WorldWideScience
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78 FR 45231 - Medicare and Medicaid Programs; Initial Approval of Center for Improvement in Healthcare Quality...  

Science.gov (United States)

...Medicare and Medicaid Programs; Initial Approval of Center for Improvement in Healthcare Quality's (CIHQ's) Hospital Accreditation Program AGENCY: Centers for...Center for Improvement in Healthcare Quality (CIHQ) as...Medicare or Medicaid programs. DATES: This...

2013-07-26

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Practice policy and quality initiatives quality improvement and confirmation projects: facilitating rapid, measurable performance improvement.  

Science.gov (United States)

As radiology departments continue to increase in size and complexity, the process of improving and maintaining excellent performance is becoming increasingly challenging. In response, a systematic process for efficiently implementing and sustaining measurable improvement in our radiology department has been developed, which targets focused aspects of individual performance that contribute to overall departmental quality. Projects designed to achieve such improvements have been called quality improvement and confirmation (QuIC) projects. The QuIC project process involves a project champion, medical expert, technical expert, quality improvement technologist specialist, and appropriate leaders, managers, and support personnel. The project champion conducts a preliminary investigation and organizes team members, who define the desired performance through consensus, establish data collection and analysis procedures, and prepare to launch the project. Once launched, the QuIC project process follows an execution period that is divided into four phases: (a) project launch phase, (b) support phase, (c) transition phase, and (d) maintenance phase. The first three phases focus on education, group-level feedback, and individual feedback, respectively. Weekly audits are performed to track performance improvement. Data collection, analysis, and dissemination processes are automated to the extent possible. To date, four such projects have been successfully conducted. The QuIC project concept is an attempt to apply the principles of process improvement to the process of process improvement by enabling any member of a radiology department to efficiently and reliably spearhead a quality improvement project. We consider this to be a work in progress and continue to refine the process with the goal of eventually being able to conduct many projects simultaneously. PMID:23988633

Hawkins, C Matthew; Alsip, Christopher N; Pryor, Rebecca M; Leach, Alan D; Larson, David B

2013-01-01

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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

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Quality Improvement Initiative Reduces Serious Safety Events in Pediatric Hospital Patients  

Science.gov (United States)

... Newsroom Publication # 13-RA008 Go to Online Store Quality improvement initiative reduces serious safety events in pediatric hospital patients Patient Safety and Quality During the last 10 years, hospitals have implemented ...

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Initial Steps for Quality Improvement of Obesity Care Across Divisions at a Tertiary Care Pediatric Hospital  

OpenAIRE

Background: Pediatric subspecialists can participate in the care of obese children. Objective: To describe steps to help subspecialty providers initiate quality improvement efforts in obesity care. Methods: An anonymous patient data download, provider surveys and interviews assessed subspecialty providers’ identification and perspectives of childhood obesity and gathered information on perceived roles and care strategies. Participating divisions received summary analyses of quantitative and...

Chang, Sheila Z.; Beacher, Daniel R.; Soyang Kwon; Mccarville, Megan A.; Binns, Helen J.; Ariza, Adolfo J.

2014-01-01

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The ethical review of health care quality improvement initiatives: findings from the field.  

Science.gov (United States)

Questions have been raised about whether and how health care quality improvement (QI) initiatives ought to be reviewed to address possible ethical issues associated with them. These questions have focused primarily on whether some QI initiatives meet the regulatory criteria for human subject research and should therefore be regulated and reviewed as such. Based on surveys of health care system professionals conducting QI initiatives and hospital CEOs, this issue brief finds that QI initiatives are routinely reviewed by a variety of internal mechanisms prior to implementation, although rarely through an institutional review board or another independent body charged specifically with ethical oversight of QI initiatives. Further research, the authors say, is needed to achieve a better understanding of how review mechanisms for QI initiatives are structured, including information on who reviews these activities, how they are reviewed, and whether such processes include an ethical assessment of the proposed QI initiative. PMID:20726137

Taylor, Holly A; Pronovost, Peter J; Faden, Ruth R; Kass, Nancy E; Sugarman, Jeremy

2010-08-01

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

Science.gov (United States)

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

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

2013-01-01

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

OpenAIRE

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...

Globenko, Anna; Sianova, Zinaida

2012-01-01

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

LENUS (Irish Health Repository)

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.

Ennis, Linda

2014-09-09

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Evaluation of a multidimensional cystic fibrosis transition program: a quality improvement initiative.  

Science.gov (United States)

The adequate preparation of cystic fibrosis (CF) youth for the transfer from pediatric to adult-based health care services is essential to meet the needs of this changing population. This paper describes the evolution of a transition clinic for patients with CF into a multidimensional quality improvement transition initiative. Three transition interventions (a patient transition clinical pathway; collaboration with the adult clinic; and a tool to measure transfer readiness) were sequentially implemented and evaluated. Each was found to be a valuable addition to a comprehensive transition protocol and today are endorsed as part of transition best practices. PMID:25089835

Gravelle, Anna M; Paone, Mary; Davidson, A George F; Chilvers, Mark A

2015-01-01

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Application of quality-improvement methods in a community practice: the Sandhills Pediatrics Asthma Initiative.  

Science.gov (United States)

This case study demonstrates the use of quality improvement methods to improve asthma care in a busy community practice. The practice used disease-management strategies, such as population identification, self-management education, and performance measurement and feedback. The practice then applied several practice-based quality improvement methods, such as PDSA cycles, to improve care. From 1998 to 2003, process measures, such as staging of asthmatics, use of long-term control medications, use of peak flow meters and spacers, and use of action plans, improved. There was also a substantial decrease in emergency department use and hospitalizations among patients with asthma. Although there have been several studies demonstrating the efficacy of disease management strategies, most lack generalizability to community practices. Often, interventions are so intensive and cumbersome, that they are unlikely to be replicated in primary care setting. Researchers have been unable to determine which components of the interventions are most effective and replicable. Furthermore, many studies of disease management strategies enroll participants who lack the co-morbidities seen in community practice. There are also few studies of disadvantaged populations that face other barriers to care, such as lack of transportation, poor access to specialists, and medical illiteracy. In this case study, there were several unique factors that enabled the practice to improve care for this population. The AccessCare case manager who worked with the practice not only provided data and feedback to the practice team, but also served as an improvement "coach," often pushing the team and facilitating many of the improvement efforts. AccessCare's approach is in contrast to many of the commercial disease management companies' "carve out" models that do not sufficiently involve providers or practices in their interventions. The other necessary ingredient for success in this project was organizational leadership and support. The leaders of the practice saw beyond the usual metrics of patient visit counts and relative value units (RVUs) to embrace the concept of population health: the notion that practices are not only responsible for providing acute, episodic care in the office, but also for improving health outcomes in the community in which they serve. Other important factors included ensuring a basic agreement among providers on the need for improvement and frequent communication about the goals of the project. Although the champions of the project tried to minimize formal meeting time, there was frequent informal communication between team members. In the future, there is a need to develop other approaches to stimulate these endeavors in community practices, such as "pay for performance" programs, continuing education credit, and tying maintenance of board certification to quality improvement initiatives. PMID:16130947

Wroth, Thomas H; Boals, Joseph C

2005-01-01

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Quality improvement.  

Science.gov (United States)

Ready to Lead at tinyurl.com/pd9mmuy is a collection of a short series of articles by senior improvement manager at Healthcare Improvement Scotland Steven Wilson. The collection is aimed at drawing out some of the key behaviours, skills and attributes necessary for successful quality improvement leadership. It is not intended as a comprehensive examination, but offers some alternative and creative ideas about what makes effective quality improvement leaders. PMID:25355123

2014-10-30

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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)

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.

Palmer Laura

2003-05-01

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

Science.gov (United States)

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

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

2014-03-01

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

Science.gov (United States)

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

Spielberger, Julie; Lockaby, Tracey

2008-01-01

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Impact of the breast cancer care measures pilot study on quality-improvement initiatives.  

Science.gov (United States)

As a participant in the ONS Foundation-supported Breast Cancer Care Quality Measures Set in 2010, the Edward Cancer Center (ECC) identified gaps in patient assessment. Sleep-wake disturbance and distress were two common areas that were lacking consistent assessment when nurses saw patients during their visits. Another issue is the lack of standard methods of practice or a standardized tool. The ECC, in collaboration with Edward Diabetes Center, Linden Oaks Hospital, and other outpatient offices, adopted the use of the Patient Health Questionnaire-9 depression screening tool. The ECC also modified the intervention recommendations to meet the needs of the oncology population. As a result of the findings in the pilot, the ECC was able to implement an evidence-based practice change to improve the overall quality of patient care and provide earlier intervention in an effort to further improve patient outcomes. PMID:25252986

McGovern-Phalen, Amy M

2014-10-01

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Initial tests of planar permanent magnet (PM) quadrupoles with improved high-quality field apertures  

International Nuclear Information System (INIS)

In recent years studies have been undertaken on a new class of multipoles consisting of cuboid planar permanent magnet (PM) pieces arranged in bi-planar arrays of 2-fold rotational symmetry. The bi-planarity, while geometrically allowing for the development of miniaturized machine field lattices and long short-period insertion devices with fully open horizontal apertures, also generates high levels of harmonics of the fundamental multipole order in the vicinity of the axis. To circumvent this effect, an algorithm for economically removing these higher harmonics has been recently proposed and quadrupoles based on this approach have been designed at the Stanford Synchrotron Radiation Laboratory (SSRL) and fabricated out of NdFe/B. In this paper we report on initial field measurements of these improved structures carried out at the Magnetic Measurements Laboratory at SLAC

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Shared medical appointments to screen for geriatric syndromes: preliminary data from a quality improvement initiative.  

Science.gov (United States)

Older adults are at greater risk of developing conditions that affect health outcomes, quality of life, and costs of care. Screening for geriatric conditions such as memory loss, fall risk, and depression may contribute to the prevention of adverse physical and mental comorbidities, unnecessary hospitalizations, and premature nursing home admissions. Because screening is not consistently performed in primary care settings, a shared medical appointment (SMA) program was developed to fill this gap in care. The goals of the program were to improve early identification of at-risk individuals and ensure appropriate follow-up for memory loss, fall risk, and depression; facilitate discussion about prevention, diagnosis, and treatment of these conditions; implement strategies to reduce risks for these conditions; and increase access to screening and expand preventive health services for older adults. Between August 2011 and May 2013, 136 individuals aged 60 and older participated in the program. Three case studies highlighting the psychosocial and physiological findings of participation in the program are presented. Preliminary data suggest that SMAs are an effective model of regularly screening at-risk older adults that augments primary care practice by facilitating early detection and referral for syndromes that may otherwise be missed or delayed. PMID:25440111

May, Suepattra G; Cheng, Peter H; Tietbohl, Caroline K; Trujillo, Laurel; Reilly, Kelly; Frosch, Dominick L; Lin, Grace A

2014-12-01

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

International Nuclear Information System (INIS)

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

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

Science.gov (United States)

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

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

2012-01-01

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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.

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C-A2-04: The Geisinger Transitions of Care Initiative: Overview of an Interdisciplinary Quality Improvement Process  

OpenAIRE

Background: Care transitions between inpatient and outpatient providers are quickly becoming a surrogate marker of quality for care of the hospitalized patient. Almost one in six (17.6%) Medicare patients are readmitted within 30 days of hospital discharge. As a result the Centers for Medicare and Medicaid Services (CMS) is targeting readmissions as a probable marker for both poor quality of care and money going down the drain. The Geisinger Transitions of Care Initiative (TOCI) focuses on cr...

Bulger, John B.; Maynor, Kenric A.; Frazier, Seth

2010-01-01

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Hospital quality improvement initiative for patients with acute coronary syndromes in China: a cluster randomized, controlled trial.  

Science.gov (United States)

Background- Substantial evidence-practice gaps exist in the management of acute coronary syndromes (ACS) in China. Clinical pathways are tools for improving ACS quality of care but have not been rigorously evaluated. Methods and Results- Between October 2007 and August 2010, a quality improvement program was conducted in 75 hospitals throughout China with mixed methods evaluation in a cluster randomized, controlled trial. Eligible hospitals were level 2 or level 3 centers routinely admitting >100 patients with ACS per year. Hospitals were assigned immediate implementation of the American Heart Association/American College of Cardiology guideline based clinical pathways or commencement of the intervention 12 months later. Outcomes were several key performance indicators reflecting the management of ACS. The key performance indicators were measured 12 months after commencement in intervention hospitals and compared with baseline data in control hospitals, using data collected from 50 consecutive patients in each hospital. Pathway implementation was associated with an increased proportion of patients discharged on appropriate medical therapy, with nonsignificant improvements or absence of effects on other key performance indicators. Conclusions- Among hospitals in China, the use of a clinical pathway for the treatment of ACS compared with usual care improved secondary prevention treatments, but effectiveness was otherwise limited. An accompanying process evaluation identified several health system barriers to more successful implementation. Clinical Trial Registration- URL: http://www.anzctr.org.au/default.aspx. Unique identifier: ACTRN12609000491268. PMID:24619325

Du, Xin; Gao, Runlin; Turnbull, Fiona; Wu, Yangfeng; Rong, Ye; Lo, Serigne; Billot, Laurent; Hao, Zhixin; Ranasinghe, Isuru; Iedema, Rick; Kong, Lingzhi; Hu, Dayi; Lin, Shuguang; Shen, Weifeng; Huang, Dejia; Yang, Yuejing; Ge, Junbo; Han, Yaling; Lv, Shuzheng; Ma, Aiqun; Gao, Wei; Patel, Anushka

2014-03-01

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Measuring and Improving Value of Care in Oncology Practices: ASCO Programs from Quality Oncology Practice Initiative to the Rapid Learning System.  

Science.gov (United States)

Rising cancer care costs are no longer sustainable. Medical oncologists must focus on providing the maximum value to their patients; improving short-term, intermediate and long-term outcomes; and managing overall costs. Accurate measurement of outcomes and overall cost is essential to informing providers and institutions and in the quest for continuous improvement in value. The ASCO Quality Oncology Practice Initiative (QOPI) is an excellent tool for sampling processes of care in medical oncology practices. To achieve the larger goal of improving the value of cancer care, ASCO is investing in the development of a Rapid Learning System, which will leverage emerging information technologies to more accurately measure outcomes (including those reported by the patient) and costs, resulting in highly efficient, effective, and safe cancer care. PMID:24451835

Jacobson, Joseph O; Neuss, Michael N; Hauser, Robert

2012-01-01

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Development and implementation of a medical oncology quality improvement tool for a regional community oncology network: the Fox Chase Cancer Center Partners initiative.  

Science.gov (United States)

Fox Chase Cancer Center Partners (FCCCP) is a community hospital/academic partnership consisting of 25 hospitals in the Delaware Valley. Originally created in 1986, FCCCP promotes quality community cancer care through education, quality assurance, and access to clinical trial research. An important aspect of quality assurance is a yearly medical oncology audit that benchmarks quality indicators and guidelines and provides a roadmap for quality improvement initiatives in the community oncology clinical office setting. Each year, the FCCCP team and the Partner Medical Oncologists build disease site- and stage-specific indicators based on National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology. Concordance with multiple indicators is assessed on 20 charts from each community practice. A report for each FCCCP medical oncology practice summarizes documentation, screening recommendations, new drug use, and research trends in a particular disease site. Descriptive statistics reflect indicators met, number of new cases seen per year, number of disease site cases from tumor registry information, and clinical trial accrual total. Education and documentation tools are provided to physicians and oncology office nursing staff. The FCCCP Clinical Operations Team, consisting of medical oncologists and oncology-certified nurses, has conducted quality audits in medical oncology offices for 7 years using NCCN-derived indicators. Successful audits comprising gastric, colorectal, and breast cancer have been the focus of recent evaluations. For the 2005 stage II/III breast cancer evaluation, mean compliance per parameter was 88%, with 15 of 16 practices achieving mean compliance greater than 80%. A large-scale quality assurance audit in a community cancer partner network is feasible. Recent evaluation of localized breast cancer shows high compliance with guidelines and identifies areas for focused education. Partnership between academic and community oncologists produces a quality review process that is broadly applicable and adaptable to changing medical knowledge. PMID:17977500

O'Grady, Margaret A; Gitelson, Elena; Swaby, Ramona F; Goldstein, Lori J; Sein, Elaine; Keeley, Patricia; Miller, Bonnie; Li, Tianyu; Weinstein, Alan; Cohen, Steven J

2007-10-01

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Innovative solutions: beds, baths, and bottoms: a quality improvement initiative to standardize use of beds, bathing techniques, and skin care in a general critical-care unit.  

Science.gov (United States)

As a quality improvement initiative, nurses in a general critical-care unit at a Midwest hospital constructed a plan for interventional hygiene. A nationally recognized nursing expert inspired the theoretical framework used as a basis for the initiative. A critical-care nursing clinical excellence team examined the current state and developed, implemented, and evaluated the interventional hygiene plan. Goals included standardizing bathing procedures and use of beds and reducing nosocomial infections and incontinence-associated dermatitis in critically ill adults. During the evaluation period, incidence of unit-acquired methicillin-resistant Staphylococcus aureus and incontinence-associated dermatitis decreased. Nurses reported favorable reviews for new skin care products and decreased nursing time associated with bathing. PMID:21478715

Eigsti, Janice E

2011-01-01

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SQIMSO: Quality Improvement for Small Software Organizations  

Directory of Open Access Journals (Sweden)

Full Text Available 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 major issues. The first issue is that every improvement program should be wide enough to include the three main trends. The second issue is that any process quality model should answer the question ?How to do? things. The third issue is that any suggested quality model should be cost-effective and practical enough to be implemented by small software organizations. SQIMSO also draws upon international quality standards, models, experiences and on a local field survey.

Rabih Zeineddine

2005-01-01

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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)

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.

Verstraelen Hans

2008-01-01

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Shipbuilding pipeline production quality improvement  

OpenAIRE

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...

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

2010-01-01

30

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

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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)

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.

Marsteller Jill A

2011-10-01

32

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 ( ...

33

Hanford Tanks Initiative quality assurance implementation plan  

International Nuclear Information System (INIS)

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

34

Power Quality Improvement Using UPQC  

OpenAIRE

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

Kalaipriya, K.; Jayachitra, S.

2014-01-01

35

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)

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 improved pre-operative status and shorter duration of mechanical ventilation. The significance of such associations merits further study. PMID:25135602

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

36

The Improvement of Services Quality  

Directory of Open Access Journals (Sweden)

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

Cristian-?tefan Craciun

2013-01-01

37

Shipbuilding pipeline production quality improvement  

Directory of Open Access Journals (Sweden)

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.

T. Buksa

2010-06-01

38

Power Quality Improvement Using UPQC  

Directory of Open Access Journals (Sweden)

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.

K. Kalaipriya

2014-05-01

39

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

40

Recommendations for evaluation of health care improvement initiatives.  

Science.gov (United States)

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

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

2013-01-01

41

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

42

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

43

Strategy to Support Improvement of Healthcare Quality.  

Directory of Open Access Journals (Sweden)

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.

Ing. Andrea Zejdlova

2013-01-01

44

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)

45

Finding a balance between "value added" and feeling valued: revising models of care. The human factor of implementing a quality improvement initiative using Lean methodology within the healthcare sector.  

Science.gov (United States)

Growing demand from clients waiting to access vital services in a healthcare sector under economic constraint, coupled with the pressure for ongoing improvement within a multi-faceted organization, can have a significant impact on the front-line staff, who are essential to the successful implementation of any quality improvement initiative. The Lean methodology is a management system for continuous improvement based on the Toyota Production System; it focuses on two main themes: respect for people and the elimination of waste or non-value-added activities. Within the Lean process, value-added is used to describe any activity that contributes directly to satisfying the needs of the client, and non-value-added refers to any activity that takes time, space or resources but does not contribute directly to satisfying client needs. Through the revision of existing models of service delivery, the authors' organization has made an impact on increasing access to care and has supported successful engagement of staff in the process, while ensuring that the focus remains on the central needs of clients and families accessing services. While the performance metrics continue to exhibit respectable results for this strategic priority, further gains are expected over the next 18-24 months. PMID:22008575

Deans, Rachel; Wade, Shawna

2011-01-01

46

Analyzing and Improving Data Quality  

OpenAIRE

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...

Buccella, Agustina; Cechich, Alejandra; Domingo, Gonzalo

2008-01-01

47

Ways of castings quality improvement  

International Nuclear Information System (INIS)

By the method of mathematical statistics at computer studied is the dependence of hot cracking in steam turbine castings made of 15KhM1FL steel on chemical composition and on the melting procedure (duration of oxidating and reducing periods, regime of carbon oxidation, preliminary deoxidation of metal, etc.). On the basis of results of statistical and experimental studies the melting procedure for the 15Kh1MFL steel has been modified and the optimum chemical composition, providing maximum crack resistance, has been recommended. It is found that metal quality can be sufficiently improved at the expense of its refining with synthetic slag in the ladle. Metal, treated with synthetic slag, has transition temperature lower in 20 deg C than that, melted according to the existing technology. Long-term plasticity of the 15Kh1M1FL steel treated with synthetic slag, is 20% higher than the usual one, at the same level of long-term strength at test temperature of 565 deg C that is important for service reliability of castings

48

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

49

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)

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

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

2012-06-01

50

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

Science.gov (United States)

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

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

2014-10-01

51

Improving Quality using Testing Strategies  

Directory of Open Access Journals (Sweden)

Full Text Available 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 technique and various attributes of software quality are explained. Identifying the types of testing that can be applied for checking a particular quality attribute is the aim of this thesis report. All types of testing can not be applied in all phases of software development life cycle. Which testing types are applicable in which phases of life cycle of software development is also summarized

Sahil Batra

2011-07-01

52

Changing quality initiative - does the quality profile really change?  

OpenAIRE

A firm working with quality management over time may change from total quality management to Six Sigma to lean production, but does this actually change the firm's quality profile? This paper seeks to identify specific quality profiles in service firms and how these profiles change over time. The empirical investigation is based on self-assessment studies conducted in 138 Swedish service firms. The results show that service firms often build up a specific quality profile, which they retain ov...

Johansson, Elisabeth; Witell, Lars; Elg, Mattias

2013-01-01

53

MEASURES TO IMPROVE WATER QUALITY  

OpenAIRE

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

Sa?mbotin, L.; Moisa, S.; DANA SÂMBOTIN; ANA MARIANA DINCU; Ilie, C.

2010-01-01

54

MEASURES TO IMPROVE WATER QUALITY  

Directory of Open Access Journals (Sweden)

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

L. SÂMBOTIN

2010-05-01

55

The impact of leadership qualities on quality management improvement  

Directory of Open Access Journals (Sweden)

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

Radoslaw Wolniak

2011-12-01

56

The impact of leadership qualities on quality management improvement  

Directory of Open Access Journals (Sweden)

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

Ph. D. Radoslaw Wolniak

2011-05-01

57

Power theories for improved power quality  

CERN Document Server

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

Benysek, Grzegorz

2012-01-01

58

Power Quality Improvement Using DVR  

Directory of Open Access Journals (Sweden)

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.

C. Benachaiba

2009-01-01

59

Improving quality of cancer care through surgical audit  

OpenAIRE

Abstract 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...

Gijn, W.; Velde, C. J. H.

2010-01-01

60

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)

61

Quality and Profitability improvement by Technical Audit  

Directory of Open Access Journals (Sweden)

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

Prof. Srivastava S. B.

2009-10-01

62

Creating effective quality-improvement collaboratives: A multiple case study  

OpenAIRE

Objective: To explore whether differences between collaboratives with respect to type of topic, type of targets, measures (systems) are also reflected in the degree of effectiveness. Study setting: 182 teams from long-term healthcare organisation developed improvement initiatives in seven quality-improvement collaboratives (QICs) focusing on patient safety and autonomy. Study design: Multiple case before-after study. Data collection: 75 team leaders completed a written questionnaire at the en...

Strating, M. M. H.; Nieboer, A. P.; Zuiderent-jerak, T.; Bal, R. A.

2011-01-01

63

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)

64

Melatonin improves sleep quality in hemodialysis patients  

OpenAIRE

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

Edalat-nejad, M.; Haqhverdi, F.; Hossein-tabar, T.; Ahmadian, M.

2013-01-01

65

42 CFR 422.152 - Quality improvement program.  

Science.gov (United States)

...effectiveness of its quality improvement program. (3) Remedial...SNP must conduct a quality improvement program that— (1...or treatment). (ii) Improvement in beneficiary health status...for example, quality of life indicators, depression...

2010-10-01

66

45 CFR 1304.60 - Deficiencies and quality improvement plans.  

Science.gov (United States)

...Deficiencies and quality improvement plans. 1304.60 Section...PROGRAM PROGRAM PERFORMANCE STANDARDS FOR THE...Deficiencies and quality improvement plans. (a) Early...pursuant to a Quality Improvement Plan. (c) An...

2010-10-01

67

Quality improvement program in an emergency department.  

OpenAIRE

OBJECTIVES To describe the quality assurance/improvement program in our emergency department ED. METHODS This program involved monthly data collection and analysis, data-driven process change, staff education in the core concepts of quality, and data reanalysis from the years 2003 to 2006 at the King Abdul-Aziz Hospital, Al-Ahsa, Kingdom of Saudi Arabia. Data captured during the program included census data, chart review, and focused cl...

Rifat Rehmani; Amatullah, Amira F.

2008-01-01

68

Does Audit Improve the Quality of Care?  

Directory of Open Access Journals (Sweden)

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.

Areti Tsaloglidou

2009-01-01

69

Project Hanford management contract quality improvement project management plan  

Energy Technology Data Exchange (ETDEWEB)

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

ADAMS, D.E.

1999-03-25

70

Fostering Quality Improvement in EHDI Programs  

Science.gov (United States)

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…

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

2011-01-01

71

In search of excellence—the Neonatal Intensive Care Quality Improvement Collaborative  

OpenAIRE

As part of its effort to improve the quality of care in the neonatal intensive care unit at Baylor University Medical Center (BUMC), the unit has participated in the Vermont Oxford Network. This network tracks outcomes and pools data, allowing comparisons and benchmarking. A group of 34 nurseries from the Vermont Oxford Network has collaborated in an innovative quality improvement initiative. This article describes this initiative, called the Neonatal Intensive Care Quality Collaborative 2000...

Whitfield, Jonathan; Charsha, Dianne; Sprague, Pam

2001-01-01

72

The impact of leadership qualities on quality management improvement  

OpenAIRE

Currently, the importance of leadership is considered more and more often in quality management. The need of an appropriate leader has been already emphasized in ISO 9000 standards, in TQM philosophy as well as in different models of improvement which are used in the methodologies of prizing quality. Yet, it is in the concept of TQL where the attitude based on the need of leadership in an organization has achieved its best-developed, full shape. On the basis of the conducted studies, the foll...

Radoslaw Wolniak

2011-01-01

73

Pediatric collaborative networks for quality improvement and research.  

Science.gov (United States)

Despite efforts of individual clinicians, pediatric practices, and institutions to remedy continuing deficiencies in pediatric safety and health care quality, multiple gaps and disparities exist. Most pediatric diseases are rare; thus, few practices or centers care for sufficient numbers of children, particularly in subspecialties, to achieve large and representative sample sizes, and substantial between-site variation in care and outcomes persists. Pediatric collaborative improvement networks are multi-site clinical networks that allow practice-based teams to learn from one another, test changes to improve quality, and use their collective experience and data to understand, implement, and spread what works in practice. The model was initially developed in 2002 by an American Board of Pediatrics Workgroup to accelerate the translation of evidence into practice, improve care and outcomes for children, and to serve as the gold standard for the performance in practice component of Maintenance of Certification requirements. Many features of an improvement network derive from the Institute for Healthcare Improvement's collaborative improvement model Breakthrough Series, including focus on a high-impact condition or topic; providing support from clinical content and quality improvement experts; using the Model for Improvement to set aims, use data for feedback, and test changes iteratively; providing infrastructure support for data collection, analysis and reporting, and quality improvement coaching; activities to enhance collaboration; and participation of multidisciplinary teams from multiple sites. In addition, they typically include a population registry of the children receiving care for the improvement topic of interest. These registries provide large and representative study samples with high-quality data that can be used to generate information and evidence, as well as to inform clinical decision making. In addition to quality improvement, networks serve as large-scale health system laboratories, providing the social, scientific, and technical infrastructure and data for multiple types of research. Statewide, regional, and national pediatric collaborative networks have demonstrated improvements in primary care practice as well as care for chronic pediatric diseases (eg, asthma, cystic fibrosis, inflammatory bowel disease, congenital heart disease), perinatal care, and patient safety (eg, central line-associated blood stream infections, adverse medication events, surgical site infections); many have documented improved outcomes. Challenges to spreading the improvement network model exist, including the need for the identification of stable funding sources. However, these barriers can be overcome, allowing the benefits of improved care and outcomes to spread to additional clinical and safety topics and care processes for the nation's children. PMID:24268088

Lannon, Carole M; Peterson, Laura E

2013-01-01

74

Strategy to Support Improvement of Healthcare Quality.  

OpenAIRE

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...

Ing. Andrea Zejdlova

2013-01-01

75

Pediatric CT quality management and improvement program.  

Science.gov (United States)

Modern CT is a powerful yet increasingly complex technology that continues to rapidly evolve; optimal clinical implementation as well as appropriate quality management and improvement in CT are challenging but attainable. This article outlines the organizational structure on which a CT quality management and improvement program can be built, followed by a discussion of common as well as pediatric-specific challenges. Organizational elements of a CT quality management and improvement program include the formulation of clear objectives; definition of the roles and responsibilities of key personnel; implementation of a technologist training, coaching and feedback program; and use of an efficient and accurate monitoring system. Key personnel and roles include a radiologist as the CT director, a qualified CT medical physicist, as well as technologists with specific responsibilities and adequate time dedicated to operation management, CT protocol management and CT technologist education. Common challenges in managing a clinical CT operation are related to the complexity of newly introduced technology, of training and communication and of performance monitoring. Challenges specific to pediatric patients include the importance of including patient size in protocol and dose considerations, a lower tolerance for error in these patients, and a smaller sample size from which to learn and improve. PMID:25304715

Larson, David B; Molvin, Lior Z; Wang, Jia; Chan, Frandics P; Newman, Beverley; Fleischmann, Dominik

2014-10-01

76

Pediatric CT quality management and improvement program  

Energy Technology Data Exchange (ETDEWEB)

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

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

2014-10-15

77

Pediatric CT quality management and improvement program  

International Nuclear Information System (INIS)

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

78

Quantitative data management in quality improvement collaboratives  

Directory of Open Access Journals (Sweden)

Full Text Available 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, however, has proved to be difficult. This paper provides a retrospective analysis on the process of data management in a Dutch Quality Improvement Collaborative. From this analysis general failure and success factors are identified. Discussion This paper discusses complications and dilemma's observed in the set-up of data management for QICs. An overview is presented of signals that were picked up by the data management team. These signals were used to improve the strategies for data management during the program and have, as far as possible, been translated into practical solutions that have been successfully implemented. The recommendations coming from this study are: From our experience it is clear that quality improvement programs deviate from experimental research in many ways. It is not only impossible, but also undesirable to control processes and standardize data streams. QIC's need to be clear of data protocols that do not allow for change. It is therefore minimally important that when quantitative results are gathered, these results are accompanied by qualitative results that can be used to correctly interpret them. Monitoring and data acquisition interfere with routine. This makes a database collecting data in a QIC an intervention in itself. It is very important to be aware of this in reporting the results. Using existing databases when possible can overcome some of these problems but is often not possible given the change objective of QICs. Introducing a standardized spreadsheet to the teams is a very practical and helpful tool in collecting standardized data within a QIC. It is vital that the spreadsheets are handed out before baseline measurements start.

Bal Roland

2009-09-01

79

Quantitative data management in quality improvement collaboratives  

Science.gov (United States)

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, however, has proved to be difficult. This paper provides a retrospective analysis on the process of data management in a Dutch Quality Improvement Collaborative. From this analysis general failure and success factors are identified. Discussion This paper discusses complications and dilemma's observed in the set-up of data management for QICs. An overview is presented of signals that were picked up by the data management team. These signals were used to improve the strategies for data management during the program and have, as far as possible, been translated into practical solutions that have been successfully implemented. The recommendations coming from this study are: From our experience it is clear that quality improvement programs deviate from experimental research in many ways. It is not only impossible, but also undesirable to control processes and standardize data streams. QIC's need to be clear of data protocols that do not allow for change. It is therefore minimally important that when quantitative results are gathered, these results are accompanied by qualitative results that can be used to correctly interpret them. Monitoring and data acquisition interfere with routine. This makes a database collecting data in a QIC an intervention in itself. It is very important to be aware of this in reporting the results. Using existing databases when possible can overcome some of these problems but is often not possible given the change objective of QICs. Introducing a standardized spreadsheet to the teams is a very practical and helpful tool in collecting standardized data within a QIC. It is vital that the spreadsheets are handed out before baseline measurements start. PMID:19781101

van den Berg, Mireille; Frenken, Rianne; Bal, Roland

2009-01-01

80

42 CFR 441.474 - Quality assurance and improvement plan.  

Science.gov (United States)

...remediation and quality improvement in order to learn of critical...pursue opportunities for system improvement. (b) The quality assurance and improvement plan shall also describe the system performance measures, outcome...

2010-10-01

81

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

Directory of Open Access Journals (Sweden)

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

Groene Oliver

2011-12-01

82

A Model to Improve the Quality Products  

Directory of Open Access Journals (Sweden)

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.

Hasan GOKKAYA

2010-08-01

83

Improvements in geomagnetic observatory data quality  

DEFF Research Database (Denmark)

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.

Reda, Jan; Fouassier, Danielle

2011-01-01

84

A Method to Report Utilization for Quality Initiatives in Medical Facilities  

OpenAIRE

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...

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

2001-01-01

85

Quality assurance of X-ray equipment: An inventory of initiatives in the Netherlands and abroad  

OpenAIRE

The inventory of current initiatives for the Quality Assurance (QA) and Quality Control (QC) of X-ray equipment reported was undertaken in response to a need for improvement in the QA of radiology departments expressed by the Dutch Health Care Inspectorate. Work on building the inventory started with a literature study and was further developed with the results of interviews with Dutch professionals and survey results from foreign experts. The inventory has led us to a numbe...

Bijwaard H; Mjp, Brugmans

2007-01-01

86

MOBILITY LEARNING METHODOLOGY FOR EDUCATION QUALITY IMPROVEMENT  

OpenAIRE

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...

Liviu Moldovan

2012-01-01

87

Improvement of organic apple quality and storability  

OpenAIRE

Improvements in yield and quality by increasing the light distribution and carbohydrate uptake (summer pruning and ground covering), optimizing the physiological state of harvested fruit (cultivar-specific harvesting indices), postharvest fruit protection (treatment with hot water and ethanol, respectively) and optimizing storage conditions (cultivar-specific CA and ULO storage procedures) were investigated in a set of eight organically grown apple cultivars. A combination of summer pruning a...

Tahir, Ibrahim

2012-01-01

88

Improvements in geomagnetic observatory data quality  

OpenAIRE

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 ...

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

2011-01-01

89

Quality-improving alliances in differentiated oligopoly  

OpenAIRE

We study rival firms' incentives in quality-improving Research and Development (R&D) networks. The analysis stresses the role of free riding associated to collaboration and three major consequences emerge: R&D efforts decrease with the number of partners, networks of alliances are over-connected as compared to the social optimum and the profitmaximizing number of alliances is possibly non monotonic (decreasing then increasing) with respect to inverse measure of product differentiation.

Deroian, Fre?de?ric; Gannon, Fre?de?ric

2006-01-01

90

Goal hierarchy: Improving asset data quality by improving motivation  

International Nuclear Information System (INIS)

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 furthers understanding. ? Looks at the multiple goals of each individual to determine their behavior.

91

Goal hierarchy: Improving asset data quality by improving motivation  

Energy Technology Data Exchange (ETDEWEB)

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.

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

92

HCFA's Health Care Quality Improvement Program and the Cooperative Cardiovascular Project.  

Science.gov (United States)

The Health Care Financing Administration (HCFA) is changing the direction of its quality assessment and improvement program from one that tries to identify and cull "bad apples" to one that tries to improve the mainstream of care. This strategy change is known as the "Health Care Quality Improvement Program." An important aspect of this strategy change is to develop a partnership with providers that will ensure the provision of quality improvement information that is valid and useful to them. The Health Care Quality Improvement Program consists of both quality improvement projects and a series of quality indicators. The Medicare Quality Indicator System will develop a small number of indicators or appropriateness criteria for each major medical condition that affects Medicare beneficiaries. This national monitoring system has three primary goals: (1) to track trends in the quality of care over time and in variations in the quality of care across regions; (2) to provide the basis for making decisions on where it would be appropriate to carry out quality-of-care improvement projects; and (3) to support the execution of these projects. Quality improvement projects are cooperative efforts designed to improve a specific aspect of care. The Cooperative Cardiovascular Project is an early quality improvement project focusing initially on acute myocardial infarction; it will later focus on coronary artery bypass grafting and percutaneous coronary artery angioplasty. PMID:7979782

Jencks, S F

1994-12-01

93

Improvement of image quality in MR cholangiography  

International Nuclear Information System (INIS)

Purpose: To improve the image quality of magnetic resonance cholangiopancreaticography (MRCP) by modification of examination conditions. Materials and Methods: MRCP of 72 patients was performed with a 1.5 T system (Magnetom Vision, Siemens, 25 mT/m) using two breath-hold techniques, half-fourier acquisition with multislice T2-WI HASTE in MIP technique, and single shot T2-WI turbo-spin-echo (RARE) with different slice thicknesses. The effects of n-butylscopolamine were assessed. Furthermore, oral contrast agents [barium sulfate, Fe(II)-gluconate, Fe(II, III)-oxide] in various concentrations were used. The slice thickness was varied for the RARE sequence (3-7 cm). Results: N-butylscopolamine had no influence on image quality. Improvements could be attained by variation of the slice thickness. A significant reduction of disturbing background noise was obtained by oral application of iron gluconate, or iron oxide-containing contrast media. Similar improvements were achieved with barium sulfate. Conclusions: Variation of slice thickness allows an improvement of MRCP. The expense of contrast media may be a determinant of choice. (orig.)

94

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

95

Project Hanford management contract quality improvement project management plan; TOPICAL  

International Nuclear Information System (INIS)

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

96

Lessons learned from building a culture and infrastructure for continuous quality improvement at Cabarrus Health Alliance.  

Science.gov (United States)

This case study describes a local public health agency's multiyear effort to establish an infrastructure and organizational culture for continuous quality improvement, using data from interviews with the agency's senior leaders, managers, and frontline staff. Lessons learned include the importance of setting stretch goals, engaging leaders at all levels of the organization, empowering frontline staff to make changes, providing quality improvement training for staff and leaders, starting with small projects first, spreading quality improvement efforts to involve all parts of the agency, and sustaining momentum by creating a supporting infrastructure for continuous quality improvement and continually initiating new projects. PMID:22139311

Randolph, Greg D; Stanley, Cappie; Rowe, Bobbie; Massie, Sara E; Cornett, Amanda; Harrison, Lisa Macon; Lea, C Suzanne

2012-01-01

97

INTERNET DATABASES IN QUALITY INFORMATION IMPROVEMENT  

Directory of Open Access Journals (Sweden)

Full Text Available Even though many important companies are reluctant into deploying their databases on the Internet, being too concerned about security, we would like to demonstrate that they shouldn’t be worried too much about it, but to try to provide information in real-time to management, boards or people who travel on companies interests. However, security is one of the most important factors that should be offered to websites and databases on the Internet. If we consider one of information quality metrics, the time between the sending of the message and the receiving, it can decrease considerably thanks to a secure, normalized and non-redundant database.Another direction of our study is the interdisciplinary approach, including the cooperation between management science, information technology and quantitative analysis in order to provide a perspective for improving information’s quality.

Cosmin TOMOZEI

2007-03-01

98

Using genomics to improve fruit quality  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: English Abstract in english 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.

Claudio, Meneses; Ariel, Orellana.

99

Increased office productivity through improved indoor air quality  

DEFF Research Database (Denmark)

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.

Fanger, Povl Ole

2002-01-01

100

42 CFR 422.152 - Quality improvement program.  

Science.gov (United States)

...to CMS information on quality and outcomes measures...private fee-for-service contracts, and...2) Mechanisms for monitoring MA enrollees that are...improvement program. (d) Quality improvement projects...knowledge or health services research; and...

2010-10-01

101

Biospecimen Reporting for Improved Study Quality (BRISQ)  

Energy Technology Data Exchange (ETDEWEB)

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

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

2010-09-02

102

Biospecimen Reporting for Improved Study Quality  

Energy Technology Data Exchange (ETDEWEB)

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

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

2010-12-27

103

Biospecimen Reporting for Improved Study Quality (BRISQ)  

Energy Technology Data Exchange (ETDEWEB)

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

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

2011-04-26

104

40 CFR 63.1035 - Quality improvement program for pumps.  

Science.gov (United States)

...the start of the quality improvement program for plant sites with...fourth year of the quality improvement program for plant sites...installation of multiple mechanical seals or equivalent, or...the period of the quality improvement program for the process...

2010-07-01

105

40 CFR 63.176 - Quality improvement program for pumps.  

Science.gov (United States)

...2010-07-01 false Quality improvement program for pumps. 63...third year of the quality improvement program for plant sites with...fourth year of the quality improvement program for plant sites...installation of multiple mechanical seals or equivalent,...

2010-07-01

106

40 CFR 65.116 - Quality improvement program for pumps.  

Science.gov (United States)

...third year of the quality improvement program for plant sites with...fourth year of the quality improvement program for plant sites...installation of multiple mechanical seals or equivalent, or...the period of the quality improvement program for the process...

2010-07-01

107

Understanding quality improvement at scale in general practice: a qualitative evaluation of a COPD improvement programme  

Science.gov (United States)

Background A growing body of knowledge exists to guide efforts to improve the organisation and delivery of health care, most of which is based on work carried out in hospitals. It is uncertain how transferable this knowledge is to primary care. Aim To understand the enablers and constraints to implementing a large-scale quality improvement programme in general practice, designed to improve care for people with chronic obstructive pulmonary disease. Design and setting A qualitative study of 189 general practices in a socioeconomically and ethnically-mixed, urban area in east London, UK. Method Twelve semi-structured interviews were conducted with people leading the programme and 17 in-depth interviews with those participating in it. Participants were local health system leaders, clinicians, and managers. A theoretical framework derived from evidence-based guidance for improvement programmes was used to interpret the findings. A complex improvement intervention took place with social and technical elements including training and mentorship, guidance, analytical tools, and data feedback. Results Practice staff wanted to participate in and learn from well-designed collaborative improvement projects. Nevertheless, there were limitations in the capacities and capabilities of the workforce to undertake systematic improvement, significant problems with access to and the quality of data, and tensions between the narrative-based generalist orientation of many primary care clinicians and the quantitative single-disease orientation that has characterised much of the quality improvement movement to date. Conclusion Improvement guidance derived largely from hospital-based studies is, for the most part, applicable to improvement efforts in primary care settings, although large-scale change in general practice presents some particular challenges. These need to be better understood and addressed if improvement initiatives are to be effective. PMID:25452538

Marshall, Martin; Mountford, James; Gamet, Kirsten; Gungor, Gulsen; Burke, Conor; Hudson, Robyn; Morris, Steve; Patel, Nishma; Koczan, Phil; Meaker, Rob; Chantler, Cyril; Roberts, Christopher Michael

2014-01-01

108

The European initiative for quality management in lung cancer care  

DEFF Research Database (Denmark)

Lung cancer is the commonest cause of cancer-related death worldwide and poses a significant respiratory disease burden. Little is known about the provision of lung cancer care across Europe. The overall aim of the Task Force was to investigate current practice in lung cancer care across Europe. The Task Force undertook four projects: 1) a narrative literature search on quality management of lung cancer; 2) a survey of national and local infrastructure for lung cancer care in Europe; 3) a benchmarking project on the quality of (inter)national lung cancer guidelines in Europe; and 4) a feasibility study of prospective data collection in a pan-European setting. There is little peer-reviewed literature on quality management in lung cancer care. The survey revealed important differences in the infrastructure of lung cancer care in Europe. The European guidelines that were assessed displayed wide variation in content and scope, as well as methodological quality but at the same time there was relevant duplication. The feasibility study demonstrated that it is, in principle, feasible to collect prospective demographic and clinical data on patients with lung cancer. Legal obligations vary among countries. The European Initiative for Quality Management in Lung Cancer Care has provided the first comprehensive snapshot of lung cancer care in Europe.

Blum, Torsten G; Rich, Anna

2014-01-01

109

Quality improvement in neurology: dementia management quality measures.  

Science.gov (United States)

Professional and advocacy organizations have long urged that dementia should be recognized and properly diagnosed. With the passage of the National Alzheimer's Project Act in 2011, an Advisory Council for Alzheimer's Research, Care, and Services was convened to advise the Department of Health and Human Services. In May 2012, the Council produced the first National Plan to address Alzheimer's disease, and prominent in its recommendations is a call for quality measures suitable for evaluating and tracking dementia care in clinical settings. Although other efforts have been made to set dementia care quality standards, such as those pioneered by RAND in its series Assessing Care of Vulnerable Elders (ACOVE), practitioners, healthcare systems, and insurers have not widely embraced implementation. This executive summary (full manuscript available at www.neurology.org) reports on a new measurement set for dementia management developed by an interdisciplinary Dementia Measures Work Group (DWG) representing the major national organizations and advocacy organizations concerned with the care of individuals with dementia. The American Academy of Neurology (AAN), the American Geriatrics Society, the American Medical Directors Association, the American Psychiatric Association, and the American Medical Association-convened Physician Consortium for Performance Improvement led this effort. The ACOVE measures and the measurement set described here apply to individuals whose dementia has already been identified and properly diagnosed. Although similar in concept to ACOVE, the DWG measurement set differs in several important ways; it includes all stages of dementia in a single measure set, calls for the use of functional staging in planning care, prompts the use of validated instruments in patient and caregiver assessment and intervention, highlights the relevance of using palliative care concepts to guide care before the advanced stages of illness, and provides evidence-based support for its recommendations and guidance on the selection of instruments useful in tracking patient-centered outcomes. It also specifies annual reassessment and updating of interventions and care plans for dementia-related problems that affect families and other caregivers as well as individuals with dementia. Here, a brief synopsis of why major reforms in healthcare design and delivery are needed to achieve substantive improvements in the quality of care is first provided, and then the final measures approved for publication, dissemination, and implementation are listed. PMID:24397784

Odenheimer, Germaine; Borson, Soo; Sanders, Amy E; Swain-Eng, Rebecca J; Kyomen, Helen H; Tierney, Samantha; Gitlin, Laura; Forciea, Mary Ann; Absher, John; Shega, Joseph; Johnson, Jerry

2014-03-01

110

Coaching for Quality Improvement: Lessons Learned from Quality Rating and Improvement Systems (QRIS). Research Brief  

Science.gov (United States)

Coaching and other on-site, individualized professional development strategies (consultation, mentoring, and technical assistance) are promising approaches to support the application of new teaching practices and overall quality improvement among practitioners in early care and education settings. This Research Brief summarizes a recent report…

Tout, Kathryn; Isner, Tabitha; Zaslow, Martha

2011-01-01

111

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

Energy Technology Data Exchange (ETDEWEB)

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.

NONE

1994-03-01

112

Applying PPM to ERP Maintenance and Continuous Improvement Initiatives  

DEFF Research Database (Denmark)

Enterprise Resource Planning Systems (ERP) has been implemented in many companies during the last decade and has gained an increasing significance. For many companies it means that the focus is no longer on how to implement the ERP system, but rather on how to maintain and improve the system to gain business benefits from the systems. However the ERP literature on how to do this is limited. The purpose of this article is to explore how Project Portfolio Management (PPM) from the Research and Development (R&D) literature can be applied to an ERP second wave context, when companies are to prioritize and select maintenance and continuous improvement initiatives. This is done by reviewing the existing literature in the fields of PPM from R&D literature and then by reviewing the existing literature about maintenance and improvement initiatives in the ERP literature, after which the two are compared and discussed using three case-studies. The paper contributes with a discussion on how PPM from R&D can be applied tomaintenance and continuous improvement initiatives in the second wave of ERP. The paper ends with arguing that emphasis needs to be given to this field, since a conscious and systematic prioritization of maintenance and improvement initiatives is believed to be able to increase business performance.

El-Tal, Nada Maria; Fonnesbæk, Majbrit

2006-01-01

113

Quality improvement act gets first antitrust test.  

Science.gov (United States)

In an opinion issued on February 20, 1990, the Federal District Court for the Central District of California summarily dismissed the claim of Dr. George M. Austin that Santa Barbara Cottage Hospital and five individual physicians conspired to suspend his hospital privileges in violation of Section 1 of the Sherman Act. The decision was based on the court's determination that the actions of the hospital and defendant physicians were immune from federal antitrust liability under the Health Care Quality Improvement Act of 1986. The case is the first test of the Act in connection with a staff privileges claim under the antitrust laws and is the first affirmance of the immunity protections of the Act. PMID:10113358

Barnes, C E

1990-01-01

114

Informatics: essential infrastructure for quality assessment and improvement in nursing.  

OpenAIRE

In recent decades there have been major advances in the creation and implementation of information technologies and in the development of measures of health care quality. The premise of this article is that informatics provides essential infrastructure for quality assessment and improvement in nursing. In this context, the term quality assessment and improvement comprises both short-term processes such as continuous quality improvement (CQI) and long-term outcomes management. This premise is ...

Henry, S. B.

1995-01-01

115

Higher fuel reliability by pellet quality improvements  

Energy Technology Data Exchange (ETDEWEB)

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.)

Zemek, Martin; Goll, Wolfgang [AREVA NP GmbH, Erlangen (Germany); Schnieders, Andreas [AREVA Advanced Nuclear Fuels GmbH, Lingen (Germany)

2011-07-01

116

Improved quality and information in thyroid scintigraphy  

International Nuclear Information System (INIS)

We compared rectilinear scanning, analogous gamma camera imaging and imaging using a gamma camera interfaced to a computer in order to determine which of these techniques is superior for thyroid scintigraphy. Forty patients with and without goitre and irregular activity distribution were imaged using each of the three techniques. The sets of three scintigrams per patient were rated by seven physicians. These ratings were statistically analysed using a new distribution-free test. Thyroid scintigraphy using a gamma camera interfaced to a computer turned out to be the best method, especially for detecting circumscribed areas of increased uptake. We conclude that this was due to a combination of the following factors: a computer matrix of 128x128 pixels in combination with an acquisition zoom of 1.5, the high count density of the scintigrams, computer-controlled documentation after data acquisition and the use of a continuous grey scale for documentation. The improved quality and information content of the scintigrams obtained using a gamma-camera/computer system could improve the diagnostic value of thyroid scintigraphy, especially when the scintigrams are also evaluated quantitatively. (orig.)

117

IMPROVEMENT OF POWER QUALITY OF A DISTRIBUTED GENERATION POWER SYSTEM  

OpenAIRE

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

Aruna Garipelly

2012-01-01

118

40 CFR 63.175 - Quality improvement program for valves.  

Science.gov (United States)

...subject to the quality improvement program...observed in each monitoring observation...light liquid service. (iii) If...remains in the quality improvement program...light liquid service. (iv) The...observed in each monitoring observation...maintenance or quality assurance...

2010-07-01

119

Driving perioperative nutrition quality improvement processes forward!  

Science.gov (United States)

Evidence supporting the important role of nutrition therapy in surgical patients has evolved, with several randomized trials and meta-analyses of randomized trials clearly demonstrating benefits. Despite this evidence, surgeons and anesthesiologists have been slow to adopt recommended practices, and the traditional dogma of delaying the initiation of and restricting the amount of nutrition during the postoperative period persists. Consequently, the nutrition therapy received by surgical patients remains suboptimal; thus, patients suffer worse clinical outcomes. Knowledge translation (KT) describes the process of moving evidence learned from clinical research, and summarized in clinical practice guidelines, to its incorporation into clinical and policy decision making. In this paper, we apply Graham et al's knowledge-to-action model to illuminate our understanding of the issues pertinent to KT in surgical nutrition. We illustrate various components of this model using empirically derived research, commentaries, and published studies from both critical care and surgical nutrition. Barriers to improving surgical nutrition practice may be related to (1) the nature of the underlying evidence and clinical practice guidelines; (2) guideline implementation factors; (3) characteristics of the health system, hospital, and surgical team; (4) provider attitudes and beliefs; and (5) patient factors (eg, type of surgery, underlying disease, and nutrition status). Interventions tailored to overcoming these barriers must be developed, evaluated, and implemented. A system of audit and feedback must guide this process and evaluate improvements over time so that every patient undergoing major surgery will have the opportunity to be optimally assessed and managed according to best nutrition practices. PMID:24009253

Heyland, Daren K; Dhaliwal, Rupinder; Cahill, Naomi E; Carli, Franco; Flum, David; Ko, Clifford; Kozar, Rosemary; Drover, John W; McClave, Stephen A

2013-09-01

120

Ambulatory and Hospital-based Quality Improvement Methods in Israel  

OpenAIRE

This review article compares ambulatory and hospital-based quality improvement methods in Israel. Data were collected from: reports of the National Program for Quality Indicators in community, the National Program for Quality Indicators in Hospitals, and from the Organization for Economic Cooperation and Development (OECD) Reviews of Health Care Quality.

Nava Blum; Dafna Halperin; Youssef Masharawi

2014-01-01

121

42 CFR 422.153 - Use of quality improvement organization review information.  

Science.gov (United States)

...ADVANTAGE PROGRAM Quality Improvement § 422.153 Use of quality improvement organization review information...acquire from quality improvement organizations...them. (b) Evaluate plan performance. (c) Ensure...

2010-10-01

122

Laboratory system strengthening and quality improvement in Ethiopia  

Directory of Open Access Journals (Sweden)

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.

Tilahun M. Hiwotu

2014-11-01

123

Improving eggshell quality at high temperatures with dietary sodium bicarbonate.  

Science.gov (United States)

Two experiments were conducted that confirmed the hypothesis that a dietary bicarbonate supplement will improve eggshell quality in hens at high temperatures as long as feed is consumed during the period of eggshell formation. End-of-lay hens were maintained on continuous light at temperatures of 30 and 35 C. Individual egg weights and shell quality measures for each hen were calculated as a proportion of the initial values determined during an acclimatization period at 25 C. Improvements in shell breaking strength in both experiments were observed as a result of supplementing control diets with 1% sodium bicarbonate (NaHCO3). This response to NaHCO3 was not a reflection of a reduced rate of lay or egg mass output, as these were similar or inferior on the control diets. Similar feed intakes on the control and NaHCO3 diets indicated that the response was not related to differences in calcium intakes. Supplements of zinc methionine and ascorbic acid proved to be inferior to NaHCO3. Improvements in egg weight were associated with the introduction of continuous lighting. PMID:9106886

Balnave, D; Muheereza, S K

1997-04-01

124

Quality procedure management for improved nuclear safety  

International Nuclear Information System (INIS)

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

125

Quality improvement in clinical documentation: does clinical governance work?  

Science.gov (United States)

Introduction The quality of nursing documentation is still a challenge in the nursing profession and, thus, in the health care industry. One major quality improvement program is clinical governance, whose mission is to continuously improve the quality of patient care and overcome service quality problems. The aim of this study was to identify whether clinical governance improves the quality of nursing documentation. Methods A quasi-experimental method was used to show nursing documentation quality improvement after a 2-year clinical governance implementation. Two hundred twenty random nursing documents were assessed structurally and by content using a valid and reliable researcher made checklist. Results There were no differences between a nurse’s demographic data before and after 2 years (P>0.05) and the nursing documentation score did not improve after a 2-year clinical governance program. Conclusion Although some efforts were made to improve nursing documentation through clinical governance, these were not sufficient and more attempts are needed. PMID:24324339

Dehghan, Mahlegha; Dehghan, Dorsa; Sheikhrabori, Akbar; Sadeghi, Masoume; Jalalian, Mehrdad

2013-01-01

126

Quality of provided care in vascular surgery : outcome assessment & improvement strategies  

OpenAIRE

The aim of this thesis was to evaluate the quality of care in vascular surgery in end-stage renal disease (ESRD) and peripheral arterial occlusive disease (PAOD): intermittent claudication (IC) and critical lower limb ischaemia (CLI) patients. Therefore firstly it focused on the improvement of the quality of perioperative patient management concerning: (1) a systematic review concerning all quality initiatives in vascular surgery was conducted, (2) an assessed of the implementation of establi...

Flu, Hans Christiaan

2010-01-01

127

How To Improve Software Quality Assurance In Developing Countries  

Directory of Open Access Journals (Sweden)

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.

Ali Javed

2012-04-01

128

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

Directory of Open Access Journals (Sweden)

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.

Jin Wang

2009-02-01

129

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

Science.gov (United States)

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

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

2012-05-01

130

Clinical performance feedback and quality improvement opportunities for perioperative physicians  

Directory of Open Access Journals (Sweden)

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

Kaye AD

2014-05-01

131

40 CFR Appendix F to Part 132 - Great Lakes Water Quality Initiative Implementation Procedures  

Science.gov (United States)

...Lakes Water Quality Initiative Implementation Procedures F Appendix F to Part 132 Protection of Environment ENVIRONMENTAL...QUALITY GUIDANCE FOR THE GREAT LAKES SYSTEM Pt. 132, App. F Appendix F to Part 132—Great Lakes Water Quality...

2010-07-01

132

OMERACT: An international initiative to improve outcome measurement in rheumatology  

OpenAIRE

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 enga...

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

2007-01-01

133

OMERACT: An international initiative to improve outcome measurement in rheumatology  

Directory of Open Access Journals (Sweden)

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.

Simon Lee

2007-11-01

134

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

Science.gov (United States)

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

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

2014-12-01

135

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

136

Health benefits of improving air quality in Taiyuan, China.  

Science.gov (United States)

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

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

2014-12-01

137

Quality Improvement in Initial Teacher Training and Co-operation in Distance Education in Asia: Interim Statement and Action Plans. Commonwealth Secretariat-UNESCO Regional Roundtable (Penang, Malaysia, October 24-November 4, 1992).  

Science.gov (United States)

This publication reports on the Commonwealth Secretariat UNESCO Regional Roundtable, which was held in Penang, Malaysia as a follow-up to the 1992 Colloquium on Alternatives in Initial Teacher Training, held in Colombo, Sri Lanka. There were 28 participants from Bangladesh, India, Maldives, Pakistan, Sri Lanka, Indonesia, Malaysia, Philippines,…

United Nations Educational, Scientific, and Cultural Organization, Bangkok (Thailand).

138

An Empirical Investigation of the Relationship between Quality Initiatives and Financial Performance  

Directory of Open Access Journals (Sweden)

Full Text Available Using survey data from 102 industrial enterprises, this study empirically examines the extent to which quality initiatives are implemented and the effects of quality initiatives on financial performance amongst top Turkish 500 industrial enterprises. The findings of the study are: (1 majority of Turkey’s top 500 industrial enterprises implement at least one quality initiative; (2 there are significant associations between implementing quality initiatives and top 500 ranking; (3 and qualityinitiative implementing companies outperform in financial performance compared to non-quality-initiative implementing companies.

Ali Uyar

2008-01-01

139

The role of safety and quality councils in improving the quality of healthcare: an Australian perspective.  

Science.gov (United States)

The Australian Council for Safety and Quality in Health Care (the Council) has made considerable advances in gaining acceptance of and commitment to the healthcare safety improvement agenda by all involved in healthcare in Australia. It has provided a focus for national efforts in safety and quality improvement, by raising awareness, building consensus and clarifying areas for priority action. While the Council has set the agenda for change and provides advice in relation to problems, initiatives and actions, it has limited operational capacity and lacks the statutory authority to embed a culture of safety at all levels of the healthcare system. Statutory and regulatory responsibility and accountability for implementation lies with the Australian, State and Territory Governments and organizations in the private sector. Progress depends on coordinating the activities of Departments of Health and Human Services of nine sovereign governments. The "levers for change" available to the Council were leadership, persuasion, advice and example, with the ability to develop strategies, frameworks, standards, tools and guidelines. With the end of the Council's term approaching, a recent review recommended the establishment of an Australian Commission on Safety & Quality in Health Care (the Commission). PMID:16651857

Barraclough, Bruce

2006-01-01

140

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)

141

Does the EUA Institutional Evaluation Programme Contribute to Quality Improvement?  

Science.gov (United States)

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

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

2010-01-01

142

Relation Organization of SOM Initial Map by Improved Node Exchange  

Directory of Open Access Journals (Sweden)

Full Text Available The Self Organizing Map (SOM involves neural networks, that learns the features of input data thorough unsupervised, competitive neighborhood learning. In the SOM learning algorithm, connection weights in a SOM feature map are initialized at random values, which also sets nodes at random locations in the feature map independent of input data space. The move distance of output nodes increases, slowing learning convergence. As precedence research, we proposed the method to improve this problem, initial node exchange by using a part of feature map. In this paper, we propose two improved exchange method, node exchange with fixed neighbor area and spiral node exchange. The node exchange with fixed neighbor area uses fixed position of winner node and fixed initial size of neighbor area that sets to cover whole feature map. We investigate how average move distance of all nodes and average deviation of move distance would change with the differences by type of fixed neighbor area in node exchange process. The spiral node exchange is used instead of neighbor area reduction reputation of former method. By spiral node exchange, repetition by node exchange process becomes needless and can expect speed up of total processing.

Tsutomu Miyoshi

2008-09-01

143

Basic Approaches to Improve Translation Quality Between English and Chinese  

OpenAIRE

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...

Sanning He

2009-01-01

144

Productivity quality improvement at UNC Geotech  

International Nuclear Information System (INIS)

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

145

A quality assurance initiative for commercial-scale production in high-throughput cryopreservation of blue catfish sperm.  

Science.gov (United States)

Cryopreservation of fish sperm has been studied for decades at a laboratory (research) scale. However, high-throughput cryopreservation of fish sperm has recently been developed to enable industrial-scale production. This study treated blue catfish (Ictalurus furcatus) sperm high-throughput cryopreservation as a manufacturing production line and initiated quality assurance plan development. The main objectives were to identify: (1) the main production quality characteristics; (2) the process features for quality assurance; (3) the internal quality characteristics and their specification designs; (4) the quality control and process capability evaluation methods, and (5) the directions for further improvements and applications. The essential product quality characteristics were identified as fertility-related characteristics. Specification design which established the tolerance levels according to demand and process constraints was performed based on these quality characteristics. Meanwhile, to ensure integrity throughout the process, internal quality characteristics (characteristics at each quality control point within process) that could affect fertility-related quality characteristics were defined with specifications. Due to the process feature of 100% inspection (quality inspection of every fish), a specific calculation method, use of cumulative sum (CUSUM) control charts, was applied to monitor each quality characteristic. An index of overall process evaluation, process capacity, was analyzed based on in-control process and the designed specifications, which further integrates the quality assurance plan. With the established quality assurance plan, the process could operate stably and quality of products would be reliable. PMID:23872356

Hu, E; Liao, T W; Tiersch, T R

2013-10-01

146

Improved estimation of structure predictor quality  

OpenAIRE

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 itse...

Karypis George; DeRonne Kevin W

2009-01-01

147

Patient safety and quality improvement: an overview of QI.  

Science.gov (United States)

It is important for pediatric providers to be involved in quality improvement (QI) activities to improve children’s health outcomes.• The Model for Improvement asks several key questions related to a process, then uses Plan-Do-Study-Act(PDSA) cycles to implement, test, and spread changes.• Lean and Six Sigma methodologies can improve quality by increasing workflow efficiency and decreasing variation.• Root cause analysis (RCA) is a retrospective quality tool that helps determine factors contributing to errors and adverse events, so that improvements can be implemented.• Failure modes and effects analysis (FMEA) isa prospective quality tool that anticipates system vulnerabilities and helps develop risk reduction strategies.• Evidence-based interventions, such as best-practice guidelines, promote standardization and reduce errors and adverse events, especially in high-risk health-care settings.• Team training can improve communication and situational awareness to create a safer health-care environment. PMID:22855927

Schriefer, Jan; Leonard, Michael S

2012-08-01

148

Initiative to improve process representation in chemistry-climate models  

Energy Technology Data Exchange (ETDEWEB)

The Atmospheric Chemistry and Climate Initiative (AC&C) will address the current large uncertainties in our understanding of chemistry-climate interactions for short-lived atmospheric chemical constituents (e.g. aerosols, ozone, and methane). Understanding what controls the distribution of these species, how they affect climate, and how their distributions might change with a changing climate are important for air quality and climate forecasts. AC&C will address this issue in its first phase through a series of modeling exercises designed to test models’ ability to reproduce observed changes in these species distributions, to produce a set of coordinated forecasts for their future distribution, and to understand how processes are represented in different models. Observational databases will be used to test the models and to better understand processes represented in the models. This article describes the plans for this first phase of activities and seeks participation from the research community.

Doherty, Sarah J.; Rasch, Philip J.; Ravishankara, A.R.

2009-06-16

149

Aspects of improving the organization directed to the quality  

Directory of Open Access Journals (Sweden)

Full Text Available Purpose: A new approach for organization connected with system approach, process approach, quality improvement has been presented.Design/methodology/approach: The possibility of estimation of organization quality is connected with system approach and improvement in organization. Interdependence of quality rules and quality methods in management processes has been taken into account.Findings: At the present time the enterprises should manage and control all its activities in systematic way. Such kind of strategy will enable to achieve success for these companies.Research limitations/implications: Described system approach, quality management principles can be employed in company. The possibility of improvement of organization with certificated Quality Management System has been presented.Practical implications: Analytical Model of the Quality Evaluation of the Business Administration can be used in company for evaluation of the quality indicator of organization directed to the quality.Originality/value: Describing and estimating the level of organization quality with usage of Analytical Model of the Quality Evaluation of the Business Administration has been presented. This method is a propose of new strategy of efficiency and efficiencies activities of all organization.

M. Dudek-Burlikowska

2010-06-01

150

Improving Learning Object Quality: Moodle HEODAR Implementation  

Science.gov (United States)

Automation toward efficiency is the aim of most intelligent systems in an educational context in which results calculation automation that allows experts to spend most of their time on important tasks, not on retrieving, ordering, and interpreting information. In this paper, the authors provide a tool that easily evaluates Learning Objects quality

Munoz, Carlos; Garcia-Penalvo, Francisco J.; Morales, Erla Mariela; Conde, Miguel Angel; Seoane, Antonio M.

2012-01-01

151

A quality improvement program in pathology  

Directory of Open Access Journals (Sweden)

Full Text Available Quality becomes an important measure for pathology reporting. Accreditation is one of the principal ways for quality assurance. In this study, Anatomic Pathology Checklist defined by College of American Pathologists is used as a guide by Quality Control Committee formed as a prerequisite for laboratory accreditation of our department to evaluate 1 year period, compare the results with previous periods and test the reliability of this reference. The committee choose 94 relevant criteria out of 104. Unmet criteria and causes for these are searched for. A Physician Satisfaction Survey was applied. A problem record notebook was put on desk to ascertain the problems throughout the process. Last results are compared with the first data; problems and solutions are discussed.At the end of the study, 87.2% of criteria were met. Priority was given to some of the problems according to the results of survey and evaluation of parameters. Average turnaround time decreased to 3.5 days when the pathologists were informed about this measurement. Frozen section turnaround time decreased to less than 20 minutes in 63% of cases after frozen section unit was transferred to the operating theatre. Notebook served for the quick catch up of problems and work-ups of solutions or prevention. Controls were formed for histochemistry and immunohistochemistry. Unmet 8 criteria were about turnaround time, intra- and interdepartmental consultation which requires extra work and concensus among people and, technical issues.Quality control and quality assurance methods should be used for reports bearing accurate diagnosis and data concerning treatment and, preparation for accreditation. By this way, working procedures are formed, problems are easily seen, favourable results as compared to pre-evaluation period could be obtained by discussion of suggested solutions.

Alp USUBÜTÜN

2007-05-01

152

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

Science.gov (United States)

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

Zheng, Jia-wei

2005-04-01

153

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

Directory of Open Access Journals (Sweden)

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.

Yaser hasan Al-Mamary

2014-09-01

154

Improvement and Implementation of Software Quality by Using Software Metrics  

Directory of Open Access Journals (Sweden)

Full Text Available Without the software development and software product knowledge it’s very complicated to understand, keep away from improvement in the quality of software. There should be some dimension process to forecast the software development, and to appraise software products and its quality. In This paper provides a brief view on Software Metrics, Software Quality and Software Metrics techniques that will forecast and evaluate the specified superiority factors of software which will relate to quality. It additional discusses regarding the Quality as given through the principles like ISO, principal elements necessary for the Software Metrics and Software Quality as the measurement method to forecast the Quality in the Software. Java source code evolution are using for Software Metrics, like Defect Metrics, Size Metrics, and Complexity Metrics. Presented experiments are proving that, the software quality can be analyzed, observed, and enhanced through software metrics usage.

Dileram Bansal, Ajit Saxena, Gajendra Singh

2014-06-01

155

Active filters for power quality improvement  

OpenAIRE

This paper deals with problems related with harmonics in power system networks. Several international standards issued to control power quality problems are briefly described and some important methods to analyse electrical circuits with non-sinusoidal waveforms are introduced and evaluated. One of these methods - the p-q theory - was used to implement the control algorithm of a shunt active filter, which is also described in this paper as an application example. The filter can compensate for...

Afonso, Joa?o L.; Silva, Henrique Jorge Jesus Ribeiro Da; Martins, Ju?lio S.

2001-01-01

156

INTERNET DATABASES IN QUALITY INFORMATION IMPROVEMENT  

OpenAIRE

Even though many important companies are reluctant into deploying their databases on the Internet, being too concerned about security, we would like to demonstrate that they shouldn’t be worried too much about it, but to try to provide information in real-time to management, boards or people who travel on companies interests. However, security is one of the most important factors that should be offered to websites and databases on the Internet. If we consider one of information quality metr...

Tomozei, Cosmin

2007-01-01

157

Improving wind power quality with energy storage  

OpenAIRE

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...

Rasmussen, Claus Nygaard

2009-01-01

158

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

OpenAIRE

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...

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

2013-01-01

159

Quality Improvement of an Acid Treated Fuel Oil  

Directory of Open Access Journals (Sweden)

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

Elizabeth Jumoke ETERIGHO

2008-06-01

160

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

161

40 CFR Appendix E to Part 132 - Great Lakes Water Quality Initiative Antidegradation Policy  

Science.gov (United States)

...2010-07-01 2010-07-01 false Great Lakes Water Quality Initiative Antidegradation Policy E Appendix...Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY GUIDANCE FOR THE GREAT LAKES SYSTEM...

2010-07-01

162

40 CFR Appendix F to Part 132 - Great Lakes Water Quality Initiative Implementation Procedures  

Science.gov (United States)

...2010-07-01 2010-07-01 false Great Lakes Water Quality Initiative Implementation Procedures F ...Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY GUIDANCE FOR THE GREAT LAKES SYSTEM...

2010-07-01

163

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

Science.gov (United States)

...2010-07-01 2010-07-01 false Great Lakes Water Quality Initiative B Appendix B to Part 132 ...Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY GUIDANCE FOR THE GREAT LAKES SYSTEM...

2010-07-01

164

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)

Full Text Available In order to improve the surface ozone forecast over Beijing and surrounding regions, data assimilation method integrated into a high-resolution regional air quality model and a regional air quality monitoring network are employed. Several advanced data assimilation strategies based on ensemble Kalman filter are designed to adjust O3 initial conditions, NOx initial conditions and emissions, VOCs initial conditions and emissions separately or jointly through assimilating ozone observations. As a result, adjusting precursor initial conditions demonstrates potential improvement of the 1-h ozone forecast almost as great as shown by adjusting precursor emissions. Nevertheless, either adjusting precursor initial conditions or emissions show deficiency in improving the short-term ozone forecast at suburban areas. Adjusting ozone initial values brings significant improvement to the 1-h ozone forecast, and its limitations lie in the difficulty in improving the 1-h forecast at some urban site. A simultaneous adjustment of the above five variables is found to be able to reduce these limitations and display an overall better performance in improving both the 1-h and 24-h ozone forecast over these areas. The root mean square errors of 1-h ozone forecast at urban sites and suburban sites decrease by 51% and 58% respectively compared with those in free run. Through these experiments, we found that assimilating local ozone observations is determinant for ozone forecast over the observational area, while assimilating remote ozone observations could reduce the uncertainty in regional transport ozone.

X. Tang

2011-12-01

165

How to use continuous quality improvement theory and statistical quality control tools in a multispecialty clinic.  

Science.gov (United States)

The management philosophy of continuous quality improvement (CQI) and the tools of statistical quality control (SQC) have the potential for advancing quality management in medicine as they have in industry. The authors report their favorable experience with the approach and explain how to adapt CQI principles and SQC charts and graphs, citing examples from their participation in a quality improvement effort in a multispecialty clinic serving a large hospital. The coupling of statistical techniques with modern approaches to outcome analysis may provide powerful tools not only for quality assurance and assessment but also for technology evaluation and resource allocation. PMID:2126081

Re, R N; Krousel-Wood, M A

1990-11-01

166

Danish initiatives to improve the safety of meat products  

DEFF Research Database (Denmark)

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.

Wegener, Henrik Caspar

2010-01-01

167

CONTRIBUTIONS OF WATER FILTRATION TO IMPROVING WATER QUALITY  

Science.gov (United States)

A variety of water quality improvements can be accomplished by properly operated filtration plants. These include reduction of turbidity, micro-organisms, asbestos fibers, color, trihalomethane precursors, and organics adsorbed to particulate matter. The focus of the paper is on ...

168

42 CFR 422.152 - Quality improvement program.  

Science.gov (United States)

...enrollees. As part of its ongoing quality improvement program...performance. (iv) Systematic and periodic follow-up...indicators must be based on systematic ongoing collection and analysis...must be in effect a process for formal...

2010-10-01

169

Smoke-Free Policies Improve Air Quality in Hospitality Settings  

Science.gov (United States)

... Sites Smoke-Free Policies Improve Air Quality in Hospitality Settings Share Compartir Overview Selected Studies References For ... cigars, are burned. Selected Peer-Reviewed Studies  Hospitality Settings (e.g., Bars, Restaurants, and Casinos) Studies ...

170

Quality improvement in family practice: a recipe for change.  

Science.gov (United States)

A new recipe is presented, splitting quality improvement into 4 levels. The Q1 level corresponds to the everyday processes that guide our daily work flow. Q2 corresponds to commonly thought of outcome measures such as HEDIS criteria. Q3 relates to the executive functions that permit seasoned clinicians to draw generalizations about care for individual patients by synthesizing large amounts of data from both psychosocial as well as classical history/physical sources. Finally Q4 reflects more population-based quality improvement activities. Examples are given for each. Each of these levels requires a different approach for improvement activities. Each must be seen in the context of an expanded "quality compass" and in the paradigm of the PLAN-DO-CHECK-ACT cycle of quality improvement. Finally, a practical application of how this could be instituted at a Family Practice residency is given. PMID:15115279

Elgert, Stephen

2004-01-01

171

Improvement of image quality in I.I. fluorography  

International Nuclear Information System (INIS)

X-ray image intensifiers have recently been markedly improved to produce images with good quality favorably comparing with those directly photographed. This article first represents the process of I.I. improvement, and nextly reports that it has been clarified, through analyses employing modulation transfer function, how important a role the I.I. plays for improving the image quality. It is also shown how noticeably the image obtained through the new I.I. fluorography equipment combined with the magnification technique is improved. (author)

172

Zero tolerance for failure. An AREVA initiative to improve reliability  

International Nuclear Information System (INIS)

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

173

Improvement of Power Quality Using a Hybrid Interline UPQC  

OpenAIRE

This paper proposed the reduced rating star connected transformer based interline unified power quality conditioner. This work comprises of unified power quality conditioner connected between the two feeders, star connected transformer and LC filter. This hybrid approach significantly improves the performance of UPQC under unbalance source voltage condition. The UPQC adopted to compensate current and voltage-quality problems of sensitive loads and suppressing the load current harmonics under ...

Elango, M. K.; Vengatesh, C.

2014-01-01

174

PathworX: an informatics tool for quality improvement.  

OpenAIRE

To optimize quality of care while conserving resources requires the right information and the right organizational processes. PathworX, a care management and documentation system developed at Vanderbilt, coordinates interdisciplinary care based on evidence-based best practices and provides information about the achievement of patient care goals as an indicator of quality. Using data about goal achievement and resource consumption in a process of continual quality improvement enables hospital ...

Ozbolt, J.; Brennan, G.; Hatcher, I.

2001-01-01

175

System Change: Quality Assessment and Improvement for Medicaid Managed Care  

OpenAIRE

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

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

1996-01-01

176

DIESELGENERATOR OPERATIONAL MONTORING OF QUALITY IMPROVEMENT OPPORTUNITIES  

Directory of Open Access Journals (Sweden)

Full Text Available Reliability of technical systems in the XX. and XXI. century, due to the explosive development magnitude improved and they are still improving. These things we live every day of everyday life, because objects of every day of our lives are becoming increasingly complex belongings, but in spite of increasing reliability. In contrast, human reliability, almost nothing has changed, is not a quantum leap in the manifestations of human error and lot of terms. In a well-planned operation process the weak link is the man, but as the systems reliability is not 100%, so it is necessary to have some level of human intervention. The article aims to examine the impact of human intervention in the systems reliability through an example.

FENYVESI, Csaba

2013-03-01

177

Improvement of power quality using distributed generation  

Energy Technology Data Exchange (ETDEWEB)

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)

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

178

Improving Software Quality through Program Analysis  

Science.gov (United States)

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

Zhu, Jianlin; Huang, Jin; Zhou, Daicui; Zhang, Guoping

2012-12-01

179

Improving the drug quality and safety net.  

Science.gov (United States)

When large quantities of contaminated, subpotent, or superpotent drugs are introduced into the medical supply pipeline, injury or death of hundreds or thousands of patients can occur. Tracing the origin of substandard and dangerous products and tracking across regions and countries where shipped is quite costly in both money and time. From patients' perspective, timely access to quality product is paramount. Receiving deficient product threatens their survival and creates huge sums of financial cost to both them and the medical system. With the passage of HR 3204 the FDA must now find a way to be proactive in policing the global medical product supply line without restricting market availability. Without a comprehensive, world-focused implementation plan these new regulations will fail to protect the public. PMID:24876419

Carter, Alan

2014-07-01

180

Improving Software Quality through Program Analysis  

International Nuclear Information System (INIS)

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

181

The Perceived Financial Impact of Quality Improvement Efforts in Community Health Centers  

OpenAIRE

We administered surveys to 100 chief executive officers (CEOs) of community health centers to determine their perceptions of the financial impact of the Health Disparities Collaboratives, a national quality improvement initiative. One third of the CEOs believed that the HDC had a negative financial impact on their health center, and this perception was significantly correlated with centers having a higher proportion of uninsured patients. Performance-based payment incentives may improve care ...

Cheung, Karen; Moiduddin, Adil; Chin, Marshall H.; Drum, Melinda L.; Brown, Sydney E. S.; Graber, Jessica E.; Heuer, Loretta; Quinn, Michael T.; Schaefer, Cynthia T.; Schlotthauer, Amy E.; Huang, Elbert S.

2008-01-01

182

Power quality improvement with an extended custom power park  

Energy Technology Data Exchange (ETDEWEB)

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)

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

183

Studying and improving blast furnace cast iron quality  

OpenAIRE

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

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

2014-01-01

184

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

Science.gov (United States)

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

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

2013-08-01

185

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)

186

Workbook for Taguchi Methods for Product Quality Improvement.  

Science.gov (United States)

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…

Zarghami, Ali; Benbow, Don

187

Studying and improving blast furnace cast iron quality  

Directory of Open Access Journals (Sweden)

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

?. ?. Balgabekov

2014-10-01

188

Software Quality Improvement in the OMC Team  

CERN Document Server

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...

Maier, Viktor

189

40 CFR Appendix C to Part 132 - Great Lakes Water Quality Initiative Methodologies for Development of Human Health Criteria and...  

Science.gov (United States)

...2010-07-01 2010-07-01 false Great Lakes Water Quality Initiative Methodologies... WATER QUALITY GUIDANCE FOR THE GREAT LAKES SYSTEM Pt. 132, App. C Appendix C to Part 132—Great Lakes Water Quality Initiative...

2010-07-01

190

40 CFR Appendix A to Part 132 - Great Lakes Water Quality Initiative Methodologies for Development of Aquatic Life Criteria and...  

Science.gov (United States)

...2010-07-01 2010-07-01 false Great Lakes Water Quality Initiative Methodologies... WATER QUALITY GUIDANCE FOR THE GREAT LAKES SYSTEM Pt. 132, App. A Appendix A to Part 132—Great Lakes Water Quality Initiative...

2010-07-01

191

40 CFR Appendix D to Part 132 - Great Lakes Water Quality Initiative Methodology for the Development of Wildlife Criteria  

Science.gov (United States)

...2010-07-01 2010-07-01 false Great Lakes Water Quality Initiative Methodology for... WATER QUALITY GUIDANCE FOR THE GREAT LAKES SYSTEM Pt. 132, App. D Appendix D to Part 132—Great Lakes Water Quality Initiative Methodology...

2010-07-01

192

TaaS for Improving Quality of Restful Web Services  

Directory of Open Access Journals (Sweden)

Full Text Available 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 applications, as well as improving quality of restful Web service software, in terms of correctness.

Shueh-Cheng Hu

2013-08-01

193

Improving Quality of Voice Conversion Systems  

Science.gov (United States)

New improvement scheme for voice conversion are proposed in this paper. We take Human factor cepstral coefficients (HFCC), a modification of MFCC that uses the known relationship between center frequency and critical bandwidth from human psychoacoustics to decouple filter bandwidth from filter spacing, as the basic feature. We propose U/V (Unvoiced/Voiced) decision rule such that two sets of codebooks are used to capture the difference between unvoiced and voiced segments of the source speaker. Moreover, we apply three schemes to refine the synthesized voice, including pitch refinement, energy equalization, and frame concatenation. The acceptable performance of the voice conversion system can be verified through ABX listening test and MOS grad.

Farhid, M.; Tinati, M. A.

194

Quality improvement in clinical documentation: does clinical governance work?  

Directory of Open Access Journals (Sweden)

Full Text Available Mahlegha Dehghan,1 Dorsa Dehghan,2 Akbar Sheikhrabori,3 Masoume Sadeghi,4 Mehrdad Jalalian5 1Department of Medical Surgical Nursing, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, 2Department of Pediatric Nursing, School of Nursing and Midwifery, Islamic Azad University Kerman Branch, Kerman, 3Department of Medical Surgical Nursing, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, 4Research Center for Modeling in Health, Institute of Futures Studies in Health, Kerman University of Medical Sciences, Kerman, 5Electronic Physician Journal, Mashhad, Iran Introduction: The quality of nursing documentation is still a challenge in the nursing profession and, thus, in the health care industry. One major quality improvement program is clinical governance, whose mission is to continuously improve the quality of patient care and overcome service quality problems. The aim of this study was to identify whether clinical governance improves the quality of nursing documentation. Methods: A quasi-experimental method was used to show nursing documentation quality improvement after a 2-year clinical governance implementation. Two hundred twenty random nursing documents were assessed structurally and by content using a valid and reliable researcher made checklist. Results: There were no differences between a nurse's demographic data before and after 2 years (P>0.05 and the nursing documentation score did not improve after a 2-year clinical governance program. Conclusion: Although some efforts were made to improve nursing documentation through clinical governance, these were not sufficient and more attempts are needed. Keywords: nursing documentation, clinical governance, quality improvement, nursing record

Dehghan M

2013-12-01

195

Improving initial polyp candidate extraction for CT colonography  

International Nuclear Information System (INIS)

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

196

The software improvement process - tools and rules to encourage quality  

International Nuclear Information System (INIS)

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

197

On Improving Higher Vocational College Education Quality Assessment  

Science.gov (United States)

Teaching quality assessment is a judgment process by using the theory and technology of education evaluation system to test whether the process and result of teaching have got to a certain quality level. Many vocational schools have established teaching quality assessment systems of their own characteristics as the basic means to do self-examination and teaching behavior adjustment. Combined with the characteristics and requirements of the vocational education and by analyzing the problems exist in contemporary vocational school, form the perspective of the content, assessment criteria and feedback system of the teaching quality assessment to optimize the system, to complete the teaching quality information net and offer suggestions for feedback channels, to make the institutionalization, standardization of the vocational schools and indeed to make contribution for the overall improvement of the quality of vocational schools.

Wu, Xiang; Chen, Yan; Zhang, Jie; Wang, Yi

198

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

OpenAIRE

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 ...

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

2009-01-01

199

INITIAL SOIL QUALITY ASSESSMENT WITHIN THE UPPER BIG WALNUT CREEK WATERSHED IN OHIO  

Science.gov (United States)

The Source Water Protection Initiative (SWPI) and Conservation Effects Assessment Project (CEAP) are results of congressional mandates designed to assess the impact of voluntary best management practices on soil quality, water quality, and ecology. Results will be presented from the initial soil qua...

200

45 CFR 98.51 - Activities to improve the quality of child care.  

Science.gov (United States)

...Activities to improve the quality of child care. 98.51...HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT...Activities to improve the quality...Activities to improve the quality of child care services may...

2010-10-01

201

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

Science.gov (United States)

...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...

2013-09-10

202

42 CFR 460.132 - Quality assessment and performance improvement plan.  

Science.gov (United States)

...Quality assessment and performance improvement plan. 460.132 Section...Quality assessment and performance improvement plan. (a) Basic rule...quality assessment and performance improvement plan. (b) Annual...

2010-10-01

203

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

Science.gov (United States)

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

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

2014-12-01

204

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

Science.gov (United States)

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

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

2014-01-01

205

Application of improved extension evaluation method to water quality evaluation  

Science.gov (United States)

The extension evaluation method (EEM) has been developed and applied to evaluate water quality. There are, however, negative values in the correlative degree (water quality grades from EEM) after the calculation. This is not natural as the correlative degree is essentially an index based on grades (rankings) of water quality by different methods, which are positive. To overcome this negativity issue, the interval clustering approach (ICA) was introduced, which is based on the grey clustering approach (GCA) and interval-valued fuzzy sets. However, the computing process and formulas of ICA are rather complex. This paper provides a novel method, i.e., improved extension evaluation method, so as to avoid negative values in the correlative degree. To demonstrate our proposed approach, the improved EEM is applied to evaluate the water quality of three different cross-sections of the Fen River, the second major branch river of the Yellow River in China and the Han Jiang River, one of the major branch rivers of the Yangtse River in China. The results of the improved evaluation method are basically the same as the official water quality. The proposed method possesses also the same merit as the EEM and ICA method, which can be applied to assess water quality when the levels of attributes are defined in terms of intervals in the water quality criteria. Existing methods are mostly applicable to data in the form of single numeric values.

Wong, Heung; Hu, Bao Qing

2014-02-01

206

A systems thinking approach to the sustainability of quality improvement programmes  

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english 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.

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

2014-01-01

207

[Recommendations to improve quality of obstetrics care].  

Science.gov (United States)

The maternal care represents 50 percent of surgical and medical interventions in México. Around 80% of the maternal deaths are foreseeable with actions as risk-managed prenatal care. Prevention of these complications are difficult and require of a competent obstetrician to handle them appropriate. Some assays calculate about 46.4% of maternal deaths, as related to professional responsibility, and 9.7% with hospital responsibility. In México, obstetric malpractice complaints are the most frequent, and reached 14.5% of total matters received by the National Commission of Medical Arbitration (CONAMED) between 1996 and 2001. We analyzed 121 cases concluded, specifically obstetrics-related, requested to the Commission between 1996 and 2001, to identify moments and factors of the medical attention, linked to obstetric claims. Most prominent finds were: high risk pregnancies in 57%, prior cesarean section 22%, hospital income by labor in 28%. Complications were fetal death 25%, obstetric trauma and perinatal asphyxia 12% each one. Births ocurred by cesarean in 37%. Perinatal mortality was 39% and maternal mortality in 33%. The principal deviation was deficient care of labor. They were observed medical patient communication deficiencies in 76%, incomplete expedients in 45%, ethics deviations in 30%, and malpractice in 55%. Whole this information was presented to gynaecologist leaders of opinion: speciality Council, medical associations, public and private hospitals representatives. The conclusion were Nine recommendations to improve the patients care during the pregnancy, labor and postpartum: 1) Pregnancy, labor and postpartum should be attended by personnel qualified and properly authorized; 2) Value integrally each case during the prenatal care and identify high risk patients; 3) Tighten the prenatal care during the third quarter of the gestation; 4) Provide the best obstetric care; 5) Establish best way for each birth; 6) Reduce unnecessary risks; 7) Watch narrowly all patients during the immediate postpartum; 8) Document all the process of attention; 9) Promote and facilitate health education to pregnant patients and their relatives on the gestation inherent risks. PMID:14619695

Tena-Tamayo, Carlos; Ahued-Ahued, José Roberto

2003-08-01

208

The QIBB Quality Initiative of the Vocational Training System in Austria  

Science.gov (United States)

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

Paechter, Manuela

2009-01-01

209

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

Energy Technology Data Exchange (ETDEWEB)

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.

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

2005-04-15

210

Quality of care in reproductive health programmes: concepts, assessments, barriers and improvements--an overview.  

Science.gov (United States)

At the end of the first decade of the Safe Motherhood Initiative there are still, at a minimum, 1600 women dying every day from complications of pregnancy and childbirth: this is an intolerable human tragedy. The fact that there are almost 100,000 more maternal deaths annually now compared to 10 years ago, 585,000, must present a challenge to every citizen in society. Policy makers, health professionals, social workers, religious leaders, human-rights advocates and the media all have a responsibility to ask themselves: 'What can I do?' All have a role in affecting quality reproductive-health services, which are essential for the reduction of maternal mortality and morbidity, and are an intrinsic human right. The midwife is the obvious catalyst and linch-pin for this effort in the fabric of society. Three papers will address the issues of quality of care in reproductive-health programmes with particular emphasis on safe motherhood. This, the first, article describes the concepts of quality of care in reproductive-health programmes, the determinants of quality improvement, assessment tools for service quality, barriers to quality of care and quality improvement together with examples from relevant countries. The second article will address education issues relative to quality of care, and the third will describe the monitoring and evaluation of quality of care with relevant indicators and project results. PMID:10382474

Kwast, B E

1998-06-01

211

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

212

Accelerating the spread of laboratory quality improvement efforts in Botswana  

Directory of Open Access Journals (Sweden)

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.

Kelebeletse O. Mokobela

2014-11-01

213

Bevacizumab Improves Quality of Life in Patients with Recurrent Glioblastoma  

OpenAIRE

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

Lawrence Recht; Griffith Harsh; Seema Nagpal

2011-01-01

214

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

Science.gov (United States)

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

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

2002-01-01

215

Models for continuous improvement of productivity and quality  

OpenAIRE

During the last decade there has been a tremendous revolution in quality management practices. These changes have come as a result of the necessity to change in a globally competitive environment rather as a result of any major breakthrough in science or technology. This dissertation focuses on problems that will assist the firm in increasing its productivity and improving the quality of the product. We first consider the problem of optimal allocation of work in an assembly system, we examine...

Rekhi, Ishpal Singh

1995-01-01

216

Power Quality Improvement In A Grid Connected Renewable Energy System  

OpenAIRE

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 ...

Sreya Grace Mathew; Fossy Mary Chacko

2014-01-01

217

Taking a systemwide approach to improving quality care.  

Science.gov (United States)

For the past decade, health insurer Anthem has been working with more than 300 hospitals in Ohio, Kentucky, and Indiana in a quality program designed to help them better use clinical data, monitoring, outcomes, and best practices to improve care in their facilities and promote patient safety. The results have been stimulation of new quality programs at the hospital level and a sense of partnership. PMID:11759467

Simmons, J C

2001-11-01

218

IMPROVING BANK QUALITY DIMENSIONS TO INCREASE CUSTOMER SATISFACTION  

OpenAIRE

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...

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

2011-01-01

219

Welfare Dental Intervention Improves Employment and Quality of Life  

OpenAIRE

Chronic, untreated oral disease adversely affects one's systemic health, quality of life, and economic productivity. This study evaluated the effect of rehabilitative dental treatment on the oral-health-related quality of life and employment of welfare recipients. Three hundred and seventy-seven participants in a novel welfare dental program received oral examinations, questionnaires, and rehabilitative dental treatment. Seventy-nine percent of participants exhibited improvement in their oral...

Hyde, S.; Satariano, W. A.; Weintraub, J. A.

2006-01-01

220

Introducing a quality improvement programme to primary healthcare teams  

OpenAIRE

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...

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

1998-01-01

221

Quality in home-based childcare: Impact and improvement  

OpenAIRE

The thesis ‘Quality in home-based childcare: Impact and improvement’ consists of two studies. The general aim of the first study is to examine children’s stress levels and wellbeing, and the role of caregiver stress and childcare quality. This first study is described in chapters 2, 3, and 4. Chapter 2 addresses the question whether children’s cortisol levels (and wellbeing) differ between contexts (childcare day or at home day) and setting (childcare homes and childcare centers), and...

Groeneveld, Marilene Gerarda

2010-01-01

222

The slippery slope: differentiating between quality improvement and research.  

Science.gov (United States)

As hospitals strive to create strong work environments for nurses, many use the core requirements for Magnet designation to enhance and build new programs in research and evidence-based practice into patient care and operational processes. The problem is the use of quality improvement projects in these efforts as evidence of a healthy "research" program. This confusion can lead to 3 major consequences: (1) poorly designed and interpreted studies; (2) lack of consideration of subject rights; and (3) Institutional Review Board or other regulatory sanctions for noncompliance with federal, state, and local law and institutional policies. The purpose of this article is to differentiate between research and quality improvement, explore the potential risks of confusing quality improvement with research, and suggest criteria by which to determine the difference. PMID:16609344

Newhouse, Robin P; Pettit, Joan C; Poe, Stephanie; Rocco, Laura

2006-04-01

223

A 10-year review of quality improvement monitoring in pain management: recommendations for standardized outcome measures.  

Science.gov (United States)

Quality measurement in health care is complex and in a constant state of evolution. Different approaches are necessary depending on the purpose of the measurement (e.g., accountability, research, improvement). Recent changes in health care accreditation standards are driving increased attention to measurement of the quality of pain management for improvement purposes. The purpose of this article is to determine what indicators are being used for pain quality improvement, compare results across studies, and provide specific recommendations to simplify and standardize future measurement of quality for hospital-based pain management initiatives. Pain management quality improvement monitoring experience and data from 1992 to 2001 were analyzed from 20 studies performed at eight large hospitals in the United States. Hospitals included: the University of Wisconsin Hospital and Clinics, Madison; Texas Medical Center, Houston; McAllen Medical Center, McAllen, TX; San Francisco General Hospital, San Francisco; Rush-Presbyterian-St. Luke's Medical Center and Northwestern Memorial Hospital, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York; and Kaiser Sunnyside Medical Center of Kaiser Permanente Northwest, Clackamas, OR. Analyses of data led to consensus on six quality indicators for hospital-based pain management. These indicators include: the intensity of pain is documented with a numeric or descriptive rating scale; pain intensity is documented at frequent intervals; pain is treated by a route other than intramuscular; pain is treated with regularly administered analgesics, and when possible, a multimodal approach is used; pain is prevented and controlled to a degree that facilitates function and quality of life; and patients are adequately informed and knowledgeable about pain management. Although there are no perfect measures of quality, longitudinal data support the validity of a core set of indicators that could be used to obtain benchmark data for quality improvement in pain management in the hospital setting. PMID:12454804

Gordon, Debra B; Pellino, Teresa A; Miaskowski, Christine; McNeill, Jeanette Adams; Paice, Judith A; Laferriere, Daniel; Bookbinder, Marilyn

2002-12-01

224

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

Energy Technology Data Exchange (ETDEWEB)

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 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.)

Bucourt, M. de; Zada, O.; Kaschke, H.; Rogalla, P.; Hein, P.A. [Charite Universitaetsmedizin Berlin (Germany). Dept. of Radiology; Busse, R. [Technische Univ. Belrin (Germany). Management im Gesundheitswesen; Weiss, A. [DRFZ Berlin (Germany). Statistics; Teichgraeber, U. [Charite Universitaetsmedizin Berlin (Germany). Klinik fuer Strahlenheilkunde

2011-09-15

225

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.)

226

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.)

227

Improvement of scintigram quality using alignment by flattening  

International Nuclear Information System (INIS)

The results are presented of the processing of scintigrams to improve image quality. A two-dimensional variant of the alignment method by flattening was proposed to improve visualisation of pathological foci. The results obtained are analysed and assessed by image contrast and significance index of focal detection. Such scintigram processing has been shown fast and effective. The results of the study are illustrated with scintigrams

228

Radionuclide calibrator comparisons and 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

229

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)

230

Radionuclide calibrator comparisons ad quality improvement in nuclear medicine  

Energy Technology Data Exchange (ETDEWEB)

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)

Oropesa, Pilar [Centro de Isotopos (CENTIS), Habana (Cuba)], E-mail: poropesa@centis.edu.cu; Woods, Mike J. [Ionising Radiation Metrology Consultants Ltd., Teddington (United Kingdom)], E-mail: mike.woods@blueyonder.co.uk; Olsovcova, Veronica [Czech Metrological Institute, Prague (Czech Republic)], E-mail: volsovcova@cmi.cz; Santos, Joyra A. dos [Comissao Nacional de Energia Nuclear (CNEN), Rio de Janeiro, RJ (Brazil)], E-mail: joyra@cnen.gov.br

2007-07-01

231

Radionuclide calibrator comparisons and quality improvement in nuclear medicine  

Energy Technology Data Exchange (ETDEWEB)

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.

Oropesa, P. [Centro de Isotopos (CENTIS), P.O. Box 3415, San Jose de las Lajas, Havana (Cuba)], E-mail: poropesa@centis.edu.cu; Woods, M.J. [Ionising Radiation Metrology Consultants Ltd., Teddington (United Kingdom); Olsovcova, V. [Czech Metrological Institute, Prague (Czech Republic); Santos, J.A. dos [Comissao Nacional de Energia Nuclear (CNEN), Rio de Janeiro (Brazil)

2008-03-15

232

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)

233

Improving Handover Quality in 4G Mobile Systems  

Science.gov (United States)

In this paper, we propose a new handover algorithm to guarantee handover quality in 4G mobile systems. The proposed algorithm limits the handover interruption time by improving the HARQ retransmission latency of the first packet transmitted from new serving cell. Through the simulations, we proved that our algorithm meets the requirement of handover interruption time for TCP services with high rate.

Kim, Dongwook; Lee, Hanjin; Kim, Namgi; Yoon, Hyunsoo

234

Software quality and process improvement in scientific simulation codes  

Energy Technology Data Exchange (ETDEWEB)

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.

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

1997-11-01

235

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...

236

An Assessment System for Teacher Education Program Quality Improvement  

Science.gov (United States)

Purpose: The purpose of this study is to describe how one US Midwestern university implements quality principles, based on the value added premise in a teacher preparation program that yields accountability, teacher education standards attainment and ultimately improvement of teacher candidates and overall programs. Design/methodology/approach:…

Reusser, Janet; Butler, Loren; Symonds, Matthew; Vetter, Rheba; Wall, Timothy J.

2007-01-01

237

Faculty Development on Item Writing Substantially Improves Item Quality  

Science.gov (United States)

The quality of items written for in-house examinations in medical schools remains a cause of concern. Several faculty development programs are aimed at improving faculty's item writing skills. The purpose of this study was to evaluate the effectiveness of a faculty development program in item development. An objective method was developed and used…

Naeem, Naghma; van der Vleuten, Cees; Alfaris, Eiad Abdelmohsen

2012-01-01

238

Soil quality and organic carbon sequestration with improved pasture management  

Science.gov (United States)

Improved pasture management systems are needed to restore soil quality, sequester soil organic C, and build the productive capacity of soils in grassland environments so that (1) precipitation can be effectively utilized by plants, (2) water runoff and contaminant transport can be minimized, (3) nat...

239

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

Science.gov (United States)

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

Antelman, Albert

1991-01-01

240

Activated charcoal-alum-zeolite improve the water quality  

International Nuclear Information System (INIS)

The composite of charcoal-tawas-zeolite has been studied to improve a drinking water quality. This study was doing to find the optimum composition in preparation of a simple technology og bath and small volume drinking treatment this treatment consist of coagulation, floculation, precipitation, ion exchange and adsorption. The improvement of water quality has been observed from a turbidity, a permanganate number and a quality of Cu, Cd, Pb, Al ions and coli bactery containing in the water after processing. It has been concluded that the composite materials has an ability to decrease the turbidity more than its components. The starch addition in the composite can be accelerate water clarity process. By this composite the turbidity, the permanganate number and the coli bacteria in the water can be decreased significantly. The optimum composite composition is 1000 mg activated charcoal, 1000 mg zeolite, 60 mg tawas, 40 mg natrium bicarbonate and 50 mg starch with grains size less than 80 mesh

241

Surface quality of silicon wafer improved by hydrodynamic effect polishing  

Science.gov (United States)

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.

Peng, Wenqiang; Guan, Chaoliang; Li, Shengyi

2014-08-01

242

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

Science.gov (United States)

In partnership with the US EPA, NOAA has developed, tested and implemented the first two stages of a national air quality forecast capability into the National Weather Service (NWS) operational suite. The initial capability was implemented in September, 2004 and provided ground-level ozone predictions over Northeastern United States. In a program of phased development and testing to expand this capability, the domain has been extended over the entire Eastern United states as of August 31, 2005. Predictions are made with the NOAA-EPA Community Model for Air Quality (CMAQ) driven by NOAA's operational mesoscale weather prediction model (Eta-12). The capability is an end-to-end forecast guidance system providing twice daily predictions of hour-by-hour ground-level ozone concentrations on a 12km grid, disseminated over operational NWS and EPA dataservers. Forecast guidance products are hosted on operational dataservers: fully backed up, with archiving and near-real-time verification in place to monitor forecast accuracy. In order to demonstrate readiness for operational implementation, required accuracy of 90% and reliability of 95% on-time delivery have been demonstrated in the pre-deployment testing. During the Summers of 2004 and 2005, pre-deployment testing of forecast domains over Northeastern US and Eastern US, respectively, have led to operational implementation of the first two stages of the capability. Prior to pre-deployment testing, developmental testing was conducted to demonstrate feasibility of the prototype operational configuration using forecast components for air quality (CMAQ and pollutant emissions pre-processing) adapted from research and assessment simulations. Developmental testing identified priorities for system enhancements needed to improve guidance accuracy; for example: improved model linkage, updated emissions information, improved treatments of solar radiation for photolysis rate estimation, and improved treatments of vertical mixing and transport within clouds. The current phase of developmental testing, over an expanded coast-to-coast domain, was begun during Summer, 2005. The impact of much deeper boundary layers over western US on predicted ground-level ozone has emphasized the need to improve vertical mixing relative to simplistic approaches that have been demonstrated to be effective in Eastern US. We are therefore now testing more advanced vertical mixing schemes and evaluating the optimal use of real-time satellite data on upper-atmosphere ozone in the developmental forecast capability. Within the next year, we will convert from Eta-12 to WRF as the driving meteorological model when it becomes NOAA's new operational mesoscale numerical prediction model. Targeted deployment of nationwide ozone forecasts within 5 years will be followed by the addition of particulate matter forecasts and an extended forecast period- out to day 2 and beyond.

Davidson, P.

2005-12-01

243

Improved initial guess for minimum energy path calculations  

CERN Document Server

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...

Smidstrup, Søren; Stokbro, Kurt; Jónsson, Hannes

2014-01-01

244

Continuous Improvement in Nursing Education through Total Quality Management (TQM  

Directory of Open Access Journals (Sweden)

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.

Tang Wai Mun

2013-11-01

245

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

Science.gov (United States)

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% ± 50.33%, 126.26% ± 53.69%, 100.58% ± 22.83%, and 104.07% ± 5.45%, respectively. The improvements in these areas were 61.12% ± 13.2%, 60.47% ± 28.91%, 34.41% ± 22.96%, 49.22% ± 25.39%, and 73.70% ± 5.24%, respectively. The intangible achievements were reflected as follows: 5% of QCC members showed an activity growth value of 1-2 points, 83% 1-2 points, 12% more than 2 points. As a result, QCC activity showed prominent results in fostering long-lasting improvement in the quality of medical institutions in terms of both tangible and intangible factors. In short, QCC can be used as an effective tool to improve medical quality. PMID:23641318

Wang, Lin-Run; Wang, Yang; Lou, Yan; Li, Ying; Zhang, Xing-Guo

2013-12-01

246

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

Science.gov (United States)

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…

Ji, Zhou

2009-01-01

247

Defect Investigation as a Tool for Quality Improvement  

Directory of Open Access Journals (Sweden)

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.

B. Gurumurthy

2012-04-01

248

40 CFR Appendix F to Part 132 - Great Lakes Water Quality Initiative Implementation Procedures  

Science.gov (United States)

...2010-07-01 false Great Lakes Water Quality Initiative...GUIDANCE FOR THE GREAT LAKES SYSTEM Pt. 132...parameters in the Great Lakes System, with...allocations is not greater than the loading...iii. Anticipated decreases in pollutant...

2010-07-01

249

Sustaining Quality Improvement in Community Health Centers: Perceptions of Leaders and Staff  

OpenAIRE

The Health Disparities Collaboratives (HDC) are the largest national quality improvement (QI) initiative in community health centers. This paper identifies the incentives and assistance personnel believe are necessary to sustain QI. In 2004, 1006 survey respondents (response rate 67%) at 165 centers cited lack of resources, time, and staff burnout as common barriers. Release time was the most desired personal incentive. The highest funding priorities were direct patient care services (44% ran...

Chin, Marshall H.; Kirchhoff, Anne C.; Schlotthauer, Amy E.; Graber, Jessica E.; Brown, Sydney E. S.; Rimington, Ann; Drum, Melinda L.; Schaefer, Cynthia T.; Heuer, Loretta J.; Huang, Elbert S.; Shook, Morgan E.; Tang, Hui; Casalino, Lawrence P.

2008-01-01

250

Review Paper: Quality Improvement through Six Sigma DMAIC Methodology  

Directory of Open Access Journals (Sweden)

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.

Patel Rumana*

2014-12-01

251

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

Directory of Open Access Journals (Sweden)

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.

Dnyaneshwar.K

2013-12-01

252

Improved initial guess for minimum energy path calculations  

Energy Technology Data Exchange (ETDEWEB)

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.

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

2014-06-07

253

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

254

Improved initial guess for minimum energy path calculations  

Science.gov (United States)

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.

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

2014-06-01

255

Quality improvement of tomato dried by microwave hot air with power density control.  

OpenAIRE

The aim of this study was to improve the quality of dried tomato by the use of microwaves combined to hot air (MOAC). The main point was to preserve the quality of dried tomato avoiding the appearance of black spots which often occur during microwaves heating which result from local overheating of the product when it becomes dry. Therefore, an MOAC drying system with ability of automatic control of the power density was developed under LabView®. After an initial study where the applied micro...

Kone, Kisselmina

2011-01-01

256

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

Science.gov (United States)

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

Chassin, Mark R

2013-10-01

257

GENETICS AND MOLECULAR BIOLOGY AND PIG MEAT QUALITY IMPROVEMENT  

Directory of Open Access Journals (Sweden)

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.

BULLA, J.

2007-01-01

258

GENETICS AND MOLECULAR BIOLOGY AND PIG MEAT QUALITY IMPROVEMENT  

Directory of Open Access Journals (Sweden)

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.

J. BULLA

2013-12-01

259

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

260

Making the cut: options for making initial evaluations of malting quality in barley  

Science.gov (United States)

Alternatives to traditional methods for generating the initial estimate of the potential malting quality of early-generation barley lines are examined through their application to a Regional Spring Barley Nursery. Comparisons are made between the standard malting quality parameters applied to a Cong...

261

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

Science.gov (United States)

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

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

2012-01-01

262

Improvement of image quality using interpolated projection in myocardial SPECT  

Directory of Open Access Journals (Sweden)

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

Mohamad-Ali Askari

2010-10-01

263

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

DEFF Research Database (Denmark)

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.

TØttenborg, Sandra SØgaard; Thomsen, Reimar W.

2012-01-01

264

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

Science.gov (United States)

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

Conrad, Douglas A; Perry, Lisa

2009-01-01

265

76 FR 53137 - Bundled Payments for Care Improvement Initiative: Request for Applications  

Science.gov (United States)

...the Bundled Payments for Care Improvement initiative: Improve care coordination, patient experience, and...continuously reengineering care to deliver better care...decreasing the cost of an acute or chronic episode of care while...

2011-08-25

266

Continuous quality improvement. A proposal for Arabian Gulf Medical Associations.  

Directory of Open Access Journals (Sweden)

Having well-established and active medical associations in the Arabian Gulf countries is a promising event. Ideally, however, it must be assured that these associations are efficiently and effectively functioning in a manner designed to serve the ultimate goal of promoting the standards of the medical profession and thus, the quality of health care in the region. This paper is designed to promote the application of Continuous Quality Improvement principles by the medical associations in the Arabian Gulf. The paper is presented in a general format so as to allow for appropriate modifications according to the specific objectives of different medical associations. The indicators identified in this proposal to assess the quality of structure, process or outcome are not intended as a comprehensive list. Rather, the authors aim at establishing a framework on which various fine-tuned and appropriately tailored systems can be based.

M. Z. Al-Shahri

2000-02-01

267

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

OpenAIRE

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

Trefler, Daniel

2009-01-01

268

Casting Defect Detection and Quality Improvement by Industrial CT  

International Nuclear Information System (INIS)

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

269

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

270

Improving image quality of parallel phase-shifting digital holography  

Energy Technology Data Exchange (ETDEWEB)

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

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

2008-11-01

271

Crystal quality analysis and improvement using x-ray topography  

International Nuclear Information System (INIS)

The Topography X-ray Laboratory of the Advanced Photon Source (APS) at Argonne National Laboratory operates as a collaborative effort with APS users to produce high performance crystals for APS X-ray beamline experiments. For many years the topography laboratory has worked closely with an on-site optics shop to help ensure the production of crystals with the highest quality, most stress-free surface finish possible. It has been instrumental in evaluating and refining methods used to produce high quality crystals. Topographical analysis has shown to be an effective method to quantify and determine the distribution of stresses, to help identify methods that would mitigate the stresses and improve the Rocking curve, and to create CCD images of the crystal. This paper describes the topography process and offers methods for reducing crystal stresses in order to substantially improve the crystal optics.

272

[Steps to improve the quality of urinary incontinence care].  

Science.gov (United States)

Urinary incontinence is a frequent symptom rarely spontaneously reported. This emphasizes the need to address it in every patient. Once disclosed, its origin needs to be specified so that therapeutic issues may be reached. These being often efficient, patient quality of life will improve significantly. In order to improve urinary incontinence management, a multidisciplinary group of healthcare professionals of our institution have proposed to spread basic knowledge, screening tools and evaluation scales of this bothersome worldwide symptom. This team enables healthcare providers to unite themselves in a network which will help to orientate patients in order to fulfill their needs. PMID:24416886

Kassouha, Ammar; Gogniat, Véronique; Vuagnat, Hubert; Meriat, Habib; Iselin, Christophe

2013-12-01

273

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.

274

Improvement of bacteriological quality of frozen chicken by gamma radiation  

International Nuclear Information System (INIS)

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

275

Quality improvement in industrial process plants - the role of radioisotopes  

International Nuclear Information System (INIS)

Supported by appropriate case studies, this paper argues that radioisotope techniques have an important part to play in the quality improvement processes currently being undertaken by many industrial companies. Examples, which are drawn predominantly from large-scale chemical industry, include the use of sealed and unsealed sources of radiation in instruments for measurement and control, the application of radioisotope tracers to investigate a range of process problems, and an activable tracer-technique applied to a solids blending study. (author)

276

Ampli er with improved quality for nuclear particle detectors  

International Nuclear Information System (INIS)

Preamplifiers for a drift chambers developed on the basis of amplifier with improved pulse quality are described. Their circuits and parameters are given: for a high amplifier with a current input (tsub(H) approximately 4 ns, Isub(np-p) approximately 5 ?A); amplifier with a current input and low noise (Isub(np-p) -15C). The application of an amplifier with current input or of charge sensitive amplifier with optimum shaping allows one to obtain good characteristics of transistor preamplifier

277

Improving Quality of Service from TCP/IP Performance Degradation  

OpenAIRE

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...

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

2011-01-01

278

Studying and simulating transformer configuration to improve power quality  

OpenAIRE

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...

Pen?a Huaringa, Oscar J.

2011-01-01

279

Studying and simulating transformer configuration to improve power quality  

Directory of Open Access Journals (Sweden)

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.

Oscar J. Peña Huaringa

2011-07-01

280

Improving Quality of Clustering using Cellular Automata for Information retrieval  

OpenAIRE

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...

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

2014-01-01

281

Improving machine translation quality prediction with syntactic tree kernels  

OpenAIRE

We investigate the problem of predicting the quality of a given Machine Translation (MT) output segment as a binary classification task. In a study with four different data sets in two text genres and two language pairs, we show that the performance of a Support Vector Machine (SVM) classifier can be improved by extending the feature set with implicitly defined syntactic features in the form of tree kernels over syntactic parse trees. Moreover, we demonstrate that syntax tree kernels achieve ...

Hardmeier, Christian

2011-01-01

282

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

OpenAIRE

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...

Tang Wai Mun; Ghani, Muhammad Faizal A.

2013-01-01

283

IMPROVEMENT OF POWER QUALITY OF A DISTRIBUTED GENERATION POWER SYSTEM  

Directory of Open Access Journals (Sweden)

Full Text Available The aim of this work is to improve the power quality for Distributed Generation (DG with power storage system. Power quality is the combination of voltage quality and current quality. Power quality is the set of limits of electrical properties that allows electrical systems to function in their intended manner without significant loss of performance or life. The electrical power quality is more concerned issue. The main problems are stationery and transient distortions in the line voltage such as harmonics, flicker, swells, sags and voltage asymmetries. Distributed Generation (DG also called as site generation, dispersed generation, embedded generation, decentralized generation, decentralized energy or distributed energy, generates electricity from the many small energy sources. In recent years, micro electric power systems such as photovoltaic generation systems, wind generators and micro gas turbines, etc., have increased with the deregulation and liberalization of the power market. Under such circumstances the environment surrounding the electric power industry has become ever more complicated and provides high-quality power in a stable manner which becomes an important topic. Here DG is assumed to include Wind power Generation (WG and Fuel Cells (FC, etc. Advantages of this system are constant power supply, constant voltage magnitude, absence of harmonics in supply voltage, un-interrupted power supply. In this project the electric power qualities in two cases will be compared. Case I: With the storage battery when it is introduced. Case II: Without the storage battery. The storage battery executes the control that maintains the voltage in the power system. It will be found that the electric power quality will be improved, when storage battery is introduced. The model system used in this Project work is composed of a Wind Turbine, an Induction Generator, Fuel Cells, An Inverter and a Storage Battery. A miniature Wind Power Generator is represented by WG. A fuel cell module is represented by FC. Transmission lines will be simulated by resistors and coils. The combined length of the lines from synchronous generator to the load terminal is 1.5 km. This model will be simulated using MATLAB/SIMULINK.

Aruna Garipelly

2012-11-01

284

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

Science.gov (United States)

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

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

2015-01-01

285

Turning the Tide on Chronic Disease: How a Province Is Using Evidence to Build Quality Improvement Capacity  

OpenAIRE

Saskatchewan's Chronic Disease Management Collaborative is a quality improvement model that brings together healthcare providers to learn about, test and share experiences with improvement ideas in diabetes and coronary artery disease care. This innovative initiative was recently featured in Promising Practices, a monthly series produced by the Canadian Health Services Research Foundation highlighting organizations that have invested their time, energy and resources to try to improve their ab...

2007-01-01

286

Improved model quality assessment using ProQ2  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Employing methods to assess the quality of modeled protein structures is now standard practice in bioinformatics. In a broad sense, the techniques can be divided into methods relying on consensus prediction on the one hand, and single-model methods on the other. Consensus methods frequently perform very well when there is a clear consensus, but this is not always the case. In particular, they frequently fail in selecting the best possible model in the hard cases (lacking consensus or in the easy cases where models are very similar. In contrast, single-model methods do not suffer from these drawbacks and could potentially be applied on any protein of interest to assess quality or as a scoring function for sampling-based refinement. Results Here, we present a new single-model method, ProQ2, based on ideas from its predecessor, ProQ. ProQ2 is a model quality assessment algorithm that uses support vector machines to predict local as well as global quality of protein models. Improved performance is obtained by combining previously used features with updated structural and predicted features. The most important contribution can be attributed to the use of profile weighting of the residue specific features and the use features averaged over the whole model even though the prediction is still local. Conclusions ProQ2 is significantly better than its predecessors at detecting high quality models, improving the sum of Z-scores for the selected first-ranked models by 20% and 32% compared to the second-best single-model method in CASP8 and CASP9, respectively. The absolute quality assessment of the models at both local and global level is also improved. The Pearson’s correlation between the correct and local predicted score is improved from 0.59 to 0.70 on CASP8 and from 0.62 to 0.68 on CASP9; for global score to the correct GDT_TS from 0.75 to 0.80 and from 0.77 to 0.80 again compared to the second-best single methods in CASP8 and CASP9, respectively. ProQ2 is available at http://proq2.wallnerlab.org.

Ray Arjun

2012-09-01

287

Improved radionuclide bone imaging agent injection needle withdrawal method can improve image quality  

International Nuclear Information System (INIS)

Objective: To investigate the improvement of radionuclide bone imaging agent injection needle withdrawal method on whole body bone scan image quality. Methods: Elbow vein injection syringe needle directly into the bone imaging agent in the routine group of 117 cases, with a cotton swab needle injection method for the rapid pull out the needle puncture point pressing, pressing moment. Improvement of 117 cases of needle injection method to put two needles into the skin swabs and blood vessels, pull out the needle while pressing two or more entry point 5min. After 2 hours underwent whole body bone SPECT imaging plane. Results: The conventional group at the injection site imaging agents uptake rate was 16.24%, improved group was 2.56%. Conclusion: The modified bone imaging agent injection needle withdrawal method, injection-site imaging agent uptake were significantly decreased whole body bone imaging can improve image quality. (authors)

288

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)

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.

White, Mark

2014-05-14

289

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)

290

The relationship between Total Quality Management and School Improvement  

OpenAIRE

The poor functioning of a large number of the black schools and the urgent need to transform them was identified as a problematic phenomenon particular to post apartheid South Africa. Notwithstanding various government interventions/initiatives (COLTS, Tirisano, Call to Action, Batho-Pele) for the improvement of schools aimed at correcting this situation, many schools remain dysfunctional and/or operate within a negative culture of teaching, learning and services. The purpose...

Rampa, Seake Harry

2005-01-01

291

Quality improvement in acute coronary syndromes: translating evidence into practice.  

Science.gov (United States)

Despite the substantial progress in elucidating the pathophysiology of acute coronary syndromes (ACS) and developing an array of therapeutic advances for the management of these conditions, several challenges still persist. The use of guideline recommendations for the care of patients with ACS by both healthcare providers and hospitals can improve short-term and long-term outcomes and potentially reduce healthcare costs. However, evidence suggests that adherence to guidelines is suboptimal. Several quality improvement programs, by both governmental and nongovernmental organizations, have been developed in an attempt to encourage maximal utilization of evidence-based interventions. In this review, we will examine the evidence for the importance of guideline adherence in the management of ACS, explore predictors of adherence to these guidelines, and provide evidence-based strategies for improving their implementation. PMID:25370002

Sinha, Shashank S; Eagle, Kim A; Vaishnava, Prashant

2015-01-01

292

Extended student quality improvement programs of Xiamen University.  

Science.gov (United States)

This paper describes the recent educational activities and programs organized by the IEEE Engineering in Medicine and Biology Society (EMBS) Xiamen University Student Club. The educational programs covered the undergraduate student mentoring program, seminar series, the top-quality course project, and student scientific projects and contests. These activities have successfully cultivated our students strong interests in the field of biomedical engineering, and also trained our students the skills of solving real-world problems and experience of teamwork collaborations. Our initiatives provide a good example of well-organized education practice for IEEE EMBS student organizations. PMID:25571156

Kaizhi Liu; Xin Luo; Shanshan Yang; Meihong Wu; Yunfeng Wu

2014-08-01

293

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)

294

Quality improvement in radiography in a neonatal intensive care unit  

Energy Technology Data Exchange (ETDEWEB)

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

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

2008-10-15

295

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

Science.gov (United States)

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

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

2013-12-01

296

Optimized Sedation Improves Colonoscopy Quality Long-Term  

Science.gov (United States)

Background. Quality monitoring and improvement is prerequisite for efficient colonoscopy. Aim. To assess the effects of increased sedation administration on colonoscopy performance. Materials and Methods. During Era 1 we prospectively measured four colonoscopy quality indicators: sedation administration, colonoscopy completion rate, adenoma detection rate, and early complications rate in three cohorts: cohort A: intention for total colonoscopy cases; cohort B: cohort A excluding bowel obstruction cases; cohort C: CRC screening-surveillance cases within cohort B. We identified deficiencies and implemented our plan to optimize sedation. We prospectively evaluated its effects in both short- (Era 2) and long-term period (Era 3). Results. We identified that sedation administration and colonoscopy completion rates were below recommended standards. After sedation optimization its use rate increased significantly (38.1% to 55.8% to 69.5%) and colonoscopy completion rate increased from 88.3% to 90.6% to 96.4% in cohort B and from 93.2% to 95.3% to 98.3% in cohort C, in Eras 1, 2, and 3, respectively. Adenoma detection rate increased in cohort C (25.9% to 30.6% to 35%) and early complications rate decreased from 3.4% to 1.9% to 0.3%. Most endoscopists increased significantly their completion rate and this was preserved long-term. Conclusion. Increased sedation administration results in long-lasting improvement of colonoscopy quality indicators.

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

2015-01-01

297

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.

298

Hygienic Quality Improvement of Kung Chom by Gamma Irradiation  

International Nuclear Information System (INIS)

Full text: Sixty four samples of fermented shrimp (Kung Chom) from Buri-Rum province were picked for microbiological quality and chemical properties investigation. The effect of gamma radiation at dose 2 to 8 kGy on microbiological and sensory quality of Kung Chom were evaluated. It was found that the fifty five samples(85.94%) could not meet the Thai Community Product Standard of Kung Chom (TCPS147/2546). Approximately 69 and 6 percent of examined samples were contaminated with Bacillus cereus and Clostridium perfringens, respectively. Irradiation at 8 kGy resulted in upgrading Kung Chom quality to meet the TCPS. In addition, the amount of B. cereus and C. perfringens could be eliminated below detectable level at this dose. For the sensory evaluation, significant changes in color and odor of 6 and 8 kGy irradiated Kung Chom were observed. However, these changes were still within acceptable range. From this study, it can be concluded that the dosage at 8 kGy appeared to be sufficient for improving the microbiological quality of Kung Chom. The irradiated Kung Chom could be kept for 35 days at ambient temperature

299

Improving Service Quality by Using Organizational Citizenship Behavior: Iranian Evidence  

Directory of Open Access Journals (Sweden)

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.

Nour-Mohammad Yaghoubi

2011-09-01

300

Evaluation of an intervention to improve quality of care in family planning programme in the Philippines.  

Science.gov (United States)

This paper presents the results of a longitudinal intervention study carried out in the Davao del Norte province of the Philippines. The intervention, tested through a quasi-experimental design, consisted of training of family planning service providers in information exchange and training of their supervisors in facilitative supervision. The training intervention significantly improved providers' knowledge and quality of care received by clients. Moreover, good quality care received by clients at the time of initiating contraception use increased the likelihood of contraceptive continuation and decreased the likelihood of both having an unintended pregnancy and an unwanted birth. However, comparison of women in the experimental group with those in the control group did not show any significant effect of provider-level training intervention on these client-level outcomes. The reasons for this conundrum and the implications for quality of care are discussed. PMID:21933467

Jain, Anrudh K; Ramarao, Saumya; Kim, Jacqueline; Costello, Marilou

2012-01-01

301

A major advance in the quality of the training aimed at improving results; Un avance importante en la calidad de la formacion orientada a la mejora de resultados  

Energy Technology Data Exchange (ETDEWEB)

Tecnatom has made in the last years several initiatives focused on improving quality and standards of training services with respect to processes,methodology and instructor qualification. Main areas of actuation are described in this article. (Author)

Delgado, J. L.; Gonzalez Anez, F.

2013-03-01

302

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

DEFF Research Database (Denmark)

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.

Quaade, F; Astrup, A

1989-01-01

303

Asan Medical Information System for Healthcare Quality Improvement  

Science.gov (United States)

Objectives This purpose of this paper is to introduce the status of the Asan Medical Center (AMC) medical information system with respect to healthcare quality improvement. Methods Asan Medical Information System (AMIS) is projected to become a completely electronic and digital information hospital. AMIS has played a role in improving the health care quality based on the following measures: safety, effectiveness, patient-centeredness, timeliness, efficiency, privacy, and security. Results AMIS consisted of several distinctive systems: order communication system, electronic medical record, picture archiving communication system, clinical research information system, data warehouse, enterprise resource planning, IT service management system, and disaster recovery system. The most distinctive features of AMIS were the high alert-medication recognition & management system, the integrated and severity stratified alert system, the integrated patient monitoring system, the perioperative diabetic care monitoring and support system, and the clinical indicator management system. Conclusions AMIS provides IT services for AMC, 7 affiliated hospitals and over 5,000 partners clinics, and was developed to improve healthcare services. The current challenge of AMIS is standard and interoperability. A global health IT strategy is needed to get through the current challenges and to provide new services as needed. PMID:21818439

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

2010-01-01

304

ISO 15189:2003--quality management, evaluation and continual improvement.  

Science.gov (United States)

The requirements of ISO 15189:2003 are discussed in the context of a process- and outcome-based quality management model in which the user's needs are the central focus. The requirements of ISO 15189:2003 are examined in terms of organisation and a quality management system, stressing the importance of evidence, document control, and control of records and clinical material. Examples are provided from the areas of resource management, and pre-examination, examination and post-examination processes. In the final section the importance of evaluation and continual improvement is presented in relation to internal audit and external assessment, non-conformity, corrective and preventative action and management review. PMID:16729862

Burnett, David

2006-01-01

305

Improvments in heating regimes and the quality of rolled strips  

International Nuclear Information System (INIS)

The possibility of enhancing the quality of rolled strips of steels and alloys of different structure classes (12Kh18N10T, 50N, 79NM, etc.) has been studied, the improvement in the quality being effected through varying the preheating modes of slabs. The specific defects corresponding to the steels under study are considered. A mechanism of the generation of defects, which is connected with the peculiar features of preheating slabs and ingots for rolling, is shown. A dearease in the temperature of the preheating of slabs for rolling may be used as an efficient means for obviating the defects. The power parameters of the rolling process have been calculated according to the results of plastometric tests, and the preheating modes have been rendered more precise

306

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

307

Power Quality Improvement In A Grid Connected Renewable Energy System  

Directory of Open Access Journals (Sweden)

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.

Sreya Grace Mathew

2014-10-01

308

Possibilities to improve the adaptation quality of calculated material substitutes  

International Nuclear Information System (INIS)

In calculating the composition of material substitutes by a system of simultaneous equations it is possible, by using a so called quality index, to find out of the set of solutions which generally exists that solution which possesses the best adaptation quality. Further improvement is often possible by describing coherent scattering and photoelectric interaction by an own material parameter for each effect. The exact formulation of these quantities as energy indepedent functions is, however, impossible. Using a set of attenuation coefficients at suitably chosen energies as coefficients for the system of equations the best substitutes are found. The solutions for the investigated example are identical with the original relative to its chemical composition. Such solutions may be of use in connection with neutrons, protons, heavy ions and negative pions. The components taken into consideration must, of course, permit such solutions. These facts are discussed in detail by two examples. (orig.)

309

Improving water quality forecasting via data assimilation - Application of maximum likelihood ensemble filter to HSPF  

Science.gov (United States)

An ensemble data assimilation (DA) procedure is developed and evaluated for the Hydrologic Simulation Program - Fortran (HSPF), a widely used watershed water quality model. The procedure aims at improving the accuracy of short-range water quality prediction by updating the model initial conditions (IC) based on real-time observations of hydrologic and water quality variables. The observations assimilated include streamflow, biochemical oxygen demand (BOD), dissolved oxygen (DO), chlorophyll a (CHL-a), nitrate (NO3), phosphate (PO4) and water temperature (TW). The DA procedure uses the maximum likelihood ensemble filter (MLEF), which is capable of handling both nonlinear model dynamics and nonlinear observation equations, in a fixed-lag smoother formulation. For evaluation, the DA procedure was applied to the Kumho Catchment of the Nakdong River Basin in the Republic of Korea. A set of performance measures was used to evaluate analysis and prediction of streamflow and water quality variables. To remove systematic errors in the model simulation originating from structural and parametric errors, a parsimonious bias correction procedure is incorporated into the observation equation. The results show that the DA procedure substantially improves predictive skill for most variables; reduction in root mean square error ranges from 11% to 60% for Day-1 through 3 predictions for all observed variables except DO. It is seen that MLEF handles highly nonlinear hydrologic and biochemical observation equations very well, and that it is an effective DA technique for water quality forecasting.

Kim, Sunghee; Seo, Dong-Jun; Riazi, Hamideh; Shin, Changmin

2014-11-01

310

Initiatives to improve appropriate antibiotic prescribing in primary care.  

Science.gov (United States)

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

Harris, Diane J

2013-11-01

311

Seed treatment of Avena sativa l. with zinc: physiological quality and performance of initial plans  

OpenAIRE

The production and physiological seed quality are directly associated with a good availability of nutrients in the crop. Seed production in areas with zinc deficiency, can generate seeds with low content and concentration of this micronutrient, the logo may be less vigorous seedlings, which may reflect in low yield. In this context, this work aims to evaluate the influence of seed coating with zinc in oat seed physiological quality and initial growth of plants. The experimental design was com...

Sandro de Oliveira; Lizandro Ciciliano Tavares; Elisa Souza Lemes; André Pich Brunes; Igor Leitzke Dias; Géri Eduardo Meneghello

2014-01-01

312

Initial appraisal of aspects of quality assurance in the conditioning of radioactive wastes. Part 1 - quality control and process modelling  

Energy Technology Data Exchange (ETDEWEB)

Basic methodology is presented for examining proposed HLW and ILW waste conditioning processes to identify the quality control and assurance measures to be adopted for both the products and the processes employed. Within the comprehensive quality assurance plan necessary for all radwaste immobilisation schemes an integrated set of features are set out embodying for the product: product fitness quality characteristics; product model; plant product specification; and for the process: process model; process specification; process monitoring and recording procedure. Examples of these sets of features are provided as a basis for adoption and extension on developing process routes. Details of some models and specifications are provided in appendices to aid examination and to invite augmentation and improvements. Standard sampling and inspection procedures and process control methods are briefly reviewed as directed to radwaste processing and package. A substantial appendix examines the application of quality control methods to a specific case of cemented ILW.

Taylor, R.F.; Fellingham, L.R.; Purcell, A.M.

1986-09-01

313

Impacts of Evidence-Based Quality Improvement on Depression in Primary Care: A Randomized Experiment  

Science.gov (United States)

CONTEXT Previous studies testing continuous quality improvement (CQI) for depression showed no effects. Methods for practices to self-improve depression care performance are needed. We assessed the impacts of evidence-based quality improvement (EBQI), a modification of CQI, as carried out by 2 different health care systems, and collected qualitative data on the design and implementation process. OBJECTIVE Evaluate impacts of EBQI on practice-wide depression care and outcomes. DESIGN Practice-level randomized experiment comparing EBQI with usual care. SETTING Six Kaiser Permanente of Northern California and 3 Veterans Administration primary care practices randomly assigned to EBQI teams (6 practices) or usual care (3 practices). Practices included 245 primary care clinicians and 250,000 patients. INTERVENTION Researchers assisted system senior leaders to identify priorities for EBQI teams; initiated the manual-based EBQI process; and provided references and tools. EVALUATION PARTICIPANTS Five hundred and sixty-seven representative patients with major depression. MAIN OUTCOME MEASURES Appropriate treatment, depression, functional status, and satisfaction. RESULTS Depressed patients in EBQI practices showed a trend toward more appropriate treatment compared with those in usual care (46.0% vs 39.9% at 6 months, P = .07), but no significant improvement in 12-month depression symptom outcomes (27.0% vs 36.1% poor depression outcome, P = .18). Social functioning improved significantly (mean score 65.0 vs 56.8 at 12 months, P = .02); physical functioning did not. CONCLUSION Evidence-based quality improvement had perceptible, but modest, effects on practice performance for patients with depression. The modest improvements, along with qualitative data, identify potential future directions for improving CQI research and practice. PMID:16836631

Rubenstein, Lisa V; Meredith, Lisa S; Parker, Louise E; Gordon, Nancy P; Hickey, Scot C; Oken, Carole; Lee, Martin L

2006-01-01

314

A New Model for Software Engineering Systems Quality Improvement  

Directory of Open Access Journals (Sweden)

Full Text Available In the continuing effort to improve the system analysis and design process, several different approaches have been developed. This study will propose a new process methodology solves some problems in traditional system development methodologies it will study the strength and limitation of existing system development methodologies from traditional waterfall to iterative model including (Prototyping, Spiral, Rapid Application Development, XP and RUP to Agility. Propose a new methodology focus on produce a high quality product and suitable for all kind of project. Compare the new methodology with others to view some features that is differentiating it from previous methodologies.

Ahmad A. Al-Rababah

2014-04-01

315

Field quality improvements in superconducting magnets for RHIC  

International Nuclear Information System (INIS)

A number of techniques have been developed-and tested to improve the field quality in the superconducting dipole and quadrupole magnets to be used in the Relativistic Heavy Ion Collider (RHIC). These include adjustment in the coil midplane gap to compensate for the allowed and non-allowed harmonics, inclusion of holes and cutouts in the iron yoke to reduce the so harmonics, and magnetic tuning shims to correct for the residual errors. We compare the measurements with the calculations to test the validity of these concepts

316

Improving health outcomes: innovation, coverage, quality and adherence  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract The Israeli health system has made considerable progress in reducing deaths amenable to medical care but has more to do. This commentary describes how progress in this area results from innovation, coverage, quality, and adherence to treatment. It describes what is being done in Israel and beyond to address each of these factors but concentrates on the often poorly recognised problem of adherence to treatment, describing the growing evidence that it is often sub-optimal and reviewing evidence on what can be done to improve it.

McKee Martin

2012-10-01

317

Learning leadership skills in practice through quality improvement.  

Science.gov (United States)

The development of leadership skills in doctors in training is essential to support both their professional development and the future supply of clinical leaders the NHS so desperately needs. There is, however, limited opportunity in current training programmes for trainees to learn and develop these skills, and what opportunity there is has often focused on management rather than leadership skills. Involvement in trainee-led supported quality improvement projects can teach these skills. We summarise the current limitations in leadership training and discuss how the College's 'Learning To Make a Difference' programme, and others like it, are helping to teach leadership. PMID:24532736

Gamble, James; Vaux, Emma

2014-02-01

318

Using DSP technology to improve sound quality in active speakers  

OpenAIRE

Aditus Science has developed a system to improve the sound quality in speaker systems, using DSP technology. Software developed in MATLAB is being used to make measurements of the speakers via microphones. Based on those results, the parameters for the signal processing in the DSP can be set. A prototype model of the system was used as hardware when the software was developed. The system has several analog and digital inputs and outputs over SPDIF, Ethernet, 3.5mm analog stereo plug etcetera....

Magnusson, Mattias

2010-01-01

319

Voltage Quality Improvement in Islanded Microgrids Supplying Nonlinear Loads  

DEFF Research Database (Denmark)

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.

T. Dehghani, Mohammad; Vahedi, Abolfazl

2012-01-01

320

Process for improving anti-knock qualities of petrol  

Energy Technology Data Exchange (ETDEWEB)

Sulphur compounds and dienes are removed from petrol to improve the anti-knock qualities. According to the invention, this can be achieved in one stage of the process, where petrol is mixed with additives, the mixture is heated to 80 to 100/sup 0/C and the end product is distilled. Iron, nickel and molybdenum carbonyl are suitable as additives, and so are a mixture of iron and manganese carbonyl, a complex mixture of cobalt carbonyl and triphenyl phosphene, a complex mixture of manganese chloride, triphenyl phosphene and lithium-aluminium hydride. The octane number rises in this process. 10 examples illustrate the process.

Namjotkin, N.S.; Gubin, S.P.; Tjurin, W.D.; Fjodorow, W.W.; Usatschjow, W.S.; Matweew, M.S.; Larionow, L.I.; Eliner, A.S.; Baraschkow, R.J.

1977-03-03

321

Lead/acid batteries in systems to improve power quality  

Science.gov (United States)

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

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

322

78 FR 12325 - Medicare and Medicaid Programs; Application From the Center for Improvement in Healthcare Quality...  

Science.gov (United States)

...Medicare and Medicaid Programs; Application From the Center for Improvement in Healthcare Quality (CIHQ) for...Hospital Accreditation Program AGENCY: Centers for...Center for Improvement in Healthcare Quality (CIHQ) for...Medicare or Medicaid programs. DATES: To be...

2013-02-22

323

Air Quality in Mexico City: Policies Implemented for its Improvement  

Science.gov (United States)

Ozone and suspended particles (PM) are two pollutants in the atmosphere of Mexico City Metropolitan Area (MCMA) that still exceed the recommended Mexican health standards. The other criteria pollutants very seldom exceed their corresponding standards. In 2006, the maximum ozone concentrations were above the health standard (0.11 ppm in 1 hour) during 59 percent of the days for an average of 2.2 hours and 130 points of the Air Quality Index (Índice Metropolitano de la Calidad del Aire - IMECA). In contrast, in 1991, 98 percent of the days exceeded the ozone health standard for an average of 6.6 hours and 200 IMECA points. With regards to PM10, in 2006, 80 percent of the sampled concentrations were below the health standard of 120 µg/m3 in 24 hours. However, the annual health standard of 50 µg/m3 is still exceeded. The air quality management in the MCMA is a difficult task due to several adverse factors. The main one is the large population that increased from nearly 15 million in 1992 to more than 18 million at present. As a result, the urban area grows in the adjoined municipalities of the State of Mexico. The vehicular fleet increases also to almost 4 million and the number of industrial facilities is at present 50,000. Consequently, the fuel consumption is very high. The daily energy consumption is estimated to be 44 million liters of equivalent of gasoline. Despite the fact that the air quality has improved in recent years, the related health standards are still exceeded and therefore it is necessary to continue applying the most cost-effective actions to improve the environment quality. Some actions that have contributed most to the reduction of pollutant emissions are the following: Continuous update of the inspection and maintenance program of the vehicular fleet; substitution of the catalytic converters at the end of their useful life; self-regulation of the diesel fleet; use of alternative fuels; update the No-Driving-Day program; establishment of more stringent emission levels of the gasoline fleet; update the detention of pollutant vehicles program; partial exemption of the inspection and maintenance program for cleaner and or highly efficient vehicles; substitution of 3,000 microbuses, 40,000 taxis and 1,200 buses; commissioning of the first Bus Rapid Transit system; implementation of a program for the emissions reduction for the 300 most polluted industrial facilities; and continuous update of the air quality environmental management programs. To continue improving the air quality in the MCMA, the environmental authorities will continue the implementation of the 2002-2010 Air Quality Improvement Program. In 2007 the Green Program was started, this includes those actions that have proven to be effective reduction of pollutant emissions and incorporates new actions for the reduction of local and global pollutant emissions. The most important of these new actions are: substitution of 9,500 microbuses; renewal of all the taxis fleet; commissioning of 10 Bus Rapid Transit lines; commissioning of Line 12 of the underground system; schedules and routes limitations to the cargo fleet; increase 5 percent the number of non-motorized trips (bicycling and walking); regulation of the private public transport passenger stops; requirement of private schools to provide school transport; regulation of non-occupied taxis in circulation; modifications to the circulation of 350 critical crossing points in the city; adoption of intelligent traffic lights systems; complete substitution of the local government vehicle's fleet; implement the inspection and maintenance of the cargo fleet; introduction of low- sulfur diesel, among other measures.

Paramo, V.

2007-12-01

324

Radiological information systems: improvements in service, economy, and quality control?  

International Nuclear Information System (INIS)

By means of complete service control and standardized accounting processes, radiological information systems clearly contribute to improved results. They provide the prerequisites for the establishment of expanded networks and allow comprisons with comparable institutions. The quality of patient care can be improved since, for example, the production time from referral to finished result becomes shorter. Direct access to patient and findings data from several positions is possible. Preliminary results can be viewed immediately. The patient's history is accessible to authorized users at all times. The exact reproducibility and assignment of services leads to more clarity. By means of the information available form RIS, rapid adaptive processes can be undertaken. The system assists the to fulfill the requirements of health regulations. The above-mentioned relationships demonstrate that the EDP systems are well accepted by physicians, medical assistants, and administrators and represent an indispensable aid for solving problems. (orig.)

325

Personal informatics in practice: Improving quality of life through data  

DEFF Research Database (Denmark)

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.

Li, Ian; Medynskiy, Yevgeniy

2012-01-01

326

A New Framework for improving low Quality Fingerprint Images  

Directory of Open Access Journals (Sweden)

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

JitendraChoudhary

2011-11-01

327

Quality, cost efficiency, the new quality-cost imperative: systemwide improvements can yield financial gains.  

Science.gov (United States)

The need to focus internally on cost management has largely replaced the revenue growth model of the past two decades and the external pursuit of opportunities for market and service expansion, according to Stephen R Mayfield, DHA, senior vice president of quality and performance improvement for the American Hospital Association. Outside financial pressure from primarily uncontrollable forces--the potential bundling of Medicare reimbursements to hospitals and nonpayments for readmissions and adverse events, to name a few--have compelled healthcare organizations to spend more time looking inward to finetune existing capabilities. As a result, quality improvement is evolving into a strategy for fiscal stability as well as a critical priority in itself. PMID:21053652

Birk, Susan

2010-01-01

328

Sodium bisulfite improves rhizome yield and quality in Paris polyphylla.  

Science.gov (United States)

Rhizomes of the perennial herb Paris polyphylla have been used in traditional Chinese medicine for hundreds of years. Agricultural production of the rhizomes requires 7-10 years, which is too long to meet the demand of the medicinal industry. Therefore, studies on improving the yield of the herb and shortening the culturing period are imperative. The present work aimed to investigate the effect of sodium bisulfite (NaHSO (3)) on rhizome yield and quality, as well as some related metabolic features of P. polyphylla. The rhizome yield was improved by NaHSO (3) treatment in long-term experiments conducted during 2006 and 2007, with 2 mM NaHSO (3) giving the highest yield. HPLC analysis revealed that NaHSO (3) treatment increased the total saponin content (49 %), including three pennogenin glycosides and two diosgenin glycosides. In a short-term experiment, NaHSO (3) treatment resulted in an enhanced net photosynthetic rate (Pn) for about 4 days without significant changes in the chlorophyll or carotenoid content. The total soluble sugars and sucrose contents in the leaves also significantly increased after 2 mM NaHSO (3) treatment, whereas the starch content changed only slightly. The activities of the enzymes involved in ammonium assimilation (glutamine synthetase [GS] and glutamate dehydrogenase [GDH]) were not significantly influenced. In a long-term experiment, chlorophylls and carotenoids were not significantly affected, and neither was the starch content in leaves, but the total soluble sugars and sucrose contents in leaves increased significantly. The NaHSO (3) treatment significantly increased GS and GDH activities. These results indicate that NaHSO (3) treatment improved the rhizome yield in P. polyphylla, not only through enhancement of Pn but also by improving carbohydrate accumulation and ammonium assimilation. The increased saponin content after NaHSO (3) treatment was indicative of high rhizome quality. PMID:19844861

Yu, Kun; Wang, Yan; Wei, Jian-Rong; Ma, Qing; Wang, Bu-Qiong; Yang, Chang-Hong; Wang, Ming-Hui; Yu, Dan; Li, Jia-Ru

2010-03-01

329

Analysis of Power Quality Based on Real Data and Quality Improvement at Campus Distribution System  

Science.gov (United States)

In recent years, a lot of equipments have been made using the inverter technology from home electric appliances to office automation apparatuses and industrial equipments with the development of power electronics technology. The voltage distortion of a distribution system has increased due to the harmonic currents generated from these apparatuses, and the increase in harmonics continues to be expected. In addition, the distribution system forms the circuit of harmonic distortion expansion by the prevalence of static capacitor without L for power factor improvement. Moreover, the voltage imbalance occurs by diversification of loads or imbalanced connection of single-phase loads. The deterioration of power quality in the distribution system causes various problems such as the overheating of equipments and malfunction of rotating machines. Since the power quality changes according to air temperature and date, it is desirable to measure the voltages and currents continuously for a long time. In this study, the authors focus attention on the distribution system in the University of Fukui campus, and the authors have measured the voltages and currents in the distribution system for a long period with WAMS (Wide Area Measurement System) using NCT (Network Computing Terminal). Based on the obtained data, the authors analyzed the power quality of the campus distribution system from viewpoints of voltage imbalance, current imbalance, voltage THD (Total Harmonic Distortion), and current THD. Furthermore, the improvement effect of power quality of the campus distribution system by exchange of single-phase load connection is described.

Kawasaki, Shoji; Matsuki, Junya; Hayashi, Yasuhiro; Ito, Akitoshi

330

Improvement of Power Quality Using a Hybrid Interline UPQC  

Directory of Open Access Journals (Sweden)

Full Text Available This paper proposed the reduced rating star connected transformer based interline unified power quality conditioner. This work comprises of unified power quality conditioner connected between the two feeders, star connected transformer and LC filter. This hybrid approach significantly improves the performance of UPQC under unbalance source voltage condition. The UPQC adopted to compensate current and voltage-quality problems of sensitive loads and suppressing the load current harmonics under distorted supply conditions. The series converter control strategy is based on the fuzzy-logic controller. The extensive simulation results have carried out in MATLAB/Simulink environment power system blockset toolboxes. From the results it has shown that hybrid interline UPQC achieves superior capability of mitigating the effects of voltage sag/swell and suppressing the load current harmonics, phase current harmonics and neutral current under distorted supply conditions. To validate the results produced by the proposed method, it is compared with the conventional UPQC method and better results obtained from the hybrid approach.

M.K.Elango

2014-05-01

331

Improving Quality of Service from TCP/IP Performance Degradation  

Directory of Open Access Journals (Sweden)

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.

Prof.N..Penchalaiah

2011-02-01

332

IMPROVING BANK QUALITY DIMENSIONS TO INCREASE CUSTOMER SATISFACTION  

Directory of Open Access Journals (Sweden)

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.

L?cr?mioara RADOMIR

2011-01-01

333

ANALYZING AND IMPROVING WEB APPLICATION QUALITY USING DESIGN PATTERNS  

Directory of Open Access Journals (Sweden)

Full Text Available With the mounting demand of web applications, a number of issues allied to its quality have came in existence. In the meadow of web applications, it is very thorny to develop high quality web applications. A design pattern is a general repeatable solution to a generally stirring problem in software design. It should be noted that design pattern is not a finished product that can be directly transformed into source code. Rather design pattern is a depiction or template that describes how to find solution of a problem that can be used in many different situations. Past research has shown that design patterns greatly improved the execution speed of a software application. Design pattern are classified as creational design patterns, structural design pattern, behavioral design pattern, etc. MVC design pattern is very productive for architecting interactive software systems and web applications. This design pattern is partition-independent, because it is expressed in terms of an interactive application running in a single address space. We will design and analyze an algorithm by using MVC approach to improve the performance of web based application. The objective of our study will be to reduce one of the major object oriented features i.e. coupling between model and view segments of web based application. The implementation for the same will be done in by using .NET framework.

Shikha Bhatia

2012-04-01

334

Uncertainty in BMP optimization to improve watershed scale water quality  

Science.gov (United States)

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.

Chaubey, I.; Maringanti, C.

2010-12-01

335

Ripening for improving the quality of inoculated cheese Rhizopus oryzae  

Directory of Open Access Journals (Sweden)

Full Text Available Estikomah SA, Sutarno, Pangastuti A 2010. Ripening for improving the quality of inoculated cheese Rhizopus oryzae. Nusantara Bioscience 2: 1-6. Cheese is dairy product resulted from fermented milk in which the fermentation process can be done by lactic acid bacteria or fungus. Rhizopus oryzae is able to produce lactic acid, protease and lipase. The ripening process changes the taste and texture. The purpose of this study is ripening to improve the quality of inoculated cheese R. oryzae. In this research the ripening was conducted the concentration variation of temperature (5oC, 10oC, 15oC, and time (7 days, 14 days. The procedure of research consisted of two steps, namely un-ripened cheese preparation followed by ripening cheese preparation. Cheese produced in this study analyzed the value of pH, fat content, protein content, amino acid levels and identification of microbe with ANOVA then followed by DMRT at 5% level of significance. Data results were analyzed with the like’s nonparametric statistical test, followed by Fridman Wilcoxon Signed Rank Test (WSRT at 5% level significance. The results showed that the preferred ripened cheese panelist was at a temperature of 15oC for 14 days. Ripening conditions affect pH, fat content, protein content and do not affect the levels of amino acids that formed ripened cheese. The best quality ripened cheese i.e. at a temperature of 15°C for 14 days, had a pH value of 4.40, the highest protein content of 9.78%, and fat content of 35.02%. The results of identified microbe in un-ripened cheese and ripened cheese include Enterococcus hirae (Enterococcus faecalis, Bacillus subtilis, and Aspergillus sp.

ARTINI PANGASTUTI

2010-01-01

336

Implementation of biochemical screening to improve baking quality of barley  

DEFF Research Database (Denmark)

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.

Vincze, Éva; Dionisio, Giuseppe

2011-01-01

337

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

Science.gov (United States)

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

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

2014-11-20

338

SRGM Analyzers Tool of SDLC for Software Improving Quality  

Directory of Open Access Journals (Sweden)

Full Text Available Software Reliability Growth Models (SRGM have been developed to estimate software reliability measures such as software failure rate, number of remaining faults and software reliability. In this paper, the software analyzers tool proposed for deriving several software reliability growth models based on Enhanced Non-homogeneous Poisson Process (ENHPP in the presence of imperfect debugging and error generation. The proposed models are initially formulated for the case when there is no differentiation between failure observation and fault removal testing processes and then this extended for the case when there is a clear differentiation between failure observation and fault removal testing processes. Many Software Reliability Growth Models (SRGM have been developed to describe software failures as a random process and can be used to measure the development status during testing. With SRGM software consultants can easily measure (or evaluate the software reliability (or quality and plot software reliability growth charts.

Mr. Girish Nille

2014-11-01

339

Better quality of life with neuropsychological improvement on HAART  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Successful highly active antiretroviral therapy (HAART regimens have resulted in substantial improvements in the systemic health of HIV infected persons and increased survival times. Despite increased systemic health, the prevalence of minor HIV-associated cognitive impairment appears to be rising with increased longevity, and it remains to be seen what functional outcomes will result from these improvements. Cognitive impairment can dramatically impact functional ability and day-to-day productivity. We assessed the relationship of quality of life (QOL and neuropsychological functioning with successful HAART treatment. Methods In a prospective longitudinal study, subjects were evaluated before instituting HAART (naïve or before changing HAART regimens because current therapy failed to maintain suppression of plasma viral load (treatment failure. Subjects underwent detailed neuropsychological and neurological examinations, as well as psychological evaluation sensitive to possible confounds. Re-evaluation was performed six months after institution of the new HAART regimen and/or if plasma viral load indicated treatment failure. At each evaluation, subjects underwent ultrasensitive HIV RNA quantitative evaluation in both plasma and cerebrospinal fluid. Results HAART successes performed better than failures on measures exploring speed of mental processing (p Conclusion Our study investigated the relationship between HIV-associated neurocognitive impairment and quality of life. HAART failures experienced slower psychomotor processing, and had increased self-reports of physical health complaints and substance abuse. Contrariwise, HAART successes experienced improved mental processing, demonstrating the impact of successful treatment on functioning. With increasing life expectancy for those who are HIV seropositive, it is important to measure cognitive functioning in relation to the actual QOL these individuals report. The study results have implications for the optimal management of HIV-infected persons. Specific support or intervention may be beneficial for those who have failed HAART in order to decrease substance abuse and increase overall physical health.

Hall Colin D

2006-02-01

340

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

OpenAIRE

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...

Buavaraporn, Nattapan

2010-01-01

341

40 CFR Appendix A to Part 132 - Great Lakes Water Quality Initiative Methodologies for Development of Aquatic Life Criteria and...  

Science.gov (United States)

...2010-07-01 2010-07-01 false Great Lakes Water Quality Initiative Methodologies for Development of...Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY GUIDANCE FOR THE GREAT LAKES SYSTEM...

2010-07-01

342

40 CFR Appendix D to Part 132 - Great Lakes Water Quality Initiative Methodology for the Development of Wildlife Criteria  

Science.gov (United States)

...2010-07-01 2010-07-01 false Great Lakes Water Quality Initiative Methodology for the Development...Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY GUIDANCE FOR THE GREAT LAKES SYSTEM...

2010-07-01

343

40 CFR Appendix C to Part 132 - Great Lakes Water Quality Initiative Methodologies for Development of Human Health Criteria and...  

Science.gov (United States)

...2010-07-01 2010-07-01 false Great Lakes Water Quality Initiative Methodologies for Development of...Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY GUIDANCE FOR THE GREAT LAKES SYSTEM...

2010-07-01

344

Limited Impact of a Multicenter Intervention To Improve the Quality and Efficiency of Pneumonia Care*  

Science.gov (United States)

Study objectives To evaluate the impact of a multifactorial intervention to improve the quality, efficiency, and patient understanding of care for community-acquired pneumonia. Design Times series cohort study. Setting Four academic health centers in the New York City metropolitan area. Patients or participants All consecutive adults hospitalized for pneumonia during a 5-month period before (n = 1,013) and after (n = 1,081) implementation of an inpatient quality improvement (QI) initiative. Interventions A multidisciplinary team of opinion leaders developed evidence-based treatment guidelines and critical pathways, conducted educational sessions with physicians, distributed pocket reminder cards, promoted standardized orders, and developed bilingual patient education materials. Measurements and results The average age was 71.4 years, and 44.1% of cases were low risk, 36.8% were moderate risk, and 19.2% were high risk. The preintervention and postintervention groups were well matched on age, sex, race, nursing home residence, pneumonia severity, initial presentation, and most major comorbidities. The intervention increased the use of guideline-recommended antimicrobial therapy from 78.1 to 83.4% (p = 0.003). There was also a borderline decrease in the proportion of patients being discharged prior to becoming clinically stable, from 27.0 to 23.5% (p = 0.06). However, there were no improvements in the other targeted indicators, including time to first dose of antibiotics, proportion receiving antibiotics within 8 h, timely switch to oral antibiotics, timely discharge, length of stay, or patient education outcomes. Conclusions This real-world QI program was able to improve modestly on some quality indicators, but not effect resource use or patient knowledge of their disease. Changing physician and organizational behavior in academic health centers will require the development and implementation of more intensive, system-oriented strategies. PMID:15249449

Halm, Ethan A.; Horowitz, Carol; Silver, Alan; Fein, Alan; Dlugacz, Yosef D.; Hirsch, Bruce; Chassin, Mark R.

2015-01-01

345

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

Scientific Electronic Library Online (English)

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.

J, Dörner; F, Zúñiga; I, López.

2013-06-01

346

Pleural mesothelioma: management updates and nursing initiatives to improve patient care  

Directory of Open Access Journals (Sweden)

Full Text Available Rebecca H LehtoCollege of Nursing, Michigan State University, East Lansing, MI, USAAbstract: Malignant pleural mesothelioma is a relatively rare but aggressive malignancy that is primarily associated with occupational asbestos exposure. While treatment options for mesothelioma have expanded, the disease carries a poor prognosis, with a median of 8 months to 1 year of survival postdiagnosis. This article synthesizes current disease-management practices, including the diagnostic workup, treatment modalities, emerging therapies, and symptom management, and identifies comprehensive nursing strategies that result in the best care based on updated evidence. Multidisciplinary coordination, palliative care initiation, survivorship, and end-of-life care are discussed. Findings may be applied in clinical environments as a resource to help nurses better understand treatment options and care for patients facing malignant pleural mesothelioma. Recommendations for future research are made to move nursing science forward and to improve patient well-being and health-related quality-of-life outcomes for patients and their family members.Keywords: pleural mesothelioma, cancer, symptom management, evidence-based care

Lehto RH

2014-05-01

347

Improving the Optical Quality Factor of the WGM Resonator  

Science.gov (United States)

Resonators usually are characterized with two partially dependent values: finesse (F) and quality factor (Q). The finesse of an empty Fabry-Perot (FP) resonator is defined solely by the quality of its mirrors and is calculated as F=piR(exp 1/2)/(1-R). The maximum up-to-date value of reflectivity R approximately equal to 1 - 1.6 x 10(exp -6) is achieved with dielectric mirrors. An FP resonator made with the mirrors has finesse F=1.9 x 10(exp 6). Further practical increase of the finesse of FP resonators is problematic because of the absorption and the scattering of light in the mirror material through fundamental limit on the reflection losses given by the internal material losses and by thermodynamic density fluctuations on the order of parts in 109. The quality factor of a resonator depends on both its finesse and its geometrical size. A one-dimensional FP resonator has Q=2 F L/lambda, where L is the distance between the mirrors and lambda is the wavelength. It is easy to see that the quality factor of the resonator is unlimited because L is unlimited. F and Q are equally important. In some cases, finesse is technically more valuable than the quality factor. For instance, buildup of the optical power inside the resonator, as well as the Purcell factor, is proportional to finesse. Sometimes, however, the quality factor is more valuable. For example, inverse threshold power of intracavity hyperparametric oscillation is proportional to Q(exp 2) and efficiency of parametric frequency mixing is proportional to Q(exp 3). Therefore, it is important to know both the maximally achievable finesse and quality factor values of a resonator. Whispering gallery mode (WGM) resonators are capable of achieving larger finesse compared to FP resonators. For instance, fused silica resonators with finesse 2.3 x 10(exp 6) and 2.8 x 10(exp 6) have been demonstrated. Crystalline WGM resonators reveal even larger finesse values, F=6.3 x 10(exp 6), because of low attenuation of light in the transparent optical crystals. The larger values of F and Q result in the enhancement of various nonlinear processes. Low-threshold Raman lasing, optomechanical oscillations, frequency doubling, and hyperparametric oscillations based on these resonators have been recently demonstrated. Theory predicts a possibility of nearly 10(exp 14) room-temperature optical Q-factors of optical crystalline WGM resonators, which correspond to finesse levels higher than 10(exp 9). Experiments have shown numbers a thousand times lower than that. The difference occurs due to media imperfections. To substantially reduce the optical losses caused by the imperfections, a specific, multi-step, asymptotic processing of the resonator is implemented. The technique has been initially developed to reduce microwave absorption in dielectric resonators. One step of the process consists of mechanical polishing performed after high temperature annealing. Several steps repeat one after another to lead to significant reduction in optical attenuation and, as a result, to the increase of Q-factor as well as finesse of the resonator which demonstrates a CaF2 WGM resonator with F greater than 10(exp 7) and Q greater than 10(exp 11).

Savchenkov, Anatoliy; Matsko, Andrey; Iltchenko, Vladimir

2008-01-01

348

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.

349

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

350

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

351

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)

352

Quality Improvement of Olive Oils Produced In The Eastern Morocco  

Directory of Open Access Journals (Sweden)

Full Text Available The aim of this study is to characterize olive oils and to distinguish the production areas according to the specific soil and climate. The goal is to label "local product" olive oils produced in the eastern region of Morocco. The studies focus on oils from three consecutive olives harvest periods. Olive oils, obtained from eastern small olive oil-producers, characteristics were determined using conventional methods analysis, fatty acid and triacylglycerol compositions. This study shows a marked improvement in quality parameters of olive oils produced in this region. There is a difference in the phenol content between oils of different origins; this parameter content can be used as marker to distinguish olive oils according to the production area

Tanouti K

2011-01-01

353

Improvement of Tagliatelle Quality by Addition of Red Quinoa Flour  

Directory of Open Access Journals (Sweden)

Full Text Available In order to diversification of tagliatelle pasta and increasing segment of consumers it was intended to improvement of tagliatelle pasta quality by addition of red quinoa flour. The products obtained at Bakery Pilot Station of University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca was the result of original recipe. To optimize the recipe were made four experimental variants, white flour and red quinoa flour is used in different proportions: Variant 1 – plain tagliatelle pasta (control sample who used white flour WF in 100%, Variant 2 consisting of 15% red quinoa flour (15 QF, Variant 3 consisting of 30 % red quinoa flour (30 QF and Variant 4 consisting of 50 % red quinoa flour (50 RQF. The experimental variants was analyzed for physico-chemical: moisture content, protein content and acidity. The sensory attributes, were evaluated by using a 9-point Hedonic scale. Present study indicated that the variant 3 were most accepted by consumers.

Anamaria Pop

2014-11-01

354

Focused anesthesia interview resource to improve efficiency and quality.  

Science.gov (United States)

In an effort to reduce costs, many hospitals may use registered nurses (RNs) with little to no formal education or training in anesthetic or surgical risk to perform anesthesia preoperative interviews (APIs). This lack of education and training can result in day of surgery delays and cancellations because of suboptimal preparation of patients for anesthesia and surgery. The Focused Anesthesia Interview Resource (FAIR) establishes minimum educational preparation for conducting APIs through educational modules and electronic triggers that prompt further questions and consultation flags or comorbidities for which an anesthesia provider is consulted. The goal of this process improvement project was to determine if fidelity to the FAIR tool enhanced the ability of RNs to perform preoperative anesthesia interviews and, if so, did this result in decreased surgical cancellations and delays? Retrospectively, we assessed completion rates of the training modules and anesthesia preoperative records as well as day of surgery cancellation and delay rates before and after the implementation of the FAIR tool. All RNs who might rotate to the API clinic (n=33) were included in the sample. Nurse fidelity to completion of the training modules was high (91%). Five hundred anesthesia interview records were randomly selected, reviewed, and completion rates scored. Our pre-/post-quasi-experimental design compared record completion rates. After the implementation of FAIR, significant improvement in identification of patients with hypertension (P<.01) and cardiac disease (P<.05) was noted. In addition, cancellation rates declined from 3.33% to 2.31% (P<.05) and first case delays decreased from 7.54% to 6.99%, although this was not statistically significant. FAIR improved preoperative record completion rates and decreased surgical cancellations, which improved perioperative quality and efficiency. PMID:23164202

Muckler, Virginia C; Vacchiano, Charles A; Sanders, Edward G; Wilson, Janet P; Champagne, Mary T

2012-12-01

355

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

OpenAIRE

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...

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

2009-01-01

356

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

Science.gov (United States)

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

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

2014-12-01

357

Improving the quality of cancer care in America.  

Science.gov (United States)

Thomas Feeley is the Helen Shafer Fly Distinguished Professor of Anesthesiology, and the Head of the Institute for Cancer Care Innovation at the University of Texas MD Anderson Cancer Center (TX, USA), which he has led since its formation in 2008. He received his undergraduate degree and M.D. from Boston University (MA, USA) and trained in anesthesiology and critical care medicine at Harvard’s Beth Israel Hospital in Boston. He was a faculty member at Stanford University (CA, USA) for 19 years prior to moving to The University of Texas MD Anderson Cancer Center in 1997 to lead the then newly created Division of Anesthesiology and Critical Care. Dr Feeley served on the Institute of Medicine’s Committee on Improving the Quality of Cancer Care: Addressing the Challenges of an Aging Population that published its report in September of 2013. He was recently appointed by Texas Governor Rick Perry to the board of directors of the Texas Institute for Health Care Quality and Efficiency. In addition to his research and administrative roles, Dr Feeley provides patient care services in the delivery of anesthesia. PMID:24947254

Feeley, Thomas W; Lake, Francesca

2014-05-01

358

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

359

Quality improvement of patient care - forensic pathologists' perspective.  

Science.gov (United States)

In the U.S. today, the pathologists, both hospital-based and forensic, are regularly involved in quality assurance (QA) programs, the evaluation of patient safety at all levels of medical care, including treatments in walk-in clinics and medical offices. In the United States, official death investigations are conducted by the Medical Examiner's Office. The Medical Examiner's Office is aided in its work by a network of coordinating agencies to provide complete, comprehensive reporting and investigation of deaths placed under its jurisdiction. Those agencies are the Health Department, the Registrar of Vital Statistics on Births and Deaths, Division of Health Facilities, the Hospital Office of Decedent Affairs and the State medical licensing agencies, as well as the various law enforcement and regulatory agencies and the prosecuting attorney's office. Forensic pathologists are witnesses to the fatal results of often avoidable untoward events. They need to use their experiences to address and emphasize overall prevention programs to improve the quality of life in the community, to publicize the avoidable actions which can lead to untoward results. In the current growing atmosphere of threatening chemical, biological and radiation terrorist attacks, the health care system, especially hospitals, including emergency services, are mobilizing to develop plans to meet possible anticipated need for disaster preparedness. PMID:17275382

Noguchi, Thomas T; Rogers, Christopher; Sathyavagiswaran, Lakshmanan

2007-03-01

360

Improving regional variation using quality of care measures  

Directory of Open Access Journals (Sweden)

Full Text Available Scott A Berkowitz1, Gary Gerstenblith1, Robert Herbert2, Gerard Anderson1,21Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; 2Center for Hospital Finance and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USAAbstract: There is significant regional variability in the quality of care provided in the United States. This article compares regional performance for three measures that focus on transitions in care, and the care of patients with multiple conditions. Admissions for people with ambulatory care-sensitive conditions, hospital readmissions within 30 days of discharge, and compliance with practice guidelines for people with three chronic conditions (congestive heart failure, chronic obstructive pulmonary disease, and diabetes were analyzed using data drawn from the Centers for Medicare & Medicaid Services’ Standard Analytic Files for 5% of a 2004 national sample of Medicare beneficiaries which was divided by hospital referral regions and regional performance. There were significant regional differences in performance which we hypothesize could be improved through better care coordination and system management.Keywords: performance, quality, chronic condition, ambulatory care, sensitive conditions, readmissions

Scott A Berkowitz

2009-11-01

361

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)

362

Does laboratory automation for the preanalytical phase improve data quality?  

Science.gov (United States)

Our aim was to evaluate whether automation for the preanalytical phase improves data quality. Blood from 100 volunteers was collected into two vacuum tubes. One sample from each volunteer was respectively assigned to (G1) traditional processing, starting with centrifugation at 1200 g for 10 min, and (G2) the MODULAR PRE-ANALYTICALS EVO-MPA system. The routine clinical chemistry tests were performed in duplicate on the same instrument Cobas 6000 module. G1 samples were uncapped manually and immediately placed into the instrument. G2 samples were directly fed from the MPA system to the instrument without further staff intervention. At the end, (1) the G1 samples were stored for 6 h at 4 °C as prescribed in our accredited laboratory and (2) the G2 samples were stored for 6 h in the MPA output buffer. Results from G1 and G2, before and after storage, were compared. Significant increases were observed in G1 compared with G2 samples as follows: (1) before storage for alkaline phosphatase (ALP), lactate dehydrogenase (LDH), phosphate (P), magnesium (MG), iron (FE), and hemolysis index and (2) after storage for total cholesterol (COL), triglycerides (TG), total protein (TP), albumin (ALB), blood urea nitrogen (BUN), creatinine (CRE), uric acid (UA), ALP, pancreatic amylase, aspartate aminotransferase (AST), alanine aminotransferase (ALT), g-glutamyltransferase (GGT), LDH, creatine kinase (CK), calcium (CA), FE, sodium (NA), potassium (K), and hemolysis index. Moreover, significant increases were observed in (3) G1-after versus G1-before storage samples for COL, high-density lipoprotein cholesterol, TG, TP, ALB, BUN, CRE, UA, AST, ALT, GGT, LDH, P, CA, MG, FE, NA, K, and hemolysis index and (4) G2-after versus G2-before storage only for BUN, AST, LDH, P, and CA. In conclusion, our results show that the MPA system improves the quality of laboratory testing. PMID:23686657

Lima-Oliveira, Gabriel; Lippi, Giuseppe; Salvagno, Gian Luca; Danese, Elisa; Montagnana, Martina; Brocco, Giorgio; Voi, Monica; Picheth, Geraldo; Guidi, Gian Cesare

2013-10-01

363

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

364

Flattening filter removal for improved image quality of megavoltage fluoroscopy  

Energy Technology Data Exchange (ETDEWEB)

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.

Christensen, James D.; Kirichenko, Alexander; Gayou, Olivier [Department of Radiation Oncology, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212 (United States)

2013-08-15

365

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)

366

AISI/DOE Technology Roadmap Program: Improved Surface Quality of Exposed Automotive Sheet Steels  

Energy Technology Data Exchange (ETDEWEB)

Surface quality of sheet steels is an important economic and technical issue for applications such as critical automotive surfaces. This project was therefore initiated to develop a more quantitative methodology for measuring surface imperfections, and to assess their response to forming and painting, particularly with respect to their visibility or invisibility after painting. The objectives were met, and included evaluation of a variety of imperfections present on commercial sheet surfaces or simulated using methods developed in the laboratory. The results are expected to have significant implications with respect to the methodology for assessing surface imperfections, development of quantitative criteria for surface inspection, and understanding and improving key painting process characteristics that influence the perceived quality of sheet steel surfaces.

John G. Speer; David K. Matlock; Noel Meyers; Young-Min Choi

2002-10-10

367

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

368

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

Science.gov (United States)

...Assessment and Performance Improvement § 460.134 Minimum requirements...assessment and performance improvement program. (a) Minimum...assessment and performance improvement program must include, but...functioning. (v) Quality of life of participants....

2010-10-01

369

Cost Sharing and Water Pricing to Improve River Water Quality  

Directory of Open Access Journals (Sweden)

Full Text Available 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 River basin is determined with Analytic Hierarchy Process (AHP with Expert Choice 2000. The charge percentage of BJP-SDA toward the cost is recovered with three criteria, those are the raw water (domestic and industry 28.4% ; hydropower 28.8% ; irrigation 27.9% ; flood control 12.5% and to improve the water quality 2.3%. The charge percentage of BJD-SDA toward the cost is recovered with four criterias, they are: the raw water 26.10%; hydropower 32.7%; irrigation 27.7% ; flood control 11,3% and to improvement of the water quality 2.2%. With the allocation of river water for dilution is 7.5 m3 /sec during three months on dry season, BJP-SDA charge to improve the water quality in Brantas River has the lowest, that is, 2.2 � 2.3% from the cost which will be covered. Under the O and M cost, the percentage of the BJP-SDA charge is 0.8% and under the benefit value of the user is 1.7% from the cost which will be covered. The water pricing of BJP-SDA for the beneficiaries of the river water quality improvement is the water allocation for dilution divides with the cost which will be covered. For the O and M cost recovery, the water price is Rp. 112 until Rp. 117 per m3, and for the full cost recovery is Rp. 126 until Rp. 132 per m3. Normal 0 false false false IN X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} [How to cite this article: Sangkawati, S., Hadihardaja, I.K, and Hadihardaja, J. (2013. Cost Sharing and Water Pricing to Improve River Water Quality. International Journal of Waste Resources (IJWR, 3(1, 26-33]. doi: 10.12777/ijwr.3.1.2013.26-33] Normal 0 false false false IN X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

Iwan K. Hadihardaja

2013-02-01

370

The Physician Mentored Implementation Model: A Promising Quality Improvement Framework for Health Care Change.  

Science.gov (United States)

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

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

2014-10-28

371

Improvement of reflux symptom related quality of life after Helicobacter pylori eradication therapy.  

Science.gov (United States)

The relationship between Helicobacter pylori (H. pylori) eradication therapy and the risk of developing gastroesophageal reflux disease (GERD) is controversial. We investigated the influence of H. pylori eradication on the risk of GERD by focusing on the quality of life (QOL) and evaluating reflux symptoms. Patients with H. pylori infection were administered triple therapy for H. pylori eradication. At 3 months and 1 year after the eradication therapy, surveys were conducted to determine the health-related QOL by quality of life in reflux and dyspepsia-Japanese version, (QOLRAD-J) and the severity of GERD symptoms by Carlsson-Dent questionnaire (CDQ). Forty patients were included in the analysis. Although no significant changes of these scores were apparent 3 months after H. pylori eradication, the QOLRAD-J and CDQ scores were significantly improved after 1 year. The degree of improvement was even more marked in cases with initially low scores. In conclusion, improved GERD-related QOL and reflux symptoms were noted 1 year after H. pylori eradication therapy. In addition, the degree of improvement was more marked in cases with severe reflux symptoms. PMID:23524980

Hirata, Kenro; Suzuki, Hidekazu; Matsuzaki, Juntaro; Masaoka, Tatsuhiro; Saito, Yoshimasa; Nishizawa, Toshihiro; Iwasaki, Eisuke; Fukuhara, Seiichiro; Okada, Sawako; Hibi, Toshifumi

2013-03-01

372

Validation of a Method for Assessing Resident Physicians’ Quality Improvement Proposals  

Science.gov (United States)

BACKGROUND Residency programs involve trainees in quality improvement (QI) projects to evaluate competency in systems-based practice and practice-based learning and improvement. Valid approaches to assess QI proposals are lacking. OBJECTIVE We developed an instrument for assessing resident QI proposals—the Quality Improvement Proposal Assessment Tool (QIPAT-7)—and determined its validity and reliability. DESIGN QIPAT-7 content was initially obtained from a national panel of QI experts. Through an iterative process, the instrument was refined, pilot-tested, and revised. PARTICIPANTS Seven raters used the instrument to assess 45 resident QI proposals. MEASUREMENTS Principal factor analysis was used to explore the dimensionality of instrument scores. Cronbach’s alpha and intraclass correlations were calculated to determine internal consistency and interrater reliability, respectively. RESULTS QIPAT-7 items comprised a single factor (eigenvalue?=?3.4) suggesting a single assessment dimension. Interrater reliability for each item (range 0.79 to 0.93) and internal consistency reliability among the items (Cronbach’s alpha?=?0.87) were high. CONCLUSIONS This method for assessing resident physician QI proposals is supported by content and internal structure validity evidence. QIPAT-7 is a useful tool for assessing resident QI proposals. Future research should determine the reliability of QIPAT-7 scores in other residency and fellowship training programs. Correlations should also be made between assessment scores and criteria for QI proposal success such as implementation of QI proposals, resident scholarly productivity, and improved patient outcomes. PMID:17602270

Leenstra, James L.; Beckman, Thomas J.; Reed, Darcy A.; Mundell, William C.; Thomas, Kris G.; Krajicek, Bryan J.; Cha, Stephen S.; Kolars, Joseph C.

2007-01-01

373

Technological developments and approaches to improving service quality.  

Science.gov (United States)

In summary, major paradigm shifts in the health care industry are altering the way technology is maintained and supported. Service organizations are now responsible for maintaining a broader base of technology within the health care delivery network and must to this on an extremely rapid, efficient, and productive basis. A number of new technologies are coming on-line, which can allow a health care technology service organization to experience significant improvements in profitability, efficiency, and productivity. To realize maximum benefit from these technologies, service organizations may find themselves re-engineering their service processes. The author believes that this is a requirement for many service organizations, regardless of whether new technology is implemented. The traditional approaches to service delivery are ineffective in managing the new structural realities and service requirements of today's health care environment. New strategies and tactics are required for ensuring that these requirements are met. These approaches will no doubt improve the overall quality, productivity, and efficiency of service and are based on best practices utilized by leading OEMs and ISOs in the medical electronics and other high technology service industry such as information technology and telecommunications, where the service organization is responsible for supporting a broad array of the technology over a large geography with a densely populated installed base, not unlike the typical health care delivery service environment. Once operational improvements are made, a service organization can take advantage of the productivity and efficiency gains brought on by new technology. Organizations interested in doing so are urged to thoroughly research the current state-of-the-art and best practices, because there are numerous systems currently available off-the-shelf. The author believes that new technology will be a basic requirement for competing in the health care technology service marketplace, because it can significantly affect the profitability of service organizations. This technology will help level the playing field between ISOs, OEMs, and biomedical personnel. As our research suggests, efficiently operating biomedical personnel can achieve a significantly higher utilization and profitability than efficiently operating OEMs, due to the advantages of lower overhead and operating cost structure. In general, the process to improve service productivity and efficiency involves a review of current service operations and understanding of the customer environment perceptions as well as understanding of key service factors parameters. From there, service organizations should identify the current state-of-the-art service and infrastructure systems and technology. Based on this assessment, a service organization can evaluate best practices and identify new strategies and tactics for improving service delivery. Through better service management control and education of users on the improvement in service, which the new processes and technologies provide, the service organization can realize real, quantifiable improvements in service quality, productivity, and profitability. PMID:10067179

Blumberg, M R

1999-01-01

374

A Knowledge Management Approach to Support Software Process Improvement Implementation Initiatives  

Science.gov (United States)

The success of software process improvement (SPI) implementation initiatives depends fundamentally of the strategies adopted to support the execution of such initiatives. Therefore, it is essential to define adequate SPI implementation strategies aiming to facilitate the achievement of organizational business goals and to increase the benefits of process improvements. The objective of this work is to present an approach to support the execution of SPI implementation initiatives. We also describe a methodology applied to capture knowledge related to critical success factors that influence SPI initiatives. This knowledge was used to define effective SPI strategies aiming to increase the success of SPI initiatives coordinated by a specific SPI consultancy organization. This work also presents the functionalities of a set of tools integrated in a process-centered knowledge management environment, named CORE-KM, customized to support the presented approach.

Montoni, Mariano Angel; Cerdeiral, Cristina; Zanetti, David; Cavalcanti da Rocha, Ana Regina

375

NASA Symposium on Productivity and Quality: Strategies for Improving Operations in Government and Industry  

Science.gov (United States)

The purpose of the Symposium is to increase the awareness of productivity and quality issues in the United States, and to foster national initiatives through government and industry executive leadership. The Symposium will provide a forum for discussion of white-collar productivity issues by experienced executives from successful organizations and an opportunity to share information learned through Productivity initiatives in govemment, industry and academic organizations. It will focus on white-collar organizational issues that are common to large companies and technology oriented organizations. The Symposium program will include strategies for improving operations in government and industry and will be responsive to the management issues viewed necessary to increase our nation's productivity growth rate.

1984-01-01

376

[Continuous nursing education to improve the quality of health care].  

Science.gov (United States)

Health care and today's medical and technical achievements and approved standards of treatment provide comprehensive quality, safety and traceability of medical procedures respecting the principles of health protection. Continuous education improves the quality of nursing health care and increases the effectiveness of patient care, consequently maintaining and enhancing patient safety. Patient health problems impose the need of appropriate, planned and timely nursing care and treatment. In providing quality nursing care, attention is focused on the patient and his/her needs in order to maintain and increase their safety, satisfaction, independence and recovery or peaceful death, so the health and nursing practices must be systematized, planned and based on knowledge and experience. Health and nursing care of patients at risk of developing acute and chronic wounds or already suffering from some form of this imply preventive measures that are provided through patient education, motivation, monitoring, early recognition of risk factors and causes, and reducing or removing them through the prescribed necessary medical treatment which is safe depending on the patient health status. Except for preventive measures, nursing care of patients who already suffer from some form of acute or chronic wounds is focused on the care and treatment of damaged tissue by providing appropriate and timely diagnosis, timely and proper evaluation of the wound and patient general status, knowledge and understanding of the wide range of local, oral and parenteral therapy and treatment, aiming to increase patient safety by preventing progression of the patient general condition and local wound status and reducing the possibility of developing infection or other complications of the underlying disease. In the overall patient management, through nursing process, medical interventions are implemented and aimed to maintain and optimize health status, prevent complications of existing diseases and conditions, provide appropriate wound treatment, increase satisfaction, reduce pain, increase mobility, reduce and eliminate aggravating factors, and achieve a satisfactory functional and aesthetic outcome. Many scientific researches and knowledge about the pathophysiological processes of wound formation and healing are currently available. Modern achievements can accelerate independence, reduce pain and encourage faster wound healing, thus it is important to continuously develop awareness, knowledge and experience, along with the treatment to achieve, maintain and enhance the quality of health care and patient safety. PMID:25326985

Fumi?, Nera; Marinovi?, Marin; Brajan, Dolores

2014-10-01

377

Understanding context for quality improvement: artefacts, affordances and socio-material infrastructure.  

Science.gov (United States)

Against a backdrop of growing concern for patient safety and service quality, modern health-care systems are witnessing a proliferation of improvement initiatives. The impact is often variable, however, and a key theme to emerge from evaluations of these efforts is a recognition of the effects of local context on the success or otherwise of an intervention. However, the 'context' tends to be understood in terms of higher order issues such as structure, culture and leadership. This article explores a dimension of context not typically taken into account in the health-care improvement literature: the infrastructural context. Many quality improvement interventions hinge on the introduction of artefacts to support behavioural change in the workplace. Despite calls from scholars of technology in practice for a greater acknowledgement of the role of such mundane artefacts in supporting the organisation of health-care work, they are rarely considered in these terms in evaluations of improvement efforts. In this article, I argue that understanding the potential generative effects of artefacts for quality improvement purposes requires an understanding of their 'affordances' and how these relate to the socio-material infrastructure into which they are to be introduced, and/or the technologies they are designed to replace. Integrated care pathway implementation is examined to illustrate this position. Drawing on qualitative case studies of integrated care pathway development processes undertaken in the UK National Health Service and ethnographic research on the international care pathway community, I consider the infrastructural reasons behind the challenges of making pathways work in organising health care, and why, contrary to the aspirations of their proponents, they often appear to increase rather than decrease paperwork. PMID:23117591

Allen, Davina

2013-09-01

378

The improvement of quality and analysis of radionuclide images  

International Nuclear Information System (INIS)

The quality of images was improved by constructing equipment and developing techniques that performed time of flight (TOF) positron emission computed tomography (PECT). The merits of incorporating TOF into PECT have been assessed by measurement of temporal resolution, positional accuracy and variation in response of discrete radioactive line sources (RLS), together with estimation of contrast resolution (CR) from a simulated tomographic imaging system. The accuracy and reproducibility of extracting numerical data from images has been examined by developing two edge detection algorithms (EDAs) for defining regions of interest (ROI) about an organ. The EDAs were assessed by using computed simulations, radioactive phantoms, clinical studies and comparisons with other EDAs and methods of defining ROIs. The criteria of an EDA's response under varying imaging conditions have been established. The results show the factors which limit the application of EDAs and show that the EDAs developed improve correlation in measuring left ventricular ejection fractions with other imaging techniques and reduce intra- and inter-observer variation in comparison with other methods of defining ROIs. (U.K.)

379

Spherical deconvolution improves quality of single particle reconstruction.  

Science.gov (United States)

One single-particle reconstruction technique is the reconstruction of macromolecules from projection images of randomly oriented particles (SPRR). In SPRR the reliability and consequent interpretation of the final reconstruction is affected by errors arising from incorrect assignment of projection angles to individual particles. In order to improve the resolution of SPRR we studied the influence of imperfect assignment on 3D blurring. We find that this blurring can be described as a Point Spread Function (PSF) that depends on the distance from geometrical center of the reconstructed volume and that blurring is higher at the periphery. This particular PSF can be described by an almost pure tangential angular function with a negligible radial component. We have developed a reliable algorithm for spherical deconvolution of the 3D reconstruction. This spherical deconvolution operation was tested on reconstructions of GroEL and mitochondrial ribosomes. We show that spherical deconvolution improves the quality of SPRR by reducing blurring and enhancing high frequency components, particularly near the periphery of the reconstruction. PMID:24841283

Kishchenko, Gregory P; Leith, Ardean

2014-07-01

380

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

381

Improving Industrial Energy Quality by an Active Current Filter  

Directory of Open Access Journals (Sweden)

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.

Reyes–Trujillo E

2010-10-01

382

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

Directory of Open Access Journals (Sweden)

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.

Rubenstein Lisa V

2011-08-01

383

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

Science.gov (United States)

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. PMID:21806808

2011-01-01

384

A SELF PROCESS IMPROVEMENT FOR ACHIEVING HIGH SOFTWARE QUALITY  

OpenAIRE

Quality has been one of the most important factors in judging any product. Quality means “a degree or grade of excellence or worth”. Quality is a term that is usually described using adjectives. Quality has several attributes to it, some of which can be quantified using metrics. These attributes such as usability, portability, security, performance, reliability etc have different importance in different projects. Different software quality assurance methods & practices have been used in d...

Joshi, Dr Shashank D.; Bhor, Milind P.; Mr. J.NAVEENKUMAR,

2011-01-01

385

Quality Improvement in Acute Coronary Care : Combining the Use of an Interactive Quality Registry with a Quality Improvement Collaborative to Improve Clinical Outcome in Patients with Acute Myocardial Infarction  

OpenAIRE

The quality of care for Swedish patients with acute myocardial infarction (AMI) is continuously increasing. Nevertheless, a great potential for improvement still exists. The aim of the present study was to design and implement a systematic quality improvement (QI) collaborative in the area of AMI care, and to validate its usefulness primarily by analyzing its effect on hospital adherence to national guidelines. Also, the impact on patient morbidity and mortality was to be evaluated. The inter...

Carlhed, Rickard

2012-01-01

386

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

Energy Technology Data Exchange (ETDEWEB)

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.)

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

387

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.)

388

TOWARDS A CULTURE OF QUALITY IN HIGHER EDUCATION INITIATIVES : RUSA IN HIMACHAL PRADESH  

Directory of Open Access Journals (Sweden)

Full Text Available Development of a knowledge economy is a prerequisite for the advancement of a society and a nation, at large. While access and equity in education is important, it is quality of education that should be considered paramount. Various agencies of the Government of India have been working towards providing the best education to its citizens. With relation to higher education in India, the introduction of RUSA (Rashtriya Uchchatar Shiksha Abhiyan is one such flagship initiative. It is an endeavor towards providing better quality higher education in India. Despite being a project with a progressive vision and intent, the program suffers from certain structural, systemic and administrative impediments that need rectification. This paper is an attempt to highlight some of these impediments that lay in the way of effective implementation of RUSA in Himachal Pradesh. A special emphasis will be laid on the need for quality in higher education and RUSA, in particular, at the executional level.

Shelly Parul Bhadwal

2014-04-01

389

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

DEFF Research Database (Denmark)

Quality of pork has become a complex and dynamic theme involving the total pork chain from fork-to-farm-to-fork with a multitude of interacting aspects related to people's demands as consumers, and the demands of people as citizens and producers for economic and environmental sustainability. The European Unions self-sufficiency and leading position in the global market for pork and pork products is challenged by a number of non-European countries. Therefore, there is a need for developing innovative, integrated, and sustainable food production chains of high quality pork products matching consumer demands. A large EU-project (Q-PorkChains) funded by EU 6th framework programme was initiated in January 2007. The aim of Q-PorkChains is to improve the quality of pork and its products for the consumer and to develop innovative, integrated and sustainable food production chains with low environmental impact. Q-PorkChains is composed of six research modules (consumer and citizen demands, pig production, product development, pork chain management, molecular quality control and knowledge synthesis) and two horizontal modules focusing on implementation of obtained knowledge in pilot and demonstration chains and dissemination to stakeholders at all levels. The project comprises 51 partners from 15 European and 4 non-European countries (China South Africa, Brazil and USA).

Christensen, M.; Grunert, Klaus G.

390

Accreditation and improvement in process quality: A nationwide study  

DEFF Research Database (Denmark)

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.

Bie Bogh, SØren

391

Improvement of Power Quality by UPQC Using Different Intelligent Controls: A Literature Review  

Directory of Open Access Journals (Sweden)

Full Text Available This paper presents a comprehensive review on the unified power quality conditioner (UPQC to improve electric power quality. This is intended to present a broad overview on the different possible intelligent controls used with UPQC.

Manoj Kumar

2013-03-01

392

Improvement of Power Quality by UPQC Using Different Intelligent Controls: A Literature Review  

OpenAIRE

This paper presents a comprehensive review on the unified power quality conditioner (UPQC) to improve electric power quality. This is intended to present a broad overview on the different possible intelligent controls used with UPQC.

Mr. Manoj Kumar; Rintu Khanna; Vinita Vasundhara

2013-01-01

393

Improving ammonia emissions in air quality modelling for France  

Science.gov (United States)

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.

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

2014-08-01

394

Quality assurance through quality improvement and professional development in the National Breast and Cervical Cancer Early Detection Program.  

Science.gov (United States)

Quality assurance (QA) is the process of providing evidence that the outcome meets the established standards. Quality improvement (QI), by contrast, is the act of methodically developing ways to meet acceptable quality standards and evaluating current processes to improve overall performance. In the case of the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), the desired outcome is the delivery of quality health care services to program clients. The NBCCEDP provides professional development to ensure that participating providers have current knowledge of evidence-based clinical standards regarding breast and cervical cancer screening and diagnosis and are monitoring women with abnormal screening results for timely follow-up. To assess the quality of clinical care provided to NBCCEDP clients, performance data are collected by NBCCEDP grantees and compared against predetermined Centers for Disease Control and Prevention (CDC) benchmarks known as Data Quality Indicator Guides. In this article, the authors describe 1) the development and use of indicators for QI in the NBCCEDP and 2) the professional development activities implemented to improve clinical outcomes. QA identifies problems, whereas QI systematically corrects them. The quality of service delivery and improved patient outcomes among NBCCEDP grantees has enhanced significantly because of continuous monitoring of performance and professional development. By using QA, NBCCEDP grantees can maximize the quality of patient screening, diagnostic services, and follow-up. Examples of grantee activities to maintain quality of care are also described in this report. PMID:25099901

Siegl, Elvira J; Miller, Jacqueline W; Khan, Kris; Harris, Susan E

2014-08-15

395

A longitudinal, experiential quality improvement curriculum meeting ACGME competencies for geriatrics fellows: lessons learned.  

Science.gov (United States)

Quality improvement (QI) initiatives are critical in the care of older adults who are more vulnerable to substandard care. QI education meets aspects of core Accreditation Council of Graduate Medical Education competencies and prepares learners for the rising focus on performance measurement in health care. The authors developed, implemented, and evaluated a QI curriculum for geriatrics fellows. The evidence-based curriculum included didactics and a fellow-led QI intervention based on audit and feedback through the Practice Improvement Module in Care of the Vulnerable Elderly. QI knowledge, attitudes, and behaviors were assessed before and after the improvement project. Fellows' knowledge of QI improved (p = .0156), but behavior did not change significantly across a short-term improvement project. A structured focus group with fellows revealed themes of accountability and the importance of interprofessional teamwork in QI. QI education for geriatrics fellows can be feasible, well received, and prepare future physician leaders for patient-centered care, performance measurement, and effecting systems change. PMID:23972275

Callahan, Kathryn E; Rogers, Matthew T; Lovato, James F; Fernandez, Helen M

2013-01-01

396

TO IMPROVE QUALITY MANAGEMENT PROCESS : Case: Aiya Restaurant Chain  

OpenAIRE

The commissioner of this thesis was Aiya Restaurant Chain, a newly opened yet well known restaurant chain in Vietnam. The core idea of this restaurant is to provide its customers with high quality and hygienic street-side foods. However, the current food quality control process in Aiya is incomplete and leaves space for many defects. Food quality has always been the crucial issue to all restaurants. Yet to Aiya, it is considered even more important, because the quality of food relates directl...

Nguyen Thi, Tram Anh

2012-01-01

397

Quality Improvement Guidelines for Radiofrequency Ablation of Liver Tumours  

International Nuclear Information System (INIS)

The development of image-guided percutaneous techniques for local tumour ablation has been one of the major advances in the treatment of liver malignancies. Among these methods, radiofrequency ablation (RFA) is currently established as the primary ablative modality at most institutions. RFA is accepted as the best therapeutic choice for patients with early-stage hepatocellular carcinoma (HCC) when liver transplantation or surgical resection are not suitable options [1, 2]. In addition, RFA is considered a viable alternate to surgery (1) for inoperable patients with limited hepatic metastatic disease, especially from colorectal cancer, and (2) for patients deemed ineligible for surgical resection because of extent and location of the disease or concurrent medical conditions [3]. These guidelines were written to be used in quality-improvement programs to assess RFA of HCC and liver metastases. The most important processes of care are (1) patient selection, (2) performing the procedure, and (3) monitoring the patient. The outcome measures or indicators for these processes are indications, success rates, and complication rates.

398

Improvement of X-ray Quality Using Multiple Electron Beams  

International Nuclear Information System (INIS)

The improvement of x-ray quality through the increase of brightness and uniformity of spatial intensity distribution is of interest because of several applications including lithography and mammography. Lithography devices require high brightness x-rays that shortens the exposure time. Synchrotrons can generate x-rays with brightness higher than 1015 phs/mm2.mrad2.s and xray free-electron lasers can produce brightness above 1022. Despite the advantage of high brightness, their huge size hinders the table-top applications. Conventional x-ray tubes have limited brightness because of thermionic electron emission. Cold field emission has several advantages in comparison to the thermionic emission, including higher current density and low emittance. Due to these advantages, x-ray tubes based on carbon-nano tube (CNT) have been developed recently. The low threshold field for electron emission and a high current density owing to high aspect ratio makes CNTs as the best field emitters. The brightness of x-ray tube can be increased by minimizing the effective focal spot size. Moreover, the smaller spot size is helpful in increasing the spatial resolution. That is why, microfocus x-ray tubes have now become popular for high-resolution x-ray imaging with greater brightness

399

Interventions to reduce hospitalizations from nursing homes: evaluation of the INTERACT II collaborative quality improvement project.  

Science.gov (United States)

A substantial proportion of hospitalizations of nursing home (NH) residents may be avoidable. Medicare payment reforms, such as bundled payments for episodes of care and value-based purchasing, will change incentives that favor hospitalization but could result in care quality problems if NHs lack the resources and training to identify and manage acute conditions proactively. Interventions to Reduce Acute Care Transfers (INTERACT) II is a quality improvement intervention that includes a set of tools and strategies designed to assist NH staff in early identification, assessment, communication, and documentation about changes in resident status. INTERACT II was evaluated in 25 NHs in three states in a 6-month quality improvement initiative that provided tools, on-site education, and teleconferences every 2 weeks facilitated by an experienced nurse practitioner. There was a 17% reduction in self-reported hospital admissions in these 25 NHs from the same 6-month period in the previous year. The group of 17 NHs rated as engaged in the initiative had a 24% reduction, compared with 6% in the group of eight NHs rated as not engaged and 3% in a comparison group of 11 NHs. The average cost of the 6-month implementation was $7,700 per NH. The projected savings to Medicare in a 100-bed NH were approximately $125,000 per year. Despite challenges in implementation and caveats about the accuracy of self-reported hospitalization rates and the characteristics of the participating NHs, the trends in these results suggest that INTERACT II should be further evaluated in randomized controlled trials to determine its effect on avoidable hospitalizations and their related morbidity and cost. PMID:21410447

Ouslander, Joseph G; Lamb, Gerri; Tappen, Ruth; Herndon, Laurie; Diaz, Sanya; Roos, Bernard A; Grabowski, David C; Bonner, Alice

2011-04-01

400

Improving Patent Quality through Pre-grant Opposition in Thailand  

OpenAIRE

Quality control in granting patents is a strong concern nowadays because granting patents without effective quality control will lead to negative spillover effects on competition, innovation, and the economy and adversely affect the public interest. More often than not, patent quality suffers...

Wanwipar Puasiri

2013-01-01

401

Designing effective healthcare quality improvement training programs: Perceptions of nursing and other senior leaders  

Directory of Open Access Journals (Sweden)

Full Text Available Objective: This study focused on best practices for designing effective quality improvement (QI training programs for nursing leaders and other senior leaders in a health care organization. Background: Leadership models for quality improvement in healthcare are underdeveloped. Challenged by a wide range of professional roles and responsibilities, nursing leaders are less likely than health professional trainees to have formal training in QI or patient safety. We highlight the experiences that nursing leaders, as well as other senior leaders, from a large health care organization had in participating in a quality improvement training program. Methods: Qualitative methods were used to assess senior leaders’ perceptions and recommendations for creating effective QI training programs. Semi-structured interviews with nursing leaders and other senior health care leaders were conducted to explore participants’ experiences with the training program and their perceptions about whether information gained from the program has the potential to transfer into clinical practice. Participants’ pre and post course knowledge tests were also analyzed to assess overall QI knowledge improvement. Results: Findings suggest that QI knowledge gains for nursing leaders and others were strongest for vocabulary and major concepts, as well as specific QI tools. Additionally, nursing leaders overwhelming appreciated the opportunity to design a QI project, where learning how to write a proper aim statement, was among the biggest benefit to this exercise. Participants in the QI course felt that it was a good investment of their time. The training program also served as a helpful reminder of the importance of quality improvement as well as an awareness of the organization’s commitment to it. Nursing leaders recommended that QI training programs be tailored to their level of existing QI knowledge, their availability and preferences for learning styles, as well as interest in translating QI projects to practice for the purpose of sustaining QI interventions. Conclusions: The findings from this research provide strong evidence that senior QI leadership training programs are important investments for health care organizations. Results indicate that nursing leaders and others in leadership positions can be effectively trained, become very knowledgeable about QI terms and skills, and apply these skills to support staff initiatives to improve outcomes.  

Sarah C Blake

2012-12-01

402

When does quality improvement count as research? Human subject protection and theories of knowledge  

OpenAIRE

?? The publication of insights from a quality improvement project recently precipitated a ruling by the lead federal regulatory agency that regulations providing protection for human subjects of research should apply. The required research review process did not match the rapid changes, small samples, limited documentation, clinician management, and type of information commonly used in quality improvement. Yet quality improvement can risk harm to patients, so some review might be in order...

Lynn, J.

2004-01-01

403

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

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...

Michael Schredl; Daniel Erlacher; Carmen Gebhart

2011-01-01

404

Evaluation of a Practice-Development Initiative to Improve Breastfeeding Rates  

OpenAIRE

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...

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

2010-01-01

405

Study on Software Quality Improvement based on Rayleigh Model and PDCA Model  

Directory of Open Access Journals (Sweden)

Full Text Available As the software industry gradually becomes mature, software quality is regarded as the life of a software enterprise. This article discusses how to improve the quality of software, applies Rayleigh model and PDCA model to the software quality management, combines with the defect removal effectiveness index, exerts PDCA model to solve the problem of quality management objectives when using the Rayleigh model in bidirectional quality improvement strategies of software quality management, and puts it into the application to achieve good results.  

Ning Jingfeng

2013-08-01

406

Engaging Front-Line Staff: How a Long-Term Care Home Is Using Evidence to Build a Quality Improvement Culture  

OpenAIRE

St. Peter's Residence at Chedoke in Hamilton, Ontario, a 210-bed long-term care facility, is building the capacity of front-line employees to become engaged in quality improvement. With training and tools, teams made up of front-line and other staff are becoming engaged in creating a quality improvement culture. This innovative initiative was recently featured in Promising Practices in Research Use, a series produced by the Canadian Health Services Research Foundation highlighting organizatio...

2008-01-01

407

A METHOD FOR IMPROVEMENT OF OBJECTIVITY OF E-SERVICE QUALITY EVALUATION  

OpenAIRE

Measurement and improvement of e-service quality is important for sustaining competitive advantage of an e-commerce web site. A number of e-service quality measures have recently been developed that predominantly rely on the subjective evaluation of diverse quality attributes. To increase the objectivity of e-service quality measurement a recently developed measure of e-service quality has been adapted in a way that replaces its Likert type scales for evaluation of specific attributes with ch...

Renata Mekovec; Goran Bubaš; Neven Vr?ek

2007-01-01

408

Improving quality and safety in the hospital: The link between organisational culture,burnout and quality of care  

OpenAIRE

The need to improve quality of care represents a major goal of all health care systems. The objective of this series is to illuminate how the contextual factors of hospitals from eight European countries, and the well-being of their healthcare professionals, contribute to either construct or degrade quality of care. The studies reported here provide an important bottom-up perspective on quality of care, and the way that burnout and organizational cultur...

Montgomery Anthony; Todorova Irina; Baban Adriana; Panagopoulou Efharis

2013-01-01

409

Continuing quality improvement procedures for a clinical PACS.  

Science.gov (United States)

The University of California at San Francisco (USCF) Department of Radiology currently has a clinically operational picture archiving and communication system (PACS) that is thirty-five percent filmless, with the goal of becoming seventy-five percent filmless within the year. The design and implementation of the clinical PACS has been a collaborative effort between an academic research laboratory and a commercial vendor partner. Images are digitally acquired from three computed radiography (CR) scanners, five computed tomography (CT) scanners, five magnetic resonance (MR) imagers, three digital fluoroscopic rooms, an ultrasound mini-PACS and a nuclear medicine mini-PACS. The DICOM (Digital Imaging and Communications in Medicine) standard communications protocol and image format is adhered to throughout the PACS. Images are archived in hierarchical staged fashion, on a RAID (redundant array of inexpensive disks) and on magneto-optical disk jukeboxes. The clinical PACS uses an object-oriented Oracle SQL (systems query language) database, and interfaces to the Radiology Information System using the HL7 (Health Languages 7) standard. Components are networked using a combination of switched and fast ethernet, and ATM (asynchronous transfer mode), all over fiber optics. The wide area network links six UCSF sites in San Francisco. A combination of high and medium resolution dual-monitor display stations have been placed throughout the Department of Radiology, the Emergency Department (ED) and Intensive Care Units (ICU). A continuing quality improvement (CQI) committee has been formed to facilitate the PACS installation and training, workflow modifications, quality assurance and clinical acceptance. This committee includes radiologists at all levels (resident, fellow, attending), radiology technologists, film library personnel, ED and ICU clinician end-users, and PACS team members. The CQI committee has proved vital in the creation of new management procedures, providing a means for user feedback and education, and contributing to the overall acceptance of, and user satisfaction with the system. Well developed CQI procedures have been essential to the successful clinical operation of the PACS as UCSF Radiology moves toward a filmless department. PMID:9735446

Andriole, K P; Gould, R G; Avrin, D E; Bazzill, T M; Yin, L; Arenson, R L

1998-08-01

410

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

Science.gov (United States)

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…

Kristensen, Bente

2010-01-01

411

Air quality and emissions reduction initiatives at the City of Calgary  

International Nuclear Information System (INIS)

To conserve, protect and improve the environment for the benefits of the citizens living in Calgary, the City of Calgary is committed to environmental leadership, as declared by the author as an opening statement to this Power Point presentation. The author described some of the partnerships and alliances to which the City of Calgary adheres, such as partner for climate protection program, the Federation of Canadian Municipalities and the International Council for Local Environmental Initiatives (ICLEI). The City is aiming at a 20 per cent reduction of 1990 greenhouse gas emission levels within ten years for municipal operations. The Greenhouse Gas Reduction Commitment is divided in three parts: (1) baseline inventory, (2) economic and emissions abatement assessment, and (3) implementation and each phase was explained. Phase 1 relates to an inventory of equivalent carbon dioxide as a standardized measure of greenhouse gases. Both municipal and corporate reduction targets have been identified, as well as targets for buildings. An innovative cooperative partnership with private industry has been initiated, called the energy performance contracting (EPC), where EPC provides upgraded building infrastructure with more energy efficient equipment. The entire concept was detailed. Other initiatives include green power substitutions and street lighting retrofits. The author concluded by providing a greenhouse gas reduction score sheet. Some initiatives at the community level i Some initiatives at the community level include Web business office/Web initiatives, a public education outreach program and third party agencies. figs

412

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)

413

Improvement of the social requirements of the quality social accountability-health and safety integrated management system  

OpenAIRE

The paper has the goal to present a method to improve the social requirements of the quality-social accountability-health and safety integrated management system with the social requirements of the Business Social Compliance Initiative (BSCI) Code of conduct because SA 8000 standard have to fulfill all the requirements of BSCI Code of conduct. The method used was to make a correspondence between the SA 8000 standard requirements and the BSCI Code of conduct requirements because the requiremen...

Denuntzio, Romeo

2013-01-01

414