WorldWideScience

Sample records for quality improvement initiative

  1. Health care provider quality improvement organization Medicare data-sharing: a diabetes quality improvement initiative.

    OpenAIRE

    Ballard, David J.; Nicewander, David; Skinner, Cheryl

    2002-01-01

    BACKGROUND: This paper describes a collaborative Medicare claims data linkage and sharing effort between the Baylor Health Care System (BHCS) and Texas Medical Foundation (TMF, the Texas Quality Improvement Organization) designed to assess the effect of three quality improvement interventions on care delivered to elderly patients with diabetes. The randomized controlled trial is being conducted among a network of primary care physician practices owned by BHCS and focuses on measures of care p...

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

    OpenAIRE

    Wray Julie; Weavers Annette; Rose Val; Bick Debra E; Beake Sarah

    2011-01-01

    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) ...

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

    International Nuclear Information System (INIS)

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

  4. Evaluation and measurement for improvement in service-level quality improvement initiatives.

    Science.gov (United States)

    Russell, Nicholas C C; Wallace, Louise M; Ketley, Diane

    2011-11-01

    The National Health Service (NHS) in England, as with other health services worldwide, currently faces the need to reduce costs and to improve the quality of patient care. Evidence gathered through effective and appropriate measurement and evaluation, is essential to achieving this. Through interviews with service improvement managers and analysis of comments in a seminar of NHS staff involved in health service improvement, we found a lack of understanding regarding the definition and methodology of both measurement and evaluation, which decreases the likelihood that NHS staff will be competent to commission or provide these skills. In addition, we highlight the importance of managers assessing their organizations' 'readiness' to undergo change before embarking on a quality improvement (QI) initiative, to ensure that the initiative's impact can be adequately judged. We provide definitions of measurement for improvement and of evaluation, and propose a comparative framework from which to gauge an appropriate approach. Examples of two large-scale QI initiatives are also given, along with descriptions of some of their problems and solutions, to illustrate the use of the framework. We recommend that health service managers use the framework to determine the most appropriate approach to evaluation and measurement for improvement for their context, to ensure that their decisions are evidence based. PMID:22040945

  5. Pursuing Perfection: An Asthma Quality Improvement Initiative in School-Based Health Centers with Community Partners

    OpenAIRE

    Mansour, Mona E.; Rose, Barbara; Toole, Kim; Luzader, Carolyn P.; Atherton, Harry D.

    2008-01-01

    This article describes an innovative asthma quality improvement initiative conducted in school-based health centers (SBHCs) with collaboration among multiple community partners including the children's hospital, a federally qualified health center, the health department, the public school, and parents of children with asthma. The aim was to improve the health of children with asthma in these schools, as measured by minimal asthma-related activity restriction and reduction in asthma-related em...

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

    Science.gov (United States)

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

    2015-02-01

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

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

    OpenAIRE

    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 t...

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

    LENUS (Irish Health Repository)

    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.

  9. Approaches to quality improvement in nursing homes: Lessons learned from the six-state pilot of CMS's Nursing Home Quality Initiative

    Directory of Open Access Journals (Sweden)

    Palmer Laura

    2003-05-01

    Full Text Available Abstract Background In November 2002, the Centers for Medicare & Medicaid Services (CMS launched a Nursing Home Quality Initiative that included publicly reporting a set of Quality Measures for all nursing homes in the country, and providing quality improvement assistance to nursing homes nationwide. A pilot of this initiative occurred in six states for six months prior to the launch. Methods Review and analysis of the lessons learned from the six Quality Improvement Organizations (QIOs that led quality improvement efforts in nursing homes from the six pilot states. Results QIOs in the six pilot states found several key outcomes of the Nursing Home Quality Initiative that help to maximize the potential of public reporting to leverage effective improvement in nursing home quality of care. First, public reporting focuses the attention of all stakeholders in the nursing home industry on achieving good quality outcomes on a defined set of measures, and creates an incentive for partnership formation. Second, publicly reported quality measures motivate nursing home providers to improve in certain key clinical areas, and in particular to seek out new ways of changing processes of care, such as engaging physicians and the medical director more directly. Third, the lessons learned by QIOs in the pilot of this Initiative indicate that certain approaches to providing quality improvement assistance are key to guiding nursing home providers' desire and enthusiasm to improve towards a using a systematic approach to quality improvement. Conclusion The Nursing Home Quality Initiative has already demonstrated the potential of public reporting to foster collaboration and coordination among nursing home stakeholders and to heighten interest of nursing homes in quality improvement techniques. The lessons learned from this pilot project have implications for any organizations or individuals planning quality improvement projects in the nursing home setting.

  10. A quality improvement initiative to reduce unnecessary follow-up imaging for adnexal lesions.

    Science.gov (United States)

    Hui, Jamie S; Kramer, Dawna J; Blackmore, C Craig; Hashimoto, Beverly E; Coy, David L

    2014-04-01

    Our objective was to improve the quality of pelvic ultrasound reports and decrease the number of physiologic and benign adnexal lesions unnecessarily referred for follow-up. We performed a prospective cohort study of 2 quality improvement interventions: academic detailing with education for the ultrasound radiologists and sonographers, and implementation of a national consensus guideline on adnexal cysts. Our primary quality outcome measure was the proportion of pelvic ultrasound exams in which follow-up was recommended for an adnexal lesion. Baseline data collection in January 2006 identified 252 pelvic ultrasound exams, of which 58 (23%) reported an adnexal lesion and 31 (12%) recommended follow-up. Retrospective review revealed that 17 of 31 (55%) reported adnexal lesions with follow-up recommended were physiologic or benign. After intervention 1, 59 of 214 (28%) pelvic ultrasound exams from January 2008 reported an adnexal lesion, with 18 (8%) recommending follow-up. After intervention 2, 64 of 296 (22%) pelvic ultrasound exams from January 2011 reported an adnexal lesion, with 16 (5%) recommending follow-up. Follow-up recommendations decreased 58% (12% versus 5%, P = .004), with significant increase in the proportion characterized as physiologic or benign (P = .001). Through a quality initiative aimed at appropriate description and follow-up recommendations for adnexal cystic lesions identified at ultrasound, we effectively reduced unnecessary imaging referrals. We conclude that: (1) acceptance of an expert consensus guideline was important to add credibility, (2) accessible image-rich charts are invaluable tools at point of use, and (3) elimination of some unnecessary imaging is under the control of the radiologist. PMID:24139962

  11. Quality Improvement Initiative in School-Based Health Centers across New Mexico

    Science.gov (United States)

    Booker, John M.; Schluter, Janette A.; Carrillo, Kris; McGrath, Jane

    2011-01-01

    Background: Quality improvement principles have been applied extensively to health care organizations, but implementation of quality improvement methods in school-based health centers (SBHCs) remains in a developmental stage with demonstration projects under way in individual states and nationally. Rural areas, such as New Mexico, benefit from the…

  12. Quality improvement.

    Science.gov (United States)

    2015-01-28

    The Health Foundation is working with NHS England to implement the 2013 Berwick Report recommendation to 'organise a national system of NHS improvement fellowships' that will connect people to share ideas across the UK healthcare system. The project, referred to as 5,000 Safety Fellows, will initially recruit a cohort of between 150 and 250 in early 2015. Participants will have a wide network of people with whom to test ideas and from whom to gain advice as well as opportunities to network and develop activities, and the chance to join 'improvement laboratories', where they can work with others to address specific challenges to making care safer. PMID:25629342

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

    Science.gov (United States)

    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 researchers to go beyond the traditional studies examining predictors of treatment outcome and to see things instead in terms of the "bigger picture", i.e., the improvement of the process outcome, the quality of the service. PMID:19294433

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

    Directory of Open Access Journals (Sweden)

    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.

  15. Doing the right thing for women and babies: policy initiatives to improve maternity care quality and value.

    Science.gov (United States)

    Corry, Maureen P; Jolivet, Rima

    2009-01-01

    When defined within the context of maternity care, the Institute of Medicine's six aims for health-care quality improvement provide a framework for Childbirth Connection's Maternity Quality Matters Initiative, a multipronged program agenda intended to foster a maternity care system that delivers care of the highest quality and value in order to achieve optimal health outcomes and experiences for mothers and babies. These aims also provide childbirth educators and others in the maternity care community with an ethical framework for efforts to serve childbearing women and families and ensure the best outcomes for women, babies, and families. PMID:19436596

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

    Science.gov (United States)

    Philp, Lauren; Umraw, Nisha; Cartotto, Robert

    2012-01-01

    Many approaches to surgical management of the severely burned face are described, but there are few objective outcome studies. The purpose of this study was to perform a detailed evaluation of the late outcomes in adult patients who have undergone grafting using a standardized surgical and rehabilitation approach for full-thickness (FT) facial burns to identify areas for improvement in the treatment strategy of authors. This was a prospective observational study in which patients who had undergone grafting for FT facial burns by the senior investigator at a regional burn centre between 1999 and 2010 were examined by a single evaluator. The surgical approach included tangential excision based on the facial aesthetic units, temporary cover with allograft then autografting with scalp skin preferentially, split grafts for the upper eyelid, and FT grafts for the lower eyelid. Rehabilitation included compression (uvex and or soft cloth), scar massage, and silicone gel sheeting. Of 35 patients with facial grafts, 14 subjects (age 43 ± 16 years with 22 ± 21% TBSA burns) returned for late follow-up at 40 ± 33 months (range, 5-91 months). A mean of four facial aesthetic units per patient were grafted (range, 1-9 units), with six full facial grafts performed. Scalp was used as donor in 10 of 14 cases. Scalp donor sites were well tolerated with minor alopecia visible in only one case although the donor site visibly extended slightly past the hairline in two cases. Color match with native skin was rated at 8.8 ± 0.8 of 10 when scalp skin was used compared with 7.5 ± 1.6 with other donor sites (P = .06). On the lip and chin, hypertrophic scars were significantly worse compared with the rest of the facial grafts (Vancouver scar scale 8 ± 2 vs 3 ± 1, P 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

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

    Science.gov (United States)

    ... Library of Resources Resources Education & Training Continuing Education Curriculum Tools Hospitals & Health Systems Hospital Resources Long-Term ... Children's Health Insurance Program Reauthorization Act (CHIPRA) National Evaluation of the Quality Demonstration Grant ... Research Tools & Data Data Resources Data Sources Available from ...

  18. Three Proposed Initiatives for Improving Mobility, Quality of Life, and Economic Growth in the West Bank

    Science.gov (United States)

    What might be one way to improve life in the West Bank? Most people might not immediately think of a new infrastructure corridor, but the RAND Corporation thinks that might be part of the solution. The RAND Corporation has been working with the Palestinian Authority (PA) to encourage economic development in the region, while also advancing the U.S. policy agenda in the Middle East. This 20-page paper offers a few practical suggestions based on five years of consultations between RAND and the PA. Their suggestions include creating a regional transit system for the West Bank, the creation of several new urban districts, and a design of the first national physical plan for Palestine. The bulk of the report consists of artistic renderings of these new environments, along with a general overview of this plan.

  19. Achieving Improvement Through Nursing Home Quality Measurement

    OpenAIRE

    Harris, Yael; Clauser, Steven B.

    2002-01-01

    CMS has initiated the Nursing Home Quality Initiative (NHQI) to improve the quality of nursing home care. Central to the NHQI is the public reporting of nursing home quality measures that serve as the basis for the Initiative's communication and quality improvement program. This article provides an overview of the NHQI, focusing on the role of nursing home quality measures in achieving improvements in nursing home care. We also describe the evolution of quality measurement in nursing homes, a...

  20. Mothers' "liquid gold": a quality improvement initiative to support early colostrum delivery via oral immune therapy (OIT) to premature and critically ill newborns.

    Science.gov (United States)

    Pletsch, Donna; Ulrich, Cindy; Angelini, Michelle; Fernandes, Gail; Lee, David S C

    2013-01-01

    Early breast milk, known as colostrum ("liquid gold") provides immune benefits to infants, offering potential risk reduction for nosocomial infection (NI) and necrotizing enterocolitis (NEC), a serious gastrointestinal emergency. Provision of colostrum is recognized as oral immune therapy (OIT) and is valuable to all NICU infants unable to feed orally. A quality improvement project was initiated by the multidisciplinary NICU Quality Care Council at London Health Sciences Centres-Victoria (LHSC-VH) to obtain mothers' colostrum for early OIT. The initiative was driven by the Canadian EPIQ (Evidence-based Practice for Improving Quality) group as a means of reducing the rates of NEC and NI, two major morbidities in the NICU. The overall aim was to facilitate the availability of OIT to preterm and critically ill neonates as soon as possible after birth. PMID:24860950

  1. SQIMSO: Quality Improvement for Small Software Organizations

    OpenAIRE

    Rabih Zeineddine; Nashat Mansour

    2005-01-01

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

  2. Improving quality in stroke rehabilitation.

    Science.gov (United States)

    Dowla, Nizar; Chan, Leighton

    2010-01-01

    Given the numerous quality improvement (QI) initiatives that have been undertaken in various medical fields, it is clear that inpatient rehabilitation services, particularly those geared toward stroke rehabilitation, can also benefit from these programs. To effectively evaluate the quality of rehabilitation services, indicators measuring structure, process, and outcomes must be included as part of any QI initiative. In addition to measuring quality, these indicators can be used to describe and address disparities in the provision of rehabilitation services on the basis of race, socioeconomic status, geography, disability status, and a multitude of other demographic factors. To improve quality and address health disparities associated with stroke rehabilitation, QI initiatives must be scientifically driven, continuing the trend of evidence-based practice in medicine. They must also remain flexible, because the science of quality improvement is an ever-changing field. It will be a challenge to convince physicians and other health care professionals that QI initiatives are a worthwhile investment of their limited time and resources, and further research is required to move the field of quality in stroke rehabilitation forward. PMID:20826411

  3. Quality Measurement and Improvement in General Surgery

    OpenAIRE

    Cevasco, Marisa; Ashley, Stanley W.

    2011-01-01

    Increasing emphasis is being placed on health care quality measurement and improvement in the US. Within general surgery, several sophisticated quality-measurement and outcomes systems have been developed. These include the National Surgical Quality Improvement Program, the use of selective referral and centers of excellence, the Surgical Care Improvement Project, and the World Health Organization Surgical Safety Checklist. This article reviews each of these quality-improvement initiatives, h...

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

    OpenAIRE

    Andersson Ann-Christine; Elg Mattias; Perseius Kent-Inge; Idvall Ewa

    2013-01-01

    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. Met...

  5. Screening for inter-hospital differences in cesarean section rates in low-risk deliveries using administrative data: An initiative to improve the quality of care

    Directory of Open Access Journals (Sweden)

    Verstraelen Hans

    2008-01-01

    Full Text Available Abstract Background Rising national cesarean section rates (CSRs and unexplained inter-hospital differences in CSRs, led national and international bodies to select CSR as a quality indicator. Using hospital discharge abstracts, we aimed to document in Belgium (1 inter-hospital differences in CSRs among low risk deliveries, (2 a national upward CSR trend, (3 lack of better neonatal outcomes in hospitals with high CSRs, and (4 possible under-use of CS. Methods We defined a population of low risk deliveries (singleton, vertex, full-term, live born, 2499 g. Using multivariable logistic regression techniques, we provided degrees of evidence regarding the observed departure ([relative risk-1]*100 of each hospital (N = 107 from the national CSR and its trend. To determine a benchmark, we defined three CSR groups (high, average and low and compared them regarding 1 minute Apgar scores and other neonatal endpoints. An anonymous feedback is provided to the hospitals, the College of Physicians (with voluntary disclosure of the outlying hospitals for quality improvement purposes and to the policy makers. Results Compared with available information, the completeness and accuracy of the data, regarding the variables selected to determine our study population, showed adequate. Important inter-hospital differences were found. Departures ranged from -65% up to +75%, and 9 "high CSR" and 13 "low CSR" outlying hospitals were identified. We observed a national increasing trend of 1.019 (95%CI [1.015; 1.022] per semester, adjusted for age groups. In the "high CSR" group 1 minute Apgar scores Conclusion Rather than firm statements about quality of care, our results are to be considered a useful screening. The inter-hospital differences in CSR, the national CS upward trend, the indications of over-use and under-use, the geographically different obstetric patterns and the admission day-related concentration of deliveries, whether or not by CS, may trigger initiatives aiming at improving quality of care.

  6. Medical engagement in organisation-wide safety and quality-improvement programmes: experience in the UK Safer Patients Initiative.

    OpenAIRE

    Parand, A.; Burnett, S; Benn, J.; Iskander, S.; Pinto, A.; Vincent, C.

    2010-01-01

    OBJECTIVES: To identify factors affecting doctors' engagement with the Safer Patients Initiative (SPI). DESIGN: Qualitative interview study. SETTING: Four organisations participating in phase 1 of the SPI programme, from four different geographical locations in the UK. PARTICIPANTS: 34 staff members, comprising senior executive/management leads involved in the SPI programme, the principal SPI programme coordinator and the operational leads in each of the SPI clinical work areas. MAIN OUTCOME ...

  7. Consumer Participation in Quality Improvements for Chronic Disease Care: Development and Evaluation of an Interactive Patient-Centered Survey to Identify Preferred Service Initiatives

    Science.gov (United States)

    Paul, Christine L; Bryant, Jamie; Roos, Ian A; Henskens, Frans A; Paul, David J

    2014-01-01

    Background With increasing attention given to the quality of chronic disease care, a measurement approach that empowers consumers to participate in improving quality of care and enables health services to systematically introduce patient-centered initiatives is needed. A Web-based survey with complex adaptive questioning and interactive survey items would allow consumers to easily identify and prioritize detailed service initiatives. Objective The aim was to develop and test a Web-based survey capable of identifying and prioritizing patient-centered initiatives in chronic disease outpatient services. Testing included (1) test-retest reliability, (2) patient-perceived acceptability of the survey content and delivery mode, and (3) average completion time, completion rates, and Flesch-Kincaid reading score. Methods In Phase I, the Web-based Consumer Preferences Survey was developed based on a structured literature review and iterative feedback from expert groups of service providers and consumers. The touchscreen survey contained 23 general initiatives, 110 specific initiatives available through adaptive questioning, and a relative prioritization exercise. In Phase II, a pilot study was conducted within 4 outpatient clinics to evaluate the reliability properties, patient-perceived acceptability, and feasibility of the survey. Eligible participants were approached to complete the survey while waiting for an appointment or receiving intravenous therapy. The age and gender of nonconsenters was estimated to ascertain consent bias. Participants with a subsequent appointment within 14 days were asked to complete the survey for a second time. Results A total of 741 of 1042 individuals consented to participate (71.11% consent), 529 of 741 completed all survey content (78.9% completion), and 39 of 68 completed the test-retest component. Substantial or moderate reliability (Cohen’s kappa>0.4) was reported for 16 of 20 general initiatives with observed percentage agreement ranging from 82.1%-100.0%. The majority of participants indicated the Web-based survey was easy to complete (97.9%, 531/543) and comprehensive (93.1%, 505/543). Participants also reported the interactive relative prioritization exercise was easy to complete (97.0%, 189/195) and helped them to decide which initiatives were of most importance (84.6%, 165/195). Average completion time was 8.54 minutes (SD 3.91) and the Flesch-Kincaid reading level was 6.8. Overall, 84.6% (447/529) of participants indicated a willingness to complete a similar survey again. Conclusions The Web-based Consumer Preferences Survey is sufficiently reliable and highly acceptable to patients. Based on completion times and reading level, this tool could be integrated in routine clinical practice and allows consumers to easily participate in quality evaluation. Results provide a comprehensive list of patient-prioritized initiatives for patients with major chronic conditions and delivers practice-ready evidence to guide improvements in patient-centered care. PMID:25532217

  8. Physician-led sepsis quality improvement team.

    Science.gov (United States)

    Hampe, Holly M

    2015-01-01

    Over the last decade, hospitalizations for sepsis have more than doubled and the incidence of postsurgical sepsis tripled between 1997 and 2006. This upward trend is expected to continue for several reasons, including population-specific characteristics (eg, age, chronic disease status) and health care-specific characteristics (eg, lack of understanding of sepsis, medical treatments that leave patients susceptible). Highly effective, focused, quality improvement teams need to be established in order to successfully manage this condition. Quality improvement, and specifically quality improvement in health care, has evolved substantially over the past few decades. This evolution has been pushed by government initiatives and private accrediting bodies that have exposed concerns regarding quality of care. Hospitals have responded with not only corrective actions but also actions that improve quality despite a lack of noted deficiencies (ie, taking quality from "good" to "better"). Key components of a successful quality improvement program have been identified, as have components of successful quality improvement teams. By applying these components to a physician-led sepsis quality improvement team, hospitals can successfully decrease sepsis mortality and increase compliance with the application of sepsis best practice in the emergency department, intensive care unit, or non-intensive care unit nursing units. PMID:25741960

  9. Shipbuilding pipeline production quality improvement

    OpenAIRE

    Buksa, T.; Pavletic, D.; Sokovic, M.

    2010-01-01

    Purpose: The pipeline production is one of major processes in shipbuilding industry. Quality improvement and risk assessment in this process can yield significant savings, both in terms of internal quality costs as well as in terms of customer satisfactions.Design/methodology/approach: Shipbuilding pipeline production quality improvement has been carried out by application of FMEA (Failure Mode and Effect Analysis) method. For the successful implementation of FMEA method it is necessary to id...

  10. Preanalytical quality improvement : in quality we trust

    OpenAIRE

    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 been achieved thanks to improvements in both reliability and standardization of analytical techniques, reagents, and instrumentation. Notable advances in information technology, quality control and qu...

  11. Improving quality of care among COPD outpatients in Denmark 2008-2011

    DEFF Research Database (Denmark)

    TØttenborg, Sandra SØgaard; Thomsen, Reimar Wernich

    2013-01-01

    To examine whether the quality of care among Danish patients with chronic obstructive pulmonary disease (COPD) has improved since the initiation of a national multidisciplinary quality improvement program.

  12. Improving soybean seed quality

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    Marsteller Jill A

    2011-10-01

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

  14. Canada-wide standards and innovative transboundary air quality initiatives.

    Science.gov (United States)

    Barton, Jane

    2008-01-01

    Canada's approach to air quality management is one that has brought with it opportunities for the development of unique approaches to risk management. Even with Canada's relatively low levels of pollution, science has demonstrated clearly that air quality and ecosystem improvements are worthwhile. To achieve change and address air quality in Canada, Canadian governments work together since, under the constitution, they share responsibility for the environment. At the same time, because air pollution knows no boundaries, working with the governments of other nations is essential to get results. International cooperation at all levels provides opportunities with potential for real change. Cooperation within transboundary airsheds is proving a fruitful source of innovative opportunities to reduce cross-border barriers to air quality improvements. In relation to the NERAM Colloquium objective to establish principles for air quality management based on the identification of international best practice in air quality policy development and implementation, Canada has developed, both at home and with the United States, interesting air management strategies and initiatives from which certain lessons may be taken that could be useful in other countries with similar situations. In particular, the Canada-wide strategies for smog and acid rain were developed by Canadian governments, strategies that improve and protect air quality at home, while Canada-U.S. transboundary airshed projects provide examples of international initiatives to improve air quality. PMID:18080897

  15. Ten Tips to Improve Indoor Air Quality

    Science.gov (United States)

    ... Effective Disinfection Ten Tips to Improve Indoor Air Quality If you don’t use a toxic chemical ... Tip Sheets Ten Tips to Improve Indoor Air Quality (English) >> Ten Tips to Improve Indoor Air Quality ( ...

  16. Mexico City Air Quality Research Initiative

    International Nuclear Information System (INIS)

    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

  17. Impact of prenatal diagnosis in survivors of initial palliation of single ventricle heart disease: analysis of the national pediatric cardiology quality improvement collaborative database.

    Science.gov (United States)

    Brown, David W; Cohen, Katie E; O'Brien, Patricia; Gauvreau, Kimberlee; Klitzner, Thomas S; Beekman, Robert H; Kugler, John D; Martin, Gerard R; Neish, Steven R; Rosenthal, Geoffrey L; Lannon, Carole; Jenkins, Kathy J

    2015-02-01

    Among infants with single ventricle congenital heart disease (SVD) requiring Stage I palliation (S1P), the impact of prenatal diagnosis (PD) on outcomes has been variably characterized. We investigated the impact of PD in a large multi-center cohort of survivors of S1P in the National Pediatric Cardiology Quality Improvement Collaborative (NPCQIC) registry. Retrospective analysis of demographic and outcomes data among infants enrolled in the NPCQIC database; eligibility includes SVD requiring S1P and survival to discharge. From 43 contributing surgical centers, 591 infants had data available through time of BDG (519) or interstage death (55). Median gestational age was 39 weeks (31-46), and 66% had variants of hypoplastic left heart syndrome. PD was made in 445 (75%), with significant variation by center (p = 0.004). While infants with PD had slightly lower gestational age at birth (p SVD surviving to hospital discharge after S1P, PD showed significant inter-site variation and was associated with improved pre-operative status and shorter duration of mechanical ventilation. The significance of such associations merits further study. PMID:25135602

  18. Continuous improvement of software quality

    International Nuclear Information System (INIS)

    The present report is the first Halden Work Report delivered from the OECD Halden Reactor Project's research activity on formal methods and software quality. Of particular concern in this activity is to reach a consensus between regulators, licensees and the nuclear industry on questions related to the effective, industrial use of formal methods. The report gives considerable attention to the importance of continuous improvement as a characteristic of a living software quality system, and to the need of providing a basis for software process/product quality integration. In particular, the report discusses these aspects from the perspectives of defect prevention, formal methods, Total Quality Management (TQM), and Bayesian Belief Nets. Another concern is to promote controlled experiments on the use of new methods, techniques, and tools. This is achieved partly by reviewing suggestions on the collection and experimental use of data, and by surveying a number of metrics believed to have some potential for comparison studies (author) (ml)

  19. Continuous improvement of software quality

    Energy Technology Data Exchange (ETDEWEB)

    Sivertsen, Terje

    1999-04-15

    The present report is the first Halden Work Report delivered from the OECD Halden Reactor Project's research activity on formal methods and software quality. Of particular concern in this activity is to reach a consensus between regulators, licensees and the nuclear industry on questions related to the effective, industrial use of formal methods. The report gives considerable attention to the importance of continuous improvement as a characteristic of a living software quality system, and to the need of providing a basis for software process/product quality integration. In particular, the report discusses these aspects from the perspectives of defect prevention, formal methods, Total Quality Management (TQM), and Bayesian Belief Nets. Another concern is to promote controlled experiments on the use of new methods, techniques, and tools. This is achieved partly by reviewing suggestions on the collection and experimental use of data, and by surveying a number of metrics believed to have some potential for comparison studies (author) (ml)

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

    Science.gov (United States)

    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…

  1. Improved patient safety and outcomes with a comprehensive interdisciplinary improvement initiative in kidney transplant recipients.

    Science.gov (United States)

    Taber, David J; Pilch, Nicole A; McGillicuddy, John W; Bratton, Charles F; Chavin, Kenneth D; Baliga, Prabhakar K

    2013-01-01

    Although kidney transplant recipients at the authors' institution had a short length of stay (LOS), delayed discharges and early readmissions were common; medication use and safety were at the core of these issues. A multidisciplinary quality improvement initiative was developed that targeted eliminating these issues. The team developed key initiatives including improved medication reconciliation, development of a diabetes management service, and improved discharge medication dispensing, delivery, education, and scrutiny. Follow-up analysis demonstrated reduced medication discrepancies by >2 per patient and obtaining 100% adherence with reconciliation. Pharmacists reviewed discharge medications, reaching 100% by study end, leading to a 40% reduction in medication safety issues. LOS remained short, and delayed discharges were reduced by 14%; 7-day readmission rates decreased by 50%. Acute rejection and infection rates also significantly decreased. In conclusion, a multidisciplinary quality improvement initiative can improve medication safety in kidney transplant patients, which can lead to improved clinical outcomes. PMID:22822171

  2. Shipbuilding pipeline production quality improvement

    Directory of Open Access Journals (Sweden)

    T. Buksa

    2010-06-01

    Full Text Available Purpose: The pipeline production is one of major processes in shipbuilding industry. Quality improvement and risk assessment in this process can yield significant savings, both in terms of internal quality costs as well as in terms of customer satisfactions.Design/methodology/approach: Shipbuilding pipeline production quality improvement has been carried out by application of FMEA (Failure Mode and Effect Analysis method. For the successful implementation of FMEA method it is necessary to identify process failure modes or possibility of the appearance of non-compliance, as well as their possible causes. For qualitative analysis of key input variables of the process, in the paper is used Ishikawa diagram and p-chart.Findings: It is shown that proposed approach to risk assessment in shipbuilding pipeline production is applicable to real casa scenario. The analysis has identified the points in the process with the highest probability of occurrence of nonconformities, or the highest risk for error.Research limitations/implications: As the experimenting has been conducted in shipyard, within production process, research schedule must have been set in accordance with production pace. Also, due to character of production process the data collecting was adopted to the production plan in that particular moment.Practical implications: Dealing with causes of potential nonconformities in the process can significantly contribute to the reliability and robustness of the process. Corrective actions that have been taken based on results of analysis significantly contributed to the level of quality in the pipeline production process.Originality/value: The pepper is dealing with a well known method applied in different production environment that are mostly conservative in production approach. It was shown that successful application of proposed approach can yield benefits especially in improved quality of produced pipelines within shipbuilding industry.

  3. 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.

    Science.gov (United States)

    Kumar, Pravindra; Gómez-Gil, Leticia; Mohammadi, Mahmood; Sylvestre, Michel; Eltis, Lindsay D; Bolin, Jeffrey T

    2011-01-01

    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 P2(1). PMID:21206025

  4. Power Quality Improvement Using UPQC

    Directory of Open Access Journals (Sweden)

    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.

  5. Reinventing VA health care: systematizing quality improvement and quality innovation.

    Science.gov (United States)

    Kizer, K W; Demakis, J G; Feussner, J R

    2000-06-01

    The Veterans Health Administration (VHA) in the US Department of Veterans Affairs (VA) manages the largest fully integrated health care system in the United States. In 1995, the VHA initiated a reinvention effort that included the most radical redesign of VA health care to occur since the veterans health care system was formally established in 1946. The 2 paramount goals of this reinvention effort were to ensure the predictable and consistent provision of high-quality care everywhere in the system and to optimize the value of VA health care. Although still a work in progress, dramatic results have been achieved toward these ends during the past 5 years. This article provides an overview of the veterans health care system, and it highlights selected aspects of the system's reengineering. It also describes various steps that have been taken to better manage performance and to systematize quality improvement and quality innovation. This information provides a global context that should facilitate understanding of the genesis and purposes of the Quality Enhancement Research Initiative that is described in other articles in this issue of Medical Care. PMID:10843266

  6. Trading emissions improve air quality

    International Nuclear Information System (INIS)

    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

  7. Can Quality Improvement System Improve Childcare Site Performance in School Readiness?

    Science.gov (United States)

    Ma, Xin; Shen, Jianping; Lu, Xuejin; Brandi, Karen; Goodman, Jeff; Watson, Grace

    2013-01-01

    The authors evaluated the effectiveness of the Quality Improvement System (QIS) developed and implemented by Children's Services Council of Palm Beach County (Florida) as a voluntary initiative to improve the quality of childcare and education. They adopted a growth model approach to investigate whether childcare sites that participated in…

  8. Improvement of nuclear filter quality

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-07-01

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

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Fontaras, Georgios, E-mail: georgios.fontaras@jrc.ec.europa.eu [Institute for Energy and Transport, Joint Research Centre, Ispra (Italy); Martini, Giorgio; Manfredi, Urbano; Marotta, Alessandro; Krasenbrink, Alois [Institute for Energy and Transport, Joint Research Centre, Ispra (Italy); Maffioletti, Francesco; Terenghi, Roberto; Colombo, Mauro [AMSA, Azienda Milanese Servizi Ambientali, Milano (Italy)

    2012-06-01

    This paper summarizes the results of an extensive experimental study aiming to evaluate the performance and pollutant emissions of diesel and CNG waste collection trucks under realistic and controlled operating conditions in order to support a fleet renewal initiative in the city of Milan. Four vehicles (1 diesel and 3 CNG) were tested in two phases using a portable emission measurement system. The first phase included real world operation in the city of Milan while the second involved controlled conditions in a closed track. Emissions recorded from the diesel truck were on average 2.4 kg/km for CO{sub 2}, 0.21 g/km for HC, 7.4 g/km for CO, 32.3 g/km for NO{sub x} and 46.4 mg/km for PM. For the CNG the values were 3.6 kg/km for CO{sub 2}, 2.19 g/km for HC, 15.8 g/km for CO, 4.38 g/km for NO{sub x} and 11.4 mg/km for PM. CNG vehicles presented an important advantage with regards to NO{sub x} and PM emissions but lack the efficiency of their diesel counterparts when it comes to CO, HC and particularly greenhouse gas emissions. This tradeoff needs to be carefully analyzed prior to deciding if a fleet should be shifted towards either technology. In addition it was shown that existing emission factors, used in Europe for environmental assessment studies, reflect well the operation for CNG but were not so accurate when it came to the diesel engine truck particularly for CO{sub 2} and NO{sub x}. With regard to NO{sub x}, it was also shown that the limits imposed by current emission standards are not necessarily reflected in real world operation, under which the diesel vehicle presented almost 4 times higher emissions. Regarding CO{sub 2}, appropriate use of PEMS data and vehicle information allows for accurate emission monitoring through computer simulation. - Highlights: Black-Right-Pointing-Pointer Investigated diesel and CNG Euro V waste collection vehicles for municipal use Black-Right-Pointing-Pointer NO{sub x}-GhG emission trade-off should be considered prior to fleet renewal initiatives. Black-Right-Pointing-Pointer NO{sub x} and CO emissions exceeded the emission standard values over realistic conditions. Black-Right-Pointing-Pointer Current emission factors reflect adequately CNG but need update for diesel trucks. Black-Right-Pointing-Pointer Simulation successfully used for CO{sub 2} monitoring, opens path for regulatory initiatives.

  11. Total quality drives nuclear plant improvements

    International Nuclear Information System (INIS)

    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

  12. Strategy to Support Improvement of Healthcare Quality.

    Directory of Open Access Journals (Sweden)

    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.

  13. Improvement of nuclear filter quality

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

    Fontaras, Georgios; Martini, Giorgio; Manfredi, Urbano; Marotta, Alessandro; Krasenbrink, Alois; Maffioletti, Francesco; Terenghi, Roberto; Colombo, Mauro

    2012-06-01

    This paper summarizes the results of an extensive experimental study aiming to evaluate the performance and pollutant emissions of diesel and CNG waste collection trucks under realistic and controlled operating conditions in order to support a fleet renewal initiative in the city of Milan. Four vehicles (1 diesel and 3 CNG) were tested in two phases using a portable emission measurement system. The first phase included real world operation in the city of Milan while the second involved controlled conditions in a closed track. Emissions recorded from the diesel truck were on average 2.4 kg/km for CO(2), 0.21 g/km for HC, 7.4 g/km for CO, 32.3 g/km for NO(x) and 46.4 mg/km for PM. For the CNG the values were 3.6 kg/km for CO(2), 2.19 g/km for HC, 15.8 g/km for CO, 4.38 g/km for NO(x) and 11.4 mg/km for PM. CNG vehicles presented an important advantage with regards to NO(x) and PM emissions but lack the efficiency of their diesel counterparts when it comes to CO, HC and particularly greenhouse gas emissions. This tradeoff needs to be carefully analyzed prior to deciding if a fleet should be shifted towards either technology. In addition it was shown that existing emission factors, used in Europe for environmental assessment studies, reflect well the operation for CNG but were not so accurate when it came to the diesel engine truck particularly for CO(2) and NO(x). With regard to NO(x), it was also shown that the limits imposed by current emission standards are not necessarily reflected in real world operation, under which the diesel vehicle presented almost 4 times higher emissions. Regarding CO(2), appropriate use of PEMS data and vehicle information allows for accurate emission monitoring through computer simulation. PMID:22503608

  15. Analyzing and Improving Data Quality

    OpenAIRE

    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. E...

  16. Towards improvement in quality assurance

    International Nuclear Information System (INIS)

    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

  17. Does Audit Improve the Quality of Care?

    OpenAIRE

    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...

  18. Evaluation of a clinical genetics service--a quality initiative.

    Science.gov (United States)

    Elliott, Alison M; Chodirker, Bernard N; Bocangel, Patricia; Mhanni, Aizeddin A

    2014-10-01

    Paper-based surveys are an effective means of evaluating the quality of a clinical service. As part of ongoing quality improvement initiatives within our Genetics Program, new patients were invited to participate in a paper-based survey. Issues related to the quality of counseling based on educational/informational aspects (e.g. whether testing was explained fully, testing options, the meaning of normal/abnormal testing), competency, respect and nondirectiveness of counseling in addition to clinical environment/setting were evaluated. Data related to demographics, discipline seen within the program and whether the patient was seen by a physician or genetic counselor were also captured. Five hundred questionnaires were distributed. One hundred and forty-seven questionnaires were returned, with a response rate of 29.4 %. The majority of patients seen were prenatal (pregnant) patients and comprised a heterogeneous group including those seen for advanced maternal age and abnormal maternal serum screening. Overall, 98.6 % of respondents felt their appointment in genetics was a positive experience. Issues related to confidentiality, pros and cons of testing, meaning of an abnormal test result and time allotted for decision making were significantly different in some disciplines between genetic counselor and geneticist. However, when controlling for referral indication, these differences lost significance with the exception of issues relating to confidentiality and perceived time allotted to organize thoughts and questions. This survey provided valuable information to allow for improvement in the quality of the provision of service. PMID:24647747

  19. Quality-of-care initiative in patients treated surgically for perforated peptic ulcer

    DEFF Research Database (Denmark)

    MØller, M H; Larsson, Heidi Jeanet

    2013-01-01

    Mortality and morbidity are considerable after treatment for perforated peptic ulcer (PPU). Since 2003, a Danish nationwide quality-of-care (QOC) improvement initiative has focused on reducing preoperative delay, and improving perioperative monitoring and care for patients with PPU. The present study reports the results of this initiative.

  20. Improving Quality using Testing Strategies

    OpenAIRE

    sahil batra

    2011-01-01

    Software testing is a technique aimed at evaluating an attribute or capability/usability of a program or product/system and determining that it meets its quality. Although crucial to software quality and widely deployed by programmer & testers, software testing still remains an art, due to limited understanding of the principles of software. Software testing is an important technique for assessing the quality of a software product. In this paper, various types of software testing techniqu...

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

    Science.gov (United States)

    Roche, B G; Sommer, C

    1995-01-01

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

  2. Quality improvement practices and trends in Denmark

    DEFF Research Database (Denmark)

    Dahlgaard, Jens JØrn; Hartz, Ove

    1998-01-01

    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.

  3. Improve Power Quality Problem Using Series Compensator .

    OpenAIRE

    Pooja Shrivas; Arun Pachori

    2013-01-01

    This paper discusses study of design and simulation of series compensator for improving power quality and reduces the harmonic distortion of sensitive load. Electronic device and control technologies have made it possible to mitigate power quality problems &maintain the operation of sensitive load. The use of a series compensator (SC) to improve power quality is an isolated power system is investigated. The role of the compensator is not only to mitigate the effects of voltage sag, but also t...

  4. Power Quality Improvement Using DVR

    OpenAIRE

    Benachaiba, C.; Ferdi, B.

    2009-01-01

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

  5. Power theories for improved power quality

    CERN Document Server

    Benysek, Grzegorz

    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 base

  6. Power Quality Improvement Using DVR

    Directory of Open Access Journals (Sweden)

    C. Benachaiba

    2009-01-01

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

  7. Bus Passes, Budgets, and Turnover: Lessons in Quality Improvement.

    Science.gov (United States)

    Lalley, Richard A.

    2001-01-01

    A former superintendent explains the value of teamwork for solving problems involving bus passes, budgets, and faculty attrition. His continuous-quality-improvement initiatives sparked creative impulses while underscoring the importance of redesigning work procedures and giving people the time and encouragement to be inventive. (MLH)

  8. Improving the quality of existing quadrupoles

    International Nuclear Information System (INIS)

    A cost-effective method is shown for improving the quality of existing quadrupole magnets. In this case, the LAMPF side-coupled-linac (SCL) quadrupole doublets are being upgraded so that improved harmonics and increased integrated gradient strength can be achieved. Data are shown for the old and new states that verify these improvements. The use of investment casting technology to achieve these improvements is documented

  9. Quantitative data management in quality improvement collaboratives

    OpenAIRE

    Bal Roland; Frenken Rianne; van den Berg Mireille

    2009-01-01

    Abstract Background Collaborative approaches in quality improvement have been promoted since the introduction of the Breakthrough method. The effectiveness of this method is inconclusive and further independent evaluation of the method has been called for. For any evaluation to succeed, data collection on interventions performed within the collaborative and outcomes of those interventions is crucial. Getting enough data from Quality Improvement Collaboratives (QICs) for evaluation purposes, h...

  10. Activities toward PSA quality improvement in Japan

    International Nuclear Information System (INIS)

    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)

  11. Drinking water quality improvement plan: Final summary report

    Energy Technology Data Exchange (ETDEWEB)

    1990-01-01

    This summary report is based on two years of study and summarizes the information in three technical reports that address the respective initiatives. A summary of each initiative's findings is contained in the appendices. The purpose of this summary report is to describe a water quality improvement plan that can be pursued by GVWD to address documented water quality problems. The benefits and drawbacks of potential solutions are presented to help GVWD to determine at what pace it wants to proceed to resolve the problems.

  12. The disparity of frontline clinical staff and managers' perceptions of a quality and patient safety initiative.

    OpenAIRE

    Parand, A.; Burnett, S; Benn, J.; Pinto, A.; Iskander, S.; Vincent, C.

    2011-01-01

    RATIONALE, AIMS AND OBJECTIVES: Arguably, a shared perspective between managers and their clinical staff on an improvement initiative would allow for most effective implementation and increase programme success. However, it has been reported that research has failed to differentiate between managers and line employees on quality management implementation and examine their differences in perceptions of quality and safety initiatives. The aim of this study was to compare clinical frontline staf...

  13. Improvement in spring wheat quality in pakistan

    International Nuclear Information System (INIS)

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

  14. EXFOR: Improving the quality of international databases

    International Nuclear Information System (INIS)

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

  15. Implementing Quality Oncology Practice Initiative (QOPI) participation in a community oncology practice.

    Science.gov (United States)

    Peterson, Jennifer

    2012-01-01

    The American Society of Clinical Oncology's (ASCO's) Quality Oncology Practice Initiative (QOPI) has been developed to assist medical oncology practices in implementing continuous quality improvement. In addition, starting in 2010, ASCO started including certification measures in the QOPI program enabling practices that participate in the QOPI data collection to seek QOPI certification. In spite of a desire to wait until an electronic medical record (EMR) had been implemented, Mid-Illinois Hematology and Oncology Associates, Ltd. (MIHOA) proceeded with implementing QOPI participation in late 2011. Through internal mini QOPI audits, multiple committee meetings, ongoing quality improvement efforts, participation in the spring 2012 QOPI data collection round and continual auditing and continuous quality improvement, MIHOA staff has worked to implement QOPI documentation requirements and to improve quality of care provided in the practice. As of this writing, MIHOA is waiting to participate in the second 2012 QOPI data collection round in September with hopes of achieving QOPI certification. PMID:23493020

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

    Science.gov (United States)

    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…

  17. Engaging with quality improvement in anticoagulation management.

    Science.gov (United States)

    Barnes, Geoffrey D; Kline-Rogers, Eva

    2015-04-01

    Anticoagulants are highly effective at preventing thrombosis across a variety of clinical indications. However, their use can also lead to devastating effects, including major bleeding and death. Anticoagulation providers strive to balance the benefits of anticoagulant therapy with the risks of major bleeding. A measure of quality care can be used to assess the strengths and potential weaknesses in any system of coordinated care delivery. Quality measures in anticoagulation include patient-centered outcomes (e.g. major bleeding, time in the therapeutic range) and provider- or process-focused outcomes (e.g. compliance with guideline recommendations and response times to out-of-range laboratory values). Engaging in quality improvement activities allows anticoagulation providers to assess their own performance and identify areas for targeted interventions. This review summarizes the justification for engaging in quality improvement for anticoagulation management and describes a number of example programs. Interventions benefiting the management of both warfarin and the direct oral anticoagulants are included. The review also details potential quality measures and resources for any anticoagulation provider looking to begin a quality improvement process. PMID:25772116

  18. Does Audit Improve the Quality of Care?

    Directory of Open Access Journals (Sweden)

    Areti Tsaloglidou

    2009-01-01

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

  19. A Model to Improve Service Quality

    OpenAIRE

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

    2013-01-01

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

  20. Economic valuation of coastal zone quality improvements

    OpenAIRE

    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 qua...

  1. Fostering Quality Improvement in EHDI Programs

    Science.gov (United States)

    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…

  2. AQIP and Accreditation: Improving Quality and Performance

    Science.gov (United States)

    Spangehl, Stephen D.

    2012-01-01

    For the past 12 years, the Academic Quality Improvement Program (AQIP) has offered an innovative means for colleges and universities to maintain regional accreditation with the Higher Learning Commission (HLC), the only regional U.S. accrediting commission currently providing alternative pathways for maintaining accreditation. Although all HLC…

  3. Improving the Quality Factor of Superconducting Resonators

    Science.gov (United States)

    Megrant, Anthony; Neill, Charles; Barends, Rami; Chiaro, Ben; Lenander, Mike; Palmstrom, Chris; Martinis, John; Cleland, Andrew

    2012-02-01

    Superconducting resonators hold great promise for quantum information storage in quantum computing. Improving the coherence lifetimes is therefore of central interest. We have focused on improving the interface between the resonator's underlying dielectric and superconducting metallization, as simulations have shown this interface to be a major source of loss, possibly associated with two-level states. After mitigating for stray light and magnetic fields, we have achieved low power intrinsic quality factors in excess of one million at single photon energies, with high power Q's in excess of ten million. Attaining such high quality factors is dependent on substrate preparation before depositing the superconductor, as well as the deposition method. We will describe the fabrication method and characterization of resonators that consistently achieve quality factors above one million.

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

    Science.gov (United States)

    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…

  5. Strategy to Support Improvement of Healthcare Quality.

    OpenAIRE

    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...

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

    Directory of Open Access Journals (Sweden)

    Gerdien Franx

    2009-06-01

    Full Text Available 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 the uptake of clinical depression guidelines in daily practice as well as the collaboration between different mental health professionals. Method: A Depression Breakthrough Collaborative was initiated from December 2006 until March 2008. The activities included the development and implementation of a stepped care depression model, a care pathway with two levels of treatment intensity: a first step treatment level for patients with non-severe depression (brief or mild depressive symptoms and a second step level for patients with severe depression. Twelve months data were measured by the teams in terms of one outcome and several process indicators. Qualitative data were gathered by the national project team with a semi-structured questionnaire amongst the local team coordinators. Results: Thirteen multidisciplinary teams participated in the project. In total 101 health professionals were involved, and 536 patients were diagnosed. Overall 356 patients (66% were considered non-severely depressed and 180 (34% patients showed severe symptoms. The mean percentage of non-severe patients treated according to the stepped care model was 78%, and 57% for the severely depressed patient group. The proportion of non-severely depressed patients receiving a first step treatment according to the stepped care model, improved during the project, this was not the case for the severely depressed patients. The teams were able to monitor depression symptoms to a reasonable extent during a period of 6 months. Within 3 months, 28% of monitored patients had recovered, meaning a Beck Depression Inventory (BDI score of 10 and lower, and another 27% recovered between 3 and 6 months. Conclusions and discussion: A stepped care approach seems acceptable and feasible in primary care, introducing different levels of care for different patient groups. Future implementation projects should pay special attention to the quality of care for severely depressed patients. Although the Depression Breakthrough Collaborative introduced new treatment concepts in primary and specialty care, the change capacity of the method remains unclear. Thorough data gathering is needed to judge the real value of these intensive improvement projects.

  7. The Quality Assurance Project: introducing quality improvement to primary health care in less developed countries.

    Science.gov (United States)

    Nicholas, D D; Heiby, J R; Hatzell, T A

    1991-01-01

    Persistently excessive morbidity and mortality rates in less developed countries (LDCs) served by primary health care systems suggest that the quality of services is inadequate. The PRICOR project, sponsored by the United States Agency for International Development, has designed and implemented methods for quality assessment and problem solving in LDC health systems. After developing comprehensive lists of essential activities and tasks, similar to practice parameters, for seven child survival interventions, PRICOR supported comprehensive quality assessment studies in twelve LDC countries. The studies, yielding over 6000 observations of health worker-client encounters, indicated highly prevalent, serious program deficiencies in areas including diagnosis, treatment, patient education and supervision. To facilitate corrective action, PRICOR assisted managers in conducting operations research to resolve priority problems revealed by the assessments. The recently initiated Quality Assurance Project is building on PRICOR techniques in designing and implementing sustainable continuous quality improvement programs for LDC health systems. PMID:1782383

  8. A Method to Report Utilization for Quality Initiatives in Medical Facilities

    OpenAIRE

    Krousel-wood, M. A.; Re, Richard N.; Abdoh, Ahmed; Gomez, Natalie; Chambers, Richard B.; Bradford, David; Kleit, Andrew

    2001-01-01

    Objective: We undertook this project to outline a methodology for quantifying aggregate health care utilization of medical “technologies” that could be rank ordered by volume. The identification of specific high-volume technologies could guide future efforts for quality initiatives such as program planning, preventive services implementation, quality improvement activities, and innovative and cost-effective technology development. Design: This study utilized a retrospective cross-sectiona...

  9. [Quality assurance and continuous quality improvement--assessment of the current status of physician self-control for quality assurance in medicine 1955-1995].

    Science.gov (United States)

    Ollenschläger, G; Thomeczek, C

    1996-07-01

    In April 1996 the working group of the leading statutory health service officials (Arbeitsgemeinschaft der Leitenden Medizinalbeamten der Länder [AGLMB]) organised a hearing in the course of which the German Medical Association and the National Association of CHI Physicians presented a joint stocktaking of their activities in the discipline of quality assurance during 1955 to 1995. On the basis of this analysis 10 theses have been evolved to develop quality assurance in Germany: (1) quality assurance and quality improvement are in the interest of the medical care of patients. (2) The main task of quality assurance and quality improvement is not the improvement of efficiency. (3) Quality assurance schemes must be problem-orientated and coordinated; there must not be a difference in the quality of out-patient and in-patient medical care. (4) There has to be a systematic evaluation of the suitability of quality assurance schemes. (5) Transparency, communication and cooperation are preconditions for a successful quality assurance and quality improvement. (6) Continuous quality improvement is based on an extensive internal quality assurance. (7) The initiative for the priority development of internal quality assurance procedures must come from external quality assurance. (8) Quality assurance has only a chance of being realised if the individual is convinced and anxious to provide high-quality services, to continuously review and improve his services and to compare them with other services. (9) Quality has its price. (10) Quality assurance and continuous quality improvement are the cornerstones of a quality policy in the health care system. The article concludes with extracts from the checkup and the relevant literature. PMID:8963101

  10. Improvements in geomagnetic observatory data quality

    DEFF Research Database (Denmark)

    Reda, Jan; Fouassier, Danielle

    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 issues.

  11. A Model to Improve the Quality Products

    Directory of Open Access Journals (Sweden)

    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.

  12. Improvements in geomagnetic observatory data quality

    OpenAIRE

    Reda, Jan; Fouassier, Danielle; Isac, Anca; Linthe, Hans-joachim; Matzka, Ju?rgen; Turbitt, Christopher William

    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 ...

  13. MOBILITY LEARNING METHODOLOGY FOR EDUCATION QUALITY IMPROVEMENT

    OpenAIRE

    Liviu Moldovan

    2012-01-01

    This paper presents some results of the project entitled "Mobility learning methodology for European trainers and VET systems quality improvement" (acronym Global-SRS). The overall aim of the project is to implement Student Response System (SRS) methodology in partners' countries in the project. During the project we have organised a transfer workshop of the SRS. The SRS provides user interfaces that are intuitive to use: session control, a flexible framework for generating questionnaires, ea...

  14. In Brief: Improving Mississippi River water quality

    Science.gov (United States)

    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.

  15. Multichannel DBS halftoning for improved texture quality

    Science.gov (United States)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Unsworth, Kerrie, E-mail: Kerrie.unsworth@uwa.edu.au [UWA Business School, University of Western Australia, Crawley, WA 6009 (Australia); Adriasola, Elisa; Johnston-Billings, Amber; Dmitrieva, Alina [UWA Business School, University of Western Australia, Crawley, WA 6009 (Australia); Hodkiewicz, Melinda [School of Mechanical Engineering, University of Western Australia, Crawley, WA 6009 (Australia)

    2011-11-15

    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.

  17. Increased Mercury Bioaccumulation Follows Water Quality Improvement

    International Nuclear Information System (INIS)

    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 aties. 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

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

    International Nuclear Information System (INIS)

    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

  19. Improving the quality by a competitive comparison

    Directory of Open Access Journals (Sweden)

    Bujaloboková Beáta

    2001-12-01

    Full Text Available The improvement of the competitiveness of a company assumes the use of efficient tools and methods of analysis and assessment of production and processes. There is no doubt that one of these tools is benchmarking. The paper discusses the scope of benchmarking and his classification. The Advance of benchmarking have four points: Planning, Analysis, Integration and Implementation, Upgrade. Benchmarking is a methods of development supports orientation on the inside and outside background. The category of benchmarking focuses on the comparison of processes and products. Benchmarking is not a simple comparison of certain information. It is the comparison which is evaluated and which emphasis es the necessity for the actions after the comparisons and necessity of the implementation of findings. In order to make benchmarking significant for the company, it is important, to direct it on the quality factors. Keywords of quality factors rank among marketing, human factors, finances, management. In case of benchmarking entrepreneur?s, processes are analysed and compared to entrepreneur?s processes. This processes do not depend on the production.This method significantly contributes to the identification of the quality improvement and also helps to solve specific problems in these processes or products and the effective entrepreneur?s strategy.

  20. Improving the beam quality in LMA fibers

    Science.gov (United States)

    Voiculescu, Emil; Hotoleanu, Mircea; Csipkes, Gabor

    2008-02-01

    The paper presents the results concerning with beam quality improvement by concurrently modifying the index and the doping profile in LMA fibers. Further, the mode effective area is maximized by providing a passive ring in the cladding. The influence of the index profile over the distribution of the optical power among various modes is presented. The aim is to favor the fundamental mode by concurrently rejecting the higher modes, i.e. generating a quality beam. Simulation results and manufacturer's tests led to a novel design which consists in providing a passive ring in the cladding. That was of great help in rejecting the higher-order modes, and it can be applied to a large range of LMA fibers. The cladding ring procedure is of interest for Liekki, and it is very likely that it would be put into production.

  1. Improving pain assessment in the NICU: a quality improvement project.

    Science.gov (United States)

    Reavey, Daphne A; Haney, Barbara M; Atchison, Linda; Anderson, Betsi; Sandritter, Tracy; Pallotto, Eugenia K

    2014-06-01

    Pain assessment documentation was inadequate because of the use of a subjective pain assessment strategy in a tertiary level IV neonatal intensive care unit (NICU). The aim of this study was to improve consistency of pain assessment documentation through implementation of a multidimensional neonatal pain and sedation assessment tool. The study was set in a 60-bed level IV NICU within an urban children's hospital. Participants included NICU staff, including registered nurses, neonatal nurse practitioners, clinical nurse specialists, pharmacists, neonatal fellows, and neonatologists. The Plan Do Study Act method of quality improvement was used for this project. Baseline assessment included review of patient medical records 6 months before the intervention. Documentation of pain assessment on admission, routine pain assessment, reassessment of pain after an elevated pain score, discussion of pain in multidisciplinary rounds, and documentation of pain assessment were reviewed. Literature review and listserv query were conducted to identify neonatal pain tools. Survey of staff was conducted to evaluate knowledge of neonatal pain and also to determine current healthcare providers' practice as related to identification and treatment of neonatal pain. A multidimensional neonatal pain tool, the Neonatal Pain, Agitation, and Sedation Scale (N-PASS), was chosen by the staff for implementation. Six months and 2 years following education on the use of the N-PASS and implementation in the NICU, a chart review of all hospitalized patients was conducted to evaluate documentation of pain assessment on admission, routine pain assessment, reassessment of pain after an elevated pain score, discussion of pain in multidisciplinary rounds, and documentation of pain assessment in the medical progress note. Documentation of pain scores improved from 60% to 100% at 6 months and remained at 99% 2 years following implementation of the N-PASS. Pain score documentation with ongoing nursing assessment improved from 55% to greater than 90% at 6 months and 2 years following the intervention. Pain assessment documentation following intervention of an elevated pain score was 0% before implementation of the N-PASS and improved slightly to 30% 6 months and 47% 2 years following implementation. Identification and implementation of a multidimensional neonatal pain assessment tool, the N-PASS, improved documentation of pain in our unit. Although improvement in all quality improvement monitors was noted, additional work is needed in several key areas, specifically documentation of reassessment of pain following an intervention for an elevated pain score. PMID:24796482

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

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    Chopra Mickey

    2009-11-01

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

  4. Increased office productivity through improved indoor air quality

    DEFF Research Database (Denmark)

    Fanger, Povl Ole

    2002-01-01

    Control of indoor pollution sources and ventilation are both means of improving indoor air quality. Three independent experiments have recently documented that removing a pollution source or increasing the ventilation rate will improve perceived air quality, reduce the intensity of several Sick Building Syndrome (SBS) symptoms and improve the productivity of office workers. In these experiments, the performance of simulated office work (text typing, addition and proof-reading, all typical office tasks requiring concentration) improved monotonically as the proportion of persons dissatisfied with the air quality was reduced by either measure. The quantitative relationsh8ip was 1.1% change in performance per 10% dissatisfied, in the range 25-70% dissatisifed, or 0.5% change in performance per 1 decipol (dp), in the range 2-13 dp. Significant improvements in performance occurred only when the intensity of general SBS symptoms such as headache and difficulty in thinking clearly were significantly reduced, which implies that this was the mechanism of causation. The performance of simulated office work increased monotonically with decreasing pollution load by a 1.6% increase in performance for each twofold decrease of pollution load in the range 0.3-2 olf/m2floor, and with increasing outdoor air supply rate by a 1.8% increase in performance for each twofold increase in the outdoor air supply rate in the range 0.8-5.3 L/s per olf. As these results clearly justify increased initial and operating costs, future developments in HVCAC technology may include "personalized air ", new ways of improving the quality of supply air (e.g., by filtration), more extensive use of heat recovery from exhaust air and systematic selection of low-polluting building and furnishing materials.

  5. Using genomics to improve fruit quality

    Scientific Electronic Library Online (English)

    Claudio, Meneses; Ariel, Orellana.

    Full Text Available New fruit varieties are needed to satisfy consumers, and the industry is facing new challenges in order to respond to these demands. The emergence of genomic tools is releasing information on polymorphisms that can be utilized to expedite breeding processes in species that are difficult to breed, gi [...] ven the long periods of time required to get new varieties. The present review describes the current stages of the ongoing efforts that are being taken to apply these technologies to obtain varieties with improved fruit quality in species of the family Rosaceae.

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

    Science.gov (United States)

    Sprau Coulter, Tabitha L.

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

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

    International Nuclear Information System (INIS)

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

  8. Thoughts about conceptual models, theories, and quality improvement projects.

    Science.gov (United States)

    Fawcett, Jacqueline

    2014-10-01

    This essay focuses on how a conceptual model of nursing can be the basis for identification of the phenomenon of interest for a quality improvement project and how a theory of quality improvement or a theory of change is the methodological guide for the project. An explanation and examples of conceptual-theoretical-empirical structures for quality improvement projects are given. PMID:25248780

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

    Science.gov (United States)

    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…

  10. Improving smoked herring quality by gamma irradiation

    International Nuclear Information System (INIS)

    Smoked herring which is a highly purchasable product in Egypt, was exposed to different gamma irradiation doses (1.5,3.0 and 5.0 kGy) and stored at environmental temperature (12± 2 deg C) until spoilage of the control. Microbiological, chemical and sensory analyses were performed throughout storage to monitor the quality attributes. It is worthy to mention that irradiation reduced the population of bacteria and the effect was more pronounced at the highest dose used (5.0 kGy). At the same time 1.5 kGy completely eliminated staphylococcus aureus (coagulase + ve) and coliforms. By chemical analysis, there was significant decrease in average moisture content by different gamma irradiation doses and storage. Although the average thiobarbituric acid reactive substances (TBARS) increased slightly by ?-irradiation, this increase was highly significant by storage . At the same time there was a significant (p< 0.05)decrease in the average trimethylamine (TMA) value of all irradiated samples compared with unirradiated control, this value increased significantly by storage. interestingly, the average histamine value decreased significantly in all irradiated samples. The sensory analysis revealed a highly significant difference in the average acceptability scores between different irradiation doses used and also by storage. Therefore it could be concluded that the quality of smoked herring during storage at environmental temperature (12 ± 2 deg C) could be improved by using 5. 2 deg C) could be improved by using 5.0 kGy ? -irradiation

  11. 76 FR 46814 - Medicare Program; Evaluation Criteria and Standards for Quality Improvement Program Contracts...

    Science.gov (United States)

    2011-08-03

    ...the 10th Statement of Work) The QIO must improve...breast cancer screening in women ages 40 through 69; improving...the 10th Statement of Work) Learning and Action...about quality improvement work: (1) Initiation and...to give access to the right information and...

  12. Enhanced fuel performance by improving pellet quality and fabrication technology

    International Nuclear Information System (INIS)

    As part of Westinghouse flawless fuel initiatives, Westinghouse has initiated companywide efforts to enhance overall quality of UO2 pellets by enhancing pellet surface quality, pressing processes, examining pellet handling during various stages of pellet fabrication process and enhancing inspection process with primary focus of reducing pellets with missing surfaces. Benchmarking/best practices were examined among all Westinghouse and some of the Westinghouse licensee sites to minimize pellet chipping, enhance overall pellet quality and improve inspection processes. Numbers of 3-Dimensional (3-D) finite element models were developed to analyze the impact of cladding and pellet defects on the cladding temperature, stress and strain. The Finite Element Analysis (FEA) results demonstrated that: 1. Large Missing Pellet Surface (MPS) influences the fuel rod performance characteristics such as temperature, stress and strain distributions and 2. MPS dimensions should be controlled to improve the fuel rod performance characteristic impact. Based on the FEA conclusion, review of the in-reactor fuel performance of pellets with chamfers, characterization of pellets with side chips and correlating all of the above, a new set of criteria for side chips was identified and implemented. By analyzing each process step in pellet manufacturing and performing studies to determine forces needed to induce chipping in pellets, a knowledge based handling system can be established. based handling system can be established. Critical steps were identified and analyzed for handling of pellets between the processes steps of pellet pressing and storage. Extensive process evaluations and tests have been completed in manufacturing to show that manual inspection is effective. As deemed necessary, manual inspection process was modified to further enhance current manual inspection process. Westinghouse has also initiated a development effort to replace manual inspection with an automatic inspection system for pellets. Different sites use different conversion and pelleting processes and therefore site specific improvements are being made where it would have most impact. (author)

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

    Scientific Electronic Library Online (English)

    Lorenza Nogueira, Campos; Cibele Comini, César; Mark Drew Crosland, Guimarães.

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

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

    Directory of Open Access Journals (Sweden)

    Lorenza Nogueira Campos

    2009-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1994-03-01

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

  16. Designing a Large-Scale Multilevel Improvement Initiative: The Improving Performance in Practice Program

    Science.gov (United States)

    Margolis, Peter A.; DeWalt, Darren A.; Simon, Janet E.; Horowitz, Sheldon; Scoville, Richard; Kahn, Norman; Perelman, Robert; Bagley, Bruce; Miles, Paul

    2010-01-01

    Improving Performance in Practice (IPIP) is a large system intervention designed to align efforts and motivate the creation of a tiered system of improvement at the national, state, practice, and patient levels, assisting primary-care physicians and their practice teams to assess and measurably improve the quality of care for chronic illness and…

  17. Nuclear power stations and air quality improvement

    International Nuclear Information System (INIS)

    In order to overcome the oil crisis of the 70s, E.D.F. undertook a large nuclear program for substituting its conventional thermal power plants. This policy resulted in a significant improvement of air quality. As a matter of fact, E.D.F. pollutant emissions (SO2, NOx, particulates) had been divided by 10 since 1980. E.D.F. contribution to french national SO2 emission decrease rose to 25%. This performance was carried out without adding any particular devices to purify fossil-fired power plant flue gases, which would have resulted in a high solid waste discharge (gypsum) and unavoidable pollutant emissions, like CO2, responsible of the greenhouse effect

  18. Foliage Plants for Improving Indoor Air Quality

    Science.gov (United States)

    Wolverton, B. C.

    1988-01-01

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

  19. Higher fuel reliability by pellet quality improvements

    International Nuclear Information System (INIS)

    Optimal utilization of the nuclear fuel can be achieved by modifications of the core loading pattern and adaptations of the operational mode of the reactors what will generally lead to more fuel assemblies having a high load. Under those conditions, the quality of the fuel column surface in the fuel rod becomes increasingly important for the fuel rod reliability. It was observed that in regions of elevated power levels fuel rods failed during a power transient. The post-irradiation examinations performed in cooperation with RWE Power revealed that the so-called non-classical pelletcladding interaction (PCI) induced by missing-pellet-surface (MPS) was the mechanism of the fuel failure. The mechanism of this failure mode mainly includes the stress elevation in the cladding due to MPS. Such effect was described in detail in different scientific and technical reports. The hot cell results clearly showed that pellet surface imperfections can adversely affect the fuel rod performance. Only the improvement of the surface quality of fuel can assure the high fuel reliability in all modes of operation. With the Zero Tolerance for Failure program AREVA NP follows a strategy towards higher fuel reliability what is described in the present paper. (orig.)

  20. Improving quality of cancer care through surgical audit

    DEFF Research Database (Denmark)

    van Gijn, W; van de Velde, C J H

    2010-01-01

    Quality of healthcare is a hot topic and this is especially true for cancer care. New surgical techniques and effective neoadjuvant treatment regimens have significantly improved colorectal cancer outcome. Nevertheless, there seem to be substantial differences in quality of care between European countries, hospitals and doctors. To reduce hospital variation, most initiatives aim on selective referral, encouraging patients to seek care in high-volume hospitals, where cancer care is concentrated to site-specialist multidisciplinary teams. As an alternative to volume-based referral, hospitals and surgeons can also improve their results by learning from their own outcome statistics and those from colleagues treating a similar patient group. European national audit registries in surgical oncology have led to improvements with a greater impact on survival than any of the adjuvant therapies currently under study. Moreover, they offer the possibility to perform research on patient groups that are usually excluded from clinical trials. Nevertheless, between European countries remain differences in outcome and treatment schedules that cannot be easily explained. The European CanCer Organisation (ECCO) has recognised these importances and created the 'European Registration of Cancer Care' (EURECCA) framework to develop a European colorectal audit structure. EURECCA will advance future treatment improvements and spread these to all European cancer patients. It provides opportunities to treat elderly and comorbid patients evidence based while it offers an unique insight in social-economical healthcare matters such as the consequences of commercialisation, treatment availability and screening initiatives. As such, ECCO has established the basis for a strong, multidisciplinary audit structure with the commitment to improve cancer care for every European cancer patient.

  1. Improved type many kinds of enrichment initial charge core

    International Nuclear Information System (INIS)

    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.)

  2. 40 CFR 63.175 - Quality improvement program for valves.

    Science.gov (United States)

    2010-07-01

    ...subject to the quality improvement program...the instrument model number, and date...or light liquid service. (iii) If...remains in the quality improvement program...or light liquid service. (iv) The...adjusted, instrument model number, and date...maintenance or quality assurance...

  3. Quality management initiatives at Carolina Power and Light Company

    International Nuclear Information System (INIS)

    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.)

  4. Effect of alternate day collection on semen quality of Asian elephants (Elephas maximus) with poor initial fresh semen quality.

    Science.gov (United States)

    Imrat, P; Mahasawangkul, S; Thitaram, C; Suthanmapinanth, P; Kornkaewrat, K; Sombutputorn, P; Jansittiwate, S; Thongtip, N; Pinyopummin, A; Colenbrander, B; Holt, W V; Stout, T A E

    2014-06-30

    In captivity, male Asian elephants often yield poor quality semen after transrectal manually assisted semen collection; however, the reasons for the disappointing semen quality are not clear. Here we test the hypothesis that accumulation of senescent spermatozoa is a contributory factor, and that semen quality can therefore be improved by more frequent ejaculation. To this end we investigated the effect of collecting semen five times on alternate days, after a long period of sexual rest, on semen quality in Asian elephants known to deliver poor semen during infrequent single collections. All eight bulls initially displayed a high incidence of detached sperm heads and low percentages of motile (close to 0%) spermatozoa. After semen collection on alternate days, the percentages of detached sperm heads, and head and mid-piece abnormalities, were reduced significantly (p<0.05). In particular, one bull showed markedly improved sperm motility (increased from 0% to 60%) and membrane integrity (increased from 5% to 75%). In addition, advancing age significantly (p<0.01) correlated with lower percentages of sperm with intact membranes and a higher frequency of detached sperm heads. In contrast to sperm accumulation problems in other species, a small ampullary diameter correlated significantly (p<0.05) with reduced semen quality. PMID:24832106

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

    Directory of Open Access Journals (Sweden)

    Abdullah Al Mamun

    2013-02-01

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

  6. Laboratory system strengthening and quality improvement in Ethiopia

    Directory of Open Access Journals (Sweden)

    Tilahun M. Hiwotu

    2014-11-01

    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 hours for 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 rating levels. 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% of the 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.

  7. DEVELOPING WEED SUPPRESSIVE SOILS THROUGH IMPROVED SOIL QUALITY MANAGEMENT

    Science.gov (United States)

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

  8. Improvement of quality service based on common benchmarks and indicators

    Directory of Open Access Journals (Sweden)

    Pohaydak, Olha Bohdanivna

    2011-11-01

    Full Text Available Consider ways to improve the quality management system based on common criteria and indicators for evaluating the quality of products, works and services in housing and domestic service.

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

    Directory of Open Access Journals (Sweden)

    Simon Lee

    2007-11-01

    Full Text Available 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 process.

  10. OMERACT: an international initiative to improve outcome measurement in rheumatology.

    Science.gov (United States)

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

    2007-01-01

    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 process. PMID:18039364

  11. Gibberellin inhibitors improve embryogenic tissue initiation in conifers.

    Science.gov (United States)

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

    2005-02-01

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

  12. How To Improve Software Quality Assurance In Developing Countries

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    Jin Wang

    2009-02-01

    Full Text Available Quality improvement and quality innovation are the important approach to enhance competitive force for enterprises. Quality improvement is a process of knowledge innovation in nature which must be actualized by organizational learning.This article starts from the relations among quality improvement, quality innovation and the ability of organizational learning, analyzes the knowledge moving rule in the interior process of quality improvement and innovation and expatiates on the creation, development and diffusion mechanisms of quality knowledge in the quality flow based on the knowledgefermenting theory of organizational learning. Furthermore, taking the quality control (QC group as an example, this article analyzes the behaviors and functions of nuclear factors such as quality knowledge sourdough, quality knowledge matrix and quality knowledge enzyme in the process of quality knowledge fermenting, and these nuclear factors function mutually in the quality knowledge fermenting bar. This article also puts forward five types of quality knowledge fermentation and analyzes their characters respectively, points out the implementation of knowledge fermentation possesses meanings to enhance the level of quality improvement and quality innovation for enterprises.

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

    International Nuclear Information System (INIS)

    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

  15. Assessing organizational readiness for depression care quality improvement: relative commitment and implementation capability.

    Science.gov (United States)

    Rubenstein, Lisa V; Danz, Marjorie S; Crain, A; Glasgow, Russell E; Whitebird, Robin R; Solberg, Leif I

    2014-12-01

    BackgroundDepression is a major cause of morbidity and cost in primary care patient populations. Successful depression improvement models, however, are complex. Based on organizational readiness theory, a practice¿s commitment to change and its capability to carry out the change are both important predictors of initiating improvement. We empirically explored the links between relative commitment (i.e., the intention to move forward within the following year) and implementation capability.MethodsThe DIAMOND initiative administered organizational surveys to medical and quality improvement leaders from each of 83 primary care practices in Minnesota. Surveys preceded initiation of activities directed at implementation of a collaborative care model for improving depression care. To assess implementation capability, we developed composites of survey items for five types of organizational factors postulated to be collaborative care barriers and facilitators. To assess relative commitment for each practice, we averaged leader ratings on an identical survey question assessing practice priorities. We used multivariable regression analyses to assess the extent to which implementation capability predicted relative commitment. We explored whether relative commitment or implementation capability measures were associated with earlier initiation of DIAMOND improvements.ResultsAll five implementation capability measures independently predicted practice leaders¿ relative commitment to improving depression care in the following year. These included the following: quality improvement culture and attitudes (p =0.003), depression culture and attitudes (p commitment (p¿=¿0.002) and prior depression quality improvement activities appeared to be associated with earlier participation in the DIAMOND initiative.ConclusionsThe study supports the concept of organizational readiness to improve quality of care and the use of practice leader surveys to assess it. Practice leaders¿ relative commitment to depression care improvement may be a useful measure of the likelihood that a practice is ready to initiate evidence-based depression care changes. A comprehensive organizational assessment of implementation capability for depression care improvement may identify specific barriers or facilitators to readiness that requires targeted attention from implementers. PMID:25443652

  16. Brassinolide improves embryogenic tissue initiation in conifers and rice.

    Science.gov (United States)

    Pullman, G S; Zhang, Y; Phan, B H

    2003-09-01

    Somatic embryogenesis (SE), the most promising technology for the large-scale production of high-value coniferous trees from advanced breeding and genetic engineering programs, is expected to play an important role in increasing productivity, sustainability, and the uniformity of future U.S. forests. To be successful for commercial use, SE technology must work with a variety of genetically diverse trees. Initiation in loblolly pine ( Pinus taeda L.), our main focus species, is often recalcitrant for desirable genotypes. Initiation percentages of loblolly pine, Douglas-fir [ Pseudotsuga menziesii (Mirb.) Franco], and Norway spruce ( Picea abies L., Karst.) were improved through the use of brassinolide. Brassinosteroids, which include brassinolide, are a relatively new group of natural plant growth regulators that are found in many plant species. They have been shown to have diverse, tissue-specific, and species-specific effects, including the stimulation of cell elongation and ethylene production and increasing resistance to abiotic stress. In our media, brassinolide was effective at concentrations ranging from 0.005-0.25 micro M. Using control medium (no brassinolide) and brassinolide-supplemented (0.1 micro M) medium, we achieved improved initiation percentages in loblolly pine, Douglas-fir, Norway spruce, and rice-15.0% to 30.1%, 16.1% to 36.3%, 34.6% to 47.4%, and 10%, respectively. Brassinolide increased the weight of loblolly pine embryogenic tissue by 66% and stimulated initiation in the more recalcitrant families of loblolly pine and Douglas-fir, thus compensating somewhat for genotypic differences in initiation. Initiation percentages in loblolly pine were improved through the combination of modified 1/2-P6 salts, 50 mg/l activated carbon (AC), adjusted levels of Cu and Zn (to compensate for adsorption by AC), 1.5% maltose, 2% myo-inositol (to raise the osmotic level, partially simulating the megagametophyte environment), 500 mg/l casamino acids, 450 mg/l glutamine, 2 mg/l alpha-naphthaleneacetic acid, 0.63 mg/l 6-benzylaminopurine, 0.61 mg/l kinetin, 3.4 mg/l silver nitrate, 10 micro M cGMP, 0.1 micro M brassinolide, and 2 g/l Gelrite. Across 12 open-pollinated families of loblolly pine, initiation percentages ranged from 2.5% to 50.7%, averaging 22.5%. PMID:12879262

  17. An initial approach towards quality of service based Spectrum Trading

    Science.gov (United States)

    Bastidas, Carlos E. Caicedo; Vanhoy, Garret; Volos, Haris I.; Bose, Tamal

    Spectrum scarcity has become an important issue as demands for higher data rates increase in diverse wireless applications and aerospace communication scenarios. To address this problem, it becomes necessary to manage radio spectrum assignment in a way that optimizes the distribution of spectrum resources among several users while taking into account the quality of service (QoS) characteristics desired by the users of spectrum. In this paper, a novel approach to managing spectrum assignment based on Spectrum Trading (ST) will be presented. Market based spectrum assignment mechanisms such as spectrum trading are of growing interest to many spectrum management agencies that are planning to increase the use of these mechanisms for spectrum management and reduce their emphasis on command and control methods. This paper presents some of our initial work into incorporating quality of service information into the mechanisms that determine how spectrum should be traded when using a spectrum exchange. Through simulations and a testbed implementation of a QoS aware spectrum exchange our results show the viability of using QoS based mechanisms in spectrum trading and in the enhancement of dynamic spectrum assignment systems.

  18. Quality Rating and Improvement Systems: A Strategic Movement for Defining Quality

    Science.gov (United States)

    Neugebauer, Roger

    2009-01-01

    One of the most important trends in the early childhood field is the emergence of quality rating systems (QRS), or quality rating and improvement systems (QRIS), which are designed to assess, improve, and communicate the level of quality of early and school-age care programs. QRS came onto the scene in 1998 when Oklahoma enacted its "Reaching for…

  19. The quality of reporting in clinical research: the CONSORT and STROBE initiatives.

    Science.gov (United States)

    Bolignano, Davide; Mattace-Raso, Francesco; Torino, Claudia; D'Arrigo, Graziella; Abd ElHafeez, S; Elhafeez, Samar Abd; Provenzano, Fabio; Zoccali, Carmine; Tripepi, Giovanni

    2013-04-01

    Inaccurate reporting of data hampers the generalizability and the correct interpretation of results of scientific medical papers. The Consolidated Standards of Reporting Trials (CONSORT) and Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) initiatives, both included in the Enhancing the Quality and Transparency of Health Research (EQUATOR) international network, have elaborated appropriate guidelines in order to improve the transparence, clearness and completeness of scientific literature. The CONSORT statement consists of a 25 items checklist and a flow-chart diagram which provide guidance to Authors on how to report randomized clinical trials. The STROBE is a checklist of 22 items which should be addressed when observational studies (case-control, cohort and cross-sectional) are made up. Many editorial committees and prestigious international journals have now embraced these guidelines to improve the quality and methodology of their scientific reports. PMID:23740628

  20. Quality control of physician-performed mammography. Importance of original attempts to improve quality

    International Nuclear Information System (INIS)

    In order to perform effective breast cancer screening with mammography, family doctors should be encouraged to participate. At institutions without specific radiology technicians, physicians themselves are required to perform mammography and operate the equipment, otherwise it is difficult to consistently obtain good-quality mammograms. Our institutions have been given a grade ''A'' evaluation by the Central Committee for Quality Control of Mammographic Screening (CCQCMS), due largely to our own efforts and promotion. Here we report our experience in solving a number of problems that occurred during the establishment of our system. We used the SEPIO standard mammography apparatus with a MD-100/CM-H screen/filter system, and developed films using a TCX-202 automatic film processor. Problems due to asymmetry of the bilateral breasts and lack of retroglandular fat tissue space and inframammary folds seen on our initial mammograms were overcome by placing marks at the postion of the AEC sensor, and at both ends and the center of the film on a bucky table. We simplified the markers by removing several complicated ones. We tried to rectify areas of the image that were obscured due to the difference in size between the inside of the cassette and the screen. Physicians and a radiology technician attended a mammography study course once weekly, and attempted to improve the quality of mammograms and our reading ability by obtaining advice from members of the CCQCMS. Manufacturece from members of the CCQCMS. Manufacturers responded with considerable delay to our attempt to overcome the troublesome appearance of numerous microcalfication-like artifact shadows caused by screens. In conclusion, in order to perform effective breast cancer screening with mammography, we must obtain mammograms of good quality, for which it is necessary to always try to seek new ways of improving. At the same time, manufacturers need to respond quickly to queries and problems related to quality control. (author)

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

    International Nuclear Information System (INIS)

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

  2. Basic Approaches to Improve Translation Quality Between English and Chinese

    OpenAIRE

    Sanning He

    2009-01-01

    Translation quality assessment, with which both translation theory and practice are concerned, has been discussed and stressed. Translation quality improvement should also be reviewed before assessing and criticizing a translation version. It is very important for the beginners to have the textual awareness, to consider the intra-lingual, the extra-lingual and the transcultural aspects so as to improve translation quality in the process of translating. The awareness development and practice s...

  3. Reviewing the quality of care: Priorities for improvement

    OpenAIRE

    Roberts, James S.

    1987-01-01

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

  4. [Critical reflexion on quality improvement and networking].

    Science.gov (United States)

    Adler, R

    2012-06-01

    Qualitiy-control and networking are two issues of debate in modern medicine. The origin of these terms is not to be found in medicine, but rather in industry. However their naive transfer to the field of medicine causes damage. It is relatively easy to test industrial products for their quality. Dealing with meaningful medical problems is far too complex. Simple data such as blood pressure, HbA1c, etc. may be assessed. The only means of quality-control of complex medical situations and actions are ward rounds by attending physicians, case presentations at staff meetings, etc. Issues of clinical quality-control are discussed on the basis of the history of an aged couple. Furthermore a personal clinical experience illustrates how doctors create a useful network with other physicians and how they eliminate "useless" colleagues from their network. Economists should have no influence or impact whatsoever on the quality-control and networking of physicians. PMID:22669781

  5. THE IMPACT OF SYSTEM QUALITY AND INFORMATION QUALITY IN IMPROVE THE ORGANIZATIONAL PERFORMANCE

    OpenAIRE

    Yaser hasan Al-Mamary; Alina Shamsuddin; Nor Aziati

    2014-01-01

    A system that utilizes user-friendly and modern technologies can present information to users in an easy-to-understand format enabling them to use information systems effectively and improve the performance , high quality of the system leads to high quality of the information .The high quality of information helps organizations in managing their business processes , making decisions , and improve organizational performance. The aim of study is to clarify the impact of system quality, an...

  6. Combining traditional breeding and genomics to improve pork quality

    OpenAIRE

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

    2003-01-01

    Breeding for improved pork quality has been the focus of much research in recent years and some of the results have already been put into practice. The realized genetic response in pork quality to selection within lines has generally been limited, however, compared with the responses obtained for other traits. The relatively limited progress has been caused by lack of incentive to producers from industry, lack of clear definition of pork quality, high costs of collection of pork quality estim...

  7. Improved estimation of structure predictor quality

    OpenAIRE

    Karypis George; DeRonne Kevin W

    2009-01-01

    Abstract Background Methods that can automatically assess the quality of computationally predicted protein structures are important, as they enable the selection of the most accurate structure from an ensemble of predictions. Assessment methods that determine the quality of a predicted structure by comparing it against the various structures predicted by different servers have been shown to outperform approaches that rely on the intrinsic characteristics of the structure itself. Results We ex...

  8. Quality Improvement in Management System: A Case Study of CCTEC Company China

    Directory of Open Access Journals (Sweden)

    Giron Kamonja

    2014-04-01

    Full Text Available Certain difficulties are inherent in the implementation of the improvement of the quality of service, particularly in the Design Management Department. There is often a difference on the issue of translating vision between senior management and Design Department for service improvement into effective, operational QI programs. Middle managers have a key role to play, but often they are overlooked which leads to undermining their efforts to improve the quality programs offered by senior management. This paper describes the first phase of a PhD research project to determine and develop the role of middle management in successful implementation of quality management programs. A framework for quality improvement implementation, including key issues of importance to middle managers regarding their proactive involvement in QI, is suggested. Finally, the initial implementation of the model in a company is discussed.

  9. Nuclear Regulatory Commission initiative for technical specification improvement

    International Nuclear Information System (INIS)

    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

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

    DEFF Research Database (Denmark)

    Boulet, Louis-Philippe; FitzGerald, J Mark

    2012-01-01

    In 1995, the Global Initiative for Asthma (GINA) published an evidence-based workshop report as a guide to clinicians managing asthma patients, and has updated it annually to ensure that recommendations remain current. Although the report has been widely disseminated and influenced clinical 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 settings.

  11. The role of quality control circles in sustained improvement of medical quality

    OpenAIRE

    Wang, Lin-run; Wang, Yang; Lou, Yan; Li, Ying; Zhang, Xing-guo

    2013-01-01

    We used quality control circles (QCC) followed by the PDCA Deming cycle and analyzed the application of QCC to the sustained improvement of a medical institution in Zhejiang province. Analyses of the tangible and intangible achievements of QCC revealed that the achievement indices for reductions in internal errors, reductions in costs, improvements in the degree of patient satisfaction, improvements in work quality, and improvements in economic performance were 109.84% ± 16.47%, 135.04% ± 5...

  12. THE IMPACT OF SYSTEM QUALITY AND INFORMATION QUALITY IN IMPROVE THE ORGANIZATIONAL PERFORMANCE

    Directory of Open Access Journals (Sweden)

    Yaser hasan Al-Mamary

    2014-09-01

    Full Text Available A system that utilizes user-friendly and modern technologies can present information to users in an easy-to-understand format enabling them to use information systems effectively and improve the performance , high quality of the system leads to high quality of the information .The high quality of information helps organizations in managing their business processes , making decisions , and improve organizational performance. The aim of study is to clarify the impact of system quality, and information quality in organizational performance, and explain the relationship between system quality , information quality and organizational performance. This paper reviews other researches. Synthesizing from the literature , We hypothesize a positive relationship between system quality , information quality and organizational performance.

  13. Integrating quality improvement into continuing medical education activities within a community hospital system.

    Science.gov (United States)

    Eiser, Arnold R; McNamee, William B; Miller, Jean Yodis

    2013-01-01

    The integration of the Mercy Health System's quality improvement (QI) and continuing medical educational (CME) activities is described. With the implementation of computerized medical data, the opportunities for QI-focused CME are growing. The authors reviewed their regularly scheduled series and special CME programs to assess their impact on quality care processes. Clinical improvements were affected by combining national guidelines and advancements with local clinical data and interactions with physicians within interdisciplinary as well as specialty conferences. Case-based, multidisciplinary conferences lent themselves to this process to a greater extent than didactic conferences. The latter also could lead to QI when the topics were focused on specific quality initiatives that often are part of a national QI initiative. Although the authors consider these efforts to be at an intermediate stage of development, they have observed several QI/patient safety process improvements. PMID:22984092

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

    OpenAIRE

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

    2005-01-01

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

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

    OpenAIRE

    Parand, A.; Dopson, S.; Vincent, C.

    2013-01-01

    OBJECTIVES: To identify the critical dimensions of hospital Chief Executive Officers' (CEOs) involvement in a quality and safety 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 programm...

  16. Danish initiatives to improve the safety of meat products

    DEFF Research Database (Denmark)

    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 system, as well as increased international collaboration on surveillance, are both elements in this new strategy.

  17. Improving wind power quality with energy storage

    OpenAIRE

    Rasmussen, Claus Nygaard

    2011-01-01

    The results of simulation of the influence of energy storage on wind power quality are presented. Simulations are done using a mathematical model of energy storage. Results show the relation between storage power and energy, and the obtained increase in minimum available power from the combination of wind and storage. The introduction of storage enables smoothening of wind power on a timescale proportional to the storage energy. Storage does not provide availability of wind power at all times...

  18. IUPQC Simulations for Power Quality Improvement

    OpenAIRE

    Rajeev, S.

    2014-01-01

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

  19. Improved estimation of structure predictor quality

    Directory of Open Access Journals (Sweden)

    Karypis George

    2009-06-01

    Full Text Available Abstract Background Methods that can automatically assess the quality of computationally predicted protein structures are important, as they enable the selection of the most accurate structure from an ensemble of predictions. Assessment methods that determine the quality of a predicted structure by comparing it against the various structures predicted by different servers have been shown to outperform approaches that rely on the intrinsic characteristics of the structure itself. Results We examined techniques to estimate the quality of a predicted protein structure based on prediction consensus. LGA is used to align the structure in question to the structures for the same protein predicted by different servers. We examine both static (e.g. averaging and dynamic (e.g. support vector machine methods for aggregating these distances on two datasets. Conclusion We find that a constrained regression approach shows consistently good performance. Although it is not always the absolute best performing scheme, it is always performs on par with the best schemes across multiple datasets. The work presented here provides the basis for the construction of a regression model trained on data from existing structure prediction servers.

  20. Process safety improvement-Quality and target zero

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-11-15

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

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

    Science.gov (United States)

    Van Scyoc, Karl

    2008-11-15

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

  2. Process safety improvement-Quality and target zero

    International Nuclear Information System (INIS)

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

  3. A Systemwide Approach to Improving Early Childhood Program Quality in the Detroit Metropolitan Area. Final Report.

    Science.gov (United States)

    Shouse, A. Clay; Epstein, Ann S.

    This document is the final report of the McGregor-funded High/Scope training initiative, a system-wide approach to improving the quality of early childhood programs in the Detroit metropolitan area. The 3-year project was based on the validated High/Scope educational approach and training model, which advocates hands-on active learning for both…

  4. Initiatives for the improvement of continuous management training

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

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

    2014-01-01

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

  6. Computer supported visualization to support continuous improvements within quality systems

    OpenAIRE

    Blome?, Mikael; Odenrick, Per

    2001-01-01

    This paper presents a study wherein computer supported visualization is used to design and enhance understanding of quality systems. The study attempts to discover if a quality system such as ISO 9000 can be visualized, and how the visualization should be designed in order to support continuous improvement. Three companies in southern Sweden have set up special groups (here called design groups) whose purpose is to establish principles for models to visualize their quality systems on the Intr...

  7. IMPROVING (SOFTWARE) PATENT QUALITY THROUGH THE ADMINISTRATIVE PROCESS

    OpenAIRE

    Rai, Arti K.

    2013-01-01

    The available evidence indicates that patent quality, particularly in the area of software, needs improvement. This Article argues that even an agency as institutionally constrained as the U.S. Patent and Trademark Office (“PTO”) could implement a portfolio of pragmatic, cost-effective quality improvement strategies. The argument in favor of these strategies draws upon not only legal theory and doctrine but also new data from a PTO software examination unit with relatively strict practice...

  8. Managing soil under vegetable production to improve soil quality

    Science.gov (United States)

    Over the years, soil quality has eroded as soil organic matter has declined on farms across North Carolina. This study is assessing the effects of tillage practice, winter cover cropping and compost use on changes in soil function and improvement in soil quality under vegetable production. The field...

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

    Science.gov (United States)

    Forer, Mike; Haus, El

    2000-01-01

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

  10. A Glaser magnet of improved field quality

    International Nuclear Information System (INIS)

    Glaser magnets are used for focusing low-energy charged particle beams. But these magnets show appreciable aberrations which cause an increase in the beam emittance. We have designed and fabricated an improved Glaser magnet which reduces these aberrations. This has been achieved by tapering the pole pieces of the magnet. (author)

  11. [Quality assurance and quality improvement in medical practice. Part 3: Clinical audit in medical practice].

    Science.gov (United States)

    Godény, Sándor

    2012-02-01

    The first two articles in the series were about the definition of quality in healthcare, the quality approach, the importance of quality assurance, the advantages of quality management systems and the basic concepts and necessity of evidence based medicine. In the third article the importance and basic steps of clinical audit are summarised. Clinical audit is an integral part of quality assurance and quality improvement in healthcare, that is the responsibility of any practitioner involved in medical practice. Clinical audit principally measures the clinical practice against clinical guidelines, protocols and other professional standards, and sometimes induces changes to ensure that all patients receive care according to principles of the best practice. The clinical audit can be defined also as a quality improvement process that seeks to identify areas for service improvement, develop and carry out plans and actions to improve medical activity and then by re-audit to ensure that these changes have an effect. Therefore, its aims are both to stimulate quality improvement interventions and to assess their impact in order to develop clinical effectiveness. At the end of the article key points of quality assurance and improvement in medical practice are summarised. PMID:22275732

  12. Quality improvement in neurology: Distal symmetric polyneuropathy quality measures.

    Science.gov (United States)

    England, John D; Franklin, Gary; Gjorvad, Gina; Swain-Eng, Rebecca; Brannagan, Thomas H; David, William S; Dubinsky, Richard M; Smith, Benn E

    2014-05-13

    Peripheral neuropathy is a common neurologic disorder, affecting 2% to 8% of the population in population-based studies with confirmation by neurologist examination. These prevalence numbers are remarkably stable across developed countries. In 1999, 8.6% of Medicare beneficiaries had neuropathy as a primary or secondary diagnosis, and the cost of treatment was estimated at $3.5 billion (Consumer Price Index adjusted to 2013 $4.9 billion), which did not include outpatient medications. Peripheral neuropathy has many causes and varies in regard to its clinical manifestations and severity. Distal symmetric polyneuropathy (DSP) is the most common pattern of peripheral neuropathy generally and the most common phenotype of neuropathy due to diabetes. Reported prevalence rates of DSP among diabetic patients range from 15% to 37% across large population-based studies, and the prevalence among those with impaired glucose tolerance has been reported to be 11%. DSP can result in weakness, sensory loss, pain, autonomic dysfunction, gait impairment, falls, disability, and impaired quality of life. PMID:24696504

  13. Advanced quality management for wood-fired cogeneration plants. Transfrontier initiative; Neues Qualitaetsmanagement fuer Holzheizwerke. Grenzueberschreitende Initiative

    Energy Technology Data Exchange (ETDEWEB)

    Leuchtweis, C.; Krapf, G. [C.A.R.M.E.N. e.V., Straubing (Germany)

    2005-09-15

    Modern wood-fuelled heating systems provide low-emission heat with high efficiency. In order to improve the quality of their systems, experts from Baden-Wuerttemberg, Bavaria, Austria and Switzerland developed common quality standards for bigger wood-fuelled heating systems in the so-called ''QM Holzheizwerke'' project. (orig.)

  14. Using IT to Improve Quality at NewYork-Presybterian Hospital: A Requirements-Driven Strategic Planning Process

    OpenAIRE

    Kuperman, Gilad J.; Boyer, Aurelia; Cole, Curt; Forman, Bruce; Stetson, Peter D.; Cooper, Mary

    2006-01-01

    At NewYork-Presbyterian Hospital, we are committed to the delivery of high quality care. We have implemented a strategic planning process to determine the information technology initiatives that will best help us improve quality. The process began with the creation of a Clinical Quality and IT Committee. The Committee identified 2 high priority goals that would enable demonstrably high quality care: 1) excellence at data warehousing, and 2) optimal use of automated clinical documentation to c...

  15. Continuous Quality Improvement: Implementation and Sustainability

    OpenAIRE

    Yella, Gilbert Ncheh; Atem, Tongwa Ivo

    2007-01-01

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

  16. A Model to Improve the Quality Products

    OpenAIRE

    Gokkaya, Hasan; Boca, Gratiela Dana

    2010-01-01

    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 ac...

  17. Early-career registered nurses' participation in hospital quality improvement activities.

    Science.gov (United States)

    Djukic, Maja; Kovner, Christine T; Brewer, Carol S; Fatehi, Farida K; Bernstein, Ilya

    2013-01-01

    We surveyed 2 cohorts of early-career registered nurses from 15 states in the US, 2 years apart, to compare their reported participation in hospital quality improvement (QI) activities. We anticipated differences between the 2 cohorts because of the growth of several initiatives for engaging nurses in QI. There were no differences between the 2 cohorts across 14 measured activities, except for their reported use of appropriate strategies to improve hand-washing compliance to reduce nosocomial infection rates. PMID:23192224

  18. Improvement of power quality using distributed generation

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-12-15

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

  19. Quality improvement: analysis and modeling based on survey results.

    Science.gov (United States)

    Radovilsky, Z D

    1993-12-01

    This paper describes the results of the survey conducted in the manufacturing, distribution, and service organizations regarding total quality management (TQM) implementation. These results proved that an effective TQM program should contain consistent training of all employees and managers in TQM issues, significant improvement in communication methods between departments implementing TQM, development of the standards to measure and control the cost of quality, and reliable information about the results of TQM implementation. Based on the survey results, the quantitative relationships between quality improvement characteristics and different internal factors are presented. Statistical models described in the paper revealed leading predictors of a successful TQM implementation. PMID:7952972

  20. Combining clinical microsystems and an experiential quality improvement curriculum to improve residency education in internal medicine.

    Science.gov (United States)

    Tess, Anjala V; Yang, Julius J; Smith, C Christopher; Fawcett, Caitlin M; Bates, Carol K; Reynolds, Eileen E

    2009-03-01

    Beth Israel Deaconess Medical Center's internal medicine residency program was admitted to the new Education Innovation Project accreditation pathway of the Accreditation Council of Graduate Medical Education to begin in July 2006. The authors restructured the inpatient medical service to create clinical microsystems in which residents practice throughout residency. Program leadership then mandated an active curriculum in quality improvement based in those microsystems. To provide the experience to every graduating resident, a core faculty in patient safety was trained in the basics of quality improvement. The authors hypothesized that such changes would increase the number of residents participating in quality improvement projects, improve house officer engagement in quality improvement work, enhance the culture of safety the residents perceive in their training environment, improve work flow on the general medicine ward rotations, and improve the overall educational experience for the residents on ward rotations.The authors describe the first 18 months of the intervention (July 2006 to January 2008). The authors assessed attitudes and the educational experience with surveys and evaluation forms. After the intervention, the authors documented residents' participation in projects that overlapped with hospital priorities. More residents reported roles in designing and implementing quality improvement changes. Residents also noted greater satisfaction with the quality of care they deliver. Fewer residents agreed or strongly agreed that the new admitting system interfered with communication. Ongoing residency program assessment showed an improved perception of workload, and educational ratings of rotations improved. The changes required few resources and can be transported to other settings. PMID:19240439

  1. Peripheral intravenous and central catheter algorithm: a proactive quality initiative.

    Science.gov (United States)

    Wilder, Kerry A; Kuehn, Susan C; Moore, James E

    2014-12-01

    Peripheral intravenous (PIV) infiltrations causing tissue damage is a global issue surrounded by situations that make vascular access decisions difficult. The purpose of this quality improvement project was to develop an algorithm and assess its effectiveness in reducing PIV infiltrations in neonates. The targeted subjects were all infants in our neonatal intensive care unit (NICU) with a PIV catheter. We completed a retrospective chart review of the electronic medical record to collect 4th quarter 2012 baseline data. Following adoption of the algorithm, we also performed a daily manual count of all PIV catheters in the 1st and 2nd quarters 2013. Daily PIV days were defined as follows: 1 patient with a PIV catheter equals 1 PIV day. An infant with 2 PIV catheters in place was counted as 2 PIV days. Our rate of infiltration or tissue damage was determined by counting the number of events and dividing by the number of PIV days. The rate of infiltration or tissue damage was reported as the number of events per 100 PIV days. The number of infiltrations and PIV catheters was collected from the electronic medical record and also verified manually by daily assessment after adoption of the algorithm. To reduce the rate of PIV infiltrations leading to grade 4 infiltration and tissue damage by at least 30% in the NICU population. Incidence of PIV infiltrations/100 catheter days. The baseline rate for total infiltrations increased slightly from 5.4 to 5.68/100 PIV days (P = .397) for the NICU. We attributed this increase to heightened awareness and better reporting. Grade 4 infiltrations decreased from 2.8 to 0.83/100 PIV catheter days (P = .00021) after the algorithm was implemented. Tissue damage also decreased from 0.68 to 0.3/100 PIV days (P = .11). Statistical analysis used the Fisher exact test and reported as statistically significant at P < .05. Our findings suggest that utilization of our standardized decision pathway was instrumental in providing guidance for problem solving related to vascular access decisions. We feel this contributed to the overall reduction in grade 4 intravenous infiltration and tissue damage rates. Grade 4 infiltration reductions were highly statistically significant (P = .00021). PMID:25313800

  2. Power quality improvement with an extended custom power park

    Energy Technology Data Exchange (ETDEWEB)

    Meral, M. Emin; Teke, Ahmet; Bayindir, K. Cagatay; Tumay, Mehmet [Cukurova University, Department of Electrical and Electronics Engineering, Balcali, 01330, Adana (Turkey)

    2009-11-15

    This paper describes the operation principles of an extended custom power park (CPP). The proposed park is more effective when it is compared to the conventional power parks regarding the yield of improving both current and voltage quality of linear and nonlinear loads using dynamic voltage restorer (DVR), active power filter (APF), static transfer switch (STS) and diesel generator (DG). Moreover, a supervisory power quality control centre is presented to coordinate these custom power (CP) devices by providing pre-specified quality of power. A fast sag/swell detection unit is also presented to improve the system response. The ability of the extended CPP for power quality improvements is further analyzed using PSCAD/EMTDC through a set of simulation tests. (author)

  3. Sources of Indoor Air Pollution- Improving Indoor Air Quality

    Science.gov (United States)

    There are three basic strategies to improve indoor air quality: source control, improved ventilation, and air cleaners. This site offers the reader some insights to improving air quality through increased ventilation, air cleaners for particle removal, and other common sense methods that may be employed. Many times the quality of the air in our homes and public or office buildings is marginal at best. The sources of indoor pollution may be outside of our ability to rectify or it may be as simple as adjusting the flame on our furnace or kitchen stove or maybe something as simple as opening a door or window. However, in many instances we have no control over the air quality because of the materials used in the construction of the building.

  4. Quality assurance and performance improvement in intraoperative neurophysiologic monitoring programs.

    Science.gov (United States)

    Tamkus, Arvydas A; Rice, Kent S; McCaffrey, Michael T

    2013-03-01

    Quality assurance (QA) as it relates to intraoperative neurophysiological monitoring (IONM) can be defined as the systematic monitoring, evaluation, and modification of the IONM service to insure that desired standards of quality are being met. In practice, that definition is usually extended to include the concept that the quality of the IONM service will be improved wherever possible and, although there are some differences in the two terms, in this article the term QA will be understood to include quality improvement (QI) processes as well. The measurement and documentation of quality is becoming increasingly important to healthcare providers. This trend is being driven by pressures from accrediting agencies, payers, and patients. The essential elements of a QA program are described. A real-life example of QA techniques and management relevant to IONM providers is presented and discussed. PMID:23682539

  5. Workbook for Taguchi Methods for Product Quality Improvement.

    Science.gov (United States)

    Zarghami, Ali; Benbow, Don

    Taguchi methods are methods of product quality improvement that analyze major contributions and how they can be controlled to reduce variability of poor performance. In this approach, knowledge is used to shorten testing. Taguchi methods are concerned with process improvement rather than with process measurement. This manual is designed to be used…

  6. Applying GRA and QFD to Improve Library Service Quality

    Science.gov (United States)

    Chen, Yen-Ting; Chou, Tsung-Yu

    2011-01-01

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

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

    Science.gov (United States)

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

    2013-08-01

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

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

    International Nuclear Information System (INIS)

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

  9. Perceptions of the impact of a large-scale collaborative improvement programme: experience in the UK Safer Patients Initiative.

    OpenAIRE

    Benn, J.; Burnett, S; Parand, A.; Pinto, A.; Iskander, S.; Vincent, C.

    2009-01-01

    RATIONALE AND AIMS: In several countries, collaborative improvement programmes involving multiple health care organizations have been developed to address the issue of patient safety and reliability of care at an organization-wide level. In the UK, the Health Foundation's Safer Patients Initiative (SPI) was developed to achieve breakthrough improvement in the quality and safety of care in 24 acute hospital Trusts between 2004 and 2008. Research evidence for the effectiveness of programmes of ...

  10. Software Quality Improvement in the OMC Team

    CERN Document Server

    Maier, Viktor

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

  11. Design and Simulation of STATCOM to Improve Power Quality

    Directory of Open Access Journals (Sweden)

    Md. Nazrul Islam

    2013-07-01

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

  12. 78 FR 55257 - Patient Safety and Quality Improvement: Civil Money Penalty Inflation Adjustment

    Science.gov (United States)

    2013-09-10

    ...DEPARTMENT OF HEALTH AND HUMAN SERVICES Patient Safety and Quality Improvement: Civil...confidentiality provisions of the Patient Safety and Quality Improvement Rule is...INFORMATION: I. Background The Patient Safety and Quality and Improvement...

  13. 42 CFR 460.136 - Internal quality assessment and performance improvement activities.

    Science.gov (United States)

    2010-10-01

    ...of quality assessment and performance improvement activities...in quality assessment and performance improvement activities...that all interdisciplinary team members, PACE staff, and...of quality assessment and performance improvement activities...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-04-15

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

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

    Scientific Electronic Library Online (English)

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

    2014-01-01

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

  16. 42 CFR 482.21 - Condition of participation: Quality assessment and performance improvement program.

    Science.gov (United States)

    2010-10-01

    ...Quality assessment and performance improvement program. 482...DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED...Quality assessment and performance improvement program. The...implement an information technology system...

  17. Improvement of cassava cooking quality through mutation breeding

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    Kelebeletse O. Mokobela

    2014-11-01

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

  19. Quality improvement process pilot project at Gallagher station

    International Nuclear Information System (INIS)

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

  20. Assessing local resources and culture before instituting quality improvement projects.

    Science.gov (United States)

    Hawkins, C Matthew

    2014-12-01

    The planning phases of quality improvement projects are commonly overlooked. Disorganized planning and implementation can escalate chaos, intensify resistance to change, and increase the likelihood of failure. Two important steps in the planning phase are (1) assessing local resources available to aid in the quality improvement project and (2) evaluating the culture in which the desired change is to be implemented. Assessing local resources includes identifying and engaging key stakeholders and evaluating if appropriate expertise is available for the scope of the project. This process also involves engaging informaticists and gathering available IT tools to plan and automate (to the extent possible) the data-gathering, analysis, and feedback steps. Culture in a department is influenced by the ability and willingness to manage resistance to change, build consensus, span boundaries between stakeholders, and become a learning organization. Allotting appropriate time to perform these preparatory steps will increase the odds of successfully performing a quality improvement project and implementing change. PMID:25467724

  1. The strategic deployment of quality-improvement innovations

    OpenAIRE

    Costa, Luis Almeida; Dierickx, Ingmar

    2005-01-01

    While most of the literature on innovation has been concerned with the firm's research and development decisions, this paper addresses the question of how to deploy an innovation to fully realize its rent potential. More specifically, we use a game theoretic model to study the deployment of quality-improving innovation, i.e., innovations that enhance the quality of an existing (or basic) product. Three deployment strategies are compared: captive use, where the firm uses the innovation to enha...

  2. Improving the Quality of FORS2 Reduced Spectra

    CERN Document Server

    Moehler, Sabine; Boffin, Henri; Rupprecht, Gero; Saviane, Ivo; Freudling, Wolfram

    2015-01-01

    The FORS2 instrument is one of the most widely used and productive instruments on the Very Large Telescope. This article reports on a project to improve the quality of the reduced FORS2 spectra that can be produced with the software provided by ESO. The result of this effort is that spectra of significantly higher quality can now be produced with substantially lower effort by the science user of the data.

  3. Quality improvement in nursing: Administrative mandate or professional responsibility?

    OpenAIRE

    Izumi, Shigeko

    2012-01-01

    For professionals, providing quality service and striving for excellence are ethical responsibilities. In many hospitals in the U.S., however, there is evidence indicating current quality improvement (QI) involving nurses is not always driven by their professional accountability and professional values. QI has become more an administrative mandate than an ethical standard for nurses. In this paper, the tension between QI as nurses’ professional ethics and an administrative mandate will be d...

  4. IMPROVING BANK QUALITY DIMENSIONS TO INCREASE CUSTOMER SATISFACTION

    OpenAIRE

    Radomir, La?cra?mioara; Wilson, Alan; Andrei Mircea Scridon

    2011-01-01

    The purpose of this study is twofold: 1. examine the relationship betweenservice quality dimensions and customer satisfaction with bank territorialunits; 2. establish which quality measure method out of the four considered inthis study should be applied in order to better determine the areas that needfurther improvement and investment. In this respect, we performed PrincipalComponent Regression (PCR) and considered direct importance andperformance measures as well. Our results reveal that hum...

  5. Introducing a quality improvement programme to primary healthcare teams

    OpenAIRE

    Hearnshaw, H.; Reddish, S.; Carlyle, D.; Baker, R.; Robertson, N.

    1998-01-01

    OBJECTIVES: To evaluate a programme in which quality improvement was facilitated, based on principles of total quality management, in primary healthcare teams, and to determine its feasibility, acceptability, effectiveness, and the duration of its effect. METHOD: Primary healthcare teams in Leicestershire (n = 147) were invited to take part in the facilitated programme. The programme comprised seven team meetings, led by a researcher, plus up to two facilitated meeting...

  6. Air Quality in Leiden. Assessment of measures to improve the air quality in Leiden

    International Nuclear Information System (INIS)

    Extra measures to improve the air quality in the city of Leiden, Netherlands, are required in order to meet European regulation with respect to the emission of nitrogen oxides and particulates (PM10). An overview is given of the feasibility of measures as formulated in the Air Quality Plan for Leiden

  7. Improved initial guess for minimum energy path calculations

    OpenAIRE

    Smidstrup, Søren; Pedersen, Andreas; Stokbro, Kurt; Jo?nsson, Hannes

    2014-01-01

    A method is presented for generating a good initial guess of a transition path between given initial and final states of a system without evaluation of the energy. An objective function surface is constructed using an interpolation of pairwise distances at each discretization point along the path and the nudged elastic band method then used to find an optimal path on this image dependent pair potential (IDPP) surface. This provides an initial path for the more computationall...

  8. CT-guided biopsies. Quality, complications and impact on treatment. A retrospective initial quality control

    International Nuclear Information System (INIS)

    Purpose: To retrospectively evaluate the quality and complications of CT-guided biopsies and their impact on treatment. Materials and Methods: A total of 265 CT-guided interventions performed during a 6-month period were extracted by digital database query. These included 127 CT-guided biopsies, which were classified by patient age, organ/body area, histopathological biopsy diagnosis, complications, and performing physician. Results: In 51 % of cases (65/127), CT-guided biopsies led to a malignant diagnosis and a change in the patient's treatment. Retrospectively, complications were to be expected in a range of 12 - 26 %, given a 95 % confidence interval. In terms of organ/body area, most complications occurred in lung biopsies (23 / 56; 41 %). 80 % of CT-guided biopsies were performed without complications. 2 of the 11 physicians performed 66 % of all biopsies (84 / 127) and had significantly fewer complications than the others. Patient age was a statistically significant factor for complications (p < 0.018) as well as for a malignant biopsy diagnosis (p < 0.009). Conclusion: Our initial quality control assessment suggests that frequent use of CT-guided biopsy by the performing physician rather than the general level of experience is associated with fewer complications for patients. Age is a significant factor for complications of CT-guided biopsies, thus leading to an increased risk/benefit ratio. As expected, age also significantly increases the risk of a malignantficantly increases the risk of a malignant biopsy result. Complications and malignant biopsy results were not significantly associated. CT-guided biopsies triggered a change in treatment in over 50 % of cases. (orig.)

  9. Active power line conditioners for improving electric power quality

    Energy Technology Data Exchange (ETDEWEB)

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

    1992-12-31

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

  10. No Respect: Research in Quality, Safety, and Process Improvement

    OpenAIRE

    Rubinfeld, Ilan S.; Horst, H. Mathilda

    2009-01-01

    The need for good quality and safety research has never been more imperative, but even as we encourage and promote such work, we seem to suppress it through institutional bias and inertia. Indeed the culture of health care seems to have a love-hate relationship with quality-improvement work as a whole. In this commentary we explore some of the implications of the application of pure science standards at the sharp end of clinical practice, where the down-and-dirty street-level improvement work...

  11. Progress report: Chile's primary health care quality assessment and improvement program.

    Science.gov (United States)

    1992-05-01

    A progress report on the primary health care quality assessment and improvement program in Chile is presented. In March 1991, the Quality Assurance Project (QAP) and the Primary Health Care Department of the Ministry of Health of Chile initiated a collaborative effort to improve the quality of primary health care services. During the first year of the project, significant progress has been made. Over 400 health professionals nationwide have received basic training in quality assurance, and over 30 quality improvement activities are underway. The project started by raising awareness among top-level managers. Next, reflecting the decentralized focus of Chile's health system, training and technical assistance were provided to managers and supervisors at the district level. Chilean health professionals trained by QAP are encouraged to meet with their clinic staffs to identify problems that affect the quality of their services, and determine the causes of these problems. While the project focuses on primary health care clinics in the public sector, QAP is also working with universities, professional associations, and nongovernmental organizations. Because of their expertise and influence in primary health care, these entities have been an integral part of the effort from the outset. Included in this paper are the three main components of the quality assurance (QA) effort in Chile: training, application of QA methods, and institutionalization. PMID:12295541

  12. Data quality objectives for the initial fuel conditioning examinations

    International Nuclear Information System (INIS)

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

  13. IMPROVING CONCEPTUAL DESIGN QUALITY : BY USE OF QFD & DFMA PROCESSES

    DEFF Research Database (Denmark)

    Bush, Stuart; Robotham, Antony John

    1999-01-01

    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 developers, and the successes achieved using each have been widely reported. Here, though, we will share our experiences of using these tools with novice designers, i.e. student engineers.The use of both QFD and DFMA has proven to be a valuable approach for ensuring that a balanced consideration of design 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 ofDFMA analysis results allows the novice 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 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.

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

    International Nuclear Information System (INIS)

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

  15. Effect of alternate day collection on semen quality of Asian elephants (Elephas maximus) with poor initial fresh semen quality

    OpenAIRE

    Imrat, Podjana; Mahasawangkul, Sittidet; Thitaram, C.; Suthanmapinanth, P.; Kornkaewrat, K.; Sombutputorn, P.; Jansittiwate, S.; Thongtip, N.; Pinyopummin, A.; Colenbrander, B.; Holt, W. V.; Stout, Tom A. E.

    2014-01-01

    In captivity, male Asian elephants often yield poor quality semen after transrectal manually assisted semen collection; however, the reasons for the disappointing semen quality are not clear. Here we test the hypothesis that accumulation of senescent spermatozoa is a contributory factor, and that semen quality can therefore be improved by more frequent ejaculation. To this end we investigated the effect of collecting semen five times on alternate days, after a long period of sexual rest, on s...

  16. Continuous quality improvement: educating towards a culture of clinical governance

    OpenAIRE

    Heard, S.; Schiller, G.; Aitken, M.; Fergie, C.; Hall, L.

    2001-01-01

    The National Health Service in England and Wales has recently adopted a policy aimed at embedding continuous quality improvement (CQI) at all levels and across all services. The key goal is to achieve changes in practice which improve patient outcomes. This paper describes the use of a training course for multiprofessional groups of participants tailored to offer them relevant knowledge, management and team working skills, and approaches to personal and career development. These were intended...

  17. PROCESSES FOR QUALITY IMPROVEMENTS IN RADIATION ONCOLOGY CLINICAL TRIALS

    OpenAIRE

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

    2008-01-01

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

  18. TaaS for Improving Quality of Restful Web Services

    OpenAIRE

    Shueh-Cheng Hu; I-Ching Chen

    2013-01-01

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

  19. Radionuclide calibrator comparisons ad quality improvement in nuclear medicine

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  1. Improved initial guess for minimum energy path calculations

    CERN Document Server

    Smidstrup, Søren; Stokbro, Kurt; Jónsson, Hannes

    2014-01-01

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

  2. Defining and assessing quality improvement outcomes: a framework for public health.

    Science.gov (United States)

    McLees, Anita W; Nawaz, Saira; Thomas, Craig; Young, Andrea

    2015-04-01

    We describe an evidence-based framework to define and assess the impact of quality improvement (QI) in public health. Developed to address programmatic and research-identified needs for articulating the value of public health QI in aggregate, this framework proposes a standardized set of measures to monitor and improve the efficiency and effectiveness of public health programs and operations. We reviewed the scientific literature and analyzed QI initiatives implemented through the Centers for Disease Control and Prevention's National Public Health Improvement Initiative to inform the selection of 5 efficiency and 8 effectiveness measures. This framework provides a model for identifying the types of improvement outcomes targeted by public health QI efforts and a means to understand QI's impact on the practice of public health. PMID:25689185

  3. PLACEMENT OF RIPARIAN FOREST BUFFERS TO IMPROVE WATER QUALITY

    Science.gov (United States)

    Riparian forest buffers can improve stream water quality, provided they intercept and remove contaminants from surface runoff and/or shallow groundwater. Soils, topography, hydrology, and surficial geology determine the capability of forest buffers to intercept and treat these flows. This paper desc...

  4. ACHIEVING IRRIGATION RETURN FLOW QUALITY CONTROL THROUGH IMPROVED LEGAL SYSTEMS

    Science.gov (United States)

    The key to irrigated agricultural return flow quality control is proper utilization and management of the resource itself, and an accepted tool in out society is the law. This project is designed to develop legal alternatives that will facilitate the implementation of improved wa...

  5. Software quality and process improvement in scientific simulation codes

    Energy Technology Data Exchange (ETDEWEB)

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

    1997-11-01

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

  6. Surface quality of silicon wafer improved by hydrodynamic effect polishing

    Science.gov (United States)

    Peng, Wenqiang; Guan, Chaoliang; Li, Shengyi

    2014-08-01

    Differing from the traditional pad polishing, hydrodynamic effect polishing (HEP) is non-contact polishing with the wheel floated on the workpiece. A hydrodynamic lubricated film is established between the wheel and the workpiece when the wheel rotates at a certain speed in HEP. Nanoparticles mixed with deionized water are employed as the polishing slurry, and with action of the dynamic pressure, nanoparticles with high chemisorption due to the high specific surface area can easily reacted with the surface atoms forming a linkage with workpiece surface. The surface atoms are dragged away when nanoparticles are transported to separate by the flow shear stress. The development of grand scale integration put extremely high requirements on the surface quality on the silicon wafer with surface roughness at subnanometer and extremely low surface damage. In our experiment a silicon sample was processed by HEP, and the surface topography before and after polishing was observed by the atomic force microscopy. Experiment results show that plastic pits and bumpy structures on the initial surface have been removed away clearly with the removal depth of 140nm by HEP process. The processed surface roughness has been improved from 0.737nm RMS to 0.175nm RMS(10?m×10?m) and the section profile shows peaks of the process surface are almost at the same height. However, the machining ripples on the wheel surface will duplicate on the silicon surface under the action of the hydrodynamic effect. Fluid dynamic simulation demonstrated that the coarse surface on the wheel has greatly influence on the distribution of shear stress and dynamic pressure on the workpiece surface.

  7. Current issues in quality improvement in cystic fibrosis.

    Science.gov (United States)

    Quinton, Hebe B; O'Connor, Gerald T

    2007-06-01

    The modern history of cystic fibrosis (CF) is one of continuous improvement. Guidelines and evidence-based medicine provide a general roadmap for directing improvement efforts. Data and measurement are central to quality improvement (QI), a way of keeping score and staying on track. This article describes the history and context of QI in CF, the use of guidelines and data with some examples from the work of one regional consortium, some approaches to developing QI skills with a view to implementing and managing desired changes in CF clinic settings, and the potential benefits and impact of public reporting and data transparency. PMID:17467560

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

    Directory of Open Access Journals (Sweden)

    Tang Wai Mun

    2013-11-01

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

  9. INTEGRATED SAFETY MANAGEMENT SYSTEM SAFETY CULTURE IMPROVEMENT INITIATIVE

    Energy Technology Data Exchange (ETDEWEB)

    MCDONALD JA JR

    2009-01-16

    In 2007, the Department of Energy (DOE) identified safety culture as one of their top Integrated Safety Management System (ISMS) related priorities. A team was formed to address this issue. The team identified a consensus set of safety culture principles, along with implementation practices that could be used by DOE, NNSA, and their contractors. Documented improvement tools were identified and communicated to contractors participating in a year long pilot project. After a year, lessons learned will be collected and a path forward determined. The goal of this effort was to achieve improved safety and mission performance through ISMS continuous improvement. The focus of ISMS improvement was safety culture improvement building on operating experience from similar industries such as the domestic and international commercial nuclear and chemical industry.

  10. Participatory Patterns in an International Air Quality Monitoring Initiative

    CERN Document Server

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Hans Viggo Sæbø

    2014-12-01

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

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

    Ji, Zhou

    2009-01-01

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

  14. Improved initial guess for minimum energy path calculations

    International Nuclear Information System (INIS)

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

  15. Improved initial guess for minimum energy path calculations

    Science.gov (United States)

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

    2014-06-01

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

  16. Guided imagery: an innovative approach to improving maternal sleep quality.

    Science.gov (United States)

    Schaffer, Linda; Jallo, Nancy; Howland, Lois; James, Kathy; Glaser, Dale; Arnell, Kathy

    2013-01-01

    Mothers of preterm infants are at risk for poor sleep quality, which may adversely affect their health, maternal-infant attachment, and infant caretaking activities. This study examined the relationship of an 8-week relaxation guided imagery intervention on sleep quality and the association between sleep quality and maternal distress (perceived stress, depressive symptoms, and state anxiety) in 20 mothers of hospitalized preterm infants. Mothers received a CD (compact disc) with three 20-minutes recordings and were asked to listen to at least 1 recording daily for 8 weeks. This analysis used self-report data gathered at baseline and 8 weeks. Pearson correlations were used to examine the relationships between mean cumulative relaxation guided imagery use and measures of maternal distress and sleep quality scores at 8 weeks. Complete data on 19 mothers were available for analysis. At 8 weeks, higher mean relaxation guided imagery use was inversely correlated with sleep quality scores (r = -0.30); sleep quality scores were positively correlated with stress (r = 0.42), depressive symptoms (r = 0.34), and anxiety (r = 0.39) scores. In mothers of preterm infants, sleep quality was negatively affected by mental distress and may be improved by a guided imagery intervention. PMID:23618936

  17. Is the quality of care in general medical practice improving? Results of a longitudinal observational study.

    OpenAIRE

    Campbell, Stephen; Steiner, Andrea; Robison, Judy; Webb, Dale; Raven, Ann; Roland, Martin

    2003-01-01

    BACKGROUND: The demand for increased accountability within health care has led to a myriad of government initiatives in the United Kingdom, with the aim of improving care, setting minimum standards, and addressing poor performance. AIM: To assess the quality of care in English general practice in the year 2001 compared with 1998, in terms of access, interpersonal care, and clinical care (chronic disease management, elderly care, and mental health care). DESIGN OF STUDY: Observational study in...

  18. Defect Investigation as a Tool for Quality Improvement

    Directory of Open Access Journals (Sweden)

    B. Gurumurthy

    2012-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Xiaowei Jiang

    2013-07-01

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

  20. SPIHT Algorithm with Huffman Encoding for Image Compression and Quality Improvement over MIMO OFDM Channel

    Directory of Open Access Journals (Sweden)

    Dnyaneshwar.K

    2013-12-01

    Full Text Available In this paper, Compression and improving the Quality of images during the transmission using SPIHT algorithm combined with Huffman encoding over OFDM channel has been proposed. Initially decompose the image in to different level, the compressed coefficients are arranged in descending order of priority and mapped over the channels. The coefficients with lower importance level, which are likely to mapped over the bad sub channels, are discarded at the transmitter to save power without significant loss of reception quality. Next SPIHT embedded encoder algorithm combined with Huffman encoder is applied for further compression. Finally the Huffman and SPIHT decoding of the embedded encoder is done. In this technique reduce the number of encoding bits and improving the Quality of image.

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

    Directory of Open Access Journals (Sweden)

    Patel Rumana*

    2014-12-01

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

  2. Radionuclide calibrator comparisons and quality improvement in nuclear medicine

    International Nuclear Information System (INIS)

    This paper presents and discusses the evaluation over time of the quality of activity measurement results obtained in Cuban nuclear medicine, on the basis of statistical samples taken during the radionuclide calibrator comparison programme that has been operating since 2000. Particularly, results of Cuban comparisons have demonstrated that the relative standard combined uncertainty of Cuban radionuclide calibrator activity measurement results performed in accordance with adequate quality control measurement procedures, can be ascertain as equal to 3.3 % for employed in comparisons nuclides namely, 131I, 99mTc and 201Tl. Therefore, this is also a confirmation of that CENTIS-DMR Calibration and Measurement Capabilities for 131I, 99mTc and 201Tl radionuclide calibrator calibration services also satisfy established in Cuban regulations ± 10% accuracy limit. On the other hand, an attempt has been made to evaluate the role played by radionuclide calibrator comparisons in quality measurement improvement in nuclear medicine, on the basis of comparisons results obtained in a number of countries and published by several authors over a period of time. Data of gamma-emitters such as 99mTc, 201Tl, 67Ga and 131I are employed for this analysis. A ?2 test is applied to determine the character of association between the observed performance and the period of time rved performance and the period of time when the exercises were organized at a significance level ?=0.05. Specifically, improvements of the measurement performance over time assessed by such exercises were found dissimilar in magnitudes in different countries Two moments could be distinguished in the improvement process over time. Firstly, a fast improvement can be obtained resulting from the improvement in measurement accuracy of devices. After that, the achievement of new and sustained improvements goes slowly and requires the application of quality assurance programs where the qualification upgrading of personnel become an essential point

  3. Implementing a systems-oriented morbidity and mortality conference in remote rural Nepal for quality improvement

    Science.gov (United States)

    Schwarz, Dan; Schwarz, Ryan; Gauchan, Bikash; Andrews, Jason; Sharma, Ranju; Karelas, Gregory; Rajbhandari, Ruma; Acharya, Bibhav; Mate, Kedar; Bista, Amir; Bista, Megha Giri; Sox, Colin

    2011-01-01

    Problem In hospitals in rural, resource-limited settings, there is an acute need for simple, practical strategies to improve healthcare quality. Setting A district hospital in remote western Nepal. Key measures for improvement To provide a mechanism for systems-level reflection so that staff can identify targets for quality improvement in healthcare delivery. Strategies for change To develop a morbidity and mortality conference (M&M) quality improvement initiative that aims to facilitate structured analysis of patient care and identify barriers to providing quality care, which can subsequently be improved. Design The authors designed an M&M involving clinical and non-clinical staff in conducting root-cause analyses of healthcare delivery at their hospital. Weekly conferences focus on seven domains of causal analysis: operations, supply chain, equipment, personnel, outreach, societal, and structural. Each conference focuses on assessing the care provided, and identifying ways in which services can be improved in the future. Effects of change Staff reception of the M&Ms was positive. In these M&Ms, staff identified problem areas in healthcare delivery and steps for improvement. Subsequently, changes were made in hospital workflow, supply procurement, and on-site training. Lessons learnt While widely practiced throughout the world, M&Ms typically do not involve both clinical and non-clinical staff members and do not take a systems-level approach. The authors' experience suggests that the adapted M&M conference is a simple, feasible tool for quality improvement in resource-limited settings. Senior managerial commitment is crucial to ensure successful implementation of M&Ms, given the challenging logistics of implementing these programmes in resource-limited health facilities. PMID:21949441

  4. An educational approach to improve outcomes in acute kidney injury (AKI): report of a quality improvement project

    Science.gov (United States)

    Xu, Gang; Baines, Richard; Westacott, Rachel; Selby, Nick; Carr, Susan

    2014-01-01

    Objective To assess the impact of a quality improvement project that used a multifaceted educational intervention on how to improve clinician's knowledge, confidence and awareness of acute kidney injury (AKI). Setting 2 large acute teaching hospitals in England, serving a combined population of over 1.5 million people. Participants All secondary care clinicians working in the clinical areas were targeted, with a specific focus on clinicians working in acute admission areas. Interventions A multifaceted educational intervention consisting of traditional didactic lectures, case-based teaching in small groups and an interactive web-based learning resource. Outcome measures We assessed clinicians’ knowledge of AKI and their self-reported clinical behaviour using an interactive questionnaire before and after the educational intervention. Secondary outcome measures included clinical audit of patient notes before and after the intervention. Results 26% of clinicians reported that they were aware of local AKI guidelines in the preintervention questionnaire compared to 64% in the follow-up questionnaire (?²=60.2, paudit makers showed a trend towards better clinical practice. Conclusions This quality improvement project utilising a multifaceted educational intervention improved awareness of AKI as demonstrated by changes in the clinician's self-reported management of patients with AKI. Elements of the project have been sustained beyond the project period, and demonstrate the power of quality improvement projects to help initiate changes in practice. Our findings are limited by confounding factors and highlight the need to carry out formal randomised studies to determine the impact of educational initiatives in the clinical setting. PMID:24650804

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

    Science.gov (United States)

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

    2012-10-01

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

  6. GENETICS AND MOLECULAR BIOLOGY AND PIG MEAT QUALITY IMPROVEMENT

    Directory of Open Access Journals (Sweden)

    BULLA, J.

    2007-01-01

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

  7. GENETICS AND MOLECULAR BIOLOGY AND PIG MEAT QUALITY IMPROVEMENT

    Directory of Open Access Journals (Sweden)

    J. BULLA

    2013-12-01

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

  8. Statistical process management: An essential element of quality improvement

    Science.gov (United States)

    Buckner, M. R.

    Successful quality improvement requires a balanced program involving the three elements that control quality: organization, people and technology. The focus of the SPC/SPM User's Group is to advance the technology component of Total Quality by networking within the Group and by providing an outreach within Westinghouse to foster the appropriate use of statistic techniques to achieve Total Quality. SPM encompasses the disciplines by which a process is measured against its intrinsic design capability, in the face of measurement noise and other obscuring variability. SPM tools facilitate decisions about the process that generated the data. SPM deals typically with manufacturing processes, but with some flexibility of definition and technique it accommodates many administrative processes as well. The techniques of SPM are those of Statistical Process Control, Statistical Quality Control, Measurement Control, and Experimental Design. In addition, techniques such as job and task analysis, and concurrent engineering are important elements of systematic planning and analysis that are needed early in the design process to ensure success. The SPC/SPM User's Group is endeavoring to achieve its objectives by sharing successes that have occurred within the member's own Westinghouse department as well as within other US and foreign industry. In addition, failures are reviewed to establish lessons learned in order to improve future applications. In broader terms, the Group is interested in making SPM the accepted way of doing business within Westinghouse.

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

    International Nuclear Information System (INIS)

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

  10. Initial growth stage evaluation of high quality ZnSe films deposited on glass substrate

    International Nuclear Information System (INIS)

    Initial growth stage evaluation of high quality ZnSe films deposited on a glass substrate was investigated. The self-limiting monolayer epitaxial process was used to pregrowth the buffer layer for a zinc selenide (ZnSe) film deposited. After alternating depositions for several cycles, the growth mode was changed to the molecular beam deposition mode under growth conditions. Films deposited at substrate temperatures of 250-350 deg. C and Se/Zn beam equivalent pressure ratios of 0.77-1.87 were investigated. The crystal structure and the preferred orientation of as-grown ZnSe films were examined using x-ray diffraction patterns. The optical properties of the ZnSe films were revealed by photoluminescence spectra. The characteristics of the ZnSe films with and without a buffer layer were compared and discussed in detail. Finally, the results demonstrate how the quality of ZnSe film can be improved on glass substrates for application to various devices.

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

    Science.gov (United States)

    Ruza, Nadiah; Mustafa, Zainol

    2013-04-01

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

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

    Science.gov (United States)

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

    2013-02-01

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

  13. Application of project design peer review to improve quality assurance

    International Nuclear Information System (INIS)

    DOE ORDER 5481.1B Safety Analysis and Review Systems and DOE ORDER 6430.1A General Design Criteria require that the design of facilities shall incorporate the necessary Quality Assurance review requirements to assure that the established program quality assurance objectives are met in the design criteria and the construction documents. The use of Project Design Peer Review to satisfy these requirements is presented. The University of California manages the Lawrence Berkeley Laboratory, the Lawrence Livermore National Laboratory, and the Los Alamos National Scientific Laboratory. The 1988 University Seismic Safety Policy requires the use of independent Project Design Peer Review in its capital improvement and seismic reconstruction program

  14. The process of initial perception of quality for customers of a durable product

    OpenAIRE

    Torazzo, Annamaria; Marchese, Aurelio; Bechis, Marco

    1999-01-01

    The initial perception of quality of a product during the first moments of possession strongly influences the customer’s satisfaction. This is the reason in purchasing motivation of the product itself. The present note analyses, with statistical instruments, the process of initial perception of anomalies for a complex durable consumer good after its painting cycle.

  15. Improving Quality of Care among COPD outpatients in Denmark 2008-2011

    DEFF Research Database (Denmark)

    TØttenborg, Sandra SØgaard; Thomsen, Reimar W.

    2012-01-01

    OBJECTIVE: To examine whether the quality of care among Danish patients with chronic obstructive pulmonary disease (COPD) has improved since the initiation of a national multidisciplinary quality improvement program. METHODS: We conducted a nationwide, population-based prospective cohort study using data from the Danish Clinical Register of COPD (DrCOPD). Since 2008 the register has systematically monitored and audited the use of recommended processes of COPD care. RESULTS: Substantial improvements were observed for all processes of care and registration fulfillment increased to well above 85% for all indicators. Compared to 2008, a higher proportion of COPD outpatients in 2011 received annual measurements of the forced expiratory volume in one second in percent of predicted (FEV1% predicted) (RR 2.14, 95% CI, 2.09; 2.19), assessment of BMI (RR 2.24, 95% CI, 2.19; 2.29), assessment of dyspnea using the Medical Research Council (MRC) scale (RR 2.25, 95% CI, 2.20; 2.31), registration of smoking status (RR2.41, 95% CI, 2.35; 2.47), smoking cessation recommendation (RR 3.40, 95% CI, 3.18; 3.64) and offering of pulmonary rehabilitation (RR 2.78, 95% CI, 2.65; 2.90). Moderate variation in quality of care fulfillment between regions and hospital clinics still existed in 2011. The proportion of patients with mild- to moderate COPD increased during the study period (p<0.0001). CONCLUSION: Based on increased registration practice of important processes of care, the present study indicates a substantial improvement in the quality of care of COPD in Danish hospitals following the initiation of a national multidisciplinary quality improvement program in 2008. In the forthcoming years, it will be interesting to observe if this will translate into a better prognosis of Danish patients with COPD.

  16. Improvement of image quality using interpolated projection in myocardial SPECT

    Directory of Open Access Journals (Sweden)

    Mohamad-Ali Askari

    2010-10-01

    Full Text Available Introduction: Myocardial SPECT imaging is usually performed acquiring 32 views in 180 degree with equal steps of 5.625 degrees. Acquiring more images requires spending more time or injection of more activity to the patients. An idea to improve the quality reconstructed images without acquiring extra images is producing the extra images interpolating the data between adjacent projections. The aim of present study was investigation the feasibility of this idea. Methods: Obviously such investigation cannot be performed on real patient's data. Therefore, data were simulated using NCAT digital phantom and SimSET Monte Carlo code. The imaging was performed as usual, acquiring 32 views from right anterior oblique to left posterior oblique. The data were interpolated to construct 5 images between adjacent projections convert it into 187 projections. The simulation was performed again acquiring 187 images as the reference. The conventional, interpolated and reference data set were reconstructed and compared for improvement and degradation in quality of final images. The above procedure was repeated for phantoms representing different types of heart disease, different cardiac size and different count densities. Results: The results showed that Hermit interpolation technique produces better quality images comparing to other interpolation methods tested. Results also confirmed that streak artifacts decreases, signal to noise ratio and contrast increased due to increasing the number of samples. Conclusion: These results indicate that the physical properties of reconstructed images improve significantly. This directly must improve the lesions delectability of images. However the matter is still under investigation

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

    OpenAIRE

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

    2010-01-01

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

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

    OpenAIRE

    Sva?rdh, Joakim

    2013-01-01

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

  19. ELECTRICAL SAFETY IMPROVEMENT PROJECT A COMPLEX WIDE TEAMING INITIATIVE

    Energy Technology Data Exchange (ETDEWEB)

    GRAY BJ

    2007-11-26

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

  20. Improving and Communicating Workforce Skills: A Regional Initiative

    Science.gov (United States)

    Baird, Dee

    2011-01-01

    The demand for improved workplace skills in the U.S. is rapidly rising, and U.S. industries, employees, and educational systems are struggling to respond. This paper describes the Skills Advantage program, an effort led by employers and facilitated by Kirkwood Community College to address regional employment needs. This work-ready certificate…

  1. Processes for Quality Improvements in Radiation Oncology Clinical Trials

    International Nuclear Information System (INIS)

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

  2. Skill Gap Analysis for Improved Skills and Quality Deliverables

    Directory of Open Access Journals (Sweden)

    Mallikarjun Koripadu

    2014-10-01

    Full Text Available With a growing pressure in identifying the skilled resources in Clinical Data Management (CDM world of clinical research organizations, to provide the quality deliverables most of the CDM organizations are planning to improve the skills within the organization. In changing CDM landscape the ability to build, manage and leverage the skills of clinical data managers is very critical and important. Within CDM to proactively identify, analyze and address skill gaps for all the roles involved. In addition to domain skills, the evolving role of a clinical data manager demands diverse skill sets such as project management, six sigma, analytical, decision making, communication etc. This article proposes a methodology of skill gap analysis (SGA management as one of the potential solutions to the big skill challenge that CDM is gearing up for bridging the gap of skills. This would in turn strength the CDM capability, scalability, consistency across geographies along with improved productivity and quality of deliverables

  3. Studying and simulating transformer configuration to improve power quality

    Directory of Open Access Journals (Sweden)

    Oscar J. Peña Huaringa

    2011-07-01

    Full Text Available This paper presents a study and simulation of transformer configurations to improve power quality; it provides theoretical support based on the expansion of the Fourier series and analysis of symmetrical components. A test system was set up in the laboratory, taking measurements and checking configuration effectiveness in reducing the system’s harmonic content. The configurations were modelled with PSCAD / EMTDC software, using two 6 pulse rectifiers as test loads and two variable speed drives.

  4. Studying and simulating transformer configuration to improve power quality

    OpenAIRE

    Pen?a Huaringa, Oscar J.

    2011-01-01

    This paper presents a study and simulation of transformer configurations to improve power quality; it provides theoretical support based on the expansion of the Fourier series and analysis of symmetrical components. A test system was set up in the laboratory, taking measurements and checking configuration effectiveness in reducing the system’s harmonic content. The configurations were modelled with PSCAD / EMTDC software, using two 6 pulse rectifiers as test loads and two vari...

  5. REVIEW OF UPQC CONTROL TECHNIQUES FOR POWER QUALITY IMPROVEMENT

    Directory of Open Access Journals (Sweden)

    Kolipaka Srivani

    2014-04-01

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

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

    OpenAIRE

    Sree, P. K.; Raju, G. V. S.; Babu, I. R.; Raju, S. V.

    2008-01-01

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

  7. Cost Sharing and Water Pricing to Improve River Water Quality

    OpenAIRE

    Hadihardaja, Iwan K.; Sri Sangkawati; Joetata Hadihardaja

    2013-01-01

    When the water is polluted, it can be improved by diluting the degradated water with the higher quality water. Supply of water dilution trigger several costs, as the cost to build reservoir for water discharge. The clasification of project in river basin is appropriate with the benefit, there are single purpose and multi purposes project, so in relation to water discharge as dilution, it needs cost sharing with other beneficiaries. The cost sharing of BJP-SDA with the case study on Brantas ...

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

    OpenAIRE

    Tang Wai Mun; Ghani, Muhammad Faizal A.

    2013-01-01

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

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

    OpenAIRE

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

    2011-01-01

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

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

    OpenAIRE

    Xiaowei Jiang

    2013-01-01

    In order to solve the problems existing in the manufacturing practice of mechanical industrial design, a series of methods and concrete measures are proposed, so as to improve the quality of manufacturing practice of mechanical industrial design. In this study, the problems existing in the manufacturing practice of mechanical industrial design are analyzed detailedly. And the methods and concrete measures including establishing the new mode of manufacturing practice of mechanical industrial d...

  11. Quality Improvement Methodologies – PDCA Cycle, RADAR Matrix, DMAIC and DFSS

    OpenAIRE

    Sokovic, M.; Pavletic, D.; Kern Pipan, K.

    2010-01-01

    Purpose: of this paper is to introduce the reader to the characteristics of PDCA tool and Six Sigma (DMAIC, DFSS) techniques and EFQM Excellence Model (RADAR matrix), which are possible to use for the continuous quality improvement of products, processes and services in organizations.Design/methodology/approach: We compared the main characteristics of the presented methodologies aiming to show the main prerequisites, differences, strengths and limits in their application.Findings: Depending o...

  12. The Epistemology of Quality Improvement: It's All Greek

    OpenAIRE

    Perla, Rocco J.; Parry, Gareth John

    2011-01-01

    In Plato's Theaetetus, knowledge is defined as the intersection of truth and belief, where knowledge cannot be claimed if something is true but not believed or believed but not true. Using an example from neonatal intensive care, this paper adapts Plato's definition of the concept ‘knowledge’ and applies it to the field of quality improvement in order to explore and understand where current tensions may lie for both practitioners and decision makers. To increase the uptake of effective in...

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  15. Using creative problem solving (TRIZ) in improving the quality of hospital services.

    Science.gov (United States)

    LariSemnani, Behrouz; Mohebbi Far, Rafat; Shalipoor, Elham; Mohseni, Mohammad

    2015-01-01

    TRIZ is an initiative and SERVQUAL is a structured methodology for quality improvement. Using these tools, inventive problem solving can be applied for quality improvement, and the highest quality can be reached using creative quality improvement methodology. The present study seeks to determine the priority of quality aspects of services provided for patients in the hospital as well as how TRIZ can help in improving the quality of those services. This Study is an applied research which used a dynamic qualitative descriptive survey method during year 2011. Statistical population includes every patient who visited in one of the University Hospitals from March 2011. There existed a big gap between patients' expectations from what seemingly is seen (the design of the hospital) and timely provision of services with their perceptions. Also, quality aspects of services were prioritized as follows: keeping the appearance of hospital (the design), accountability, assurance, credibility and having empathy. Thus, the only thing which mattered most for all staff and managers of studied hospital was the appearance of hospital as well as its staff look. This can grasp a high percentage of patients' satisfaction. By referring to contradiction matrix, the most important principles of TRIZ model were related to tangible factors including principles No. 13 (discarding and recovering), 25 (self-service), 35 (parameter changes), and 2 (taking out). Furthermore, in addition to these four principles, principle No. 24 (intermediary) was repeated most among the others. By utilizing TRIZ, hospital problems can be examined with a more open view, Go beyond The conceptual framework of the organization and responded more quickly to patients ' needs. PMID:25560360

  16. Using Creative Problem Solving (TRIZ in Improving the Quality of Hospital Services

    Directory of Open Access Journals (Sweden)

    Behrouz LariSemnani

    2014-07-01

    Full Text Available TRIZ is an initiative and SERVQUAL is a structured methodology for quality improvement. Using these tools, inventive problem solving can be applied for quality improvement, and the highest quality can be reached using creative quality improvement methodology. The present study seeks to determine the priority of quality aspects of services provided for patients in the hospital as well as how TRIZ can help in improving the quality of those services. This Study is an applied research which used a dynamic qualitative descriptive survey method during year 2011. Statistical population includes every patient who visited in one of the University Hospitals from March 2011. There existed a big gap between patients’ expectations from what seemingly is seen (the design of the hospital and timely provision of services with their perceptions. Also, quality aspects of services were prioritized as follows: keeping the appearance of hospital (the design, accountability, assurance, credibility and having empathy. Thus, the only thing which mattered most for all staff and managers of studied hospital was the appearance of hospital as well as its staff look. This can grasp a high percentage of patients’ satisfaction. By referring to contradiction matrix, the most important principles of TRIZ model were related to tangible factors including principles No. 13 (discarding and recovering, 25 (self-service, 35 (parameter changes, and 2 (taking out. Furthermore, in addition to these four principles, principle No. 24 (intermediary was repeated most among the others. By utilizing TRIZ, hospital problems can be examined with a more open view, Go beyond The conceptual framework of the organization and responded more quickly to patients ' needs.

  17. QUALITY IMPROVEMENT METHODS AND THEIR USAGE IN ALBANIAN PUBLIC UNIVERSITIES

    Directory of Open Access Journals (Sweden)

    Arjan QEFALIA

    2012-06-01

    Full Text Available Education and higher education in particular is one of strategic priorities for development, which guarantees progress. Its role is related to all characteristics of a society, and it undoubtedly constitutes one of the most important areas of life of a nation. It has stable and long-term impact on all aspects of activities related to people and their welfare. The challenge to be faced in the transition period requires that higher education in Albania to be developed, consolidated and follow the trend of higher education in developed countries. Quality itself and by using the continuous quality improvement methods by universities, it constitutes the basis for ensuring the success of the Albanian higher education institutions in the future.In this paper, through the use of literature, the questionnaires and interviews directed mainly to the professors / pedagogues working in Albanian public higher education institutions, the focus is to show the continuous quality improvement methods used by universities / faculties / departments, and to test the hypothesis: The use or not of the continuous improvement methods is dependent on the studies type (those higher education institutions that offer first cycle studies, first and second cycle studies, or first, second and third cycle studies that the higher education institution offers.

  18. The impact of a large-scale quality improvement programme on work engagement: Preliminary results from a national cross-sectional-survey of the 'Productive Ward'

    LENUS (Irish Health Repository)

    White, Mark

    2014-05-14

    Quality improvement (QI) Programmes, like the Productive Ward: Releasing-time-to-care initiative, aim to \\'engage\\' and \\'empower\\' ward teams to actively participate, innovate and lead quality improvement at the front line. However, little is known about the relationship and impact that QI work has on the \\'engagement\\' of the clinical teams who participate and vice-versa.

  19. Will financial incentives stimulate quality improvement? Reactions from frontline physicians.

    Science.gov (United States)

    Teleki, Stephanie S; Damberg, Cheryl L; Pham, Chau; Berry, Sandra H

    2006-01-01

    Pay-for-performance is being applied at the physician level to stimulate improvements in quality of care and cost efficiency; however, little is known about how physicians will respond. We interviewed physicians exposed to a financial incentive program in California to identify possible barriers to the successful application of financial incentives by exploring physicians' opinions of and experiences with pay-for-performance programs. Reasons physicians cited for quality deficiencies included insurance coverage limitations and lack of patient compliance, time, and proper physician oversight. Physicians believe that they play a significant role and have a moderate to high degree of control over quality of care and that it is important to self-monitor. Physicians expressed the need for accurate and timely data, peer comparisons, and more patient time, staff support, and consultations with colleagues to successfully monitor and deliver quality care. Many support increased pay for delivering high-quality care but question measurement accuracy, bonus payment financing, and health plan involvement. PMID:17077418

  20. Macroergonomic analysis and design for improved safety and quality performance.

    Science.gov (United States)

    Kleiner, B M

    1999-01-01

    Macroergonomics, which emerged historically after sociotechnical systems theory, quality management, and ergonomics, is presented as the basis for a needed integrative methodology. A macroergonomics methodology was presented in some detail to demonstrate how aspects of microergonomics, total quality management (TQM), and sociotechnical systems (STS) can be triangulated in a common approach. In the context of this methodology, quality and safety were presented as 2 of several important performance criteria. To demonstrate aspects of the methodology, 2 case studies were summarized with safety and quality performance results where available. The first case manipulated both personnel and technical factors to achieve a "safety culture" at a nuclear site. The concept of safety culture is defined in INSAG-4 (International Atomic Energy Agency, 1991). as "that assembly of characteristics and attitudes in organizations and individuals which establishes that, as an overriding priority, nuclear plant safety issues receive the attention warranted by their significance." The second case described a tire manufacturing intervention to improve quality (as defined by Sink and Tuttle, 1989) through joint consideration of technical and social factors. It was suggested that macroergonomics can yield greater performance than can be achieved through ergonomic intervention alone. Whereas case studies help to make the case, more rigorous formative and summative research is needed to refine and validate the proposed methodology respectively. PMID:10602647

  1. Systems-based Quality Improvement as a tool to implement the Surgical Safety Checklist in Rwanda

    Directory of Open Access Journals (Sweden)

    Gita N. Mody

    2014-03-01

    Full Text Available Objective: Effective strategies for implementation of the World Health Organization’s Surgical Safety Checklist (SSCL are not well characterized in resource-limited settings. Our objective was to utilize a systems-based quality improvement (QI approach to initially implement a single, high-priority item from the SSCL. Setting: Butaro Hospital, a rural district hospital in northern Rwanda. Methods: A surgical service QI team was formed and trained with support of local leadership and expatriate staff trained in QI methodology. The team identifid perioperative antibiotic administration as the fist SSCL area for improvement. Baseline performance was measured by sampled chart review of Cesarean sections. Using systems-based QI methods and the Model for Improvement, a protocol for choice and timing of perioperative antibiotics was identifid as the necessary intervention, developed, and then implemented. The impact on performance and spread of QI was measured. Results: At baseline, only 5.2% of Cesarean section patients received both correct choice and timing of a prophylactic antibiotic agent. After development of the protocol, appropriate choice and timing of antibiotic was observed in 61.7% of cases (p < 0.001. This initial QI initiative stimulated additional projects to implement other components of the SSCL and to improve quality of surgical and anesthetic care. Conclusions: Implementing one component of the SSCL using QI methodology focused on stakeholder engagement, measurement, and team-based development of iterative systems of improvements facilitated a cultural change at Butaro Hospital. Training and support in QI methods can create an environment in which the SSCL and other efforts for quality in surgical and anesthetic care can be more readily implemented.

  2. Improving Rule Base Quality to Enhance Production Systems Performance

    Directory of Open Access Journals (Sweden)

    Nabil Arman

    2012-12-01

    Full Text Available Production systems have a special value since they are used in state-space searching algorithms and expert systems in addition to their use as a model for problem solving in artificial intelligence. Therefore, it is of high importance to consider different techniques to improve their performance. In this research, rule base is the component of the production system that we aim to focus on. This work therefore seeks to investigate this component and its relationship with other components and demonstrate how the improvement of its quality has a great impact on the performance of the production system as a whole. In this paper, the improvement of rule base quality is accomplished in two steps. The first step involves re-writing the rules having conjunctions of literals and producing a new set of equivalent rules in which long inference chains can be obtained easily. The second step involves augmenting the rule base with inference short-cut rules devised from the long inference chains. These inference short-cut rules have a great impact on the performance of the production system. Finally, simulations are performed on randomly generated rule bases with different sizes and goals to be proved. The simulations demonstrate that the suggested enhancements are very beneficial in improving the performance of production systems.

  3. Improvement of ozone forecast over Beijing based on ensemble Kalman filter with simultaneous adjustment of initial conditions and emissions

    Directory of Open Access Journals (Sweden)

    X. Tang

    2011-03-01

    Full Text Available We performed ozone data assimilation by simultaneously adjusting the ozone initial conditions, precursor initial conditions and emissions based on the Ensemble Kalman Filter (EnKF and assessed its impacts on ozone modeling and forecasting in Beijing and nearby regions. A high-resolution regional air quality model and a newly established regional monitoring network covering Beijing and its surrounding areas were employed. At each assimilation cycle, the forecast error covariance was sampled from a set of forecast ensembles that were generated by perturbing ozone precursor initial conditions, emissions, photolysis rates and deposition velocity. A model-error module and a local analysis scheme have been introduced to reduce the impact of filter divergence and spurious correlation that accompanied with EnKF. The results showed significant improvement of 1-hour ozone forecast in Beijing and its surrounding areas through separately adjusting ozone initial conditions, precursor initial conditions and emissions with ozone observations. However, adjustment of precursor initial conditions and emissions had minor effect on the 1-hour ozone forecast in suburban area. The best ozone forecast skill was obtained through jointly adjusting ozone initial conditions, NOx and VOC initial conditions and emissions. The root mean square errors of 1-hour ozone forecast at urban sites and suburban sites decreased by 54% and 59% respectively compared with those in free run. Furthermore, the specific impacts of observations from urban and suburban sites on ozone data assimilation were evaluated by implementing sensitivity experiments. Both urban and suburban sites were found to be very important for the improvement of regional ozone forecast. The importance of observational data at urban sites was particularly highlighted through its role in constraining the uncertainty of precursor initial conditions and emission rates. Further improvement of regional ozone forecast might therefore be expected with more routine regional air pollution monitoring stations.

  4. The physician quality reporting initiative: what is it, will it increase health care quality, and should wide participation be encouraged?

    Science.gov (United States)

    Harolds, Jay A; Merrill, Janette K

    2011-02-01

    The physician quality reporting initiative (PQRI) is a voluntary program for reporting certain quality measures on Medicare patients in return for receiving a small bonus payment. However, the PQRI procedures are such that a large number of those who try to participate do not receive incentive payments. Also, many indicate that the small bonus for participation is not worth the effort and costs incurred. Furthermore, it has been found that many of the quality measures are not a good indicator of a favorable outcome, and do not clearly promote significant increases in the quality of patient care. However, penalties will be given from the year 2015 for not participating in PQRI. Also, it is expected that PQRI will be a precursor to Pay for Performance legislation, which will require mandatory participation by physicians. Therefore, participation in PQRI now is recommended by many experts, so that health care professionals can learn the procedures and make necessary adjustments in their practice procedures. PMID:21220973

  5. Implementing a nationwide quality improvement approach in health services.

    Science.gov (United States)

    Sahel, Amina; DeBrouwere, Vincent; Dujardin, Bruno; Kegels, Guy; Belkaab, Nejoua; Alaoui Belghiti, Abdelali

    2015-01-01

    Purpose - The purpose of this paper is to present an innovative quality improvement intervention developed in Morocco and discuss its implementation. Until 2004, the Moroccan Ministry of Health (MoH) encouraged pilots of quality improvement approaches but none of them were revealed to be sustainable. Internal assessments pinpointed factors such as lack of recognition of the participating team's efforts and lack of pressure on managers to become more accountable. In 2005, Morocco opted for an intervention called "Quality Contest" (QC) targeting health centres, hospitals and health district offices and combining quality measurement with structures ranking, performance disclosure and reward system. Design/methodology/approach - The QC is organized every 18 months. After the self-assessment and external audit step, the participating structures are ranked according to their scores. Their performances are then disseminated and the highest performing structures are rewarded. Findings - The results showed an improvement in performance among participating structures, constructive exchange of successful experiences between structures, as well as communication of constraints, needs and expectations between MoH managers at central and local levels; the use of peer-auditors was appreciated as it enabled an exchange of best practices between auditors and audited teams but this was mitigated by the difficulty of ensuring their neutrality; and the recognition of efforts was appreciated but seemed insufficient to ensure a sense of justice and maintain motivation. Originality/value - This intervention is an example of MoH leadership that has succeeded in introducing transparency and accountability mechanisms (ranking and performance disclosure) as leverage to change the management culture of the public health services; setting up a reward system to reinforce motivation and adapting continuously the intervention to enhance its sustainability and acceptability. PMID:25751246

  6. Improving the hygienic quality of chicken through radiation processing

    International Nuclear Information System (INIS)

    Irradiation is considered one of the most efficient technological processes for the reduction of microorganisms in food, It can be used to improve the safety of food products, and to extend their shelf lives. The aim of this study was to improve the hygienic quality of chicken through radiation processing. As part of the study a microbial assessment of broiler chicken thighs from three retail outlets (supermarket, local markets and farms) was conducted. The total viable count and total coliform counts were determined. Hygienic quality indicator organisms such as Escherichia coli, Salmonella and Staphylococcus aureus were isolated and microbial counts made. Radiation sensitivity test to determine the D10 (decimal reduction does) of E. coli on chicken at refrigeration and frozen temperature were conducted. D10 values were 0.22 ± 0.02 and 0.32 ± 0.03 kGy at refrigerated and frozen temperatures respectively. A storage test consisting of an uninoculated pack experiment and a challenge test to explore the effect of irradiation and frozen food storage on the total viable count and survival of E. coli was conducted. Chicken thigh samples were treated with 0 (non irradiated), 2.0, 4.0, 6.0 and 8.0 kGy of gamma irradiation and held frozen for 56 days. The control and irradiated samples were stored at -18 oC and underwent microbial analysis and sensory evaluation at 7 days intervals. It was observed that irradiation and frozen storage reduced mirradiation and frozen storage reduced microbial loads. There were significant differences in sensory quality characteristics during freezing storage in chicken meat. The combination of irradiation and frozen storage resulted in greater overall reductions on microbial loads thus improving hygienic quality. (au)

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

    International Nuclear Information System (INIS)

    The primary objective of this study was to ensure that X-rays performed consistently adhere to established technological quality standards and are achieved without compromising patient care while minimizing exposure risks. The secondary objective was to evaluate whether educational sessions targeting areas deemed suboptimal would facilitate improvement. A retrospective, 1-week review of all neonatal X-rays and documentation of clinical information on X-ray requisitions (n = 132) was completed in a tertiary care neonatal intensive care unit (NICU), by a single observer. Standards for X-ray evaluation were defined a priori based on radiographic principles and essential documented medical information for correct interpretation. Targeted areas for improvement were identified and addressed through brief educational sessions and printed pamphlets. The review was repeated after recommendations were implemented. 1 month (n = 93) and 1 year (n = 76) later. Improvements were evident in both the completion of X-ray requisitions and image quality. In particular, there was a statistically significant improvement in requisition legibility (P = 0.019), completeness of the medical history (P < 0.001), reduction in X-ray rotation (P < 0.001), collimation to the specific area of interest (P <0.001), gonadal shielding (P < 0.001), and decrease in monitor leads or artifacts obscuring views (P < 0.001). These improvements were sustained both 1 month and 1 year following the educational seth and 1 year following the educational sessions. A neonatal X-ray audit is a simple, effective way to evaluate radiographic technique and encourage provision of basic clinical information for diagnostic interpretation by radiologists and neonatologists. As well, structured, collaborative educational sessions between radiology and neonatology staff appear to be a successful and sustainable method to effect overall improvement. (author)

  8. Investigating organizational quality improvement systems, patient empowerment, organizational culture, professional involvement and the quality of care in European hospitals: the 'Deepening our Understanding of Quality Improvement in Europe (DUQuE)' project

    OpenAIRE

    Thompson Andrew; Arah Onyebuchi A; Wagner Cordula; Klazinga Niek; Groene Oliver; Bruneau Charles; Suñol Rosa

    2010-01-01

    Abstract Background Hospitals in European countries apply a wide range of quality improvement strategies. Knowledge of the effectiveness of these strategies, implemented as part of an overall hospital quality improvement system, is limited. Methods/Design We propose to study the relationships among organisational quality improvement systems, patient empowerment, organisational culture, professionals' involvement with the quality of hospital care, including clinical effectiveness, patient safe...

  9. The Use of Quality Improvement and Health Information Technology Approaches to Improve Diabetes Outcomes in African-American and Hispanic Patients

    OpenAIRE

    Baig, Arshiya A.; Wilkes, Abigail E.; Davis, Andrew M.; Peek, Monica E.; Huang, Elbert S.; Bell, Douglas S.; Chin, Marshall H.

    2010-01-01

    Differences in rates of diabetes-related lower extremity amputations represent one of the largest and most persistent health disparities found for African-Americans and Hispanics compared to whites in the United States. Since many minority patients receive care in under-resourced settings, quality improvement (QI) initiatives in these settings may offer a targeted approach to improve diabetes outcomes in these patient populations. Health information technology (health IT) is widely viewed as ...

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

    DEFF Research Database (Denmark)

    Quaade, F; Astrup, A

    1989-01-01

    Thirty-eight consecutive obese persons were treated as outpatients. The treatment commenced with VLCD formula diet NUPO (females 388 kcal, 1600 kJ, 56 g protein; males 446 kcal, 1864 kJ, 69 g protein). VLCD had no untoward effects and was continued for as long as the patient would accept. After that the formula diet was supplemented with ordinary items of food and drink to the level of 1000 kcal (4200 kJ) for women and 1100 kcal (4600 kJ) for men. After 5 months the data were analyzed separately according to the duration of VLCD: group 1 (n = 20): VLCD for less than 2 months, and group 2 (n = 18): VLCD for 2 months or more. The two groups were comparable with regard to height, absolute weight and percentual overweight, but group 2 was somewhat older than group 1 (49.5 vs 38.3 years, P less than 0.01). Group 2 lost significantly more weight, both totally (17.1 kg (7.8-40.1] and on VLCD alone (12.3 kg (4.1-28.8], than group 1 (8.7 kg (-1.1 to 19.1), P = 0.008; and 7.3 kg (0.9-18.2 P = 0.01). Weight losses in both groups eliminated or strongly reduced the need for a wide variety of expensive drugs: antidiabetics, diuretics, antihypertensives, analgetics, etc. It is concluded that VLCD is an effective and encouraging way of starting a dieting program, and that it should be continued for at least two months, as the length of the initial VLCD period related significantly to the amount of weight eventually lost.

  11. Smoothing depth maps for improved steroscopic image quality

    Science.gov (United States)

    Tam, Wa James; Alain, Guillaume; Zhang, Liang; Martin, Taali; Renaud, Ronald

    2004-10-01

    A technique to improve the image quality of stereoscopic pictures generated from depth maps (depth image based rendering or DIBR) is examined. In general, there are two fundamental problems with DIBR: a depth map could contain artifacts (e.g., noise or "blockiness") and there is no explicit information on how to render newly exposed regions ("holes") in the rendered image as a result of new virtual camera positions. We hypothesized that smoothing depth maps before rendering will not only minimize the effects of noise and distortions in the depth maps but will also reduce areas of newly exposed regions where potential artifacts can arise. A formal subjective assessment of four stereoscopic sequences of natural scenes was conducted with 23 viewers. The stereoscopic sequences consisted of source images for the left-eye view and rendered images for the right-eye view. The depth maps were smoothed with a Gaussian blur filter at different levels of strength before depth image based rendering. Results indicated that ratings of perceived image quality improved with increasing levels of smoothing of the depth maps. Even though the depth maps were smoothed, a negative effect on ratings of overall perceived depth quality was not found.

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

    International Nuclear Information System (INIS)

    The continued reliance of manual data capture in engineering asset intensive organisations highlights the critical role played by those responsible for recording raw data. The potential for data quality variance across individual operators also exposes the need to better manage this particular group. This paper evaluates the relative importance of the human factors associated with data quality. Using the theory of planned behaviour this paper considers the impact of attitudes, perceptions and behavioural intentions on the data collection process in an engineering asset context. Two additional variables are included, those of time pressure and operator feedback. Time pressure is argued to act as a moderator between intention and data collection behaviour, while perceived behavioural control will moderate the relationship between feedback and data collection behaviour. Overall the paper argues that the presence of best practice procedures or threats of disciplinary sanction are insufficient controls to determine data quality. Instead those concerned with improving the data collection performance of operators should consider the operator's perceptions of group attitude towards data quality, the level of feedback provided to data collectors and the impact of time pressures on procedure compliance. A range of practical recommendations are provided to those wishing to improve the quality of their manually acquired data.

  13. Improving Service Quality by Using Organizational Citizenship Behavior: Iranian Evidence

    Directory of Open Access Journals (Sweden)

    Nour-Mohammad Yaghoubi

    2011-09-01

    Full Text Available Nowadays, with increasing service industries, service marketing and service quality have become an important challenge to organizations. The attempts of organizations in this situation are witnesses to this matter. In the past years, the organizations tried to reach service quality appropriation and satisfaction of self-external customers by concepts and approaches of external marketing. One of the important features of service is the direct interaction with customers and having customer-oriented behaviors. Furthermore, with introducing the internal marketing and the important roles of it, an internal customer of organizations, on achievement of organizational plans, was noted to internal marketing more and more than before. So, the study researchers are going to argue about internal marketing and the effect of it on organizational citizenship behaviors and service quality and the important role of it on development and improvement of service quality by using organizational citizenship behaviors. For this purpose, first the researchers have studied internal marketing and its important components and then have done the same to the other items and finally have applied a quantitative study on all of them. It should be mentioned that the researchers have employed SPSS 17.0 and Lisrel 8.54 for data analysis. The findings of the present study illustrated that there is an appropriate interaction among all the items, which has been studied here and the structural equations for the conceptual framework of this study are goodness of fit.

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

    Directory of Open Access Journals (Sweden)

    Jessina Masamha

    2014-11-01

    Full Text Available Background: Launched in 2009, the Strengthening Laboratory Management Toward Accreditation (SLMTA programme has emerged as an innovative approach for the improvement of laboratory quality. In order to ensure sustainability, Mozambique embedded the SLMTA programme within the existing Ministry of Health (MOH laboratory structure. Objective: This article outlines the steps followed to establish a national framework for quality improvement and embedding the SLMTA programme within existing MOH laboratory systems. Methods: The MOH adopted SLMTA as the national laboratory quality improvement strategy, hired a dedicated coordinator and established a national laboratory quality technical working group comprising mostly personnel from key MOH departments. The working group developed an implementation framework for advocacy, training, mentorship, supervision and audits. Emphasis was placed on building local capacity for programme activities. After receiving training, a team of 25 implementers (18 from the MOH and seven from partner organisations conducted baseline audits (using the Stepwise Laboratory Quality Improvement Process Towards Accreditation [SLIPTA] checklist, workshops and site visits in six reference and two central hospital laboratories. Exit audits were conducted in six of the eight laboratories and their results are presented. Results: The six laboratories demonstrated substantial improvement in audit scores; median scores increased from 35% at baseline to 57% at exit. It has been recommended that the National Tuberculosis Reference Laboratory apply for international accreditation. Conclusion: Successful implementation of SLMTA requires partnership between programme implementers, whilst effectiveness and long-term viability depend on country leadership, ownership and commitment. Integration of SLMTA into the existing MOH laboratory system will ensure durability beyond initial investments. The Mozambican model holds great promise that country leadership, ownership and institutionalisation can set the stage for programme success and sustainability.

  15. Implementing change in perfusion practice: quality improvement vs. experimentation?

    Science.gov (United States)

    Newland, Richard F; Baker, Robert A

    2009-12-01

    The desire to optimize techniques and interventions that comprise clinical practice will inevitably involve the implementation of change in the process of care. To confirm the intended benefits of instituting clinical change, the process should be undertaken in a scientific manner. Although implementing changes in perfusion practice is limited by the availability of evidence based practice guidelines, we have the opportunity to audit our current practice according to institutional guidelines using quality improvement methods. Current electronic data collection technology is a useful tool available to facilitate the reporting of both clinical and process outcome improvements. The model of clinical effectiveness can be used as a systematic approach to introducing change in clinical practice, which involves reviewing the literature, acquiring appropriate skills and resources, auditing the change, and implementing continuous quality improvement to standardize the process. Finally, reporting the findings allows dissemination of the knowledge that can be generalized. Reporting change strengthens our efforts in clinical effectiveness, highlights the importance of perfusion practice, and increases the influence of the profession. PMID:20092082

  16. Adequate images in intraoperative transoesophageal echocardiography: a quality improvement project.

    Science.gov (United States)

    Graham, J; Sidebotham, D; Story, D A; Hu, R; Parker, F

    2014-09-01

    A suggested standard examination (SSE) for intraoperative transoesophageal echocardiography for cardiac surgery was developed at the Green Lane Department of Cardiothoracic and Otorhinolaryngology Anaesthesia at the Auckland City Hospital. The examination includes views to be recorded in all patients pre- and post-cardiopulmonary bypass. There are also additional views to be recorded in patients with valvular pathology. Using the SQUIRE (Standards for Quality Improvement Reporting Excellence) guidelines, we report an audit comparing acquisition ratios before and after introduction of the SSE. A baseline mean acquisition ratio of 0.62 was achieved, which was not significantly changed by the introduction of the SSE. Nevertheless, we found the SSE to be a useful audit tool and believe it might be of interest to others to assist with perioperative transoesophageal echocardiography quality assurance and education. PMID:25233179

  17. Quality Improvement of MARS Code and Establishment of Code Coupling

    International Nuclear Information System (INIS)

    The improvement of MARS code quality and coupling with regulatory auditing code have been accomplished for the establishment of self-reliable technology based regulatory auditing system. The unified auditing system code was realized also by implementing the CANDU specific models and correlations. As a part of the quality assurance activities, the various QA reports were published through the code assessments. The code manuals were updated and published a new manual which describe the new models and correlations. The code coupling methods were verified though the exercise of plant application. The education-training seminar and technology transfer were performed for the code users. The developed MARS-KS is utilized as reliable auditing tool for the resolving the safety issue and other regulatory calculations. The code can be utilized as a base technology for GEN IV reactor applications

  18. Mission operations and command assurance: Flight operations quality improvements

    Science.gov (United States)

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

    1994-01-01

    Mission Operations and Command Assurance (MO&CA) is a Total Quality Management (TQM) task on JPL projects to instill quality in flight mission operations. From a system engineering view, MO&CA facilitates communication and problem-solving among flight teams and provides continuous solving among flight teams and provides continuous process improvement to reduce risk in mission operations by addressing human factors. The MO&CA task has evolved from participating as a member of the spacecraft team, to an independent team reporting directly to flight project management and providing system level assurance. JPL flight projects have benefited significantly from MO&CA's effort to contain risk and prevent rather than rework errors. MO&CA's ability to provide direct transfer of knowledge allows new projects to benefit from previous and ongoing flight experience.

  19. Power Quality Improvement In A Grid Connected Renewable Energy System

    Directory of Open Access Journals (Sweden)

    Sreya Grace Mathew

    2014-10-01

    Full Text Available In distributed system, renewable energy resources (RES are increasingly incorporated using power electronics interfaces. Extensive use of power electronics devices generate harmonic current and may reduce quality of power. In this paper, renewable energy resources (RES is connected to the grid through a grid interfacing inverter for power quality improvement. The grid interfacing inverter is connected to a 3-phase 4-wire system and hysteresis current control method is used to generate gate pulses. Here renewable energy resource (RES is represented as a dc source. The grid interfacing inverter has the capability of injecting RES power to the grid and also reduces load unbalance, load harmonics and reactive power demand is compensated. Total Harmonic Distortion (THD of the grid connected system is analyzed. The simulation has been carried out in MATLAB/Simulink.

  20. Increasing the use of 'smart' pump drug libraries by nurses: a continuous quality improvement project.

    Science.gov (United States)

    Harding, Andrew D

    2012-01-01

    The use of infusion pumps that incorporate "smart" technology (smart pumps) can reduce the risks associated with receiving IV therapies. Smart pump technology incorporates safeguards such as a list of high-alert medications, soft and hard dosage limits, and a drug library that can be tailored to specific patient care areas. Its use can help to improve patient safety and to avoid potentially catastrophic harm associated with medication errors. But when one independent community hospital in Massachusetts switched from older mechanical pumps to smart pumps, it neglected to assign an "owner" to oversee the implementation process. One result was that nurses were using the smart pump library for only 37% of all infusions.To increase pump library usage percentage-thereby reducing the risks associated with infusion and improving patient safety-the hospital undertook a continuous quality improvement project over a four-month period in 2009. With the involvement of direct care nurses, and using quantitative data available from the smart pump software, the nursing quality and pharmacy quality teams identified ways to improve pump and pump library use. A secondary goal was to calculate the hospital's return on investment for the purchase of the smart pumps. Several interventions were developed and, on the first of each month, implemented. By the end of the project, pump library usage had nearly doubled; and the hospital had completely recouped its initial investment. PMID:22186702

  1. Voltage Quality Improvement in Islanded Microgrids Supplying Nonlinear Loads

    DEFF Research Database (Denmark)

    T. Dehghani, Mohammad; Vahedi, Abolfazl

    2012-01-01

    The aim of this paper is to improve voltage quality at the terminals of distributed generators (DGs) in an islanded microgrid. To achieve this goal, it is proposed to include separate voltage and current control loops for the fundamental and harmonics frequencies. This way, it is not necessary to consider additional controllers to provide voltage harmonic compensation. The proposed control system can be implemented in a very simple way. The control structure of every single DG unit consists of active and reactive power droop controllers and voltage and current control loops. Simulation results are provided in order to show the effectiveness of the proposed control approach.

  2. Improvement of graphene quality synthesized by cluster ion implantation

    International Nuclear Information System (INIS)

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

  3. Improving Recommendation Quality by Merging Collaborative Filtering and Social Relationships

    CERN Document Server

    De Meo, Pasquale; Fiumara, Giacomo; Provetti, Alessandro

    2011-01-01

    Matrix Factorization techniques have been successfully applied to raise the quality of suggestions generated by Collaborative Filtering Systems (CFSs). Traditional CFSs based on Matrix Factorization operate on the ratings provided by users and have been recently extended to incorporate demographic aspects such as age and gender. In this paper we propose to merge CFS based on Matrix Factorization and information regarding social friendships in order to provide users with more accurate suggestions and rankings on items of their interest. The proposed approach has been evaluated on a real-life online social network; the experimental results show an improvement against existing CFSs. A detailed comparison with related literature is also present.

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

    OpenAIRE

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

    2012-01-01

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

  5. A New Framework for improving low Quality Fingerprint Images

    Directory of Open Access Journals (Sweden)

    JitendraChoudhary

    2011-11-01

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

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

    DEFF Research Database (Denmark)

    Li, Ian; Medynskiy, Yevgeniy

    2012-01-01

    Personal informatics refers to a class of software and hardware systems that help individuals collect personal information to improve self-understanding. Improving self-understanding can foster self-insight and promote positive behaviors: healthy living, energy conservation, etc. The development of personal informatics applications poses new challenges for human-computer interaction and creates opportunities for applications in various domains related to quality of life, such as fitness, nutrition, wellness, mental health, and sustainability. This workshop will continue the conversations from the CHI 2010 and CHI 2011 workshops on personal informatics [6][7]. The focal themes for this workshop are: (1) practical lessons from previous research and development experiences that can guide interface design for systems that allow users to collect and reflect on personal data; (2) requirements for building robust personal informatics applications; and (3) design and development of infrastructures that make personal informatics applications easier to create and evaluate.

  7. Coaching as Part of a Pilot Quality Rating Scale Initiative: Challenges to--and Supports for--the Change-Making Process

    Science.gov (United States)

    Ackerman, Debra J.

    2008-01-01

    Several nonprofit agencies in a large Midwestern city provide assistance to early care and education programs participating in a pilot Quality Rating Scale (QRS) initiative by pairing them with itinerant consultants, who are known as coaches. Despite this assistance, not all programs improve their QRS score. Furthermore, while pilot stakeholders…

  8. Air Quality Model Evaluation International Initiative (AQMEII) - Utrecht, Netherlands The May 8, 2012

    Science.gov (United States)

    The 4th workshop of the Air Quality Model Evaluation International Initiative (AQMEII) was held on May 8 in Utrecht, The Netherlands, in conjunction with the NATO/SPS International Technical Meeting on Air Pollution Modeling and Its Application. AQMEII was launched in 2009 as a l...

  9. Increasing Extender Viscosity Improves the Quality of Cooled Boar Semen

    Directory of Open Access Journals (Sweden)

    Maria Cruz Gil

    2014-02-01

    Full Text Available The use of several types of gelling extenders for the storage of semen from several domestic species in the solid state has been shown to have beneficial effects on some semen quality parameters. The objective of this study was to evaluate the effect of a new high-viscosity semen extender, Zoosperm ND-5 3D® (Import-Vet, Centelles, Spain, on the the quality of boar spermatozoa at preserved at 17ºC for 7 days. Sodium alginate was used for the first time to increase the viscosity of the extender for the liquid storage of boar semen. The same extender, but without increased viscosity, was used as a control extender (Zoosperm ND-5®, Import-Vet, Centelles, Spain. Sixteen ejaculates from four Pietrain boars were evaluated for motility (by the CASA system, and for viability, acrosome status, plasma membrane fluidity, externalization of phosphatidylserine at the plasma membrane of the spermatozoa and mitochondrial membrane potential (by flow cytometry. In samples diluted with the Zoosperm ND-5 3D® viscous extender, the STR (straightness parameter and the number of progressively motile spermatozoa were higher compared to those of the non-viscous extender (p < 0.05. In addition, the number of spermatozoa with damaged acrosomes, an unstable sperm plasma membrane and externalization of phosphatidylserine at the plasma membrane was lower in samples treated with the viscous extender (p < 0.05. In conclusion, an increase in extender viscosity improves quality of boar spermatozoa following long-term storage.

  10. IMPROVING BANK QUALITY DIMENSIONS TO INCREASE CUSTOMER SATISFACTION

    Directory of Open Access Journals (Sweden)

    L?cr?mioara RADOMIR

    2011-01-01

    Full Text Available The purpose of this study is twofold: 1. examine the relationship betweenservice quality dimensions and customer satisfaction with bank territorialunits; 2. establish which quality measure method out of the four considered inthis study should be applied in order to better determine the areas that needfurther improvement and investment. In this respect, we performed PrincipalComponent Regression (PCR and considered direct importance andperformance measures as well. Our results reveal that human resourceshave the greatest impact on customers’ satisfaction with bank territorial unitsand that both “Convenience and Efficiency” and “Bank personnel” are thedimensions that bank management should consider in their efforts to improveand maintain the service quality level. To the best of our knowledge, this isthe first study which tries to emphasize the relationship between servicequality dimensions and Romanian customers’ satisfaction with bank territorialunits. The main limit of the study lies in the fact that data were collectedamong the customers of a single bank. Nevertheless, it provides valuableinformation about the Romanian market and ought to be considered astarting point for further studies.

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

    Directory of Open Access Journals (Sweden)

    Prof.N..Penchalaiah

    2011-02-01

    Full Text Available TCP is currently the dominate congestion control protocol for the Internet. However, as the Internet evolves into a high-speed wired-cum-wireless hybrid network, performance degradation problems of TCP have appeared, such as underutilizing high-speed links, regarding wireless loss as congestion signal, and unfairness among flows with different RTTs. In order to improve the quality of service for such highspeed hybrid networks, we propose a router-assisted congestion control protocol called Quick Flow Control Protocol (QFCP. The convergence of many traditional services over IPbased infrastructures drastically increases the amount of IP data traffic to be delivered to user clients, thus raising questions about the management of quality of service in such networks. Quality of service will be of primary importance in order to ensure right operation, and to face the occurrence of congestion conditions, due to bandwidth demandingmultimedia services. in this paper, shows that QFCP can significantly shorten flow completion time, fairly allocate bandwidth resource, and be robust to non-congestion related loss. Also we consider a possible scenarios in which multiple multimedia and control streams are conveyed over the same HAN, and study a possible solution for the implementation of an easily manageable QoS framework, that relies on a QoS router based on open source software.

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

    Science.gov (United States)

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

    2012-12-01

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

  13. Uncertainty in BMP optimization to improve watershed scale water quality

    Science.gov (United States)

    Chaubey, I.; Maringanti, C.

    2010-12-01

    There is a growing interest in the development of various optimization techniques for the selection and placement of best management practices (BMPs) for reducing nonpoint source (NPS) pollution from mixed land use watersheds. One of the limitations of the currently available optimization approaches is that the BMP strategies are considered deterministic. Uncertainties in land use and climate inputs along with model parameters are important sources of uncertainty in estimating hydrology and water quality response of a watershed. Consequently, these uncertainties also affect estimated water quality benefits from BMPs implemented in the watershed. In this research we present a novel methodology that can be used to quantify uncertainties in BMP optimization solutions due to uncertainties in model parameters, land use and climate change. Model parameters were perturbed randomly between the lower and upper bounds for each parameter. Synthetic land use scenarios were generated to represent future developments in the watershed. The climate change data were obtained from three GCM climate models (viz. HadCM3, NCAR-PCM, and GFDL) for different emission scenarios (A1, A1B, B2). The future climate data were compared with historic data, both data obtained from the climate model simulations, to quantify the monthly variability in precipitation and temperature. A watershed model (Soil and Water Assessment Tool or SWAT) was used to simulate the hydrology and water quality in the Wildcat Creek watershed, located in north-central Indiana, for various incremented levels in precipitation and temperature changes. The SWAT model was also used to represent various BMPs in the watershed needed to improve water quality. SWAT model parameters, land use change parameters, and climate change parameters were altered randomly using in Monte-Carlo framework. Both the net cost and the pollution reduction efficiencies of the BMPs were used in a multi-objective genetic algorithm to obtain the optimal selection and placement of BMPs in the watershed. It was observed that model parameters, land use and climate changes resulted in considerable uncertainties in BMP performance in reducing P, N, and sediment loads. In addition, climate change scenarios also affected uncertainties in SWAT simulated crop yields. Considerable uncertainties in the net cost and the water quality improvements resulted due to uncertainties in land use, climate change, and model parameter values.

  14. Quality assurance of radiotherapy in cancer treatment: toward improvement of patient safety and quality of care.

    Science.gov (United States)

    Ishikura, Satoshi

    2008-11-01

    The process of radiotherapy (RT) is complex and involves understanding of the principles of medical physics, radiobiology, radiation safety, dosimetry, radiation treatment planning, simulation and interaction of radiation with other treatment modalities. Each step in the integrated process of RT needs quality control and quality assurance (QA) to prevent errors and to give high confidence that patients will receive the prescribed treatment correctly. Recent advances in RT, including intensity-modulated and image-guided RT, focus on the need for a systematic RTQA program that balances patient safety and quality with available resources. It is necessary to develop more formal error mitigation and process analysis methods, such as failure mode and effect analysis, to focus available QA resources optimally on process components. External audit programs are also effective. The International Atomic Energy Agency has operated both an on-site and off-site postal dosimetry audit to improve practice and to assure the dose from RT equipment. Several countries have adopted a similar approach for national clinical auditing. In addition, clinical trial QA has a significant role in enhancing the quality of care. The Advanced Technology Consortium has pioneered the development of an infrastructure and QA method for advanced technology clinical trials, including credentialing and individual case review. These activities have an impact not only on the treatment received by patients enrolled in clinical trials, but also on the quality of treatment administered to all patients treated in each institution, and have been adopted globally; by the USA, Europe and Japan also. PMID:18952706

  15. Sustained Self-Regulation of Energy Intake: Initial Hunger Improves Insulin Sensitivity

    OpenAIRE

    Lorenzo Borselli; Martine van Weeren; Willem de Hahn; Boudewijn de Pont; Massimiliano Sifone; Riccardo Bianchi; Mario Ciampolini; David Lovell-Smith; Angelo Pietrobelli

    2010-01-01

    Background. Excessive energy intake has been implicated in diabetes, hypertension, coronary artery disease, and obesity. Dietary restraint has been unsuccessful as a method for the self-regulation of eating. Recognition of initial hunger (IH) is easily learned, can be validated by associated blood glucose (BG) concentration, and may improve insulin sensitivity. Objective. To investigate whether the initial hunger meal pattern (IHMP) is associated with improved insulin sensitivity over a 5-mon...

  16. Initiatives and results of quality assurance at national level: Federal Republic of Germany, Austria and Switzerland

    International Nuclear Information System (INIS)

    Starting in the mid-thirties, guidelines for quality assurance have been developed in Germany as well as in Austria and Switzerland on the basis of local or individual activities, with the aim of comparing the radiographs of parts of the human body to be examined under standardised conditions. The fact that the dose or dose rate necessary to produce a radiographic image of good quality varies widely without improving the retrieval of useful information calls for the introduction of improved methods of quality control. These methods are partly included in legal regulations, standards or provisions of scientific or medical organisations of the three nations. The implementation of uniform quality assurance programmes at national level for different examination techniques and the development of criteria describing details and critical structures which are essential for diagnosing pathological conditions, will further improve image quality and reduce costs within the X-ray department and private offices. The role of the different organisations and bodies in elaborating appropriate recommendations and guidelines for quality assurance in the Federal Republic of Germany, Austria and Switzerland is described in detail. (author)

  17. Lessons in flying: crew resource management as a quality improvement method for acute coronary syndromes care.

    Science.gov (United States)

    Levy, Phillip D; Dancy, Janeen N; Stowell, Stephanie A; Hoekstra, James W; Arthur, Crystal L; Wilson, Charles H; Bednar, John M; Dorman, Todd; Hiestand, Brian

    2014-03-01

    Providing timely, high-quality, guideline-based care to patients with acute coronary syndromes (ACS) who present to the emergency department is critically dependent on cooperation, coordination, and communication between emergency medicine physicians and cardiologists. However, to achieve sustained improvement at the individual institution level, consistent implementation of quality improvement (QI) activities is needed. We describe a QI initiative for ACS care in the emergency setting that combined clinical education with a curriculum based on crew resource management (CRM) principles-a set of tools and techniques for communication, teamwork, and error avoidance used in the aviation industry and with proven applicability in the healthcare setting. Educational training sessions were open to multidisciplinary healthcare teams at 3 hospital sites, and participants were provided practical tools and resources to enhance communication, teamwork, and patient-centered care. Through patient chart reviews, participant surveys, and clinician interviews, baseline assessments of clinical performance measures and team communication-, logistics-, and skills-based efficiencies were performed and reported before the educational training was delivered at each QI site. Reviews of pre- and postinitiative participant surveys demonstrated improvement in knowledge and confidence in the delivery of appropriate and effective ACS care; however, reviews of pre- and postinitiative patient charts revealed limited process improvements. Altogether, this multicenter study of a continuing medical education program based on CRM principles was associated with improvements in provider knowledge and confidence regarding the delivery of appropriate ACS care, but had limited impact on clinical performance measures. PMID:24526150

  18. Initial studies of oxidation processes on filter surfaces and their impact on perceived air quality.

    Science.gov (United States)

    Bekö, G; Halás, O; Clausen, G; Weschler, C J

    2006-02-01

    Used filters can be a strong sensory pollutant source. Oxidation processes, especially those initiated by ozone, may contribute to the pollutants emitted from such filters. In the present study, ozone was added to the airstream passing through used ventilation filters. Two flow rates were examined. While the upstream ozone concentration was approximately 75 ppb, the concentrations downstream of the filter were initially 35-50% lower. However, within an hour downstream concentrations were only 5-10% lower than those upstream. These filter samples were then placed for 48 h in nitrogen, ambient air containing less than 5 ppb ozone, or ambient air at an elevated temperature. This resulted in partial regeneration of the ozone removal capability of the filter. In analogous experiments, lower ozone removal occurred when the filter samples were first ventilated for 24 h with ozone-free air before making the measurements. Samples from a new filter removed air passing through various used filter samples. In the initial evaluation each of the four filter samples, taken from the same filter and ventilated for 24 h, were assessed to be equivalent. The next evaluation was immediately after the samples had been kept for 24 h in either nitrogen, air, air at an elevated temperature or ozone. The nitrogen-treated filter was assessed to be best, while the ozone-treated filter was assessed to be the worst. The final evaluation occurred after ambient air had passed through the 'treated' filters for 2 h. All such ventilated filters were assessed to be more acceptable than immediately after the 24-h treatments; the ozonized and air-treated filters were the most polluting of the four. Practical Implications The present paper supports previous findings that loaded ventilation filters can be significant sources of sensory pollution. Replacing a loaded filter with a new filter temporarily removes this source of pollution. However, the present study does not provide an answer to how frequently changes are needed under different conditions. The results indicate that in cases of intermittent operation of ventilation systems, the airflow through the polluted filters should be restarted in sufficient time prior to occupancy to purge odorous pollutants that have accumulated on the filter surface. Removal of ozone upstream of the particle filters may further improve perceived air quality in the space downstream of the filter bank. Future efforts related to the development and application of low-polluting filtration systems are warranted. PMID:16420498

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

    DEFF Research Database (Denmark)

    Vincze, Éva; Dionisio, Giuseppe

    2011-01-01

    Barley (Hordeum vulgare) has the potential to offer considerable human nutritional benefits, especially as supplement to wheat-based breads. Under current commercial baking conditions it is not possible to introduce more that 20% barley flour to the wheat bread without negative impact on the physical chemical properties of the bread products due to the poor baking properties of barley flour. As a consequence, the nutritional advantages of barley are not fully exploited. The inferior leavening and baking properties of barley can, in part, be attributed to the physical properties of the storage proteins. Changing the storage protein composition can lessen this problem. Our working hypothesis was that exploiting the substantial genetic variation within the gene pool for storage proteins could enable improving the baking qualities of barley flour. We characterised forty-nine barley cultivars for variations in storage protein and AA composition. These cultivars were selected based on their higher protein contents (11.8–17.6%). The results obtained indicated that substantial variation not only in the distribution of the hordein polypeptides but also in the relative proportions of the storage proteins affecting the AA compositions as well. Studies based on small scaled baking trials and protein pattern analysis by SDS-PAGE on the high protein barley cultivars suggested differences in baking quality and a correlation between baking quality and the high molecular weight (HMW)-storage proteins. Mass spectrometry (Q-TOF) proved the identity of the HMW proteins and sequencing the digested peptides also revealed possible post translational modifications of the identified HMW hordeins. Our results strongly indicate that the variations in the relative proportions of the storage proteins of barley affect both the amino acid compositions and baking quality.

  20. "Why Didn't They Ask Me?": Student Perspectives on a School Improvement Initiative

    Science.gov (United States)

    Scanlon, Lesley

    2012-01-01

    This is the first in a series of articles which will examine the results of a qualitative, longitudinal study of school improvement initiatives from the perspective of school stakeholders. The article captures the responses of students from a low socio-economic status school in NSW, Australia to a school initiative that restructured the learning…

  1. Induced mutation for quality improvement in Egyptian (Gossypium barbadense L.) cotton

    International Nuclear Information System (INIS)

    The mutagenic effect of gamma rays (15,20,25 and 30 kR) and Ethyl methane sulphonate (0.1,0.2 and 0.4%) after 2 and 4 hours of soaking in inducing positive micro mutations in quality trait of cotton was studied in Suvin variety of cotton. The results indicate that desirable mutants could be obtained with low doses and short duration of treatments. The initial studies indicate the possibility of isolating desirable segregants with improved fibre length, uniformity ratio and fibre strength. However, the increase in micronaire values were only marginal. (author)

  2. Quality improvement at GPU nuclear through application of the Deming management method

    International Nuclear Information System (INIS)

    GPU Nuclear Corporation (GPUNC) is taking significant initiatives to upgrade the quality of our activities, both at the plant sites and at the corporate headquarters. One part of the corporation's basic philosophy has been a continuing Search for Excellence which recognizes that any level of performance can always be improved. About two years ago the company did an evaluation of management and decided to adapt relevant aspects of this philosophy to the specific needs of GPUNC. One reason for this decision was that many ideas advocated by Dr. Deming were consistent with company activities already completed or in progress. This paper discusses our progress in applying this philosophy to GPUNC activities

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

    OpenAIRE

    Buavaraporn, Nattapan

    2010-01-01

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

  4. MAUVE: A European Initiative for Developing and Improving Satellite Derived Ultraviolet Maps

    International Nuclear Information System (INIS)

    Increased exposure to UV radiation is known to have a significant effect on human health, ecosystems or crop production. The link between stratospheric ozone depletion and increased surface UV radiation is now established. Large increases in UV radiation have been observed in association with the ozone hole at high southern latitudes. A clear sign of the growing importance of gathering better information on the UV radiation is given by the emergence of a number of initiatives both at the national and international level. MAUVE (MApping of UV by Europe) is a pilot project supported by the European Commission in the 4th R and D Framework Programme. The project officially started on 1 December 1997, and will last for two years. The main objective of MAUVE is to establish maps of surface UV radiation, derived from satellite data, as a recognised source of information for a variety of users. This is achieved by (1) defining the UV map products together with the users, (2) producing 'pilot products' by customising and improving methodologies developed in the framework of several national projects, and (3) thoroughly assessing their quality and usefulness on the European scale using existing infrastructure and data sets. (author)

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

    Science.gov (United States)

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

    2008-04-01

    Deficiencies in the quality of health care are major limiting factors to the achievement of the Millennium Development Goals for child and maternal health. Quality of patient care in hospitals is firmly on the agendas of Western countries but has been slower to gain traction in developing countries, despite evidence that there is substantial scope for improvement, that hospitals have a major role in child survival, and that inequities in quality may be as important as inequities in access. There is now substantial global experience of strategies and interventions that improve the quality of care for children in hospitals with limited resources. The World Health Organization has developed a toolkit that contains adaptable instruments, including a framework for quality improvement, evidence-based clinical guidelines in the form of the Pocket Book of Hospital Care for Children, teaching material, assessment, and mortality audit tools. These tools have been field-tested by doctors, nurses, and other child health workers in many developing countries. This collective experience was brought together in a global World Health Organization meeting in Bali in 2007. This article describes how many countries are achieving improvements in quality of pediatric care, despite limited resources and other major obstacles, and how the evidence has progressed in recent years from documenting the nature and scope of the problems to describing the effectiveness of innovative interventions. The challenges remain to bring these and other strategies to scale and to support research into their use, impact, and sustainability in different environments. PMID:18381526

  6. Short-term effects of different pasture improvement treatments on the physical quality of an andisol

    Scientific Electronic Library Online (English)

    J, Dörner; F, Zúñiga; I, López.

    2013-06-01

    Full Text Available SciELO Chile | Language: English Abstract in english The improvement of degraded pastures is important for increasing pasture herbage mass and animal production in southern Chile. While research has normally focused on how animal treading affects soil compaction, no major work has yet been done to define the impact of pasture improvement managements o [...] n soil physical functions, particularly when the initial situation is a degraded pasture. Thus, the aim of this study is to define the short-term effects of different pasture improvement managements on the physical quality and related processes of a volcanic ash soil. Four treatments were defined: two tilled, fertilized and seeded plots (T1 and T2), one non-tilled and non-fertilized plot (T3) and one non-tilled and fertilized plot (T4), all of which were compared to the initial situation of a highly degraded pasture (IS). Undisturbed soil samples were collected (1-10 cm) and the volumetric water content and temperature was continuously monitored at the 10 cm depth. The short-term effects of pasture improvement managements on soil physical quality and related processes differed in relation to the treatment method. As compared to the non-tilled plots, the aggregate destruction after tillage induced an increase in the water holding capacity, but a decrease in the air capacity and pore-continuity values due to grazing. The physical quality assessed by the S-Index reflected a good soil structural quality (S > 0.035). The tilled plots presented a higher S-Index as compared to the non-tilled plots, which is related to a slightly lower mechanical strength and larger water holding capacity. The latter also increased due to tillage and was positively correlated to pasture yields during the first intensive soil drying. Soil temperature differences between treatments were assessed and can be related to the higher water contents in the tilled plots and the presence of broad-leaf species in the non-tilled pastures. Finally, in order to properly understand how the implementation of pasture improvement managements affects the soil physical quality and related processes, long-term studies are required.

  7. The effectiveness of service delivery initiatives at improving patients' waiting times in clinical radiology departments: a systematic review.

    Science.gov (United States)

    Olisemeke, B; Chen, Y F; Hemming, K; Girling, A

    2014-12-01

    We reviewed the literature for the impact of service delivery initiatives (SDIs) on patients' waiting times within radiology departments. We searched MEDLINE, EMBASE, CINAHL, INSPEC and The Cochrane Library for relevant articles published between 1995 and February, 2013. The Cochrane EPOC risk of bias tool was used to assess the risk of bias on studies that met specified design criteria. Fifty-seven studies met the inclusion criteria. The types of SDI implemented included extended scope practice (ESP, three studies), quality management (12 studies), productivity-enhancing technologies (PETs, 29 studies), multiple interventions (11 studies), outsourcing and pay-for-performance (one study each). The uncontrolled pre- and post-intervention and the post-intervention designs were used in 54 (95%) of the studies. The reporting quality was poor: many of the studies did not test and/or report the statistical significance of their results. The studies were highly heterogeneous, therefore meta-analysis was inappropriate. The following type of SDIs showed promising results: extended scope practice; quality management methodologies including Six Sigma, Lean methodology, and continuous quality improvement; productivity-enhancing technologies including speech recognition reporting, teleradiology and computerised physician order entry systems. We have suggested improved study design and the mapping of the definitions of patient waiting times in radiology to generic timelines as a starting point for moving towards a situation where it becomes less restrictive to compare and/or pool the results of future studies in a meta-analysis. PMID:24888629

  8. Quality assurance and the World Health Organization initiative of 'Health for All'

    International Nuclear Information System (INIS)

    Following a workshop held in Neuherberg, FRG, in 1980 a guide for quality assurance in diagnostic radiology was published by WHO in 1982. Quality assurance programmes were recognized as being necessary for three main objectives: first the improvement of medical diagnostic imaging, secondly cost containment, and thirdly the reduction of radiation exposure. Concurrently, because of the paramount importance for basic diagnostic imaging, WHO prepared Technical Specifications for the X-ray Apparatus to be Used in a Basic Radiological System (BRS), governed by the concepts of ''design-out maintenance'' and ''design-in quality assurance''. The outcome of WHO's efforts, in comparison with the recognized quality assurance objectives, indicates that, although it is too early to measure overall improvements in medical diagnostic imaging, the two main aspects, accessibility and image quality, should be improved. Regarding cost containment, elimination of many logistical and support requirements should result in considerable savings. Regarding the reduction of radiation exposure, and using the entrance skin exposure as an indicator, an important finding is that with the WHO-BRS type X-ray equipment, in most cases the patient exposure was less than the average values in the United States. (author)

  9. Effectiveness of the stormwater quality devices to improve water quality at Putrajaya

    International Nuclear Information System (INIS)

    Development of Putrajaya has changed the character of the natural landform by covering the land with impervious surfaces. Houses, office buildings, commercial place and shopping centres have provided places to live and work. The route between buildings is facilitated and encouraged by a complex network of roads and car parks. However, this change from natural landforms and vegetative cover to impervious surfaces has major effect on stormwater which are water quality (non-point source pollution). This paper describes the effectiveness of the stormwater quality devices to improve water quality at selected Putrajaya for demonstration in order to evaluate low cost storm inlet type devices in the Putrajaya Catchment. Five stormwater quality devices were installed and monitored during the study. The devices include Ultra Drain Guard Recycle model, Ultra Curb Guard Plus, Ultra Grate Guard, Absorbent Tarp and Ultra Passive Skimmer. This paper will provide information on the benefits and costs of these devices, including operations and maintenance requirements. Applicability of these devices in gas stations, small convenience stores, residential and small parking lots in the catchment are possible due to their low cost.

  10. Application of quality improvement strategies in 389 European hospitals: results of the MARQuIS project

    OpenAIRE

    Lombarts, M. J. M. H.; Rupp, I.; Vallejo, P.; Sun?ol, R.; Klazinga, N. S.

    2009-01-01

    Context: This study was part of the Methods of Assessing Response to Quality Improvement Strategies (MARQuIS) research project investigating the impact of quality improvement strategies on hospital care in various countries of the European Union (EU), in relation to specific needs of cross-border patients. Aim: This paper describes how EU hospitals have applied seven quality improvement strategies previously defined by the MARQuIS study: organisational quality management programmes; systems f...

  11. ECG-synchronized DSA exposure control: improved cervicothoracic image quality

    International Nuclear Information System (INIS)

    An electrocardiogram (ECG)-synchronized x-ray exposure sequence was used to acquire digital subtraction angiographic (DSA) images during 13 arterial injection studies of the aortic arch or carotid bifurcations. These gated images were compared with matched ungated DSA images acquired using the same technical factors, contrast material volume, and patient positioning. Subjective assessments by five experienced observers of edge definition, vessel conspicuousness, and overall diagnostic quality showed overall preference for one of the two acquisition methods in 69% of cases studied. Of these, the ECG-synchronized exposure series were rated superior in 76%. These results, as well as the relatively simple and inexpensive modifications required, suggest that routine use of ECG exposure control can facilitate improved arterial DSA evaluations of suspected cervicothoracic vascular disease

  12. Mesh quality improvement for SciDAC applications

    International Nuclear Information System (INIS)

    Accurate and efficient numerical solution of partial differential equations requires well-formed meshes that are non-inverted, smooth, well-shaped, oriented, and size-adapted. The Mesquite mesh quality improvement toolkit is a software library that applies optimization algorithms to create well-formed meshes via node movement. Mesquite can be run standalone using drivers or called directly from an application code. Mesquite can play an essential role in the SLAC accelerator design program as a component in automatic shape optimization software and in manufacturing defect-correction studies to smoothly deform meshes in response to geometric domain deformations guided by the optimization of design parameters. Mesquite has also been applied to problems in fusion, biology, and propellant burn studies

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

    International Nuclear Information System (INIS)

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

  14. Water quality audits can improve availability and reduce costs

    International Nuclear Information System (INIS)

    The Water Quality Audit (WQA) is an independent, detailed review and thorough analysis of an operating plant's water technology control systems and operator education (as distinguished from operator training). The need for such an audit and its role in improving the reliability and availability of both nuclear and fossil-fueled power plants is discussed. Instances of how the failure of either system hardware or operational control has caused injection of seawater, acid, caustic, or ion exchange resin into the condensate-feedwater system and steam generator are revealed. The systems to be audited are described, and the stage-wise nature of the audit explained. The potential savings of an audit are outlined and the timing and range of costs of a WQA are given

  15. Checklists to improve the quality of the orthopaedic literature.

    Science.gov (United States)

    Mundi, Raman; Chaudhry, Harman; Singh, Ishu; Bhandari, Mohit

    2008-04-01

    Several checklists have been developed in an effort to help journals and researchers improve the quality of reporting in research. The CONSORT statement and the CLEAR NPT evaluate randomized trials. The MOOSE and QUOROM checklists evaluate meta-analyses. The STROBE checklists assists readers in evaluating observational studies and the STARD checklist was developed for diagnostic test evaluation. The checklists presented here provide an invaluable source of guidance to authors, journal editors and readers who are seeking to prepare and evaluate reports. As evidence-based medicine continues to establish itself as the new paradigm by which medicine is practiced, the need for good reporting for all research designs must also become commonplace as opposed to the exception. PMID:19826520

  16. Checklists to improve the quality of the orthopaedic literature

    Directory of Open Access Journals (Sweden)

    Mundi Raman

    2008-01-01

    Full Text Available Several checklists have been developed in an effort to help journals and researchers improve the quality of reporting in research. The CONSORT statement and the CLEAR NPT evaluate randomized trials. The MOOSE and QUOROM checklists evaluate meta-analyses. The STROBE checklists assists readers in evaluating observational studies and the STARD checklist was developed for diagnostic test evaluation. The checklists presented here provide an invaluable source of guidance to authors, journal editors and readers who are seeking to prepare and evaluate reports. As evidence-based medicine continues to establish itself as the new paradigm by which medicine is practiced, the need for good reporting for all research designs must also become commonplace as opposed to the exception.

  17. Improving the quality control program for patient dose calibrator according to IEC 60580

    International Nuclear Information System (INIS)

    The objective of this work was to improve the program quality control of this equipment based on the International Standard IEC 60580 - Medical electrical equipment - Dose area product meters . The initial program was established following the recommendations of IEC 61674 quoting dosimeters with ionization chambers and / or semiconductor detectors used in diagnostic X-ray image, however, the IEC 60580 is referred specifically to gauges and KAP (kerma-area product) presents additional tests. Tests included: intrinsic relative error, repeatability, scanning resolution, settling time, restarting, float values, response time and spatial uniformity of response. As a rule, all measurements are within the range characteristic of equipment performance. Thus, the PDC (Patient Dose Calibrator) again shows a device with excellent functionality and reliability in characterization tests carried out to quality control as( for the test in clinical PKA meters

  18. Flattening filter removal for improved image quality of megavoltage fluoroscopy

    International Nuclear Information System (INIS)

    Purpose: Removal of the linear accelerator (linac) flattening filter enables a high rate of dose deposition with reduced treatment time. When used for megavoltage imaging, an unflat beam has reduced primary beam scatter resulting in sharper images. In fluoroscopic imaging mode, the unflat beam has higher photon count per image frame yielding higher contrast-to-noise ratio. The authors’ goal was to quantify the effects of an unflat beam on the image quality of megavoltage portal and fluoroscopic images.Methods: 6 MV projection images were acquired in fluoroscopic and portal modes using an electronic flat-panel imager. The effects of the flattening filter on the relative modulation transfer function (MTF) and contrast-to-noise ratio were quantified using the QC3 phantom. The impact of FF removal on the contrast-to-noise ratio of gold fiducial markers also was studied under various scatter conditions.Results: The unflat beam had improved contrast resolution, up to 40% increase in MTF contrast at the highest frequency measured (0.75 line pairs/mm). The contrast-to-noise ratio was increased as expected from the increased photon flux. The visualization of fiducial markers was markedly better using the unflat beam under all scatter conditions, enabling visualization of thin gold fiducial markers, the thinnest of which was not visible using the unflat beam.Conclusions: The removal of the flattening filter from a clinical linac leads to quantifiable improvements in the image quality of megavoltage projection images. These gains enable observers to more easily visualize thin fiducial markers and track their motion on fluoroscopic images

  19. Quality Improvement Methodologies – PDCA Cycle, RADAR Matrix, DMAIC and DFSS

    Directory of Open Access Journals (Sweden)

    M. Sokovic

    2010-11-01

    Full Text Available Purpose: of this paper is to introduce the reader to the characteristics of PDCA tool and Six Sigma (DMAIC, DFSS techniques and EFQM Excellence Model (RADAR matrix, which are possible to use for the continuous quality improvement of products, processes and services in organizations.Design/methodology/approach: We compared the main characteristics of the presented methodologies aiming to show the main prerequisites, differences, strengths and limits in their application.Findings: Depending on the purpose every organization will have to find a proper way and a combination of methodologies in its implementation process. The PDCA cycle is a well known fundamental concept of continuous-improvement processes, RADAR matrix provides a structured approach assessing the organizational performance, DMAIC is a systematic, and fact based approach providing framework of results-oriented project management, DFSS is a systematic approach to new products or processes design focusing on prevent activities.Research limitations/implications: This paper provides general information and observations on four presented methodologies. Further research could be done towards more detailed study of characteristics and positive effects of these methodologies.Practical implications: The paper presents condensed presentation of main characteristics, strengths and limitations of presented methodologies. Our findings could be used as solid information for management decisions about the introduction of various quality programmes.Originality/value: We compared four methodologies and showed their main characteristics and differences. We showed that some methodologies are more simple and therefore easily to understand and introduce (e.g. PDCA cycle. On the contrary Six Sigma and EFQM Excellence model are more complex and demanding methodologies and therefore need more time and resources for their proper implementation.

  20. The Software Improvement Process - Tools And Rules To Encourage Quality

    CERN Document Server

    Sigerud, K

    2011-01-01

    The Applications section of the CERN accelerator Controls group has decided to apply a systematic approach to quality assurance (QA), the “Software Improvement Process”, SIP. This process focuses on three areas: the development process itself, suitable QA tools, and how to practically encourage developers to do QA. For each stage of the development process we have agreed on the recommended activities and deliverables, and identified tools to automate and support the task. For example we do more code reviews. As peer reviews are resource-intensive, we only do them for complex parts of a product. As a complement, we are using static code checking tools, like FindBugs and Checkstyle. We also encourage unit testing and have agreed on a minimum level of test coverage recommended for all products, measured using Clover. Each of these tools is well integrated with our IDE (Eclipse) and give instant feedback to the developer about the quality of their code. The major challenges of SIP have been to 1) agree on com...

  1. Improvement of hygienic quality of white ginseng powders by ?-irradiation

    International Nuclear Information System (INIS)

    For the purpose of improving hygienic quality of white ginseng powders, the comparative effects of ethylene oxide (EO) fumigation and ?-irradiation (5-10 kGy) on the sterilization, physiochemical properties and organoleptic quality were investigated. EO fumigation and ?-irradiation (5-10 kGy) completely eliminated the microorganisms contaminating in white ginseng powder. There was no growth of microorganisms after 7 months storage at 30degC and different relative humidities. In the physiochemical properties, ginseng saponins were considerably resistant to ?-irradiation (less than 10 kGy) and commercial EO fumigation, while sulfur-containing amino acids, reducing sugar and acidity were significantly changed by EO fumigation. EO residues were 570 ppm in the samples taken immediately after deaeration and 170 ppm in the stored samples of 8 days at 30degC, respectively. Ethylene chlorohydrin and ethylene glycol residues as the secondary products of EO were 9,595 ppm immediately after deaeration and 221 ppm in the stored samples of 3 months at 30degC. (author)

  2. Development of high yielding winter rapeseed with improved oil quality

    International Nuclear Information System (INIS)

    In order to secure and increase the consumption of rapeseed oil in the food industry, lower linolenic acid contents are required. Varieties reaching this quality standard must also produce high oil yields for such production to become economic. In a pertinent research programme, first mutation experiments were started in 1968 resulting in an improved fatty acid (f.a.) composition of the seed oil in spring rapeseed genotypes. In the following years selected alleles controlling the expression of low linolenic acid content were transferred from spring type mutants to winter rapeseed via backcrossing. In a further mutation experiment with winter forms, genotypes were selected exhibiting less than 3% linolenic acid content in seed triacylglycerols during tests run over four years. Thus, very low linolenic acid levels were realized also in winter rapeseed varieties. By simultaneously selection for low flucosinolate (gsl) content together with the desired oil quality selection gain for seed yield was reduced considerably. Further backcrossing and continuous selection resulted in high yielding OlO lines. On the other hand S1, recurrent selection proved to be another effective method to accumulate favorable alleles for seed yield in a Ol+base population without changing its favorably low linolenic acid content. Therefore, the transferred mutant alleles do not seem to restrict yield performance. (author). 20 refs, 2 figs, 6 tabs. 20 refs, 2 figs, 6 tabs

  3. Compatible solutes from hyperthermophiles improve the quality of DNA microarrays

    Directory of Open Access Journals (Sweden)

    Evangelisti Rita

    2007-11-01

    Full Text Available Abstract Background DNA microarrays are among the most widely used technical platforms for DNA and RNA studies, and issues related to microarrays sensitivity and specificity are therefore of general importance in life sciences. Compatible solutes are derived from hyperthermophilic microorganisms and allow such microorganisms to survive in environmental and stressful conditions. Compatible solutes show stabilization effects towards biological macromolecules, including DNA. Results We report here that compatible solutes from hyperthermophiles increased the performance of the hybridization buffer for Affymetrix GeneChip® arrays. The experimental setup included independent hybridizations with constant RNA over a wide range of compatible solute concentrations. The dependence of array quality and compatible solute was assessed using specialized statistical tools provided by both the proprietary Affymetrix quality control system and the open source Bioconductor suite. Conclusion Low concentration (10 to 25 mM of hydroxyectoine, potassium mannosylglycerate and potassium diglycerol phosphate in hybridization buffer positively affected hybridization parameters and enhanced microarrays outcome. This finding harbours a strong potential for the improvement of DNA microarray experiments.

  4. Improvement of flour quality through carbohydrases treatment during wheat tempering.

    Science.gov (United States)

    Haros, Mónica; Rosell, Cristina M; Benedito, Carmen

    2002-07-01

    Wheat flour is obtained by the milling process, which includes several steps such as cleaning, tempering, and milling. In the tempering the moisture content of wheat grains is increased to 15.5% by adding an adequate amount of water. The addition of different enzymes (cellulase, xylanase, and beta-glucanase) to the tempering solution has been tested in order to modify the quality of the resulting flour. Rheological and fermentative properties were measured by the farinograph, amylograph, and rheofermentometer. The data show that the technological parameters of the resulting flours were greatly modified by the addition of enzymes to the tempering solution. The quality of the fresh bread obtained from the carbohydrase-treated wheat was improved with regard to specific bread volume, bread shape, and crumb firmness. This method is revealed as an excellent tool to ensure a good distribution of the enzymes in the resulting flour, to control dosage during milling, and to obtain flour of specific characteristics according to their final use. PMID:12083895

  5. Laser treatment improves quality of life of hirsute females.

    Science.gov (United States)

    Loo, W J; Lanigan, S W

    2002-09-01

    Hirsutism has a significant impact on the quality of life of affected patients. We report a prospective study of 45 hirsute females attending a laser clinic. Of these, 15 patients completed a pair of modified dermatology life quality index (DLQI) questionnaires, immediately before and at varying intervals (up to 6 months) after laser treatment. The mean DLQI score before treatment was 12.8 (median = 9.0, SD = 8.5). The mean DLQI score at 1-2 months was 7.0 (median = 2.5, SD = 10.0, P = 0.06), at 2-4 months it was 9.2 (median = 10.0, SD = 10.0, P = 0.48) and at 4-6 months it was 11.5 (median = 10.5, SD = 8.0, P = 0.88). There was a major improvement in DLQI score at 1-2 months but longer-term benefit was not observed. In a separate questionnaire, hirsute females (n = 45) reported a high level of patient satisfaction (71.1%) and willingness to have further treatment (77.8%) despite the fact that 97.1% had unwanted hair back at pretreatment levels at 6 months. PMID:12372078

  6. The physician mentored implementation model: a promising quality improvement framework for health care change.

    Science.gov (United States)

    Li, Jing; Hinami, Keiki; Hansen, Luke O; Maynard, Gregory; Budnitz, Tina; Williams, Mark V

    2015-03-01

    Quality improvement (QI) efforts hold great promise for improving care delivery. However, hospitals often struggle with QI implementation and fail to sustain improvement in either process changes or patient outcomes. Physician mentored implementation (PMI) is a novel approach that promotes the success and sustainability of QI initiatives at hospitals. It leverages the expertise of external physician mentors who coach QI teams to implement interventions at their local hospitals. The PMI model includes five core components: (1) a hospital self-assessment tool, (2) a face-to-face training session including direct interaction with a physician mentor, (3) a guided continuous quality improvement and systems approach, (4) yearlong individual physician mentoring, and (5) a learning community supported by a resource center, listserv, and webinars. Mentors provide content and process expertise, rather than offering "one-size-fits-all" technical assistance that might not be sustained after the mentoring year ends. Mentors support and motivate QI teams throughout the planning and implementation phases of their interventions, help to engage hospital leadership, garner local physician buy-in, and address institutional barriers. Mentors also guide hospitals to identify opportunities for the adaptation and customization of original evidence-based models of care while ensuring the fidelity of those models. More than 350 hospitals have used the PMI model to implement successful national and statewide QI initiatives. Academic medical centers are charged with improving the health of patients and reengineering care delivery; thus, they serve as the ideal source for physician mentors and can act as leaders in implementing QI projects using the PMI model. PMID:25354069

  7. School Improvement and Cultural Change: An Interim Account of the "Improving the Quality of Education for All" (IQEA) Project.

    Science.gov (United States)

    Hopkins, David

    This paper presents interim findings of the Improving the Quality of Education for All (IQEA) Project, a school-improvement and development project implemented by approximately 30 schools in East Anglia, North London, and Yorkshire in England. The overall project goal was to strengthen the school's ability to provide quality education for all…

  8. Documenting Quality Improvement and Patient Safety Efforts: The Quality Portfolio. A Statement from the Academic Hospitalist Taskforce

    OpenAIRE

    Taylor, Benjamin B.; Parekh, Vikas; Estrada, Carlos A.; Schleyer, Anneliese; Sharpe, Bradley

    2013-01-01

    Physicians increasingly investigate, work, and teach to improve the quality of care and safety of care delivery. The Society of General Internal Medicine Academic Hospitalist Task Force sought to develop a practical tool, the quality portfolio, to systematically document quality and safety achievements. The quality portfolio was vetted with internal and external stakeholders including national leaders in academic medicine. The portfolio was refined for implementation to include an outlined fr...

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

    Science.gov (United States)

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

    1996-05-01

    In 1993 the California Office of Statewide Health Planning and Development (OSHPD) began public release of risk-adjusted monitoring of outcomes (RAMO) under the California Hospital Outcomes Project. We studied how 17 acute are public hospitals in California used these RAMO data for quality improvement purposes following their initial distribution, first by analyzing the outcome data for San Francisco General Hospital Medical Center as recommended by OSHPD and, second, by querying the departments at the other 16 public hospitals to determine how their own analyses compared. We found that the hospitals generally did minimal analyses of the OSHPD RAMO data and considered the data of little value to them. Only 3 hospitals initiated quality improvement activities based on their data review. The major reasons given by the hospitals for not using the RAMO data were that their outcomes were adequate, as verified by a comparison of their observed outcomes and those expected after risk-adjustment; that the hospitals had too few patients in the diagnostic categories; that they had too few resources; and that they were not concerned with the data's public release. Other possible explanations were that awareness of the California Hospital Outcomes Project was not widespread at the time of the study, that the RAMO data were not distributed in a way that encouraged their use, and that public hospitals were not inclined to use the outcome data because the project was imposed on them. Whatever the explanation, our study suggests that the California Hospital Outcomes Project has had little effect on quality improvement in public hospitals. PMID:8686297

  10. Quality assurance of radiotherapy in cancer treatment. Toward improvement of patient safety and quality of care

    International Nuclear Information System (INIS)

    The process of radiotherapy (RT) is complex and involves understanding of the principles of medical physics, radiobiology, radiation safety, dosimetry, radiation treatment planning, simulation and interaction of radiation with other treatment modalities. Each step in the integrated process of RT needs quality control and quality assurance (QA) to prevent errors and to give high confidence that patients will receive the prescribed treatment correctly. Recent advances in RT, including intensity-modulated and image-guided RT, focus on the need for a systematic RTQA program that balances patient safety and quality with available resources. It is necessary to develop more formal error mitigation and process analysis methods, such as failure mode and effect analysis, to focus available QA resources optimally on process components. External audit programs are also effective. The International Atomic Energy Agency has operated both an on-site and off-site postal dosimetry audit to improve practice and to assure the dose from RT equipment. Several countries have adopted a similar approach for national clinical auditing. In addition, clinical trial QA has a significant role in enhancing the quality of care. The Advanced Technology Consortium has pioneered the development of an infrastructure and QA method for advanced technology clinical trials, including credentialing and individual case review. These activities have an impact not only on the treatment received by patients enr on the treatment received by patients enrolled in clinical trials, but also on the quality of treatment administered to all patients treated in each institution, and have been adopted globally; by the USA, Europe and Japan also. (author)

  11. Identifying quality improvement intervention publications - A comparison of electronic search strategies

    Directory of Open Access Journals (Sweden)

    Rubenstein Lisa V

    2011-08-01

    Full Text Available Abstract Background The evidence base for quality improvement (QI interventions is expanding rapidly. The diversity of the initiatives and the inconsistency in labeling these as QI interventions makes it challenging for researchers, policymakers, and QI practitioners to access the literature systematically and to identify relevant publications. Methods We evaluated search strategies developed for MEDLINE (Ovid and PubMed based on free text words, Medical subject headings (MeSH, QI intervention components, continuous quality improvement (CQI methods, and combinations of the strategies. Three sets of pertinent QI intervention publications were used for validation. Two independent expert reviewers screened publications for relevance. We compared the yield, recall rate, and precision of the search strategies for the identification of QI publications and for a subset of empirical studies on effects of QI interventions. Results The search yields ranged from 2,221 to 216,167 publications. Mean recall rates for reference publications ranged from 5% to 53% for strategies with yields of 50,000 publications or fewer. The 'best case' strategy, a simple text word search with high face validity ('quality' AND 'improv*' AND 'intervention*' identified 44%, 24%, and 62% of influential intervention articles selected by Agency for Healthcare Research and Quality (AHRQ experts, a set of exemplar articles provided by members of the Standards for Quality Improvement Reporting Excellence (SQUIRE group, and a sample from the Cochrane Effective Practice and Organization of Care Group (EPOC register of studies, respectively. We applied the search strategy to a PubMed search for articles published in 10 pertinent journals in a three-year period which retrieved 183 publications. Among these, 67% were deemed relevant to QI by at least one of two independent raters. Forty percent were classified as empirical studies reporting on a QI intervention. Conclusions The presented search terms and operating characteristics can be used to guide the identification of QI intervention publications. Even with extensive iterative development, we achieved only moderate recall rates of reference publications. Consensus development on QI reporting and initiatives to develop QI-relevant MeSH terms are urgently needed.

  12. The national improvement partnership network: state-based partnerships that improve primary care quality.

    Science.gov (United States)

    Shaw, Judith S; Norlin, Chuck; Gillespie, R J; Weissman, Mark; McGrath, Jane

    2013-01-01

    Improvement partnerships (IPs) are a model for collaboration among public and private organizations that share interests in improving child health and the quality of health care delivered to children. Their partners typically include state public health and Medicaid agencies, the local chapter of the American Academy of Pediatrics, and an academic health care organization or children's hospital. Most IPs also engage other partners, including a variety of public, private, and professional organizations and individuals. IPs lead and support measurement-based, systems-focused quality improvement (QI) efforts that primarily target primary care practices that care for children. Their projects are most often conducted as learning collaboratives that involve a team from each of 8 to 15 participating practices over 9 to 12 months. The improvement teams typically include a clinician, office manager, clinical staff (nurses or medical assistants), and, for some projects, a parent; the IPs provide the staff and local infrastructure. The projects target clinical topics, chosen because of their importance to public health, local clinicians, and funding agencies, including asthma, attention-deficit/hyperactivity disorder, autism, developmental screening, obesity, mental health, medical home implementation, and several others. Over the past 13 years, 19 states have developed (and 5 are exploring developing) IPs. These organizations share similar aims and methods but differ substantially in leadership, structure, funding, and longevity. Their projects generally engage pediatric and family medicine practices ranging from solo private practices to community health centers to large corporate practices. The practices learn about the project topic and about QI, develop specific improvement strategies and aims that align with the project aims, perform iterative measures to evaluate and guide their improvements, and implement systems and processes to support and sustain those improvements. Since 2008, IPs have offered credit toward Part 4 of Maintenance of Certification for participants in some of their projects. To date, IPs have focused on achieving improvements in care delivery through individual projects. Rigorous measurement and evaluation of their efforts and impact will be essential to understanding, spreading, and sustaining state/regional child health care QI programs. We describe the origins, evolution to date, and hopes for the future of these partnerships and the National Improvement Partnership Network (NIPN), which was established to support existing and nurture new IPs. PMID:24268091

  13. Improving quality of some types of cheese by gamma irradiation

    International Nuclear Information System (INIS)

    The use of ionizing radiation as a food preservation technique has been recognized for many years as a means to reduce food losses, improve food safety, and extend shelf life. Furthermore, irradiation can be an effective way of reducing the incidence of food borne disease and treating a variety of potential problems in food supplies. The treatment of food with ionizing radiation is one of the most thoroughly researched techniques available to the food processing industry. In view of the afore mentioned the objective of this study were to study the effect of irradiation time and dose on Ras cheese quality, investigate the effect of irradiation after ripening on cheese quality and possibility of prolonging the shelf-life of Ras cheese, study the effect of irradiation dose on Kareish cheese quality and its shelf- life and to monitor the chemical, microbiological and sensory changes during ripening and storage of Ras and Kareish cheeses .The results of this study will be presented in three parts: Part I: Effect of irradiation dose and time on some properties of Ras cheese:Part II: Effect of irradiation on some properties during storage of ripened Ras cheese.Part III: Effect of irradiation on the quality and shelf-life of Kareish cheese: It could be concluded that irradiation caused a significant reduction of cheese ripening indices, and count of total viable,proteolytic, lipolytic bacteria and mould and yeast. Using irradiation doses of 3 and 4 kGy were able to stop the rses of 3 and 4 kGy were able to stop the ripening factors and these safety dose were used to prevent the ripened Ras cheese irradiation of ripened Ras cheese has been prolonged the shelf-life of Ras cheese to about 32 months compared with control cheese, which showed only 18 months. The obtained results revealed that the best irradiation treatment was at the end of ripening period. Also safety irradiation of Kareish cheese has been prolonged the shelf-life of Kareish cheese to about 54 days compared with 12 days only control cheese.

  14. Could houseplants improve indoor air quality in schools?

    Science.gov (United States)

    Pegas, P N; Alves, C A; Nunes, T; Bate-Epey, E F; Evtyugina, M; Pio, C A

    2012-01-01

    Previous studies performed by the National Aeronautics Space Administration (NASA) indicated that plants and associated soil microorganisms may be used to reduce indoor pollutant levels. This study investigated the ability of plants to improve indoor air quality in schools. A 9-wk intensive monitoring campaign of indoor and outdoor air pollution was carried out in 2011 in a primary school of Aveiro, Portugal. Measurements included temperature, carbon dioxide (CO?), carbon monoxide (CO), concentrations of volatile organic compounds (VOC), carbonyls, and particulate matter (PM??) without and with plants in a classroom. PM?? samples were analyzed for the water-soluble inorganic ions, as well for carbonaceous fractions. After 6 potted plants were hung from the ceiling, the mean CO? concentration decreased from 2004 to 1121 ppm. The total VOC average concentrations in the indoor air during periods of occupancy without and with the presence of potted plants were, respectively, 933 and 249 ?g/m³. The daily PM?? levels in the classroom during the occupancy periods were always higher than those outdoors. The presence of potted plants likely favored a decrease of approximately 30% in PM?? concentrations. Our findings corroborate the results of NASA studies suggesting that plants might improve indoor air and make interior breathing spaces healthier. PMID:23095155

  15. Improving Industrial Energy Quality by an Active Current Filter

    Directory of Open Access Journals (Sweden)

    Reyes–Trujillo E

    2010-10-01

    Full Text Available The growing number of non-linear loads on industrial applications has produced an important impact on the quality of electric power supply due to the increasing of the voltage and current harmonic distortion, and low power factor. In order to solve this, arrangements of capacitors and reactors, known as passive filters have been used. However these filters may produce resonance problems with network impedance, over compensation of reactive power at fundamental frequency, and poor flexibility for dynamic compensation of different frequency harmonic components. As a solution to the problems mentioned above, the active filters have been developed, whose features can be adapted in a dynamic and adjustable way on the requirements of the system to compensate. This paper presents the modelling and simulation results of an active current filter, used to reduce the harmonic distortion and to improve the power factor in an electric industrial system. A six-pulse diode converter has been used as non-linear passive load. During the analysis, it was observed that the total current harmonic distortion (THD was reduced from 16.47% to 0.46%, and the power factor in the distribution bus has improved from 0.5 to 0.95.The waveforms of a three-phase thyristor converter with a DC machine as active non-linear load are shown.

  16. Improved quality control of carbon-14 labelled compounds

    International Nuclear Information System (INIS)

    IUT Ltd is a producer of carbon-14 labelled organic compounds like benzene, methanol, phenol, formaldehyde, Na-acetates and also special ordered compounds. The quality control of these compounds is carried out by means of HPLC and GC-MS due to chemical purity. Molar activity was determined by Liquid Scintillation Counting and HPLC being equipped by a radioactivity detector. Unfortunately the accuracy of the activity determination was arrived only ±4% relatively. This error is too high because of the large dilution factors. In respect of the IUT accreditation as an analytical laboratory in Germany the accuracy had to be improved remarkably. Therefore the GC-MS-determination of molar activities of labelled compounds is used as the 14C-labelled compound. A special evaluation code is used to determine the enrichment values relative to the unlabelled molecules. Taking into account the results of GC-MS the accuracy of molar activity determination is improved to ±2%. The spectra evaluation is demonstrated and some examples are discussed

  17. Initial Investigation of Using Planar Interdigital Sensors for Assessment of Quality in Seafood

    OpenAIRE

    Mukhopadhyay, S. C.; Jayasundera, K. P.; Mohd Syaifudin, A. R.

    2008-01-01

    A planar interdigital sensor-based sensing system has been fabricated for assessment of seafood quality. Our main objective is to sense the molecule of domoic acid presence in mussels. Three peptide derivatives namely sarcosine, proline, and hydroxylproline were used for the initial studies which are structurally closely related to our target molecule. The proline molecule is arguably the most important amino acid in peptide conformation, containing the basic structural similarity to the domo...

  18. The importance of laboratory water quality for studying initial bacterial adhesion during NF filtration processes

    OpenAIRE

    Correia-semiao, Andrea Joana; Habimana, O.; Cao, H.; Heffernan, R.; Safari, Ashkan; Casey, Eoin

    2013-01-01

    Biofouling of nanofiltration (NF) and reverse osmosis (RO) membranes for water treatment has been the subject of increased research effort in recent years. A prerequisite for undertaking fundamental experimental investigation on NF and RO processes is a procedure called compaction. This involves an initial phase of clean water permeation at high pressures until a stable permeate flux is reached. However water quality used during the compaction process may vary from one laboratory to another. ...

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-06-15

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

  1. The Medicare Physician Quality Reporting Initiative: what do chest physicians need to know?

    Science.gov (United States)

    Metersky, Mark L

    2009-12-01

    Health-care consumers, payers, and regulatory agencies have become increasingly concerned about the rising cost and perceived deficiencies in the quality of health care in the United States. Pay-for-performance initiatives, otherwise known as value-based purchasing, are gathering political and public support as a method to address these problems. The Centers for Medicare and Medicaid Services is moving rapidly toward a system in which reimbursement is linked to quality of care. Serving as a first step, the Medicare Physician Quality Reporting Initiative (PQRI) is a program that rewards providers for reporting their performance on certain quality measures. Participating providers receive a bonus equal to 2% of their entire Medicare reimbursement for the calendar year if they successfully report on at least three measures for 80% of relevant patients seen during that year. The performance data are submitted via specifically designated Current Procedural Terminology II codes that are added to the usual codes submitted on the billing claim. Physicians should strongly consider participating in PQRI because it is likely to form the framework for future pay for performance, in which the dollars at stake may be much higher. PMID:19995765

  2. Improving patient care through student leadership in team quality improvement projects.

    Science.gov (United States)

    Tschannen, Dana; Aebersold, Michelle; Kocan, Mary Jo; Lundy, Francene; Potempa, Kathleen

    2015-01-01

    In partnership with a major medical center, senior-level nursing students completed a root cause analysis and implementation plan to address a unit-specific quality issue. To evaluate the project, unit leaders were asked their perceptions of the value of the projects and impact on patient care, as well as to provide exemplars depicting how the student root cause analysis work resulted in improved patient outcome and/or unit processes. Liaisons noted benefits of having an RCA team, with positive impact on patient outcomes and care processes. PMID:25098916

  3. Managing Quality by Action Research--Improving Quality Service Delivery in Higher Education as a Marketing Strategy.

    Science.gov (United States)

    Corbitt, Brian

    1998-01-01

    Describes two action research projects undertaken at an Australian university to improve quality of services to foreign students and improve the institution's image through word of mouth, or informal marketing. Each project, although small, facilitated changes or improvements to a targeted service. The role of management in empowering employees…

  4. Accreditation and improvement in process quality: A nationwide study

    DEFF Research Database (Denmark)

    Bie Bogh, SØren

    Objectives: To examine the development in process quality related to stroke, heart failure and ulcer (bleeding and perforated) between accredited and non-accredited hospitals. Method: All Danish hospitals which treated patients with stroke or heart failure during 2004-2008 or treated patients with bleeding or perforated ulcer during 2006-2008 were included. The hospitals were categorized in two groups, non-accredited hospitals (i.e., hospitals not participating in an accreditation program) and hospitals accredited either by Joint Commission International or Health Quality Service. Individual-level processes of care data was obtained from national population-based registries. The accredited and non-accredited hospitals were compared using 20 processes of care indicators reflecting hospital compliance with national clinical guidelines. The 20 indicators included seven indicators for stroke, seven indicators for heart failure, three indicators for bleeding ulcer and three indicators for perforated ulcer. The primary outcome was the composite fulfilment of process indicators. The secondary outcome was all-or-none, defined as the proportion of patients receiving 100 % of the recommended processes of care. Two-sided t tests were used for statistical analysis with p < 0.05 as a significance level. Results: A total of 70120 patients from 24 hospitals were included. Analysis of the composite fulfilment of process indicators showed no differences at baseline between accredited and non-accredited hospitals for neither stroke (P = 0.55), heart failure (P=0.88), bleeding ulcer (P=0.67) and perforated ulcer (P =0.16). Non-accredited hospitals performed better in the study period regarding stroke (P<0.01) (table 1), whereas no clear differences were found for heart failure, bleeding ulcer or perforated ulcer. Non-accredited hospitals had statically larger improvement in all-or-none indicator related to stroke compared with accredited hospitals (P = 0.04). No difference in heart failure, bleeding ulcer or perforated ulcer wasfound. Conclusions: This study does not support the hypothesis that accredited hospitals provide better process of care quality.

  5. Initial position estimation method for permanent magnet synchronous motor based on improved pulse voltage injection

    DEFF Research Database (Denmark)

    Wang, Z.; Lu, K.

    2011-01-01

    According to saliency of permanent magnet synchronous motor (PMSM), the information of rotor position is implied in performance of stator inductances due to the magnetic saturation effect. Researches focused on the initial rotor position estimation of PMSM by injecting modulated pulse voltage vectors. The relationship between the inductance variations and voltage vector positions was studied. The inductance variation effect on estimation accuracy was studied as well. An improved five-pulses injection method was proposed, to improve the estimation accuracy by choosing optimaized voltage vectors. The experimental results show that the proposed method estimates the initial rotor position reliably and efficently. The method is also simple and can achieve satisfied estimation accuracy.

  6. Improved thermodynamic parameters and helix initiation factor to predict stability of DNA duplexes.

    OpenAIRE

    Sugimoto, N.; Nakano, S.; Yoneyama, M.; Honda, K.

    1996-01-01

    To improve the previous DNA/DNA nearest-neighbor parameters, thermodynamic parameters (deltaH degrees, deltaS degrees and deltaG degrees) of 50 DNA/DNA duplexes were measured. Enthalpy change of a helix initiation factor is also considered though the parameters reported recently did not contain the factor. A helix initiation factor for DNA/DNA duplex determined here was the same as that of RNA/RNA duplex (deltaG degrees(37) = 3.4 kcal/mol). The improved nearest-neighbor parameters reproduced ...

  7. 42 CFR 416.43 - Conditions for coverage-Quality assessment and performance improvement.

    Science.gov (United States)

    2010-10-01

    ...and improves patient safety by using quality indicators...indicators, adverse patient events, infection control...quality indicator data, including patient care and other relevant...the effectiveness and safety of its services,...

  8. (AWMA) IMPROVING EMISSION INVENTORIES FOR EFFECTIVE AIR-QUALITY MANAGEMENT ACROSS NORTH AMERICA - A NARSTO ASSESSMENT

    Science.gov (United States)

    The NARSTO Ozone and Particulate Matter Assessments emphasized that emission inventories are critical to the success of air quality management programs and that emissions inventories in Canada, Mexico, and the United States need improvement to meet expectations for quality, timel...

  9. Air Quality Improvements of Increased Integration of Renewables: Solar Photovoltaics Penetration Scenarios

    Science.gov (United States)

    Duran, P.; Holloway, T.; Brinkman, G.; Denholm, P.; Littlefield, C. M.

    2011-12-01

    Solar photovoltaics (PV) are an attractive technology because they can be locally deployed and tend to yield high production during periods of peak electric demand. These characteristics can reduce the need for conventional large-scale electricity generation, thereby reducing emissions of criteria air pollutants (CAPs) and improving ambient air quality with regard to such pollutants as nitrogen oxides, sulfur oxides and fine particulates. Such effects depend on the local climate, time-of-day emissions, available solar resources, the structure of the electric grid, and existing electricity production among other factors. This study examines the air quality impacts of distributed PV across the United States Eastern Interconnection. In order to accurately model the air quality impact of distributed PV in space and time, we used the National Renewable Energy Lab's (NREL) Regional Energy Deployment System (ReEDS) model to form three unique PV penetration scenarios in which new PV construction is distributed spatially based upon economic drivers and natural solar resources. Those scenarios are 2006 Eastern Interconnection business as usual, 10% PV penetration, and 20% PV penetration. With the GridView (ABB, Inc) dispatch model, we used historical load data from 2006 to model electricity production and distribution for each of the three scenarios. Solar PV electric output was estimated using historical weather data from 2006. To bridge the gap between dispatch and air quality modeling, we will create emission profiles for electricity generating units (EGUs) in the Eastern Interconnection from historical Continuous Emissions Monitoring System (CEMS) data. Via those emissions profiles, we will create hourly emission data for EGUs in the Eastern Interconnect for each scenario during 2006. Those data will be incorporated in the Community Multi-scale Air Quality (CMAQ) model using the Sparse Matrix Operator Kernel Emissions (SMOKE) model. Initial results indicate that PV penetration significantly reduces conventional peak electricity production and that, due to reduced emissions during periods of extremely active photochemistry, air quality could see benefits.

  10. Improving ammonia emissions in air quality modelling for France

    Science.gov (United States)

    Hamaoui-Laguel, Lynda; Meleux, Frédérik; Beekmann, Matthias; Bessagnet, Bertrand; Génermont, Sophie; Cellier, Pierre; Létinois, Laurent

    2014-08-01

    We have implemented a new module to improve the representation of ammonia emissions from agricultural activities in France with the objective to evaluate the impact of such emissions on the formation of particulate matter modelled with the air quality model CHIMERE. A novel method has been set up for the part of ammonia emissions originating from mineral fertilizer spreading. They are calculated using the one dimensional 1D mechanistic model “VOLT'AIR” which has been coupled with data on agricultural practices, meteorology and soil properties obtained at high spatial resolution (cantonal level). These emissions display high spatiotemporal variations depending on soil pH, rates and dates of fertilization and meteorological variables, especially soil temperature. The emissions from other agricultural sources (animal housing, manure storage and organic manure spreading) are calculated using the national spatialised inventory (INS) recently developed in France. The comparison of the total ammonia emissions estimated with the new approach VOLT'AIR_INS with the standard emissions provided by EMEP (European Monitoring and Evaluation Programme) used currently in the CHIMERE model shows significant differences in the spatiotemporal distributions. The implementation of new ammonia emissions in the CHIMERE model has a limited impact on ammonium nitrate aerosol concentrations which only increase at most by 10% on the average for the considered spring period but this impact can be more significant for specific pollution episodes. The comparison of modelled PM10 (particulate matter with aerodynamic diameter smaller than 10 ?m) and ammonium nitrate aerosol with observations shows that the use of the new ammonia emission method slightly improves the spatiotemporal correlation in certain regions and reduces the negative bias on average by 1 ?g m-3. The formation of ammonium nitrate aerosol depends not only on ammonia concentrations but also on nitric acid availability, which is often a limiting factor in rural regions in France, and on meteorological conditions. The presented approach of ammonia emission calculation seems suitable for use in chemistry-transport models.

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

    OpenAIRE

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

    2010-01-01

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

  12. Can Independent Directors Improve the Quality of Earnings? Evidence from Taiwan

    OpenAIRE

    Yung-Chuan Lee

    2013-01-01

    This study investigated companies publicly listed in Taiwan from 2002 to 2010 to examine whether independent directors improve the quality of earnings and analyzed whether the control rights of a controlling shareholder mitigate the impact of independent directors on earnings quality. Empirical results showed that independent directors can improve the quality of earnings, and those hired because of mandatory appointments had a greater positive effect on earnings quality compared to directors ...

  13. Water quality improving device of nuclear power plant

    International Nuclear Information System (INIS)

    In the device of the present invention, the amount of an oxygen injected to an inlet of a recombiner is automatically controlled by detecting an oxygen concentration at the exit of the recombiner. Accordingly, the range for the concentration of dissolved oxygen at the exit of the recombiner is appropriately maintained. That is, the device of the present invention comprises a hydrogen injection means, hydrogen concentration measuring means, oxygen injection means, oxygen concentration measuring means and control means. If a hydrogen gas is injected to condensates which are to be coolants of the reactor, it is combined with the dissolved oxygen in the coolants. Excessive hydrogen in this case is measured by an off-gas system, and oxygen of an amount corresponding to the amount for combining the excessive hydrogen is injected to the inlet of the recombiner. The oxygen concentration at the exit of the recombiner is measured. If the result of the measurement is out of a predetermined range, the injection amount of oxygen is increased or decreased to conduct automatic control so that oxygen is within a predetermined range. As a result, the improvement for the water quality of the reactor coolants and processing of the excessive hydrogen gas can be conducted smoothly, stably and safely. (I.S.)

  14. Improving fragment quality for de novo structure prediction.

    Science.gov (United States)

    Shrestha, Rojan; Zhang, Kam Y J

    2014-09-01

    De novo structure prediction can be defined as a search in conformational space under the guidance of an energy function. The most successful de novo structure prediction methods, such as Rosetta, assemble the fragments from known structures to reduce the search space. Therefore, the fragment quality is an important factor in structure prediction. In our study, a method is proposed to generate a new set of fragments from the lowest energy de novo models. These fragments were subsequently used to predict the next-round of models. In a benchmark of 30 proteins, the new set of fragments showed better performance when used to predict de novo structures. The lowest energy model predicted using our method was closer to native structure than Rosetta for 22 proteins. Following a similar trend, the best model among top five lowest energy models predicted using our method was closer to native structure than Rosetta for 20 proteins. In addition, our experiment showed that the C-alpha root mean square deviation was improved from 5.99 to 5.03 Å on average compared to Rosetta when the lowest energy models were picked as the best predicted models. PMID:24753351

  15. Improving Secondary Ion Mass Spectrometry Image Quality with Image Fusion

    Science.gov (United States)

    Tarolli, Jay G.; Jackson, Lauren M.; Winograd, Nicholas

    2014-12-01

    The spatial resolution of chemical images acquired with cluster secondary ion mass spectrometry (SIMS) is limited not only by the size of the probe utilized to create the images but also by detection sensitivity. As the probe size is reduced to below 1 ?m, for example, a low signal in each pixel limits lateral resolution because of counting statistics considerations. Although it can be useful to implement numerical methods to mitigate this problem, here we investigate the use of image fusion to combine information from scanning electron microscope (SEM) data with chemically resolved SIMS images. The advantage of this approach is that the higher intensity and, hence, spatial resolution of the electron images can help to improve the quality of the SIMS images without sacrificing chemical specificity. Using a pan-sharpening algorithm, the method is illustrated using synthetic data, experimental data acquired from a metallic grid sample, and experimental data acquired from a lawn of algae cells. The results show that up to an order of magnitude increase in spatial resolution is possible to achieve. A cross-correlation metric is utilized for evaluating the reliability of the procedure.

  16. Total quality management to improve gas plant profits

    International Nuclear Information System (INIS)

    This paper describes the application of total quality management (TQM) techniques to the gas processing industry. It also assesses the profit potential for applying TQM in a typical plant situation. Companies utilizing TQM techniques will enjoy a competitive advantage. It represents a new way of doing business for the gas processing industry and incorporates many of Dr. W. Edwards Deming's methods which are often cited as one of the competitive advantages used by the Japanese. TQM can be described as a collection of systems or techniques that work toward two major objectives: To continuously improve the process or operation; and To view meeting the customer's needs as an important criterion for success. As applied to a typical U.S. gas processing operation, it involves several different techniques which are outlined in the paper. The benefits of TQM are detailed in this paper. All of these benefits go directly to a plant's bottom line profitability. The paper also describes ho to establish a program and identifies the factors necessary for successful implementation

  17. Improving quality of life in multiple sclerosis: an unmet need.

    Science.gov (United States)

    Zwibel, Howard L; Smrtka, Jennifer

    2011-05-01

    Multiple sclerosis (MS) affects approximately 400,000 people in the United States and 2.1 million people worldwide. It is the most common chronic, non-traumatic neurological disorder afflicting young people during their peak productive ages. MS can diminish quality of life (QOL) by interfering with the ability to work, pursue leisure activities, and carry on usual life roles. Symptoms that affect QOL may include impaired mobility, fatigue, depression, pain, spasticity, cognitive impairment, sexual dysfunction, bowel and bladder dysfunction, vision and hearing problems, seizures, and sDwallowing and breathing difficulties. Direct medical costs of MS in the United States are estimated in excess of $10 billion per year. Indirect costs of MS include costs of reduced employment or unemployment, assistive equipment, disability related home modifications, and paid and unpaid personal care. Although direct medical costs predominate in the earlier stages of MS, indirect costs of productivity loss are responsible for higher costs later. Disease-modifying therapies (DMTs) lessen symptoms, reduce relapses, and delay disability progression. Unfortunately, many DMTs might produce only modest improvements in QOL. Although symptom-specific therapies do not delay disease progression, they may delay unemployment and dependency, thereby reducing indirect costs. PMID:21761952

  18. improving the hygienic quality of quail carcasses by gamma irradiation

    International Nuclear Information System (INIS)

    this investigation aimed to use gamma irradiation doses as compared to chemical preservative sodium tripolyphosphate (stpp) for increasing the shelf-life and improving the hygienic quality of quail carcasses during cold and frozen storage. one hundred quail carcasses were examined for the presence of salmonella. the examination illustrated that 70 carcasses from all examined carcasses were positive for salmonella. therefore, the contaminated quail carcasses were gamma irradiated at 2,4,6 and 8 kGy doses and soaking in 3% stpp and the effect of these treatments on the organoleptic, microbiological aspects and chemical properties during cold (4±1o C) and frozen storage (-18o C) of samples under investigation were evaluated .the results indicated that, the chemical composition of samples did not alter by gamma irradiation and soaking in STPP treatments. furthermore, treatments had no deleterious effects on the organoleptic properties of quail samples. irradiation of samples at doses of 2,4,6 and 8 kGy or soaking in STPP greatly reduced its microbial count and prolonged its shelf- life for 12,15,21,24 and 9 days at 4±1o C, respectively against only 6 days for control samples

  19. Moderate Exercise Plus Sleep Education Improves Self-Reported Sleep Quality, Daytime Mood, and Vitality in Adults with Chronic Sleep Complaints: A Waiting List-Controlled Trial

    OpenAIRE

    Michael Schredl; Daniel Erlacher; Carmen Gebhart

    2011-01-01

    Research indicates that physical exercise can contribute to better sleep quality. This study investigates the six-week influence of a combined intervention on self-rated sleep quality, daytime mood, and quality of life. A nonclinical sample of 114 adults with chronic initiating and the maintaining of sleep complaints participated in the study. The intervention group of 70 adults underwent moderate physical exercise, conducted weekly, plus sleep education sessions. Improvements among participa...

  20. Evaluating Quality Improvement of Service Recovery for Ocean Freight Forwarders in Taiwan

    OpenAIRE

    Pei-Pei Tsai; Ji-Feng Ding

    2012-01-01

    The main purpose of this study aims to evaluate the quality improvement of service recovery for ocean freight forwarders (F/Fs) in Taiwan. To facilitate the concepts of measuring quality improvement of service recovery, a systematically-integrated method is employed to evaluate the proposed issue. An empirical analysis is conducted to evaluate the quality improvement of service recovery. The first finding shows the freight or cost, compensation for cargo damages and the accuracy of shipping s...

  1. Linking Quality Assurance to Performance Improvement to Produce a High Reliability Organization

    International Nuclear Information System (INIS)

    Three basic change management models are currently used in healthcare to produce and sustain quality improvement. We have presented the context to determine where any particular organization stands within these paradigms. We also have introduced a change-management tool used to assess, plan, and monitor leadership effort and commitment to quality improvement and culture change activities, tracked as 'momentum for change.' This 'momentum' is measured at eight discrete levels, from recognizing a performance gap to officially implementing changes intended to improve quality

  2. The strategy for improving water-quality monitoring in the United States; final report of the Intergovernmental Task Force on Monitoring Water Quality; technical appendices

    Science.gov (United States)

    Intergovernmental Task Force on Monitoring Water Quality

    1995-01-01

    The Intergovernmental Task Force on Monitoring Water Quality (ITFM) prepared this report in collaboration with representatives of all levels of government and the private sector. The report recommends a strategy for nationwide water-quality monitoring and technical monitoring improvements to support sound water-quality decisionmaking. The strategy is intended to achieve a better return on public and private investments in monitoring, environmental protection, and natural resources management. It is also designed to expand the base of information useful to a variety of users at multiple geographic scales. Institutional and technical changes are needed to improve water-quality monitoring and to meet the full range of monitoring requirements. Monitoring must be incorporated as a critical element of program planning, implementation, and evaluation. The strategy includes recommendations in many key elements, such as the development of goal-oriented monitoring and indicators, institutional collaboration, and methods comparability. Initial actions have been taken to implement the strategy. Several Federal agencies have jointly purchased and shared remotely sensed land-cover information needed for water assessment. Major agency data systems are using common data-element names and reference tables that will ensure easy sharing of data. A number of States have held meetings with collectors of water information to initiate statewide monitoring strategies. New monitoring guidance has been developed for Federal water-quality grants to States. Many State offices have changed monitoring programs to place emphasis on priority watersheds and to improve assessment of water quality. As the competition increases for adequate supplies of clean water, concerns about public health and the environment escalate, and more demands are placed on the water information infrastructure. To meet these demands, the collaborative approach has already produced benefits, which will continue to grow as the recommendations are implemented

  3. ? Using TRIZ to a quality improvement ? Case study of Foxbro in Shanghai

    Directory of Open Access Journals (Sweden)

    GUO Yan

    2014-07-01

    Full Text Available This paper traces the origins of the TRIZ (the theory of inventive solving from the field engineer technique to management, by exploring not just the benefits associated with TRIZ knowledge and the challenges associated with its acquisition and application based on practical experience. Identifying and appropriately resolving quality improvement problems or effectively evaluating alternatives is a key point. The benefits of applying TRIZ tool to Quality improvements are examined, which it terms contradictions or conflicts. TRIZ recognizes that a novel problem has been integrated to help identify the systems and sub-systems level quality management system for quality improvement. This paper presents using TRIZ to analyze that is useful to identify conflicts of the process of quality improvement in Foxboro, which is necessary to eliminating or reducing the effects factors of the conflicts. Finally, we find that TRIZ has a positive impact on quality improvement process and the potential contribution of quality improvement, while the shortcomings of TRIZ in quality improvement process are discussed. A case study on quality improvement demonstrates the feasibility of applying TRIZ in quality management.

  4. Improved image quality with Bayesian image processing in digital mammography

    Science.gov (United States)

    Baydush, Alan H.; Floyd, Carey E., Jr.

    2000-06-01

    Recent developments in digital detectors have led to investigating the importance of grids in mammography. We propose to examine the use Bayesian Image Estimation (BIE) as a software means of removing scatter post acquisition and to compare this technique to a grid. BIE is an iterative, non- linear statistical estimation technique that reduces scatter content while improving CNR. Images of the ACR breast phantom were acquired both with and without a grid on a calibrated digital mammography system. A BIE algorithm was developed and was used to process the images acquired without the grid. Scatter fractions (SF) were compared for the image acquired with the grid, the image acquired without the grid, and the image acquired without the grid and processed by BIE. Images acquired without the anti-scatter grid had an initial SF of 0.46. Application of the Bayesian image estimation technique reduced this to 0.03. In comparison, the use of the grid reduced the SF to 0.19. The use of Bayesian image estimation in digital mammography is beneficial in reducing scatter fractions. This technique is very useful as it can reduce scatter content effectively without introducing any adverse effects such as aliasing caused by gridlines.

  5. Guidelines for improving the implementation of quality management systems to provide quality service delivery in education / Nompumelelo Yvonne Mbatha

    OpenAIRE

    Mbatha, Nompumelelo Yvonne

    2012-01-01

    The aim of this research was to develop guidelines for improving the implementation of Quality Management Systems to provide quality service delivery in education. The research was done by means of both a literature review and an empirical research. The focus of the literature review was to determine the nature and purpose of existing Quality Management Systems (QMS) in education; and the role of District Officials and Schools Management Teams (SMTs) in the implementation of QMS to provide qu...

  6. Project Specific Quality Assurance Plan Project (QAPP) W-211 Initial Tank Retrieval Systems (ITRS)

    International Nuclear Information System (INIS)

    This Quality Assurance Program Plan (QAPP) provides information on how the Project Hanford Quality Assurance Program is implemented by CH2M HILL Hanford Group Inc (CHG) for managing the Initial Tank Retrieval Systems (ITRS), Project W-211. This QAPP is responsive to the CHG Quality Assurance Program Description (QAPD) (LMH-MP-599) which provides direction for compliance to 10 CFR 830 120, ''Nuclear Safety Management, Quality Assurance Requirements'', and DOE Order 5700 6C, ''Quality Assurance'' Project W-211 modifies existing facilities and provides systems for retrieval of radioactive wastes from selected double-shell tanks (DST). The contents of these tanks are a combination of supernatant liquids and settled solids. To retrieve waste from the tanks, it is first necessary to mix the liquid and solids prior to transferring the slurry to alternative storage or treatment facilities. The ITRS will provide systems to mobilize the settled solids and transfer the wastes out of the tanks. In so doing, ITRS provides feed for future processing plants, allows for consolidation of tank solids to manage space within existing DST storage capacity, and supports continued safe storage of tank waste. This project includes the design, procurement, construction, startup and turnover of these retrieval systems This QAPP identifies organizational structures and responsibilities. Implementing procedures used by CHG project management can be found in the CHG Quality Assurance Program (CHG QAP) Implementation Matrix located in HNF-IP-0842, Volume XI, Attachment Proposed verification and inspection activities for critical items within the scope of project W-211 are identified in Attachment 1 W-211. Project participants will identify the implementing procedures used by their organization within their QAF'Ps. This project specific QAPP is used to identify requirements in addition to the QAPD and provide, by reference, additional information to other project documents

  7. Outlier filtering: a new method for improving the quality of surface measurements

    International Nuclear Information System (INIS)

    This paper introduces a new filtering technique that aims to improve the quality of measured surface data by removing measurement artefacts, such as spikes and batwings, that impact the data analysis. The methods currently available for measuring surfaces allow a large number of heights on a surface to be measured with high lateral and vertical resolution. However, measured data often contain outliers, which take the form of sharp peaks on the surface (Dirac type) and are particularly common in optical measuring methods. By nature, these peaks cannot belong to a ‘real’ surface; thus, an outlier filtering step is necessary and should be the initial preparation step for the measured data prior to any further analysis. The measurement artefacts can strongly influence the topographic characterization parameters and adversely influence quality control efforts as well as functional analyses for discrimination and correlation of the surfaces. The proposed method makes the filtering of such outliers easier and more effective with criteria linked to the standard deviation (Peirce method) and associated with a modal form-filtering method that is independent of the presence of these peaks. The filter is then applied to the surface at different scales; thus, the method is scale sensitive and improves the filter efficiency. This new method is applied to surface data that were measured by optical means from different surfaces. The surfaces were measured with a 3D-measuring laser microscope and laser scanning confocal microscopy. The results of testing these examples will determine the extent to which this method can improve the quality of measured data and thus influence the results of further analyses. (paper)

  8. 42 CFR 460.134 - Minimum requirements for quality assessment and performance improvement program.

    Science.gov (United States)

    2010-10-01

    ...quality assessment and performance improvement program...demonstrate improved performance with regard to the...professional practice standards applicable to the...participants. (c) Minimum levels of performance. The PACE...

  9. A relocation-based initialization scheme to improve track-forecasting of tropical cyclones

    Science.gov (United States)

    Gao, Feng; Childs, Peter P.; Huang, Xiang-Yu; Jacobs, Neil A.; Min, Jinzhong

    2014-01-01

    A relocation procedure to initialize tropical cyclones was developed to improve the representation of the initial conditions and the track forecast for Panasonic Weather Solutions Tropical Operational Forecasts. This scheme separates the vortex perturbation and environment field from the first guess, then relocates the initial vortex perturbations to the observed position by merging them with the environment field. The relationships of wind vector components with stream function and velocity potential are used for separating the vortex disturbance from first guess. For the separation of scalars, a low-pass Barnes filter is employed. The irregular-shaped relocation area corresponding to the specific initial conditions is determined by mapping the edge of the vortex radius in 36 directions. Then, the non-vortex perturbations in the relocation area are removed by a two-pass Barnes filter to retain the vortex perturbations, while the variable fields outside the perimeter of the modified vortex are kept identical to the original first guess. The potential impacts of this scheme on track forecasts were examined for three hurricane cases in the 2011-12 hurricane season. The experimental results demonstrate that the initialization scheme is able to effectively separate the vortex field from the environment field and maintain a relatively balanced and accurate relocated first guess. As the initial track error is reduced, the following track forecasts are considerably improved. The 72-h average track forecast error was reduced by 32.6% for the cold-start cases, and by 38.4% when using the full-cycling data assimilation because of the accumulated improvements from the initialization scheme.

  10. Has External Quality Assurance Actually Improved Quality in Higher Education over the Course of 20 Years of the "Quality Revolution"?

    Science.gov (United States)

    Kristensen, Bente

    2010-01-01

    At the beginning of the last 20 years so-called "quality revolution" it was expected from most of the established national quality agencies that internal quality systems and the development of an internal quality culture would emerge automatically in the HEI from the external quality impact. The author argues that a better balance must be found…

  11. Does updating improve the methodological and reporting quality of systematic reviews?

    Directory of Open Access Journals (Sweden)

    Hamel Candyce

    2006-06-01

    Full Text Available Abstract Background Systematic reviews (SRs must be of high quality. The purpose of our research was to compare the methodological and reporting quality of original versus updated Cochrane SRs to determine whether updating had improved these two quality dimensions. Methods We identifed updated Cochrane SRs published in issue 4, 2002 of the Cochrane Library. We assessed the updated and original versions of the SRs using two instruments: the 10 item enhanced Overview Quality Assessment Questionnaire (OQAQ, and an 18-item reporting quality checklist and flow chart based upon the Quality of Reporting of Meta-analyses (QUOROM statement. At least two reviewers extracted data and assessed quality. We calculated the percentage (with a 95% confidence interval of 'yes' answers to each question. We calculated mean differences in percentage, 95% confidence intervals and p-values for each of the individual items and the overall methodological quality score of the updated and pre-updated versions using OQAQ. Results We assessed 53 SRs. There was no significant improvement in the global quality score of the OQAQ (mean difference 0.11 (-0.28; 0.70 p = 0.52. Updated reviews showed a significant improvement of 18.9 (7.2; 30.6 p Conclusion The overall quality of Cochrane SRs is fair-to-good. Although reporting quality improved on certain individual items there was no overall improvement seen with updating and methodological quality remained unchanged. Further improvement of quality of reporting is possible. There is room for improvement of methodological quality as well. Authors updating reviews should address identified methodological or reporting weaknesses. We recommend to give full attention to both quality domains when updating SRs.

  12. Quality improvement of organic thin films deposited on vibrating substrates

    International Nuclear Information System (INIS)

    Most of the Organic Light-Emitting Diodes (OLEDs) have a multilayered structure composed of functional organic layers sandwiched between two electrodes. Thin films of small molecules are generally deposited by thermal evaporation onto glass or other rigid or flexible substrates. The interface state between two organic layers in OLED device depends on the surface morphology of the layers and affects deeply the OLED performance. The morphology of organic thin films depends mostly on substrate temperature and deposition rate. Generally, the control of the substrate temperature allows improving the quality of the deposited films. For organic compounds substrate temperature cannot be increased too much due to their poor thermal stability. However, studies in inorganic thin films indicate that it is possible to modify the morphology of a film by using substrate vibration without increasing the substrate temperature. In this work, the effect of the resonance vibration of glass and silicon substrates during thermal deposition in high vacuum environment of tris(8-quinolinolate)aluminum(III) (Alq3) and N,N?-Bis(naphthalene-2-yl)-N,N?-bis(phenyl)-benzidine (?-NPB) organic thin films with different deposition rates was investigated. The vibration used was in the range of hundreds of Hz and the substrates were kept at room temperature during the process. The nucleation and subsequent growth of the organic films on the substrates have been studied by atomic force mi have been studied by atomic force microscopy technique. For Alq3 and ?-NPB films grown with 0.1 nm/s as deposition rate and using a frequency of 100 Hz with oscillation amplitude of some micrometers, the results indicate a reduction of cluster density and a roughness decreasing. Moreover, OLEDs fabricated with organic films deposited under these conditions improved their power efficiency, driven at 4 mA/cm2, passing from 0.11 lm/W to 0.24 lm/W with an increase in their luminance of about 352 cd/m2 corresponding to an increase of about 250% in the luminance with respect to the same OLEDs fabricated in the same way and with the same conditions without substrate vibration.

  13. Improving the information competence of engineers and teachers as a factor in improving the quality of vocational education

    Directory of Open Access Journals (Sweden)

    Tatyana Patrikova

    2013-04-01

    Full Text Available The problem of improving the quality of educational services in the educational institutions of primary and secondary vocational education through the creation and development of information and communication competence of teachers and trainers in the training courses.

  14. Postinsertion central line site care: quality improvement in a medical cardiac ICU.

    Science.gov (United States)

    Hickox, Benjamin C

    2015-01-01

    Using the Six Sigma quality improvement framework of Define, Measure, Analyze, Improve, and Control, nurses in the medical cardiac intensive care unit at a large academic medical center in the Midwest identified a gap in the quality of central line site care, evaluated the current state of site care, implemented an intervention to create an improvement in nursing performance of site care, quantified this improvement, and created a model for sustained quality control. Reasons for nonocclusive dressings were revealed and addressed. An unexpected benefit was found in a unifying sense of pride in improving patient care. PMID:25545973

  15. Lot quality assurance sampling to monitor supplemental immunization activity quality: an essential tool for improving performance in polio endemic countries.

    Science.gov (United States)

    Brown, Alexandra E; Okayasu, Hiromasa; Nzioki, Michael M; Wadood, Mufti Z; Chabot-Couture, Guillaume; Quddus, Arshad; Walker, George; Sutter, Roland W

    2014-11-01

    Monitoring the quality of supplementary immunization activities (SIAs) is a key tool for polio eradication. Regular monitoring data, however, are often unreliable, showing high coverage levels in virtually all areas, including those with ongoing virus circulation. To address this challenge, lot quality assurance sampling (LQAS) was introduced in 2009 as an additional tool to monitor SIA quality. Now used in 8 countries, LQAS provides a number of programmatic benefits: identifying areas of weak coverage quality with statistical reliability, differentiating areas of varying coverage with greater precision, and allowing for trend analysis of campaign quality. LQAS also accommodates changes to survey format, interpretation thresholds, evaluations of sample size, and data collection through mobile phones to improve timeliness of reporting and allow for visualization of campaign quality. LQAS becomes increasingly important to address remaining gaps in SIA quality and help focus resources on high-risk areas to prevent the continued transmission of wild poliovirus. PMID:25316852

  16. Improving quality and the assurance of quality in the design and construction of nuclear power plants: a report to Congress

    International Nuclear Information System (INIS)

    A study was conducted of existing and alternative programs for improving quality and the assurance of quality in the design and construction of commercial nuclear power plants. A primary focus of the study was to determine the underlying causes of major quality-related problems in the construction of some nuclear power plants and the untimely detection and correction of these problems. The study concluded that the root cause for major quality-related problems was the failure or inability of some utility managements to effectively implement a management system that ensured adequate control over all aspects of the project. These management shortcoming arose in part from inexperience on the part of some project teams in the construction of nuclear power plants. NRC's past licensing and inspection practices did not adequately screen construction permit applicants for overall capability to manage or provide effective management oversight over the construction project. The study recommends a number of improvements in industry and NRC programs. For industry, the study recommends self-imposed rising standards of excellence, treatment of quality assurance as a management tool, not a substitute for management, improved trend analysis and identification of root causes of quality problems, and a program of comprehensive third party audits of present and future construction projects. To improve NRC programs, the study recommends a heavier emphasis on team inspections and resident inspectors, an enhanced review of new applicant's capabilities to construct commercial nuclear power plants, more attention to management issues, improved diagnostic and trending capabilities, improved quality and quality assurance for operating reactors, and development of guidance to facilitate the prioritization of quality assurance measures commensurate with the importance of plant structures, systems, and components to the achievement of safety

  17. Practical guidelines for radiographers to improve computed radiography image quality

    OpenAIRE

    Pongnapang, N.

    2005-01-01

    Computed Radiography (CR) has become a major digital imaging modality in a modern radiological department. CR system changes workflow from the conventional way of using film/screen by employing photostimulable phosphor plate technology. This results in the changing perspectives of technical, artefacts and quality control issues in radiology departments. Guidelines for better image quality in digital medical enterprise include professional guidelines for users and the quality control programme...

  18. Application of Improved Grey Relation Analysis to Water Quality Evaluation

    Directory of Open Access Journals (Sweden)

    Wanzhen Liu

    2015-02-01

    Full Text Available The Evaluation of water quality is one of the important aspects of water resource management. Many indicators are needed to be considered in the evaluation process and thus the water quality evaluation problem is actually a Multiple Attribute Decision Making (MADM problem. The aim of this study is to put forward a new water quality evaluation method based on grey analysis method. In order to avoid the subjective randomness on the weight of each evaluation indicator, the coefficient of variation method is adopted to determine the attribute weights of water quality evaluation. A practical example is given to illustrate the effectiveness and feasibility of the proposed method.

  19. Utilization of satellite observation of ozone and aerosols in providing initial and boundary condition for regional air quality studies

    Science.gov (United States)

    Pour-Biazar, Arastoo; Khan, Maudood; Wang, Lihua; Park, Yun-Hee; Newchurch, Mike; McNider, Richard T.; Liu, Xiong; Byun, Daewon W.; Cameron, Robert

    2011-09-01

    To demonstrate the efficacy of satellite observations in the realization of the background and transboundary transport of pollution in regional air quality modeling practices, satellite observations of ozone and aerosol optical depth were incorporated in the EPA Models-3 Community Multiscale Air Quality (CMAQ) model (http://www.cmascenter.org). Observations from Ozone Monitoring Instrument (OMI) aboard NASA's Aura satellite and AOD products from the Moderate Resolution Imaging Spectroradiometer (MODIS) onboard Terra (EOS AM) and Aqua (EOS PM) satellites were used to specify initial and lateral boundary conditions (IC/BC) for a simulation that spanned over August 2006. The tools and techniques using the satellite data were tested in the context of current regulatory air quality modeling practices. Daily satellite observations were remapped onto the modeling domain and used as IC/BC for daily segments of a month-long simulation and the results were evaluated against surface and ozonesonde observations. Compared to the standard application of CMAQ, OMI O3 profiles significantly improved model performance in the free troposphere and MODIS aerosol products substantially improved PM2.5 predictions in the boundary layer. The utilization of satellite data for BC helped in the realization of transboundary transport of pollution and was able to explain the recirculation of pollution from Northeast Corridor to the southeastern region. Ozone in the mid- to upper-troposphere was largely dominated by transport and thus benefited most from satellite provided BC. The ozone within the boundary layer was mostly affected by fast production/loss mechanisms that are impacted by surface emissions, chemistry and removal processes and was not impacted as much. A case study for August 18-22 demonstrated that model errors in the placement of a stationary front were the main reason for errors in PM2.5 predictions as the front acted as a boundary between high and low PM2.5 concentrations.

  20. Survey of Image quality and Patient Dose in Simple Radiographic Examinations in Madagascar: Initial results

    International Nuclear Information System (INIS)

    The purpose of this study is to survey image quality and patient doses in radiographic examinations and to perform comparisons with the international Diagnostic Reference Levels (DRLs). This study is part of an International Atomic energy Agency (IAEA) project (RAF/9/033) and one public hospital and two private hospitals were selected. The rate of unsatisfactory images and image qualities grade were noted, and causes for poor image quality were investigated. Doses delivered to patients were determined in terms of entrance skin dose (ESD) based on X-ray tube output measurements and X-ray exposure parameters. Corrective actions were taken mainly in termes of field size and exposure parameters adjustment and data were recollected. The image quality was improved up to 35% in these three hospitals. Results showed that there is a large variation of patient doses for common examination in three hospitals. Patient dose reductions ranging from 2 to 82% were achieved. Comparisons of dose levels with IAEA Guidance Levels (GLs) after implementing corrective actions showed that patient doses are lower than reference levels except for chest exam in two hospitals and skull in one hospital. Actions are under way to extend measurements to a national level in order to estabilish national GLs

  1. [Continuous patient survey as an instrument to improve patient satisfaction: the relevance of nurses within the process of quality judgement].

    Science.gov (United States)

    Leister, Jan Eric; Wollscheid, Marco; Snoek, Hendrik; Vogel, Sandra; Meixner, Tobias

    2011-08-01

    The satisfaction of patients with their hospital stay as well as their willingness to recommend the clinic to friends and relatives are important parameters for a hospital's success. To achieve ascertained indications for necessary improvements concerning the quality of care, HELIOS Hospital Group has established a continuous patient survey. Similar to their medical quality management system, HELIOS puts high emphasize on transparency and benchmarks in order to initiate improvement processes. A critical analysis and close look especially on bad feedbacks of patients regarding their hospital stay allows each hospital, department or ward to monthly identify major drivers for critical responses and suggests opportunities for improvement. In the first six months of 2009 64.741 questionaries were returned. Having analyzed them the patient survey showed, that nurses and medical doctors had a special influence on the patient's satisfaction and dissatisfaction with the hospital. PMID:21882625

  2. Improving Water Quality Using Soil Amendments in Conservation Tillage

    Science.gov (United States)

    Water quality is a major problem in many parts of the world. Agriculture has been blamed for adverse water quality problems because of the considerable inputs of nutrients and pesticides in high production modern agricultural systems. When runoff occurs both soluble forms and those attached to soi...

  3. Electrostatic spraying of antimicrobial coating to improve strawberry quality

    Science.gov (United States)

    The increasing consumer demand for fresh, safe, and high-quality strawberry fruits has lately gained interest on the development of new post-harvest methods to prolong their shelf-life and, at the same time, ensure safety and maintain nutritional and sensory quality. Strawberries are perishable frui...

  4. Continuous Improvement and Quality: Implications for Higher Education.

    Science.gov (United States)

    Satterlee, Brian

    This paper reviews the literature pertaining to Total Quality Management (TQM) and its application in educational settings, especially at institutions of higher education. The review is organized into the following topical areas: the concept of "quality" (usually involving customer satisfaction, executive-level leadership, and employee…

  5. Improving the quality and safety of macadamia nuts

    Science.gov (United States)

    Macadamia nuts (M. integrifolia and M. tetraphylla) are grown in subtropical and tropical regions and are valued for their delicate flavor, crunchy texture, and healthful oil profile. The highest quality kernels are cream colored, with 72 to 78% oil and 1.5% moisture. Two major quality defects of ma...

  6. School Policies and Practices that Improve Indoor Air Quality

    Science.gov (United States)

    Jones, Sherry Everett; Smith, Alisa M.; Wheeler, Lani S.; McManus, Tim

    2010-01-01

    Background: To determine whether schools with a formal indoor air quality management program were more likely than schools without a formal program to have policies and practices that promote superior indoor air quality. Methods: This study analyzed school-level data from the 2006 School Health Policies and Programs Study, a national study of…

  7. Medical Image Visual Appearance Improvement Using Bihistogram Bezier Curve Contrast Enhancement: Data from the Osteoarthritis Initiative

    OpenAIRE

    Hong-Seng Gan; Tan Tian Swee; Ahmad Helmy Abdul Karim; Khairil Amir Sayuti; Mohammed Rafiq Abdul Kadir; Weng-Kit Tham; Liang-Xuan Wong; Chaudhary, Kashif T.; Jalil Ali; Yupapin, Preecha P.

    2014-01-01

    Well-defined image can assist user to identify region of interest during segmentation. However, complex medical image is usually characterized by poor tissue contrast and low background luminance. The contrast improvement can lift image visual quality, but the fundamental contrast enhancement methods often overlook the sudden jump problem. In this work, the proposed bihistogram Bezier curve contrast enhancement introduces the concept of “adequate contrast enhancement” to overcome sudden j...

  8. The Use of Quality Improvement and Health Information Technology Approaches to Improve Diabetes Outcomes in African-American and Hispanic Patients

    Science.gov (United States)

    Baig, Arshiya A.; Wilkes, Abigail E.; Davis, Andrew M.; Peek, Monica E.; Huang, Elbert S.; Bell, Douglas S.; Chin, Marshall H.

    2011-01-01

    Differences in rates of diabetes-related lower extremity amputations represent one of the largest and most persistent health disparities found for African-Americans and Hispanics compared to whites in the United States. Since many minority patients receive care in under-resourced settings, quality improvement (QI) initiatives in these settings may offer a targeted approach to improve diabetes outcomes in these patient populations. Health information technology (health IT) is widely viewed as an essential component of health care QI and may be useful in decreasing diabetes disparities in under-resourced settings. This article reviews the effectiveness of health care interventions utilizing health IT to improve diabetes process of care and intermediate diabetes outcomes in African-American and Hispanic patients. Health IT interventions have addressed patient, provider, and system challenges in the provision of diabetes care but require further testing in minority patient populations to evaluate their effectiveness in improving diabetes outcomes and reducing diabetes-related complications. PMID:20675350

  9. Brief Report: Longitudinal Improvements in the Quality of Joint Attention in Preschool Children with Autism

    Science.gov (United States)

    Lawton, Kathy; Kasari, Connie

    2012-01-01

    Children with autism exhibit deficits in their quantity and quality of joint attention. Early autism intervention studies rarely document improvement in joint attention quality. The purpose of this study was to determine whether there was a change in joint attention quality for preschoolers with autism who were randomized to a joint attention…

  10. Improving the Quality of Services in Residential Treatment Facilities: A Strength-Based Consultative Review Process

    Science.gov (United States)

    Pavkov, Thomas W.; Lourie, Ira S.; Hug, Richard W.; Negash, Sesen

    2010-01-01

    This descriptive case study reports on the positive impact of a consultative review methodology used to conduct quality assurance reviews as part of the Residential Treatment Center Evaluation Project. The study details improvement in the quality of services provided to youth in unmonitored residential treatment facilities. Improvements were…

  11. Training Psychiatry Residents in Quality Improvement: An Integrated, Year-Long Curriculum

    Science.gov (United States)

    Arbuckle, Melissa R.; Weinberg, Michael; Cabaniss, Deborah L.; Kistler; Susan C.; Isaacs, Abby J.; Sederer, Lloyd I.; Essock, Susan M.

    2013-01-01

    Objective: The authors describe a curriculum for psychiatry residents in Quality Improvement (QI) methodology. Methods: All PGY3 residents (N=12) participated in a QI curriculum that included a year-long group project. Knowledge and attitudes were assessed before and after the curriculum, using a modified Quality Improvement Knowledge Assessment…

  12. Can Independent Directors Improve the Quality of Earnings? Evidence from Taiwan

    Directory of Open Access Journals (Sweden)

    Yung-Chuan Lee

    2013-05-01

    Full Text Available This study investigated companies publicly listed in Taiwan from 2002 to 2010 to examine whether independent directors improve the quality of earnings and analyzed whether the control rights of a controlling shareholder mitigate the impact of independent directors on earnings quality. Empirical results showed that independent directors can improve the quality of earnings, and those hired because of mandatory appointments had a greater positive effect on earnings quality compared to directors who were voluntarily hired. In addition, we also found that the controlling share held by a controlling shareholder reduces the benefit of independent directors on earnings quality.

  13. Quality assurance through outcome registration in colorectal cancer: An ECCO initiative for Europe

    Directory of Open Access Journals (Sweden)

    Van de Velde C.J.H.

    2010-01-01

    Full Text Available In recent years there have been significant improvements in outcome of rectal cancer treatment. Both new surgical techniques as well as effective neoadjuvant treatment regimens have contributed to these improvements. It is key to spread these advances towards every rectal cancer patient and to make sure that not only patients who are treated within the framework of clinical trials may benefit from these advancements. Throughout Europe there have been interesting quality programs that have proved to facilitate the spread of up to date knowledge and skills among medical professionals resulting in improved treatment outcome. Nevertheless, between European countries remain differences in outcome and treatment schedules that cannot be easily explained. The European CanCer Organisation (ECCO has recognised these importances's and created the 'European Registration of Cancer Care' (EURECCA framework to develop a European colorectal audit structure. EURECCA will advance future treatment improvements and spread these to all European cancer patients. It provides opportunities to treat elderly and comorbid patients evidence based while it offers an unique insight in social-economical healthcare matters. As such, ECCO has established the basis for a strong, multidisciplinary audit structure with the commitment to improve cancer care for every European cancer patient.

  14. Suggestion for improvement of PET quality control tests in Brazil

    International Nuclear Information System (INIS)

    Nowadays nuclear medicine has a considerable importance among the other medical specialties. This medical specialty utilizes high-tech equipment for imaging in the diagnosis, obtaining information on the clinical functionality of organs and systems of the human body through the use of radioisotopes . In view of the importance of guaranteeing the image quality in SPECT and PET systems, enabling patients not repeat exams due to lack of quality control of equipment used in nuclear medicine, this paper aims to present a possible suggestion to update the quality control tests needed for quality assurance of nuclear medicine services. They were considered the requirements of the National Commission of Nuclear Energy (CNEN) and the National Health Surveillance Agency (ANVISA) in Brazil. The minimum requirements to be defined for inclusion of quality control tests on PET in the standard CNEN are extremely important because they will guide the evaluation of PET systems, determining the quality control tests to be performed. And those tests for PET will be a regulatory requirement by the CNEN and ANVISA. As the National Health Surveillance Agency has already publication of RDC 38 with recommendations for services of nuclear medicine. This study will continue with evaluation of PET systems and presenting the tests of quality control with additional objects and simulators to ensure safety in PET systems have not standardized in nuclear medicine services in Brazil. (author)

  15. Suggestion for improvement of PET quality control tests in Brazil

    Energy Technology Data Exchange (ETDEWEB)

    Ferreira, Fernanda C.L.; Magalhaes, Cinthia M.S.; Souza, Divanizia N. [Universidade Federal de Sergipe (UFS), Aracaju, SE (Brazil). Dept. de Fisica], e-mail: fernacarlaluan@gmail.com

    2009-07-01

    Nowadays nuclear medicine has a considerable importance among the other medical specialties. This medical specialty utilizes high-tech equipment for imaging in the diagnosis, obtaining information on the clinical functionality of organs and systems of the human body through the use of radioisotopes . In view of the importance of guaranteeing the image quality in SPECT and PET systems, enabling patients not repeat exams due to lack of quality control of equipment used in nuclear medicine, this paper aims to present a possible suggestion to update the quality control tests needed for quality assurance of nuclear medicine services. They were considered the requirements of the National Commission of Nuclear Energy (CNEN) and the National Health Surveillance Agency (ANVISA) in Brazil. The minimum requirements to be defined for inclusion of quality control tests on PET in the standard CNEN are extremely important because they will guide the evaluation of PET systems, determining the quality control tests to be performed. And those tests for PET will be a regulatory requirement by the CNEN and ANVISA. As the National Health Surveillance Agency has already publication of RDC 38 with recommendations for services of nuclear medicine. This study will continue with evaluation of PET systems and presenting the tests of quality control with additional objects and simulators to ensure safety in PET systems have not standardized in nuclear medicine services in Brazil. (author)

  16. Analyzing programming behavior to support self-reflection for improving source code quality

    OpenAIRE

    Prause, Christian R.; Scheffel, Maren; Niemann, Katja; Wolpers, Martin

    2011-01-01

    Improving the quality of source code is an important aspect of reducing software development cost in industry. This position paper postulates that developers in a software team conduct different activities during software development like closing the source code editor for compilation as opposed to leaving it open that either improve or degrade the quality of resulting source code. We propose to combine mining of contextualized attention metadata with developers' quality reputations to identi...

  17. Beam quality improvement by amplitude gain control in power amplifier system

    International Nuclear Information System (INIS)

    The beam quality factor M2 could be divided into the amplitude item M2u and the phase item M2?. Compared with the phase item, M2u is more controllable for a laser power amplifier system. A power amplifier model is developed to explain the beam quality improvement by power amplifier. In such a model, the relation between the beam quality improvement and the pump mode is analyzed. Corresponding experiment results agree well with the theory model

  18. Improvement of initial permeability for Z-type ferrite by Ti and Zn substitution

    International Nuclear Information System (INIS)

    We have found that the initial permeability ?' of Co2Z ferrite is improved by the substitution of Ti4+ and Zn2+ ions for Fe3+ ions. The substituted sample of Ba3Co2TixZnxFe24-2xO41 with x=0.85 has a maximum ?' of 24, which is twice as large as that of the non-substituted sample with x=0. The particle size and shape are changed by the substitution. This is influential in the densification and the preferential orientation of a toroidal-shape sample, which results in the improvement of ?'

  19. CONSTRUCTED WETLAND TREATMENT SYSTEMS FOR WATER QUALITY IMPROVEMENT

    Energy Technology Data Exchange (ETDEWEB)

    Nelson, E.

    2010-07-19

    The Savannah River National Laboratory implemented a constructed wetland treatment system (CWTS) in 2000 to treat industrial discharge and stormwater from the Laboratory area. The industrial discharge volume is 3,030 m{sup 3} per day with elevated toxicity and metals (copper, zinc and mercury). The CWTS was identified as the best treatment option based on performance, capital and continuing cost, and schedule. A key factor for this natural system approach was the long-term binding capacity of heavy metals (especially copper, lead, and zinc) in the organic matter and sediments. The design required that the wetland treat the average daily discharge volume and be able to handle 83,280 m{sup 3} of stormwater runoff in a 24 hour period. The design allowed all water flow within the system to be driven entirely by gravity. The CWTS for A-01 outfall is composed of eight one-acre wetland cells connected in pairs and planted with giant bulrush to provide continuous organic matter input to the system. The retention basin was designed to hold stormwater flow and to allow controlled discharge to the wetland. The system became operational in October of 2000 and is the first wetland treatment system permitted by South Carolina DHEC for removal of metals. Because of the exceptional performance of the A-01 CWTS, the same strategy was used to improve water quality of the H-02 outfall that receives discharge and stormwater from the Tritium Area of SRS. The primary contaminants in this outfall were also copper and zinc. The design for this second system required that the wetland treat the average discharge volume of 415 m{sup 3} per day, and be able to handle 9,690 m{sup 3} of stormwater runoff in a 24 hour period. This allowed the building of a system much smaller than the A-01 CWTS. The system became operational in July 2007. Metal removal has been excellent since water flow through the treatment systems began, and performance improved with the maturation of the vegetation during the first season of growth of each system. Sediment samples after the first and third years of operation indicated that copper was being bound in the sediments very rapidly after entering the treatment system. The design of the system encourages low redox and sulfide production in the sediments. The objective is to stabilize metals, including mercury, as sulfide compounds in the sediments. Costs for maintenance and operation of the systems are minimal, consisting primarily of ensuring that the pipes are not clogged and that water is flowing through the system. The treatment cost per thousand gallons is many times less than conventional wastewater treatment facilities. Life expectancy and function of the biological system is based on the life of the engineering aspects and not the wetland ecology.

  20. Constructed Wetland Treatment Systems For Water Quality Improvement

    International Nuclear Information System (INIS)

    The Savannah River National Laboratory implemented a constructed wetland treatment system (CWTS) in 2000 to treat industrial discharge and stormwater from the Laboratory area. The industrial discharge volume is 3,030 m3 per day with elevated toxicity and metals (copper, zinc and mercury). The CWTS was identified as the best treatment option based on performance, capital and continuing cost, and schedule. A key factor for this natural system approach was the long-term binding capacity of heavy metals (especially copper, lead, and zinc) in the organic matter and sediments. The design required that the wetland treat the average daily discharge volume and be able to handle 83,280 m3 of stormwater runoff in a 24 hour period. The design allowed all water flow within the system to be driven entirely by gravity. The CWTS for A-01 outfall is composed of eight one-acre wetland cells connected in pairs and planted with giant bulrush to provide continuous organic matter input to the system. The retention basin was designed to hold stormwater flow and to allow controlled discharge to the wetland. The system became operational in October of 2000 and is the first wetland treatment system permitted by South Carolina DHEC for removal of metals. Because of the exceptional performance of the A-01 CWTS, the same strategy was used to improve water quality of the H-02 outfall that receives discharge and stormwater from the Tritium Area of SRS. The primary contaminantstium Area of SRS. The primary contaminants in this outfall were also copper and zinc. The design for this second system required that the wetland treat the average discharge volume of 415 m3 per day, and be able to handle 9,690 m3 of stormwater runoff in a 24 hour period. This allowed the building of a system much smaller than the A-01 CWTS. The system became operational in July 2007. Metal removal has been excellent since water flow through the treatment systems began, and performance improved with the maturation of the vegetation during the first season of growth of each system. Sediment samples after the first and third years of operation indicated that copper was being bound in the sediments very rapidly after entering the treatment system. The design of the system encourages low redox and sulfide production in the sediments. The objective is to stabilize metals, including mercury, as sulfide compounds in the sediments. Costs for maintenance and operation of the systems are minimal, consisting primarily of ensuring that the pipes are not clogged and that water is flowing through the system. The treatment cost per thousand gallons is many times less than conventional wastewater treatment facilities. Life expectancy and function of the biological system is based on the life of the engineering aspects and not the wetland ecology.

  1. Continuous quality improvement in acute health care: creating a holistic and integrated approach.

    Science.gov (United States)

    Sewell, N

    1997-01-01

    Reviews the range of quality activity in a National Health Service hospital trust, using a staff questionnaire survey, self-assessment against the Baldrige Quality Award criteria, and the application of the SERVQUAL approach to service quality assessment. Reviews the acute health care quality programme literature. Finds that there are needs for greater integration of quality effort, to engage with patients in a more meaningful manner, and to achieve greater commitment and involvement from clinicians and managers. Identifies lack of time and resources as a major barrier to greater application of quality programmes. Explores ways of developing a more holistic and integrated programme of quality improvement. Describes the creation and implementation of a model for continuous improvement in health care quality. PMID:10166023

  2. American Board of Radiology Maintenance of Certification-Part IV: Practice Quality Improvement for Radiation Oncology

    International Nuclear Information System (INIS)

    Maintenance of Certification is a physician-based response to public concerns about the quality of medical care and physician competency in a rapidly evolving, technically demanding specialty. American Board of Radiology (ABR) has previously described the first three components of the Maintenance of Certification. The ABR is currently developing a program in practice performance, completing Part IV of the competencies. The Practice Quality Improvement (PQI) program is meant to critically evaluate meaningful aspects of a physician's practice in a simple manner, using identifiable metrics and self-assessment to include an action plan for quality improvement. Each diplomate will be expected to complete three PQI projects during a full 10-year Maintenance of Certification cycle. Current diplomates with time-limited certificates will find prorated requirements determined by their year of certification on the ABR Website. Diplomates will have the option of completing zero to two Type I PQI projects (assessing factors relevant to clinical practice by peer review and self-reporting) and one to three Type II projects (i.e., at least one Type II projects of the three required, assessing parameters of practice by comparison with evidence-based guidelines, consensus statements, or peer comparisons; Type II projects are initiated and managed by professional societies). Several examples of Type I projects that might be offered by societies or directly through the ABR are provided, or directly through the ABR are provided, as well as highlights of the two Type II projects that have sought ABR qualification: American Society for Therapeutic Radiology and Oncology's Performance Assessment for the Advancement of Radiation Oncology Treatment program and American College of Radiology's RO-PEER program. An additional objective of the PQI is to develop national databases for future reference using aggregate data from the PQI projects

  3. Quality factor improvement of silicon nitride micro string resonators

    DEFF Research Database (Denmark)

    Schmid, Silvan; Malm, Bjarke

    2011-01-01

    Resonant micro and nano strings are of interest for sensor applications due to their extraordinary high quality factors, low mass and tunable resonant frequency. It has been found that the quality factor of strings is usually limited by clamping loss. In this work, clamping loss has been addressed by varying the clamping design and string geometry. We present silicon nitride micro strings with quality factors (Q) of up to 4 million in high vacuum achieved by minimizing clamping loss. For applications such as for chemical sensing, strings need to vibrate at atmospheric pressure. Maximal quality factor values in air were measured for the shortest strings with the highest resonant frequency having an optimal width to height ratio.

  4. Improving the evidence base for transfusion medicine: the work of the UK systematic review initiative.

    OpenAIRE

    Brunskill, Sj; Hyde, Cj; Stanworth, Sj; Dore?e, Cj; Roberts, Dj; Murphy, Mf

    2009-01-01

    Clarifying the existing evidence base is crucial to improve the effectiveness of transfusion practice. The UK Systematic Review Initiative has been pursuing this objective primarily through writing systematic reviews on important topics in transfusion medicine. Here, we describe our progress for the past 5 years. We are the only research group that identifies transfusion medicine randomized controlled trials (RCTs) for the Cochrane Central Register of Controlled Trials, and to date, we have c...

  5. Improving access to psychological therapy: Initial evaluation of two UK demonstration sites.

    OpenAIRE

    Clark, Dm; Layard, R.; Smithies, R.; Richards, Da; Suckling, R.; Wright, B.

    2009-01-01

    Recently the UK Government announced an unprecedented, large-scale initiative for Improving Access to Psychological Therapies (IAPT) for depression and anxiety disorders. Prior to this development, the Department of Health established two pilot projects that aimed to collect valuable information to inform the national roll-out. Doncaster and Newham received additional funds to rapidly increase the availability of CBT-related interventions and to deploy them in new clinical services, operating...

  6. Prefrontal activation predicts social functioning improvement after initial treatment in late-onset depression.

    Science.gov (United States)

    Pu, Shenghong; Nakagome, Kazuyuki; Yamada, Takeshi; Yokoyama, Katsutoshi; Matsumura, Hiroshi; Nagata, Izumi; Kaneko, Koichi

    2015-03-01

    The activation of oxygenated hemoglobin (oxy-Hb) has been shown to be lacking in the prefrontal cortex (PFC) of patients with late-onset depression (LOD), in verbal fluency task (VFT)-related near-infrared spectroscopy (NIRS). In our previous studies, we have emphasized the connection between the lack of activation in the frontopolar cortex and social functioning disorder in patients with LOD. In this study, we investigated whether the responsiveness to medical treatment of untreated patients with LOD, particularly social functioning improvements, could be predicted by NIRS findings at the initial examination. The subjects were 29 patients with LOD who were diagnosed with major depression at 65 years or older at the initial examination (mean age ± standard deviation, 72.4 ± 5.71 years). We measured the changes in hemoglobin concentration in the prefrontal and temporal cortex regions during a VFT by using 52-channel NIRS. In addition, depression status and social functioning were evaluated with the Hamilton Depression Rating Scale and the Social Adaptation Self-evaluation Scale, respectively, at the initial examination and 8 weeks after the treatment. A negative correlation was found between the NIRS activation in the right ventrolateral PFC region before treatment and the improvement in social functioning. These results suggested that the social functioning improvements were greater in LOD with initially lower NIRS activation in the right ventrolateral PFC region. NIRS is a simple technique that can be used before treatment to evaluate the social functioning levels of patients with LOD, and predict social functioning improvement after treatment. PMID:25659188

  7. Estimating The Cost of Improving Quality in Electricity Distribution: A Parametric Distance Function Approach

    OpenAIRE

    Coelli, Tim; Gautier, Axel; Perelman, Sergio; Saplacan-pop, Roxana

    2013-01-01

    The quality of electricity distribution is being more and more scrutinized by regulatory authorities, with explicit reward and penalty schemes based on quality targets having been introduced in many countries (France, Germany, Italy, UK,...). It is then of prime importance to know the cost of improving the quality for a distribution system operator. In this paper, we focus on one dimension of quality, the continuity of supply, and we estimated the cost of preventing power outages. For that, w...

  8. A Fuzzy Improved Association Mining Approach to Estimate Software Quality?

    OpenAIRE

    Sonakshi Rana; Rahul Kumar Yadav?

    2013-01-01

    Software Quality analysis is one of the major criteria required to analyze the software life as wellas software reliability. Software quality is been defined under different parameters. Software risk analysis isone such criterion required to identify the software reliability. When software is planned or being developedaccording to the type of software as well as the efforts required to develop the software collectively defines thesoftware risk. Such as the availability of the required softwar...

  9. Improving the accuracy of total quality management instruments.

    Science.gov (United States)

    Bechtel, G A; Wood, D

    1996-03-01

    Total quality management (TQM) instruments are essential tools in defining concepts identified in an Ishikawa or ¿cause-and-effect¿ diagram. Collecting meaningful and accurate data using TQM instruments is imperative if productivity and quality of care are to be enhanced. This article provides managers with techniques and guidelines that will enhance the reliability and validity of TQM instruments, thereby promoting organization efficiency and customer satisfaction. PMID:10154917

  10. MANAGING THE BUILDING DESIGN PROCESS FOR SUSTAINABILTY AND IMPROVED QUALITY

    OpenAIRE

    Sunday Bobadoye; Fadamiro, Joseph A.

    2006-01-01

    The essence of building design process and management for building sustainability in the creation and maintenance of a qualitative architectural product is investigated in this paper. The design process, concept of building sustainability and particularly the quality of the built environment are discussed. Akure, a state capital in Nigeria was used as a case study. The principles and indicators for sustainability of buildings and its implications on the quality of the environment are examined...

  11. IMPROVED SOFTWARE QUALITY ASSURANCE TECHNIQUES USING SAFE GROWTH MODEL

    Directory of Open Access Journals (Sweden)

    M.Sangeetha

    2010-09-01

    Full Text Available In our lives are governed by large, complex systems with increasingly complex software, and the safety, security, and reliability of these systems has become a major concern. As the software in today’ssystems grows larger, it has more defects, and these defects adversely affect the safety, security, and reliability of the systems. Software engineering is the application of a systematic, disciplined, quantifiable approach to the development, operation, andmaintenance of software. Software divides into two pieces: internal and external quality characteristics.External quality characteristics are those parts of a product that face its users, where internal quality characteristics are those that do not.Quality is conformance to product requirements and should be free. This research concerns the role of software Quality. Software reliability is an important facet of software quality. It is the probability of failure-freeoperation of a computer program in a specified environment for a specified time. In software reliability modeling, the parameters of the model are typically estimated from the test data of the corresponding component. However, the widely used point estimatorsare subject to random variations in the data, resulting in uncertainties in these estimated parameters. This research describes a new approach to the problem of software testing. The approach is based on Bayesian graphical models and presents formal mechanisms forthe logical structuring of the software testing problem, the probabilistic and statistical treatment of the uncertainties to be addressed, the test design and analysis process, and the incorporation and implication of test results. Once constructed, the models produced are dynamic representations of the software testingproblem. It explains need of the common test-and-fix software quality strategy is no longer adequate, and characterizes the properties of the quality strategy.

  12. A Propound Method for the Improvement of Cluster Quality

    OpenAIRE

    Shveta Kundra Bhatia; Dixit, V. S.

    2013-01-01

    In this paper Knockout Refinement Algorithm (KRA) is proposed to refine original clusters obtained by applying SOM and K-Means clustering algorithms. KRA Algorithm is based on Contingency Table concepts. Metrics are computed for the Original and Refined Clusters. Quality of Original and Refined Clusters are compared in terms of metrics. The proposed algorithm (KRA) is tested in the educational domain and results show that it generates better quality clusters in terms of impr...

  13. Leading quality management for improved public service delivery

    OpenAIRE

    Kruger, Mareli

    2012-01-01

    If service delivery involves institutional performance, then it stands that the better the performance of government, the more likely actual service delivery will match expectations. The philosophy of quality management proposes that all aspects of an organisation have to be dedicated to the goal of achieving the highest standards of performance as required by customers. In so doing, quality management leads institutions to being committed to higher performance, thereby sati...

  14. Improving response rate and quality of survey data with a scratch lottery ticket incentive

    Directory of Open Access Journals (Sweden)

    Olsen Frank

    2012-04-01

    Full Text Available Abstract Background The quality of data collected in survey research is usually indicated by the response rate; the representativeness of the sample, and; the rate of completed questions (item-response. In attempting to improve a generally declining response rate in surveys considerable efforts are being made through follow-up mailings and various types of incentives. This study examines effects of including a scratch lottery ticket in the invitation letter to a survey. Method Questionnaires concerning oral health were mailed to a random sample of 2,400 adults. A systematically selected half of the sample (1,200 adults received a questionnaire including a scratch lottery ticket. One reminder without the incentive was sent. Results The incentive increased the response rate and improved representativeness by reaching more respondents with lower education. Furthermore, it reduced item nonresponse. The initial incentive had no effect on the propensity to respond after the reminder. Conclusion When attempting to improve survey data, three issues become important: response rate, representativeness, and item-response. This study shows that including a scratch lottery ticket in the invitation letter performs well on all the three.

  15. A Cascaded Fingerprint Quality Assessment Scheme for Improved System Accuracy

    Directory of Open Access Journals (Sweden)

    Zia Saquib

    2011-03-01

    Full Text Available Poor-quality images mostly result in spurious or missing features, which further degrade the overall performance of fingerprint recognition systems. This paper proposes a reconfigurable scheme of quality checks at two different levels: i at raw image level and ii at feature level. At first level, ellipse properties are calculated through analysis of statistical attributes of the captured raw image. At second level, the singularity points (core and delta are identified and extracted (if any. These information, as quality measures, are used in a cascaded manner to block/pass the image. This model is tested on both publicly available (Cross Match Verifier 300 sensor as well as proprietary (Lumidigm Venus V100 OEM Module sensor fingerprint databases scanned at 500 dpi. The experimental results show that this cascaded arrangement of quality barricades could correctly block poor quality images and hence elevated the overall system accuracy: with quality checks, both FNMR and FMR significantly dropped to 9.52% and 0.26% respectively for Cross Match Dataset and 2.17% and 2.16% respectively for Lumidigm Dataset.

  16. Improving Quality of Perception (QoP), Quality of Experience (QoE), and Quality of Service (QoS) in agile development using Cleanroom Software Engineering (CSE)

    OpenAIRE

    Zainab, Sana E.; Munazza Jannisar; Ali Javed

    2014-01-01

    Pioneering ideas from the software engineering discipline have factually affected every sphere of life. Agile software development approach has been promoted since its commencement and stipulates strategies that improve the quality of software product. To consummate fast and reliable development processes, several agile approaches are charted and are quite popular. For quality improvement and to achieve defect free system, the concept of Cleanroom Software Engineering (CSE) is ingrained into ...

  17. Functioning of the university focused on the quality and continuous improvement

    Directory of Open Access Journals (Sweden)

    M. Dudek-Burlikowska

    2009-12-01

    Full Text Available Purpose: A new approach to the functioning of quality management system at university focused on the quality has been presented.Design/methodology/approach: The profits resulting from possessing of Quality Management System certificate in higher education has been proposed.Findings: At the present time the educational organizations should implement Quality Management Systems, and next they should try to find a possibility of estimation of this System, and the same acting according to Deming’s principles introduce philosophy of total quality management.Research limitations/implications: Generally definitions of quality educational has been described. Quality of university should implement to integrate aspects based on the quality criterion which will allow the entire organizational system of university to achieve the optimum level of the quality, of the high effectiveness and the innovation, and proquality action should include the entire organization.Practical implications: The possibility of implementing Method of Averaging Quality Groups of Rating as a factor of improving of university functioning has been shown.Originality/value: Implementing the Method of Averaging Quality Groups of Rating has been a new approach for estimating quality of university. Design the quality pattern of Criterial Model of the Evaluation of Quality University and calculate the index of quality of scientific organization become the kind of monitoring the entire university oriented on the quality.

  18. Can teaching agenda-setting skills to physicians improve clinical interaction quality? A controlled intervention

    Directory of Open Access Journals (Sweden)

    Rogers William H

    2008-01-01

    Full Text Available Abstract Background Physicians and medical educators have repeatedly acknowledged the inadequacy of communication skills training in the medical school curriculum and opportunities to improve these skills in practice. This study of a controlled intervention evaluates the effect of teaching practicing physicians the skill of "agenda-setting" on patients' experiences with care. The agenda-setting intervention aimed to engage clinicians in the practice of initiating patient encounters by eliciting the full set of concerns from the patient's perspective and using that information to prioritize and negotiate which clinical issues should most appropriately be dealt with and which (if any should be deferred to a subsequent visit. Methods Ten physicians from a large physician organization in California with baseline patient survey scores below the statewide 25th percentile participated in the agenda-setting intervention. Eleven physicians matched on baseline scores, geography, specialty, and practice size were selected as controls. Changes in survey summary scores from pre- and post-intervention surveys were compared between the two groups. Multilevel regression models that accounted for the clustering of patients within physicians and controlled for respondent characteristics were used to examine the effect of the intervention on survey scale scores. Results There was statistically significant improvement in intervention physicians' ability to "explain things in a way that was easy to understand" (p = 0.02 and marginally significant improvement in the overall quality of physician-patient interactions (p = 0.08 compared to control group physicians. Changes in patients' experiences with organizational access, care coordination, and office staff interactions did not differ by experimental group. Conclusion A simple and modest behavioral training for practicing physicians has potential to positively affect physician-patient relationship interaction quality. It will be important to evaluate the effect of more extensive trainings, including those that work with physicians on a broader set of communication techniques.

  19. Automated Data Mining of A Proprietary Database System for Physician Quality Improvement

    International Nuclear Information System (INIS)

    Purpose: Physician practice quality improvement is a subject of intense national debate. This report describes using a software data acquisition program to mine an existing, commonly used proprietary radiation oncology database to assess physician performance. Methods and Materials: Between 2003 and 2004, a manual analysis was performed of electronic portal image (EPI) review records. Custom software was recently developed to mine the record-and-verify database and the review process of EPI at our institution. In late 2006, a report was developed that allowed for immediate review of physician completeness and speed of EPI review for any prescribed period. Results: The software extracted >46,000 EPIs between 2003 and 2007, providing EPI review status and time to review by each physician. Between 2003 and 2007, the department EPI review improved from 77% to 97% (range, 85.4-100%), with a decrease in the mean time to review from 4.2 days to 2.4 days. The initial intervention in 2003 to 2004 was moderately successful in changing the EPI review patterns; it was not repeated because of the time required to perform it. However, the implementation in 2006 of the automated review tool yielded a profound change in practice. Using the software, the automated chart review required ?1.5 h for mining and extracting the data for the 4-year period. Conclusion: This study quantified the EPI review process as it evolved during a 4-year period at our institution and found that automatt our institution and found that automation of data retrieval and review simplified and facilitated physician quality improvement

  20. Case Study on Improving Quality Management of W Company’s New Product Development Project

    OpenAIRE

    Jiangping Wan; Ming Zeng

    2013-01-01

    Case study on improving quality management of W company’s new product development project includes the analysis of the current situation within the quality management of W company’s new product development project (current situation and identify existing problems), improvement study (analysis the cause of existing problems and design the improvement scheme) and implementation. Through monitoring the implementation process, we have an evaluation analysis for the implementation results. Th...

  1. What is water worth? : recreational benefits and increased demand following a quality improvement

    OpenAIRE

    Kinell, Gerda

    2008-01-01

    This study focuses on valuation of natural resources and particularly valuation of the quality of a natural resource. The aim is to value an improvement of water quality, measured as sight depth, in the bay Himmerfjärden in the Stockholm archipelago. It is desirable to attain a value of a one metre sight depth improvement in Himmerfjärden and to analyse how a sight depth improvement affects the demand for travelling to Himmerfjärden. A condtional logit model is applied to obtain these valu...

  2. Waste Management Improvement Initiatives at Atomic Energy of Canada Limited - 13091

    Energy Technology Data Exchange (ETDEWEB)

    Chan, Nicholas; Adams, Lynne; Wong, Pierre [Atomic Energy of Canada Limited, Chalk River Laboratories, Chalk River, Ontario, K0J 1J0 (Canada)

    2013-07-01

    Atomic Energy of Canada Limited's (AECL) Chalk River Laboratories (CRL) has been in operation for over 60 years. Radioactive, mixed, hazardous and non-hazardous wastes have been and continue to be generated at CRL as a result of research and development, radioisotope production, reactor operation and facility decommissioning activities. AECL has implemented several improvement initiatives at CRL to simplify the interface between waste generators and waste receivers: - Introduction of trained Waste Officers representing their facilities or activities at CRL; - Establishment of a Waste Management Customer Support Service as a Single-Point of Contact to provide guidance to waste generators for all waste management processes; and - Implementation of a streamlined approach for waste identification with emphasis on early identification of waste types and potential disposition paths. As a result of implementing these improvement initiatives, improvements in waste management and waste transfer efficiencies have been realized at CRL. These included: 1) waste generators contacting the Customer Support Service for information or guidance instead of various waste receivers; 2) more clear and consistent guidance provided to waste generators for waste management through the Customer Support Service; 3) more consistent and correct waste information provided to waste receivers through Waste Officers, resulting in reduced time and resources required for waste management (i.e., overall cost); 4) improved waste minimization and segregation approaches, as identified by in-house Waste Officers; and 5) enhanced communication between waste generators and waste management groups. (authors)

  3. Quality Improvement of Yarn by Automatic Waste Removal in Autoconer

    Directory of Open Access Journals (Sweden)

    K.SRINIVASAN

    2013-02-01

    Full Text Available Spinning is the process of conversion of fibre into yarn. The spinning process includes various operations such as cotton mixing, carding, combing, drawing, winding. Winding is the final process in spinning mill where the yarn of small quantity is wound into a big package known as cones. The important aspect in winding is removal of defects or faults in yarn produced. In manual winding when there is discontinuity of thread, during removal of faults, the knot is made by a human. This reduces the quality of yarn. To overcome this disadvantage, autoconer is used. Autoconer is an advanced machine used in winding process to get a high quality yarn with low man power. Here, threads are spliced automatically. Splicing means the process of opening of broken ends and retwisting the ends after the removal of faults. Here the joined yarn looks like parent yarn. Thus, the quality of yarn is enhanced. The drawback of autoconer is, waste collected by suction motor gets deposited on the suction panel and it should be disposed manually for a periodic time interval. If the waste is not removed it reduces the operating efficiency of the suction motor. This leads to reduction in quality of yarn. The aim of the proposed work is to design an automatic waste removal system using PLC (Programmable Logic Controller which helps us to further increase the efficiency of the suction motor and thus the quality of yarn.

  4. Integrating Service Quality Model in Quality Improvement: An Empirical Study of Employees Satisfaction for Hot Spring Industry

    OpenAIRE

    Shun-Hsing Chen

    2012-01-01

    The study addresses this deficiency by integrating the importance-satisfaction model (I-S Model) and the Performance Control Matrix (PCM) to provide a more comprehensive assessment model for improving specific quality attributes. The study applies this integrated measuring instrument in Taiwanese hot spring industry using a questionnaire survey to assess importance and satisfaction in their capacity as internal customers of the industry. The study identifies quality attributes that require im...

  5. Detection of High Quality Rainfall Data to Improve Flood Resilience

    Science.gov (United States)

    Hoang, T. C.; Tchiguirinskaia, I.; Schertzer, D. J.; Lovejoy, S.

    2012-12-01

    European flood management systems require reliable rainfall statistics, e.g. the Intensity-duration-Frequency curves for shorter and shorter durations and for a larger and larger range of return periods. Preliminary studies showed that the number of floods depends on the quality of available data, e.g. the time resolution quality. These facts suggest that a particular attention should be paid to the rainfall data quality in order to adequately investigate flood risk aiming to achieve flood resilience. The potential consequences of changes in measuring and recording techniques have been somewhat discussed in the literature with respect to a possible introduction of artificial inhomogeneities in time series. In this direction, we developed a first version of a SERQUAL procedure to automatically detect the effective time resolution of highly mixed data. We show that most of the rainfall time series have a lower recording frequency than that is assumed. This question is particularly important for operational hydrology, because an error on the effective recording high frequency introduces biases in the corresponding statistics. It is therefore essential to quantify the quality of the rainfall time series before their use. Due to the fact that the multiple scales and possible scaling behaviour of hydrological data are particularly important for many applications, including flood resilience research, this paper first investigates the sensitivity of the scaling estimates and methods to the deficit of short duration rainfall data, and consequently propose a few simple criteria for a reliable evaluation of the data quality. The SERQUAL procedure enable us to extract high quality sub-series from longer time series that will be much more reliable to calibrate and/or validate short duration quantiles and hydrological models.

  6. Mutation breeding for oil quality improvement in sunflower

    International Nuclear Information System (INIS)

    Although sunflower oil is appreciated as a high quality commodity, new emerging markets and increasing concern about health risks are demanding changes in the oil quality. The optimal quality of oils depends on their intended use either for food or non-food applications. The fatty acid composition and the total content and profile of tocopherols have been the most important traits considered in breeding for oil quality. Applications demanding a high nutritional value (salad oil) require a reduction of saturated fatty acids and enhancement of the vitamin E (alpha-tocopherol) content of the oil. The use of oils in the food industry requiring plastic fats (margarines) demand an increased concentration of saturated fatty acids to avoid hydrogenation. High temperature processes (frying, biolubricants) need oils highly resistant to thermoxidation, with a high concentration of oleic acid and antioxidants (gamma- and delta-tocopherol). In sunflower, the utilization of mutagenesis has been the most successful procedure used to generate genetic variability for these quality components. The mutagenic treatment is usually applied to seeds to obtain M1 generation and mutants are detected analysing M2 half seeds, allowing identification of mutants in one year. The most valuable sunflower oil quality mutants produced have been the high oleic acid mutant (>80%), high levels of either palmitic or stearic acid (>25%), low total saturated fatty acids and increased total saturated fatty acids and increased levels of beta- (>65%), gamma- (>95%), and delta-tocopherol (>45%). The novel traits are in all cases governed by a reduced number of genes, which facilitates their management in plant breeding. All this induced variation opens up the possibility of tailoring specialty sunflower oils for specific food and nonfood applications (author)

  7. Mutation Breeding for Oil Quality Improvement in Sunflower

    International Nuclear Information System (INIS)

    Although sunflower oil is appreciated as a high quality commodity, new emerging markets and increasing concern about health risks are demanding changes in oil quality. The optimal quality of oils depends on their intended use either for food or non-food applications. The fatty acid composition and the total content and profile of tocopherols have been the most important traits considered in breeding for oil quality. Applications demanding a high nutritional value (salad oil) require a reduction of saturated fatty acids and enhancement of the vitamin E (alpha-tocopherol) content of the oil. Uses of oils in the food industry requiring plastic fats (margarines) demand an increased concentration of saturated fatty acids to avoid hydrogenation. High temperature processes (frying, biolubricants) need oils highly resistant to thermo-oxidation, with a high concentration of oleic acid and antioxidants (gamma- and delta-tocopherol). In sunflower, the utilization of mutagenesis has been the most successful procedure to generate genetic variability for these quality components. The mutagenic treatment is usually applied to seeds to obtain the M1 generation and mutants are detected analyzing M2 half seeds, allowing identification of mutants in one year. The most valuable sunflower oil quality mutants produced have been those with high oleic acid (>80%), high levels of either palmitic or stearic acid (>25%), low total saturated fatty acids (65%)(65%), gamma- (>95%), and delta-tocopherol (>45%). The novel traits are, in all cases, governed by a small number of genes, which facilitate their management in plant breeding. This induced variation opens up the possibility of tailoring specialty sunflower oils for specific food and nonfood applications. (author)

  8. Learning from the U.S. Department of Veterans Affairs Quality Enhancement Research Initiative: QUERI Series.

    Science.gov (United States)

    Graham, Ian D; Tetroe, Jacqueline

    2009-01-01

    As the recent collection of papers from the Quality Enhancement Research Initiative (QUERI) Series indicates, knowledge is leading to considerable action in the United States (U.S.) Department of Veterans Affairs (VA). The QUERI Series offers clinical researchers, implementation scientists, health systems, and health research funders from around the globe a unique window into the both the practice and science of implementation or knowledge translation (KT) in the VA. By describing successes and challenges as well as setbacks and disappointments, the QUERI Series is all the more useful. From the vantage point of Canadian KT researchers and officials at a national health research funding agency, we offer a number of observations and lessons that can be learned from QUERI. "Knowledge, if it does not determine action, is dead to us." Plotinus (Roman philosopher 205AD-270AD). PMID:19267920

  9. Learning from the U.S. Department of Veterans Affairs Quality Enhancement Research Initiative: QUERI Series

    Directory of Open Access Journals (Sweden)

    Tetroe Jacqueline

    2009-03-01

    Full Text Available Abstract As the recent collection of papers from the Quality Enhancement Research Initiative (QUERI Series indicates, knowledge is leading to considerable action in the United States (U.S. Department of Veterans Affairs (VA. The QUERI Series offers clinical researchers, implementation scientists, health systems, and health research funders from around the globe a unique window into the both the practice and science of implementation or knowledge translation (KT in the VA. By describing successes and challenges as well as setbacks and disappointments, the QUERI Series is all the more useful. From the vantage point of Canadian KT researchers and officials at a national health research funding agency, we offer a number of observations and lessons that can be learned from QUERI. "Knowledge, if it does not determine action, is dead to us." Plotinus (Roman philosopher 205AD-270AD

  10. Increasing Extender Viscosity Improves the Quality of Cooled Boar Semen

    OpenAIRE

    Maria Cruz Gil; Francisco Javier Barón; Jesús Manuel Guerrero; Luis Jesús García-Marín; Javier Gil

    2014-01-01

    The use of several types of gelling extenders for the storage of semen from several domestic species in the solid state has been shown to have beneficial effects on some semen quality parameters. The objective of this study was to evaluate the effect of a new high-viscosity semen extender, Zoosperm ND-5 3D® (Import-Vet, Centelles, Spain), on the the quality of boar spermatozoa at preserved at 17ºC for 7 days. Sodium alginate was used for the first time to increase the viscosity of the exten...

  11. The CMS Data Quality Monitoring software experience and future improvements

    CERN Document Server

    Batinkov, Atanas Ivanov

    2013-01-01

    The Data Quality Monitoring Software proved to be a central tool in the Compact Muon Solenoid experiment. Its flexibility allowed its integration in several environments: online, for real-time detector monitoring; offline, for the final, fine-grained data certification. The usage of the Data Quality Monitoring software in the different environments and its integration in the Compact Muon Solenoid reconstruction software framework and in all production workflows are presented. The main technical challenges and the adopted solutions to them will be also discussed with emphasis on functionality, long-term robustness and performance.

  12. Induced mutagenesis for quality improvement in groundnut (Arachis Hypogaea L.)

    International Nuclear Information System (INIS)

    GPBD-4 and TPG-41 kennals were treated with gamma rays and EMS to enhance the genetic variability for quality traits. The results indicated significant genetic variability. Treatment with gamma rays resulted in isolation of more number of mutants with better quality traits like increased seed mass, protein content and O/L ratio in GPBD-4 where as, increased oil and protein in TPG-41 mutants. EMS treatment resulted in more number of mutants with increased seed mass that is required for confectionary groundnut. The mutants with significant increase in 100 seed weight, oil and protein content have been isolated from both GPBD-4 and TPG-41 background. (author)

  13. Can investigator certification improve the quality of clinical research?

    Science.gov (United States)

    Lightfoot, G D; Sanford, S M; Shefrin, A

    1999-01-01

    With costs and competitive pressures increasing, pharmaceutical sponsors and contract research organizations are examining the drug development process. Investigators who conduct clinical studies significantly impact research quality and, thereby, costs. This article reviews current investigator selection methods and their shortcomings. Using one organization's experience certifying clinical research coordinators and clinical research associates, the authors highlight certification as a means of assessing competency and discuss investigator certification as a potentially accurate indicator of competence for conducting research and as a predictor of inherent quality at the research site. PMID:10537460

  14. Water Quality Improvement Policies: Lessons Learned from the Implementation of Proposition O in Los Angeles, California

    Science.gov (United States)

    Park, Mi-Hyun; Stenstrom, Michael; Pincetl, Stephanie

    2009-03-01

    This article evaluates the implementation of Proposition O, a stormwater cleanup measure, in Los Angeles, California. The measure was intended to create new funding to help the city comply with the Total Maximum Daily Load requirements under the federal Clean Water Act. Funding water quality objectives through a bond measure was necessary because the city had insufficient revenues to deploy new projects in its budget. The bond initiative required a supermajority vote (two-thirds of the voters), hence the public had to be convinced that such funding both was necessary and would be effective. The bond act language included project solicitation from the public, as well as multiple benefit objectives. Accordingly, nonprofit organizations mobilized to present projects that included creating new parks, using schoolyards for flood control and groundwater recharge, and replacing parking lots with permeable surfaces, among others. Yet few, if any, of these projects were retained for funding, as the city itself also had a list of priorities and higher technical expertise in justifying them as delivering water quality improvements. Our case study of the implementation of Proposition O points to the potentially different priorities for the renovation of urban infrastructure that are held by nonprofit organizations and city agencies and the importance of structuring public processes clearly so that there are no misimpressions about funding and implementation responsibilities that can lead to disillusionment with government, especially under conditions of fiscal constraints.

  15. Icariin Changes ANGPTL3 Expression and LPL Activity to Improve Meat Quality in Swine

    Directory of Open Access Journals (Sweden)

    Ji-Ying Wang

    2012-01-01

    Full Text Available Excessive cholesterol and fatty acids in the diet can lead to cardiovascular disease. Recent studies have reported that elevated Angiopoietin-Like Protein 3 (ANGPTL3 expression contributes to dyslipidemia. The aim of the study was to examine the beneficial effect of icariin, an active flavonoid glucoside, on meat quality in swines and the mechanisms involved. About 36 Duroc x Landrace x Yorkshire swines with an initial average body weight 65 kg were randomly divided into 3 groups: control swines group, two groups of icariin-treated swines (0.1 or 0.3%. About 42 days after, icariin (0.1 or 0.3% treatment significantly decreased fat meat percentage, drip loss rate, plasma and hepatic total cholesterol levels, plasma and hepatic triglyceride concentrations, expression of ANGPTL3 mRNA and increased meat color, lean meat percentage, plasma high-density lipoprotein cholesterol level, activity of Lipoprotein Lipase (LPL. The present results suggest that icariin changes ANGPTL3 expression and LPL activity to improve meat quality in swine.

  16. A holistic approach to improving indoor environmental quality: A case study

    International Nuclear Information System (INIS)

    One of the big six accounting firms recently consolidated several offices into a regional headquarters located in a southern metropolitan city. This regional headquarters involved seven floors totalling 187,000 square feet of tenant space in a new high rise building. The accounting firm realized that improving their employees' work environment would provide significant savings from increased worker productivity and reduced absenteeism. Therefore, the firm retained Environmental Design International (EDI) to provide consulting services to create and maintain an environmentally healthy office space. The creation of a healthy, productive and safe indoor environment involves a total, holistic approach to the various elements that affect indoor environmental quality (IEQ) in a building. A holistic approach requires detailed evaluation of all areas that impact indoor environmental quality and not just the more common review of HVAC systems. This case study shows that the optimization of a healthy indoor environment is an endless, all inclusive process: beginning with the initial construction material selections and environmental systems design; continuing through the construction and commissioning phases; and progressing to pro-active monitoring of IEQ parameters to protect the tenant's investment in a healthy, productive and safe indoor environment

  17. WHO global salm-surv external quality assurance system (EQAS): an important step toward improving the quality of Salmonella serotyping and antimicrobial susceptibility testing worldwide

    DEFF Research Database (Denmark)

    Petersen, A.; Aarestrup, Frank MØller

    2002-01-01

    Initiated in 2000, WHO Global Salm-Surv is a global network of epidemiologists and microbiologists involved in Salmonella surveillance. WHO Global Salm-Surv seeks to enhance the capacity of national and regional reference laboratories to conduct Salmonella serotyping and antimicrobial susceptibility testing through international training courses and an External Quality Assurance System (EQAS). In 2000, 44 WHO Global Salm-Surv member laboratories from 35 countries determined the serotype and antimicrobial susceptibility pattern for eight "blinded" Salmonella isolates. For serotyping, 73% of the results were correct. For susceptibility testing, 92% of the results were in agreement with the expected results. However, only 78% of the performed tests with the E. coli ATCC 25922 reference strain were within the quality control range specified by National Committee for Clinical Laboratory Standards (NCCLS) guidelines. These EQAS results demonstrate the need for further training to improve the performance of some of the laboratories. WHO Global Salm-Surv activities, including international training courses and EQAS, represent an important step toward improving the quality of Salmonella serotyping and antimicrobial susceptibility testing worldwide, and improving the current reliability and comparability of Salmonella surveillance data obtained from different countries.

  18. Analysis of Customer Feedback System for Continual Quality Improvement-A Case Study from Lakshya Experiences

    Directory of Open Access Journals (Sweden)

    Het Ram Swami

    2006-01-01

    Full Text Available Customer's satisfaction is the measure of quality of a product or a service. Customers' feedback are important sources of product information on performance, improvements, and enhancement of ideas. The implementation of customer feedback system is essential to enhance the customers' satisfaction through continual improvement, which is essential for the survival of any organisation in a competitive environment. This study provides a structured approach to analyse and translate the customers' feedback into quality improvement of the product. The defects reported by the customers' on the unmanned aerial vehicle Lakshya systems were investigated while carrying out their rectification. Prompt remedial measures were also instituted to prevent their recurrence. This has resulted in the improvement of reliability and quality of the product. Finally, the implementation of customer feedback system and formalisation of defect investigation procedure for improving the quality and reliability of Lakshya systems has been described. A case study on Barco monitors (RGD 651 hasalso been demonstrated from Lakshya experience.

  19. Association of initial CT findings with quality-of-life outcomes for traumatic brain injury in children

    Energy Technology Data Exchange (ETDEWEB)

    Swanson, Jonathan O. [Seattle Children' s Hospital and University of Washington, Department of Radiology, Seattle, WA (United States); Vavilala, Monica S.; Wang, Jin; Rivara, Frederick P. [Harborview Medical Center, University of Washington, Department of Pediatrics, Seattle, WA (United States); Pruthi, Sumit [Monroe Carell Jr. Children' s Hospital at Vanderbilt University, Department of Radiology, Nashville, TN (United States); Fink, James [University of Washington, Department of Radiology, Seattle, WA (United States); Jaffe, Kenneth M. [University of Washington, Department of Rehabilitation Medicine, Seattle, WA (United States); Durbin, Dennis [University of Pennsylvania, Department of Pediatrics, Center for Injury Research and Prevention, The Children' s Hospital of Philadelphia, Philadelphia, PA (United States); Koepsell, Thomas [University of Washington, Department of Epidemiology, Seattle, WA (United States); Temkin, Nancy [University of Washington, Biostatistics, Seattle, WA (United States)

    2012-08-15

    Traumatic brain injury (TBI) is a leading cause of acquired disability in children and adolescents. To demonstrate the association between specific findings on initial noncontrast head CT and long-term outcomes in children who have suffered TBI. This was an IRB-approved prospective study of children ages 2-17 years treated in emergency departments for TBI and who underwent a head CT as part of the initial work-up (n = 347). The change in quality of life at 12 months after injury was measured by the PedsQL scale. Children with TBI who had intracranial injuries identified on the initial head CT had a significantly lower quality-of-life scores compared to children with TBI whose initial head CTs were normal. In multivariate analysis, children whose initial head CT scans demonstrated intraventricular hemorrhage, parenchymal injury, midline shift {>=}5 mm, hemorrhagic shear injury, abnormal cisterns or subdural hematomas {>=}3 mm had lower quality of life scores 1 year after injury than children whose initial CTs did not have these same injuries. Associations exist between findings from the initial noncontrast head CT and quality of life score 12 months after injury in children with TBI. (orig.)

  20. Association of initial CT findings with quality-of-life outcomes for traumatic brain injury in children

    International Nuclear Information System (INIS)

    Traumatic brain injury (TBI) is a leading cause of acquired disability in children and adolescents. To demonstrate the association between specific findings on initial noncontrast head CT and long-term outcomes in children who have suffered TBI. This was an IRB-approved prospective study of children ages 2-17 years treated in emergency departments for TBI and who underwent a head CT as part of the initial work-up (n = 347). The change in quality of life at 12 months after injury was measured by the PedsQL scale. Children with TBI who had intracranial injuries identified on the initial head CT had a significantly lower quality-of-life scores compared to children with TBI whose initial head CTs were normal. In multivariate analysis, children whose initial head CT scans demonstrated intraventricular hemorrhage, parenchymal injury, midline shift ?5 mm, hemorrhagic shear injury, abnormal cisterns or subdural hematomas ?3 mm had lower quality of life scores 1 year after injury than children whose initial CTs did not have these same injuries. Associations exist between findings from the initial noncontrast head CT and quality of life score 12 months after injury in children with TBI. (orig.)

  1. Air quality in Mecca and surrounding holy places in Saudi Arabia during Hajj: initial survey.

    Science.gov (United States)

    Simpson, Isobel J; Aburizaiza, Omar S; Siddique, Azhar; Barletta, Barbara; Blake, Nicola J; Gartner, Aaron; Khwaja, Haider; Meinardi, Simone; Zeb, Jahan; Blake, Donald R

    2014-08-01

    The Arabian Peninsula experiences severe air pollution, the extent and sources of which are poorly documented. Each year in Saudi Arabia this situation is intensified during Hajj, the Holy Pilgrimage of Islam that draws millions of pilgrims to Mecca. An initial study of air quality in Mecca and surrounding holy sites during the 2012 Hajj (October 24-27) revealed strongly elevated levels of the combustion tracer carbon monoxide (CO, up to 57 ppmv) and volatile organic compounds (VOCs) along the pilgrimage route-especially in the tunnels of Mecca-that are a concern for human health. The most abundant VOC was the gasoline evaporation tracer i-pentane, which exceeded 1200 ppbv in the tunnels. Even though VOC concentrations were generally lower during a follow-up non-Hajj sampling period (April 2013), many were still comparable to other large cities suffering from poor air quality. Major VOC sources during the 2012 Hajj study included vehicular exhaust, gasoline evaporation, liquefied petroleum gas, and air conditioners. Of the measured compounds, reactive alkenes and CO showed the strongest potential to form ground-level ozone. Because the number of pilgrims is expected to increase in the future, we present emission reduction strategies to target both combustive and evaporative fossil fuel sources. PMID:24983190

  2. Cathode ray tube quality control and acceptance testing program: initial results for clinical PACS displays.

    Science.gov (United States)

    Groth, D S; Bernatz, S N; Fetterly, K A; Hangiandreou, N J

    2001-01-01

    The use of picture archiving and communication systems (PACS) and primary soft-copy interpretation in radiology is growing rapidly. The authors present a cathode ray tube (CRT) acceptance test and quality control (QC) program developed over a 5-year period on the basis of experience with multiple PACS and CRT vendors. The CRT QC procedures address monitor cleanliness and setup, qualitative image quality, and quantitative luminance and color measurements. Required materials include a photometer with luminance and color probes and 100%-video, flat-field window and test images from the Society of Motion Picture Test Engineers (SMPTE). Luminance was found to change over time for all gray-scale CRTs examined, which necessitated quarterly recalibration. The phosphor color of these monitors was also found to change, but changes were consistent and slow enough to warrant only annual measurements. Color measurements were found to be especially useful at initial setup and for CRT replacement. Use of this program allowed standardization of absolute luminance of individual CRTs, matching of phosphor color for multimonitor workstations, and systematic tracking of image artifacts. Implementation of a QC program is strongly recommended owing to the dynamic nature of CRT displays. PMID:11353118

  3. Global Threat Reduction Initiative Fuel-Thermo-Physical Characterization Project Quality Assurance Plan

    Energy Technology Data Exchange (ETDEWEB)

    Pereira, Mario M.; Slonecker, Bruce D.

    2012-06-01

    The charter of the Fuel Thermo-Physical Characterization Project is to ready Pacific Northwest National Laboratory (PNNL) facilities and processes for the receipt of unirradiated and irradiated low enriched uranium (LEU) molybdenum (U-Mo) fuel element samples, and to perform analysis to support the Global Threat Reduction Initiative conversion program. PNNL’s support for the program will include the establishment of post-irradiation examination processes, including thermo-physical properties, unique to the U.S. Department of Energy laboratories. These processes will ultimately support the submission of the base fuel qualification (BFQ) to the U.S. Nuclear Regulatory Commission (NRC) and revisions to High Performance Research Reactor Safety Analysis Reports to enable conversion from highly enriched uranium to LEU fuel. This quality assurance plan (QAP) provides the quality assurance requirements and processes that support the NRC BFQ. This QAP is designed to be used by project staff, and prescribes the required management control elements that are to be met and how they are implemented. Additional controls are captured in Fuel Thermo-Physical Characterization Project plans, existing procedures, and procedures to be developed that provide supplemental information on how work is conducted on the project.

  4. Improving alfalfa silage quality with inoculants and silo management

    Science.gov (United States)

    Two areas of silage management are addressed: silage inoculants and plastic film quality. Inoculants are the most common silage additives in the United States. These products contain lactic acid bacteria to supplement the lactic acid bacteria naturally on the crop and help insure a consistent fermen...

  5. Quality improving techniques for free-viewpoint DIBR

    Science.gov (United States)

    Do, Luat; Zinger, Sveta; de With, Peter H. N.

    2010-02-01

    Interactive free-viewpoint selection applied to a 3D multi-view signal is a possible attractive feature of the rapidly developing 3D TV media. This paper explores a new rendering algorithm that computes a free-viewpoint based on depth image warping between two reference views from existing cameras. We have developed three quality enhancing techniques that specifically aim at solving the major artifacts. First, resampling artifacts are filled in by a combination of median filtering and inverse warping. Second, contour artifacts are processed while omitting warping of edges at high discontinuities. Third, we employ a depth signal for more accurate disocclusion inpainting. We obtain an average PSNR gain of 3 dB and 4.5 dB for the 'Breakdancers' and 'Ballet' sequences, respectively, compared to recently published results. While experimenting with synthetic data, we observe that the rendering quality is highly dependent on the complexity of the scene. Moreover, experiments are performed using compressed video from surrounding cameras. The overall system quality is dominated by the rendering quality and not by coding.

  6. Using the Environmental Rating Scales for Quality Improvement Projects

    Science.gov (United States)

    Robertson, Marcy

    2005-01-01

    Many tools have been created and utilized in an effort to assess the quality of early childhood programs, though few of these tools address the many programmatic elements of these programs. Some of the most comprehensive tools that are widely used are the Environmental Rating Scales developed by Thelma Harms, Debbie Cryer, and Richard Clifford.…

  7. MODELING CONSISTENCY, MODEL QUALITY, AND FOSTERING CONTINUED IMPROVEMENT

    Science.gov (United States)

    We believe that most contributors to and participants of the International Conference, Marine Waste Water Discharges 2000, "MWWD 2000," could agree that the overarching dream of the conference might be to chart a path the will lead to the best, long-term, applicable water quality...

  8. HR Manager Leadership in Quality Improvement in a College Environment

    Science.gov (United States)

    Sharabi, Moshe

    2010-01-01

    Purpose: The purpose of this paper is to present the influence of the human resource (HR) manager on the quality of service in an academic college, and the human resource management (HRM) outcomes of the process. Design/methodology/approach: The paper relates to a customer satisfaction survey. More than 120 questionnaires were completed by the…

  9. Quicksands! Sidestepping the Quality Quicksands. Setting Continuous Improvement on Bedrock.

    Science.gov (United States)

    Lewe, Glenda

    This book, which is intended for educators who are invited into workplaces to design, develop, and deliver workplace literacy and other training programs and for corporate and labor leaders involved in workplace education, examines the concepts of total quality and bedrock (foundation or basic) skills. Presented first are a glossary and…

  10. Leaching Pretreatments for Improving Biomass Quality: Feedstocks, Solvents, and Extraction Modeling

    Science.gov (United States)

    Yu, Chao Wei

    In this research, a systematic study was conducted to quantify the inorganic and organic compounds leached from rice straw, wheat straw, corn stover, switchgrass, Jose Tall Wheatgrass, Douglas fir, and Miscanthus with water, and to evaluate the feedstock quality and characteristics of leached solids for thermal process applications. Leaching feedstocks with water at ambient temperature with a 20 L/kg (dry matter) ratio for 2 hours greatly increased the ash fusion temperature of rice straw (from 1050°C to above 1550°C) and wheat straw (from 900°C to 1250°C), but the treatment only increased the ash fusion temperature of corn stover from 900°C to 950°C. Miscanthus had relatively good initial feedstock quality and leaching may not prove necessary for this feedstock in thermal systems. Leaching also changed the combustion kinetics of biomass by increasing the initial degradation temperature of most feedstocks from originally between 165°C and 186°C to between 180°C and 250°C depending on feedstock. Moreover, leaching increased the maximum rate of weight loss of feedstock by 11% to 54% and increased the corresponding temperatures for peak loss up to 34°C. Leaching removed a sizeable fraction of organic compounds (between 2% and 12% of dry matter). These organic extracts were identified as mostly sugars and acids which might be valuable co-products. Moisture contents of feedstocks after leaching were typically high, ranging between 68 and 81% wet basis. A dewatering step is generally required prior to using the leached biomass for thermochemical conversion. Solvents with ability to dissolve ion-exchangeable, organically associated, and acid soluble metals can further remove non-water soluble metals from biomass and may also improve feedstock quality. In a solvent evaluation, corn stover and wheat straw were leached with water, 1M ammonium acetate, 1M HCl, 100% methanol, 50% methanol, 100% ethanol, and 50% ethanol, and leached solids and leachate were characterized. Among these solvents, 1M HCl improved the corn stover feedstock quality better than other solvents investigated while water worked better for wheat straw. The results show that 1M HCl increased the ash fusion temperature of corn stover from 900 to 1300°C and above 1550°C for water-treated wheat straw. Leachability of each ion extracted from corn stover and wheat straw with different solvents was determined, and the results may be useful in studying the solubility of different elements in a complex ionic solution like leachate. A parallel diffusion model was developed from Fick's second law of diffusion to describe the mass transfer of compounds extracted from biomass to the bulk liquid phase. The model describes two leaching steps with two effective diffusion coefficients, the first step being an initial washing and fast diffusion ( Dfast) followed by a second slower intraparticle diffusion (Dslow). Mass concentration profiles of anions, cations, and sugars leached from wheat straw with water were developed and were used to estimate parameters in the model and for model validation. Results show that Dfast increased as leaching temperature increased while the effects of leaching ratio on Dfast and Dslow were inconclusive. The calculated Dfast and Dslow for leaching ions and sugars from wheat straw did not follow an Arrhenius behavior, suggesting that the effective diffusion coefficients were different depending on batch leaching conditions. In general, the model was able to predict the concentrations of selected anions, cations and total sugars leached from wheat straw with R2 between 0.85 and 0.99 from linear regression analysis of the experimental data versus predicted data. However, the predictability of the model significantly decreased when employing as low a leaching ratio as 15 L/kg due to the high solids concentration of the slurry and resulting inability to apply sufficient agitation. The model tended to overestimate the concentrations of ions in leachate and underestimate the total sugars during the initial 6 minutes of leaching, possibly due t

  11. Advances in improving the quality and flexibility of compound management.

    Science.gov (United States)

    Janzen, William P; Popa-Burke, Ioana G

    2009-06-01

    The process of drug discovery has evolved considerably since the advent of high-throughput screening (HTS) in the 1980s. Experts and opinion leaders today are agreeing that the current trend in the field is a focus on increasing overall quality (target, screening, and compounds), use of multiple screening approaches for lead discovery, and more flexibility in the process. The associated need for increased flexibility and quality control to support existing HTS paradigms as well as lower throughput approaches such as fragment screening, computational chemistry, focused library building, and centralized lead optimization support has required an evolution in compound management (CM, aka sample management or library management). Although there is much less published peer-reviewed data in CM, due to its historical links to HTS, it has followed very similar trends. In recent years, the focus in CM has been increasingly in compound quality and increased flexibility of the process, as opposed to number of compounds dispensed and speed of dispensing, which were standard metrics and indicators used not so long ago. Ideally, to screen the highest quality sample for every assay, one would start with a correct identity and pure solid, make a correct concentration solution in water or water-soluble/assay-compatible solvent that would allow 100% solubilization, and screen it immediately in a biological assay. Neither CM nor screening has advanced sufficiently to deliver this ideal scenario, but many significant advancements have been made in recent years both in terms of quality of compounds in stores and flexibility of the process, which will be reviewed herein. PMID:19483148

  12. Image quality improvement by the structured light illumination method in an optical readout cantilever array infrared imaging system.

    Science.gov (United States)

    Feng, Yun; Zhao, Yuejin; Liu, Ming; Dong, Liquan; Yu, Xiaomei; Kong, Lingqin; Ma, Wei; Liu, Xiaohua

    2015-04-01

    The structured light illumination method is applied in an optical readout uncooled infrared imaging system to improve the IR image quality. The unavoidable nonuniform distribution of the initial bending angles of the bimaterial cantilever pixels in the focal plane array (FPA) can be well compensated by this method. An ordinary projector is used to generate structured lights of different intensity distribution. The projected light is divided into patches of rectangular regions, and the brightness of each region can be set automatically according to the deflection angles of the FPA and the light intensity focused on the imaging plane. By this method, the FPA image on the CCD plane can be much more uniform and the image quality of the IR target improved significantly. A comparative experiment is designed to verify the effectiveness. The theoretical analysis and experimental results show that the proposed structured light illumination method outperforms the conventional one, especially when it is difficult to perfect the FPA fabrication. PMID:25831340

  13. The opportunity and strategy for quality and health-system improvement now and in the future.

    Science.gov (United States)

    Sherar, Michael; Maley, Oonagh

    2015-01-01

    Since 2004, Cancer Care Ontario (CCO) has played a leadership role in linking funding to quality of care, and in using evidence and administrative and clinical data to drive performance and quality improvement. This article describes how CCO has used its cancer and renal health system strategies to establish an environment of continuous health system improvement. The article also describes how CCO's Corporate Strategy is driving organizational improvement: evolving CCO's capacity and capability to drive quality and value across healthcare settings, and its ability to advance broader health system transformation in support of cancer and renal patients. PMID:25562136

  14. Rational medication use review: a quality assurance/improvement process for HIV/AIDS treatment programme

    Directory of Open Access Journals (Sweden)

    Henry Fomundam

    2015-04-01

    Methods: A comprehensive data collection tool was developed to systematically and retrospectively capture relevant data from randomly selected ART patient files in the four ART facilities. Results: ART data from 157 patients receiving ART services from four facilities was extracted and analysed. WHO stage 4 AIDS defining diseases were recorded in 125 (79.6% of the patients at the time of ART initiation. The most frequent opportunistic infections and/or co-morbidities were cryptosporidiosis (14.4%, HIV wasting (14.4%, tuberculosis (13% and candidiasis (17.4%. 97.8% of the patients were taking concomitant medicines. A large percentage of patients (72.4% had done a baseline CD4 test before initiation of therapy with a majority of the patients (85.8% getting their lab results within one week of the collection of the specimens. For some patients (9%, it took up to 8 weeks to get test results. About 21.8% of the patients were hospitalized at least once while on ART and 11.2% of the hospitalized patients died. Conclusion: RMUR is a simple and accurate strategy that can be appropriately modified to suite local settings. It offers a cost-effective and participatory method of identifying any factors that may negatively affect the quality and desired outcomes of ART enabling prompt correction and continuous improvement of treatment related outcomes. [Int J Res Med Sci 2015; 3(2.000: 383-390

  15. Initial Investigation of Using Planar Interdigital Sensors for Assessment of Quality in Seafood

    Directory of Open Access Journals (Sweden)

    S. C. Mukhopadhyay

    2009-01-01

    Full Text Available A planar interdigital sensor-based sensing system has been fabricated for assessment of seafood quality. Our main objective is to sense the molecule of domoic acid presence in mussels. Three peptide derivatives namely sarcosine, proline, and hydroxylproline were used for the initial studies which are structurally closely related to our target molecule. The proline molecule is arguably the most important amino acid in peptide conformation, containing the basic structural similarity to the domoic acid. Three novel interdigital sensors have been designed and fabricated. The initial result shows that sensors respond very well to the chemicals and it is possible to discriminate the different chemicals from the output of the sensor. Results from the analysis have shown that Sensor_1 has better sensitivity compared to other sensors. Sensor_1 was chosen for further analysis with real mussels. The changes in sensor impedance were then analysed with real mussels before and after adding the proline. The presence of proline on the mussel samples was detected by the sensor. Results also showed a good correlation of R2 = 0.717 between sensitivity and sample thickness.

  16. An examination of the Total Quality Management (TQM) concept given current Federal/DoD competition initiatives

    Science.gov (United States)

    Stabile, Michael E.

    1992-06-01

    Quality is vital to our defense and quality improvement is key to increasing productivity. The Department of Defense (DoD) Total Quality Management (TQM) effort has been given top priority by the Secretary of Defense. Many questions exist concerning the problems encountered when implementing TQM throughout DoD. This thesis looks at the compatibility of the TQM philosophy with current Federal Acquisition Regulation competition requirements. The writer concludes that the TQM philosophy implementation is compatible with existing competition policy.

  17. Improving safety through quality management system: SINAGAMA experience

    International Nuclear Information System (INIS)

    This paper discussed critically the policies and measures adopted during preoperational and operational stages to improve safety of workers, public, the environment as well as the products treated at SINAGAMA. (author)

  18. Sustainability of Capacity Building Activities to Improve Food Safety and Quality through Nuclear Technology and Networking

    International Nuclear Information System (INIS)

    Access to food control laboratories and related services represents a minimum requirement to generate monitoring data for food risk management activities within a nation. Along with its analytical work and component services, each laboratory has the opportunity to undertake a more active role in promoting and facilitating food safety and food quality at many points along the production and supply chain. Provided that their internal mandate allows it, laboratories can address issues such as risk assessment, design of risk-based monitoring programmes, sampling, interpretation of analytical results in the wider context of the food chain, outreach to decision makers, and also research and development activities. Implementing such a broad and multidisciplinary approach requires a step by step process with the involvement of stakeholders and a commitment to continuously build capacity through networking and learning. Currently, outsourcing analytical services and the use of private analytical laboratories through temporary contractual agreements are the only practical options available to some developing countries, and at times these arrangements prove to be unsustainable or impractical. A more sustainable and recommended approach is to establish national accredited laboratories and invest in their long term activities both as a focal point for analytical expertize and as part of a system for the control of food nationally and as traded through imports and exports. The Food and Environmental Protection Laboratory (FEPL) was successful in a competitive bidding process for funding from the USA under the Peaceful Uses Initiative (PUI). The PUI objective is to support the IAEA in facilitating greater access for Member States to peaceful applications of nuclear technology. In this context a three-year project on 'Sustainability of capacity building activities to improve food safety and quality through nuclear technology and networking' started in March 2012. The objective of this project is to ensure food safety and quality while addressing the sustainability of technical capacity, laboratory infrastructure and regional/ interregional networking. The project has taken a step forward in encouraging interactions between the laboratories and multiple stakeholders, thereby providing essential feedback and advice to help build the analytical capacity to help assess and manage risks, and also to help growers improve their production practices. The project has been designed to embrace several activities in developing countries aiming to build infrastructure for the intervention of donor organizations to facilitate the implementation of food control systems and ultimately to contribute to enhanced food safety and quality. The project follows a modular approach, applying successful strategies adopted in other countries and coordinating donor resources to accelerate the commissioning of laboratories and state of art analytical equipment. The project supports targeted capacity building in an attempt to ensure sustainability. The establishment of laboratory quality systems and the attainment of ISO 17025 accreditation are key parameters for the long term self-sustainability of activities in Member States to enhance food safety and quality. The expected project outcomes include: (1) State of the art food control laboratories, including methodologies to address identified gaps in food control systems, commissioned and fully operational. (2) Networks of laboratories and affiliated/donor/ technical cooperation agencies established and recognized internationally. (3) Analytical strategies and integrated monitoring initiated in several countries to share and ensure adequate risk management decisions. (4) A recognized platform, including a financial mechanism to ensure sustainability of capacity building activities, in place in several countries. This project emphasizes the comparative advantages of using nuclear and related technologies. All project participants are encouraged to work cooperatively on the core programme using both nuclear and comple

  19. The Quality Initiative in Rectal Cancer (QIRC trial: study protocol of a cluster randomized controlled trial in surgery

    Directory of Open Access Journals (Sweden)

    Thabane Lehana

    2008-02-01

    Full Text Available Abstract Background Two unfortunate outcomes for patients treated surgically for rectal cancer are placement of a permanent colostomy and local tumor recurrence. Total mesorectal excision is a new technique for rectal cancer surgery that can lead to improved patient outcomes. We describe a cluster randomized controlled trial that is testing if the above patient outcomes can be improved through a knowledge translation strategy called the Quality Initiative in Rectal Cancer (QIRC strategy. The strategy is designed to optimize the use of total mesorectal excision techniques. Methods and Design Hospitals were randomized to the QIRC strategy (experimental group versus normal practice environment (control group. Participating hospitals, and the respective surgeon group operating in them, are from Ontario, Canada and have an annual procedure volume for major rectal cancer resections of 15 or greater. Patients were eligible if they underwent major rectal surgery for a diagnosis of primary rectal cancer. The surgeon-directed QIRC interventions included a workshop, use of opinion leaders, operative demonstrations, a post-operative questionnaire, and, audit and feedback. For an operative demonstration participating surgeons invited a study team surgeon to assist them with a case of rectal cancer surgery. The intent was to demonstrate total mesorectal excision techniques. Control arm surgeons received no intervention. Sample size calculations were two-sided, considered the clustering of data at the hospital level, and were driven by requirements for the outcome local recurrence. To detect an improvement in local recurrence from 20% to 8% with confidence we required 16 hospitals and 672 patients – 8 hospitals and 336 patients in each arm. Outcomes data are collected via chart review for at least 30 months after surgery. Analyses will use an intention-to-treat principle and will consider the clustering of data. Data collection will be complete by the end of 2007. Discussion Lower rates of permanent colostomy and local tumour recurrence in the intervention arm would suggest the QIRC strategy is efficacious. The strategy may act as a template for efforts to improve surgical quality in other areas and will contribute to knowledge on influencing surgeon practice. Trial registration Current Controlled Trials ISRCTN78363167

  20. A Fuzzy Improved Association Mining Approach to Estimate Software Quality?

    Directory of Open Access Journals (Sweden)

    Sonakshi Rana

    2013-06-01

    Full Text Available Software Quality analysis is one of the major criteria required to analyze the software life as wellas software reliability. Software quality is been defined under different parameters. Software risk analysis isone such criterion required to identify the software reliability. When software is planned or being developedaccording to the type of software as well as the efforts required to develop the software collectively defines thesoftware risk. Such as the availability of the required software, hardware, manpower all are the predictiverisk factors. In this work, these all risk factors are defined under the fuzzy rule. Based on this fuzzyestimation to the some weightage is been assigned to these all risk factors. Finally, the aggregative risk isbeen computed to predict the software reliability under the risk vector. The presented work is capable toidentify the software risk under three levels. These three levels are individual vector risk, sub category riskand the aggregative risk.

  1. Implementation of biochemical screening to improve baking quality of Barley

    DEFF Research Database (Denmark)

    Aaslo, Per; Langkilde, Ane

    2011-01-01

    Barley (Hordeum vulgare) is mostly used in feed and malt production but has the ability to provide humans nutritional benefits. The current wheat based “barley” breads can unfortunately not exceed more than 20% barley flour mixed into the dough due to poor leavening properties. Therefore the objective is to develop barley varieties with good baking properties. The poor leavening properties of barley can be attributed, at least partially, to the physical properties of the storage proteins. Studies based on small scaled baking trials and protein pattern analysed by SDS-PAGE on a large number of high protein barley cultivars suggested differences in baking quality and correlation between baking quality and D-hordeins. The amino acid composition was measures using the newly developed AccQ Tag Ultra Amino acid (AA) derivatisation system designed for the Acquity UPLC. Obtained results from the total AA composition and the hordein pattern indicated that there are genetic variations not only in the distributions of the hordein polypeptides but also in the relative proportions of the storage proteins affecting the AA compositions. The free AA composition in the grain may also provide us the opportunity to give a forecast of the taste of the bread, as the AA composition is known to control certain aspects of the taste. We uses a MSE approach on a time of flight instrument coupled to a UPLC and in gel digestion to identify and characterize the different D-hordeins responsible for baking quality. Digesting the proteins with chymotrypsin results in approx 60% sequence coverage in Biopharmalynx but higher sequence coverage is expected using both chymotrypsin and trypsin as overlapping peptides are produced in the optimal mass range. Sequencing the digested peptides also revealed post translational modifications of the identified hordein which needs further investigation. Our results strongly indicate genetic variations in the relative proportions of the storage proteins affecting the amino acid compositions and baking quality.

  2. A Quality Matrix to Improve the Knowledge Product Management

    OpenAIRE

    Boca, Gratiela Dana

    2012-01-01

    The paper presents a quality matrix, some strategies and different tools for product evaluation using IT programs. The paper presents some solutions obtained with different programs and the influence upon the life cycle of the product, especially from design stage of technological manufacturing until the product decline. The development of a new product by a company begins when the need to create a new product appears: a new technology, the appearance of a competitive product or a change in t...

  3. Improving business intelligence data quality in sales insight area

    OpenAIRE

    Anturaniemi, Ari

    2012-01-01

    Business intelligence (BI) management is an ability of a business organization to gather and analyze systematically information about its business operations and the business environment it is having business in, and turn that information and analysis of the information as knowledge and insight for the business organization. One of the key topics in the business intelligence development and usage situation is to understand what is the data quality level needed to create new knowledge and unde...

  4. Improving quality in Iberian ”Chouriço grosso” using autochthonous starter cultures.

    OpenAIRE

    Elias, Miguel; Agulheiro-santos, Ana Cristina; Carrascosa, Alfonso

    2011-01-01

    “Chouriço Grosso“ is a traditional and high quality Portuguese sausage made with meat from Alentejano pig breed, a rustic and fatty Portuguese breed. At a traditional factory, 4 batches with 25 kg, each one, were prepared to produce “Chouriço Grosso” using different starter inoculations: 1 - with 108 cells/g of Lactobacillus sakei and 108 cells/g of Staphylococcus xylosus, 2 - with 108 cells/g of Lactobacillus sakei, 3 - with 108 cells/g of Staphylococcus xylosus, 4 - control,...

  5. Fuzzy Controller Based UPQC for Power Quality Improvement

    Directory of Open Access Journals (Sweden)

    S.Rajeev *1,

    2014-06-01

    Full Text Available The paper proposes a unified power quality controller (UPQC using a fuzzy logic controller (FLC. The results obtained through the FLC are good in terms of dynamic response because of the fact that the FLC is based on linguistic variable set theory and does not require a mathematical model of the system. Also, the tough method of tuning the PI controller is not required for FLC. Simulations are carried out using MATLAB/Simulink to validate the theoretical findings.

  6. Improving the Power Quality by Four Leg VSI

    OpenAIRE

    Chougala, Shweta R. Malluramath Prof V. M.

    2013-01-01

    This paper presents a hysteresis band current control scheme for three-phase four leg voltage source inverter that compensates power quality problems. The inverter is capable of compensating power factor, current unbalance and current harmonics. Today most inverters are designed for balanced three phase loads and consequently the associated control Strategies are quite effective for three wire system but are not able to manage load that require neutral current compensation. If four leg four w...

  7. Improving Recommendation Quality by Merging Collaborative Filtering and Social Relationships

    OpenAIRE

    Meo, Pasquale; Ferrara, Emilio; Fiumara, Giacomo; Provetti, Alessandro

    2011-01-01

    Matrix Factorization techniques have been successfully applied to raise the quality of suggestions generated by Collaborative Filtering Systems (CFSs). Traditional CFSs based on Matrix Factorization operate on the ratings provided by users and have been recently extended to incorporate demographic aspects such as age and gender. In this paper we propose to merge CFS based on Matrix Factorization and information regarding social friendships in order to provide users with more...

  8. Can Electronic Tools Help Improve Nursing Home Quality?

    OpenAIRE

    Kru?ger, Kjell; Strand, Line; Geitung, Jonn Terje; Eide, Geir Egil; Grimsmo, Anders

    2011-01-01

    Background: Nursing homes face challenges in the coming years due to the increased number of elderly. Quality will be under pressure, expectations of the services will rise, and clinical complexity will grow. New strategies are needed to meet this situation. Modern clinical information systems with decision support may be part of that.

    Objectives: To study the impact of introducing an electronic patient record system with decision support on the use of warfarin, neuroleptic...

  9. Relationships of physician characteristics to performance quality and improvement.

    OpenAIRE

    Payne, B. C.; Lyons, T. F.; Neuhaus, E.

    1984-01-01

    The quality of ambulatory medical care provided by 1,135 physicians in five separate practice settings in the Midwest was measured using predetermined process criteria. Specialists performed better in their own areas of specialized training than did family/general practitioners or specialists performing outside their specialty areas. Physicians with fewer years of practice performed somewhat better than physicians with more years since medical school graduation. Board certification was not co...

  10. Improving Quality of Service in Baseband Speech Communication

    OpenAIRE

    Petkov, Petko Nikolov

    2014-01-01

    Speech is the most important communication modality for human interaction. Automatic speech recognition and speech synthesis have extended further the relevance of speech to man-machine interaction. Environment noise and various distortions, such as reverberation and speech processing artifacts, reduce the mutual information between the message modulated inthe clean speech and the message decoded from the observed signal. This degrades intelligibility and perceived quality, which are the two ...

  11. MANAGING THE BUILDING DESIGN PROCESS FOR SUSTAINABILTY AND IMPROVED QUALITY

    Directory of Open Access Journals (Sweden)

    Sunday Bobadoye

    2006-01-01

    Full Text Available The essence of building design process and management for building sustainability in the creation and maintenance of a qualitative architectural product is investigated in this paper. The design process, concept of building sustainability and particularly the quality of the built environment are discussed. Akure, a state capital in Nigeria was used as a case study. The principles and indicators for sustainability of buildings and its implications on the quality of the environment are examined in details. Survey findings include the views of the professionals on the clients, perception on the design process as well as management of projects, and the implications on the quality of the ensuring products and the cityâ??s environment. The data were factor analyzed using varimax rotation criterion (with Kaiser Normalization. The results revealed that five factors were effective, with one of them exhibiting the greatest variability and individual differences. The variables that loaded on this factor were really the aspects of the process and management relating to the clients. The findings also revealed the professionalsâ?? wrong attitude towards design process as shown with a very high degree of variability in the study. The paper concludes by recommending the enactment and enforcement of relevant policies with adequate education of the people and the involvement of all the stakeholders in the management of building projects and environmental programmes for the realization of a qualitative architectural product.

  12. Approach to Improve Quality of E-Commerce

    Directory of Open Access Journals (Sweden)

    Satish R. Billewar

    2012-11-01

    Full Text Available E-Commerce is the purpose of Internet and the web toconduct business. E-Commerce is the future of the businesses of21st Century. But E-Commerce companies are facing bigproblems at the time of providing products to customers online.The problem is not about the quality of the products, but theinformation is not reaching to the customers easily and whateverinformation is available on the web sites of the companies that arenot satisfying the traditional product purchase habit of thecustomer. Now the need arise to redefine the quality in theapplications of the web sites as well as the implementation issuesthat become hurdle in E-Commerce business activities. The globaland Indian E-Commerce sales statistics shows the internetpenetration worldwide and E-Commerce Users World Statistics toaddress the reasons why the people have not acceptedE-Commerce in India. The study addresses to various qualityissues of the web sites which are neglected to fulfill therequirements of thee customers, and propose Total QualityManagement (TQM implementation as the best solution to sortout the issues.

  13. Simulation in Quality Management – An Approach to Improve Inspection Planning

    Directory of Open Access Journals (Sweden)

    H.-A. Crostack

    2005-01-01

    Full Text Available Production is a multi-step process involving many different articles produced in different jobs by various machining stations. Quality inspection has to be integrated in the production sequence in order to ensure the conformance of the products. The interactions between manufacturing processes and inspections are very complex since three aspects (quality, cost, and time should all be considered at the same time while determining the suitable inspection strategy. Therefore, a simulation approach was introduced to solve this problem.The simulator called QUINTE [the QUINTE simulator has been developed at the University of Dortmund in the course of two research projects funded by the German Federal Ministry of Economics and Labour (BMWA: Bundesministerium für Wirtschaft und Arbeit, the Arbeitsgemeinschaft industrieller Forschungsvereinigungen (AiF, Cologne/Germany and the Forschungsgemeinschaft Qualität, Frankfurt a.M./Germany] was developed to simulate the machining as well as the inspection. It can be used to investigate and evaluate the inspection strategies in manufacturing processes. The investigation into the application of QUINTE simulator in industry was carried out at two pilot companies. The results show the validity of this simulator. An attempt to run QUINTE in a user-friendly environment, i.e., the commercial simulation software – Arena® is also described in this paper.NOTATION: QUINTE Qualität in der Teilefertigung  (Quality in  the manufacturing process  

  14. Deciphering the imperative: translating public health quality improvement into organizational performance management gains.

    Science.gov (United States)

    Beitsch, Leslie M; Yeager, Valerie A; Moran, John

    2015-03-18

    With the launching of the national public health accreditation program under the auspices of the Public Health Accreditation Board (PHAB), health department momentum around quality improvement adoption has accelerated. Domain 9 of the PHAB standards (one of 12 domains) focuses on evaluation and improvement of performance and is acting as a strong driver for quality improvement and performance management implementation within health departments. Widespread adoption of quality improvement activities in public health trails that in other US sectors. Several performance management models have received broad acceptance, including models among government and nonprofits. A model specifically for public health has been developed and is presented herein. All models in current use reinforce customer focus; streamlined, value-added processes; and strategic alignment. All are structured to steer quality improvement efforts toward organizational priorities, ensuring that quality improvement complements performance management. High-performing health departments harness the synergy of quality improvement and performance management, providing powerful tools to achieve public health strategic imperatives. PMID:25494050

  15. Improving safety through human performance initiatives at the Kozloduy nuclear power plant

    International Nuclear Information System (INIS)

    This paper presents the results of an initial scoping study to identify human factors issues associated with the six reactor control rooms at the Kozloduy Nuclear Power Plant (NPP) in Bulgaria. This task was performed in the fall of 1994 by a team of subject matter specialists from the United States as part of a larger reactor operations feasibility study. The genesis for this study was a program initiated in 1990 by the International Atomic Energy Agency (IAEA) to assist eastern European countries in performing safety reviews of the WWER-440/230 NPPs. The initial IAEA study was a 15 month effort which brought together specialists from 21 countries to assess safety issues at p1ants in Bulgaria, Czechoslovakia, and the former USSR. The study included a series of safety review missions conducted at four plant sites, including Kozloduy in Bulgaria, during which time experts assessed specific plant design deficiencies as well as the overall conduct of operations. Site visits were concluded in October 1991 and a report summarizing the results were published in February, 1992. Of the l00 safety issues that were identified by the IAEA effort, a significant number were related to programs or conditions that could negatively affect human performance of the operating staff. In order to improve the safety of reactor operations at Kozloduy, the Committee of Energy (COE), Bulgaria, sponsored the Kozloduy reactor operations assistance feasibility study. The purpose of this study wability study. The purpose of this study was to assess the status of certain programs at Kozloduy and determine the requirements for initiating improvements to enhance safety. The feasibility study focused on four separate areas related to safety: human factors engineering, emergency operating procedures, operator training, and risk-based maintenance. This paper summarizes only the findings from the human factors task of the feasibility study, and discusses recommendations for an integrated approach to implementation. (author)

  16. Improving data quality and supervision of antiretroviral therapy sites in Malawi: an application of Lot Quality Assurance Sampling

    Directory of Open Access Journals (Sweden)

    Hedt-Gauthier Bethany L

    2012-07-01

    Full Text Available Abstract Background High quality program data is critical for managing, monitoring, and evaluating national HIV treatment programs. By 2009, the Malawi Ministry of Health had initiated more than 270,000 patients on HIV treatment at 377 sites. Quarterly supervision of these antiretroviral therapy (ART sites ensures high quality care, but the time currently dedicated to exhaustive record review and data cleaning detracts from other critical components. The exhaustive record review is unlikely to be sustainable long term because of the resources required and increasing number of patients on ART. This study quantifies the current levels of data quality and evaluates Lot Quality Assurance Sampling (LQAS as a tool to prioritize sites with low data quality, thus lowering costs while maintaining sufficient quality for program monitoring and patient care. Methods In January 2010, a study team joined supervision teams at 19 sites purposely selected to reflect the variety of ART sites. During the exhaustive data review, the time allocated to data cleaning and data discrepancies were documented. The team then randomly sampled 76 records from each site, recording secondary outcomes and the time required for sampling. Results At the 19 sites, only 1.2% of records had discrepancies in patient outcomes and 0.4% in treatment regimen. However, data cleaning took 28.5 hours in total, suggesting that data cleaning for all 377 ART sites would require over 350 supervision-hours quarterly. The LQAS tool accurately identified the sites with the low data quality, reduced the time for data cleaning by 70%, and allowed for reporting on secondary outcomes. Conclusions Most sites maintained high quality records. In spite of this, data cleaning required significant amounts of time with little effect on program estimates of patient outcomes. LQAS conserves resources while maintaining sufficient data quality for program assessment and management to allow for quality patient care.

  17. Pointing stability and image quality of the SOFIA Airborne Telescope during initial science missions

    Science.gov (United States)

    Lampater, Ulrich; Keas, Paul; Brewster, Rick; Herter, Terry; Wolf, Juergen; Pfueller, Enrico; Wiedemann, Manuel; Teufel, Stefan; Harms, Franziska; Jakob, Holger; Roser, Hans-Peter

    2011-09-01

    The Stratospheric Observatory for Infrared Astronomy (SOFIA) is an airborne observatory for astronomical observations at wavelengths ranging from 0.3-1600 µm. It consists of a telescope with an effective aperture of 2.5 m, which is mounted in a heavily modified Boeing 747SP. The aircraft features an open port cavity that gives the telescope an unobstructed view of the sky. Hence the optical system is subject to both aerodynamic loads from airflow entering the cavity, and to inertial loads introduced by motion of the airborne platform. A complex suspension assembly was designed to stabilize the telescope. Detailed end-to-end simulations were performed to estimate image stability based on the mechatronic design, the expected loads, and optical influence parameters. In December 2010 SOFIA entered its operational phase with a series of Early Science flights, which have relaxed image quality requirements compared to the full operations capability. At the same time, those flights are used to characterize image quality and image stability in order to validate models and to optimize systems. Optimization of systems is not based on analytical models, but on models derived from system identification measurements that are performed on the actual hardware both under controlled conditions and operational conditions. This paper discusses recent results from system identification measurements, improvements to image stability, and plans for the further enhancement of the system.

  18. Evaluation of COSMO-ART in the Framework of the Air Quality Model Evaluation International Initiative (AQMEII)

    Science.gov (United States)

    Giordano, Lea; Brunner, Dominik; Im, Ulas; Galmarini, Stefano

    2014-05-01

    The Air Quality Model Evaluation International Initiative (AQMEII) coordinated by the EC-JRC and US-EPA, promotes since 2008 research on regional air quality model evaluation across the atmospheric modelling communities of Europe and North America. AQMEII has now reached its Phase 2 that is dedicated to the evaluation of on-line coupled chemistry-meteorology models as opposed to Phase 1 where only off-line models were considered. At European level, AQMEII collaborates with the COST Action "European framework for on-line integrated air quality and meteorology modelling" (EuMetChem). All European groups participating in AQMEII performed simulations over the same spatial domain (Europe at a resolution of about 20 km) and using the same simulation strategy (e.g. no nudging allowed) and the same input data as much as possible. The initial and boundary conditions (IC/BC) were shared between all groups. Emissions were provided by the TNO-MACC database for anthropogenic emissions and the FMI database for biomass burning emissions. Chemical IC/BC data were taken from IFS-MOZART output, and meteorological IC/BC from the ECWMF global model. Evaluation data sets were collected by the Joint Research Center (JRC) and include measurements from surface in situ networks (AirBase and EMEP), vertical profiles from ozone sondes and aircraft (MOZAIC), and remote sensing (AERONET, satellites). Since Phase 2 focuses on on-line coupled models, a special effort is devoted to the detailed speciation of particulate matter components, with the goal of studying feedback processes. For the AQMEII exercise, COSMO-ART has been run with 40 levels of vertical resolution, and a chemical scheme that includes the SCAV module of Knote and Brunner (ACP 2013) for wet-phase chemistry and the SOA treatment according to VBS (volatility basis set) approach (Athanasopoulou et al., ACP 2013). The COSMO-ART evaluation shows that, next to a good performance in the meteorology, the gas phase chemistry is well captured throughout the year; the few cases showing a systematic underestimation of chemical concentrations arise as a consequence of the boundary conditions. Through this exercise we have identified the main critical issues in the COSMO-ART performance: sea salt and dust particulate matter components. The AQMEII exercise has provided an excellent platform to evaluate the COSMO-ART performance against both measurement data and other European regional on-line coupled models. From the analysis we have been able to identify specific model deficiencies and situations where the model cannot satisfactorily reproduce the data. Our future work will be focused on improving their modelling.

  19. Commonalty initiatives in US nuclear power plants to improve radiation protection culture and worker efficiency

    International Nuclear Information System (INIS)

    Many US nuclear power plants have learned that common procedures, policies, instrumentation, tools and work practices achieve improvements to the radiation protection culture. Significant worker efficiency achievements are accomplished especially during refuelling outages. This paper discusses commonalty initiatives currently being implemented at many US Plants to address management challenges presented by deregulation of the US electric industry, reduction in the pool of outage contractors and aging of the experienced radiation worker population. The new INPO 2005 dose goals of 650 person-mSv/year for PWRs and 1200 person-mSv/yr for PWRs will require new approaches to radiation protection management to achieve these challenging goals by 2005. (authors)

  20. Improved quality of management of eclampsia patients through criteria based audit at Muhimbili National Hospital, Dar es Salaam, Tanzania. Bridging the quality gap

    Directory of Open Access Journals (Sweden)

    Kidanto Hussein

    2012-11-01

    Full Text Available Abstract Background Criteria-based audits (CBA have been used to improve clinical management in developed countries, but have only recently been introduced in the developing world. This study discusses the use of a CBA to improve quality of care among eclampsia patients admitted at a University teaching hospital in Dar es Salaam Tanzania. Objective The prevalence of eclampsia in MNH is high (?6% with the majority of cases arriving after start of convulsions. In 2004–2005 the case-fatality rate in eclampsia was 5.1% of all pregnant women admitted for delivery (MNH obstetric data base. A criteria-based audit (CBA was used to evaluate the quality of care for eclamptic mothers admitted at Muhimbili National Hospital (MNH, Dar es Salaam, Tanzania after implementation of recommendations of a previous audit. Methods A CBA of eclampsia cases was conducted at MNH. Management practices were evaluated using evidence-based criteria for appropriate care. The Ministry of Health (MOH guidelines, local management guidelines, the WHO manual supplemented by the WHO Reproductive Health Library, standard textbooks, the Cochrane database and reviews in peer reviewed journals were adopted. At the initial audit in 2006, 389 case notes were assessed and compared with the standards, gaps were identified, recommendations made followed by implementation. A re-audit of 88 cases was conducted in 2009 and compared with the initial audit. Results There was significant improvement in quality of patient management and outcome between the initial and re-audit: Review of management plan by senior staff (76% vs. 99%; P=0.001, urine for albumin test (61% vs. 99%; P=0.001, proper use of partogram to monitor labour (75% vs. 95%; P=0.003, treatment with steroids for lung maturity (2.0% vs. 24%; P=0.001, Caesarean section within 2 hours of decision (33% vs. 61%; P=0.005, full blood count (28% vs. 93%; P=0.001, serum urea and creatinine (44% vs. 86%; P=0.001, liver enzymes (4.0% vs. 86%; P=0.001, and specialist review within 2 hours of admission (25% vs. 39%; P=0.018. However, there was no significant change in terms of delivery within 24 hours of admission (69% vs. 63%; P=0.33. There was significant reduction of maternal deaths (7.7% vs. 0%; P=0.001. Conclusion CBA is applicable in low resource setting and can help to improve quality of care in obstetrics including management of pre-eclampsia and eclampsia.