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1

NASA's Productivity Improvement and Quality Enhancement Initiatives  

Science.gov (United States)

The National Aeronautics and Space Administration celebrated its 25th Anniversary in 1983 at the Air and Space Museum in Washington, DC, with President Reagan in attendance. We look back on the accomplishments of these twenty-five years with pride in our missions and our people. NASA captured the world's imagination during the days of the Apollo mission. So much so, that we now talk about the Apollo era. In the l970s, we moved into the Space Transportation business and in the 199Os, we look forward to having a manned Space Station. Each succeeding mission has presented its own challenge in terms of technology and resources. This is especially true today, when we are being asked to do more with less. To ensure that NASA continues to be a productive and quality conscious agency, one of our highest Agency goals is leadership in the development and application of practices which contribute to high productivity and quality. greatest competitive strength, and this country has a solid scientific and engineering foundation. Traditionally we have spent more money on research and development than Japan and Europe combined, and we are the source of most of this century significant innovations. We should build on this solid base and use it more effectively.

1984-01-01

2

Highlights of contractor initiatives in quality enhancement and productivity improvement  

Science.gov (United States)

The NASA/Contractor Team efforts are presented as part of NASA's continuing effort to facilitate the sharing of quality and productivity improvement ideas among its contractors. This complilation is not meant to be a comprehensive review of contractor initiative nor does it necessarily express NASA's views. The submissions represent samples from a general survey, and were not edited by NASA. The efforts are examples of quality and productivity programs in private industry, and as such, highlight company efforts in individual areas. Topics range from modernization of equipment, hardware, and technology to management of human resources. Of particular interest are contractor initiatives which deal with measurement and evaluation data pertaining to quality and productivity performance.

1986-01-01

3

Implementing quality/productivity improvement initiatives in an engineering environment  

Science.gov (United States)

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.

Ruda, R. R.

1985-01-01

4

Quality initiatives: Quality improvement in radiology: basic principles and tools required to achieve success.  

Science.gov (United States)

All imaging departments are expected to establish and maintain effective quality, safety, and performance improvement programs. Essential components of such programs include adherence to the basic principles of quality management and appropriate utilization of quality tools. The initial step is the gathering of relevant information, followed by the collection and analysis of quality and performance data; analysis and ranking of causes that likely contributed to a process failure, error, or adverse event; and prioritization and local implementation of solutions, with careful monitoring of newly implemented processes and wider dissemination of the tools when a process proves to be successful. Quality improvement requires a careful, dedicated, and continuously planned effort by a number of skilled and committed team members, with the goal being to do the right thing in a timely fashion in every case. This process can be sustained by offering rewards and celebrating successes, with all lessons learned disseminated throughout the department or organization. PMID:21997978

Kruskal, Jonathan B; Eisenberg, Ronald; Sosna, Jacob; Yam, Chun Sham; Kruskal, Joshua D; Boiselle, Phillip M

2011-10-01

5

Quality Improvement Initiative Reduces Serious Safety Events in Pediatric Hospital Patients  

Science.gov (United States)

... home after hospitalization for stroke benefit from medication coaching by telephone Aspirin/warfarin combination reduces the risk ... Center used a quality improvement initiative focused on cultural and system changes that resulted in a significant and sustained reduction ...

6

Shower and no-dressing technique for tunneled central venous hemodialysis catheters: a quality improvement initiative.  

Science.gov (United States)

Self-care practices and quality-of-life nuances juxtaposed our tunneled hemodialysis central venous catheter (CVC) protocols. Despite our advice, individuals with CVCs were showering. As a quality improvement initiative, we compared the standard CVC dressing practices to the "shower and no-dressing" technique. After 1380 catheter months (n = 119) infection rates were 0.31 events per 1000 catheter days. The "shower and no-dressing" technique appears to be a safe CVC dressing option with improved quality of life, no increase in infection rates, and cost-effectiveness. PMID:24689266

Lawrence, Julie Ann; Seiler, Suzanne; Wilson, Barbara; Harwood, Lori

2014-01-01

7

Software Process Improvement Initiatives Based on Quality Assurance Strategies: A QATAM Pilot Application  

Science.gov (United States)

Quality Assurance (QA) strategies, i.e., bundles of verification and validation approaches embedded within a balanced software process can support project and quality managers in systematically planning and implementing improvement initiatives. New and modified processes and methods come up frequently that seems promising candidates for improvement. Nevertheless, the impact of processes and methods strongly depends on individual project contexts. A major challenge is how to systematically select and implement "bestpractices" for product construction, verification, and validation. In this paper we present the Quality Assurance Tradeoff Analysis Method (QATAM) that supports engineers in (a) systematically identifying candidate QA strategies and (b) evaluating QA strategy variants in a given project context. We evaluate feasibility and usefulness in a pilot application in a medium-size software engineering organization. Main results were that QATAM was considered useful for identifying and evaluating various improvement initiatives applicable for large organizations as well as for small and medium enterprises.

Winkler, Dietmar; Elberzhager, Frank; Biffl, Stefan; Eschbach, Robert

8

Demystifying process mapping: a key step in neurosurgical quality improvement initiatives.  

Science.gov (United States)

Reliable delivery of optimal care can be challenging for care providers. Health care leaders have integrated various business tools to assist them and their teams in ensuring consistent delivery of safe and top-quality care. The cornerstone to all quality improvement strategies is the detailed understanding of the current state of a process, captured by process mapping. Process mapping empowers caregivers to audit how they are currently delivering care to subsequently strategically plan improvement initiatives. As a community, neurosurgery has clearly shown dedication to enhancing patient safety and delivering quality care. A care redesign strategy named NERVS (Neurosurgery Enhanced Recovery after surgery, Value, and Safety) is currently being developed and piloted within our department. Through this initiative, a multidisciplinary team led by a clinician neurosurgeon has process mapped the way care is currently being delivered throughout the entire episode of care. Neurosurgeons are becoming leaders in quality programs, and their education on the quality improvement strategies and tools is essential. The authors present a comprehensive review of process mapping, demystifying its planning, its building, and its analysis. The particularities of using process maps, initially a business tool, in the health care arena are discussed, and their specific use in an academic neurosurgical department is presented. PMID:24681644

McLaughlin, Nancy; Rodstein, Jennifer; Burke, Michael A; Martin, Neil A

2014-08-01

9

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

Science.gov (United States)

Background: Pediatric subspecialists can participate in the care of obese children. Objective: To describe steps to help subspecialty providers initiate quality improvement efforts in obesity care. Methods: An anonymous patient data download, provider surveys and interviews assessed subspecialty providers’ identification and perspectives of childhood obesity and gathered information on perceived roles and care strategies. Participating divisions received summary analyses of quantitative and qualitative data and met with study leaders to develop visions for division/service-specific care improvement. Results: Among 13 divisions/services, subspecialists’ perceived role varied by specialty; many expressed the need for cross-collaboration. All survey informants agreed that identification was the first step, and expressed interest in obtaining additional resources to improve care. Conclusions: Subspecialists were interested in improving the quality and coordination of obesity care for patients across our tertiary care setting. Developing quality improvement projects to achieve greater pediatric obesity care goals starts with engagement of providers toward better identifying and managing childhood obesity. PMID:25233013

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

2014-01-01

10

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

Directory of Open Access Journals (Sweden)

Full Text Available Background: Pediatric subspecialists can participate in the care of obese children. Objective: To describe steps to help subspecialty providers initiate quality improvement efforts in obesity care. Methods: An anonymous patient data download, provider surveys and interviews assessed subspecialty providers’ identification and perspectives of childhood obesity and gathered information on perceived roles and care strategies. Participating divisions received summary analyses of quantitative and qualitative data and met with study leaders to develop visions for division/service-specific care improvement. Results: Among 13 divisions/services, subspecialists’ perceived role varied by specialty; many expressed the need for cross-collaboration. All survey informants agreed that identification was the first step, and expressed interest in obtaining additional resources to improve care. Conclusions: Subspecialists were interested in improving the quality and coordination of obesity care for patients across our tertiary care setting. Developing quality improvement projects to achieve greater pediatric obesity care goals starts with engagement of providers toward better identifying and managing childhood obesity.

Sheila Z. Chang

2014-09-01

11

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

12

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

Science.gov (United States)

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

Wroth, Thomas H; Boals, Joseph C

2005-01-01

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

Science.gov (United States)

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

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

2014-04-01

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

Science.gov (United States)

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

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

2011-01-01

15

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

Directory of Open Access Journals (Sweden)

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

Palmer Laura

2003-05-01

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background In November 2002, the Centers for Medicare & Medicaid Services (CMS) launched a Nursing Home Quality Initiative that included publicly reporting a set of Quality Measures for all nursing homes in the country, and providing quality improvement assistance to nursing homes nationwide. A pilot of this initiative occurred in six states for six months prior to the launch. Methods Review and analysis of the lessons learned from the six Quality Impro...

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

2003-01-01

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Improving resident engagement in quality improvement and patient safety initiatives at the bedside: the Advocate for Clinical Education (ACE).  

Science.gov (United States)

Quality improvement (QI) and patient safety (PS) are essential competencies in residency training; however, the most effective means to engage physicians remains unclear. The authors surveyed all medicine and surgery physicians at their institution to describe QI/PS practices and concurrently implemented the Advocate for Clinical Education (ACE) program to determine if a physician-centered program in the context of educational structures and at the point of care improved performance. The ACE rounded with medicine and surgery teams and provided individual and team-level education and feedback targeting 4 domains: professionalism, infection control, interpreter use, and pain assessment. In a pilot, the ACE observed 2862 physician-patient interactions and 178 physicians. Self-reported compliance often was greater than the behaviors observed. Following ACE implementation, observed professionalism behaviors trended toward improvement; infection control also improved. Physicians were highly satisfied with the program. The ACE initiative is one coaching/feedback model for engaging residents in QI/PS that may warrant further study. PMID:22914743

Schleyer, Anneliese M; Best, Jennifer A; McIntyre, Lisa K; Ehrmantraut, Ross; Calver, Patty; Goss, J Richard

2013-01-01

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

Science.gov (United States)

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

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

2014-03-01

19

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

Science.gov (United States)

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

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

1996-12-01

20

Analysis of Internet Usage Among Cancer Patients in a County Hospital Setting: A Quality Improvement Initiative  

Science.gov (United States)

Background Cancer is one of the most common diseases that patients research on the Internet. The Commission on Cancer (CoC) recommended that Parkland Memorial Hospital (PMH) improve the oncology services website. PMH is Dallas County’s public health care facility, serving a largely uninsured, minority population. Most research regarding patient Internet use has been conducted in insured, Caucasian populations, raising concerns that the needs of PMH patients may not be extrapolated from available data. The PMH Cancer Committee, therefore, adopted a quality improvement initiative to understand patients’ Internet usage. Objective The objective of the study was to obtain and analyze data regarding patients’ Internet usage in order to make targeted improvements to the oncology services section of the institutional website. Methods A task force developed an 11-question survey to ascertain what proportion of our patients have Internet access and use the Internet to obtain medical information as well as determine the specific information sought. Between April 2011 and August 2011, 300 surveys were administered to newly diagnosed cancer patients. Multivariate analyses were performed. Results Of 300 surveys, 291 were included. Minorities, primarily African-American and Hispanic, represented 78.0% (227/291) of patients. Only 37.1% (108/291) of patients had Internet access, most (256/291, 87.9%) having access at home. Younger patients more commonly had Internet access, with a mean age of 47 versus 58 years for those without (P<.001). Education beyond high school was associated with Internet access (P<.001). The most common reason for Internet research was to develop questions for discussion with one’s physician. Patients most frequently sought information regarding cancer treatment options, outcomes, and side effects. Conclusions Less than one-half of PMH oncology patients have Internet access. This is influenced by age, educational level, and ethnicity. Those with access use it to obtain information related to their cancer diagnosis. The most effective way of addressing our patients’ needs using the institutional website is to provide links to reputable disease-specific sites. PMID:24824330

Lilley, Lisa; Lodrigues, William; Dreadin-Pulliam, Julie; Xie, Xian-Jin; Mathur, Sakshi; Rao, Madhu; Harvey, Valorie; Leitch, Ann Marilyn; Rao, Roshni

2014-01-01

 
 
 
 
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The Commission's Improving Teacher Quality Program: 2008 Initiatives. Commission Report 08-08  

Science.gov (United States)

A number of activities are progressing in the Improving Teacher Quality (ITQ) program, the federally funded program that the Commission administers to provide professional development to California educators. This program is part of the No Child Left Behind Act of 2001 (NCLB), and continues the work that began as the Eisenhower Teacher…

California Postsecondary Education Commission, 2008

2008-01-01

22

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

Science.gov (United States)

In recent years, there has been an increase in studies that have sought to identify predictors of treatment outcome and to examine the efficacy of surgical and non-surgical treatments. In addition to the scientific advancement associated with these studies per se, the hospitals and clinics where the studies are conducted may gain indirect financial benefit from participating in such projects as a result of the prestige derived from corporate social responsibility, a reputational lever used to reward such institutions. It is known that there is a positive association between corporate social performance and corporate financial performance. However, in addition to this, the research findings and the research staff can constitute resources from which the provider can reap a more direct benefit, by means of their contribution to quality control and improvement. Poor quality is costly. Patient satisfaction increases the chances that the patient will be a promoter of the provider to friends and colleagues. As such, involvement of the research staff in the improvement of the quality of care can ultimately result in economic revenue for the provider. The most advanced methodologies for continuous quality improvement (e.g., six-sigma) are data-driven and use statistical tools similar to those utilized in the traditional research setting. Given that these methods rely on the application of the scientific process to quality improvement, researchers have the adequate skills and mind-set to embrace them and thereby contribute effectively to the quality team. The aim of this article is to demonstrate by means of real-life examples how to utilize the findings of outcome studies for quality management in a manner similar to that used in the business community. It also aims to stimulate research groups to better understand that, by adopting a different perspective, their studies can be an additional resource for the healthcare provider. The change in perspective should stimulate researchers to go beyond the traditional studies examining predictors of treatment outcome and to see things instead in terms of the "bigger picture", i.e., the improvement of the process outcome, the quality of the service. PMID:19294433

Impellizzeri, Franco M; Bizzini, Mario; Leunig, Michael; Maffiuletti, Nicola A; Mannion, Anne F

2009-08-01

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

Science.gov (United States)

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

McGovern-Phalen, Amy M

2014-10-01

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

Science.gov (United States)

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

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

2013-01-01

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U.S. initiatives for improving the quality of life using optics (Abstract only)  

Science.gov (United States)

The United States has had incredible growth, which has had a direct impact on the quality of life for Americans, during the last decade. Much of this growth has been fueled by the investments that we have made in science and technology, and particularly in initiatives such as the one on nanotechnology and information technology. There is a belief in the U.S. that optics and photonics can have a direct baring on the quality of life, whether it be homeland security, life science instrumentation, or systems that can help the aging population. Further, the lack of science and math teachers in the K-12 education system has been identified as a barrier to continued economic growth. A second barrier may be the lack of sufficient numbers of technically trained workers. A comparsion between the U.S. and other countries will be made. (Abstract only available)

Moore, Duncan T.

2003-11-01

26

The national clinical database as an initiative for quality improvement in Japan.  

Science.gov (United States)

The JCVSD (Japan Cardiovascular Surgery Database) was organized in 2000 to improve the quality of cardiovascular surgery in Japan. Web-based data harvesting on adult cardiac surgery was started (Japan Adult Cardiovascular Surgery Database, JACVSD) in 2001, and on congenital heart surgery (Japan Congenital Cardiovascular Surgery Database, JCCVSD) in 2008. Both databases grew to become national databases by the end of 2013. This was influenced by the success of the Society for Thoracic Surgeons' National Database, which contains comparable input items. In 2011, the Japanese Board of Cardiovascular Surgery announced that the JACVSD and JCCVSD data are to be used for board certification, which improved the quality of the first paperless and web-based board certification review undertaken in 2013. These changes led to a further step. In 2011, the National Clinical Database (NCD) was organized to investigate the feasibility of clinical databases in other medical fields, especially surgery. In the NCD, the board certification system of the Japan Surgical Society, the basic association of surgery was set as the first level in the hierarchy of specialties, and nine associations and six board certification systems were set at the second level as subspecialties. The NCD grew rapidly, and now covers 95% of total surgical procedures. The participating associations will release or have released risk models, and studies that use 'big data' from these databases have been published. The national databases have contributed to evidence-based medicine, to the accountability of medical professionals, and to quality assessment and quality improvement of surgery in Japan. PMID:25346898

Murakami, Arata; Hirata, Yasutaka; Motomura, Noboru; Miyata, Hiroaki; Iwanaka, Tadashi; Takamoto, Shinichi

2014-10-01

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FOCUS: The Society of Cardiovascular Anesthesiologists' Initiative to Improve Quality and Safety in the Cardiovascular Operating Room.  

Science.gov (United States)

The Society of Cardiovascular Anesthesiologists (SCA) introduced the FOCUS initiative (Flawless Operative Cardiovascular Unified Systems) in 2005 in response to the need for a rigorous scientific approach to improve quality and safety in the cardiovascular operating room (CVOR). The goal of the project, which is supported by the SCA Foundation, is to identify hazards and develop evidence-based protocols to improve cardiac surgery safety. A hazard is anything that has the potential to cause a preventable adverse event. Specifically, the strategic plan of FOCUS includes 3 goals: (1) identifying hazards in the CVOR, (2) prioritizing hazards and developing risk-reduction interventions, and (3) disseminating these interventions. Collectively, the FOCUS initiative, through the work of several groups composed of members from different disciplines such as clinical medicine, human factors engineering, industrial psychology, and organizational sociology, has identified and documented significant hazards occurring daily in our CVORs. Some examples of frequent occurrences that contribute to reduce the safety and quality of care provided to cardiac surgery patients include deficiencies in teamwork, poor OR design, incompatible technologies, and failure to adhere to best practices. Several projects are currently under way that are aimed at better understanding these hazards and developing interventions to mitigate them. The SCA, through the FOCUS initiative, has begun this journey of science-driven improvement in quality and safety. There is a long and arduous road ahead, but one we need to continue to travel. PMID:25232690

Barbeito, Atilio; Lau, William Travis; Weitzel, Nathaen; Abernathy, James H; Wahr, Joyce; Mark, Jonathan B

2014-10-01

28

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

Science.gov (United States)

Many approaches to surgical management of the severely burned face are described, but there are few objective outcome studies. The purpose of this study was to perform a detailed evaluation of the late outcomes in adult patients who have undergone grafting using a standardized surgical and rehabilitation approach for full-thickness (FT) facial burns to identify areas for improvement in the treatment strategy of authors. This was a prospective observational study in which patients who had undergone grafting for FT facial burns by the senior investigator at a regional burn centre between 1999 and 2010 were examined by a single evaluator. The surgical approach included tangential excision based on the facial aesthetic units, temporary cover with allograft then autografting with scalp skin preferentially, split grafts for the upper eyelid, and FT grafts for the lower eyelid. Rehabilitation included compression (uvex and or soft cloth), scar massage, and silicone gel sheeting. Of 35 patients with facial grafts, 14 subjects (age 43 ± 16 years with 22 ± 21% TBSA burns) returned for late follow-up at 40 ± 33 months (range, 5-91 months). A mean of four facial aesthetic units per patient were grafted (range, 1-9 units), with six full facial grafts performed. Scalp was used as donor in 10 of 14 cases. Scalp donor sites were well tolerated with minor alopecia visible in only one case although the donor site visibly extended slightly past the hairline in two cases. Color match with native skin was rated at 8.8 ± 0.8 of 10 when scalp skin was used compared with 7.5 ± 1.6 with other donor sites (P = .06). On the lip and chin, hypertrophic scars were significantly worse compared with the rest of the facial grafts (Vancouver scar scale 8 ± 2 vs 3 ± 1, P touch was 3.8 ± 0.6. Graft borders were significantly more elevated than graft seams. On the forehead, the most notable problem was a gap between the graft and hairlines of the frontal scalp and eyebrows (range, 0-40 mm). Grafted eyelids required one or more subsequent ectropion releases in the majority of cases. The most common problem for the nose was asymmetry of the nostril apertures. The most problematic late outcomes that the authors identified after facial grafting for FT facial burns included relatively poor sensory return, elevation of graft edges, eyelid ectropion, gaps between grafts and hairline, and marked hypertrophic scarring around the mouth and chin. The results indicate that possible areas for quality improvement include greater attention to the limits of scalp harvest, more attention to pressure application to graft borders and the lip and chin during rehabilitation, greater accuracy in excision and graft placement on the forehead to avoid gaps with the hairlines, and counseling of the patient regarding the high probability of diminished facial sensation. PMID:22002207

Philp, Lauren; Umraw, Nisha; Cartotto, Robert

2012-01-01

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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...

Muharrem Firat, Yilmaz

2012-01-01

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Feasibility of patient navigation in resident primary care practice: a screening mammography quality improvement initiative.  

Science.gov (United States)

Patient navigation (PN) has been used to improve breast cancer outcomes but has not been evaluated in resident practices. The objective of this study was to evaluate the feasibility of PN in resident clinics to improve biennial screening mammography. All participants whose last screening mammogram was at 18 months or after received PN. Feasibility outcomes included practicality (ability to carry out intervention), effectiveness (ability of intervention to increase biennial screening mammography rates), and acceptability (resident satisfaction with PN). Despite difficulty contacting patients, we found PN improved screening mammography adherence in resident practices serving vulnerable populations. Adherence rates increased significantly postintervention. Residents reported interest in using PN in practice. PMID:25180645

Shroff, Swati; McCoy, Molly E; Sherman, Bonnie J; Bak, Sharon M; Mandyam, Vasudev; Battaglia, Tracy A

2014-01-01

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

Science.gov (United States)

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

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

2012-01-01

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

Science.gov (United States)

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

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The Strengthening Families Initiative and Child Care Quality Improvement: How Strengthening Families Influenced Change in Child Care Programs in One State  

Science.gov (United States)

Research Findings: This study investigated how the Strengthening Families through Early Care and Education initiative in Illinois (SFI) influenced change in 4 child care programs. Findings indicate that SFI influenced quality improvements through 4 primary pathways: (a) Learning Networks, (b) the quality of training, (c) the engagement of program…

Douglass, Anne; Klerman, Lorraine

2012-01-01

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

Science.gov (United States)

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 wait time as a primary outcome in their study of 201 addiction treatment agencies in the USA. This article describes the changes made in five state data systems to monitor wait times and outlines lessons learned that could be applied to other health data tracking systems. PMID:22193826

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

2011-12-01

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Continuous quality improvement  

International Nuclear Information System (INIS)

This paper describes the various statistical tools used at the Hanford Engineering Development Laboratory to achieve continuous quality improvement in the development of Breeder Reactor Technology and in reactor operations. The role of the quality assurance professionals in this process, including quantifiable measurements using actual examples, is provided. The commitment to quality improvement through top management involvement is dramatically illustrated

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

Science.gov (United States)

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

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

2014-02-01

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

Science.gov (United States)

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

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

2014-03-01

38

SQIMSO: Quality Improvement for Small Software Organizations  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

Rabih Zeineddine; Nashat Mansour

2005-01-01

39

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

Directory of Open Access Journals (Sweden)

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.

Kwedza Ru K

2011-03-01

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Quality Measurement and Improvement in General Surgery  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

Cevasco, Marisa; Ashley, Stanley W.

2011-01-01

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

Science.gov (United States)

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

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

2012-01-01

42

Explaining the success or failure of quality improvement initiatives in long-term care organizations from a dynamic perspective.  

Science.gov (United States)

The purpose of this study was to better understand why change initiatives succeed or fail in long-term care organizations. Four case studies from Québec, Canada were contrasted retrospectively. A constipation and restraints program succeeded, while an incontinence and falls program failed. Successful programs were distinguished by the use of a change strategy that combined "let-it happen," "help-it happen," and "make-it happen" interventions to create senses of urgency, solidarity, intensity, and accumulation. These four active ingredients of the successful change strategies propelled their respective change processes forward to completion. This paper provides concrete examples of successful and unsuccessful combinations of "let-it happen," "help-it happen," and "make-it happen" change management interventions. Change managers (CM) can draw upon these examples to best tailor and energize change management strategies in their own organizations. PMID:24652889

Etheridge, Francis; Couturier, Yves; Denis, Jean-Louis; Tremblay, Lucie; Tannenbaum, Cara

2014-09-01

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

Directory of Open Access Journals (Sweden)

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

Verstraelen Hans

2008-01-01

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SQIMSO: Quality Improvement for Small Software Organizations  

Directory of Open Access Journals (Sweden)

Full Text Available Software quality improvement process remains incomplete if it is not initiated and conducted through a wide improvement program that considers process quality improvement, product quality improvement and evolution of human resources. But, small software organizations are not capable of bearing the cost of establishing software process improvement programs. In this work, we propose a new software quality improvement model for small organizations, SQIMSO, based on three major issues. The first issue is that every improvement program should be wide enough to include the three main trends. The second issue is that any process quality model should answer the question ?How to do? things. The third issue is that any suggested quality model should be cost-effective and practical enough to be implemented by small software organizations. SQIMSO also draws upon international quality standards, models, experiences and on a local field survey.

Rabih Zeineddine

2005-01-01

45

Glycohemoglobin: quality assessment and improvement  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The subject of this thesis is the quality of glycohemoglobin assays. The primary goal is improvement of analytical quality but the ultimate scope is therapeutic amelioration to prevent or delay long term complications of diabetes mellitus. ... Zie: Summary.

Weijkamp, Casper Wilhelmus

1995-01-01

46

The GSN Data Quality Initiative  

Science.gov (United States)

The Global Seismographic Network (GSN) is undertaking a renewed effort to assess and assure data quality that builds upon completion of the major installation phase of the GSN and recent funding to recapitalize most of the network’s equipment including data acquisition systems, ancillary equipment and secondary sensors. We highlight here work by the network operators, the USGS’ Albuquerque Seismological Lab and UCSD’s Project IDA, to ensure that both the quality of the waveforms collected is maximized, that the published metadata accurately reflect the instrument response of the data acquisitions systems, and that data users are informed of the status of the GSN data quality. Procedures to evaluate waveform quality blend tools made available through the IRIS DMC’s Quality Analysis Control Kit (http://www.iris.washington.edu/QUACK/), analysis results provided by the Lamont Waveform Quality Center (www.ldeo.columbia.edu/~ekstrom/Projects/WQC.html), and custom software developed by each of the operators to identify and track known hardware failure modes. Each operator’s equipment upgrade schedule is updated periodically to address sensors identified as failing or problematic and for which replacements are available. Particular attention is also paid to monitoring the GPS clock signal to guarantee that the data are timed properly. Devices based on GPS technology unavailable when the GSN began 25 years ago are being integrated into operations to verify sensor orientations. Portable, broadband seismometers whose stable response can be verified in the laboratory are now co-located with GSN sensors during field visits to verify the existing GSN sensors’ sensitivity. Additional effort is being made to analyze past calibration signals and to check the system response functions of the secondary broadband sensors at GSN sites. The new generation of data acquisition systems will enable relative calibrations to be performed more frequently than was possible in the past. Additional details of this effort can be found at the GSN Quality webpage (www.iris.edu/hq/programs/gsn/quality).

Davis, J. P.; Anderson, K. R.; Gee, L. S.

2010-12-01

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Quality Improvement by Qualified Managers  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The aim of the study was to study about the impact of quality improvement strategy on creating a sustainable competitive advantage in the qualified managers. The current study was based on empirical approach. A random sample of quality improvement was drawn from seven organizations. A self administrated questionnaire was employed to collect the required data. A number of hypotheses were formulated for this purpose. This article attempts to explain the quality improvement by qualified managers...

Dr. Nasser Fegh-hi Farahmand

2013-01-01

48

Quality Improvement by Qualified Managers  

Directory of Open Access Journals (Sweden)

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

Dr. Nasser Fegh-hi Farahmand

2013-01-01

49

Evaluation of quality improvement programmes  

Digital Repository Infrastructure Vision for European Research (DRIVER)

?? In response to increasing concerns about quality, many countries are carrying out large scale programmes which include national quality strategies, hospital programmes, and quality accreditation, assessment and review processes. Increasing amounts of resources are being devoted to these interventions, but do they ensure or improve quality of care? There is little research evidence as to their effectiveness or the conditions for maximum effectiveness. Reasons for the lack of evaluation ...

Ovretveit, J.; Gustafson, D.

2002-01-01

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Evaluating a questionnaire to measure improvement initiatives in Swedish healthcare  

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Full Text Available Abstract Background Quality improvement initiatives have expanded recently within the healthcare sector. Studies have shown that less than 40% of these initiatives are successful, indicating the need for an instrument that can measure the progress and results of quality improvement initiatives and answer questions about how quality initiatives are conducted. The aim of the present study was to develop and test an instrument to measure improvement process and outcome in Swedish healthcare. Methods A questionnaire, founded on the Minnesota Innovation Survey (MIS, was developed in several steps. Items were merged and answer alternatives were revised. Employees participating in a county council improvement program received the web-based questionnaire. Data was analysed by descriptive statistics and correlation analysis. The questionnaire psychometric properties were investigated and an exploratory factor analysis was conducted. Results The Swedish Improvement Measurement Questionnaire consists of 27 items. The Improvement Effectiveness Outcome dimension consists of three items and has a Cronbach’s alpha coefficient of 0.67. The Internal Improvement Processes dimension consists of eight sub-dimensions with a total of 24 items. Cronbach’s alpha coefficient for the complete dimension was 0.72. Three significant item correlations were found. A large involvement in the improvement initiative was shown and the majority of the respondents were satisfied with their work. Conclusions The psychometric property tests suggest initial support for the questionnaire to study and evaluate quality improvement initiatives in Swedish healthcare settings. The overall satisfaction with the quality improvement initiative correlates positively to the awareness of individual responsibilities.

Andersson Ann-Christine

2013-02-01

51

Improving soybean seed quality  

International Nuclear Information System (INIS)

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

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

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

Marsteller Jill A

2011-10-01

53

A performance improvement initiative: development of a peripheral vascular pathway.  

Science.gov (United States)

Health care institutions today are being challenged to provide cost-effective, quality care. High-cost Diagnostic Related Groups are being targeted for performance improvement initiatives. A Peripheral Vascular Bypass Chartered Team was formed to review current practices and identify opportunities for system improvements. Data analysis, the literature, and best practices were reviewed. Emphasis on the financial, clinical, and quality outcomes are discussed in relation to a clinical pathway and protocol development in an effort to better manage this population. PMID:11075090

Lewis, C K

2000-03-01

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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

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HSTART: An improved initial step size routine for ODE codes  

Energy Technology Data Exchange (ETDEWEB)

For the solution of initial value ordinary differential equations by library quality solvers, such as the DEPAC collection in the SLATEC library, it is important to start off with a good initial step size in order for the procedure to produce a reliable and efficient solution numerically. A substantial improvement has been made in the starting step size algorithm which corrects a long standing deficiency. Specifically, initial step sizes many orders from optimal (arising from stiff problems with mixed zero and nonzero initial values of disparate sizes) are brought under control.

Watts, H.A.

1986-11-01

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Improving Air Quality Forecasts with AURA Observations  

Science.gov (United States)

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.

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

57

The Improvement of Services Quality  

Directory of Open Access Journals (Sweden)

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

Cristian-?tefan Craciun

2013-01-01

58

Shipbuilding pipeline production quality improvement  

Directory of Open Access Journals (Sweden)

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

T. Buksa

2010-06-01

59

Using Quality Function Deployment to Improve Reference Services Quality  

Directory of Open Access Journals (Sweden)

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

Pao-Long Chang

1996-12-01

60

Quality Improvement Practices and Trends  

DEFF Research Database (Denmark)

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

Hartz, Ove

1998-01-01

 
 
 
 
61

Power Quality Improvement Using UPQC  

Directory of Open Access Journals (Sweden)

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

K. Kalaipriya

2014-05-01

62

Data quality improvements for FAA  

Energy Technology Data Exchange (ETDEWEB)

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

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

1997-09-01

63

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

64

Improving Health and Quality of Life  

Science.gov (United States)

... Fatigue Syndrome (CFS) Share Compartir Improving Health and Quality of Life On this Page Cognitive Behavioral Therapy (CBT) Support ... and improve their ability to function and their quality of life. Doctors may refer some of their CFS patients ...

65

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

International Nuclear Information System (INIS)

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

66

Translating improved quality of care into an improved quality of life for patients with inflammatory bowel disease.  

Science.gov (United States)

The term quality of care has been interpreted in different ways in medicine. Skeptics of the quality movement insist that checkboxes and government and payer oversight will not lead to better patient outcomes. Supporters refer to areas in medicine in which quality improvement efforts have led to improved survival, such as in cystic fibrosis and cardiovascular disease. For quality improvement to be effective, the process demands rigorous documentation, analysis, feedback, and behavioral change. This requires valid metrics and mechanisms to provide dynamic point-of-care (or close to point of care) feedback in a manner that drives improvement. For inflammatory bowel disease, work has been performed in Europe and the United States to develop a framework for how practitioners can improve quality of care. Improve Care Now has created a sophisticated quality improvement program for pediatric patients with inflammatory bowel disease. The American Gastroenterology Association has worked within the National Quality Strategy framework to develop quality measures for patients with inflammatory bowel disease that have been incorporated into Federal programs that are moving Medicare reimbursement from a volume-based to a value-based structure. The Crohn's and Colitis Foundation of America is initiating a quality intervention program that can be implemented in community and academic practices to stimulate continual improvement processes for patients with inflammatory bowel disease. All of this work is intended to make quality improvement programs both feasible and useful, with the ultimate goal of improving quality of life for our patients. PMID:23747710

Siegel, Corey A; Allen, John I; Melmed, Gil Y

2013-08-01

67

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

Science.gov (United States)

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

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

2013-01-01

68

Quality and performance improvement in critical care  

Digital Repository Infrastructure Vision for European Research (DRIVER)

In the past decade, there is an increased focus on quality and safety in health care. Decreasing variation, increasing adherence to evidence based guidelines, monitoring processes, and measuring outcomes are critical for improving quality of care. Intensivists have broad knowledge of hospital organization, and need to be leaders in quality improvement efforts.

Chelluri Lakshmi

2008-01-01

69

Improvement in spring wheat quality in pakistan  

International Nuclear Information System (INIS)

pulation. However care should be taken to maintain the current levels of various wheat quality characteristics and to make improvement in lysine, which will be appreciable for export quality wheat. This will be ultimately helpful to earn handsome foreign exchange by exporting surplus wheat. These informations will be useful for the researchers working in the field of quality improvement. (author)

70

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

71

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

Science.gov (United States)

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

Deans, Rachel; Wade, Shawna

2011-01-01

72

Quality improvement practices: enhancing quality of life during mealtimes.  

Science.gov (United States)

This article describes ten dining room problems, identified in a nursing home study, that needed quality improvement, as well as six quality practices suggested for implementation. These six quality practices provide the basis for an excellent eating experience characterized by a home-like atmosphere, high levels of staff-resident interaction, and increased attention to safety and ethical issues. The six practices also could serve as the foundation for a facility-wide, cost-effective, quality improvement program. PMID:11998672

Evans, B C; Crogan, N L

2001-01-01

73

Ways of castings quality improvement  

International Nuclear Information System (INIS)

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

74

African primary care research: quality improvement cycles  

Directory of Open Access Journals (Sweden)

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

Claire Van Deventer

2014-04-01

75

Quality improvement perspective and healthcare funding decisions  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Efforts to apply explicit prioritisation processes to healthcare funding decisions have had mixed results in New Zealand. But a quality improvement approach has advantages over existing prioritisation approaches

2003-01-01

76

Improving Quality using Testing Strategies  

Directory of Open Access Journals (Sweden)

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

Sahil Batra

2011-07-01

77

Improving Teaching Quality and the Learning Organisation  

Science.gov (United States)

This study applied a learning organisation framework to understand academic departments' efforts to improve teaching quality. The theoretical framework was generated from literature on learning organisations, organisations devoted to continuous improvement through continuous learning. Research questions addressed relationships among departments'…

Collie, Sarah L.; Taylor, Alton L.

2004-01-01

78

Quality Improvement: Lessons Learned from an Infant Mental Health-based Early Head Start Program.  

Science.gov (United States)

Continuous quality improvement efforts are vital to high-quality early intervention services. This article describes an ongoing quality improvement project within an infant mental health-based Early Head Start program. Both strategies and challenges in implementing issues and lessons learned in the initial 2-year phase of the quality improvement

Brophy-Herb, Holly; Schiffman, Rachel; McKelvey, Lorraine; Cunningham-DeLuca, Mary; Hawver, Marshelle

2001-01-01

79

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

Science.gov (United States)

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

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

2014-10-01

80

Early experiences with consumer engagement initiatives to improve chronic care.  

Science.gov (United States)

Engaging consumers to be more active participants in their health and health care is an appealing strategy for reforming the U.S. health care system, but little is known about how to mount and sustain communitywide consumer engagement initiatives. The Robert Wood Johnson Foundation launched a program in 2006 in fourteen communities to align forces around improving quality and efficiency by promoting public reporting and expanding the involvement of consumers in all facets of their care. These multistakeholder organizations provide an early glimpse into the opportunities and challenges that lie ahead as policymakers attempt to integrate consumers more completely in their reform strategies. PMID:19124880

Hurley, Robert E; Keenan, Patricia S; Martsolf, Grant R; Maeng, Daniel D; Scanlon, Dennis P

2009-01-01

 
 
 
 
81

MEASURES TO IMPROVE WATER QUALITY  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

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

2010-01-01

82

MEASURES TO IMPROVE WATER QUALITY  

Directory of Open Access Journals (Sweden)

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

L. SÂMBOTIN

2010-05-01

83

Rethinking Quality and Improvement in Higher Education  

Science.gov (United States)

Purpose: The purpose of this paper is to critically review dominant conceptions of and approaches to quality in higher education. It suggests an alternative approach with potential to shift the focus of quality activities from accountability and control to improvement. Design/methodology/approach: The applicability and limits of quality concepts…

Houston, Don

2008-01-01

84

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

DEFF Research Database (Denmark)

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

Jensen, A G; Zimmermann-Nielsen, E

2013-01-01

85

Improving mental health outcomes: achieving equity through quality improvement  

Science.gov (United States)

Objective To investigate equity of patient outcomes in a psychological therapy service, following increased access achieved by a quality improvement (QI) initiative. Design Retrospective service evaluation of health outcomes; data analysed by ANOVA, chi-squared and Statistical Process Control. Setting A psychological therapy service in Westminster, London, UK. Participants People living in the Borough of Westminster, London, attending the service (from either healthcare professional or self-referral) between February 2009 and May 2012. Intervention(s) Social marketing interventions were used to increase referrals, including the promotion of the service through local media and through existing social networks. Main Outcome Measure(s) (i) Severity of depression on entry using Patient Health Questionnaire-9 (PHQ9). (ii) Changes to severity of depression following treatment (?PHQ9). (iii) Changes in attainment of a meaningful improvement in condition assessed by a key performance indicator. Results Patients from areas of high deprivation entered the service with more severe depression (M = 15.47, SD = 6.75), compared with patients from areas of low (M = 13.20, SD = 6.75) and medium (M = 14.44, SD = 6.64) deprivation. Patients in low, medium and high deprivation areas attained similar changes in depression score (?PHQ9: M = ?6.60, SD = 6.41). Similar proportions of patients achieved the key performance indicator across initiative phase and deprivation categories. Conclusions QI methods improved access to mental health services; this paper finds no evidence for differences in clinical outcomes in patients, regardless of level of deprivation, interpreted as no evidence of inequity in the service with respect to this outcome. PMID:24521701

Poots, Alan J.; Green, Stuart A.; Honeybourne, Emmi; Green, John; Woodcock, Thomas; Barnes, Ruth; Bell, Derek

2014-01-01

86

GREAT LAKES WATER QUALITY IMPROVEMENT  

Science.gov (United States)

This paper outlines and evaluates phosphorus loadings in the Great Lakes and suggests a strategy for its control. he municipal industrial and commercial and agricultural contribution use to the Great Lakes waters has led to a concomitant deterioration of the water quality. e must...

87

Improve Quality: Use Tool Kits.  

Science.gov (United States)

Addresses issues of defining quality in both business and community service. Describes the use of a regulatory tool kit containing rules and regulations a child care center must follow to ensure children's health, safety, and well-being. Specific tool kit types described include regulatory, government funded, rating scale, and NAEYC. (SD)

Gartner, Sue

2001-01-01

88

Human Performance Improvement: Lessons To Be Learned from Quality Improvement.  

Science.gov (United States)

Discusses quality improvement (QI) and how it can help human performance improvement (HPI). Compares QI and HPI and discusses focusing on products and services; focusing on the customer; using data more effectively; continuous improvement; benchmarking; establishing standards; specialization; and involving the clients. (LRW)

Hummel, Paul A.

2003-01-01

89

Power Quality Improvement Using DVR  

Directory of Open Access Journals (Sweden)

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

C. Benachaiba

2009-01-01

90

Quality and quality improvement in occupational health nursing.  

Science.gov (United States)

Donabedian first defined quality as the result of assessing the structures, processes, and outcomes of health care. The emphasis on quality assurance is changing to quality improvement. The definition of quality in health care has expanded to include the expectations and opinion of patients, their representative, and society. As the cost of health care continues to rise at twice the rate of inflation, business wants to know how health care dollars are spent. Occupational health nurses, to add value to the businesses in which they work, must be a part of the trend in measuring the quality of the products and services of their health services. PMID:1616507

Widtfeldt, A K

1992-07-01

91

Power theories for improved power quality  

CERN Document Server

Power quality describes a set of parameters of electric power and the load's ability to function properly under specific conditions. It is estimated that problems relating to power quality costs the European industry hundreds of billions of Euros annually. In contrast, financing for the prevention of these problems amount to fragments of these costs. Power Theories for Improved Power Quality addresses this imbalance by presenting and assessing a range of methods and problems related to improving the quality of electric power supply. Focusing particularly on active compensators and the DSP base

Benysek, Grzegorz

2012-01-01

92

The impact of leadership qualities on quality management improvement  

Directory of Open Access Journals (Sweden)

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

Ph. D. Radoslaw Wolniak

2011-05-01

93

The impact of leadership qualities on quality management improvement  

Directory of Open Access Journals (Sweden)

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

Radoslaw Wolniak

2011-12-01

94

[Quality improvement potential in the pharmaceutical industry].  

Science.gov (United States)

The performance of the German pharmaceutical industry, future challenges and obstacles to quality improvement are assessed from a systems-of-innovation perspective, using appropriate innovation indicators. The current close-to-market performance indicators paint an unfavourable picture. Early R&D indicators (e.g., publications, patents), however, reveal a positive trend. A lot of obstacles to quality improvements are identified with respect to knowledge base, knowledge/technology transfer, industrial R&D processes, capital markets, market attractiveness and both regulatory and political framework conditions. On this basis, recommendations will finally be derived to improve quality in the pharmaceutical industry. PMID:17711261

Nusser, Michael

2007-01-01

95

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background Despite several years of implementation, prevention of mother-to-child transmission (PMTCT) programmes in many resource poor settings are failing to reach the majority of HIV positive women. We report on a data driven participatory quality improvement intervention implemented in a high HIV prevalence district in South Africa. Methods A participatory quality improvement intervention was implemented consisting of an initial assessment undertake...

Chopra Mickey; Doherty Tanya; Nsibande Duduzile; Mngoma Dudu

2009-01-01

96

How Can We Improve Teacher Quality?  

Science.gov (United States)

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…

Wilson, Suzanne M.

2011-01-01

97

Venture Capital Initiative: Ohio's School Improvement Effort.  

Science.gov (United States)

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

Yoo, Soonhwa; Loadman, William E.

98

The Continuous Improvement and Optimisation of Quality  

Directory of Open Access Journals (Sweden)

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

EMIL MAXIM

2006-01-01

99

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

Scrivens, E.

1997-01-01

100

Improving quality of care through improved audit and feedback  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 significa...

Hysong Sylvia J; Teal Cayla R; Khan Myrna J; Haidet Paul

2012-01-01

 
 
 
 
101

42 CFR 422.152 - Quality improvement program.  

Science.gov (United States)

...improvement projects. (1) Quality improvement projects...under the plan using quality indicators that are...this section —(1) Definition of local preferred provider...analyze, and report quality performance data identified...example, quality of life indicators,...

2010-10-01

102

42 CFR 441.474 - Quality assurance and improvement plan.  

Science.gov (United States)

...2010-10-01 false Quality assurance and improvement plan. 441.474 ...Program § 441.474 Quality assurance and improvement plan. (a) The State...discovery, remediation and quality improvement in order to learn...

2010-10-01

103

45 CFR 1304.60 - Deficiencies and quality improvement plans.  

Science.gov (United States)

... false Deficiencies and quality improvement plans. 1304.60 Section...1304.60 Deficiencies and quality improvement plans. (a) Early Head...immediately or pursuant to a Quality Improvement Plan. (c) An Early...

2010-10-01

104

40 CFR 63.175 - Quality improvement program for valves.  

Science.gov (United States)

... 2010-07-01 false Quality improvement program for valves. 63...Equipment Leaks § 63.175 Quality improvement program for valves. ...with one of the alternative quality improvement programs specified...

2010-07-01

105

42 CFR 423.162 - Quality improvement organization activities.  

Science.gov (United States)

...2010-10-01 2010-10-01 false Quality improvement organization activities. 423.162...PRESCRIPTION DRUG BENEFIT Cost Control and Quality Improvement Requirements § 423.162 Quality improvement organization activities. (a)...

2010-10-01

106

40 CFR 65.116 - Quality improvement program for pumps.  

Science.gov (United States)

... 2010-07-01 false Quality improvement program for pumps. 65...Equipment Leaks § 65.116 Quality improvement program for pumps. (a...operator shall resume the quality improvement program starting at...

2010-07-01

107

Quality Improvement: A Strategy for Planned Organizational Change.  

Science.gov (United States)

Considers strategies for the implementation of quality improvement in libraries. Highlights include structured quality improvement, especially Total Quality Management; organizational change; customer focus; continuous improvement; data-based decision making; systems thinking; employee involvement in decision making; diffusion of innovation;…

Kovel-Jarboe, Patricia

1996-01-01

108

Quality circles: Organizational adaptations, improvements and results  

Science.gov (United States)

The effective application in industry and government of quality circles work was demonstrated. The results achieved in quality and productivity improvements and cost savings are impressive. The circle process should be institutionalized within industry and government. The stages of circle program growth, innovations that help achieve circle process institutionalization, and the result achieved at Martin Marietta's Michoud Division and within the National Aeronautics and Space Administration (NASA) are addressed.

Tortorich, R.

1985-01-01

109

Optimizing patient involvement in quality improvement  

Science.gov (United States)

IntroductionPatient and public involvement in healthcare planning, service development and health-related research has received significant attention. However, evidence about the role of patient involvement in quality improvement work is more limited. We aimed to characterize patient involvement in three improvement projects and to identify strengths and weaknesses of contrasting approaches. MethodsThree case study quality improvement projects were purposively sampled from a broader programme. We used an ethnographic approach involving 126 in-depth interviews, 12?weeks of non-participant observations and documentary analysis. Data analysis was based on the constant comparative method. ResultsThe three projects differed in the ways they involved patients in their quality improvement work, including their rationales for including patients. We characterized three very different models of patient involvement, which were each influenced by project context. Patients played distinctive roles across the three projects, acting in some cases as intermediaries between the wider patient community and clinicians, and sometimes undertaking persuasive work to convince clinicians of the need for change. We identified specific strategies that can be used to help ensure that patient involvement works most effectively and that the enthusiasm of patients to make a difference is not dissipated. ConclusionPatient involvement in quality improvement work needs careful management to realize its full potential. PMID:23374430

Armstrong, Natalie; Herbert, Georgia; Aveling, Emma-Louise; Dixon-Woods, Mary; Martin, Graham

2013-01-01

110

Measuring wraparound fidelity to make quality improvements.  

Science.gov (United States)

Wraparound care coordination has offered an individualized family approach to providing services to families in our county for the past decade. Instigated by our county mental health department interested in providing quality improvements to mental health services for families, we assessed the wraparound care coordination process through use of the Wraparound Fidelity Index (WFI), which measures adherence to established principles of wraparound. This article reports on findings from WFI data collected over three summers and reported back to the management team and family organization. Improvements were decided through consensus and included recommendations of parents and care coordinators. The goal of our study was to identify which activities and supports of wraparound were in need of improvement, enact quality improvements to address these areas and determine whether we were doing a better job over time. PMID:24557530

Kernan, Joan B

2014-11-01

111

A quality improvement model for healthcare terminologies.  

Science.gov (United States)

A number of controlled healthcare terminologies and classification systems have been developed for specific purposes, resulting in variations in content, structure, process management, and quality. A terminology quality improvement (TQI) model or framework would be useful for various stakeholders to guide terminology selection, to assess the quality of healthcare terminologies and to make improvements according to an agreed standard. A TQI model, thus, was formulated based on a review of the literature and existing international standards developed for healthcare terminologies. The TQI model, adapted from Donabedian's approach, encompasses structure, process, and outcome components in relation to a terminology life cycle--change request, editing, and publication. Multi-dimensional quality outcome measures also were identified in the areas of terminology content, modeling structure, mapping, and process management. A case study was developed to validate the TQI model using the International Classification for Nursing Practice (ICNP). The TQI model represented the complexity of activities involved in terminology quality management. The ICNP case study demonstrated both the applicability of the TQI model and the appropriateness of the criteria identified in the TQI model: openness and responsiveness, clarity and reproducibility, understandability, accessibility and usability, interoperability, and quality of documentation. The applicability of the TQI model was validated using ICNP. While ICNP exhibits many of the desirable characteristics of contemporary terminologies, the case study identified a need for further work on ICNP policy and on documentation. PMID:20723616

Kim, Tae Youn; Coenen, Amy; Hardiker, Nicholas

2010-12-01

112

Epistemology and Ethics of Quality Improvement.  

Science.gov (United States)

This research conference, to be held December 8-9, 2001, will examine and develop a framework for articulating the epistemology of and ethical dilemmas produced by quality improvement (QI) efforts so as to suggest if current processes and procedures for p...

J. Lynn

2002-01-01

113

AQIP and Accreditation: Improving Quality and Performance  

Science.gov (United States)

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

Spangehl, Stephen D.

2012-01-01

114

Quality Improvements in Curricula for Global Studies  

Science.gov (United States)

Purpose: Based on an in-depth comparison of 20 multicultural university curricula, this article aims to provide practical and implementable suggestions about how to improve such curricula in order to ensure highest and globally compatible academic quality. The recently founded developmental Master's curriculum "Global Studies" (GS) at the…

Bader, Lena; Bereuther, Tabea; Deutsch, Elisabeth; Edlinger, Julia; Fureder, Silvia; Kaspar, Emanuel; Kottstorfer, Marlene; Mautner, Claudia; Rossegger, Christine; Samonig, Alina; Samonig, Stefan; Schuster, Christoph; Witz, Gerhard; Zotter, Victoria; Ahamer, Gilbert

2013-01-01

115

Fostering Quality Improvement in EHDI Programs  

Science.gov (United States)

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

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

2011-01-01

116

A Continuous Quality Improvement Approach to Discipline.  

Science.gov (United States)

This monograph offers information on basic procedures concerning disciplinary action in a continuous quality improvement setting at an institution of higher education. In particular it describes progressive discipline, the application of positive discipline in a series of steps that gradually increase in severity as an employee progresses through…

Norian, Nicole A.; Michaud, Paul J.

117

Project Hanford management contract quality improvement project management plan  

Energy Technology Data Exchange (ETDEWEB)

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

ADAMS, D.E.

1999-03-25

118

Successful integration of ergonomics into continuous improvement initiatives.  

Science.gov (United States)

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

Monroe, Kimberly; Fick, Faye; Joshi, Madina

2012-01-01

119

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

Science.gov (United States)

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

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

2010-01-01

120

Improve Power Quality Problem Using Series Compensator .  

Directory of Open Access Journals (Sweden)

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

Pooja Shrivas

2013-05-01

 
 
 
 
121

Pediatric collaborative networks for quality improvement and research.  

Science.gov (United States)

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

Lannon, Carole M; Peterson, Laura E

2013-01-01

122

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

Science.gov (United States)

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

Child Trends, 2010

2010-01-01

123

Civil Engineering : Improving the Quality of Life  

Science.gov (United States)

Civil engineering involves environmental engineering, water quality, development of physical infrastructure, and many other things that are very important to improving the quality of life on Indian Reservations. American Indians who have become successful professional engineers offer insight and advice about how to succeed in engineering. Adequate math preparation with a focus on problem-solving is critical, as is finding a mentor. The article provides links to civil engineering websites and information about programs designed to help American Indian students who want to go into engineering. Fall 2002, vol. 17, no. 4

2002-01-01

124

Pediatric CT quality management and improvement program.  

Science.gov (United States)

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

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

2014-10-01

125

40 CFR 65.116 - Quality improvement program for pumps.  

Science.gov (United States)

...remains in the quality improvement...determine if specific trouble areas can be identified...using a pump quality improvement...identifying areas associated...for rejecting specific candidate superior...documenting the quality assurance...

2010-07-01

126

40 CFR 63.176 - Quality improvement program for pumps.  

Science.gov (United States)

...maintenance or quality assurance programs...remains in the quality improvement...determine if specific trouble areas can be identified...performance for specific services...start of the quality improvement...applied to the areas...

2010-07-01

127

40 CFR 63.1035 - Quality improvement program for pumps.  

Science.gov (United States)

...remains in the quality improvement...determine if specific trouble areas can be identified...using a pump quality improvement...identifying areas associated...for rejecting specific candidate superior...documenting the quality assurance...

2010-07-01

128

40 CFR 63.175 - Quality improvement program for valves.  

Science.gov (United States)

...maintenance or quality assurance programs...remains in the quality improvement program...shall determine if specific trouble areas can be identified...or other process specific factors. ...unit is in the quality improvement...

2010-07-01

129

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

Directory of Open Access Journals (Sweden)

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

Gerdien Franx

2009-06-01

130

Improving quality of care through improved audit and feedback  

Directory of Open Access Journals (Sweden)

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

Hysong Sylvia J

2012-05-01

131

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.

132

A Model to Improve the Quality Products  

Directory of Open Access Journals (Sweden)

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

Hasan GOKKAYA

2010-08-01

133

Improvements in geomagnetic observatory data quality  

DEFF Research Database (Denmark)

Geomagnetic observatory practice and instrumentation has evolved significantly over the past 150 years. Evolution continues to be driven by advances in technology and by the need of the data user community for higher-resolution, lower noise data in near-real time. Additionally, collaboration between observatories and the establishment of observatory networks has harmonized standards and practices across the world; improving the quality of the data product available to the user. Nonetheless, operating a highquality geomagnetic observatory is non-trivial. This article gives a record of the current state of observatory instrumentation and methods, citing some of the general problems in the complex operation of geomagnetic observatories. It further gives an overview of recent improvements of observatory data quality based on presentation during 11th IAGA Assembly at Sopron and INTERMAGNET issues.

Matzka, Jürgen

2011-01-01

134

Best practices in implementing and sustaining quality of care. A review of the quality improvement literature.  

Science.gov (United States)

A literature review was undertaken to explore both published and unpublished quality improvement studies, projects, and initiatives that strove to develop more efficient systems to support an infrastructure for nursing home quality of care. The review included a search of all available, full-text published literature from 1997 to 2007 available from PubMed, CINAHL, and MEDLINE. The methods used by the researchers were varied, and this article identified several primary findings: the use of a specific, measurable mission or goal statement; the use of multidepartmental and multidisciplinary involvement; the need for further education and resource materials; the use of a reward/incentive program; the need for internal and external stakeholders to be identified along with a project champion; and the process of feedback and outcome measurement. This article summarizes the findings from the review and offers key recommendations that are supported for improving quality of care and sustaining quality gains. PMID:20077965

Compas, Carol; Hopkins, Kimberly A; Townsley, Elaine

2008-07-01

135

Developing targets for public health initiatives to improve palliative care  

Directory of Open Access Journals (Sweden)

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

Klindtworth Katharina

2010-04-01

136

Narrative methods in quality improvement research  

Digital Repository Infrastructure Vision for European Research (DRIVER)

?? 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...

Greenhalgh, T.; Russell, J.; Swinglehurst, D.

2005-01-01

137

Process evaluation on quality improvement interventions  

Digital Repository Infrastructure Vision for European Research (DRIVER)

?? To design potentially successful quality improvement (QI) interventions, it is crucial to make use of detailed breakdowns of the implementation processes of successful and unsuccessful interventions. Process evaluation can throw light on the mechanisms responsible for the result obtained in the intervention group. It enables researchers and implementers to (1) describe the intervention in detail, (2) check actual exposure to the intervention, and (3) describe the experience of those ex...

Hulscher, M.; Laurant, M.; Grol, R.

2003-01-01

138

A Report Card on Continuous Quality Improvement  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

Blumenthal, David; Kilo, Charles M.

1998-01-01

139

In Brief: Improving Mississippi River water quality  

Science.gov (United States)

If water quality in the Mississippi River and the northern Gulf of Mexico is to improve, the U.S. Environmental Protection Agency (EPA) needs to take a stronger leadership role in implementing the federal Clean Water Act, according to a 16 October report from the U.S. National Research Council. The report notes that EPA has failed to use its authority to coordinate and oversee activities along the river. In addition, river states need to be more proactive and cooperative in efforts to monitor and improve water quality, and the river should be monitored and evaluated as a single system, the report indicates. Currently, the 10 states along the river conduct separate and widely varying water quality monitoring programs. ``The limited attention being given to monitoring and managing the Mississippi's water quality does not match the river's significant economic, ecological, and cultural importance,'' said committee chair David A. Dzombak, director of the Steinbrenner Institute for Environmental Education and Research at Carnegie Mellon University, Pittsburgh, Pa. The report notes that while measures taken under the Clean Water Act have successfully reduced much point source pollution, nutrient and sediment loads from nonpoint sources continue to be significant problems. For more information, visit the Web site: http://books.nap.edu/catalog.php?record_id=12051.

Showstack, Randy

2007-10-01

140

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

Directory of Open Access Journals (Sweden)

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

Groene Oliver

2011-12-01

 
 
 
 
141

Increased Mercury Bioaccumulation Follows Water Quality Improvement  

Energy Technology Data Exchange (ETDEWEB)

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

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

1999-09-15

142

Improvement of image quality in MR cholangiography  

International Nuclear Information System (INIS)

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

143

A Method to Report Utilization for Quality Initiatives in Medical Facilities  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

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

2001-01-01

144

Improving the quality by a competitive comparison  

Directory of Open Access Journals (Sweden)

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

Bujaloboková Beáta

2001-12-01

145

Quality improvements of cell membrane chromatographic column.  

Science.gov (United States)

Cell Membrane Chromatography (CMC) is a biological affinity chromatographic method using a silica stationary phase covered with specific cell membrane. However, its short life span and poor quality control was highlighted in a lot of research articles. In this study, special attention has been paid to the disruption, cell load and packing procedure in order to improve the quality of the CMC columns. Hereto, two newly established CMC models, HSC-T6/CMC and SMMC-7721/CMC have been developed and used in this research project. The optimization of the abovementioned parameters resulted in a better reproducibility of the retention time of the compound GFT (RSDcycles (400W and 20s interval per cycle) by an ultrasonic processor reducing the total time of cell disruption to 1.5min and the packing flow rate was optimized by applying a linear gradient program. Additionally, 4% paraformaldehyde (PFA) was employed to improve the column quality and prolong the column life span. The results showed that the retention time was longer with PFA treated columns than the ones obtained with the control groups. PMID:25115453

Ding, Xuan; Chen, Xiaofei; Cao, Yan; Jia, Dan; Wang, Dongyao; Zhu, Zhenyu; Zhang, Juping; Hong, Zhanying; Chai, Yifeng

2014-09-12

146

Improving wind power quality with energy storage  

DEFF Research Database (Denmark)

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

Rasmussen, Claus Nygaard

2009-01-01

147

40 CFR 63.175 - Quality improvement program for valves.  

Science.gov (United States)

...used and the instrument readings after...remains in the quality improvement program...for technology review as specified...elects to use a quality improvement program of technology review and improvement...subject to the quality improvement...The maximum instrument readings...

2010-07-01

148

Operative blood transfusion quality improvement audit  

Science.gov (United States)

Context: To determine how current anesthesia team handless the identification of surgical anaesthetized patient (right patient). And the check of blood unit before collecting and immediately before blood administration (right blood) in operating rooms where nurses have minimal duties and responsibility to handle blood for transfusion in anaesthetized patients. Aims: To elicit the degree of anesthesia staff compliance with new policies and procedures for anaesthetized surgical patient the blood transfusion administration. Settings and Design: Setting: A large tertiary care reference and teaching hospital. Design: A prospective quality improvement. Elaboration on steps for administration of transfusion from policies and procedures to anaesthetized patients; and analysis of the audit forms for conducted transfusions. Subjects and Methods: An audit form was used to get key performance indicators (KPIs) observed in all procedures involve blood transfusion and was ticked as item was met, partially met, not met or not applicable. Statistical Analysis Used: Descriptive statistics as number and percentage Microsoft excel 2003. Central quality improvement committee presented the results in number percentage and graphs. Results: The degree of compliance in performing the phases of blood transfusion by anesthesia staff reached high percentage which let us feel certain that the quality is assured that the internal policy and procedures (IPP) are followed in the great majority of all types of red cells and other blood products transfusion from the start of requesting the blood or blood product to the prescript of checking the patient in the immediate post-transfusion period. Conclusions: Specific problem area of giving blood transfusion to anaesthetized patient was checking KPI concerning the phases of blood transfusion was audited and assured the investigators of high quality performance in procedures of transfusion.

Al Sohaibani, Mazen; Al Malki, Assaf; Pogaku, Venumadhav; Al Dossary, Saad; Al Bernawi, Hanan

2014-01-01

149

MOBILITY LEARNING METHODOLOGY FOR EDUCATION QUALITY IMPROVEMENT  

Directory of Open Access Journals (Sweden)

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

Liviu Moldovan

2012-11-01

150

IMPROVING (SOFTWARE) PATENT QUALITY THROUGH THE ADMINISTRATIVE PROCESS  

Science.gov (United States)

The available evidence indicates that patent quality, particularly in the area of software, needs improvement. This Article argues that even an agency as institutionally constrained as the U.S. Patent and Trademark Office (“PTO”) could implement a portfolio of pragmatic, cost-effective quality improvement strategies. The argument in favor of these strategies draws upon not only legal theory and doctrine but also new data from a PTO software examination unit with relatively strict practices. Strategies that resolve around Section 112 of the patent statute could usefully be deployed at the initial examination stage. Other strategies could be deployed within the new post-issuance procedures available to the agency under the America Invents Act. Notably, although the strategies the Article discusses have the virtue of being neutral as to technology, they are likely to have a very significant practical impact in the area of software.

Rai, Arti K.

2014-01-01

151

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

152

Physician quality officer: a new model for engaging physicians in quality improvement.  

Science.gov (United States)

The slow progress in health care quality improvement and patient safety in America can be attributed, in part, to the challenge of physician engagement. As multidisciplinary patient-centered care becomes the standard, it is essential to integrate physicians into this process. To this end, the UMass Memorial Medical Center redesigned its Physician Quality Officer (PQO) program in 2007. The PQOs of the UMass Memorial Medical Center, who are all practicing clinicians, are fully compensated for their time and effort, trained in safety science, and teamed with other members of the department of quality and patient safety. Over the first year of the new program, the PQOs have successfully led major hospital initiatives in areas such as surgical care improvement, critical values reporting, and medication reconciliation. In this article, the authors describe the challenges and insights in the development and implementation of this new program. PMID:19487577

Walsh, Kathleen E; Ettinger, Walter H; Klugman, Robert A

2009-01-01

153

Improving Quality Of Fractal Compressed Images  

DEFF Research Database (Denmark)

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

Nadernejad, Ehsan; Hassanpour, H.

2007-01-01

154

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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...

Jin Wang; Jinsheng He; Jiansheng Tang

2009-01-01

155

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

156

Increased office productivity through improved indoor air quality  

DEFF Research Database (Denmark)

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

Fanger, Povl Ole

2002-01-01

157

Biospecimen Reporting for Improved Study Quality (BRISQ)  

Energy Technology Data Exchange (ETDEWEB)

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

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

2011-04-26

158

Biospecimen Reporting for Improved Study Quality  

Energy Technology Data Exchange (ETDEWEB)

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

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

2010-12-27

159

Biospecimen Reporting for Improved Study Quality (BRISQ)  

Energy Technology Data Exchange (ETDEWEB)

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

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

2010-09-02

160

42 CFR 422.152 - Quality improvement program.  

Science.gov (United States)

...its ongoing quality improvement...based on a review of current quality performance...reporting instruments required by...reporting instruments required by...and report quality performance...utilization review, the...

2010-10-01

 
 
 
 
161

Quality of U.S. Diet Improves, Slightly  

Science.gov (United States)

... sharing features on this page, please enable JavaScript. Quality of U.S. Diet Improves, Slightly But Americans still ... Nutrition MONDAY, Sept. 1, 2014 (HealthDay News) -- The quality of Americans' diets has improved somewhat but remains ...

162

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

Science.gov (United States)

Colorectal cancer is one of the most common cancers in Europe. Over the past few decades, important advances have been made in screening, staging and treatment of colorectal cancer. However, considerable variation between and within European countries remains, which implies that further improvements are possible. The most important remaining question now is: when are we, health care professionals, delivering the best available care to patients with colon or rectal cancer? Currently, quality assurance is a major issue in colorectal cancer care and quality assurance awareness is developing in almost all disciplines involved in the treatment of colorectal cancer patients. Quality assurance has shown to be effective in clinical trials. For example, standardisation and quality control were introduced in the Dutch TME trial and led to marked improvements of local control and survival in rectal cancer patients. Besides, audit structures can also be very effective in monitoring cancer management and national audits showed to further improve outcome in colorectal cancer patients. To reduce the differences between European countries, an international, multidisciplinary, outcome-based quality improvement programme, European Registration of Cancer Care (EURECCA), has been initiated. In the near future, the EURECCA dataset will perform research on subgroups as elderly patients or patients with comorbidities, which are often excluded from trials. For optimal colorectal cancer care, quality assurance in guideline formation and in multidisciplinary team management is also of great importance. The aim of this review was to create greater awareness and to give an overview of quality assurance in the management of colorectal cancer. PMID:24671742

Breugom, A J; Boelens, P G; van den Broek, C B M; Cervantes, A; Van Cutsem, E; Schmoll, H J; Valentini, V; van de Velde, C J H

2014-08-01

163

Improved type many kinds of enrichment initial charge core  

International Nuclear Information System (INIS)

No. 4 plant in Hamaoka Nuclear Power Station, Chubu Electric Power Co., Inc. started the commercial operation in September, 1993 after 48 months of construction period. It is the largest BWR plant with 1137 MWe and 3293 MWt output. The basic specifications of the plant and the core fuel are shown. In the design of the core fuel, the heightening of safety and reliability has priority, and the improved technology for bettering the core performance and operability was adopted positively. As the core fuel technology, new 8 x 8 zirconium-lined fuel, improved type many kinds of enrichment initial charge core, long life hafnium type control rods and so on were adopted. The zirconium-lined fuel is to reduce pellet-clad interaction, and increase the reliability. Moreover, the nuclear design of high reactivity fuel assemblies using uranium-saving technology was adopted. The core is composed of the fuels of three kinds of enrichment, and high enrichment fuel is arranged outside, thus the taking-out burnup of initial charge fuel increases. The improvement of the design of initial charge core, the improved type many kinds of enrichment initial charge core and the core characteristics in the start-up operation are reported. It was confirmed that the good core characteristics as expected can be obtained. (K.I.)

164

The European initiative for quality management in lung cancer care.  

Science.gov (United States)

Lung cancer is the commonest cause of cancer-related death worldwide and poses a significant respiratory disease burden. Little is known about the provision of lung cancer care across Europe. The overall aim of the Task Force was to investigate current practice in lung cancer care across Europe. The Task Force undertook four projects: 1) a narrative literature search on quality management of lung cancer; 2) a survey of national and local infrastructure for lung cancer care in Europe; 3) a benchmarking project on the quality of (inter)national lung cancer guidelines in Europe; and 4) a feasibility study of prospective data collection in a pan-European setting. There is little peer-reviewed literature on quality management in lung cancer care. The survey revealed important differences in the infrastructure of lung cancer care in Europe. The European guidelines that were assessed displayed wide variation in content and scope, as well as methodological quality but at the same time there was relevant duplication. The feasibility study demonstrated that it is, in principle, feasible to collect prospective demographic and clinical data on patients with lung cancer. Legal obligations vary among countries. The European Initiative for Quality Management in Lung Cancer Care has provided the first comprehensive snapshot of lung cancer care in Europe. PMID:24659546

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

2014-05-01

165

42 CFR 422.152 - Quality improvement program.  

Science.gov (United States)

...DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE...MEDICARE ADVANTAGE PROGRAM Quality Improvement § 422...those plans, an ongoing quality improvement program...this section for the service it furnishes to its...As part of its ongoing quality improvement program,...

2010-10-01

166

Priorities of Higher Education Quality Improvement: Student and Teacher Attitude  

Science.gov (United States)

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…

Savickiene, Izabela

2006-01-01

167

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

Science.gov (United States)

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

Fawcett, Jacqueline

2014-10-01

168

Criteria for the Evaluation of Quality Improvement Programs and the Use of Quality Improvement Data  

Science.gov (United States)

This document provides a set of criteria to be used by psychologists in evaluating quality improvement programs (QIPs) that have been promulgated by health care organizations, government agencies, professional associations, or other entities. These criteria also address the privacy and confidentiality issues evoked by the intended use of patient…

American Psychologist, 2009

2009-01-01

169

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

Science.gov (United States)

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

Tout, Kathryn; Isner, Tabitha; Zaslow, Martha

2011-01-01

170

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

Energy Technology Data Exchange (ETDEWEB)

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

NONE

1994-03-01

171

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

Directory of Open Access Journals (Sweden)

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

Lorenza Nogueira Campos

2009-01-01

172

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

Henry, S. B.

1995-01-01

173

OMERACT: An international initiative to improve outcome measurement in rheumatology  

Directory of Open Access Journals (Sweden)

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

Simon Lee

2007-11-01

174

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

Science.gov (United States)

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

Murgatroyd, Stephen

1991-01-01

175

Continuous quality improvement of colorectal cancer screening.  

Science.gov (United States)

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

Madalinski, Mariusz

2013-02-01

176

IMPROVEMENT OF POWER QUALITY OF A DISTRIBUTED GENERATION POWER SYSTEM  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

Aruna Garipelly

2012-01-01

177

Basic Approaches to Improve Translation Quality Between English and Chinese  

Directory of Open Access Journals (Sweden)

Full Text Available 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 should be emphasized on. This paper attempts to explore several ways of improving translation quality, which emphasize translation accuracy, quality of writing and value of the text. Translation accuracy is the base of its quality improvement, quality of writing is the key to translation improvement, and the value of text is the essence of translation improvement.

Sanning He

2009-02-01

178

Framing quality improvement tools and techniques in healthcare: the case of Improvement Leaders' Guides  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The paper presents a study of how quality improvement tools are framed within healthcare settings. The paper employs an interpretive approach to understand how quality improvement tools and techniques are mobilised and legitimated using a case study of the NHS Modernisation Agency Improvement Leaders’ Guides. Improvement Leaders’ Guides were framed within a service improvement approach encouraging the use of quality improvement tools and techniques within healthcare settings. Thei...

Millar, Ross

2013-01-01

179

Quality procedure management for improved nuclear safety  

International Nuclear Information System (INIS)

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

180

Team Learning for Healthcare Quality Improvement  

Science.gov (United States)

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.

Eppstein, Margaret J.; Horbar, Jeffrey D.

2014-01-01

 
 
 
 
181

Laboratory system strengthening and quality improvement in Ethiopia  

Directory of Open Access Journals (Sweden)

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

Tilahun M. Hiwotu

2014-11-01

182

Quality improvement projects related to pediculosis management.  

Science.gov (United States)

Concern about student absenteeism related to repeated pediculosis infestations and the consequent risk for unsuccessful school achievement led to a quality improvement program comprised of 6 projects. The goal was to identify effective nursing interventions for children and families incurring repeated infestations. One project addressed the prevalence of infestation, frequency of school exclusion, and duration of consequential lost school days. Affirmed were low contagion in classrooms and multiple social and emotional challenges in students having chronic infestations. From other projects, the importance of establishing effective relationships with parents, students, and school staff to work toward effective management outcomes was apparent. Also identified was the need to better match hair texture with the selection of a lice comb for effective mechanical removal of lice and nits. There is a need to replicate these projects with larger numbers of students in different geographic locations. It is important to have evidence-based information about the communicability and management strategies for pediculosis to contribute to sound treatment and policy formation. PMID:12017250

Hootman, Janis

2002-04-01

183

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

Science.gov (United States)

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.

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

2005-01-01

184

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

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

2011-01-01

185

Optimism and diet quality in the Women's Health Initiative.  

Science.gov (United States)

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

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

2014-07-01

186

Improvement of quality service based on common benchmarks and indicators  

Directory of Open Access Journals (Sweden)

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

Pohaydak, Olha Bohdanivna

2011-11-01

187

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

Science.gov (United States)

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

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

188

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

Science.gov (United States)

... false Internal quality assessment and performance improvement activities. 460...ELDERLY (PACE) Quality Assessment and Performance Improvement § 460.136 Internal...activities. (2) The quality improvement coordinator...

2010-10-01

189

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

Science.gov (United States)

...requirements for quality assessment and performance improvement program. 460...ELDERLY (PACE) Quality Assessment and Performance Improvement § 460.134...requirements for quality assessment and performance improvement program....

2010-10-01

190

42 CFR 403.732 - Condition of participation: Quality assessment and performance improvement.  

Science.gov (United States)

...participation: Quality assessment and performance improvement. 403.732...participation: Quality assessment and performance improvement. The RNHCI...and maintain a quality assessment and performance improvement program....

2010-10-01

191

Improvements in thin-pulse shock initiation threshold measurements  

Energy Technology Data Exchange (ETDEWEB)

At LLNL we have been evaluating shock-initiation thresholds for various explosives for a number of years, using thin flyer plates accelerated by an electric gun as the shock stimulus (1 to 3). It is advantageous in time and expense to minimize the number of test specimens required for a threshold determination. We have recently improved our velocity calibrated and our experimental protocol in selecting firing voltages so that we can usually obtain a good estimate of the threshold using only 8 to 10 samples.

Bloom, G.; Chau, H.; Glaser, R.; Honodel, C.; Lee, R.S.; Weingart, R.C.

1983-07-14

192

Quality improvement in general surgery: Hong Kong style.  

Science.gov (United States)

A second article describing the significant move of United Christian Hospital towards "continuous quality improvement". Describes the general surgery CQI programme, its problems and successes. PMID:10137533

Ong, B H; Koch, H

1994-01-01

193

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

Directory of Open Access Journals (Sweden)

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

Jin Wang

2009-02-01

194

Methodology Matters: Possible Methods to Improve Quality  

Science.gov (United States)

This article discusses methodological issues in relation to models of quality assurance for higher education. It first traces the historical development of the widely adopted pragmatic model and shows how this model has been adapted by the Higher Education Quality Committee (HEQC) for the South African context. It then sets out some basic tenets…

Luckett, Kathy

2007-01-01

195

Health benefits of improving air quality in Taiyuan, China.  

Science.gov (United States)

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

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

2014-12-01

196

Liver Transplantation at the Ochsner Clinic: Quality and Outcomes Improvement  

Science.gov (United States)

Background In 2005, the results published by the Scientific Registry of Transplant Recipients showed that Ochsner Clinic Foundation's patient and graft survival rates were statistically lower than expected, and the United Network for Organ Sharing Membership and Professional Standards Committee placed our center under peer review. Methods In response, patient outcomes prior to August 2005 were carefully reviewed in a transparent fashion and protocols were written to standardize treatments. We renewed the focus on patient-related outcomes and regulatory adherence and empowered frontline staff to express their views, allowing for real teamwork to develop. Multiple changes were implemented in the everyday running of the program. A quality assurance and performance improvement plan (QAPI) was initiated to improve outcomes. Results In 2012, the Ochsner liver transplant program became the largest liver transplant program in the United States by volume and in 2013 was awarded the prestigious CareChex award, acknowledging it as the number one program in terms of quality of care and outcomes for liver transplantation. Conclusion The methodical application of this QAPI program achieved a remarkable transformation of the Ochsner liver transplant program and exemplifies what is possible with strong teamwork from dedicated and talented staff. PMID:24052774

Therapondos, George; Bohorquez, Humberto; Bruce, David S; Bzowej, Natalie H.; Carmody, Ian C.; Cohen, Ari J.; Girgrah, Nigel; Joshi, Shobha; Reichman, Trevor W.; Loss, Jr., George E.

2013-01-01

197

The Louisiana Medicare Electro-Convulsive Therapy Quality Improvement Project.  

Science.gov (United States)

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

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

1999-10-01

198

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

Directory of Open Access Journals (Sweden)

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

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

2009-04-01

199

IMPROVED AODV BASED ON LINK QUALITY METRICS  

Directory of Open Access Journals (Sweden)

Full Text Available The wireless interfaces in mobile ad-hoc networks (MANET have limited transmission range; communication traffic is relayed over several intermediate nodes to ensure a communication link between two nodes. Since the destination is reached using multiple hops from the source, routing plays an important role in Ad hoc network reliability. Since the network is dynamic in nature, conventional routing protocol may not perform well during adverse conditions like poor link quality, high mobility. In this paper, a new MANET routing method based on Ad hoc On demand Distance Vector (AODV and Ant Colony Optimization (ACO is proposed for networks with varying levels of link quality. ACO is inspired from the biological behaviour of ants. Achievement of complex solutions with limited intelligence and individual capacity within these communities can be emulated in ad hoc networks. A new link quality metric is defined to enhance AODV routing algorithm so that it can handle link quality between nodes to evaluate routes.

V. Duraisamy

2012-11-01

200

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

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

Ali Uyar

2008-01-01

 
 
 
 
201

Interventions and targets aimed at improving quality in inflammatory bowel disease ambulatory care  

Directory of Open Access Journals (Sweden)

Full Text Available Over the past decade, there has been increasing focus on improving the quality of healthcare delivered to patients with chronic diseases, including inflammatory bowel disease. Inflammatory bowel disease is a complex, chronic condition with associated morbidity, health care costs, and reductions in quality of life. The condition is managed primarily in the outpatient setting. The delivery of high quality of care is suboptimal in several ambulatory inflammatory bowel disease domains including objective assessments of disease activity, the use of steroid-sparing agents, screening prior to anti-tumor necrosis factor therapy, and monitoring thiopurine therapy. This review outlines these gaps in performance and provides potential initiatives aimed at improvement including reimbursement programs, quality improvement frameworks, collaborative efforts in quality improvement, and the use of healthcare information technology.

Geoffrey C Nguyen

2013-01-01

202

Does the EUA Institutional Evaluation Programme Contribute to Quality Improvement?  

Science.gov (United States)

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

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

2010-01-01

203

Effects of Quality Improvement System for Child Care Centers  

Science.gov (United States)

Using multiple years of data collected from about 100 child care centers in Palm Beach County, Florida, the authors studied whether the Quality Improvement System (QIS) made a significant impact on quality of child care centers. Based on a pre- and postresearch design spanning a period of 13 months, QIS appeared to be effective in improving

Ma, Xin; Shen, Jianping; Kavanaugh, Amy; Lu, Xuejin; Brandi, Karen; Goodman, Jeff; Till, Lance; Watson, Grace

2011-01-01

204

Technical report for effective estimation and improvement of quality system  

International Nuclear Information System (INIS)

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

205

Improving the accuracy of template-based predictions by mixing and matching between initial models  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Comparative modeling is a technique to predict the three dimensional structure of a given protein sequence based primarily on its alignment to one or more proteins with experimentally determined structures. A major bottleneck of current comparative modeling methods is the lack of methods to accurately refine a starting initial model so that it approaches the resolution of the corresponding experimental structure. We investigate the effectiveness of a graph-theoretic clique finding approach to solve this problem. Results Our method takes into account the information presented in multiple templates/alignments at the three-dimensional level by mixing and matching regions between different initial comparative models. This method enables us to obtain an optimized conformation ensemble representing the best combination of secondary structures, resulting in the refined models of higher quality. In addition, the process of mixing and matching accumulates near-native conformations, resulting in discriminating the native-like conformation in a more effective manner. In the seventh Critical Assessment of Structure Prediction (CASP7 experiment, the refined models produced are more accurate than the starting initial models. Conclusion This novel approach can be applied without any manual intervention to improve the quality of comparative predictions where multiple template/alignment combinations are available for modeling, producing conformational models of higher quality than the starting initial predictions.

Guerquin Michal

2008-05-01

206

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

International Nuclear Information System (INIS)

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

207

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

Directory of Open Access Journals (Sweden)

Full Text Available 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 through improving quality assurance of labs which satisfy the students. Improvement in Teaching staff so that pure knowledge reaches to passing out generation. Total Quality Management (TQM is recognized as an important management philosophy and iswidely used in industries. Over the last few years, TQM has been applied in the education industry.

Abhishek Soni

2013-11-01

208

Basic Approaches to Improve Translation Quality Between English and Chinese  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

Sanning He

2009-01-01

209

Improving the Improved Modified Euler Method for Better Performance on Autonomous Initial Value Problems  

Directory of Open Access Journals (Sweden)

Full Text Available The purpose of this paper was to propose a modification that would lead to a much improved approximation technique for the computation of the numerical solutions of initial value problems, particularly the autonomous type. The method that has been improved upon is our Improved Modified Euler method. By the simple modification effected, a much better performance was achieved, not just for the autonomous problem, but for the non-autonomous problem as well. The new method was also shown to be of order 2.

Abraham OCHOCHE

2008-06-01

210

Danish initiatives to improve the safety of meat products  

DEFF Research Database (Denmark)

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

Wegener, Henrik Caspar

2010-01-01

211

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.)

212

Zero tolerance for failure. An AREVA initiative to improve reliability  

Energy Technology Data Exchange (ETDEWEB)

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

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

2010-04-15

213

Patient safety and quality improvement: an overview of QI.  

Science.gov (United States)

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

Schriefer, Jan; Leonard, Michael S

2012-08-01

214

Improving Learning Object Quality: Moodle HEODAR Implementation  

Science.gov (United States)

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

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

2012-01-01

215

A quality improvement program in pathology  

Directory of Open Access Journals (Sweden)

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

Alp USUBÜTÜN

2007-05-01

216

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

Science.gov (United States)

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. PMID:22282546

Boulet, Louis-Philippe; FitzGerald, J Mark; Levy, Mark L; Cruz, Alvaro A; Pedersen, Soren; Haahtela, Tari; Bateman, Eric D

2012-05-01

217

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

DEFF Research Database (Denmark)

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

Boulet, Louis-Philippe; FitzGerald, J Mark

2012-01-01

218

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

Science.gov (United States)

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

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

2013-10-01

219

Reducing hospital-acquired pressure ulcers: a quality improvement project across 21 hospitals.  

Science.gov (United States)

A quality improvement initiative across 21 hospitals incorporated a multidisciplinary approach, breakthrough collaborative methods, evidence-based improvement methods and care guidelines, front-line rapid improvement cycles, consistent process-of-care documentation, and real-time incidence data. Statistically significant decreases in both all-stage and stages III, IV, and unstageable hospital-acquired pressure ulcers rates have been sustained for 5 years. PMID:24647120

Crawford, Barbara; Corbett, Nancy; Zuniga, Anita

2014-01-01

220

From Planning to Improvement: Monash University Library's Quality Review  

Science.gov (United States)

During 2003, Monash University Library conducted a comprehensive quality review as part of the university's program of reviews. A quality management group was established in September 2002 to drive the process. All staff were given the opportunity to contribute input to the initial self-review. Methods of collecting data, collating responses and…

Pernat, Marie

2004-01-01

 
 
 
 
221

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

222

IUPQC Simulations for Power Quality Improvement  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

Rajeev, S.

2014-01-01

223

Aspects of improving the organization directed to the quality  

Directory of Open Access Journals (Sweden)

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

M. Dudek-Burlikowska

2010-06-01

224

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

Science.gov (United States)

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%.

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

2012-03-01

225

Population growth "neutralizes" India's efforts to improve quality of life.  

Science.gov (United States)

With one of the world's oldest family welfare programs, direct interventions, and policy initiatives, India has managed to reduce its crude birth rate from 41.7/1000 in 1951-61 to 27.4/1000 today; the crude death rate and infant mortality rate have also fallen. However, despite these successes, efforts to improve the quality of life in India have been neutralized by population growth. Policies are therefore now targeted to the employment-oriented development of the rural infrastructure. The resulting interventions have led to a reduction in both rural and urban poverty. An holistic approach is being applied to poverty alleviation, including institutional reforms, capacity building, and asset creation through sustainable productive economic processes and the involvement of communities and nongovernmental organizations in family welfare initiatives, with emphasis upon population and health and special focus upon vulnerable sections. The problems of infants and the elderly must be addressed. A community needs assessment has been underway since April 1996 in the attempt to achieve decentralized participatory planning at the service provider's level. PMID:12294106

1998-01-01

226

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

Directory of Open Access Journals (Sweden)

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

Giron Kamonja

2014-04-01

227

Improving quality through patient-provider communication.  

Science.gov (United States)

Though three hospitals and their patient populations were similar, one hospital was rated significantly higher on quality by its patients than were the other hospitals. Patients at that hospital felt significantly more confident that their hospital performed reliably and that they would have successful medical outcomes than did patients at the other hospitals. Analysis of patient responses shows that communicativeness (information giving and taking) and understanding (interest shown in patient's personal concerns) of medical personnel were significantly different across the three hospitals. Results underscore the importance of educating medical consumers about their medical needs and of understanding and responding to their psychosocial needs. PMID:10115901

John, J

1991-12-01

228

Quality Improvement of Business Critical Systems  

Directory of Open Access Journals (Sweden)

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

Mr. P. Jitendra Srinivas Kumar

2011-11-01

229

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

Science.gov (United States)

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.

Jardim, Kevin P.

230

Improvement and Implementation of Software Quality by Using Software Metrics  

Directory of Open Access Journals (Sweden)

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

Dileram Bansal, Ajit Saxena, Gajendra Singh

2014-06-01

231

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

Directory of Open Access Journals (Sweden)

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

Avetisyan Ruzan

2011-01-01

232

Quality of life improvements in dialysis patients receiving darbepoetin alfa.  

Science.gov (United States)

Short-acting hematopoietic agents can improve the quality of life (QOL) of hemodialysis patients, but questions remain regarding the domains of QOL affected, the relative importance of initial and final hemoglobin (Hb) concentrations, and the use of long-acting hematopoietic agents. We measured Hb concentrations and QOL in 487 hemodialysis patients who were switched from treatment with recombinant human erythropoietin to treatment with darbepoetin alfa. QOL was measured with the Japanese-language version of the SF-36, at the start of therapy with darbepoetin alfa and again 7-14 weeks later. We examined changes in QOL over time in the group as a whole, and in subgroups stratified by the change in Hb concentration. We also studied relationships between the final Hb concentration achieved and the magnitude of change in QOL. QOL scores increased significantly in all SF-36 domains except Social Functioning. The greatest increases were in vitality and in the two role-functioning domains. The magnitude of the increase in Hb concentration was related to the magnitude of the increase in QOL for only one subscale: Vitality. Patients with higher final Hb concentrations also had greater increases in Vitality scores. Hematopoiesis induced by darbepoetin alfa is associated with increased vitality and may also be associated with improved role functioning. Vitality increased significantly only in those patients with the greatest increases in Hb concentration and in those with higher final Hb concentrations. PMID:18257816

Fukuhara, Shunichi; Akizawa, Tadao; Morita, Satoshi; Koshikawa, Shozo

2008-02-01

233

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

Directory of Open Access Journals (Sweden)

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

Yaser hasan Al-Mamary

2014-09-01

234

Process safety improvement--quality and target zero.  

Science.gov (United States)

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

Van Scyoc, Karl

2008-11-15

235

Process safety improvement-Quality and target zero  

Energy Technology Data Exchange (ETDEWEB)

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.

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

236

Quality improvement in neurology: Distal symmetric polyneuropathy quality measures.  

Science.gov (United States)

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

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

2014-05-13

237

DIESELGENERATOR OPERATIONAL MONTORING OF QUALITY IMPROVEMENT OPPORTUNITIES  

Directory of Open Access Journals (Sweden)

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

FENYVESI, Csaba

2013-03-01

238

Quality Improvement of Business Critical Systems  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Today’s society is crucially dependent on software systems. The number of areas where functioning software is at the core of operation is growing steadily. Both financial systems and e-business systems relies on increasingly larger and more complex computer and software systems. To increase e.g. the reliability and performance of such systems we rely on a plethora of methods, techniques and processes specifically aimed at improving the development, operation and maintenance of such s...

Jitendra Srinivas Kumar, P.

2011-01-01

239

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

Science.gov (United States)

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

2010-07-01

240

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

Science.gov (United States)

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

2010-07-01

 
 
 
 
241

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

Science.gov (United States)

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

2010-07-01

242

Improvement of power quality using distributed generation  

Energy Technology Data Exchange (ETDEWEB)

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

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

2010-12-15

243

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.

244

Do farm audits improve milk quality?  

Science.gov (United States)

Milk quality is assessed using bulk milk analysis and by farm audits in the Netherlands. However, the extent of the effect that dairy farm audits have on milk quality is unknown. Data from over 13,000 audits performed on 12,855 dairy farms from February 2006 to April 2008 were merged with laboratory test results of 325,150 bulk milk samples collected 6 mo before and after the audit. A linear mixed model with the method of restricted maximum likelihood was conducted to study whether the total bacterial counts (TBC) of bulk milk were lower during the periods before and after the dairy farm audit. Results showed that TBC values were 2 to 6% lower (i.e., 0.010 to 0.026 log cfu/mL) for a period from 1.5 to at least 6 mo after an audit. Additionally, several variables were significantly associated with bulk milk TBC values: seasonality, total number of attention points (given if some checklist points were not appropriate), audit type, audit result, and the categories milking equipment maintenance, and utility room-tank maintenance. The TBC values increased with a higher level of attention points. Furthermore, the farms rejected based on the audit results had the highest average TBC values and the approved farms had the lowest values. If dairy farms had an overall negative audit assessment and consequently needed a re-audit in the following year, the TBC values of bulk milk were more likely to be higher. Auditing may provide dairy farmers the opportunity to receive advice about factors that influence bulk milk TBC values, for a period of at least 6 mo following the audit. PMID:24183685

Flores-Miyamoto, A; Reij, M W; Velthuis, A G J

2014-01-01

245

42 CFR 422.152 - Quality improvement program.  

Science.gov (United States)

...action. For each plan, the organization...for specialized MA Plans for special needs...quality improvement program that— (1...condition) at the plan level. (2... (iii) Staff implementation of the SNP model...Comprehensive health risk assessment as evidenced...

2010-10-01

246

42 CFR 422.152 - Quality improvement program.  

Science.gov (United States)

...SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE...improvement program. (3) Remedial action. For each plan, the organization...measures from the care coordination domain (for example, service and...psychosocial, or clinical domains (for example, quality of...

2010-10-01

247

Improvement of Flow Quality in NAL Chofu Mach 10 Nozzle  

Science.gov (United States)

As a result of CFD analysis and remachining of the nozzle, the flow quality of the Mach 10 Hypersonic Wind Tunnel at NAL Chofu, Japan was improved. The subsequent test results validated the CFD analytical predictions by NASA and MHL.

Lacey, John; Inoue, Yasutoshi; Higashida, Akio; Inoue, Manabu; Ishizaka, Kouichi; Korte, John J.

2002-01-01

248

42 CFR 423.162 - Quality improvement organization activities.  

Science.gov (United States)

...CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality Improvement Requirements...health care services, including those related to prescription drug therapy, in accordance with contracts...

2010-10-01

249

Improvement of image quality in I.I. fluorography  

International Nuclear Information System (INIS)

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

250

Quality councils as catalysts and leaders in quality improvement: the experience of the health quality council in Saskatchewan.  

Science.gov (United States)

Quality councils are an increasingly common phenomenon in Canada. The Health Quality Council in Saskatchewan, the largest such council in Canada, is similar to other councils in that it reports publicly on quality of care, but it differs in that it has an explicit, central role to support quality improvement activities. The HQC strives to gain buy-in and cooperation from provider groups, even those identified as having suboptimal care, by offering them quality improvement training, measurement tools, information about best practices and advice from experts in change management, group psychology, process redesign and operations research. Developing relationships with stakeholders is a very labour- intensive process, but it is essential to fostering a blame-free culture of quality improvement. The HQC works with senior leaders to help coordinate province-wide priorities for quality improvement and with middle managers and frontline staff to establish local quality improvement teams. It does not alter the structure of existing accountability relationships; rather, it tries to make the dialogue more quality-focused. Its largest-scale activity is a Learning Collaborative involving 20% of all family physicians in the province in an effort to improve chronic disease management. The HQC believes that these targeted, coordinated activities in quality improvement will ultimately be far more effective than simply releasing reports or making recommendations. PMID:16651859

Chan, Benjamin T B; Smadu, Marlene; McMillan, J Stewart

2006-01-01

251

Leadership – The Key Element in Improving Quality Management  

Directory of Open Access Journals (Sweden)

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

Iveta Paulová

2011-10-01

252

Examining Pre-School Classroom Quality in a Statewide Quality Rating and Improvement System  

Science.gov (United States)

Background: Research has documented the importance of high-quality early childhood experiences in preparing children for school. Quality rating and improvement systems (QRIS) have recently emerged in many states as a way to build quality of child care and to promote better child outcomes. Objective: The goal of this study was to determine if…

Jeon, Lieny; Buettner, Cynthia K.; Hur, Eunhye

2014-01-01

253

Continuous quality improvement in dialysis units: basic tools.  

Science.gov (United States)

Physicians and allied health professionals are expected to understand and participate in the assessment and improvement of the quality of care delivered to patients in end-stage renal disease (ESRD) treatment centers. Participating in the quality improvement process will bring clinicians into contact with special knowledge and skills drawn from the areas of statistical process control and industrial engineering. Some of the more frequently encountered of these concepts and tools are described. PMID:11349249

McClellan, W M; Goldman, R S

2001-04-01

254

Quality improvement of paediatric care in the Netherlands  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The development of the quality improvement programme of the Paediatric Association of the Netherlands is described within the setting of the national programme of the Dutch government. The programme is based on four pillars: site visits by peers (visitatie), continuous medical and professional education, development of clinical (evidence based) guidelines and patient safety with complication registration. The site visits by peers play a central role in assessing the quality improvement activi...

Schulpen, Tom W. J.; Lombarts, Kiki M. J.

2007-01-01

255

Improved Power Quality SMPS for Personal Computer Applications  

Science.gov (United States)

The design and control of an improved power quality two stage dc-dc converter based switched mode power supply (SMPS) is carried out for personal computer applications. The proposed SMPS is formed by a diode bridge rectifier which is connected to a non-isolated converter. The output of this stage is connected to a high frequency isolated multiple output dc-dc converter. The output dc voltage at both the stages is regulated for power quality improvement.

Singh, S.; Bhuvaneswari, G.; Singh, B.

2012-09-01

256

A comparison of two optimization methods for mesh quality improvement.  

Energy Technology Data Exchange (ETDEWEB)

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

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

2005-03-01

257

Continuous Quality Improvement: Integrating Best Practice into Teacher Education  

Science.gov (United States)

Purpose: This paper aims to provide a framework for continuous, quality, low cost professional development opportunities at the university level to improve the quality of the instructional practices and/or curriculum used in the teacher education program. Design/methodology/approach: Background of the design, needs assessment and implementation of…

Edmonds, Carole

2007-01-01

258

Effective Interventions on Service Quality Improvement in a Physiotherapy Clinic  

Directory of Open Access Journals (Sweden)

Full Text Available 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 participation of 324 patients and their coadjutors. The study questionnaire consisted of 7 questions about demographic factors and 38 questions for eleven aspects of service quality. Data were then analyzed using paired samples t-test by SPSS16. Results: In the pre intervention phase, six aspects of service quality including choice of provider, safety, prevention and early detection, dignity, autonomy and availability achieved non-acceptable scores. Following interventions, all aspects of the service quality improved and also total service quality score improved from 8.58 to 9.83 (P<0.001. Conclusion: Service quality can be improved by problem implementation of appropriate interventions. The acquired results can be used in health system fields to create respectful environments for healthcare customers.

Farid Gharibi

2014-07-01

259

Institutional Research and Improving the Quality of Student Engagement  

Science.gov (United States)

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

Zepke, Nick; Butler, Philippa; Leach, Linda

2012-01-01

260

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background Previous research addressed the development of a classification scheme for quality improvement systems in European hospitals. In this study we explore associations between the 'maturity' of the hospitals' quality improvement system and clinical outcomes. Methods The maturity classification scheme was developed based on survey results from 389 hospitals in eight European countries. We matched the hospitals from the Spanish sample (113 hospital...

Groene Oliver; Mora Nuria; Thompson Andrew; Saez Mercedes; Casas Mercè; Suñol Rosa

2011-01-01

 
 
 
 
261

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

Directory of Open Access Journals (Sweden)

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

Abhishek Soni, Sanjay Soni, Dr. Sameer Vaidhya

2014-06-01

262

Software Quality Improvement in the OMC Team  

CERN Document Server

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

Maier, Viktor

263

Quality rice improvement by mutation breeding  

International Nuclear Information System (INIS)

''Basmati'' being fragrant and fine grained represents a major export crop of India. Due to its good quality but poor yield its market price is high. Jhona-349 has also slender grains but a much higher yield than ''Basmati'' and is cheaper. Its grains after fine milling and heavy polishing are sold in common markets as ''Basmati''. But this variety is tall and lodging susceptible with bolder grains than Basmati. Following treatment with 1.5% EMS or 20 kR gamma-rays + 1% EMS, two mutants Jm1 and Jm4 were selected in M2 and studied through M3-M5 generations (Table). Both these mutants are shorter and higher yielding than the parent. Jm4 has a higher grain number and yield than Jm1 and ''Jhona''. Crossing these mutants yielded a recombinant JJ1.4 that is short statured and higher grain yielding than ''Jhona'' and ''Basmati''. In addition, its grain fineness is better and equals that of ''Basmati''. Compared to ''Basmati'', this recombinant is 50% shorter in culm height, 80% higher in grain number/plant and 70% higher in grain yield. Moreover, this recombinant exhibits about 10% increase in hulling and milling

264

A Longitudinal, Experiential Quality Improvement Curriculum Meeting ACGME Competencies for Geriatrics Fellows: Lessons Learned  

Science.gov (United States)

Quality improvement (QI) initiatives are critical in the care of older adults who are more vulnerable to substandard care. QI education meets aspects of core Accreditation Council of Graduate Medical Education competencies and prepares learners for the rising focus on performance measurement in health care. The authors developed, implemented, and…

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

2013-01-01

265

Partnerships for Quality: Improving Infant-Toddler Child Care for Low-Income Families.  

Science.gov (United States)

This report describes what has been learned in the first year of a study to examine collaborative community initiatives designed to improve low-income families' access to good-quality infant-toddler child care; the report examines the Early Head Start/child care partnerships in detail and identifies emerging themes to consider in more depth as the…

Paulsell, Diane; Cohen, Julie; Stieglitz, Ali; Lurie-Hurvitz, Erica; Fenichel, Emily; Kisker, Ellen

266

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

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

2010-01-01

267

Grid quality improvement by a grid adaptation technique  

Science.gov (United States)

A grid adaptation technique is presented which improves grid quality. The method begins with an assessment of grid quality by defining an appropriate grid quality measure. Then, undesirable grid properties are eliminated by a grid-quality-adaptive grid generation procedure. The same concept has been used for geometry-adaptive and solution-adaptive grid generation. The difference lies in the definition of the grid control sources; here, they are extracted from the distribution of a particular grid property. Several examples are presented to demonstrate the versatility and effectiveness of the method.

Lee, K. D.; Henderson, T. L.; Choo, Y. K.

1991-01-01

268

Sources of Indoor Air Pollution- Improving Indoor Air Quality  

Science.gov (United States)

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

2007-01-21

269

Power quality improvement with an extended custom power park  

Energy Technology Data Exchange (ETDEWEB)

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

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

2009-11-15

270

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

Science.gov (United States)

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

Szablowski, Katarzyna M

2014-01-01

271

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

Science.gov (United States)

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

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

2013-08-01

272

Applying GRA and QFD to Improve Library Service Quality  

Science.gov (United States)

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

Chen, Yen-Ting; Chou, Tsung-Yu

2011-01-01

273

Workbook for Taguchi Methods for Product Quality Improvement.  

Science.gov (United States)

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

Zarghami, Ali; Benbow, Don

274

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)

275

Studying and improving blast furnace cast iron quality  

Directory of Open Access Journals (Sweden)

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

?. ?. Balgabekov

2014-10-01

276

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

Science.gov (United States)

Introduction To combat the AIDS epidemic and increase HIV treatment access, the South African government implemented a nurse-based, doctor-supported model of care that decentralizes administration of antiretroviral treatment (ART) for HIV positive patients through nurse initiated and managed ART. Médecins Sans Frontières (MSF) implemented a mentorship programme to ensure successful task-shifting, subsequently assessing the quality of clinical care provided by nurses. Methods A before-after cross-sectional study was conducted on nurses completing the mentorship programme in Khayelitsha, South Africa, from February 2011-September 2012. Routine clinical data from 229 patient folders and 21 self-assessment questionnaires was collected to determine the number of patients initiated on ART by nurses; quality of ART management before-after mentorship; patient characteristics for doctor and nurse ART initiations; and nurse self-assessments after mentorship. Results Twenty one nurses were authorized by one nurse mentor with one part-time medical officer's support, resulting in nurses initiating 77% of ART eligible patients. Improvements in ART management were found for drawing required bloods (91% vs 99%, p?=?0.03), assessing adherence (50% vs 78%, p<0.001) and WHO staging (63% vs 91%, p<0.001). Nurse ART initiation indicators were successfully completed at 95–100% for 11 of 16 indicators: clinical presentation; patient weight; baseline blood work (CD4, creatinine, haemoglobin); STI screening; WHO stage, correlating medical history; medications prescribed appropriately; ART start date; and documented return date. Doctors initiated more patients with TB/HIV co-infection and WHO Stage 3 and 4 disease than nurses. Nurse confidence improved for managing HIV-infected children and pregnant women, blood result interpretation and long-term side effects. Conclusions Implementation of a clinical mentorship programme in Khayelitsha led to nurse initiation of a majority of eligible patients, enabling medical officers to manage complex cases. As mentorship can increase clinical confidence and enhance professional development, it should be considered essential for universal ART access in resource limited settings. PMID:24887260

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

2014-01-01

277

Improving arteriovenous fistula rate: Effect on hemodialysis quality.  

Science.gov (United States)

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

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

2014-04-01

278

Patient Satisfaction Survey as a Tool Towards Quality Improvement  

Directory of Open Access Journals (Sweden)

Full Text Available Over the past 20 years, patient satisfaction surveys have gained increasing attention as meaningful and essential sources of information for identifying gaps and developing an effective action plan for quality improvement in healthcare organizations. However, there are very few published studies reporting of the improvements resulting from feedback information of patient satisfaction surveys, and in most cases, these studies are contradictory in their findings. This article investigates in-depth a number of research studies that critically discuss the relationship of dependent and independent influential attributes towards overall patient satisfaction in addition to its impact on the quality improvement process of healthcare organizations.

Rashid Al-Abri

2014-01-01

279

Quality improvement in clinical documentation: does clinical governance work?  

Directory of Open Access Journals (Sweden)

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

Dehghan M

2013-12-01

280

The ReACH Collaborative--improving quality home care.  

Science.gov (United States)

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

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

2007-08-01

 
 
 
 
281

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)

282

Design and Simulation of STATCOM to Improve Power Quality  

Directory of Open Access Journals (Sweden)

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

Md. Nazrul Islam

2013-07-01

283

Quality control in the initiation of eukaryotic DNA replication  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

Diffley, John F. X.

2011-01-01

284

Ten tips for incorporating scientific quality improvement into everyday work.  

Science.gov (United States)

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

Goldmann, Don

2011-04-01

285

Enhancing the quality of humanitarian assistance: taking stock and future initiatives.  

Science.gov (United States)

During the last five years, the debate on the performance of humanitarian assistance has intensified. The motivation to "do better" has come both from within the humanitarian agencies as well as from pressure exerted by the donors and the media. Paradoxically, until now, the voice of those who are to benefit from this assistance has not been heard. This paper is an overview of the most important initiatives to increase the quality of humanitarian assistance. The introduction of the logical framework and the increasing body of knowledge made available through guidelines have improved project management by measuring process and outcomes. Increasingly, evaluations are used to give account and to learn from experiences. But, current evaluation practice must develop in a wider variety of approaches more appropriate to create change of the operations in the field. Some agencies oppose new developments like the Sphere and the Humanitarian Accountability Projects, arguing that standards and regulation would undermine necessary flexibility to adjust responses to the local context, or be a threat to their independence. Nonetheless, standards are considered to be a prerequisite as reference to assess performance. Furthermore, it is hoped that a new breakthrough will be achieved by improved accountability towards beneficiaries. An option to address some of the gaps in the current quality assessment tools was to widen the perspective on performance from projects to the organisations behind them. Quality management models may provide the required framework, and they also can be used to embed current initiatives by organisations. Humanitarian organisations may want to develop forms of self-regulation rather than waiting for accreditation by donors. Another area in which progress is needed is a system-wide approach to performance. At this level, the influence of political actors, donors, national governments, and other representatives of the parties in a conflict also should be assessed. It is their legal obligation to protect the basic right to assistance of persons affected by disasters, as enshrined in international law. PMID:12090200

Griekspoor, A; Sondorp, E

2001-01-01

286

Improved initial guess for minimum energy path calculations  

CERN Document Server

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

Smidstrup, Søren; Stokbro, Kurt; Jónsson, Hannes

2014-01-01

287

AQMEII: A New International Initiative on Air Quality Model Evaluation  

Science.gov (United States)

We provide a conceptual view of the process of evaluating regional-scale three-dimensional numerical photochemical air quality modeling system, based on an examination of existing approached to the evaluation of such systems as they are currently used in a variety of application....

288

To participate or not in the physician quality reporting initiative (PQRI); that is the question.  

Science.gov (United States)

The Tax Relief and Health Care Act of 2006 authorized the establishment of a physician quality reporting system which would tie a reimbursement incentive to compliance with benchmarks that are considered proxies of quality patient care. The Centers for Medicare and Medicare Services (CMS) has called this the Physician Quality Reporting Initiative (PQRI). A brief historical background about how this program evolved, how one participates in this initiative, and the strengths and weaknesses of current and new benchmarks is presented. PMID:17536577

Elliott, Brett

2007-05-01

289

Quality of life improvement with sublingual immunotherapy: a prospective study of efficacy.  

Science.gov (United States)

Due to its excellent safety profile, ease of administration, and economic considerations, sublingual immunotherapy (SLIT) is becoming a preferred form of allergen specific immunotherapy. The efficacy of SLIT is still debated. The purpose of this act of practice trial is to evaluate quality of life outcomes in patients treated with SLIT. Fifty one patients with allergic rhinoconjunctivitis demonstrated by skin testing completed the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) at initiation, at four months and at 10-12 months of SLIT. Significant improvement (P RQLQ questionnaire was noted. Total RQLQ scores also showed significant improvement. This study supports SLIT as a modality effective in controlling allergic symptoms. PMID:22500181

Morris, Mary S; Lowery, Amanda; Theodoropoulos, Demetrios S; Duquette, R Daniel; Morris, David L

2012-01-01

290

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

Science.gov (United States)

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 based on the Baldrige Award criteria. These data were combined with independently collected data on perceived impact and objective measures of clinical efficiency (i.e., charges and length of stay) for six clinical conditions. STUDY DESIGN: The study involved cross-sectional examination of the named relationships. DATA COLLECTION/EXTRACTION METHODS: Reliable and valid scales for the organizational culture and quality improvement implementation measures were developed based on responses from over 7,000 individuals across the 61 hospitals with an overall completion rate of 72 percent. Independent data on perceived impact were collected from a national survey and independent data on clinical efficiency from a companion study of managed care. PRINCIPAL FINDINGS: A participative, flexible, risk-taking organizational culture was significantly related to quality improvement implementation. Quality improvement implementation, in turn, was positively associated with greater perceived patient outcomes and human resource development. Larger-size hospitals experienced lower clinical efficiency with regard to higher charges and higher length of stay, due in part to having more bureaucratic and hierarchical cultures that serve as a barrier to quality improvement implementation. CONCLUSIONS: What really matters is whether or not a hospital has a culture that supports quality improvement work and an approach that encourages flexible implementation. Larger-size hospitals face more difficult challenges in this regard. PMID:7782222

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

291

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

Science.gov (United States)

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

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

2011-01-01

292

Enzymatic treatment to improve the quality of black tea extracts.  

Science.gov (United States)

Enzymatic extraction was investigated to improve the quality of black tea extracts with pretreatment of pectinase and tannase independently, successively and simultaneously. Pectinase improved the extractable-solids-yield (ESY) up to 11.5%, without much of an improvement in polyphenols recovery, while tannase pre-treatment showed a significant improvement in polyphenols recovery (14.3%) along with an 11.1% improvement in ESY. Among the four treatments, tannase-alone treatment showed the maximum improvement in tea quality, with higher polyphenols-in-extracted solids. Treatments involving tannase resulted in the significant release of gallic acid, due to its hydrolytic activity, leading to greater solubility besides favourably improving TF/TR ratio. The results suggested that employing a single enzyme, tannase, for the pre-treatment of black tea is desirable. Enzymatic extraction may be preferred over enzymatic clarification as it not only displayed reduction in tea cream and turbidity but also improved the recovery of polyphenols and ESY in the extract, as well as maintaining a good balance of tea quality. PMID:25214094

Chandini, S K; Rao, L Jaganmohan; Gowthaman, M K; Haware, D J; Subramanian, R

2011-08-01

293

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

Science.gov (United States)

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

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

2002-01-01

294

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

295

INTEGRATED SAFETY MANAGEMENT SYSTEM SAFETY CULTURE IMPROVEMENT INITIATIVE  

Energy Technology Data Exchange (ETDEWEB)

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

MCDONALD JA JR

2009-01-16

296

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

Science.gov (United States)

...requirements for quality assessment and performance improvement program. 460.134...requirements for quality assessment and performance improvement program. (a) Minimum...organization's quality assessment and performance improvement program must...

2010-10-01

297

42 CFR 438.240 - Quality assessment and performance improvement program.  

Science.gov (United States)

...false Quality assessment and performance improvement program. 438.240...240 Quality assessment and performance improvement program. (a) General...ongoing quality assessment and performance improvement program for the...

2010-10-01

298

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

Science.gov (United States)

...participation: Quality assessment and performance improvement program. 482.21...participation: Quality assessment and performance improvement program. The hospital...data-driven quality assessment and performance improvement program. The...

2010-10-01

299

42 CFR 438.240 - Quality assessment and performance improvement program.  

Science.gov (United States)

...2010-10-01 false Quality assessment and performance improvement program. 438... MANAGED CARE Quality Assessment and Performance Improvement Measurement and...interventions to achieve improvement in quality. (iii)...

2010-10-01

300

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

Science.gov (United States)

...of participation: Quality assessment and performance improvement. 418.58 Section...of participation: Quality assessment and performance improvement. The hospice...ongoing program for quality improvement and patient...

2010-10-01

 
 
 
 
301

42 CFR 460.132 - Quality assessment and performance improvement plan.  

Science.gov (United States)

...2010-10-01 false Quality assessment and performance improvement plan. 460.132...ELDERLY (PACE) Quality Assessment and Performance Improvement § 460.132 Quality assessment and performance improvement plan. (a)...

2010-10-01

302

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

Science.gov (United States)

...for coverage-Quality assessment and performance improvement. 416.43...coverage—Quality assessment and performance improvement. The ASC...data-driven quality assessment and performance improvement (QAPI)...

2010-10-01

303

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

Science.gov (United States)

...2010-10-01 2010-10-01 false Use of quality improvement organization review information. ...PROGRAM MEDICARE ADVANTAGE PROGRAM Quality Improvement § 422.153 Use of quality improvement organization review information....

2010-10-01

304

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

Science.gov (United States)

...false Condition: Quality assessment and performance improvement. 494.110 Section...110 Condition: Quality assessment and performance improvement. The dialysis...demonstrate evidence of its quality improvement and performance...

2010-10-01

305

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

Science.gov (United States)

...received from, the hospital's Quality Improvement Organization. (2) The hospital...hospital must document what quality improvement projects are being conducted...That an ongoing program for quality improvement and patient safety,...

2010-10-01

306

39 CFR 3050.42 - Proceedings to improve the quality of financial data.  

Science.gov (United States)

...Proceedings to improve the quality of financial data. 3050.42 Section...Proceedings to improve the quality of financial data. The Commission...proceedings to improve the quality, accuracy, or completeness of Postal Service data required under §...

2010-07-01

307

Accelerating the spread of laboratory quality improvement efforts in Botswana  

Directory of Open Access Journals (Sweden)

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

Kelebeletse O. Mokobela

2014-11-01

308

Improved initial guess for minimum energy path calculations  

Science.gov (United States)

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

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

2014-06-01

309

Improved initial guess for minimum energy path calculations.  

Science.gov (United States)

A method is presented for generating a good initial guess of a transition path between given initial and final states of a system without evaluation of the energy. An objective function surface is constructed using an interpolation of pairwise distances at each discretization point along the path and the nudged elastic band method then used to find an optimal path on this image dependent pair potential (IDPP) surface. This provides an initial path for the more computationally intensive calculations of a minimum energy path on an energy surface obtained, for example, by ab initio or density functional theory. The optimal path on the IDPP surface is significantly closer to a minimum energy path than a linear interpolation of the Cartesian coordinates and, therefore, reduces the number of iterations needed to reach convergence and averts divergence in the electronic structure calculations when atoms are brought too close to each other in the initial path. The method is illustrated with three examples: (1) rotation of a methyl group in an ethane molecule, (2) an exchange of atoms in an island on a crystal surface, and (3) an exchange of two Si-atoms in amorphous silicon. In all three cases, the computational effort in finding the minimum energy path with DFT was reduced by a factor ranging from 50% to an order of magnitude by using an IDPP path as the initial path. The time required for parallel computations was reduced even more because of load imbalance when linear interpolation of Cartesian coordinates was used. PMID:24907989

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

2014-06-01

310

A systems thinking approach to the sustainability of quality improvement programmes  

Scientific Electronic Library Online (English)

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

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

311

A systems thinking approach to the sustainability of quality improvement programmes  

Scientific Electronic Library Online (English)

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

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

2014-01-01

312

Raising the bar: using program evaluation for quality improvement.  

Science.gov (United States)

The Cancer Quality Council of Ontario has undertaken 3 programmatic reviews, in partnership with Cancer Care Ontario, to evaluate an emerging or existing program and to provide future directions. The reviews are a quality improvement tool consisting of an assessment of the program's current state, a critical appraisal, and an environmental scan in advance of an event where attendees hear best practices from jurisdictions and participate in a discussion leading to a set of recommendations for the program. PMID:24696943

Anas, Rebecca; Stiff, Jennifer; Speller, Brittany; Foster, Nicoda; Bell, Robert; McLaughlin, Virginia; Evans, William K

2013-01-01

313

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

314

Data quality objectives for the initial fuel conditioning examinations  

International Nuclear Information System (INIS)

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

315

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

Energy Technology Data Exchange (ETDEWEB)

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

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

2011-09-15

316

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

International Nuclear Information System (INIS)

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

317

Rapid core measure improvement through a "business case for quality".  

Science.gov (United States)

Incentives to improve performance are emerging as revenue or financial penalties are linked to the measured quality of service provided. The HCA "Getting to Green" program was designed to rapidly increase core measure performance scores. Program components included (1) the "business case for quality"-increased awareness of how quality drives financial performance; (2) continuous communication of clinical and financial performance data; and (3) evidence-based clinical protocols, incentives, and tools for process improvement. Improvement was measured by comparing systemwide rates of adherence to national quality measures for heart failure (HF), acute myocardial infarction (AMI), pneumonia (PN), and surgical care (SCIP) to rates from all facilities reporting to the Centers for Medicare and Medicaid Services (CMS). As of the second quarter of 2011, 70% of HCA total measure set composite scores were at or above the 90th percentile of CMS scores. A test of differences in regression coefficients between the CMS national average and the HCA average revealed significant differences for AMI (p = .001), HF (p = .012), PN (p < .001), and SCIP (p = .015). This program demonstrated that presentation of the financial implications of quality, transparency in performance data, and clearly defined goals could cultivate the desire to use improvement tools and resources to raise performance. PMID:22931509

Perlin, Jonathan B; Horner, Stephen J; Englebright, Jane D; Bracken, Richard M

2014-01-01

318

A new quality assessment and improvement system for print media  

Science.gov (United States)

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.

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

2012-12-01

319

Power Quality Disturbances and Improving Power System Reliability?  

Directory of Open Access Journals (Sweden)

Full Text Available Create unfavorable influence on production processes and assemblies, reducing product quality, making the production processes interrupt, and thus causing huge economic losses. Here we introduce customer power technology which is emerging area in mitigating power quality disturbances and improving power system reliability. The various power quality disturbances and exiting solutions are also discussed. . Power stability highly demanded due to the harms of disturbances. The response time is about 25 ms, and this is much less than some of the traditional methods of voltage correction such as tap-changing transformers.

Sonia

2014-09-01

320

Improving the quality of technical co-operation projects  

International Nuclear Information System (INIS)

Improving project quality was the dominant theme in the IAEA programme of technical co-operation for 1995. The quality standards introduced with 'model projects', especially the emphasis on end-users embodied in the new approach known as 'partners in development', became the hallmark for the entire technical assistance programme. With the first set of model projects nearing completion, assessment of their performance led to a number of important lessons. In turn, these lessons have prompted an increased emphasis on quality assurance mechanisms - which brings into clear focus the importance of the upstream worked being done through the country programme framework process and thematic/sectoral planning

 
 
 
 
321

Improving quality and efficiency of postpartum hospital education.  

Science.gov (United States)

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 registered nurses before and after implementation of an intervention. Results indicated that a comprehensive educational booklet and enhanced documentation can improve efficiency in the patient education process for nurses. PMID:23997552

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

2012-01-01

322

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

DEFF Research Database (Denmark)

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

Robotham, Antony John

1999-01-01

323

77 FR 20317 - Acquisition, Protection, and Disclosure of Quality Improvement Organization Information  

Science.gov (United States)

...480 Acquisition, Protection, and Disclosure of Quality Improvement Organization Information CFR Correction In Title...ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION INFORMATION [FR Doc....

2012-04-04

324

42 CFR 482.96 - Condition of participation: Quality assessment and performance improvement (QAPI).  

Science.gov (United States)

...false Condition of participation: Quality assessment and performance improvement (QAPI). 482.96 Section 482...96 Condition of participation: Quality assessment and performance improvement (QAPI). Transplant...

2010-10-01

325

Patient Safety Reporting Systems: Sustained Quality Improvement Using a Multidisciplinary Team and "Good Catch" Awards  

Science.gov (United States)

Background Since 1999, hospitals have made substantial commitments to healthcare quality and patient safety through individual initiatives of executive leadership involvement in quality, investments in safety culture, education and training for medical students and residents in quality and safety, the creation of patient safety committees, and implementation of patient safety reporting systems. Cohesive quality and safety approaches have become comprehensive programs to identify and mitigate hazards that could harm patients. This article moves to the next level with an intense refocusing of attention on one of the individual components of a comprehensive program--the patient safety reporting system—with a goal of maximized usefulness of the reports and long-term sustainability of quality improvements arising from them. Methods A six-phase framework was developed to deal with patient safety hazards: identify, report, analyze, mitigate, reward, and follow up. Unique features of this process included a multidisciplinary team to review reports, mitigate hazards, educate and empower providers, recognize the identifying/reporting individuals or groups with “Good Catch” awards, and follow up to determine if quality improvements were sustained over time. Results To date, 29 patient safety hazards have gone through this process with “Good Catch” awards being granted at our institution. These awards were presented at various times over the past 4 years since the process began in 2008. Follow-up revealed that 86% of the associated quality improvements have been sustained over time since the awards were given. We present the details of two of these “Good Catch” awards: vials of heparin with an unusually high concentration of the drug that posed a potential overdose hazard and a rapid infusion device that resisted practitioner control. Conclusion A multidisciplinary team's analysis and mitigation of hazards identified in a patient safety reporting system, positive recognition with a “Good Catch” award, education of practitioners, and long-term follow-up resulted in an outcome of sustained quality improvement initiatives. PMID:22946251

Herzer, Kurt R.; Mirrer, Meredith; Xie, Yanjun; Steppan, Jochen; Li, Matthew; Jung, Clinton; Cover, Renee; Doyle, Peter A.; Mark, Lynette J.

2014-01-01

326

Institutions for Quality Cooperation for Development: Clarifications and Initial Proposals  

Directory of Open Access Journals (Sweden)

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

Rafael Grasa Hernández

2006-01-01

327

Improvement of scintigram quality using alignment by flattening  

International Nuclear Information System (INIS)

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

328

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

Science.gov (United States)

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.

Capps, Gregory

329

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

Science.gov (United States)

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.

Kim, Sun-Bae; Kim, Ji-Hwan

2011-03-01

330

AIP: a proposed mechanism for evaluating adherence improvement initiatives.  

Science.gov (United States)

Pharmacy prescription databases are useful for determining rates of adherence to long-term medication therapy. Thus far, however, analyses based on such databases have provided only snapshots of adherence rates over discrete time intervals and have been of limited usefulness for the timely measurement of adherence trends when adherence improvement strategies change over time. The Adherence Index of Performance is new mechanism that can be used to monitor pharmacy prescription databases over time to detect changes that occur when adherence improvement strategies are changed during a therapeutic period. PMID:16020399

Day, David

2005-01-01

331

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

Energy Technology Data Exchange (ETDEWEB)

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

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

2004-09-15

332

Radionuclide calibrator comparisons and quality improvement in nuclear medicine  

International Nuclear Information System (INIS)

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

333

Surface quality of silicon wafer improved by hydrodynamic effect polishing  

Science.gov (United States)

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

Peng, Wenqiang; Guan, Chaoliang; Li, Shengyi

2014-08-01

334

Faculty Development on Item Writing Substantially Improves Item Quality  

Science.gov (United States)

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

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

2012-01-01

335

IMPROVING NATIONAL AIR QUALITY FORECASTS WITH SATELLITE AEROSOL OBSERVATIONS  

Science.gov (United States)

Air quality forecasts for major US metropolitan areas have been provided to the public through a partnership between the US Environmental Protection Agency and state and local air agencies since 1997. Recent years have witnessed improvement in forecast skill and expansion of fore...

336

Requirements and improving methods of electron beam quality for FEL  

International Nuclear Information System (INIS)

The requirements of emittance, energy spread, and stability of electron beam for FEL research are presented. The use of harmonically resonant cavity can effectively reduce the energy spread and emittance growth. On the basis of analysing the photocathode RF gun and super-conduction technology are used to improve the quality of electron beam. These effective methods are also presented

337

Software quality and process improvement in scientific simulation codes  

Energy Technology Data Exchange (ETDEWEB)

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

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

1997-11-01

338

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

Science.gov (United States)

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

Antelman, Albert

1991-01-01

339

40 CFR 63.175 - Quality improvement program for valves.  

Science.gov (United States)

(a) In Phase III, an owner or operator may elect to comply with one of the alternative quality improvement programs specified in paragraphs (d) and (e) of this section. The decision to use one of these alternative provisions to comply with the requirements of §...

2010-07-01

340

Activated charcoal-alum-zeolite improve the water quality  

International Nuclear Information System (INIS)

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

 
 
 
 
341

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

International Nuclear Information System (INIS)

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

342

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

Science.gov (United States)

... Great Lakes Water Quality Initiative...to Part 132 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER...derived using four methods. Measured...external body surfaces....

2010-07-01

343

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

Science.gov (United States)

... Great Lakes Water Quality Initiative...to Part 132 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER...and identify the methods for implementing...loading of BCCs to surface waters of...

2010-07-01

344

Design and Simulation of STATCOM to Improve Power Quality  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

Md Nazrul Islam; Md. Arifur Kabir; Yashiro Kazushige

2013-01-01

345

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

Science.gov (United States)

We used quality control circles (QCC) followed by the PDCA Deming cycle and analyzed the application of QCC to the sustained improvement of a medical institution in Zhejiang province. Analyses of the tangible and intangible achievements of QCC revealed that the achievement indices for reductions in internal errors, reductions in costs, improvements in the degree of patient satisfaction, improvements in work quality, and improvements in economic performance were 109.84% ± 16.47%, 135.04% ± 50.33%, 126.26% ± 53.69%, 100.58% ± 22.83%, and 104.07% ± 5.45%, respectively. The improvements in these areas were 61.12% ± 13.2%, 60.47% ± 28.91%, 34.41% ± 22.96%, 49.22% ± 25.39%, and 73.70% ± 5.24%, respectively. The intangible achievements were reflected as follows: 5% of QCC members showed an activity growth value of 1-2 points, 83% 1-2 points, 12% more than 2 points. As a result, QCC activity showed prominent results in fostering long-lasting improvement in the quality of medical institutions in terms of both tangible and intangible factors. In short, QCC can be used as an effective tool to improve medical quality. PMID:23641318

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

2013-12-01

346

Radionuclide calibrator comparisons and quality improvement in nuclear medicine  

International Nuclear Information System (INIS)

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

347

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

Science.gov (United States)

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 wind and self-pollination. Bee-pollinated fruits were heavier, had less malformations and reached higher commercial grades. They had increased redness and reduced sugar-acid-ratios and were firmer, thus improving the commercially important shelf life. Longer shelf life reduced fruit loss by at least 11%. This is accounting for 0.32 billion US$ of the 1.44 billion US$ provided by bee pollination to the total value of 2.90 billion US$ made with strawberry selling in the European Union 2009. The fruit quality and yield effects are driven by the pollination-mediated production of hormonal growth regulators, which occur in several pollination-dependent crops. Thus, our comprehensive findings should be transferable to a wide range of crops and demonstrate bee pollination to be a hitherto underestimated but vital and economically important determinant of fruit quality. PMID:24307669

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

2014-01-22

348

GENETICS AND MOLECULAR BIOLOGY AND PIG MEAT QUALITY IMPROVEMENT  

Directory of Open Access Journals (Sweden)

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

J. BULLA

2013-12-01

349

GENETICS AND MOLECULAR BIOLOGY AND PIG MEAT QUALITY IMPROVEMENT  

Directory of Open Access Journals (Sweden)

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

BULLA, J.

2007-01-01

350

Statistical process management: An essential element of quality improvement  

Science.gov (United States)

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

Buckner, M. R.

351

Quality and productivity improvement program (PPKP) from alumni perspective  

Science.gov (United States)

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

Ruza, Nadiah; Mustafa, Zainol

2013-04-01

352

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

Science.gov (United States)

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

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

2013-12-01

353

Quality improvement in small office settings: an examination of successful practices  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background Physicians in small to moderate primary care practices in the United States (U.S.) (<25 physicians) face unique challenges in implementing quality improvement (QI) initiatives, including limited resources, small staffs, and inadequate information technology systems 23,36. This qualitative study sought to identify and understand the characteristics and organizational cultures of physicians working in smaller practices who are actively engaged in measurement...

Sofaer Shoshanna; Leas Brian; Bernabeo Elizabeth; Wolfson Daniel; Pawlson Gregory; Pillittere Donna

2009-01-01

354

A leadership initiative to improve communication and enhance safety.  

Science.gov (United States)

The EMPOWER project was a collaborative effort to promote a culture of patient safety at Danbury Hospital through an interdisciplinary leadership-driven communication program. The "EMPOWER" component includes Educating and Mentoring Paraprofessionals On Ways to Enhance Reporting of changes in patient status. Specifically, the EMPOWER program was designed to prepare paraprofessional staff (PPS) to communicate changes in patient status using SBAR (situation, background, assessment, recommendations) structured communication. The specific project goals included (a) translation of SBAR structured communication methods for use with PPS, (b) reduction of cultural and educational barriers to interdisciplinary communication, and (c) examination of the effect of the EMPOWER intervention on the PPS communication practices and perceptions of the patient safety culture. Results of the project indicate a change in the use of SBAR throughout the institution, with particular improvement in communication from PPS to professional staff. PMID:21224466

Donahue, Moreen; Miller, Matthew; Smith, Lisa; Dykes, Patricia; Fitzpatrick, Joyce J

2011-01-01

355

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

Science.gov (United States)

...Affect health outcomes, patient safety, and quality of care. (2) Performance...designed to improve patient safety and quality of care. This project, in...priorities for improved quality of care and patient safety; and that all...

2010-10-01

356

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

International Nuclear Information System (INIS)

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

357

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

DEFF Research Database (Denmark)

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

Quaade, F; Astrup, A

1989-01-01

358

Casting Defect Detection and Quality Improvement by Industrial CT  

International Nuclear Information System (INIS)

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

359

Improvement of still-video camera picure quality  

Science.gov (United States)

It is more than seven years since the advent of the electronic still video (SV) cameraY)It gave a pretty big impact to the conventional film and camera-relating industry at first The market of still video cameras, however, did not grow as rapidly as expected. So far, only a commercial market has been created, where instantness and ability to display on TV screen and to transmit by telephone cable are considered to be important. For a new consumer market, not only above mentioned advantages, but also better picture quality, smaller camera size, and lower price are reqired. Those requirements have been fullfilled step by step by improving CCD and signal processing circuit, and production technology. Here, we tried further improvement of picture quality of still video camera by developing a digital still video camera.

Ochi, Shigeharu; Otsuka, Kikuo; Nishi, Seiki; Nishimura, Toru

1989-05-01

360

Improving the quality of diabetes care in primary care practice.  

Science.gov (United States)

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

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

2004-01-01

 
 
 
 
361

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.

362

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

Science.gov (United States)

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

Conrad, Douglas A; Perry, Lisa

2009-01-01

363

Using Quality Measures for Quality Improvement: The Perspective of Hospital Staff  

Science.gov (United States)

Research objective This study examines the perspectives of a range of key hospital staff on the use, importance, scientific background, availability of data, feasibility of data collection, cost benefit aspects and availability of professional personnel for measurement of quality indicators among Iranian hospitals. The study aims to facilitate the use of quality indicators to improve quality of care in hospitals. Study design A cross-sectional study was conducted over the period 2009 to 2010. Staff at Iranian hospitals completed a self-administered questionnaire eliciting their views on organizational, clinical process, and outcome (clinical effectiveness, patient safety and patient centeredness) indicators. Population studied 93 hospital frontline staff including hospital/nursing managers, medical doctors, nurses, and quality improvement/medical records officers in 48 general and specialized hospitals in Iran. Principal findings On average, only 69% of respondents reported using quality indicators in practice at their affiliated hospitals. Respondents varied significantly in their reported use of organizational, clinical process and outcome quality indicators. Overall, clinical process and effectiveness indicators were reported to be least used. The reported use of indicators corresponded with their perceived level of importance. Quality indicators were reported to be used among clinical staff significantly more than among managerial staff. In total, 74% of the respondents reported to use obligatory indicators, while this was 68% for voluntary indicators (plevel. PMID:24465842

Aghaei Hashjin, Asgar; Ravaghi, Hamid; Kringos, Dionne S.; Ogbu, Uzor C.; Fischer, Claudia; Azami, Saeid Reza; Klazinga, Niek S.

2014-01-01

364

Studying and simulating transformer configuration to improve power quality  

Directory of Open Access Journals (Sweden)

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

Oscar J. Peña Huaringa

2011-07-01

365

Research on Improving Manufacturing Practice Quality in Mechanical Industrial Design  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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...

Xiaowei Jiang

2013-01-01

366

Digital TV image quality improvement considering distributions of edge characteristic  

Science.gov (United States)

Sharpness enhancement is widely used technique for improving the perceptual quality of an image by emphasizing its high-frequency component. In this paper, a psychophysical experiment is conducted by the 20 observers with simple linear unsharp masking for sharpness enhancement. The experimental result is extracted using z-score analysis and linear regression. Finally using this result we suggest observer preferable sharpness enhancement method for digital television.

Hong, Sang-Gi; Kim, Jae-Chul; Park, Jong-Hyun

2003-12-01

367

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

368

Improving image quality in portal venography with spectral CT imaging  

Energy Technology Data Exchange (ETDEWEB)

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

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

2012-08-15

369

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

Science.gov (United States)

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

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

2014-01-01

370

QUALITY IMPROVEMENT METHODS AND THEIR USAGE IN ALBANIAN PUBLIC UNIVERSITIES  

Directory of Open Access Journals (Sweden)

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.

Arjan QEFALIA

2012-06-01

371

Improvement in quality-of-life after laparoscopic nissen fundoplication.  

Science.gov (United States)

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. PMID:25296081

Kappaz, Guilherme Tommasi; Sallum, Rubens Antonio Aissar; Szachnowicz, Sergio; Rocha, Julio Rafael Mariano; Cecconello, Ivan

2014-09-01

372

DOES BOSNIAN LEAGUE BASKETBALL HAVE A TENDENCY OF QUALITY IMPROVEMENT?  

Directory of Open Access Journals (Sweden)

Full Text Available This work is based on 13 standard indicators of situational effectiveness in basketball and its aim is to get the answer to the question whether Bosnian League basketball has a tendency of quality improvement. Two seasons of League 6, basketball championship in Bosnia and Herzegovina, 2004/2005 & 2009/2010, were used to get the data for this research. Thirty (30 games were played in each of the two seasons. T-test was used to determine the significance of arithmetic means between winning and losing sides in applied situational indicators, and discriminative analysis was used to determine the difference on a global level as well as contribution of each situational indicator to discriminant function. Research results confirm that the quality of Bosnian League basketball in the 2009/2010 playoff games is equally dispersive on a balanced level for almost every team (6, so in comparison to the 2004/2005 season, it can be said that Bosnian League basketball has reached considerably higher level of quality. Balanced quality of teams in Bosnian League 6 in the 2009/2010 season causes high quality defense, and such defense on the other hand creates versatility and new quality on the offensive end, so now three-point field goal made and blocked shot appear as new indicators which create difference between winners and losers. It can be expected that in the near future some other team will by its quality pull away from the other teams, and create a new and positive tendency of basketball development in Bosnia and Herzegovina.

Vlatko Šeparovi?

2010-06-01

373

Improved model quality assessment using ProQ2  

Directory of Open Access Journals (Sweden)

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

Ray Arjun

2012-09-01

374

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

Directory of Open Access Journals (Sweden)

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

Alistair Inglis

2005-03-01

375

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

Directory of Open Access Journals (Sweden)

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

X. Tang

2011-03-01

376

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

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

Talkmore Maruta

2011-12-01

377

Improving quality measures in colonoscopy and its therapeutic intervention  

Science.gov (United States)

Colonoscopy with polypectomy has been shown to reduce the risk of colon cancer. The critical element in the quality of colonoscopy in terms of polyp detection and removal continues to be the performance of the endoscopist, independent of patient-related factors. Improved results in terms of polyp detection and complete removal have implications regarding the development of screening and surveillance intervals and the reduction of interval cancers after negative colonoscopy. Advances in colonoscopy techniques such as high-definition colonoscopy, hood-assisted colonoscopy and dye-based chromoendoscopy have improved the detection of small and flat-type colorectal polyps. Virtual chromoendoscopy has not proven to improve polyp detection but may be useful to predict polyp pathology. The majority of polyps can be removed endoscopically. Available polypectomy techniques include cold forceps polypectomy, cold snare polypectomy, conventional polypectomy, endoscopic mucosal resection and endoscopic submucosal dissection. The preferred choice depends on the polyp size and characteristics. Other useful techniques include colonoscopic hemostasis for acute colonic diverticular bleeding, endoscopic decompression using colonoscopic stenting, and transanal tube placement for colorectal obstruction. Here we review the current knowledge concerning the improvement of quality measures in colonoscopy and colonoscopy-related therapeutic interventions.

Horiuchi, Akira; Tanaka, Naoki

2014-01-01

378

Infrastructure for Large-Scale Quality-Improvement Projects: Early Lessons from North Carolina Improving Performance in Practice  

Science.gov (United States)

Introduction: Little is known regarding how to accomplish large-scale health care improvement. Our goal is to improve the quality of chronic disease care in all primary care practices throughout North Carolina. Methods: Methods for improvement include (1) common quality measures and shared data system; (2) rapid cycle improvement principles; (3)…

Newton, Warren P.; Lefebvre, Ann; Donahue, Katrina E.; Bacon, Thomas; Dobson, Allen

2010-01-01

379

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

Science.gov (United States)

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.…

Devaney, Elizabeth; Smith, Charles; Wong, Kenneth

2012-01-01

380

Quantity-quality measuring method possibilities in improving operator's learning quality  

International Nuclear Information System (INIS)

Possibilities of obtainnjng qualitative-quantitative estimations of different aspects of learning process and their application in determination of learning purposes, substantiation of the training program choice of types and forms of studies directed at quality improvement of operator learning are considered

 
 
 
 
381

Quality improvement in radiography in a neonatal intensive care unit  

Energy Technology Data Exchange (ETDEWEB)

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

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

2008-10-15

382

Improving urban air quality in China: Beijing case study.  

Science.gov (United States)

China is undergoing rapid urbanization because of unprecedented economic growth. As a result, many cities suffer from air pollution. Two-thirds of China's cities have not attained the ambient air quality standards applicable to urban residential areas (Grade II). Particulate matter (PM), rather than sulfur dioxide (SO2), is the major pollutant reflecting the shift from coal burning to mixed source pollution. In 2002, 63.2 and 22.4% of the monitored cities have PM and SO2 concentrations exceeding the Grade II standard, respectively. Nitrogen oxides (NOx) concentration kept a relatively stable level near the Grade II standard in the last decade and had an increasing potential in recent years because of the rapid motorization. In general, the air pollutants emission did not increase as quickly as the economic growth and energy consumption, and air quality in Chinese cities has improved to some extent. Beijing, a typical representative of rapidly developing cities, is an example to illustrate the possible options for urban air pollution control. Beijing's case provides hope that the challenges associated with improving air quality can be met during a period of explosive development and motorization. PMID:16259425

Hao, Jiming; Wang, Litao

2005-09-01

383

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

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

Aleš Straže

2011-03-01

384

Improving Service Quality by Using Organizational Citizenship Behavior: Iranian Evidence  

Directory of Open Access Journals (Sweden)

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

Nour-Mohammad Yaghoubi

2011-09-01

385

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

Science.gov (United States)

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

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

2014-09-01

386

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

387

Improving the quality of brain CT image from Wavelet filters  

International Nuclear Information System (INIS)

An algorithm to reduce Poisson noise is described using Wavelet filters. Five tomographic images of patients and a head anthropomorphic phantom were used. They were acquired with two different CT machines. Due to the original images contain the acquisition noise; some simulated free noise lesions were added to the images and after that the whole images were contaminated with noise. Contaminated images were filtered with 9 Wavelet filters at different decomposition levels and thresholds. Image quality of filtered and unfiltered images was graded using the Signal to Noise ratio, Normalized Mean Square Error and the Structural Similarity Index, as well as, by the subjective JAFROC methods with 5 observers. Some filters as Bior 3.7 and dB45 improved in a significant way head CT image quality (p<0.05) producing an increment in SNR without visible structural distortions

388

Improving the Quality of Published Chemical Names with Nomenclature Software  

Directory of Open Access Journals (Sweden)

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

Gernot A. Eller

2006-11-01

389

Power Quality Improvement In A Grid Connected Renewable Energy System  

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

Sreya Grace Mathew

2014-10-01

390

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.

391

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

Energy Technology Data Exchange (ETDEWEB)

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.

Murphy, Glen D. [Cooperative Research Centre for Integrated Engineering Asset Management (CIEAM), School of Management, Queensland University of Technology, PO Box 2434, Brisbane 4001 (Australia)], E-mail: gd.murphy@qut.edu.au

2009-12-15

392

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

LENUS (Irish Health Repository)

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

White, Mark

2014-05-14

393

Improving health outcomes: innovation, coverage, quality and adherence  

Directory of Open Access Journals (Sweden)

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

McKee Martin

2012-10-01

394

A New Model for Software Engineering Systems Quality Improvement  

Directory of Open Access Journals (Sweden)

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

Ahmad A. Al-Rababah

2014-04-01

395

A Novel Facts Based Improvement of Power Quality  

Directory of Open Access Journals (Sweden)

Full Text Available Modulated power filter compensator (MPFC scheme for the smart grid stabilization and efficient utilization is shown in this paper. A novel tri-loop dynamic error driven inter coupled modified PID controller is used to control MPFC. For effective power quality (PQ improvement, voltage stabilization, power factor correction and transmission line loss reduction, MATLAB digital simulation models of the proposed MPFC scheme has been fully validated. The proposed FACTS based scheme can be extended to distributed/dispersed renewable energy interface and utilization systems and can be easily modified for other specific stabilization, compensation requirements, voltage regulation and efficient utilization.

S.V.D.Anil Kumar

2014-05-01

396

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

397

Improving Recommendation Quality by Merging Collaborative Filtering and Social Relationships  

CERN Document Server

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

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

2011-01-01

398

Lead/acid batteries in systems to improve power quality  

Science.gov (United States)

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

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

399

Quality improvement in small office settings: an examination of successful practices  

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Full Text Available Abstract Background Physicians in small to moderate primary care practices in the United States (U.S. ( Methods We undertook a qualitative study, based on semi-structured, open-ended interviews conducted with practices (N = 39 that used performance data to drive quality improvement activities. Results Physicians indicated that benefits to performing measurement and QI included greater practice efficiency, patient and staff retention, and higher staff and clinician satisfaction with practice. Internal facilitators included the designation of a practice champion, cooperation of other physicians and staff, and the involvement of practice leaders. Time constraints, cost of activities, problems with information management and or technology, lack of motivated staff, and a lack of financial incentives were commonly reported as barriers. Conclusion These findings shed light on how physicians engage in quality improvement activities, and may help raise awareness of and aid in the implementation of future initiatives in small practices more generally.

Sofaer Shoshanna

2009-02-01

400

Using lean methodology to teach quality improvement to internal medicine residents at a safety net hospital.  

Science.gov (United States)

The overall objective of this initiative was to develop a quality improvement (QI) curriculum using Lean methodology for internal medicine residents at Boston Medical Center, a safety net academic hospital. A total of 90 residents and 8 School of Public Health students participated in a series of four, 60- to 90-minute interactive and hands-on QI sessions. Seventeen QI project plans were created and conducted over a 4-month period. The curriculum facilitated internal medicine residents' learning about QI and development of positive attitudes toward QI (assessed using pre- and post-attitude surveys) and exposed them to an interprofessional team structure that duplicates future working relationships. This QI curriculum can be an educational model of how health care trainees can work collaboratively to improve health care quality. PMID:23382452

Weigel, Charlene; Suen, Winnie; Gupte, Gouri

2013-01-01