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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. 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...

  9. 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...

  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. 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 ...

  7. 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...

  8. 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

  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 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

  10. 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'…

  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. 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...

  14. 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...

  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. 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.

  2. 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.

  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. 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…

  6. 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.

  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. 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.)

  17. 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.)

  18. 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

  19. 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...

  20. 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.

  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. 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...

  17. 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...

  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 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.

  20. 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...

  1. 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.

  2. 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....

  3. 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...

  4. 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.)

  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. 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...

  15. 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...

  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. 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

  19. 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.

  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. 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...

  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. 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

  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. 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.

  20. 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...

  1. 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…

  2. 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...

  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 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...

  9. 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

  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. 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

  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. 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)

  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. 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....

  6. 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)

  7. 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.…

  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. 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