WorldWideScience

Sample records for quality improvement initiative

  1. Implementing quality/productivity improvement initiatives in an engineering environment

    Science.gov (United States)

    Ruda, R. R.

    1985-01-01

    Quality/Productivity Improvement (QPI) initiatives in the engineering environment at McDonnell Douglas-Houston include several different, distinct activities, each having its own application, yet all targeted toward one common goal - making continuous improvement a way of life. The chief executive and the next two levels of management demonstrate their commitment to QPI with hands-on involvement in several activities. Each is a member of a QPI Council which consists of six panels - Participative Management, Communications, Training, Performance/Productivity, Human Resources Management and Strategic Management. In addition, each manager conducts Workplace Visits and Bosstalks, to enhance communications with employees and to provide a forum for the identification of problems - both real and perceived. Quality Circles and Project Teams are well established within McConnel Douglas as useful and desirable employee involvement teams. The continued growth of voluntary membership in the circles program is strong evidence of the employee interest and management support that have developed within the organization.

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

    OpenAIRE

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

    2002-01-01

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

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

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    Wray Julie

    2011-11-01

    Full Text Available Abstract Background Despite major policy initiatives in the United Kingdom to enhance women's experiences of maternity care, improving in-patient postnatal care remains a low priority, although it is an aspect of care consistently rated as poor by women. As part of a systems and process approach to improving care at one maternity unit in the South of England, the views and perspectives of midwives responsible for implementing change were sought. Methods A Continuous Quality Improvement (CQI approach was adopted to support a systems and process change to in-patient care and care on transfer home in a large district general hospital with around 6000 births a year. The CQI approach included an initial assessment to identify where revisions to routine systems and processes were required, developing, implementing and evaluating revisions to the content and documentation of care in hospital and on transfer home, and training workshops for midwives and other maternity staff responsible for implementing changes. To assess midwifery views of the quality improvement process and their engagement with this, questionnaires were sent to those who had participated at the outset. Results Questionnaires were received from 68 (46% of the estimated 149 midwives eligible to complete the questionnaire. All midwives were aware of the revisions introduced, and two-thirds felt these were more appropriate to meet the women's physical and emotional health, information and support needs. Some midwives considered that the introduction of new maternal postnatal records increased their workload, mainly as a consequence of colleagues not completing documentation as required. Conclusions This was the first UK study to undertake a review of in-patient postnatal services. Involvement of midwives at the outset was essential to the success of the initiative. Midwives play a lead role in the planning and organisation of in-patient postnatal care and it was important to obtain their feedback on whether revisions were pragmatic and achieved anticipated improvements in care quality. Their initial involvement ensured priority areas for change were identified and implemented. Their subsequent feedback highlighted further important areas to address as part of CQI to ensure best quality care continues to be implemented. Our findings could support other maternity service organisations to optimise in-patient postnatal services.

  5. Improving care in patients with acute coronary syndromes: the Erlanger quality improvement initiative.

    Science.gov (United States)

    Fesmire, Francis M

    2004-09-01

    Quality improvement (QI) in emergency department (ED) patients with acute coronary syndromes (ACS) is a complex and dynamic phenomenon. ED physicians are faced with the challenge of multitasking a variety of patient complaints. This chaotic environment frequently hampers the ED physician's ability to properly evaluate and treat chest pain patients. Just as an airplane pilot would never take off without performing the comprehensive preflight operational checklist, the ED physician should have a standardized protocol for the evaluation and treatment of chest pain patients. In this report, we describe Erlanger Medical Center's 10-year QI initiative in developing a successful chest pain protocol for the rapid evaluation and treatment of patients with suspected ACS. Our initiative resulted from a collaborative effort among emergency physicians, cardiologists, nuclear radiologists, nursing staff, and administration. The systematic step-wise approach we utilized at our institution consisted of identification of the problem, development of standardized protocols, hospital-based QI initiatives, and continuation of QI efforts through national initiatives. Through this "building of bridges" among physicians, nursing, and administration, we hope that other institutions will modify our protocols to assist them in the development of their own successful QI program for improving the evaluation, treatment, and disposition of patients with suspected ACS. PMID:18340159

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

    Science.gov (United States)

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

    2010-03-01

    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

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

    Science.gov (United States)

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

    2015-01-01

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

  8. Pain Management in Long-Term Care Communities: A Quality Improvement Initiative

    OpenAIRE

    Reid, Cary; O’Neil, Kevin W.; Dancy, JaNeen; Berry, Carolyn A.; Stowell, Stephanie A.

    2015-01-01

    Pain is underrecognized and undertreated in the long-term care (LTC) setting. To improve the management of pain for LTC residents, the authors implemented a quality improvement (QI) initiative at one LTC facility. They conducted a needs assessment to identify areas for improvement and designed a 2-hour educational workshop for facility staff and local clinicians. Participants were asked to complete a survey before and after the workshop, which showed significant improvement in their knowledge...

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

    OpenAIRE

    Thawesaengskulthai, Natcha

    2007-01-01

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

  10. Florida Initiative for Quality Cancer Care: Improvements on Colorectal Cancer Quality of Care Indicators during a 3-Year Interval

    Science.gov (United States)

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

    2015-01-01

    BACKGROUND The quality of cancer care has become a national priority; however, there are few ongoing efforts to assist medical oncology practices in identifying areas for improvement. The Florida Initiative for Quality Cancer Care is a consortium of 11 medical oncology practices that evaluates the quality of cancer care across Florida. Within this practice-based system of self-assessment, we determined adherence to colorectal cancer quality of care indicators (QCIs) in 2006, disseminated results to each practice and reassessed adherence in 2009. The current report focuses on evaluating the direction and magnitude of change in adherence to QCIs for colorectal cancer patients between the 2 assessments. STUDY DESIGN Medical records were reviewed for all colorectal cancer patients seen by a medical oncologist in 2006 (n = 489) and 2009 (n = 511) at 10 participating practices. Thirty-five indicators were evaluated individually and changes in QCI adherence over time and by site were examined. RESULTS Significant improvements were noted from 2006 to 2009, with large gains in surgical/pathological QCIs (eg, documenting rectal radial margin status, lymphovascular invasion, and the review of ?12 lymph nodes) and medical oncology QCIs (documenting planned treatment regimen and providing recommended neoadjuvant regimens). Documentation of perineural invasion and radial margins significantly improved; however, adherence remained low (47% and 71%, respectively). There was significant variability in adherence for some QCIs across institutions at follow-up. CONCLUSIONS The Florida Initiative for Quality Cancer Care practices conducted self-directed quality-improvement efforts during a 3-year interval and overall adherence to QCIs improved. However, adherence remained low for several indicators, suggesting that organized improvement efforts might be needed for QCIs that remained consistently low over time. Findings demonstrate how efforts such as the Florida Initiative for Quality Cancer Care are useful for evaluating and improving the quality of cancer care at a regional level. PMID:24275073

  11. Reducing Unnecessary Portable Pelvic Radiographs in Trauma Patients: A Resident-Driven Quality Improvement Initiative.

    Science.gov (United States)

    Langer, Jessica M; Tsai, Emily B; Luhar, Aarti; McWilliams, Justin; Motamedi, Kambiz

    2015-09-01

    Quality improvement is increasingly important in the changing health care climate. We aim to establish a methodology and identify critical factors leading to successful implementation of a resident-led radiology quality improvement intervention at the institutional level. Under guidance of faculty mentors, the first-year radiology residents developed a quality improvement initiative to decrease unnecessary STAT pelvic radiographs (PXRs) in hemodynamically stable trauma patients who would additionally receive STAT pelvic CT scans. Development and implementation of this initiative required multiple steps, including: establishing resident and faculty leadership, gathering evidence from published literature, cultivating multidisciplinary support, and developing and implementing an institution-wide ordering algorithm. A visual aid and brief questionnaire were distributed to clinicians for use during treatment of trauma cases to ensure sustainability of the initiative. At multiple time points, pre- and post-intervention, residents performed a retrospective chart review to evaluate changes in imaging-ordering trends for trauma patients. Chart review showed a decline in the number of PXRs for hemodynamically stable trauma patients, as recommended in the ordering algorithm: 78% of trauma patients received both a PXR and a pelvic CT scan in the first 24 hours of the initiative, compared with 26% at 1 month; 24% at 6 months; and 18% at 10 to 12 months postintervention. The resident-led radiology quality improvement initiative created a shift in ordering culture at an institutional level. Development and implementation of this algorithm exemplified the impact of a multidisciplinary collaborative effort involving multiple departments and multiple levels of the medical hierarchy. PMID:25868670

  12. Evolution and Initial Experience of a Statewide Care Transitions Quality Improvement Collaborative: Preventing Avoidable Readmissions Together.

    Science.gov (United States)

    Axon, R Neal; Cole, Laura; Moonan, Aunyika; Foster, Richard; Cawley, Patrick; Long, Laura; Turley, Christine B

    2016-02-01

    Increasing scrutiny of hospital readmission rates has spurred a wide variety of quality improvement initiatives. The Preventing Avoidable Readmissions Together (PART) initiative is a statewide quality improvement learning collaborative organized by stakeholder organizations in South Carolina. This descriptive report focused on initial interventions with hospitals. Eligible participants included all acute care hospitals plus home health organizations, nursing facilities, hospices, and other health care organizations. Measures were degree of statewide participation, curricular engagement, adoption of evidence-based improvement strategies, and readmission rate changes. Fifty-nine of 64 (92%) acute care hospitals and 9 of 10 (90%) hospital systems participated in collaborative events. Curricular engagement included: webinars and coaching calls (49/59, 83%), statewide in-person meetings (35/59, 59%), regional in-person meetings (44/59, 75%), and individualized consultations (46/59, 78%). Among 34 (58%) participating hospitals completing a survey at the completion of Year 1, respondents indicated complete implementation of multidisciplinary rounding (58%), post-discharge telephone calls (58%), and teach-back (32%), and implementation in process of high-quality transition records (52%), improved discharge summaries (45%), and timely follow-up appointments (39%). A higher proportion of hospitals had significant decreases (?10% relative change) in all-cause readmission rates for acute myocardial infarction (55.6% vs. 30.4%, P=0.01), heart failure (54.2% vs. 31.7%, P=0.09), and chronic obstructive pulmonary disease (41.7% vs. 33.3%, P=0.83) between 2011-2013 compared to earlier (2009-2011) trends. Focus on reducing readmissions is driving numerous, sometimes competing, quality improvement initiatives. PART successfully engaged the majority of acute care facilities in one state to harmonize and accelerate adoption of evidence-based care transitions strategies. (Population Health Management 2016;19:4-10). PMID:26102592

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

    Science.gov (United States)

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

    2015-02-01

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

  14. The Maryland Resilience Breakthrough Series Collaborative: A Quality Improvement Initiative for Children's Mental Health Services Providers.

    Science.gov (United States)

    Backer, Penina M; Kiser, Laurel J; Gillham, Jane E; Smith, Joan

    2015-08-01

    The Maryland Resilience Breakthrough Series Collaborative (BSC), a recent quality improvement initiative for children's mental health services providers, is aimed at bridging the gap between resilience theory and mental health service practices. Six provider teams across the state attended resilience training sessions and incrementally implemented practice improvements at their agencies. Group discussions and surveys administered to teams before and after the BSC indicate that the BSC facilitated breakthrough changes in the areas of resilience-enhanced assessment and treatment practices, as well as family and community resilience. This column presents quantitative and anecdotal outcomes and makes recommendations for the provider community. PMID:25930048

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

    OpenAIRE

    Globenko, Anna; Sianova, Zinaida

    2012-01-01

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

  16. 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

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

    LENUS (Irish Health Repository)

    Ennis, Linda

    2014-09-09

    The aim of this quality improvement initiative was to incorporate a paediatric early warning score (PEWS) and track and trigger system in the routine care of children in an acute general children\\'s ward at a regional hospital in the Republic of Ireland. In the absence of a nationally recommended specific PEWS strategy, a local plan was developed. The experience of structuring and implementing the PEWS and track and trigger system is presented in this article. Data from the first year of use were collected to evaluate the clinical utility and effectiveness of this system. In the busy acute children\\'s service, the PEWS initiative was found to benefit processes of early detection, prompt referral and timely, appropriate management of children at potential risk of clinical deterioration. Nursing staff were empowered and supported to communicate concerns immediately and to seek rapid medical review, according to an agreed PEWS escalation plan. Outcomes were significantly improved.

  18. QUALITY IMPROVEMENT INITIATIVES FOR SUPPORT FUNCTIONS IN AN INDUSTRY: TWO CASES

    Directory of Open Access Journals (Sweden)

    Shirshendu Roy

    2011-09-01

    Full Text Available The concept of quality improvement in industry has originated from the involvement of inspector which has become the most important part of manufacturing process or development activity. Over years, this initiative is migrated to various support functions of the industry. In this paper, emphasis has been given particularly in the areas related to support functions where improvement project s can be effectively done and hence organization wide impact is assessed. Two case studies are presented here in this context. The first study shows how smaller change in content structure and delivery met hod can drastically improve the training feedback and the second one demonstrates minimizing lead time to recruitment with a cost-effective process modification.

  19. The European Society of Gastrointestinal Endoscopy Quality Improvement Initiative: developing performance measures.

    Science.gov (United States)

    Rutter, Matthew D; Senore, Carlo; Bisschops, Raf; Domagk, Dirk; Valori, Roland; Kaminski, Michal F; Spada, Cristiano; Bretthauer, Michael; Bennett, Cathy; Bellisario, Cristina; Minozzi, Silvia; Hassan, Cesare; Rees, Colin; Dinis-Ribeiro, Mário; Hucl, Tomas; Ponchon, Thierry; Aabakken, Lars; Fockens, Paul

    2016-01-01

    The European Society of Gastrointestinal Endoscopy (ESGE) and United European Gastroenterology (UEG) have a vision to create a thriving community of endoscopy services across Europe, collaborating with each other to provide high quality, safe, accurate, patient-centered and accessible endoscopic care. Whilst the boundaries of what can be achieved by advanced endoscopy are continually expanding, we believe that one of the most fundamental steps to achieving our goal is to raise the quality of everyday endoscopy. The development of robust, consensus- and evidence-based key performance measures is the first step in this vision.ESGE and UEG have identified quality of endoscopy as a major priority. This paper explains the rationale behind the ESGE Quality Improvement Initiative and describes the processes that were followed. We recommend that all units develop mechanisms for audit and feedback of endoscopist and service performance using the ESGE performance measures that will be published in future issues of this journal over the next year. We urge all endoscopists and endoscopy services to prioritize quality and to ensure that these performance measures are implemented and monitored at a local level, so that we can provide the highest possible care for our patients. PMID:26662057

  20. Integrating risk management data in quality improvement initiatives within an academic neurosurgery department.

    Science.gov (United States)

    McLaughlin, Nancy; Garrett, Matthew C; Emami, Leila; Foss, Sarah K; Klohn, Johanna L; Martin, Neil A

    2016-01-01

    OBJECT While malpractice litigation has had many negative impacts on health care delivery systems, information extracted from lawsuits could potentially guide toward venues to improve care. The authors present a comprehensive review of lawsuits within a tertiary academic neurosurgical department and report institutional and departmental strategies to mitigate liability by integrating risk management data with quality improvement initiatives. METHODS The Comprehensive Risk Intelligence Tool database was interrogated to extract claims/suits abstracts concerning neurosurgical cases that were closed from January 2008 to December 2012. Variables included demographics of the claimant, type of procedure performed (if any), claim description, insured information, case outcome, clinical summary, contributing factors and subfactors, amount incurred for indemnity and expenses, and independent expert opinion in regard to whether the standard of care was met. RESULTS During the study period, the Department of Neurosurgery received the most lawsuits of all surgical specialties (30 of 172), leading to a total incurred payment of $4,949,867. Of these lawsuits, 21 involved spinal pathologies and 9 cranial pathologies. The largest group of suits was from patients with challenging medical conditions who underwent uneventful surgeries and postoperative courses but filed lawsuits when they did not see the benefits for which they were hoping; 85% of these claims were withdrawn by the plaintiffs. The most commonly cited contributing factors included clinical judgment (20 of 30), technical skill (19 of 30), and communication (6 of 30). CONCLUSIONS While all medical and surgical subspecialties must deal with the issue of malpractice and liability, neurosurgery is most affected both in terms of the number of suits filed as well as monetary amounts awarded. To use the suits as learning tools for the faculty and residents and minimize the associated costs, quality initiatives addressing the most frequent contributing factors should be instituted in care redesign strategies, enabling strategic alignment of quality improvement and risk management efforts. PMID:26230469

  1. Responses of Aboriginal and Torres Strait Islander Primary Health-Care Services to Continuous Quality Improvement Initiatives

    OpenAIRE

    Larkins, Sarah; Woods, Cindy E.; Matthews, Veronica; Sandra C Thompson; Schierhout, Gill; Mitropoulos, Maxwell; Patrao, Tania; Panzera, Annette; Bailie, Ross Stewart

    2016-01-01

    Background Indigenous primary health-care (PHC) services participating in continuous quality improvement (CQI) cycles show varying patterns of performance over time. Understanding this variation is essential to scaling up and sustaining quality improvement initiatives. The aim of this study is to examine trends in quality of care for services participating in the ABCD National Research Partnership and describe patterns of change over time and examine health service characteristics associat...

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

    Directory of Open Access Journals (Sweden)

    Palmer Laura

    2003-05-01

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

  3. Costs and financing of improvements in the quality of maternal health services through the Bamako Initiative in Nigeria.

    Science.gov (United States)

    Ogunbekun, I; Adeyi, O; Wouters, A; Morrow, R H

    1996-12-01

    This paper reports on a study to assess the quality of maternal health care in public health facilities in Nigeria and to identify the resource implications of making the necessary quality improvements. Drawing upon unifying themes from quality assurance, basic microeconomics and the Bamako Initiative, locally defined norms were used to estimate resource requirements for improving the quality of maternal health care. Wide gaps existed between what is required (the norm) and what was available in terms of fixed and variable resources required for the delivery of maternal health services in public facilities implementing the Bamako Initiative in the Local Government Areas studied. Given such constraints, it was highly unlikely that technically acceptable standards of care could be met without additional resource inputs to meet the norm. This is part of the cost of doing business and merits serious policy dialogue. Revenue generation from health services was poor and appeared to be more related to inadequate supply of essential drugs and consumables than to the use of uneconomic fee scales. It is likely that user fees will be necessary to supplement scarce government budgets, especially to fund the most critical variable inputs associated with quality improvements. However, any user fee system, especially one that raises fees to patients, will have to be accompanied by immediate and visible quality improvements. Without such quality improvements, cost recovery will result in even lower utilization and attempts to generate new revenues are unlikely to succeed. PMID:10164194

  4. Reducing inappropriate hypnotic prescribing using a quality improvement initiative in a rural practice

    OpenAIRE

    Togher, Fiona; Tilling, Michelle; Bee, David; Siriwardena, A Niroshan

    2010-01-01

    Context This improvement project was set in a single general practice in rural Lincolnshire, East Midlands, UK. All doctors and practice staff were actively engaged in reducing inappropriate long term prescribing of hypnotic drugs in the practice population as part of a Quality Improvement Collaborative (QIC). Problem Hypnotic drugs are only licensed for short term use but inappropriate long-term prescribing of hypnotics is common. Evidence from previous studies shows that hypnotic...

  5. Nursing Home Quality Initiative

    Data.gov (United States)

    U.S. Department of Health & Human Services — This Nursing Home Quality Initiative (NHQI) website provides consumer and provider information regarding the quality of care in nursing homes. NHQI discusses...

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

    Directory of Open Access Journals (Sweden)

    Stacey R. Lim

    2015-02-01

    Full Text Available Hearing loss present from birth can have a detrimental impact on later language and educational outcomes. Newborn hearing screening has allowed early identification and intervention of hearing loss, giving children the opportunity to develop age-appropriate language skills. The aim of this quality initiative study was to evaluate the quality of the newborn hearing screening program in the context of a newly implemented Baby-Friendly Hospital Initiative Program at Summa Health System Akron City Hospital. The goals were (1 to determine whether screening environment (mother’s room vs. nursery affected screening results, (2 to identify challenges and positive outcomes encountered by the audiologists, and (3 to ensure that Pass/Refer rates met state standards. A Quest Technologies sound level meter (Model 1800; St. Paul, MN, USA was used to measure noise levels in the nursery rooms where newborns were tested. The length of screening time was determined using a calibrated SP® Traceable® (ISO 17025 stopwatch (McGraw Park, IL, USA. Pass/Refer rates and observed challenges and benefits were noted. All well-baby infants born in the month of February 2013 (n = 101 were included, and Pass/Refer results were compared to those in years 2008-2012.Noise levels in the mother’s room did not appear to negatively affect the Pass/Refer rates. Some challenges were present, including interruptions and louder environmental noise. This protocol was considered appropriate for assessing a hearing screening program in a Baby-Friendly Hospital Initiative (BFHI setting.Benefits of performing hearing screening in the mother’s room included test transparency for parents and the ability to immediately discuss the results. Results obtained in the mother’s room were comparable to past results obtained in the nursery. Noise levels in the screening rooms and challenges should be noted, to ensure accuracy of screening results.

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

    Science.gov (United States)

    McGovern-Phalen, Amy M

    2014-01-01

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

  8. Practice policy and quality initiatives: using lean principles to improve screening mammography workflow.

    Science.gov (United States)

    Shah, Carla J; Sullivan, Julie R; Gonyo, Mary Beth; Wadhwa, Anubha; DuBois, Melissa S

    2013-01-01

    The "lean" approach is a quality improvement method that focuses on maximizing activities that are valued by the customer and eliminating waste that impedes efficiency in the workplace. The unique philosophy of the lean approach encourages all members of the team to be directly involved in identifying areas of waste and generating solutions to eliminate them. When the breast imaging section at the authors' institution became part of a multispecialty breast care center, the result was escalating examination volumes, more complex cases, and overall increased demand on radiologists' time. After several unsuccessful attempts to improve the efficiency of the section, including evaluation by outside consultants, the decision was made to embark on a comprehensive quality improvement program using the lean approach. A team of radiologists, technologists, file room personnel, information technology (IT) representatives, and administrators from the breast imaging section met twice a month to learn about lean principles and how to apply them to screening mammography workflows. Sources of inefficiency (waste) were identified, and potential solutions were generated. Multiple trials were performed to test these solutions. Throughout the process, all team members were engaged in identifying the problems, suggesting solutions, and implementing change. Most of the tested solutions were successful and resulted in decreased patient wait times, improved efficiency for the technologists and radiologists, faster report turnaround, and advances in IT. In addition, staff members were introduced to the lean philosophy and became actively involved in improving their workplace, resulting in a more cohesive section. PMID:23813321

  9. Pittsburgh Regional Healthcare Initiative puts new spin on improving healthcare quality.

    Science.gov (United States)

    2002-11-01

    For nearly 4 years, the Pittsburgh Regional Healthcare Initiative (PRHI) has been working to improve the way healthcare is delivered in southwestern Pennsylvania by combining the voices and resources of hospitals, providers, the business community, insurers, health plans, and federal agencies. As one example of borrowing from business, the PRHI has created a new learning and management system, called Perfecting Patient Care, which is based on the Toyota Production System model and is now being used successfully in hospitals. PMID:12497771

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

    Directory of Open Access Journals (Sweden)

    Chanin Johann C

    2008-09-01

    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.

  11. Six Sigma within Construction Context : As a Quality Initiative, Performance Indicator/Improver, Management strategy

    OpenAIRE

    Muharrem Firat, Yilmaz

    2012-01-01

    Six Sigma was developed in 1980s in manufacturing industry and became popular as a process improvement method. However, the adoption of this concept is new in construction industry and the aim of this study is to evaluate Six Sigma as a process improvement method within construction context. This thesis includes Literature Review and three interviews. Literature Review had discussed process improvement methods used in construction industry and analyzed the basic features and principles of Six...

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

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

    2012-01-01

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

  14. Implementation and evaluation of a multisite drug usage evaluation program across Australian hospitals - a quality improvement initiative

    OpenAIRE

    Robertson Marion B; Maxwell David J; Wai Angela; Pulver Lisa K; Riddell Steven

    2011-01-01

    Abstract Background With the use of medicines being a broad and extensive part of health management, mechanisms to ensure quality use of medicines are essential. Drug usage evaluation (DUE) is an evidence-based quality improvement methodology, designed to improve the quality, safety and cost-effectiveness of drug use. The purpose of this paper is to describe a national DUE methodology used to improve health care delivery across the continuum through multi-faceted intervention involving audit ...

  15. Continuous practice quality improvement initiative for communication of critical findings in neuroradiology.

    Science.gov (United States)

    Babiarz, Lukasz S; Lewin, Jonathan S; Yousem, David M

    2015-01-01

    The authors examined faculty's compliance with a hospital-approved neuroradiology critical findings (CFs) policy, which requires urgent verbal communication with the clinical team when 17 specific critical pathologies are identified. During June 2011 to July 2013, 50 random neuroradiology reports were sampled monthly for the presence of CFs and appropriate action. Faculty were provided ongoing feedback, and at the end of 2 years, the medical records for cases with noncommunicated CFs were reviewed to identify potential adverse outcomes. Of the 1200 reviewed reports, 195 (16.3%) had and 1005 (83.8%) did not have a CF. A total of 176 of 195 (90.3%) cases with CFs were communicated, and compliance increased from 77.4% to 85.6% (P = .027) since the monthly sampling was instituted; 1 of 19 (5.3%) noncommunicated CFs resulted in a potential adverse event. The ongoing monthly feedback resulted in improved faculty compliance with the CF policy. However, a small number of cases with CFs are still not being communicated. PMID:24934127

  16. The preclinical data forum network: A new ECNP initiative to improve data quality and robustness for (preclinical) neuroscience.

    Science.gov (United States)

    Steckler, Thomas; Brose, Katja; Haas, Magali; Kas, Martien J; Koustova, Elena; Bespalov, Anton

    2015-10-01

    Current limitations impeding on data reproducibility are often poor statistical design, underpowered studies, lack of robust data, lack of methodological detail, biased reporting and lack of open data sharing, coupled with wrong research incentives. To improve data reproducibility, robustness and quality for brain disease research, a Preclinical Data Forum Network was formed under the umbrella of the European College of Neuropsychopharmacology (ECNP). The goal of this network, members of which met for the first time in October 2014, is to establish a forum to collaborate in precompetitive space, to exchange and develop best practices, and to bring together the members from academia, pharmaceutical industry, publishers, journal editors, funding organizations, public/private partnerships and non-profit advocacy organizations. To address the most pertinent issues identified by the Network, it was decided to establish a data sharing platform that allows open exchange of information in the area of preclinical neuroscience and to develop an educational scientific program. It is also planned to reach out to other organizations to align initiatives to enhance efficiency, and to initiate activities to improve the clinical relevance of preclinical data. Those Network activities should contribute to scientific rigor and lead to robust and relevant translational data. Here we provide a synopsis of the proceedings from the inaugural meeting. PMID:26073278

  17. Implementation of ICU palliative care guidelines and procedures: a quality improvement initiative following an investigation of alleged euthanasia.

    Science.gov (United States)

    Kuschner, Ware G; Gruenewald, David A; Clum, Nancy; Beal, Alice; Ezeji-Okoye, Stephen C

    2009-01-01

    Ethical conflicts are commonly encountered in the course of delivering end-of-life care in the ICU. Some ethical concerns have legal dimensions, including concerns about inappropriate hastening of death. Despite these concerns, many ICUs do not have explicit policies and procedures for withdrawal of life-sustaining treatments. We describe a US Office of Inspector General (OIG) investigation of end-of-life care practices in our ICU. The investigation focused on care delivered to four critically ill patients with terminal diseases and an ICU nurse's concern that the patients had been subjected to euthanasia. The OIG investigation also assessed the validity of allegations that patient flow in and out of our ICU was inappropriately influenced by scheduled surgeries and that end-of-life care policies in our ICU were not clear. Although the investigation did not substantiate the allegations of euthanasia or inappropriate ICU patient flow, it did find that the policies that discuss end-of-life care issues were not clear and allowed for wide-ranging interpretations. Acting on the OIG recommendations, we developed a quality improvement initiative addressing end-of-life care in our ICU, intended to enhance communication and understanding about palliative care practices in our ICU, to prevent ethical conflicts surrounding end-of-life care, and to improve patient care. The initiative included the introduction of newly developed ICU comfort care guidelines, a physician order set, and a physician template note. Additionally, we implemented an educational program for ICU staff. Staff feedback regarding the initiative has been highly favorable, and the nurse whose concerns led to the investigation was satisfied not only with the investigation but also the policies and procedures that were subsequently introduced in our ICU. PMID:19136403

  18. Improving substance abuse data systems to measure `waiting time to treatment': Lessons learned from a quality improvement initiative

    OpenAIRE

    Hoffman, Kim A; Quanbeck, Andrew; Ford, James H.; Wrede, Fritz; Wright, Dagan; Lambert-Wacey, Dawn; Chvojka, Phil; Hanchett, Andrew; McCarty, Dennis

    2011-01-01

    Robust data measurement systems assess health care performance and monitor population-level treatment trends. A key challenge in the assessment of substance abuse treatment is the development of systems to accurately monitor service delivery indicators. Wait time to treatment, as defined by the days between first request for service and first treatment, is an important measure of organizational process and delivery of care. The Network for the Improvement of Addiction Treatment emphasizes wai...

  19. 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)

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

    2014-02-01

    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

  20. Implementation and evaluation of a multisite drug usage evaluation program across Australian hospitals - a quality improvement initiative

    Directory of Open Access Journals (Sweden)

    Robertson Marion B

    2011-08-01

    Full Text Available Abstract Background With the use of medicines being a broad and extensive part of health management, mechanisms to ensure quality use of medicines are essential. Drug usage evaluation (DUE is an evidence-based quality improvement methodology, designed to improve the quality, safety and cost-effectiveness of drug use. The purpose of this paper is to describe a national DUE methodology used to improve health care delivery across the continuum through multi-faceted intervention involving audit and feedback, academic detailing and system change, and a qualitative assessment of the methodology, as illustrated by the Acute Postoperative Pain Management (APOP project. Methods An established methodology, consisting of a baseline audit of inpatient medical records, structured patient interviews and general practitioner surveys, followed by an educational intervention and follow-up audit, is used. Australian hospitals, including private, public, metropolitan and regional, are invited to participate on a voluntary basis. De-identified data collected by hospitals are collated and evaluated nationally to provide descriptive comparative analyses. Hospitals benchmark their practices against state and national results to facilitate change. The educational intervention consists of academic detailing, group education, audit and feedback, point-of-prescribing prompts and system changes. A repeat data collection is undertaken to assess changes in practice. An online qualitative survey was undertaken to evaluate the APOP program. Qualitative assessment of hospitals' perceptions of the effectiveness of the overall DUE methodology and changes in procedure/prescribing/policy/clinical practice which resulted from participation were elicited. Results 62 hospitals participated in the APOP project. Among 23 respondents to the evaluation survey, 18 (78% reported improvements in the documentation of pain scores at their hospital. 15 (65% strongly agreed or agreed that participation in APOP directly resulted in increased prescribing of multimodal analgesia for pain relief in postoperative patients. Conclusions This national DUE program has facilitated the engagement and participation of a number of acute health care facilities to address issues relating to quality use of medicine. This approach has been perceived to be effective in helping them achieve improvements in patient care.

  1. Use of CAHPS® patient experience survey data as part of a patient-centered medical home quality improvement initiative

    Directory of Open Access Journals (Sweden)

    Quigley DD

    2015-07-01

    Full Text Available Denise D Quigley,1 Peter J Mendel,1 Zachary S Predmore,2 Alex Y Chen,3 Ron D Hays41RAND Corporation, Santa Monica, CA, 2RAND Corporation, Boston, MA, 3AltaMed Health Services Corporation, 4Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles, CA, USAObjective: To describe how practice leaders used Consumer Assessment of Healthcare Providers and Systems (CAHPS® Clinician and Group (CG-CAHPS data in transitioning toward a patient-centered medical home (PCMH.Study design: Interviews conducted at 14 primary care practices within a large urban Federally Qualified Health Center in California.Participants: Thirty-eight interviews were conducted with lead physicians (n=13, site clinic administrators (n=13, nurse supervisors (n=10, and executive leadership (n=2.Results: Seven themes were identified on how practice leaders used CG-CAHPS data for PCMH transformation. CAHPS® was used: 1 for quality improvement (QI and focusing changes for PCMH transformation; 2 to maintain focus on patient experience; 3 alongside other data; 4 for monitoring site-level trends and changes; 5 to identify, analyze, and monitor areas for improvement; 6 for provider-level performance monitoring and individual coaching within a transparent environment of accountability; and 7 for PCMH transformation, but changes to instrument length, reading level, and the wording of specific items were suggested.Conclusion: Practice leaders used CG-CAHPS data to implement QI, develop a shared vision, and coach providers and staff on performance. They described how CAHPS® helped to improve the patient experience in the PCMH model, including access to routine and urgent care, wait times, provider spending enough time and listening carefully, and courteousness of staff. Regular reporting, reviewing, and discussing of patient-experience data alongside other clinical quality and productivity measures at multilevels of the organization was critical in maximizing the use of CAHPS® data as PCMH changes were made. In sum, this study found that a system-wide accountability and data-monitoring structure relying on a standardized and actionable patient-experience survey, such as CG-CAHPS, is key to supporting the continuous QI needed for moving beyond formal PCMH recognition to maximizing primary care medical home transformation.Keywords: PCMH, performance improvement, accountability, CAHPS®

  2. Delivery of maternal health care in Indigenous primary care services: baseline data for an ongoing quality improvement initiative

    Directory of Open Access Journals (Sweden)

    Kwedza Ru K

    2011-03-01

    Full Text Available Abstract Background Australia's Aboriginal and Torres Strait Islander (Indigenous populations have disproportionately high rates of adverse perinatal outcomes relative to other Australians. Poorer access to good quality maternal health care is a key driver of this disparity. The aim of this study was to describe patterns of delivery of maternity care and service gaps in primary care services in Australian Indigenous communities. Methods We undertook a cross-sectional baseline audit for a quality improvement intervention. Medical records of 535 women from 34 Indigenous community health centres in five regions (Top End of Northern Territory 13, Central Australia 2, Far West New South Wales 6, Western Australia 9, and North Queensland 4 were audited. The main outcome measures included: adherence to recommended protocols and procedures in the antenatal and postnatal periods including: clinical, laboratory and ultrasound investigations; screening for gestational diabetes and Group B Streptococcus; brief intervention/advice on health-related behaviours and risks; and follow up of identified health problems. Results The proportion of women presenting for their first antenatal visit in the first trimester ranged from 34% to 49% between regions; consequently, documentation of care early in pregnancy was poor. Overall, documentation of routine antenatal investigations and brief interventions/advice regarding health behaviours varied, and generally indicated that these services were underutilised. For example, 46% of known smokers received smoking cessation advice/counselling; 52% of all women received antenatal education and 51% had investigation for gestational diabetes. Overall, there was relatively good documentation of follow up of identified problems related to hypertension or diabetes, with over 70% of identified women being referred to a GP/Obstetrician. Conclusion Participating services had both strengths and weaknesses in the delivery of maternal health care. Increasing access to evidence-based screening and health information (most notably around smoking cessation were consistently identified as opportunities for improvement across services.

  3. End-Stage Renal Disease (ESRD) Quality Initiative

    Data.gov (United States)

    U.S. Department of Health & Human Services — The End Stage Renal Disease (ESRD) Quality Initiative promotes ongoing CMS strategies to improve the quality of care provided to ESRD patients. This initiative...

  4. End-Stage Renal Disease (ESRD) Quality Initiative

    Data.gov (United States)

    U.S. Department of Health & Human Services — The End Stage Renal Disease (ESRD) Quality Initiative promotes ongoing CMS strategies to improve the quality of care provided to ESRD patients. This initiative...

  5. SQIMSO: Quality Improvement for Small Software Organizations

    OpenAIRE

    Rabih Zeineddine; Nashat Mansour

    2005-01-01

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

  6. IMPROVING CONCEPTUAL DESIGN QUALITY

    DEFF Research Database (Denmark)

    Bush, Stuart; Robotham, Antony John

    This paper will consider how Quality Function Deployment (QFD) and Design for Manufacture and Assembly (DFMA) processes can be used to improve the design quality of products at the concept stage. We appreciate that both QFD and DFMA are techniques that have been used for some time by mature product...... quality is maintained in design project work. The projects described have been carried out with products manufactured by small to medium sized enterprises (SME's), where we have found significant opportunities for product improvement. The quantitative nature of DFMA analysis results allows the novice...... continuous improvement of their products. However, we consider that if novice designers are able to successfully utilise design tools like QFD and DFMA and achieve improvements in design quality, then SME’s have no excuses for ignoring the benefits they could bring to their own product development activity....

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

    Science.gov (United States)

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

    2015-05-01

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

  8. Regional Quality Groups Enhance Effectiveness of Vascular Quality Initiative(®).

    Science.gov (United States)

    Dunn, Joie; Weaver, Fred A; Woo, Karen

    2015-10-01

    The Vascular Quality Initiative (VQI)(®) is a national collaborative of regional quality groups that collect and analyze data to improve vascular health care. The Southern California Vascular Outcomes Improvement Collaborative (So Cal VOICe) is the regional quality group for southern California. Initial quality initiatives chosen by the So Cal VOICe are preoperative and discharge antiplatelet and statin therapy and vascular access guidance during percutaneous endovascular procedures. The objective of this study is to examine the influence of the regional quality group structure on the effectiveness of the So Cal VOICe. Data are entered by each institution into a cloud-based data collection and reporting system. So Cal VOICe data from January 2011 to July 2014 was analyzed in 6-month intervals. Preoperative statin and antiplatelet use increased from 58.87 to 71.81 per cent (P = 0.0082) and 60.8 to 78.38 per cent (P structure of the VQI(®) improves compliance with selected process measures in the So Cal VOICe. Continued data collection will determine the impact of these process improvements on long-term patient outcomes. PMID:26463296

  9. Improving health-related quality of life through an evidence-based obesity reduction program: the Healthy Weights Initiative

    OpenAIRE

    Lemstra ME; Rogers

    2016-01-01

    Mark E Lemstra,1 Marla R Rogers,21Alliance Health, Moose Jaw, 2Department of Physical Medicine and Rehabilitation, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada Abstract: When evaluating any health intervention, it is critical to include the impact of the intervention on health-related quality of life (HRQL). Among those who are obese, HRQL is often lower than the general population and even more when considering obesity-related comorbidities and bodily pain. The obj...

  10. Delivery of maternal health care in Indigenous primary care services: baseline data for an ongoing quality improvement initiative

    OpenAIRE

    Kwedza Ru K; Liddle Helen E; O'Donoghue Lynette; Cox Rhonda J; Kennedy Catherine M; Dowden Michelle C; Si Damin; Bailie Ross S; Rumbold Alice R; Thompson Sandra C; Burke Hugh P; Brown Alex DH; Weeramanthri Tarun; Connors Christine M

    2011-01-01

    Abstract Background Australia's Aboriginal and Torres Strait Islander (Indigenous) populations have disproportionately high rates of adverse perinatal outcomes relative to other Australians. Poorer access to good quality maternal health care is a key driver of this disparity. The aim of this study was to describe patterns of delivery of maternity care and service gaps in primary care services in Australian Indigenous communities. Methods We undertook a cross-sectional baseline audit for a qua...

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

    OpenAIRE

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

    2010-01-01

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

  12. IMPROVING CONCEPTUAL DESIGN QUALITY

    DEFF Research Database (Denmark)

    Bush, Stuart; Robotham, Antony John

    1999-01-01

    This paper will consider how Quality Function Deployment (QFD) and Design for Manufacture and Assembly (DFMA) processes can be used to improve the design quality of products at the concept stage. We appreciate that both QFD and DFMA are techniques that have been used for some time by mature product developers, and the successes achieved using each have been widely reported. Here, though, we will share our experiences of using these tools with novice designers, i.e. student engineers.The use of b...

  13. Hospital Quality Initiative - Outcome Measures

    Data.gov (United States)

    U.S. Department of Health & Human Services — In the interest of promoting high-quality, patient-centered care and accountability, the Centers for Medicare and Medicaid Services (CMS) and Hospital Quality...

  14. Health Insurance Marketplace Quality Initiatives

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Affordable Care Act requires the U.S. Department of Health and Human Services (HHS) to develop quality data collection and reporting tools such as a Quality...

  15. Hospital Quality Initiative - Outcome Measures

    Data.gov (United States)

    U.S. Department of Health & Human Services — In the interest of promoting high-quality, patient-centered care and accountability, the Centers for Medicare and Medicaid Services (CMS) and Hospital Quality...

  16. Improving the Multilayer Perceptron Learning by Using a Method to Calculate the Initial Weights with the Similarity Quality Measure Based on Fuzzy Sets and Particle Swarms

    Directory of Open Access Journals (Sweden)

    Lenniet Coello

    2015-01-01

    Full Text Available The most widely used neural network model is Multilayer Perceptron (MLP, in which training of the connection weights is normally completed by a Back Propagation learning algorithm. G ood initial values of weights bear a fast convergence and a better generalization capability even with simple gradient - based error minimization techniques. This work presen ts a method to calculate the initial weights in order to train the Multilayer Perceptron Model. The method named PSO+RST+FUZZY is based on the similarity quality measure proposed within the framework of the extended Rough Set Theory that employs fuzzy sets to characterize the domain of similarity thresholds. Sensitivity of BP to initial weights with PSO+RST+FUZZY was studied experimentally, showing better performance than other methods used to calculate feature weights .

  17. Shipbuilding pipeline production quality improvement

    OpenAIRE

    T. Buksa; D. Pavletic; M. Sokovic

    2010-01-01

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

  18. Pet food: quality and quality improvement

    OpenAIRE

    Cipollini, Irene

    2008-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Marsteller Jill A

    2011-10-01

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

  20. 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

  1. NETWORKS AND QUALITY IMPROVEMENT

    Directory of Open Access Journals (Sweden)

    Miodrag Hadžistevi?

    2009-12-01

    Full Text Available Tools used in the past to analyze business value creation, such as value chain and process models, are simply too slow, inadequate, or inappropriate to address this new level of business complexity. In stead of that, company has to find way to create quality management system in a multi-layered supply chain. The problem can be solved by networking in the cluster. Cluster can be known as a competitive cooperation in the purpose to gain higher level of competitiveness and success. Bat there is another problem: Organization of the production process in a company is extremely complex process itself, and when we transfer it to the cluster level, we get a complex task which is difficult to solve. For that purpose, this paper analyses the conditions and possibilities that would enable those structures to adapt to changes in the surroundings - flexibility and management adequacy of production and organizational structures - by creating network value system.

  2. Hanford Tanks Initiative quality assurance implementation plan

    International Nuclear Information System (INIS)

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

  3. Hanford Tanks Initiative quality assurance implementation plan

    Energy Technology Data Exchange (ETDEWEB)

    Huston, J.J.

    1998-06-23

    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.

  4. Mexico City Air Quality Research Initiative

    International Nuclear Information System (INIS)

    The Mexico City Air Quality Research Initiative is one project that is examining the complex relationship between air pollution, economic growth, societal values, and air quality policies. This paper describes the programs that are being used to fulfill the three tasks of the project: air pollution modeling and simulation, air pollution monitoring, and strategic evaluation. The two lead institutions for this project are the Mexican Petroleum Institute and Los Alamos National Laboratory

  5. Power Quality Improvement Using UPQC

    OpenAIRE

    K. Kalaipriya; S. Jayachitra

    2014-01-01

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

  6. [Financial incentives for quality improvement].

    Science.gov (United States)

    Belicza, Eva; Evetovits, Tamás

    2010-05-01

    Policy makers and payers of health care services devote increasing attention to improve quality of services by incentivising health care providers. These--so called--pay for performance (P4P) programmes have so far been introduced in few countries only and evidence on their effectiveness is still scarce. Therefore we do not know yet which instruments of these programmes are most effective and efficient in improving quality. The P4P systems implemented so far in primary care and in integrated delivery systems use indicators for measurement of performance and the basis for rewards. These indicators are mostly process indicators, but there are some outcome indicators as well. The desired quality improvement effects are most likely to be achieved with programmes that provide seizable financial rewards and cover the extra cost of quality improvement efforts as well. Administration of the programme has to be fully transparent and clear to all involved. It has to be based on scientific evidence and supported with sufficient dedicated funding. Conducting pilot studies is a precondition for large scale implementation. PMID:20533704

  7. 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)

  8. Improving care at cystic fibrosis centers through quality improvement.

    Science.gov (United States)

    Kraynack, Nathan C; McBride, John T

    2009-10-01

    Quality improvement (QI) using a clinical microsystems approach provides cystic fibrosis (CF) centers the opportunity to make a significant positive impact on the health of their patients. The availability of center-specific outcomes data and the support of the Cystic Fibrosis Foundation are important advantages for these quality improvement efforts. This article illustrates how the clinical microsystems methodology can improve care delivery and outcomes by describing the gradual application of quality improvement principles over the past 5 years by the CF team at the Lewis Walker Cystic Fibrosis Center at Akron Children's Hospital in Akron, Ohio. Using the example of a project to improve the pulmonary function of the pediatric patients at our center as a framework, we describe the QI process from the initial team-building phase, through the assessment of care processes, standardization of care, and developing a culture of continuous improvement. We outline how enthusiastic commitment from physician leadership, clinical managers and central administration, the availability of coaches, and an appreciation of the importance of measurement, patient involvement, communication, and standardization are critical components for successful process improvement. PMID:19760542

  9. Improving Air Quality Forecasts with AURA Observations

    Science.gov (United States)

    Newchurch, M. J.; Biazer, A.; Khan, M.; Koshak, W. J.; Nair, U.; Fuller, K.; Wang, L.; Parker, Y.; Williams, R.; Liu, X.

    2008-01-01

    Past studies have identified model initial and boundary conditions as sources of reducible errors in air-quality simulations. In particular, improving the initial condition improves the accuracy of short-term forecasts as it allows for the impact of local emissions to be realized by the model and improving boundary conditions improves long range transport through the model domain, especially in recirculating anticyclones. During the August 2006 period, we use AURA/OMI ozone measurements along with MODIS and CALIPSO aerosol observations to improve the initial and boundary conditions of ozone and Particulate Matter. Assessment of the model by comparison of the control run and satellite assimilation run to the IONS06 network of ozonesonde observations, which comprise the densest ozone sounding campaign ever conducted in North America, to AURA/TES ozone profile measurements, and to the EPA ground network of ozone and PM measurements will show significant improvement in the CMAQ calculations that use AURA initial and boundary conditions. Further analyses of lightning occurrences from ground and satellite observations and AURA/OMI NO2 column abundances will identify the lightning NOx signal evident in OMI measurements and suggest pathways for incorporating the lightning and NO2 data into the CMAQ simulations.

  10. Shipbuilding pipeline production quality improvement

    Directory of Open Access Journals (Sweden)

    T. Buksa

    2010-06-01

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

  11. Power Quality Improvement Using UPQC

    Directory of Open Access Journals (Sweden)

    K. Kalaipriya

    2014-05-01

    Full Text Available This paper presents the power quality improvement using UPQC. UPQC consists of series inverter, shunt inverter and capacitance. Every inverter connected with pulse generator for switching on. UPQC is especially obtained to resolve different kind of power quality drawback like reactive power compensation, voltage interruption and harmonics. DVR is connected in series to deliver the active and reactive power to distribution network. DC-link capacitors stay high as a result of the DVR needs a minimum amount of DC-link voltage to compensate sag. So, DC –link voltage is connected with PV module to reduce the cost. Design of UPQC device with multi-bus system obtained using MATLAB/SIMULINK and simulation results are mentioned to support the developed conception.

  12. Quality Improvement Practices and Trends

    DEFF Research Database (Denmark)

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

    1998-01-01

    The following article, "Quality Improvement Practices and Trends in Denmark," is the first in a series of papers arranged for and co-authored by Dr. Rick L. Edgeman. Rick is a member of QE's Editorial Board and is on sabbatical from Colorado State University. During the year, Rick and his family 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 paperswit...

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-06-01

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

  15. 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

  16. Developing targets for public health initiatives to improve palliative care

    OpenAIRE

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

    2010-01-01

    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 initiative...

  17. Quality improvement in cardiac critical care

    OpenAIRE

    Lobdell, K; Camp, S., de; Stamou, S.; Swanson, R.; Reames, M; Madjarov, J; Stiegel, R; Skipper, E; Geller, R; Velardo, B; Mishra, A.(Indian Institute of Technology, Indore, India (IITI)); F. Robicsek

    2009-01-01

    Our quality improvement program began in 2004 to improve cardiac surgery outcomes. Early tracheal extubation in the cardiovascular intensive unit was utilized as a multidisciplinary driver for the quality improvement program. Continuous improvement in the rate of early extubation to drive multidisciplinary quality improvement in cardiac critical care correlated with decreased mortality, morbidity, and improved operational efficiency. Supportive educational efforts included, but were not limit...

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

    Science.gov (United States)

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

    2012-06-01

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

  19. Improvement of nuclear filter quality

    International Nuclear Information System (INIS)

    'Full-text:' The investigation was aimed at development of method and methodology of improvement of nuclear filter quality. Nuclear filters are used to manufacture high quality articles used to clean potable water from germ dredge, blood plasmaphoresis, clarification and microbiological stabilization of medical preparations, air and gas secondary cleaning from aerosols and germs. The basis of nuclear filter manufacture process is discriminatory etching of the charged particle-destructed polymer, which depends on destruction degree and destructed channel diameter. During irradiation some areas are destructed in some film regions as a result of ion treatment; during physico-chemical treatment (ultra-violet irradiation, etching in NaOH solution) that follows these areas allow obtain pores with cylindrical form. To ensure pore uniform distribution throughout the irradiated film, it is necessary to locate irradiated material surface perpendicularly to the incident ion beam and correlate polymer material velocity and bombarding charged particle flow density. Milor films was irradiated using the cyclotron P7 (-120) by eight argon charged ions with the energy of 1,0-1,1 MeV/ nucleon. Milor films with the thickness of 10 and width of 320mm were irradiated. During irradiation film motion was normal to the charged particle beam. Film velocity during irradiation was changing in the range of 1,5 m/min 15 m/min depending on charged particle flow density. Research done showed that 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)

  20. Improvement of nuclear filter quality

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-07-01

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

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

    OpenAIRE

    Grant, J B; Hayes, R P; Pates, R D; Elward, K S; Ballard, D J

    1996-01-01

    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. Since then,...

  2. Analyzing and Improving Data Quality

    OpenAIRE

    Buccella, Agustina; Cechich, Alejandra; Domingo, Gonzalo

    2008-01-01

    Data quality is a research area strongly investigated during the 90’s. However, few companies in Argentina apply data quality methodologies or tools during the analysis, design or implementation phases of software development process. Developers generally use techniques to design systems such as UML without considering mechanisms for future data quality problems. In this work we propose a methodology in which the data quality is an essential part of the whole software development process. Ear...

  3. Total quality drives nuclear plant improvements

    International Nuclear Information System (INIS)

    Total quality (TQ) at Carolina Power and Light (CP and L) is fulfilling a 1985 vision of Sherwood H. Smith, Jr., CP and L's chairman, president, and chief executive officer. The TQ concept has provided a way for employees to align their creative energies toward meeting the business needs of the company. Throughout CP and L, TQ has been recognized as the vehicle for reducing operating costs and improving customer satisfaction. Within the nuclear organization, application of the TQ process has helped to improve communications, resolve challenges, and provide more consistent work practices among CP and L's three nuclear plants. Total quality was introduced from the top down, with initial benefits coming from team interactions. Senior management at CP and L defined the corporate expectations and outlined the training requirements for implementing TQ. Management staffs at each organizational level became steering committees for TQ team activities within their departments. Teams of employees most knowledgeable about a given work area were empowered to solve problems or overcome obstacles related to that work area. Employees learned to become better team players and to appreciate the quality of decisions reached through group consensus. Now, formalized methods that started TQ are becoming part of the day-to-day work ethic

  4. Strategy to Support Improvement of Healthcare Quality.

    Directory of Open Access Journals (Sweden)

    Ing. Andrea Zejdlova

    2013-01-01

    Full Text Available One of the latest market-based solutions to the rising costs and quality gaps in health care is pay for performance. Pay for performance is the use of financial incentives to promote the delivery of designated standards of care. It is an emerging movement in health insurance (initially in Britain and United States. Providers under this arrangement are rewarded for meeting pre-established targets for delivery of healthcare services. This is a fundamental change from fee for service payment.Also known as "P4P" or “value-based purchasing,” this payment model rewards physicians, hospitals, medical groups, and other healthcare providers for meeting certain performance measures for quality and efficiency. Disincentives, such as eliminating payments for negative consequences of care (medical errors or increased costs, have also been proposed. In the developed nations, the rapidly aging population and rising health care costs have recently brought P4P to the forefront of health policy discussions. Pilot studies underway in several large healthcare systems have shown modest improvements in specific outcomes and increased efficiency, but no cost savings due to added administrative requirements. Statements by professional medical societies generally support incentive programs to increase the quality of health care, but express concern with the validity of quality indicators, patient and physician autonomy and privacy, and increased administrative burdens. This article serves as an introduction to pay for performance. We discuss the goals and structure of pay for performance plans and their limitations and potential consequences in the health care area.

  5. Changing quality initiative - does the quality profile really change?

    OpenAIRE

    Johansson, Elisabeth; Witell, Lars; Elg, Mattias

    2013-01-01

    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...

  6. Improving Quality using Testing Strategies

    Directory of Open Access Journals (Sweden)

    sahil batra

    2011-07-01

    Full Text Available Software testing is a technique aimed at evaluating an attribute or capability/usability of a program or product/system and determining that it meets its quality. Although crucial to software quality and widely deployed by programmer & testers, software testing still remains an art, due to limited understanding of the principles of software. Software testing is an important technique for assessing the quality of a software product. In this paper, various types of software testing technique and various attributes of software quality are explained. Identifying the types of testing that can be applied for checking a particular quality attribute is the aim of this thesis report. All types of testing can not be applied in all phases of software development life cycle. Which testing types are applicable in which phases of life cycle of software development is also summarized

  7. Improving Health and Quality of Life

    Science.gov (United States)

    ... of All Medicines and Supplements Managing Activities and Exercise Improving Health and Quality of Life Pediatric Definition and Diagnosis Management and Treatment Factsheets Healthcare Professionals ...

  8. MEASURES TO IMPROVE WATER QUALITY

    OpenAIRE

    L. SÂMBOTIN; S. MOISA; DANA SÂMBOTIN; ANA MARIANA DINCU; Ilie, C.

    2010-01-01

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

  9. Power Quality Improvement Using DVR

    OpenAIRE

    C. BENACHAIBA; B. Ferdi

    2009-01-01

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

  10. Methods for evaluation of small scale quality improvement projects

    OpenAIRE

    Harvey, G; Wensing, M

    2003-01-01

    ?? Evaluation is an integral component of quality improvement and there is much to be learned from the evaluation of small scale quality improvement initiatives at a local level. This type of evaluation is useful for a number of different reasons including monitoring the impact of local projects, identifying and dealing with issues as they arise within a project, comparing local projects to draw lessons, and collecting more detailed information as part of a bigger evaluation project. Focused ...

  11. Electronic health records improve clinical note quality

    OpenAIRE

    Burke, Harry B; SESSUMS, LAURA L; Hoang, Albert; Becher, Dorothy A; Fontelo, Paul; Liu, Fang; Stephens, Mark; Pangaro, Louis N; O'Malley, Patrick G; Baxi, Nancy S; Bunt, Christopher W; Capaldi, Vincent F; Chen, Julie M; Cooper, Barbara A; Djuric, David A

    2014-01-01

    Background and objective The clinical note documents the clinician's information collection, problem assessment, clinical management, and its used for administrative purposes. Electronic health records (EHRs) are being implemented in clinical practices throughout the USA yet it is not known whether they improve the quality of clinical notes. The goal in this study was to determine if EHRs improve the quality of outpatient clinical notes.

  12. Nationwide quality improvement in lung cancer care

    DEFF Research Database (Denmark)

    Jakobsen, Erik Winther; Green, Anders; Oesterlind, Kell; Rasmussen, Torben Riis; Iachina, Maria; Palshof, Torben

    2013-01-01

    To improve prognosis and quality of lung cancer care the Danish Lung Cancer Group has developed a strategy consisting of national clinical guidelines and a clinical quality and research database. The first edition of our guidelines was published in 1998 and our national lung cancer registry was opened for registrations in 2000. This article describes methods and results obtained by multidisciplinary collaboration and illustrates how quality of lung cancer care can be improved by establishing and...

  13. Nationwide quality improvement in lung cancer care

    DEFF Research Database (Denmark)

    Jakobsen, Erik Winther; Green, Anders; Oesterlind, Kell; Rasmussen, Torben Riis; Iachina, Maria; Palshof, Torben

    2013-01-01

    To improve prognosis and quality of lung cancer care the Danish Lung Cancer Group has developed a strategy consisting of national clinical guidelines and a clinical quality and research database. The first edition of our guidelines was published in 1998 and our national lung cancer registry was...... opened for registrations in 2000. This article describes methods and results obtained by multidisciplinary collaboration and illustrates how quality of lung cancer care can be improved by establishing and monitoring result and process indicators....

  14. Practical Approaches to Quality Improvement for Radiologists.

    Science.gov (United States)

    Kelly, Aine Marie; Cronin, Paul

    2015-10-01

    Continuous quality improvement is a fundamental attribute of high-performing health care systems. Quality improvement is an essential component of health care, with the current emphasis on adding value. It is also a regulatory requirement, with reimbursements increasingly being linked to practice performance metrics. Practice quality improvement efforts must be demonstrated for credentialing purposes and for certification of radiologists in practice. Continuous quality improvement must occur for radiologists to remain competitive in an increasingly diverse health care market. This review provides an introduction to the main approaches available to undertake practice quality improvement, which will be useful for busy radiologists. Quality improvement plays multiple roles in radiology services, including ensuring and improving patient safety, providing a framework for implementing and improving processes to increase efficiency and reduce waste, analyzing and depicting performance data, monitoring performance and implementing change, enabling personnel assessment and development through continued education, and optimizing customer service and patient outcomes. The quality improvement approaches and underlying principles overlap, which is not surprising given that they all align with good patient care. The application of these principles to radiology practices not only benefits patients but also enhances practice performance through promotion of teamwork and achievement of goals. (©)RSNA, 2015. PMID:26466176

  15. Quality improvement practices and trends in Denmark

    DEFF Research Database (Denmark)

    Dahlgaard, Jens JØrn; Hartz, Ove

    1998-01-01

    It is now well known that the history of quality improvement is neither uniquely American, nor uniquely Japanese, although the contributions from these two nations have received more attention perhaps than those originating elsewhere. This is the first in a series of articles intended to increase awareness of quality improvement practices and trends in various European nations, with particular emphasis on western Europe and Scandinavia. Herein the recent history of quality improvement in Denmark is explored and the quality improvement efforts in two Danish companies are chronicled. It is hoped that taken in its entirety, this series of articles will contribute to understanding both the rich fabric of European quality improvement that is independent of national boundaries and the colorful national fibers of which the fabric is made.

  16. The Continuous Improvement and Optimisation of Quality

    OpenAIRE

    EMIL MAXIM

    2006-01-01

    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 increa...

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

    Science.gov (United States)

    Mayer-Amberg, Norbert; Woltmann, Rainer; Walther, Stefanie

    2016-01-01

    The optimal treatment of schizophrenia patients requires integration of medical and psychosocial inputs. In Germany, various health-care service providers and institutions are involved in the treatment process. Early and continuous treatment is important but often not possible because of the fragmented medical care system in Germany. The Integrated Care Initiative Schizophrenia has implemented a networked care concept in the German federal state of Lower Saxony that integrates various stakeholders of the health care system. In this initiative, office-based psychiatrists, specialized nursing staff, psychologists, social workers, hospitals, psychiatric institutional outpatient’s departments, and other community-based mental health services work together in an interdisciplinary approach. Much emphasis is placed on psychoeducation. Additional efforts cover socio-therapy, visiting care, and family support. During the period from October 2010 (start of the initiative) to December 2012, first experiences and results of quality indicators were collected of 713 registered patients and summarized in a quality monitoring report. In addition, standardized patient interviews were conducted, and duration of hospital days was recorded in 2013. By the end of 2012, patients had been enrolled for an average of 18.7?months. The overall patient satisfaction measured in a patient survey in June 2013 was high and the duration of hospital days measured in a pre–post analysis in July 2013 was reduced by 44%. Two years earlier than planned, the insurance fund will continue the successfully implemented Integrated Care Initiative and adopt it in the regular care setting. This initiative can serve as a learning case for how to set up and measure integrated care systems that may improve outcomes for patients suffering from schizophrenia. PMID:26779043

  18. Status of quality initiatives, Part II.

    Science.gov (United States)

    Combes, J R; Scanlan, G F; Priselac, T M

    2001-01-01

    Speaking at the first national Summit on Medical Errors and Patient Safety Research last September, former American Hospital Association Chairman Gordon Sprenger called for plugging the research holes in several areas to improve patient safety. He identified critical areas where more research to improve patient safety would be helpful: changing the culture of health care, learning from other high-risk fields, studying the value of current safety practices, examining safety in nonhospital setting, closing the gaps between knowledge and practice, creating early warning systems, and looking at the human factors. Specifically, Sprenger raised the following questions to explore: What are the critical factors that make for a more open learning environment? What regulatory and legislative changes are necessary to create a nonpunitive, blameless environment? What has worked to improve safety in other fields? What is transferable to health care? Which of the current safety practices work well and how can they be improved? Which don't? How can systems solutions that prevent errors be adapted for settings outside of the hospital that are smaller and have less organizational structure? How can accepted standards of care and appropriate use of new technologies to improve care be better shared? Are they properly used? How can we make better use of precursor events to predict the occurrence of medical error? How can we involve patients in identifying potential errors? How can we advance our understanding of why humans err? PMID:11372517

  19. Power Quality Improvement Using DVR

    Directory of Open Access Journals (Sweden)

    C. Benachaiba

    2009-01-01

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

  20. Using information systems to measure and improve quality.

    Science.gov (United States)

    Bates, D W; Pappius, E; Kuperman, G J; Sittig, D; Burstin, H; Fairchild, D; Brennan, T A; Teich, J M

    1999-01-01

    Information systems (IS) are increasingly important for measuring and improving quality. In this paper, we describe our integrated delivery system's plan for and experiences with measuring and improving quality using IS. Our belief is that for quality measurement to be practical, it must be integrated with the routine provision of care and whenever possible should be done using IS. Thus, at one hospital, we now perform almost all quality measurement using IS. We are also building a clinical data warehouse, which will serve as a repository for quality information across the network. However, IS are not only useful for measuring care, but also represent powerful tools for improving care using decision support. Specific areas in which we have already seen significant benefit include reducing the unnecessary use of laboratory testing, reporting important abnormalities to key providers rapidly, prevention and detection of adverse drug events, initiatives to change prescribing patterns to reduce drug costs and making critical pathways available to providers. Our next major effort will be introduce computerized guidelines on a more widespread basis, which will be challenging. However, the advent of managed care in the US has produced strong incentives to provide high quality care at low cost and our perspective is that only with better IS than exist today will this be possible without compromising quality. Such systems make feasible implementation of quality measurement, care improvement and cost reduction initiatives on a scale which could not previously be considered. PMID:10193881

  1. Improving food quality through new technology.

    Science.gov (United States)

    Peters, A R

    1990-06-01

    New technological developments make it possible to improve the quality of animal disease therapy, prophylaxis and diagnosis, and to improve animals' growth and fertility. The term 'quality' includes not only objective measurements, such as the fatness or leanness of meat, but also organoleptic factors such as flavour and others which are of increasing importance to consumers, such as animal welfare. Is new technology consistent with the improvement of quality? For example, beta-agonists and porcine somatotrophin reduce the fatness and increase the protein content of carcases, but there are also subtle positive relationships between fatness and eating quality. In contrast, bovine somatotrophin appears to have no effect on milk composition but there are indications that it may affect the perception of milk quality by some consumers. Improved vaccines can increase food quality by improving animal health and welfare and increasing the uniformity of the product; immunological techniques may also be used to improve meat quality. A gulf has developed between the benefits from new technology and consumer perceptions; indeed there is evidence of political resistance to some technological advances. Despite the stringent regulation of veterinary medicinal products in the United Kingdom and other countries, there is continued pressure for greater political control over their approval. The exchange of information between scientists, industry, the legal regulators and consumers must be improved so that advances in technology are acceptable to the majority and used to the advantage of all. PMID:2195756

  2. Quality improvement through multiple response optimization

    International Nuclear Information System (INIS)

    The performance of a product is often evaluated by several quality characteristics. Optimizing the manufacturing process with respect to only one quality characteristic will not always lead to the optimum values for other characteristics. Hence, it would be desirable to improve the overall quality of a product by improving quality characteristics, which are considered to be important. The problem consists of optimizing several responses using multiple objective decision making approach and design of experiments. A case study will be discussed to show the application of the proposal method

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

    Science.gov (United States)

    Yoo, Soonhwa; Loadman, William E.

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

  4. The impact of leadership qualities on quality management improvement

    Directory of Open Access Journals (Sweden)

    Ph. D. Radoslaw Wolniak

    2011-05-01

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

  5. The impact of leadership qualities on quality management improvement

    Directory of Open Access Journals (Sweden)

    Radoslaw Wolniak

    2011-12-01

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

  6. Targeting Quality Improvement in Clinical Practice Guidelines.

    Science.gov (United States)

    Mims, James W

    2015-12-01

    Clinical practice guidelines provide key action statements targeted at quality improvements. Areas of potential quality improvement can be identified by exploring known contributors to cognitive errors. Three common contributors to medical error and reduced quality care are (1) the complexity of modern medicine, (2) the tendency to apply cause and effect to random associations, and (3) our bias to our first intuition. Future authors of clinical practice guidelines should consider these 3 influences when deciding how to best provide guidance to improve patient care. PMID:26459246

  7. Quality improvement and accountability in the Danish health care system

    DEFF Research Database (Denmark)

    Mainz, Jan; Kristensen, Solvejg

    2015-01-01

    Denmark has unique opportunities for quality measurement and benchmarking since Denmark has well-developed health registries and unique patient identifier that allow all registries to include patient-level data and combine data into sophisticated quality performance monitoring. Over decades, Denmark has developed and implemented national quality and patient safety initiatives in the healthcare system in terms of national clinical guidelines, performance and outcome measurement integrated in clinical databases for important diseases and clinical conditions, measurement of patient experiences, reporting of adverse events, national handling of patient complaints, national accreditation and public disclosure of all data on the quality of care. Over the years, Denmark has worked up a progressive and transparent just culture in quality management; the different actors at the different levels of the healthcare system are mutually attentive and responsive in a coordinated effort for quality of the healthcare services. At national, regional, local and hospital level, it is mandatory to participate in the quality initiatives and to use data and results for quality management, quality improvement, transparency in health care and accountability. To further develop the Danish governance model, it is important to expand the model to the primary care sector. Furthermore, a national quality health programme 2015-18 recently launched by the government supports a new development in health care focusing upon delivering high-quality health care-high quality is defined by results of value to the patients.

  8. Quality improvement and accountability in the Danish health care system.

    Science.gov (United States)

    Mainz, Jan; Kristensen, Solvejg; Bartels, Paul

    2015-12-01

    Denmark has unique opportunities for quality measurement and benchmarking since Denmark has well-developed health registries and unique patient identifier that allow all registries to include patient-level data and combine data into sophisticated quality performance monitoring. Over decades, Denmark has developed and implemented national quality and patient safety initiatives in the healthcare system in terms of national clinical guidelines, performance and outcome measurement integrated in clinical databases for important diseases and clinical conditions, measurement of patient experiences, reporting of adverse events, national handling of patient complaints, national accreditation and public disclosure of all data on the quality of care. Over the years, Denmark has worked up a progressive and transparent just culture in quality management; the different actors at the different levels of the healthcare system are mutually attentive and responsive in a coordinated effort for quality of the healthcare services. At national, regional, local and hospital level, it is mandatory to participate in the quality initiatives and to use data and results for quality management, quality improvement, transparency in health care and accountability. To further develop the Danish governance model, it is important to expand the model to the primary care sector. Furthermore, a national quality health programme 2015-18 recently launched by the government supports a new development in health care focusing upon delivering high-quality health care-high quality is defined by results of value to the patients. PMID:26443814

  9. Power theories for improved power quality

    CERN Document Server

    Pasko, Marian

    2012-01-01

    Power quality describes a set of parameters of electric power and the load’s ability to function properly under specific conditions. It is estimated that problems relating to power quality costs the European industry hundreds of billions of Euros annually. In contrast, financing for the prevention of these problems amount to fragments of these costs. Power Theories for Improved Power Quality addresses this imbalance by presenting and assessing a range of methods and problems related to improving the quality of electric power supply. Focusing particularly on active compensators and the DSP based control algorithms, Power Theories for Improved Power Quality introduces the fundamental problems of electrical power. This introduction is followed by chapters which discuss: •‘Power theories’ including their historical development and application to practical problems, •operational principles of active compensator’s DSP control based algorithms using examples and results from laboratory research, and •t...

  10. Training for quality management: report on a nationwide distance learning initiative for physicians in Spain.

    Science.gov (United States)

    Saturno, P J

    1999-02-01

    Under the sponsorship of a pharmaceutical firm, a distance-learning course on Quality Management methods was developed at the University of Murcia (Spain) and offered nationwide to primary health care physicians working in the public system. A total of 7104 physicians (47.7% of the census) signed up (at least one in 92.2% of the health centres). The course content follows the author's model of quality improvement, monitoring and design trilogy, but focuses mainly on methods for a quality improvement cycle using a learning-by-doing and problem-solving approach. The unexpected success of this initiative has led us to reflect on the interest in learning about quality improvement methods shown by physicians, the usefulness of the distance-learning approach, and also to continue the project with new initiatives such as: a summary poster, software containing all the necessary tools and data analysis for quality improvement, and a manual. PMID:10411291

  11. Quality improvement to meet competitive fringe

    OpenAIRE

    Matsushima, Noriaki; Liu, Ren-Jye

    2012-01-01

    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...

  12. How Can We Improve Teacher Quality?

    Science.gov (United States)

    Wilson, Suzanne M.

    2011-01-01

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

  13. Water Quality Improvement Using Renewable Energies

    Directory of Open Access Journals (Sweden)

    Mocanu Catalina Raluca

    2014-06-01

    Full Text Available To reduce the negative effects of eutrophication processes in water bodies it is necessary to improve water quality by ensuring the necessary oxygen concentration. The paper proposes a new innovative solution for the improvement of lake water quality. The premises for the implementation of the experimental floating platform which will aerate the lake waters will be presented. To give a specific view over the oxygen dispersion into the lake, numerical simulations in CFD software will be presented in different cases.

  14. Improving quality of cancer care through surgical audit

    OpenAIRE

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

    2010-01-01

    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...

  15. Improving quality of cancer care through surgical audit

    DEFF Research Database (Denmark)

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

    2010-01-01

    Quality of healthcare is a hot topic and this is especially true for cancer care. New surgical techniques and effective neoadjuvant treatment regimens have significantly improved colorectal cancer outcome. Nevertheless, there seem to be substantial differences in quality of care between European countries, hospitals and doctors. To reduce hospital variation, most initiatives aim on selective referral, encouraging patients to seek care in high-volume hospitals, where cancer care is concentrated t...

  16. Improving Quality of Care in Peptic Ulcer Bleeding

    DEFF Research Database (Denmark)

    Rosenstock, Steffen Jais; Møller, Morten H; Larsson, Heidi; Johnsen, Søren P; Madsen, Anders H; Bendix, Jørgen; Adamsen, Sven; Jensen, Anders G; Zimmermann-Nielsen, Erik; Nielsen, Ann-Sophie; Kallehave, Finn; Oxholm, Dorthe; Skarbye, Mona; Jølving, Line R; Schaffalitzky de Muckadell, Ove B.; Thomsen, RW; Jørgensen, Henrik Stig

    2013-01-01

    OBJECTIVES:The treatment of peptic ulcer bleeding (PUB) is complex, and mortality remains high. We present results from a nationwide initiative to monitor and improve the quality of care (QOC) in PUB.METHODS:All Danish hospitals treating PUB patients between 2004 and 2011 prospectively registered demographic, clinical, and prognostic data. QOC was evaluated using eight process and outcome indicators, including time to initial endoscopy, hemostasis obtainment, proportion undergoing surgery, reble...

  17. The Results of Testing Zeolite Filters to Improve Petrol Quality

    International Nuclear Information System (INIS)

    On the basis of carried out investigations the possibility of improving petrol quality using acid-modified species of natural zeolite-clinoptilolite is propozed. Low octane and high-octane petrol brands have been used for the experiments. Chromatografic analysis has shown that treated petrols contain less amount of n-parafins than initial petrols. (author)

  18. Improving the feedstock quality for xylite production

    Energy Technology Data Exchange (ETDEWEB)

    Kilmova, Z.K.; Belen' kii, S.I.; Epshtein, Ya.V.; Grankina, L.G.; Kondrashova, E.I.; Larina, V.V.; Polyakova, L.P.

    1981-01-01

    For improving the quality of the feedstock -- cottonseed hulls employable for xylite production -- separation of unhulled seeds down to the required technical specification for their content of less than or equal to 1.5% on the absolute dry weight is necessary. Also a reduction in seed moisture content and contamination and an improvement in storage conditions is necessary.

  19. EXFOR: Improving the quality of international databases

    International Nuclear Information System (INIS)

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

  20. Improvement in spring wheat quality in pakistan

    International Nuclear Information System (INIS)

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

  1. Quality improvement in end-of-life critical care.

    Science.gov (United States)

    Kahn, Jeremy M

    2012-08-01

    Patients, clinicians and policy makers are increasingly interested in measuring and improving the quality of health care at the end of life. The intensive care unit (ICU) is characterized by high mortality and frequent use of life-sustaining treatments, making critical care a natural target for these efforts. Indeed, multiple local and regional quality improvement efforts now specifically target the dying experience for ICU patients, patients at risk for ICU admission, and their families. These activities either target ICU caregivers through educational programs and quality incentives, or target patients and their families directly through palliative care and efforts to improve decisions around the end of life. Although these initiatives hold great promise, they also face inherent challenges-it is difficult to measure the quality of end-of-life care, we lack practical targets for affecting quality, and uncertain political climates can often preclude serious discussions about end-of-life care. Moreover, these programs may lead to unintended consequences, potentially negatively impacting the very care they seek to improve. Future innovations surrounding how we measure the quality of end-of-life care and paradigm shifts in the way we think about ICU quality may help us to fully realize the goal of improving the dying process for ICU patients. PMID:22875384

  2. The DSN Asset Management/Maintenance Improvement Initiative

    Science.gov (United States)

    Wackley, J.; Dundics, D.

    2011-11-01

    This article describes the Asset Management/Maintenance Improvement (AMMI) initiative: the first focused Deep Space Network (DSN) initiative intended to improve the efficiency and efficacy of maintenance, support improvement in equipment reliability, and provide metrics for use in understanding equipment reliability and the use of maintenance resources. The initiative has resulted in the introduction of many new processes and procedures including the global use of a computerized maintenance management system (CMMS) and Reliability-Centered Maintenance (RCM) concepts. The work performed as part of the AMMI initiative represents significant changes to the DSN maintenance culture that has been in place for over 40 years.

  3. A roadmap for improving healthcare service quality.

    Science.gov (United States)

    Kennedy, Denise M; Caselli, Richard J; Berry, Leonard L

    2011-01-01

    A data-driven, comprehensive model for improving service and creating long-term value was developed and implemented at Mayo Clinic Arizona (MCA). Healthcare organizations can use this model to prepare for value-based purchasing, a payment system in which quality and patient experience measures will influence reimbursement. Surviving and thriving in such a system will require a comprehensive approach to sustaining excellent service performance from physicians and allied health staff (e.g., nurses, technicians, nonclinical staff). The seven prongs in MCA's service quality improvement model are (1) multiple data sources to drive improvement, (2) accountability for service quality, (3) service consultation and improvement tools, (4) service values and behaviors, (5) education and training, (6) ongoing monitoring and control, and (7) recognition and reward. The model was fully implemented and tested in five departments in which patient perception of provider-specific service attributes and/or overall quality of care were below the 90th percentile for patient satisfaction in the vendor's database. Extent of the implementation was at the discretion of department leadership. Perception data rating various service attributes were collected from randomly selected patients and monitored over a 24-month period. The largest increases in patient perception of excellence over the pilot period were realized when all seven prongs of the model were implemented as a comprehensive improvement approach. The results of this pilot may help other healthcare organizations prepare for value-based purchasing. PMID:22201201

  4. Trans-disciplinary community groups: an initiative for improving healthcare.

    Science.gov (United States)

    Sideras, James Demetri

    2016-02-01

    Purpose - In the context of budget constraints and the current quality crisis facing UK healthcare, the purpose of this paper is to examine the use of trans-disciplinary community groups (TCG) - an innovative and inexpensive initiative for improving patient care. Design/methodology/approach - Using an action research study, TCG was implemented within a private healthcare firm for vulnerable adults. Qualitative data were gathered over 12 months from 33 participants using depth interviews and focus groups. Findings - TCG led to improved patient activities and increased patient decision-making and confidence in self-advocacy. Key prerequisites were top management commitment, democratic leadership and employee empowerment. However, staff nurses resisted TCG because they were inclined to using managerial control and their own independent clinical judgements. Research limitations/implications - Whilst the findings from this study should not be generalized across all healthcare sectors, its results could be replicated in contexts where there is wide commitment to TCG and where managers adopt a democratic style of leadership. Researchers could take this study further by exploring the applicability of TCG in public healthcare organizations or other multi-disciplinary service contexts. Practical implications - The findings of this research paper provide policy makers and healthcare managers with practical insights on TCG and the factors that are likely to obstruct and facilitate its implementation. Originality/value - Adopting TCG could enable healthcare managers to ameliorate their services with little or no extra cost, which is especially important in a budget constraint context and the current quality crisis facing UK healthcare. PMID:26771062

  5. Using the IRB Researcher Assessment Tool to Guide Quality Improvement.

    Science.gov (United States)

    Hall, Daniel E; Hanusa, Barbara H; Ling, Bruce S; Stone, Roslyn A; Switzer, Galen E; Fine, Michael J; Arnold, Robert M

    2015-12-01

    Institutional Review Boards (IRBs) are intended to protect those who participate in research. However, because there is no established measure of IRB quality, it is unclear whether these committees achieve their goal. The IRB Researcher Assessment Tool is a previously validated, internally normed, proxy measure of IRB quality that assesses 45 distinct IRB activities and functions. We administered this instrument to a sample of investigators and IRB members at a large urban VA Medical Center. We describe a systematic approach to analyze and interpret survey responses that can identify the IRB activities and functions most in need of quality improvement. The proposed approach to empirical data analysis and presentation could inform local initiatives to improve the quality of IRB review. PMID:26527369

  6. Team Learning for Healthcare Quality Improvement

    OpenAIRE

    Manukyan, Narine; Eppstein, Margaret J.; Horbar, Jeffrey D.

    2013-01-01

    In organized healthcare quality improvement collaboratives (QICs), teams of practitioners from different hospitals exchange information on clinical practices with the aim of improving health outcomes at their own institutions. However, what works in one hospital may not work in others with different local contexts because of nonlinear interactions among various demographics, treatments, and practices. In previous studies of collaborations where the goal is a collective problem solving, teams ...

  7. Increased office productivity through improved indoor air quality

    DEFF Research Database (Denmark)

    Fanger, Povl Ole

    2002-01-01

    Control of indoor pollution sources and ventilation are both means of improving indoor air quality. Three independent experiments have recently documented that removing a pollution source or increasing the ventilation rate will improve perceived air quality, reduce the intensity of several Sick...... 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....

  8. Re-Engineering a Small Oncology Practice for Quality Using the ASCO Quality Oncology Practice Initiative

    OpenAIRE

    Hendricks, Carolyn B.

    2013-01-01

    The field of quality improvement is expanding rapidly, and small oncology practices need to adapt and rise to future challenges. Additional quality measures from ASCO and other organizations will likely focus on palliative care, the Top Five, and electronic measures.

  9. Successful integration of ergonomics into continuous improvement initiatives.

    Science.gov (United States)

    Monroe, Kimberly; Fick, Faye; Joshi, Madina

    2012-01-01

    Process improvement initiatives are receiving renewed attention by large corporations as they attempt to reduce manufacturing costs and stay competitive in the global marketplace. These initiatives include 5S, Six Sigma, and Lean. These programs often take up a large amount of available time and budget resources. More often than not, existing ergonomics processes are considered separate initiatives by upper management and struggle to gain a seat at the table. To effectively maintain their programs, ergonomics program managers need to overcome those obstacles and demonstrate how ergonomics initiatives are a natural fit with continuous improvement philosophies. PMID:22316947

  10. Fostering Quality Improvement in EHDI Programs

    Science.gov (United States)

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

    2011-01-01

    State coordinators of early hearing detection and intervention (EHDI) programs completed a strengths, weaknesses, opportunities, and threats, or SWOT, analysis that consisted of 12 evaluative areas of EHDI programs. For the quality improvement area, a total of 218 items were listed by 47 EHDI coordinators, and themes were identified in each…

  11. Teaching Quality Improvement Through a Book Club

    Directory of Open Access Journals (Sweden)

    Benjamin Doolittle

    2015-12-01

    Full Text Available Introduction: Quality Improvement projects are an important part of residency education in the United States and are required for accreditation by the Accreditation Council for Graduate Medical Education. Participation in standard chart-based quality improvement had failed to generate excitement among residents in our program. The objective of our innovation was to inspire interest in quality improvement among our residents. Methods: Our residency program instituted a book discussion group. Attendance and participation of attendees was recorded, and residents were sent a follow-up survey one month after the activity to gauge their impressions. Results: Out of 16 residents in the program, 12 attended the discussion group, and all attendees participated in the discussion. The follow-up survey revealed that 10/11 (91% of respondents had read at least part of the book and 11/11 (100% wanted to have another book discussion group in the upcoming year. Conclusion: We believe that the use of a book discussion group can be a novel, inspiring strategy to teach quality improvement in a residency program.

  12. Improving Quality of Care in Peptic Ulcer Bleeding

    DEFF Research Database (Denmark)

    Rosenstock, Steffen J; Møller, Morten H; Larsson, Heidi Jeanet; Johnsen, Søren Paaske; Madsen, Anders Husted; Bendix, Jørgen; Adamsen, Sven; Jensen, Anders G.; Zimmermann-Nielsen, Erik; Nielsen, Ann-Sophie; Kallehave, Finn; Oxholm, Dorthe; Skarbye, Mona; Jølving, Line R; Jørgensen, Henrik S; Schaffalitzky de Muckadell, Ove B.; Thomsen, Reimar W.

    2013-01-01

    nonsignificantly over time (adjusted RR 0.89 (0.78-1.00)).CONCLUSIONS:QOC in PUB has improved substantially in Denmark, but the 30-day mortality remains high. Future initiatives to improve outcomes may include earlier endoscopy, having fully trained endoscopists on call, and increased focus on managing coexisting......OBJECTIVES:The treatment of peptic ulcer bleeding (PUB) is complex, and mortality remains high. We present results from a nationwide initiative to monitor and improve the quality of care (QOC) in PUB.METHODS:All Danish hospitals treating PUB patients between 2004 and 2011 prospectively registered...... demographic, clinical, and prognostic data. QOC was evaluated using eight process and outcome indicators, including time to initial endoscopy, hemostasis obtainment, proportion undergoing surgery, rebleeding risks, and 30-day mortality.RESULTS:A total of 13,498 PUB patients (median age 74 years) were included...

  13. The impact of leadership qualities on quality management improvement

    OpenAIRE

    Radoslaw Wolniak

    2011-01-01

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

  14. Project Hanford management contract quality improvement project management plan; TOPICAL

    International Nuclear Information System (INIS)

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

  15. Project Hanford management contract quality improvement project management plan

    Energy Technology Data Exchange (ETDEWEB)

    ADAMS, D.E.

    1999-03-25

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

  16. Engaging Clinical Nurses in Quality Improvement Projects.

    Science.gov (United States)

    Moore, Susan; Stichler, Jaynelle F

    2015-10-01

    Clinical nurses have the knowledge and expertise required to provide efficient and proficient patient care. Time and knowledge deficits can prevent nurses from developing and implementing quality improvement or evidence-based practice projects. This article reviews a process for professional development of clinical nurses that helped them to define, implement, and analyze quality improvement or evidence-based practice projects. The purpose of this project was to educate advanced clinical nurses to manage a change project from inception to completion, using the Six Sigma DMAIC (Define, Measure, Analyze, Improve, Control) Change Acceleration Process as a framework. One-to-one mentoring and didactic in-services advanced the knowledge, appreciation, and practice of advanced practice clinicians who completed multiple change projects. The projects facilitated clinical practice changes, with improved patient outcomes; a unit cultural shift, with appreciation of quality improvement and evidence-based projects; and engagement with colleagues. Project outcomes were displayed in poster presentations at a hospital exposition for knowledge dissemination. PMID:26430867

  17. Quality improvement in surgery: the American College of Surgeons National Surgical Quality Improvement Program approach.

    Science.gov (United States)

    Ingraham, Angela M; Richards, Karen E; Hall, Bruce L; Ko, Clifford Y

    2010-01-01

    The history and development of the NSQIP, from its inception in the Veterans Administration Health System to its implementation within the private sector sponsored by the ACS, documents the growth of a program that has substantially improved the quality of surgical care and has had a considerable influence on the culture of quality improvement in the profession. The success of the ACS NSQIP is the result of providing hospitals with rigorous, clinical data, networking opportunities, and resources to improve their risk-adjusted outcomes. In this manner, the ACS NSQIP challenges its hospitals and health care providers to continually improve the care they provide. In addition to reducing the complications and mortality experienced by patients after surgical procedures, hospitals that participate in the ACS NSQIP have seen the financial rewards of their quality improvement efforts. Continued growth of the ACS NSQIP will facilitate achievement of the primary goal surrounding the current health care reform debate: efficient, high-quality care. PMID:20919525

  18. Developing targets for public health initiatives to improve palliative care

    Directory of Open Access Journals (Sweden)

    Klindtworth Katharina

    2010-04-01

    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.

  19. Pediatric CT quality management and improvement program

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-10-15

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

  20. Pediatric CT quality management and improvement program

    International Nuclear Information System (INIS)

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

  1. IMPROVING THE QUALITY OF MECHANIZED OPERATIONS

    Directory of Open Access Journals (Sweden)

    Maslov G. G.

    2015-03-01

    Full Text Available The article presents analysis of the problem of increasing the quality of the implementation of mechanized operations to harvest crops and seed dressing chemicals. The quality of grain harvesting combine harvesters was considered for the new modern harvesters in terms of crop losses, grain crushing and microdamages. The quality of seed treatment is considered on the basis of the ejection slot-spraying nozzles at ultra low seed coming down with a conical distribution surface, ending rounded shape logisticians. The problem of improving the quality of the grain harvest is mainly due to its losses for the combine and injury. By the way, the amount of grain crushing almost half its losses determines the percentage of the combine. The greatest fragmentation occurs in the threshing and separating device (LSG combines with a hammer drums and several times lower - in the axial rotor LSG. At last there is a big advantage - high performance combines that preference when replacing obsolete machines with a hammer apparatus. Quality depends on the etching uniformity of distribution of atomized liquid droplets and completeness of etching. The proposed new flowsheet Dressers fixed flow distribution and ejection-slotted spray solution of the working fluid has significant advantages: reliable processing of seeds, completeness (not less than 97% and uniformity (98% of dressing material. Optimal duty cycle flow of seeds created by a fixed cone with an angle of 45 degrees, the spatial arrangement of ejection nozzles relative to the flow of processed seeds provide good quality of work

  2. Improving quality and operational reliability through organizational change

    OpenAIRE

    Heiska, Otto

    2015-01-01

    This thesis is based on an organizational change project initiated by Lufthansa Cargo management and Swissport Cargo Services management in late autumn 2014. The idea of the project was to improve the quality and operational reliability of an outsourced Lufthansa Cargo dedicated service unit. The unit operating under Swissport Cargo Services in Helsinki airport was to be restructured and redeveloped to better suit the changed operational environment. The purpose of this thesis is to prese...

  3. Improving quality of care through improved audit and feedback

    Directory of Open Access Journals (Sweden)

    Hysong Sylvia J

    2012-05-01

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

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

    DEFF Research Database (Denmark)

    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

    2014-01-01

    . 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...... among countries. The European Initiative for Quality Management in Lung Cancer Care has provided the first comprehensive snapshot of lung cancer care in Europe....

  5. Improvements to the construction of binary black hole initial data

    CERN Document Server

    Ossokine, Serguei; Pfeiffer, Harald P; Boyle, Michael; Szilágyi, Béla

    2015-01-01

    Construction of binary black hole initial data is a prerequisite for numerical evolutions of binary black holes. This paper reports improvements to the binary black hole initial data solver in the Spectral Einstein Code, to allow robust construction of initial data for mass-ratio above 10:1, and for dimensionless black hole spins above 0.9, while improving efficiency for lower mass-ratios and spins. We implement a more flexible domain decomposition, adaptive mesh refinement and an updated method for choosing free parameters. We also introduce a new method to control and eliminate residual linear momentum in initial data for precessing systems, and demonstrate that it eliminates gravitational mode mixing during the evolution. Finally, the new code is applied to construct initial data for hyperbolic scattering and for binaries with very small separation.

  6. A Model to Improve the Quality Products

    Directory of Open Access Journals (Sweden)

    Hasan GOKKAYA

    2010-08-01

    Full Text Available The topic of this paper is to present a solution who can improve product qualityfollowing the idea: “Unlike people who have verbal skills, machines use "sign language"to communicate what hurts or what has invaded their system’. Recognizing the "signs"or symptoms that the machine conveys is a required skill for those who work withmachines and are responsible for their care and feeding. The acoustic behavior of technical products is predominantly defined in the design stage, although the acoustic characteristics of machine structures can be analyze and give a solution for the actual products and create a new generation of products. The paper describes the steps intechnological process for a product and the solution who will reduce the costs with the non-quality of product and improve the management quality.

  7. Improving quality of service in the internet

    CERN Document Server

    Flückiger, François

    2000-01-01

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

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

    International Nuclear Information System (INIS)

    Many have recognized the need for high quality data on assets and the problems in obtaining them, particularly when there is a need for human observation and manual recording. Yet very few have looked at the role of the data collectors themselves in the data quality process. This paper argues that there are benefits to more fully understanding the psychological factors that lay behind data collection and we use goal hierarchy theory to understand these factors. Given the myriad of potential reasons for poor-quality data it has previously proven difficult to identify and successfully deploy employee-driven interventions; however, the goal hierarchy approach looks at all of the goals that an individual has in their life and the connections between them. For instance, does collecting data relate to whether or not they get a promotion? Stay safe? Get a new job? and so on. By eliciting these goals and their connections we can identify commonalities across different groups, sites or organizations that can influence the quality of data collection. Thus, rather than assuming what the data collectors want, a goal hierarchy approach determines that empirically. Practically, this supports the development of customized interventions that will be much more effective and sustainable than previous efforts. - Highlights: → We need to consider psychological aspects of data collectors to improve data quality. → We show how goal hierarchy theory furthers understanding. → Looks at the multiple goals of each individual to determine their behavior.

  9. Quality Improvement in Inflammatory Bowel Disease

    OpenAIRE

    Melmed, Gil Y; SIEGEL, COREY A.

    2013-01-01

    Chronic illnesses such as inflammatory bowel disease (IBD) present a unique opportunity to define and improve the quality of care. Processes of care can be complex, and outcomes of care may vary across different healthcare delivery settings. Patients with IBD are managed over long periods of time and often by the same physician within a single care delivery system. Both patients with Crohn’s disease and ulcerative colitis have variable courses of disease progression that require changes in th...

  10. Narrative methods in quality improvement research

    OpenAIRE

    Greenhalgh, T; RUSSELL, J; Swinglehurst, D

    2005-01-01

    ?? 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 ...

  11. Multichannel DBS halftoning for improved texture quality

    Science.gov (United States)

    Slavuj, Radovan; Pedersen, Marius

    2015-01-01

    The paper aims to develop a method for multichannel halftoning based on the Direct Binary Search (DBS) algorithm. We integrate specifics and benefits of multichannel printing into the halftoning method in order to further improve texture quality of DBS and to create halftoning that would suit for multichannel printing. Originally, multichannel printing is developed for an extended color gamut, at the same time additional channels can help to improve individual and combined texture of color halftoning. It does so in a similar manner to the introduction of the light colors (diluted inks) in printing. Namely, if one observes Red, Green and Blue inks as the light version of the M+Y, C+Y, C+M combinations, the visibility of the unwanted halftoning textures can be reduced. Analogy can be extent to any number of ink combinations, or Neugebauer Primaries (NPs) as the alternative building blocks. The extended variability of printing spatially distributed NPs could provide many practical solution and improvements in color accuracy, image quality, and could enable spectral printing. This could be done by selection of NPs per dot area location based on the constraint of the desired reproduction. Replacement with brighter NP at the location could induce a color difference where a tradeoff between image quality and color accuracy is created. With multichannel enabled DBS haftoning, we are able to reduce visibility of the textures, to provide better rendering of transitions, especially in mid and dark tones.

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

    Science.gov (United States)

    Sprau Coulter, Tabitha L.

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

  13. Increased Mercury Bioaccumulation Follows Water Quality Improvement

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-09-15

    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.

  14. Increased Mercury Bioaccumulation Follows Water Quality Improvement

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  16. Investigating Service Quality Initiatives of Pakistani Commercial Banks

    OpenAIRE

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

    2012-01-01

    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. The study concluded that customers, employees,...

  17. Improving the quality of care for patients with hypertension in Moshupa District, Botswana: Quality improvement cycle

    Directory of Open Access Journals (Sweden)

    Cathy Kande

    2014-01-01

    Full Text Available Background: Although there are no prevalence studies on hypertension in Botswana, this condition is thought to be common and the quality of care to be poor.Aim: The aim of this project was to assess and improve the quality of primary care forhypertension.Setting: Moshupa clinic and catchment area, Botswana.Methods: Quality improvement cycle.Results: Two hundred participants were included in the audit. Sixty-eight per cent were women with a mean age of 55 years. In the baseline audit none of the target standards were met. During the re-audit six months later, six out of nine structural target standards, five out of 11 process target standards and one out of two outcome target standards were achieved. Statistically-significant improvement in performance (p < 0.05 was shown in 10 criteria although the target standard was not always met. In the re-audit, the target of achieving blood pressure control (< 140/90 in 70% of patients was achieved.Conclusion: The quality of care for hypertension was suboptimal in our setting. Simple interventions were designed and implemented to improve the quality of care. These interventions led to significant improvement in structural and process criteria. A corresponding significant improvement in the control of blood pressure was also seen.

  18. Applying PPM to ERP Maintenance and Continuous Improvement Initiatives

    DEFF Research Database (Denmark)

    El-Tal, Nada Maria; Fonnesbæk, Majbrit

    2006-01-01

    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.

  19. Improving wind power quality with energy storage

    DEFF Research Database (Denmark)

    Rasmussen, Claus Nygaard

    2009-01-01

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

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

    DEFF Research Database (Denmark)

    Blum, Torsten G; Rich, Anna

    2014-01-01

    Lung cancer is the commonest cause of cancer-related death worldwide and poses a significant respiratory disease burden. Little is known about the provision of lung cancer care across Europe. The overall aim of the Task Force was to investigate current practice in lung cancer care across Europe. The Task Force undertook four projects: 1) a narrative literature search on quality management of lung cancer; 2) a survey of national and local infrastructure for lung cancer care in Europe; 3) a benchmarking project on the quality of (inter)national lung cancer guidelines in Europe; and 4) a feasibility study of prospective data collection in a pan-European setting. There is little peer-reviewed literature on quality management in lung cancer care. The survey revealed important differences in the infrastructure of lung cancer care in Europe. The European guidelines that were assessed displayed 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.

  1. Improvements in geomagnetic observatory data quality

    DEFF Research Database (Denmark)

    Reda, Jan; Fouassier, Danielle; Isac, Anca; Linthe, Hans-Joachim; Matzka, Jürgen; Turbitt, Christopher William

    Geomagnetic observatory practice and instrumentation has evolved significantly over the past 150 years. Evolution continues to be driven by advances in technology and by the need of the data user community for higher-resolution, lower noise data in near-real time. Additionally, collaboration...... current state of observatory instrumentation and methods, citing some of the general problems in the complex operation of geomagnetic observatories. It further gives an overview of recent improvements of observatory data quality based on presentation during 11th IAGA Assembly at Sopron and INTERMAGNET...

  2. Using genomics to improve fruit quality

    Scientific Electronic Library Online (English)

    Claudio, Meneses; Ariel, Orellana.

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

  3. MOBILITY LEARNING METHODOLOGY FOR EDUCATION QUALITY IMPROVEMENT

    Directory of Open Access Journals (Sweden)

    Liviu Moldovan

    2012-11-01

    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.

  4. Improving the quality of nursing documentation: An action research project

    Scientific Electronic Library Online (English)

    Elisha M., Okaisu; Florence, Kalikwani; Grace, Wanyana; Minette, Coetzee.

    Full Text Available BACKGROUND: Documentation is an important function of professional nursing practise. In spite of numerous improvement efforts globally, inadequate documentation continues to be reported as nurse authors investigate barriers and challenges. OBJECTIVES: The project aimed to improve nurses' documentati [...] on of their patient assessments at the CURE Children's Hospital of Uganda in order to enhance the quality of nursing practise. METHOD: An action research methodology, using repeated cycles of planning, intervention, reflection and modification, was used to establish best practise approaches in this context for improving nurses' efficacy in documenting assessments in the patient record. The researchers gathered data from chart audits, literature reviews and key informant interviews. Through analysis and critical reflection, these data informed three cycles of systems and practise modifications to improve the quality of documentation. RESULTS: The initial cycle revealed that staff training alone was insufficient to achieve the project goal. To achieve improved documentation, broader changes were necessary, including building a critical mass of competent staff, redesigned orientation and continuing education, documentation form redesign, changes in nurse skill mix, and continuous leadership support. CONCLUSION: Improving nursing documentation involved complex challenges in this setting and demanded multiple approaches. Evidence-based practise was the foundation of changes in systems required to produce visible improvement in practise. The involved role of leadership in these efforts was very important.

  5. Image quality improvement of polygon computer generated holography.

    Science.gov (United States)

    Pang, Xiao-Ning; Chen, Ding-Chen; Ding, Yi-Cong; Chen, Yi-Gui; Jiang, Shao-Ji; Dong, Jian-Wen

    2015-07-27

    Quality of holographic reconstruction image is seriously affected by undesirable messy fringes in polygon-based computer generated holography. Here, several methods have been proposed to improve the image quality, including a modified encoding method based on spatial-domain Fraunhofer diffraction and a specific LED light source. Fast Fourier transform is applied to the basic element of polygon and fringe-invisible reconstruction is achieved after introducing initial random phase. Furthermore, we find that the image with satisfactory fidelity and sharp edge can be reconstructed by either a LED with moderate coherence level or a modulator with small pixel pitch. Satisfactory image quality without obvious speckle noise is observed under the illumination of bandpass-filter-aided LED. The experimental results are consistent well with the correlation analysis on the acceptable viewing angle and the coherence length of the light source. PMID:26367569

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

    International Nuclear Information System (INIS)

    This conference provided a forum for policy makers, environmental managers, urban designers and citizens to discuss current air quality issues. It provided information on urban sprawl and the resulting human health impacts. Many presentations described efforts that are currently underway to improve local air quality through smart growth initiatives, new urban design approaches, successful airshed management and planning legislation. The roles that industry, community groups and governments play in achieving air quality improvements were also highlighted. The mitigation efforts relate to both natural areas and industrial corridors and involve reducing waste, consuming less energy, changing our modes of transportation, and wise land use in urban areas. Sixteen presentations were indexed separately for inclusion in this database. refs., tabs., figs

  7. Biospecimen Reporting for Improved Study Quality (BRISQ)

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-09-02

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

  8. Biospecimen Reporting for Improved Study Quality (BRISQ)

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-04-26

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

  9. Biospecimen Reporting for Improved Study Quality

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-12-27

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

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

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1994-03-01

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

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

    OpenAIRE

    Jin Wang; Jinsheng He; Jiansheng Tang

    2009-01-01

    Quality improvement and quality innovation are the important approach to enhance competitive force for enterprises. Quality improvement is a process of knowledge innovation in nature which must be actualized by organizational learning.This article starts from the relations among quality improvement, quality innovation and the ability of organizational learning, analyzes the knowledge moving rule in the interior process of quality improvement and innovation and expatiates on the creation, deve...

  12. Increased office productivity through improved indoor air quality

    DEFF Research Database (Denmark)

    Fanger, Povl Ole

    2002-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Lorenza Nogueira Campos

    2009-01-01

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

  14. San Francisco Bay Water Quality Improvement Fund 2015

    Data.gov (United States)

    U.S. Environmental Protection Agency — The San Francisco Bay Water Quality Improvement Fund is a competitive grant program that is helping implement TMDLs to improve water quality, protect wetlands, and...

  15. PROCESS VARIABILITY REDUCTION THROUGH STATISTICAL PROCESS CONTROL FOR QUALITY IMPROVEMENT

    OpenAIRE

    B.P. Mahesh; M.S. Prabhuswamy

    2010-01-01

    Quality has become one of the most important customer decision factors in the selection among the competing product and services. Consequently, understanding and improving quality is a key factor leading to business success, growth and an enhanced competitive position. Hence quality improvement program should be an integral part of the overall business strategy. According to TQM, the effective way to improve the Quality of the product or service is to improve the process used to build the pro...

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

    Science.gov (United States)

    Savickiene, Izabela

    2006-01-01

    Higher education quality improvement is a constant and continuous university activity and its implementation should be given a priority. This article analyses the most important tasks set at three Lithuanian universities seeking to improve higher education quality: the improvement of higher education quality assurance system, teacher professional…

  17. Nuclear power stations and air quality improvement

    International Nuclear Information System (INIS)

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

  18. Making quality improvement stick and stay: Two lines of insurance.

    Science.gov (United States)

    Weaver, Lynda; Bossé, Isabelle; Sinclair, Dionne; Blais, Bernard; Pereira, José

    2016-01-01

    This article examines issues related to sustaining Quality Improvement (QI) initiatives in a Canadian subacute care hospital and recommends strategies to address them. The authors define two levels of sustainability, the QI project and the corporate/organizational and how they influence a LEADS (Lead Self, Engage Others, Achieve Results, Develop Coalition and System Transformation) culture. The authors then reflect on the differing factors for QI sustainability and present them under five essential categories of accountability, education, communication, monitoring and reporting, and structure and processes. PMID:26656388

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

    Science.gov (United States)

    Tout, Kathryn; Isner, Tabitha; Zaslow, Martha

    2011-01-01

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

  20. MKK3 deletion improves mitochondrial quality.

    Science.gov (United States)

    Srivastava, Anup; McGinniss, John; Wong, Yao; Shinn, Amanda S; Lam, TuKiet T; Lee, Patty J; Mannam, Praveen

    2015-10-01

    Sepsis, a severe response to infection, leads to excessive inflammation and is the major cause of mortality in intensive care units. Mitochondria have been shown to influence the outcome of septic injury. We have previously shown that MAP kinase kinase 3 (MKK3)(-/-) mice are resistant to septic injury and MKK3(-/-) macrophages have improved mitochondrial function. In this study we examined processes that lead to improved mitochondrial quality in MKK3(-/-) mouse embryonic fibroblasts (MEFs) and specifically the role of mitophagy in mitochondrial health. MKK3(-/-) MEFs had lower inflammatory cytokine release and oxidant production after lipopolysaccharide (LPS) stimulation, confirming our earlier observations. MKK3(-/-) MEFs had better mitochondrial function as measured by mitochondrial membrane potential (MMP) and ATP, even after LPS treatment. We observed higher mitophagy in MKK3(-/-) MEFs compared to wild type (WT). Transmission electron microscopy studies showed longer and larger mitochondria in MKK3(-/-) MEFs, indicative of healthier mitochondria. We performed a SILAC (stable isotope labeling by/with amino acids in cell culture) study to assess differences in mitochondrial proteome between WT and MKK3(-/-) MEFs and observed increased expression of tricarboxylic acid (TCA) cycle enzymes and respiratory complex subunits. Further, inhibition of mitophagy by Mdivi1 led to loss in MMP and increased cytokine secretion after LPS treatment in MKK3(-/-) MEFs. In conclusion, this study demonstrates that MKK3 influences mitochondrial quality by affecting the expression of mitochondrial proteins, including TCA cycle enzymes, and mitophagy, which consequently regulates the inflammatory response. Based on our results, MKK3 could be a potential therapeutic target for inflammatory diseases like sepsis. PMID:26119780

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

    Directory of Open Access Journals (Sweden)

    Simon Lee

    2007-11-01

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

  2. The PBRN Initiative: Transforming New Technologies to Improve Patient Care

    OpenAIRE

    Curro, F.A.; Vena, D.; Naftolin, F; Terracio, L.; Thompson, V.P.

    2012-01-01

    The NIDCR-supported Practice-based Research Network initiative presents dentistry with an unprecedented opportunity by providing a pathway for modifying and advancing the profession. It encourages practitioner participation in the transfer of science into practice for the improvement of patient care. PBRNs vary in infrastructure and design, and sustaining themselves in the long term may involve clinical trial validation by regulatory agencies. This paper discusses the PBRN concept in general ...

  3. Improving scar quality: a prospective clinical study.

    Science.gov (United States)

    Atiyeh, Bishara S; Ioannovich, John; Al-Amm, Christian A; El-Musa, Kusai A; Dham, Ruwayda

    2002-01-01

    Following traumatic or surgical injury to the skin, wounds do not heal by tissue regeneration but rather by scar formation. Though healing is definitely a welcomed event, the resultant scar, very often, is not aesthetically pleasing, and not infrequently, may be pathologic causing serious deformities and contractures. Management of problematic scars continues to be a frustrating endeavor with less than optimal results. Prophylactic methods of wound management to minimize serious scarring are being developed. In a previously published study, we have demonstrated improved healing of split thickness skin graft donor sites following treatment with Moist Exposed Burn Ointment (MEBO, Julphar Gulf Pharmaceutical Industries, Ras Al-Khaimah, UAE). At present, we are reporting the results of a comparative clinical prospective study evaluating scar quality following primary healing of elective surgical and traumatic facial wounds with prophylactic MEBO application, topical antibiotic ointment application, and no topical therapy at all. Scars were evaluated according to the Visual Analogue Scale for scar assessment. Statistical analysis of scar assessment scores demonstrated marked prevention of unfavorable scars with improved cosmetic results following MEBO prophylactic therapy. PMID:12621572

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

    Science.gov (United States)

    Murgatroyd, Stephen

    1991-01-01

    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)

  5. PROCESS VARIABILITY REDUCTION THROUGH STATISTICAL PROCESS CONTROL FOR QUALITY IMPROVEMENT

    Directory of Open Access Journals (Sweden)

    B.P. Mahesh

    2010-09-01

    Full Text Available Quality has become one of the most important customer decision factors in the selection among the competing product and services. Consequently, understanding and improving quality is a key factor leading to business success, growth and an enhanced competitive position. Hence quality improvement program should be an integral part of the overall business strategy. According to TQM, the effective way to improve the Quality of the product or service is to improve the process used to build the product. Hence, TQM focuses on process, rather than results as the results are driven by the processes. Many techniques are available for quality improvement. Statistical Process Control (SPC is one such TQM technique which is widely accepted for analyzing quality problems and improving the performance of the production process. This article illustrates the step by step procedure adopted at a soap manufacturing company to improve the Quality by reducing process variability using Statistical Process Control.

  6. Clinical performance feedback and quality improvement opportunities for perioperative physicians.

    Science.gov (United States)

    Kaye, Alan David; Okanlawon, Olutoyin J; Urman, Richard D

    2014-01-01

    Clinical performance feedback is an important component of the ongoing development and education of health care practitioners. For physicians, feedback about their clinical practice and outcomes is central to developing both confidence and competence at all stages of their medical careers. Cultural and financial infrastructures need to be in place, and the concept of feedback needs to be readily embraced and encouraged by clinical leadership and other stakeholders. The "buy-in" includes the expectation and view that feedback occurs on a routine basis, and those engaged in the process are both encouraged to participate and held accountable. Feedback must be part of an overarching quality improvement and physician education agenda; it is not meant to be an isolated, fragmented initiative that is typically undermined by lack of resources or systemic barriers to gaining improvement within programs. Effective feedback should be an integral part of clinical practice. Anesthesiologists and other perioperative physicians are identifying specialty-specific indicators that can be used when creating a broader quality improvement agenda. Placing a more immediate formal feedback strategy that focuses on goal-oriented behavior is rapidly becoming a mainstay. Physicians may use their individual feedback reports for reflection and designing personal development plans as lifelong learners and leaders in improving patient care. PMID:24833948

  7. Design, implementation, and initial results from a water-quality monitoring network for Atlanta, Georgia, USA

    Science.gov (United States)

    Horowitz, A.J.; Elrick, K.A.; Smith, J.J.

    2005-01-01

    In cooperation with the City of Atlanta, Georgia, the US Geological Survey has designed and implemented a water-quantity and quality monitoring network that measures a variety of biological and chemical constituents in water and suspended sediment. The network consists of 20 long-term monitoring sites and is intended to assess water-quality trends in response to planned infrastructural improvements. Initial results from the network indicate that nonpoint-source contributions may be more significant than point-source contributions for selected sediment associated trace elements and nutrients. There also are indications of short-term discontinuous point-source contributions of these same constituents during baseflow.

  8. Continuous quality improvement of colorectal cancer screening

    Directory of Open Access Journals (Sweden)

    Mariusz Madalinski

    2013-01-01

    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.

  9. Relation Organization of SOM Initial Map by Improved Node Exchange

    Directory of Open Access Journals (Sweden)

    Tsutomu Miyoshi

    2008-09-01

    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.

  10. 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

  11. Team Learning for Healthcare Quality Improvement.

    Science.gov (United States)

    Manukyan, Narine; Eppstein, Margaret J; Horbar, Jeffrey D

    2013-08-28

    In organized healthcare quality improvement collaboratives (QICs), teams of practitioners from different hospitals exchange information on clinical practices with the aim of improving health outcomes at their own institutions. However, what works in one hospital may not work in others with different local contexts because of nonlinear interactions among various demographics, treatments, and practices. In previous studies of collaborations where the goal is a collective problem solving, teams of diverse individuals have been shown to outperform teams of similar individuals. However, when the purpose of collaboration is knowledge diffusion in complex environments, it is not clear whether team diversity will help or hinder effective learning. In this paper, we first use an agent-based model of QICs to show that teams comprising similar individuals outperform those with more diverse individuals under nearly all conditions, and that this advantage increases with the complexity of the landscape and level of noise in assessing performance. Examination of data from a network of real hospitals provides encouraging evidence of a high degree of similarity in clinical practices, especially within teams of hospitals engaging in QIC teams. However, our model also suggests that groups of similar hospitals could benefit from larger teams and more open sharing of details on clinical outcomes than is currently the norm. To facilitate this, we propose a secure virtual collaboration system that would allow hospitals to efficiently identify potentially better practices in use at other institutions similar to theirs without any institutions having to sacrifice the privacy of their own data. Our results may also have implications for other types of data-driven diffusive learning such as in personalized medicine and evolutionary search in noisy, complex combinatorial optimization problems. PMID:25360395

  12. IMPROVEMENT OF POWER QUALITY OF A DISTRIBUTED GENERATION POWER SYSTEM

    OpenAIRE

    Aruna Garipelly

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Abdullah Al Mamun

    2013-02-01

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

  14. Improving Water Quality With Conservation Buffers

    Science.gov (United States)

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

    2003-12-01

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

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

    International Nuclear Information System (INIS)

    In the case of the Saint-Laurent-des-Eaux French nuclear power station, the author comments the elements and principles of human factor policy which have been implemented, the organizational implications of this implementation (building up of an internal human factors network), and briefly evokes studies and initiatives aimed at improving the quality of operation from a general point of view and through projects aiming at analyzing and at a valorisation of human reliability in activities dealing with reactor operation. He also comments the perception and appropriation of quality in the different departments

  16. Danish initiatives to improve the safety of meat products

    DEFF Research Database (Denmark)

    Wegener, Henrik Caspar

    2010-01-01

    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......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...

  17. Laboratory system strengthening and quality improvement in Ethiopia

    Directory of Open Access Journals (Sweden)

    Tilahun M. Hiwotu

    2014-09-01

    Full Text Available Background: In 2010, a National Laboratory Strategic Plan was set forth in Ethiopia to strengthen laboratory quality systems and set the stage for laboratory accreditation. As a result, the Strengthening Laboratory Management Toward Accreditation (SLMTA programme was initiated in 45 Ethiopian laboratories.Objectives: This article discusses the implementation of the programme, the findings from the evaluation process and key challenges.Methods: The 45 laboratories were divided into two consecutive cohorts and staff from each laboratory participated in SLMTA training and improvement projects. The average amount of supportive supervision conducted in the laboratories was 68 hours for cohort I and two hoursfor cohort II. Baseline and exit audits were conducted in 44 of the laboratories and percent compliance was determined using a checklist with scores divided into zero- to five-star ratinglevels.Results: Improvements, ranging from < 1 to 51 percentage points, were noted in 42 laboratories, whilst decreases were recorded in two. The average scores at the baseline and exit audits were 40% and 58% for cohort I (p < 0.01; and 42% and 53% for cohort II (p < 0.01,respectively. The p-value for difference between cohorts was 0.07. At the exit audit, 61% ofthe first and 48% of the second cohort laboratories achieved an increase in star rating. Poor awareness, lack of harmonisation with other facility activities and the absence of a quality manual were challenges identified.Conclusion: Improvements resulting from SLMTA implementation are encouraging. Continuous advocacy at all levels of the health system is needed to ensure involvement of stakeholders and integration with other improvement initiatives and routine activities.

  18. 40 CFR Appendix B to Part 132 - Great Lakes Water Quality Initiative

    Science.gov (United States)

    2010-07-01

    ...Great Lakes Water Quality Initiative...Environment ENVIRONMENTAL PROTECTION...CONTINUED) WATER PROGRAMS WATER QUALITY GUIDANCE...Lakes Water Quality Guidance...ambient water and food...from all environmental...

  19. Nursing Leader Collaboration to Drive Quality Improvement and Implementation Science.

    Science.gov (United States)

    Ryan, Rosemary W; Harris, Karen K; Mattox, Lisa; Singh, Olivine; Camp, Melanie; Shirey, Maria R

    2015-01-01

    Nursing leadership opportunities to improve quality and align resources in health care exist. An estimated 18% of United States gross domestic product is spent on health care delivery systems that produce poor outcomes. The purpose of this article was to describe how quality improvement and implementation science initiatives enhance outcomes using nursing leadership strategies that play an integral role in aligning key colleagues to drive the collaborative process. A critical appraisal of the literature was conducted, which supports the importance of evidenced-based practice improvement, collaborative change process, and professional role of nursing leadership. Limited evidence exists related to practice strategies for nursing leaders to implement sustainable change at the unit level for successful alignment of resources. Strategies based on Rogers' Diffusion of Innovation Theory are recommended to address the gap in the literature. The strategies aim to increase meaningful knowledge or the "why," create a tipping point, and implement sustainable change starting with the end in mind. Nurse leaders are a central component for driving alignment and implementing change at the unit level. Uses of the described evidenced-based strategies have implications for nursing practice, education, and scholarship. PMID:26049600

  20. Effect of a quality improvement programme on leadership, innovation and use of quality improvement methods in general practice

    OpenAIRE

    Togher, Fiona; Siriwardena, A. Niroshan; Flynn, John; Dewey, Michael

    2011-01-01

    Introduction Market mechanisms and pay-for-performance have failed to deliver continuing improvements in UK clinical care. Leadership and innovation are currently seen as essential to maintain and improve clinical quality but little is known about the relationship between these and the extent to which quality improvement (QI) methods are used in general practice. This study aimed to investigate the effect of quality improvement training on leadership behaviour, culture of innovation and a...

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

    OpenAIRE

    Abhishek Soni

    2013-01-01

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

  2. DEVELOPING WEED SUPPRESSIVE SOILS THROUGH IMPROVED SOIL QUALITY MANAGEMENT

    Science.gov (United States)

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

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

    Science.gov (United States)

    Asiyai, Romina Ifeoma

    2015-01-01

    This paper discusses the roles of stakeholders in improving quality of university education in Nigeria. Internal and external stakeholders are identified and the various roles they could play in improving the quality of university education are discussed. The paper contends that continuous and holistic improvement in university education system…

  4. Good air quality in offices improves productivity

    DEFF Research Database (Denmark)

    Fanger, Povl Ole

    2000-01-01

    Three recent independent studies have documented that the quality of indoor air has a significant and positive influence or? the productivity of office workers. A combined analysis of the results of the three studies shows a significant relationship between productivity and perceived indoor air...... quality. The impact on productivity justifies a much higher indoor air quality than the minimum levels prescribed in present standards and guidelines. One way of providing air of high quality for people to breathe, without involving excessive ventilation rates and energy use, is to provide "personalized...

  5. Good air quality in offices improves productivity

    DEFF Research Database (Denmark)

    Fanger, Povl Ole

    2000-01-01

    Three recent independent studies have documented that the quality of indoor air has a significant and positive influence on the productivity of office workers. A combined analysis of the results of the three studies shows a significant relationship between productivity and perceived indoor air...... quality. The impact on productivity justifies a much higher indoor air quality than the minimum levels prescribed in present standards and guidelines. One way of providing air of high quality for people to breathe, without involving excessive ventilation rates and energy use, is to provide "personalized...

  6. Aspects of improving the organization directed to the quality

    OpenAIRE

    M. Dudek-Burlikowska

    2010-01-01

    Purpose: A new approach for organization connected with system approach, process approach, quality improvement has been presented.Design/methodology/approach: The possibility of estimation of organization quality is connected with system approach and improvement in organization. Interdependence of quality rules and quality methods in management processes has been taken into account.Findings: At the present time the enterprises should manage and control all its activities in systematic way. Su...

  7. Clinical performance feedback and quality improvement opportunities for perioperative physicians

    Directory of Open Access Journals (Sweden)

    Kaye AD

    2014-05-01

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

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

    Directory of Open Access Journals (Sweden)

    Scoggins Amanda

    2008-10-01

    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.

  9. Quality Tools for Professional Higher Education Review and Improvement

    OpenAIRE

    Dahl Jørgensen, Malene; Sparre Kristensen, Regitze; Wipf, Alexandre; Delplace, Stefan; PHExcel Consortium

    2014-01-01

    The report is the project’s first outcome, and provides an overview of quality tools, quality models and quality labels, currently in use in (professional) higher education. It is followed by a gap analysis as regards the Standards and Guidelines for quality assurance in the European Higher Education Area (ESG), and the identified characteristics of PHE. The report is structured as follows: Chapter I presents the background of the PHExcel initiative and introduces the preliminary HAPHE defini...

  10. Assessing the impact of continuous quality improvement/total quality management: concept versus implementation.

    OpenAIRE

    Shortell, S M; O’Brien, J. L.; Carman, J M; Foster, R W; Hughes, E F; Boerstler, H; O'Connor, E J

    1995-01-01

    OBJECTIVE: This study examines the relationships among organizational culture, quality improvement processes and selected outcomes for a sample of up to 61 U. S. hospitals. DATA SOURCES AND STUDY SETTING: Primary data were collected from 61 U. S. hospitals (located primarily in the midwest and the west) on measures related to continuous quality improvement/total quality management (CQI/TQM), organizational culture, implementation approaches, and degree of quality improvement implementation ba...

  11. Improving the quality of head and neck cancer care.

    Science.gov (United States)

    Weber, Randal S

    2007-12-01

    The 2001 report by the Institute of Medicine (IOM) titled Crossing the Quality Chasm: A New Health System for the 21st Century highlighted the gap that exists between what we know to be effective, beneficial care and the care that is often delivered to an individual patient.(1) In the report, the IOM stated, "Between the health care we have and the care we could have lies not just a gap, but a chasm."(1)((p1)) The report, signifying a national initiative to improve the quality of care in the United States, articulated the following 6 aims for a new health care system: (1) to increase the safety of health care by avoiding injuries to patients through care intended to help them; (2) to provide effective services based on scientific knowledge and to avoid services of no proven benefit; (3) to deliver individualized treatment respectful of and responsive to the patient's preferences, needs, and values; (4) to deliver timely care by reducing wait times and harmful delays; (5) to increase efficiency by not wasting equipment, supplies, ideas, and energy; and (6) to deliver care that is equitable and does not vary by personal characteristics, patient sex, ethnicity, geography, and social economic status. The IOM also recognized a need to optimize quality cancer care in the United States. PMID:18086958

  12. Danish initiatives to improve the safety of meat products

    DEFF Research Database (Denmark)

    Wegener, Henrik Caspar

    2010-01-01

    During the last two decades the major food safety problems in Denmark, as determined by the number of human patients, has been associated with bacterial infections stemming from meat products and eggs. The bacterial pathogens causing the majority of human infections has been Salmonella and Campylobacter, and to a lesser extent Yersinia, Escherichia coli O157 and Listeria. Danish initiatives to improve the safety of meat products have focused on the entire production chain from the farm to the consumer, with a special emphasis on the pre-harvest stage of production. The control of bacterial pathogens which are resistant to antibiotics has been a new area of attention in the recent decade, and recently, the increasing globalization of the domestic food supply has called for a complete rethinking of the national food safety strategies. The implementations of a ‘‘case-by-case” risk assessment system, as well as increased international collaboration on surveillance, are both elements in this new strategy.

  13. Unitary-Feedback-Improved Qubit Initialization in the Dispersive Regime

    Science.gov (United States)

    Govia, Luke C. G.; Wilhelm, Frank K.

    2015-11-01

    The read-out of the state of a superconducting qubit by homodyne detection of the output signal from a dispersively coupled microwave resonator is a common technique in circuit quantum electrodynamics and is often claimed to be quantum nondemolition (QND) up to the same order of approximation as that of the dispersive approximation. However, in this work we show that only in the limit of infinite measurement time is this protocol QND, as the formation of a dressed coherent state in the qubit-cavity system applies an effective rotation to the qubit state. We show how this rotation can be corrected by a unitary operation, leading to improved qubit initialization by measurement and unitary feedback.

  14. Zero tolerance for failure. An AREVA initiative to improve reliability

    International Nuclear Information System (INIS)

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

  15. Assessment literacy to improve assessment quality

    OpenAIRE

    Joosten-ten Brinke, Desirée

    2013-01-01

    Assessment is an important determinant for the quality of the learning processes and it is more than constructing a test and present it to the students. In this part of the course, we will discuss the quality of assessment on different levels during the assessment cycle from design and development to analyses and evaluation. How to design a valid and reliable assessment with objective, efficient and relevant items that suits the requirements of a balanced assessment programme and the assessme...

  16. Initial application of digital tomosynthesis to improve brachytherapy treatment planning

    Science.gov (United States)

    Baydush, Alan H.; Mirzaei McKee, Mahta; King, June; Godfrey, Devon J.

    2007-03-01

    We present preliminary investigations that examine the feasibility of incorporating volumetric images generated using digital tomosynthesis into brachytherapy treatment planning. The Integrated Brachytherapy Unit (IBU) at our facility consists of an L-arm, C-arm isocentric motion system with an x-ray tube and fluoroscopic imager attached. Clinically, this unit is used to generate oblique, anterior-posterior, and lateral images for simple treatment planning and dose prescriptions. Oncologists would strongly prefer to have volumetric data to better determine three dimensional dose distributions (dose-volume histograms) to the target area and organs at risk. Moving the patient back and forth to CT causes undo stress on the patient, allows extensive motion of organs and treatment applicators, and adds additional time to patient treatment. We propose to use the IBU imaging system with digital tomosynthesis to generate volumetric patient data, which can be used for improving treatment planning and overall reducing treatment time. Initial image data sets will be acquired over a limited arc of a human-like phantom composed of real bones and tissue equivalent material. A brachytherapy applicator will be incorporated into one of the phantoms for visualization purposes. Digital tomosynthesis will be used to generate a volumetric image of this phantom setup. This volumetric image set will be visually inspected to determine the feasibility of future incorporation of these types of images into brachytherapy treatment planning. We conclude that initial images using the tomosynthesis reconstruction technique show much promise and bode well for future work.

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

    DEFF Research Database (Denmark)

    Tøttenborg, Sandra Søgaard; Thomsen, Reimar Wernich; Statistician, Henrik Nielsen; Johnsen, Søren Paaske; Hansen, Ejvind Frausing; Lange, Peter

    2013-01-01

    OBJECTIVE: To examine whether the quality of care among Danish patients with chronic obstructive pulmonary disease (COPD) has improved since the initiation of a national multidisciplinary quality improvement program. METHODS: We conducted a nationwide, population-based prospective cohort study using data from the Danish Clinical Register of COPD (DrCOPD). Since 2008 the register has systematically monitored and audited the use of recommended processes of COPD care. RESULTS: Substantial improveme...

  18. Improvement in the textural qualities of irradiated legumes

    International Nuclear Information System (INIS)

    The potential for use of gamma radiation processing to improve texture, hydration and cooking quality of pulses, particularly red gram, has been examined. The textural changes in irradiated pulses in terms of softening is measured by a texturometer, Radiation (1 Mrad) processing of pulses resulted in reduction of cooking time varying from 8 to 39%, red gram showing the maximum reduction. Initial higher hydration rate on soaking and cooking, stabilized on prolonged cooking and resulted in better and uniform texture of irradiated red gram. In the uncooked, irradiated (1 Mrad) sample, destruction of riboflavin was negligible, whereas thiamine and niacin showed about 7% loss. However, the vitamins were retained better in the samples irradiated and then cooked, compared to the corresponding control ones. (F.J.)

  19. Initiatives for the improvement of continuous management training

    Directory of Open Access Journals (Sweden)

    Jon Landeta

    2015-03-01

    Full Text Available Purpose. This work aims to present, from the company viewpoint, a structured account of management proposals and practices directed toward improving the intensity and effectiveness of continuous management training (CMT. Design/methodology/approach. The article takes as its main theoretical referents the Theory of Human Capital, the Resource-Based Vision and the contributions made via the new institutional economy with regard to the problems of information asymmetry between companies, employees and training providers and completes the proposals that derive from this theoretical approach. To do this, experience-based contributions are collected from a selection of company training and HR managers from twelve Basque companies characterised by their strong investment in management training. The methodology used was qualitative and obtained by different qualitative techniques: Focus Groups, Nominal Groups and the Delphi Method, which make up the so-called Hybrid Delphi. Findings and implications. The proposals are aimed at the main agents in training activity: training providers, associations and public agents engaged in management training and, particularly, companies themselves. The initiatives seek above all to increase training market transparency, to improve mutual commitments between companies and managers, and to link training and development with culture and strategic management, so that firms make optimal investment in management training. Originality/value. The methodology used is original, and the contributions are consistent with the theory, have a proven practical utility, and are presented in a hierarchy, which facilitates decision making.

  20. The Osteoarthritis Initiative (OAI) magnetic resonance imaging quality assurance update

    Science.gov (United States)

    Schneider, E.; NessAiver, M.

    2012-01-01

    Objective Longitudinal quantitative evaluation of cartilage disease requires reproducible measurements over time. We report 8 years of quality assurance (QA) metrics for quantitative magnetic resonance (MR) knee analyses from the Osteoarthritis Initiative (OAI) and show the impact of MR system, phantom, and acquisition protocol changes. Method Key 3 T MR QA metrics, including signal-to-noise, signal uniformity, T2 relaxation times, and geometric distortion, were quantified monthly on two different phantoms using an automated program. Results Over 8 years, phantom measurements showed root-mean-square coefficient-of-variation reproducibility of <0.25% (190.0 mm diameter) and <0.20% (148.0 mm length), resulting in spherical volume reproducibility of <0.35%. T2 relaxation time reproducibility varied from 1.5% to 5.3%; seasonal fluctuations were observed at two sites. All other QA goals were met except: slice thicknesses were consistently larger than nominal on turbo spin echo images; knee coil signal uniformity and signal level varied significantly over time. Conclusions The longitudinal variations for a spherical volume should have minimal impact on the accuracy and reproducibility of cartilage volume and thickness measurements as they are an order of magnitude smaller than reported for either unpaired or paired (repositioning and reanalysis) precision errors. This stability should enable direct comparison of baseline and follow-up images. Cross-comparison of the geometric results from all four OAI sites reveal that the MR systems do not statistically differ and enable results to be pooled. MR QA results identified similar technical issues as previously published. Geometric accuracy stability should have the greatest impact on quantitative analysis of longitudinal change in cartilage volume and thickness precision. PMID:23092792

  1. International Accreditations as Drivers of Business School Quality Improvement

    Science.gov (United States)

    Bryant, Michael

    2013-01-01

    Business schools are under pressure to implement continuous improvement and quality assurance processes to remain competitive in a globalized higher education market. Drivers for quality improvement include external, environmental pressures, regulatory bodies such as governments, and, increasingly, voluntary accreditation agencies such as AACSB…

  2. The Role of Staff in Quality Improvement in Early Childhood

    Science.gov (United States)

    Sims, Margaret; Waniganayake, Manjula

    2015-01-01

    There is international recognition of the importance of high quality services for young children with a consensus that three pillars contribute to quality improvement: adult: child ratios, staff qualifications and group size. In Australia over the past 5 years, early childhood policy has attempted to drive improvements in early childhood service…

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

    DEFF Research Database (Denmark)

    Boulet, Louis-Philippe; FitzGerald, J Mark

    2012-01-01

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

  4. Reviewing the quality of care: Priorities for improvement

    OpenAIRE

    Roberts, James S.

    1987-01-01

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

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

    OpenAIRE

    Sanning He

    2009-01-01

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

  6. Improving wind power quality with energy storage

    DEFF Research Database (Denmark)

    Rasmussen, Claus Nygaard

    2009-01-01

    The results of simulation of the influence of energy storage on wind power quality are presented. Simulations are done using a mathematical model of energy storage. Results show the relation between storage power and energy, and the obtained increase in minimum available power from the combinatio...

  7. Impact of initial surface parameters on the final quality of laser micro-polished surfaces

    Science.gov (United States)

    Chow, Michael; Bordatchev, Evgueni V.; Knopf, George K.

    2012-03-01

    Laser micro-polishing (L?P) is a new laser-based microfabrication technology for improving surface quality during a finishing operation and for producing parts and surfaces with near-optical surface quality. The L?P process uses low power laser energy to melt a thin layer of material on the previously machined surface. The polishing effect is achieved as the molten material in the laser-material interaction zone flows from the elevated regions to the local minimum due to surface tension. This flow of molten material then forms a thin ultra-smooth layer on the top surface. The L?P is a complex thermo-dynamic process where the melting, flow and redistribution of molten material is significantly influenced by a variety of process parameters related to the laser, the travel motions and the material. The goal of this study is to analyze the impact of initial surface parameters on the final surface quality. Ball-end micromilling was used for preparing initial surface of samples from H13 tool steel that were polished using a Q-switched Nd:YAG laser. The height and width of micromilled scallops (waviness) were identified as dominant parameter affecting the quality of the L?Ped surface. By adjusting process parameters, the Ra value of a surface, having a waviness period of 33 ?m and a peak-to-valley value of 5.9 ?m, was reduced from 499 nm to 301 nm, improving the final surface quality by 39.7%.

  8. Improving the quality of clinical coding: a comprehensive audit model

    OpenAIRE

    Hamid Moghaddasi; Reza Rabiei; Nasrin Sadeghi

    2014-01-01

    Introduction: The review of medical records with the aim of assessing the quality of codes has long been conducted in different countries. Auditing medical coding, as an instructive approach, could help to review the quality of codes objectively using defined attributes, and this in turn would lead to improvement of the quality of codes. Method: The current study aimed to present a model for auditing the quality of clinical codes. The audit model was formed after reviewing other a...

  9. Combining traditional breeding and genomics to improve pork quality

    OpenAIRE

    Heuven, H.C.M.; wijk, H.J. van der; Van Arendonk, J A M

    2003-01-01

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

  10. Physical Activity Improves Quality of Life

    Science.gov (United States)

    ... to Control Stress Four Ways to Deal With Stress Quit Smoking Quitting Smoking Why Quit Smoking? Smoking: Do you ... under control Helps in the battle to quit smoking Improves blood cholesterol levels ... Releases tension Promotes enthusiasm and optimism Counters anxiety ...

  11. Patient safety and quality improvement: an overview of QI.

    Science.gov (United States)

    Schriefer, Jan; Leonard, Michael S

    2012-08-01

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

  12. 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.

  13. Improving quality in paediatric respiratory disease management.

    Science.gov (United States)

    Harrop, Michele; Amegavie, Laweh

    2003-11-01

    Throughout the development, implementation and dissemination of the Paediatric Respiratory Newsletter, effective channels of communication between healthcare professionals have been established, highlighting the importance of collaboration. Promoting education, training, audit and research, the newsletter has nurtured both professional and practice development. The work begun during this project, and the outcomes it has achieved, have been developed into an ethos that recognises effective clinical practice and organisational development as central to the delivery of a quality service. This work informs and is informed by strategic developments, in particular, research and development, clinical audit, quality, practice development and clinical risk, all of which are observed to be the key elements of clinical governance. On a personal level, the project has provided me with an opportunity to consolidate information, forge links with the multidisciplinary team and establish a framework for the development of paediatric respiratory services. We hope it will continue to respond to, and be influenced by, changing health and social care demands. PMID:14669699

  14. 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

  15. Improving wind power quality with energy storage

    DEFF Research Database (Denmark)

    Rasmussen, Claus Nygaard

    2009-01-01

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

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

    OpenAIRE

    Yaser hasan Al-Mamary; Alina Shamsuddin; Nor Aziati

    2014-01-01

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

  17. Improving quality of tuberculosis care in India.

    Science.gov (United States)

    Pai, Madhukar; Satyanarayana, Srinath; Hopewell, Phil

    2014-01-01

    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

  18. Systematic Quality Improvement in Medicine: Everyone Can Do It

    Directory of Open Access Journals (Sweden)

    Mark L. Zeidel

    2011-07-01

    Full Text Available In this brief review, written from the perspective of a physician-leader who has fostered the development of comprehensive quality improvement efforts at two academic medical centers, I review the need for improvement, some conceptual barriers that must be overcome, the goals of a comprehensive quality improvement (QI effort, some of the results we have obtained, and some observations on how to develop a culture of continuous improvement in an academic medical center. The mandate for quality improvement is clear; current healthcare is wasteful and error-prone, leading to excessive morbidity and mortality and unsustainably high costs. Successful quality improvement requires the abandonment of two paradigms: the craft model of medical practice and the notion that many forms of harm to patients are not preventable. I will describe how dramatic improvement has been achieved in reducing, by up to 10-fold, rates of central line infections, ventilator-associated pneumonias, peritonitis in peritoneal dialysis patients, and mortality due to cardiac arrest in hospital. I will describe as well how these methods can improve access to out-patient clinics dramatically and enhance the reliability and safety of hand-offs between covering physicians. To develop and maintain systematic quality improvement in all phases of medical care we must articulate a culture in which: everyone working at the medical center makes improvements every day; front-line staff, who know best how the work is done, are empowered to improve the processes of care; and multidisciplinary teams create the protocols that reduce variation that is due to physician preference, leaving only the variation required by the individual needs of patients. I will review as well the crucial elements of education of trainees and faculty members needed to guide and sustain a culture of quality. Finally, I will add some observations on how oversight boards and medical center leaders can help create systematic quality improvement in their medical centers.

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

    Science.gov (United States)

    Zheng, Jia-wei

    2005-04-01

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

  20. Quality leadership: involving staff in continuous quality improvement.

    Science.gov (United States)

    Flarey, D L

    1996-12-01

    Helen and I hope that you have gained a deeper insight into what it means to be a dynamic leader. We are convinced that leadership skills can be learned. Once learned, they must be operationalized in practice. Practice makes perfect, and the more you use leadership skills the more you master the art of leadership and become more of a craftsman reaping the benefits of intense learning and work. Leadership is a journey. It is a long and often painful one. But, it is the only safe road to travel in this turbulent time. You can become a dynamic leader. The articles in this issue are just an initial step to help you realize your leadership potential and direct you on the right road to fast becoming an effective leader. Helen and I, and her staff thank you for allowing us to share the dynamics of leadership. Hopefully, one day soon I can write a commentary on your success story. Please contact me with your stories so that we can learn through your particular experiences. I invite those interested in contributing to this column to contact me directly. Thank you, and may the road you travel always be the long hard road to success. PMID:9052273

  1. Improvement of power quality using distributed generation

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-12-15

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

  2. 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.

  3. Quality Improvement of an Acid Treated Fuel Oil

    Directory of Open Access Journals (Sweden)

    Elizabeth Jumoke ETERIGHO

    2008-06-01

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

  4. Achieving faster quality improvement through the 24-hour team.

    Science.gov (United States)

    Carboneau, C E

    1999-01-01

    This article describes how Great Plains Regional Medical Center (GPRMC) in North Platte, NE, changed its quality improvement (QI) methodology and its mind-set toward team time management to accelerate its improvement efforts. The "24-hour road map" and the improved FOCUS-PDSA methodology, coupled with strong leadership, make up the team time management element that has been missing from healthcare quality improvement but is critically needed to accelerate the process. At GPRMC, a major criterion for success is now a 6-month-or-less improvement cycle for cross-functional teams to complete their QI efforts. The lessons learned at GPRMC can help others in healthcare improve quality, lower costs, and do both more quickly. PMID:10558058

  5. Improve strategic supplier performance using DMAIC to develop a Quality Improvement Plan

    Science.gov (United States)

    Jardim, Kevin P.

    Supplier performance that meets the requirements of the customer has long plagued quality professionals. Despite the vast efforts by organizations to improve supplier performance, little has been done to standardize the plan to improve performance. This project presents a guideline and problem-solving strategy using a Define, Measure, Analyze, Improve, and Control (DMAIC) structured tool that will assist in the management and improvement of supplier performance. An analysis of benchmarked Quality Improvement Plans indicated that this topic needs more focus on how to accomplish improved supplier performance. This project is part of a growing body of supplier continuous improvement efforts. With the input of Zodiac Aerospace quality professionals this project's results provide a solution to Quality Improvement Plans and show objective evidence of its benefits. This project contributes to the future research on similar topics.

  6. 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

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

    Science.gov (United States)

    Van Scyoc, Karl

    2008-11-15

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

  8. Process safety improvement-Quality and target zero

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-11-15

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

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

    Science.gov (United States)

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

    2015-05-01

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

  10. Improving Quality of Life and Depression After Stroke Through Telerehabilitation

    OpenAIRE

    Linder, Susan M.; Rosenfeldt, Anson B; Bay, R. Curtis; Sahu, Komal; Wolf, Steven L; Alberts, Jay L.

    2015-01-01

    Robot-assisted interventions and home exercise programs administered using a telerehabilitation model may be valuable components of programs to improve quality of life and depression in people after stroke.

  11. 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 ...

  12. Software Quality Improvement in the OMC Team

    CERN Document Server

    Maier, Viktor

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

  13. Effective Interventions on Service Quality Improvement in a Physiotherapy Clinic

    OpenAIRE

    Farid Gharibi; Jafar Sadegh Tabrizi; Mir Ali Eteraf Oskouei; Mohammad AsghariJafarabadi

    2014-01-01

    Background: Service quality is considered as a main domain of quality associated with non-clinical aspect of healthcare. This study aimed to survey and improves service quality of delivered care in the Physiotherapy Clinic affiliated with the Tabriz University of Medical Sciences, Tabriz, Iran. Methods: A quasi experimental interventional study was conducted in the Physiotherapy Clinic, 2010-2011. Data were collected using a validated and reliable researcher made questionnaire with partici...

  14. Leadership – The Key Element in Improving Quality Management

    Directory of Open Access Journals (Sweden)

    Iveta Paulová

    2011-10-01

    Full Text Available The present contribution is processed partial results of the survey application of leadership as one of the fundamental principles of quality management in organizations in the Slovak Republic. This survey was conducted in the research project VEGA No. 1/0229/08 Perspectives of quality management development in coherence with requirements of Slovak republic market. Results from the survey were the basis for proposals to improve the quality management in Slovak industrial organizations

  15. Leadership – The Key Element in Improving Quality Management

    OpenAIRE

    Iveta Paulová; Miroslava M?kva

    2011-01-01

    The present contribution is processed partial results of the survey application of leadership as one of the fundamental principles of quality management in organizations in the Slovak Republic. This survey was conducted in the research project VEGA No. 1/0229/08 Perspectives of quality management development in coherence with requirements of Slovak republic market. Results from the survey were the basis for proposals to improve the quality management in Slovak industrial organizations

  16. Improvement and Implementation of Software Quality by Using Software Metrics

    OpenAIRE

    Dileram Bansal, Ajit Saxena, Gajendra Singh

    2014-01-01

    Without the software development and software product knowledge it’s very complicated to understand, keep away from improvement in the quality of software. There should be some dimension process to forecast the software development, and to appraise software products and its quality. In This paper provides a brief view on Software Metrics, Software Quality and Software Metrics techniques that will forecast and evaluate the specified superiority factors of softwa...

  17. Quality Management Plus: The Continuous Improvement of Education.

    Science.gov (United States)

    Kaufman, Roger; Zahn, Douglas

    This book applies quality management, an organizational theory that has been successful in business and industry, to education. Chapter 1 describes the basic elements of quality management (QM)--continuous improvement, client satisfaction, positive return on investment, and doing it right the first and every time. Ways to implement Deming's 14…

  18. Quality Rating and Improvement Systems and Children's Cognitive Development

    Science.gov (United States)

    Jeon, Lieny; Buettner, Cynthia K.

    2015-01-01

    Background: Providing enriched learning environments is important to stimulating children's development in early childhood. Early child-care policymakers in many states in the US have adopted Quality Rating and Improvement Systems (QRIS) as a way to verify quality of child care and to support children's school readiness. Objective: The purpose of…

  19. Using Deming To Improve Quality in Colleges and Universities.

    Science.gov (United States)

    Cornesky, Robert A.; And Others

    Of all the people known for stressing quality in industry, W. Edwards Deming is the pioneer. He stresses statistical process control (SPC) and a 14-point process for managers to improve quality and productivity. His approach is humanistic and treats people as intelligent human beings who want to do a good job. Twelve administrators in a university…

  20. Ripening for improving the quality of inoculated cheese Rhizopus oryzae

    OpenAIRE

    ARTINI PANGASTUTI; SUTARNO; SOLIKAH ANA ESTIKOMAH

    2010-01-01

    Estikomah SA, Sutarno, Pangastuti A 2010. Ripening for improving the quality of inoculated cheese Rhizopus oryzae. Nusantara Bioscience 2: 1-6. Cheese is dairy product resulted from fermented milk in which the fermentation process can be done by lactic acid bacteria or fungus. Rhizopus oryzae is able to produce lactic acid, protease and lipase. The ripening process changes the taste and texture. The purpose of this study is ripening to improve the quality of inoculated cheese R. oryzae. In th...

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

    OpenAIRE

    Pongchai Nimcharoenwon; Graham Miller

    2012-01-01

    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...

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

    OpenAIRE

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

    2014-01-01

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

  3. Mindfulness meditation to improve care quality and quality of life in long-term care settings.

    Science.gov (United States)

    Zeller, Janice M; Lamb, Karen

    2011-01-01

    Quality of long-term care has been the focus of 2 recent Institute of Medicine reports: "Improving the Quality of Long-Term Care"(1) and "Improving the Quality of Care in Nursing Homes."(2) Although there has been some improvement in care quality since regulatory reforms were enacted in 1987,(3) poor care persists.(4) Certified nursing assistants (CNAs) are challenged in the provision of optimal care by chronic stress in the workplace, leading to absenteeism, reduced job satisfaction, and increased turnover.(5-7) Mindfulness training, which cultivates a practice of being present in the moment, recognizing stressful situations when they arise, and responding to stress in an adaptive manner,(8) holds promise as a simple, inexpensive approach to reduce CNA stress and improve quality of care and quality of life for residents in long-term care settings. Formal and informal mindfulness practices can readily be incorporated into CNA educational programs. PMID:21239085

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

    OpenAIRE

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

    2005-01-01

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

  5. Crossing the quality chasm: lessons from health care quality improvement efforts in England

    OpenAIRE

    Madhok, Rajan

    2002-01-01

    The second report from the US Institute of Medicine Crossing the Quality Chasm, highlighted the deficiencies in health care quality in the USA, analyzed the contributory factors, and proposed 13 recommendations for improvements. Clearly, the challenges are enormous. Can anything be learned from the experiences of other countries? This article describes the author's experiences of health care quality improvement efforts in the National Health Service in England and their implications for the U...

  6. Accounting for quality: on the relationship between accounting and quality improvement in healthcare

    OpenAIRE

    Pflueger, Dane

    2015-01-01

    Background Accounting-that is, standardized measurement, public reporting, performance evaluation and managerial control-is commonly seen to provide the core infrastructure for quality improvement in healthcare. Yet, accounting successfully for quality has been a problematic endeavor, often producing dysfunctional effects. This has raised questions about the appropriate role for accounting in achieving quality improvement. This paper contributes to this debate by contrasting the specific way ...

  7. Understanding Why Quality Initiatives Succeed or Fail: A Sociotechnical Systems Perspective.

    Science.gov (United States)

    Wiegmann, Douglas A

    2016-01-01

    Efforts to implement quality improvements in surgery are notoriously problematic. One needs to look no farther than recent attempts to implement checklists, team training, and surgical briefings. These interventions have been empirically shown to improve team communication and performance. Yet numerous barriers to implementation have limited their broad adoption and use. Apparently, knowing the remedy (intervention) does not translate into knowing how to administer (implement) it. Or in surgical terms, knowing "what" procedure needs to be performed does not necessarily mean that one knows "how" to perform it.Surgeons serve a vital leadership role in driving quality and patient safety initiatives in the operating room. Achieving success requires both an in-depth understanding of the intervention and the complex dynamics of the elements involved in the implementation process. To aid in this endeavor, the present article describes a Model for Understanding System Transitions Associated with the Implementation of New Goals (MUSTAING). The model highlights important variables associated with implementation success. It also provides a tool for diagnosing why certain interventions may not have worked as intended so that improvements in the implementation process can be made. Finally, the model offers a general framework for guiding future implementation or "how to" research. PMID:26079907

  8. Manufacturing R&D Initiative Lowers Costs and Boosts Quality

    Energy Technology Data Exchange (ETDEWEB)

    None

    2015-06-30

    Fact sheet that provides an overview of DOE's Manufacturing R&D Initiative, which supports projects aimed at developing better-performing, lower-cost solid-state lighting while encouraging engineering and manufacturing in the United States.

  9. Space-Time Analysis of the Air Quality Model Evaluation International Initiative (AQMEII) Phase 1 Air Quality Simulations

    Science.gov (United States)

    This study presents an evaluation of summertime daily maximum ozone concentrations over North America (NA) and Europe (EU) using the database generated during Phase 1 of the Air Quality Model Evaluation International Initiative (AQMEII). The analysis focuses on identifying tempor...

  10. Improved initial guess for minimum energy path calculations

    CERN Document Server

    Smidstrup, Søren; Stokbro, Kurt; Jónsson, Hannes

    2014-01-01

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

  11. Does quality disclosure improve quality? Responses to the introduction of nursing home report cards in Germany

    OpenAIRE

    Herr, Annika; Nguyen, Thu-Van; Schmitz, Hendrik

    2015-01-01

    Since 2009, German nursing homes have been evaluated regularly with quality report cards published online. We argue that most of the information in the report cards does not reliably measure quality of care, but a subset of seven measures does. Using a sample of more than 3,000 nursing homes with information on two waves, we find a significant improvement in the nursing home quality from the first to the second evaluation. Both indicators comprising either the two outcome quality measures or ...

  12. Improvement of a Harvester Based, Multispectral, Seed Cotton Fiber Quality Sensor

    Science.gov (United States)

    A multispectral sensor for in-situ seed cotton fiber quality measurement was developed and tested at Texas A&M University. Results of initial testing of the sensor using machine harvested seed cotton have shown promise. Improvements have been made to the system and the measurement method to meet t...

  13. ICD and overdentures: improving esthetics, mastication and quality of life

    Directory of Open Access Journals (Sweden)

    José Augusto César Discacciati

    2012-04-01

    Full Text Available The teeth total loss is one of the worst clinical situations that can be found in Dentistry and it may cause masticatory ability reduction and consequent interference in food digestion. Besides, it may affect esthetics and phonation. This situation contributes to a decrease of life quality and self-esteem. The complete denture is the most used therapeutic modality in the rehabilitation of complete edentulous people. A problem that should be faced, when the total prosthesis is indicated, lays exactly on the fact that the patients resist being toothless, while they wait for the osseous and tissue repairs, used in the posterior prosthesis confection. Another problem is associated with much reabsorbed ridges, which are unable to present retention and stability conditions to a complete denture. The utilization of immediate complete dentures (ICD and dental implants can solve these problems. The SUS doesn't offer these treatment modalities, neither in the basic attention, nor in the special. The curricular disciplines of FOUFMG don't offer the necessary information on how to rehabilitate edentulous people with few residual alveolar ridge using implants or those unsatisfied with the use of their complete denture. The the objective of the Immediate Total Prosthesis/Overdentures Project implantation was to fill the lack of that practice in the curriculum and in the patient treatment. The present work aims to present the PTI/Overdentures Project to the academic community, a project with assistance characteristics, practical/theoretical nature and that was developed for the FOUFMG graduation students and for the patients, who use complete denture or with indication to use it. The activity shows a huge utility, both to users and students, as it fulfills a gap in the health social service and of the curriculum. The impact in the improving patients' life quality is evaluated by applying the Oral Health Impact Profile - OHIP-14 questionary. The initial objectives selected by the project coordinators have satisfactorily been reached because a well defined attendance and a dynamic and interdisciplinary action were made. Also, the extension activity has provided an interaction between learning, research and knowledge production areas, giving a high impact in the academic formation of the participant students and consolidating the formation of a citizen professional, and a positive dialogic relationship with the assisted community. Besides, it resulted on a high improvement in the life quality of the patients. The conclusion is that the project has been satisfactorily achieved its objectives, benefiting students and patients.

  14. Improving the Quality of Electric Energy to Electric Arc Furnace

    Directory of Open Access Journals (Sweden)

    Adrian-Ioan Toma

    2011-10-01

    Full Text Available This paper presents a study of power quality problems created by an electric arc furnace (EAF with eccentric bottom tap (EBT at power system. The analysis have been done to EAF of 100 t capacity used for steel melting. Experimental results show this EAF is substantial source of electric disturbances, such as voltage fluctuations, flicker, harmonics, and unbalance between phases. Improvement of the quality of electric energy at EAF imposes a careful technical and economical analysis. Of all possible solutions for improvement of the power quality for an EAF (passive filter, STATCOM or SVC, SVC is the ideal solution.

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

    DEFF Research Database (Denmark)

    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

    2014-01-01

    Lung cancer is the commonest cause of cancer-related death worldwide and poses a significant respiratory disease burden. Little is known about the provision of lung cancer care across Europe. The overall aim of the Task Force was to investigate current practice in lung cancer care across Europe. The Task Force undertook four projects: 1) a narrative literature search on quality management of lung cancer; 2) a survey of national and local infrastructure for lung cancer care in Europe; 3) a benchm...

  16. The QIBB Quality Initiative of the Vocational Training System in Austria

    Science.gov (United States)

    Paechter, Manuela

    2009-01-01

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

  17. Galantamine improves sleep quality in patients with dementia.

    Science.gov (United States)

    Naharci, Mehmet Ilkin; Ozturk, Ahmet; Yasar, Halit; Cintosun, Umit; Kocak, Necmettin; Bozoglu, Ergun; Tasci, Ilker; Doruk, Huseyin

    2015-12-01

    The purpose of the study was to evaluate the influences of cholinesterase inhibitors on sleep pattern and sleep disturbance. A total of 87 mild to moderate stage dementia patients who were not on cholinesterase enzyme inhibitor and memantine treatment were included in the study. The dementia patients were treated with donepezil, galantamine or rivastigmine, depending on the preference of the clinician. Fifty-five dementia patients (63.2 %) completed the study. Twenty-three elderly subjects, who had normal cognitive functions, were included in the study as the control group. The Pittsburgh Sleep Quality Index was used for evaluating the sleep quality at the beginning and at the final assessment. The improvement in sleep quality was better with regard to changes in Pittsburgh Sleep Quality Index scores with galantamine treatment compared to the donepezil and the control groups. A significant decrease in Pittsburgh Sleep Quality Index scores was detected in the galantamine group after treatment. Although statistically not significant, rivastigmine decreased and donepezil increased the Pittsburgh Sleep Quality Index scores after treatment. Dementia patients who had a poor sleep quality (n: 36), the rate of improvement in sleep disturbance was 81.8 % in the galantamine group, 75 % in the rivastigmine, and 50 % in the donepezil group. Galantamine may be the first choice of cholinesterase inhibitor in mild to moderate dementia patients in terms of improving sleep quality. PMID:25777522

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-04-15

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

  19. Hospital value-based purchasing (VBP) program: measurement of quality and enforcement of quality improvement.

    Science.gov (United States)

    Szablowski, Katarzyna M

    2014-01-01

    VBP program is a novel medicare payment estimatin tool used to encourage clinical care quality improvement as well as improvement of patient experience as a customer of a health care system. The program utilizes well established tools of measuring clinical care quality and patient satisfaction such as the hospital IQR program and HCAHPS survey to estimate Medicare payments and encourage hospitals to continuosly improve the level of care they provide. PMID:24600783

  20. Studying and improving blast furnace cast iron quality

    OpenAIRE

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

    2014-01-01

    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 %.

  1. Applying GRA and QFD to Improve Library Service Quality

    Science.gov (United States)

    Chen, Yen-Ting; Chou, Tsung-Yu

    2011-01-01

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

  2. Workbook for Taguchi Methods for Product Quality Improvement.

    Science.gov (United States)

    Zarghami, Ali; Benbow, Don

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

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

    Science.gov (United States)

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

    2013-08-01

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

  4. 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)

  5. CHAMBER: A Regional Performance Improvement CME Initiative for Breast Cancer Health Care Providers.

    Science.gov (United States)

    Sutton, Linda M; Geradts, Joseph; Hamilton, Erika P; Havlin, Kathleen A; Kimmick, Gretchen G; Marcom, P Kelly; Spector, Neil L; Watson, Melanie; Rabin, Daniel U; Bruno, Theodore O; Noe, Amanda; Miller, Stacy; Subramaniam, Chitra; Layton, Sherry; Grichnik, Katherine

    2015-08-01

    CHAMBER was a regional educational initiative for providers of care to patients with HER2+ breast cancer. The study goals were to (1) enhance testing for HER2/neu overexpression in patients with invasive breast cancer; (2) increase the appropriate use of targeted therapy for patients with HER2+ breast cancer; and (3) enhance patients' coping ability. This Performance Improvement Continuing Medical Education (PI-CME) initiative included clinical practice assessment, educational activities, and reassessment. Chart review revealed a high rate of HER2 testing (98%) before and after education. Targeted therapy for patients with HER2+ breast cancer declined after the program (from 96% to 61%), perhaps attributable to an increase in awareness of medical reasons to avoid use of targeted therapy. Assessment for patients' emotional coping ability increased after education (from 55% to 76%; P=.01). Rates of testing for HER2 amplification and assessment of emotional well-being after education were consistent with ASCO Quality Oncology Practice Initiative benchmark values. Documentation of actions to address emotional problems remained an area for improvement. PMID:26285246

  6. Improved initial guess for minimum energy path calculations

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-06-07

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

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

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.)

  8. The software improvement process - tools and rules to encourage quality

    International Nuclear Information System (INIS)

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

  9. Design and Simulation of STATCOM to Improve Power Quality

    Directory of Open Access Journals (Sweden)

    Md. Nazrul Islam

    2013-07-01

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

  10. The ReACH Collaborative--improving quality home care.

    Science.gov (United States)

    Boyce, Patricia Simino; Pace, Karen B; Lauder, Bonnie; Solomon, Debra A

    2007-08-01

    Research on quality of care has shown that vigorous leadership, clear goals, and compatible incentive systems are critical factors in influencing successful change (Institute of Medicine, 2001). Quality improvement is a complex process, and clinical quality improvement applications are more likely to be effective in organizations that are ready for change and have strong leaders, who are committed to creating and reinforcing a work environment that supports quality goals (Shortell, 1998). Key leadership roles include providing clear and sustained direction, articulating a coherent set of values and incentives to guide group and individual activities, aligning and integrating improvement efforts into organizational priorities, obtaining or freeing up resources to implement improvement activities, and creating a culture of "continuous improvement" that encourages and rewards the pursuit and achievement of shared quality aims (Institute of Medicine, 2001, 70-71). In summary, home health care is a significant and growing sector of the health care system that provides care to millions of vulnerable patients. There seems little doubt that home health agencies want to focus on quality of care issues and provide optimal care to home-based patients. Furthermore, there is a growing awareness of the value for adapting innovative, effective models for improving the culture of home care practice. This awareness stems from the notion that some agencies see quality improvement activities as a way for them to distinguish themselves not only to regulators and customers, but also to meet the cultural and transformational needs to remain viable in a constantly evolving and competitive health care industry. PMID:17966307

  11. Challenges of Using Quality Improvement Methods in Nursing Homes that “Need Improvement

    OpenAIRE

    Rantz, Marilyn J.; Zwygart-Stauffacher, Mary; Flesner, Marcia; Hicks, Lanis; Mehr, David; Russell, Teresa; Minner, Donna

    2012-01-01

    A randomized, two-group, repeated-measures design was used to test a two year intervention for improving quality of care and resident outcomes in facilities in “need of improvement”. Intervention group (n=29) received an experimental multilevel intervention designed to help them (1) use quality-improvement methods, (2) use team and group process for direct-care decision-making, (3) focus on accomplishing the basics of care, and (4) maintain more consistent nursing and administrative leadershi...

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

    Science.gov (United States)

    Goldmann, Don

    2011-04-01

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

  13. Institutions for Quality Cooperation for Development: Clarifications and Initial Proposals

    Directory of Open Access Journals (Sweden)

    Rafael Grasa Hernández

    2006-01-01

    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.”

  14. Quality improvement 101 for surgeons: Navigating the alphabet soup.

    Science.gov (United States)

    Santore, Matthew T; Islam, Saleem

    2015-12-01

    It is a fundamental value of the surgical profession to improve care for its patients. In the last 100 years, the principles of prospective quality improvement have started to work their way into the traditional method of retrospective case review in morbidity and mortality conference. This article summarizes the history of "improvement science" and its intersection with the field of surgery. It attempts to clarify the principles and jargon that may be new or confusing to surgeons with a different vocabulary and experience. This is done to bring the significant power and resources of improvement science to the traditional efforts to improve surgical care. PMID:26653158

  15. Integration Quality Function Deployment and Analytic Hierarchy Process Methods to Improve Service Quality

    Directory of Open Access Journals (Sweden)

    Shun-Hsing Chen

    2015-01-01

    Full Text Available Customer needs regarding product and service quality are rising. Because of the economic recession, the food and beverage industry faces strong competition. Customer needs can be satisfied only by understanding their needs. Therefore, this study uses Quality Function Deployment (QFD and the Analytic Hierarchy Process (AHP to clarify customer needs and to explore the most effective options to improve service quality in the vegetarian foods industry. This study primary objective included: (1 Prioritizing customer needs to vegetarian food providers according to the level of importance and (2 Prioritizing technology quality for improving products and services as a reference for vegetarian food providers.

  16. A Novel Quality Measure and Correction Procedure for the Annotation of Microbial Translation Initiation Sites

    Science.gov (United States)

    Overmars, Lex; Siezen, Roland J.; Francke, Christof

    2015-01-01

    The identification of translation initiation sites (TISs) constitutes an important aspect of sequence-based genome analysis. An erroneous TIS annotation can impair the identification of regulatory elements and N-terminal signal peptides, and also may flaw the determination of descent, for any particular gene. We have formulated a reference-free method to score the TIS annotation quality. The method is based on a comparison of the observed and expected distribution of all TISs in a particular genome given prior gene-calling. We have assessed the TIS annotations for all available NCBI RefSeq microbial genomes and found that approximately 87% is of appropriate quality, whereas 13% needs substantial improvement. We have analyzed a number of factors that could affect TIS annotation quality such as GC-content, taxonomy, the fraction of genes with a Shine-Dalgarno sequence and the year of publication. The analysis showed that only the first factor has a clear effect. We have then formulated a straightforward Principle Component Analysis-based TIS identification strategy to self-organize and score potential TISs. The strategy is independent of reference data and a priori calculations. A representative set of 277 genomes was subjected to the analysis and we found a clear increase in TIS annotation quality for the genomes with a low quality score. The PCA-based annotation was also compared with annotation with the current tool of reference, Prodigal. The comparison for the model genome of Escherichia coli K12 showed that both methods supplement each other and that prediction agreement can be used as an indicator of a correct TIS annotation. Importantly, the data suggest that the addition of a PCA-based strategy to a Prodigal prediction can be used to ‘flag’ TIS annotations for re-evaluation and in addition can be used to evaluate a given annotation in case a Prodigal annotation is lacking. PMID:26204119

  17. Improving the quality of clinical coding: a comprehensive audit model

    Directory of Open Access Journals (Sweden)

    Hamid Moghaddasi

    2014-04-01

    Full Text Available Introduction: The review of medical records with the aim of assessing the quality of codes has long been conducted in different countries. Auditing medical coding, as an instructive approach, could help to review the quality of codes objectively using defined attributes, and this in turn would lead to improvement of the quality of codes. Method: The current study aimed to present a model for auditing the quality of clinical codes. The audit model was formed after reviewing other audit models, considering their strengths and weaknesses. A clear definition was presented for each quality attribute and more detailed criteria were then set for assessing the quality of codes. Results: The audit tool (based on the quality attributes included legibility, relevancy, completeness, accuracy, definition and timeliness; led to development of an audit model for assessing the quality of medical coding. Delphi technique was then used to reassure the validity of the model. Conclusion: The inclusive audit model designed could provide a reliable and valid basis for assessing the quality of codes considering more quality attributes and their clear definition. The inter-observer check suggested in the method of auditing is of particular importance to reassure the reliability of coding.

  18. Participatory Patterns in an International Air Quality Monitoring Initiative

    CERN Document Server

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2002-01-01

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

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

    OpenAIRE

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

    2010-01-01

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

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

    OpenAIRE

    Mayer-Amberg, Norbert; Woltmann, Rainer; Walther, Stefanie

    2016-01-01

    The optimal treatment of schizophrenia patients requires integration of medical and psychosocial inputs. In Germany, various health-care service providers and institutions are involved in the treatment process. Early and continuous treatment is important but often not possible because of the fragmented medical care system in Germany. The Integrated Care Initiative Schizophrenia has implemented a networked care concept in the German federal state of Lower Saxony that integrates various stakeho...

  2. X-ray scatter correction method for dedicated breast computed tomography: improvements and initial patient testing

    Science.gov (United States)

    Ramamurthy, Senthil; D’Orsi, Carl J.; Sechopoulos, Ioannis

    2016-02-01

    A previously proposed x-ray scatter correction method for dedicated breast computed tomography was further developed and implemented so as to allow for initial patient testing. The method involves the acquisition of a complete second set of breast CT projections covering 360° with a perforated tungsten plate in the path of the x-ray beam. To make patient testing feasible, a wirelessly controlled electronic positioner for the tungsten plate was designed and added to a breast CT system. Other improvements to the algorithm were implemented, including automated exclusion of non-valid primary estimate points and the use of a different approximation method to estimate the full scatter signal. To evaluate the effectiveness of the algorithm, evaluation of the resulting image quality was performed with a breast phantom and with nine patient images. The improvements in the algorithm resulted in the avoidance of introduction of artifacts, especially at the object borders, which was an issue in the previous implementation in some cases. Both contrast, in terms of signal difference and signal difference-to-noise ratio were improved with the proposed method, as opposed to with the correction algorithm incorporated in the system, which does not recover contrast. Patient image evaluation also showed enhanced contrast, better cupping correction, and more consistent voxel values for the different tissues. The algorithm also reduces artifacts present in reconstructions of non-regularly shaped breasts. With the implemented hardware and software improvements, the proposed method can be reliably used during patient breast CT imaging, resulting in improvement of image quality, no introduction of artifacts, and in some cases reduction of artifacts already present. The impact of the algorithm on actual clinical performance for detection, diagnosis and other clinical tasks in breast imaging remains to be evaluated.

  3. Quality factors for the nano-mechanical tubes with thermoelastic damping and initial stress

    Science.gov (United States)

    Kim, Sun-Bae; Kim, Ji-Hwan

    2011-03-01

    The Quality factors (Q-factor) are defined as the ratio of the kinetic and potential energy to dissipation for various damping mechanisms of structures. Therefore, improvement in the Q-factors is an important issue in micro- and nano-resonator applications for the high performance. Also, it is well known that the thermoelastic damping is more crucial than the other damping factors in a device. Thus, the vibration of nano-mechanical circular tube is investigated with thermoelastic damping and initial stress effects in this work. To simplify the shell equations for the transverse displacement-dominated problems, the Donnell-Mushtari-Vlasov (DMV) approach is adopted. Applying the stress function, the equations of motion for deflection, compatibility equation and heat conduction equation are derived. Using an iterative scheme, the natural frequencies and the Q-factors under the initial stress are obtained, and the influences of the dimensions of the shell, the mode numbers and initial stress are discussed in detail.

  4. 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

  5. Development of improvement initiatives in an ICT department.

    OpenAIRE

    Golo, Hagan Dennis; Popov, Dimitar

    2014-01-01

    [ABSTRACT] The main goal of this thesis is to study processes in an ICT department of Barcelona Airport and propose some solutions for improvement based on data collected and analyzed. The improvement follows the concept of Lean Six Sigma (LSS) and ITIL framework. The main outcome of this thesis will be to optimize the incidents resolution times. It has been noticed that, too much time elapses from the time an incident is opened and the time an incident is closed. Even though in several insta...

  6. Participatory Patterns in an International Air Quality Monitoring Initiative.

    Science.gov (United States)

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

    2015-01-01

    The issue of sustainability is at the top of the political and societal agenda, being considered of extreme importance and urgency. Human individual action impacts the environment both locally (e.g., local air/water quality, noise disturbance) and globally (e.g., climate change, resource use). Urban environments represent a crucial example, with an increasing realization that the most effective way of producing a change is involving the citizens themselves in monitoring campaigns (a citizen science bottom-up approach). This is possible by developing novel technologies and IT infrastructures enabling large citizen participation. Here, in the wider framework of one of the first such projects, we show results from an international competition where citizens were involved in mobile air pollution monitoring using low cost sensing devices, combined with a web-based game to monitor perceived levels of pollution. Measures of shift in perceptions over the course of the campaign are provided, together with insights into participatory patterns emerging from this study. Interesting effects related to inertia and to direct involvement in measurement activities rather than indirect information exposure are also highlighted, indicating that direct involvement can enhance learning and environmental awareness. In the future, this could result in better adoption of policies towards decreasing pollution. PMID:26313263

  7. Data quality objectives for the initial K West fuel examinations

    International Nuclear Information System (INIS)

    The Data Quality Objectives (DQOs) were established for the examinations of the first group of fuel samples shipped from the K West Basin to the Hanford 327 Building hot cells for examinations to support the Path Forward recommended to solve the safety and environmental concerns associated with the deteriorating fuel in the K Basins. A separate DQO will be prepared for each future shipment of samples to the hot cells. The material stored in the K West Basin must ultimately be removed from the basin and placed in a stable storage configuration until it can be disposed of in a repository. The condition of the fuel in the closed canisters is a major uncertainty for any of the proposed actions. The major question to answer is what are the conditions of the materials in the closed canisters? The data to be gathered during the canister opening, handling, transport, associated hot cell handling, and examinations will also support decisions related to the Path Forward primarily in areas of transportation and the Multi-Canister Overpack (MCO) design

  8. Improving the Quality of FORS2 Reduced Spectra

    CERN Document Server

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

    2015-01-01

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

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

    OpenAIRE

    Izumi, Shigeko

    2012-01-01

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

  10. Measuring and improving quality of care in surgical oncology

    OpenAIRE

    Wouters, Michael Wilhelmus Jacobus Maria

    2013-01-01

    This thesis shows that quality of care in surgical oncology varies by provider and is partly based on differences in procedural volume and other attributes of hospitals. Especially for low-volume high-risk surgical procedures concentration of services in hospitals with better outcomes (outcome-based referral) can lead to dramatic improvement in short- as well as long-term outcomes. Casemix- and reliability adjustments are essential in the evaluation of quality of care. In addit...

  11. Improving Quality and Efficiency of Postpartum Hospital Education

    OpenAIRE

    Buchko, Barbara L.; Gutshall, Connie H.; Jordan, Elizabeth T.

    2012-01-01

    The purpose of this study was to investigate the implementation of an evidence-based, streamlined, education process (comprehensive education booklet, individualized education plan, and integration of education into the clinical pathway) and nurse education to improve the quality and efficiency of postpartum education during hospitalization. A one-group pretest–posttest design was used to measure the quality of discharge teaching for new mothers and efficiency of the education process for reg...

  12. Improving the Quality of Electric Energy to Electric Arc Furnace

    OpenAIRE

    Adrian-Ioan Toma; Andrei Romanescu

    2011-01-01

    This paper presents a study of power quality problems created by an electric arc furnace (EAF) with eccentric bottom tap (EBT) at power system. The analysis have been done to EAF of 100 t capacity used for steel melting. Experimental results show this EAF is substantial source of electric disturbances, such as voltage fluctuations, flicker, harmonics, and unbalance between phases. Improvement of the quality of electric energy at EAF imposes a careful technical and economical...

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

    Science.gov (United States)

    Hawkins, C Matthew

    2014-12-01

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

  14. 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

  15. Improving and Communicating Workforce Skills: A Regional Initiative

    Science.gov (United States)

    Baird, Dee

    2011-01-01

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

  16. Applying PPM to ERP Maintenance and Continuous Improvement Initiatives

    DEFF Research Database (Denmark)

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

    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...

  17. ELECTRICAL SAFETY IMPROVEMENT PROJECT A COMPLEX WIDE TEAMING INITIATIVE

    Energy Technology Data Exchange (ETDEWEB)

    GRAY BJ

    2007-11-26

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

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

    Science.gov (United States)

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

    2014-12-01

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

  19. Quality Circle Effectiveness as a Function of Upper-Management Support, Circle Initiation, and Collar Color.

    Science.gov (United States)

    Tang, Thomas Li-Ping; And Others

    Japanese management practices have attracted much interest in the United States. The use of quality circles (QCs) common in Japan, has been considered a promising approach to improving Americn workers' productivity. A quality circle is made up of workers from the same group who meet to discuss quality problems, recommend solutions, and implement…

  20. A new quality assessment and improvement system for print media

    Science.gov (United States)

    Liu, Mohan; Konya, Iuliu; Nandzik, Jan; Flores-Herr, Nicolas; Eickeler, Stefan; Ndjiki-Nya, Patrick

    2012-12-01

    Print media collections of considerable size are held by cultural heritage organizations and will soon be subject to digitization activities. However, technical content quality management in digitization workflows strongly relies on human monitoring. This heavy human intervention is cost intensive and time consuming, which makes automization mandatory. In this article, a new automatic quality assessment and improvement system is proposed. The digitized source image and color reference target are extracted from the raw digitized images by an automatic segmentation process. The target is evaluated by a reference-based algorithm. No-reference quality metrics are applied to the source image. Experimental results are provided to illustrate the performance of the proposed system. We show that it features a good performance in the extraction as well as in the quality assessment step compared to the state-of-the-art. The impact of efficient and dedicated quality assessors on the optimization step is extensively documented.

  1. 76 FR 1180 - FDA Transparency Initiative: Improving Transparency to Regulated Industry

    Science.gov (United States)

    2011-01-07

    ...Docket No. FDA-2009-N-0247] FDA Transparency Initiative: Improving Transparency to Regulated Industry AGENCY: Food and...SUMMARY: As part of the third phase of the Transparency Initiative, the Food and Drug...

  2. Using measures to guide the continuous improvement journey: a partnership between quality assurance and toxicology.

    Science.gov (United States)

    Gentry, P E; Sites, D L

    1994-03-01

    It has been said that you cannot improve what you cannot measure. At Eli Lilly and Company, measurement is one of the five pillars of Total Quality. Quality Assurance and Toxicology have partnered in the use of measures to drive improvements in both areas. Quality Assurance and Toxicology have embarked on a journey in Total Quality to achieve customer satisfaction and drive continuous improvement. Measurement in the research and development world has traditionally not been well received. Contrary to popular belief, we have found that many processes can be measured in the research and development environment. Measurement is critical to the continuous improvement of processes because improvements are made using data. In Quality Assurance and Toxicology, the initial measures were put in place to gather baseline data. As we learned from our measures, we customized them to align with all of our processes. This article describes the journey of measuring Quality Assurance and Toxicology, including highlights of implementation strategies and lessons learned along the way. PMID:7804620

  3. Product manufacturing, quality, and reliability initiatives to maintain a competitive advantage and meet customer expectations in the semiconductor industry

    Science.gov (United States)

    Capps, Gregory

    Semiconductor products are manufactured and consumed across the world. The semiconductor industry is constantly striving to manufacture products with greater performance, improved efficiency, less energy consumption, smaller feature sizes, thinner gate oxides, and faster speeds. Customers have pushed towards zero defects and require a more reliable, higher quality product than ever before. Manufacturers are required to improve yields, reduce operating costs, and increase revenue to maintain a competitive advantage. Opportunities exist for integrated circuit (IC) customers and manufacturers to work together and independently to reduce costs, eliminate waste, reduce defects, reduce warranty returns, and improve quality. This project focuses on electrical over-stress (EOS) and re-test okay (RTOK), two top failure return mechanisms, which both make great defect reduction opportunities in customer-manufacturer relationship. Proactive continuous improvement initiatives and methodologies are addressed with emphasis on product life cycle, manufacturing processes, test, statistical process control (SPC), industry best practices, customer education, and customer-manufacturer interaction.

  4. [Telecommunication--a medium for improving prenatal diagnosis and gynecologic ultrasound diagnosis? Initial experiences].

    Science.gov (United States)

    Sohn, C; Beldermann, F; Wallwiener, D; Lepold, H; Bastert, G

    1997-01-01

    To establish the requirements for real-time transfer of an ultrasound examination via telecommunication network the following tests were performed: The ultrasound data were transferred from the video out of an ultrasound system to a basis terminal of the German Telekom. Simultaneously, an external video camera filmed the positioning and movements of the ultrasound transducer, and the verbal comments were recorded. These informations were transmitted to Karlsruhe and London, where they were rerouted to the examination room in Heidelberg. Here the informations were received on a Telecom reception unit/terminal and compared directly with the initial signal. The quality was sufficient if the moving ultrasound images and the camera image of the transducer as well as the oral comment were transmitted over 2 parallel ISDN lines. The delay to a real-time transmission of the examination process is only in the range of milliseconds. If only one ISDN line is used, the image quality is unsatisfactory, three parallel lines do not bring significant improvement of image quality. Telemedicine seems a new possibility to bring the knowledge of specialized centers to the practicing gynaecologists thus avoiding unnecessary referrals. Still unanswered, however, are the problem of liability, data protection and costs. PMID:9206924

  5. A Systems Thinking Approach To The Sustainability Of Quality Improvement Programmes

    Directory of Open Access Journals (Sweden)

    Van Dyk, Dirk Johannes

    2014-05-01

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

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

    Scientific Electronic Library Online (English)

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

    2014-01-01

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

  7. Active power line conditioners for improving electric power quality

    Energy Technology Data Exchange (ETDEWEB)

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

    1992-12-31

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

  8. 77 FR 43822 - Proposed Information Collection Request; Comment Request; Valuing Improved Water Quality in the...

    Science.gov (United States)

    2012-07-26

    ...Improved Water Quality in the Chesapeake...AGENCY: Environmental Protection...SUMMARY: The Environmental Protection...Improved Water Quality in the Chesapeake...Center for Environmental Economics...improvements in Bay water quality under...

  9. Functional fitness improvements after a worksite-based yoga initiative.

    Science.gov (United States)

    Cowen, Virginia S

    2010-01-01

    This study explored the benefits of yoga on functional fitness, flexibility, and perceived stress. A quasi-experimental design was used to measure benefits of yoga in sample of firefighters from a major metropolitan fire department. Yoga classes were conducted on-shift, in the fire stations over the period of 6 weeks. The classes included pranayama (breathing), asana (postures), and savasana (relaxation); 108 firefighters enrolled in the study, most were physically active but had no prior experience with yoga. Baseline and post-yoga assessments were completed by 77 participants. Paired t-tests revealed significant improvements in the Functional Movement Screen, a seven item test that measures functional fitness. Improvements were also noted in trunk flexibility and perceived stress. Participants also reported favorable perceptions of yoga: feeling more focused and less musculoskeletal pain. These findings - along with the retention of the majority of the participants - indicate that participants benefited from yoga. PMID:20006289

  10. Quality improvement in breast cancer project: compliance with antiresorptive agents and changing patterns of drug use.

    Science.gov (United States)

    Borden, Charles P; Shapiro, Charles L; Ramirez, Maria Teresa; Kotur, Linda; Farrar, William

    2014-02-01

    The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute participated in NCCN's Quality Improvement in Breast Cancer initiative. The Opportunities for Improvement (OFI) team elected to improve concordance with the NCCN Clinical Practice Guidelines in Oncology for Breast Cancer recommendation that all patients diagnosed with skeletal metastases receive bisphosphonates. Assembling a multidisciplinary team of clinicians, researchers, and administrative stakeholders, the OFI team followed Six Sigma's approach to problem-solving known as DMAIC (define, measure, analyze, improve, and control). Baseline concordance was 79%, which was below the recommended target range. Initial analysis quickly revealed that 5 cases were concordant, resulting in a new baseline of 89%. The key root cause identified for the remaining gap was lack of documentation. The solution included education regarding documentation for existing staff, in addition to hard-wiring the material into new physician orientation, discussion of all patients with bone disease at tumor board meetings, and improved consistency with use of the new electronic medical record system. After implementation, the reported concordance was 92%, and the lack of documentation problem decreased from 11% in the baseline study to 6%. The team concluded that use of the NCCN Oncology Outcomes Database as an opportunity for clinical quality improvement initiatives not only is possible but also should be an essential element of any clinical program looking to continuously improve. PMID:24614050

  11. 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.)

  12. Quality evaluation of initial formation in the third year of medical course.

    Directory of Open Access Journals (Sweden)

    Berto Delis Conde Fernández

    2011-09-01

    Full Text Available The priority given by Cuba to the accreditation of initial formation in medical course encourages the introduction of procedures for self assessment. With the objective to contribute to quality management in initial formation of this course by means of the implementation of a self assessment institutional system applicable to the University Hospital, a quasi experiemental investigation was made in “Camilo Cienfuegos” Provincial Hospital, Sancti Spiritus during the period 2005-2010. Different instruments were applied for obtaining the initial information and were determined quality indicators, methods and evaluation procedures, from which it was designed and validated a methodology for the self assessment process, including its quality standard. The results of measurements and the analysis of quality tendency were presented. It concludes highlighting the contribution achieved due to the development of a quality culture and evaluation, orientation towards the continuous perfectioning and organizational change.

  13. Improvement in Adherence to Surgical Antimicrobial Prophylaxis Guidelines after Implementation of a Multidisciplinary Quality Improvement Project

    OpenAIRE

    Shorouq Telfah; Lama Nazer; Manar Dirani; Faiez Daoud

    2015-01-01

    Objectives: This study aimed to show the impact of a multidisciplinary quality improvement project on adherence to antimicrobial prophylaxis guidelines in oncological surgery. Methods: This pre- and post-intervention prospective observational study was carried out at the King Hussein Cancer Centre (KHCC) in Amman, Jordan, between August 2009 and February 2012. The quality improvement project consisted of revising the institutional guidelines for surgical antimicrobial prophylaxis,...

  14. 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)

  15. 76 FR 46814 - Medicare Program; Evaluation Criteria and Standards for Quality Improvement Program Contracts...

    Science.gov (United States)

    2011-08-03

    ... Restraints, Nursing Home Systemic Improvement, Adverse Drug Events, Quality Reporting and Improvement... ischemic vascular disease; improving blood pressure control in patients with hypertension; improving...

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

    DEFF Research Database (Denmark)

    Li, Ian; Medynskiy, Yevgeniy; Froehlich, Jon; Larsen, Jakob Eg

    2012-01-01

    Personal informatics refers to a class of software and hardware systems that help individuals collect personal information to improve self-understanding. Improving self-understanding can foster self-insight and promote positive behaviors: healthy living, energy conservation, etc. The development of personal informatics applications poses new challenges for human-computer interaction and creates opportunities for applications in various domains related to quality of life, such as fitness, nutriti...

  17. Quality Improvement Of Fan Manufacturing Industry By Using Basic Seven Tools Of Quality: A Case Study

    Directory of Open Access Journals (Sweden)

    Sulaman Muhammad

    2015-04-01

    Full Text Available Research was carried out in a Fan manufacturing industry to address the quality related problems and improve their quality level by implementing basic seven tools of quality. These are important tools used worldwide in manufacturing industries for continual improvement. Flow chart, Check sheet, Histogram, Cause & Effect diagram, Pareto chart, Scatter diagram & Control charts were implemented in different steps of manufacturing process to define the problem, measure its impact, finding out its root cause and its removal to ensure the production of non defective items. The case study was carried out in “FECTO FAN” Gujranwala, Pakistan.

  18. Radionuclide calibrator comparisons and quality improvement in nuclear medicine

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-03-15

    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.

  19. Radionuclide calibrator comparisons ad quality improvement in nuclear medicine

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-07-01

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

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

    Science.gov (United States)

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

    2013-12-01

    What fraction of the black carbon arriving on Yala Glacier in Langtang, Nepal, is from cooking fires in the houses in the valley below? What fraction is from elsewhere in rural Nepal? What fraction is from industrial and transport sources in Kathmandu? What fraction is from northern India and beyond? What fraction is from the high altitude forest fires that take place during March or April? Effectively mitigating the impacts of black carbon and other short-lived climate forcers requires detailed understanding not just of emissions and impacts, but also of the atmospheric transport pathways that connect the two. In mountainous areas of the Hindu-Kush Himalaya detailed quantitative knowledge about emissions, atmospheric processes, and impacts is still largely missing. The International Centre for Integrated Mountain Development (ICIMOD) is an intergovernmental organization covering Afghanistan, Pakistan, India, Nepal, China, Bhutan, Bangladesh, and Myanmar. ICIMOD's recently established Atmosphere Initiative not only assesses mitigation options and contributes to policy and capacity building in the region, but also works actively to promote collaboration among researchers in the region, while building up an in-house team whose research will address key questions about SLCF. In Spring 2013 ICIMOD's Atmosphere Initiative, in collaboration with the Institute for Advanced Sustainability Studies (IASS) in Potsdam, Germany, carried out the largest field campaign to date in Nepal, hosting instruments belonging to dozens of institutions around the world, at nine field site within and upwind of the Kathmandu Valley, Nepal. The dataset that has been collected gives unprecedented insights into the emissions and atmospheric processes taking place downwind of and within the largest urban agglomeration in the Himalaya region. Meanwhile, in collaboration with national partner institutions, ICIMOD is in the process of setting up one atmospheric observatory each in Bhutan and in 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.

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

    Science.gov (United States)

    Peng, Wenqiang; Guan, Chaoliang; Li, Shengyi

    2014-08-01

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

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

    Science.gov (United States)

    Antelman, Albert

    1991-01-01

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

  3. Software quality and process improvement in scientific simulation codes

    Energy Technology Data Exchange (ETDEWEB)

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

    1997-11-01

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

  4. Improving Lecture Quality through Training in Public Speaking

    Science.gov (United States)

    Mowbray, Robert; Perry, Laura B.

    2015-01-01

    Lecturing is a common instructional format but poor lecturing skills can detract from students' learning experiences and outcomes. As lecturing is essentially a form of public communication, training in public speaking may improve lecture quality. Twelve university lecturers in Malaysia participated in a six-week public speaking skills…

  5. Voltage Quality Improvement in Islanded Microgrids Supplying Nonlinear Loads

    DEFF Research Database (Denmark)

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

    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...

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

    DEFF Research Database (Denmark)

    Quaade, F; Astrup, A

    1989-01-01

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

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

    Science.gov (United States)

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

    1990-10-01

    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

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

    OpenAIRE

    TORAZZO, Annamaria; MARCHESE, Aurelio; BECHIS, Marco

    1999-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Tang Wai Mun

    2013-11-01

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

  10. 40 CFR Appendix D to Part 132 - Great Lakes Water Quality Initiative Methodology for the Development of Wildlife Criteria

    Science.gov (United States)

    2010-07-01

    ...Lakes Water Quality Initiative Methodology for the Development of Wildlife...Water Quality Initiative Methodology for the Development of Wildlife...substance of concern and quantitative information about the...a GLWC is derived using a methodology similar to that...

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

    OpenAIRE

    Trefler, Daniel

    2009-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Xiaowei Jiang

    2013-07-01

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

  13. Defect Investigation as a Tool for Quality Improvement

    Directory of Open Access Journals (Sweden)

    B. Gurumurthy

    2002-10-01

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

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

    Directory of Open Access Journals (Sweden)

    Patel Rumana*

    2014-12-01

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

  15. 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

  16. IMPROVING THE QUALITY OF MAINTENANCE PROCESSES USING INFORMATION TECHNOLOGY

    Directory of Open Access Journals (Sweden)

    Zora Arsovski

    2008-06-01

    Full Text Available In essence, process of maintaining equipment is a support process, because it indirectly contributes to operational ability of the production process necessary for the supply chain of the new value. Taking into account increased levels of automatization and quality, this proces s becomes more and more significant and for some branches of industry, even crucial. Due to the fact that the quality of the entire process is more and more dependent on the maintenance process, these processes must be carefully designed and effectively im plemented. There are various techniques and approaches at our disposal, such as technical, logistical and intensive application of the information - communication technologies. This last approach is presented in this work. It begins with organizational goa ls, especially quality objectives. Then, maintenance processes and integrated information system structures are defined. Maintenance process quality and improvement processes are defined using a set of performances, with a special emphasis placed on effectiveness and quality economics. At the end of the work, information system for improving maintenance economics is structured. Besides theoretical analysis, work also presents results authors obtained analyzing food industry, metal processing industry an d building materials industry.

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

    Science.gov (United States)

    Chassin, Mark R

    2013-10-01

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

  18. GENETICS AND MOLECULAR BIOLOGY AND PIG MEAT QUALITY IMPROVEMENT

    Directory of Open Access Journals (Sweden)

    BULLA, J.

    2007-01-01

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

  19. GENETICS AND MOLECULAR BIOLOGY AND PIG MEAT QUALITY IMPROVEMENT

    Directory of Open Access Journals (Sweden)

    J. BULLA

    2013-12-01

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

  20. Conducting a Successful Practice Quality Improvement Project for American Board of Radiology Certification.

    Science.gov (United States)

    Lee, Cindy S; Wadhwa, Vibhor; Kruskal, Jonathan B; Larson, David B

    2015-10-01

    Practice quality improvement (PQI) is a required component of the American Board of Radiology (ABR) Maintenance of Certification (MOC) cycle, with the goal to "improve the quality of health care through diplomate-initiated learning and quality improvement." The essential requirements of PQI projects include relevance to one's practice, achievability in one's clinical setting, results suited for repeat measurements during an ABR MOC cycle, and reasonable expectation to result in quality improvement (QI). PQI projects can be performed by a group or an individual or as part of a participating institution. Given the interdisciplinary nature of radiology, teamwork is critical to ensure patient safety and the success of PQI projects. Additionally, successful QI requires considerable investment of time and resources, coordination, organizational support, and individual engagement. Group PQI projects offer many advantages, especially in larger practices and for processes that cross organizational boundaries, whereas individual projects may be preferred in small practices or for focused projects. In addition to the three-phase "plan, do, study, act" model advocated by the ABR, there are several other improvement models, which are based on continuous data collection and rapid simultaneous testing of multiple interventions. When properly planned, supported, and executed, group PQI projects can improve the value and viability of a radiology practice. (©)RSNA, 2015. PMID:26334572

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

    Science.gov (United States)

    Ruza, Nadiah; Mustafa, Zainol

    2013-04-01

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

  2. Improved image quality in mammography due to moving grids

    International Nuclear Information System (INIS)

    The article deals with the question of how to improve the picture quality in mammography by using suitable moving grids. As application of moving grids increases the patient dose, dose-reducing film-foil systems available on the market and combinations of materials testing film with fine drawing back foil are used for phantom and patient pictures. This shows that using film-foil-combinations and moving grids provides for dose reductions in comparison with the usual technique with mammography film, while the picture quality remains the same. (orig.)

  3. Software Defect Prediction Models for Quality Improvement: A Literature Study

    Directory of Open Access Journals (Sweden)

    Mrinal Singh Rawat

    2012-09-01

    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.

  4. Intelligent Packet Shaper to Avoid Network Congestion for Improved Streaming Video Quality at Clients

    DEFF Research Database (Denmark)

    Kaul, Manohar; Khosla, Rajiv; Mitsukura, Y

    2003-01-01

    This paper proposes a traffic shaping algorithm based on neural networks, which adapts to a network over which streaming video is being transmitted. The purpose of this intelligent shaper is to eradicate all traffic congestion and improve the end-user's video quality. It possesses the capability to predict, to a very high level of accuracy, a state of congestion based upon the training data collected about the network behaviour. Initially, the current traffic shaping technologies are discussed a...

  5. A Systems Thinking Approach To The Sustainability Of Quality Improvement Programmes

    OpenAIRE

    Van Dyk, Dirk Johannes; Pretorius, Leon

    2014-01-01

    The challenge for organisations to continually provide the best return on investment for their shareholders has become increasingly difficult through globalisation of the market place. There are many responses a company could make to these challenges for example, new product development, increased market capitalisation, cost reduction initiatives, and quality management. This last response focuses on, but is not restricted to, customer satisfaction, continuous improvement, and environmental i...

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

    OpenAIRE

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

    1996-01-01

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

  7. Psychosocial interventions to improve quality of life and emotional wellbeing for recently diagnosed cancer patients

    OpenAIRE

    Galway, Karen; Black, Amanda; Cantwell, Marie; Cardwell, Christopher; Mills, Moyra; Donnelly, Michael

    2012-01-01

    BACKGROUND:A cancer diagnosis may lead to significant psychological distress in up to 75% of cases. There is a lack of clarity about the most effective ways to address this psychological distress.OBJECTIVES:To assess the effects of psychosocial interventions to improve quality of life (QoL) and general psychological distress in the 12-month phase following an initial cancer diagnosis.SEARCH METHODS:We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library ...

  8. Nursing Staff Develop a Video to Prevent Falls: A Quality Improvement Project.

    Science.gov (United States)

    Silkworth, Amelia L; Baker, Jennifer; Ferrara, Joseph; Wagner, Molly; Gevaart, Melinda; Morin, Karen

    2016-01-01

    Many fall prevention strategies exist with some degree of effectiveness. Evidence to support 1 unique bundling of strategies is limited. The purpose of this article is to describe a staff-driven quality improvement initiative to develop a video in partnership with patients and families to prevent falls when hospitalized. Since the video's release, the fall rate has decreased by 29.4%. PMID:26121052

  9. Accounting for Quality : On the Relationship Between Accounting and Quality Improvement in Healthcare

    DEFF Research Database (Denmark)

    Pflueger, Dane

    2015-01-01

    Background: Accounting-that is, standardized measurement, public reporting, performance evaluation and managerial control-is commonly seen to provide the core infrastructure for quality improvement in healthcare. Yet, accounting successfully for quality has been a problematic endeavor, often producing dysfunctional effects. This has raised questions about the appropriate role for accounting in achieving quality improvement. This paper contributes to this debate by contrasting the specific way in which accounting is understood and operationalized for quality improvement in the UK National Health Service (NHS) with findings from the broadly defined ‘social studies of accounting’ literature and illustrative examples. Discussion: This paper highlights three significant differences between the way that accounting is understood to operate in the dominant health policy discourse and recent healthcare reforms, and in the social studies of accounting literature. It shows that accounting does not just find things out, but makes them up. It shows that accounting is not simply a matter of substance, but of style. And it shows that accounting does not just facilitate, but displaces, control. Summary: The illumination of these differences in the way that accounting is conceptualized helps to diagnose why accounting interventions often fail to produce the quality improvements that were envisioned. This paper concludes that accounting is not necessarily incompatible with the ambition of quality improvement, but that it would need to be understood and operationalized in new ways in order to contribute to this end. Proposals for this new way of advancing accounting are discussed. They include the cultivation of overlapping and even conflicting measures of quality, the evaluation of accounting regimes in terms of what they do to practice, and the development of distinctively skeptical calculative cultures.

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

    Directory of Open Access Journals (Sweden)

    Dnyaneshwar.K

    2013-12-01

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

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

    Science.gov (United States)

    Ji, Zhou

    2009-01-01

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

  12. Interdisciplinary teamwork and the power of a quality improvement collaborative in tertiary neonatal intensive care units.

    Science.gov (United States)

    Grover, Theresa R; Pallotto, Eugenia K; Brozanski, Beverly; Piazza, Anthony J; Chuo, John; Moran, Susan; McClead, Richard; Mingrone, Teresa; Morelli, Lorna; Smith, Joan R

    2015-01-01

    Significant gaps in healthcare quality and outcomes can be reduced via quality improvement collaboratives (QICs), which improve care by leveraging data and experience from multiple organizations.The Children's Hospital Neonatal Consortium Collaborative Initiatives for Quality Improvement team developed an infrastructure for neonatal QICs. We describe the structure and components of an effective multi-institutional neonatal QIC that implemented the "SLUG Bug" project designed to reduce central line-associated bloodstream infections (CLABSIs).The operational infrastructure of SLUG Bug involved 17 tertiary care neonatal intensive care units with a goal to reduce CLABSI in high-risk neonates. Clinical Practice Recommendations were produced, and the Institute of Healthcare Improvement Breakthrough Series provided the framework for the collaborative. Process measures studied the effectiveness of the collaborative structure.CLABSI rates decreased by 20% during a 12-month study period. Compliance bundle reporting exceeded 80%. A QIC score of 2.5 or more ("improvement") was achieved by 94% of centers and a score 4 or more ("significant improvement") was achieved by 35%.Frequent interactive project meetings, well-defined project metrics, continual shared learning opportunities, and individual team coaching were key QIC success components. Through a coordinated approach and committed leadership, QICs can effectively implement change and improve the care of neonates with complex diagnoses and rare diseases. PMID:25919608

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

    Science.gov (United States)

    Conrad, Douglas A; Perry, Lisa

    2009-01-01

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

  14. 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

  15. Skill Gap Analysis for Improved Skills and Quality Deliverables

    Directory of Open Access Journals (Sweden)

    Mallikarjun Koripadu

    2014-10-01

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

  16. Crystal quality analysis and improvement using x-ray topography

    International Nuclear Information System (INIS)

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

  17. Improving image quality of parallel phase-shifting digital holography

    International Nuclear Information System (INIS)

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

  18. Essentials of navigating and teaching surgical quality improvement.

    Science.gov (United States)

    Raval, Mehul V; Kenney, Brian D

    2015-12-01

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

  19. IMS Meteorological Data, Current Status and Improvement of Data Quality

    Science.gov (United States)

    Martysevich, Pavel; Marty, Julien; Polzer, Peter

    2015-04-01

    The objective of the poster is to present the efforts made by the Provisional Technical Secretariat (PTS) over the last 3 years to assess and improve the quality of the meteorological data recorded at International Monitoring System (IMS) infrasound stations. This includes the processing and assessment of the data recorded since 2000, the organization of Expert Group Meetings, comparison of the IMS and World Meteorological Organization requirements to the meteorological data and the list of actions taken/to be taken for improving the reliability and accuracy of IMS meteorological data.

  20. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-08-15

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

  2. Improving quality of joints of mine shaft concrete lining

    Energy Technology Data Exchange (ETDEWEB)

    Abramson, Kh.I.; Veisbein, D.A.; Cheremisin, L.P.

    1980-09-01

    This article discusses damage to monolithic concrete shaft lining in the Donbass, caused by filtration of corrosive mine water through the lining. The filtration is caused by poor quality of concrete and cement used to form the lining as well as by the particularly low quality of joints in the monolothic concrete. Regulations state that the monolithic concrete lining of shafts should be watertight when affected by high hydrostatic pressures (10-15) 10at5 MPa. Investigations show, however, that watertightness of the lining is much lower: (1-5) x 10at5 MPa. Water permeability of monolithic concrete lining is particularly high in places where sections of the monolithic lining are jointed (at intervals 10 to 24 h). Analysis of data collected in the Donbass shows that water permeability at joints is 10 times higher than water permeability elsewhere in the lining. Improving quality of concrete (quality of cement and type and grain size distribution of aggregate) can increase adhesion of concrete at the joints by 1.2 to 1.5 times. Another way of improving watertight properties of concrete is a new technology of forming the lining. At present the lining is laid in the full thickness of the concrete shell. Laying concrete in two layers, inner and outer, is proposed. It is suggested that such a method efficiently prevents creation of joints as the joint of the outer layer of the shell is closed by the inner monolithic part of the shell and vice versa.

  3. Improvement of bacteriological quality of frozen chicken by gamma radiation

    International Nuclear Information System (INIS)

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

  4. 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

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

    OpenAIRE

    Xiaowei Jiang

    2013-01-01

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

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

    OpenAIRE

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

    2011-01-01

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

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

    OpenAIRE

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

    2010-01-01

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

  8. Improvement of Tagliatelle Quality by Addition of Red Quinoa Flour

    OpenAIRE

    Anamaria Pop; Sevasti?a Muste; Simona Man; Crina Mure?an

    2014-01-01

    In order to diversification of tagliatelle pasta and increasing segment of consumers it was intended to improvement of tagliatelle pasta quality by addition of red quinoa flour. The products obtained at Bakery Pilot Station of University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca was the result of original recipe. To optimize the recipe were made four experimental variants, white flour and red quinoa flour is used in different proportions: Variant 1 – plain tagliatelle pasta...

  9. Skill Gap Analysis for Improved Skills and Quality Deliverables

    OpenAIRE

    Mallikarjun Koripadu; K. Venkata Subbiah

    2014-01-01

    With a growing pressure in identifying the skilled resources in Clinical Data Management (CDM) world of clinical research organizations, to provide the quality deliverables most of the CDM organizations are planning to improve the skills within the organization. In changing CDM landscape the ability to build, manage and leverage the skills of clinical data managers is very critical and important. Within CDM to proactively identify, analyze and address skill gaps for all the ro...

  10. A Method for Improving the Quality of Data in STOR*

    OpenAIRE

    Van Metre, John E.; Whiting-O'Keefe, Quinn E.; Kahn, Michael G.; Warger, Anne W.

    1984-01-01

    An interactive dictionary driven system (Input Standardization System—ISS) has been designed and implemented. The function of the system is to improve the quality of data entered by medically untrained input clerks into the problem/manifestation and therapy descriptor fields in STOR, a computerized ambulatory care medical record system at UCSF. The ISS is able to (1) correct spelling errors, (2) expand abbreviations and truncations, and (3) suggest possible correct words to substitute for rec...

  11. Improving the quality of processes by using knowledge continuity ensuring

    OpenAIRE

    Urbancová, Hana; K?íž, Josef

    2012-01-01

    In the current knowledge economy the workers are the key competitive advantage and their knowledge is the most important asset in the various business processes. If people leave the organization they will take their knowledge with them and it can jeopardize the quality of the processes. This paper focuses on the topic of the ensuring the knowledge continuity as a tool for fluent improvement of processes in organizations. The processes and the areas were identified within the organizatio...

  12. Consumers´opinion of inflation bias due to quality improvements.

    Czech Academy of Sciences Publication Activity Database

    Hanousek, Jan; Filer, R. K.

    2004-01-01

    Ro?. 53, ?. 1 (2004), s. 235-254. ISSN 0013-0079 R&D Projects: GA MŠk ME 595 Institutional research plan: CEZ:AV0Z7085904 Keywords : consumers´opinion * inflation bias * quality improvements Subject RIV: AH - Economics Impact factor: 0.373, year: 2004 http://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=14886614&site=ehost-live

  13. A Model for Curricular Quality Assessment and Improvement

    OpenAIRE

    Ried, L. Douglas

    2011-01-01

    The article describes a systematic assessment model and its potential application to a college's ongoing curricular assessment activities. Each component of the continuous quality improvement model is discussed, including (1) the definition of a competent practitioner, (2) development of the core curricular competencies and course objectives, (3) students’ baseline characteristics and educational attainment, (4) implementation of the curriculum, (5) data collection about the students’ actual ...

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

    OpenAIRE

    Tang Wai Mun; Muhammad Faizal A. Ghani

    2013-01-01

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

  15. Improving quality and use of data through data-use workshops: Zanzibar, United Republic of Tanzania

    Directory of Open Access Journals (Sweden)

    Jørn Braa

    2012-05-01

    Full Text Available PROBLEM: In Zanzibar, United Republic of Tanzania, as in many developing countries, health managers lack faith in the national Health Management Information System (HMIS. The establishment of parallel data collection systems generates a vicious cycle: national health data are used little because they are of poor quality, and their relative lack of use, in turn, makes their quality remain poor. APPROACH: An action research approach was applied to strengthen the use of information and improve data quality in Zanzibar. The underlying premise was that encouraging use in small incremental steps could help to break the vicious cycle and improve the HMIS. LOCAL SETTING: To test the hypothesis at the national and district levels a project to strengthen the HMIS was established in Zanzibar. The project included quarterly data-use workshops during which district staff assessed their own routine data and critiqued their colleagues' data. RELEVANT CHANGES: The data-use workshops generated inputs that were used by District Health Information Software developers to improve the tool. The HMIS, which initially covered only primary care outpatients and antenatal care, eventually grew to encompass all major health programmes and district and referral hospitals. The workshops directly contributed to improvements in data coverage, data set quality and rationalization, and local use of target indicators. LESSONS LEARNT: Data-use workshops with active engagement of data users themselves can improve health information systems overall and enhance staff capacity for information use, presentation and analysis for decision-making.

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

    Directory of Open Access Journals (Sweden)

    X. Tang

    2011-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Arjan QEFALIA

    2012-06-01

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

  18. IMPROVEMENT IN QUALITY-OF-LIFE AFTER LAPAROSCOPIC NISSEN FUNDOPLICATION

    Directory of Open Access Journals (Sweden)

    Guilherme Tommasi KAPPAZ

    2014-09-01

    Full Text Available Context Evaluating quality of life after surgery for gastroesophageal reflux is fundamental, since improvement of symptoms is the main goal of treatment. Objective To compare the satisfaction of patients operated for GERD, interviewed at the office, with patients interviewed by telephone. Methods One hundred and seventy-eight patients were submitted to laparoscopic Nissen fundoplication. Ninety patients were found, and 45 agreed to come to the hospital’s office. The other 45 patients were interviewed by telephone. Quality of life was evaluated using three methods: The GERD-HRQL questionnaire, translated to Portuguese; question “If you could choose it today, would you do surgery again?”; and question “If you could classify your symptom improvement between 0 and 10, which grade would you give?” Patients were divided in group A (office interview and B (telephone interview. Statistical analysis was performed. Results The average GERD-HRQL score in group A was 6.29, while in group B was 14.09(P = 0.002. There was no statistical difference between groups A and B regarding patients choice of doing the surgery again(P = 0.714 and their grade of postoperative symptom improvement (P = 0.642. Conclusion The overall postoperative satisfaction was high. The GERD-HRQL questionnaire might not be suitable for application by telephone in our population, and based on other analyzes, the satisfaction and quality of life of patients interviewed at the office or by telephone was similar.

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

    Science.gov (United States)

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

    2015-01-01

    Background. Colorectal cancer remains the second most common cause of death from malignancies, but treatment results show high diversity. Certified bowel cancer centres (BCC) are the basis of a German project for improvement of treatment. The aim of this study was to analyze if certification would enhance short-term outcome in rectal cancer surgery. Material and Methods. This quality assurance study included 8197 patients with rectal cancer treated between 1 January 2008 and 31 December 2010. We compared cohorts treated in certified and noncertified hospitals regarding preoperative variables and perioperative outcomes. Outcomes were verified by matched-pair analysis. Results. Patients of noncertified hospitals had higher ASA-scores, higher prevalence of risk factors, more distant metastases, lower tumour localization, lower frequency of pelvic MRI, and higher frequencies of missing values and undetermined TNM classifications (significant differences only). Outcome analysis revealed more general complications in certified hospitals (20.3% versus 17.4%, p = 0.03). Both cohorts did not differ significantly in percentage of R0-resections, intraoperative complications, anastomotic leakage, in-hospital death, and abdominal wall dehiscence. Conclusions. The concept of BCC is a step towards improving the structural and procedural quality. This is a good basis for improving outcome quality but cannot replace it. For a primary surgical disease like rectal cancer a specific, surgery-targeted program is still needed. PMID:26064091

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

    Directory of Open Access Journals (Sweden)

    Martin Bac

    2015-02-01

    Full Text Available Background: The short timeframe of medical students’ rotations is not always conducive to successful, in-depth quality-improvement projects requiring a more longitudinal approach.Aim: To describe the process of inducting students into a longitudinal quality-improvement project,using the topic of the Mother- and Baby-Friendly Initiative as a case study; and to explore the possible contribution of a quality-improvement project to the development of student competencies.Setting: Mpumalanga clinical learning centres, where University of Pretoria medical students did their district health rotations.Method: Consecutive student groups had to engage with a hospital’s compliance with specific steps of the Ten Steps to Successful Breastfeeding that form the standards for the Mother- and Baby-Friendly Initiative. Primary data sources included an on-site PowerPoint group presentation (n = 42, a written group report (n = 42 and notes of individual interviews in an end-of-rotation objectively structured clinical examination station (n = 139.Results: Activities in each rotation varied according to the needs identified through the application of the quality-improvement cycle in consultation with the local health team. The development of student competencies is described according to the roles of a medical expert in the CanMEDS framework: collaborator, health advocate, scholar, communicator, manager and professional. The exposure to the real-life situation in South African public hospitals had a great influence on many students, who also acted as catalysts for transforming practice.Conclusion: Service learning and quality-improvement projects can be successfully integrated in one rotation and can contribute to the development of the different roles of a medical expert. More studies could provide insight into the potential of this approach in transforming institutions and student learning.

  1. Improving the Data Quality of Advanced LIGO Based on Early Engineering Run Results

    CERN Document Server

    Nuttall, L K; Areeda, J; Betzwieser, J; Dwyer, S; Effler, A; Fisher, R P; Fritschel, P; Kissel, J S; Lundgren, A P; Macleod, D M; Martynov, D; McIver, J; Mullavey, A; Sigg, D; Smith, J R; Vajente, G; Williamson, A R; Wipf, C C

    2015-01-01

    The Advanced Laser Interferometer Gravitational-wave Observatory (LIGO) detectors have completed their initial upgrade phase and will enter the first observing run in late 2015, with detector sensitivity expected to improve in future runs. Through the combined efforts of on-site commissioners and the Detector Characterization group of the LIGO Scientific Collaboration, interferometer performance, in terms of data quality, at both LIGO observatories has vastly improved from the start of commissioning efforts to present. Advanced LIGO has already surpassed Enhanced LIGO in sensitivity, and the rate of noise transients, which would negatively impact astrophysical searches, has improved. Here we give details of some of the work which has taken place to better the quality of the LIGO data ahead of the first observing run.

  2. Improving the data quality of Advanced LIGO based on early engineering run results

    Science.gov (United States)

    Nuttall, L. K.; Massinger, T. J.; Areeda, J.; Betzwieser, J.; Dwyer, S.; Effler, A.; Fisher, R. P.; Fritschel, P.; Kissel, J. S.; Lundgren, A. P.; Macleod, D. M.; Martynov, D.; McIver, J.; Mullavey, A.; Sigg, D.; Smith, J. R.; Vajente, G.; Williamson, A. R.; Wipf, C. C.

    2015-12-01

    The Advanced Laser Interferometer Gravitational-wave Observatory (LIGO) detectors have completed their initial upgrade phase and will enter the first observing run in late 2015, with detector sensitivity expected to improve in future runs. Through the combined efforts of on-site commissioners and the Detector Characterization Group of the LIGO Scientific Collaboration, interferometer performance, in terms of data quality, at both LIGO observatories has vastly improved from the start of commissioning efforts to present. Advanced LIGO has already surpassed Enhanced LIGO in sensitivity, and the rate of noise transients, which would negatively impact astrophysical searches, has improved. Here we give details of some of the work which has taken place to better the quality of the LIGO data ahead of the first observing run.

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

    Science.gov (United States)

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

    2015-01-01

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

  4. Improving the hygienic quality of chicken through radiation processing

    International Nuclear Information System (INIS)

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

  5. Understanding the "How" of Quality Improvement: Lessons from the Rhode Island Program Quality Intervention

    Science.gov (United States)

    Devaney, Elizabeth; Smith, Charles; Wong, Kenneth

    2012-01-01

    Over the past 10 years, afterschool and youth development programming has moved from providing childcare for working parents to being an integral component of the learning day, supporting the academic, social, and emotional development of young people. An important part of that transition has been a growing emphasis on improving program quality.…

  6. Leading quality improvement in primary care: recommendations for success.

    Science.gov (United States)

    Van Hoof, Thomas J; Bisognano, Maureen; Reinertsen, James L; Meehan, Thomas P

    2012-09-01

    Leadership is increasingly recognized as a potential factor in the success of primary care quality improvement efforts, yet little is definitively known about which specific leadership behaviors are most important. Until more research is available, the authors suggest that primary care clinicians who are committed to developing their leadership skills should commit to a series of actions. These actions include embracing a theory of leadership, modeling the approach for others, focusing on the goal of improving patient outcomes, encouraging teamwork, utilizing available sources of power, and reflecting on one's approach in order to improve it. Primary care clinicians who commit themselves to such actions will be more effective leaders and will be more prepared as new research becomes available on this important factor. PMID:22800874

  7. Interventions to improve water quality for preventing diarrhoea

    Science.gov (United States)

    Clasen, Thomas F; Alexander, Kelly T; Sinclair, David; Boisson, Sophie; Peletz, Rachel; Chang, Howard H; Majorin, Fiona; Cairncross, Sandy

    2015-01-01

    Background Diarrhoea is a major cause of death and disease, especially among young children in low-income countries. In these settings, many infectious agents associated with diarrhoea are spread through water contaminated with faeces. In remote and low-income settings, source-based water quality improvement includes providing protected groundwater (springs, wells, and bore holes), or harvested rainwater as an alternative to surface sources (rivers and lakes). Point-of-use water quality improvement interventions include boiling, chlorination, flocculation, filtration, or solar disinfection, mainly conducted at home. Objectives To assess the effectiveness of interventions to improve water quality for preventing diarrhoea. Search methods We searched the Cochrane Infectious Diseases Group Specialized Register (11 November 2014), CENTRAL (the Cochrane Library, 7 November 2014), MEDLINE (1966 to 10 November 2014), EMBASE (1974 to 10 November 2014), and LILACS (1982 to 7 November 2014). We also handsearched relevant conference proceedings, contacted researchers and organizations working in the field, and checked references from identified studies through 11 November 2014. Selection criteria Randomized controlled trials (RCTs), quasi-RCTs, and controlled before-and-after studies (CBA) comparing interventions aimed at improving the microbiological quality of drinking water with no intervention in children and adults. Data collection and analysis Two review authors independently assessed trial quality and extracted data. We used meta-analyses to estimate pooled measures of effect, where appropriate, and investigated potential sources of heterogeneity using subgroup analyses. We assessed the quality of evidence using the GRADE approach. Main results Forty-five cluster-RCTs, two quasi-RCTs, and eight CBA studies, including over 84,000 participants, met the inclusion criteria. Most included studies were conducted in low- or middle-income countries (LMICs) (50 studies) with unimproved water sources (30 studies) and unimproved or unclear sanitation (34 studies). The primary outcome in most studies was self-reported diarrhoea, which is at high risk of bias due to the lack of blinding in over 80% of the included studies. Source-based water quality improvements There is currently insufficient evidence to know if source-based improvements such as protected wells, communal tap stands, or chlorination/filtration of community sources consistently reduce diarrhoea (one cluster-RCT, five CBA studies, very low quality evidence). We found no studies evaluating reliable piped-in water supplies delivered to households. Point-of-use water quality interventions On average, distributing water disinfection products for use at the household level may reduce diarrhoea by around one quarter (Home chlorination products: RR 0.77, 95% CI 0.65 to 0.91; 14 trials, 30,746 participants, low quality evidence; flocculation and disinfection sachets: RR 0.69, 95% CI 0.58 to 0.82, four trials, 11,788 participants, moderate quality evidence). However, there was substantial heterogeneity in the size of the effect estimates between individual studies. Point-of-use filtration systems probably reduce diarrhoea by around a half (RR 0.48, 95% CI 0.38 to 0.59, 18 trials, 15,582 participants, moderate quality evidence). Important reductions in diarrhoea episodes were shown with ceramic filters, biosand systems and LifeStraw® filters; (Ceramic: RR 0.39, 95% CI 0.28 to 0.53; eight trials, 5763 participants, moderate quality evidence; Biosand: RR 0.47, 95% CI 0.39 to 0.57; four trials, 5504 participants, moderate quality evidence; LifeStraw®: RR 0.69, 95% CI 0.51 to 0.93; three trials, 3259 participants, low quality evidence). Plumbed in filters have only been evaluated in high-income settings (RR 0.81, 95% CI 0.71 to 0.94, three trials, 1056 participants, fixed effects model). In low-income settings, solar water disinfection (SODIS) by distribution of plastic bottles with instructions to leave filled bottles in direct sunlight for at least six hours before drinking p

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

    International Nuclear Information System (INIS)

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

  9. Effectiveness of a quality improvement curriculum for medical students

    Directory of Open Access Journals (Sweden)

    Kimberly M. Tartaglia

    2015-05-01

    Full Text Available Introduction: As health systems find ways to improve quality of care, medical training programs are finding opportunities to prepare learners on principles of quality improvement (QI. The impact of QI curricula for medical students as measured by student learning is not well delineated. The aim of this study is to evaluate the effectiveness of a QI curriculum for senior medical students as measured by student knowledge and skills. Methods: This study was an observational study that involved a self-assessment and post-test Quality Improvement Knowledge Application Tool (QIKAT for intervention and control students. A QI curriculum consisting of online modules, live discussions, independent readings and reflective writing, and participation in a mentored QI project was offered to fourth-year medical students completing an honor's elective (intervention group. Senior medical students who received the standard QI curriculum only were recruited as controls. Results: A total of 22 intervention students and 12 control students completed the self-assessment and QIKAT. At baseline, there was no difference between groups in self-reported prior exposure to QI principles. Students in the intervention group reported more comfort with their skills in QI overall and in 9 of the 12 domains (p<0.05. Additionally, intervention students performed better in each of the three case scenarios (p<0.01. Discussion: A brief QI curriculum for senior medical students results in improved comfort and knowledge with QI principles. The strengths of our curriculum include effective use of classroom time and faculty mentorship with reliance on pre-existing online modules and written resources. Additionally, the curriculum is easily expandable to larger groups of students and transferable to other institutions.

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

    Martell, Charles

    1981-01-01

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

  12. 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

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

    Directory of Open Access Journals (Sweden)

    Nour-Mohammad Yaghoubi

    2011-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Gita N. Mody

    2014-03-01

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

  15. Improving the Quality of Published Chemical Names with Nomenclature Software

    Directory of Open Access Journals (Sweden)

    Gernot A. Eller

    2006-11-01

    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.

  16. 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

  17. Putting the spotlight on health literacy to improve quality care.

    Science.gov (United States)

    2003-07-01

    A recent survey from the American Medical Association Foundation found that the issue of health literacy is just a blip on many physicians' radar screens. However, this problem is beginning to receive greater attention because of its magnitude: An estimated 90 million adult Americans face challenges in understanding basic, common instructions given to them by their physicians. Related to low health literacy is the potential impact on patient outcomes, which could mean additional healthcare costs of up to $73 billion annually. This issue of The Quality Letter for Healthcare Leaders looks at how health literacy is defined and what can be done to improve communication among providers and patients from all walks of life to promote quality healthcare. PMID:12918286

  18. QUALITY IMPROVEMENT IN MULTIRESPONSE EXPERIMENTS THROUGH ROBUST DESIGN METHODOLOGY

    Directory of Open Access Journals (Sweden)

    M. Shilpa

    2012-06-01

    Full Text Available Robust design methodology aims at reducing the variability in the product performance in the presence of noise factors. Experiments involving simultaneous optimization of more than one quality characteristic are known as multiresponse experiments which are used in the development and improvement of industrial processes and products. In this paper, robust design methodology is applied to optimize the process parameters during a particular operation of rotary driving shaft manufacturing process. The three important quality characteristics of the shaft considered here are of type Nominal-the-best, Smaller-the-better and Fraction defective. Simultaneous optimization of these responses is carried out by identifying the control parameters and conducting the experimentation using L9 orthogonal array.

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

    Science.gov (United States)

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

    1994-01-01

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

  20. BIOCHAR TO IMPROVE THE QUALITY AND PRODUCTIVITY OF SOILS

    Directory of Open Access Journals (Sweden)

    Mariola ?cis?owska

    2015-06-01

    Full Text Available The paper presents the results of research focused on the investigations of the possibilities to use biochar to improve the quality and productivity of soils. Biochar is a material similar to the commonly known charcoal obtained from the thermolysis process (a process similar to dry distillation of wood. The structure and technical properties of biochar depend on the type of biomass which is produced and the thermal decomposition process conditions: process time, temperature and atmosphere. It was found that a positive effect of biochar on the soil properties is manifested through the improvement of soil fertility, better water retention, improvement of the cation exchange, and the regulation of the pH. The biochar used in the present study was obtained by autothermal thermolysis of biomass at 300 °C. Three types of biochars of different origin were used. The biochar samples were subjected to ultimate and proximate analysis, as well as structural and porosimetric investigations. The experimental research were also conducted on the experimental test field and gave a positive effect of the presence of biochar on soil quality and plant yield. Biochar introduced into soil allows for long-term storage of carbon. The introduction of biochar to soil has a positive effect on plant growth, higher dose resulted in an increase in biochar and plant mass.

  1. Performance indicators: A tool for continuous quality improvement

    Science.gov (United States)

    Bhatnagar, Nidhi M; Soni, Shital; Gajjar, Maitrey; Shah, Mamta; Shah, Sangita; Patel, Vaidehi

    2016-01-01

    Background: Performance monitoring is an important tool which can be used for setting priorities for process improvement. At our centre, we have been monitoring every step in the processes, right from inventory of consumables (both critical and routine) to number of donors reactive for TTI. We conducted a study to measure the impact of monitoring Performance Indicators and how it could be used as a tool for Continuous Quality Improvement (CQI). Materials and Methods: The present study was a retrospective study where the performance indicator (PI) data of blood bank was analyzed for over four years. For certain parameters, benchmarks or thresholds were set that represented warning limits or action limits. The yearly data were collated from monthly data. Shifts or Trends, if any, were identified and Corrective and Preventive Action (CAPA) taken accordingly. At the end, outcomes of the analysis were charted. Results: After the yearly data evaluation, outcomes obtained were used to plan, correct and amend processes and systems in the blood center. It was observed that the workload of the center showed an upward trend. This helped us to plan for the purchase of consumables and management of manpower. The monitoring of usage and discard of blood helped in the efficient management of blood stocks. The need for any new equipment could also be judged by the trends in workload. Conclusion: Performance indicators are indispensible tools which various stakeholders in the Blood Transfusion centres should implement to improve on quality performance.

  2. 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.

  3. The Association of Couples' Relationship Status and Quality with Breastfeeding Initiation

    Science.gov (United States)

    Gibson-Davis, Christina M.; Brooks-Gunn, Jeanne

    2007-01-01

    Using data from the Fragile Families and Child Wellbeing Survey (N= 3,567), we examine the links between relationship status, relationship quality, and race and ethnicity in breastfeeding initiation. We consider four relationship types: married, cohabiting, romantically involved but not cohabiting (termed visiting), and nonromantically involved…

  4. Assessment of improvement scenario for water quality in Mogan Lake by using the AQUATOX Model.

    Science.gov (United States)

    Akkoyunlu, Atilla; Karaaslan, Yakup

    2015-09-01

    In this study, the improvement scenarios for water quality in Mogan Lake were investigated using the AQUATOX Model. The ecosystem model AQUATOX simulates conventional pollutants, such as nutrients and sediments, and considers several trophic levels, including attached and planktonic algae, submerged aquatic vegetation, several types of invertebrates, and several types of fish. In this study, all data measured at both lakes and creeks was loaded into the AQUATOX Model including both initial concentration and dynamic loading for the year 2002. Then, the AQUATOX Model was calibrated and verified for the years 2004 and 2005. Accordingly, the Aquatox Model was utilized for the analysis of future scenarios as to improve water quality in terms of conventional parameters such as dissolved oxygen, temperature, total suspended solids, pH, total nitrogen, total phosphorus, and labile and refractory organic matters in water colon and sediment. During the development of future scenarios, some plans regarding measures were taken into account the modeling periods. In one of the scenarios, constructed wetlands located in big creeks' mouths were used for improving the water quality in Mogan Lake. The results indicated that Mogan Lake would improve its hypertrophic situation towards eutrophic situation. It would be anticipated that if the situation goes on like this, Mogan Lake would improve eutrophic situation towards mezotrophic situation. PMID:26257116

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

    Science.gov (United States)

    Batalden, P B

    1991-01-01

    At the heart of organization-wide quality improvement in healthcare is the need to build knowledge for improvement that complements the subject matter knowledge of healthcare. Dr. W. Edwards Deming, the quality improvement pioneer, has suggested that "profound knowledge," or knowledge required for improvement, consists of four basic dimensions: Knowledge of the organization as a system. At its heart this knowledge is an understanding of the methods of production, the methods of improvement, and the aim of the entire enterprise. This concept was first presented by Deming at Mount Hakone, Japan, in 1950. In his book Out of the Crisis (1986), Deming illustrates the organization as a system. Knowledge of variation. This understanding comes from the awareness that a system of causes is at work producing any result. These sources of the variation, which can be observed in any process, are what must be acted upon to improve the results of the process. Studying the variation in a process can provide clues to the most economical actions that managers can take for improvement. It involves knowledge of the difference between common and special cause variation. Knowledge of psychology. The focus is on an awareness of the power of intrinsic motivation, a sense of self-worth and pride in what is done in the workplace. Theory of knowledge. How is new knowledge built? What is the purpose of knowledge? What is the nature of knowledge? Unless these issues are clear, it will not be easy to build useful knowledge. Deming has provided further insight into this framework in a recent unpublished essay and is currently working to further expand these concepts in additional publications in preparation. This framework helps build the knowledge necessary for the improvement of healthcare. As you work to build that knowledge, however, you will confront a wide variety of terms and a language that may in some ways be unfamiliar. In recognition of that, an introductory glossary is offered for your use and reference. With time, it can, should, and will be replaced by an expanded lexicon. Other sources that interested readers may wish to consult include the references listed at the end of the glossary. PMID:10112990

  6. A new research agenda for improvements in quality of life

    CERN Document Server

    Maggino, Filomena

    2015-01-01

    This book presents a new research agenda for improvements in Quality of Life research. It includes topics such as: -Studying QoL in particular subpopulations and selected subgroups -Disentangling the difficult task of identifying determinants of QoL -Perfectionating the measurement of conceptual dimensions -Defining new indicators able to measure and monitor particular social conditions and shows that these are not separated fields of studies but intersect each other and produce different outcomes which can be with difficulty classifiable, consistent with the idea of the complexity of

  7. A quality improvement study performed at Creative Factory

    OpenAIRE

    Venter, Dewald

    2013-01-01

    This report will give and overview of what is done during the year at Creative Factory to improve the quality of the plastic products that they produce. The factory is analysed on a macro level to identify the problems that the factory experience and then a faulty production line is analysed on a micro level to give more detail on the problem. This production line is used to illustrate how Industrial Engineering techniques can be used to create a set of heuristic rules in order to solve the p...

  8. 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

  9. Using DSP technology to improve sound quality in active speakers

    OpenAIRE

    Magnusson, Mattias

    2010-01-01

    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....

  10. A New Model for Software Engineering Systems Quality Improvement

    Directory of Open Access Journals (Sweden)

    Ahmad A. Al-Rababah

    2014-04-01

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

  11. 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

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

    CERN Document Server

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

    2011-01-01

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

  13. Learning leadership skills in practice through quality improvement.

    Science.gov (United States)

    Gamble, James; Vaux, Emma

    2014-02-01

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

  14. Quality Improvement of Multispectral Images for Ancient Document Analysis.

    Czech Academy of Sciences Publication Activity Database

    Bianco, G.; Bruno, F.; Salerno, E.; Tonazzini, A.; Zitová, Barbara; Šroubek, Filip

    Budapest : ARCHAEOLINGUA, 2010 - (Ioannides, M.; Fellner, D.; Georgopoulos, A.; Hadjimitsis, D.), s. 29-34 ISBN 978-963-9911-16-1. [3rd International Conference dedicated on Digital Heritage. Limasol (CY), 08.11.2010-13.11.2010] R&D Projects: GA MŠk 1M0572; GA ?R GA102/08/1593 Institutional research plan: CEZ:AV0Z10750506 Keywords : document analysis * deblurring * image registration * multispectral imaging * blind source deconvolution Subject RIV: JD - Computer Applications, Robotics http:// library .utia.cas.cz/separaty/2010/ZOI/zitova-quality%20improvement%20of%20multispectral%20images%20for%20ancient%20document%20analysis.pdf

  15. Electronic Data Collection Tools for Quality Improvement: Antibiotic Utilization Project

    OpenAIRE

    Benson, Kristin

    2003-01-01

    The project goal is to provide data on patterns of broad-spectrum antibiotic use in a pediatric clinic by utilizing electronic data collection tools. This was carried out as a quality improvement project sponsored by a local health network and one of its affiliated pediatric clinics. Pharmacy data was available to show relative rates of broad-spectrum antibiotic use, but this data was not linked to diagnostic categories or to total patient visits. There was also a lack of data showing the inf...

  16. Sleep Quality Improves During Treatment With Bryophyllum pinnatum

    Science.gov (United States)

    Hassani, Taziri Al; Müller-Hübenthal, Boris; Pittl, Sandra; Kuck, Angela; Meden, Harald; Eberhard, Jutta; Decker, Michael; Fürer, Karin; von Mandach, Ursula

    2015-01-01

    Hypothesis. Cancer patients frequently suffer from poor sleep quality. Bryophyllum pinnatum is a herbal medication used in anthroposophic medicine, which has been shown to be associated with improvements in sleep quality during pregnancy with only few and minor or moderate side-effects reported. In this study, the sleep quality of cancer patients during treatment with B pinnatum was investigated. Study Design. In this prospective, observational study, cancer patients suffering from sleep problems were treated with B pinnatum (350 mg tablets, corresponding to 50% of leaf pressed juice [Weleda AG, Arlesheim, Switzerland], dosage at physician’s consideration, but most frequently 2 tablets with evening meal and 2 before going to bed). Methods. Sleep quality (Pittsburgh Sleep Quality Index [PSQI]), daily sleepiness (Epworth Sleeping Scale [ESS]), and fatigue (Fatigue Severity Scale [FSS]) were assessed at the beginning of the treatment and after 3 weeks. Possible adverse drug reactions perceived by the patients during the treatment were recorded. From the 28 recruited patients, 20 completed both questionnaires and were considered in the present analysis. Data are expressed as mean ± standard deviation. Results. Patients were 61 ± 10.4 years old and the majority were female (17 out of 20). During treatment with B pinnatum, the PSQI decreased from 12.2 ± 3.62 to 9.1 ± 3.61 (P < .01), and ESS changed from 8.4 ± 3.18 to 7.1 ± 3.98 (P < .05). There was no change in FSS. The treatment was well tolerated by the majority of patients, with only 6 patients reporting discomfort that might have been caused by B pinnatum (fatigue n = 3, dry throat n = 1, agitation n = 1, difficult digestion n = 1). No serious adverse drug reactions were detected. Conclusion. B pinnatum may be a suitable treatment for sleep problems of cancer patients. Controlled, randomized clinical trials of the use of B pinnatum in sleep disorders are urgently needed. PMID:25873294

  17. Multi-hospital Community NICU Quality Improvement Improves Survival of ELBW Infants.

    Science.gov (United States)

    Owens, Jack D; Soltau, Thomas; McCaughn, Danny; Miller, Jason; O'Mara, Patrick; Robbins, Kenny; Temple, David M; Wender, David F

    2015-08-01

    Quality improvement or high reliability in medicine is an evolving science where we seek to integrate evidence-based medicine, structural resources, process management, leadership models, culture, and education. Newborn Associates is a community-based neonatology practice that staffs and manages neonatal intensive care units (NICU's) at Central Mississippi Medical Center, Mississippi Baptist Medical Center, River Oaks Hospital, St Dominic's Hospital and Woman's Hospital within the Jackson, Mississippi, metropolitan area. These hospitals participate in the Vermont-Oxford Neonatal Network (VON), which is a voluntary national network of about 1000 NICU groups that submit data allowing them to benchmark their patient outcome. This network currently holds data on 1.5 million infants. Participation may also include the Newborn Improvement Quality Collaborative (NICQ) which is an intensive quality improvement program where 40-60 of the almost 1000 VON centers participate each year or the iNICQ, which is an internet-based collaborative involving about 150 centers per year. From 2008-2009, our group concentrated efforts on quality improvement which included consolidating resources of three corporately managed hospitals to allow focused care of babies under 800-1000 grams at a single center, expanding participation in the VON NICQ to include all physicians and centers, and establishing a group QI focused committee aimed at sharing practice bundles and adopting quality improvement methodology. The goal of this article is to report the impact of these QI activities on survival of the smallest preterm infants who weigh less than 1500 grams at birth. Two epochs were compared: 2006-2009, and 2010-2013. 551 VLBW (< 1 500 grams) infants from epoch I were compared to 583 VLBW infants from epoch 2. Mortality in this group decreased from 18% to 11.1% (OR 0.62,95% CI 0.44-0.88). Mortality in the 501-750 grams birth weight category decreased from 45.7% to 18% (OR 0.39,95% CI 0.21-0.74). Improved survival was noted in all centers over the time period. These findings suggest that a physician-driven, multidisciplinary, individualized and multifactorial quality improvement effort can positively impact the care of extremely preterm infants in the community NICU setting. PMID:26521537

  18. Air Quality in Mexico City: Policies Implemented for its Improvement

    Science.gov (United States)

    Paramo, V.

    2007-12-01

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

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

    DEFF Research Database (Denmark)

    Li, Ian; Medynskiy, Yevgeniy

    2012-01-01

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

  20. Methods for improving image quality in whole body PET scanning

    International Nuclear Information System (INIS)

    Whole body PET imaging is performed by acquiring data at multiple axial positions. From this data set, coronal and sagittal cross section images are formed by reorienting the transaxial tomographic images. Due to the short acquisition time at each axial position the noise levels in the final images are relatively high. The aim of this paper is to optimize some of the scanning parameters for whole body PET imaging to achieve best possible image quality. The detection efficiency of the PET system can be improved by using more coincidence plane combinations in addition to the conventional direct and cross planes. The effect of acquiring an additional set of coincidence planes with a plane separation of ± 2 was studied and showed a reduction in noise and improved uniformity without a significant loss in resolution

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

    OpenAIRE

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

    2009-01-01

    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...

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

    DEFF Research Database (Denmark)

    Christensen, M.; Grunert, Klaus G.; Bonneau, M.; Arnau, J.; Trienekens, J.; Oksbjerg, Niels; de Greef, K.; Petersen, B.; Karlsson, A. H.; Karlsson, Anders H

    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...... 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...... 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...

  3. Evaluating a nursing care delivery model using a quality improvement design.

    Science.gov (United States)

    Nardone, P L; Markie, J W; Tolle, S

    1995-10-01

    The goal to develop and implement a new model of nursing care delivery grew out of administrative and shared governance initiatives to improve the quality of nursing care. This evaluative study used both quantitative and qualitative methods. Seven principles related to quality were identified and became the driving force behind the changes. Aspects of these changes in care delivery were piloted on a neurological unit and included implementation of collaborative rounds, a modular structure, role changes, and work redesign. Frequency distribution, questionnaire, focus group, and financial data indicated that there had been improvement in the delivery of care in addition to financial benefits. A considerable amount of the data provided evidence that supported continuing the changes. PMID:7579550

  4. Triage or Tapestry? Teacher Unions' Work toward Improving Teacher Quality in an Era of Systemic Reform. A Research Report. Document R-03-1

    Science.gov (United States)

    Bascia, Nina

    2003-01-01

    This report looks at and identifies emerging trends in the roles that teacher unions play in educational reform and improving the quality of teaching. A description of the efforts of six teacher unions to improve teacher quality within the context of the current systemic reform movement shows a range and depth of union initiatives beyond what is…

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

    LENUS (Irish Health Repository)

    White, Mark

    2014-05-14

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

  6. A Knowledge Management Approach to Support Software Process Improvement Implementation Initiatives

    Science.gov (United States)

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

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

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

    Directory of Open Access Journals (Sweden)

    Jessina Masamha

    2014-09-01

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

  8. Improving reliability of SCB initiators based on Al/Ni multilayer nanofilms

    Science.gov (United States)

    Zhu, Peng; Li, Dongle; Fu, Shuai; Hu, Bo; Shen, Ruiqi; Ye, Yinghua

    2013-07-01

    This paper exploits an energetic initiator realized by integrating Al/Ni multilayer nanofilms with semiconductor bridge (SCB). The as-deposited nanofilms have been characterized with varied analytical techniques. Results show that distinct nanofilms are sputter deposited in a layered geometry and give a heat of reaction equal to 1134 J/g. The firing tests of the initiators were accomplished using capacitor discharge unit. Results show that the initiators possess several excellent characteristics such as fast ignition time, low power consumption, high output energy and so on. Therefore, Al/Ni multilayer nanofilms are suitable heat source for improving the reliability of SCB initiators.

  9. Implementation of quality improvement techniques for management and technical processes in the ACRV project

    Science.gov (United States)

    Raiman, Laura B.

    1992-01-01

    Total Quality Management (TQM) is a cooperative form of doing business that relies on the talents of everyone in an organization to continually improve quality and productivity, using teams and an assortment of statistical and measurement tools. The objective of the activities described in this paper was to implement effective improvement tools and techniques in order to build work processes which support good management and technical decisions and actions which are crucial to the success of the ACRV project. The objectives were met by applications in both the technical and management areas. The management applications involved initiating focused continuous improvement projects with widespread team membership. The technical applications involved applying proven statistical tools and techniques to the technical issues associated with the ACRV Project. Specific activities related to the objective included working with a support contractor team to improve support processes, examining processes involved in international activities, a series of tutorials presented to the New Initiatives Office and support contractors, a briefing to NIO managers, and work with the NIO Q+ Team. On the technical side, work included analyzing data from the large-scale W.A.T.E.R. test, landing mode trade analyses, and targeting probability calculations. The results of these efforts will help to develop a disciplined, ongoing process for producing fundamental decisions and actions that shape and guide the ACRV organization .

  10. Implementation of quality improvement techniques for management and technical processes in the ACRV project

    Science.gov (United States)

    Raiman, Laura B.

    1992-12-01

    Total Quality Management (TQM) is a cooperative form of doing business that relies on the talents of everyone in an organization to continually improve quality and productivity, using teams and an assortment of statistical and measurement tools. The objective of the activities described in this paper was to implement effective improvement tools and techniques in order to build work processes which support good management and technical decisions and actions which are crucial to the success of the ACRV project. The objectives were met by applications in both the technical and management areas. The management applications involved initiating focused continuous improvement projects with widespread team membership. The technical applications involved applying proven statistical tools and techniques to the technical issues associated with the ACRV Project. Specific activities related to the objective included working with a support contractor team to improve support processes, examining processes involved in international activities, a series of tutorials presented to the New Initiatives Office and support contractors, a briefing to NIO managers, and work with the NIO Q+ Team. On the technical side, work included analyzing data from the large-scale W.A.T.E.R. test, landing mode trade analyses, and targeting probability calculations. The results of these efforts will help to develop a disciplined, ongoing process for producing fundamental decisions and actions that shape and guide the ACRV organization .

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

    Directory of Open Access Journals (Sweden)

    Prof.N..Penchalaiah

    2011-02-01

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

  12. IMPROVING BANK QUALITY DIMENSIONS TO INCREASE CUSTOMER SATISFACTION

    Directory of Open Access Journals (Sweden)

    L?cr?mioara RADOMIR

    2011-01-01

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

  13. Improving Inland Water Quality Monitoring through Remote Sensing Techniques

    Directory of Open Access Journals (Sweden)

    Igor Ogashawara

    2014-11-01

    Full Text Available Chlorophyll-a (chl-a levels in lake water could indicate the presence of cyanobacteria, which can be a concern for public health due to their potential to produce toxins. Monitoring of chl-a has been an important practice in aquatic systems, especially in those used for human services, as they imply an increased risk of exposure. Remote sensing technology is being increasingly used to monitor water quality, although its application in cases of small urban lakes is limited by the spatial resolution of the sensors. Lake Thonotosassa, FL, USA, a 3.45-km2 suburban lake with several uses for the local population, is being monitored monthly by traditional methods. We developed an empirical bio-optical algorithm for the Moderate Resolution Imaging Spectroradiometer (MODIS daily surface reflectance product to monitor daily chl-a. We applied the same algorithm to four different periods of the year using 11 years of water quality data. Normalized root mean squared errors were lower during the first (0.27 and second (0.34 trimester and increased during the third (0.54 and fourth (1.85 trimesters of the year. Overall results showed that Earth-observing technologies and, particularly, MODIS products can also be applied to improve environmental health management through water quality monitoring of small lakes.

  14. SQUIRE 2.0 (Standards for QUality Improvement Reporting Excellence)

    Science.gov (United States)

    Ogrinc, Greg; Davies, Louise; Goodman, Daisy; Batalden, Paul; Davidoff, Frank; Stevens, David

    2015-01-01

    In the past several years, the science of health care improvement has advanced considerably. In this article, we describe the development of SQUIRE 2.0 and its key components. We undertook the revision between 2012 and 2015 using (1) interviews and focus groups to evaluate SQUIRE 1.0 plus feedback from an international steering group, (2) face-to-face consensus meetings to develop interim drafts, and (3) pilot testing with authors and a public comment period. SQUIRE 2.0 emphasizes 3 key components of systematic efforts to improve the quality, value, and safety of health care: formal and informal theory in planning, implementing, and evaluating improvement work; the context in which the work is done; and the study of the intervention(s). SQUIRE 2.0 is intended for reporting the range of methods used to improve health care, recognizing that they can be complex and multidimensional. It provides common ground to share these discoveries in the scholarly literature (www.squire-statement.org). PMID:26497490

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

    Directory of Open Access Journals (Sweden)

    Pongchai Nimcharoenwon

    2012-11-01

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

  16. Controlled therapeutic gas delivery systems for quality-improved transplants.

    Science.gov (United States)

    Steiger, Christoph; Wollborn, Jakob; Gutmann, Marcus; Zehe, Markus; Wunder, Christian; Meinel, Lorenz

    2015-11-01

    Therapeutic gases enriched into perfusion solutions have been effectively used for the improvement of organ transplant quality. At present, the enrichment of perfusion solutions with gases requires complex machinery/containers and handling precautions. Alternatively, the gas is generated within the perfusion solution by supplemented carbonylated transition metal complexes with associated toxicological concerns when these metals contact the transplant. Therefore, we developed therapeutic gas releasing systems (TGRSs) allowing for the controlled generation and release of therapeutic gases (carbon monoxide and hydrogen sulfide) from otherwise hermetically sealed containers, such that the perfusion solution for the transplant is saturated with the gas but no other components from the TGRS are liberated in the solution. The release from the TGRS into the perfusion solution can be tailored as a function of the number and thickness of gas permeable membranes leading to release patterns having been linked to therapeutic success in previous trials. Furthermore, the surrogate biomarker HMGB1 was significantly downregulated in ischemic rat liver transplants perfused with enriched CO solution as compared to control. In conclusion, the TGRS allows for easy, reliable, and controlled generation and release of therapeutic gases while removing safety concerns of current approaches, thereby positively impacting the risk benefit profile of using therapeutic gases for transplant quality improvement in the future. PMID:26527426

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

    Science.gov (United States)

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

    1993-01-01

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

  18. Ripening for improving the quality of inoculated cheese Rhizopus oryzae

    Directory of Open Access Journals (Sweden)

    ARTINI PANGASTUTI

    2010-01-01

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

  19. Quality of care in reproductive health programmes: monitoring and evaluation of quality improvement.

    Science.gov (United States)

    Kwast, B E

    1998-12-01

    As 200 million women become pregnant every year, at least 30 million will develop life-threatening complications requiring emergency treatment at any level of society where they live. But it is a basic human right that pregnancy be made safe for all women as complications are mostly unpredictable. This requires reproductive health programmes which are responsive to women's and their families' needs and expectations on the one hand and enhancement of community participation, high quality obstetric services, and both provider collaboration and satisfaction on the other. Monitoring and evaluation of these facets need to be an integral part of any safe motherhood programme, not only to assess progress, but also to use this information for subsequent planning and implementation cycles of national programmes. Lessons learned from ten years' implementation of Safe Motherhood programmes indicate that process and outcome indicators are more feasible for short-term evaluation purposes than impact indicators, such as maternal mortality reduction. The former are described in this paper with relevant country examples. This is the third, and last, article in a series on quality of care in reproductive health programmes. The first (Kwast 1998a) contains an overview of concepts, assessments, barriers and improvements of quality of care. The second (Kwast 1998b) addresses education issues for quality improvement. PMID:10076314

  20. Development of process and outcome measures for improvement: lessons learned in a quality improvement collaborative for pediatric inflammatory bowel disease.

    Science.gov (United States)

    Crandall, Wallace V; Boyle, Brendan M; Colletti, Richard B; Margolis, Peter A; Kappelman, Michael D

    2011-10-01

    The Institute of Medicine's publications, To Err is Human and Crossing the Quality Chasm, publicized the widespread deficits in healthcare quality. The quality of care in inflammatory bowel disease (IBD) has not been comprehensively evaluated, in part due to a lack of well-established IBD measures of quality. Quality can be measured for evaluation, benchmarking, or continuous quality improvement, using structural, process, and outcome measures. Measurement is an essential component of the model for improvement, necessary to determine whether changes made have resulted in improvement. Measures used for quality improvement should be based on evidence and consensus, be clear and collectable in a timely fashion, occur with sufficient frequency, and have the potential to improve outcomes. While no current IBD measures of quality are perfect, an iterative process of measure development can produce a set of measures that are feasible, relevant, and useful for performing quality improvement. This review describes the history, rationale, and methods of quality measurement and discusses the early work and lessons learned from measuring quality of care in a pediatric IBD quality improvement collaborative. PMID:21456033

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

    DEFF Research Database (Denmark)

    Vincze, Éva; Dionisio, Giuseppe

    2011-01-01

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

  2. Improving critical care discharge summaries: a collaborative quality improvement project using PDSA

    Science.gov (United States)

    Goulding, Lucy; Parke, Hannah; Maharaj, Ritesh; Loveridge, Robert; McLoone, Anne; Hadfield, Sophie; Helme, Eloise; Hopkins, Philip; Sandall, Jane

    2015-01-01

    Around 110,000 people spend time in critical care units in England and Wales each year. The transition of care from the intensive care unit to the general ward exposes patients to potential harms from changes in healthcare providers and environment. Nurses working on general wards report anxiety and uncertainty when receiving patients from critical care. An innovative form of enhanced capability critical care outreach called ‘iMobile’ is being provided at King's College Hospital (KCH). Part of the remit of iMobile is to review patients who have been transferred from critical care to general wards. The iMobile team wished to improve the quality of critical care discharge summaries. A collaborative evidence-based quality improvement project was therefore undertaken by the iMobile team at KCH in conjunction with researchers from King's Improvement Science (KIS). Plan, Do, Study, Act (PDSA) methodology was used. Three PDSA cycles were undertaken. Methods adopted comprised: a scoping literature review to identify relevant guidelines and research evidence to inform all aspects of the quality improvement project; a process mapping exercise; informal focus groups / interviews with staff; patient story-telling work with people who had experienced critical care and subsequent discharge to a general ward; and regular audits of the quality of both medical and nursing critical care discharge summaries. The following behaviour change interventions were adopted, taking into account evidence of effectiveness from published systematic reviews and considering the local context: regular audit and feedback of the quality of discharge summaries, feedback of patient experience, and championing and education delivered by local opinion leaders. The audit results were mixed across the trajectory of the project, demonstrating the difficulty of sustaining positive change. This was particularly important as critical care bed occupancy and through-put fluctuates which then impacts on work-load, with new cohorts of staff regularly passing through critical care. In addition to presenting the results of this quality improvement project, we also reflect on the lessons learned and make suggestions for future projects.

  3. Improving critical care discharge summaries: a collaborative quality improvement project using PDSA.

    Science.gov (United States)

    Goulding, Lucy; Parke, Hannah; Maharaj, Ritesh; Loveridge, Robert; McLoone, Anne; Hadfield, Sophie; Helme, Eloise; Hopkins, Philip; Sandall, Jane

    2015-01-01

    Around 110,000 people spend time in critical care units in England and Wales each year. The transition of care from the intensive care unit to the general ward exposes patients to potential harms from changes in healthcare providers and environment. Nurses working on general wards report anxiety and uncertainty when receiving patients from critical care. An innovative form of enhanced capability critical care outreach called 'iMobile' is being provided at King's College Hospital (KCH). Part of the remit of iMobile is to review patients who have been transferred from critical care to general wards. The iMobile team wished to improve the quality of critical care discharge summaries. A collaborative evidence-based quality improvement project was therefore undertaken by the iMobile team at KCH in conjunction with researchers from King's Improvement Science (KIS). Plan, Do, Study, Act (PDSA) methodology was used. Three PDSA cycles were undertaken. Methods adopted comprised: a scoping literature review to identify relevant guidelines and research evidence to inform all aspects of the quality improvement project; a process mapping exercise; informal focus groups / interviews with staff; patient story-telling work with people who had experienced critical care and subsequent discharge to a general ward; and regular audits of the quality of both medical and nursing critical care discharge summaries. The following behaviour change interventions were adopted, taking into account evidence of effectiveness from published systematic reviews and considering the local context: regular audit and feedback of the quality of discharge summaries, feedback of patient experience, and championing and education delivered by local opinion leaders. The audit results were mixed across the trajectory of the project, demonstrating the difficulty of sustaining positive change. This was particularly important as critical care bed occupancy and through-put fluctuates which then impacts on work-load, with new cohorts of staff regularly passing through critical care. In addition to presenting the results of this quality improvement project, we also reflect on the lessons learned and make suggestions for future projects. PMID:26734368

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

    Science.gov (United States)

    Ishikura, Satoshi

    2008-11-01

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

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

    International Nuclear Information System (INIS)

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

  6. Better quality of life with neuropsychological improvement on HAART

    Directory of Open Access Journals (Sweden)

    Hall Colin D

    2006-02-01

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

  7. Implementation of the National Nursing Quality Report Initiative in Canada: Insights From Pilot Participants.

    Science.gov (United States)

    Jeffs, Lianne; Doran, Diane; Hayes, Laureen; Mainville, Claude; VanDeVelde-Coke, Susan; Lamont, Lori; Boal, Anne Sutherland

    2015-01-01

    A qualitative study was undertaken to explore the perceptions and experiences of nurse leaders associated with their participation in the pilot testing of a national nursing database. Interviews with 18 participants were conducted and analyzed using a direct content analysis approach. Three themes emerged including selecting, accessing, and uploading indicators; using indicators and monitoring tools for improvement; and perceiving involvement as a catalyst. Study findings may inform quality improvement efforts in health care organizations. PMID:25851073

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

    Science.gov (United States)

    Varkey, P; Kollengode, A

    2011-01-01

    Healthcare in India has been undergoing rapid changes in the last decade. As demand outpaces supply, quality improvement (QI) initiatives and tools can be beneficial to enhance safe, effective, efficient, equitable and timely care. Healthcare quality is the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge. This article discusses the framework for QI and reviews the Plan-Do-Study-Act (PDSA), Lean and Six Sigma methodologies, and briefly discusses key patient safety and quality measurement concepts. The PDSA cycle assists in testing the ideas through small tests of change or "pilots". Six Sigma aims at reducing variations in processes, and the Lean methodology predominantly focuses on enhancing process efficiency and eliminating non-value added steps in the process. It is likely that such structured problem solving approaches will provide an objective and systematic method of enhancing quality in healthcare institutions across India. As increasing attention being is paid on enhancing the quality of life through the Quality Council of India and accreditation of hospitals in India through the International Organization for standardization and National Accreditation Board for hospitals and healthcare providers, a focus on QI by institutional leaders and healthcare providers is key to enhancing the safety and quality of healthcare in India. Central to this also will be leadership buy-in, identification of a core faculty or team that will be the initiators of change, a respect for the need for faculty training and education in QI, measurement of issues to identify key priorities to focus on, and enhanced information systems where resources permit the same. PMID:21941069

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

    Directory of Open Access Journals (Sweden)

    P Varkey

    2011-01-01

    Full Text Available Healthcare in India has been undergoing rapid changes in the last decade. As demand outpaces supply, quality improvement (QI initiatives and tools can be beneficial to enhance safe, effective, efficient, equitable and timely care. Healthcare quality is the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge. This article discusses the framework for QI and reviews the Plan-Do-Study-Act (PDSA, Lean and Six Sigma methodologies, and briefly discusses key patient safety and quality measurement concepts. The PDSA cycle assists in testing the ideas through small tests of change or "pilots". Six Sigma aims at reducing variations in processes, and the Lean methodology predominantly focuses on enhancing process efficiency and eliminating non-value added steps in the process. It is likely that such structured problem solving approaches will provide an objective and systematic method of enhancing quality in healthcare institutions across India. As increasing attention being is paid on enhancing the quality of life through the Quality Council of India and accreditation of hospitals in India through the International Organization for standardization and National Accreditation Board for hospitals and healthcare providers, a focus on QI by institutional leaders and healthcare providers is key to enhancing the safety and quality of healthcare in India. Central to this also will be leadership buy-in, identification of a core faculty or team that will be the initiators of change, a respect for the need for faculty training and education in QI, measurement of issues to identify key priorities to focus on, and enhanced information systems where resources permit the same.

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

    OpenAIRE

    Buavaraporn, Nattapan

    2010-01-01

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

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

    Science.gov (United States)

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

    2014-12-01

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

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

    OpenAIRE

    Ning Jingfeng; Hu Ming

    2013-01-01

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

  13. Impact of Relaxation and Group Psycho-Education on Health Outcomes Using Integrated Care Models and Quality Improvement

    OpenAIRE

    Martha Okafor; Victor Ede; Rosemary Kinuthia; Debbie Strotz; Cathryn Marchman; Scott Weeks; David Satcher

    2014-01-01

    The purpose of this Integrated Care Practice Change and Quality Improvement (ICPCQI) initiative was to evaluate the impact of wellness and relaxation and group psycho-education on health out-comes in an integrated care setting. Individuals diagnosed with mental illness and a co-occurring chronic medical condition participated in the ICPCQI initiatives which were run by peer support and wellness experts in an integrated care setting over the one-year project implementation period. Evaluation o...

  14. Improvement in Adherence to Surgical Antimicrobial Prophylaxis Guidelines after Implementation of a Multidisciplinary Quality Improvement Project

    Science.gov (United States)

    Telfah, Shorouq; Nazer, Lama; Dirani, Manar; Daoud, Faiez

    2015-01-01

    Objectives: This study aimed to show the impact of a multidisciplinary quality improvement project on adherence to antimicrobial prophylaxis guidelines in oncological surgery. Methods: This pre- and post-intervention prospective observational study was carried out at the King Hussein Cancer Centre (KHCC) in Amman, Jordan, between August 2009 and February 2012. The quality improvement project consisted of revising the institutional guidelines for surgical antimicrobial prophylaxis, assigning a clinical pharmacist to the surgical department, establishing an operating room satellite pharmacy and providing education regarding the appropriate utilisation of antibiotics. The medical records of adult cancer patients who underwent surgery were evaluated one month before and one month after the project was implemented to assess adherence to the guidelines with regards to antibiotics prescribed, drug doses and timing and treatment duration. Results: A total of 70 patients were evaluated before and 97 patients were evaluated after the intervention, of which 57 (81.4%) and 95 (97.9%) patients received antibiotics, respectively. In comparing the pre- and post-intervention groups, an improvement was observed in the proportion of patients who received antibiotics at the appropriate time (n = 12 versus n = 79; 21.1% versus 83.2%; P <0.01), for the appropriate duration of time (n = 22 versus n = 94; 38.6% versus 99.0%; P <0.01) and in the appropriate dose (n = 9 versus n = 87; 56.3% versus 98.9%; P <0.01). Conclusion: Adherence to the antimicrobial prophylaxis guidelines at KHCC improved significantly after the implementation of a quality improvement project. PMID:26629381

  15. Improvement in Adherence to Surgical Antimicrobial Prophylaxis Guidelines after Implementation of a Multidisciplinary Quality Improvement Project

    Directory of Open Access Journals (Sweden)

    Shorouq Telfah

    2015-11-01

    Full Text Available Objectives: This study aimed to show the impact of a multidisciplinary quality improvement project on adherence to antimicrobial prophylaxis guidelines in oncological surgery. Methods: This pre- and post-intervention prospective observational study was carried out at the King Hussein Cancer Centre (KHCC in Amman, Jordan, between August 2009 and February 2012. The quality improvement project consisted of revising the institutional guidelines for surgical antimicrobial prophylaxis, assigning a clinical pharmacist to the surgical department, establishing an operating room satellite pharmacy and providing education regarding the appropriate utilisation of antibiotics. The medical records of adult cancer patients who underwent surgery were evaluated one month before and one month after the project was implemented to assess adherence to the guidelines with regards to antibiotics prescribed, drug doses and timing and treatment duration. Results: A total of 70 patients were evaluated before and 97 patients were evaluated after the intervention, of which 57 (81.4% and 95 (97.9% patients received antibiotics, respectively. In comparing the pre- and post-intervention groups, an improvement was observed in the proportion of patients who received antibiotics at the appropriate time (n = 12 versus n = 79; 21.1% versus 83.2%; P <0.01, for the appropriate duration of time (n = 22 versus n = 94; 38.6% versus 99.0%; P <0.01 and in the appropriate dose (n = 9 versus n = 87; 56.3% versus 98.9%; P <0.01. Conclusion: Adherence to the antimicrobial prophylaxis guidelines at KHCC improved significantly after the implementation of a quality improvement project.

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

    OpenAIRE

    Nieboer Anna P; Strating Mathilde MH

    2009-01-01

    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 program for...

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

    Directory of Open Access Journals (Sweden)

    Vladislav V. Serikov

    2015-09-01

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

  18. 77 FR 43822 - Proposed Information Collection Request; Comment Request; Valuing Improved Water Quality in the...

    Science.gov (United States)

    2012-07-26

    ... AGENCY Proposed Information Collection Request; Comment Request; Valuing Improved Water Quality in the... request (ICR), ``Valuing Improved Water Quality in the Chesapeake Bay Using Stated Preference Methods (New... Act (CWA) directs EPA to coordinate Federal and State efforts to improve water quality in...

  19. Examining Changes to Michigan's Early Childhood Quality Rating and Improvement System (QRIS). REL 2015-029

    Science.gov (United States)

    Faria, Ann-Marie; Hawkinson, Laura E.; Greenberg, Ariela C.; Howard, Eboni C.; Brown, Leah

    2015-01-01

    Documenting and improving early childhood program quality is a national priority, leading to a rapid expansion of Quality Rating and Improvement Systems (QRISs). QRISs document and improve the quality of early childhood education programs and provide clear information to families about their child care choices. The current study described how…

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

    DEFF Research Database (Denmark)

    Boulet, Louis-Philippe; FitzGerald, J Mark; Levy, Mark L; Cruz, Alvaro A; Pedersen, Soren; Haahtela, Tari; Bateman, Eric D

    2012-01-01

    In 1995, the Global Initiative for Asthma (GINA) published an evidence-based workshop report as a guide to clinicians managing asthma patients, and has updated it annually to ensure that recommendations remain current. Although the report has been widely disseminated and influenced clinical practice and research, its major objective, of forming the basis for local and national initiatives to improve services for asthma patients, remains to be achieved. Over recent years, the science of guideline...

  1. ISTC projects devoted to improving laser beam quality

    Science.gov (United States)

    Malakhov, Yu. I.

    2007-05-01

    Short overview is done about the activity of ISTC in a direction concerned with improving powerful laser beam quality by means of nonlinear and linear adaptive optics methods. Completed projects #0591 and #1929 resulted in the development of a stimulated Brillouin scattering (SBS) phase conjugation mirror of superhigh fidelity employing the kinoform optical elements (rasters of small lenses) of new generation designed for pulsed or pulse-periodic lasers with nanosecond scale pulse duration. Project #2631 is devoted to development of an adaptive optical system for phase registration and correction of laser beams with wave front vortices. The principles of operation of conventional adaptive systems are based on the assumption that the phase is a smooth continuous function in space. Therefore the solution of the Project tasks will assume a new step in adaptive optics.

  2. Improvement of Tagliatelle Quality by Addition of Red Quinoa Flour

    Directory of Open Access Journals (Sweden)

    Anamaria Pop

    2014-11-01

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

  3. Utilization of Portulaca Oleracea L. to Improve Quality of Yoghurt

    International Nuclear Information System (INIS)

    The present investigation was conducted to study the possibility of using Portulaca Oleracea L. as a source of Omega - 3 and Omega - 6 fatty acids as well as high vitamins and minerals, to improve the quality of yoghurt. Also, the microbial characteristics the treated yoghurt were evaluated. The obtained results showed that the replacement of milk fat by dry leaves of P. Oleracea had no effect on the chemical composition and the sensory properties of the treated yoghurt with 50 and 100% P. Oleracea L. leaves oil as milk fat substitute compared to the untreated one. In conclusion, manufacturing yoghurt is suitable as a rich nutrient food stuff for people suffering from blood hypertension, high blood cholesterol, liver and heart diseases

  4. 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

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

    International Nuclear Information System (INIS)

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

  6. Improving regional variation using quality of care measures

    Directory of Open Access Journals (Sweden)

    Scott A Berkowitz

    2009-11-01

    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

  7. Embryo Aggregation in Pig Improves Cloning Efficiency and Embryo Quality

    Science.gov (United States)

    Buemo, Carla Paola; Gambini, Andrés; Moro, Lucia Natalia; Hiriart, María Inés; Fernández-Martín, Rafael; Collas, Philippe; Salamone, Daniel Felipe

    2016-01-01

    In this study, we analyzed the effects of the cloned embryo aggregation on in vitro embryo development and embryo quality by measuring blastocyst diameter and cell number, DNA fragmentation levels and the expression of genes associated with pluripotency, apoptosis, trophoblast and DNA methylation in the porcine. Zona-free reconstructed cloned embryos were cultured in the well of the well system, placing one (1x non aggregated group) or three (3x group) embryos per microwell. Our results showed that aggregation of three embryos increased blastocyst formation rate and blastocyst diameter of cloned pig embryos. DNA fragmentation levels in 3x aggregated cloned blastocysts were significantly decreased compared to 1x blastocysts. Levels of Oct4, Klf4, Igf2, Bax and Dnmt 1 transcripts were significantly higher in aggregated embryos, whereas Nanog levels were not affected. Transcripts of Cdx2 and Bcl-xl were essentially non-detectable. Our study suggests that embryo aggregation in the porcine may be beneficial for cloned embryo development and embryo quality, through a reduction in apoptotic levels and an improvement in cell reprogramming. PMID:26894831

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

    CERN Document Server

    Sigerud, K

    2011-01-01

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

  9. 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)

  10. Improvements in biosolids quality resulting from the Clean Water Act.

    Science.gov (United States)

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

    2014-02-01

    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

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

    Science.gov (United States)

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

    2014-03-01

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

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

    Directory of Open Access Journals (Sweden)

    M. Sokovic

    2010-11-01

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

  13. Improvement of Groundwater Quality Using Constructed Wetland for Agricultural Irrigation

    Directory of Open Access Journals (Sweden)

    Pantip Klomjek

    2014-06-01

    Full Text Available This research was designed to evaluate the performance of Constructed Wetlands (CW for groundwater quality improvement. In the first phase of this study, performance of CW planted with cattails for Manganese (Mn and Iron (Fe reduction was evaluated at 12, 24 and 48 hours of Hydraulic Retention Time (HRT. Average efficiencies of all tested CW systems were higher than 90 and 75% for Mn and Fe concentration reduction. Subsequently, the efficiency of CW operated at 12 hours of HRT was investigated at different plant harvest intervals. In the second phase of study, Mn and Fe removal efficiencies were 75-100 and 48-99%, respectively. Both Mn and Fe removal efficiencies for the CW system were not different between 4, 6 and 8 weeks of harvest intervals. However, the efficiency obviously increased after the first plant harvest. Average Mn and Fe removal rates of the CWs operated at the tested harvest intervals were 0.068 to 0.092 and 0.383 to 0.432 g/m2/d, respectively. Fe removal rate was not significantly different under the various test conditions. However the highest Mn removal rate was obtained in CWs operated with a harvest interval of 4 weeks. Mn accumulation rates in cattail shoots and roots were 0.04-8.25 and 0.83-23.14 mg/m2/d, respectively. Fe accumulation rates in those were 0.04-164.27 and 249.62-1,701.54 mg/m2/d, respectively. Obviously, cattail underground tissues accumulated both Mn and Fe at higher concentrations than those of the above ground tissue. These results show that CW can improve the quality of groundwater before agricultural irrigation.

  14. Use of densimetric table to improve the quality of commercial castor bean seeds

    Directory of Open Access Journals (Sweden)

    Antônio Lucrécio dos Santos Neto

    2012-01-01

    Full Text Available Castor bean fruits are already used for biodiesel production but obtaining quality seeds is still a challenge. Seed cleaning improves lot quality but little is known about the effects of upgrading castor bean seed lots on a densimetric table. The objective of this study was to evaluate the influence of cleaning castor bean seed lots on a densimetric table on their physical, physiological and sanitary characteristics. Two commercial lots of the AL Guarani 2002 cultivar, separated into five categories according to their classification on a densimetric table (uncleaned and low, low intermediate, high intermediate and high outlets, were evaluated. Tests for the yield, one-thousand seed weight, germination, seedling emergence, electrical conductivity and seed health were performed. The classification of castor bean seeds on a densimetric table significantly improved the physical, physiological and sanitary quality of commercial seed lots. The physiological response of the different classified lots varied according to their initial weight. Castor bean seeds separated on a densimetric table for the upper outlet showed a better physical, physiological and sanitary quality compared to those for the lower outlet.

  15. 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.

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

    Science.gov (United States)

    Sidek, L. M.; Basri, H.; Noh, M. N. Md; Ainan, A.; Mohd Puad, A. H.

    2013-06-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Navid Afkar

    2015-02-01

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

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

    DEFF Research Database (Denmark)

    Wang, Z.; Lu, K.

    2011-01-01

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

  19. Technological developments and approaches to improving service quality.

    Science.gov (United States)

    Blumberg, M R

    1999-01-01

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

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

    DEFF Research Database (Denmark)

    TØttenborg, Sandra SØgaard; Thomsen, Reimar Wernich

    2013-01-01

    OBJECTIVE: To examine whether the quality of care among Danish patients with chronic obstructive pulmonary disease (COPD) has improved since the initiation of a national multidisciplinary quality improvement program. METHODS: We conducted a nationwide, population-based prospective cohort study using data from the Danish Clinical Register of COPD (DrCOPD). Since 2008 the register has systematically monitored and audited the use of recommended processes of COPD care. RESULTS: Substantial improvements were observed for all processes of care and registration fulfillment increased to well above 85% for all indicators. Compared to 2008, a higher proportion of COPD outpatients in 2011 received annual measurements of the forced expiratory volume in one second in percent of predicted (FEV1% predicted) (RR 2.14, 95% CI, 2.09; 2.19), assessment of BMI (RR 2.24, 95% CI, 2.19; 2.29), assessment of dyspnea using the Medical Research Council (MRC) scale (RR 2.25, 95% CI, 2.20; 2.31), registration of smoking status (RR 2.41,95% 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