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1

Practice and documentation of palliative sedation: a quality improvement initiative  

Science.gov (United States)

Background Palliative sedation (ps), the continuous use of sedating doses of medication to intentionally reduce consciousness and relieve refractory symptoms at end of life, is ethically acceptable if administered according to standards of best practice. Procedural guidelines outlining the appropriate use of ps and the need for rigorous documentation have been developed. As a quality improvement strategy, we audited the practice and documentation of ps on our palliative care unit (pcu). Methods A pharmacy database search of admissions in 2008 identified, for a subsequent chart review, patients who had received either a continuous infusion of midazolam (?10 mg/24 h), regular parenteral dosing of methotrimeprazine (?75 mg daily), or regular phenobarbital. Documentation of the decision-making process, consent, and medication use was collected using a data extraction form based on current international ps standards. Results Interpretation and comparison of data were difficult because of an apparent lack of a consistent operational definition of ps. Patient records had no specific documentation in relation to ps initiation, to clearly identified refractory symptoms, and to informed consent in 60 (64.5%), 43 (46.2%), and 38 (40.9%) charts respectively. Variation in the medications used was marked: 54 patients (58%) were started on a single agent and 39 (42%), on multiple agents. The 40 patients (43%) started on midazolam alone received a mean daily dose of 21.4 mg (standard deviation: 24.6 mg). Conclusions The lack of documentation and standardized practice of ps on our pcu has resulted in a quality improvement program to address those gaps. They also highlight the importance of conducting research and developing clinical guidelines in this area.

McKinnon, M.; Azevedo, C.; Bush, S.H.; Lawlor, P.; Pereira, J.

2014-01-01

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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

3

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 ...

4

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

Science.gov (United States)

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

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

2010-03-01

5

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

Thawesaengskulthai, Natcha

2007-01-01

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

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

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

2008-01-01

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

International Nuclear Information System (INIS)

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

1991-12-11

9

Preventability of 30-day readmissions for heart failure patients before and after a quality improvement initiative.  

Science.gov (United States)

The objective of this study was to estimate the frequency of heart failure (HF) readmissions that can be prevented through a quality improvement (QI) program. All HF patients at the University of Connecticut Health Center who had a readmission within 30 days of discharge in the year before (2008) and the year after (2011) a QI program were studied. Through chart review, the percentage of patients who had preventable readmissions in each year was estimated. Prior to the QI initiative, chart reviewers identified that 20% to 30% of readmissions were preventable. The decrease in readmissions after the QI program was similar at 28%. Fewer readmissions after the QI initiative were deemed preventable compared with before. In conclusion, this study found a percentage of preventable readmissions similar to the actual 28% reduction in readmissions after a QI program was launched. Preventable readmissions were less common after the QI program was in place. PMID:23956341

Ryan, Jason; Andrews, Rebecca; Barry, Mary Beth; Kang, Sangwook; Iskandar, Aline; Mehla, Priti; Ganeshan, Raj

2014-01-01

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 Impro...

Kissam Stephanie; Gifford David; Parks Peggy; Patry Gail; Palmer Laura; Wilkes Linda; Fitzgerald Matthew; Petrulis Alice; Barnette Leslie

2003-01-01

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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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Improvement in quality of life after initiation of lamotrigine therapy in patients with epilepsy in a naturalistic treatment setting.  

Science.gov (United States)

Quality of life is impaired in patients with epilepsy and can be improved by effective therapy. Randomised clinical trials have shown that lamotrigine treatment is associated with improved quality of life. However, little information is available on quality of life or treatment effects in patients with epilepsy in the general population. The objective of this study was to estimate the impact of lamotrigine on quality of life in a naturalistic treatment setting. The study included adult patients with epilepsy in whom lamotrigine therapy was initiated. Each subject completed the Quality of Life in Epilepsy Inventory (QOLIE)-31 quality of life questionnaire at inclusion and at a follow-up visit in the next 4 months. Demographic information and medical history were provided by the investigator. These were evaluated as potential determinants of change in quality of life using logistic regression. Three hundred and forty-one patients were evaluated, 192 starting lamotrigine in combination with another drug, 90 as a first-line monotherapy, 45 as a switch from another drug and 14 as a reduction to monotherapy from a previous combination. Baseline scores on the QOLIE-31 ranged from 53.8 in the combination group to 69.5 in the first-line group. 34.6% of patients were considered to be responders, with no significant differences between treatment regimen. Most improvement was seen for the energy-fatigue and medication effects subscales and, for the first-line group, seizure worry. Seizure type was the only determinant of improvement of quality of life identified. In conclusion, lamotrigine treatment is associated with improved quality of life, regardless of treatment regimen. PMID:17208465

Allain, Hervé; Schück, Stéphane; Nachit-Ouinekh, Fatima; Plouin, Perrine; Brunon, Anne-Marie; Boulliat, Jacques; Mercier, Florence; Slama, Alain; Baulac, Michel; El Hasnaoui, Abdelkader

2007-03-01

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A crisis management quality improvement initiative in a children's psychiatric hospital: design, implementation, and outcome.  

Science.gov (United States)

Behavioral crisis management, including the use of seclusion and restraint, is the most high risk process in the psychiatric care of children and adolescents. The authors describe hospital-wide programmatic changes implemented at a children's psychiatric hospital that aimed to improve the quality of crisis management services. Pre/post quantitative and qualitative data suggest reduced restraint and seclusion use, reduced patient and staff injury related to crisis management, and increased patient satisfaction during the post-program period. Factors deemed beneficial in program implementation are discussed. PMID:22805906

Paccione-Dyszlewski, Margaret R; Conelea, Christine A; Heisler, Walter C; Vilardi, Jodie C; Sachs, Henry T

2012-07-01

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

Directory of Open Access Journals (Sweden)

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

Chanin Johann C

2008-09-01

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Quality initiatives: planning, setting up, and carrying out radiology process improvement projects.  

Science.gov (United States)

In the coming decades, those who provide radiologic imaging services will be increasingly challenged by the economic, demographic, and political forces affecting healthcare to improve their efficiency, enhance the value of their services, and achieve greater customer satisfaction. It is essential that radiologists master and consistently apply basic process improvement skills that have allowed professionals in many other fields to thrive in a competitive environment. The authors provide a step-by-step overview of process improvement from the perspective of a radiologic imaging practice by describing their experience in conducting a process improvement project: to increase the daily volume of body magnetic resonance imaging examinations performed at their institution. The first step in any process improvement project is to identify and prioritize opportunities for improvement in the work process. Next, an effective project team must be formed that includes representatives of all participants in the process. An achievable aim must be formulated, appropriate measures selected, and baseline data collected to determine the effects of subsequent efforts to achieve the aim. Each aspect of the process in question is then analyzed by using appropriate tools (eg, flowcharts, fishbone diagrams, Pareto diagrams) to identify opportunities for beneficial change. Plans for change are then established and implemented with regular measurements and review followed by necessary adjustments in course. These so-called PDSA (planning, doing, studying, and acting) cycles are repeated until the aim is achieved or modified and the project closed. PMID:22745219

Tamm, Eric P; Szklaruk, Janio; Puthooran, Leejo; Stone, Danna; Stevens, Brian L; Modaro, Cathy

2012-01-01

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

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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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Improving Quality in Stroke Rehabilitation  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Given the numerous quality improvement (QI) initiatives that have been undertaken in various medical fields, it is clear that inpatient rehabilitation services, particularly those geared toward stroke rehabilitation, can also benefit from these programs. To effectively evaluate the quality of rehabilitation services, indicators measuring structure, process, and outcomes must be included as part of any QI initiative. In addition to measuring quality, these indicators can be used to describe an...

2010-01-01

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

Science.gov (United States)

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 creating reliable, sustained change that is broad based, cross platform and applicable to all patients. Methods: Geisinger’s approach to address transitions of care is a team-based model. It begins with nurses screening patients’ readmission risk status using an electronic health record tool developed from national evidence and modified based upon GHS’s local experience. Once a patient identified as high risk is admitted, nursing performs a checklist of activities for early care activation (e.g. screening for the need for post acute infusion) and care management prepares a discharge plan and completes a detailed assessment of the patient’s support environment. On selected units, high risk patients are followed for a month post-discharge using an outpatient care management protocol that leverages telephonic case management and remote monitoring tools that can be customized to the patient’s medical plan. The final core pilot encompasses our transition bundle. This includes automation of primary care physician follow-up appointment scheduling and discharge communication. Results: The pilots were implemented in May and June of 2008. Because of the low frequency of readmissions, we have yet to evaluate whether early promising results are statistically significant. We have been able to demonstrate reliable emergency department screening and transition bundle performance and the reliability of implementing this complex model is improving each month. Approximately 2,000 patients have been discharged from units where the pilots were in operation. Conclusions: The TOCI approach is interdisciplinary at all level’s governance, coordination, and patient care. We believe the methods that are developed and utilized, including specialized screening tools, nursing and care management protocols, interdisciplinary team rounds, discharge protocols and post acute care management strategies, will be essential components of the national strategy to reduce readmissions.

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

2010-01-01

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

Science.gov (United States)

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

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

2014-02-01

 
 
 
 
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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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SQIMSO: Quality Improvement for Small Software Organizations  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 ...

Rabih Zeineddine; Nashat Mansour

2005-01-01

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

Directory of Open Access Journals (Sweden)

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

Colom Joan

2010-10-01

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Water Quality Improvement Grant  

...BasinWater Quality Improvement GrantPublic participation in river basin planningClimate ChangeAssessing the Impact...PlanEconomic Value of WaterEarlier River Basin PlanningGlossary of TermsUseful Links...

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Evaluating a questionnaire to measure improvement initiatives in Swedish healthcare  

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BACKGROUND: Quality improvement initiatives have expanded recently within the healthcare sector. Studies have shown that less than 40% of these initiatives are successful, indicating the need for an instrument that can measure the progress and results of quality improvement initiatives and answer questions about how quality initiatives are conducted. The aim of the present study was to develop and test an instrument to measure improvement process and outcome in Swedish healthcare. METHODS: A ...

Andersson, Ann-christine; Elg, Mattias; Perseius, Kent-inge; Idwall, Ewa

2013-01-01

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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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The Childhood Development Initiative: Developing Quality Services  

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The Childhood Development Initiative (CDI) has created a ten-year strategy to improve the health, safety and learning of the children of Tallaght West, and to strengthen their sense of belonging in their own communities. This paper portrays an overview of the strategy, the principles of freedom and prevention which underpin the project and outlines two of the eight activities, namely the Early Childhood Care and Education (ECCE) programme and the Enhancing Quality through Integration and Trai...

2008-01-01

28

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

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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...

2011-01-01

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Quality Improvement by Qualified Managers  

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

Dr. Nasser Fegh-hi Farahmand

2013-01-01

31

Shipbuilding pipeline production quality improvement  

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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...

2010-01-01

32

Preanalytical quality improvement: in quality we trust  

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Total quality in laboratory medicine should be defined as the guarantee that each activity throughout the total testing process is correctly performed, providing valuable medical decision-making and effective patient care. In the past decades, a 10-fold reduction in the analytical error rate has been achieved thanks to improvements in both reliability and standardization of analytical techniques, reagents, and instrumentation. Notable advances in information technology, quality control and qu...

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

2013-01-01

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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

34

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

Science.gov (United States)

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.

2011-01-01

35

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 trait is stable over at least three generations. (author). 12 refs, 2 figs

1995-11-01

36

Quality improvement and network externalities  

Digital Repository Infrastructure Vision for European Research (DRIVER)

We analyse the optimal pricing choice of an incumbent firm that sells a good with network externalities and is threatened by the entry of a higher quality variant. In the framework of a vertical differentiation model, we find a necessary and sufficient condition under which quality improvement occurs as a result of this competition.

Gabszewicz, Jean; Garcia, Filomena

2005-01-01

37

Preanalytical quality improvement: in quality we trust.  

Science.gov (United States)

Total quality in laboratory medicine should be defined as the guarantee that each activity throughout the total testing process is correctly performed, providing valuable medical decision-making and effective patient care. In the past decades, a 10-fold reduction in the analytical error rate has been achieved thanks to improvements in both reliability and standardization of analytical techniques, reagents, and instrumentation. Notable advances in information technology, quality control and quality assurance methods have also assured a valuable contribution for reducing diagnostic errors. Nevertheless, several lines of evidence still suggest that most errors in laboratory diagnostics fall outside the analytical phase, and the pre- and postanalytical steps have been found to be much more vulnerable. This collective paper, which is the logical continuum of the former already published in this journal 2 years ago, provides additional contribution to risk management in the preanalytical phase and is a synopsis of the lectures of the 2nd European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)-Becton Dickinson (BD) European Conference on Preanalytical Phase meeting entitled "Preanalytical quality improvement: in quality we trust" (Zagreb, Croatia, 1-2 March 2013). The leading topics that will be discussed include quality indicators for preanalytical phase, phlebotomy practices for collection of blood gas analysis and pediatric samples, lipemia and blood collection tube interferences, preanalytical requirements of urinalysis, molecular biology hemostasis and platelet testing, as well as indications on best practices for safe blood collection. Auditing of the preanalytical phase by ISO assessors and external quality assessment for preanalytical phase are also discussed. PMID:23072858

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

2013-01-01

38

Hanford Tanks Initiative quality assurance implementation plan  

Energy Technology Data Exchange (ETDEWEB)

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.

Huston, J.J.

1998-06-23

39

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

DEFF Research Database (Denmark)

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.

Tøttenborg, Sandra Søgaard; Thomsen, Reimar Wernich

2013-01-01

40

Clinical Pathways for Non-ST Elevation Acute Coronary Syndrome in Oman: An Oman Heart Association Protocol for Hospital Quality Improvement Initiative  

Directory of Open Access Journals (Sweden)

Full Text Available In 2012, Oman Heart Association (OHA published its own guidelines for the management of patients with unstable angina/non–ST-elevation myocardial infarction, the aim was not to be comprehensive but rather simplified and practical in order to reduce the gap between the long comprehensive guidelines and our actual practice. However, we still feel that the busy registrars and residents need simpler and direct clinical pathways or protocol to be used in the emergency departments, coronary care units and in the wards. Clinical pathways are now one of the main tools used to manage the quality in healthcare concerning the standardization of care processes. It has been shown that their implementation reduces the variability in clinical practice and improves outcomes in acute care.

Mohammed H. El-Deeb

2014-03-01

 
 
 
 
41

Human factors and quality improvement.  

Science.gov (United States)

Human factors analysis (HFE) presents a formidable contribution to quality improvement (QI) in the neonatal intensive care unit (NICU). The science behind the fundamental principles concerning the design of work systems that match the needs of the people who work in them is sound and is applied widely in other safety critical situations. Early application of HFE in NICUs has shown the usefulness of these methods for frontline teams working to improve quality, reliability, and safety. The inclusion of human factors considerations in the design of structure and process has the potential to improve outcomes for patients and families and to improve the comfort and usability of work systems for providers who work in them. New technologies and continual change must be informed and designed through the application of HFE methods and principles to realize the full potential of QI. PMID:20363451

Handyside, James; Suresh, Gautham

2010-03-01

42

Continuous improvement of software quality  

International Nuclear Information System (INIS)

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

1999-01-01

43

Culture shock: Improving software quality  

Energy Technology Data Exchange (ETDEWEB)

The concept of software quality can represent a significant shock to an individual who has been developing software for many years and who believes he or she has been doing a high quality job. The very idea that software includes lines of code and associated documentation is foreign and difficult to grasp, at best. Implementation of a software quality program hinges on the concept that software is a product whose quality needs improving. When this idea is introduced into a technical community that is largely ''self-taught'' and has been producing ''good'' software for some time, a fundamental understanding of the concepts associated with software is often weak. Software developers can react as if to say, ''What are you talking about. What do you mean I'm not doing a good job. I haven't gotten any complaints about my code yetexclamation'' Coupling such surprise and resentment with the shock that software really is a product and software quality concepts do exist, can fuel the volatility of these emotions. In this paper, we demonstrate that the concept of software quality can indeed pose a culture shock to developers. We also show that a ''typical'' quality assurance approach, that of imposing a standard and providing inspectors and auditors to assure its adherence, contributes to this shock and detracts from the very goal the approach should achieve. We offer an alternative, adopted through experience, to implement a software quality program: cooperative assistance. We show how cooperation, education, consultation and friendly assistance can overcome this culture shock. 3 refs.

de Jong, K.; Trauth, S.L.

1988-01-01

44

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

45

Using Quality Function Deployment to Improve Reference Services Quality  

Directory of Open Access Journals (Sweden)

Full Text Available Much research has been conducted regarding how reference librarians can evaluate and improve the quality of the answers they provide to users' inquiries. There has been considerably less discussion, however, concerning how to improve the quality of the delivery of those answers, and to upgrade the overall quality of reference services as a whole. Suggestions for improving the quality of service contained within the business literature may be applied to improve library services as well. In this paper the use of Quality Function Deployment (QFD as a tool for improving reference services quality is explored and an adapted framework referred to as service quality function deployment is proposed.

Pao-Long Chang

1996-12-01

46

Quality Improvement Practices and Trends  

DEFF Research Database (Denmark)

The following article, "Quality Improvement Practices and Trends in Denmark," is the first in a series of papers arranged for and co-authored by Dr. Rick L. Edgeman. Rick is a member of QE's Editorial Board and is on sabbatical from Colorado State University. During the year, Rick and his family will be visiting various countries in Europe and he will be reporting to us with respect to each country in which they stay for any period of time. His reports will take the form of co-authored paperswith the other authors including distinguished faculty from the universities with which he works as a visiting professor, as well as key individuals from various industries. In addition to the above activities, Rick will be working with the European Foundation for Quality Management on their "European Master's Programme in Total Quality Management." That program involves a consortium of European universities. Rick has begun the process of developing a comparable consortium of American universities for the same purpose-- an activity which is cosponsored by the Education Division of the American Society for Quality (ASQ).

Hartz, Ove

1998-01-01

47

Data quality improvements for FAA  

Energy Technology Data Exchange (ETDEWEB)

Effective communication among air safety professionals is only as good as the information being communicated. Data sharing cannot be effective unless the data are relevant to aviation safety problems, and decisions based on faulty data are likely to be invalid. The validity of aviation safety data depends on satisfying two primary characteristics. Data must accurately represent or conform to the real world (conformance), and it must be relevant or useful to addressing the problems at hand (utility). The FAA, in efforts to implement the Safety Performance Analysis System (SPAS), identified significant problems in the quality of the data which SPAS and FAA air safety professionals would use in defining the state of aviation safety in the US. These finding were reinforced by Department of Transportation Inspector General and General Accounting Office investigations into FAA surveillance of air transport operations. Many recent efforts to improve data quality have been centered on technological solutions to the problems. They concentrate on reducing errors in the data (conformance), but they cannot adequately address the relationship of data to need (utility). Sandia National Laboratories, working with the FAA`s Airport and Aircraft Safety Research and Development Division and the Flight Standards Service, has been involved in four programs to assist FAA in addressing their data quality problems. The Sandia approach has been data-driven rather than technology-driven. In other words, the focus has been on first establishing the data requirements by analyzing the FAA`s surveillance and decision-making processes. This process analysis looked at both the data requirements and the methods used to gather the data in order to address both the conformance and utility problems inherent in existing FAA data systems. This paper discusses Sandia`s data quality programs and their potential improvements to the safety analysis processes and surveillance programs of the FAA.

Perry, R.; Marlman, K.; Olson, D.; Werner, P.

1997-09-01

48

[Continuous quality improvement in anesthesia].  

Science.gov (United States)

Slow continuous quality improvement (SCQI) in anesthesia is a process that allows identification of problems and their causes. Implementing measures to correct them and continuous monitoring to ensure that the problems have been eliminated are necessary. The basic assumption of CQI is that the employees of an organization are competent and working to the best of their abilities. If problems occur they are the consequences of inadequacies in the process rather that in the individual. The CQI program is a dynamic but gradual system that invokes a slower rate of response in comparison with other quality methods, like quality assurance. Spectacular results following a system change are not to be expected an the ideal is slow and continuous improvement. A SCQI program was adapted by our department in May 1994, according to the recommendations of the American Society of Anesthesiologists. Problem identification was based on 65 clinical indicators, reflecting negative events related to anesthesia. Data were collected using a specially designed computer database. 4 events were identified as crossing previously established thresholds (hypertension, hypotension, hypoxia and inadequate nerve block). Statistical process control was used to establish stability of the system and whether negative events were influenced only by the common causes. The causes responsible for these negative events were identified using specific SCQI tools, such as control-charts, cause-effect diagrams and Pareto diagrams. Hypertension and inadequate nerve block were successfully managed. The implementation of corrective measures for the other events that cross the threshold is still in evolution. This program requires considerable dedication on the part of the staff, and it is hoped that it will improve our clinical performance. PMID:9517270

Gaitini, L; Vaida, S; Madgar, S

1998-01-01

49

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

1993-01-01

50

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

1996-01-01

51

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

Energy Technology Data Exchange (ETDEWEB)

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

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

2012-06-01

52

Improvement of nuclear filter quality  

Energy Technology Data Exchange (ETDEWEB)

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

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

2004-07-01

53

Measuring quality in healthcare and its implications for pay-for-performance initiatives  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The quality of healthcare is important to American consumers, and discussion on quality will be a driving force towards improving the delivery of healthcare in America. Funding agencies are proposing a variety of quality measures, such as Centers of Excellence, Pay-for-Participation and Pay-for-Performance initiatives, to overhaul the healthcare delivery system in this country. However, it is quite uncertain whether these quality initiatives will succeed in curbing the unchecked growth in hea...

2009-01-01

54

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

55

Quality improvement of extracted coal  

Energy Technology Data Exchange (ETDEWEB)

Deals with the problem of improving the quality of coal mined in the Ukraine with the example of anthracite that constitutes 11% of the output. In the USSR the ash content norm for associations that mine anthracite is 27%. Increase in ash content in coal mined in the individual mines and associations is reviewed. Dependence of ash content in anthracite and sidewall rock on the number of longwalls and seams is shown in graphs. Measures are recommended that will enable output to be determined only by the amount of coal that passes into concentrate, i.e. the saleable coal, the ash content in the coal mined to be reduced (as production will be paid only for clean coal), ash content in run-of-mine coal to be established (with the means of mechanization to be accounted for). If the ash content is exceeded the mine will have to compensate for additional coal preparation cost; it will be reimbursed for lower ash content. 4 refs.

Astrov-Shumilov, G.K.; Esenkov, V.M. (Obedinenie Roven' kiantratsit (USSR))

1991-03-01

56

Changing quality initiative - does the quality profile really change?  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

57

African primary care research: quality improvement cycles  

Directory of Open Access Journals (Sweden)

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

Claire Van Deventer

2014-04-01

58

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

Science.gov (United States)

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

Roche, B G; Sommer, C

1995-01-01

59

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

DEFF Research Database (Denmark)

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

Møller, M H; Larsson, Heidi Jeanet

2013-01-01

60

Narrative methods in quality improvement research.  

Science.gov (United States)

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

Greenhalgh, T; Russell, J; Swinglehurst, D

2005-12-01

 
 
 
 
61

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

62

Linking Planning, Quality Improvement, and Institutional Research  

Science.gov (United States)

External and internal forces are driving institutions not only to create departments and positions that specialize in planning, quality improvement, and institutional research but also to link them within a systems context.

Seymour, Daniel; Kelley, John M.; Jasinski, John

2004-01-01

63

Quality improvement to meet competitive fringe  

Digital Repository Infrastructure Vision for European Research (DRIVER)

We investigate what kind of competitive pressure induces existing firms to engage in more intensive innovation activities. We examine two types of competitive pressure: a price decrease in competitive fringe firms and a quality improvement therein. We use an oligopoly model with vertical differentiation to investigate this question. We show that a decrease in the exogenous price of competitive firms induces the two existent leading firms (one high-quality firm and one mid-quality firm) to eng...

Matsushima, Noriaki; Liu, Ren-jye

2012-01-01

64

USHER: Improving data quality with dynamic forms  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Data quality is a critical problem in modern databases. Data entry forms present the first and arguably best opportunity for detecting and mitigating errors, but there has been little research into automatic methods for improving data quality at entry time. In this paper, we propose USHER, an end-to-end system for form design, entry, and data quality assurance. Using previous form submissions, USHER learns a probabilistic model over the questions of the form. USHER then applies this model at ...

Chen, Harr; Chen, Kuang; Conway, Neil; Hellerstein, Joseph M.; Parikh, Tapan S.

2010-01-01

65

Improving quality of cancer care through surgical audit  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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...

2010-01-01

66

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)

2009-05-10

67

Quantitative data management in quality improvement collaboratives  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 evalu...

van den Berg Mireille; Frenken Rianne; Bal Roland

2009-01-01

68

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

69

The Continuous Improvement and Optimisation of Quality  

Directory of Open Access Journals (Sweden)

Full Text Available Accomplishing not only corporate goals, but also those of the economy as a whole, requires a continuously growing interest towards quality. This interest has evolved constantly from inspection, to control, insurance and, presently, total quality management. The management that is oriented towards total quality requires a shift from the interest of optimising quality to one that concerns continuous improvement. The link between the two and the manner in which they might contribute to an increase in the organisations’ performance are aspects that shall be addressed in the following article.

EMIL MAXIM

2006-01-01

70

Putting continuous quality improvement into accreditation: improving approaches to quality assessment.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The accreditation systems of the United States, Canada, and Australia have been restructured to reflect the adoption by health services of the industrial model of continuous quality improvement. The industrial model of quality makes assumptions about management structures and the relation of process to outcome which are not readily transferable to the assessment of quality in health care. The accreditation systems have therefore had to adapt the principles of continuous quality improvement to...

Scrivens, E.

1997-01-01

71

Venture Capital Initiative: Ohio's School Improvement Effort.  

Science.gov (United States)

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

Yoo, Soonhwa; Loadman, William E.

72

Minnesota's provider-initiated approach yields care quality gains at participating nursing homes.  

Science.gov (United States)

Minnesota's Performance-Based Incentive Payment Program uses a collaborative, provider-initiated approach to nursing home quality improvement: up-front funding of evidence-based projects selected and designed by participating facilities, with accountable performance targets. During the first 4 rounds of funding (2007-10), 66 projects were launched at 174 facilities. Using a composite quality measure representing multiple dimensions of clinical care, we found that facilities participating during this period exhibited significantly greater gains than did nonparticipating facilities, in both targeted areas and overall quality, and maintained their quality advantage after project completion. Participating and nonparticipating facilities were similar at baseline with respect to quality scores and improvement trends, as well as acuity-adjusted payment, operating costs, and nurse staffing. Although self-selection precludes firm conclusions regarding the program's impacts, early findings indicate that the program shows promise for incentivizing nursing home quality improvement, both in facility-identified areas of concern and overall. PMID:24019369

Arling, Greg; Cooke, Valerie; Lewis, Teresa; Perkins, Anthony; Grabowski, David C; Abrahamson, Kathleen

2013-09-01

73

ISO certification pays off in quality improvement  

Energy Technology Data Exchange (ETDEWEB)

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

Vermeer, F.J.G. (Brooks Instrument, Statesboro, GA (US))

1992-04-13

74

76 FR 61365 - Bundled Payments for Care Improvement Initiative  

Science.gov (United States)

...the Bundled Payments for Care Improvement initiative...better health, better health care, and reduced expenditures...Beneficiaries can experience improved health outcomes and patient experience when health care providers work in a...

2011-10-04

75

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

76

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

Science.gov (United States)

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

Child Trends, 2010

2010-01-01

77

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

78

AQIP and Accreditation: Improving Quality and Performance  

Science.gov (United States)

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

Spangehl, Stephen D.

2012-01-01

79

The impact of leadership qualities on quality management improvement  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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...

2011-01-01

80

Improve Power Quality Problem Using Series Compensator .  

Directory of Open Access Journals (Sweden)

Full Text Available This paper discusses study of design and simulation of series compensator for improving power quality and reduces the harmonic distortion of sensitive load. Electronic device and control technologies have made it possible to mitigate power quality problems &maintain the operation of sensitive load. The use of a series compensator (SC to improve power quality is an isolated power system is investigated. The role of the compensator is not only to mitigate the effects of voltage sag, but also to reduce the harmonic distortion due to the presence of non linear loads in the network. The series compensator consists of injection transformer, filter, ESS, VSI, & control. In SC LC filter can be achieved by eliminating the unwanted harmonics. The ESS can be a capacitor of suitable capacity. The modelling and simulation of the proposed series compensator was implement in matlab simulink work space .Simulation results verify that the SC is effective in reducing the harmonic distortions and thus improving the supply quality of isolated power system.

Pooja Shrivas

2013-05-01

 
 
 
 
81

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

82

Initial testing and quality control for radionuclide dose calibrators  

International Nuclear Information System (INIS)

This monograph describes the use of the well-type ionization chamber for assays of radioactivity in radiopharmaceuticals and radionuclides used in nuclear medicine. The basic initial testing and subsequent quality control are discussed with particular reference to factors governing accuracy and reproducibility, geometry and photon absorption, and linear response. (U.K.)

1986-01-01

83

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

Directory of Open Access Journals (Sweden)

Full Text Available Background: Improving the healthcare for patients with depression is a priority health policy across the world. Roughly, two major problems can be identified in daily practice: (1 the content of care is often not completely consistent with recommendations in guidelines and (2 the organization of care is not always integrated and delivered by multidisciplinary teams. Aim: To describe the content and preliminary results of a quality improvement project in primary care, aiming at improving the uptake of clinical depression guidelines in daily practice as well as the collaboration between different mental health professionals. Method: A Depression Breakthrough Collaborative was initiated from December 2006 until March 2008. The activities included the development and implementation of a stepped care depression model, a care pathway with two levels of treatment intensity: a first step treatment level for patients with non-severe depression (brief or mild depressive symptoms and a second step level for patients with severe depression. Twelve months data were measured by the teams in terms of one outcome and several process indicators. Qualitative data were gathered by the national project team with a semi-structured questionnaire amongst the local team coordinators. Results: Thirteen multidisciplinary teams participated in the project. In total 101 health professionals were involved, and 536 patients were diagnosed. Overall 356 patients (66% were considered non-severely depressed and 180 (34% patients showed severe symptoms. The mean percentage of non-severe patients treated according to the stepped care model was 78%, and 57% for the severely depressed patient group. The proportion of non-severely depressed patients receiving a first step treatment according to the stepped care model, improved during the project, this was not the case for the severely depressed patients. The teams were able to monitor depression symptoms to a reasonable extent during a period of 6 months. Within 3 months, 28% of monitored patients had recovered, meaning a Beck Depression Inventory (BDI score of 10 and lower, and another 27% recovered between 3 and 6 months. Conclusions and discussion: A stepped care approach seems acceptable and feasible in primary care, introducing different levels of care for different patient groups. Future implementation projects should pay special attention to the quality of care for severely depressed patients. Although the Depression Breakthrough Collaborative introduced new treatment concepts in primary and specialty care, the change capacity of the method remains unclear. Thorough data gathering is needed to judge the real value of these intensive improvement projects.

Gerdien Franx

2009-06-01

84

A Method to Report Utilization for Quality Initiatives in Medical Facilities  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

Improving quality of service in the internet  

CERN Multimedia

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

Flückiger, François

2000-01-01

86

Improving quality of care through improved audit and feedback  

Directory of Open Access Journals (Sweden)

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

Hysong Sylvia J

2012-05-01

87

MOBILITY LEARNING METHODOLOGY FOR EDUCATION QUALITY IMPROVEMENT  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

88

A Report Card on Continuous Quality Improvement  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Efforts to incorporate the principles of continuous quality improvement (CQI) into health care have been underway for about ten years. In order to understand the lessons of this decade of experience, senior organizational leaders and experts in the field of health care were interviewed. This select group agreed that there have been concrete accomplishments: the tactic of assigning blame for mistakes to individuals is gradually giving way to an emphasis on detecting problems with process; ther...

1998-01-01

89

Improving the quality of spatial quantum channels  

Digital Repository Infrastructure Vision for European Research (DRIVER)

We show, for the non-Markovian or time-dependent Markovian process, by breaking up a spatial quantum channel (SQC) into a series of periodically arranged sub-components, that the quality of information transmission described by the purity, fidelity and concurrence of the output states can be improved. The relation to the quantum zero effect and possible applications of the idea have been discussed.

Tang, Ning; Fan, Zi-long; Zeng, Hao-sheng

2013-01-01

90

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

91

Biospecimen Reporting for Improved Study Quality.  

Science.gov (United States)

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 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 Biospecimen Reporting for Improved Study Quality 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. PMID:21826252

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

2011-04-01

92

Increased Mercury Bioaccumulation Follows Water Quality Improvement  

Energy Technology Data Exchange (ETDEWEB)

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

Bogle, M.A.; Peterson, M.J.; Smith, J.G.; Southworth, G.R.

1999-09-15

93

Developing targets for public health initiatives to improve palliative care  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Palliative Care is an approach that improves quality of life for patients and their families facing the problems associated with incurable life-threatening illness. In many countries, due to the rapidly ageing population, increasingly more people are suffering from serious chronic disease towards the end of life, making further development in palliative care a major public health challenge. The aim of this study was to develop the first targets for public health initiatives to improve palliative care in Germany. Methods Based on the findings from pilot studies (qualitative interviews and surveys with different stakeholders in the health care system, we conducted a modified Delphi study with two rounds of questionnaires with experts in public health and palliative care. In the first round, the experts commented on the findings from the pilot studies. The answers were evaluated descriptively and with qualitative content analysis, resulting in the formulation of 25 targets. These were presented to the experts in the second Delphi round to assess each of them separately with regard to its importance and current implementation (7-point answer scales and in relation to the other targets (defining the five most important of the 25 targets. Results Six most relevant targets for public health initiatives to improve palliative care in Germany were worked out: Supporting palliative care as a basic attitude for the care of people in the last phase of life; coordinating healthcare for people in the last phase of life; establishing cooperation among health professions and disciplines; establishing education in palliative care for all professional groups with contact to people in the last phase of life; reviewing the evidence of palliative care measures; offering support to family members who are caring for someone in the last phase of life. Conclusions To systematically develop palliative care, it makes sense to define fields of action with individual targets. For Germany, it can be recommended to give priority to the targets that were highlighted as the most relevant in this study. The next step will be to develop, implement and evaluate tangible measures to achieve these targets.

Klindtworth Katharina

2010-04-01

94

Improving the Blanco Telescope's delivered image quality  

Science.gov (United States)

The V. M. Blanco 4-m telescope at Cerro Tololo Inter-American Observatory is undergoing a number of improvements in preparation for the delivery of the Dark Energy Camera. The program includes upgrades having potential to deliver gains in image quality and stability. To this end, we have renovated the support structure of the primary mirror, incorporating innovations to improve both the radial support performance and the registration of the mirror and telescope top end. The resulting opto-mechanical condition of the telescope is described. We also describe some improvements to the environmental control. Upgrades to the telescope control system and measurements of the dome environment are described in separate papers in this conference.

Abbott, Timothy M. C.; Montane, Andrés; Tighe, Roberto; Walker, Alistair R.; Gregory, Brooke; Smith, R. Christopher; Cisternas, Alfonso

2010-07-01

95

Improving the quality by a competitive comparison  

Directory of Open Access Journals (Sweden)

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

Bujaloboková Beáta

2001-12-01

96

Investigating Service Quality Initiatives of Pakistani Commercial Banks  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The study investigated the service quality initiatives taken by Pakistani commercial banks in Lahore based on the perceptions of 447 respondents, selected by using multistage random sampling technique, through SERVQUAL scale which was found reliable at 0.866 Cronbach’s alpha. Mean scores, alphas, and correlations were calculated. One-Sample t-test, Independent Samples t-test, and One-way ANOVA were employed for significance and variance analysis. Th...

Shaukat Ali Raza; Zia, Shahid A.; Syed Abir Hassan Naqvi; Asghar Ali

2012-01-01

97

Improving wind power quality with energy storage  

DEFF Research Database (Denmark)

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

Rasmussen, Claus Nygaard

2009-01-01

98

Improving Pain Assessment in the NICU: A Quality Improvement Project.  

Science.gov (United States)

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

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

2014-06-01

99

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.

100

Improvement of quality of speech signal  

Digital Repository Infrastructure Vision for European Research (DRIVER)

In this work is analyzed the use of digital filter to improve the quality of a speech signal. For this purpose the influence of noises on the understanding of language is inspected and the digital filter design with optimal pole placement is presented. In the process of experimentation the speech signal was recorded by using Praat program, generated noise is made by means of Matlab function randn (n) or the sum two or one cosines. The notated speech signal is mixed with the generated noise. T...

2005-01-01

 
 
 
 
101

MOBILITY LEARNING METHODOLOGY FOR EDUCATION QUALITY IMPROVEMENT  

Directory of Open Access Journals (Sweden)

Full Text Available 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, easy to use interfaces for controlling the voting session by the teachers, and easy to use interfaces for voting on mobile devices by the students.

Liviu Moldovan

2012-11-01

102

The European initiative for quality management in lung cancer care.  

Science.gov (United States)

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. PMID:24659546

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

2014-05-01

103

A Model to Improve Service Quality  

Directory of Open Access Journals (Sweden)

Full Text Available Improving service quality is a very important task in management. Importance Satisfaction models (I-S model can identify the service items for improvement but not determine whether the items can really enhance the customer satisfaction. Additionally, Kano model can find the service items enhancing the customer satisfaction but not measure the actual feelings of customers. The present study integrates both abovementioned models to identify the service items which can actually enhance the customer satisfaction. Moreover, a comparison of socio-demographic characteristics can help managers to find groups to enhance the satisfaction. The results give managers a more accurate and faster way to achieve the goal of enhancing customer satisfaction.

Chun-Wu Yeh

2013-01-01

104

Improving Quality Of Fractal Compressed Images  

DEFF Research Database (Denmark)

This paper proposes a new quality improvement technique for fractal-based image compression techniques using diffusion equations. Fractal coding uses a contractive mapping scheme to represent an image. This process of contractive mapping causes artifacts and blocking effects in encoded images. This problem is severed when compression ratio is increased or there are high frequency regions in the image. Hence, to amulet the deficiency of fractal coding approaches in image compression, we propose using diffusion equations as a post processor. Diffusion equations are powerful tools for image enhancement. This technique has been examined on a variety of standard images. The obtained results indicate that the proposed method improves performance of fractal-based image compression techniques.

Nadernejad, Ehsan; Hassanpour, H.

2007-01-01

105

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

106

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

107

Quality improvement principles boost SCADA system reliability  

Energy Technology Data Exchange (ETDEWEB)

A major section of Chevron Pipe Line Co.'s SCADA system was recently brought up to the industry-standard 99.5% data-reporting reliability by an intercompany team applying quality improvement (QI) principles. To make the study manageable, the scope was limited to only half the CPL SCADA system, southeast Texas. The study concentrated on 20% of these remote sites which all happened to operate below 90% reliability. The team surveyed 21 sites and recorded data on reliability problem root causes. The data were categorized and formed into a Pareto chart. This chart indicated the root cause of 80% of problems was related to lack of maintenance on both radio equipment and RTU/PLCs. These results were presented to management along with recommendations for forming a quality improvement team to work on developing a preventative maintenance system, a task to be performed jointly between the radio technicians and the pipe line technicians. Goal was to allow the technicians to develop a working relationship with one another and to facilitate a better knowledge of the physical interfaces involved.

Boling, J.E. (Chevron Information Technology Co., New Orleans, LA (United States))

1994-08-01

108

Biospecimen reporting for improved study quality (BRISQ).  

Science.gov (United States)

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. PMID:21574648

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

2011-08-01

109

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

110

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

111

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

112

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

Directory of Open Access Journals (Sweden)

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

Lorenza Nogueira Campos

2009-01-01

113

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

114

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

115

Tracking neonatal nosocomial infection: the continuous quality improvement cycle.  

Science.gov (United States)

Neonatal nosocomial infection (NNI) is a major complication of neonatal care, increasing mortality, morbidity and the costs of healthcare. Management of NNI involves attention to many details of care, creating a culture of change within a neonatal unit and the implementation of a continuous quality improvement cycle. This paper describes the initiation of a quality improvement team (QIT) and the aspects of infection control bundles that have been implemented. The setting was a single large perinatal centre over a seven-year period. Statistical tracking of NNI in exceedingly premature infants was by control charting methodology. A steady and statistically significant decline in NNI rates from 13 to seven episodes per 1000 bed-days (censored to day 35) for infants less than 29 weeks of gestation has been recorded. A multidisciplinary QIT has managed the implementation of measures designed to reduce NNI in the unit. These have included raising awareness of the need for asepsis, improved hand hygiene, increased vigilance in using central lines, monitoring blood culture collection techniques and improving the environment. We believe such measures in conjunction with the positive feedback obtained from charting have been responsible for the steady decline in NNI. This study is one of the first to close the QIT loop and to demonstrate statistical improvement in NNI through the introduction of specific care bundles. PMID:21411185

Gill, A W; Keil, A D; Jones, C; Aydon, L; Biggs, S

2011-05-01

116

Increasing capacity for quality improvement in underresourced primary care settings.  

Science.gov (United States)

While hospitals have widely adopted quality improvement (QI) initiatives, primary care practices continue to face unique challenges to QI implementation. The purpose of this article is to outline a strategy for promoting QI in primary care practices by introducing specially trained nurses. Two case examples are described, one with a QI nurse external to the practice and one with a nurse internal to the practice. Lessons learned and barriers and facilitators to QI in primary care are presented. Barriers and facilitators are identified in the following categories: practice infrastructure, practice leadership, and practice organizational culture. Implications for primary care practitioners and avenues for future work are discussed. PMID:24978164

Hudson, Shannon M; Hiott, Deanna B; Cole, Jeff; Davis, Robert; Egan, Brent M; Laken, Marilyn A

2014-01-01

117

Improved quality assurance testing of respirator filters  

Energy Technology Data Exchange (ETDEWEB)

The overall objective of this project was to evaluate alternative materials, devices, and procedures that could improve performance test methods for high-efficiency particulate air (HEPA) filters and media and could lead to a new generation of quality assurance (QA) test equipment. Shortcomings of the current QA test equipment and procedures include the use of di-(2-ethylhexyl)phthalate (DEHP), a suspect carcinogen, and ambiguities in particle sizing and penetration measurement. Evaluation of a prototype replacement penetrometer system built for the US Army by A. D. Little, Inc., revealed serious deficiencies in aerosol generation and particle sizing. Studies of chemical degradation in circumstances approximating use conditions and of particle size stability in high-humidity conditions suggested that tetraethylene glycol and oleic acid might be appropriate DEHP substitutes in a new generation of flash vaporization generators of QA test aerosols. The successful completion of this project provided a solid foundation for proceeding in the assembly and testing of improved penetrometers for QA testing of HEPA respirator filters. 109 refs., 20 figs., 13 tabs.

Soderholm, S.C.; Strandberg, S.W.; Ortiz, L.W.; Nielsen, S.D.; Tillery, M.I.; Gerber, B.V.; Ettinger, H.J.

1985-05-01

118

Improving access to quality maternal health services.  

Science.gov (United States)

The accessibility of maternal health care services depends on more than their mere existence. While access to routine prenatal care can be increased through use of mobile outreach clinics or peripheral health facilities, access to care for delivery is complicated by the unscheduled nature of labor, by women's other responsibilities, and by fears for women's safety during night travel. Current modes of service delivery must be changed to make care accessible. Physical barriers posed by lack of communication and transportation must be overcome. Possible strategies include establishment of maternity waiting homes, emergency transport and referral mechanisms, and enhanced communications systems. Another strategy is to authorize health care workers at the lowest level of the health care system to perform emergency obstetric services, such as Cesarean sections. Cost is also a barrier, and institution of user fees has prevented many women from seeking care. There are even hidden costs when services are provided free or for a nominal charge. Efforts to overcome these economic barriers include health insurance schemes. In the long term, communities must be educated to recognize and respond to obstetric emergencies, and the quality of health care offered to women must be improved. In addition, communication must be improved between formal and informal health care systems, between communities and health care facilities, and between women and providers. PMID:12293657

Abouzahr, C

1998-01-01

119

Improved quality and information in thyroid scintigraphy  

Energy Technology Data Exchange (ETDEWEB)

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 goiter 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 128 x 128 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.

Baehre, M.; Luig, H.; Emrich, D.; Neumann, P.; Rosenfeld, M.; Neumann, N.

1985-11-01

120

Improving quality of cancer care through surgical audit  

DEFF Research Database (Denmark)

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

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

2010-01-01

 
 
 
 
121

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

Science.gov (United States)

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

Murgatroyd, Stephen

1991-01-01

122

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

Science.gov (United States)

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

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

2014-06-30

123

Optimism and Diet Quality in the Women's Health Initiative.  

Science.gov (United States)

Diet quality has not been well studied in relation to positive psychological traits. Our purpose was to investigate the relationship between optimism and diet quality in postmenopausal women enrolled in the Women's Health Initiative observational study (OS) and clinical trials (CTs), and to determine whether optimism was associated with diet change after a 1-year dietary intervention. Diet quality was scored with the Alternate Healthy Eating Index (AHEI) and optimism assessed with the Life Orientation Test-Revised. Baseline characteristics were compared across AHEI quintiles or optimism tertiles using regression models with each variable of interest as a function of quintiles or tertiles (OS, n=87,630; CT, n=65,360). Association between optimism and baseline AHEI and change in AHEI over 1 year were tested using multivariate linear regression (CT, n=13,645). Potential interaction between optimism and trial arm and demographic/lifestyle factors on AHEI change was tested using likelihood ratio test (CT intervention, n=13,645; CT control, n=20,242). Women reporting high AHEI were non-Hispanic white, educated, physically active, past or never smokers, hormone therapy users, had lower body mass index and waist circumference, and were less likely to have chronic conditions. In the CT intervention, higher optimism was associated with higher AHEI at baseline and with greater change over 1 year (P=0.001). Effect modification by intervention status was observed (P=0.014), whereas control participants with highest optimism achieved threefold greater AHEI increase compared with those with the lowest optimism. These data support a relationship between optimism and dietary quality score in postmenopausal women at baseline and over 1 year. PMID:24556429

Hingle, Melanie D; Wertheim, Betsy C; Tindle, Hilary A; Tinker, Lesley; Seguin, Rebecca A; Rosal, Milagros C; Thomson, Cynthia A

2014-07-01

124

Developing targets for public health initiatives to improve palliative care  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background Palliative Care is an approach that improves quality of life for patients and their families facing the problems associated with incurable life-threatening illness. In many countries, due to the rapidly ageing population, increasingly more people are suffering from serious chronic disease towards the end of life, making further development in palliative care a major public health challenge. The aim of this study was to develop the first targets for public ...

Schneider Nils; Lueckmann Sara L; Kuehne Franziska; Klindtworth Katharina; Behmann Mareike

2010-01-01

125

Systematic Quality Improvement in Medicine: Everyone Can Do It  

Digital Repository Infrastructure Vision for European Research (DRIVER)

In this brief review, written from the perspective of a physician-leader who has fostered the development of comprehensive quality improvement efforts at two academic medical centers, I review the need for improvement, some conceptual barriers that must be overcome, the goals of a comprehensive quality improvement (QI) effort, some of the results we have obtained, and some observations on how to develop a culture of continuous improvement in an academic medical center. The mandate for quality...

Zeidel, Mark L.

2011-01-01

126

Continuous quality improvement of colorectal cancer screening  

Directory of Open Access Journals (Sweden)

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

Mariusz Madalinski

2013-01-01

127

Continuous quality improvement of colorectal cancer screening.  

Science.gov (United States)

Quality assurance is a key issue in colorectal cancer screening, because effective screening is able to improve primary prevention of the cancer. The quality measure may be described in terms: how well the screening test tells who truly has a disease (sensitivity) and who truly does not have a disease (specificity). This paper raises concerns about identification of the optimal screening test for colorectal cancer. Colonoscopy vs flexible sigmoidoscopy in colorectal cancer screening has been a source of ongoing debate. A multicentre randomised controlled trial comparing flexible sigmoidoscopy with usual care showed that flexible sigmoidoscopy screening is able to diminish the incidence of distal and proximal colorectal cancer, and also mortality related to the distal colorectal cancer. However, colonoscopy provides a more complete examination and remains the more sensitive exam than flexible sigmoidoscopy. Moreover, colonoscopy with polypectomy significantly reduces colorectal cancer incidence and colorectal cancer-related mortality in the general population. The article considers the relative merits of both methods and stresses an ethical aspect of patient's involvement in decision-making. Patients should be informed not only about tests tolerability and risk of endoscopy complications, but also that different screening tests for bowel cancer have different strength to exclude colonic cancer and polyps. The authorities calculate effectiveness and costs of the screening tests, but patients may not be interested in statistics regarding flexible sigmoidoscopy screening and from an ethical point of view, they have the right to chose colonoscopy, which is able to exclude a cancer and precancerous lesions in the whole large bowel. PMID:23516135

Madalinski, Mariusz

2013-02-01

128

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 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

1995-10-01

129

After-School Toolkit: Tips, Techniques and Templates for Improving Program Quality  

Science.gov (United States)

This toolkit offers program managers a hands-on guide for implementing quality programming in the after-school hours. The kit includes tools and techniques that increased the quality of literacy programming and helped improve student reading gains in the Communities Organizing Resources to Advance Learning (CORAL) initiative of The James Irvine…

Gutierrez, Nora; Bradshaw, Molly; Furano, Kathryn

2008-01-01

130

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

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

2011-01-01

131

Danish initiatives to improve the safety of meat products  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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...

Wegener, Henrik Caspar

2009-01-01

132

Gibberellin inhibitors improve embryogenic tissue initiation in conifers.  

Science.gov (United States)

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

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

2005-02-01

133

Some questions of improving quality control of well construction  

Energy Technology Data Exchange (ETDEWEB)

Main avenues for improving quality control of drilling operations are covered. Measures are suggested which are the basis for the system of quality control of well construction which have been developed in the Nizhnevartovskneftegaz association.

Syromyatinkov, Ye.S.; Fumberg, V.A.; Isangulov, K.I.; Zaripov, R.I.

1984-01-01

134

Application of improved quality control technology to pressure vessels  

International Nuclear Information System (INIS)

Within the last decade, ASME Boiler and Pressure Vessel Code Section VIII-1 instituted requirements for a formal written quality control system. The results, good and bad, of this requirement are discussed. The effects are far reaching from a national economic standpoint. Quality control technology has improved. These improvements are discussed and compared to existing requirements of the CODE. Recommended improvements are suggested

1985-01-01

135

Global gasoline, diesel quality continues to improve  

Energy Technology Data Exchange (ETDEWEB)

Global fuel quality trends include reduced use of lead, increased gasoline research octane number (RON), reduced diesel sulfur levels, and increased diesel cetane number. These are the findings of a recently released 1995 fuel quality survey conducted by Associated Octel Co. Ltd., Milton Keynes, UK. Octel`s survey quotes officially published statistics, if available. When possible, the survey uses the actual quality of fuels found in the marketplace rather than legislated specifications. The paper describes gasoline demand, gasoline quality, diesel quality, and additive use.

NONE

1996-09-16

136

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).

137

Improving the quality of parameter estimates obtained from slug tests  

Science.gov (United States)

The slug test is one of the most commonly used field methods for obtaining in situ estimates of hydraulic conductivity. Despite its prevalence, this method has received criticism from many quarters in the ground-water community. This criticism emphasizes the poor quality of the estimated parameters, a condition that is primarily a product of the somewhat casual approach that is often employed in slug tests. Recently, the Kansas Geological Survey (KGS) has pursued research directed it improving methods for the performance and analysis of slug tests. Based on extensive theoretical and field research, a series of guidelines have been proposed that should enable the quality of parameter estimates to be improved. The most significant of these guidelines are: (1) three or more slug tests should be performed at each well during a given test period; (2) two or more different initial displacements (Ho) should be used at each well during a test period; (3) the method used to initiate a test should enable the slug to be introduced in a near-instantaneous manner and should allow a good estimate of Ho to be obtained; (4) data-acquisition equipment that enables a large quantity of high quality data to be collected should be employed; (5) if an estimate of the storage parameter is needed, an observation well other than the test well should be employed; (6) the method chosen for analysis of the slug-test data should be appropriate for site conditions; (7) use of pre- and post-analysis plots should be an integral component of the analysis procedure, and (8) appropriate well construction parameters should be employed. Data from slug tests performed at a number of KGS field sites demonstrate the importance of these guidelines.

Butler, Jr. , J. J.; McElwee, C. D.; Liu, W.

1996-01-01

138

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

International Nuclear Information System (INIS)

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

2011-06-01

139

Improving Requirements Selection Quality in Market-Driven Software Development  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The thesis aims at finding means for assessing and improving the requirements engineering (RE) process in order to enhance software product quality and increase the competitive edge of software organisations. Quality can be defined as the ability to satisfy the customers’ expectations. Thus, from an RE perspective, improved quality implies improved requirements elicitation and prioritisation efforts. The thesis focuses on software-developing organisations that release their ...

Karlsson, Lena

2003-01-01

140

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

 
 
 
 
141

Initiation from hemodialysis treatment: quality of life, feelings and difficulties  

Directory of Open Access Journals (Sweden)

Full Text Available Objective: to know the perception of the chronic renal patient on quality of life. Methods: qualitative study, with patients that started the hemodialysis’ treatment from September 2007 to February 2008, in a hospital from Vale do Paraiba, Săo Paulo state. It were participated all patients with Chronic Renal Failure and excluding children under 18 and those with difficulty of communication. Data was organized and analyzed based on hermeneutics methodology. Results: 37 patients were studied, most males (23/62%, predominantly in the age of 51 to 60 years. In the subjects examined, 57% reported having received information about the hemodialysis, the first professional guidance through the medical and day-to-day treatment by the nursing staff. The information of the need for dialysis was received with mixed feelings as many, acceptance, concern, sadness, among others. It was observed that patients identify the food as the primary care related to their health. Conclusion: the upheld and reciprocity of health professionals as well as family support are factors that contribute to better adherence to treatment, helping them to live with the conflicting feelings, thus improving their quality of life.

Maria Leopoldino da Rocha, Sheila dos Santos Vieira, Sheyla de Oliveira Braga, Vanessa de Brito Poveda, Elizabeth Hoffman Sanchez

2009-04-01

142

Improving data quality with dynamic forms  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Organizations in developing regions want to efficiently collect digital data, but standard data gathering practices from the developed world are often inappropriate. Traditional techniques for form design and data quality are expensive and labour-intensive. We propose a new data-driven approach to form design, execution (filling) and quality assurance. We demonstrate USHER, an end-to-end system that automatically generates data entry forms that enforce and maintain data quality constraints du...

Chen, Kuang; Chen, Harr; Conway, Neil; Dolan, Heather; Hellerstein, Joseph M.; Parikh, Tapan S.

2010-01-01

143

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

Directory of Open Access Journals (Sweden)

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

Scoggins Amanda

2008-10-01

144

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

Du?ckers, M. L. A.

2009-01-01

145

Improving courseware quality through life-cycle encompassing quality assurance  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The quality of courseware development is affected by four factors: content and instructional issues; management; technical and graphical issues; and concerns of the customer. In this paper we describe IntView, a courseware development method that integrates these four factors throughout the whole development life-cycle. By combining existing courseware quality assurance methodologies with software engineering techniques such as inspections and tests the interests of the participating roles ar...

Gru?tzner, I.; Waterson, P.; Weibelzahl, S.

2003-01-01

146

O processo da avaliaçăo institucional como multiplicador de iniciativas para o aperfeiçoamento docente: 2Ş parte The institutional evaluation process as a multiplier of initiatives for quality improvement of the teaching staff: part 2  

Directory of Open Access Journals (Sweden)

Full Text Available O presente trabalho propőe uma reflexăo a respeito do processo de avaliaçăo institucional, especialmente da avaliaçăo docente, como possibilidade de aperfeiçoamento didático-pedagógico de professores.This paper proposes an alternative reflection regarding the institutional evaluation process, in particular the evaluation of the teaching staff, as a possibility of didactic and pedagogic improvement of the professors.

Antonio Reges Brasil

2007-12-01

147

The Louisiana Medicare Electro-Convulsive Therapy Quality Improvement Project.  

Science.gov (United States)

The first collaborative statewide psychiatric quality improvement project, initiated by Louisiana Health Care Review, Inc, focused on the practice of inpatient electro-convulsive therapy (ECT) among Medicare patients. Data from the project indicated that the majority of Medicare patients receiving ECT were white females living at home, in good physical health, in their seventies, and with a diagnosis of major depression or major depression with psychotic features. The quality indicators for the project included: (documentation of) monitoring of cognitive side effects, monitoring of depressive target symptoms, ECT appropriateness, electrode placement, anesthesia evaluation, and dental examination. An additional indicator (administration of possibly detrimental medication during ECT) was developed based on the recommendation by the study group. At project conclusion, significant improvement occurred in all project indicators. ECT as practiced in the participating hospitals was effective and appropriate. Appropriateness was determined as depression refractory to two medication trails or an emergency due to severe suicidal ideation or physical deterioration secondary to malnutrition. Transient hypertension (13%) and cardiac dysrhythmia (3.5%) which resolved in the recovery period were the most frequent complications. PMID:10546434

Westphal, J R; Sakauye, K; Rush, J; Kumar, S

1999-10-01

148

Feedback from a collective outage improvement initiative at an EDF nuclear power plant  

International Nuclear Information System (INIS)

The author reports various efforts made by EDF to improve nuclear safety during shutdowns or outages of its nuclear power plants. One of the initiatives was the creation of the 'activities coordinator' job category for the coordination and the overseeing of all maintenance activities. The coordination is based on a quality plan, the content of which being briefly indicated. The author presents the organisation implemented for the unit outage. He reports and comments group training activities and experience feedback, illustrates and comments the performance improvements in terms of technical issues as well as nuclear safety

1995-06-19

149

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

150

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. 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)

2006-03-01

151

Recent improvements in quality control at Quintette Operating Corporation  

Energy Technology Data Exchange (ETDEWEB)

Historical ash control at Quintette, recent process changes in the plant, improvement of coal recovery of blends, and bias tracking and quality control are described. An ash control chart was developed for use in the plant. Quality control was improved at the Quintette clean coal stockpiles at Ridley Terminals. The processing plant at Quintette Coal Limited was modified in 1992-93 to improve the efficiency of recovery of clean coal. Since the ash content of the seams are uneven, new problems with ash quality control resulted. The ash quality control problems and their solutions are discussed. 8 figs., 2 tabs.

Leeder, W.R.; Smith, R.J.; Blocka, R.L. [Quintette Operating Corporation, Tumbler Ridge, BC (Canada)

1994-12-31

152

Technical report for effective estimation and improvement of quality system  

Energy Technology Data Exchange (ETDEWEB)

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

Kim, Kwan Hyun

2000-06-01

153

Enhancing K-means Clustering Algorithm with Improved Initial Center  

Directory of Open Access Journals (Sweden)

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

Srinivasa.T.M

2010-05-01

154

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

155

Software metrics to improve software quality in HEP  

Energy Technology Data Exchange (ETDEWEB)

The ALEPH reconstruction program maintainability has been evaluated with a case tool implementing an ISO standard methodology based on software metrics. It has been found that the overall quality of the program is good and has shown improvement over the past five years. Frequently modified routines exhibits lower quality; most buys were located in routines with particularly low quality. Implementing from the beginning a quality criteria could have avoided time losses due to bug corrections. (author)

Lancon, E. [CEA Centre d' Etudes de Saclay, 91 - Gif-sur-Yvette (France). Dept. d' Astrophysique, de la Physique des Particules, de la Physique Nucleaire et de l' Instrumentation Associee

1996-07-01

156

Software metrics to improve software quality in HEP  

International Nuclear Information System (INIS)

The ALEPH reconstruction program maintainability has been evaluated with a case tool implementing an ISO standard methodology based on software metrics. It has been found that the overall quality of the program is good and has shown improvement over the past five years. Frequently modified routines exhibits lower quality; most buys were located in routines with particularly low quality. Implementing from the beginning a quality criteria could have avoided time losses due to bug corrections. (author)

1995-09-18

157

Quality initiatives related to moderately preterm, late preterm, and early term births.  

Science.gov (United States)

Most premature infants born in the United States each year are classified as either moderately preterm (MPT) or late preterm (LPT) infants. Unnecessary variation in care and lack of evidence-based practices may contribute to the morbidities of prematurity. Quality-improvement (QI) initiatives designed for neonates have primarily focused on extremely low-gestational-age newborns. However, the lessons learned in this group of infants could be applied to decreasing unnecessary variation among MPT and LPT infants. Practice variation in the timing of nonindicated preterm deliveries, the use of progesterone, respiratory care practices, feeding management, and discharge planning are particularly in need of QI. PMID:24182961

Trembath, Andrea N; Iams, Jay D; Walsh, Michele

2013-12-01

158

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

159

Improving housing quality as a marketing strategy  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Prospective housing clients in Portugal face up a marked lack of information on the characteristics of housing products, which most often turn out to be very different to their expectations. This lack of information does not allow them to relate quality and cost adequately.

Fernandes, Si?lvia; Teixeira, Jose? M. Cardoso; Lopes, Jorge

2007-01-01

160

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

 
 
 
 
161

The quality of care for adults with epilepsy: an initial glimpse using the QUIET measure  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background We examined the quality of adult epilepsy care using the Quality Indicators in Epilepsy Treatment (QUIET measure, and variations in quality based on the source of epilepsy care. Methods We identified 311 individuals with epilepsy diagnosis between 2004 and 2007 in a tertiary medical center in New England. We abstracted medical charts to identify the extent to which participants received quality indicator (QI concordant care for individual QI's and the proportion of recommended care processes completed for different aspects of epilepsy care over a two year period. Finally, we compared the proportion of recommended care processes completed for those receiving care only in primary care, neurology clinics, or care shared between primary care and neurology providers. Results The mean proportion of concordant care by indicator was 55.6 (standard deviation = 31.5. Of the 1985 possible care processes, 877 (44.2% were performed; care specific to women had the lowest concordance (37% vs. 42% [first seizure evaluation], 44% [initial epilepsy treatment], 45% [chronic care]. Individuals receiving shared care had more aspects of QI concordant care performed than did those receiving neurology care for initial treatment (53% vs. 43%; X2 = 9.0; p = 0.01 and chronic epilepsy care (55% vs. 42%; X2 = 30.2; p Conclusions Similar to most other chronic diseases, less than half of recommended care processes were performed. Further investigation is needed to understand whether a shared-care model enhances quality of care, and if so, how it leads to improvements in quality.

Avetisyan Ruzan

2011-01-01

162

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 â??â??case-by-caseâ?ť risk assessment system, as well as increased international collaboration on surveillance, are both elements in this new strategy.

Wegener, Henrik Caspar

2010-01-01

163

Zero tolerance for failure. An AREVA initiative to improve reliability  

Energy Technology Data Exchange (ETDEWEB)

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

Lippert, Hans-Joachim [AREVA NP GmbH, Erlangen (Germany); Gentet, Guy; Mollard, Pierre [AREVA NP S.A.S., Lyon (France); Garner, Norman [AREVA NP Inc., Richland, WA (United States)

2010-04-15

164

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

165

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

166

Improving the quality of installation construction at the Balakovo NPP  

International Nuclear Information System (INIS)

Experience in improving the guality of main installation construction at the Balakovo NPP is analysed. It is marked that high quality is reached due to accurate industrial production preparation, the introduction of new technology and modern high-duty mechanisms, industrialization of works, the improvement of labour culture, accurate quality control, the presence of high-qualified workers. The standing commission for quality, performing control in all stages beginning from foundation production till putting the object into operation, is organized to keep performance quality on the required level

1986-01-01

167

Improving wind power quality with energy storage  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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...

2009-01-01

168

Improvement of cassava quality through mutation breeding  

International Nuclear Information System (INIS)

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

1993-09-20

169

Improving wind power quality with energy storage  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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...

2011-01-01

170

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

DEFF Research Database (Denmark)

In 1995, the Global Initiative for Asthma (GINA) published an evidence-based workshop report as a guide to clinicians managing asthma patients, and has updated it annually to ensure that recommendations remain current. Although the report has been widely disseminated and influenced clinical practice and research, its major objective, of forming the basis for local and national initiatives to improve services for asthma patients, remains to be achieved. Over recent years, the science of guideline implementation has progressed, and encouraging examples of successful asthma programmes have been published. This report is intended to draw on this experience and assist with the translation of asthma guideline recommendations into quality programmes for patients with asthma using current knowledge translation principles. It also provides examples of successful initiatives in various socioeconomic settings.

Boulet, Louis-Philippe; FitzGerald, J Mark

2012-01-01

171

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

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

2013-01-01

172

Improving quality of tuberculosis care in India.  

Science.gov (United States)

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

Pai, Madhukar; Satyanarayana, Srinath; Hopewell, Phil

2014-01-01

173

Improving coal tar quality by centrifugation  

Energy Technology Data Exchange (ETDEWEB)

Quality of coal tar from coking plants in the USSR is deteriorating. Its density, ash content, content of toluene-insoluble and quinoline-insoluble compounds are increasing. A method for coal tar upgrading by centrifugation was successfully tested in the Orsko-Khalilovskii coking plant. After dewatering and sedimentation, coal tar was treated by centrifugation which reduced moisture content in the tar by 52.2% and ash content by 47.9%. Physical properties of coal tar before and after centrifugation are analyzed. The optimum procedure for centrifugation is described. 5 references.

Vorob' ev, S.E.; Bukreev, V.P.

1986-09-01

174

Treatment: improvement or deterioration of water quality?  

Science.gov (United States)

The formation of trihalomethanes through chlorination has shown very clearly that water treatment processes may adversely affect water quality. There are many more examples of such effects, including the following which are discussed in detail: 1. Formation of organohalogen compounds in addition to trihalomethanes by chlorination and other oxidation processes. 2. Formation of more polar, more biodegradable organics by ozonation for example, and the consequent increase in bacterial growth in the distribution system. 3. Formation and removal of organic and inorganic corrosion inhibitors by treatment, and the consequent higher heavy metal concentrations in tap water. PMID:7233162

Kühn, W; Sontheimer, H

1981-04-01

175

Quality improvement in neurology: Distal symmetric polyneuropathy quality measures.  

Science.gov (United States)

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

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

2014-05-13

176

A Glaser magnet of improved field quality  

Energy Technology Data Exchange (ETDEWEB)

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

Sarma, P.R. E-mail: sarma@veccal.ernet.in; Pattanayak, S.K.; Bandyopadhyay, D.K.; Bhandari, R.K

1999-08-11

177

A Glaser magnet of improved field quality  

CERN Document Server

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

Sarma, P R; Bandyopadhyay, D; Bhandari, R K

1999-01-01

178

Biospecimen Reporting for Improved Study Quality  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 ...

2011-01-01

179

Biospecimen Reporting for Improved Study Quality (BRISQ)  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 ...

2011-01-01

180

Quality Improvement of Business Critical Systems  

Directory of Open Access Journals (Sweden)

Full Text Available Today’s society is crucially dependent on software systems. The number of areas where functioning software is at the core of operation is growing steadily. Both financial systems and e-business systems relies on increasingly larger and more complex computer and software systems. To increase e.g. the reliability and performance of such systems we rely on a plethora of methods, techniques and processes specifically aimed at improving the development, operation and maintenance of such software. The Business Critical Systems generally seek to develop and evaluate methods to improve the support for development, operation and maintenance of Business Critical System and systems. Improving software processes relies on the ability to analyze previous projects and derive concrete improvement proposals.This paper is a part of the work done on the BCS basic research and development project (Business Critical System. The BCS project was funded by two small software companies, based at Hyderabad, Andhra Pradesh, India, as a basic R&D project in IT in the year 2004.

Mr. P. Jitendra Srinivas Kumar

2011-11-01

 
 
 
 
181

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

2008-11-15

182

Process safety improvement--quality and target zero.  

Science.gov (United States)

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

Van Scyoc, Karl

2008-11-15

183

Computerised clinical pathway as process quality improvement tool.  

Science.gov (United States)

Experiences from other industries show that process quality improvement (PQI) is far more effective than product quality assurance in ensuring quality outputs and cost savings. The PQI approach is becoming more important to the healthcare industry as healthcare professionals struggle to cope with increasing demands for productivity gains, the raising patient acuity and need to curtail the large number of adverse medical events. This paper presents a continuous process quality improvement operational model for healthcare quality improvement and operationalization of the model through the implementation of a computerised clinical pathway management system (CCPMS). It also reports on a small-scale evaluative study conducted to assess the effectiveness of the PQI approach using the CCMPS prototype. PMID:11604906

Chu, S

2001-01-01

184

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

185

Study of Parameters for Improving Quality of Technical Education with Customer Satisfaction via Quality Function Deployment  

Directory of Open Access Journals (Sweden)

Full Text Available Quality is the link that attracts customers. The Technical Institutes are processor which introduces quality products (technocrats in the market. Changing scenario has compelled for Quality improvement in the institutes and this can be achieved only by improving conditions prevailing in the institutes. Traditional methods of designing disregard the voice of customers as well as disregard the competition. Thus lacking in commitment of improvement. Improvement in the practical knowledge imparted through improving quality assurance of labs which satisfy the students. Improvement in teaching staff so that pure knowledge reaches to passing out generation. Quality of technical education is its ability to produce a steady flow of people with high intelligence and commitment to learning that will continue the process of transmission and advancement of knowledge. Quality Function Deployment (QFD is one of the Total Quality Management (TQM techniques which can be applied for process and design improvement. This study uses QFD as a tool for quality improvement and benchmarking in Technical Institutions. The study is based on primary data collected from students which are considered as customers and teachers, considered as technical describers from six different branches of a technical institute. A self designed questionnaire was used for data collection. The data was analyzed using the techniques of QFD on a technical institu

Abhishek Soni, Sanjay Soni, Dr. Sameer Vaidhya

2014-06-01

186

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 hospital...

Groene Oliver; Mora Nuria; Thompson Andrew; Saez Mercedes; Casas Mercč; Suńol Rosa

2011-01-01

187

Initial Assessment of TxDOT Binder Quality Assurance Program.  

Science.gov (United States)

Most state departments of transportation (DOT) maintain asphalt binder quality assurance (QA) programs to ensure that asphalt binders used in the construction of their road system meet specifications stipulated for each project. TxDOT samples and approves...

A. Epps C. Spiegelman E. Park E. Arambula T. Ahmed

2001-01-01

188

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 ...

189

Knowledge-based clinical pathway for medical quality improvement  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Clinical pathways have been adopted for various diseases in clinical departments for quality improvement as a result of standardization of medical activities in treatment process. Using knowledge-based decision support on the basis

2012-01-01

190

Improving Quality in Evolving Software Development Team Practices  

Digital Repository Infrastructure Vision for European Research (DRIVER)

This thesis deals with a software development team’s desire to improve quality by developing working practices. Quality management is about ensuring the quality of the end product and fulfilling the customer’s needs. Efficient working practices are an important component in the process. The objective of this study was to find and develop such practices for the team in question. Software projects within the organization are executed with traditional project management methods. The team...

Jussila, Annikki

2013-01-01

191

Improved initial osteoblast functions on amino-functionalized titanium surfaces.  

Science.gov (United States)

Adhesion and spreading of cells on biomaterials are integrin-mediated processes. But recent findings indicate a key role of the cell membrane associated matrix substance hyaluronan (HA) in interface interactions. Because HA is a negatively charged molecule we assume that a biomaterial surface with an opposed charge could boost the first contact of the cell to the surface. Polished cp titanium (R(a)=0.19 microm) was coated with an amino-group containing plasma polymer (Ti PPA). For this purpose, a microwave excited, pulsed, low-pressure plasma was used. Additionally, collagen was immobilized on Ti PPA with polyethylene glycol diacid (PEG-DA), catalyzed by carbodiimide (CDI). The physico-chemical surface analytical techniques like XPS, FT-IR, water contact angle and zeta-potential verified the retention of the allylamine precursor structure. Human osteoblasts were cultured in serum-free Dulbecco's modified Eagle medium (DMEM). Adhesion and cell cycle phases were calculated by flow cytometry. Spreading and actin cytoskeleton were visualized by confocal microscopy. Gene expression of osteogenic markers was detected by real-time RT-PCR. Ti PPA is significantly advantageous concerning initial adhesion and spreading during the first hours of the cell contact to the surface. The proliferation of osteoblasts is positively influenced. Gene expression of the differentiation marker bone sialoprotein was upregulated after 24h. Our results demonstrate that functionalization of titanium with positively charged amino-groups is sufficiently enough to significantly improve initial steps of the cellular contact to the material surface. PMID:17825608

Nebe, Barbara; Finke, Birgit; Lüthen, Frank; Bergemann, Claudia; Schröder, Karsten; Rychly, Joachim; Liefeith, Klaus; Ohl, Andreas

2007-11-01

192

Implementation of a quality improvement program to improve sweat test performance in a pediatric hospital.  

Science.gov (United States)

Context.-All positive screening of newborns for cystic fibrosis using the dried blood spot 2-tiered immunoreactive trypsinogen/DNA method requires subsequent sweat chloride testing for confirmation. Obtaining an adequate volume of sweat to measure chloride is a challenge for many cystic fibrosis centers across the nation. The standard for patients older than 3 months is less than 5% quantity not sufficient (QNS) and for patients 3 months or younger is less than 10% QNS. Objective.-To set up a quality improvement (QI) program for sweat testing to improve QNS rates using the Wescor Macroduct (Wescor, Inc, Logan, Utah) method at Texas Children's Hospital's laboratory, Houston, Texas. Design.-Single-center study. Results.-Quantity not sufficient rates were evaluated for 4 months before and 8 months after implementation of the QI program for patients aged 3 months or younger and those older than 3 months. The QI program included changes in technician training, service, site of collection, mode of collection, weekly review, and forms to screen patients for medications that may alter sweat production. A marked improvement was observed in the rates of QNS, which declined considerably from 16.7% to 8.5% (?3 months old) and from 9.3% to 2.2% (>3 months old) after implementation of the QI initiative in both age categories. Conclusion.-This report demonstrates the effectiveness of the QI program in significantly improving QNS rates in sweat chloride testing in a pediatric hospital. PMID:24568729

Aqil, Barina; West, Aaron; Dowlin, Michael; Tam, Estella; Nordstrom, Cristy; Buffone, Gregory; Devaraj, Sridevi

2014-07-01

193

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

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

2005-01-01

194

Continuous Quality Improvement: Implementation and Sustainability  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

Yella, Gilbert Ncheh; Atem, Tongwa Ivo

2007-01-01

195

A comparison of two optimization methods for mesh quality improvement.  

Energy Technology Data Exchange (ETDEWEB)

We compare inexact Newton and coordinate descent optimization methods for improving the quality of a mesh by repositioning the vertices, where the overall quality is measured by the harmonic mean of the mean-ratio metric. The effects of problem size, element size heterogeneity, and various vertex displacement schemes on the performance of these algorithms are assessed for a series of tetrahedral meshes.

Munson, Todd (Argonne National Laboratory, Argonne, IL); Diachin, Lori Freitag (Lawrence Livermore National Laboratory, Livermore, CA); Knupp, Patrick Michael; Shontz, Suzanne M. (University of Minnesota, Minneapolis, MN)

2005-03-01

196

Institutional Research and Improving the Quality of Student Engagement  

Science.gov (United States)

This article asks whether institutional research could help improve the quality of student engagement by researching at sub-institutional levels such as in courses bridging students from school into higher education. In answer it argues two interacting propositions: one, that student engagement provides useful indicators of quality in higher…

Zepke, Nick; Butler, Philippa; Leach, Linda

2012-01-01

197

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

198

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.

2012-12-13

199

Ripening for improving the quality of inoculated cheese Rhizopus oryzae  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract. 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. ory...

2010-01-01

200

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

2012-01-01

 
 
 
 
201

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 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.

2010-04-07

202

Improving initial polyp candidate extraction for CT colonography  

Science.gov (United States)

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

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

2010-04-01

203

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

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

2010-01-01

204

Clinical Mentorship of Nurse Initiated Antiretroviral Therapy in Khayelitsha, South Africa: A Quality of Care Assessment  

Science.gov (United States)

Introduction To combat the AIDS epidemic and increase HIV treatment access, the South African government implemented a nurse-based, doctor-supported model of care that decentralizes administration of antiretroviral treatment (ART) for HIV positive patients through nurse initiated and managed ART. Médecins Sans Frontičres (MSF) implemented a mentorship programme to ensure successful task-shifting, subsequently assessing the quality of clinical care provided by nurses. Methods A before-after cross-sectional study was conducted on nurses completing the mentorship programme in Khayelitsha, South Africa, from February 2011-September 2012. Routine clinical data from 229 patient folders and 21 self-assessment questionnaires was collected to determine the number of patients initiated on ART by nurses; quality of ART management before-after mentorship; patient characteristics for doctor and nurse ART initiations; and nurse self-assessments after mentorship. Results Twenty one nurses were authorized by one nurse mentor with one part-time medical officer's support, resulting in nurses initiating 77% of ART eligible patients. Improvements in ART management were found for drawing required bloods (91% vs 99%, p?=?0.03), assessing adherence (50% vs 78%, pHIV-infected children and pregnant women, blood result interpretation and long-term side effects. Conclusions Implementation of a clinical mentorship programme in Khayelitsha led to nurse initiation of a majority of eligible patients, enabling medical officers to manage complex cases. As mentorship can increase clinical confidence and enhance professional development, it should be considered essential for universal ART access in resource limited settings.

Green, Ann; de Azevedo, Virginia; Patten, Gabriela; Davies, Mary-Ann; Ibeto, Mary; Cox, Vivian

2014-01-01

205

Quality control in the initiation of eukaryotic DNA replication  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Origins of DNA replication must be regulated to ensure that the entire genome is replicated precisely once in each cell cycle. In human cells, this requires that tens of thousands of replication origins are activated exactly once per cell cycle. Failure to do so can lead to cell death or genome rearrangements such as those associated with cancer. Systems ensuring efficient initiation of replication, while also providing a robust block to re-initiation, play a crucial role in genome stability....

Diffley, John F. X.

2011-01-01

206

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

207

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 132âGreat Lakes Water Quality Initiative...

2010-07-01

208

Overview of the VA Quality Enhancement Research Initiative (QUERI and QUERI theme articles: QUERI Series  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Continuing challenges to timely adoption of evidence-based clinical practices in healthcare have generated intense interest in the development and application of new implementation methods and frameworks. These challenges led the United States (U.S. Department of Veterans Affairs (VA to create the Quality Enhancement Research Initiative (QUERI in the late 1990s. QUERI's purpose was to harness VA's health services research expertise and resources in an ongoing system-wide effort to improve the performance of the VA healthcare system and, thus, quality of care for veterans. QUERI in turn created a systematic means of involving VA researchers both in enhancing VA healthcare quality, by implementing evidence-based practices, and in contributing to the continuing development of implementation science. The efforts of VA researchers to improve healthcare delivery practices through QUERI and related initiatives are documented in a growing body of literature. The scientific frameworks and methodological approaches developed and employed by QUERI are less well described. A QUERI Series of articles in Implementation Science will illustrate many of these QUERI tools. This Overview article introduces both QUERI and the Series. Methods The Overview briefly explains the purpose and context of the QUERI Program. It then describes the following: the key operational structure of QUERI Centers, guiding frameworks designed to enhance implementation and related research, QUERI's progress and promise to date, and the Series' general content. QUERI's frameworks include a core set of steps for diagnosing and closing quality gaps and, simultaneously, advancing implementation science. Throughout the paper, the envisioned involvement and activities of VA researchers within QUERI Centers also are highlighted. The Series is then described, illustrating the use of QUERI frameworks and other tools designed to respond to implementation challenges. Conclusion QUERI's simultaneous pursuit of improvement and research goals within a large healthcare system may be unique. However, descriptions of this still-evolving effort, including its conceptual frameworks, methodological approaches, and enabling processes, should have applicability to implementation researchers in a range of health care settings. Thus, the Series is offered as a resource for other implementation research programs and researchers pursuing common goals in improving care and developing the field of implementation science.

Mittman Brian S

2008-02-01

209

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)

2011-01-01

210

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

211

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

212

Applying GRA and QFD to Improve Library Service Quality  

Science.gov (United States)

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

Chen, Yen-Ting; Chou, Tsung-Yu

2011-01-01

213

Improving arteriovenous fistula rate: Effect on hemodialysis quality.  

Science.gov (United States)

Vascular access (VA) is the lifeline for patients with end-stage renal disease on regular hemodialysis (HD). Tunneled catheters have been associated with increased risk of luminal thrombosis, infection, hospitalization, and high cost. Our aims were to follow the "Fistula First Initiative," avoid or reduce the rate of catheter insertion, improve the rate of arteriovenous fistula (AVF) use, and study the effect of increased AVF use on quality of dialysis and patient's outcome. A VA program has been established in collaboration with an enthusiastic and professional vascular surgery team to manage 358 patients who have been on regular HD treatment for a period ranging from 1 to 252 months. The mean ± standard deviation age of patients was 52 ± 15 years with 62% male patients. Over a period of 2 years, 408 procedures were performed. These include 293 AVFs and 56 arteriovenous grafts (AVGs). Other procedures include 39 permanent catheter insertions, 8 AVF aneurysmectomy, removal of 6 AVGs, embolectomy of 4 AVGs, excision of 1 AVG lymphocele, and ligation of 1 AVF. This program resulted in significant increase in AVF rate from 35% to 82%; reduction in catheter rate from 62% to 10.9%; infection rate down from 6.6% to 0.6%; VA clotting down from 5.1% to 1.0%; and increase in average blood flow rate from 214 ± 32 to 298 ± 37 mL/min (P < 0.01). These results have been associated with improved average single pool Kt/V from 0.88 ± 0.19 to 1.28 ± 0.2 (P < 0.01); increased hemoglobin from 9.2 ± 1.2 to 10.9 ± 0.9 g/dL (P < 0.01); improved serum albumin from 3.2 ± 0.5 to 3.7 ± 0.4 g/dL (P < 0.05); reduction in administered erythropoietin dose by 19%; and significant drop in hospitalization rate from 6.1% to 3.8%. These results confirm the great benefits of AVF on quality of HD and patient outcome, and clearly affirm that AVF should always be considered first. PMID:24164935

Karkar, Ayman; Chaballout, Ahmed; Ibrahim, Maher Haj; Abdelrahman, Mohammed; Al Shubaili, Mona

2014-04-01

214

Design and Simulation of STATCOM to Improve Power Quality  

Directory of Open Access Journals (Sweden)

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

Md. Nazrul Islam

2013-07-01

215

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 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.)

2011-09-01

216

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

217

Uniting board to bedside: the use of driver diagrams in quality monitoring and improvement at Trillium Health Centre.  

Science.gov (United States)

Boards of directors of healthcare organizations are increasingly being urged to extend their governance activities beyond financial matters to include the quality of patient care. Recently, Trillium Health Centre identified four big dot indicators and generated corollary driver diagrams aimed at helping its board understand and measure the organization's quality improvement plans, efforts and results. In addition to keeping board members up to date on these developments, the driver diagrams have supported quality improvements in their own right--for example, with hospital-acquired pressure ulcers--and have helped staff to focus and become more deeply engaged in Trillium's patient-centred quality improvement initiatives. PMID:22116567

Cochrane, Patti; Ginzburg, Amir; Spencer, Gary; Marani, Farah

2011-01-01

218

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

219

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

1997-07-01

220

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

 
 
 
 
221

Institutions for Quality Cooperation for Development: Clarifications and Initial Proposals  

Directory of Open Access Journals (Sweden)

Full Text Available In his analysis of institutions for quality cooperation for development, focusing basically on the Spanish case, the author first clarifies and defines the concepts of “institution”, governance,and the so-called three sectors, that is, the State and administrations, the market and civil society. Good government depends on the capabilities and synergies among these threesectors as well as on their relationships with the different institutions and their social context, and this ensures governance, that is, development or, in this case, cooperation for development.The second part of the article poses the question: How are we doing in all of this in the case of Spanish cooperation for development and, therefore, in its ability to affect the generation or strengthening of development policies in the different sectors of the countries of the South? To answer this question, the author considers three aspects: a the chronic lack of institutions; b the excess of legislation and formality, rooted in Latin political and organisational culture, and c the need for new instruments and procedures, reflected, but only partially, in the new Directing Plan and in the proposals of Catalan cooperation, translated into institutional terms. Finally, the article makes reference to “decentralised” cooperation, its challenges and prospects, and a “decalogue” of good government which “only aims to serve to open debate on the need for new institutions for quality cooperation for development congruent with the development policies of the actors of the South.”

Rafael Grasa Hernández

2006-01-01

222

Qualifound - A modular tool developed for quality improvement in foundries  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Purpose – Castings defects are usually easy to characterize, but to eradicate them can be a difficult task. In many cases, defects are caused by the combined effect of different factors, whose identification is often difficult. Besides, the real non-quality costs are usually unknown, and even neglected. This paper aims to describe the development of a modular tool for quality improvement in foundries, and its main objective is to present the application potential and the foundry...

Santos, Gilberto; Barbosa, J.

2006-01-01

223

Quality in home-based childcare: Impact and improvement  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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...

2010-01-01

224

Models for continuous improvement of productivity and quality  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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...

1995-01-01

225

Quality improvement process pilot project at Gallagher station  

International Nuclear Information System (INIS)

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

1992-04-13

226

The development of a quality assurance project plan for the USEPA dioxin exposure initiative program  

Energy Technology Data Exchange (ETDEWEB)

All projects planned and implemented under the United States Environmental Protection Agency (USEPA) Dioxin Exposure Initiative are required to have completed Quality Assurance Projects Plans (QAPPs). EPA Order 5360.1 A2 states, ''All work funded by the United States Environmental Protection Agency (EPA) that involves the acquisition of environmental data generated from direct measurement activities, collected from other sources, or compiled from computerized data bases and information systems are implemented in accordance with an approved QA Project Plan except under circumstances requiring immediate actions to protect human health and the environment or operations conducted under police powers''. This policy is based on the newly revised national consensus standard, ANSI/ASQC E-4-2004. These QAPPs have proven invaluable in the development and improvement of analytical methodology for dioxin-like compounds over the intervening years and in the verification and validation of the results of dioxin exposure studies.

Byrne, C.; Ferrario, J. [Stennis Space Center, MS (USA). USEPA Environmental Chemistry Laboratory

2004-09-15

227

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, Sřren; Stokbro, Kurt; Jónsson, Hannes

2014-01-01

228

INTERNATIONAL TENDENCIES OF INFOMATIZATION DEVELOPMENT AND IMPROVEMENT OF EDUCATION QUALITY ?????????? ????????? ???????? ?????????????? ?????? ?? ?????????? ?? ??????  

Directory of Open Access Journals (Sweden)

Full Text Available In the article actual tendencies of educational system informatization development in the world are analyzed. There are stated the basic advantages of information and communication technologies (ICT use in the educational process. It is presented experience of the coordination of national standards with international ones in the different countries of the world which will give the chance to Ukraine to be guided for improvement of education quality, that means improvement of information technologies (I? quality. As Ukraine is a part of the European and international information and educational space, therefore in this branch there should be a development responding to the level of other countries.? ?????? ???????????? ????????? ????????? ???????? ?????????????? ?????? ?????? ? ?????. ? ?????? ????????? ??????? ???????? ???????????? ????????????-?????????????? ?????????? (??? ? ??????? ????????. ?????????????? ?????? ?????????? ???????????? ?????????? ?? ???????????? ? ?????? ??????? ?????, ?????????? ????? ????? ?????????? ???????????? ?????????? ?????? ??????, ?????? ?????????? ?????? ????????????? ?????????? (?? ? ???????. ???????? ??????? ?????? ?? ????????? ? ???????????? ???????? ???????, ??????????? ??????? ?????????? ?????? ??? ???????? ?????? ?? ?????????????? ????? ??????? ??????????.

A.?. ????

2011-02-01

229

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

2009-01-01

230

No respect: research in quality, safety, and process improvement.  

Science.gov (United States)

The need for good quality and safety research has never been more imperative, but even as we encourage and promote such work, we seem to suppress it through institutional bias and inertia. Indeed the culture of health care seems to have a love-hate relationship with quality-improvement work as a whole. In this commentary we explore some of the implications of the application of pure science standards at the sharp end of clinical practice, where the down-and-dirty street-level improvement work happens. PMID:20740106

Rubinfeld, Ilan S; Horst, H Mathilda

2009-01-01

231

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

Science.gov (United States)

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

Rubinfeld, Ilan S; Horst, H Mathilda

2009-01-01

232

How can we improve outcomes for patients and families under palliative care? implementing clinical audit for quality improvement in resource limited settings  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Palliative care in India has made enormous advances in providing better care for patients and families living with progressive disease, and many clinical services are well placed to begin quality improvement initiatives, including clinical audit. Clinical audit is recognized globally to be essential in all healthcare, as a way of monitoring and improving quality of care. However, it is not common in developing country settings, including India. Clinical audit is a cyclical activity involving:...

Selman Lucy; Harding Richard

2010-01-01

233

How Can We Improve Outcomes for Patients and Families Under Palliative Care? Implementing Clinical Audit for Quality Improvement in Resource Limited Settings  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Palliative care in India has made enormous advances in providing better care for patients and families living with progressive disease, and many clinical services are well placed to begin quality improvement initiatives, including clinical audit. Clinical audit is recognized globally to be essential in all healthcare, as a way of monitoring and improving quality of care. However, it is not common in developing country settings, including India. Clinical audit is a cyclical activity involving:...

Selman, Lucy; Harding, Richard

2010-01-01

234

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

DEFF Research Database (Denmark)

This paper will consider how Quality Function Deployment (QFD) and Design for Manufacture and Assembly (DFMA) processes can be used to improve the design quality of products at the concept stage. We appreciate that both QFD and DFMA are techniques that have been used for some time by mature product developers, and the successes achieved using each have been widely reported. Here, though, we will share our experiences of using these tools with novice designers, i.e. student engineers.The use of both QFD and DFMA has proven to be a valuable approach for ensuring that a balanced consideration of design quality is maintained in design project work. The projects described have been carried out with products manufactured by small to medium sized enterprises (SME's), where we have found significant opportunities for product improvement. The quantitative nature ofDFMA analysis results allows the novice designer to identify clear targets for design improvement and to measure the effectiveness of any new solution, whilst attention to QFD ensures customer requirements are still being satisfied.Often, SME's are not aware of many of the best design practices and so are not able to meet the demand for continuous improvement of their products. However, we consider that if novice designers are able to successfully utilise design tools like QFD and DFMA and achieve improvements in design quality, then SMEâ??s have no excuses for ignoring the benefits they could bring to their own product development activity.

Bush, Stuart; Robotham, Antony John

1999-01-01

235

Improving quality in cancer screening: the excellence report for colonoscopy.  

Science.gov (United States)

The goal of this project was to create and evaluate a quality measures program for colonoscopy procedures using measures recently defined by multi-specialty groups and using resources of the Clinical Outcomes Research Initiative (CORI), a gastrointestinal endoscopy research consortium. Participants collect procedure data through an endoscopic reporting system developed by CORI. Endoscopists practicing at 35 sites in 21 communities and 16 states were included in the study. Individual quality reports with 15 measures were made available monthly to endoscopists in 2/3 of the communities. Compliance with the quality measures was captured for each endoscopist prior to and at the end of the one-year intervention period. Changes in measure compliance were small and limited by lack of pathology data and documentation as well as modifications to the computing system during the study period. This study points out the difficulties of utilizing quality report cards with data captured during clinical care. PMID:21347021

Logan, Judith R; Holub, Jennifer L; Peters, Dawn; Brandstater, Anke

2010-01-01

236

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.)

1984-06-01

237

INTEGRATED SAFETY MANAGEMENT SYSTEM SAFETY CULTURE IMPROVEMENT INITIATIVE  

Energy Technology Data Exchange (ETDEWEB)

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

MCDONALD JA JR

2009-01-16

238

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. PMID:24907989

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

2014-06-01

239

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)

2007-01-01

240

Initiatives of EFOMP in the field of radiation protection and quality assurance  

International Nuclear Information System (INIS)

The initiatives of EFOMP in the field of radiation protection and quality assurance are presented, with a particular emphasis on the activities of the Scientific Committee and the Education, Training and Professional Committee. (Author)

1993-10-01

 
 
 
 
241

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)

2007-10-05

242

Quality management science in clinical chemistry: a dynamic framework for continuous improvement of quality.  

Science.gov (United States)

Current quality assurance approaches will not be adequate to satisfy the needs for quality in the next decade. Quality management science (QMS), as evolving in industry today, provides the dynamic framework necessary to provide continuous improvement of quality. QMS emphasizes the importance of defining quality goals based on the needs and expectations (implied needs) of customers. The laboratory can develop customer-friendly goals and measures of quality by recognizing that customers' experiences are represented by a totality of results. Quality goals and measures are best communicated as "total performance" by specifying a limit and percentile of the distribution, rather than a mean and standard deviation. Application of quality goals within the laboratory will usually require partitioning the total performance goal into components and translating those components into specifications to guide the operation and management of production processes. QMS also extends beyond technical processes to people processes and provides guidance for improving the quality of worklife and caring for the laboratory's most essential resource--our people. PMID:2208645

Westgard, J O; Burnett, R W; Bowers, G N

1990-10-01

243

A resident-led institutional patient safety and quality improvement process.  

Science.gov (United States)

The authors used a multipronged approach to gain resident involvement in institutional quality improvement over a 3-year period; the initiative included a survey, a retreat, workgroups, a resurvey, and another retreat. Survey results (from 2007 compared with those of 2010) demonstrated significant improvement in almost all the top issues concerning patient safety for residents-emergency department boarding and crowding, adequacy of patient flow through the institution, adequacy of nursing and technical support staffing, and laboratory specimen handling (initial overall mean concern level was 2.87, and final concern level was 2.19; P < .01). This perceived improvement in patient safety concerns for residents was associated with observable improvements in areas of high concern for hospital leaders. By surveying residents and students, prioritizing concerns, convening a hospital-wide retreat with key leaders, and implementing accountable plans, the authors have demonstrated that resident perceptions of quality and safety can help drive quality improvement and engage residents in improvement efforts at an institutional level. PMID:22345131

Stueven, Jeremy; Sklar, David P; Kaloostian, Paul; Jaco, Cathy; Kalishman, Summers; Wayne, Sharon; Doering, Andrew; Gonzales, David

2012-01-01

244

Initial Housing Element and Capital Improvements Program: Bude, Mississippi.  

Science.gov (United States)

The housing study evaluates the nature, extent, location and cause of blight or deterioration within the area and recommends a comprehensive, coordinated, and continuing housing plan and program for the Town of Bude, Mississippi. The capital improvements ...

1973-01-01

245

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...

246

Biking improves the air quality; Fietsen schept lucht  

Energy Technology Data Exchange (ETDEWEB)

The Dutch Association for Cyclists is looking for ways to create more interest for the use of bikes in the debate on improving the air quality in the Netherlands. [Dutch] De Fietsersbond zoekt naar mogelijkheden om de fiets hoger op de agenda te krijgen in het debat over de luchtkwaliteit in Nederland.

Borgman, F. [Fietsersbond, Utrecht (Netherlands)

2007-06-15

247

Understanding quality improvement is more important now than ever before.  

Science.gov (United States)

With provider payments being adjusted for performance and emphasis being placed on value-based care, large health care systems are already developing the resources necessary to pursue quality improvement (QI) in their practices. This article explains why smaller and/or rural practices also need to learn about and implement QI. PMID:24830501

Watkins, R W

2014-01-01

248

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

249

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

250

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

International Nuclear Information System (INIS)

Grain legumes provide an essential part of the diet in developing countries in terms of protein. Besides increasing production also improving the grain quality would be an important objective. The paper discusses the methodology for protein improvement in seeds of pigeon pea. Variety Hy-2 was irradiated with 20, 25, 30 and 35 Kr of gamma radiation and the M_2 population was screened for total sulfur content

1982-02-01

251

Research on Improving Manufacturing Practice Quality in Mechanical Industrial Design  

Directory of Open Access Journals (Sweden)

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

Xiaowei Jiang

2013-07-01

252

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

Science.gov (United States)

The project will create resources for States regarding the evaluation of child care quality rating systems (QRSs), systems that have been put in place to measure, monitor, and promote high-quality child care. The project has five goals: (1) to provide des...

2010-01-01

253

Radionuclide calibrator comparisons and quality improvement in nuclear medicine  

International Nuclear Information System (INIS)

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

2006-11-13

254

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

Torazzo, Annamaria; Marchese, Aurelio; Bechis, Marco

1999-01-01

255

Design and Simulation of STATCOM to Improve Power Quality  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The performance of power systems decreases with the size, the loading and the complexity of the networks. This is related to problems with load flow, power oscillations and voltage quality. Such problems are even deepened by the changing situations resulting from deregulation of the electrical power markets, where contractual power flows do no more follow the initial design criteria of the existing network configuration. Additional problems can arise in case of large system interconnections, ...

Md. Nazrul Islam; Md. Arifur Kabir; Yashiro Kazushige

2013-01-01

256

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 protocol

2010-10-01

257

Breeding and biotechnology for improving berry nutritional quality.  

Science.gov (United States)

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

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

2005-01-01

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

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

260

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

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

2012-01-01

 
 
 
 
261

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

262

Quality and productivity improvement program (PPKP) from alumni perspective  

Science.gov (United States)

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

Ruza, Nadiah; Mustafa, Zainol

2013-04-01

263

Improving the Quality of Published Chemical Names with Nomenclature Software  

Digital Repository Infrastructure Vision for European Research (DRIVER)

This work deals with the use of organic systematic nomenclature in scientific literature, its quality, and computerized methods for its improvement. Criteria for classification of systematic names in terms of quality/correctness are discussed and applied to a sample set of several hundred names extracted from the literature. The same structures are named with three popular state-of-the-art nomenclature programs – AutoNom 2000, ChemDraw 10.0, and ACD/Name 9.0. When comparing the r...

Eller, Gernot A.

2006-01-01

264

Software Defect Prediction Models for Quality Improvement: A Literature Study  

Directory of Open Access Journals (Sweden)

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

Mrinal Singh Rawat

2012-09-01

265

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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...

2008-01-01

266

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

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

1996-01-01

267

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

Science.gov (United States)

...the Bundled Payments for Care Improvement initiative...better health, better health care, and reduced expenditures...Beneficiaries can experience improved health outcomes and patient experience when health care providers work in a...

2011-08-25

268

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

269

Applying PPM to ERP Maintenance and Continuous Improvement Initiatives  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 ...

El-tal, Nada Maria; Fonnesbćk, Majbrit; Krćmmergaard, Pernille

2006-01-01

270

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

271

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

2008-05-01

272

Improving the quality of diabetes care in primary care practice.  

Science.gov (United States)

The quality of care delivered to patients with diabetes has an impact on long-term outcomes. The purpose of this quality improvement project was to examine the effect of a Diabetes Disease Management Program (DDMP) on compliance with recommended process measures of care in primary care practice settings. Certified diabetes nurse educators visited five participating primary care practices biweekly for 1 year providing education to physicians and office staff on standards for diabetes management and to patients regarding self-management. Among 208 participants, 85.5% had >2 HbA1cs, 93.6% had lipid profiles, and 100% had foot examinations. Improvements in HbA1c (9.0% to 7.7%) were observed. Implementation of DDMP effectively promotes compliance with care standards in primary care practices. PMID:15352340

Zgibor, Janice C; Rao, Harsha; Wesche-Thobaben, Jacqueline; Gallagher, Nancie; McWilliams, Janis; Korytkowski, Mary T

2004-01-01

273

Continuous quality improvement for the clinical decision unit.  

Science.gov (United States)

Clinical decision units (CDUs) are a relatively new and growing area of medicine in which patients undergo rapid evaluation and treatment. Continuous quality improvement (CQI) is important for the establishment and functioning of CDUs. CQI in CDUs has many advantages: better CDU functioning, fulfillment of Joint Commission on Accreditation of Healthcare Organizations mandates, greater efficiency/productivity, increased job satisfaction, better performance improvement, data availability, and benchmarking. Key elements include a database with volume indicators, operational policies, clinical practice protocols (diagnosis specific/condition specific), monitors, benchmarks, and clinical pathways. Examples of these important parameters are given. The CQI process should be individualized for each CDU and hospital. PMID:14763318

Mace, Sharon E

2004-01-01

274

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

275

Quality Improvement, Quality Assurance, and Benchmarking: Comparing two frameworks for managing quality processes in open and distance learning  

Directory of Open Access Journals (Sweden)

Full Text Available Managing quality processes become critically important for higher education institutions generally, but especially for institutions involved in open and distance learning. In Australia, managers of centers responsible for open and distance learning have identified two frameworks that potentially offer ways of conceiving of the application of quality processes: the Quality Framework published in Inglis, Ling, and Joosten (1999; and the Benchmarking Framework published in McKinnon, Walker, and Davis (2000. However, managers who have been considering applying one or other framework within their institutional contexts have had to face the issue of how they should choose between, or combine the use, of these frameworks. Part of their dilemma lies in distinguishing among the related functions of quality improvement, quality assurance, and benchmarking. This article compares the frameworks in terms of their scope, institutional application, structures, and method of application, and then considers what implications the similarities and differences between the frameworks have for their use.

Alistair Inglis

2005-03-01

276

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.

2012-08-01

277

Improvement of bacteriological quality of frozen shrimp by gamma radiation  

International Nuclear Information System (INIS)

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

1985-01-01

278

Sediment quality guidelines: challenges and opportunities for improving sediment management.  

Science.gov (United States)

During the International Conference on Deriving Environmental Quality Standards for the Protection of Aquatic Ecosystems held in Hong Kong in December 2011, an expert group, comprising scientists, government officials, and consultants from four continents, was formed to discuss the important scientific and regulatory challenges with developing sediment quality guidelines (SQGs). We identified the problems associated with SQG development and made a series of recommendations to ensure that the methods being applied were scientifically defensible and internationally applicable. This document summarizes the key findings from the expert group. To enable evaluation of current SQG derivation and application systems, a feedback mechanism is required to communicate confounding factors and effects in differing environments, while field validation is necessary to gauge the effectiveness of SQG values in sediment quality assessments. International collaboration is instrumental to knowledge exchange and method advancement, as well as promotion of 'best practices'. Since the paucity of sediment toxicity data poses the largest obstacle to improving current SQGs and deriving new SQGs, a standardized international database should be established as an information resource for sediment toxicity testing and monitoring data. We also identify several areas of scientific research that are needed to improve sediment quality assessment, including determining the importance of dietary exposure in sediment toxicity, mixture toxicity studies, toxicity screening of emerging chemicals, how climate change influence sediments and its biota, and possible use of new toxicity study approaches such as high throughput omic-based toxicity screenings. PMID:23673922

Kwok, Kevin W H; Batley, Graeme E; Wenning, Richard J; Zhu, Lingyan; Vangheluwe, Marnix; Lee, Shirley

2014-01-01

279

Improving image quality in portal venography with spectral CT imaging  

Energy Technology Data Exchange (ETDEWEB)

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.

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

2012-08-15

280

Checklists to improve the quality of the orthopaedic literature  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Several checklists have been developed in an effort to help journals and researchers improve the quality of reporting in research. The CONSORT statement and the CLEAR NPT evaluate randomized trials. The MOOSE and QUOROM checklists evaluate meta-analyses. The STROBE checklists assists readers in evaluating observational studies and the STARD checklist was developed for diagnostic test evaluation. The checklists presented here provide an invaluable source of guidance to authors, journal editors...

2008-01-01

 
 
 
 
281

Voltage Quality Improvement in Islanded Microgrids Supplying Nonlinear Loads  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 o...

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

2012-01-01

282

Sardinian fermented sheep sausage: microbial biodiversity resource for quality improvement  

Digital Repository Infrastructure Vision for European Research (DRIVER)

With the aim of improving the quality and the value of the Sardinian sheep sausage, the microflora involved in fermentation and ripening processes of this traditional foodstuff has been studied and characterized. During the fermentation phase a prominent presence of micrococci and staphylococci has been observed. The lactic acid bacteria (LAB) that were showing a slow growth rate during the first days were found as the prevalent microflora during the ripening. The presence of coliforms was ob...

2006-01-01

283

Influence of Initial Wood Quality and Drying Process on Utilization Grades of Sawn Spruce Timber  

Directory of Open Access Journals (Sweden)

Full Text Available European spruce (Picea abies Karst. belongs to the most easily dried wood species, but nevertheless cracking and warping often reduce the quality of dried sawnwood. Larger surface and end crackingwas noticed at industrial drying practice in cold winter season, especially in using fast drying schedules. For the assessment of factors infl uencing the quality of dried wood some drying runs with varying drying conditions were carried out in an experimental kiln dryer. The quality of sawnwood was evaluated on green material using standard procedures and compared with the quality at the end of drying processes. Drying of spruce sawnwood at sharper drying conditions was more risky, resulting in a larger number of cracks as well as larger fi nal MC distribution, larger MC gradients and casehardening. Additionally, signifi cant correlation was confi rmed between the quality of dried wood and input quality of fresh material. More downgrading after the drying was observed in case of initially low graded material.

Aleš Straže

2011-03-01

284

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

285

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

Directory of Open Access Journals (Sweden)

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

Talkmore Maruta

2011-12-01

286

Quality  

Science.gov (United States)

... User Administration Sign Up Sign In Sign Out Quality Americans' health care should be safe, coordinated, evidence- ... Affordable Care Act established the National Strategy for Quality Improvement in Health Care (the National Quality Strategy ) ...

287

Improvements in quality of clinical care in English general practice 1998-2003: longitudinal observational study  

Science.gov (United States)

Objective To measure changes in quality of care for three major chronic diseases (coronary heart disease, asthma, and type 2 diabetes) between 1998 and 2003. Design Longitudinal cohort study. Setting 42 general practices in six geographical areas of England (Avon, Bury/Rochdale, Enfield, Oldham, Somerset, South Essex). Participants Medical record data for 2300 patients with diabetes, asthma, or coronary heart disease in 1998, and 1495 patients in 2003. Main outcome measure Quality of care assessed against predefined evidence based review criteria. Results Between 1998 and 2003, quality of care improved markedly in terms of maximum possible scores on the review criteria, from 60.5% to 78.1% for coronary heart disease (change = 17.6, 95% confidence interval 13.9 to 21.4; P diabetes (7.3, 3.5 to 11.1; P = 0.001). Important changes occurred to several indicators potentially related to improved health outcomes. These included improved control of serum cholesterol (to ? 5 mmol/l) from 17.6% to 61.4% in coronary heart disease and from 21.5% to 52% in diabetes and control of blood pressure to ? 150/90 in coronary heart disease from 47.3% to 72.2% and to ? 145/85 in diabetes from 21.8% to 35.8%. A small, non-significant improvement in glycaemic control occurred among diabetic patients (37.9% to 39.7% with HbA1c diabetes. Over the five years, more improvement in coronary heart disease care occurred in large practices and practices in affluent areas. Conclusions Substantial improvements were seen in quality of care for the three conditions studied between 1998 and 2003, a time of systematic quality improvement initiatives in the NHS. The changes were most marked for coronary heart disease. English general practices could be expected to achieve high clinical quality scores in the initial year of a new contact, which provides financial incentives for high quality care from 2004.

Campbell, Stephen M; Roland, Martin O; Middleton, Elizabeth; Reeves, David

2005-01-01

288

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

X. Tang

2011-03-01

289

Evaluation of regional HIV provider quality groups to improve care for people living with HIV served in the United States.  

Science.gov (United States)

HIVQUAL-US is a capacity-building quality initiative for federally-funded HIV primary care clinics. Since 2004, HIVQUAL-US has supported the formation of regional groups, geographically-clustered clinics that build quality management capacity through collective learning about quality improvement. The purpose of this qualitative study was to examine members' experiences participating in groups and their self-reported quality management and improvement outcomes related to HIV primary care. Interviews were conducted with a sample of three HIVQUAL-US coaches who facilitated 11 regional groups and with nine of the clinic representatives participating in the regional groups. The regional groups were heterogeneous in composition, focus and style, but shared common activities. Benefits included implementation of group quality improvement projects and opportunities for sharing activities and challenges. Improved performance in targeted areas, enhanced understanding/use of improvement methods, and increased quality management capacity were reported outcomes. Regional groups can effectively promote peer-to-peer learning, develop leadership, strengthen quality management capacity, and improve quality of care for the HIV population. PMID:22864496

Schneider, Karen L; Agins, Bruce D; Ng, Darryl W; Monserrate, Joan M; Hirschhorn, Lisa R

2012-08-01

290

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

2007-08-16

291

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.

2009-12-01

292

An Ontology of Quality Initiatives and a Model for Decentralized, Collaborative Quality Management on the (Semantic) World Wide Web  

Digital Repository Infrastructure Vision for European Research (DRIVER)

This editorial provides a model of how quality initiatives concerned with health information on the World Wide Web may in the future interact with each other. This vision fits into the evolving "Semantic Web" architecture - ie, the prospective that the World Wide Web may evolve from a mess of unstructured, human-readable information sources into a global knowledge base with an additional layer providing richer and more meaningful relationships between resources. One first prerequisite for for...

Eysenbach, Gunther

2001-01-01

293

Improving the Quality of Published Chemical Names with Nomenclature Software  

Directory of Open Access Journals (Sweden)

Full Text Available This work deals with the use of organic systematic nomenclature in scientific literature, its quality, and computerized methods for its improvement. Criteria for classification of systematic names in terms of quality/correctness are discussed and applied to a sample set of several hundred names extracted from the literature. The same structures are named with three popular state-of-the-art nomenclature programs – AutoNom 2000, ChemDraw 10.0, and ACD/Name 9.0. When comparing the results, all nomenclature tools show a significantly better performance than 'average chemists'. One program allows the generation not only of IUPAC names but also of CAS-like index names that are compared with the officially registered names. The scope and limitations of nomenclature software are discussed and a comparison of the programs' actual capabilities is given.

Gernot A. Eller

2006-11-01

294

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

2010-01-01

295

Mission operations and command assurance: Flight operations quality improvements  

Science.gov (United States)

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

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

1994-01-01

296

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

297

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

2010-01-01

298

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

2010-01-01

299

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

2010-01-01

300

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

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

2012-01-01

 
 
 
 
301

Industrial power system configuration criteria focused on power quality improvement  

Energy Technology Data Exchange (ETDEWEB)

An alternative to reduce harmonic distortion and to improve power quality is presented. The concept bases itself on the physical distribution of non-linear loads and the configuration of the industrial power system. This allows an important reduction on total harmonic distortion levels and significant increases in operational power factor on the system busbars. This is achieved by redistributing equipment and loads of the system. This work bases it`s study on a steel mill industrial power system with a 60 MVA size. The criteria developed are generic and their application is possible in any distribution system. 9 refs, 8 figs, 4 tabs

Wiechmann, E.P.; Ward, P.A.; Rodriguez, J.R. [Concepcion Univ (Chile)

1995-12-31

302

Improving Recommendation Quality by Merging Collaborative Filtering and Social Relationships  

CERN Multimedia

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

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

2011-01-01

303

Using DSP technology to improve sound quality in active speakers  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

304

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

1994-07-01

305

Comparing hospital perinatal mortality rates: a quality improvement instrument.  

Science.gov (United States)

This article describes the development of a reliable measurement instrument for the quality of perinatal care. The Hospital Perinatal Mortality Comparison (HPMC) predicts the expected perinatal mortality for individual hospitals, based on the perinatal mortality experienced in a group of similar newborns in a large reference population. Out of the 76 hospitals analyzed in 1990, 2 performed significantly better and 5 performed significantly worse than expected according to the logistic regression model. These results may lead to the identification of opportunities for improving the process of medical care in these hospitals. PMID:8366682

Holthof, B; Prins, P

1993-09-01

306

Three methods that improve the visual quality of colour anaglyphs  

Science.gov (United States)

Anaglyphs are one of the most economical methods for three-dimensional visualization. This method, however, suffers from severe drawbacks such as loss of colour and extreme discomfort for prolonged viewing. We propose several methods for anaglyph enhancement that rely on stereo image registration, defocusing and nonlinear operations on synthesized depth maps. These enhancements substantially reduce unwanted ghosting artefacts, improve the visual quality of the images, and make comfortable viewing of the same sequence possible in three-dimensional as well as the two-dimensional mode of the same sequence.

Ideses, Ianir; Yaroslavsky, Leonid

2005-12-01

307

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) < or approximately 0.3 ?A) charge sensitive amplifier (s approximately 3.5 V/pC, Qsub(np-p) <= 2x10"-"1"5C). 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

1982-01-01

308

Improvement of graphene quality synthesized by cluster ion implantation  

International Nuclear Information System (INIS)

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

2013-07-15

309

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

Science.gov (United States)

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

310

Prolonging the female reproductive lifespan and improving egg quality with dietary omega-3 fatty acids.  

Science.gov (United States)

Women approaching advanced maternal age have extremely poor outcomes with both natural and assisted fertility. Moreover, the incidence of chromosomal abnormalities and birth defects increases with age. As of yet, there is no effective and practical strategy for delaying ovarian aging or improving oocyte quality. We demonstrate that the lifelong consumption of a diet rich in omega-3 fatty acids prolongs murine reproductive function into advanced maternal age, while a diet rich in omega-6 fatty acids is associated with very poor reproductive success at advanced maternal age. Furthermore, even short-term dietary treatment with a diet rich in omega-3 fatty acids initiated at the time of the normal age-related rapid decline in murine reproductive function is associated with improved oocyte quality, while short-term dietary treatment with omega-6 fatty acids results in very poor oocyte quality. Thus, omega-3 fatty acids may provide an effective and practical avenue for delaying ovarian aging and improving oocyte quality at advanced maternal age. PMID:22978268

Nehra, Deepika; Le, Hau D; Fallon, Erica M; Carlson, Sarah J; Woods, Dori; White, Yvonne A; Pan, Amy H; Guo, Lankai; Rodig, Scott J; Tilly, Jonathan L; Rueda, Bo R; Puder, Mark

2012-12-01

311

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

312

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

International Nuclear Information System (INIS)

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

1985-01-01

313

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

314

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

315

Increasing Extender Viscosity Improves the Quality of Cooled Boar Semen  

Directory of Open Access Journals (Sweden)

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

Maria Cruz Gil

2014-02-01

316

42 CFR 494.110 - Condition: Quality assessment and performance improvement.  

Science.gov (United States)

...Quality assessment and performance improvement. 494...FOR COVERAGE FOR END-STAGE RENAL DISEASE FACILITIES...Quality assessment and performance improvement. The...facility operations. These performance components must influence... (ii) Nutritional status. (iii)...

2009-10-01

317

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.

Mr. Harshpreet Singh

2012-04-01

318

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

Directory of Open Access Journals (Sweden)

Full Text Available Research indicates that many of symptoms attributed to the Sick Building Syndrome in air-conditioned office buildings are a result of considerably reduced negative ions in the internal atmosphere and that replacing the depleted negative ions can improve indoor air quality. This paper describes a method used to develop a formula (DOF-NIL formula for calculating the amount of negative ions to be added to air-conditioned buildings, to improve air quality. The formula enables estimates to be made based on how negative ions in the air are reduced by three main factors namely, Video Display Terminals (VDT; heating, ventilation and air conditioning (HVAC and Building Contents (BC. Calculations for a typical air-conditioned office, are compared with an Air Ion Counter instrument. The results show that the formula, when applied to a typical air-conditioned office, provides an accurate estimate for design purposes. The typical rate of additional negative-ions (ion-generating for a negative ion condition is found to be approximately 12.0 billion ions/hr for at least 4 hour ion-generating.

Pongchai Nimcharoenwon

2012-11-01

319

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

Science.gov (United States)

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

Ishikura, Satoshi

2008-11-01

320

Industrial models of continuous quality improvement. Implications for emergency medicine.  

Science.gov (United States)

CQI or TQM programs were developed from industrial models dating back to the 1930s. The original philosophic underpinnings guiding CQI included SPC, in which rigorous statistical methods were used to study industrial flow processes. As originally adopted by the Japanese, CQI is credited, to a significant degree, with the emergence of the Japanese economy as a major world leader. Nonetheless, the original CQI concepts were developed and implemented by American researchers, including Deming and Juran. The application of industrial models of quality improvement to service businesses in general and the health care industry in particular have met with substantial success in a number of different settings. Far from representing a management fad, CQI represents a solid management philosophy with a strong statistical background that stands in sharp contrast to traditional management in this country. CQI recognizes that the majority of defects result from a failure of the processes through which the product or service is generated, as opposed to the workers themselves. To a significant degree, CQI empowers service providers (through the strong commitment of top management) to participate in improving the processes through which products and services are delivered. As efforts unfold to contain health care costs and maintain quality in the face of declining resources, CQI programs are likely to be essential to success. Nonetheless, adopting CQI requires a significant commitment on the part of top management to the training and retraining of health care providers and the recognition that traditional management philosophies and techniques have largely failed to produce the quantum leaps in quality that will be required in the coming years. PMID:1628558

Mayer, T A

1992-08-01

 
 
 
 
321

Psychometric test of the Team Climate Inventory-short version investigated in Dutch quality improvement teams  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract BACKGROUND: Although some studies have used the Team Climate Inventory within teams working in health care settings, none of these included quality improvement teams. The aim of our study is to investigate the psychometric properties of the 14-item version of the Team Climate Inventory in healthcare quality improvement teams participating in a Dutch quality collaborative. METHODS: This study included quality improvement teams participating in the Care for Better improvement p...

Strating, M. M. H.; Nieboer, A. P.

2009-01-01

322

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 (11.8â??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, Ă?va; Dionisio, Giuseppe

2011-01-01

323

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

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

2010-01-01

324

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

Science.gov (United States)

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

Ackerman, Debra J.

2008-01-01

325

Wake up safe and root cause analysis: quality improvement in pediatric anesthesia.  

Science.gov (United States)

In 2006, the Quality and Safety Committee of the Society for Pediatric Anesthesia initiated a quality improvement project for the specialty of pediatric anesthesiology that ultimately resulted in the development of Wake Up Safe (WUS), a patient safety organization that maintains a registry of de-identified, serious adverse events. The ultimate goal of WUS is to implement change in processes of care that improve the quality and safety of anesthetic care provided to pediatric patients nationwide. Member institutions of WUS submit data regarding the types and numbers of anesthetics performed and information pertaining to serious adverse events. Before a member institution submits data for any serious adverse event, 3 anesthesiologists who were not involved in the event must analyze the event with a root cause analysis (RCA) to identify the causal factor(s). Because institutions across the country use many different RCA methods, WUS educated its members on RCA methods in an effort to standardize the analysis and evaluate each serious adverse event that is submitted. In this review, we summarize the background and development of this patient safety initiative, describe the standardized RCA method used by its members, demonstrate the use of this RCA method to analyze a serious event that was reported, and discuss the ways WUS plans to use the data to promote safer anesthetic practices for children. PMID:24945124

Tjia, Imelda; Rampersad, Sally; Varughese, Anna; Heitmiller, Eugenie; Tyler, Donald C; Lee, Angela C; Hastings, Laura A; Uejima, Tetsu

2014-07-01

326

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

In recent years there have been significant improvements in outcome of rectal cancer treatment. Both new surgical techniques as well as effective neoadjuvant treatment regimens have contributed to these improvements. It is key to spread these advances towards every rectal cancer patient and to make sure that not only patients who are treated within the framework of clinical trials may benefit from these advancements. Throughout Europe there have been interesting quality programs that have pro...

Van Gijn W.; Van de Velde C.J.H.

2010-01-01

327

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 (naďve 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

328

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

329

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

International Nuclear Information System (INIS)

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

1999-10-18

330

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

331

Improvement of the quality of wheat bread by addition of glycoside hydrolase family 10 xylanases.  

Science.gov (United States)

Although many xylanases are widely used in the baking industry, only one glycoside hydrolase family 10 (GH 10) xylanase has previously been reported to be effective in baking. In this study, we compared the effectiveness of two GH 10 xylanases, psychrophilic XynA from Glaciecola mesophila and mesophilic EX1 from Trichoderma pseudokoningii, in bread making. The optimal dosages needed to improve wheat flour dough and bread quality were 270-U/kg flour for EX1 and 0.9-U/kg flour for XynA. At their optimal dosage, both XynA and EX1 had significant dough-softening ability, resulting in a 50% reduction in Brabender units. XynA was more effective than EX1 in reducing the time to reach maximum consistency. XynA and EX1 showed similar effects in improving the bread volume (~30% increase). EX1 was more effective in reducing the initial crumb firmness. Although both enzymes exhibited similar anti-staling effects on the bread, based on a decrease in the bread firmness, XynA had a greater effect on reducing the firming rate, and EX1 showed an enhanced reduction in the initial firmness. These results show that these two GH 10 xylanases have unique advantages in improving dough and bread quality and indicate their potential in bread making. PMID:21249355

Zheng, Han; Guo, Bing; Chen, Xiu-Lan; Fan, Sou-Jin; Zhang, Yu-Zhong

2011-04-01

332

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

Science.gov (United States)

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

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

2014-03-01

333

Alberta Initiative for School Improvement: AISI Handbook for Cycle 3, 2006-2009  

Science.gov (United States)

The purpose of the AISI (Alberta Initiative for School Improvement) Handbook for Cycle 3, 2006-2009 is to provide school authorities with the provincial and local requirements and processes for planning, funding, implementing, managing, evaluating, reporting and sharing school improvement projects. The handbook provides a framework for the…

Online Submission, 2006

2006-01-01

334

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.

2013-06-17

335

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

1984-04-01

336

Checklists to improve the quality of the orthopaedic literature  

Directory of Open Access Journals (Sweden)

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

Mundi Raman

2008-01-01

337

ECG-synchronized DSA exposure control: improved cervicothoracic image quality  

Energy Technology Data Exchange (ETDEWEB)

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

Kelly, W.M.; Gould, R.; Norman, D.; Brant-Zawadzki, M.; Cox, L.

1984-10-01

338

Improvement of graphene quality synthesized by cluster ion implantation  

Energy Technology Data Exchange (ETDEWEB)

Graphene was prepared by negative C{sub 4} cluster ion implantation at 5 keV/atom followed by vacuum thermal annealing and cooling. The surface morphology and structure of samples were studied by scanning electron microscopy, atomic force microscopy, and Raman spectroscopy. Improvement of the graphene quality was realized by optimization of the post thermal processes. 1–2 layer graphene was obtained with I{sub 2D}/I{sub G} ratio of 1.43 and I{sub D}/I{sub G} ratio of 0.07 at the implantation dose of 12 × 10{sup 15} atoms/cm{sup 2} and annealed at 900 °C followed by cooling at 20 °C/min.

Zhang, Z.D.; Wang, Z.S.; Zhang, R. [School of Physics and Technology and Key Laboratory of Artificial Micro- and Nano-Materials of Ministry of Education, Wuhan University, Wuhan 430072 (China); Wu, X.Y. [Key Laboratory of Beam Technology and Material Modification of Ministry of Education, Beijing Normal University, Beijing 100875 (China); Fu, D.J., E-mail: djfu@whu.edu.cn [School of Physics and Technology and Key Laboratory of Artificial Micro- and Nano-Materials of Ministry of Education, Wuhan University, Wuhan 430072 (China); Liu, J.R. [School of Physics and Technology and Key Laboratory of Artificial Micro- and Nano-Materials of Ministry of Education, Wuhan University, Wuhan 430072 (China)

2013-07-15

339

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

340

AN IMPROVEMENT OF STRUCTURAL SIMILARITY INDEX FOR IMAGE QUALITY ASSESSMENT  

Directory of Open Access Journals (Sweden)

Full Text Available The image quality assessment has been widely used in image processing. Several researches have been developed and carried considering the Human Visual System (HVS. Under the hypothesis that human visual perception is extremely adapted to retrieve structural information from a scene, the SSIM index is the most widely used in this area, which leads to a better correlation with HVS. Despite its robustness the SSIM presents some limitations in the presence of blur affecting images. In this study, we propose an improved version of the SSIM for blur image assessment. The idea is to combine gradient based SSIM score with that of the structural information of the blur. Experimental results show a good performance.

Emna Chebbi

2014-01-01

 
 
 
 
341

Mesh quality improvement for SciDAC applications  

Energy Technology Data Exchange (ETDEWEB)

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.

Knupp, P [MS 1111, Sandia National Laboratories, Albuquerque, NM (United States)

2006-09-15

342

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

2006-09-01

343

Improving packaged food quality and safety. Part 2: nanocomposites.  

Science.gov (United States)

This paper gathers a number of significant results where nanotechnology was satisfactorily applied to improve packaged food quality and safety by increasing the barrier properties to oxygen of an ethylene-vinyl alcohol copolymer (EVOH) in dry and under humid conditions and of a poly(lactic acid) (PLA) biopolymer. The nanodispersion in the polymer matrix of modified monolayers of clays included in positive lists for food-contact applications is an adequate methodology to increase packaged food shelf-life. In spite of the fact that, in principle, there is no reason to believe that 'adequately' modified nanocomposites making use of substances in positive lists can impose any immediate risk threat for food-contact applications, further studies concerning potential migration issues and life-cycle analysis have to still emerge within the overall field of nanotechnology to corroborate the fact. PMID:16227184

Lagarón, J M; Cabedo, L; Cava, D; Feijoo, J L; Gavara, R; Gimenez, E

2005-10-01

344

Implementation of quality improvement methodology and the medical profession.  

Science.gov (United States)

Modern quality management (QM) has evolved in industry over the last few decades to be a major factor in organizational structure and focus. The health industry has to a degree recognized or perceived merits in this model and has applied the principles of QM to many of its activities. It has also incorporated the concept of a commitment to quality improvement (QI) into its most recognized peer-review structure, hospital accreditation (ACHS). Apparent resistance exists in the medical fraternity to a transition from audit-focused quality assurance to contemporary systematic QI. An understanding of this issue may be gained from analysis of the medical profession's perception of QI, factors in the historical structures within health, and a review of the factors which hinder the transition to QI. By considering within a framework of organisational behaviour theory (OBT), some key concepts it is possible to work towards some solutions and proposals. These concepts include attitude, motivation, conflict, organizational change and development. It is likely that the appropriate focus should be broader than the 'recalcitrant group of conservative practitioners who resist change'. Indeed where a deficiency exists, QI methodology would have us look beyond an individual or single group towards the processes that create the opportunity for deficiency to occur. Within the current context, such processes are inherently structural and are historically established within the health industry. A solution to this problem requires organizational commitment and a period of analysis as well as the transformation of attitudes and practices. Organizational commitment will take the form of adequate resourcing and a developmental approach to organizational change. Internal professional change (perhaps guided by organizational development) must address the interface between the 'medical profession' and the broader group of professional health-care providers. PMID:9631352

Kennedy, M P

1998-06-01

345

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 O_lO lines. On the other hand S_1, recurrent selection proved to be another effective method to accumulate favorable alleles for seed yield in a O_l+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

1994-12-01

346

The Software Improvement Process - Tools And Rules To Encourage Quality  

CERN Multimedia

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

Sigerud, K

2011-01-01

347

Improvements in biosolids quality resulting from the Clean Water Act.  

Science.gov (United States)

Promulgation of the Clean Water Act (CWA) authorized the United States Environmental Protection Agency (U.S. EPA) to regulate quality standards for surface waters and establish regulations limiting the amounts and types of pollutants entering the nation's waters. U.S. EPA imposed national pretreatment standards on industrial wastes discharged to the collection systems of publicly owned treatment works (POTWs) and promulgated General Pretreatment Regulations in 1978. This study analyzed trace metals data from the National Sewage Sludge Surveys conducted by U.S. EPA and the American Metropolitan Sewage Agencies (AMSA) to evaluate the effect of implementation of the national industrial pretreatment standards on concentrations of trace metals in sludges generated by POTWs in the United States. The data showed that implementation of pretreatment programs has been highly effective in reducing the amount of pollutants that enter POTWs and has resulted in a substantial reduction in the levels of trace metals in the municipal sludges. Concentrations of chromium, lead, and nickel in sludge declined by 78, 73, and 63%, respectively, within a year after promulgation of General Pretreatment Regulations. Resulting from these measures, metal concentrations in the sludges generated by a majority of POTWs in the United States are sufficiently low that the sludges can be classified as biosolids and also meet the U.S. EPA's exceptional quality criteria for trace metals in biosolids. This improvement gives POTWs the option to use their biosolids beneficially through land application. PMID:24645543

Hundal, Lakhwinder S; Kumar, Kuldip; Cox, Albert; Zhang, Heng; Granato, Thomas

2014-02-01

348

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

349

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)

1994-12-01

350

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

Directory of Open Access Journals (Sweden)

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

M. Sokovic

2010-11-01

351

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

352

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

2013-08-01

353

Cardio-renal syndromes: report from the consensus conference of the Acute Dialysis Quality Initiative  

Digital Repository Infrastructure Vision for European Research (DRIVER)

A consensus conference on cardio-renal syndromes (CRS) was held in Venice Italy, in September 2008 under the auspices of the Acute Dialysis Quality Initiative (ADQI). The following topics were matter of discussion after a systematic literature review and the appraisal of the best available evidence: definition/classification system; epidemiology; diagnostic criteria and biomarkers; prevention/protection strategies; management and therapy. The umbrella term CRS was used to identify a disorder ...

Ronco, Claudio; Mccullough, Peter; Anker, Stefan D.; Anand, Inder; Aspromonte, Nadia; Bagshaw, Sean M.; Bellomo, Rinaldo; Berl, Tomas; Bobek, Ilona; Cruz, Dinna N.; Daliento, Luciano; Davenport, Andrew; Haapio, Mikko; Hillege, Hans; House, Andrew A.

2010-01-01

354

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

355

Yoga for improving sleep quality and quality of life for older adults.  

Science.gov (United States)

Context • The aging process is associated with physiological changes that affect sleep. In older adults, undiagnosed and untreated insomnia may cause impaired daily function and reduced quality of life (QoL). Insomnia is also a risk factor for accidents and falls that are the main cause of accidental deaths in older adults and, therefore, is associated with higher morbidity and mortality rates in older populations. Objectives • The research team aimed to (1) examine the efficacy of a yoga intervention (YI) for the treatment of insomnia in older adults, (2) determine the ability of yoga to enhance the QoL of older adults, and (3) establish the applicability of yoga practice for older people in a Western cultural setting. Design • A waiting-list controlled trial. Settings • The study took place in Jerusalem, Israel, from 2008-2009. Participants • Participants were older men and women (age ? 60 y) with insomnia. Intervention • The YI group participated in 12 wk of classes, held 2 ×/wk, incorporating yoga postures, meditative yoga, and daily home practice of meditative yoga. Outcome Measures • The study used self-report assessments of sleep quality using the following: (1) sleep quality-the Karolinska Sleepiness Scale (KSS), the Epworth Sleepiness Scale (ESS), and the Pittsburgh Sleep Quality Index (PSQI), and daliy sleep and practice logs; (2) mood states-the Depression Anxiety Stress Scale long form (DASS-42) and the Profile of Mood States short form (POMS-SF); (3) a health survey (SF-36); and (4) mobile at-home sleep studies. Results • Compared with controls, the YI group showed significant improvements in a range of subjective factors, including overall sleep quality; sleep efficiency; sleep latency and duration; self-assessed sleep quality; fatigue; general well-being; depression; anxiety; stress; tension; anger; vitality; and function in physical, emotional, and social roles. Conclusions • Yoga was shown to be safe and improved sleep and QoL in a group of older adults with insomnia. Outcomes depended on practice compliance. PMID:24755569

Halpern, Jonathan; Cohen, Marc; Kennedy, Gerard; Reece, John; Cahan, Clement; Baharav, Armanda

2014-01-01

356

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.)

2013-06-01

357

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

358

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 "1"4C-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

1997-10-01

359

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.)

1982-01-01

360

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

 
 
 
 
361

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

362

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

Science.gov (United States)

...indicators related to improved health outcomes...including adverse patient events, and other...assess processes of care, hospital service...improvement and patient safety, including...priorities for improved quality of care and patient safety; and...

2009-10-01

363

42 CFR 418.58 - Condition of participation: Quality assessment and performance improvement.  

Science.gov (United States)

...indicators related to improved palliative outcomes...including adverse patient events, and other...assess processes of care, hospice services...improvement and patient safety is defined...priorities for improved quality of care and patient safety, and...

2009-10-01

364

Improvement of shelf-life and microbiological quality of minimally processed refrigerated capsicum by gamma irradiation.  

Science.gov (United States)

Shelf-life, microbiological and chemical quality of minimally processed capsicum subjected to radiation doses of 1, 2 and 3 kGy followed by storage at 5 degrees C and 10 degrees C were evaluated. Irradiation at an optimal dose of 2 kGy reduced the initial bacterial population by 2-3 log cycles and eliminated the coliforms Listeria and Yersinia. Chemical analysis revealed that the initial contents of ascorbic acid (127.7 mg/100 g), carotenoid (110 microg/100 g) and chlorophyll (7.75 mg/g) were reduced marginally by 5-10% with increasing radiation dose. However, during subsequent storage, up to 4 weeks, the temperature-dependent losses in vitamin C and chlorophyll content of irradiated samples were less compared with non-irradiated samples. The total carotenoid content of capsicum irradiated and stored for up to 2 weeks at 10 degrees C showed a similar trend. Thus, gamma irradiation at 2 kGy was found to improve both the hygienic quality and shelf-life without affecting the nutritional quality of minimally processed capsicum. PMID:15369983

Ramamurthy, M S; Kamat, Anu; Kakatkar, Arati; Ghadge, Nandkumar; Bhushan, Brij; Alur, Madhavesh

2004-06-01

365

Air quality simulations over Europe using the CAMx-RSM-MM5 system: sensitivity to meteorology and initial concentrations  

Energy Technology Data Exchange (ETDEWEB)

In this contribution we have used the MM5-RSM-CAMx system over the European domain with 50 km gridcell to study the impact on the ozone concentrations of using different initial concentration fields. The regional spectral model (RSM) (NCEP/NOAA, USA) is running over an Alpha/Compaq XP1000 machine and the MM5 model (Pennsylvania State University / NCAR, USA) over a Pentium III 1000 under LINUX OS. Both meteorological models are used to provide input meteorological information to the CAMx air pollution transport model (ENVIRON Co.). EMEP emission inventory is used to provide input emission data into the simulation system. The CBM-IV chemical mechanism (simplified version) is also used into the CAMx module. Two different initial concentration fields are used to compare the quality of the results with observations (Madrid and Bilbao (Spain)) and also Leicester (United Kingdom). Two different scenarios are defined: (a) initial concentrations are set to zero and (b) initial concentrations are taken after five days of running the model over the European domain. Results show an important improvement when using the (b) scenario particularly with the MM5 model. The system is expected to be running operationally in our web site in the near future. (orig.)

Jose, R.S.; Perez, J.L.; Salas, I.; Perez, J.I.; Martin, A.; Suarez, R. [Technical Univ. of Madrid (Spain). Computer Science School; Gonzalez, R.M. [Univ. Complutense de Madrid (Spain). Dept. of Geophysics and Meteorology

2002-07-01

366

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

367

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

368

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

DEFF Research Database (Denmark)

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

Wang, Z.; Lu, K.

2011-01-01

369

BWR improved refueling patterns; reduction in gadolinia residual; axial-blanket optimization; improved initial-core design  

International Nuclear Information System (INIS)

Four of the alternatives evaluated as part of the DOE/TVA/GE Phase I Improved Uranium Utilization (IUU) Program, were: improved refueling patterns, reduction of gadolinia residual, axial blanket optimization, and improved initial core design. This report is a topical summary of the evaluations. The first three evaluations were focused on a selected operating reference reactor, the TVA Browns Ferry-3 Station. The fourth evaluation was for a BWR/6 reactor. The primary objectives of the evaluations were to determine to what extent the alternatives could be used to reduce BWR uranium and separative work requirements, to increase discharge burnup, to decrease fuel cycle cost and to improve plant capacity factors. Impact on overall reactor performance also was evaluated

1981-01-01

370

A SELF PROCESS IMPROVEMENT FOR ACHIEVING HIGH SOFTWARE QUALITY  

Directory of Open Access Journals (Sweden)

Full Text Available 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 different software projects to attain the true value. Quality is an attribute which is a distinct feature and it differs with people’s perception. Achieving high software quality involves measurement of software metrics and optimization based on estimated values. As the software systems grow larger, complexity ofdesign and implementation increases, and this in turn is more prone to defects and hence directly affect the quality of the systems. However, in any software project, high quality is always desirable, and many projects have specific quality requirements. Achieving high software quality involves measurement of software metrics and optimization based on estimated values. Developing high quality software is governed by factors such as people, process, technology and cost. This paper attempts to present a novel approach towards achieving high software quality in various kinds of projects under given constraints.

DR. SHASHANK.D.JOSHI

2011-05-01

371

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 t...

Ning Jingfeng; Hu Ming

2013-01-01

372

Industrial gamma radiography: recent developments towards improved quality and safety  

International Nuclear Information System (INIS)

Gamma radiography has been one of the most important NDT techniques for more than 40 years. The success has been based on the wide range of applications, unambiguous results, as well as easy to operate and unexpensive equipment, which can be used under almost all environmental conditions. Most recently improved levels of quality and safety have been reached by new equipment designs as well as from the availability of a new isotope -Se-75. Various national and international standards define requirements of gammagraphic apparatus to ensure safe and reliable operation and minimize potential hazards for the operator and the environment by faulty operation. This especially includes self-controlling safety functions as well as monitoring and clear display of safe/unsafe conditions. Lately, the ISO DIS 3999 (1998) has successfully passed voting of the international community involved in the evaluation of this ISO standard. The gammagraphic apparatus' GAMMAMAT TSI for Ir-192 and GAMMA-MAT SE for Se-75 are in full compliance to the latest versions of the national standards and also the ISO DIS 3999 (1998). In addition to their unparalleled reliability and longest operational life the equipment design includes low level of leakage radiation, real source position control, safe/unsafe display and automatic source locking. The isotope Se-75 is offering low radiation energies, which result in high radiographic contrast and resolution for improved flaw detectability. Sources of activity up to 3 TBq/80 Ci are available and most commonly used. The physical parameters of the isotope offer many other practical advantages. The half-life of 120 days results in 60% more useful lifetime over an Ir-192 source. The low radiation energies allow a special designed container of incredibly low 7 kg total weight. Radiation protection during NDT work can be achieved much more easily and radiation controlled areas can be much smaller. (Author)

1999-03-05

373

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.

374

Evaluation of a Practice-Development Initiative to Improve Breastfeeding Rates  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

375

Quality improvement of cleft lip and palate treatment.  

Science.gov (United States)

Improvement of quality of care for children with clefts requires longitudinal assessments of the outcomes of treatment. The aim of this study was to review the teamwork periodically to evaluate the clinical treatment outcome. In this retrospective study, the outcome of the dental arch relationship was studied using a Goslon yardstick between two cohorts of complete unilateral cleft lip and palate patients. Consecutive series of 9-year-old patients (27 boys, 20 girls) born in 1983- 1984 and 1992-1993 from two cleft centers were compared. All the patients were treated according to the same protocol. The results show no statistically significant difference between the cohorts of 1980s and 1990s (P = .170). The treatment results of center A as measured in this study are better than those of center R (P = .003). A possible explanation for this difference in performance can be the fact that the number of surgeons involved in the care in the center R is higher than that in A. PMID:16539551

Prahl-Andersen, Birte; Ju, Qiao

2006-03-01

376

improving the hygienic quality of quail carcasses by gamma irradiation  

International Nuclear Information System (INIS)

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

2002-01-01

377

Water quality improving device of nuclear power plant  

International Nuclear Information System (INIS)

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

1992-09-24

378

Improving SEM image quality using pixel super resolution technique  

Science.gov (United States)

The most decent scanning electron microscopy (SEM) can provide image magnification up to 500kX which seems to be suitable to image semiconductor devices for the advanced technology nodes. However, SEM images at such a high magnification often suffer from the drift and space related displacement errors, potentially causing image blur and distortion. To circumvent this, we apply the super-resolution (SR) technique to enhance the resolution of the CD-SEM metrology by using the advanced signal processing algorithms. The resolution enhancement can be realized by exploiting the multiple low resolution (LR) images that include unique information of an imaging target by looking at a slightly different position. We experimentally demonstrate image quality improvement gained by the SR technique after correcting the time-dependent drift/displacement and mapping estimated information onto the high resolution (HR) pixel grid with the non-linear pixel interpolation scheme. In addition, estimating the time-dependent drifts of the wafer position could be useful to investigate the drift properties of the CD-SEM tool.

Lee, Myungjun; Cantone, Jason; Xu, Ji; Sun, Lei; Kim, Ryoung-han

2014-04-01

379

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

Science.gov (United States)

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

Zwibel, Howard L; Smrtka, Jennifer

2011-05-01

380

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

International Nuclear Information System (INIS)

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

2000-01-01

 
 
 
 
381

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

382

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

Science.gov (United States)

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

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

2011-12-01

383

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

Directory of Open Access Journals (Sweden)

Full Text Available 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 completely randomized in a factorial 2 X 5, two products (Teprosyn ™ Zn and seed Quimifol 78 ® and five doses (0, 100, 200, 300 and 400 of the product 100 ml kg-1 seed with four replications. The treated seed physiological quality was evaluated by testing first germination, germination and accelerated aging. For the initial plant growth variables plant height, leaf area and dry weight of plants were evaluated, and with the data of leaf area and dry matter of the plants was calculated growth rates of culture (TCC, rate relative growth (RGR and net assimilation rate (NAR and measured in the same three periods (10, 20 and 30 DAE. The Teprosyn ™ Zn and seed Quimifol 78 ® products can be used as a seed treatment to doses of 100 and 200 mL 100 kg-1 seed respectively, without harming the seed quality. The Teprosyn Zn ™ product with 17 g L-1 of nitrogen and 600 g of zinc L-1, from the dose of 200 mL for 100 kg-1 seeds, 30 days after emergence, plant shows reduced growth and leaf area compared to maximum dose of technical efficiency.

Sandro de Oliveira

2014-06-01

384

Improving Notification of Sexually Transmitted Infections: A Quality Improvement Project and Planned Experiment  

Science.gov (United States)

BACKGROUND AND OBJECTIVE: Inadequate follow-up of positive sexually transmitted infection (STI) test results is a gap in health care quality that contributes to the epidemic of STIs in adolescent women. The goal of this study was to improve our ability to contact adolescent women with positive STI test results after an emergency department visit. METHODS: We conducted an interventional quality improvement project at a pediatric emergency department. Phase 1 included plan-do-study-act cycles to test interventions such as provider education and system changes. Phase 2 was a planned experiment studying 2 interventions (study cell phone and patient activation card), using a 2 × 2 factorial design with 1 background variable and 2 replications. Outcomes were: (1) the proportion of women aged 14 to 21 years with STI testing whose confidential telephone number was documented in the electronic medical record; (2) the proportion of STI positive women successfully contacted within 7 days. RESULTS: Phase 1 interventions increased the proportion of records with a confidential number from 24% to 58% and the proportion contacted from 45% to 65%, and decreased loss to follow-up from 40% to 24%. In phase 2, the proportion contacted decreased after the electronic medical record system changed and recording of the confidential number decreased. Study interventions (patient activation card and study cell phone) had a synergistic effect on successful contact, especially when confidential numbers were less reliably documented. CONCLUSIONS: Feasible and sustainable interventions such as improved documentation of a confidential number worked synergistically to increase our ability to successfully contact adolescent women with their STI test results.

Reed, Jennifer L.; Munafo, Jennifer Knopf; Ekstrand, Rachel; Gillespie, Gordon; Holland, Carolyn; Britto, Maria T.

2012-01-01

385

The Acute Dialysis Quality Initiative--part II: patient selection for CRRT.  

Science.gov (United States)

The delivery of optimal acute dialytic support requires that the correct patients be selected for such treatment in a timely fashion and that such treatment be delivered at the appropriate dose, for an appropriate length of time, and for the appropriate indications. The Acute Dialysis Quality Initiative sought to address these issues through an expert-enhanced review of the literature. This article represents a condensation of its findings with regard to patients selection for CRRT, indications for initiation of treatment, transition to other treatments, cessation of treatment, and availability of continuous therapy. The article offers recommendations for clinical practice based on the findings of the expert group. It also offers suggestions and sets priorities for future research in this important area of critical care nephrology. PMID:12382227

Bellomo, Rinaldo; Angus, Derek; Star, Robert A

2002-10-01

386

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

387

Sustainability of quality improvement programmes in a heavy engineering manufacturing environment : a system dynamics approach  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Companies realize to stay competitive they have to introduce quality improvement programs. Many companies are challenged today with the sustainability of these quality improvement programs. Generally the understanding of the dynamic behaviour of quality improvement programs is poorly understood with soft issues as factors of the system. System dynamics may solve this problem. This research was focussed on operational management of operations. The organising framework of this...

Dyk, Johannes Dirk

2013-01-01

388

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

Ji-Feng Ding; Pei-Pei Tsai

2012-01-01

389

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

International Nuclear Information System (INIS)

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

2008-05-01

390

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

391

Quality improvement of organic thin films deposited on vibrating substrates  

Energy Technology Data Exchange (ETDEWEB)

Most of the Organic Light-Emitting Diodes (OLEDs) have a multilayered structure composed of functional organic layers sandwiched between two electrodes. Thin films of small molecules are generally deposited by thermal evaporation onto glass or other rigid or flexible substrates. The interface state between two organic layers in OLED device depends on the surface morphology of the layers and affects deeply the OLED performance. The morphology of organic thin films depends mostly on substrate temperature and deposition rate. Generally, the control of the substrate temperature allows improving the quality of the deposited films. For organic compounds substrate temperature cannot be increased too much due to their poor thermal stability. However, studies in inorganic thin films indicate that it is possible to modify the morphology of a film by using substrate vibration without increasing the substrate temperature. In this work, the effect of the resonance vibration of glass and silicon substrates during thermal deposition in high vacuum environment of tris(8-quinolinolate)aluminum(III) (Alq{sub 3}) and N,N Prime -Bis(naphthalene-2-yl)-N,N Prime -bis(phenyl)-benzidine ({beta}-NPB) organic thin films with different deposition rates was investigated. The vibration used was in the range of hundreds of Hz and the substrates were kept at room temperature during the process. The nucleation and subsequent growth of the organic films on the substrates have been studied by atomic force microscopy technique. For Alq{sub 3} and {beta}-NPB films grown with 0.1 nm/s as deposition rate and using a frequency of 100 Hz with oscillation amplitude of some micrometers, the results indicate a reduction of cluster density and a roughness decreasing. Moreover, OLEDs fabricated with organic films deposited under these conditions improved their power efficiency, driven at 4 mA/cm{sup 2}, passing from 0.11 lm/W to 0.24 lm/W with an increase in their luminance of about 352 cd/m{sup 2} corresponding to an increase of about 250% in the luminance with respect to the same OLEDs fabricated in the same way and with the same conditions without substrate vibration.

Paredes, Y.A.; Caldas, P.G.; Prioli, R.; Cremona, M., E-mail: cremona@fis.puc-rio.br

2011-12-30

392

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 include Web business office/Web initiatives, a public education outreach program and third party agencies. figs

2001-10-17

393

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

Science.gov (United States)

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 su