 3% error in the matter power spectrum at $z=1$. Particle linear theory (PLT) (Marcos et al. 2006) analytically describes this effect for particle lattices and reveals that the continuum growing modes are not the proper lattice growing modes, which excites transient power. We develop initial conditions with the correct growing modes and additionally rescale these modes to account for growth suppression. We also introduce a scheme for computing second-order Lagrangian perturbation theory (2LPT) from direct force calculations without using Fourier transforms. We test rescaling and our 2LPT by comparing the $z=1$ haloes and power spectra with those of an oversampled reference simulation. The combination of rescaling and 2LPT achieves 1% accur...

  4. Intensive-care unit lungs - possibilities to improve the quality

    X-ray lung diagnosis in an intensive-care unit makes special demands on technique, imaging and on the physician's experience. The quality of image interpretation and evaluation is considerably improved by superimposing the technical data on the X-ray image and by using an antiscatter grid cassette. Proper evaluation of the parameters important for diagnosis is improved by registration of the data on the X-ray film; taking a maximum possible score of 100 as reference value, quality of evaluation is improved from 66.5 points to 71.8 points by data registration on the film itself, whereas the simultaneous use of an antiscatter grid cassette improves the score still further, namely, to 84.3 points. The importance of the clinical condition of the patient, and of the type of breathing chosen, for assessing the chest X-ray, is emphasized. (orig.)

  5. Role of configuration management in improving quality of metal products

    The Configuration Management (CM) is an imperative discipline which helps in producing quality metal products for the customers. CM implements a graded approach to Configuration Items whose failure poses human as well as product losses. Effective CM provides information to Project Management, Quality Control, and Quality Assurance in identifying schedules and processes related to metal component production. The CM is a supportive function, mostly working side by side with Quality Assurance and Quality Control in the development / production of metal parts. The CM provides tools and guidelines for managing a product while Quality Assurance verifies and validates the same outside the scope of Configuration Audits. Configuration Management raises productivity of metal product, makes-available design reuse, reduces service and support costs, enhances visibility and eliminates rework on metal products. The elements of CM i.e. Identification, Control, Status Accounting and Audits playa vital role to enhance the quality of metal products. Only established CM System can make it possible to swing initial development criteria to final user friendly metal products. The challenges of today in our metal industry are to design and develop state-of-the-art products, for which, CM ideas given in this paper, will help to achieve all the set goals. (author)

  6. Improvement in Adherence to Surgical Antimicrobial Prophylaxis Guidelines after Implementation of a Multidisciplinary Quality Improvement Project

    Shorouq Telfah; Lama Nazer; Manar Dirani; Faiez Daoud

    2015-01-01

    Objectives: This study aimed to show the impact of a multidisciplinary quality improvement project on adherence to antimicrobial prophylaxis guidelines in oncological surgery. Methods: This pre- and post-intervention prospective observational study was carried out at the King Hussein Cancer Centre (KHCC) in Amman, Jordan, between August 2009 and February 2012. The quality improvement project consisted of revising the institutional guidelines for surgical antimicrobial prophylaxis,...

  7. Quality Improvement Of Fan Manufacturing Industry By Using Basic Seven Tools Of Quality: A Case Study

    Sulaman Muhammad

    2015-04-01

    Full Text Available Research was carried out in a Fan manufacturing industry to address the quality related problems and improve their quality level by implementing basic seven tools of quality. These are important tools used worldwide in manufacturing industries for continual improvement. Flow chart, Check sheet, Histogram, Cause & Effect diagram, Pareto chart, Scatter diagram & Control charts were implemented in different steps of manufacturing process to define the problem, measure its impact, finding out its root cause and its removal to ensure the production of non defective items. The case study was carried out in “FECTO FAN” Gujranwala, Pakistan.

  8. TaaS for Improving Quality of Restful Web Services

    Shueh-Cheng Hu; I-Ching Chen

    2013-01-01

    In view of its critical role and popularity in the area of software architecting, Internet of things, and software as a service, a method for improving restful Web service programs' quality obviously is critical and valuable. Consequently, this article presents a service for improving the efficiency of testing restful Web service programs, the corresponding design rationale and impact are described. This kind of services will be helpful in speeding up the testing tasks of restful Web applicat...

  9. Four-wire Solid State Transformer to Improve Current Quality

    BANAEI, Mohamad Reza; Salary, Ebrahim

    2012-01-01

    Solid state transformers (SST) are used to perform typical functions and improve power quality in series operation of three-phase power systems. Generally, current harmonics and unbalances and neutral wire current are generated due to nonlinear, unbalance load and supply voltage distortion. In this paper operation of three-phase four-wire SST to improve current harmonics, current unbalances, neutral wire current and reactive power of nonlinear load as an active filter synchronous by feeding l...

  10. Collaborative environments, a way to improve quality in higher education

    Rodríguez Donaire, Silvia; Amante García, Beatriz

    2012-01-01

    The aim of this research is to observe how Collaborative Web-Based Environments (CWBEs) foster higher education quality improvement by means of enhancing students' teamwork skills, the use of CWBEs and the use of teaching methodologies, particularly PBL. A survey was conducted in three different subjects with similar characteristics in courses held at the ETSEIATBarcelonaTECH among a sample of 98 students. Results shed light on two aspects which improve teamwork performance: 1) the ...

  11. Farming and processing stategies for improving poultry meat quality

    Rimini, Simone

    2014-01-01

    The purpose of the PhD research was the identification of new strategies of farming and processing, with the aim to improve the nutritional and technological characteristics of poultry meat. Part of the PhD research was focused on evaluation of alternative farming systems, with the aim to increase animal welfare and to improve the meat quality and sensorial characteristics in broiler chickens. It was also assessed the use of innovative ingredients for marination of poultry meat (sodium bicarb...

  12. Radionuclide calibrator comparisons and quality improvement in nuclear medicine.

    Oropesa, P; Woods, M J; Olsovcová, V; dos Santos, J A

    2008-03-01

    The traceability of activity measurements performed during the development phase of the radiopharmaceutical and in its clinical application is essential for establishing the comparability of clinical results reported in the nuclear medicine field. This paper presents and discusses the evaluation over time of the quality of activity measurement results obtained in Cuban nuclear medicine, on the basis of statistical samples taken during the radionuclide calibrator comparison program. An attempt is also made to evaluate the role played by such comparisons in quality measurement improvement in nuclear medicine, on the basis of results obtained in a number of countries and published by several authors over a period of time. Specifically, improvements of the measurement performance over time assessed by such exercises were found dissimilar in magnitudes for different countries. Two phases could be distinguished in the improvement process over time. Firstly, a fast improvement can be obtained resulting from the improvement in measurement accuracy of devices. After that, the achievement of new and sustained improvements goes slowly and requires an application of quality assurance programs where the qualification upgrading of personnel become an essential point. PMID:17855099

  13. Quality councils as change agents and drivers of quality improvement in healthcare.

    Plumb, Michael; Cowell, John W F

    2006-01-01

    This commentary addresses four key questions raised in the lead paper. We recognize that health quality councils have a delimited range of tools available to bring about needed change. They have neither funding and regulatory powers nor day-to-day operational authority. Nevertheless, based on the Health Quality Council of Alberta's (HQCA) successes to date using a multidimensional change strategy, we are confident that quality councils can play a vital role in driving and sustaining quality improvement in provincial healthcare systems. The provisos are that the councils need to be sufficiently empowered, establish themselves as trusted partners and independent advisors, use effective change strategies, focus on strategic priorities and gain strong stakeholder support for needed changes. We are also convinced that multilevel measurement is an essential tool for learning, priority setting, establishing the imperative for action and assessing progress. Finally, in terms of the value proposition - the relationship between resource inputs and healthcare outcomes - we strongly suggest that health quality councils work collaboratively with service providers to obtain better value for money by improving quality rather than aligning themselves with funders and rely on "pay for quality" incentives to "compel" quality improvement. PMID:16651861

  14. Improving SLCF Science in the Himalayan Region: ICIMOD's Atmosphere Initiative

    Panday, A. K.; Pradhan, B. B.; Surapipith, V.

    2013-12-01

    What fraction of the black carbon arriving on Yala Glacier in Langtang, Nepal, is from cooking fires in the houses in the valley below? What fraction is from elsewhere in rural Nepal? What fraction is from industrial and transport sources in Kathmandu? What fraction is from northern India and beyond? What fraction is from the high altitude forest fires that take place during March or April? Effectively mitigating the impacts of black carbon and other short-lived climate forcers requires detailed understanding not just of emissions and impacts, but also of the atmospheric transport pathways that connect the two. In mountainous areas of the Hindu-Kush Himalaya detailed quantitative knowledge about emissions, atmospheric processes, and impacts is still largely missing. The International Centre for Integrated Mountain Development (ICIMOD) is an intergovernmental organization covering Afghanistan, Pakistan, India, Nepal, China, Bhutan, Bangladesh, and Myanmar. ICIMOD's recently established Atmosphere Initiative not only assesses mitigation options and contributes to policy and capacity building in the region, but also works actively to promote collaboration among researchers in the region, while building up an in-house team whose research will address key questions about SLCF. In Spring 2013 ICIMOD's Atmosphere Initiative, in collaboration with the Institute for Advanced Sustainability Studies (IASS) in Potsdam, Germany, carried out the largest field campaign to date in Nepal, hosting instruments belonging to dozens of institutions around the world, at nine field site within and upwind of the Kathmandu Valley, Nepal. The dataset that has been collected gives unprecedented insights into the emissions and atmospheric processes taking place downwind of and within the largest urban agglomeration in the Himalaya region. Meanwhile, in collaboration with national partner institutions, ICIMOD is in the process of setting up one atmospheric observatory each in Bhutan and in Nepal. Each will be on a mountain peak overlooking the Indo-Gangetic Plains. A building will house laboratories and visitor space, and will have a small tower. Each site will be equipped with a Picarro G2401 analyzer for CO, CO¬2, methane and water vapor, aerosol filter samplers, as well as instruments to measure black carbon, ozone, aerosol size distribution, aerosol scattering, cloud condensation nuclei, solar radiation, aerosol optical depth, and meteorology. Together with output from ICIMOD's new atmospheric modeling centre, the data from the sites will allow quantifying the flux of pollutants from the Indo-Gangetic Plains towards the high Himalaya, and to estimate emissions of SLCFs within the Himalayan foothills region. The infrastructure at both observatory sites is designed to accommodate training and future expansion as well as to host visiting instruments.

  15. Improving Service Quality of Rusunawa Implementation Program in Kudus

    Septiana Pancawati

    2014-02-01

    Full Text Available Development of housing and settlements are still faced the main problems as follows: the limited supply of homes, inadequate housing that is not supported by infrastructure, environmental facilities and public utilities, as well as the growing slums widespread. Government issues Rusunawa Implementation Program to overcome those problems. However some problems arose in its implementation, such as poor environmental condition, poor building quality, inadequate infrastructure and public services. The objectives of the research are to describe, to analyze, and to interpret things as follows: (1 The management of Rusunawa implementation program in order to improve service quality, (2 Improving service quality of Rusunawa program by the authorities. This research used qualitative method with descriptive approach. Information can be obtained byinterview stakeholders, field observations and documentation. From research findings, there are some records that should be highlighted as follows: (1 Rusunawa construction and its supervision influence the building quality. Low performance of those service providers will result in low building quality and vice versa. (2 Rent arrears are higher, an indication of dissatisfaction Rusunawa residents during they stay there. Keywords: Rusunawa, building condition, service quality

  16. Quality is free: A cost-benefit analysis of early child development initiatives

    Trefler, Daniel

    2009-01-01

    High-quality early child development initiatives are expensive. However, careful analysis of the returns on investment for such initiatives establishes that, from the government’s perspective, the initiatives all but pay for themselves. The explanation for this is twofold. First, early childhood interventions enhance adult employability and earnings of program participants. This generates $8.2 billion in tax revenues that partially offset program costs. Second, early childhood interventions r...

  17. Initial very low calorie diet (VLCD) improves ultimate weight loss

    Quaade, F; Astrup, A

    = 18): VLCD for 2 months or more. The two groups were comparable with regard to height, absolute weight and percentual overweight, but group 2 was somewhat older than group 1 (49.5 vs 38.3 years, P less than 0.01). Group 2 lost significantly more weight, both totally (17.1 kg (7.8-40.1] and on VLCD...... is an effective and encouraging way of starting a dieting program, and that it should be continued for at least two months, as the length of the initial VLCD period related significantly to the amount of weight eventually lost....... alone (12.3 kg (4.1-28.8], than group 1 (8.7 kg (-1.1 to 19.1), P = 0.008; and 7.3 kg (0.9-18.2 P = 0.01). Weight losses in both groups eliminated or strongly reduced the need for a wide variety of expensive drugs: antidiabetics, diuretics, antihypertensives, analgetics, etc. It is concluded that VLCD...

  18. PIES free boundary stellarator equilibria with improved initial conditions

    The MFBE procedure developed by Strumberger (1997 Nucl. Fusion 37 19) is used to provide an improved starting point for free boundary equilibrium computations in the case of W7-X (Nuehrenberg and Zille 1986 Phys. Lett. A 114 129) using the Princeton iterative equilibrium solver (PIES) code (Reiman and Greenside 1986 Comput. Phys. Commun. 43 157). Transferring the consistent field found by the variational moments equilibrium code (VMEC) (Hirshmann and Whitson 1983 Phys. Fluids 26 3553) to an extended coordinate system using the VMORPH code, a safe margin between plasma boundary and PIES domain is established. The new EXTENDERP code implements a generalization of the virtual casing principle, which allows field extension both for VMEC and PIES equilibria. This facilitates analysis of the 5/5 islands of the W7-X standard case without including them in the original PIES computation

  19. Improving treatment adherence in your patients with schizophrenia: the STAY initiative.

    Cañas, Fernando; Alptekin, Koksal; Azorin, Jean Michel; Dubois, Vincent; Emsley, Robin; García, Antonio G; Gorwood, Philip; Haddad, Peter M; Naber, Dieter; Olivares, José M; Papageorgiou, Georgios; Roca, Miquel

    2013-02-01

    Partial and non-adherence to medication is a common problem in schizophrenia, leading to an increased risk of relapse, increased likelihood of hospitalization and poorer long-term outcomes. In contrast, continuous medication in the treatment of schizophrenia is associated with positive outcomes, including improved clinical status, improved quality of life and functioning, and reduced risk of relapse and rehospitalization. Strategies aimed at improving medication adherence are therefore key for patients to achieve their treatment goals. In an attempt to address the issues of partial/non-adherence to antipsychotic medication in schizophrenia, a group of psychiatrists convened to discuss and develop a set of principles aimed at helping patients adhere to their medication. These principles were then refined and developed into the STAY (the Six principles to improve Treatment Adherence in Your patients) initiative following presentation to a wider group of psychiatrists from across Europe. This manuscript summarizes these principles and explains the rationale for their selection. These principles are: (1) recognizing that most patients with schizophrenia are at risk of partial/non-adherence at some time during the course of their illness; (2) the benefits of a good therapeutic alliance for identifying potential adherence issues; (3) tailored treatment plans to meet an individual's needs, including the most suitable route of delivery of antipsychotic medication; (4) involving family/key persons in care and psychoeducation of the patient, assuming the patient agrees to this; (5) ensuring optimal effectiveness of care; and (6) ensuring continuity in the care of patients with schizophrenia. The application of these six principles should help to raise awareness of and address poor patient adherence, as well as generally improving care of patients with schizophrenia. In turn, this should lead to improved overall clinical outcomes for patients receiving long-term treatment for schizophrenia. PMID:23288695

  20. Improving Lecture Quality through Training in Public Speaking

    Mowbray, Robert; Perry, Laura B.

    2015-01-01

    Lecturing is a common instructional format but poor lecturing skills can detract from students' learning experiences and outcomes. As lecturing is essentially a form of public communication, training in public speaking may improve lecture quality. Twelve university lecturers in Malaysia participated in a six-week public speaking skills

  1. Voltage Quality Improvement in Islanded Microgrids Supplying Nonlinear Loads

    T. Dehghani, Mohammad; Vahedi, Abolfazl; Savaghebi, Mehdi; Guerrero, Josep M.

    The aim of this paper is to improve voltage quality at the terminals of distributed generators (DGs) in an islanded microgrid. To achieve this goal, it is proposed to include separate voltage and current control loops for the fundamental and harmonics frequencies. This way, it is not necessary to...

  2. Improving NAVFAC's total quality management of construction drawings with CLIPS

    Antelman, Albert

    1991-01-01

    A diagnostic expert system to improve the quality of Naval Facilities Engineering Command (NAVFAC) construction drawings and specification is described. C Language Integrated Production System (CLIPS) and computer aided design layering standards are used in an expert system to check and coordinate construction drawings and specifications to eliminate errors and omissions.

  3. 40 CFR 65.116 - Quality improvement program for pumps.

    2010-07-01

    ... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Quality improvement program for pumps. 65.116 Section 65.116 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR..., a plant site, a company, or a group of process units. (v) The first analysis of the data shall...

  4. Improving Lecture Quality through Training in Public Speaking

    Mowbray, Robert; Perry, Laura B.

    2015-01-01

    Lecturing is a common instructional format but poor lecturing skills can detract from students' learning experiences and outcomes. As lecturing is essentially a form of public communication, training in public speaking may improve lecture quality. Twelve university lecturers in Malaysia participated in a six-week public speaking skills…

  5. Software quality and process improvement in scientific simulation codes

    Ambrosiano, J.; Webster, R. [Los Alamos National Lab., NM (United States)

    1997-11-01

    This report contains viewgraphs on the quest to develope better simulation code quality through process modeling and improvement. This study is based on the experience of the authors and interviews with ten subjects chosen from simulation code development teams at LANL. This study is descriptive rather than scientific.

  6. Improving the Quality of Instruction through a Service Teaching Framework

    Husband, Terry

    2013-01-01

    Many professors lack sufficient pedagogical training needed to teach their courses effectively. In an effort to aid professors in improving the quality of instruction in their courses, this article distills the principles embedded within a service teaching framework for instruction. The principles discussed throughout this article pertain to:…

  7. 40 CFR 63.175 - Quality improvement program for valves.

    2010-07-01

    ... 40 Protection of Environment 9 2010-07-01 2010-07-01 false Quality improvement program for valves... performance criteria for acceptance of valves and specifies criteria for the precision and accuracy of the... low probability of failure, or as having no external actuating mechanism in contact with the...

  8. Use of different additives to improve low quality surimi gelation.

    Deysi Cando

    2014-06-01

    In conclusion, in general, the physicochemical and viscoelastic properties of gels were improved by the addition of both ingredients, giving stronger gels even at very low level of salt. These results indicate that both ingredients, which do not add calories to the final gels, can be used as a good alternative for the better gelation of the low quality surimis.

  9. Implementation of Consolidated HIS: Improving Quality and Efficiency of Healthcare

    Choi, Jinwook; Kim, Jin Wook; Seo, Jeong-Wook; Chung, Chun Kee; Kim, Kyung-Hwan; Kim, Ju Han; Kim, Jong Hyo; Chie, Eui Kyu; Cho, Hyun-Jai; Goo, Jin Mo; Lee, Hyuk-Joon; Wee, Won Ryang; Nam, Sang Mo; Lim, Mi-sun; Kim, Young-Ah

    2010-01-01

    Objectives Adoption of hospital information systems offers distinctive advantages in healthcare delivery. First, implementation of consolidated hospital information system in Seoul National University Hospital led to significant improvements in quality of healthcare and efficiency of hospital management. Methods The hospital information system in Seoul National University Hospital consists of component applications: clinical information systems, clinical research support systems, administrati...

  10. Using Marketing Research Techniques To Improve Quality and Service.

    Rahilly, Tony

    Marketing in the business world has long used focus group interviews and survey techniques to explore the attitudes, behaviors, and perceptions of their customers. In the college setting, these same techniques are now being used to improve program quality, assess the effectiveness of publications, and explore the image of the college. At Durham…

  11. Improving the quality of asphalt coating with carbon nanomodifiers

    Larisa, Urkhanova; Nikolay, Shestakov; Aleksandr, Semenov; Natalya, Smirnyagina; Irina, Semenova

    2015-07-01

    This article deals with the possibility of modifying the binder by adding carbon nanomodifier to bitumen to improve the quality of asphalt. Addition of 0.05%-0.5% of nanomodifier significantly changes the properties of bitumen. Asphalt with this astringent has increased strength, heat resistance and shear resistance.

  12. Matrix of regularity for improving the quality of ECGs

    The 12-lead electrocardiography (ECG) is the gold standard for diagnosis of abnormalities of the heart. However, the ECG is susceptible to artifacts, which may lead to wrong diagnosis and thus mistreatment. It is a clinical challenge of great significance differentiating ECG artifacts from patterns of diseases. We propose a computational framework, called the matrix of regularity, to evaluate the quality of ECGs. The matrix of regularity is a novel mechanism to fuse results from multiple tests of signal quality. Moreover, this method can produce a continuous grade, which can more accurately represent the quality of an ECG. When tested on a dataset from the Computing in Cardiology/PhysioNet Challenge 2011, the algorithm achieves up to 95% accuracy. The area under the receiver operating characteristic curve is 0.97. The developed framework and computer program have the potential to improve the quality of ECGs collected using conventional and portable devices. (paper)

  13. Continuous Improvement in Nursing Education through Total Quality Management (TQM

    Tang Wai Mun

    2013-11-01

    Full Text Available Total Quality Management (TQM has generally been validated as a crucial revolution in the management field. Many academicians believe that the concept of TQM is applicable to academics and provides guiding principles towards improving education. Therefore, an increasing number of educational institutions such as schools, colleges and universities have started to embrace TQM philosophies to their curricula.Within the context of TQM, this paper would explore the concept of continuous improvement by using the Deming philosophy. Subsequently, this paper would elaborate on the application of TQM to bring about continuous improvement in the current education system.

  14. Counseling in Primary Care Improves Depression and Quality of Life

    Carta, MG; Petretto, D; Adamo, S; Bhat, KM; Lecca, ME; Mura, G; Carta, V; Angermeyer, M; Moro, MF

    2012-01-01

    Introduction: To measure the effectiveness on Quality of Life of adjunctive cognitive behavioral counseling in the setting of General Practitioners (GPs) along with the treatment as usual (TAU;) for the treatment of depression. Methods: Six month-controlled trial of patients who were referred to randomly assigned GPs (four for experimental group of patients and ten for the control) was done. Experimental sample had 34 patients with DSM-IV diagnosis of Depression (Depressed Episode, Dysthymia, or Adjustment Disorder with Depressed Mood) receiving the TAU supplemented with counseling. Control group had 30 patients with diagnosis of Depression receiving only the TAU. Results: The Beck Depression Inventory (BDI) score improved in both groups. Patients in the experimental group showed greater improvement compared to the control group at T2. The World Health Organization Quality OF Life Questionnaire (WHOQOL) score also improved in the experimental group but not in the control group. The improvement in the experimental group was statistically significant in terms of both BDI and WHOQOL scores. Conclusions: Adding counseling to TAU in general medical practice settings is more effective in controlling the symptoms of depression and improving the quality of life as measured over a period of six months, than TAU alone. These results while encouraging, also calls for a larger study involving a largersample size and a longer period of time. PMID:23173011

  15. Improvement of protein quality in grain legumes. An overview on mutational improvement of protein quality in pigeon pea

    Grain legumes provide an essential part of the diet in developing countries in terms of protein. Besides increasing production also improving the grain quality would be an important objective. The paper discusses the methodology for protein improvement in seeds of pigeon pea. Variety Hy-2 was irradiated with 20, 25, 30 and 35 Kr of gamma radiation and the M2 population was screened for total sulfur content

  16. Stimulating a Culture of Improvement: Introducing 
an Integrated Quality Tool for Organizational Self-Assessment.

    Coleman, Cathy

    2015-06-01

    As leaders and systems-level agents of change, oncology nurses are challenged by opportunities to guide organizational transformation from the front line to the board room. Across all care settings, reform and change initiatives are constants in the quest to optimize quality and healthcare outcomes for individuals, teams, populations, and organizations. This article describes a practical, evidence-based, integrated quality tool for initiating organizational self-assessment to prioritize issues and stimulate a culture of continuous improvement. PMID:26000575

  17. Collaborative quality improvement in the cardiac intensive care unit: development of the Paediatric Cardiac Critical Care Consortium (PC4).

    Gaies, Michael; Cooper, David S; Tabbutt, Sarah; Schwartz, Steven M; Ghanayem, Nancy; Chanani, Nikhil K; Costello, John M; Thiagarajan, Ravi R; Laussen, Peter C; Shekerdemian, Lara S; Donohue, Janet E; Willis, Gina M; Gaynor, J William; Jacobs, Jeffrey P; Ohye, Richard G; Charpie, John R; Pasquali, Sara K; Scheurer, Mark A

    2015-06-01

    Despite many advances in recent years for patients with critical paediatric and congenital cardiac disease, significant variation in outcomes remains across hospitals. Collaborative quality improvement has enhanced the quality and value of health care across specialties, partly by determining the reasons for variation and targeting strategies to reduce it. Developing an infrastructure for collaborative quality improvement in paediatric cardiac critical care holds promise for developing benchmarks of quality, to reduce preventable mortality and morbidity, optimise the long-term health of patients with critical congenital cardiovascular disease, and reduce unnecessary resource utilisation in the cardiac intensive care unit environment. The Pediatric Cardiac Critical Care Consortium (PC4) has been modelled after successful collaborative quality improvement initiatives, and is positioned to provide the data platform necessary to realise these objectives. We describe the development of PC4 including the philosophical, organisational, and infrastructural components that will facilitate collaborative quality improvement in paediatric cardiac critical care. PMID:25167212

  18. Quality improvement in basic histotechnology: the lean approach.

    Clark, David

    2016-01-01

    Lean is a comprehensive system of management based on the Toyota production system (TPS), encompassing all the activities of an organization. It focuses management activity on creating value for the end-user by continuously improving operational effectiveness and removing waste. Lean management creates a culture of continuous quality improvement with a strong emphasis on developing the problem-solving capability of staff using the scientific method (Deming's Plan, Do, Check, Act cycle). Lean management systems have been adopted by a number of histopathology departments throughout the world to simultaneously improve quality (reducing errors and shortening turnround times) and lower costs (by increasing efficiency). This article describes the key concepts that make up a lean management system, and how these concepts have been adapted from manufacturing industry and applied to histopathology using a case study of lean implementation and evidence from the literature. It discusses the benefits, limitations, and pitfalls encountered when implementing lean management systems. PMID:26306714

  19. Research on Improving Manufacturing Practice Quality in Mechanical Industrial Design

    Xiaowei Jiang

    2013-07-01

    Full Text Available In order to solve the problems existing in the manufacturing practice of mechanical industrial design, a series of methods and concrete measures are proposed, so as to improve the quality of manufacturing practice of mechanical industrial design. In this study, the problems existing in the manufacturing practice of mechanical industrial design are analyzed detailedly. And the methods and concrete measures including establishing the new mode of manufacturing practice of mechanical industrial design, improving the understanding to manufacturing practice and knowing the major role, establishing a professional characteristic base of manufacturing practice and strengthening the construction of instructor troops of manufacturing practice are proposed, which will certainly have a profound theoretical and practical guiding significance. On this foundation, the research conclusion on improving manufacturing practice quality in mechanical industrial design is done.

  20. Involving patients in care decisions improves satisfaction: an outcomes-based quality improvement project.

    Leff, Ellen W

    2004-05-01

    A home care agency used quality improvement processes to improve patient satisfaction survey ratings. The focus was on involving patients in decisions about their care. A multidisciplinary team developed creative strategies to increase staff awareness and enhance customer service skills, which had dramatic results. PMID:15131417

  1. Review Paper: Quality Improvement through Six Sigma DMAIC Methodology

    Patel Rumana*

    2014-12-01

    Full Text Available This paper is an attempt to review and present how the DMAIC methodology has been studied and researched by various researchers. Globalization, advanced technology, and increased sophisticated customer demands change the way of conducting business. Old business models no longer work in new economy. Defects rate of product plays an important role for the improvement of yield and financial conditions of any company. Business performance excellence is the competitive edge for commercial firms to survive in highly competitive markets. Among the many business improvement approaches available, the Six-Sigma approach has been recognized as one of the most effective methods. Organizations are increasingly adopting Six Sigma in a bid to improve the quality of their processes and products, and thus achieve competitive advantage. Six Sigma is a smarter way to manage business or department. It is a vision of quality that equates with only 3.4 defects for million opportunities for each product or service transactions, Strives for perfection. Ultimate objectives of the methodology to solve problems, improve the quality, profitability and customers satisfaction. Six Sigma is the tool through which we can improve the Quality and profitability by removing the cause of defects and variability in manufacturing and business processes. Six Sigma has been on an incredible run for over 14 years, producing significant savings to the bottom-line of many large and small organizations. Six sigma take the users away from ‘intuition-based’ decisions to ‘fact-based’ decisions. The objective of this paper is to present an overview of six sigma. The DMAIC Methodology (Define, Measure, Analyses, Innovation, Improve and Control the problem solving steps used for six sigma projects are also reviewed in detail in this paper.

  2. Radionuclide calibrator comparisons and quality improvement in nuclear medicine

    This paper presents and discusses the evaluation over time of the quality of activity measurement results obtained in Cuban nuclear medicine, on the basis of statistical samples taken during the radionuclide calibrator comparison programme that has been operating since 2000. Particularly, results of Cuban comparisons have demonstrated that the relative standard combined uncertainty of Cuban radionuclide calibrator activity measurement results performed in accordance with adequate quality control measurement procedures, can be ascertain as equal to 3.3 % for employed in comparisons nuclides namely, 131I, 99mTc and 201Tl. Therefore, this is also a confirmation of that CENTIS-DMR Calibration and Measurement Capabilities for 131I, 99mTc and 201Tl radionuclide calibrator calibration services also satisfy established in Cuban regulations ± 10% accuracy limit. On the other hand, an attempt has been made to evaluate the role played by radionuclide calibrator comparisons in quality measurement improvement in nuclear medicine, on the basis of comparisons results obtained in a number of countries and published by several authors over a period of time. Data of gamma-emitters such as 99mTc, 201Tl, 67Ga and 131I are employed for this analysis. A χ2 test is applied to determine the character of association between the observed performance and the period of time when the exercises were organized at a significance level α=0.05. Specifically, improvements of the measurement performance over time assessed by such exercises were found dissimilar in magnitudes in different countries Two moments could be distinguished in the improvement process over time. Firstly, a fast improvement can be obtained resulting from the improvement in measurement accuracy of devices. After that, the achievement of new and sustained improvements goes slowly and requires the application of quality assurance programs where the qualification upgrading of personnel become an essential point

  3. IMPROVING THE QUALITY OF MAINTENANCE PROCESSES USING INFORMATION TECHNOLOGY

    Zora Arsovski

    2008-06-01

    Full Text Available In essence, process of maintaining equipment is a support process, because it indirectly contributes to operational ability of the production process necessary for the supply chain of the new value. Taking into account increased levels of automatization and quality, this proces s becomes more and more significant and for some branches of industry, even crucial. Due to the fact that the quality of the entire process is more and more dependent on the maintenance process, these processes must be carefully designed and effectively im plemented. There are various techniques and approaches at our disposal, such as technical, logistical and intensive application of the information - communication technologies. This last approach is presented in this work. It begins with organizational goa ls, especially quality objectives. Then, maintenance processes and integrated information system structures are defined. Maintenance process quality and improvement processes are defined using a set of performances, with a special emphasis placed on effectiveness and quality economics. At the end of the work, information system for improving maintenance economics is structured. Besides theoretical analysis, work also presents results authors obtained analyzing food industry, metal processing industry an d building materials industry.

  4. Image Quality Improvement after Implementation of a CT Accreditation Program

    The purpose of this study was to evaluate any improvement in the quality of abdominal CTs after the utilization of the nationally based accreditation program. Approval was obtained from the Institutional Review Board, and informed consent was waived. We retrospectively analyzed 1,011 outside abdominal CTs, from 2003 to 2007. We evaluated images using a fill-up sheet form of the national accreditation program, and subjectively by grading for the overall CT image quality. CT scans were divided into two categories according to time periods; before and after the implementation of the accreditation program. We compared CT scans between two periods according to parameters pertaining to the evaluation of images. We determined whether there was a correlation between the results of a subjective assessment of the image quality and the evaluation scores of the clinical image. The following parameters were significantly different after the implementation of the accreditation program: identifying data, display parameters, scan length, spatial and contrast resolution, window width and level, optimal contrast enhancement, slice thickness, and total score. The remaining parameters were not significantly different between scans obtained from the two different periods: scan parameters, film quality, and artifacts. After performing the CT accreditation program, the quality of the outside abdominal CTs show marked improvement, especially for the parameters related to the scanning protocol

  5. Improving Volunteered Geographic Data Quality Using Semantic Similarity Measurements

    Vandecasteele, A.; Devillers, R.

    2013-05-01

    Studies have analysed the quality of volunteered geographic information (VGI) datasets, assessing the positional accuracy of features and the completeness of specific attributes. While it has been shown that VGI can, in some context, reach a high positional accuracy, these works have also highlighted a large spatial heterogeneity in positional accuracy, completeness but also with regards to the semantics of the objects. Such high semantic heterogeneity of VGI datasets becomes a significant obstacle to a number of possible uses that could be made of the data. This paper proposes an approach for both improving the semantic quality and reducing the semantic heterogeneity of VGI dat asets. The improvement of the semantic quality is achieved by automatically suggesting attributes to contributors during the editing process. The reduction of semantic heterogeneity is achieved by automatically notifying contributors when two attributes are too similar or too dissimilar. The approach was implemented into a plugin for OpenStreetMap and different examples illustrate how this plugin can be used to improve the quality of VGI data.

  6. GENETICS AND MOLECULAR BIOLOGY AND PIG MEAT QUALITY IMPROVEMENT

    BULLA, J.

    2007-01-01

    Full Text Available The main goals in pig breeding have for many years been to improve growth rate, feedconversion and carcass composition. There have been less efforts to improve meat qualityparameters (WHC, pH, tenderness, colour etc. but the main contribution has been areduction of stress susceptibility and PSE meat. Unfortunately, the quantitative geneticapproach has yielded few clues regarding the fundamental genetic changes that accompaniedthe selection of animal for superior carcass attributes. While mapping efforts are makingsignificant major effects on carcass and his quality composition DNA test would be availableto detect some positive or negative alleles. There are clear breed effects on meat quality,which in some cases are fully related to the presence of a single gene with major effect (RYR1,MYF4, H-FABP, LEPR, IGF2. Molecular biology methods provides excellent opportunitiesto improve meat quality in selection schemes within breeds and lines. Selection on majorgenes will not only increase average levels of quality but also decrease variability (ei increaseuniformity. The aim of this paper is to discuss there genetic and non-genetic opportunities.

  7. GENETICS AND MOLECULAR BIOLOGY AND PIG MEAT QUALITY IMPROVEMENT

    J. BULLA

    2013-12-01

    Full Text Available The main goals in pig breeding have for many years been to improve growth rate, feedconversion and carcass composition. There have been less efforts to improve meat qualityparameters (WHC, pH, tenderness, colour etc. but the main contribution has been areduction of stress susceptibility and PSE meat. Unfortunately, the quantitative geneticapproach has yielded few clues regarding the fundamental genetic changes that accompaniedthe selection of animal for superior carcass attributes. While mapping efforts are makingsignificant major effects on carcass and his quality composition DNA test would be availableto detect some positive or negative alleles. There are clear breed effects on meat quality,which in some cases are fully related to the presence of a single gene with major effect (RYR1,MYF4, H-FABP, LEPR, IGF2. Molecular biology methods provides excellent opportunitiesto improve meat quality in selection schemes within breeds and lines. Selection on majorgenes will not only increase average levels of quality but also decrease variability (ei increaseuniformity. The aim of this paper is to discuss there genetic and non-genetic opportunities.

  8. Conducting a Successful Practice Quality Improvement Project for American Board of Radiology Certification.

    Lee, Cindy S; Wadhwa, Vibhor; Kruskal, Jonathan B; Larson, David B

    2015-10-01

    Practice quality improvement (PQI) is a required component of the American Board of Radiology (ABR) Maintenance of Certification (MOC) cycle, with the goal to "improve the quality of health care through diplomate-initiated learning and quality improvement." The essential requirements of PQI projects include relevance to one's practice, achievability in one's clinical setting, results suited for repeat measurements during an ABR MOC cycle, and reasonable expectation to result in quality improvement (QI). PQI projects can be performed by a group or an individual or as part of a participating institution. Given the interdisciplinary nature of radiology, teamwork is critical to ensure patient safety and the success of PQI projects. Additionally, successful QI requires considerable investment of time and resources, coordination, organizational support, and individual engagement. Group PQI projects offer many advantages, especially in larger practices and for processes that cross organizational boundaries, whereas individual projects may be preferred in small practices or for focused projects. In addition to the three-phase "plan, do, study, act" model advocated by the ABR, there are several other improvement models, which are based on continuous data collection and rapid simultaneous testing of multiple interventions. When properly planned, supported, and executed, group PQI projects can improve the value and viability of a radiology practice. PMID:26334572

  9. Improving quality of care in substance abuse treatment using five key process improvement principles

    Hoffman, Kim A; Green, Carla A; Ford, James H.; Wisdom, Jennifer P; Gustafson, David H.; McCarty, Dennis

    2012-01-01

    Process and quality improvement techniques have been successfully applied in health care arenas, but efforts to institute these strategies in alcohol and drug treatment are underdeveloped. The Network for the Improvement of Addiction Treatment (NIATx) teaches participating substance abuse treatment agencies to use process improvement strategies to increase client access to, and retention in, treatment. NIATx recommends five principles to promote organizational change: 1) Understand and involv...

  10. Quality and productivity improvement program (PPKP) from alumni perspective

    Ruza, Nadiah; Mustafa, Zainol

    2013-04-01

    Defining the quality of the university education system is not easy. Institutions of higher education, through curriculum are hoped to provide the knowledge, wisdom and personality of students. It is questionable of how far Quality and Productivity Improvement Program (PPKP) are capable to ensure the courses offered relevant and effective in preparing the students for job market. The effectiveness of a university to undertake responsibilities and the impact given to students even after they graduate can be a measure of education quality at university. So, the quality of education can be enhanced and improved from time to time. In general, this study is aims to determine the effectiveness of PPKP's education system from the perspective of their alumni as well as their satisfaction and the importance level based on how PPKP be able to meet their needs. In overall, summary of open-ended questions from the questionnaire, Importance-Performance analysis and correlation analysis were conducted for this study. Based on result, it appears that there are still some deficiencies that can be improve, particularly in terms of teaching skills and PPKP's relationships with external organizations to enable knowledge be channel effectively. Importance-Performance analysis highlights some topics or courses that should be offered by PPKP based on their importance in industrial practice. Summary of the results of correlation analysis was found that women are more positive and not too demanding compared to men. In addition, it is found that the responsibilities and workload of the older generations, higher income and a high level of experience demands them to use and practice what they have learned during their studies at PPKP. Results of this study are hoped could be used to improve the quality of education system at PPKP.

  11. IMPROVEMENT OF ROAD TRAFFIC QUALITY IN ACCIDENT CLUSTERS

    D. V. Kapsky

    2015-05-01

    Full Text Available Road traffic with its share from 2/3 to 3/4 of the total volume of transport service represents rather large and complicated social and production system with several subsystems that include roads, transport facilities, road traffic organization, law enforcement, personnel training, road traffic service and others. Road traffic quality can be quantitatively evaluated in accordance with values of losses pertaining to social and economic cost of discretionary (unenforced expenses for road traffic process. Road traffic contains accident, ecological, economic and social risks. Accidence is considered as the most important risk for participants involved in road traffic because it directly concerns their life, health and welfare. So accident response has rather high social significance and it is considered as a matter of national importance. In this connection role of road traffic organization has become very important and it is directed on improvement of its quality including security in the accident clusters.Methodological principles for improvement of road traffic quality have been developed in the paper. These principles presuppose the following: maximization of danger while selecting investigation object; minimization of total losses while evaluating quality and selecting solutions on improvement in road traffic safety; balanced accountability of accidental and ecological losses while selecting solutions on higher road traffic safety in ambiguous situations; minimization of total cost pertaining to object operation while selecting measures on improvement of road traffic safety; obligatory operative control evaluation of accidence on the basis of method for conflict situations while introducing measures of road traffic safety. Such approaches will contribute to higher quality of the decisions taken in the field of road traffic organization.

  12. Software Defect Prediction Models for Quality Improvement: A Literature Study

    Mrinal Singh Rawat

    2012-09-01

    Full Text Available In spite of meticulous planning, well documentation and proper process control during software development, occurrences of certain defects are inevitable. These software defects may lead to degradation of the quality which might be the underlying cause of failure. In todays cutting edge competition its necessary to make conscious efforts to control and minimize defects in software engineering. However, these efforts cost money, time and resources. This paper identifies causative factors which in turn suggest the remedies to improve software quality and productivity. The paper also showcases on how the various defect prediction models are implemented resulting in reduced magnitude of defects.

  13. Using quality improvement to promote implementation and increase well child visits in home visiting.

    Goyal, Neera K; Ammerman, Robert T; Massie, Julie A; Clark, Margaret; Van Ginkel, Judith B

    2016-03-01

    A key goal of home visiting is to connect children with medical homes through anticipatory guidance regarding recommended well child care (WCC). Substantial barriers to WCC among low socioeconomic families can limit achievement of this outcome. Quality improvement strategies have been widely adopted in healthcare but only recently implemented in home visiting to achieve program outcomes. The objective of this initiative was to increase the percentage of infants enrolled in home visiting who completed at least 3 recommended WCC visits in the first 6 months of life within a large, multi-model program comprised of 11 sites. A series of 33 quality improvement cycles were conducted at 3 sites involving 18 home visitors and 139 families with infants in the target age range. These were deployed sequentially, and changes within and across sites were monitored using trend charts over time. Adopted strategies were then implemented program-wide. Initiatives focused on staff training in WCC recommendations, data collection processes, monthly family tracking reports, and enhanced communication with primary care offices. Data were shared in iterative sessions to identify methods for improving adherence. Wide baseline variability across sites was observed, with the percentage of infants with recommended care ranging from 35% to 83%. Over the project timeline, the percentage of infants receiving at least 3 WCC visits in the first 6 months increased from 58% to 86%. Quality improvement within home visiting can be used to improve WCC adherence and provides an example of maximizing implementation of home visiting interventions. PMID:26699456

  14. A Systems Thinking Approach To The Sustainability Of Quality Improvement Programmes

    Van Dyk, Dirk Johannes; Pretorius, Leon

    2014-01-01

    The challenge for organisations to continually provide the best return on investment for their shareholders has become increasingly difficult through globalisation of the market place. There are many responses a company could make to these challenges for example, new product development, increased market capitalisation, cost reduction initiatives, and quality management. This last response focuses on, but is not restricted to, customer satisfaction, continuous improvement, and environmental i...

  15. Quality improvement and practice-based research in neurology using the electronic medical record

    Maraganore, Demetrius M.; Frigerio, Roberta; Kazmi, Nazia; Meyers, Steven L.; Sefa, Meredith; Walters, Shaun A.; Silverstein, Jonathan C.

    2015-01-01

    Abstract We describe quality improvement and practice-based research using the electronic medical record (EMR) in a community health system–based department of neurology. Our care transformation initiative targets 10 neurologic disorders (brain tumors, epilepsy, migraine, memory disorders, mild traumatic brain injury, multiple sclerosis, neuropathy, Parkinson disease, restless legs syndrome, and stroke) and brain health (risk assessments and interventions to prevent Alzheimer disease and rela...

  16. Reducing the frequency of episiotomies through a continuous quality improvement program.

    Reynolds, J L

    1995-01-01

    OBJECTIVE: To determine the effectiveness of a continuous quality improvement (CQI) program in reducing episiotomy rates. DESIGN: Before-and-after study; CQI methods were used to examine the process of care during labour and birth. INTERVENTIONS: Identification of care factors that would increase the probability of episiotomy. Implementation of initiatives that would change the process of care to minimize the probability of episiotomy. Educational strategies included promotion of better under...

  17. Psychosocial interventions to improve quality of life and emotional wellbeing for recently diagnosed cancer patients

    Galway, Karen; Black, Amanda; Cantwell, Marie; Cardwell, Christopher; Mills, Moyra; Donnelly, Michael

    2012-01-01

    BACKGROUND:A cancer diagnosis may lead to significant psychological distress in up to 75% of cases. There is a lack of clarity about the most effective ways to address this psychological distress.OBJECTIVES:To assess the effects of psychosocial interventions to improve quality of life (QoL) and general psychological distress in the 12-month phase following an initial cancer diagnosis.SEARCH METHODS:We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library ...

  18. Use of risk-adjusted outcome data for quality improvement by public hospitals.

    Luce, J M; Thiel, G D; Holland, M R; Swig, L.; Currin, S A; Luft, H. S.

    1996-01-01

    In 1993 the California Office of Statewide Health Planning and Development (OSHPD) began public release of risk-adjusted monitoring of outcomes (RAMO) under the California Hospital Outcomes Project. We studied how 17 acute are public hospitals in California used these RAMO data for quality improvement purposes following their initial distribution, first by analyzing the outcome data for San Francisco General Hospital Medical Center as recommended by OSHPD and, second, by querying the departme...

  19. Impacts of Security Improvements on Service Quality in Maritime Transport: An Empirical Study of Vietnam

    Vinh V Thai

    2007-01-01

    In recent years, maritime security has become a major concern on the international maritime agenda. If security measures and initiatives are not carefully designed and effectively implemented, they can negatively impact the whole maritime transport chain. Security improvements resulting from maritime security requirements may also bring about some benefits to service quality and business performance for the organisation. However, there are limited studies conducted on these aspects. In this p...

  20. Quality-based financial incentives in health care: can we improve quality by paying for it?

    Conrad, Douglas A; Perry, Lisa

    2009-01-01

    This article asks whether financial incentives can improve the quality of health care. A conceptual framework drawn from microeconomics, agency theory, behavioral economics, and cognitive psychology motivates a set of propositions about incentive effects on clinical quality. These propositions are evaluated through a synthesis of extant peer-reviewed empirical evidence. Comprehensive financial incentives--balancing rewards and penalties; blending structure, process, and outcome measures; emphasizing continuous, absolute performance standards; tailoring the size of incremental rewards to increasing marginal costs of quality improvement; and assuring certainty, frequency, and sustainability of incentive payoffs--offer the prospect of significantly enhancing quality beyond the modest impacts of prevailing pay-for-performance (P4P) programs. Such organizational innovations as the primary care medical home and accountable health care organizations are expected to catalyze more powerful quality incentive models: risk- and quality-adjusted capitation, episode of care payments, and enhanced fee-for-service payments for quality dimensions (e.g., prevention) most amenable to piece-rate delivery. PMID:19296779

  1. 42 CFR 416.43 - Conditions for coverage-Quality assessment and performance improvement.

    2010-10-01

    ... patient safety by using quality indicators or performance measures associated with improved health... outcomes, patient safety, and quality of care. (2) Performance improvement activities must track adverse... track quality indicators, adverse patient events, infection control and other aspects of...

  2. Improving quality while managing costs in emergency medicine.

    West, T D; Pitzer, S A

    1997-01-01

    This article correlates quality of care with cost of care. The authors describe their experience in developing an internal measure of quality and two surrogates for cost. They examine archival data for 3,671 patients in the emergency department of a large community teaching hospital. Their results indicate statistically significant differences among emergent, urgent, and routine care assessments by triage staff, nurses, and physicians. Only 56 percent of the assessments were consistent. Triage was significantly less predictive of nursing acuity assessments than physician resource-based relative value scale codes. The authors conclude that by reducing process variation in patient acuity assessments, health care managers can improve quality of care while managing costs. PMID:9327356

  3. Leveraging Trainees to Improve Quality and Safety at the Point of Care: Three Models for Engagement.

    Johnson Faherty, Laura; Mate, Kedar S; Moses, James M

    2016-04-01

    Trainees, as frontline providers who are acutely aware of quality improvement (QI) opportunities and patient safety (PS) issues, are key partners in achieving institutional quality and safety goals. However, as academic medical centers accelerate their initiatives to prioritize QI and PS, trainees have not always been engaged in these efforts. This article describes the development of an organizing framework with three suggested models of varying scopes and time horizons to effectively involve trainees in the quality and safety work of their training institutions. The proposed models, which were developed through a literature review, expert interviews with key stakeholders, and iterative testing, are (1) short-term, team-based, rapid-cycle initiatives; (2) medium-term, unit-based initiatives; and (3) long-term, health-system-wide initiatives. For each, the authors describe the objective, scope, duration, role of faculty leaders, steps for implementation in the clinical setting, pros and cons, and examples in the clinical setting. There are many barriers to designing the ideal training environments that fully engage trainees in QI/PS efforts, including lack of protected time for faculty mentors, time restrictions due to rotation-based training, and structural challenges. However, one of the most promising strategies for overcoming these barriers is integrating QI/PS principles into routine clinical care. These models provide opportunities for trainees to successfully learn and apply quality and safety principles to routine clinical care at the team, unit, and system level. PMID:26535866

  4. Personal informatics in practice: Improving quality of life through data

    Li, Ian; Medynskiy, Yevgeniy; Froehlich, Jon; Larsen, Jakob Eg

    Personal informatics refers to a class of software and hardware systems that help individuals collect personal information to improve self-understanding. Improving self-understanding can foster self-insight and promote positive behaviors: healthy living, energy conservation, etc. The development ...... building robust personal informatics applications; and (3) design and development of infrastructures that make personal informatics applications easier to create and evaluate.......Personal informatics refers to a class of software and hardware systems that help individuals collect personal information to improve self-understanding. Improving self-understanding can foster self-insight and promote positive behaviors: healthy living, energy conservation, etc. The development of...... personal informatics applications poses new challenges for human-computer interaction and creates opportunities for applications in various domains related to quality of life, such as fitness, nutrition, wellness, mental health, and sustainability. This workshop will continue the conversations from the CHI...

  5. Interdisciplinary teamwork and the power of a quality improvement collaborative in tertiary neonatal intensive care units.

    Grover, Theresa R; Pallotto, Eugenia K; Brozanski, Beverly; Piazza, Anthony J; Chuo, John; Moran, Susan; McClead, Richard; Mingrone, Teresa; Morelli, Lorna; Smith, Joan R

    2015-01-01

    Significant gaps in healthcare quality and outcomes can be reduced via quality improvement collaboratives (QICs), which improve care by leveraging data and experience from multiple organizations.The Children's Hospital Neonatal Consortium Collaborative Initiatives for Quality Improvement team developed an infrastructure for neonatal QICs. We describe the structure and components of an effective multi-institutional neonatal QIC that implemented the "SLUG Bug" project designed to reduce central line-associated bloodstream infections (CLABSIs).The operational infrastructure of SLUG Bug involved 17 tertiary care neonatal intensive care units with a goal to reduce CLABSI in high-risk neonates. Clinical Practice Recommendations were produced, and the Institute of Healthcare Improvement Breakthrough Series provided the framework for the collaborative. Process measures studied the effectiveness of the collaborative structure.CLABSI rates decreased by 20% during a 12-month study period. Compliance bundle reporting exceeded 80%. A QIC score of 2.5 or more ("improvement") was achieved by 94% of centers and a score 4 or more ("significant improvement") was achieved by 35%.Frequent interactive project meetings, well-defined project metrics, continual shared learning opportunities, and individual team coaching were key QIC success components. Through a coordinated approach and committed leadership, QICs can effectively implement change and improve the care of neonates with complex diagnoses and rare diseases. PMID:25919608

  6. Improving image quality of parallel phase-shifting digital holography

    Awatsuji, Yasuhiro; Tahara, Tatsuki; Kaneko, Atsushi; Koyama, Takamasa; Nishio, Kenzo; Ura, Shogo [Kyoto Institute of Technology, Matsugasaki, Sakyo-ku, Kyoto 606-8585 (Japan); Kubota, Toshihiro [Kubota Holography Laboratory Co., Nishihata 34-1-609, Ogura-cho, Uji, 611-0042 (Japan); Matoba, Osamu [Kobe University, Rokkodai 1-1, Nada-ku, Kobe 657-8501 (Japan)], E-mail: awatsuji@kit.ac.jp

    2008-11-01

    The authors propose parallel two-step phase-shifting digital holography to improve the image quality of parallel phase-shifting digital holography. The proposed technique can increase the effective number of pixels of hologram twice in comparison to the conventional parallel four-step technique. The increase of the number of pixels makes it possible to improve the image quality of the reconstructed image of the parallel phase-shifting digital holography. Numerical simulation and preliminary experiment of the proposed technique were conducted and the effectiveness of the technique was confirmed. The proposed technique is more practical than the conventional parallel phase-shifting digital holography, because the composition of the digital holographic system based on the proposed technique is simpler.

  7. Improving image quality of parallel phase-shifting digital holography

    The authors propose parallel two-step phase-shifting digital holography to improve the image quality of parallel phase-shifting digital holography. The proposed technique can increase the effective number of pixels of hologram twice in comparison to the conventional parallel four-step technique. The increase of the number of pixels makes it possible to improve the image quality of the reconstructed image of the parallel phase-shifting digital holography. Numerical simulation and preliminary experiment of the proposed technique were conducted and the effectiveness of the technique was confirmed. The proposed technique is more practical than the conventional parallel phase-shifting digital holography, because the composition of the digital holographic system based on the proposed technique is simpler.

  8. Casting Defect Detection and Quality Improvement by Industrial CT

    A 3D-CT system provides complete volume information on the testing objects and gives us many possibilities in the nondestructive testing area. As the development in automobile and aircraft industry, needs for casting parts with high quality and reliability become more and more important. The 3D-CT system can be applied not only to the sample testing in order to find and avoid casting defects by mass production but also to the development of a prototype. In this work porosities and shrinkages in die-casting parts were analyzed with the CT system to make improvement in the quality of castings. The CT scan system combined with simulation technology in the field of mold filling and solidification is expected to be the most effective tool for improving productivity in the die-casting production.

  9. IMS Meteorological Data, Current Status and Improvement of Data Quality

    Martysevich, Pavel; Marty, Julien; Polzer, Peter

    2015-04-01

    The objective of the poster is to present the efforts made by the Provisional Technical Secretariat (PTS) over the last 3 years to assess and improve the quality of the meteorological data recorded at International Monitoring System (IMS) infrasound stations. This includes the processing and assessment of the data recorded since 2000, the organization of Expert Group Meetings, comparison of the IMS and World Meteorological Organization requirements to the meteorological data and the list of actions taken/to be taken for improving the reliability and accuracy of IMS meteorological data.

  10. Improving Quality of Seal Leak Test Product using Six Sigma

    Luthfi Malik, Abdullah; Akbar, Muhammad; Irianto, Dradjad

    2016-02-01

    Seal leak test part is a polyurethane material-based product. Based on past data, defect level of this product was 8%, higher than the target of 5%. Quality improvement effort was done using six sigma method that included phases of define, measure, analyse, improve, and control. In the design phase, a Delphi method was used to identify factors that were critical to quality. In the measure phase, stability and process capability was measured. Fault tree analysis (FTA) and failure mode and effect analysis (FMEA) were used in the next phase to analize the root cause and to determine the priority issues. Improve phase was done by compiling, selecting, and designing alternative repair. Some improvement efforts were identified, i.e. (i) making a checklist for maintenance schedules, (ii) making written reminder form, (iii) modifying the SOP more detail, and (iv) performing a major service to the vacuum machine. To ensure the continuity of improvement efforts, some control activities were executed, i.e. (i) controlling, monitoring, documenting, and setting target frequently, (ii) implementing reward and punishment system, (iii) adding cleaning tool, and (iv) building six sigma organizational structure.

  11. Improving image quality in portal venography with spectral CT imaging

    Zhao, Li-qin, E-mail: zhaolqzr@sohu.com [Department of Radiology, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing,100050 (China); He, Wen, E-mail: hewen1724@sina.com [Department of Radiology, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing,100050 (China); Li, Jian-ying, E-mail: jianying.li@med.ge.com [CT Advanced Application and Research, GE Healthcare, 100176 China (China); Chen, Jiang-hong, E-mail: chenjianghong1973@hotmail.com [Department of Radiology, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing,100050 (China); Wang, Ke-yang, E-mail: ke7ke@sina.com [Department of Radiology, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing,100050 (China); Tan, Li, E-mail: Litan@ge.com [CT product, GE Healthcare, 100176 China (China)

    2012-08-15

    Objective: To investigate the effect of energy spectral CT on the image quality of CT portal venography in cirrhosis patients. Materials and methods: 30 portal hypertension patients underwent spectral CT examination using a single-tube, fast dual tube voltage switching technique. 101 sets of monochromatic images were generated from 40 keV to 140 keV. Image noise and contrast-to-noise ratio (CNR) for portal veins from the monochromatic images were measured. An optimal monochromatic image set was selected for obtaining the best CNR for portal veins. The image noise and CNR of the intra-hepatic portal vein and extra-hepatic main stem at the selected monochromatic level were compared with those from the conventional polychromatic images. Image quality was also assessed and compared. Results: The monochromatic images at 51 keV were found to provide the best CNR for both the intra-hepatic and extra-hepatic portal veins. At this energy level, the monochromatic images had about 100% higher CNR than the polychromatic images with a moderate 30% noise increase. The qualitative image quality assessment was also statistically higher with monochromatic images at 51 keV. Conclusion: Monochromatic images at 51 keV for CT portal venography could improve CNR for displaying hepatic portal veins and improve the overall image quality.

  12. Improving image quality in portal venography with spectral CT imaging

    Objective: To investigate the effect of energy spectral CT on the image quality of CT portal venography in cirrhosis patients. Materials and methods: 30 portal hypertension patients underwent spectral CT examination using a single-tube, fast dual tube voltage switching technique. 101 sets of monochromatic images were generated from 40 keV to 140 keV. Image noise and contrast-to-noise ratio (CNR) for portal veins from the monochromatic images were measured. An optimal monochromatic image set was selected for obtaining the best CNR for portal veins. The image noise and CNR of the intra-hepatic portal vein and extra-hepatic main stem at the selected monochromatic level were compared with those from the conventional polychromatic images. Image quality was also assessed and compared. Results: The monochromatic images at 51 keV were found to provide the best CNR for both the intra-hepatic and extra-hepatic portal veins. At this energy level, the monochromatic images had about 100% higher CNR than the polychromatic images with a moderate 30% noise increase. The qualitative image quality assessment was also statistically higher with monochromatic images at 51 keV. Conclusion: Monochromatic images at 51 keV for CT portal venography could improve CNR for displaying hepatic portal veins and improve the overall image quality.

  13. Improvement of bacteriological quality of frozen shrimp by gamma radiation

    The possible use of gamma irradiation at doses of 2 and 3 kGy to improve bacteriological quality of frozen shrimp was investigated. The effects of gamma irradiation on salmonella viability in frozen shrimp and on sensory quality of frozen shrimp were also evaluated. Treatment of frozen shrimp at 3 kGy reduced bacterial load by 2 log cycles and eliminated Enterobacteriaceae, E. coli, V. parahaemolyticus, and S. aureus. Coliform was still present in a 3 kGy treated samples but in a very small percentage and the count was less than 10 cell/g. Salmonella was not detected in either irradiated or non-irradiated frozen shrimp. A difference in radiation resistance was noted among five salmonella serotypes tested. S. lexington was the most resistant and S. anatum was the least resistant. Salmonella resistance was higher in frozen inoculated shrimp than in refrigerated inoculated shrimp. A dose of at least 4.2 kGy is required for a seven log cycle reduction of salmonella contamination in frozen shrimp. Off-flavors were produced in frozen shrimp irradiated at 4.2 kGy but diminished during subsequent frozen storage. However, irradiated frozen shrimp was of acceptable quality for at least four months. Dosage at 3 kGy appeared to be sufficient for improving bacteriological quality of frozen shrimp

  14. Improving quality of joints of mine shaft concrete lining

    Abramson, Kh.I.; Veisbein, D.A.; Cheremisin, L.P.

    1980-09-01

    This article discusses damage to monolithic concrete shaft lining in the Donbass, caused by filtration of corrosive mine water through the lining. The filtration is caused by poor quality of concrete and cement used to form the lining as well as by the particularly low quality of joints in the monolothic concrete. Regulations state that the monolithic concrete lining of shafts should be watertight when affected by high hydrostatic pressures (10-15) 10at5 MPa. Investigations show, however, that watertightness of the lining is much lower: (1-5) x 10at5 MPa. Water permeability of monolithic concrete lining is particularly high in places where sections of the monolithic lining are jointed (at intervals 10 to 24 h). Analysis of data collected in the Donbass shows that water permeability at joints is 10 times higher than water permeability elsewhere in the lining. Improving quality of concrete (quality of cement and type and grain size distribution of aggregate) can increase adhesion of concrete at the joints by 1.2 to 1.5 times. Another way of improving watertight properties of concrete is a new technology of forming the lining. At present the lining is laid in the full thickness of the concrete shell. Laying concrete in two layers, inner and outer, is proposed. It is suggested that such a method efficiently prevents creation of joints as the joint of the outer layer of the shell is closed by the inner monolithic part of the shell and vice versa.

  15. Quantitative study designs used in quality improvement and assessment.

    Ormes, W S; Brim, M B; Coggan, P

    2001-01-01

    This article describes common quantitative design techniques that can be used to collect and analyze quality data. An understanding of the differences between these design techniques can help healthcare quality professionals make the most efficient use of their time, energies, and resources. To evaluate the advantages and disadvantages of these various study designs, it is necessary to assess factors that threaten the degree with which quality professionals may infer a cause-and-effect relationship from the data collected. Processes, the conduits of organizational function, often can be assessed by methods that do not take into account confounding and compromising circumstances that affect the outcomes of their analyses. An assumption that the implementation of process improvements may cause real change is incomplete without a consideration of other factors that might also have caused the same result. It is only through the identification, assessment, and exclusion of these alternative factors that administrators and healthcare quality professionals can assess the degree to which true process improvement or compliance has occurred. This article describes the advantages and disadvantages of common quantitative design techniques and reviews the corresponding threats to the interpretability of data obtained from their use. PMID:11378972

  16. Improvement of bacteriological quality of frozen chicken by gamma radiation

    The possible use of gamma irradiation at doses of 1.6 to 4.0 kGy to improve bacteriological quality of frozen chicken was investigated. The effects of gamma irradiation on salmonella viability in frozen chicken and on sensory quality of frozen chicken were also evaluated. D10-values for different isolated strains of salmonella in frozen chicken varied from 0.41 to 0.57 kGy. A dose of 4 kGy is required for a seven log cycle reduction of salmonella contamination in frozen chicken. Approximately 21 per cent of frozen chicken examined were contaminated with salmonella. Salmonella typhimurium, salmonella virchow, and salmonella java were predominant. Irradiation of frozen chicken at a minimum dose of 3.2 kGy eliminated salmonella, coliform, Escherichia coli, and Staphylococcus aureus and, in addition, reduced baterial load by 2 log cycles. Faecal streptococci was still present in a 3.2 kGy samples but in a very small percentage and the count was not over 100 colonies per g. Discoloring of chicken meat was noted after a 2 kGy treatment. The sensory quality of frozen chicken irradiated at 3 and 4 kGy tended to decrease during frozen storage but was within the acceptable range on a nine point hedonic scale even after eight months of frozen storage. Dosage at 3.2 kGy appeared to be sufficient for improving bacteriological quality of frozen chicken

  17. A measurement instrument for spread of quality improvement in healthcare

    Slaghuis, Sarah; Strating, Mathilde; Bal, Roland; Nieboer, Anna

    2013-01-01

    textabstractAbstract Objective. The aim of this study was to develop and test a measurement instrument for spread of quality improvement in healthcare. The instrument distinguishes: (i) spread of work practices and their results and (ii) spread practices and effectiveness. Relations between spread and sustainability of changed work practices were also explored to assess convergent validity. Design. We developed and tested a measurement instrument for spread in a follow-up study. The instrumen...

  18. Improving Quality of Service from TCP/IP Performance Degradation

    Prof.N..Penchalaiah; Dr.R.Seshadri,

    2011-01-01

    TCP is currently the dominate congestion control protocol for the Internet. However, as the Internet evolves into a high-speed wired-cum-wireless hybrid network, performance degradation problems of TCP have appeared, such as underutilizing high-speed links, regarding wireless loss as congestion signal, and unfairness among flows with different RTTs. In order to improve the quality of service for such highspeed hybrid networks, we propose a router-assisted congestion control protocol called Qu...

  19. Continuous Improvement in Nursing Education through Total Quality Management (TQM)

    Tang Wai Mun; Muhammad Faizal A Ghani

    2013-01-01

    Total Quality Management (TQM) has generally been validated as a crucial revolution in the management field. Many academicians believe that the concept of TQM is applicable to academics and provides guiding principles towards improving education. Therefore, an increasing number of educational institutions such as schools, colleges and universities have started to embrace TQM philosophies to their curricula.Within the context of TQM, this paper would explore the concept of continuous improveme...

  20. Skill Gap Analysis for Improved Skills and Quality Deliverables

    Mallikarjun Koripadu; K. Venkata Subbiah

    2014-01-01

    With a growing pressure in identifying the skilled resources in Clinical Data Management (CDM) world of clinical research organizations, to provide the quality deliverables most of the CDM organizations are planning to improve the skills within the organization. In changing CDM landscape the ability to build, manage and leverage the skills of clinical data managers is very critical and important. Within CDM to proactively identify, analyze and address skill gaps for all the ro...

  1. BIOCHAR TO IMPROVE THE QUALITY AND PRODUCTIVITY OF SOILS

    Mariola Ścisłowska; Renata Włodarczyk; Rafał Kobyłecki; Zbigniew Bis

    2015-01-01

    The paper presents the results of research focused on the investigations of the possibilities to use biochar to improve the quality and productivity of soils. Biochar is a material similar to the commonly known charcoal obtained from the thermolysis process (a process similar to dry distillation of wood). The structure and technical properties of biochar depend on the type of biomass which is produced and the thermal decomposition process conditions: process time, temperature and atmosphere. ...

  2. REVIEW OF UPQC CONTROL TECHNIQUES FOR POWER QUALITY IMPROVEMENT

    Kolipaka Srivani; Aiswarya rajalaxmi

    2014-01-01

    This paper deals with the UPQC with different control techniques for solve the power quality problems such as harmonics, sag, swell, voltage regulation, load balancing and power factor improvement in the 3-phase distribution system. UPQC is the combination of both shunt and series active filter connected to dc common link. Voltage based distortions are solved by series active filters and current based problems solved by shunt active filter. MATLAB/SIMILINK is used for modeling of UPQC.

  3. Improving the quality of processes by using knowledge continuity ensuring

    Urbancov, Hana; K?, Josef

    2012-01-01

    In the current knowledge economy the workers are the key competitive advantage and their knowledge is the most important asset in the various business processes. If people leave the organization they will take their knowledge with them and it can jeopardize the quality of the processes. This paper focuses on the topic of the ensuring the knowledge continuity as a tool for fluent improvement of processes in organizations. The processes and the areas were identified within the organizatio...

  4. Research on Improving Manufacturing Practice Quality in Mechanical Industrial Design

    Xiaowei Jiang

    2013-01-01

    In order to solve the problems existing in the manufacturing practice of mechanical industrial design, a series of methods and concrete measures are proposed, so as to improve the quality of manufacturing practice of mechanical industrial design. In this study, the problems existing in the manufacturing practice of mechanical industrial design are analyzed detailedly. And the methods and concrete measures including establishing the new mode of manufacturing practice of mechanical industrial d...

  5. A Method for Improving the Quality of Data in STOR*

    Van Metre, John E.; Whiting-O'Keefe, Quinn E.; Kahn, Michael G.; Warger, Anne W.

    1984-01-01

    An interactive dictionary driven system (Input Standardization SystemISS) has been designed and implemented. The function of the system is to improve the quality of data entered by medically untrained input clerks into the problem/manifestation and therapy descriptor fields in STOR, a computerized ambulatory care medical record system at UCSF. The ISS is able to (1) correct spelling errors, (2) expand abbreviations and truncations, and (3) suggest possible correct words to substitute for rec...

  6. Improving Delivery Quality in Supply Chain : a Case Study

    Leppänen, Sanna

    2015-01-01

    This thesis was carried out as a case study for a company in the technology industry with the purpose of evaluating the logistics service level and quality of the delivery process in a supply chain, following the DMAIC-process of Six Sigma. The main objective was to detect the most relevant root causes for defectives and to provide improvement solutions for supply chain processes - packaging and material handling as the main focus. By applying methodology from literature references and m...

  7. Improvement of Tagliatelle Quality by Addition of Red Quinoa Flour

    Anamaria Pop; Sevastiţa Muste; Simona Man; Crina Mureșan

    2014-01-01

    In order to diversification of tagliatelle pasta and increasing segment of consumers it was intended to improvement of tagliatelle pasta quality by addition of red quinoa flour. The products obtained at Bakery Pilot Station of University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca was the result of original recipe. To optimize the recipe were made four experimental variants, white flour and red quinoa flour is used in different proportions: Variant 1 – plain tagliatelle pasta...

  8. Improving quality and use of data through data-use workshops: Zanzibar, United Republic of Tanzania

    Jørn Braa

    2012-05-01

    Full Text Available PROBLEM: In Zanzibar, United Republic of Tanzania, as in many developing countries, health managers lack faith in the national Health Management Information System (HMIS. The establishment of parallel data collection systems generates a vicious cycle: national health data are used little because they are of poor quality, and their relative lack of use, in turn, makes their quality remain poor. APPROACH: An action research approach was applied to strengthen the use of information and improve data quality in Zanzibar. The underlying premise was that encouraging use in small incremental steps could help to break the vicious cycle and improve the HMIS. LOCAL SETTING: To test the hypothesis at the national and district levels a project to strengthen the HMIS was established in Zanzibar. The project included quarterly data-use workshops during which district staff assessed their own routine data and critiqued their colleagues' data. RELEVANT CHANGES: The data-use workshops generated inputs that were used by District Health Information Software developers to improve the tool. The HMIS, which initially covered only primary care outpatients and antenatal care, eventually grew to encompass all major health programmes and district and referral hospitals. The workshops directly contributed to improvements in data coverage, data set quality and rationalization, and local use of target indicators. LESSONS LEARNT: Data-use workshops with active engagement of data users themselves can improve health information systems overall and enhance staff capacity for information use, presentation and analysis for decision-making.

  9. IMPROVEMENT IN QUALITY-OF-LIFE AFTER LAPAROSCOPIC NISSEN FUNDOPLICATION

    Guilherme Tommasi KAPPAZ

    2014-09-01

    Full Text Available Context Evaluating quality of life after surgery for gastroesophageal reflux is fundamental, since improvement of symptoms is the main goal of treatment. Objective To compare the satisfaction of patients operated for GERD, interviewed at the office, with patients interviewed by telephone. Methods One hundred and seventy-eight patients were submitted to laparoscopic Nissen fundoplication. Ninety patients were found, and 45 agreed to come to the hospitals office. The other 45 patients were interviewed by telephone. Quality of life was evaluated using three methods: The GERD-HRQL questionnaire, translated to Portuguese; question If you could choose it today, would you do surgery again?; and question If you could classify your symptom improvement between 0 and 10, which grade would you give? Patients were divided in group A (office interview and B (telephone interview. Statistical analysis was performed. Results The average GERD-HRQL score in group A was 6.29, while in group B was 14.09(P = 0.002. There was no statistical difference between groups A and B regarding patients choice of doing the surgery again(P = 0.714 and their grade of postoperative symptom improvement (P = 0.642. Conclusion The overall postoperative satisfaction was high. The GERD-HRQL questionnaire might not be suitable for application by telephone in our population, and based on other analyzes, the satisfaction and quality of life of patients interviewed at the office or by telephone was similar.

  10. QUALITY IMPROVEMENT METHODS AND THEIR USAGE IN ALBANIAN PUBLIC UNIVERSITIES

    Arjan QEFALIA

    2012-06-01

    Full Text Available Education and higher education in particular is one of strategic priorities for development, which guarantees progress. Its role is related to all characteristics of a society, and it undoubtedly constitutes one of the most important areas of life of a nation. It has stable and long-term impact on all aspects of activities related to people and their welfare. The challenge to be faced in the transition period requires that higher education in Albania to be developed, consolidated and follow the trend of higher education in developed countries. Quality itself and by using the continuous quality improvement methods by universities, it constitutes the basis for ensuring the success of the Albanian higher education institutions in the future.In this paper, through the use of literature, the questionnaires and interviews directed mainly to the professors / pedagogues working in Albanian public higher education institutions, the focus is to show the continuous quality improvement methods used by universities / faculties / departments, and to test the hypothesis: The use or not of the continuous improvement methods is dependent on the studies type (those higher education institutions that offer first cycle studies, first and second cycle studies, or first, second and third cycle studies that the higher education institution offers.

  11. Partnering health disparities research with quality improvement science in pediatrics.

    Lion, K Casey; Raphael, Jean L

    2015-02-01

    Disparities in pediatric health care quality are well described in the literature, yet practical approaches to decreasing them remain elusive. Quality improvement (QI) approaches are appealing for addressing disparities because they offer a set of strategies by which to target modifiable aspects of care delivery and a method for tailoring or changing an intervention over time based on data monitoring. However, few examples in the literature exist of QI interventions successfully decreasing disparities, particularly in pediatrics, due to well-described challenges in developing, implementing, and studying QI with vulnerable populations or in underresourced settings. In addition, QI interventions aimed at improving quality overall may not improve disparities, and in some cases, may worsen them if there is greater uptake or effectiveness of the intervention among the population with better outcomes at baseline. In this article, the authors review some of the challenges faced by researchers and frontline clinicians seeking to use QI to address health disparities and propose an agenda for moving the field forward. Specifically, they propose that those designing and implementing disparities-focused QI interventions reconsider comparator groups, use more rigorous evaluation methods, carefully consider the evidence for particular interventions and the context in which they were developed, directly engage the social determinants of health, and leverage community resources to build collaborative networks and engage community members. Ultimately, new partnerships between communities, providers serving vulnerable populations, and QI researchers will be required for QI interventions to achieve their potential related to health care disparity reduction. PMID:25560436

  12. Medical education and the quality improvement spiral: A case study from Mpumalanga, South Africa

    Martin Bac

    2015-02-01

    Full Text Available Background: The short timeframe of medical students’ rotations is not always conducive to successful, in-depth quality-improvement projects requiring a more longitudinal approach.Aim: To describe the process of inducting students into a longitudinal quality-improvement project,using the topic of the Mother- and Baby-Friendly Initiative as a case study; and to explore the possible contribution of a quality-improvement project to the development of student competencies.Setting: Mpumalanga clinical learning centres, where University of Pretoria medical students did their district health rotations.Method: Consecutive student groups had to engage with a hospital’s compliance with specific steps of the Ten Steps to Successful Breastfeeding that form the standards for the Mother- and Baby-Friendly Initiative. Primary data sources included an on-site PowerPoint group presentation (n = 42, a written group report (n = 42 and notes of individual interviews in an end-of-rotation objectively structured clinical examination station (n = 139.Results: Activities in each rotation varied according to the needs identified through the application of the quality-improvement cycle in consultation with the local health team. The development of student competencies is described according to the roles of a medical expert in the CanMEDS framework: collaborator, health advocate, scholar, communicator, manager and professional. The exposure to the real-life situation in South African public hospitals had a great influence on many students, who also acted as catalysts for transforming practice.Conclusion: Service learning and quality-improvement projects can be successfully integrated in one rotation and can contribute to the development of the different roles of a medical expert. More studies could provide insight into the potential of this approach in transforming institutions and student learning.

  13. Sleep Quality Improves During Treatment With Bryophyllum pinnatum

    Hassani, Taziri Al; Müller-Hübenthal, Boris; Pittl, Sandra; Kuck, Angela; Meden, Harald; Eberhard, Jutta; Decker, Michael; Fürer, Karin; von Mandach, Ursula

    2015-01-01

    Hypothesis. Cancer patients frequently suffer from poor sleep quality. Bryophyllum pinnatum is a herbal medication used in anthroposophic medicine, which has been shown to be associated with improvements in sleep quality during pregnancy with only few and minor or moderate side-effects reported. In this study, the sleep quality of cancer patients during treatment with B pinnatum was investigated. Study Design. In this prospective, observational study, cancer patients suffering from sleep problems were treated with B pinnatum (350 mg tablets, corresponding to 50% of leaf pressed juice [Weleda AG, Arlesheim, Switzerland], dosage at physician’s consideration, but most frequently 2 tablets with evening meal and 2 before going to bed). Methods. Sleep quality (Pittsburgh Sleep Quality Index [PSQI]), daily sleepiness (Epworth Sleeping Scale [ESS]), and fatigue (Fatigue Severity Scale [FSS]) were assessed at the beginning of the treatment and after 3 weeks. Possible adverse drug reactions perceived by the patients during the treatment were recorded. From the 28 recruited patients, 20 completed both questionnaires and were considered in the present analysis. Data are expressed as mean ± standard deviation. Results. Patients were 61 ± 10.4 years old and the majority were female (17 out of 20). During treatment with B pinnatum, the PSQI decreased from 12.2 ± 3.62 to 9.1 ± 3.61 (P cancer patients. Controlled, randomized clinical trials of the use of B pinnatum in sleep disorders are urgently needed. PMID:25873294

  14. Improving the Data Quality of Advanced LIGO Based on Early Engineering Run Results

    Nuttall, L K; Areeda, J; Betzwieser, J; Dwyer, S; Effler, A; Fisher, R P; Fritschel, P; Kissel, J S; Lundgren, A P; Macleod, D M; Martynov, D; McIver, J; Mullavey, A; Sigg, D; Smith, J R; Vajente, G; Williamson, A R; Wipf, C C

    2015-01-01

    The Advanced Laser Interferometer Gravitational-wave Observatory (LIGO) detectors have completed their initial upgrade phase and will enter the first observing run in late 2015, with detector sensitivity expected to improve in future runs. Through the combined efforts of on-site commissioners and the Detector Characterization group of the LIGO Scientific Collaboration, interferometer performance, in terms of data quality, at both LIGO observatories has vastly improved from the start of commissioning efforts to present. Advanced LIGO has already surpassed Enhanced LIGO in sensitivity, and the rate of noise transients, which would negatively impact astrophysical searches, has improved. Here we give details of some of the work which has taken place to better the quality of the LIGO data ahead of the first observing run.

  15. Improving the data quality of Advanced LIGO based on early engineering run results

    Nuttall, L. K.; Massinger, T. J.; Areeda, J.; Betzwieser, J.; Dwyer, S.; Effler, A.; Fisher, R. P.; Fritschel, P.; Kissel, J. S.; Lundgren, A. P.; Macleod, D. M.; Martynov, D.; McIver, J.; Mullavey, A.; Sigg, D.; Smith, J. R.; Vajente, G.; Williamson, A. R.; Wipf, C. C.

    2015-12-01

    The Advanced Laser Interferometer Gravitational-wave Observatory (LIGO) detectors have completed their initial upgrade phase and will enter the first observing run in late 2015, with detector sensitivity expected to improve in future runs. Through the combined efforts of on-site commissioners and the Detector Characterization Group of the LIGO Scientific Collaboration, interferometer performance, in terms of data quality, at both LIGO observatories has vastly improved from the start of commissioning efforts to present. Advanced LIGO has already surpassed Enhanced LIGO in sensitivity, and the rate of noise transients, which would negatively impact astrophysical searches, has improved. Here we give details of some of the work which has taken place to better the quality of the LIGO data ahead of the first observing run.

  16. An ontology of quality initiatives and a model for decentralized, collaborative quality management on the (semantic) World-Wide-Web.

    Eysenbach, G

    2001-01-01

    This editorial provides a model of how quality initiatives concerned with health information on the World Wide Web may in the future interact with each other. This vision fits into the evolving "Semantic Web" architecture - ie, the prospective that the World Wide Web may evolve from a mess of unstructured, human-readable information sources into a global knowledge base with an additional layer providing richer and more meaningful relationships between resources. One first prerequisite for forming such a "Semantic Web" or "web of trust" among the players active in quality management of health information is that these initiatives make statements about themselves and about each other in a machine-processable language. I present a concrete model on how this collaboration could look, and provide some recommendations on what the role of the World Health Organization (WHO) and other policy makers in this framework could be. PMID:11772549

  17. Quality function deployment (QFD in the initial stages of the development of a car odorizer

    Carlos Eduardo Appolo Unterleider

    2012-06-01

    Full Text Available This paper presents an application of QFD (Quality Function Deployment, whose objective was to identify and translate into quality requirements, the demands of users of a car air freshener. The development is presented and discussed from market research to planning of quality improvement. The method used included the following steps: (i construction of quality matrix, (ii construction of the product matrix, (iii construction of the processes matrices, (iv construction of the resources matrix, and (vi planning of quality items and objectives. By the application, it was possible to identify the quality demands of customers and define which actions should be implemented in order to meet these demands. The analysis considered factors available in the company, such as financial, human resources and infrastructure.

  18. Does arthroscopic subacromial decompression improve quality of life

    Whiteman, A; Wilson, J; Paul, E; Roy, B

    2015-01-01

    Introduction There has been a significant rise in the volume of subacromial decompression surgery performed in the UK. This study aimed to determine whether arthroscopic subacromial decompression improves health related quality of life in a cost effective manner. Methods Patients undergoing arthroscopic subacromial decompression surgery for impingement were enrolled between 2012 and 2014. The Oxford shoulder score and the EQ-5D™ instruments were completed prior to and following surgery. A cost–utility analysis was performed. Results Eighty-three patients were eligible for the study with a mean follow-up duration of 15 months (range: 4–27 months). The mean Oxford shoulder score improved by 13 points (95% confidence interval [CI]: 11–15 points). The mean health utility gain extrapolated from the EQ-5D™ questionnaire improved by 0.23 (95% CI: 0.16–0.30), translating to a minimum cost per QALY of £5,683. Conclusions Subacromial decompression leads to significant improvement in function and quality of life in a cost effective manner. This provides justification for its ongoing practice by appropriately trained shoulder surgeons in correctly selected patients. PMID:26263808

  19. An Ontology of Quality Initiatives and a Model for Decentralized, Collaborative Quality Management on the (Semantic) World Wide Web

    Eysenbach, Gunther

    2001-01-01

    This editorial provides a model of how quality initiatives concerned with health information on the World Wide Web may in the future interact with each other. This vision fits into the evolving "Semantic Web" architecture - ie, the prospective that the World Wide Web may evolve from a mess of unstructured, human-readable information sources into a global knowledge base with an additional layer providing richer and more meaningful relationships between resources. One first prerequisite for for...

  20. Improving the hygienic quality of chicken through radiation processing

    Irradiation is considered one of the most efficient technological processes for the reduction of microorganisms in food, It can be used to improve the safety of food products, and to extend their shelf lives. The aim of this study was to improve the hygienic quality of chicken through radiation processing. As part of the study a microbial assessment of broiler chicken thighs from three retail outlets (supermarket, local markets and farms) was conducted. The total viable count and total coliform counts were determined. Hygienic quality indicator organisms such as Escherichia coli, Salmonella and Staphylococcus aureus were isolated and microbial counts made. Radiation sensitivity test to determine the D10 (decimal reduction does) of E. coli on chicken at refrigeration and frozen temperature were conducted. D10 values were 0.22 ± 0.02 and 0.32 ± 0.03 kGy at refrigerated and frozen temperatures respectively. A storage test consisting of an uninoculated pack experiment and a challenge test to explore the effect of irradiation and frozen food storage on the total viable count and survival of E. coli was conducted. Chicken thigh samples were treated with 0 (non irradiated), 2.0, 4.0, 6.0 and 8.0 kGy of gamma irradiation and held frozen for 56 days. The control and irradiated samples were stored at -18 oC and underwent microbial analysis and sensory evaluation at 7 days intervals. It was observed that irradiation and frozen storage reduced microbial loads. There were significant differences in sensory quality characteristics during freezing storage in chicken meat. The combination of irradiation and frozen storage resulted in greater overall reductions on microbial loads thus improving hygienic quality. (au)

  1. Interventions to improve water quality for preventing diarrhoea

    Clasen, Thomas F; Alexander, Kelly T; Sinclair, David; Boisson, Sophie; Peletz, Rachel; Chang, Howard H; Majorin, Fiona; Cairncross, Sandy

    2015-01-01

    Background Diarrhoea is a major cause of death and disease, especially among young children in low-income countries. In these settings, many infectious agents associated with diarrhoea are spread through water contaminated with faeces. In remote and low-income settings, source-based water quality improvement includes providing protected groundwater (springs, wells, and bore holes), or harvested rainwater as an alternative to surface sources (rivers and lakes). Point-of-use water quality improvement interventions include boiling, chlorination, flocculation, filtration, or solar disinfection, mainly conducted at home. Objectives To assess the effectiveness of interventions to improve water quality for preventing diarrhoea. Search methods We searched the Cochrane Infectious Diseases Group Specialized Register (11 November 2014), CENTRAL (the Cochrane Library, 7 November 2014), MEDLINE (1966 to 10 November 2014), EMBASE (1974 to 10 November 2014), and LILACS (1982 to 7 November 2014). We also handsearched relevant conference proceedings, contacted researchers and organizations working in the field, and checked references from identified studies through 11 November 2014. Selection criteria Randomized controlled trials (RCTs), quasi-RCTs, and controlled before-and-after studies (CBA) comparing interventions aimed at improving the microbiological quality of drinking water with no intervention in children and adults. Data collection and analysis Two review authors independently assessed trial quality and extracted data. We used meta-analyses to estimate pooled measures of effect, where appropriate, and investigated potential sources of heterogeneity using subgroup analyses. We assessed the quality of evidence using the GRADE approach. Main results Forty-five cluster-RCTs, two quasi-RCTs, and eight CBA studies, including over 84,000 participants, met the inclusion criteria. Most included studies were conducted in low- or middle-income countries (LMICs) (50 studies) with unimproved water sources (30 studies) and unimproved or unclear sanitation (34 studies). The primary outcome in most studies was self-reported diarrhoea, which is at high risk of bias due to the lack of blinding in over 80% of the included studies. Source-based water quality improvements There is currently insufficient evidence to know if source-based improvements such as protected wells, communal tap stands, or chlorination/filtration of community sources consistently reduce diarrhoea (one cluster-RCT, five CBA studies, very low quality evidence). We found no studies evaluating reliable piped-in water supplies delivered to households. Point-of-use water quality interventions On average, distributing water disinfection products for use at the household level may reduce diarrhoea by around one quarter (Home chlorination products: RR 0.77, 95% CI 0.65 to 0.91; 14 trials, 30,746 participants, low quality evidence; flocculation and disinfection sachets: RR 0.69, 95% CI 0.58 to 0.82, four trials, 11,788 participants, moderate quality evidence). However, there was substantial heterogeneity in the size of the effect estimates between individual studies. Point-of-use filtration systems probably reduce diarrhoea by around a half (RR 0.48, 95% CI 0.38 to 0.59, 18 trials, 15,582 participants, moderate quality evidence). Important reductions in diarrhoea episodes were shown with ceramic filters, biosand systems and LifeStraw® filters; (Ceramic: RR 0.39, 95% CI 0.28 to 0.53; eight trials, 5763 participants, moderate quality evidence; Biosand: RR 0.47, 95% CI 0.39 to 0.57; four trials, 5504 participants, moderate quality evidence; LifeStraw®: RR 0.69, 95% CI 0.51 to 0.93; three trials, 3259 participants, low quality evidence). Plumbed in filters have only been evaluated in high-income settings (RR 0.81, 95% CI 0.71 to 0.94, three trials, 1056 participants, fixed effects model). In low-income settings, solar water disinfection (SODIS) by distribution of plastic bottles with instructions to leave filled bottles in direct sunlight for at least six hours before drinking probably

  2. Quality Improvement Project to Improve Patient Satisfaction With Pain Management: Using Human-Centered Design.

    Trail-Mahan, Tracy; Heisler, Scott; Katica, Mary

    2016-01-01

    In this quality improvement project, our health system developed a comprehensive, patient-centered approach to improving inpatient pain management and assessed its impact on patient satisfaction across 21 medical centers. Using human-centered design principles, a bundle of 6 individual and team nursing practices was developed. Patient satisfaction with pain management, as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems pain composite score, increased from the 25th to just under the 75th national percentile. PMID:26447343

  3. Increased office productivity through improved indoor air quality

    Fanger, Povl Ole

    2002-01-01

    Building Syndrome (SBS) symptoms and improve the productivity of office workers. In these experiments, the performance of simulated office work (text typing, addition and proof-reading, all typical office tasks requiring concentration) improved monotonically as the proportion of persons dissatisfied with...... intensity of general SBS symptoms such as headache and difficulty in thinking clearly were significantly reduced, which implies that this was the mechanism of causation. The performance of simulated office work increased monotonically with decreasing pollution load by a 1.6% increase in performance for each......, future developments in HVCAC technology may include "personalized air ", new ways of improving the quality of supply air (e.g., by filtration), more extensive use of heat recovery from exhaust air and systematic selection of low-polluting building and furnishing materials....

  4. Quality improvement in radiography in a neonatal intensive care unit

    The primary objective of this study was to ensure that X-rays performed consistently adhere to established technological quality standards and are achieved without compromising patient care while minimizing exposure risks. The secondary objective was to evaluate whether educational sessions targeting areas deemed suboptimal would facilitate improvement. A retrospective, 1-week review of all neonatal X-rays and documentation of clinical information on X-ray requisitions (n = 132) was completed in a tertiary care neonatal intensive care unit (NICU), by a single observer. Standards for X-ray evaluation were defined a priori based on radiographic principles and essential documented medical information for correct interpretation. Targeted areas for improvement were identified and addressed through brief educational sessions and printed pamphlets. The review was repeated after recommendations were implemented. 1 month (n = 93) and 1 year (n = 76) later. Improvements were evident in both the completion of X-ray requisitions and image quality. In particular, there was a statistically significant improvement in requisition legibility (P = 0.019), completeness of the medical history (P < 0.001), reduction in X-ray rotation (P < 0.001), collimation to the specific area of interest (P <0.001), gonadal shielding (P < 0.001), and decrease in monitor leads or artifacts obscuring views (P < 0.001). These improvements were sustained both 1 month and 1 year following the educational sessions. A neonatal X-ray audit is a simple, effective way to evaluate radiographic technique and encourage provision of basic clinical information for diagnostic interpretation by radiologists and neonatologists. As well, structured, collaborative educational sessions between radiology and neonatology staff appear to be a successful and sustainable method to effect overall improvement. (author)

  5. Using creative problem solving (TRIZ) in improving the quality of hospital services.

    LariSemnani, Behrouz; Mohebbi Far, Rafat; Shalipoor, Elham; Mohseni, Mohammad

    2015-01-01

    TRIZ is an initiative and SERVQUAL is a structured methodology for quality improvement. Using these tools, inventive problem solving can be applied for quality improvement, and the highest quality can be reached using creative quality improvement methodology. The present study seeks to determine the priority of quality aspects of services provided for patients in the hospital as well as how TRIZ can help in improving the quality of those services. This Study is an applied research which used a dynamic qualitative descriptive survey method during year 2011. Statistical population includes every patient who visited in one of the University Hospitals from March 2011. There existed a big gap between patients' expectations from what seemingly is seen (the design of the hospital) and timely provision of services with their perceptions. Also, quality aspects of services were prioritized as follows: keeping the appearance of hospital (the design), accountability, assurance, credibility and having empathy. Thus, the only thing which mattered most for all staff and managers of studied hospital was the appearance of hospital as well as its staff look. This can grasp a high percentage of patients' satisfaction. By referring to contradiction matrix, the most important principles of TRIZ model were related to tangible factors including principles No. 13 (discarding and recovering), 25 (self-service), 35 (parameter changes), and 2 (taking out). Furthermore, in addition to these four principles, principle No. 24 (intermediary) was repeated most among the others. By utilizing TRIZ, hospital problems can be examined with a more open view, Go beyond The conceptual framework of the organization and responded more quickly to patients ' needs. PMID:25560360

  6. Effectiveness of a quality improvement curriculum for medical students

    Kimberly M. Tartaglia

    2015-05-01

    Full Text Available Introduction: As health systems find ways to improve quality of care, medical training programs are finding opportunities to prepare learners on principles of quality improvement (QI. The impact of QI curricula for medical students as measured by student learning is not well delineated. The aim of this study is to evaluate the effectiveness of a QI curriculum for senior medical students as measured by student knowledge and skills. Methods: This study was an observational study that involved a self-assessment and post-test Quality Improvement Knowledge Application Tool (QIKAT for intervention and control students. A QI curriculum consisting of online modules, live discussions, independent readings and reflective writing, and participation in a mentored QI project was offered to fourth-year medical students completing an honor's elective (intervention group. Senior medical students who received the standard QI curriculum only were recruited as controls. Results: A total of 22 intervention students and 12 control students completed the self-assessment and QIKAT. At baseline, there was no difference between groups in self-reported prior exposure to QI principles. Students in the intervention group reported more comfort with their skills in QI overall and in 9 of the 12 domains (p<0.05. Additionally, intervention students performed better in each of the three case scenarios (p<0.01. Discussion: A brief QI curriculum for senior medical students results in improved comfort and knowledge with QI principles. The strengths of our curriculum include effective use of classroom time and faculty mentorship with reliance on pre-existing online modules and written resources. Additionally, the curriculum is easily expandable to larger groups of students and transferable to other institutions.

  7. The Association of Couples' Relationship Status and Quality with Breastfeeding Initiation

    Gibson-Davis, Christina M.; Brooks-Gunn, Jeanne

    2007-01-01

    Using data from the Fragile Families and Child Wellbeing Survey (N= 3,567), we examine the links between relationship status, relationship quality, and race and ethnicity in breastfeeding initiation. We consider four relationship types: married, cohabiting, romantically involved but not cohabiting (termed visiting), and nonromantically involved…

  8. The Association of Couples' Relationship Status and Quality with Breastfeeding Initiation

    Gibson-Davis, Christina M.; Brooks-Gunn, Jeanne

    2007-01-01

    Using data from the Fragile Families and Child Wellbeing Survey (N= 3,567), we examine the links between relationship status, relationship quality, and race and ethnicity in breastfeeding initiation. We consider four relationship types: married, cohabiting, romantically involved but not cohabiting (termed visiting), and nonromantically involved

  9. Improving Service Quality by Using Organizational Citizenship Behavior: Iranian Evidence

    Nour-Mohammad Yaghoubi

    2011-09-01

    Full Text Available Nowadays, with increasing service industries, service marketing and service quality have become an important challenge to organizations. The attempts of organizations in this situation are witnesses to this matter. In the past years, the organizations tried to reach service quality appropriation and satisfaction of self-external customers by concepts and approaches of external marketing. One of the important features of service is the direct interaction with customers and having customer-oriented behaviors. Furthermore, with introducing the internal marketing and the important roles of it, an internal customer of organizations, on achievement of organizational plans, was noted to internal marketing more and more than before. So, the study researchers are going to argue about internal marketing and the effect of it on organizational citizenship behaviors and service quality and the important role of it on development and improvement of service quality by using organizational citizenship behaviors. For this purpose, first the researchers have studied internal marketing and its important components and then have done the same to the other items and finally have applied a quantitative study on all of them. It should be mentioned that the researchers have employed SPSS 17.0 and Lisrel 8.54 for data analysis. The findings of the present study illustrated that there is an appropriate interaction among all the items, which has been studied here and the structural equations for the conceptual framework of this study are goodness of fit.

  10. Systems-based Quality Improvement as a tool to implement the Surgical Safety Checklist in Rwanda

    Gita N. Mody

    2014-03-01

    Full Text Available Objective: Effective strategies for implementation of the World Health Organization’s Surgical Safety Checklist (SSCL are not well characterized in resource-limited settings. Our objective was to utilize a systems-based quality improvement (QI approach to initially implement a single, high-priority item from the SSCL. Setting: Butaro Hospital, a rural district hospital in northern Rwanda. Methods: A surgical service QI team was formed and trained with support of local leadership and expatriate staff trained in QI methodology. The team identifid perioperative antibiotic administration as the fist SSCL area for improvement. Baseline performance was measured by sampled chart review of Cesarean sections. Using systems-based QI methods and the Model for Improvement, a protocol for choice and timing of perioperative antibiotics was identifid as the necessary intervention, developed, and then implemented. The impact on performance and spread of QI was measured. Results: At baseline, only 5.2% of Cesarean section patients received both correct choice and timing of a prophylactic antibiotic agent. After development of the protocol, appropriate choice and timing of antibiotic was observed in 61.7% of cases (p < 0.001. This initial QI initiative stimulated additional projects to implement other components of the SSCL and to improve quality of surgical and anesthetic care. Conclusions: Implementing one component of the SSCL using QI methodology focused on stakeholder engagement, measurement, and team-based development of iterative systems of improvements facilitated a cultural change at Butaro Hospital. Training and support in QI methods can create an environment in which the SSCL and other efforts for quality in surgical and anesthetic care can be more readily implemented.

  11. QUALITY IMPROVEMENT IN MULTIRESPONSE EXPERIMENTS THROUGH ROBUST DESIGN METHODOLOGY

    M. Shilpa

    2012-06-01

    Full Text Available Robust design methodology aims at reducing the variability in the product performance in the presence of noise factors. Experiments involving simultaneous optimization of more than one quality characteristic are known as multiresponse experiments which are used in the development and improvement of industrial processes and products. In this paper, robust design methodology is applied to optimize the process parameters during a particular operation of rotary driving shaft manufacturing process. The three important quality characteristics of the shaft considered here are of type Nominal-the-best, Smaller-the-better and Fraction defective. Simultaneous optimization of these responses is carried out by identifying the control parameters and conducting the experimentation using L9 orthogonal array.

  12. Quality Improvement of MARS Code and Establishment of Code Coupling

    The improvement of MARS code quality and coupling with regulatory auditing code have been accomplished for the establishment of self-reliable technology based regulatory auditing system. The unified auditing system code was realized also by implementing the CANDU specific models and correlations. As a part of the quality assurance activities, the various QA reports were published through the code assessments. The code manuals were updated and published a new manual which describe the new models and correlations. The code coupling methods were verified though the exercise of plant application. The education-training seminar and technology transfer were performed for the code users. The developed MARS-KS is utilized as reliable auditing tool for the resolving the safety issue and other regulatory calculations. The code can be utilized as a base technology for GEN IV reactor applications

  13. Improving the Quality of Published Chemical Names with Nomenclature Software

    Gernot A. Eller

    2006-11-01

    Full Text Available This work deals with the use of organic systematic nomenclature in scientific literature, its quality, and computerized methods for its improvement. Criteria for classification of systematic names in terms of quality/correctness are discussed and applied to a sample set of several hundred names extracted from the literature. The same structures are named with three popular state-of-the-art nomenclature programs – AutoNom 2000, ChemDraw 10.0, and ACD/Name 9.0. When comparing the results, all nomenclature tools show a significantly better performance than 'average chemists'. One program allows the generation not only of IUPAC names but also of CAS-like index names that are compared with the officially registered names. The scope and limitations of nomenclature software are discussed and a comparison of the programs' actual capabilities is given.

  14. Improving the quality of manually acquired data: Applying the theory of planned behaviour to data quality

    The continued reliance of manual data capture in engineering asset intensive organisations highlights the critical role played by those responsible for recording raw data. The potential for data quality variance across individual operators also exposes the need to better manage this particular group. This paper evaluates the relative importance of the human factors associated with data quality. Using the theory of planned behaviour this paper considers the impact of attitudes, perceptions and behavioural intentions on the data collection process in an engineering asset context. Two additional variables are included, those of time pressure and operator feedback. Time pressure is argued to act as a moderator between intention and data collection behaviour, while perceived behavioural control will moderate the relationship between feedback and data collection behaviour. Overall the paper argues that the presence of best practice procedures or threats of disciplinary sanction are insufficient controls to determine data quality. Instead those concerned with improving the data collection performance of operators should consider the operator's perceptions of group attitude towards data quality, the level of feedback provided to data collectors and the impact of time pressures on procedure compliance. A range of practical recommendations are provided to those wishing to improve the quality of their manually acquired data.

  15. The Importance of Employment Contract for Umsida Quality Employees Improvement

    Noor Fatimah Mediawati

    2015-12-01

    Full Text Available The absence of employment contracts in UMSIDA recognized cause some problems. Especially in improving the performance of employees. Issues a little more disturbing harmonious labor relations between employees and UMSIDA. In the terminology of the Labour Act, employment contract terms it is known as the Employment Agreement. Where the existence of labor agreement / contract employment is expected to harmonize the working relationship with the employer in accordance with the applicable rules. The existence of employment contracts is also a legal instrument which according to researchers ought to be put forward in efforts to increase the qualifications and competence of employees. By contract it will also avoid things that are not desirable in an employment relationship, because each party will always carry out their rights and responsibilities are aligned and balanced. Tranquility in the work and the guarantee of legal protection are expected to improve employee performance especially towards quality UMSIDA 2020. So this study explored further the urgency employment contract once its design. How To Cite: Mediawati, N., & Phahlevy, R. (2015. The Importance of Employment Contract for Umsida Quality Employees Improvement. Rechtsidee, 2(2, 141-156. doi:http://dx.doi.org/10.21070/jihr.v2i2.106

  16. Performance indicators: A tool for continuous quality improvement

    Bhatnagar, Nidhi M; Soni, Shital; Gajjar, Maitrey; Shah, Mamta; Shah, Sangita; Patel, Vaidehi

    2016-01-01

    Background: Performance monitoring is an important tool which can be used for setting priorities for process improvement. At our centre, we have been monitoring every step in the processes, right from inventory of consumables (both critical and routine) to number of donors reactive for TTI. We conducted a study to measure the impact of monitoring Performance Indicators and how it could be used as a tool for Continuous Quality Improvement (CQI). Materials and Methods: The present study was a retrospective study where the performance indicator (PI) data of blood bank was analyzed for over four years. For certain parameters, benchmarks or thresholds were set that represented warning limits or action limits. The yearly data were collated from monthly data. Shifts or Trends, if any, were identified and Corrective and Preventive Action (CAPA) taken accordingly. At the end, outcomes of the analysis were charted. Results: After the yearly data evaluation, outcomes obtained were used to plan, correct and amend processes and systems in the blood center. It was observed that the workload of the center showed an upward trend. This helped us to plan for the purchase of consumables and management of manpower. The monitoring of usage and discard of blood helped in the efficient management of blood stocks. The need for any new equipment could also be judged by the trends in workload. Conclusion: Performance indicators are indispensible tools which various stakeholders in the Blood Transfusion centres should implement to improve on quality performance.

  17. Quality of life among HIV-infected patients in Brazil after initiation of treatment

    Lorenza Nogueira Campos; Cibele Comini Csar; Mark Drew Crosland Guimares

    2009-01-01

    INTRODUCTION: Despite improvement in clinical treatment for HIV-infected patients, the impact of antiretroviral therapy on the overall quality of life has become a major concern. OBJECTIVE: To identify factors associated with increased levels of self-reported quality of life among HIV-infected patients after four months of antiretroviral therapy. METHODS: Patients were recruited at two public health referral centers for AIDS, Belo Horizonte, Brazil, for a prospective adherence study. Patients...

  18. Corporatization as a means of improving water quality: the experience in Victoria, Australia.

    Martin, Narelle

    Factors including fragmentation, a lack of direction, poor accountability, poor water quality, and a sizable state government subsidy contributed to the rural water industry in Victoria, Australia, in 1993. In 1993 the state government set out parameters for reform to change the size, structure, performance, and culture of the water industry. The path taken was not privatization, but corporatization. Tools used included amalgamation of organizations; separating water provisions from local government; changing the composition and reporting mechanisms of the boards; establishing clear benchmarks and performance criteria; making information publicly available; and providing a commercial orientation. The outcomes of the reforms were to be a focus on water quality and effluent management. In 2001, 15 water authorities were in place. There were significant improvements in accountability, finances, and performance. The authorities provided information on performance to both the state and the public. Reductions of operating costs have been in the range of 20-35%, with savings put back into new infrastructure. Water quality has significantly improved in a number of parameters and effluent management has also improved. This paper describes the challenges faced before the reform process, the reforms initiated, and the outcomes. It argues that privatization is not the only path to improvement: Developing a corporate structure and accountability can also deliver substantial improvements. PMID:15371224

  19. Learning leadership skills in practice through quality improvement.

    Gamble, James; Vaux, Emma

    2014-02-01

    The development of leadership skills in doctors in training is essential to support both their professional development and the future supply of clinical leaders the NHS so desperately needs. There is, however, limited opportunity in current training programmes for trainees to learn and develop these skills, and what opportunity there is has often focused on management rather than leadership skills. Involvement in trainee-led supported quality improvement projects can teach these skills. We summarise the current limitations in leadership training and discuss how the College's 'Learning To Make a Difference' programme, and others like it, are helping to teach leadership. PMID:24532736

  20. A Novel Facts Based Improvement of Power Quality

    S.V.D.Anil Kumar

    2014-05-01

    Full Text Available Modulated power filter compensator (MPFC scheme for the smart grid stabilization and efficient utilization is shown in this paper. A novel tri-loop dynamic error driven inter coupled modified PID controller is used to control MPFC. For effective power quality (PQ improvement, voltage stabilization, power factor correction and transmission line loss reduction, MATLAB digital simulation models of the proposed MPFC scheme has been fully validated. The proposed FACTS based scheme can be extended to distributed/dispersed renewable energy interface and utilization systems and can be easily modified for other specific stabilization, compensation requirements, voltage regulation and efficient utilization.

  1. Importance of Active Filters for Improvement of Power Quality

    Sandeep G J S M#1 , Sk Rasoolahemmed

    2013-04-01

    Full Text Available The Problems due to Harmonics and reactive power loses has been pertaining from the decades. Since many methods are proposed to reduce those above mentioned problems. one of the best method is employing Active Filters for the elimination of Harmonics and compensation of reactive power problems. This paper mainly explains about the new AF technology and different topologies utilizing in the present scenario, economical approach etc for the improvement of power quality. Presently many countries has been using this AF technology, because of its capacity to eliminate the harmonics up to 25th level & more and also size of filter is also reduced.

  2. Field quality improvements in superconducting magnets for RHIC

    A number of techniques have been developed-and tested to improve the field quality in the superconducting dipole and quadrupole magnets to be used in the Relativistic Heavy Ion Collider (RHIC). These include adjustment in the coil midplane gap to compensate for the allowed and non-allowed harmonics, inclusion of holes and cutouts in the iron yoke to reduce the so harmonics, and magnetic tuning shims to correct for the residual errors. We compare the measurements with the calculations to test the validity of these concepts

  3. A New Model for Software Engineering Systems Quality Improvement

    Ahmad A. Al-Rababah

    2014-04-01

    Full Text Available In the continuing effort to improve the system analysis and design process, several different approaches have been developed. This study will propose a new process methodology solves some problems in traditional system development methodologies it will study the strength and limitation of existing system development methodologies from traditional waterfall to iterative model including (Prototyping, Spiral, Rapid Application Development, XP and RUP to Agility. Propose a new methodology focus on produce a high quality product and suitable for all kind of project. Compare the new methodology with others to view some features that is differentiating it from previous methodologies.

  4. Use of different additives to improve low quality surimi gelation.

    Deysi Cando

    2014-01-01

    Differences in price induce to use, when it is possible, low quality surimi to elaborate certain products. In this case high proportion of starch is use to maintain the gel texture. In order to reduce the caloric input of starches and to improve gelation, the addition of certain additives and the reduction of NaCl are checked with the purpose to elaborate more healthy products. The additives tested were 0.3% sodium ascorbate (-S-) and 0.1 % cystine (-C-). Two different NaCl concentrations...

  5. A new method for improving beam quality of LINAC

    The principle of the self-adaptive feed-forward (SAFF) control to improve the beam quality of linac is introduced. the analytical procedure for calculating the control signals, the structure of a practical control system, and applications of SAFF in klystron, RF gun, and linac are presented, especially the application in the thermionic gun whose response is non-linear, time-variant and of large time-delay. The described control system is operational and some primary experimental results have been obtained, including the control of amplitude and phase fluctuations of the klystron output, the microwave field in the gun cavity and linac

  6. Smart homes to improve the quality of life for all.

    Aiello, Marco; Aloise, Fabio; Baldoni, Roberto; Cincotti, Febo; Guger, Christoph; Lazovik, Alexander; Mecella, Massimo; Pucci, Paolo; Rinsma, Johanna; Santucci, Giuseppe; Taglieri, Massimiliano

    2011-01-01

    A home is smart when, being aware of its own state and that of its users, is capable of controlling itself in order to support the user wishes and thus improving their quality of life. This holds both for users with special needs and for those with ordinary domestic needs. In this paper, we overview the Smart Homes for All project which represents the current state of the art with respect to software control and user interfaces in the smart homes arena. PMID:22254672

  7. The Review of Quality System on IAEA Safeguards to Improve the Quality of National Safeguards Inspection

    Korea is the 6th largest producer of nuclear power in the world and also has many extensive nuclear research programs. As a result, Korea is also the 3rd most frequent inspected country by the IAEA. Nuclear nonproliferation has been a supreme concern in Korea; and the government has fully understood the importance of nuclear safeguards inspection. KOREA established a state system of accounting for and control of nuclear material (SSAC), immediately after the safeguards agreement with the IAEA on 14 November 1975. The Nuclear Control Team from MEST (government) has the primary responsibility to oversee safeguards and KINAC has been entrusted to perform this duty under the delegated authority by the Atomic Energy Act. Safeguards Activities from KINAC have been conducted over the last 20 years. Yet Quality System concerning national safeguards inspection has not been taken into consideration. In order to have an effective and efficient national safeguards inspection program, it is time to seriously consider Quality System. In this paper, the quality assurance with regulatory bodies which was recommended by IAEA, the quality management system in IAEA safeguards department, and other countries cases were reviewed and analyzed. From this initial step, an attempt was made to design a more efficiently and effectively quality system for conducting national safeguards inspection

  8. MAUVE: A European Initiative for Developing and Improving Satellite Derived Ultraviolet Maps

    Increased exposure to UV radiation is known to have a significant effect on human health, ecosystems or crop production. The link between stratospheric ozone depletion and increased surface UV radiation is now established. Large increases in UV radiation have been observed in association with the ozone hole at high southern latitudes. A clear sign of the growing importance of gathering better information on the UV radiation is given by the emergence of a number of initiatives both at the national and international level. MAUVE (MApping of UV by Europe) is a pilot project supported by the European Commission in the 4th R and D Framework Programme. The project officially started on 1 December 1997, and will last for two years. The main objective of MAUVE is to establish maps of surface UV radiation, derived from satellite data, as a recognised source of information for a variety of users. This is achieved by (1) defining the UV map products together with the users, (2) producing 'pilot products' by customising and improving methodologies developed in the framework of several national projects, and (3) thoroughly assessing their quality and usefulness on the European scale using existing infrastructure and data sets. (author)

  9. Pleural mesothelioma: management updates and nursing initiatives to improve patient care

    Lehto RH

    2014-05-01

    Full Text Available Rebecca H LehtoCollege of Nursing, Michigan State University, East Lansing, MI, USAAbstract: Malignant pleural mesothelioma is a relatively rare but aggressive malignancy that is primarily associated with occupational asbestos exposure. While treatment options for mesothelioma have expanded, the disease carries a poor prognosis, with a median of 8 months to 1 year of survival postdiagnosis. This article synthesizes current disease-management practices, including the diagnostic workup, treatment modalities, emerging therapies, and symptom management, and identifies comprehensive nursing strategies that result in the best care based on updated evidence. Multidisciplinary coordination, palliative care initiation, survivorship, and end-of-life care are discussed. Findings may be applied in clinical environments as a resource to help nurses better understand treatment options and care for patients facing malignant pleural mesothelioma. Recommendations for future research are made to move nursing science forward and to improve patient well-being and health-related quality-of-life outcomes for patients and their family members.Keywords: pleural mesothelioma, cancer, symptom management, evidence-based care

  10. Air Quality in Mexico City: Policies Implemented for its Improvement

    Paramo, V.

    2007-12-01

    Ozone and suspended particles (PM) are two pollutants in the atmosphere of Mexico City Metropolitan Area (MCMA) that still exceed the recommended Mexican health standards. The other criteria pollutants very seldom exceed their corresponding standards. In 2006, the maximum ozone concentrations were above the health standard (0.11 ppm in 1 hour) during 59 percent of the days for an average of 2.2 hours and 130 points of the Air Quality Index (Índice Metropolitano de la Calidad del Aire - IMECA). In contrast, in 1991, 98 percent of the days exceeded the ozone health standard for an average of 6.6 hours and 200 IMECA points. With regards to PM10, in 2006, 80 percent of the sampled concentrations were below the health standard of 120 µg/m3 in 24 hours. However, the annual health standard of 50 µg/m3 is still exceeded. The air quality management in the MCMA is a difficult task due to several adverse factors. The main one is the large population that increased from nearly 15 million in 1992 to more than 18 million at present. As a result, the urban area grows in the adjoined municipalities of the State of Mexico. The vehicular fleet increases also to almost 4 million and the number of industrial facilities is at present 50,000. Consequently, the fuel consumption is very high. The daily energy consumption is estimated to be 44 million liters of equivalent of gasoline. Despite the fact that the air quality has improved in recent years, the related health standards are still exceeded and therefore it is necessary to continue applying the most cost-effective actions to improve the environment quality. Some actions that have contributed most to the reduction of pollutant emissions are the following: Continuous update of the inspection and maintenance program of the vehicular fleet; substitution of the catalytic converters at the end of their useful life; self-regulation of the diesel fleet; use of alternative fuels; update the No-Driving-Day program; establishment of more stringent emission levels of the gasoline fleet; update the detention of pollutant vehicles program; partial exemption of the inspection and maintenance program for cleaner and or highly efficient vehicles; substitution of 3,000 microbuses, 40,000 taxis and 1,200 buses; commissioning of the first Bus Rapid Transit system; implementation of a program for the emissions reduction for the 300 most polluted industrial facilities; and continuous update of the air quality environmental management programs. To continue improving the air quality in the MCMA, the environmental authorities will continue the implementation of the 2002-2010 Air Quality Improvement Program. In 2007 the Green Program was started, this includes those actions that have proven to be effective reduction of pollutant emissions and incorporates new actions for the reduction of local and global pollutant emissions. The most important of these new actions are: substitution of 9,500 microbuses; renewal of all the taxis fleet; commissioning of 10 Bus Rapid Transit lines; commissioning of Line 12 of the underground system; schedules and routes limitations to the cargo fleet; increase 5 percent the number of non-motorized trips (bicycling and walking); regulation of the private public transport passenger stops; requirement of private schools to provide school transport; regulation of non-occupied taxis in circulation; modifications to the circulation of 350 critical crossing points in the city; adoption of intelligent traffic lights systems; complete substitution of the local government vehicle's fleet; implement the inspection and maintenance of the cargo fleet; introduction of low- sulfur diesel, among other measures.

  11. Multi-hospital Community NICU Quality Improvement Improves Survival of ELBW Infants.

    Owens, Jack D; Soltau, Thomas; McCaughn, Danny; Miller, Jason; O'Mara, Patrick; Robbins, Kenny; Temple, David M; Wender, David F

    2015-08-01

    Quality improvement or high reliability in medicine is an evolving science where we seek to integrate evidence-based medicine, structural resources, process management, leadership models, culture, and education. Newborn Associates is a community-based neonatology practice that staffs and manages neonatal intensive care units (NICU's) at Central Mississippi Medical Center, Mississippi Baptist Medical Center, River Oaks Hospital, St Dominic's Hospital and Woman's Hospital within the Jackson, Mississippi, metropolitan area. These hospitals participate in the Vermont-Oxford Neonatal Network (VON), which is a voluntary national network of about 1000 NICU groups that submit data allowing them to benchmark their patient outcome. This network currently holds data on 1.5 million infants. Participation may also include the Newborn Improvement Quality Collaborative (NICQ) which is an intensive quality improvement program where 40-60 of the almost 1000 VON centers participate each year or the iNICQ, which is an internet-based collaborative involving about 150 centers per year. From 2008-2009, our group concentrated efforts on quality improvement which included consolidating resources of three corporately managed hospitals to allow focused care of babies under 800-1000 grams at a single center, expanding participation in the VON NICQ to include all physicians and centers, and establishing a group QI focused committee aimed at sharing practice bundles and adopting quality improvement methodology. The goal of this article is to report the impact of these QI activities on survival of the smallest preterm infants who weigh less than 1500 grams at birth. Two epochs were compared: 2006-2009, and 2010-2013. 551 VLBW (< 1 500 grams) infants from epoch I were compared to 583 VLBW infants from epoch 2. Mortality in this group decreased from 18% to 11.1% (OR 0.62,95% CI 0.44-0.88). Mortality in the 501-750 grams birth weight category decreased from 45.7% to 18% (OR 0.39,95% CI 0.21-0.74). Improved survival was noted in all centers over the time period. These findings suggest that a physician-driven, multidisciplinary, individualized and multifactorial quality improvement effort can positively impact the care of extremely preterm infants in the community NICU setting. PMID:26521537

  12. [Company Wide Quality Control (total quality): methodological principles and intervention techniques for step-by-step improvement].

    Corbara, F; Di Cristofaro, E

    1996-01-01

    The concept of Quality is particularly up to date and not a new one for the Journal. The need for better Quality is a must also in Medical care. Quality doesn't mean additional costs and excessive burden for the co-workers. On the contrary, initial costs can be compensated for through a more rational utilisation of the resources. The consequent better service for the patient results in an ameliorated working environment, with high profits. Fundamental requirements for reaching concrete results are: 1) the convinced involvement in the idea of all levels (division, service, laboratory) in order to have the different groups act in synergism towards common goals; 2) the knowledge of appropriate methods. The Authors examine this last point with a deep analysis of the techniques involved in Company Wide Quality Control (C.W.Q.C.) or Total Quality. The improving process has to the continuous and proceed in small steps, each time being constituted by 4 different phases, represented by the PDCA cycle, or Demining wheel, where: P = PLAN, which means plan before acting; D = DO, perform what has been planned; C = CHECK, verify the results; A = ACT, standardize if the results are positive, repeat the process if negative. Each process of improvement implies a prior precise definition of a project, i.e. a problem whose solution has been planned. The project must always presume: a specific subject--a goal--one or more people to reach it--a limited time to work it out. The most effective way to ameliorate Quality is performing projects. Step by Step amelioration is synonymous of performance of many projects. A brilliant way to produce many projects remains their "industrialization", which can be reached by means of 6 basic criteria: 1) full involvement of the Direction; 2) potential co-working in the projects of all employees; 3) employment of simple instruments; 4) respect of a few procedural formalities; 5) rewarding of personnel; 6) continuous promotion of the concepts of quality and ongoing improvement. The Authors describe for each of the previous criteria approaching methods and best operative techniques, according C.W.Q.C. PMID:8682262

  13. Quality Improvement With Discrete Event Simulation: A Primer for Radiologists.

    Booker, Michael T; O'Connell, Ryan J; Desai, Bhushan; Duddalwar, Vinay A

    2016-04-01

    The application of simulation software in health care has transformed quality and process improvement. Specifically, software based on discrete-event simulation (DES) has shown the ability to improve radiology workflows and systems. Nevertheless, despite the successful application of DES in the medical literature, the power and value of simulation remains underutilized. For this reason, the basics of DES modeling are introduced, with specific attention to medical imaging. In an effort to provide readers with the tools necessary to begin their own DES analyses, the practical steps of choosing a software package and building a basic radiology model are discussed. In addition, three radiology system examples are presented, with accompanying DES models that assist in analysis and decision making. Through these simulations, we provide readers with an understanding of the theory, requirements, and benefits of implementing DES in their own radiology practices. PMID:26922594

  14. Evaluating a nursing care delivery model using a quality improvement design.

    Nardone, P L; Markie, J W; Tolle, S

    1995-10-01

    The goal to develop and implement a new model of nursing care delivery grew out of administrative and shared governance initiatives to improve the quality of nursing care. This evaluative study used both quantitative and qualitative methods. Seven principles related to quality were identified and became the driving force behind the changes. Aspects of these changes in care delivery were piloted on a neurological unit and included implementation of collaborative rounds, a modular structure, role changes, and work redesign. Frequency distribution, questionnaire, focus group, and financial data indicated that there had been improvement in the delivery of care in addition to financial benefits. A considerable amount of the data provided evidence that supported continuing the changes. PMID:7579550

  15. Triage or Tapestry? Teacher Unions' Work toward Improving Teacher Quality in an Era of Systemic Reform. A Research Report. Document R-03-1

    Bascia, Nina

    2003-01-01

    This report looks at and identifies emerging trends in the roles that teacher unions play in educational reform and improving the quality of teaching. A description of the efforts of six teacher unions to improve teacher quality within the context of the current systemic reform movement shows a range and depth of union initiatives beyond what is…

  16. The impact of a large-scale quality improvement programme on work engagement: Preliminary results from a national cross-sectional-survey of the 'Productive Ward'

    White, Mark

    2014-05-14

    Quality improvement (QI) Programmes, like the Productive Ward: Releasing-time-to-care initiative, aim to \\'engage\\' and \\'empower\\' ward teams to actively participate, innovate and lead quality improvement at the front line. However, little is known about the relationship and impact that QI work has on the \\'engagement\\' of the clinical teams who participate and vice-versa.

  17. TOOLS OF QUALITY IMPROVEMENT – MEASURING CUSTOMER SATISFACTION

    Catalina Soriana Sitnikov

    2009-01-01

    Nowadays, quality is often divided into service quality and product quality. The dimensions of quality of service are quite different from the quality of product due to the main difference between services and products (service intangibility and the customer who can use it only once). Customer satisfaction is one of the topics related with the quality due to the main measurement of quality is customer service. The main question about quality service is what the customer expects to get from th...

  18. Working toward a sustainable laboratory quality improvement programme through country ownership: Mozambiques SLMTA story

    Jessina Masamha

    2014-09-01

    Full Text Available Background: Launched in 2009, the Strengthening Laboratory Management Toward Accreditation (SLMTA programme has emerged as an innovative approach for the improvement of laboratory quality. In order to ensure sustainability, Mozambique embedded the SLMTA programme within the existing Ministry of Health (MOH laboratory structure.Objective: This article outlines the steps followed to establish a national framework for quality improvement and embed the SLMTA programme within existing MOH laboratory systems.Methods: The MOH adopted SLMTA as the national laboratory quality improvement strategy, hired a dedicated coordinator and established a national laboratory quality technical working group comprising mostly personnel from key MOH departments. The working group developed an implementation framework for advocacy, training, mentorship, supervision and audits. Emphasis was placed on building local capacity for programme activities. After receiving training, a team of 25 implementers (18 from the MOH and sevenfrom partner organisations conducted baseline audits (using the Stepwise Laboratory Quality Improvement Process Towards Accreditation [SLIPTA] checklist, workshops and site visits in six reference and two central hospital laboratories. Exit audits were conducted in six of the eight laboratories and their results are presented.Results: The six laboratories demonstrated substantial improvement in SLIPTA checklistscores; median scores increased from 35% at baseline to 57% at exit. It has been recommended that the National Tuberculosis Reference Laboratory apply for international accreditation.Conclusion: Successful implementation of SLMTA requires partnership between programme implementers, whilst effectiveness and long-term viability depend on country leadership, ownership and commitment. Integration of SLMTA into the existing MOH laboratory system will ensure durability beyond initial investments. The Mozambican model holds great promise that country leadership, ownership and institutionalisation can set the stage for programme success and sustainability.

  19. A Knowledge Management Approach to Support Software Process Improvement Implementation Initiatives

    Montoni, Mariano Angel; Cerdeiral, Cristina; Zanetti, David; Cavalcanti da Rocha, Ana Regina

    The success of software process improvement (SPI) implementation initiatives depends fundamentally of the strategies adopted to support the execution of such initiatives. Therefore, it is essential to define adequate SPI implementation strategies aiming to facilitate the achievement of organizational business goals and to increase the benefits of process improvements. The objective of this work is to present an approach to support the execution of SPI implementation initiatives. We also describe a methodology applied to capture knowledge related to critical success factors that influence SPI initiatives. This knowledge was used to define effective SPI strategies aiming to increase the success of SPI initiatives coordinated by a specific SPI consultancy organization. This work also presents the functionalities of a set of tools integrated in a process-centered knowledge management environment, named CORE-KM, customized to support the presented approach.

  20. Improving reliability of SCB initiators based on Al/Ni multilayer nanofilms

    Zhu, Peng; Li, Dongle; Fu, Shuai; Hu, Bo; Shen, Ruiqi; Ye, Yinghua

    2013-07-01

    This paper exploits an energetic initiator realized by integrating Al/Ni multilayer nanofilms with semiconductor bridge (SCB). The as-deposited nanofilms have been characterized with varied analytical techniques. Results show that distinct nanofilms are sputter deposited in a layered geometry and give a heat of reaction equal to 1134 J/g. The firing tests of the initiators were accomplished using capacitor discharge unit. Results show that the initiators possess several excellent characteristics such as fast ignition time, low power consumption, high output energy and so on. Therefore, Al/Ni multilayer nanofilms are suitable heat source for improving the reliability of SCB initiators.

  1. Improving Quality of Service from TCP/IP Performance Degradation

    Prof.N..Penchalaiah

    2011-02-01

    Full Text Available TCP is currently the dominate congestion control protocol for the Internet. However, as the Internet evolves into a high-speed wired-cum-wireless hybrid network, performance degradation problems of TCP have appeared, such as underutilizing high-speed links, regarding wireless loss as congestion signal, and unfairness among flows with different RTTs. In order to improve the quality of service for such highspeed hybrid networks, we propose a router-assisted congestion control protocol called Quick Flow Control Protocol (QFCP. The convergence of many traditional services over IPbased infrastructures drastically increases the amount of IP data traffic to be delivered to user clients, thus raising questions about the management of quality of service in such networks. Quality of service will be of primary importance in order to ensure right operation, and to face the occurrence of congestion conditions, due to bandwidth demandingmultimedia services. in this paper, shows that QFCP can significantly shorten flow completion time, fairly allocate bandwidth resource, and be robust to non-congestion related loss. Also we consider a possible scenarios in which multiple multimedia and control streams are conveyed over the same HAN, and study a possible solution for the implementation of an easily manageable QoS framework, that relies on a QoS router based on open source software.

  2. Improving Inland Water Quality Monitoring through RemoteSensing Techniques

    Igor Ogashawara

    2014-11-01

    Full Text Available Chlorophyll-a (chl-a levels in lake water could indicate the presence of cyanobacteria, which can be a concern for public health due to their potential to produce toxins. Monitoring of chl-a has been an important practice in aquatic systems, especially in those used for human services, as they imply an increased risk of exposure. Remote sensing technology is being increasingly used to monitor water quality, although its application in cases of small urban lakes is limited by the spatial resolution of the sensors. Lake Thonotosassa, FL, USA, a 3.45-km2 suburban lake with several uses for the local population, is being monitored monthly by traditional methods. We developed an empirical bio-optical algorithm for the Moderate Resolution Imaging Spectroradiometer (MODIS daily surface reflectance product to monitor daily chl-a. We applied the same algorithm to four different periods of the year using 11 years of water quality data. Normalized root mean squared errors were lower during the first (0.27 and second (0.34 trimester and increased during the third (0.54 and fourth (1.85 trimesters of the year. Overall results showed that Earth-observing technologies and, particularly, MODIS products can also be applied to improve environmental health management through water quality monitoring of small lakes.

  3. IMPROVING BANK QUALITY DIMENSIONS TO INCREASE CUSTOMER SATISFACTION

    Lăcrămioara RADOMIR

    2011-01-01

    Full Text Available The purpose of this study is twofold: 1. examine the relationship betweenservice quality dimensions and customer satisfaction with bank territorialunits; 2. establish which quality measure method out of the four considered inthis study should be applied in order to better determine the areas that needfurther improvement and investment. In this respect, we performed PrincipalComponent Regression (PCR and considered direct importance andperformance measures as well. Our results reveal that human resourceshave the greatest impact on customers’ satisfaction with bank territorial unitsand that both “Convenience and Efficiency” and “Bank personnel” are thedimensions that bank management should consider in their efforts to improveand maintain the service quality level. To the best of our knowledge, this isthe first study which tries to emphasize the relationship between servicequality dimensions and Romanian customers’ satisfaction with bank territorialunits. The main limit of the study lies in the fact that data were collectedamong the customers of a single bank. Nevertheless, it provides valuableinformation about the Romanian market and ought to be considered astarting point for further studies.

  4. Implementation of quality improvement techniques for management and technical processes in the ACRV project

    Raiman, Laura B.

    1992-01-01

    Total Quality Management (TQM) is a cooperative form of doing business that relies on the talents of everyone in an organization to continually improve quality and productivity, using teams and an assortment of statistical and measurement tools. The objective of the activities described in this paper was to implement effective improvement tools and techniques in order to build work processes which support good management and technical decisions and actions which are crucial to the success of the ACRV project. The objectives were met by applications in both the technical and management areas. The management applications involved initiating focused continuous improvement projects with widespread team membership. The technical applications involved applying proven statistical tools and techniques to the technical issues associated with the ACRV Project. Specific activities related to the objective included working with a support contractor team to improve support processes, examining processes involved in international activities, a series of tutorials presented to the New Initiatives Office and support contractors, a briefing to NIO managers, and work with the NIO Q+ Team. On the technical side, work included analyzing data from the large-scale W.A.T.E.R. test, landing mode trade analyses, and targeting probability calculations. The results of these efforts will help to develop a disciplined, ongoing process for producing fundamental decisions and actions that shape and guide the ACRV organization .

  5. Implementation of quality improvement techniques for management and technical processes in the ACRV project

    Raiman, Laura B.

    1992-12-01

    Total Quality Management (TQM) is a cooperative form of doing business that relies on the talents of everyone in an organization to continually improve quality and productivity, using teams and an assortment of statistical and measurement tools. The objective of the activities described in this paper was to implement effective improvement tools and techniques in order to build work processes which support good management and technical decisions and actions which are crucial to the success of the ACRV project. The objectives were met by applications in both the technical and management areas. The management applications involved initiating focused continuous improvement projects with widespread team membership. The technical applications involved applying proven statistical tools and techniques to the technical issues associated with the ACRV Project. Specific activities related to the objective included working with a support contractor team to improve support processes, examining processes involved in international activities, a series of tutorials presented to the New Initiatives Office and support contractors, a briefing to NIO managers, and work with the NIO Q+ Team. On the technical side, work included analyzing data from the large-scale W.A.T.E.R. test, landing mode trade analyses, and targeting probability calculations. The results of these efforts will help to develop a disciplined, ongoing process for producing fundamental decisions and actions that shape and guide the ACRV organization .

  6. SQUIRE 2.0 (Standards for QUality Improvement Reporting Excellence)

    Ogrinc, Greg; Davies, Louise; Goodman, Daisy; Batalden, Paul; Davidoff, Frank; Stevens, David

    2015-01-01

    In the past several years, the science of health care improvement has advanced considerably. In this article, we describe the development of SQUIRE 2.0 and its key components. We undertook the revision between 2012 and 2015 using (1) interviews and focus groups to evaluate SQUIRE 1.0 plus feedback from an international steering group, (2) face-to-face consensus meetings to develop interim drafts, and (3) pilot testing with authors and a public comment period. SQUIRE 2.0 emphasizes 3 key components of systematic efforts to improve the quality, value, and safety of health care: formal and informal theory in planning, implementing, and evaluating improvement work; the context in which the work is done; and the study of the intervention(s). SQUIRE 2.0 is intended for reporting the range of methods used to improve health care, recognizing that they can be complex and multidimensional. It provides common ground to share these discoveries in the scholarly literature (www.squire-statement.org). PMID:26497490

  7. Controlled therapeutic gas delivery systems for quality-improved transplants.

    Steiger, Christoph; Wollborn, Jakob; Gutmann, Marcus; Zehe, Markus; Wunder, Christian; Meinel, Lorenz

    2015-11-01

    Therapeutic gases enriched into perfusion solutions have been effectively used for the improvement of organ transplant quality. At present, the enrichment of perfusion solutions with gases requires complex machinery/containers and handling precautions. Alternatively, the gas is generated within the perfusion solution by supplemented carbonylated transition metal complexes with associated toxicological concerns when these metals contact the transplant. Therefore, we developed therapeutic gas releasing systems (TGRSs) allowing for the controlled generation and release of therapeutic gases (carbon monoxide and hydrogen sulfide) from otherwise hermetically sealed containers, such that the perfusion solution for the transplant is saturated with the gas but no other components from the TGRS are liberated in the solution. The release from the TGRS into the perfusion solution can be tailored as a function of the number and thickness of gas permeable membranes leading to release patterns having been linked to therapeutic success in previous trials. Furthermore, the surrogate biomarker HMGB1 was significantly downregulated in ischemic rat liver transplants perfused with enriched CO solution as compared to control. In conclusion, the TGRS allows for easy, reliable, and controlled generation and release of therapeutic gases while removing safety concerns of current approaches, thereby positively impacting the risk benefit profile of using therapeutic gases for transplant quality improvement in the future. PMID:26527426

  8. Combating the 'Sick Building Syndrome' by Improving Indoor Air Quality

    Pongchai Nimcharoenwon

    2012-11-01

    Full Text Available Research indicates that many of symptoms attributed to the Sick Building Syndrome in air-conditioned office buildings are a result of considerably reduced negative ions in the internal atmosphere and that replacing the depleted negative ions can improve indoor air quality. This paper describes a method used to develop a formula (DOF-NIL formula for calculating the amount of negative ions to be added to air-conditioned buildings, to improve air quality. The formula enables estimates to be made based on how negative ions in the air are reduced by three main factors namely, Video Display Terminals (VDT; heating, ventilation and air conditioning (HVAC and Building Contents (BC. Calculations for a typical air-conditioned office, are compared with an Air Ion Counter instrument. The results show that the formula, when applied to a typical air-conditioned office, provides an accurate estimate for design purposes. The typical rate of additional negative-ions (ion-generating for a negative ion condition is found to be approximately 12.0 billion ions/hr for at least 4 hour ion-generating.

  9. Quality of care in reproductive health programmes: monitoring and evaluation of quality improvement.

    Kwast, B E

    1998-12-01

    As 200 million women become pregnant every year, at least 30 million will develop life-threatening complications requiring emergency treatment at any level of society where they live. But it is a basic human right that pregnancy be made safe for all women as complications are mostly unpredictable. This requires reproductive health programmes which are responsive to women's and their families' needs and expectations on the one hand and enhancement of community participation, high quality obstetric services, and both provider collaboration and satisfaction on the other. Monitoring and evaluation of these facets need to be an integral part of any safe motherhood programme, not only to assess progress, but also to use this information for subsequent planning and implementation cycles of national programmes. Lessons learned from ten years' implementation of Safe Motherhood programmes indicate that process and outcome indicators are more feasible for short-term evaluation purposes than impact indicators, such as maternal mortality reduction. The former are described in this paper with relevant country examples. This is the third, and last, article in a series on quality of care in reproductive health programmes. The first (Kwast 1998a) contains an overview of concepts, assessments, barriers and improvements of quality of care. The second (Kwast 1998b) addresses education issues for quality improvement. PMID:10076314

  10. Ripening for improving the quality of inoculated cheese Rhizopus oryzae

    ARTINI PANGASTUTI

    2010-01-01

    Full Text Available Estikomah SA, Sutarno, Pangastuti A 2010. Ripening for improving the quality of inoculated cheese Rhizopus oryzae. Nusantara Bioscience 2: 1-6. Cheese is dairy product resulted from fermented milk in which the fermentation process can be done by lactic acid bacteria or fungus. Rhizopus oryzae is able to produce lactic acid, protease and lipase. The ripening process changes the taste and texture. The purpose of this study is ripening to improve the quality of inoculated cheese R. oryzae. In this research the ripening was conducted the concentration variation of temperature (5oC, 10oC, 15oC, and time (7 days, 14 days. The procedure of research consisted of two steps, namely un-ripened cheese preparation followed by ripening cheese preparation. Cheese produced in this study analyzed the value of pH, fat content, protein content, amino acid levels and identification of microbe with ANOVA then followed by DMRT at 5% level of significance. Data results were analyzed with the like’s nonparametric statistical test, followed by Fridman Wilcoxon Signed Rank Test (WSRT at 5% level significance. The results showed that the preferred ripened cheese panelist was at a temperature of 15oC for 14 days. Ripening conditions affect pH, fat content, protein content and do not affect the levels of amino acids that formed ripened cheese. The best quality ripened cheese i.e. at a temperature of 15°C for 14 days, had a pH value of 4.40, the highest protein content of 9.78%, and fat content of 35.02%. The results of identified microbe in un-ripened cheese and ripened cheese include Enterococcus hirae (Enterococcus faecalis, Bacillus subtilis, and Aspergillus sp.

  11. Two Different Strategies to Facilitate Involvement in Healthcare Improvements: A Swedish County Council Initiative

    Andersson, Ann-Christine; Idvall, Ewa; Perseius, Kent-Inge; Elg, Mattias

    2014-01-01

    Background: From a management point of view, there are many different approaches from which to choose to engage staff members in initiatives to improve performance. Objective: The present study evaluated how two different types of improvement strategies facilitate and encourage involvement of different professional groups in health-care organizations. Methods/Design: Empirical data of two different types of strategies were collected within an improvement project in a County Council in Sweden....

  12. Quality assurance and the World Health Organization initiative of 'Health for All'

    Following a workshop held in Neuherberg, FRG, in 1980 a guide for quality assurance in diagnostic radiology was published by WHO in 1982. Quality assurance programmes were recognized as being necessary for three main objectives: first the improvement of medical diagnostic imaging, secondly cost containment, and thirdly the reduction of radiation exposure. Concurrently, because of the paramount importance for basic diagnostic imaging, WHO prepared Technical Specifications for the X-ray Apparatus to be Used in a Basic Radiological System (BRS), governed by the concepts of ''design-out maintenance'' and ''design-in quality assurance''. The outcome of WHO's efforts, in comparison with the recognized quality assurance objectives, indicates that, although it is too early to measure overall improvements in medical diagnostic imaging, the two main aspects, accessibility and image quality, should be improved. Regarding cost containment, elimination of many logistical and support requirements should result in considerable savings. Regarding the reduction of radiation exposure, and using the entrance skin exposure as an indicator, an important finding is that with the WHO-BRS type X-ray equipment, in most cases the patient exposure was less than the average values in the United States. (author)

  13. Quality assurance of radiotherapy in cancer treatment. Toward improvement of patient safety and quality of care

    The process of radiotherapy (RT) is complex and involves understanding of the principles of medical physics, radiobiology, radiation safety, dosimetry, radiation treatment planning, simulation and interaction of radiation with other treatment modalities. Each step in the integrated process of RT needs quality control and quality assurance (QA) to prevent errors and to give high confidence that patients will receive the prescribed treatment correctly. Recent advances in RT, including intensity-modulated and image-guided RT, focus on the need for a systematic RTQA program that balances patient safety and quality with available resources. It is necessary to develop more formal error mitigation and process analysis methods, such as failure mode and effect analysis, to focus available QA resources optimally on process components. External audit programs are also effective. The International Atomic Energy Agency has operated both an on-site and off-site postal dosimetry audit to improve practice and to assure the dose from RT equipment. Several countries have adopted a similar approach for national clinical auditing. In addition, clinical trial QA has a significant role in enhancing the quality of care. The Advanced Technology Consortium has pioneered the development of an infrastructure and QA method for advanced technology clinical trials, including credentialing and individual case review. These activities have an impact not only on the treatment received by patients enrolled in clinical trials, but also on the quality of treatment administered to all patients treated in each institution, and have been adopted globally; by the USA, Europe and Japan also. (author)

  14. Quality assurance of radiotherapy in cancer treatment: toward improvement of patient safety and quality of care.

    Ishikura, Satoshi

    2008-11-01

    The process of radiotherapy (RT) is complex and involves understanding of the principles of medical physics, radiobiology, radiation safety, dosimetry, radiation treatment planning, simulation and interaction of radiation with other treatment modalities. Each step in the integrated process of RT needs quality control and quality assurance (QA) to prevent errors and to give high confidence that patients will receive the prescribed treatment correctly. Recent advances in RT, including intensity-modulated and image-guided RT, focus on the need for a systematic RTQA program that balances patient safety and quality with available resources. It is necessary to develop more formal error mitigation and process analysis methods, such as failure mode and effect analysis, to focus available QA resources optimally on process components. External audit programs are also effective. The International Atomic Energy Agency has operated both an on-site and off-site postal dosimetry audit to improve practice and to assure the dose from RT equipment. Several countries have adopted a similar approach for national clinical auditing. In addition, clinical trial QA has a significant role in enhancing the quality of care. The Advanced Technology Consortium has pioneered the development of an infrastructure and QA method for advanced technology clinical trials, including credentialing and individual case review. These activities have an impact not only on the treatment received by patients enrolled in clinical trials, but also on the quality of treatment administered to all patients treated in each institution, and have been adopted globally; by the USA, Europe and Japan also. PMID:18952706

  15. Development of process and outcome measures for improvement: lessons learned in a quality improvement collaborative for pediatric inflammatory bowel disease.

    Crandall, Wallace V; Boyle, Brendan M; Colletti, Richard B; Margolis, Peter A; Kappelman, Michael D

    2011-10-01

    The Institute of Medicine's publications, To Err is Human and Crossing the Quality Chasm, publicized the widespread deficits in healthcare quality. The quality of care in inflammatory bowel disease (IBD) has not been comprehensively evaluated, in part due to a lack of well-established IBD measures of quality. Quality can be measured for evaluation, benchmarking, or continuous quality improvement, using structural, process, and outcome measures. Measurement is an essential component of the model for improvement, necessary to determine whether changes made have resulted in improvement. Measures used for quality improvement should be based on evidence and consensus, be clear and collectable in a timely fashion, occur with sufficient frequency, and have the potential to improve outcomes. While no current IBD measures of quality are perfect, an iterative process of measure development can produce a set of measures that are feasible, relevant, and useful for performing quality improvement. This review describes the history, rationale, and methods of quality measurement and discusses the early work and lessons learned from measuring quality of care in a pediatric IBD quality improvement collaborative. PMID:21456033

  16. Decorative cosmetics improve the quality of life in patients with disfiguring skin diseases.

    Boehncke, Wolf-Henning; Ochsendorf, Falk; Paeslack, Ingrid; Kaufmann, Roland; Zollner, Thomas Matthias

    2002-01-01

    Dermatoses may have a significant impact on a patient's quality of life, namely the relationship to others, self-image and self-esteem. We therefore asked whether the application of decorative cosmetics might increase their quality of life. Twenty female patients (16-69 y) with skin diseases affecting the patients' face (acne, n = 8; rosacea, n = 9; chronic discoid lupus erythematodes, n = 2; vitiligo, n = 1) were investigated. The patients were instructed by a cosmetician how to use decorative cosmetics (Unifiance , La Roche-Posay, France) and applied it daily for 2 weeks. The dermatology quality of life questionnaire (DLQI) was performed before the first application and 2 weeks afterwards. The clinical course was documented by standardised photography. Unifiance was well tolerated and no side effects occurred. It completely masked the unwanted coloration and application resulted in a significant amelioration of the appearance. The mean DLQI score dropped significantly from 9.2 to 5.5 (p = 0.0009). Improvement of quality of life reached statistical significance among patients with acne (2.8 versus 7.8, p = 0.0078) and among individuals with a less severe initial impairment of quality of life (2.4 versus 4.2, p = 0.007). Thus, the use of decorative cosmetics in disfiguring skin diseases is an effective, well-tolerated measure increasing the patients' quality of life. We therefore suggest that decorative cosmetics can complement the treatment of disfiguring skin diseases. PMID:12459532

  17. A framework for healthcare quality improvement in India: The time is here and now!

    P Varkey

    2011-01-01

    Full Text Available Healthcare in India has been undergoing rapid changes in the last decade. As demand outpaces supply, quality improvement (QI initiatives and tools can be beneficial to enhance safe, effective, efficient, equitable and timely care. Healthcare quality is the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge. This article discusses the framework for QI and reviews the Plan-Do-Study-Act (PDSA, Lean and Six Sigma methodologies, and briefly discusses key patient safety and quality measurement concepts. The PDSA cycle assists in testing the ideas through small tests of change or "pilots". Six Sigma aims at reducing variations in processes, and the Lean methodology predominantly focuses on enhancing process efficiency and eliminating non-value added steps in the process. It is likely that such structured problem solving approaches will provide an objective and systematic method of enhancing quality in healthcare institutions across India. As increasing attention being is paid on enhancing the quality of life through the Quality Council of India and accreditation of hospitals in India through the International Organization for standardization and National Accreditation Board for hospitals and healthcare providers, a focus on QI by institutional leaders and healthcare providers is key to enhancing the safety and quality of healthcare in India. Central to this also will be leadership buy-in, identification of a core faculty or team that will be the initiators of change, a respect for the need for faculty training and education in QI, measurement of issues to identify key priorities to focus on, and enhanced information systems where resources permit the same.

  18. Better quality of life with neuropsychological improvement on HAART

    Hall Colin D

    2006-02-01

    Full Text Available Abstract Background Successful highly active antiretroviral therapy (HAART regimens have resulted in substantial improvements in the systemic health of HIV infected persons and increased survival times. Despite increased systemic health, the prevalence of minor HIV-associated cognitive impairment appears to be rising with increased longevity, and it remains to be seen what functional outcomes will result from these improvements. Cognitive impairment can dramatically impact functional ability and day-to-day productivity. We assessed the relationship of quality of life (QOL and neuropsychological functioning with successful HAART treatment. Methods In a prospective longitudinal study, subjects were evaluated before instituting HAART (naïve or before changing HAART regimens because current therapy failed to maintain suppression of plasma viral load (treatment failure. Subjects underwent detailed neuropsychological and neurological examinations, as well as psychological evaluation sensitive to possible confounds. Re-evaluation was performed six months after institution of the new HAART regimen and/or if plasma viral load indicated treatment failure. At each evaluation, subjects underwent ultrasensitive HIV RNA quantitative evaluation in both plasma and cerebrospinal fluid. Results HAART successes performed better than failures on measures exploring speed of mental processing (p Conclusion Our study investigated the relationship between HIV-associated neurocognitive impairment and quality of life. HAART failures experienced slower psychomotor processing, and had increased self-reports of physical health complaints and substance abuse. Contrariwise, HAART successes experienced improved mental processing, demonstrating the impact of successful treatment on functioning. With increasing life expectancy for those who are HIV seropositive, it is important to measure cognitive functioning in relation to the actual QOL these individuals report. The study results have implications for the optimal management of HIV-infected persons. Specific support or intervention may be beneficial for those who have failed HAART in order to decrease substance abuse and increase overall physical health.

  19. Improving critical care discharge summaries: a collaborative quality improvement project using PDSA.

    Goulding, Lucy; Parke, Hannah; Maharaj, Ritesh; Loveridge, Robert; McLoone, Anne; Hadfield, Sophie; Helme, Eloise; Hopkins, Philip; Sandall, Jane

    2015-01-01

    Around 110,000 people spend time in critical care units in England and Wales each year. The transition of care from the intensive care unit to the general ward exposes patients to potential harms from changes in healthcare providers and environment. Nurses working on general wards report anxiety and uncertainty when receiving patients from critical care. An innovative form of enhanced capability critical care outreach called 'iMobile' is being provided at King's College Hospital (KCH). Part of the remit of iMobile is to review patients who have been transferred from critical care to general wards. The iMobile team wished to improve the quality of critical care discharge summaries. A collaborative evidence-based quality improvement project was therefore undertaken by the iMobile team at KCH in conjunction with researchers from King's Improvement Science (KIS). Plan, Do, Study, Act (PDSA) methodology was used. Three PDSA cycles were undertaken. Methods adopted comprised: a scoping literature review to identify relevant guidelines and research evidence to inform all aspects of the quality improvement project; a process mapping exercise; informal focus groups / interviews with staff; patient story-telling work with people who had experienced critical care and subsequent discharge to a general ward; and regular audits of the quality of both medical and nursing critical care discharge summaries. The following behaviour change interventions were adopted, taking into account evidence of effectiveness from published systematic reviews and considering the local context: regular audit and feedback of the quality of discharge summaries, feedback of patient experience, and championing and education delivered by local opinion leaders. The audit results were mixed across the trajectory of the project, demonstrating the difficulty of sustaining positive change. This was particularly important as critical care bed occupancy and through-put fluctuates which then impacts on work-load, with new cohorts of staff regularly passing through critical care. In addition to presenting the results of this quality improvement project, we also reflect on the lessons learned and make suggestions for future projects. PMID:26734368

  20. The effectiveness of service delivery initiatives at improving patients' waiting times in clinical radiology departments: a systematic review.

    Olisemeke, B; Chen, Y F; Hemming, K; Girling, A

    2014-12-01

    We reviewed the literature for the impact of service delivery initiatives (SDIs) on patients' waiting times within radiology departments. We searched MEDLINE, EMBASE, CINAHL, INSPEC and The Cochrane Library for relevant articles published between 1995 and February, 2013. The Cochrane EPOC risk of bias tool was used to assess the risk of bias on studies that met specified design criteria. Fifty-seven studies met the inclusion criteria. The types of SDI implemented included extended scope practice (ESP, three studies), quality management (12 studies), productivity-enhancing technologies (PETs, 29 studies), multiple interventions (11 studies), outsourcing and pay-for-performance (one study each). The uncontrolled pre- and post-intervention and the post-intervention designs were used in 54 (95%) of the studies. The reporting quality was poor: many of the studies did not test and/or report the statistical significance of their results. The studies were highly heterogeneous, therefore meta-analysis was inappropriate. The following type of SDIs showed promising results: extended scope practice; quality management methodologies including Six Sigma, Lean methodology, and continuous quality improvement; productivity-enhancing technologies including speech recognition reporting, teleradiology and computerised physician order entry systems. We have suggested improved study design and the mapping of the definitions of patient waiting times in radiology to generic timelines as a starting point for moving towards a situation where it becomes less restrictive to compare and/or pool the results of future studies in a meta-analysis. PMID:24888629