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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. The process of managerial control in quality improvement initiatives.

    Slovensky, D J; Fottler, M D

    1994-11-01

    The fundamental intent of strategic management is to position an organization with in its market to exploit organizational competencies and strengths to gain competitive advantage. Competitive advantage may be achieved through such strategies as low cost, high quality, or unique services or products. For health care organizations accredited by the Joint Commission on Accreditation of Healthcare Organizations, continually improving both processes and outcomes of organizational performance--quality improvement--in all operational areas of the organization is a mandated strategy. Defining and measuring quality and controlling the quality improvement strategy remain problematic. The article discusses the nature and processes of managerial control, some potential measures of quality, and related information needs. PMID:10138526

  3. 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

  4. A Blueprint for Early Care and Education Quality Improvement Initiatives. Publication #2015-07

    Tout, Kathryn; Epstein, Dale; Soli, Meg; Lowe, Claire

    2015-01-01

    As Quality Rating and Improvement Systems (QRIS) continue to launch and mature across states, questions emerge from stakeholders about how to design and implement effective quality improvement (QI) initiatives that accompany a QRIS. Funders, policymakers, and program developers with limited resources are looking to invest in activities that will…

  5. The role of chief executive officers in a quality improvement initiative: a qualitative study

    Parand, Anam; Dopson, Sue; Vincent, Charles

    2013-01-01

    Objectives To identify the critical dimensions of hospital Chief Executive Officers’ (CEOs) involvement in a quality and safety initiative and to offer practical guidance to assist CEOs to fulfil their leadership role in quality improvement (QI). Design Qualitative interview study. Setting 20 organisations participating in the main phase of the Safer Patients Initiative (SPI) programme across the UK. Participants 17 CEOs overseeing 19 organisations participating in the main phase of the SPI p...

  6. 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...

  7. Supporting 'Baby Friendly': a quality improvement initiative for the management of transitional neonatal hypoglycaemia.

    Stewart, Claire Elizabeth; Sage, Emma Louise Maitland; Reynolds, Peter

    2016-07-01

    We describe a quality improvement initiative conducted in a medium-sized district general hospital with a neonatal intensive care unit, which involved working with the multidisciplinary team to create a 'Baby Friendly' neonatal hypoglycaemia pathway with implementation of dextrose gel as a first-line treatment. As a result of the project, formula supplementation rates and admissions for transitional hypoglycaemia were reduced and breastfeeding rates at 3 months improved. This initiative demonstrates that evidence-based guidelines with multidisciplinary team input can improve standards of care. PMID:26644391

  8. 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. PMID:26102592

  9. Quality Improvement in the National Cancer Institute Community Cancer Centers Program: The Quality Oncology Practice Initiative Experience

    Siegel, Robert D.; Castro, Kathleen M.; Eisenstein, Jana; Stallings, Holley; Hegedus, Patricia D.; Bryant, Donna M.; Kadlubek, Pam J.; Clauser, Steven B.

    2015-01-01

    Purpose: The National Cancer Institute (NCI) Community Cancer Centers Program (NCCCP) began in 2007; it is a network of community-based hospitals funded by the NCI. Quality of care is an NCCCP priority, with participation in the American Society of Clinical Oncology Quality Oncology Practice Initiative (QOPI) playing a fundamental role in quality assessment and quality improvement (QI) projects. Using QOPI methodology, performance on quality measures was analyzed two times per year over a 3-year period to enhance our implementation of quality standards at NCCCP hospitals. Methods: A data-sharing agreement allowed individual-practice QOPI data to be electronically sent to the NCI. Aggregated data with the other NCCCP QOPI participants were presented to the network via Webinars. The NCCCP Quality of Care Subcommittee selected areas in which to focus subsequent QI efforts, and high-performing practices shared voluntarily their QI best practices with the network. Results: QOPI results were compiled semiannually between fall 2010 and fall 2013. The network concentrated on measures with a quality score of ≤ 0.75 and planned voluntary group-wide QI interventions. We identified 13 measures in which the NCCCP fell at or below the designated quality score in fall 2010. After implementing a variety of QI initiatives, the network registered improvements in all parameters except one (use of treatment summaries). Conclusion: Using the NCCCP as a paradigm, QOPI metrics provide a useful platform for group-wide measurement of quality performance. In addition, these measurements can be used to assess the effectiveness of QI initiatives. PMID:25538082

  10. Service quality in healthcare: quality improvement initiatives through the prism of patients’ and providers’ perspectives

    Globenko, Anna; Sianova, Zinaida

    2012-01-01

    Efficient functioning of service providing organizations highly depends on quality of their services as it contributes to companies’ competitiveness and customers’ satisfaction (Gill, 2009, p. 533). Thus, quality management should be an integral part of service organizations’ performance. Healthcare industry is a specific representative of the service industry that regards quality as a fundamental value of medical care. To manage quality within the healthcare settings is a challenging task du...

  11. 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

  12. 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.

  13. Improving the provision of pregnancy care for Aboriginal and Torres Strait Islander women: a continuous quality improvement initiative

    Gibson-Helm, Melanie E.; Rumbold, Alice R; Teede, Helena J; Ranasinha, Sanjeeva; Bailie, Ross S; Jacqueline A. Boyle

    2016-01-01

    Background Australian Aboriginal and Torres Strait Islander (Indigenous) women are at greater risk of adverse pregnancy outcomes than non-Indigenous women. Pregnancy care has a key role in identifying and addressing modifiable risk factors that contribute to adverse outcomes. We investigated whether participation in a continuous quality improvement (CQI) initiative was associated with increases in provision of recommended pregnancy care by primary health care centers (PHCs) in predominantly I...

  14. 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.

  15. 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

  16. Quality Improvement Initiative to Decrease Variability of Emergency Physician Opioid Analgesic Prescribing

    John H. Burton

    2016-05-01

    Full Text Available Introduction: Addressing pain is a crucial aspect of emergency medicine. Prescription opioids are commonly prescribed for moderate to severe pain in the emergency department (ED; unfortunately, prescribing practices are variable. High variability of opioid prescribing decisions suggests a lack of consensus and an opportunity to improve care. This quality improvement (QI initiative aimed to reduce variability in ED opioid analgesic prescribing. Methods: We evaluated the impact of a three-part QI initiative on ED opioid prescribing by physicians at seven sites. Stage 1: Retrospective baseline period (nine months. Stage 2: Physicians were informed that opioid prescribing information would be prospectively collected and feedback on their prescribing and that of the group would be shared at the end of the stage (three months. Stage 3: After physicians received their individual opioid prescribing data with blinded comparison to the group means (from Stage 2 they were informed that individual prescribing data would be unblinded and shared with the group after three months. The primary outcome was variability of the standard error of the mean and standard deviation of the opioid prescribing rate (defined as number of patients discharged with an opioid divided by total number of discharges for each provider. Secondary observations included mean quantity of pills per opioid prescription, and overall frequency of opioid prescribing. Results: The study group included 47 physicians with 149,884 ED patient encounters. The variability in prescribing decreased through each stage of the initiative as represented by the distributions for the opioid prescribing rate: Stage 1 mean 20%; Stage 2 mean 13% (46% reduction, p<0.01, and Stage 3 mean 8% (60% reduction, p<0.01. The mean quantity of pills prescribed per prescription was 16 pills in Stage 1, 14 pills in Stage 2 (18% reduction, p<0.01, and 13 pills in Stage 3 (18% reduction, p<0.01. The group mean

  17. "Know your CD4 campaign": 6-year outcomes from a quality improvement initiative to promote earlier initiation of antiretroviral therapy in Tanzania

    Peter Memiah; Constance Shumba; Yvonne Henley; Sekela Mwakyusa; Abuu Maghimbi; Patience Komba; Anthony Mlila; Venosa Haule; Tuhuma Tulli; Stafford Kristen; Martine Etienne-Mesubi; Carla Alexander

    2014-01-01

    Background: Late initiation of treatment for illness secondary to the human immunodeficiency virus (HIV) remains a major challenge in developing countries. Despite the World Health Organization (WHO) recommendation that treatment be initiated early in disease management, health providers conducting quality improvement monitoring in one region of Tanzania noted that common management practice relies upon clinical signs of advanced disease alone for initiation of combination antiretroviral ther...

  18. Initial benzodiazepine use and improved health-related quality of life.

    van Hulten, Rolf; Teeuw, Bart; Bakker, Albert; Leufkens, Hubert G

    2005-01-01

    OBJECTIVE: The health-related quality of life (HRQOL) of initial benzodiazepine users was measured over time. Furthermore, benzodiazepine usage characteristics as determinants of change in mental and physical health status of the benzodiazepine users were examined. METHODS: In the only pharmacy of a

  19. Palm Beach County's Prime Time Initiative: Improving the Quality of After-School Programs

    Spielberger, Julie; Lockaby, Tracey

    2008-01-01

    This report covers the third year of Chapin Hall's process evaluation of the Prime Time Initiative of Palm Beach County, Florida, a system-building effort to strengthen the quality of after-school programs in the county. During the past two decades, the after-school field has expanded enormously, partly in response to increasing concern about…

  20. 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

  1. 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...

  2. Quality Initiatives - General Information

    U.S. Department of Health & Human Services — CMS has developed a standardized approach for the development of quality measures that it uses in its quality initiatives. Known as the Measures Management System...

  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. 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.

  6. 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…

  7. Money matters: exploiting the data from outcomes research for quality improvement initiatives.

    Impellizzeri, Franco M; Bizzini, Mario; Leunig, Michael; Maffiuletti, Nicola A; Mannion, Anne F

    2009-08-01

    In recent years, there has been an increase in studies that have sought to identify predictors of treatment outcome and to examine the efficacy of surgical and non-surgical treatments. In addition to the scientific advancement associated with these studies per se, the hospitals and clinics where the studies are conducted may gain indirect financial benefit from participating in such projects as a result of the prestige derived from corporate social responsibility, a reputational lever used to reward such institutions. It is known that there is a positive association between corporate social performance and corporate financial performance. However, in addition to this, the research findings and the research staff can constitute resources from which the provider can reap a more direct benefit, by means of their contribution to quality control and improvement. Poor quality is costly. Patient satisfaction increases the chances that the patient will be a promoter of the provider to friends and colleagues. As such, involvement of the research staff in the improvement of the quality of care can ultimately result in economic revenue for the provider. The most advanced methodologies for continuous quality improvement (e.g., six-sigma) are data-driven and use statistical tools similar to those utilized in the traditional research setting. Given that these methods rely on the application of the scientific process to quality improvement, researchers have the adequate skills and mind-set to embrace them and thereby contribute effectively to the quality team. The aim of this article is to demonstrate by means of real-life examples how to utilize the findings of outcome studies for quality management in a manner similar to that used in the business community. It also aims to stimulate research groups to better understand that, by adopting a different perspective, their studies can be an additional resource for the healthcare provider. The change in perspective should stimulate

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

    Chanin Johann C; Chou Ann F; Henke Rachel; Zides Amanda B; Scholle Sarah

    2008-01-01

    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 cond...

  9. The National Clinical Database as an Initiative for Quality Improvement in Japan

    Murakami, Arata; Hirata, Yasutaka; Motomura, Noboru; Miyata, Hiroaki; Iwanaka, Tadashi; Takamoto, Shinichi

    2014-01-01

    The JCVSD (Japan Cardiovascular Surgery Database) was organized in 2000 to improve the quality of cardiovascular surgery in Japan. Web-based data harvesting on adult cardiac surgery was started (Japan Adult Cardiovascular Surgery Database, JACVSD) in 2001, and on congenital heart surgery (Japan Congenital Cardiovascular Surgery Database, JCCVSD) in 2008. Both databases grew to become national databases by the end of 2013. This was influenced by the success of the Society for Thoracic Surgeons...

  10. Quality improvement initiatives by Aga Khan Health Service in the mountains of northern Pakistan.

    Jassani, Kashif; Essani, Rozina Roshan Ali; Abbas, Nadeem; Ahmed, Rashida

    2015-01-01

    Improving health care quality in a resource constraint environment in an emerging economy that is in a hard-to-reach geographic terrain can become a challenge especially when it has to follow the international standard which AKHS, P envisions to implement across the nation in all of its health facilities. Healthcare of the nation is a responsibility which is shouldered by both the government and the private sector. Private-sector, however, remains under pressure as its resource size is limited and it remains subject to stringent regulation and quality control requirements regardless of whether it is in the remotest corner of the country where proper land routes are either lacking or not safe. This article shares the unique experience of AKHS, P in achieving ISO 9001:2008 International Quality Management System Certification. Particularly at one of the "world's highest valleys -situated at Gilgit Baltistan at an altitude of 13,083 ft. above sea level in Northern Pakistan. The experience was unique in terms of demonstrating and recording how a quality management system can be implemented in one of the most difficult to reach areas where compliance to international quality standards was previously unthinkable. PMID:26058290

  11. Improving the quality of the experimental reconstructions as the initial equilibrium state for the NIMROD code

    King, Jacob; Kruger, Scott; NIMROD Team

    2014-10-01

    High quality equilibria are essential for extended-MHD modeling with the initial-value NIMROD code. Typically the spatial resolution requirements for extended-MHD modeling, which must resolve singular-layer physics and highly anisotropic diffusion, are more stringent than the resolution of equilibrium reconstructions from experimental discharges. With the current workflow, reconstructed fields are mapped onto the NIMROD finite-element grid, and the disparity between the coarse resolution reconstruction and the fine resolution FE grid can create artificial small-scale artifacts. Extended-MHD modeling, which contains many high-order differential operators, can be corrupted by the mapping errors. We describe efforts to re-solve the Grad-Shafranov equation with open-flux regions using the NIMEQ solver to generate a new equilibrium while using the mapped results for both an initial guess and to specify the boundary conditions. Effects on computations with and without the re-solving for force balance will be described. Work funded by US DOE.

  12. Improving water quality through California's Clean Beach Initiative: an assessment of 17 projects.

    Dorsey, John H

    2010-07-01

    California's Clean Beach Initiative (CBI) funds projects to reduce loads of fecal indicator bacteria (FIB) impacting beaches, thus providing an opportunity to judge the effectiveness of various CBI water pollution control strategies. Seventeen initial projects were selected for assessment to determine their effectiveness on reducing FIB in the receiving waters along beaches nearest to the projects. Control strategies included low-flow diversions, sterilization facilities, sewer improvements, pier best management practices (BMPs), vegetative swales, and enclosed beach BMPs. Assessments were based on statistical changes in pre- and postproject mean densities of FIB at shoreline monitoring stations targeted by the projects. Most low-flow diversions and the wetland swale project were effective in removing all contaminated runoff from beaches. UV sterilization was effective when coupled with pretreatment filtration and where effluent was released within a few hundred meters of the beach to avoid FIB regrowth. Other BMPs were less effective because they treated only a portion of contaminant sources impacting their target beach. These findings should be useful to other coastal states and agencies faced with similar pollution control problems. PMID:19496001

  13. A quality improvement initiative to increase pneumococcal vaccination coverage among children after kidney transplant.

    Malone, Kathryn; Clark, Stephanie; Palmer, Jo Ann; Lopez, Sonya; Pradhan, Madhura; Furth, Susan; Kim, Jason; Fisher, Brian; Laskin, Benjamin

    2016-09-01

    Pneumococcal vaccination rates among children receiving a kidney transplant remain suboptimal. Current practice guidelines in the United States recommend giving the PPSV23 after priming with the PCV13. We conducted a QI initiative to increase pneumococcal vaccine rates in our kidney transplant recipients by developing an age-based vaccine algorithm, obtaining vaccine records, and generating reminders for patients and clinicians. A monthly report from the EHR tracked outcomes. The process metric was missed vaccine opportunities, and the overall objective was to improve coverage with both the PCV13 and PPSV23. Over the first six months, we increased the percentage of visits where the vaccine was given from a baseline of 4% to 33%. However, by the end of the 12-month period, the percentage of eligible visits where the vaccine was given decreased to 8.7%. Nevertheless, over the 12-month observation period, we were able to increase the percentage of transplant patients receiving the PCV13 and PPSV23 from 6% to 52%. Utilizing an age-based algorithm and the electronic medical record, vaccine champions can track both missed visit opportunities and the number of vaccinated patients to improve pneumococcal immunization coverage for these high-risk patients. PMID:27334506

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

    ... Into Practice Tools Quality Purchaser-Provider Synergies Overview Primary Care Minority Health Medical Errors and Patient Safety Health Literacy and Cultural Competency Coronary Artery Disease ...

  15. Late outcomes after grafting of the severely burned face: a quality improvement initiative.

    Philp, Lauren; Umraw, Nisha; Cartotto, Robert

    2012-01-01

    between the graft and hairlines of the frontal scalp and eyebrows (range, 0-40 mm). Grafted eyelids required one or more subsequent ectropion releases in the majority of cases. The most common problem for the nose was asymmetry of the nostril apertures. The most problematic late outcomes that the authors identified after facial grafting for FT facial burns included relatively poor sensory return, elevation of graft edges, eyelid ectropion, gaps between grafts and hairline, and marked hypertrophic scarring around the mouth and chin. The results indicate that possible areas for quality improvement include greater attention to the limits of scalp harvest, more attention to pressure application to graft borders and the lip and chin during rehabilitation, greater accuracy in excision and graft placement on the forehead to avoid gaps with the hairlines, and counseling of the patient regarding the high probability of diminished facial sensation. PMID:22002207

  16. The Best Laid Plans: An Examination of School Plan Quality and Implementation in a School Improvement Initiative

    Strunk, Katharine O.; Marsh, Julie A.; Bush-Mecenas, Susan C.; Duque, Matthew R.

    2016-01-01

    Purpose: A common strategy used in school improvement efforts is a mandated process of formal planning, yet little is known about the quality of plans or the relationship between plan quality and implementation. This mixed-methods article investigates plan quality, factors associated with plan quality, and the relationship between plan quality and…

  17. "Know your CD4 campaign": 6-year outcomes from a quality improvement initiative to promote earlier initiation of antiretroviral therapy in Tanzania

    Peter Memiah

    2014-07-01

    Full Text Available Background: Late initiation of treatment for illness secondary to the human immunodeficiency virus (HIV remains a major challenge in developing countries. Despite the World Health Organization (WHO recommendation that treatment be initiated early in disease management, health providers conducting quality improvement monitoring in one region of Tanzania noted that common management practice relies upon clinical signs of advanced disease alone for initiation of combination antiretroviral therapy (ART. Although Tanzanian National Treatment Guidelines followed standard WHO recommendations, few patients initiated ART based on laboratory parameters. As a potential barrier to optimal patient outcomes, further investigation of this inconsistency led to recognition of challenges reflecting patient, healthcare staff, and laboratory levels that might inhibit the use of CD4 cell counts as the entryway to care. Materials and Methods: Using a quality improvement approach, investigations were pursued for six discrete activities of HIV care delivery with before and after measures of selected indicators. With respect to patient engagement, meetings and informal educational sessions were held to promote understanding of the meaning of and need for CD4 testing. For clinic staff: (1 Qualitative interviews were conducted with providers to understand why laboratory data was not being used and (2 on-site interviews were conducted with laboratory personnel to review beliefs, methods, and practices related to measurement of CD4 cells testing. A large scale local campaign was mounted to (1 educate and empower patients to recognize a need for CD4 information in management of their own care; (2 re-educate and encourage providers to use measured, rather than clinical observation alone to initiate ART; and (3 understand and resolve clinical and laboratory challenges. Based upon findings from the interviews: (1 Meetings with hospital administrations were effected to resolve

  18. 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

  19. 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…

  20. Quality improvement techniques to improve patient satisfaction.

    Torres, E Joseph; Guo, Kristina L

    2004-01-01

    This paper describes several approaches for implementing quality improvement initiatives to improve patient satisfaction, which enables health-care organizations to position themselves for success in today's global and increasingly competitive environment. Specifically, measuring the views of patients, improving patient satisfaction through a community-wide effort, and using a Six Sigma program are discussed. Each of these programs can be an effective mechanism for quality improvement. A key component to quality improvement techniques involves collaborative efforts by all health-care professionals and managers as they seek to increase patient satisfaction. PMID:15552388

  1. Evaluation of a programme for ‘Rapid Assessment of Febrile Travelers’ (RAFT): a clinic-based quality improvement initiative

    Jazuli, Farah; Lynd, Terence; Mah, Jordan; Klowak, Michael; Jechel, Dale; Klowak, Stefanie; Ovens, Howard; Sabbah, Sam; Boggild, Andrea K

    2016-01-01

    Background Fever in the returned traveller is a potential medical emergency warranting prompt attention to exclude life-threatening illnesses. However, prolonged evaluation in the emergency department (ED) may not be required for all patients. As a quality improvement initiative, we implemented an algorithm for rapid assessment of febrile travelers (RAFT) in an ambulatory setting. Methods Criteria for RAFT referral include: presentation to the ED, reported fever and travel to the tropics or subtropics within the past year. Exclusion criteria include Plasmodium falciparum malaria, and fulfilment of admission criteria such as unstable vital signs or significant laboratory derangements. We performed a time series analysis preimplementation and postimplementation, with primary outcome of wait time to tropical medicine consultation. Secondary outcomes included number of ED visits averted for repeat malaria testing, and algorithm adherence. Results From February 2014 to December 2015, 154 patients were seen in the RAFT clinic: 68 men and 86 women. Median age was 36 years (range 16–78 years). Mean time to RAFT clinic assessment was 1.2±0.07 days (range 0–4 days) postimplementation, compared to 5.4±1.8 days (range 0–26 days) prior to implementation (ptraveller's diarrhoea (n=27, 17.5%), dengue (n=12, 8%), viral upper respiratory tract infection (n=11, 7%), chikungunya (n=10, 6.5%), laboratory-confirmed influenza (n=8, 5%) and lobar pneumonia (n=8, 5%). Conclusions In addition to provision of more timely care to ambulatory febrile returned travellers, we reduced ED bed-usage by providing an alternate setting for follow-up malaria screening, and treatment of infectious diseases manageable in an outpatient setting, but requiring specific therapy. PMID:27473947

  2. Continuous quality improvement programs provide new opportunities to drive value innovation initiatives in hospital-based radiology practices.

    Steele, Joseph R; Schomer, Don F

    2009-07-01

    Imaging services constitute a huge portion of the of the total dollar investment within the health care enterprise. Accordingly, this generates competition among medical specialties organized along service lines for their pieces of the pie and increased scrutiny from third-party payers and government regulators. These market and political forces create challenge and opportunity for a hospital-based radiology practice. Clearly, change that creates or builds greater value for patients also creates sustainable competitive advantage for a radiology practice. The somewhat amorphous concept of quality constitutes a significant value driver for innovation in this scenario. Quality initiatives and programs seek to define and manage this amorphous concept and provide tools for a radiology practice to create or build more value. Leadership and the early adoption of these inevitable programs by a radiology practice strengthens relationships with hospital partners and slows the attrition of imaging service lines to competitors. PMID:19560065

  3. 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

  4. 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

  5. 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

  6. 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

  7. 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

  8. 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...

  9. Results of a sector-wide quality improvement initiative for substance-abuse care: an uncontrolled before-after study in Catalonia, Spain

    Colom Joan

    2010-10-01

    Full Text Available Abstract Background The Health Department of the Regional Government of Catalonia, Spain, issued a quality plan for substance abuse centers. The objective of this paper is to evaluate the impact of a multidimensional quality improvement initiative in the field of substance abuse care and to discuss potentials and limitations for further quality improvement. Methods The study uses an uncontrolled, sector-wide pre-post design. All centers providing services for persons with substance abuse issues in the Autonomous Community of Catalonia participated in this assessment. Measures of compliance were developed based on indicators reported in the literature and by broad stakeholder involvement. We compared pre-post differences in dimension-specific and overall compliance-scores using one-way ANOVA for repeated measures and the Friedman statistic. We described the spread of the data using the inter-quartile range and the Fligner-Killen statistic. Finally, we adjusted compliance scores for location and size using linear and logistic regression models. Results We performed a baseline and follow up assessment in 22 centers for substance abuse care and observed substantial and statistically significant improvements for overall compliance (pre: 60.9%; post: 79.1% and for compliance in the dimensions 'care pathway' (pre: 66.5%; post: 83.5% and 'organization and management' (pre: 50.5%; post: 77.2%. We observed improvements in the dimension 'environment and infrastructure' (pre: 81.8%; post: 95.5% and in the dimension 'relations and user rights' (pre: 66.5%; post: 72.5%; however, these were not statistically significant. The regression analysis suggests that improvements in compliance are positively influenced by being located in the Barcelona region in case of the dimension 'relations and user rights'. Conclusion The positive results of this quality improvement initiative are possibly associated with the successful involvement of stakeholders, the consciously

  10. Pillar Initiated Growth of High Indium Content Bulk Indium Gallium Nitride to Improve the Material Quality for Photonic Devices

    McFelea, Heather Dale

    The goal of this research was to reduce dislocations and strain in high indium content bulk InGaN to improve quality for optical devices. In an attempt to achieve this goal, InGaN pillars were grown with compositions that matched the composition of the bulk InGaN grown on top. Pillar height and density were optimized to facilitate coalescence on top of the pillars. It was expected that dislocations within the pillars would bend to side facets, thereby reducing the dislocation density in the bulk overgrowth, however this was not observed. It was also expected that pillars would be completely relaxed at the interface with the substrate. It was shown that pillars are mostly relaxed, but not completely. Mechanisms are proposed to explain why threading dislocations did not bend and how complete relaxation may have been achieved by mechanisms outside of interfacial misfit dislocation formation. Phase separation was not observed by TEM but may be related to the limitations of the sample or measurements. High indium observed at facets and stacking faults could be related to the extra photoluminescence peaks measured. This research focused on the InGaN pillars and first stages of coalescence on top of the pillars, saving bulk growth and device optimization for future research.

  11. 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...... 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...... 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....

  12. Quality improvement - the future begins

    The comprehensive quality improvement program of the Florida Power and Light Co. is described: management commitment, quality improvement process, quality improvement teams, policy development, and quality in daily work are discussed

  13. Enhancing the Quality of Prescribing Practices for Older Veterans Discharged from the Emergency Department (EQUiPPED): Preliminary Results from Enhancing Quality of Prescribing Practices for Older Veterans Discharged from the Emergency Department, a Novel Multicomponent Interdisciplinary Quality Improvement Initiative.

    Stevens, Melissa B; Hastings, Susan Nicole; Powers, James; Vandenberg, Ann E; Echt, Katharina V; Bryan, William E; Peggs, Kiffany; Markland, Alayne D; Hwang, Ula; Hung, William W; Schmidt, Anita J; McGwin, Gerald; Ikpe-Ekpo, Edidiong; Clevenger, Carolyn; Johnson, Theodore M; Vaughan, Camille P

    2015-05-01

    Suboptimal medication prescribing for older adults has been described in a number of emergency department (ED) studies. Despite this, few studies have examined ED-targeted interventions aimed at reducing the use of potentially inappropriate medications (PIMs). Enhancing Quality of Prescribing Practices for Older Veterans Discharged from the ED (EQUiPPED) is an ongoing multicomponent, interdisciplinary quality improvement initiative in eight Department of Veterans Affairs EDs. The project aims to decrease the use of PIMs, as identified by the Beers criteria, prescribed to veterans aged 65 and older at the time of ED discharge. Interventions include provider education; informatics-based clinical decision support with electronic medical record-embedded geriatric pharmacy order sets and links to online geriatric content; and individual provider education including academic detailing, audit and feedback, and peer benchmarking. Poisson regression was used to compare the number of PIMs that staff providers prescribed to veterans aged 65 and older discharged from the ED before and after the initiation of the EQUiPPED intervention. Initial data from the first implementation site show that the average monthly proportion of PIMs that staff providers prescribed was 9.4±1.5% before the intervention and 4.6±1.0% after the initiation of EQUiPPED (relative risk=0.48, 95% confidence interval=0.40-0.59, P<.001). Preliminary evaluation demonstrated a significant and sustained reduction of ED-prescribed PIMs in older veterans after implementation of EQUiPPED. Longer follow-up and replication at collaborating sites would allow for an assessment of the effect on health outcomes and costs. PMID:25945692

  14. 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

  15. 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...

  16. 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...

  17. 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

  18. Quality improvement as an investment.

    Weeks, William B

    2002-01-01

    Health care organizations are experiencing increasing internal and external pressures to improve the quality of care that they provide. However, there is not a framework that can be used to help understand the value of quality improvement projects and to prioritize competing projects. By understanding the current processes, costs and outcomes of care, enumerating the costs and benefits of change, anticipating the timing of the costs and benefits, and performing a financial analysis, quality improvement efforts can be evaluated as investments. Only by understanding and adapting to the financial environments in which health care organizations operate can continuous quality improvement in health care succeed. PMID:12512466

  19. Evaluating a questionnaire to measure improvement initiatives in Swedish healthcare

    Andersson Ann-Christine

    2013-02-01

    Full Text Available Abstract Background Quality improvement initiatives have expanded recently within the healthcare sector. Studies have shown that less than 40% of these initiatives are successful, indicating the need for an instrument that can measure the progress and results of quality improvement initiatives and answer questions about how quality initiatives are conducted. The aim of the present study was to develop and test an instrument to measure improvement process and outcome in Swedish healthcare. Methods A questionnaire, founded on the Minnesota Innovation Survey (MIS, was developed in several steps. Items were merged and answer alternatives were revised. Employees participating in a county council improvement program received the web-based questionnaire. Data was analysed by descriptive statistics and correlation analysis. The questionnaire psychometric properties were investigated and an exploratory factor analysis was conducted. Results The Swedish Improvement Measurement Questionnaire consists of 27 items. The Improvement Effectiveness Outcome dimension consists of three items and has a Cronbach’s alpha coefficient of 0.67. The Internal Improvement Processes dimension consists of eight sub-dimensions with a total of 24 items. Cronbach’s alpha coefficient for the complete dimension was 0.72. Three significant item correlations were found. A large involvement in the improvement initiative was shown and the majority of the respondents were satisfied with their work. Conclusions The psychometric property tests suggest initial support for the questionnaire to study and evaluate quality improvement initiatives in Swedish healthcare settings. The overall satisfaction with the quality improvement initiative correlates positively to the awareness of individual responsibilities.

  20. 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

  1. 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

  2. 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

  3. 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

  4. Harmonisation Initiatives of Copernicus Data Quality Control

    Vescovi, F. D.; Lankester, T.; Coleman, E.; Ottavianelli, G.

    2015-04-01

    The Copernicus Space Component Data Access system (CSCDA) incorporates data contributions from a wide range of satellite missions. Through EO data handling and distribution, CSCDA serves a set of Copernicus Services related to Land, Marine and Atmosphere Monitoring, Emergency Management and Security and Climate Change. The quality of the delivered EO products is the responsibility of each contributing mission, and the Copernicus data Quality Control (CQC) service supports and complements such data quality control activities. The mission of the CQC is to provide a service of quality assessment on the provided imagery, to support the investigation related to product quality anomalies, and to guarantee harmonisation and traceability of the quality information. In terms of product quality control, the CQC carries out analysis of representative sample products for each contributing mission as well as coordinating data quality investigation related to issues found or raised by Copernicus users. Results from the product analysis are systematically collected and the derived quality reports stored in a searchable database. The CQC service can be seen as a privileged focal point with unique comparison capacities over the data providers. The comparison among products from different missions suggests the need for a strong, common effort of harmonisation. Technical terms, definitions, metadata, file formats, processing levels, algorithms, cal/val procedures etc. are far from being homogeneous, and this may generate inconsistencies and confusion among users of EO data. The CSCDA CQC team plays a significant role in promoting harmonisation initiatives across the numerous contributing missions, so that a common effort can achieve optimal complementarity and compatibility among the EO data from multiple data providers. This effort is done in coordination with important initiatives already working towards these goals (e.g. INSPIRE directive, CEOS initiatives, OGC standards, QA4EO

  5. IMPROVING CONCEPTUAL DESIGN QUALITY

    Bush, Stuart; Robotham, Antony John

    1999-01-01

    designer to identify clear targets for design improvement and to measure the effectiveness of any new solution, whilst attention to QFD ensures customer requirements are still being satisfied.Often, SME's are not aware of many of the best design practices and so are not able to meet the demand for...

  6. 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.

  7. Lessons from the Educational Quality Indicators Initiative.

    McEwen, Nelly

    The Educational Quality Indicators (EQI) initiative was a collaboration between Alberta Education (Alberta, Canada) and 12 school jurisdictions to develop and implement indicator systems to measure the success of the educational enterprise. Ten concurrent collaborative projects were conducted between 1989 and 1992 to develop indicator systems for…

  8. Pet food: quality and quality improvement

    Cipollini, Irene

    2008-01-01

    Today’s pet food industry is growing rapidly, with pet owners demanding high-quality diets for their pets. The primary role of diet is to provide enough nutrients to meet metabolic requirements, while giving the consumer a feeling of well-being. Diet nutrient composition and digestibility are of crucial importance for health and well being of animals. A recent strategy to improve the quality of food is the use of “nutraceuticals” or “Functional foods”. At the moment, probiotics...

  9. Rice Quality Improvement in China

    2002-01-01

    @@ 1. Demand for high quality rice in China Rice is the leading cereal crop that contributes about 40% of the national grain production in China. The total output and areas rank the first and the second position in the world, respectively. In recent years, rice production grows steadily, but the quality improvement has been lagged and the quality becomes a limiting factor. As the grain supply exceeding the demand and the grain price plummeted, the State Council put forward expanding China′ s ongoing reform of the grain distribution system in 1998. Along with the foodstuff circulating system reform and market driving, the structure of rice production is adjusted,the planting acreage of early indica rice with poor quality decreased, and that of japonica rice in north China with good quality increased. With the challenge of China joining the WTO, Chinese government starts to pay premium on good quality rice.

  10. 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

  11. 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.

  12. Some measures for improving the pre-baked anode quality at initial stage of the second phase of baking%提高预焙阳极质量的一些措施

    贺成平

    2011-01-01

    从焙烧工艺和焙烧炉燃烧设备两个方面介绍了中铝青海分公司炭素厂二期焙烧车间投产初期提高预焙阳极质量的一些措施,对焙烧车间提高预焙阳极质量有一定借鉴意义.%Some measures for improving the pre-baked anode quality at initial stage of production of the second phase of baking in Carbon Plant, Qinghai Branch of Chalco, were described from the view of baking process and the baking furnace equipment, which could give a reference for improving pre-baked anode quality.

  13. 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)....

  14. Improving mental health outcomes: achieving equity through quality improvement

    Poots, Alan J; Green, Stuart A.; Honeybourne, Emmi; Green, John; Woodcock, Thomas; Barnes, Ruth; Bell, Derek

    2014-01-01

    Objective To investigate equity of patient outcomes in a psychological therapy service, following increased access achieved by a quality improvement (QI) initiative. Design Retrospective service evaluation of health outcomes; data analysed by ANOVA, chi-squared and Statistical Process Control. Setting A psychological therapy service in Westminster, London, UK. Participants People living in the Borough of Westminster, London, attending the service (from either healthcare professional or self-r...

  15. 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...... 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)....

  16. 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...

  17. Modalities of hemodialysis: Quality improvement

    Ayman Karkar

    2012-01-01

    Full Text Available Hemodialysis (HD treatment had, over many years, improved the survival rate of patients with end-stage renal disease. However, standard or conventional HD prescription is far from being optimal in replacing the function of normal kidneys. Its unphysiologic clearance pattern and inability to remove all types and sizes of uremic toxins results in inter- and intra-dialysis complications and an unacceptably high rate of cardiovascular morbidity and mortality. Efficiency of HD can be improved by increasing blood and dialysate flow rates, dialyzer size and surface area and duration and frequency of dialysis sessions. Home HD, where short daily or long slow nocturnal HD sessions can conveniently be performed, provides an excellent option for quality of life improvement and reduction in morbidity and mortality. Recent innovations in the specifications of HD machines and improvement in dialysis membranes characteristics and water treatment technology paved the way for achieving quality HD. These advancements have resulted in efficient implementation of adsorption, diffusion and/or convection principles using adsorption HD, hemofiltration, hemodiafiltration (HDF and online HDF modalities in order to achieve optimum HD. Implementation of these innovations resulted in better quality care achievements in clinical practice and reduction in morbidity and mortality rates among HD patients.

  18. 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

  19. 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…

  20. How to Improve the Quality of Screening Endoscopy in Korea: National Endoscopy Quality Improvement Program.

    Cho, Yu Kyung

    2016-07-01

    In Korea, gastric cancer screening, either esophagogastroduodenoscopy or upper gastrointestinal series (UGIS), is performed biennially for adults aged 40 years or older. Screening endoscopy has been shown to be associated with localized cancer detection and better than UGIS. However, the diagnostic sensitivity of detecting cancer is not satisfactory. The National Endoscopy Quality Improvement (QI) program was initiated in 2009 to enhance the quality of medical institutions and improve the effectiveness of the National Cancer Screening Program (NCSP). The Korean Society of Gastrointestinal Endoscopy developed quality standards through a broad systematic review of other endoscopic quality guidelines and discussions with experts. The standards comprise five domains: qualifications of endoscopists, endoscopic unit facilities and equipment, endoscopic procedure, endoscopy outcomes, and endoscopic reprocessing. After 5 years of the QI program, feedback surveys showed that the perception of QI and endoscopic practice improved substantially in all domains of quality, but the quality standards need to be revised. How to avoid missing cancer in endoscopic procedures in daily practice was reviewed, which can be applied to the mass screening endoscopy. To improve the quality and effectiveness of NCSP, key performance indicators, acceptable quality standards, regular audit, and appropriate reimbursement are necessary. PMID:27484810

  1. 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.

  2. Recommendations for evaluation of health care improvement initiatives.

    Parry, Gareth J; Carson-Stevens, Andrew; Luff, Donna F; McPherson, Marianne E; Goldmann, Donald A

    2013-01-01

    Intensive efforts are underway across the world to improve the quality of health care. It is important to use evaluation methods to identify improvement efforts that work well before they are replicated across a broad range of contexts. Evaluation methods need to provide an understanding of why an improvement initiative has or has not worked and how it can be improved in the future. However, improvement initiatives are complex, and evaluation is not always well aligned with the intent and maturity of the intervention, thus limiting the applicability of the results. We describe how initiatives can be grouped into 1 of 3 improvement phases-innovation, testing, and scale-up and spread-depending on the degree of belief in the associated interventions. We describe how many evaluation approaches often lead to a finding of no effect, consistent with what has been termed Rossi's Iron Law of Evaluation. Alternatively, we recommend that the guiding question of evaluation in health care improvement be, "How and in what contexts does a new model work or can be amended to work?" To answer this, we argue for the adoption of formative, theory-driven evaluation. Specifically, evaluations start by identifying a program theory that comprises execution and content theories. These theories should be revised as the initiative develops by applying a rapid-cycle evaluation approach, in which evaluation findings are fed back to the initiative leaders on a regular basis. We describe such evaluation strategies, accounting for the phase of improvement as well as the context and setting in which the improvement concept is being deployed. Finally, we challenge the improvement and evaluation communities to come together to refine the specific methods required so as to avoid the trap of Rossi's Iron Law. PMID:24268081

  3. 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

  4. 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...

  5. Solutions to Improve Educational Management Quality

    Ramezan Jahanian; Masoomeh Motahari

    2013-01-01

    Nowadays, enhancing the quality in educational systems of different countries has gained especial importance and stand. Improving utilizing and increasing the quality in our country’s educational system is felt too. One of the utilizing factors in education system is to improve the educational management quality.In this article, effective factors in educational management quality and one of its improving solutions, thorough management quality, is analyzed.

  6. SAMIRA - SAtellite based Monitoring Initiative for Regional Air quality

    Schneider, Philipp; Stebel, Kerstin; Ajtai, Nicolae; Diamandi, Andrei; Horalek, Jan; Nicolae, Doina; Stachlewska, Iwona; Zehner, Claus

    2016-04-01

    Here, we present a new ESA-funded project entitled Satellite based Monitoring Initiative for Regional Air quality (SAMIRA), which aims at improving regional and local air quality monitoring through synergetic use of data from present and upcoming satellites, traditionally used in situ air quality monitoring networks and output from chemical transport models. Through collaborative efforts in four countries, namely Romania, Poland, the Czech Republic and Norway, all with existing air quality problems, SAMIRA intends to support the involved institutions and associated users in their national monitoring and reporting mandates as well as to generate novel research in this area. Despite considerable improvements in the past decades, Europe is still far from achieving levels of air quality that do not pose unacceptable hazards to humans and the environment. Main concerns in Europe are exceedances of particulate matter (PM), ground-level ozone, benzo(a)pyrene (BaP) and nitrogen dioxide (NO2). While overall sulfur dioxide (SO2) emissions have decreased in recent years, regional concentrations can still be high in some areas. The objectives of SAMIRA are to improve algorithms for the retrieval of hourly aerosol optical depth (AOD) maps from SEVIRI, and to develop robust methods for deriving column- and near-surface PM maps for the study area by combining satellite AOD with information from regional models. The benefit to existing monitoring networks (in situ, models, satellite) by combining these datasets using data fusion methods will be tested for satellite-based NO2, SO2, and PM/AOD. Furthermore, SAMIRA will test and apply techniques for downscaling air quality-related EO products to a spatial resolution that is more in line with what is generally required for studying urban and regional scale air quality. This will be demonstrated for a set of study sites that include the capitals of the four countries and the highly polluted areas along the border of Poland and the

  7. Improving Health and Quality of Life

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

  8. 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...

  9. 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

  10. Data Mining Consulting Improve Data Quality

    Li, Xingsen; Shi, Yong; Li, Jun; Zhang, Peng

    2007-01-01

    Data are important for making decisions. However, the quality of the data affects the quality of decisions. Data mining as one of the most important sources of knowledge needs high quality data to mine, but there are not enough good quality data in many enterprises. By analyzing the reasons for low data quality systematically, a new method called data mining consulting for improving data quality has been established. It defines data quality in a wider sense from the view of data mining, finds...

  11. Preanalytical quality improvement : in quality we trust

    Lippi, Giuseppe; Becan-McBride, Kathleen; Behulova, Darina; Bowen, Raffick A.; Church, Stephen; Delanghe, Joris; Grankvist, Kjell; Kitchen, Steve; Nybo, Mads; Nauck, Matthias; Nikolac, Nora; Palicka, Vladimir; Plebani, Mario; Sandberg, Sverre; Simundic, Ana-Maria

    2013-01-01

    Total quality in laboratory medicine should be defined as the guarantee that each activity throughout the total testing process is correctly performed, providing valuable medical decision-making and effective patient care. In the past decades, a 10-fold reduction in the analytical error rate has bee

  12. Anaerobic crystallization and initial X-ray diffraction data of biphenyl 2,3-dioxygenase from Burkholderia xenovorans LB400: addition of agarose improved the quality of the crystals

    Biphenyl 2,3-dioxygenase from B. xenovorans LB400 and its variants BPDOP4 and BPDORR41 were crystallized using agarose gel and the crystals were characterized using X-ray diffraction. Biphenyl 2,3-dioxygenase (BPDO; EC 1.14.12.18) catalyzes the initial step in the degradation of biphenyl and some polychlorinated biphenyls (PCBs). BPDOLB400, the terminal dioxygenase component from Burkholderia xenovorans LB400, a proteobacterial species that degrades a broad range of PCBs, has been crystallized under anaerobic conditions by sitting-drop vapour diffusion. Initial crystals obtained using various polyethylene glycols as precipitating agents diffracted to very low resolution (∼8 Å) and the recorded reflections were diffuse and poorly shaped. The quality of the crystals was significantly improved by the addition of 0.2% agarose to the crystallization cocktail. In the presence of agarose, wild-type BPDOLB400 crystals that diffracted to 2.4 Å resolution grew in space group P1. Crystals of the BPDOP4 and BPDORR41 variants of BPDOLB400 grew in space group P21

  13. 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....

  14. 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...

  15. Towards improvement in quality assurance

    This first document in the series of the International Nuclear Safety Advisory Group (INSAG) Technical Notes is a general guideline for the establishment of effective quality assurance procedures at nuclear facilities. It sets out primary requirements such as quality objectives, methods for measuring the effectiveness of the quality assurance programme, priority of activities in relation to importance of safety of items, motivation of personnel

  16. 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

  17. 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.

  18. Physical Activity Improves Quality of Life

    ... Workplace Food and Beverage Toolkit Physical activity improves quality of life Updated:Mar 2,2015 Do you want to ... illnesses and diseases associated with aging and maintains quality of life and independence longer for seniors So why not ...

  19. Prehospital quality improvement: past , present and future

    Siriwardena, A Niroshan

    2015-01-01

    This keynote lecture describes developments in prehospital and ambulance quality improvement in the UK. Firstly it maps progress in the past decade focussing on the national structures for research and audit, the development of clinical indicators and the use of quality improvement methods to advance performance in key areas of clinical practice. Secondly, it discusses key areas of interest for current improvement studies. Finally it presents future research likely to affect quality of care a...

  20. 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...

  1. 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...

  2. 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.

  3. CONTINUOUS IMPROVEMENT THROUGH INTEGRATION OF QUALITY TOOLS

    2006-01-01

    The relationship between major quality tools such as quality function development (QFD),failure mode and effects analysis (FMEA), design of experiments (DOE) and statistical process control (SPC) is analyzed through an extensive review of the literature and the concurrent quality engineering philosophy, and a basic structure for the integration of quality tools is presented. An integrated quality management system (IQMS) is developed using C++ Builder, nmning in the Windows 2000 Server environment with the basic internet connections, and SQL Server 2000 as the platform for developing the database. An illustrative example applying IQMS to the continuous quality improvement for a crane equipment manufacturing is reported. The result shows that the application of IQMS can optimize the process of design and manufacturing, shorten the cycle time of product, reduce the cost, and realize quality improvement continuously. The proposed integrated framework with IQMS is believed to be applicable to continuous quality improvement in many manufacturing companies.

  4. Rethinking Quality and Improvement in Higher Education

    Houston, Don

    2008-01-01

    Purpose: The purpose of this paper is to critically review dominant conceptions of and approaches to quality in higher education. It suggests an alternative approach with potential to shift the focus of quality activities from accountability and control to improvement. Design/methodology/approach: The applicability and limits of quality concepts…

  5. 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.

  6. Nationwide quality improvement in lung cancer care

    Jakobsen, Erik Winther; Green, Anders; Oesterlind, Kell;

    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....

  7. 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; Thomsen, I.K.

    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...

  8. 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

  9. Quality improvement practices and trends in Denmark

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

    It is now well known that the history of quality improvement is neither uniquely American, nor uniquely Japanese, although the contributions from these two nations have received more attention perhaps than those originating elsewhere. This is the first in a series of articles intended to increase...... 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...... taken in its entirety, this series of articles will contribute to understanding both the rich fabric of European quality improvement that is independent of national boundaries and the colorful national fibers of which the fabric is made....

  10. 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

  11. 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…

  12. TECHNOLOGICAL MEASURES TO IMPROVE AUTOMOTIVE PRODUCT QUALITY

    Gladkov, V.; Kruglov, S.

    2010-01-01

    The paper examines the basic technological measures aimed at improving product quality in automotive industry. While paying due attention to solving organizational and technological problems, including the development of certification systems for production processes, it is also necessary to improve the technical standards of specific technologies, equipment and materials as they largely determine product quality. Special emphasis is given to the importance of improving the production of auto...

  13. Can Technology Improve the Quality of Colonoscopy?

    Thirumurthi, Selvi; Ross, William A; Raju, Gottumukkala S

    2016-07-01

    In order for screening colonoscopy to be an effective tool in reducing colon cancer incidence, exams must be performed in a high-quality manner. Quality metrics have been presented by gastroenterology societies and now include higher adenoma detection rate targets than in the past. In many cases, the quality of colonoscopy can often be improved with simple low-cost interventions such as improved procedure technique, implementing split-dose bowel prep, and monitoring individuals' performances. Emerging technology has expanded our field of view and image quality during colonoscopy. We will critically review several technological advances in the context of quality metrics and discuss if technology can really improve the quality of colonoscopy. PMID:27255334

  14. 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.

  15. 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.

  16. Quality-control analytical methods: continuous quality improvement.

    Venti, Eden M

    2006-01-01

    It is vital that all compounding pharmacies have a continuous quality improvement program in place by way of standard operating procedures to assure that patients receive high-quality preparations. The program should take into consideration any federal and state regulatory requirements, as well as professional association expectations. Quality control measurements and regular review of those measurements are the foundations of a good quality plan. All pharmacy personnel should be aware of the importance of reporting potential internal quality concerns or problems and should be encouraged to do so without fear of repercussions. Ideally, an error-free compounding pracitice would be the goal. Since this is not practical, quality issues should not be viewed as problems, but as opportunities to improve compounding practices by correcting, before they become pervasive, the processes used in the preparation of prescriptions. PMID:23974418

  17. 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

  18. 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...

  19. 添加初花期骆驼刺改善苜蓿青贮品质%Improve alfalfa silage quality by adding alhagi sparsifolia shap in initial bloom stage

    蒋慧; 方雷; 周小玲; 李胜利

    2014-01-01

    .05); the numbers of lactobacillus in the silage of different treatments were 5.1×105 (Ⅰ), 1.5×1011 (Ⅱ), 3.5×106 (Ⅲ), 3.5×107 (Ⅳ), and 6.5×107 (Ⅴ), respectively, and those in forage at harvest were 3.3×104, 5.5×106, 6.5×104, 7.3×104, and 7.2×105, respectively. The numbers of yeast living cells in silage were 3.3×104 (Ⅰ), 5.5×106 (Ⅱ), 6.5×104 (Ⅲ), 7.3×104 (Ⅳ) and 7.2×105 (Ⅴ), respectively, while those in forage at harvest (P<0.05) were 3.5×105, 6.5×103, 4.5×105, 1.5×105 and 6.5×104, respectively. The pH values of the groupⅡwas minimum (3.72);compared with that of the control group (4.32), adding A. sparsifolia Shap could significantly reduce the pH value. Lactic acid (LA) contents were higher in mix-silage (Ⅲ, Ⅳ, and Ⅴ were 4.70 %, 5.25%and 6.12 %, respectively) than in alfalfa silage (Ⅰwas 3.73%, P<0.01). The contents of propionic acid (PA), butyric acid (BA), isovaleric, methanol, ethanol, propanol were lower in mixed silage than in alfalfa silage (P<0.05);PA and BA contents in alfalfa silage were 0.43%and 1.347%, respectively, and the minimums of PA and BA contents in mixed silage were 0.26% (Ⅳ) and 0.357% (Ⅴ), respectively. Meanwhile, PA and BA contents were higher in mixed silage than in A. sparsifolia Shap silage (it’s traces). The maximum of isolaleric content was 0.42% inⅠ and the minimum was 0.20% in Ⅴ. The contents of methanol, ethanol, propanol in mixed silage (Ⅲ, Ⅳ, Ⅴ) were at trace level or not detectable. The ammonia nitrogen contents of mixed silage were significantly decreased compared with that of alfalfa silage (P<0.05), the maximum was 10.16% and the minimum was 4.76%of ratio of ammonia nitrogen to total nitrogen in Ⅰ and Ⅲ, respectively. In conclusion, mixed silage improves silage quality of alfalfa, and also softens camel thorn spiny of A. sparsifolia Shap in initial bloom stage. Mixed silages are excellent in sensory and fermented quality. To improve the quality of the silage, A

  20. 添加初花期骆驼刺改善苜蓿青贮品质%Improve alfalfa silage quality by adding alhagi sparsifolia shap in initial bloom stage

    蒋慧; 方雷; 周小玲; 李胜利

    2014-01-01

    .12 %, respectively) than in alfalfa silage (Ⅰwas 3.73%, P<0.01). The contents of propionic acid (PA), butyric acid (BA), isovaleric, methanol, ethanol, propanol were lower in mixed silage than in alfalfa silage (P<0.05);PA and BA contents in alfalfa silage were 0.43%and 1.347%, respectively, and the minimums of PA and BA contents in mixed silage were 0.26% (Ⅳ) and 0.357% (Ⅴ), respectively. Meanwhile, PA and BA contents were higher in mixed silage than in A. sparsifolia Shap silage (it’s traces). The maximum of isolaleric content was 0.42% inⅠ and the minimum was 0.20% in Ⅴ. The contents of methanol, ethanol, propanol in mixed silage (Ⅲ, Ⅳ, Ⅴ) were at trace level or not detectable. The ammonia nitrogen contents of mixed silage were significantly decreased compared with that of alfalfa silage (P<0.05), the maximum was 10.16% and the minimum was 4.76%of ratio of ammonia nitrogen to total nitrogen in Ⅰ and Ⅲ, respectively. In conclusion, mixed silage improves silage quality of alfalfa, and also softens camel thorn spiny of A. sparsifolia Shap in initial bloom stage. Mixed silages are excellent in sensory and fermented quality. To improve the quality of the silage, A. sparsifolia Shap should account for no less than 30%of mixed silage.

  1. Improving Quality Assurance in Australian Higher Education.

    Linke, Russell D.

    1995-01-01

    Origins of Australia's university quality improvement program are outlined, and its design is examined. Issues discussed include implications of the program for individual institutions, its proposed method of redistributing research funds, and potential problems associated with performance appraisal. (MSE)

  2. How Can We Improve Teacher Quality?

    Wilson, Suzanne M.

    2011-01-01

    Research on teacher quality is not definitive. But, we know that developing high-quality teachers requires a multipronged approach: We need to recruit promising teachers. We need to retain and reward effective early career teachers. We need mechanisms to dismiss those who don't improve. We need to focus teacher preparation on the foundations of…

  3. Activities toward PSA quality improvement in Japan

    PSA of adequate quality is indispensable for expanding the field of risk-informed plant management. Activities to construct framework of improving PSA quality in Japan, such as arrangement of PSA standard, adopting parameters based on operational experience of Japanese NPPs, and implementation of PSA peer review, are in progress. (author)

  4. 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. Materials and methods A five and a half year longitudin...

  5. Economic valuation of coastal zone quality improvements

    Halkos, George

    2011-01-01

    Individuals’ decision to use a particular coastal beach is influenced by their preferences and perceptions as well as beach’s characteristics. This study examines visitors’ attributes and desired site specific characteristics in order to determine the factors affecting willingness to pay for an improvement quality (environment, water as well as recreation activities) program. A contingent valuation survey is carried out in order to evaluate the economic benefits of improving coastal quality o...

  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. 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.

  9. Improving Teaching Quality and the Learning Organisation

    Collie, Sarah L.; Taylor, Alton L.

    2004-01-01

    This study applied a learning organisation framework to understand academic departments' efforts to improve teaching quality. The theoretical framework was generated from literature on learning organisations, organisations devoted to continuous improvement through continuous learning. Research questions addressed relationships among departments'…

  10. Improving embryo quality in assisted reproduction

    E. Mantikou

    2013-01-01

    The goal of this thesis was to improve embryo quality in assisted reproductive technologies by gaining more insight into human preimplantation embryo development and by improving in vitro culture conditions. To do so, we investigated an intriguing feature of the human preimplantation embryo, i.e. it

  11. Quality improvement- where do we stand?

    Green, Ben; Janaway, Ben M; Brennan, Peter A

    2016-07-01

    Improvements in quality are commonly used to measure outcome in modern medicine. The drive to improve services nationally and to reduce the financial burden, which is at the forefront of NHS policy, attracts political debate and is constantly the focus of media attention. However, before this can be done in surgery, we need to learn from ongoing work and recognised systems for quality review and implementation, and develop national processes for sustained improvement. As a specialty, Oral and maxillofacial surgery is a good example. PMID:27025233

  12. Software Quality Metrics for Geant4: An Initial Assessment

    Ronchieri, Elisabetta; Giacomini, Francesco

    2016-01-01

    In the context of critical applications, such as shielding and radiation protection, ensuring the quality of simulation software they depend on is of utmost importance. The assessment of simulation software quality is important not only to determine its adoption in experimental applications, but also to guarantee reproducibility of outcome over time. In this study, we present initial results from an ongoing analysis of Geant4 code based on established software metrics. The analysis evaluates the current status of the code to quantify its characteristics with respect to documented quality standards; further assessments concern evolutions over a series of release distributions. We describe the selected metrics that quantify software attributes ranging from code complexity to maintainability, and highlight what metrics are most effective at evaluating radiation transport software quality. The quantitative assessment of the software is initially focused on a set of Geant4 packages, which play a key role in a wide...

  13. On the improvement of precipitation forecast skill from physical initialization

    Krishnamurti, T. N.; Rohaly, G. D.; Bedi, H S

    2011-01-01

    This study explores the impact of physical initialization on the numerical weather prediction of tropical rainfall. The goal is to improve the definition of the initial state by assimilation of proposed or currently available surface and satellite-based observations during a pre-integration phase using a global spectral model. Physical initialization refers to the use of reverse algorithms consistent with the physics of the numerical model which can provide a modification of the initial state...

  14. Melatonin improves sleep quality in hemodialysis patients

    Edalat-Nejad, M.; Haqhverdi, F.; Hossein-Tabar, T.; Ahmadian, M.

    2013-01-01

    Disturbed sleep is common in end-stage renal disease (ESRD). Exogenous melatonin has somniferous properties in normal subjects and can improve sleep quality (SQ) in several clinical conditions. Recent studies have shown that melatonin may play a role in improving sleep in patients undergoing dialysis. The goal of the present study was to assess the effect of exogenous melatonin administration on SQ improvement in daytime hemodialysis patients. Lipid profile and the required dose of erythropoi...

  15. Architectural Design Quality in Local Authority Private Finance Initiative Projects

    Giddings, Bob; Sharma, Monika; Jones, Paul; Jensen, Phil

    2010-01-01

    Since the 1990s, when the Private Finance Initiative was developed as the primary method for delivering major public capital projects, there has been concern about the quality of many of the products. Initially, it was the architectural community that raised doubts, but it has subsequently been joined by user groups. As the contractual period is over 30 years, there are issues such as ongoing maintenance, facilities management and operational factors, that need to be balanced with design qual...

  16. Virginia Star Quality Initiative: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

    Child Trends, 2010

    2010-01-01

    This paper presents a profile of Virginia's Star Quality Initiative prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4) Indicators…

  17. 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

  18. 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

  19. 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

  20. Current concept review: quality and process improvement in orthopedics

    Pinney SJ

    2015-12-01

    Full Text Available Stephen J Pinney,1 Alexandra E Page,2 David S Jevsevar,3 Kevin J Bozic4 1Department of Orthopaedic Surgery, St Mary's Medical Center, San Francisco, CA, USA; 2Orthopaedic Surgery, AAOS Health Care Systems Committee, San Diego, CA, USA; 3Department of Orthopaedics, Geisel School of Medicine, Dartmouth University, Hanover, NH, USA; 4Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas, Austin, TX, USAAbstract: Multiple health care stakeholders are increasingly scrutinizing musculoskeletal care to optimize quality and cost efficiency. This has led to greater emphasis on quality and process improvement. There is a robust set of business strategies that are increasingly being applied to health care delivery. These quality and process improvement tools (QPITs have specific applications to segments of, or the entire episode of, patient care. In the rapidly changing health care world, it will behoove all orthopedic surgeons to have an understanding of the manner in which care delivery processes can be evaluated and improved. Many of the commonly used QPITs, including checklist initiatives, standardized clinical care pathways, lean methodology, six sigma strategies, and total quality management, embrace basic principles of quality improvement. These principles include focusing on outcomes, optimizing communication among health care team members, increasing process standardization, and decreasing process variation. This review summarizes the common QPITs, including how and when they might be employed to improve care delivery. Keywords: clinical care pathway, musculoskeletal care, outcomes, quality management, six sigma, lean thinking

  1. 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.

  2. 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.

  3. The Quality of Cancer Care Initiative in the Netherlands

    Wouters, Michel W. J. M.; Jansen-Landheer, Marlies L. E. A.; van de Velde, Cornelis J. H.

    2010-01-01

    Abstract Background In 2007 the Dutch Cancer Society formed a `Quality of Cancer Care? taskforce comprising medical specialists, from all disciplines involved in the care for cancer patients. This taskforce was charged with the evaluation of quality of cancer care in the Netherlands and the development of strategies for improvement. Objective The experts first focused on the relation between procedural volume and patient outcome and later aimed to i...

  4. Big Earth Data Initiative: Metadata Improvement: Case Studies

    Kozimor, John; Habermann, Ted; Farley, John

    2016-01-01

    Big Earth Data Initiative (BEDI) The Big Earth Data Initiative (BEDI) invests in standardizing and optimizing the collection, management and delivery of U.S. Government's civil Earth observation data to improve discovery, access use, and understanding of Earth observations by the broader user community. Complete and consistent standard metadata helps address all three goals.

  5. 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.

  6. 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…

  7. Semen quality improves marginally during young adulthood

    Perheentupa, Antti; Sadov, Sergey; Rönkä, Riitta;

    2016-01-01

    STUDY QUESTION: Does semen quality improve during early adulthood? SUMMARY ANSWER: Semen variables change little during the third decade of life, however some improvement in sperm morphology and motility may occur. WHAT IS KNOWN ALREADY: A suspicion of deteriorating semen quality has been raised in...... several studies. The longitudinal development of semen quality in early adulthood is insufficiently understood. STUDY DESIGN, SIZE, DURATION: A longitudinal follow-up of two cohorts of volunteer young adult Finnish men representing the general population was carried out. Cohorts A (discovery cohort, born....... The overall participation rate was 13.4%. MAIN RESULTS AND THE ROLE OF CHANCE: During the follow-up, the percentage of sperm with normal morphology and the percentage of motile sperm increased significantly both in the discovery (A) (P < 0.001 at 19 versus 29 years for both) and validation (B) (P < 0...

  8. The impact of leadership qualities on quality management improvement

    Radoslaw Wolniak

    2011-01-01

    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 foll...

  9. Strategy to Support Improvement of Healthcare Quality.

    Ing. Andrea Zejdlova

    2013-01-01

    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.Al...

  10. 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

  11. 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

  12. ADVANCES IN TRANSGENIC MAIZE FOR QUALITY IMPROVEMENT

    M.Rajendar Reddy

    2015-12-01

    Full Text Available Maize (Zea mays is a major food and animal feed worldwide and occupies a relevant place in the world economy and trade as an industrial grain crop. Currently more than 70% of maize production is used for food and feed; therefore, knowledge of genes involved in grain structure and chemical is important for improving the nutritional and food-making properties of maize. It is a good source of carbohydrates, fats, proteins, vitamins and minerals but deficient in two essential amino acids, Viz., lysine and tryptophan. To overcome this problem and to improve the above quality characters the maize breeders have followed different strategies like opaque 2, QPM and development of transgenic maize with improved quality characters. Finally we can conclude that the conventional breeding techniques and now plant biotechnology are helping meet the growing demand for food production, nutrition security while preserving our environment for future generations

  13. Overview of the Veterans Health Administration (VHA) Quality Enhancement Research Initiative (QUERI)

    McQueen, Lynn; Mittman, Brian S; Demakis, John G.

    2004-01-01

    The U.S. Veterans Health Administration (VHA)'s Quality Enhancement Research Initiative (QUERI) is an innovative integration of health services research, policy, and clinical care delivery designed to improve the quality, outcomes, and efficiency of VHA health care through the identification and implementation of evidence-based practices in routine care settings. A total of eight condition-specific QUERI centers are currently in operation, each pursuing an integrated portfolio of activities d...

  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 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...

  16. 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

  17. 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.)

  18. 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.)

  19. OUTLOOK ON BASIC EDUCATION QUALITY IMPROVEMENT

    Burhanuddin Tola

    2014-03-01

    Full Text Available This study aims to explore an outlook of future quality basic education by deploying reference analysis varied sorts of resources. The analysis was conducted by analyzing current condition of improvement and enhancement of the learning access and opportunities of all primary school-aged children who reach Minimum Participation Rate (MPR of 100% by 2015. This involved less economically developed, people living in remote, border and isolated areas and districts. Current and future analysis suggests the quality education lies not merely on achieving the MPR indicators of 100% along with the reduction of the percentage of students’ learning period and the number of dropouts and retakes, but also on analyzing the periodical competence benchmark on the literacy achievement of Indonesian children. The achievement is greatly influenced by economic growth illustrated in Gross National Income (GNI and Gross Domestic Product (GDP. This study found that future basic education quality significantly affect the economic growth of Indonesia.

  20. Improving Quality of Care in Peptic Ulcer Bleeding

    Rosenstock, Steffen J; 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; Jørgensen, Henrik S; de Muckadell, Ove B Schaffalitzky; Thomsen, Reimar W

    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...... demographic, clinical, and prognostic data. QOC was evaluated using eight process and outcome indicators, including time to initial endoscopy, hemostasis obtainment, proportion undergoing surgery, rebleeding risks, and 30-day mortality.RESULTS:A total of 13,498 PUB patients (median age 74 years) were included...

  1. 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

  2. Improving quality of service in the internet

    Flückiger, François

    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.

  3. 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.

  4. Improvements in geomagnetic observatory data quality

    Reda, Jan; Fouassier, Danielle; Isac, Anca;

    2011-01-01

    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...... between observatories and the establishment of observatory networks has harmonized standards and practices across the world; improving the quality of the data product available to the user. Nonetheless, operating a highquality geomagnetic observatory is non-trivial. This article gives a record...... of the 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...

  5. In Brief: Improving Mississippi River water quality

    Showstack, Randy

    2007-10-01

    If water quality in the Mississippi River and the northern Gulf of Mexico is to improve, the U.S. Environmental Protection Agency (EPA) needs to take a stronger leadership role in implementing the federal Clean Water Act, according to a 16 October report from the U.S. National Research Council. The report notes that EPA has failed to use its authority to coordinate and oversee activities along the river. In addition, river states need to be more proactive and cooperative in efforts to monitor and improve water quality, and the river should be monitored and evaluated as a single system, the report indicates. Currently, the 10 states along the river conduct separate and widely varying water quality monitoring programs. ``The limited attention being given to monitoring and managing the Mississippi's water quality does not match the river's significant economic, ecological, and cultural importance,'' said committee chair David A. Dzombak, director of the Steinbrenner Institute for Environmental Education and Research at Carnegie Mellon University, Pittsburgh, Pa. The report notes that while measures taken under the Clean Water Act have successfully reduced much point source pollution, nutrient and sediment loads from nonpoint sources continue to be significant problems. For more information, visit the Web site: http://books.nap.edu/catalog.php?record_id=12051.

  6. OUTLOOK ON BASIC EDUCATION QUALITY IMPROVEMENT

    Burhanuddin Tola

    2014-01-01

    This study aims to explore an outlook of future quality basic education by deploying reference analysis varied sorts of resources. The analysis was conducted by analyzing current condition of improvement and enhancement of the learning access and opportunities of all primary school-aged children who reach Minimum Participation Rate (MPR) of 100% by 2015. This involved less economically developed, people living in remote, border and isolated areas and districts. Current and future analysis sug...

  7. An Economic Analysis of Improved Water Quality

    Alam, Khorshed; Rolfe, John; Donaghy, Peter

    2006-01-01

    The research reported in this paper is focused on the cost-effectiveness of intervention strategies to reduce pollution loads and improve water quality in South-east Queensland. Strategies considered include point and non-point source interventions. Predicted reductions in pollution levels were calculated for each action based on the expected population growth. The costs of the interventions included the full investment and annual running costs as well as planned public investment by the stat...

  8. 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.

  9. 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.

  10. Bioethanol Quality Improvement of Coffee Fruit Leather

    Edahwati Luluk

    2016-01-01

    Full Text Available Recently, Indonesia’s dependence on petroleum is to be reduced and even eliminated. To overcome the problem of finding the needed alternative materials that can produce ethanol, in this case as a substitute material or a transport fuel mix, boosting the octane number, and gasoline ethanol (gasohol can be conducted. In the red coffee processing (cooking that will produce 65% and 35% of coffee beans, coffee leather waste is a source of organic material with fairly high cellulose content of 46.82%, 3.01% of pectin and 7.68% of lignin. In this case, its existence is abundant in Indonesia and optimally utilized. During the coffee fruit peeling, the peel waste is only used as a mixture of animal feed or simply left to rot. The purpose of this study was to produce and improve the quality of the fruit skin of bioethanol from coffee cellulose. However, to improve the quality of bioethanol, the production of the lignin content in the skin of the coffee fruit should be eliminated or reduced. Hydrolysis process using organosolve method is expected to improve the quality of bioethanol produced. In particular, the use of enzyme Saccharomyces and Zymmomonas will change the resulting sugar into bioethanol. On one hand, by using batch distillation process for 8 hours with Saccharomyces, bioethanol obtains high purity which is 39.79%; on the other hand, by using the same batch distillation process with Zymmomonas, the bioethanol obtains 38.78%.

  11. Applying PPM to ERP Maintenance and Continuous Improvement Initiatives

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

    2006-01-01

    gain business benefits from the systems. However the ERP literature on how to do this is limited. The purpose of this article is to explore how Project Portfolio Management (PPM) from the Research and Development (R&D) literature can be applied to an ERP second wave context, when companies are to...... 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...

  12. 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

  13. IS TOTAL QUALITY MANAGEMENT/ CONTINOUS QUALITY IMPROVEMENT OR QUALITY ASSURANCE APPLICABLE IN HEALTH SERVICES?

    Sidin, Andi Indahwaty

    2015-01-01

    In modern society, people are likely to be consumerism. They tend to be concerned about the quality of goods or services. In the same way, health care had to pay attention as the patients seem to be familiarized with health services quality. Health care has tried to adapt TQM/Continuous Quality Improvement (CQI) as well as Quality Assurance (QA) which is also adapted from manufacturing. However, some characteristics in the health industry are dissimilar to manufacturing. It can be explained ...

  14. Is the maturity of hospitals' quality improvement systems associated with measures of quality and patient safety?

    Groene Oliver

    2011-12-01

    Full Text Available Abstract Background Previous research addressed the development of a classification scheme for quality improvement systems in European hospitals. In this study we explore associations between the 'maturity' of the hospitals' quality improvement system and clinical outcomes. Methods The maturity classification scheme was developed based on survey results from 389 hospitals in eight European countries. We matched the hospitals from the Spanish sample (113 hospitals with those hospitals participating in a nation-wide, voluntary hospital performance initiative. We then compared sample distributions and explored associations between the 'maturity' of the hospitals' quality improvement system and a range of composite outcomes measures, such as adjusted hospital-wide mortality, -readmission, -complication and -length of stay indices. Statistical analysis includes bivariate correlations for parametrically and non-parametrically distributed data, multiple robust regression models and bootstrapping techniques to obtain confidence-intervals for the correlation and regression estimates. Results Overall, 43 hospitals were included. Compared to the original sample of 113, this sample was characterized by a higher representation of university hospitals. Maturity of the quality improvement system was similar, although the matched sample showed less variability. Analysis of associations between the quality improvement system and hospital-wide outcomes suggests significant correlations for the indicator adjusted hospital complications, borderline significance for adjusted hospital readmissions and non-significance for the adjusted hospital mortality and length of stay indicators. These results are confirmed by the bootstrap estimates of the robust regression model after adjusting for hospital characteristics. Conclusions We assessed associations between hospitals' quality improvement systems and clinical outcomes. From this data it seems that having a more

  15. 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

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

    Norbert eMayer-Amberg; Rainer eWoltmann; Stefanie eWalther

    2016-01-01

    The optimal treatment of schizophrenia patients requires integration of medical and psychosocial inputs. In Germany, various healthcare 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 current work is a quality monitoring report of a novel care setting, called Integrated Care Initiative Schizophrenia. It has implemented a networked care con...

  17. Application of Six-Sigma for Data Quality Improvement in an Insurance Company

    Mohit Panwar

    2015-01-01

    Abstract Billions of dollars annually is what poor data quality costs Insurance businesses according to the Data Warehousing Institute. Poor data is also the leading cause of many IT project failures. Many companies are designing their data management programs and quality initiatives to deal with this problem of erroneous and inconsistent data. This paper discusses these topics as well as those detailing how companies can improve their data quality using the quality improvement technique of a...

  18. 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.

  19. Improving the Effectiveness of TalentCorp’s Initiatives

    World Bank

    2015-01-01

    The information contained in this summary report reflects the analysis and assessment that have been undertaken beginning January 2013 mainly to assess the effectiveness of TalentCorp’s efforts to attract and retain global talent through its Returning Expert Program (REP) and Residence Pass-Talent (RP-T). The initial research included various activities aimed at improving the client’s abil...

  20. Improved type many kinds of enrichment initial charge core

    No. 4 plant in Hamaoka Nuclear Power Station, Chubu Electric Power Co., Inc. started the commercial operation in September, 1993 after 48 months of construction period. It is the largest BWR plant with 1137 MWe and 3293 MWt output. The basic specifications of the plant and the core fuel are shown. In the design of the core fuel, the heightening of safety and reliability has priority, and the improved technology for bettering the core performance and operability was adopted positively. As the core fuel technology, new 8 x 8 zirconium-lined fuel, improved type many kinds of enrichment initial charge core, long life hafnium type control rods and so on were adopted. The zirconium-lined fuel is to reduce pellet-clad interaction, and increase the reliability. Moreover, the nuclear design of high reactivity fuel assemblies using uranium-saving technology was adopted. The core is composed of the fuels of three kinds of enrichment, and high enrichment fuel is arranged outside, thus the taking-out burnup of initial charge fuel increases. The improvement of the design of initial charge core, the improved type many kinds of enrichment initial charge core and the core characteristics in the start-up operation are reported. It was confirmed that the good core characteristics as expected can be obtained. (K.I.)

  1. 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.

  2. IMPROVEMENTS IN THE QUALITY OF COURIER DELIVERY

    Jacek Karcz

    2016-06-01

    Full Text Available The functioning of courier companies is a vital component of modern trade. E-commerce services are changing the way of shopping. Along with them, also courier services change and become more advance. Customers of courier companies become more aware of quality, which they should expect from supplier of these services. The article presents the result of the research of the effectiveness and the timelines of deliveries realized by one of the terminals of a leading courier operator in Poland. The survey involved 55 courier routes over the course of 10 business days. The author analyses weak points of the supply chain and presents two solutions, which may improve quality of delivery processes.

  3. 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...... 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....... 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...

  4. 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....

  5. Medical education and the quality improvement spiral: A case study from Mpumalanga, South Africa

    Martin Bac; Anne-Marie Bergh; Etsane, Mama E.; Jannie Hugo

    2015-01-01

    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 clini...

  6. Quality improvement in depression care in the Netherlands: the Depression Breakthrough Collaborative. A quality improvement report.

    2009-01-01

    Background: Improving the healthcare for patients with depression is a priority health policy across the world. Roughly, two major problems can be identified in daily practice: (1) the content of care is often not completely consistent with recommendations in guidelines and (2) the organization of care is not always integrated and delivered by multidisciplinary teams. Aim: To describe the content and preliminary results of a quality improvement project in primary care, aiming at improving th...

  7. 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

  8. 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.)

  9. 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

  10. 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.

  11. 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.

  12. 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.

  13. 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

  14. OMERACT: An international initiative to improve outcome measurement in rheumatology

    Simon Lee; Brooks Peter; Boers Maarten; Tugwell Peter; Strand Vibeke; Idzerda Leanne

    2007-01-01

    Abstract OMERACT is the acronym for an international, informally organized network initiated in 1992 aimed at improving outcome measurement in rheumatology. Chaired by an executive committee, it organizes consensus conferences in a 2-yearly cycle that circles the globe. Data driven recommendations are prepared and updated by expert working groups. Recommendations include core sets of measures for most of the major rheumatologic conditions. Since 2002 patients have been actively engaged in the...

  15. 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...

  16. 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

  17. 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

  18. 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.

  19. 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

  20. 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…

  1. 42 CFR 441.474 - Quality assurance and improvement plan.

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Quality assurance and improvement plan. 441.474... pursue opportunities for system improvement. (b) The quality assurance and improvement plan shall also... SERVICES Optional Self-Directed Personal Assistance Services Program § 441.474 Quality assurance...

  2. 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

  3. Initializing an unmodulated spin chain to operate as a high-quality quantum data bus

    Bayat, Abolfazl; Banchi, Leonardo; Bose, Sougato; Verrucchi, Paola

    2011-06-01

    We study the quality of state and entanglement transmission through quantum channels described by spin chains varying both the system parameters and the initial state of the channel. We consider a vast class of one-dimensional many-body models which contains some of the most relevant experimental realizations of quantum data buses. In particular, we consider spin-1/2 XY and XXZ models with open boundary conditions. Our results show a significant difference between free-fermionic (noninteracting) systems (XY) and interacting ones (XXZ), where in the former case initialization can be exploited for improving the entanglement distribution, while in the latter case it also determines the quality of state transmission. In fact, we find that in noninteracting systems the exchange with fermions in the initial state of the chain always has a destructive effect, and we prove that it can be completely removed in the isotropic XX model by initializing the chain in a ferromagnetic state. On the other hand, in interacting systems constructive effects can arise by scattering between hopping fermions and a proper initialization procedure. Our results are an example in which state and entanglement transmission show maxima at different points as the interactions and initializations of spin chain channels are varied.

  4. Continuous quality improvement of colorectal cancer screening

    Mariusz; Madalinski

    2013-01-01

    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 patient’s 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.

  5. 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.

  6. Aging Q3: an initiative to improve internal medicine residents' geriatrics knowledge, skills, and clinical performance.

    Moran, William P; Zapka, Jane; Iverson, Patty J; Zhao, Yumin; Wiley, M Kathleen; Pride, Pamela; Davis, Kimberly S

    2012-05-01

    A growing number of older adults coupled with a limited number of physicians trained in geriatrics presents a major challenge to ensuring quality medical care for this population. Innovations to incorporate geriatrics education into internal medicine residency programs are needed. To meet this need, in 2009, faculty at the Medical University of South Carolina developed Aging Q(3)-Quality Education, Quality Care, and Quality of Life. This multicomponent initiative recognizes the need for improved geriatrics educational tools and faculty development as well as systems changes to improve the knowledge and clinical performance of residents. To achieve these goals, faculty employ multiple intervention strategies, including lectures, rounds, academic detailing, visual cues, and electronic medical record prompts and decision support. The authors present examples from specific projects, based on care areas including vision screening, fall prevention, and caring for patients with dementia, all of which are based on the Assessing Care of Vulnerable Elders quality indicators. The authors describe the principles driving the design, implementation, and evaluation of the Aging Q(3) program. They present data from multiple sources that illustrate the effectiveness of the interventions to meet the knowledge, skill level, and behavior goals. The authors also address major challenges, including the maintenance of the teaching and modeling interventions over time within the context of demanding primary care and inpatient settings. This organized, evidence-based approach to quality improvement in resident education, as well as faculty leadership development, holds promise for successfully incorporating geriatrics education into internal medicine residencies. PMID:22450181

  7. 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

  8. IMPROVING QUALITY OF LIFE AT EDERLY PEOPLE, THROUGH GIMN ACTIVITIES

    Ganciu Mihaela

    2015-10-01

    Full Text Available In light of permanent education, physical education and sports activities should be integrated throughout life. The objective of the research is to improve the quality of life of older people to the initiation of maintenance programs by simple methods, reliable and inexpensive. Therapeutic strategies will be adapted practitioners age, associated diseases, profession. The sample under investigation comprised 30 elderly people who participated in two gymnastics lessons a week and a society dance lesson. Inspection methods that I used: bibliographic study, experimental method, survey method and statistical method - mathematical and graphical representation. Quality of life assessment was done by assessing exercise capacity, the survey method and the call routed. Through a sustained program and rhythmic exercise improves cardiovascular activity, as evidenced by increased exercise capacity by lowering resting heart rate, a major component of cardiovascular disease prevention. Decrease abdominal fat and increased muscle tone abdominal favorable effects on biomechanics of the lumbar spine dynamics can thus be considered to be the prevention of back pain. In summary the study conducted, in order to highlight the benefits of the sport for optimal physical condition and fight aging, it can be concluded that physical activity has a beneficial role for the body, both physically and mentally. Survey conducted among people aged III revealed the following: Practicing the sport of gymnastics in a systematic, consistent results in improving health and fitness as well as comfort, good mood, optimism, improving intellectual activity. In short, we can say that these people the sport of gymnastics has improved quality of life.

  9. A guide to the translation of the Global Initiative for Asthma (GINA) strategy into improved care

    Boulet, Louis-Philippe; FitzGerald, J Mark; Levy, Mark L;

    2012-01-01

    practice and research, its major objective, of forming the basis for local and national initiatives to improve services for asthma patients, remains to be achieved. Over recent years, the science of guideline implementation has progressed, and encouraging examples of successful asthma programmes have been...... published. This report is intended to draw on this experience and assist with the translation of asthma guideline recommendations into quality programmes for patients with asthma using current knowledge translation principles. It also provides examples of successful initiatives in various socioeconomic...

  10. Good air quality in offices improves productivity

    Fanger, Povl Ole

    2000-01-01

    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...

  11. 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.

  12. Improving Water Quality With Conservation Buffers

    Lowrance, R.; Dabney, S.; Schultz, R.

    2003-12-01

    Conservation buffer technologies are new approaches that need wider application. In-field buffer practices work best when used in combination with other buffer types and other conservation practices. Vegetative barriers may be used in combination with edge-of-field buffers to protect and improve their function and longevity by dispersing runoff and encouraging sediment deposition upslope of the buffer. It's important to understand how buffers can be managed to help reduce nutrient transport potential for high loading of nutrients from manure land application sites, A restored riparian wetland buffer retained or removed at least 59 percent of the nitrogen and 66 percent of the phosphorus that entered from an adjacent manure land application site. The Bear Creek National Restoration Demonstration Watershed project in Iowa has been the site of riparian forest buffers and filter strips creation; constructed wetlands to capture tile flow; stream-bank bioengineering; in-stream structures; and controlling livestock grazing. We need field studies that test various widths of buffers of different plant community compositions for their efficacy in trapping surface runoff, reducing nonpoint source pollutants in subsurface waters, and enhancing the aquatic ecosystem. Research is needed to evaluate the impact of different riparian grazing strategies on channel morphology, water quality, and the fate of livestock-associated pathogens and antibiotics. Integrating riparian buffers and other conservation buffers into these models is a key objective in future model development.

  13. 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.

  14. Reforming primary care in England--again. Plans for improving the quality of care.

    Baker, R

    2000-06-01

    An extensive programme of health service reform has begun in England. Improvement in the quality of care is a key objective of the reforms, and several initiatives are being introduced in response. These include systems to provide national guidance about appropriate treatment and services, a local system to support quality improvement and arrangements to monitor performance, including a new performance framework, an inspection agency and an annual survey of patients. The local quality improvement system has features of particular interest. These include arrangements for setting objectives for quality improvement, the use of various quality improvement methods tailored to local needs and a new system to provide accountability to both the health service and the public. The introduction of clinical governance and all the other reforms presents primary care practitioners with a major challenge. However, if sufficient time is allowed and adequate resources are made available, the reforms do have the potential to improve health care in England. PMID:10944059

  15. 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

  16. Improving quality model construction through knowledge reuse

    Carvallo Vega, Juan Pablo; Franch Gutiérrez, Javier; Quer Bosor, Maria Carme

    2015-01-01

    Software quality models provide a framework to measure and evaluate software quality of software systems. They are the basis upon which classify requirements and may be eventually used to guide the quantification of these requirements, especially non-functional requirements. Lots of approaches for building quality models have been proposed in the last decades, but still their reuse along different projects is a challenge. In this paper we present several types of knowledge repositories and re...

  17. Total Quality Management in Educational Process Focused on Quality Improvement of Institute with Customer Satisfaction & Teaching Improvement .

    Abhishek Soni

    2013-01-01

    Quality is the link that attract customers. The Technical Institutes are processor which introduce quality products (technocrats) in the market. Changing scenario has compelled for Quality improvement in the institutes and this can be achieved only by improving conditions prevailing in the institutes. Traditional methods of designing disregard the voice of customers as well as disregard the competition. Thus lacking in commitment of improvement. Improvement in the practical knowledge imparted...

  18. Quality Control, Quality Assurance, and Quality Improvement-What is the Difference and Why Should Compounding Pharmacies Care?

    Cabaleiro, Joe

    2009-01-01

    This article provides scenarios of three different pharmacies in the areas of quality control, quality assurance, and quality improvement. The scenarios show the importance that each pharmacy placed on a problem of dented capsules and the potential impact that an unresolved problem can have on a compounding pharmacy's business. Although this article focuses on one particular procedure, the purpose of th article is to help pharmacists understand the differences between quality control, quality assurance, and quality improvement. PMID:23966522

  19. Good air quality in offices improves productivity

    Fanger, Povl Ole

    2000-01-01

    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......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...

  20. The quality of spa services and possibilities of their improvement

    Issentayeva, Alma

    2011-01-01

    This thesis analyzes the quality of the spa services. The aim of this paper is to assess the quality of the services provided in the wellness hotel President and to propose to the hotel management options to improve the services.

  1. 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...

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

    Asiyai, Romina Ifeoma

    2015-01-01

    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…

  3. 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...

  4. 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...

  5. Danish initiatives to improve the safety of meat products

    Wegener, Henrik Caspar

    2010-01-01

    During the last two decades the major food safety problems in Denmark, as determined by the number of human patients, has been associated with bacterial infections stemming from meat products and eggs. The bacterial pathogens causing the majority of human infections has been Salmonella and...... 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...

  6. 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.

  7. 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

  8. Quality improvement teaching at medical school: a student perspective

    Nair P; Barai I; Prasad S; Gadhvi K

    2016-01-01

    Pooja Nair, Ishani Barai, Sunila Prasad, Karishma Gadhvi Department of Medicine, Imperial College School of Medicine, Imperial College London, London, UK Abstract: Guidelines in the UK require all doctors to actively take part in quality improvement. To ease future doctors into the process, formal quality improvement teaching can be delivered during medical school. Keywords: quality improvement, medical school, patient safety, patient satisfaction, medical student, clinical audit

  9. 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...

  10. 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.

  11. 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.

  12. Initializing an unmodulated spin chain to operate as a high quality quantum data-bus

    Bayat, Abolfazl; Bose, Sougato; Verrucchi, Paola

    2011-01-01

    We study the quality of state and entanglement transmission through quantum channels described by spin chains varying both the system parameters and the initial state of the channel. We consider a vast class of one-dimensional many-body models which contains some of the most relevant experimental realizations of quantum data-buses. In particular, we consider spin-1/2 XY and XXZ model with open boundary conditions. Our results show a significant difference between free-fermionic (non-interacting) systems (XY) and interacting ones (XXZ), where in the former case initialization can be exploited for improving the entanglement distribution, while in the latter case it also determines the quality of state transmission. In fact, we find that in non interacting systems the exchange with fermions in the initial state of the chain always has a destructive effect, and we prove that it can be completely removed in the isotropic XX model by initializing the chain in a ferromagnetic state. On the other hand, in interacting...

  13. Leadership: improving the quality of patient care.

    Clegg, A

    The satisfaction staff achieve from their work is in part determined by the style of management they work under. This article analyses the impact of a proactive leadership style on team performance and the quality of patient care. PMID:11973895

  14. Health benefits of improving air quality in Taiyuan, China.

    Tang, Deliang; Wang, Cuicui; Nie, Jiesheng; Chen, Renjie; Niu, Qiao; Kan, Haidong; Chen, Bingheng; Perera, Frederica

    2014-12-01

    Since 2000, the government in Shanxi province has mounted several initiatives and mandated factory shutdowns with the goal of reducing coal burning emissions and the environmental impacts of industrialization. We estimated the health benefits associated with air quality improvement from 2001 to 2010 in Taiyuan, Shanxi Province, using disability-adjusted life years (DALYs) and monetized the health benefits using value of statistical life (VOSL). Data were collected on annual average concentrations of particulate matter less than 10 μm in aerodynamic diameter (PM10) and relevant health outcomes in Taiyuan from 2001 to 2010. Selected exposure-response functions were used to calculate the cases of death or disease attributable to PM10 annually over a 10-year period. These were summed to calculate the DALYs lost and their monetary value associated with PM10 each year between 2001 and 2010. Air quality improvement from 2001 to 2010 was estimated to have prevented 2810 premature deaths, 951 new cases of chronic bronchitis, 141,457 cases of outpatient visits, 969 cases of emergency-room visits and 31,810 cases of hospital admissions. The DALYs (VOSL) decreased by 56.92% (52.68%) from 52,937 (7274 million Yuan) in 2001 to 22,807 (3442 million Yuan) in 2010. Premature deaths accounted for almost 95% of the total DALYs. Our analysis demonstrates that air pollution abatement during the last decade in Taiyuan has generated substantial health benefits. PMID:25168129

  15. 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

  16. 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...

  17. The Total Quality Initiative at South Bank University.

    Geddes, Tommy

    1993-01-01

    Application of the Total Quality Management approach to one aspect of the administration of South Bank University (England), the relationship between student as customer and university as supplier, is described. The technique includes development of service quality standards and agreements for each service, support, and academic department. (MSE)

  18. 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.)

  19. Demonstration of the Health Literacy Universal Precautions Toolkit: Lessons for Quality Improvement.

    Mabachi, Natabhona M; Cifuentes, Maribel; Barnard, Juliana; Brega, Angela G; Albright, Karen; Weiss, Barry D; Brach, Cindy; West, David

    2016-01-01

    The Agency for Healthcare Research and Quality Health Literacy Universal Precautions Toolkit was developed to help primary care practices assess and make changes to improve communication with and support for patients. Twelve diverse primary care practices implemented assigned tools over a 6-month period. Qualitative results revealed challenges practices experienced during implementation, including competing demands, bureaucratic hurdles, technological challenges, limited quality improvement experience, and limited leadership support. Practices used the Toolkit flexibly and recognized the efficiencies of implementing tools in tandem and in coordination with other quality improvement initiatives. Practices recommended reducing Toolkit density and making specific refinements. PMID:27232681

  20. Contrasting continuous quality improvement, Six Sigma, and lean management for enhanced outcomes in US hospitals

    Charles R. Gowen III; Kathleen L. McFadden; Sriranjita Settaluri

    2012-01-01

    Rapidly rising healthcare costs, partially due to preventable medical errors, have led hospitals to redouble their process improvement (PI) efforts. The purpose of this paper is to examine how PI initiatives mediate the effect of medical error sources to enhance three hospital outcomes (patient safety, operational effectiveness, and competitiveness). Drawing from Dynamic Capabilities Theory, the authors develop a framework to explore three PI initiatives: Continuous Quality Improvement (CQI),...

  1. 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

  2. The Efficacy of Quality Improvement Programs in Education.

    Curley, John R.

    Total Quality Management (TQM) is being adopted by many governmental entities, including public school districts. A basic tenet of quality improvement is that the customer, not the organization, defines quality. Other tenets are that the organization must satisfy the customer in order to best the competition; and that the organization must change…

  3. Improving initial polyp candidate extraction for CT colonography

    Zhu, Hongbin; Fan, Yi; Lu, Hongbing; Liang, Zhengrong

    2010-04-01

    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.

  4. 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.

  5. Small Steps, Big Reward: Quality Improvement through Pilot Groups.

    Bindl, Jim; Schuler, Jim

    1988-01-01

    Because of a need for quality improvement, Wisconsin Power and Light trained two six-person pilot groups in statistical process control, had them apply that knowledge to actual problems, and showed management the dollars-and-cents savings that come from quality improvement. (JOW)

  6. Does the EUA Institutional Evaluation Programme Contribute to Quality Improvement?

    Tavares, Diana Amado; Rosa, Maria Joao; Amaral, Alberto

    2010-01-01

    Purpose: This paper aims to reflect on the relevance of the Institutional Evaluation Programme (IEP) of the European University Association (EUA) to universities' quality improvement. It aims to analyse IEP follow-up reports to determine whether the programme contributes to the development of a quality improvement culture.…

  7. 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....

  8. 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

  9. 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

  10. How to Improve Hotel Service Quality

    高婧

    2014-01-01

    This paper states the importance of provide quality service in hotel industry. The key lessons to be gleaned from the present review are:the advanced training design;the development of service culture&service value throughout the organization; and positive attitudes to complaints. It is also important to have a key person in the organization to stimulate and facilitate the whole process.

  11. Monitoring and improving quality of colonoscopy

    S.C. van Doorn

    2015-01-01

    Colorectal cancer (CRC) is one of the most commonly diagnosed cancers in the western world. High quality colonoscopy has the potential to reduce CRC mortality by detecting carcinomas in early stages and reduce its incidence by detecting and removing its main precursor lesions, adenomas. Variability

  12. From sensor output to improved product quality

    Hertog, M.L.A.T.M.; Vollebregt, Martijntje; Unzueta, I.; Hoofman, R.J.O.M.; Lammertyn, J.

    2015-01-01

    The research conducted in the European PASTEUR project focussed on perishables monitoring through smart tracking of lifetime and quality. The aim was to develop a wireless sensor platform to monitor the environmental conditions of perishable goods in the supply chain between producer and consumer

  13. QUALITY IMPROVEMENT MODEL AT THE MANUFACTURING PROCESS PREPARATION LEVEL

    Dusko Pavletic

    2009-12-01

    Full Text Available 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 conducted and results of methods and tools application possibilities in real manufacturing processes shipbuilding and automotive industry. Basic model structure is described and presented by appropriate general algorithm. Operational quality improvement model developed lays down main guidelines for practical and systematic application of quality improvements methods and tools.

  14. Application of Six-Sigma for Data Quality Improvement in an Insurance Company

    Mohit Panwar

    2015-08-01

    Full Text Available Abstract Billions of dollars annually is what poor data quality costs Insurance businesses according to the Data Warehousing Institute. Poor data is also the leading cause of many IT project failures. Many companies are designing their data management programs and quality initiatives to deal with this problem of erroneous and inconsistent data. This paper discusses these topics as well as those detailing how companies can improve their data quality using the quality improvement technique of applying Six-Sigma. The method of creating a new initiative for identifying measuring and controlling the data errors is discussed in this paper. Finally the paper ends with a conclusion and expected results and benefits of the technique. The insurance industry is data-dependent. Today carriers and intermediaries are engaged in improving data capture to help them to better manage their business manage their risk and know their customers. Business and regulatory drivers are pushing the industry to manage its data better.

  15. 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...

  16. 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

  17. 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...

  18. Quality improvement through the paradigm of learning

    Hafford-Letchfield, Trish; Lavender, Peter

    2015-01-01

    Purpose - If we are to achieve meaningful participation and co-production for older people in care, more radical approaches are required. This project explores an innovation where older people using social care were matched to community based learning mentors to develop partnerships within which learning interventions were facilitated. We explore how the concept of learning might be used as a paradigm to raise the quality of care in institutionalised settings using a co-productive and relati...

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

    Blum, Torsten G; Rich, Anna; Baldwin, David;

    2014-01-01

    Lung cancer is the commonest cause of cancer-related death worldwide and poses a significant respiratory disease burden. Little is known about the provision of lung cancer care across Europe. The overall aim of the Task Force was to investigate current practice in lung cancer care across Europe....... 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...

  20. Related Measures on Improving the Teaching Quality of DGED Course

    JIN Yi; SHAN Hong-bo; WANG Xiao-hong; YU Hai-yan; GE Bin

    2013-01-01

    Engineering Drawing course is one of the main contents of teaching at most of science and engineering colleges or univer-sities. In this paper, some feasible measures is discussed on improving the teaching quality of Engineering Drawing course from four aspects, including diversified teacher participation and coordinating the teaching process, optimizing the content of teaching and im-proving teaching quality, improving teaching effect and reforming teaching methods, and integrating practice and cultivating practi-cal ability.

  1. Implementation of a heart failure quality initiative in a skilled nursing facility: lessons learned.

    Nazir, Arif; Dennis, M E; Unroe, Kathleen T

    2015-05-01

    Skilled nursing facilities (SNFs) are organizations that represent complex adaptive systems, offering barriers to the implementation of quality improvement (QI) initiatives. The current article describes the authors' efforts to use the approach of reflective adaptive process to implement a new model of care (i.e., the Skilled Heart Unit Program) for effective heart failure (HF) care in one SNF. A team of stakeholders from the local hospital system and a local SNF was convened to design and implement this new model. Evaluation of the implementation processes confirmed the value of the implementation approach, which centered on team-based approaches, staff engagement, and flexibility of processes to respect the SNF's needs and culture. Interviews with facility staff and the administrator revealed their perceptions that the strategy resulted in better HF care, enhanced teamwork between staff and clinicians, and improved staff job satisfaction. This work provides a unique blueprint of strategic QI implementation for patients with HF in the SNF setting. PMID:25531299

  2. 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.

  3. It Pays to Improve School Quality

    Hanushek, Eric A.; Ruhose, Jens; Woessmann, Ludger

    2016-01-01

    Congress passed the Every Student Succeeds Act, supplanting No Child Left Behind and placing responsibility for public school improvement squarely upon each of the 50 states. With the federal government's role in school accountability sharply diminished, it now falls to state and local governments to take decisive action. Even though most…

  4. AN IMPROVED LEVEL-SET RE-INITIALIZATION SOLVER

    王志亮; 周哲玮

    2004-01-01

    Re-initialization procedure in level-set interface capturing method were investigated. The algorithm accomplishes the re-initialization step through locking the interface positions. Better accuracy was obtained both on the interface positions and the total fluid volume keeping. Though one more step of the interpolations is added in the procedure, there is no significant increase in total machine time spent.

  5. 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

  6. Quality of Instruction Improved by Evaluation and Consultation of Instructors

    Rindermann, Heiner; Kohler, Jurgen; Meisenberg, Gerhard

    2007-01-01

    One aim of student evaluation of instruction is the improvement of teaching quality, but there is little evidence that student assessment of instruction alone improves teaching. This study tried to improve the effects of evaluation by combining evaluation with individual counselling in an institutional development approach. Evaluation was…

  7. 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

  8. Improving Willingness to Pay Estimates for Quality Improvements through Joint Estimation with Quality Perceptions

    John C. Whitehead

    2005-01-01

    Willingness to pay for quality change may depend on heterogeneous perceived quality levels. In these instances, contingent valuation studies should include measures of quality perceptions as covariates in the willingness to pay model in order to avoid omitted variable bias. Variation in quality perceptions across respondents leads to a potential endogeneity of quality perceptions. We address the potential for endogeneity bias using an instrumental variables approach in which a measure of qual...

  9. Evidence-Based Practice and Quality Improvement in Nursing Education.

    Balakas, Karen; Smith, Joan R

    2016-01-01

    For more than a decade, nursing education has experienced several significant changes in response to challenges faced by healthcare organizations. Accrediting organizations have called for improved quality and safety in care, and the Institute of Medicine has identified evidence-based practice and quality improvement as 2 core competencies to include in the curricula for all healthcare professionals. However, the application of these competencies reaches far beyond the classroom setting. For nurses to possess the knowledge, skills, and attitudes to apply evidence-based practice and quality improvement to the real-world setting, academic-clinical institution partnerships are vital. PMID:27465447

  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. 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.

  12. 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)

  13. 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...

  14. 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.

  15. Pulmonary rehabilitation improves sleep quality in chronic lung disease.

    Soler, Xavier; Diaz-Piedra, Carolina; Ries, Andrew L

    2013-04-01

    Sleep-related disorders are common in patients with chronic obstructive pulmonary disease (COPD) and, possibily, other lung disorders. Exercise has been shown to improve sleep disturbances. In patients with COPD, pulmonary rehabilitation (PR) produces important health benefits with improvement in symptoms, exercise tolerance, and quality of life. However, the effect of PR on sleep quality remains unknown. The aim of this observational study was to evaluate sleep quality in patients with chronic lung disease and the role of PR as a non-pharmacologic treatment to improve sleep. Sixty-four patients with chronic lung disease enrolled in an 8-week comprehensive PR program, and completed the study (48% male; obstructive [72%], restrictive [20%], mixed [8%]; 44% on supplemental oxygen). Baseline spirometry [mean (SD)]: FEV1% pred = 48.9 (17.4), FVC% pred = 72.5 (18.1), and FEV1/FVC% = 53.1 (18.9). Exercise tolerance and questionnaires related to symptoms, health-related quality of life (HRQL), and sleep quality using the Pittsburgh Sleep Quality Index (PSQI) were obtained before and after PR. 58% reported poor sleep quality (PSQI > 5) at baseline. Sleep quality improved by 19% (p = 0.017) after PR, along with significant improvements in dyspnea, exercise tolerance, self-efficacy, and HRQL. Sleep quality in patients with chronic lung disease was poor. In addition to expected improvements in symptoms, exercise tolerance, and HRQL after PR, the subgroup of patients with COPD had a significant improvement in sleep quality. These findings suggest that PR may be an effective, non-pharmacologic treatment option for sleep problems in patients with COPD. PMID:23514215

  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. 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…

  18. Tracking the Quality of Care for Sick Children Using Lot Quality Assurance Sampling: Targeting Improvements of Health Services in Jigawa, Nigeria

    Oladele, Edward Adekola; Ormond, Louise; Adeyemi, Olusegun; Patrick, David; Okoh, Festus; Oresanya, Olusola Bukola; Valadez, Joseph J

    2012-01-01

    Background In Nigeria, 30% of child deaths are due to malaria. The National Malaria Control Program of Nigeria (NMCP) during 2009 initiated a program to improve the quality of paediatric malaria services delivered in health facilities (HF). This study reports a rapid approach used to assess the existing quality of services in Jigawa state at decentralised levels of the health system. Methods NMCP selected Lot Quality Assurance Sampling (LQAS) to identify the variation in HF service quality am...

  19. 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

  20. 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

  1. 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.

  2. 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...

  3. Improving the quality of cardiovascular preventive care in general practice

    Lobo, Claudia

    2002-01-01

    textabstractIn this thesis we target cardiovascular preventive care from a continuous quality improvement point of view in a project called CARPE (CArdiovascular Risk reduction in Primary carE). We created a multifaceted intervention based on a ·quality cycle· and used outreach visitors for its implementation, since this approach has proven successful in modifying professional behavior. 13 In addressing prevention we considered Donebedian's model 14 to assess quality of care: i.e. we distingu...

  4. 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

  5. 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

  6. Measuring and Costing Quality in Education: Using Quality and Productivity Methods To Improve Schools.

    Spanbauer, Stanley J.

    The Measurement and Costing Model (MCM) described in this book was developed and tested at Fox Valley Technical College (FVTC), Wisconsin, to enhance the college's quality improvement process and to serve as a guide to other institutions interested in improving their quality. The book presents a description of the model and outlines seven steps…

  7. The cost-effectiveness of using financial incentives to improve provider quality: a framework and application

    Meacock, R.; Kristensen, Søren Rud; Sutton, M.

    2014-01-01

    whether performance improvement is a transitory or investment activity. Our application to the Advancing Quality initiative demonstrates that the incentive payments represented less than half of the 13m pound total programme costs. By generating approximately 5200 quality-adjusted life years and 4.4m...... pound of savings in reduced length of stay, we find that the programme was a cost-effective use of resources in its first 18months. Copyright (c) 2013 John Wiley & Sons, Ltd....

  8. Impact of mentorship on WHO-AFRO Strengthening Laboratory Quality Improvement Process Towards Accreditation (SLIPTA)

    Talkmore Maruta; David Motebang; Lebina Mathabo; Philip J. Rotz; Joseph Wanyoike; Trevor Peter

    2011-01-01

    Background: The improvment of the quality of testing services in public laboratories is a high priority in many countries. Consequently, initiatives to train laboratory staff on quality management are being implemented, for example, the World Health Organization Regional Headquarters for Africa (WHO-AFRO) Strengthening Laboratory Management Towards Accreditation (SLMTA). Mentorship may be an effective way to augment these efforts. Methods: Mentorship was implemented at four hospital laborator...

  9. 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…

  10. Combining traditional breeding and genomics to improve pork quality

    Heuven, H.C.M.; Wijk, van H.J.; Arendonk, van J.A.M.

    2003-01-01

    Breeding or improved pork quality has been the focus of much research in recent years and some of the results have already been put into practice. The realized genetic response in pork quality to selection within lines has generally been limited, however, compared with the responses obtained for oth

  11. IMPROVEMENT OF QUALITY IN PRODUCTION PROCESS BY APPLYING KAIKAKU METHOD

    Milan Radenkovic

    2013-12-01

    Full Text Available In this paper, Kaikaku method is presented. The essence of this method is introduction, principles and ways of implementation in the real systems. The main point how Kaikaku method influences on quality. It is presented on the practical example (furniture industry, one way how to implement Kaikaku method and how influence on quality improvement of production process.

  12. Optimized Sedation Improves Colonoscopy Quality Long-Term

    Konstantinos Triantafyllou; Sioulas, Athanasios D; Theodora Kalli; Nikolaos Misailidis; Dimitrios Polymeros; Papanikolaou, Ioannis S; George Karamanolis; Ladas, Spiros D.

    2015-01-01

    Background. Quality monitoring and improvement is prerequisite for efficient colonoscopy. Aim. To assess the effects of increased sedation administration on colonoscopy performance. Materials and Methods. During Era 1 we prospectively measured four colonoscopy quality indicators: sedation administration, colonoscopy completion rate, adenoma detection rate, and early complications rate in three cohorts: cohort A: intention for total colonoscopy cases; cohort B: cohort A excluding bowel obstruc...

  13. Improving the Quality of Behavioral Health Care for Medicaid Beneficiaries

    Allison Siegwarth

    2015-01-01

    This brief highlights Mathematica’s work to find opportunities for quality improvement in Medicaid’s behavioral health services, develop measures that can help monitor the quality of care, and to identify innovative strategies to better coordinate behavioral and physical health care.

  14. Effects of Quality Improvement System for Child Care Centers

    Ma, Xin; Shen, Jianping; Kavanaugh, Amy; Lu, Xuejin; Brandi, Karen; Goodman, Jeff; Till, Lance; Watson, Grace

    2011-01-01

    Using multiple years of data collected from about 100 child care centers in Palm Beach County, Florida, the authors studied whether the Quality Improvement System (QIS) made a significant impact on quality of child care centers. Based on a pre- and postresearch design spanning a period of 13 months, QIS appeared to be effective in improving…

  15. ????????? ???? ???????? ????????????: ??????????? ?????????????????? // 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.

  16. Bee pollination improves crop quality, shelf life and commercial value

    Björn K. Klatt; Holzschuh, Andrea; Westphal, Catrin; Clough, Yann; Smit, Inga; Pawelzik, Elke; Tscharntke, Teja

    2015-01-01

    Pollination improves the yield of most crop species and contributes to one-third of global crop production, but comprehensive benefits including crop quality are still unknown. Hence, pollination is underestimated by international policies, which is particularly alarming in times of agricultural intensification and diminishing pollination services. In this study, exclusion experiments with strawberries showed bee pollination to improve fruit quality, quantity and market value compared with wi...

  17. System Change: Quality Assessment and Improvement for Medicaid Managed Care

    Smith, Wally R.; Cotter, J. James; Louis F Rossiter

    1996-01-01

    Rising Medicaid health expenditures have hastened the development of State managed care programs. Methods to monitor and improve health care under Medicaid are changing. Under fee-for-service (FFS), the primary concern was to avoid overutilization. Under managed care, it is to avoid underutilization. Quality enhancement thus moves from addressing inefficiency to addressing insufficiency of care. This article presents a case study of Virginia's redesign of Quality Assessment and Improvement (Q...

  18. Asan Medical Information System for Healthcare Quality Improvement

    Ryu, Hyeon Jeong; Kim, Woo Sung; Lee, Jae Ho; Min, Sung Woo; Kim, Sun Ja; Lee, Yong Su; Lee, Young Ha; Nam, Sang Woo; Eo, Gi Seung; Seo, Sook Gyoung; Nam, Mi Hyun

    2010-01-01

    Objectives This purpose of this paper is to introduce the status of the Asan Medical Center (AMC) medical information system with respect to healthcare quality improvement. Methods Asan Medical Information System (AMIS) is projected to become a completely electronic and digital information hospital. AMIS has played a role in improving the health care quality based on the following measures: safety, effectiveness, patient-centeredness, timeliness, efficiency, privacy, and security. Results AMI...

  19. 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.

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

    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

  1. 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

  2. Improved initial guess for minimum energy path calculations.

    Smidstrup, Søren; Pedersen, Andreas; Stokbro, Kurt; Jónsson, Hannes

    2014-06-01

    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 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. PMID:24907989

  3. 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.

  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. Facilitators and barriers to applying a national quality registry for quality improvement in stroke care

    Eldh, Ann Catrine; Fredriksson, Mio; Halford, Christina; Wallin, Lars; Dahlström, Tobias; Vengberg, Sofie; Winblad, Ulrika

    2014-01-01

    Background: National quality registries (NQRs) purportedly facilitate quality improvement, while neither the extent nor the mechanisms of such a relationship are fully known. The aim of this case study is to describe the experiences of local stakeholders to determine those elements that facilitate and hinder clinical quality improvement in relation to participation in a well-known and established NQR on stroke in Sweden. Methods: A strategic sample was drawn of 8 hospitals in 4 county council...

  6. 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 ...

  7. 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...

  8. 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

  9. 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...

  10. 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.

  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. 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, Andrea; Mueller, Juergen; Peters, Jan; Ricchiuti, Ferdinando; Saracino, Fabio; Servedio, Vito D P; Stumme, Gerd; Theunis, Jan; Tria, Francesca; Van den Bossche, Joris

    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 into participatory patterns emerging from this study. Interesting effects related to inertia and to direct involvement in measurement activities rather than indirect information exposure are also highlighted, indicating that direct involvement can enhance learning and environmental awareness. In the future, this could result in better adoption of policies towards decreasing pollution. PMID:26313263

  13. 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.

  14. 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)

  15. Improving Milk Quality for Dairy Goat Farm Development

    L. Cyrilla

    2015-12-01

    Full Text Available The present study was designed to evaluate factors affecting goat’s milk quality, consumer’s satisfaction to goat’s milk, and technical responses associated with goat’s milk quality. Three farms having more than 100 dairy goats were purposively selected for the study. Thirty consumers were determined by using judgement sampling techniques to assess the satisfaction of consumer to goat’s milk quality. Data were analyzed by using fishbone diagram and House of Quality matrix. The study revealed that milk quality produced by dairy goat farms met the standard quality of milk composition namely; specific gravity, total solid, fat, protein, and total solid non-fat. The main factors affecting goat milk quantity and quality were the quality of does, pregnancy status, number of kids per birth, shape and size of the udder, lactation length, and the health status of the goat. The attributes of goat’s milk that were able to achieve customer’s satisfaction targets were nutritional content, packaging size, and goat milk color. Technical responses that were major concern in ensuring goat’s milk quality included goat breed quality and health conditions, skills and performances of farmers and employees, feed quality, farm equipment hygiene and completeness, cleanliness, and hygiene of livestock housing and environment. Technical response on livestock health condition was the first priority to be improved.

  16. 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…

  17. 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

  18. Using AMLO to Improve the Quality of Teacher Education Outcomes

    Al-Shammari, Zaid

    2012-01-01

    This study aims to find ways to improve learning outcomes in teacher education courses by using an Analysis Model for Learning Outcomes (AMLO). It addresses the improvement of the quality of teacher education by analyzing learning outcomes and implementing curriculum modifications related to specific learning objectives and their effects on…

  19. 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)

  20. Measuring long-term effects of a school improvement initiative

    Svärdh, Joakim

    2013-01-01

    There is a growing demand for studies applying quantitative methods to large-scale data sets for the purpose of evaluating the effects of educational reforms (UVK, 2010). In this thesis the statistical method, Propensity Score Analysis (PSA), is presented and explored in the evaluating context of an extensive educational initiative within science and technology education; the Science and Technology for All-program (NTA). The research question put forward reads; under what conditions are PSA-a...

  1. Ten tips for incorporating scientific quality improvement into everyday work.

    Goldmann, Don

    2011-04-01

    Healthcare personnel often find it challenging to incorporate disciplined quality improvement into their daily work. Planning, managing and completing improvement projects with sufficient rigour to generate credible evidence and potentially publishable knowledge are even more difficult. Nonetheless, careful set-up and agile leveraging of existing resources and expertise can lead to surprisingly robust results. Project designs that integrate data collection with the work itself are especially helpful. Although the general perception is that top-flight journals are loath to publish the results of quality improvement work, accumulating experience suggests that this hurdle can be overcome. The Standards for Quality Improvement Reporting Excellence guidelines provide a promising framework for crafting publications that can meet the exacting standards of peer-reviewed journals. PMID:21450777

  2. Ergonomic redesign using quality improvement for pre-hospital care of acute myocardial infarction

    Essam, Nadya; Wood, Kate; Hall, Mark; Shaw, Deborah; Spaight, Anne; Baird, Andrew; Siriwardena, A Niroshan

    2012-01-01

    Context: Frontline emergency ambulance clinicians collaborated in a national quality improvement (QI) initiative to improve pre-hospital care for patients with acute myocardial infarction (AMI). Problem: The National Ambulance Clinical Performance Indicator (CPI) care bundle for AMI (consisting of aspirin, GTN, pain assessment and administration of analgesia) highlighted a consistent shortfall in patient pain assessment and inadequate provision of analgesia. Ineffective pain management in...

  3. Developing and assessing initiatives designed to improve clinical teaching performance.

    Khandelwal, Sorabh; Bernard, Aaron W; Wald, David A; Manthey, David E; Fisher, Jonathan; Ankel, Felix; Williams, Sarah R; Szyld, Demian; Riddle, Janet; Anders Ericsson, K

    2012-12-01

    To improve the teaching performance of emergency physicians, it is necessary to understand the attributes of expert teachers and the optimal methods to deliver faculty development. A working group of medical educators was formed to review the literature, summarize what is known on the topic, and provide recommendations for future research. This occurred as a track of the 2012 Academic Emergency Medicine (AEM) consensus conference "Education Research in Emergency Medicine: Opportunities, Challenges, and Strategies for Success." The group concluded that the current state of research on these topics is limited. Improvement in understanding will come through research focusing on Kirkpatrick's higher levels of evaluation (behavior and results). PMID:23216823

  4. 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.

  5. Bevacizumab Improves Quality of Life in Patients with Recurrent Glioblastoma

    Seema Nagpal; Griffith Harsh; Lawrence Recht

    2011-01-01

    Objective. To quantify the benefits in survival and quality of life in patients receiving bevacizumab (BEV) for recurrent glioblastoma (GBM). Methods. This is a retrospective study of 40 adult patients with recurrent GBM treated between 2005 and 2009 at a single institution. All patients had initial treatment with surge...

  6. 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…

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

    Pannick, Samuel; Sevdalis, Nick; Athanasiou, Thanos

    2016-09-01

    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 universal challenge; moreover, there is evidence that managers-particularly middle managers-also have a role to play in quality improvement. Yet managerial participation in quality improvement interventions is often assumed, rather than proven. We identify specific factors that influence the coordination of front-line staff and managers in quality improvement, and integrate these factors into a novel model: the model of alignment. We use this model to explore the implementation of an interdisciplinary intervention in a recent trial, describing different participation incentives and barriers for different staff groups. The extent to which clinical and managerial interests align may be an important determinant of the ultimate success of quality improvement interventions. PMID:26647411

  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. 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

  10. NOAA-EPA's New National Air Quality Forecast Capability: Initial Steps

    Davidson, P.

    2005-12-01

    In partnership with the US EPA, NOAA has developed, tested and implemented the first two stages of a national air quality forecast capability into the National Weather Service (NWS) operational suite. The initial capability was implemented in September, 2004 and provided ground-level ozone predictions over Northeastern United States. In a program of phased development and testing to expand this capability, the domain has been extended over the entire Eastern United states as of August 31, 2005. Predictions are made with the NOAA-EPA Community Model for Air Quality (CMAQ) driven by NOAA's operational mesoscale weather prediction model (Eta-12). The capability is an end-to-end forecast guidance system providing twice daily predictions of hour-by-hour ground-level ozone concentrations on a 12km grid, disseminated over operational NWS and EPA dataservers. Forecast guidance products are hosted on operational dataservers: fully backed up, with archiving and near-real-time verification in place to monitor forecast accuracy. In order to demonstrate readiness for operational implementation, required accuracy of 90% and reliability of 95% on-time delivery have been demonstrated in the pre-deployment testing. During the Summers of 2004 and 2005, pre-deployment testing of forecast domains over Northeastern US and Eastern US, respectively, have led to operational implementation of the first two stages of the capability. Prior to pre-deployment testing, developmental testing was conducted to demonstrate feasibility of the prototype operational configuration using forecast components for air quality (CMAQ and pollutant emissions pre-processing) adapted from research and assessment simulations. Developmental testing identified priorities for system enhancements needed to improve guidance accuracy; for example: improved model linkage, updated emissions information, improved treatments of solar radiation for photolysis rate estimation, and improved treatments of vertical mixing and

  11. 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.

  12. 'Wading through treacle': quality improvement lessons from the frontline.

    Roueche, Alice; Hewitt, Jocelyn

    2012-03-01

    In a time of financial uncertainty and structural reform, the National Health Service (NHS) in England needs clinical leadership to help improve the quality of patient care. Increasingly, leadership development is being targeted at doctors in postgraduate training to help prepare them for their future leadership roles as consultants and general practitioners. However, there is a risk that we are missing an opportunity here by failing to recognise the role that doctors in training can play now, during their training. As our frontline clinicians they have a unique view of the health service and the inefficiencies therein. The London Deanery has been running an educational programme called Beyond Audit to provide doctors in training with quality improvement skills. During this programme we have been given a unique insight into NHS systems as viewed by junior doctors. They have identified a wide range of small system problems that, when combined, result in large-scale inefficiency and prevent the delivery of high quality patient care. These problems they identify have implications for cost, efficiency, patient safety, team-working and patient experience. Any attempt to improve the quality of care delivered in the NHS needs to look at the system from the point of view of those delivering the care, including our doctors in postgraduate training. By empowering them to make improvements to the systems that they see, there is the potential to make significant improvement in the quality of patient care that they deliver. PMID:22198901

  13. An Initial Study of Improving English Reading Efficiency

    刘琼

    2013-01-01

    Reading,as an important medium for human beings to gain knowledge,also plays a major part in the teaching and learning of English.Nevertheless,in practical teaching,we find that the students are quite at a loss at what to do.This article will probe into how to improve the reading efficiency from two aspects:linguistic factors and non-linguistic factors.

  14. 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…

  15. 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...

  16. 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

  17. 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

  18. The Relationship Between Initial Quality Perceptions and Maintenance Behavior: The Case of the Automotive Industry

    Edward Conlon; Sarv Devaraj; Khalil F. Matta

    2001-01-01

    We examine the relationship between quality, represented by consumer ratings, and quality-related activities by the customer, represented by maintenance activities in the automotive industry. Based on several converging theoretical perspectives, we present and test a model relating vehicle initial quality ratings to consumers' routine maintenance. Three types of data were collected for the study: (1) vehicle service records at a local dealership, (2) primary data from a survey of vehicle owne...

  19. IMPROVING BANK QUALITY DIMENSIONS TO INCREASE CUSTOMER SATISFACTION

    Lăcrămioara RADOMIR; Alan WILSON; Andrei Mircea Scridon

    2011-01-01

    The purpose of this study is twofold: 1. examine the relationship between service quality dimensions and customer satisfaction with bank territorial units; 2. establish which quality measure method out of the four considered in this study should be applied in order to better determine the areas that need further improvement and investment. In this respect, we performed Principal Component Regression (PCR) and considered direct importance and performance measures as well. Our results reveal th...

  20. Improving Quality of Clustering using Cellular Automata for Information retrieval

    Sree, Pokkuluri Kiran; Babu, Inampudi Ramesh

    2014-01-01

    Clustering has been widely applied to Information Retrieval (IR) on the grounds of its potential improved effectiveness over inverted file search. Clustering is a mostly unsupervised procedure and the majority of the clustering algorithms depend on certain assumptions in order to define the subgroups present in a data set .A clustering quality measure is a function that, given a data set and its partition into clusters, returns a non-negative real number representing the quality of that clust...

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

    Kelebeletse O. Mokobela; Mpho T. Moatshe; Mosetsanagape Modukanele

    2014-01-01

    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 ...

  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. 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

  4. 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)...

  5. 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...

  6. 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.

  7. 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...

  8. 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

  9. Indoor climate quality after renovation for improved energy efficiency

    Gunnarsen, Lars Bo; Løck, Sebastian; Kolarik, Barbara;

    2016-01-01

    performance. The indoor quality classifications show minor improvements. By using design tools beyond the simple legal requirements, the rental dwelling marked is a far step ahead of most retrofitting of owner-occupied dwellings and houses. The fear of indoor climate degradation from retrofitted energy saving...... projects through both planning and construction. Advanced tools for design of retrofitting measures to increase energy performance and quality of the thermal indoor climate were used during the planning processes. Energy performance and indoor climate quality were assessed using simple classification tools...

  10. Evidence of improved quality of life with pediatric palliative care.

    O'Quinn, Lucy P; Giambra, Barbara K

    2014-01-01

    Pediatric nurses provide holistic family-centered care for children with life-limiting illnesses while being sensitive to children's growth and developmental needs. To learn how pediatric palliative care programs benefit children and their families, the following clinical question was asked: Among children with a life-limiting illness, does the use of a palliative care program compared with not using a palliative care program improve quality of life for patients and their families? Evidence from two studies found that palliative care services improve quality of life for children with life-limiting illness and their families in the areas of the child's emotional well-being and parental perception of preparation for the child's end of life, resulting in a low grade for the body of evidence. Future research should include high quality studies with larger sample sizes and control groups, and include children's perspectives--from both patients and siblings--to give a more complete picture of how best to improve their quality of life. A reliable tool is needed that includes a spiritual component and sensitive indicators specific to children with a life-limiting illness. Future research using this tool will more fully answer how palliative care services improve children's quality of life. PMID:25929123

  11. 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...

  12. Is the maturity of hospitals' quality improvement systems associated with measures of quality and patient safety?

    Groene Oliver; Mora Nuria; Thompson Andrew; Saez Mercedes; Casas Mercè; Suñol Rosa

    2011-01-01

    Abstract Background Previous research addressed the development of a classification scheme for quality improvement systems in European hospitals. In this study we explore associations between the 'maturity' of the hospitals' quality improvement system and clinical outcomes. Methods The maturity classification scheme was developed based on survey results from 389 hospitals in eight European countries. We matched the hospitals from the Spanish sample (113 hospitals) with those hospitals partici...

  13. Advances in genomics for the improvement of quality in coffee.

    Tran, Hue Tm; Lee, L Slade; Furtado, Agnelo; Smyth, Heather; Henry, Robert J

    2016-08-01

    Coffee is an important crop that provides a livelihood to millions of people living in developing countries. Production of genotypes with improved coffee quality attributes is a primary target of coffee genetic improvement programmes. Advances in genomics are providing new tools for analysis of coffee quality at the molecular level. The recent report of a genomic sequence for robusta coffee, Coffea canephora, is a major development. However, a reference genome sequence for the genetically more complex arabica coffee (C. arabica) will also be required to fully define the molecular determinants controlling quality in coffee produced from this high quality coffee species. Genes responsible for control of the levels of the major biochemical components in the coffee bean that are known to be important in determining coffee quality can now be identified by association analysis. However, the narrow genetic base of arabica coffee suggests that genomics analysis of the wild relatives of coffee (Coffea spp.) may be required to find the phenotypic diversity required for effective association genetic analysis. The genomic resources available for the study of coffee quality are described and the potential for the application of next generation sequencing and association genetic analysis to advance coffee quality research are explored. © 2016 Society of Chemical Industry. PMID:26919810

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

    Quaade, F; Astrup, A

    1989-01-01

    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): 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....

  15. 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.

  16. 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)

  17. Integration of quality improvement and cost-efficiency through industrial improvement techniques

    Vink, Jasper

    2016-01-01

    Jasper P Vink,1 Maxime T Rigaudy,1,2 Karl O Elmqvist11Imperial College Business School, Imperial College London, London, 2Hull York Medical School, York, UKIn this journal, Crema and Verbano1 discussed the importance of defining quality of health care and how quality can be improved through various industrial instruments and techniques. Quality of health care is a heavily debated topic that requires a wide scope of considerations across the many stakeholders of the health system. We acknowled...

  18. 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.)

  19. Initiatives to improve appropriate antibiotic prescribing in primary care.

    Harris, Diane J

    2013-11-01

    Influencing clinicians' prescribing behaviour is important because inappropriate use and overuse of antibiotics are major drivers of antibiotic resistance. A systematic review of interventions for promoting prudent prescribing of antibiotics by general practitioners suggests that multifaceted interventions will maximize acceptability. This article reports how this type of approach has been used successfully in Derbyshire, UK over the last 4 years. The range of interventions that have been used includes educational meetings (both open group events and others targeted at higher prescribers in the surgery) using a supportive and guiding ethos; the provision of support materials aimed at empowering avoidance or delayed antibiotic prescribing, where appropriate, and improving patients' knowledge and confidence in self-management; and the production of different treatment guidelines incorporating key messages with evidence, indicating where antibiotics are unlikely to be of benefit. Education on antibiotics in schools was a novel approach, which was developed in North Derbyshire to increase public awareness of the appropriate treatment for common illnesses without using antibiotics. PMID:24030546

  20. 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.

  1. Improving quality on the pediatric surgery service: Missed opportunities and making it happen.

    Berman, Loren; Vinocur, Charles D

    2015-12-01

    In surgery, quality improvement efforts have evolved from the traditional case-by-case review typical for morbidity and mortality conferences to more accurate and comprehensive data collection accomplished through participation in national registries such as the National Surgical Quality Improvement Program. Gaining administrative support to participate in these kinds of initiatives and commitment of the faculty and staff to make change in a data-driven manner rather than as a reaction to individual events can be a challenge. This article guides the reader through the process of interacting with administrative leadership to gain support for evidence-based quality improvement endeavors. General principles that are discussed include stakeholder engagement, taking advantage of preexisting resources, and the sharing of data in order to shape QI efforts and demonstrate their effectiveness. PMID:26653165

  2. Issues of therapeutic communication relevant for improving quality of care

    Popa-Velea, O; Purcărea, VL

    2014-01-01

    Communication issues are extensively considered a topic of high interest for improving the efficacy of the therapeutic act. This article aimed to overview several issues of therapeutic communication relevant for improving quality of care. A number of 15 bibliographic resources on these topics published in peer-reviewed journals between 1975 and 2010, and indexed in PubMed, ProQuest and EBSCO databases were examined, to seek for evidence regarding these data. Results highlight a number of comm...

  3. PROCESSES FOR QUALITY IMPROVEMENTS IN RADIATION ONCOLOGY CLINICAL TRIALS

    FitzGerald, TJ; Urie, Marcia; Ulin, Kenneth; Laurie, Fran; Yorty, Jeffrey; Hanusik, Richard; Kessel, Sandy; Jodoin, Maryann Bishop; Osagie, Gani; Giulia Cicchetti, M.; Pieters, Richard; McCarten, Kathleen; Rosen, Nancy

    2008-01-01

    Quality assurance in radiation therapy has been an integral aspect of cooperative group clinical trials since 1970. In early clinical trials data acquisition was non-uniform and inconsistent; computational models for radiation dose calculation varied significantly. Process improvements developed for data acquisition, credentialing, and data management have provided the necessary infrastructure for uniform data. With continued improvement in the technology and delivery of radiation therapy, ev...

  4. 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...

  5. Improving Compliance with NICE Guidelines on Parkinson's isease: A Quality Improvement Study

    Agha, Riaz; Edison, Eric; Fielder Camm, Christian; Cheng, Lisa; Gajendragadkar, Pushpaj; Borland, Colin

    2012-01-01

    Parkinson's disease can progressively affect daily function and multidisciplinary teamwork is essential to provide high quality care. The National Institute of Health and Clinical Excellence (NICE) issued guidelines regarding diagnosis, follow-up, and multidisciplinary care. This quality improvement project sought to measure and improve the compliance of service provision against the guidelines. In total, 3 audit cycles were completed. Each audit involved reviewing notes of patients attending...

  6. 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

  7. 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

  8. Training in data definitions improves quality of intensive care data

    Arts, DGT; Bosman, RJ; de Jonge, E; Joore, JCA; de Keizer, NF

    2003-01-01

    Background Our aim was to assess the contribution of training in data definitions and data extraction guidelines to improving quality of data for use in intensive care scoring systems such as the Acute Physiology and Chronic Health Evaluation (APACHE) II and Simplified Acute Physiology Score (SAPS)

  9. IMPROVING NATIONAL AIR QUALITY FORECASTS WITH SATELLITE AEROSOL OBSERVATIONS

    Air quality forecasts for major US metropolitan areas have been provided to the public through a partnership between the US Environmental Protection Agency and state and local air agencies since 1997. Recent years have witnessed improvement in forecast skill and expansion of fore...

  10. Guiding and Modelling Quality Improvement in Higher Education Institutions

    Little, Daniel

    2015-01-01

    The article considers the process of creating quality improvement in higher education institutions from the point of view of current organisational theory and social-science modelling techniques. The author considers the higher education institution as a functioning complex of rules, norms and other organisational features and reviews the social…

  11. 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...

  12. Dramatic Improvements in Beach Water Quality Following Gull Removal

    Gulls are often cited as important contributors of fecal contamination to surface waters, and some recreational beaches have used gull control measures to improve microbial water quality. In this study, gulls were chased from a Lake Michigan beach using specially trained dogs, a...

  13. 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.

  14. Improving of the management quality of human resources

    Miceski, Trajko

    2004-01-01

    Improvement of the management quality of human resources is a continuous process, based on multidimensional concept of activities, with special emphasis on increasing the level of competence of the employees both in their working place and in additional activities in the decision making bodies.

  15. Identifying targets for quality improvement in hospital antibiotic prescribing

    Spreuwel, P.C. van; Blok, H.; Langelaar, M.F.; Kullberg, B.J.; Mouton, J.W.; Natsch, S.S.

    2015-01-01

    OBJECTIVES: To audit antibiotic use in a university hospital and to identify targets for quality improvement in a setting with low antibiotic use and resistance rates. METHODOLOGY: A point-prevalence survey (PPS), using a patient-based audit tool for antibiotic use, was executed in the Radboud Unive

  16. 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…

  17. 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.

  18. 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.

  19. 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...

  20. Quality Assessment and Improvement Methods in Statistics – what Works?

    Hans Viggo Sæbø

    2014-12-01

    Full Text Available Several methods for quality assessment and assurance in statistics have been developed in a European context. Data Quality Assessment Methods (DatQAM were considered in a Eurostat handbook in 2007. These methods comprise quality reports and indicators, measurement of process variables, user surveys, self-assessments, audits, labelling and certifi cation. The entry point for the paper is the development of systematic quality work in European statistics with regard to good practices such as those described in the DatQAM handbook. Assessment is one issue, following up recommendations and implementation of improvement actions another. This leads to a discussion on the eff ect of approaches and tools: Which work well, which have turned out to be more of a challenge, and why? Examples are mainly from Statistics Norway, but these are believed to be representative for several statistical institutes.

  1. 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)

  2. 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.

  3. Initiating Improvements: The HR Department as the Architect of Quality-of-Life Initiatives.

    Reis, Frank William

    2002-01-01

    Describes how a wellness program, campus safety and security program, and institutional knowledge management program are succeeding at Cuyahoga Community College after the human resources (HR) department won administrative support for their implementation. (EV)

  4. 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

  5. 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

  6. Defect Investigation as a Tool for Quality Improvement

    B. Gurumurthy

    2002-10-01

    Full Text Available Defect investigation is an important tool for quality improvement as it identifies the root cause of errors and steps to be taken to eliminate these. In this paper, four cases of defect investigation are presented. The case studies cover link elevator, wing-fuselage attachment bolt, and stiff nut for Lakshya unmanned aerial vehicle. It was observed that the link elevator was discolourised even though the material used was the stainless steel. Investigations revealed that the stainless steel was heat-treated. In the case of leading edge, it was found that there was no provision for the location of a component in the tool, resulting in mismatch. Thread damage was noticed in wing-fuselage attachment bolts because of over tightening. All these studies resulted in improvement in the raw material bonding, inspection procedures, and fabrication methods, thus resulting in quality improvement.

  7. 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

  8. Using quality measures for quality improvement: the perspective of hospital staff.

    Asgar Aghaei Hashjin

    Full Text Available RESEARCH OBJECTIVE: This study examines the perspectives of a range of key hospital staff on the use, importance, scientific background, availability of data, feasibility of data collection, cost benefit aspects and availability of professional personnel for measurement of quality indicators among Iranian hospitals. The study aims to facilitate the use of quality indicators to improve quality of care in hospitals. STUDY DESIGN: A cross-sectional study was conducted over the period 2009 to 2010. Staff at Iranian hospitals completed a self-administered questionnaire eliciting their views on organizational, clinical process, and outcome (clinical effectiveness, patient safety and patient centeredness indicators. POPULATION STUDIED: 93 hospital frontline staff including hospital/nursing managers, medical doctors, nurses, and quality improvement/medical records officers in 48 general and specialized hospitals in Iran. PRINCIPAL FINDINGS: On average, only 69% of respondents reported using quality indicators in practice at their affiliated hospitals. Respondents varied significantly in their reported use of organizational, clinical process and outcome quality indicators. Overall, clinical process and effectiveness indicators were reported to be least used. The reported use of indicators corresponded with their perceived level of importance. Quality indicators were reported to be used among clinical staff significantly more than among managerial staff. In total, 74% of the respondents reported to use obligatory indicators, while this was 68% for voluntary indicators (p<0.05. CONCLUSIONS: There is a general awareness of the importance and usability of quality indicators among hospital staff in Iran, but their use is currently mostly directed towards external accountability purposes. To increase the formative use of quality indicators, creation of a common culture and feeling of shared ownership, alongside an increased uptake of clinical process and

  9. Breeding and biotechnology for improving berry nutritional quality.

    Scalzo, Jessica; Battino, Maurizio; Costantini, Elisa; Mezzetti, Bruno

    2005-01-01

    Breeding and biotechnological approaches are currently used to increase the content of specific bioactive components of plants, but the manipulation of plant metabolism is still not easy to address. There is an increasing awareness that multiple genetic and environmental factors affect production and accumulation of bioactive compounds, but these factors are rarely taken into account when fruit is marketed. Rigorous and unprejudiced evaluation of scientific evidence requires a defined set of criteria and methods of evaluation, particularly when breeding and biotech programs are aimed of producing new varieties with improved nutritional values combined with high plant production efficiency and fruit quality. In order to develop new genotypes and commercial cultivars the availability of new sources of Quality Attributes (QA) and Nutritional Attributes (NA) should be explored. In the strawberry, wild species such as F. virginiana glauca and F. vesca are good sources of bioactive compounds, but in raspberries the introduction of the wild germplasm (R. parvifolium) did not improve the nutritional quality of fruit. The methods available for detecting fruit TAC, combined with TPH and other quality parameters such as sugars, total acidity and fruit color, can be proposed as excellent tools for developing a fast and reliable program for screening large breeding populations for high nutritional quality genotypes. Furthermore, NA can represent a useful tool to facilitate analysis of "substantial equivalence" of transgenic and control derived fruit. PMID:16498208

  10. Improving the Quality of Imaging in the Emergency Department.

    Blackmore, C Craig; Castro, Alexandra

    2015-12-01

    Imaging is critical for the care of emergency department (ED) patients. However, much of the imaging performed for acute care today is overutilization, creating substantial cost without significant benefit. Further, the value of imaging is not easily defined, as imaging only affects outcomes indirectly, through interaction with treatment. Improving the quality, including appropriateness, of emergency imaging requires understanding of how imaging contributes to patient care. The six-tier efficacy hierarchy of Fryback and Thornbury enables understanding of the value of imaging on multiple levels, ranging from technical efficacy to medical decision-making and higher-level patient and societal outcomes. The imaging efficacy hierarchy also allows definition of imaging quality through the Institute of Medicine (IOM)'s quality domains of safety, effectiveness, patient-centeredness, timeliness, efficiency, and equitability and provides a foundation for quality improvement. In this article, the authors elucidate the Fryback and Thornbury framework to define the value of imaging in the ED and to relate emergency imaging to the IOM quality domains. PMID:26568040

  11. 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.

  12. 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.

  13. Improving the quality of health care: what's taking so long?

    Chassin, Mark R

    2013-10-01

    Nearly fourteen years ago the Institute of Medicine's report, To Err Is Human: Building a Safer Health System, triggered a national movement to improve patient safety. Despite the substantial and concentrated efforts that followed, quality and safety problems in health care continue to routinely result in harm to patients. Desired progress will not be achieved unless substantial changes are made to the way in which quality improvement is conducted. Alongside important efforts to eliminate preventable complications of care, there must also be an effort to seriously address the widespread overuse of health services. That overuse, which places patients at risk of harm and wastes resources at the same time, has been almost entirely left out of recent quality improvement endeavors. Newer and much more effective strategies and tools are needed to address the complex quality challenges confronting health care. Tools such as Lean, Six Sigma, and change management are proving highly effective in tackling problems as difficult as hand-off communication failures and patient falls. Finally, the organizational culture of most American hospitals and other health care organizations must change. To create a culture of safety, leaders must eliminate intimidating behaviors that suppress the reporting of errors and unsafe conditions. Leaders must also hold everyone accountable for adherence to safe practices. PMID:24101066

  14. Nutritional quality of Australian breakfast cereals. Are they improving?

    Louie, Jimmy Chun Yu; Dunford, Elizabeth K; Walker, Karen Z; Gill, Timothy P

    2012-10-01

    The nutritional quality of Australian breakfast cereals is not systematically monitored despite the importance of breakfast for general health. We examined whether the nutritional quality of Australian breakfast cereals has improved between 2004 and 2010, and whether any change could be detected after the introduction of Daily Intake Guide (DIG) front-of-pack labelling. Supermarket surveys were conducted in 2004 and 2010 using the same methodology to collect information from the nutrition information panels of Australian breakfast cereals and the nutrient content of cereals was compared by year. Breakfast cereals with and without DIG labelling in 2010 were also compared. Nutritional quality was assessed using UK Traffic Light criteria. No significant difference was detected in nutritional composition of breakfast cereals between 2004 and 2010. There was no notable improvement in nutritional composition of breakfast cereals marketed as the same product in both years. Overall there has been little improvement in the nutritional quality of Australian breakfast cereals in the 6 year period. A large proportion of Australian breakfast cereals were considered high sugar. In conclusion, the introduction of DIG labelling does not appear to have promoted product reformulation, and breakfast cereals carrying DIG labels were not consistently healthier. PMID:22728950

  15. 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

  16. IMPROVEMENT OF ROAD TRAFFIC QUALITY IN ACCIDENT CLUSTERS

    D. V. Kapsky

    2015-01-01

    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.

  17. 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.

  18. 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

  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. 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

  1. 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

  2. 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

  3. Teaching Evaluation: A Critical Measure for Improving the Quality of Education

    Ji, Zhou

    2009-01-01

    In the coming period, the main task for China's higher education system is to improve the quality of education, and the key to improving the quality of education is to improve the quality of teaching. Teaching evaluations are a critical measure for improving the quality of teaching. The work of evaluating teaching at institutions of higher…

  4. 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...

  5. Skill Gap Analysis for Improved Skills and Quality Deliverables

    Mallikarjun Koripadu

    2014-10-01

    Full Text Available 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 roles involved. In addition to domain skills, the evolving role of a clinical data manager demands diverse skill sets such as project management, six sigma, analytical, decision making, communication etc. This article proposes a methodology of skill gap analysis (SGA management as one of the potential solutions to the big skill challenge that CDM is gearing up for bridging the gap of skills. This would in turn strength the CDM capability, scalability, consistency across geographies along with improved productivity and quality of deliverables

  6. 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.

  7. Processes for Quality Improvements in Radiation Oncology Clinical Trials

    Quality assurance in radiotherapy (RT) has been an integral aspect of cooperative group clinical trials since 1970. In early clinical trials, data acquisition was nonuniform and inconsistent and computational models for radiation dose calculation varied significantly. Process improvements developed for data acquisition, credentialing, and data management have provided the necessary infrastructure for uniform data. With continued improvement in the technology and delivery of RT, evaluation processes for target definition, RT planning, and execution undergo constant review. As we move to multimodality image-based definitions of target volumes for protocols, future clinical trials will require near real-time image analysis and feedback to field investigators. The ability of quality assurance centers to meet these real-time challenges with robust electronic interaction platforms for imaging acquisition, review, archiving, and quantitative review of volumetric RT plans will be the primary challenge for future successful clinical trials

  8. Processes for quality improvements in radiation oncology clinical trials.

    FitzGerald, T J; Urie, Marcia; Ulin, Kenneth; Laurie, Fran; Yorty, Jeffrey; Hanusik, Richard; Kessel, Sandy; Jodoin, Maryann Bishop; Osagie, Gani; Cicchetti, M Giulia; Pieters, Richard; McCarten, Kathleen; Rosen, Nancy

    2008-01-01

    Quality assurance in radiotherapy (RT) has been an integral aspect of cooperative group clinical trials since 1970. In early clinical trials, data acquisition was nonuniform and inconsistent and computational models for radiation dose calculation varied significantly. Process improvements developed for data acquisition, credentialing, and data management have provided the necessary infrastructure for uniform data. With continued improvement in the technology and delivery of RT, evaluation processes for target definition, RT planning, and execution undergo constant review. As we move to multimodality image-based definitions of target volumes for protocols, future clinical trials will require near real-time image analysis and feedback to field investigators. The ability of quality assurance centers to meet these real-time challenges with robust electronic interaction platforms for imaging acquisition, review, archiving, and quantitative review of volumetric RT plans will be the primary challenge for future successful clinical trials. PMID:18406943

  9. Essentials of navigating and teaching surgical quality improvement.

    Raval, Mehul V; Kenney, Brian D

    2015-12-01

    Quality improvement (QI) has become a focus of contemporary surgical practice. The purpose of this review is to provide a framework of working knowledge regarding QI for the practicing surgeon. QI design, implementation methods, measurement tactics, statistical analysis, and presentation tools based on the Institute of Healthcare Improvement model are reviewed. Additional principles to optimize QI success such as fostering communication, building a culture of QI, leadership involvement, and financial planning are also explored. Lastly, resources for QI education and teaching are provided for those interested in learning more about this expanding field. PMID:26653159

  10. Improving operator quality at Genkai Nuclear Power Plant

    Improvement in operator quality, or improvement in an operator's skill and professional knowledge, is of prime importance because of its great influence on safe and steady plant operation. This paper describes the education and training of reactor operators at the Genkai pressurized water reactor nuclear power plant with respect to the following topics: organization of Genkai power plant; education and training program management; training at the Nuclear Training Center; training and education on-site including emergency procedures training, normal operating procedures training, informational study of emergency conditions in existing plants, and all-around training of operators; qualifying tests for supervisors; and operator motivation

  11. 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.

  12. 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

  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 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.

  15. 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.

  16. Power Quality Improvement of a Distributed Generation Power System

    Panga Harish

    2016-06-01

    Full Text Available 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 such as harmonics, flicker, swells, sags and voltage asymmetries. Distributed Generation (DG also called as site generation, dispersed generation, embedded generation, decentralized generation, decentralized energy or distributed energy, generates electricity from the many small energy sources. In recent years, micro electric power systems such as photovoltaic generation systems, wind generators and micro gas turbines, etc., have increased with the deregulation and liberalization of the power market. Under such circumstances the environment surrounding the electric power industry has become ever more complicated and provides high-quality power in a stable manner which becomes an important topic. Here DG is assumed to include Wind power Generation (WG and Fuel Cells (FC, etc. Advantages of this system are constant power supply, constant voltage magnitude, absence of harmonics insupply voltage, un-interrupted power supply. In this project the electric power qualities in two cases will be compared. Case I: With the storage battery when it is introduced. Case II: Without the storage battery. The storage battery executes the control that maintains the voltage in the power system. It will be found that the Electric power quality will be improved, when storage battery is introduced. The model system used in this Project work is composed of a Wind Turbine, an Induction Generator, Fuel Cells, An Inverter and a Storage Battery. A miniature Wind Power Generator is

  17. 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...

  18. German Bowel Cancer Center: An Attempt to Improve Treatment Quality

    Olof Jannasch; Andrej Udelnow; Stefanie Wolff; Hans Lippert; Pawel Mroczkowski

    2015-01-01

    Background. Colorectal cancer remains the second most common cause of death from malignancies, but treatment results show high diversity. Certified bowel cancer centres (BCC) are the basis of a German project for improvement of treatment. The aim of this study was to analyze if certification would enhance short-term outcome in rectal cancer surgery. Material and Methods. This quality assurance study included 8197 patients with rectal cancer treated between 1 January 2008 and 31 December 2010....

  19. Global initiatives for improving hospital care for children: state of the art and future prospects

    Campbell, Harry; Duke, Trevor; Weber, Martin; English, Mike; Carai, Susanne; Tamburlini, Giorgio

    2008-01-01

    Deficiencies in the quality of health care are major limiting factors to the achievement of the Millennium Development Goals for child and maternal health. Quality of patient care in hospitals is firmly on the agendas of Western countries, but has been slower to gain traction in developing countries, despite evidence that there is substantial scope for improvement, that hospitals have a major role in child survival and that inequities in quality may be as important as inequities in access. Th...

  20. Global initiatives for improving hospital care for children: State of the art and future prospects

    Campbell, Harry; Duke, Trevor; Weber, Martin; English, Mike; Carai, Susanne; Tamburlini, Giorgio; Pediat Hosp Improvement Grp

    2008-01-01

    Deficiencies in the quality of health care are major limiting factors to the achievement of the Millennium Development Goals for child and maternal health. Quality of patient care in hospitals is firmly on the agendas of Western countries but has been slower to gain traction in developing countries, despite evidence that there is substantial scope for improvement, that hospitals have a major role in child survival, and that inequities in quality may be as important as inequities in access. Th...

  1. 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.

  2. 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

  3. 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.

  4. German Bowel Cancer Center: An Attempt to Improve Treatment Quality

    Olof Jannasch

    2015-01-01

    Full Text Available Background. Colorectal cancer remains the second most common cause of death from malignancies, but treatment results show high diversity. Certified bowel cancer centres (BCC are the basis of a German project for improvement of treatment. The aim of this study was to analyze if certification would enhance short-term outcome in rectal cancer surgery. Material and Methods. This quality assurance study included 8197 patients with rectal cancer treated between 1 January 2008 and 31 December 2010. We compared cohorts treated in certified and noncertified hospitals regarding preoperative variables and perioperative outcomes. Outcomes were verified by matched-pair analysis. Results. Patients of noncertified hospitals had higher ASA-scores, higher prevalence of risk factors, more distant metastases, lower tumour localization, lower frequency of pelvic MRI, and higher frequencies of missing values and undetermined TNM classifications (significant differences only. Outcome analysis revealed more general complications in certified hospitals (20.3% versus 17.4%, p=0.03. Both cohorts did not differ significantly in percentage of R0-resections, intraoperative complications, anastomotic leakage, in-hospital death, and abdominal wall dehiscence. Conclusions. The concept of BCC is a step towards improving the structural and procedural quality. This is a good basis for improving outcome quality but cannot replace it. For a primary surgical disease like rectal cancer a specific, surgery-targeted program is still needed.

  5. An Improved Sequential Initiation Method for Multitarget Track in Clutter with Large Noise Measurement

    Daxiong Ji

    2014-01-01

    Full Text Available This paper proposes an improved sequential method for underwater multiple objects tracks initiation in clutter, estimating the initial position for the trajectory. The underwater environment is complex and changeable, and the sonar data are not very ideal. When the detection distance is far, the error of measured data is also great. Besides that, the clutter has a grave effect on the tracks initiation. So it is hard to initialize a track and estimate the initial position. The new tracks initiation is that when at least six of ten points meet the requirements, then we determine that there is a new track and the initial states of the parameters are estimated by the linear least square method. Compared to the conventional tracks initiation methods, our method not only considers the kinematics information of targets, but also regards the error of the sonar sensors as an important element. Computer simulations confirm that the performance of our method is very nice.

  6. 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…

  7. 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

  8. 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.

  9. Evaluating the Quality of Colorectal Cancer Care in the State of Florida: Results From the Florida Initiative for Quality Cancer Care

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

    2012-01-01

    Although the quality of care delivered within the Florida Initiative for Quality Cancer Care practices seems to be high, several components of care were identified that warrant further scrutiny on a systemic level and at individual centers.

  10. 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

  11. 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)

  12. Through Their Eyes: Lessons Learned Using Participatory Methods in Health Care Quality Improvement Projects.

    Balbale, Salva N; Locatelli, Sara M; LaVela, Sherri L

    2016-08-01

    In this methodological article, we examine participatory methods in depth to demonstrate how these methods can be adopted for quality improvement (QI) projects in health care. We draw on existing literature and our QI initiatives in the Department of Veterans Affairs to discuss the application of photovoice and guided tours in QI efforts. We highlight lessons learned and several benefits of using participatory methods in this area. Using participatory methods, evaluators can engage patients, providers, and other stakeholders as partners to enhance care. Participant involvement helps yield actionable data that can be translated into improved care practices. Use of these methods also helps generate key insights to inform improvements that truly resonate with stakeholders. Using participatory methods is a valuable strategy to harness participant engagement and drive improvements that address individual needs. In applying these innovative methodologies, evaluators can transcend traditional approaches to uniquely support evaluations and improvements in health care. PMID:26667882

  13. Impact of mentorship on WHO-AFRO Strengthening Laboratory Quality Improvement Process Towards Accreditation (SLIPTA

    Talkmore Maruta

    2011-12-01

    Full Text Available Background: The improvment of the quality of testing services in public laboratories is a high priority in many countries. Consequently, initiatives to train laboratory staff on quality management are being implemented, for example, the World Health Organization Regional Headquarters for Africa (WHO-AFRO Strengthening Laboratory Management Towards Accreditation (SLMTA. Mentorship may be an effective way to augment these efforts. Methods: Mentorship was implemented at four hospital laboratories in Lesotho, three districts and one central laboratory, between June 2009 and December 2010. The mentorship model that was implemented had the mentor fully embedded within the operations of each of the laboratories. It was delivered in a series of two mentoring engagements of six and four week initial and follow-up visits respectively. In total, each laboratory received 10 weeks mentorship that was separated by 6–8 weeks. Quality improvements were measured at baseline and at intervals during the mentorship using the WHO-AFRO Strengthening Laboratory Quality Improvement Process Towards Accreditation (SLIPTA checklist and scoring system. Results: At the beginning of the mentorship, all laboratories were at the SLIPTA zero star rating. After the initial six weeks of mentorship, two of the three district laboratories had improved from zero to one (out of five star although the difference between their baseline (107.7 and the end of the six weeks (136.3 average scores was not statistically significant (p = 0.25. After 10 weeks of mentorship there was a significant improvement in average scores (182.3; p = 0.034 with one laboratory achieving WHO-AFRO three out of a possible five star status and the two remaining laboratories achieving a two star status. At Queen Elizabeth II (QE II Central Laboratory, the average baseline score was 44%, measured using a section-specific checklist. There was a significant improvement by five weeks (57.2%; p = 0.021. Conclusion

  14. 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 the improvement of medical diagnostic imaging, cost containment, and reduction of radiation exposure. Concurrently, WHO prepared Technical Specifications for the X-ray Apparatus to be Used in a Basic Radiological System (BRS), governed by concepts of ''design maintenance'' and ''design-in quality assurance''. The outcome of WHO's efforts, indicates that, accessibility and image quality should be improved. Regarding cost containment, elimination of many logistical and support requirements should result in considerable savings. Using entrance skin exposure as an indicator, an important finding is that with the WHO-BRS type X-ray equipment, in most cases patient exposure was less than average values in the United States. The comparison between objectives and results shows that the WHO-BRS performs exceptionally well. (author)

  15. 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....

  16. Context Matters: Practitioner Perspectives on Immunization Delivery Quality Improvement Efforts.

    Gingold, Janet A; Briccetti, Christine; Zook, Kathleen; Gillespie, Catherine W; Gubernick, Ruth S; Moon, Rachel Y; Fu, Linda Y

    2016-08-01

    Uneven adherence to immunization guidelines might leave some communities vulnerable to outbreaks of vaccine-preventable diseases. To examine factors related to implementation of immunization delivery best practices, we analyzed responses to monthly surveys and debriefing interviews from 16 diverse pediatric practices engaged in a year-long virtual learning collaborative. The collaborative provided a toolkit, online learning sessions, performance feedback, and conference calls with a quality improvement coach. Participants used iterative plan-do-study-act cycles to implement self-selected changes in immunization practices. Descriptive statistics were applied to quantitative data; qualitative data were analyzed using a framework approach. Impediments to implementing guidelines included difficulties with electronic record systems, rigid management structures, competing priorities, and parental resistance. Facilitators included linkage with regional immunization registries, positive social interactions, and performance feedback. Findings suggest that improving immunization delivery requires not only awareness of recommendations and training in improvement methods but also efforts to ameliorate contextual factors that impede immunization delivery. PMID:26743455

  17. 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

  18. Quality improvement in radiography in a neonatal intensive care unit

    Loovere, L.; Boyle, E.M. [Dept. of Pediatrics, McMaster Univ., Hamilton, Ontario (Canada); Blatz, S. [Dept. of Pediactrics, McMaster Children' s Hospital, Hamilton Health Sciences, Hamilton, Ontario (Canada); Bowslaugh, M.; Kereliuk, M. [Dept. of Radiology, Diagnostic Imaging, Hamilton Health Sciences, Hamilton, Ontario (Canada); Paes, B. [Dept. of Pediatrics, McMaster Univ., Hamilton, Ontario (Canada)], E-mail: paes@mcmaster.ca

    2008-10-15

    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)

  19. 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)

  20. 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.

  1. 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.

  2. 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

  3. 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.

  4. Improving the Effectiveness of Libraries through Improvements in the Quality of Working Life.

    Martell, Charles

    1981-01-01

    The implementation of work redesign techniques described or similar advanced methods of organization and work system design should allow academic libraries to respond more effectively to rapid changes in user demand and improve the quality of working life of their employees. Included are 44 references. (Author/RAA)

  5. 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

  6. Quality Improvement of Pork Loin by Dry Aging

    Jo, Cheorun; Lee, Kyung Haeng; You, Insin

    2016-01-01

    This study aimed to investigate the effects of dry aging on the quality of pork loin. Longissimus lumborum muscles were dissected from the right half of five pork carcasses and were used as the control samples. The left halves of the carcasses were aged at 2±1℃ and a relative humidity of 80% for 40 d. The total aerobic bacteria count was similar between the control and dry-aged pork loin (p>0.05). Lactic-acid bacteria was absent in both the control and dry-aged pork loins. Dry-aged pork loin contained low moisture and high protein and ash compared to the controls (p0.05). Dry-aged pork loin had lower hardness and shear force and received higher core in sensory evaluation than the control (p<0.05). According to the results, dry aging improved textural and sensorial quality of pork loin.

  7. 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.

  8. Improving the quality of manually acquired data: Applying the theory of planned behaviour to data quality

    Murphy, Glen D. [Cooperative Research Centre for Integrated Engineering Asset Management (CIEAM), School of Management, Queensland University of Technology, PO Box 2434, Brisbane 4001 (Australia)], E-mail: gd.murphy@qut.edu.au

    2009-12-15

    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.

  9. 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.

  10. 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

  11. Does the UK Local Finance Improvement Trust (Lift)Initiative Improve Risk Management in Public-Private Procurement?

    Fitzsimmons, D.; S. Brown; Beck, M.

    2009-01-01

    The UK government introduced the Private Finance Initiative (PFI) and, latterly, the Local Improvement Finance Trust (LIFT) in an attempt to improve public service provision. As a variant of PFI, LIFT seeks to create a framework for the effective provision of primary care facilities. Like conventional PFI procurement, LIFT projects involve long-term contracts, complex multi-party interactions and thus create various risks to public sector clients. This paper investigates the advantages and di...

  12. 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

  13. Can mental healthcare nurses improve sleep quality for inpatients?

    de Niet, Gerrit; Tiemens, Bea; Hutschemaekers, Giel

    This article describes a pilot study that was carried out to in order to gain an indication as to whether mental healthcare nurses can apply evidence-based interventions for sleep problems effectively in inpatient mental health care. The study had a pre-test/post-test design and a comparison group was used. The study was performed on three psychiatric admission wards, located in three different towns in one province of The Netherlands. The participants were inpatients (18-60 years old) admitted owing to severe mental health problems like psychotic, mood or anxiety disorders. Of the newly admitted patients, 62.8% perceived having a sleep problem. Two brief, evidence-based interventions were introduced on two of the wards: the first with stimulus control (SC) as active component; the second with music-assisted relaxation (MAR). A third ward, with no interventions other than usual care, served as a point of comparison. Sleep quality was monitored using the Richards-Campbell Sleep Questionnaire (RCSQ). The change score means of the treatment groups were compared with the mean score of the comparison group by means of a t-test. Estimates of effect were calculated. The results of this study showed that MAR produced a statistically significant improvement of sleep quality and showed a large effect size. The total RCSQ score did not improve significantly. SC failed to produce statistically significant improvement of sleep quality, nor of the RCSQ total score. This pilot study provided a strong indication that mental health nurses can apply MAR effectively. No such indication was found for stimulus control. PMID:20871513

  14. 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

  15. Lead/acid batteries in systems to improve power quality

    Taylor, P.; Butler, P.; Nerbun, W.

    Increasing dependence on computer technology is driving needs for extremely high-quality power to prevent loss of information, material, and workers' time that represent billions of dollars annually. This cost has motivated commercial and Federal research and development of energy storage systems that detect and respond to power-quality failures in milliseconds. Electrochemical batteries are among the storage media under investigation for these systems. Battery energy storage systems that employ either flooded lead/acid or valve-regulated lead/acid battery technologies are becoming commercially available to capture a share of this emerging market. Cooperative research and development between the US Department of Energy and private industry have led to installations of lead/acid-based battery energy storage systems to improve power quality at utility and industrial sites and commercial development of fully integrated, modular battery energy storage system products for power quality. One such system by AC Battery Corporation, called the PQ2000, is installed at a test site at Pacific Gas and Electric Company (San Ramon, CA, USA) and at a customer site at Oglethorpe Power Corporation (Tucker, GA, USA). The PQ2000 employs off-the-shelf power electronics in an integrated methodology to control the factors that affect the performance and service life of production-model, low-maintenance, flooded lead/acid batteries. This system, and other members of this first generation of lead/acid-based energy storage systems, will need to compete vigorously for a share of an expanding, yet very aggressive, power quality market.

  16. Building knowledge for quality improvement in healthcare: an introductory glossary.

    Batalden, P B

    1991-01-01

    At the heart of organization-wide quality improvement in healthcare is the need to build knowledge for improvement that complements the subject matter knowledge of healthcare. Dr. W. Edwards Deming, the quality improvement pioneer, has suggested that "profound knowledge," or knowledge required for improvement, consists of four basic dimensions: Knowledge of the organization as a system. At its heart this knowledge is an understanding of the methods of production, the methods of improvement, and the aim of the entire enterprise. This concept was first presented by Deming at Mount Hakone, Japan, in 1950. In his book Out of the Crisis (1986), Deming illustrates the organization as a system. Knowledge of variation. This understanding comes from the awareness that a system of causes is at work producing any result. These sources of the variation, which can be observed in any process, are what must be acted upon to improve the results of the process. Studying the variation in a process can provide clues to the most economical actions that managers can take for improvement. It involves knowledge of the difference between common and special cause variation. Knowledge of psychology. The focus is on an awareness of the power of intrinsic motivation, a sense of self-worth and pride in what is done in the workplace. Theory of knowledge. How is new knowledge built? What is the purpose of knowledge? What is the nature of knowledge? Unless these issues are clear, it will not be easy to build useful knowledge. Deming has provided further insight into this framework in a recent unpublished essay and is currently working to further expand these concepts in additional publications in preparation. This framework helps build the knowledge necessary for the improvement of healthcare. As you work to build that knowledge, however, you will confront a wide variety of terms and a language that may in some ways be unfamiliar. In recognition of that, an introductory glossary is offered for

  17. The Quality Improvement of Stony Construction and Demolition Waste (CDW)

    XING Wei-hong; Alex Fraaij; Hans Pietersen; Peter Rem; Koen Van Dijk

    2004-01-01

    Worldwide construction and demolition waste (CDW) is currently dumped. To close the building cycle and the building materials cycle by recycling CDW in high technical applications, the technical quality of stony materials must be improved. For this purpose, concrete rubbles and brick rubbles, the two major stony constituents of CDW, should be separated from each other. Based on the differences in density and content of Fe2O3 between the two materials, a wet method of jigging and a dry method of magnetic separation are effective,tested.

  18. 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

  19. 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

  20. Improvement of graphene quality synthesized by cluster ion implantation

    Graphene was prepared by negative C4 cluster ion implantation at 5 keV/atom followed by vacuum thermal annealing and cooling. The surface morphology and structure of samples were studied by scanning electron microscopy, atomic force microscopy, and Raman spectroscopy. Improvement of the graphene quality was realized by optimization of the post thermal processes. 1–2 layer graphene was obtained with I2D/IG ratio of 1.43 and ID/IG ratio of 0.07 at the implantation dose of 12 × 1015 atoms/cm2 and annealed at 900 °C followed by cooling at 20 °C/min

  1. Improving the quality of pork and pork products (EU-project)

    Christensen, M.; Grunert, Klaus G.; Bonneau, M.;

    Quality of pork has become a complex and dynamic theme involving the total pork chain from fork-to-farm-to-fork with a multitude of interacting aspects related to people's demands as consumers, and the demands of people as citizens and producers for economic and environmental sustainability. The...... European Unions self-sufficiency and leading position in the global market for pork and pork products is challenged by a number of non-European countries. Therefore, there is a need for developing innovative, integrated, and sustainable food production chains of high quality pork products matching consumer...... demands. A large EU-project (Q-PorkChains) funded by EU 6th framework programme was initiated in January 2007. The aim of Q-PorkChains is to improve the quality of pork and its products for the consumer and to develop innovative, integrated and sustainable food production chains with low environmental...

  2. 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

  3. 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)

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

    Li, Ian; Medynskiy, Yevgeniy; Froehlich, Jon;

    2012-01-01

    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...... 2010 and CHI 2011 workshops on personal informatics [6][7]. The focal themes for this workshop are: (1) practical lessons from previous research and development experiences that can guide interface design for systems that allow users to collect and reflect on personal data; (2) requirements for...

  5. A New Framework for improving low Quality Fingerprint Images

    JitendraChoudhary

    2011-11-01

    Full Text Available Fingerprints are the oldest and most widely used form of biometric identification. A fingerprint image may not always be well defined due to elements of noise that corrupts the clarity of the ridge structures or basic information, which is required for recognition. Noise may occur due to variations in skin and impression condition. Thus, image enhancement techniques are often used to reduce the noise and enhance the structure of ridges and valleys for minutiae detection. in this paper, we present a fingerprint image enhancement method which can adaptively improve the clarity of ridge and furrow structures of input fingerprint image based on the frequency and spatial domain filtering , local orientation estimation , local frequency estimation and morphological operation. There set of operation applied on own database DB-Finger that Improve the quality of fingerprint Image

  6. Quality improvement in small office settings: an examination of successful practices

    Sofaer Shoshanna

    2009-02-01

    Full Text Available Abstract Background Physicians in small to moderate primary care practices in the United States (U.S. ( Methods We undertook a qualitative study, based on semi-structured, open-ended interviews conducted with practices (N = 39 that used performance data to drive quality improvement activities. Results Physicians indicated that benefits to performing measurement and QI included greater practice efficiency, patient and staff retention, and higher staff and clinician satisfaction with practice. Internal facilitators included the designation of a practice champion, cooperation of other physicians and staff, and the involvement of practice leaders. Time constraints, cost of activities, problems with information management and or technology, lack of motivated staff, and a lack of financial incentives were commonly reported as barriers. Conclusion These findings shed light on how physicians engage in quality improvement activities, and may help raise awareness of and aid in the implementation of future initiatives in small practices more generally.

  7. 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.

  8. 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...

  9. Quality of life is social--towards an improvement of social abilities in patients with epilepsy.

    Szemere, Emily; Jokeit, Hennric

    2015-03-01

    Quality of life (QoL) for people with epilepsy is considered worse than the condition's clinical and medical prognosis would predict. Quantity and quality of social interaction considerably determine QoL. Research shows that a significant proportion of patients with epilepsy experience difficulties with social functioning that is thought to be related to impaired QoL. The aim of this review article is to provide an evidence base for conceptualising and developing interventions to improve quality of life through social functioning, for adults with epilepsy. Previous and current research is considered initially with regards to why such difficulties arise and established interventions that address social competence and functioning are reviewed and explored from the field of schizophrenia, a condition also associated with similar difficulties in social cognition, cognition and negative symptoms. The paper considers the advantages and disadvantages of these interventions, the outcomes and emerging research in this area. Positive findings are found from interventional studies in schizophrenia such as the enhancing potential and generalisation of training in social cognition, the benefits of an integrated approach to improving social functioning and proposal of 'online' interaction approaches. These findings provide interesting and exciting directions for the ultimate goal towards interventions for the improvement of social functioning and quality of life in patients with epilepsy. This is of particular significance as at present there is currently no such dedicated program for people with epilepsy. PMID:25799896

  10. 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 .

  11. Working toward a sustainable laboratory quality improvement programme through country ownership: Mozambique’s 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

  12. 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.

  13. Improving Quality of Clustering using Cellular Automata for Information retrieval

    P. K. Sree

    2008-01-01

    Full Text Available Clustering has been widely applied to Information Retrieval (IR on the grounds of its potential improved effectiveness over inverted file search. Clustering is a mostly unsupervised procedure and the majority of the clustering algorithms depend on certain assumptions in order to define the subgroups present in a data set .A clustering quality measure is a function that, given a data set and its partition into clusters, returns a non-negative real number representing the quality of that clustering. Moreover, they may behave in a different way depending on the features of the data set and their input parameters values. Therefore, in most applications the resulting clustering scheme requires some sort of evaluation as regards its validity. The quality of clustering can be enhanced by using a Cellular Automata Classifier for information retrieval. In this study we take the view that if cellular automata with clustering is applied to search results (query-specific clustering, then it has the potential to increase the retrieval effectiveness compared both to that of static clustering and of conventional inverted file search. We conducted a number of experiments using ten document collections and eight hierarchic clustering methods. Our results show that the effectiveness of query-specific clustering with cellular automata is indeed higher and suggest that there is scope for its application to IR.

  14. Improving UK Air Quality Modelling Through Exploitation of Satellite Observations

    Pope, R.; Chipperfield, M.; Savage, N.

    2012-12-01

    The Met Office's operational regional Air Quality Unified Model (AQUM) contains a description of atmospheric chemistry/aerosols which allows for the short-term forecast of chemical weather (e.g. high concentrations of ozone or nitrogen dioxide, which can trigger warnings of poor air quality). AQUM's performance has so far only been tested against a network of surface monitoring stations. Therefore, with recent improvements in the quality and quantity of satellite measurements, data products (e.g. tropospheric columns, vertical profiles) from several satellite instruments will be used to test the performance of the model. First comparisons between an AQUM simulation for the UK heatwave event of July 2006 and data from OMI, TES (both on AURA) and MODIS (on AQUA) have identified multiple model-satellite biases. The chemical/aerosol species investigated for this simulation include nitrogen dioxide (NO2), ozone (O3), formaldehyde (HCHO), carbon monoxide (CO) and aerosol optical depth (AOD) at 0.55 microns wavelength. NO2 spatial positive mean biases (AQUM-OMI July 2006 monthly mean tropospheric columns) over north- east England suggest model overestimation in the area's urban regions. Currently, sensitivity tests of the NOx emission datasets are investigating these biases and the model's represent of urban pollution. In the UK O3 monthly mean vertical profile comparisons (AQUM-TES), strong positive mean biases are detected in the upper troposphere/lower stratosphere. Since the AQUM does not use a stratospheric chemistry scheme, the satellite climatological vertical boundary conditions will be investigated (e.g. test the model with new boundary conditions using multiple satellite instruments or perturb existing climatologies). Comparisons of HCHO (AQUM-OMI monthly mean tropospheric columns) biases highlight strong negative biases over continental Europe and sporadic positive biases in the south-east lateral boundary conditions. Therefore, evaluation and development of

  15. 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

  16. (abstract) Mission Operations and Control Assurance: Flight Operations Quality Improvements

    Welz, Linda L.; Bruno, Kristin J.; Kazz, Sheri L.; Witkowski, Mona M.

    1993-01-01

    Mission Operations and Command Assurance (MO&CA), a recent addition to flight operations teams at JPL. provides a system level function to instill quality in mission operations. MO&CA's primary goal at JPL is to help improve the operational reliability for projects during flight. MO&CA tasks include early detection and correction of process design and procedural deficiencies within projects. Early detection and correction are essential during development of operational procedures and training of operational teams. MO&CA's effort focuses directly on reducing the probability of radiating incorrect commands to a spacecraft. Over the last seven years at JPL, MO&CA has become a valuable asset to JPL flight projects. JPL flight projects have benefited significantly from MO&CA's efforts to contain risk and prevent rather than rework errors. MO&CA's ability to provide direct transfer of knowledge allows new projects to benefit directly from previous and ongoing experience. Since MO&CA, like Total Quality Management (TQM), focuses on continuous improvement of processes and elimination of rework, we recommend that this effort be continued on NASA flight projects.

  17. 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.

  18. 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.

  19. The Implementation of Quality Management Initiatives in the Context of Organisational Learning.

    Roche, Evelyn

    2002-01-01

    An Irish company embarked on implementing a business excellence model and continuous improvement initiatives. Some employees' reluctance to participate impeded organizational learning, but the creation of a culture that encouraged, facilitated, and rewarded learning enabled movement toward excellence. (Contains 64 references.) (SK)

  20. 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)

  1. 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.

  2. A framework for healthcare quality improvement in India: the time is here and now!

    Varkey, P; Kollengode, A

    2011-01-01

    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. PMID:21941069

  3. 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

  4. Bevacizumab Improves Quality of Life in Patients with Recurrent Glioblastoma

    Seema Nagpal

    2011-01-01

    Full Text Available Objective. To quantify the benefits in survival and quality of life in patients receiving bevacizumab (BEV for recurrent glioblastoma (GBM. Methods. This is a retrospective study of 40 adult patients with recurrent GBM treated between 2005 and 2009 at a single institution. All patients had initial treatment with surgery, radiation, and concurrent temozolomide, then monthly temozolomide. Over 250 charts were screened. Sufficient data was available for 20 patients treated with BEV and 20 patients who did not receive BEV at the time of recurrence. The independent living score (ILS, designed to reward long-term independent survival, was calculated for each patient. Results. The mean ILS was nearly double in the BEV group compared to the No-BEV group (15.0 versus 8.2, =0.002, t-test. Two months after initiation of therapy, the median steroid dose dropped by over 90% in patients treated with BEV, but doubled in the NoBEV group. Median survival from the time of recurrence was significantly affected: 10.6 months in the BEV group versus 4.2 months (<0.001, log rank survival in the NoBEV group. Conclusions. BEV increases independent living and lengthens overall survival after GBM recurrence. Reduction in steroid dose may contribute to prolonged independence.

  5. 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

  6. Iterative reconstruction techniques for computed tomography part 2: initial results in dose reduction and image quality

    Willemink, Martin J.; Leiner, Tim; Jong, Pim A. de; Nievelstein, Rutger A.J.; Schilham, Arnold M.R. [Utrecht University Medical Center, Department of Radiology, P.O. Box 85500, Utrecht (Netherlands); Heer, Linda M. de [Cardiothoracic Surgery, Utrecht (Netherlands); Budde, Ricardo P.J. [Utrecht University Medical Center, Department of Radiology, P.O. Box 85500, Utrecht (Netherlands); Gelre Hospital, Department of Radiology, Apeldoorn (Netherlands)

    2013-06-15

    To present the results of a systematic literature search aimed at determining to what extent the radiation dose can be reduced with iterative reconstruction (IR) for cardiopulmonary and body imaging with computed tomography (CT) in the clinical setting and what the effects on image quality are with IR versus filtered back-projection (FBP) and to provide recommendations for future research on IR. We searched Medline and Embase from January 2006 to January 2012 and included original research papers concerning IR for CT. The systematic search yielded 380 articles. Forty-nine relevant studies were included. These studies concerned: the chest(n = 26), abdomen(n = 16), both chest and abdomen(n = 1), head(n = 4), spine(n = 1), and no specific area (n = 1). IR reduced noise and artefacts, and it improved subjective and objective image quality compared to FBP at the same dose. Conversely, low-dose IR and normal-dose FBP showed similar noise, artefacts, and subjective and objective image quality. Reported dose reductions ranged from 23 to 76 % compared to locally used default FBP settings. However, IR has not yet been investigated for ultra-low-dose acquisitions with clinical diagnosis and accuracy as endpoints. Benefits of IR include improved subjective and objective image quality as well as radiation dose reduction while preserving image quality. Future studies need to address the value of IR in ultra-low-dose CT with clinically relevant endpoints. (orig.)

  7. Improving Health Promotion Using Quality Improvement Techniques in Australian Indigenous Primary Health Care.

    Percival, Nikki; O'Donoghue, Lynette; Lin, Vivian; Tsey, Komla; Bailie, Ross Stewart

    2016-01-01

    Although some areas of clinical health care are becoming adept at implementing continuous quality improvement (CQI) projects, there has been limited experimentation of CQI in health promotion. In this study, we examined the impact of a CQI intervention on health promotion in four Australian Indigenous primary health care centers. Our study objectives were to (a) describe the scope and quality of health promotion activities, (b) describe the status of health center system support for health promotion activities, and (c) introduce a CQI intervention and examine the impact on health promotion activities and health centers systems over 2 years. Baseline assessments showed suboptimal health center systems support for health promotion and significant evidence-practice gaps. After two annual CQI cycles, there were improvements in staff understanding of health promotion and systems for planning and documenting health promotion activities had been introduced. Actions to improve best practice health promotion, such as community engagement and intersectoral partnerships, were inhibited by the way health center systems were organized, predominately to support clinical and curative services. These findings suggest that CQI can improve the delivery of evidence-based health promotion by engaging front line health practitioners in decision-making processes about the design/redesign of health center systems to support the delivery of best practice health promotion. However, further and sustained improvements in health promotion will require broader engagement of management, senior staff, and members of the local community to address organizational and policy level barriers. PMID:27066470

  8. Atmospheric Motion Vectors from INSAT-3D: Initial quality assessment and its impact on track forecast of cyclonic storm NANAUK

    Deb, S. K.; Kishtawal, C. M.; Kumar, Prashant; Kiran Kumar, A. S.; Pal, P. K.; Kaushik, Nitesh; Sangar, Ghansham

    2016-03-01

    The advanced Indian meteorological geostationary satellite INSAT-3D was launched on 26 July 2013 with an improved imager and an infrared sounder and is placed at 82°E over the Indian Ocean region. With the advancement in retrieval techniques of different atmospheric parameters and with improved imager data have enhanced the scope for better understanding of the different tropical atmospheric processes over this region. The retrieval techniques and accuracy of one such parameter, Atmospheric Motion Vectors (AMV) has improved significantly with the availability of improved spatial resolution data along with more options of spectral channels in the INSAT-3D imager. The present work is mainly focused on providing brief descriptions of INSAT-3D data and AMV derivation processes using these data. It also discussed the initial quality assessment of INSAT-3D AMVs for a period of six months starting from 01 February 2014 to 31 July 2014 with other independent observations: i) Meteosat-7 AMVs available over this region, ii) in-situ radiosonde wind measurements, iii) cloud tracked winds from Multi-angle Imaging Spectro-Radiometer (MISR) and iv) numerical model analysis. It is observed from this study that the qualities of newly derived INSAT-3D AMVs are comparable with existing two versions of Meteosat-7 AMVs over this region. To demonstrate its initial application, INSAT-3D AMVs are assimilated in the Weather Research and Forecasting (WRF) model and it is found that the assimilation of newly derived AMVs has helped in reduction of track forecast errors of the recent cyclonic storm NANAUK over the Arabian Sea. Though, the present study is limited to its application to one case study, however, it will provide some guidance to the operational agencies for implementation of this new AMV dataset for future applications in the Numerical Weather Prediction (NWP) over the south Asia region.

  9. Business process improvement methodology adoption for improving service quality: case studies of financial institutions in Thailand

    Buavaraporn, Nattapan

    2010-01-01

    To stay competitive and sustain long-term profitability, Business Process Improvement (BPI) methodologies have become strategically important for financial institutions in recent years. These include well-known approaches such as Total Quality Management (TQM), Business Process Reengineering (BPR), Six Sigma and Lean. The customer-focused themes of BPI should be of particular interest to service practitioners, in order to achieve both process excellence and superlative customer service. The a...

  10. Improvement in the Quality of Worklife and Productivity: A Joint Venture Between Management and Employees. Final Report.

    Glaser, Edward M.; And Others

    A 3-year research project conducted at a new pharmaceutical manufacturing plant was designed to determine whether quality of worklife (QWL) consultation provided to a new plant during its planning, staffing, organizing, and initial operation would contribute to improved job satisfaction and productivity as compared with a long-established, more…

  11. IMPROVING INITIAL GENERATIONS IN PSO ALGORITHM FOR TRANSPORTATION NETWORK DESIGN PROBLEM

    Navid Afkar

    2015-02-01

    Full Text Available Transportation Network Design Problem (TNDP aims to select the best project sets among a number of new projects. Recently, metaheuristic methods are applied to solve TNDP in the sense of finding better solutions sooner. PSO as a metaheuristic method is based on stochastic optimization and is a parallel revolutionary computation technique. The PSO system initializes with a number of random solutions and seeks for optimal solution by improving generations. This paper studies the behavior of PSO on account of improving initial generation and fitness value domain to find better solutions in comparison with previous attempts.

  12. [Improvement of medical processes with Six Sigma - practicable zero-defect quality in preparation for surgery].

    Sobottka, Stephan B; Töpfer, Armin; Eberlein-Gonska, Maria; Schackert, Gabriele; Albrecht, D Michael

    2010-01-01

    Six Sigma is an innovative management- approach to reach practicable zero- defect quality in medical service processes. The Six Sigma principle utilizes strategies, which are based on quantitative measurements and which seek to optimize processes, limit deviations or dispersion from the target process. Hence, Six Sigma aims to eliminate errors or quality problems of all kinds. A pilot project to optimize the preparation for neurosurgery could now show that the Six Sigma method enhanced patient safety in medical care, while at the same time disturbances in the hospital processes and failure costs could be avoided. All six defined safety relevant quality indicators were significantly improved by changes in the workflow by using a standardized process- and patient- oriented approach. Certain defined quality standards such as a 100% complete surgical preparation at start of surgery and the required initial contact of the surgeon with the patient/ surgical record on the eve of surgery could be fulfilled within the range of practical zero- defect quality. Likewise, the degree of completion of the surgical record by 4 p.m. on the eve of surgery and their quality could be improved by a factor of 170 and 16, respectively, at sigma values of 4.43 and 4.38. The other two safety quality indicators "non-communicated changes in the OR- schedule" and the "completeness of the OR- schedule by 12:30 a.m. on the day before surgery" also show an impressive improvement by a factor of 2.8 and 7.7, respectively, corresponding with sigma values of 3.34 and 3.51. The results of this pilot project demonstrate that the Six Sigma method is eminently suitable for improving quality of medical processes. In our experience this methodology is suitable, even for complex clinical processes with a variety of stakeholders. In particular, in processes in which patient safety plays a key role, the objective of achieving a zero- defect quality is reasonable and should definitely be aspirated. PMID

  13. PEDAGOGICAL RESEARCH: IN SEARCH FOR MEANS OF QUALITY IMPROVEMENT

    Vladislav V. Serikov

    2015-01-01

    Full Text Available The aim of the investigation is to disclose lacks of dissertational works on pedagogics and to show possible ways of improvement of their quality.Results. It is stated that despite high volume and a variety of dissertational researches on pedagogical sciences, efficiency of their influence on education practice still remains rather low. The reason is low degree of quality of researches as many researches do not stimulate occurrence of innovations and growth of quality of education. As shown in the article the basic lacks that obstruct practical application are the following: a triviality and the unsubstantiated character, and insufficient novelty and excessive « scientificity». The author finds out the process and result of the most widespread type of the pedagogical research devoted to process of formation of personal quality, a kind of cultural experience or any pupils’ competence. The result of pedagogical research should contain criteria characteristic: the purposes of this process; maintenances of «transferred» experience; psychological conditions of its mastering; the description of system of pedagogical means and the receptions providing actualisation of these conditions; criteria and indicators of productivity of process; requirements to the teachers who are carrying out this process, and characteristics of pupils for which the offered technique is the most effective. The typical errors made by authors of researches are listed: psychological conditions (common factors, mechanisms of expected innovations are not revealed; as a result the choice of means has no sufficient bases and reached effect can be a simple accident; authors do not provide evidence of changes that have resulted from application of any stated technique; the role of personal and professional qualities of the researcher are not pointed out, though it always takes a considerable place n pedagogical systems.cientific novelty. The paper is rather useful as the author

  14. A variation reduction allocation model for quality improvement to minimize investment and quality costs by considering suppliers’ learning curve

    Rosyidi, C. N.; Jauhari, WA; Suhardi, B.; Hamada, K.

    2016-02-01

    Quality improvement must be performed in a company to maintain its product competitiveness in the market. The goal of such improvement is to increase the customer satisfaction and the profitability of the company. In current practice, a company needs several suppliers to provide the components in assembly process of a final product. Hence quality improvement of the final product must involve the suppliers. In this paper, an optimization model to allocate the variance reduction is developed. Variation reduction is an important term in quality improvement for both manufacturer and suppliers. To improve suppliers’ components quality, the manufacturer must invest an amount of their financial resources in learning process of the suppliers. The objective function of the model is to minimize the total cost consists of investment cost, and quality costs for both internal and external quality costs. The Learning curve will determine how the employee of the suppliers will respond to the learning processes in reducing the variance of the component.

  15. Organization Complexity and Primary Care Providers' Perceptions of Quality Improvement Culture Within the Veterans Health Administration.

    Korom-Djakovic, Danijela; Canamucio, Anne; Lempa, Michele; Yano, Elizabeth M; Long, Judith A

    2016-03-01

    This study examined how aspects of quality improvement (QI) culture changed during the introduction of the Veterans Health Administration (VHA) patient-centered medical home initiative and how they were influenced by existing organizational factors, including VHA facility complexity and practice location. A voluntary survey, measuring primary care providers' (PCPs') perspectives on QI culture at their primary care clinics, was administered in 2010 and 2012. Participants were 320 PCPs from hospital- and community-based primary care practices in Pennsylvania, West Virginia, Delaware, New Jersey, New York, and Ohio. PCPs in community-based outpatient clinics reported an improvement in established processes for QI, and communication and cooperation from 2010 to 2012. However, their peers in hospital-based clinics did not report any significant improvements in QI culture. In both years, compared with high-complexity facilities, medium- and low-complexity facilities had better scores on the scales assessing established processes for QI, and communication and cooperation. PMID:25414376

  16. Evaluation of a Practice-Development Initiative to Improve Breastfeeding Rates

    Barnes, Margaret; Cox, Julie; Doyle, Bronwyn; Reed, Rachel

    2010-01-01

    The benefits of breastfeeding for infant, mother, family, and community are well recognized, and increasing breastfeeding rates is considered an important health-promotion strategy. Improving breastfeeding knowledge and practice among individuals caring for breastfeeding women is considered an important aspect of this strategy. The practice-development initiative described in this article aimed to improve hospital-based breastfeeding rates through the implementation of The Ten Steps to Succes...

  17. Collective action initiatives to improve marketing performance: Lessons from farmer groups in Tanzania

    Barham, James; Chitemi, Clarence

    2008-01-01

    "The primary inquiry of this study is to identify and understand the underlying factors that enable smallholder farmer groups to improve their market situation. The specific objective of this paper is to examine to what extent certain group characteristics and asset endowments facilitate collective action initiatives to improve group marketing performance. This objective is approached through an evaluation of a government-led program in Tanzania, which is attempting to increase smallholder fa...

  18. Implementation of biochemical screening to improve baking quality of barley

    Vincze, Éva; Dionisio, Giuseppe; Aaslo, Per;

    2011-01-01

    Barley (Hordeum vulgare) has the potential to offer considerable human nutritional benefits, especially as supplement to wheat-based breads. Under current commercial baking conditions it is not possible to introduce more that 20% barley flour to the wheat bread without negative impact on the...... physical chemical properties of the bread products due to the poor baking properties of barley flour. As a consequence, the nutritional advantages of barley are not fully exploited. The inferior leavening and baking properties of barley can, in part, be attributed to the physical properties of the storage...... proteins. Changing the storage protein composition can lessen this problem. Our working hypothesis was that exploiting the substantial genetic variation within the gene pool for storage proteins could enable improving the baking qualities of barley flour. We characterised forty-nine barley cultivars for...

  19. Approaches to improving the nutritional quality of barley seed proteins

    The poor nutritional quality of barley grain is determined by the low level of lysine in the prolamin storage proteins (hordein). These account for between 35 to 50% of the total grain nitrogen, depending on the nutritional status of the plant. There is a reduced proportion of hordein in mutant high lysine lines but these also have reduced synthesis of storage carbohydrates and hence low yields. Three strategies for improvement are discussed. Increases in the lysine content of hordein may be difficult to achieve because of the presence of complex families of structural genes. It would also be necessary to insert a large number of additional lysine residues. Two more promising approaches are to increase the level of expression of genes coding for lysine-rich globulin storage proteins and to increase the pool of free lysine by selecting mutant lines with relaxed feedback regulation of lysine synthesis. (author)

  20. Hybrid fluorescence tomography/x-ray tomography improves reconstruction quality

    Schulz, R. B.; Ale, A.; Sarantopoulos, A.; Freyer, M.; Söhngen, R.; Zientkowska, M.; Ntziachristos, V.

    2009-07-01

    A novel hybrid imaging system for simultaneous X-ray and Fluorescence Tomography is presented, capitalizing on 360°-projection free-space fluorescence tomography. The system is implemented within a commercial micro-CT scanner allowing reconstructions with a resolution of 95μm. Acquired data sets are intrinsically coregistered in the same coordinate system and can be used to correctly localize reconstructed fluorescence distributions with morphological features. More importantly, the micro-CT data, automatically segmented into different organ and tissue segments can be used to guide the fluorescence reconstruction algorithm and reduce the ill coditioning of the inverse problem. We showcase the use of the system and the improvements in image quality for lesions in brain and lung.