Performance management in healthcare : performance indicator development, task uncertainty, and types of performance indicators

NARCIS (Netherlands)

Geer-Rutten-Rijswijk, van der E.; Tuijl, van H.F.J.M.; Rutte, C.G.

2009-01-01

In healthcare, performance indicators are increasingly used to measure and control quality and efficiency of care-providing teams. This article demonstrates that when controllability is emphasized during indicator development, the level of task uncertainty influences the type of resulting

Risk-based plant performance indicators

International Nuclear Information System (INIS)

Boccio, J.L.; Azarm, M.A.; Hall, R.E.

1991-01-01

Tasked by the 1979 President's Commission on the Accident at Three Mile Island, the U.S. nuclear power industry has put into place a performance indicator program as one means for showing a demonstrable record of achievement. Largely through the efforts of the Institute of Nuclear Power Operations (INPO), plant performance data has, since 1983, been collected and analyzed to aid utility management in measuring their plants' performance progress. The U.S. Nuclear Regulatory Commission (NRC) has also developed a set of performance indicators. This program, conducted by NRC's Office for the Analysis and Evaluation of Operational Data (AEOD), is structured to present information on plant operational performance in a manner that could enhance the staff's ability to recognize changes in the safety performance. Both organizations recognized that performance indicators have limitations and could be subject to misinterpretation and misuse with the potential for an adverse impact on safety. This paper reports on performance indicators presently in use, e.g., unplanned automatic scrams, unplanned safety system actuation, safety system failures, etc., which are logically related to safety. But, a reliability/risk-based method for evaluating either individual indicators or an aggregated set of indicators is not yet available

E-Commerce Performance. Shopping Cart Key Performance Indicators

Directory of Open Access Journals (Sweden)

Mihaela I. MUNTEAN

2016-01-01

Full Text Available In an e-commerce performance framework is important to identify the key performance indicators that measure success and together provide the greatest context into the business perfor-mance. Shopping carts are an essential part of ecommerce, a minimal set of key performance indicators being the subject of our debate. The theoretical approach is sustained by a case study, an e-shop implemented using PHP and MySQL, for simulating main business processes within the considered performance framework. Our approach opens a perspective for future research using additional indicators in order to properly evaluate the global performance of any e-shop.

NRC performance indicator program

International Nuclear Information System (INIS)

Singh, R.N.

1987-01-01

The performance indicator development work of the US Nuclear Regulatory Commission (NRC) interoffice task group involved several major activities that included selection of candidate indicators for a trial program, data collection and review, validation of the trial indicators, display method development, interactions with the industry, and selection of an optimum set of indicators for the program. After evaluating 27 potential indicators against certain ideal attributes, the task group selected 17 for the trial program. The pertinent data for these indicators were then collected from 50 plants at 30 sites. The validation of the indicators consisted of two primary processes: logical validity and statistical analysis. The six indicators currently in the program are scrams, safety system actuations, significant events, safety system failures, forced outage rate, and equipment forced outages per 100 critical hours. A report containing data on the six performance indicators and some supplemental information is issued on a quarterly basis. The NRC staff is also working on refinements of existing indicators and development of additional indicators as directed by the commission

[Identifying indicators of good practice in clinical and healthcare management].

Science.gov (United States)

Bermúdez Tamayo, C; Olry de Labry Lima, A; García Mochón, L

2018-03-06

To identify good practices in order to develop and implement indicators of health outcomes for clinical and healthcare management, as well as the characteristics for an indicator to be considered adequate. A scoping review was performed, with the following phases: 1) Search and identification of bibliography. 2) Selection of relevant documents. Including those studies that discussed issues related to good practices for the use of health indicators in the management field. Those published in a language other than English or Spanish or before 2006 were excluded. 3) Analysis and extraction of information. 4) Consultation with stakeholders, using a qualitative methodology through Concept Mapping, with the participation of 40 experts (decision-makers, scientific societies, and health professionals). The data collection process included an inductive and structured procedure, with prioritisation of ideas grouped into clusters, according to feasibility and importance criteria (0-10 scale). Good practices identified 2 levels: 1) macro-management: Define a framework for the evaluation of indicators and establish a benchmark of indicators. 2) meso-management: Establish indicators according to evidence and expert consensus, taking into account priority areas and topics, testing before final use, and communicate results adequately. The characteristics of a suitable indicator are: 1) Approach of an important issue, 2) Scientific validity, 3) Possibility of measurement with reliable data, 4) Meaning of useful and applicable measurement, and 5) Wide scope. The best practices for the use of indicators in clinical and healthcare management can make it easier to monitor performance and accountability, as well as to support the decision-making addressed at the development of initiatives for quality improvement. Copyright © 2018 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

Performance indicators of work activity.

Science.gov (United States)

Lahoz, Manoela de Assis; Camarotto, João Alberto

2012-01-01

The measurement of performance is a current topic in the management of people in companies, used as a parameter of effectiveness of processes and operations of production. The methods and models of the indicators of current use in the production have concentrated in the assessment of people's performance as determinative resource of the organizational success in the search for the competitiveness. Associated with the classic indicators of performance assessment of the production proceeding, other indicators are used in the assessment of risks and hazards, however with methods focused in the tasks, without connection with the real work activity. The present article explores literature on the models of performance measurement in use in companies and a field research to understand how companies interpret and use indicators that relate health and work, to direct future studies on the subject. Regarding the literature review, one can see that health indicators can be basically divided into two major groups: the legal and managerial indicators. When conducting case studies, it can be realized that companies do not have precisely the concept of health indicator, or were unable to define which of the indicators could be considered indicators of health, considering that absenteeism was the indicator mentioned by the four companies.

Optimization of contrast-enhanced spectral mammography depending on clinical indication.

Science.gov (United States)

Dromain, Clarisse; Canale, Sandra; Saab-Puong, Sylvie; Carton, Ann-Katherine; Muller, Serge; Fallenberg, Eva Maria

2014-10-01

The objective is to optimize low-energy (LE) and high-energy (HE) exposure parameters of contrast-enhanced spectral mammography (CESM) examinations in four different clinical applications for which different levels of average glandular dose (AGD) and ratios between LE and total doses are required. The optimization was performed on a Senographe DS with a SenoBright® upgrade. Simulations were performed to find the optima by maximizing the contrast-to-noise ratio (CNR) on the recombined CESM image using different targeted doses and LE image quality. The linearity between iodine concentration and CNR as well as the minimal detectable iodine concentration was assessed. The image quality of the LE image was assessed on the CDMAM contrast-detail phantom. Experiments confirmed the optima found on simulation. The CNR was higher for each clinical indication than for SenoBright®, including the screening indication for which the total AGD was 22% lower. Minimal iodine concentrations detectable in the case of a 3-mm-diameter round tumor were 12.5% lower than those obtained for the same dose in the clinical routine. LE image quality satisfied EUREF acceptable limits for threshold contrast. This newly optimized set of acquisition parameters allows increased contrast detectability compared to parameters currently used without a significant loss in LE image quality.

Dashboard report on performance on select quality indicators to cancer care providers.

Science.gov (United States)

Stattin, Pär; Sandin, Fredrik; Sandbäck, Torsten; Damber, Jan-Erik; Franck Lissbrant, Ingela; Robinson, David; Bratt, Ola; Lambe, Mats

2016-01-01

Cancer quality registers are attracting increasing attention as important, but still underutilized sources of clinical data. To optimize the use of registers in quality assurance and improvement, data have to be rapidly collected, collated and presented as actionable, at-a-glance information to the reporting departments. This article presents a dashboard performance report on select quality indicators to cancer care providers. Ten quality indicators registered on an individual patient level in the National Prostate Cancer Register of Sweden and recommended by the National Prostate Cancer Guidelines were selected. Data reported to the National Prostate Cancer Register are uploaded within 24 h to the Information Network for Cancer Care platform. Launched in 2014, "What''s Going On, Prostate Cancer" provides rapid, at-a-glance performance feedback to care providers. The indicators include time to report to the National Prostate Cancer Register, waiting times, designated clinical nurse specialist, multidisciplinary conference, adherence to guidelines for diagnostic work-up and treatment, and documentation and outcome of treatment. For each indicator, three performance levels were defined. What's Going On, a dashboard performance report on 10 selected quality indicators to cancer care providers, provides an example of how data in cancer quality registers can be transformed into condensed, at-a-glance information to be used as actionable metrics for quality assurance and improvement.

Risk-based performance indicators

International Nuclear Information System (INIS)

Azarm, M.A.; Boccio, J.L.; Vesely, W.E.; Lofgren, E.

1987-01-01

The purpose of risk-based indicators is to monitor plant safety. Safety is measured by monitoring the potential for core melt (core-melt frequency) and the public risk. Targets for these measures can be set consistent with NRC safety goals. In this process, the performance of safety systems, support systems, major components, and initiating events can be monitored using measures such as unavailability, failure or occurrence frequency. The changes in performance measures and their trends are determined from the time behavior of monitored measures by differentiation between stochastical and actual variations. Therefore, degradation, as well as improvement in the plant safety performance, can be determined. The development of risk-based performance indicators will also provide the means to trace a change in the safety measures to specific problem areas which are amenable to root cause analysis and inspection audits. In addition, systematic methods will be developed to identify specific improvement policies using the plant information system for the identified problem areas. The final product of the performance indicator project will be a methodology, and an integrated and validated set of software packages which, if properly interfaced with the logic model software of a plant, can monitor the plant performance as plant information is provided as input

Fishery Performance Indicators

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Performance indicators for landings, effort, revenue and distribution of revenue are collected for various fisheries nation-wide. The fisheries include catch and...

Prioritizing public- private partnership models for public hospitals of iran based on performance indicators.

Science.gov (United States)

Gholamzadeh Nikjoo, Raana; Jabbari Beyrami, Hossein; Jannati, Ali; Asghari Jaafarabadi, Mohammad

2012-01-01

The present study was conducted to scrutinize Public- Private Partnership (PPP) models in public hospitals of different countries based on performance indicators in order to se-lect appropriated models for Iran hospitals. In this mixed (quantitative-qualitative) study, systematic review and expert panel has been done to identify varied models of PPP as well as performance indicators. In the second step we prioritized performance indicator and PPP models based on selected performance indicators by Analytical Hierarchy process (AHP) technique. The data were analyzed by Excel 2007 and Expert Choice11 software's. In quality - effectiveness area, indicators like the rate of hospital infections (100%), hospital accidents prevalence rate (73%), pure rate of hospital mortality (63%), patient satisfaction percentage (53%), in accessibility equity area indicators such as average inpatient waiting time (100%) and average outpatient waiting time (74%), and in financial - efficiency area, indicators including average length of stay (100%), bed occupation ratio (99%), specific income to total cost ratio (97%) have been chosen to be the most key performance indicators. In the pri¬oritization of the PPP models clinical outsourcing, management, privatization, BOO (build, own, operate) and non-clinical outsourcing models, achieved high priority for various performance in¬dicator areas. This study had been provided the most common PPP options in the field of public hospitals and had gathered suitable evidences from experts for choosing appropriate PPP option for public hospitals. Effect of private sector presence in public hospital performance, based on which PPP options undertaken, will be different.

Quantifying and visualizing site performance in clinical trials.

Science.gov (United States)

Yang, Eric; O'Donovan, Christopher; Phillips, JodiLyn; Atkinson, Leone; Ghosh, Krishnendu; Agrafiotis, Dimitris K

2018-03-01

One of the keys to running a successful clinical trial is the selection of high quality clinical sites, i.e., sites that are able to enroll patients quickly, engage them on an ongoing basis to prevent drop-out, and execute the trial in strict accordance to the clinical protocol. Intuitively, the historical track record of a site is one of the strongest predictors of its future performance; however, issues such as data availability and wide differences in protocol complexity can complicate interpretation. Here, we demonstrate how operational data derived from central laboratory services can provide key insights into the performance of clinical sites and help guide operational planning and site selection for new clinical trials. Our methodology uses the metadata associated with laboratory kit shipments to clinical sites (such as trial and anonymized patient identifiers, investigator names and addresses, sample collection and shipment dates, etc.) to reconstruct the complete schedule of patient visits and derive insights about the operational performance of those sites, including screening, enrollment, and drop-out rates and other quality indicators. This information can be displayed in its raw form or normalized to enable direct comparison of site performance across studies of varied design and complexity. Leveraging Covance's market leadership in central laboratory services, we have assembled a database of operational metrics that spans more than 14,000 protocols, 1400 indications, 230,000 unique investigators, and 23 million patient visits and represents a significant fraction of all clinical trials run globally in the last few years. By analyzing this historical data, we are able to assess and compare the performance of clinical investigators across a wide range of therapeutic areas and study designs. This information can be aggregated across trials and geographies to gain further insights into country and regional trends, sometimes with surprising results. The

Facilities Performance Indicators Report, 2008-09

Science.gov (United States)

Hills, Christina, Ed.

2010-01-01

This paper features another expanded Web-based Facilities Performance Indicators Report (FPI). The purpose of APPA's Facilities Performance Indicators is to provide a representative set of statistics about facilities in educational institutions. The 2008-09 iteration of the Web-based Facilities Performance Indicators Survey was posted and…

Prioritizing Public- Private Partnership Models for Public Hospitals of Iran Based on Performance Indicators

Directory of Open Access Journals (Sweden)

Mohammad Asghari Jaafarabadi

2012-12-01

Full Text Available Background: The present study was conducted to scrutinize Public- Private Partnership (PPP models in public hospitals of different countries based on performance indicators in order to se-lect appropriated models for Iran hospitals.Methods: In this mixed (quantitative-qualitative study, systematic review and expert panel hasbeen done to identify varied models of PPP as well as performance indicators. In the second stepwe prioritized performance indicator and PPP models based on selected performance indicatorsby Analytical Hierarchy process (AHP technique. The data were analyzed by Excel 2007 andExpert Choice11 software’s.Results: In quality – effectiveness area, indicators like the rate of hospital infections(100%, hospital accidents prevalence rate (73%, pure rate of hospital mortality (63%, patientsatisfaction percentage (53%, in accessibility equity area indicators such as average inpatientwaiting time (100% and average outpatient waiting time (74%, and in financial – efficiency area,indicators including average length of stay (100%, bed occupation ratio (99%, specific incometo total cost ratio (97% have been chosen to be the most key performance indicators. In the prioritizationof the PPP models clinical outsourcing, management, privatization, BOO (build, own,operate and non-clinical outsourcing models, achieved high priority for various performance indicatorareas.Conclusion: This study had been provided the most common PPP options in the field of public hospitals and had gathered suitable evidences from experts for choosing appropriate PPP option for public hospitals. Effect of private sector presence in public hospital performance, based on which PPP options undertaken, will be different.

Associations between HIV-RNA-based indicators and virological and clinical outcomes

DEFF Research Database (Denmark)

Laut, Kamilla G; Shepherd, Leah C; Pedersen, Court

2016-01-01

OBJECTIVES: To evaluate and compare the performance of six HIV-RNA-based quality of care indicators for predicting short-term and long-term outcomes. DESIGN: Multinational cohort study. METHODS: We included EuroSIDA patients on antiretroviral therapy (ART) with at least three viral load measureme......OBJECTIVES: To evaluate and compare the performance of six HIV-RNA-based quality of care indicators for predicting short-term and long-term outcomes. DESIGN: Multinational cohort study. METHODS: We included EuroSIDA patients on antiretroviral therapy (ART) with at least three viral load...... measurements after baseline (the latest of 01/01/2001 or entry into EuroSIDA). Using multivariate Poisson regression, we modelled the association between short-term (resistance, triple-class failure) and long-term (all-cause mortality, any AIDS/non-AIDS clinical event) outcomes and the indicators: viraemia...

The impact of removing financial incentives from clinical quality indicators: longitudinal analysis of four Kaiser Permanente indicators.

Science.gov (United States)

Lester, Helen; Schmittdiel, Julie; Selby, Joe; Fireman, Bruce; Campbell, Stephen; Lee, Janelle; Whippy, Alan; Madvig, Philip

2010-05-11

To evaluate the effect of financial incentives on four clinical quality indicators common to pay for performance plans in the United Kingdom and at Kaiser Permanente in California. Longitudinal analysis. 35 medical facilities of Kaiser Permanente Northern California, 1997-2007. 2 523 659 adult members of Kaiser Permanente Northern California. Main outcomes measures Yearly assessment of patient level glycaemic control (HbA(1c) financial incentives were attached to screening for diabetic retinopathy (1999-2003), the rate rose from 84.9% to 88.1%. This was followed by four years without incentives when the rate fell year on year to 80.5%. During the two initial years when financial incentives were attached to cervical cancer screening (1999-2000), the screening rate rose slightly, from 77.4% to 78.0%. During the next five years when financial incentives were removed, screening rates fell year on year to 74.3%. Incentives were then reattached for two years (2006-7) and screening rates began to increase. Across the 35 facilities, the removal of incentives was associated with a decrease in performance of about 3% per year on average for screening for diabetic retinopathy and about 1.6% per year for cervical cancer screening. Policy makers and clinicians should be aware that removing facility directed financial incentives from clinical indicators may mean that performance levels decline.

Association Between Undergraduate Performance Predictors and Academic and Clinical Performance of Osteopathic Medical Students.

Science.gov (United States)

Agahi, Farshad; Speicher, Mark R; Cisek, Grace

2018-02-01

Medical schools use a variety of preadmission indices to select potential students. These indices generally include undergraduate grade point average (GPA), Medical College Admission Test (MCAT) scores, and preadmission interviews. To investigate whether the admission indices used by Midwestern University Arizona College of Osteopathic Medicine are associated with the academic and clinical performance of their students. Associations between the prematriculation variables of undergraduate science GPA, undergraduate total GPA, MCAT component scores, and interview scores and the academic and clinical variables of the first- and second-year medical school GPA, Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) Level 1 and Level 2-Cognitive Evaluation (CE) total and discipline scores, scores in clinical rotations for osteopathic competencies, COMLEX-USA Level 2-Performance Evaluation passage, and match status were evaluated. Two-tailed Pearson product-moment correlations with a Bonferroni adjustment were used to examine these relationships. The traditional predictors of science and total undergraduate GPA as well as total and component MCAT scores had small to moderate associations with first- and second-year GPA, as well as COMLEX-USA Level 1 and Level 2-CE total scores. Of all predictors, only the MCAT biological sciences score had a statistically significant correlation with failure of the COMLEX-USA Level 2-Performance Evaluation examination (P=.009). Average interview scores were associated only with the osteopathic competency of medical knowledge (r=0.233; n=209; P=.001), as assessed by clerkship preceptors. No predictors were associated with scores in objective structured clinical encounters or with failing to match to a residency position. The data indicate that traditional predictors of academic performance (undergraduate GPA, undergraduate science GPA, and MCAT scores) have small to moderate association with medical school grades and

Competency Assessment Using Key Performance Indicators

OpenAIRE

Elena Alexandra Toader; Laura Brad

2015-01-01

The paper proposes a method for computing the scores of the key performance indicators resulted in the competency assessment process. The key performance indicators are estimated considering four performance levels that an IT professional can obtain at the end of the assessment process. We suggest as the best approach for estimating the performance key indicators an online questionnaire filled by 60 employees that work in IT Romanian companies. The results provide evidence that the difference...

Performance of clinical mammography: a nationwide study from Denmark

DEFF Research Database (Denmark)

Jensen, Allan; Vejborg, Ilse; Severinsen, Niels

2006-01-01

that clinical mammography worked best in patient populations of purely symptomatic women. Our data indicate that to increase the accuracy of clinical mammography at the community level, the presence of an experienced radiologist should be prioritized ahead of raising the clinic size.......Clinical mammography is the key tool for breast cancer diagnosis, but little is known about the impact of the organisational set-up on the performance. We evaluated whether organisational factors influence the performance of clinical mammography. Clinical mammography data from all clinics...... in Denmark in the year 2000 were collected and linked to cancer outcome. Use of the National Institute of Radiation Hygiene register for identification of radiology clinics ensured comprehensive nationwide registration. We used the final mammographic assessment at the end of the imaging work-up to determine...

Driver competence performance indicators using OTMR

Energy Technology Data Exchange (ETDEWEB)

Hassan EL Rashidy, R.A.

2016-07-01

The current practice for assessing driver competence performance is in-cab riding by driver managers. However, this paper investigates whether real-world driving data extracted from on-train monitoring recorders data (OTMR) can be used to assess the driver performance. A number of indicators were used to evaluate the drivers’ performance. These include: their use of the emergency bypass switch, the driver's reminder appliance as well as the driver’s reaction time. A study case illustrated the applicability of OTMR data to estimate the proposed indicators, which suggests that the indicators can be useful in the driver management system in addition to the current indicators. Furthermore, the proposed indicators could be used to tailor the driver training schemes up to their individual needs and evaluate their effectiveness. They could even be used for improving driver competence performance and reducing crash involvement by revealing potentially detrimental driving performance. (Author)

Indicators of safety culture - selection and utilization of leading safety performance indicators

Energy Technology Data Exchange (ETDEWEB)

Reiman, Teemu; Pietikaeinen, Elina (VTT, Technical Research Centre of Finland (Finland))

2010-03-15

Safety indicators play a role in providing information on organizational performance, motivating people to work on safety and increasing organizational potential for safety. The aim of this report is to provide an overview on leading safety indicators in the domain of nuclear safety. The report explains the distinction between lead and lag indicators and proposes a framework of three types of safety performance indicators - feedback, monitor and drive indicators. Finally the report provides guidance for nuclear energy organizations for selecting and interpreting safety indicators. It proposes the use of safety culture as a leading safety performance indicator and offers an example list of potential indicators in all three categories. The report concludes that monitor and drive indicators are so called lead indicators. Drive indicators are chosen priority areas of organizational safety activity. They are based on the underlying safety model and potential safety activities and safety policy derived from it. Drive indicators influence control measures that manage the socio technical system; change, maintain, reinforce, or reduce something. Monitor indicators provide a view on the dynamics of the system in question; the activities taking place, abilities, skills and motivation of the personnel, routines and practices - the organizational potential for safety. They also monitor the efficacy of the control measures that are used to manage the socio technical system. Typically the safety performance indicators that are used are lagging (feedback) indicators that measure the outcomes of the socio technical system. Besides feedback indicators, organizations should also acknowledge the important role of monitor and drive indicators in managing safety. The selection and use of safety performance indicators is always based on an understanding (a model) of the socio technical system and safety. The safety model defines what risks are perceived. It is important that the safety

Indicators of safety culture - selection and utilization of leading safety performance indicators

International Nuclear Information System (INIS)

Reiman, Teemu; Pietikaeinen, Elina

2010-03-01

Safety indicators play a role in providing information on organizational performance, motivating people to work on safety and increasing organizational potential for safety. The aim of this report is to provide an overview on leading safety indicators in the domain of nuclear safety. The report explains the distinction between lead and lag indicators and proposes a framework of three types of safety performance indicators - feedback, monitor and drive indicators. Finally the report provides guidance for nuclear energy organizations for selecting and interpreting safety indicators. It proposes the use of safety culture as a leading safety performance indicator and offers an example list of potential indicators in all three categories. The report concludes that monitor and drive indicators are so called lead indicators. Drive indicators are chosen priority areas of organizational safety activity. They are based on the underlying safety model and potential safety activities and safety policy derived from it. Drive indicators influence control measures that manage the socio technical system; change, maintain, reinforce, or reduce something. Monitor indicators provide a view on the dynamics of the system in question; the activities taking place, abilities, skills and motivation of the personnel, routines and practices - the organizational potential for safety. They also monitor the efficacy of the control measures that are used to manage the socio technical system. Typically the safety performance indicators that are used are lagging (feedback) indicators that measure the outcomes of the socio technical system. Besides feedback indicators, organizations should also acknowledge the important role of monitor and drive indicators in managing safety. The selection and use of safety performance indicators is always based on an understanding (a model) of the socio technical system and safety. The safety model defines what risks are perceived. It is important that the safety

Key performance indicators to benchmark hospital information systems - a delphi study.

Science.gov (United States)

Hübner-Bloder, G; Ammenwerth, E

2009-01-01

To identify the key performance indicators for hospital information systems (HIS) that can be used for HIS benchmarking. A Delphi survey with one qualitative and two quantitative rounds. Forty-four HIS experts from health care IT practice and academia participated in all three rounds. Seventy-seven performance indicators were identified and organized into eight categories: technical quality, software quality, architecture and interface quality, IT vendor quality, IT support and IT department quality, workflow support quality, IT outcome quality, and IT costs. The highest ranked indicators are related to clinical workflow support and user satisfaction. Isolated technical indicators or cost indicators were not seen as useful. The experts favored an interdisciplinary group of all the stakeholders, led by hospital management, to conduct the HIS benchmarking. They proposed benchmarking activities both in regular (annual) intervals as well as at defined events (for example after IT introduction). Most of the experts stated that in their institutions no HIS benchmarking activities are being performed at the moment. In the context of IT governance, IT benchmarking is gaining importance in the healthcare area. The found indicators reflect the view of health care IT professionals and researchers. Research is needed to further validate and operationalize key performance indicators, to provide an IT benchmarking framework, and to provide open repositories for a comparison of the HIS benchmarks of different hospitals.

Indicators to monitor NPP operational safety performance

International Nuclear Information System (INIS)

Gomez-Cobo, Ana

2002-01-01

Since December 1995 the IAEA activities on safety performance indicators focused on the elaboration of a framework for the establishment of an operational safety performance indicator programme. The development of this framework began with the consideration of the concept of NPP operational safety performance and the identification of operational safety attributes. For each operational safety attribute, overall indicators, envisioned as providing an overall evaluation of relevant aspects of safety performance, were established. Associated with each overall indicator is a level of strategic indicators intended to provide a bridge from overall to specific indicators. Finally each strategic indicator was supported by a set of specific indicators, which represent quantifiable measures of performance. The programme development was enhanced by pilot plant studies, conducted over a 15 month period from January 1998 to March 1999. The result of all this work is compiled in the IAEA-TECDOC-1141, to be published shortly. This paper presents a summary of this IAEA TECDOC. It describes the operational safety performance indicator framework proposed and discusses the results of and lessons learned from the pilot studies. Despite the efforts described, it is clear that additional research is still necessary in areas such as plant-specific adaptation of proposed frameworks in order to suit individual data collection systems and plant characteristics, indicator selection, indicator definition, goal setting, action thresholds, analysis of trends, indicator display systems, analysis of overall safety performance (i.e., aggregation or combination of indicators), safety culture indicators, qualitative indicators, and use of additional indicators to address issues such as industrial safety attitude and performance, staff welfare, and environmental compliance. This is the rationale for a new IAEA Coordinated Research Project on 'Development and application of indicators to monitor NPP

Performance indicators for roadway bridges

OpenAIRE

Strauss, A.; Vidovic, A.; Zambon, I.; Dengg, F.; Tanasic, N.; Matos, José C.

2016-01-01

Publicado em "Maintenance, monitoring, safety, risk and resilience of bridges and bridge networks". ISBN 978-1-138-02851-7 The performance indicators should, by its definition, allow capturing the life-cycle degradation processes affecting maintenance plans or the remaining lifetime. The qualitative or quantitative performance indicators are obtained through visual inspections, non-destructive tests or monitoring systems. After their quantification and the comparison with the resp...

[STRATEGY OF USE AND MAINTENANCE OF CLINICAL HOSPITAL CENTER RIJEKA IN ACCORDANCE WITH KEY PERFORMANCE INDICATORS FOR STRATEGIC HEALTHCARE FACILITIES MAINTENANCE].

Science.gov (United States)

Sjekavica, Mariela; Haller, Herman; Cerić, Anita

2015-01-01

Building usage is the phase in the building life cycle that is most time-consuming, most functional, most significant due to building purpose and often systematically ignored. Maintenance is the set of activities that ensure the planned duration of facility exploitation phase in accordance with the requirements for quality maintenance of a large number of important building features as well as other elements immanent to the nature of facilities' life. The aim of the study is to show the analysis of the current state of organized, planned and comprehensive managerial approach in hospital utilization and maintenance in the Republic of Croatia, given on the case study of Clinical hospital center in Rijeka. The methodology used consists of relevant literature section of theory of facility utilization, maintenance and management in general, hospital buildings especially, display of practice on case study, and comparison of key performance indicators values obtained through interview with those that author Igal M. Shohet defined in his study by field surveys and statistical analyses. Despite many positive indicators of Clinical hospital center Rijeka maintenance, an additional research is needed in order to define a more complete national hospital maintenance strategy.

Effects of basic clinical skills training on objective structured clinical examination performance.

Science.gov (United States)

Jünger, Jana; Schäfer, Sybille; Roth, Christiane; Schellberg, Dieter; Friedman Ben-David, Miriam; Nikendei, Christoph

2005-10-01

The aim of curriculum reform in medical education is to improve students' clinical and communication skills. However, there are contradicting results regarding the effectiveness of such reforms. A study of internal medicine students was carried out using a static group design. The experimental group consisted of 77 students participating in 7 sessions of communication training, 7 sessions of skills-laboratory training and 7 sessions of bedside-teaching, each lasting 1.5 hours. The control group of 66 students from the traditional curriculum participated in equally as many sessions but was offered only bedside teaching. Students' cognitive and practical skills performance was assessed using Multiple Choice Question (MCQ) testing and an objective structured clinical examination (OSCE), delivered by examiners blind to group membership. The experimental group performed significantly better on the OSCE than did the control group (P < 0.01), whereas the groups did not differ on the MCQ test (P < 0.15). This indicates that specific training in communication and basic clinical skills enabled students to perform better in an OSCE, whereas its effects on knowledge did not differ from those of the traditional curriculum. Curriculum reform promoting communication and basic clinical skills are effective and lead to an improved performance in history taking and physical examination skills.

Development of safety performance indicators in Japan

International Nuclear Information System (INIS)

Ohashi, H.; Tamao, S.; Tanaka, J.; Sawayama, T.

2001-01-01

For the purpose of safety regulations of operating nuclear power stations in Japan, the regulatory authorities utilize two types of regulations. One is the direct regulation, such as periodical inspection to inspect the function and performance of equipment important to safety, and the other is the audit type regulation such as preservation inspection to audit the compliance with the safety preservation rules. As performance indicators are expected to be an effective tool to evaluate the activities by audit type regulations, NUPEC is studying a comprehensive set of operational performance indicators to meet the effective evaluation method for the safety preservation activities in the audit type regulations under the frame of current safety regulation system. The study includes the establishment of comprehensive operational performance indicators applicable in Japan, the effective application of performance indicators to the current Japanese regulation, the clarification of the applicable scope of utilization, the possibility of applying the performance indicators. This report describes the present status of our performance indicator studies. After the completion of these studies the regulatory authorities will evaluate if and how the new set of comprehensive performance indicators could be introduced to Japanese regulatory scheme. (author)

CHALLENGES WHEN DEVELOPING PERFORMANCE INDICATORS

Directory of Open Access Journals (Sweden)

Brindusa Maria POPA

2015-04-01

Full Text Available Abstract Developing key performance indicators (KPIs represents one step closer to the achievement of objectives and strategic vision of the organization. They are important elements of the pathway towards performance, they evaluate and indicate the level of progress, guide the organizational strategy, they can be considered even the qualitative or quantitative expression of the execution of the strategy. Building reliable and appropriate measurement systems is one of the most difficult stage in the performance evaluation process. Such systems of management will help the executives and the management teams identify and build upon the elements that create competitive advantage and opportunities for better results.

Performance indicators and decision making for outsourcing public health laboratory services.

Science.gov (United States)

Santos, Maria Angelica Borges dos; Moraes, Ricardo Montes de; Passos, Sonia Regina Lambert

2012-06-01

To develop performance indicators for outsourcing clinical laboratory services, based on information systems and public administrative records. In the municipality of Rio de Janeiro, Southern Brazil, the public health laboratory network comprised 33 laboratories with automated equipment (but no integrated information system), 90 primary care units (where sample collection was performed) and 983 employees. Information records were obtained from the administrative records of the Budget Information System for Public Health and the Outpatient and Hospital Information System of the Unified Health System. Performance indicators (production, productivity, usage and costs) were generated from data collected routinely from 2006 to 2008. The variations in production, costs and unit prices for tests were analyzed by Laspeyres and Paasche indices, which specifically measure laboratory activity, and by the Consumer Price Index from the Brazilian Institute of Geography and Statistics. A total of 10,359,111 tests were performed in 2008 (10.6% increase over 2006), and the test/employee ratio grew by 8.6%. The costs of supplies, wages and providers increased by 2.3%, 45.4% and 18.3%, respectively. The laboratory tests per visit and hospitalizations increased by 10% and 20%, respectively. The direct costs totaled R$ 63.2 million in 2008, representing an increase of 22.2% in current values during the period analyzed. The direct costs deflated by the Brazilian National Consumer Price Index (9.5% for the period) showed an 11.6% increase in production volumes. The activity-specific volume index, which considers changes in the mix of tests, showed increases of 18.5% in the test price and 3.1% in the production volume. The performance indicators, particularly the specific indices for volume and price of activity, constitute a baseline of performance potential for monitoring private laboratories and contractors. The economic performance indicators demonstrated the need for network

Material management performance indicators for upper management

International Nuclear Information System (INIS)

O'Loughlin, R.C.

1987-01-01

The purpose of this paper is to develop a case for the use of performance indicators by upper management to monitor the effectiveness of material management operations at nuclear power plants. The paper establishes that the use of performance indicators is not a pro forma matter. There are specific standards and conditions to which the material management operation must conform for the performance measures to be meaningful. The paper concludes with discussion of the application and use of specific performance indicators. Proper use of selected performance indicators can remove the mystery and uncertainty for management about an aspect of nuclear plant operations that has significant budget implications

Development of key performance indicators for prehospital emergency care.

Science.gov (United States)

Murphy, Adrian; Wakai, Abel; Walsh, Cathal; Cummins, Fergal; O'Sullivan, Ronan

2016-04-01

Key performance indicators (KPIs) are used to monitor and evaluate critical areas of clinical and support functions that influence patient outcome. Traditional prehospital emergency care performance monitoring has focused solely on response time metrics. The landscape of emergency care delivery in Ireland is in the process of significant national reconfiguration. The development of KPIs is therefore considered one of the key priorities in prehospital research. The aim of this study was to develop a suite of KPIs for prehospital emergency care in Ireland. A systematic literature review of prehospital care performance measurement was undertaken followed by a three-round Delphi consensus process facilitated by a broad-based multidisciplinary group of panellists. The consensus process was conducted between June 2012 and October 2013. Each candidate indicator on the Delphi survey questionnaire was rated using a 5-point Likert-type rating scale. Agreement was defined as at least 70% of responders rating an indicator as 'agree' or 'strongly agree' on the rating scale. Data were analysed using descriptive statistics. Sensitivity of the ratings was examined for robustness by bootstrapping the original sample. Of the 78 citations identified by the systematic review, 5 relevant publications were used to select candidate indicators for the Delphi round 1 questionnaire. Response rates in Delphi rounds 1 and 2 were 89% and 83%, respectively. Following the consensus development conference, 101 KPIs reached consensus. Based on the Donabedian framework for quality-of-care indicators, 7 of the KPIs which reached agreement were structure KPIs, 74 were process KPIs and 20 were outcome KPIs. The highest ranked indicator was a process KPI ('Direct transport of ST-elevation myocardial infarction patients to a primary percutaneous intervention (PCI)-capable facility for ECG to PCI time performance measurement using scientifically valid and reliable KPIs. Employing a Delphi panel of key

Key indicators for organizational performance measurement

Directory of Open Access Journals (Sweden)

Firoozeh Haddadi

2014-09-01

Full Text Available Each organization for assessing the amount of utility and desirability of their activities, especially in complex and dynamic environments, requires determining and ranking the vital performance indicators. Indicators provide essential links among strategy, execution and ultimate value creation. The aim of this paper is to develop a framework, which identifies and prioritizes Key Performance Indicators (KPIs that a company should focus on them to define and measure progress towards organizational objectives. For this purpose, an applied research was conducted in 2013 in an Iranian telecommunication company. We first determined the objectives of the company with respect to four perspectives of BSC (Balanced Scorecard framework. Next, performance indicators were listed and paired wise comparisons were accomplished by company's high-ranked employees through standard Analytic Hierarchy Process (AHP questionnaires. This helped us establish the weight of each indicator and to rank them, accordingly.

Impact of an educational intervention and clinical performance ...

African Journals Online (AJOL)

... reduced (p=0.002 and p<0.001, respectively). Conclusion. This study demonstrates that adopting a relatively simple educational tool, making use of a clinical performance dashboard indicator and benchmarking practice can significantly reduce the level of neonatal sepsis while also reducing contaminated blood cultures.

Development and integration of programmatic performance indicators

International Nuclear Information System (INIS)

Modarres, M.; Wrethall, J.; Appignani, P.L.

1989-01-01

This paper describes the results of an evaluation of maintenance-related programmatic performance indicators, and summarizes the direction being taken in a new project to integrate indirect performance indicators for nuclear power plants. Programmatic indicators allow NRC to monitor, at a distance, trends in functional activities before a significant impact appears on safety. Previously presented work described the selection of candidate performance indicators associated with maintenance for continued analysis. This evaluation focused on two aspects of the selected indicators: (1) an evaluation of the state of maintenance programs in the narrative text of SALP reports versus the frequencies of inadvertent ESF actuations from test and maintenance errors; and (2) an evaluation of alternative methods for analyzing the thermal performance of plants as an integral indicator of maintenance program effectiveness. 1 ref., 1 fig

Establishing Key Performance Indicators : Case company X

OpenAIRE

Singh, Jatinder

2015-01-01

The key performance indicators serve as the navigational tools for a business organization to monitor its performance. They enable the management team to take real time decisions to keep organization’s resources aligned to its business strategy to accomplish its strategic objec-tives. This research was conducted to analyse the process of establishing successful key per-formance indicators for a business organization. The research was conducted to recommend key performance indicators developme...

Constructing core competency indicators for clinical teachers in Taiwan: a qualitative analysis and an analytic hierarchy process.

Science.gov (United States)

Li, Ai-Tzu; Lin, Jou-Wei

2014-04-11

The objective of this study was to construct a framework of core competency indicators of medical doctors who teach in the clinical setting in Taiwan and to evaluate the relative importance of the indicators among these clinical teachers. The preliminary framework of the indicators was developed from an in-depth interview conducted with 12 clinical teachers who had previously been recognized and awarded for their teaching excellence in university hospitals. The framework was categorized into 4 dimensions: 1) Expertise (i.e., professional knowledge and skill); 2) Teaching Ability; 3) Attitudes and Traits; and 4) Beliefs and Values. These areas were further divided into 11 sub-dimensions and 40 indicators. Subsequently, a questionnaire built upon this qualitative analysis was distributed to another group of 17 clinical teachers. Saaty's eigenvector approach, or the so-called analytic hierarchy process (AHP), was applied to perform the pairwise comparisons between indicators and to determine the ranking and relative importance of the indicators. Fourteen questionnaires were deemed valid for AHP assessment due to completeness of data input. The relative contribution of the four main dimensions was 31% for Attitudes and Traits, 30% for Beliefs and Values, 22% for Expertise, and 17% for Teaching Ability. Specifically, 9 out of the 10 top-ranked indicators belonged to the "Attitudes and Traits" or "Beliefs and Values" dimensions, indicating that inner characteristics (i.e., attitudes, traits, beliefs, and values) were perceived as more important than surface ones (i.e., professional knowledge, skills, and teaching competency). We performed a qualitative analysis and developed a questionnaire based upon an interview with experienced clinical teachers in Taiwan, and used this tool to construct the key features for the role model. The application has also demonstrated the relative importance in the dimensions of the core competencies for clinical teachers in Taiwan.

How reliable are geometry-based building indices as thermal performance indicators?

International Nuclear Information System (INIS)

Rodrigues, Eugénio; Amaral, Ana Rita; Gaspar, Adélio Rodrigues; Gomes, Álvaro

2015-01-01

Highlights: • Geometry-based building indices are tested in different European climate regions. • Building design programs are used to randomly generate sets of simulation models. • Some indices correlate in specific climates and design programs. • Shape-based Relative Compactness presented the best correlation of all indices. • Window-to-Surface Ratio was the window-based index with best correlation. - Abstract: Architects and urban planners have been relying on geometry-based indices to design more energy efficient buildings for years. The advantage of such indices is their ease of use and capability to capture the relation of a few geometric variables with the building’s performance. However, such relation is usually found using only a few simple building models and considering only a few climate regions. This paper presents the analysis of six geometry-based building indices to determine their adequacy in eight different climate regions in Europe. For each location, three residential building design programs were used as building specifications. Two algorithms were employed to randomly generate and assess the thermal performance of three sets of 500 alternative building models. The results show that geometry-based indices only correlate with the buildings’ thermal performance according to specific climate regions and building design programs

Measuring individual work performance: identifying and selecting indicators.

Science.gov (United States)

Koopmans, Linda; Bernaards, Claire M; Hildebrandt, Vincent H; de Vet, Henrica C W; van der Beek, Allard J

2014-01-01

Theoretically, individual work performance (IWP) can be divided into four dimensions: task performance, contextual performance, adaptive performance, and counterproductive work behavior. However, there is no consensus on the indicators used to measure these dimensions. This study was designed to (1) identify indicators for each dimension, (2) select the most relevant indicators, and (3) determine the relative weight of each dimension in ratings of work performance. IWP indicators were identified from multiple research disciplines, via literature, existing questionnaires, and expert interviews. Subsequently, experts selected the most relevant indicators per dimension and scored the relative weight of each dimension in ratings of IWP. In total, 128 unique indicators were identified. Twenty-three of these indicators were selected by experts as most relevant for measuring IWP. Task performance determined 36% of the work performance rating, while the other three dimensions respectively determined 22%, 20% and 21% of the rating. Notable consensus was found on relevant indicators of IWP, reducing the number from 128 to 23 relevant indicators. This provides an important step towards the development of a standardized, generic and short measurement instrument for assessing IWP.

Development of safety performance indicators for HANARO

International Nuclear Information System (INIS)

Wu, Jong-Sup; Jung, Hoan-Sung; Ahn, Guk-Hoon; Lee, Kye-Hong; Lim, In-Cheol

2007-01-01

The nuclear facilities need an extensive basis for ensuring their safety. An operating organization should conduct its operation and utilization important to the safety in accordance with approved procedures and regulations. The general aims of a management system for nuclear facilities are to improve the safety performance through a planning, control and supervision of safety related activities and to foster a strong safety culture. The effectiveness of a management system can be monitored and measured to confirm the ability of its processes to achieve the intended safety performance by an assessment of the operational performance. The Operational Safety Performance Indicators, also known as SPI, help an organization define and measure a progress with regard to safety activity goals. The elements of a SPI are quantifiable measurements that reflect the critical success factors of an organizational safety. Since 1995, efforts have been directed towards the elaboration of a framework for the establishment of an operational safety performance indicator program in nuclear power plants (NPP). IAEA-TECDOC-1141, 'Operational safety performance indicators for NPP' attempted to provide a frame work for an identification of performance indicators which have a relationship to the desired safety attributes, and therefore, to a safe plant operation. Three key attributes of a smooth operation, an operation with a low risk, and an operation with a positive safety attitude, were recommended, which are associated with a safe operation. Because these attributes cannot be directly measured, an indicator structure is expanded further until a level of easily quantifiable or directly measurable indicators is identified. The intention of this approach is to use quantitative information provided by the specific indicators and to analyze performance trends relative to established goals. The safety activities in HANARO have been continuously conducted to enhance its safe operation. HANARO

[Influence of the professional experience of the clinical cardiologist on the adequacy of the clinical indications of myocardial perfusion gated-SPECT].

Science.gov (United States)

Dominguez-Rodriguez, Alberto; Avanzas, Pablo; Abreu-Gonzalez, Pedro; Sanchez Grande-Flecha, Alejandro; García-Baute, María Del Carmen; Gómez, María Ángeles

2017-11-30

During cardiology training, the cardiology fellow has to be trained in all things related to the indication, interpretation, and performing of nuclear cardiology studies using single photon emission computed tomography (SPECT). The aim of the present study was to analyse the relationship between the adequacy of indications of myocardial perfusion gated-SPECT and the years of experience since the completion of cardiology training. A descriptive, retrospective analysis was performed on a single-centre register, in which the indications (adequate or inadequate use) were recorded according to myocardial perfusion gated-SPECT guidelines, prescribed by cardiologists of a university hospital. A total of 950 gated-SPECT tests were analysed according to the appropriate or inadequate indication. The sample of study was distributed in quartiles (years) since the cardiologist finished the residency. Cardiologists with less than 10 years of clinical experience reported a higher proportion of gated-SPECT tests compared to the more experienced cardiologists (87.6 vs. 9.3%, P<.001). After adjusting for age, gender, and cardiovascular risk factors, the multivariate analysis showed that, for each year of experience after completion of cardiology training, the probability of adequately indicating the test (OR: 1.33, 95% CI: 1.29-1.38, P<.001) was statistically significant. The professional experience of the clinical cardiologist is the most important factor to perform an appropriate indication of gated-SPECT myocardial perfusion. Copyright © 2017 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.

Clinical indications for antibiotic use in Danish general practice

DEFF Research Database (Denmark)

Aabenhus, Rune; Hansen, Malene Plejdrup; Siersma, Volkert Dirk

2017-01-01

of routine electronic antibiotic prescriptions from Danish general practice. Subjects: All 975,626 patients who redeemed an antibiotic prescription at outpatient pharmacies during the 1-year study period (July 2012 to June 2013). Main outcome measures: Number of prescriptions per clinical indication. Number......Objective: To assess the availability and applicability of clinical indications from electronic prescriptions on antibiotic use in Danish general practice. Design: Retrospective cohort register-based study including the Danish National Prescription Register. Setting: Population-based study...... from electronic prescriptions are accessible and available to provide an overview of drug use, in casu antibiotic prescriptions, in Danish general practice. These clinical indications may be further explored in detail to assess rational drug use and congruence with guidelines, but validation...

Effects of Clinical Mastitis on Reproductive Performance in Holstein Cows

Directory of Open Access Journals (Sweden)

A. Gunay

2008-01-01

Full Text Available The objective of this study was to determine the effects of clinical mastitis on reproductive performance in 135 early lactation cows. The animals were divided into two groups according to the occurrence of mastitis as follows: group I (n = 45, clinical mastitis prior to the first artificial insemination breeding; group II (n = 45, clinical mastitis after artificial insemination and being diagnosed pregnant. Forty-five cows without any mastitis served as control group. Calving to first service intervals were significantly longer (P P P < 0.05 in cows with clinical mastitis after first service (3.4 ± 0.9 than in cows with clinical mastitis before first service (2.1 ± 0.9 and in cows with no clinical mastitis (1.8 ± 0.8. This study indicated that clinical mastitis during early lactation in Holstein cows had a negative impact on their reproductive performance.

Key Performance Indicators for Primary Schools.

Science.gov (United States)

Strand, Steve

Focusing mostly on their application for primary schools, this document describes the educational key performance indicators (KPI) employed by the Wendsworth, England, Local Educational Authority (LEA). Indicators are divided into 3 areas, educational context, resource development, and outcomes. Contextual indicators include pupil mobility, home…

Development and integration of programmatic performance indicators

International Nuclear Information System (INIS)

Wreathall, J.; Appignani, P.; Modarres, M.

1990-01-01

Work is currently being performed to develop and integrate programmatic performance indicators, that is, indicators of performance associated with the influence on safety associated with plant functional areas like maintenance, operations and training. The process for identifying and evaluating indicators associated with maintenance and training has been described earlier. Since that time, the authors have evaluated the maintenance indicators: inadvertent engineered safety feature actuations due to test and maintenance errors, and daily power loss (DPL), which seemingly show relationships to safety. Work on training process will lead to characteristic sorts of behavior. In the integration study, several frameworks have been developed to provide a basis for describing the interrelationships of plant behavior, personnel behavior, and safety. These will be applied in the next phase of the work to perform the nominal integration

Is medical perspective on clinical governance practices associated with clinical units’ performance and mortality? A cross-sectional study through a record-linkage procedure

Directory of Open Access Journals (Sweden)

Guido Sarchielli

2016-07-01

Full Text Available Objective: Assessment of the knowledge and application as well as perceived utility by doctors of clinical governance tools in order to explore their impact on clinical units’ performance measured through mortality rates and efficiency indicators. Methods: This research is a cross-sectional study with a deterministic record-linkage procedure. The sample includes n = 1250 doctors (n = 249 chiefs of clinical units; n = 1001 physicians working in six public hospitals located in the Emilia-Romagna Region in Italy. Survey instruments include a checklist and a research-made questionnaire which were used for data collection about doctors’ knowledge and application as well as perceived utility of clinical governance tools. The analysis was based on clinical units’ performance indicators which include patients’ mortality, extra-region active mobility rate, average hospital stay, bed occupancy, rotation and turnover rates, and the comparative performance index as efficiency indicators. Results: The clinical governance tools are known and applied differently in all the considered clinical units. Significant differences emerged between roles and organizational levels at which the medical leadership is carried out. The levels of knowledge and application of clinical governance practices are correlated with the clinical units’ efficiency indicators (bed occupancy rate, bed turnover interval, and extra-region mobility. These multiple linear regression analyses highlighted that the clinical governance knowledge and application is correlated with clinical units’ mortality rates (odds ratio, −8.677; 95% confidence interval, −16.654, −0.700. Conclusion: The knowledge and application, as well as perceived utility by medical professionals of clinical governance tools, are associated with the mortality rates of their units and with some efficiency indicators. However, the medical frontline staff seems to not consider homogeneously useful

Current status on performance of CT colonography and clinical indications

International Nuclear Information System (INIS)

Laghi, Andrea; Rengo, Marco; Graser, Anno; Iafrate, Franco

2013-01-01

CT colonography (CTC) is a robust and reliable imaging test of the colon. Accuracy for the detection of colorectal cancer (CRC) is as high as conventional colonoscopy (CC). Identification of polyp is size dependent, with large lesions (≥10 mm) accurately detected and small lesions (6–9 mm) identified with moderate to good sensitivity. Recent studies show good sensitivity for the identification of nonpolypoid (flat) lesions as well. Current CTC indications include the evaluation of patients who had undergone a previous incomplete CC or those who are unfit for CC (elderly and frail individuals, patients with underlying severe clinical conditions, or with contraindication to sedation). CTC can also be efficiently used in the assessment of diverticular disease (excluding patients with acute diverticulitis, where the exam should be postponed), before laparoscopic surgery for CRC (to have an accurate localization of the lesion), in the evaluation of colonic involvement in the case of deep pelvic endometriosis (replacing barium enema). CTC is also a safe procedure in patients with colostomy. For CRC screening, CTC should be considered an opportunistic screening test (not available for population, or mass screening) to be offered to asymptomatic average-risk individuals, of both genders, starting at age 50. The use in individuals with positive family history should be discussed with the patient first. Absolute contraindication is to propose CTC for surveillance of genetic syndromes and chronic inflammatory bowel diseases (in particular, ulcerative colitis). The use of CTC in the follow-up after surgery for CRC is achieving interesting evidences despite the fact that literature data are still relatively weak in terms of numerosity of the studied populations. In patients who underwent previous polypectomy CTC cannot be recommended as first test because debate is still open. It is desirable that in the future CTC would be the first-line and only diagnostic test for

Current status on performance of CT colonography and clinical indications

Energy Technology Data Exchange (ETDEWEB)

Laghi, Andrea, E-mail: andrea.laghi@uniroma1.it [Department of Radiological Sciences, Oncology and Pathology Sapienza – Università di Roma, Polo Pontino, I.C.O.T. Hospital, Via Franco Faggiana 43, 04100 Latina (Italy); Rengo, Marco [Department of Radiological Sciences, Oncology and Pathology Sapienza – Università di Roma, Polo Pontino, I.C.O.T. Hospital, Via Franco Faggiana 43, 04100 Latina (Italy); Graser, Anno [InstitutfürKlinische Radiologie, Klinikumder Ludwig-Maximilians-Universität München, Campus Großhadern, Marchioninistr. 15, 81377 München (Germany); Iafrate, Franco [Department of Radiological Sciences, Oncology and Pathology Sapienza – Università di Roma, Policlinico Umberto I, Viale Regina Elena 324, 00161 Rome (Italy)

2013-08-15

CT colonography (CTC) is a robust and reliable imaging test of the colon. Accuracy for the detection of colorectal cancer (CRC) is as high as conventional colonoscopy (CC). Identification of polyp is size dependent, with large lesions (≥10 mm) accurately detected and small lesions (6–9 mm) identified with moderate to good sensitivity. Recent studies show good sensitivity for the identification of nonpolypoid (flat) lesions as well. Current CTC indications include the evaluation of patients who had undergone a previous incomplete CC or those who are unfit for CC (elderly and frail individuals, patients with underlying severe clinical conditions, or with contraindication to sedation). CTC can also be efficiently used in the assessment of diverticular disease (excluding patients with acute diverticulitis, where the exam should be postponed), before laparoscopic surgery for CRC (to have an accurate localization of the lesion), in the evaluation of colonic involvement in the case of deep pelvic endometriosis (replacing barium enema). CTC is also a safe procedure in patients with colostomy. For CRC screening, CTC should be considered an opportunistic screening test (not available for population, or mass screening) to be offered to asymptomatic average-risk individuals, of both genders, starting at age 50. The use in individuals with positive family history should be discussed with the patient first. Absolute contraindication is to propose CTC for surveillance of genetic syndromes and chronic inflammatory bowel diseases (in particular, ulcerative colitis). The use of CTC in the follow-up after surgery for CRC is achieving interesting evidences despite the fact that literature data are still relatively weak in terms of numerosity of the studied populations. In patients who underwent previous polypectomy CTC cannot be recommended as first test because debate is still open. It is desirable that in the future CTC would be the first-line and only diagnostic test for

CREDIT Performance Indicator Framework

DEFF Research Database (Denmark)

Frandsen, Anne Kathrine; Bertelsen, Niels Haldor; Haugbølle, Kim

2010-01-01

During the past two years the Nordic Baltic research project CREDIT (Construction and Real Estate – Developing Indicators for Transparency) has worked with the aim to improve transparency of value creation in building and real estate. One of the central deliverables of the CREDIT project was a fr......During the past two years the Nordic Baltic research project CREDIT (Construction and Real Estate – Developing Indicators for Transparency) has worked with the aim to improve transparency of value creation in building and real estate. One of the central deliverables of the CREDIT project...... was a framework of indicators relevant in building and real estate and applicable in the Nordic and Baltic countries as well as a proposal for a set of key indicators. The study resulting in CREDIT Performance Indicator Framework has been based on 28 case studies of evaluation practises in the building and real...... estate sector each addressing three interlinked levels: building/ projects level, company or enterprise level and benchmarking system level. Additionally it has been based on dialogue with researchers and professional organisation, international research and standardisation work and national building...

Sustainable Transport and Performance Indicators

DEFF Research Database (Denmark)

Gudmundsson, Henrik

2004-01-01

Sustainable transport has become a major policy concern in recent years. The term suggests a need to consider transport in a comprehensive perspective including the well-being of both present and future generations, and taking environmental, social and economic issues into account. Indicators...... in forecasting and tracking the performance of transport systems increasingly guide sustainable transport policy making. This review explores the implications of the sustainable transport” concept and how it can be made operational with indicators. A number of indicator systems are reviewed, and some strengths...

School infrastructure performance indicator system (SIPIS)

CSIR Research Space (South Africa)

Gibberd, Jeremy T

2007-05-01

Full Text Available This paper describes the School Infrastructure Performance Indicator System (SIPIS) project which explores how an indicator system could be developed for school infrastructure in South Africa. It outlines the key challenges faced by the system...

Performance Indicators of Operating Reactors

Data.gov (United States)

Nuclear Regulatory Commission — A list of Performance Indicators (PI) that are reported to the NRC by licensees at the end of each quarter in accordance with Inspection Manual Chapters (IMC) 0608,...

Corporate performance indicators: The case of universities

Directory of Open Access Journals (Sweden)

Bakae Aubrey Mokoena

2016-11-01

Full Text Available This paper re-examines the long-standing and unresolved debate regarding the use of performance indicators in higher education. This paper aims to identify the primary variables that comprise university performance from the perspectives of academics within universities of technology in South Africa. A structured questionnaire was administered to a conveniently selected sample of 507 academics recruited from five universities of technology in South Africa. Using the exploratory factor analysis technique, five indicators were used as sub-dimensions to measure university performance were identified. These were 1 recognition, 2 image, 3 collaboration, 4 spin-off, 5 employability and 6 research. Overall, the research results suggests that these five performance indicators can assist South Africa’s universities of technology to achieve a higher level of institutional performance. The boards responsible for running universities of technology should consider which strategic management approaches they are currently utilising and streamline them to cement their competitive advantage and superior performance.

Sustainable Transport and Performance Indicators

DEFF Research Database (Denmark)

Gudmundsson, H.

2004-01-01

ustainable transport has become a major policy concern in recent years. The term suggests a need to consider transport in a comprehensive perspective including the well-being of both present and future generations, and taking environmental, social and economic issues into account. Indicators...... in forecasting and tracking the performance of transport systems increasingly guide sustainable transport policy making. This review explores the implications of the "sustainable transport" concept and how it can be made operational with indicators. A number of indicator systems are reviewed, and some strengths...... and weaknesses are highlighted with regard to the support they provide for sustainable transport development....

Organizational performance and regulatory compliance as measured by clinical pertinence indicators before and after implementation of Anesthesia Information Management System (AIMS).

Science.gov (United States)

Choi, Clark K; Saberito, Darlene; Tyagaraj, Changa; Tyagaraj, Kalpana

2014-01-01

Previous studies have suggested that electronic medical records (EMR) can lead to a greater reduction of medical errors and better adherence to regulatory compliance than paper medical records (PMR). In order to assess the organizational performance and regulatory compliance, we tracked different clinical pertinence indicators (CPI) in our anesthesia information management system (AIMS) for 5 years. These indicators comprised of the protocols from the Surgical Care Improvement Project (SCIP), elements of performance (EP) from The Joint Commission (TJC), and guidelines from the Centers for Medicare and Medicaid Services (CMS). A comprehensive AIMS was initiated and the CPI were collected from October 5, 2009 to December 31, 2010 (EMR period) and from January 1, 2006 to October 4, 2009 (PMR period). Fourteen CPI were found to be common between the EMR and PMR periods. Based on the statistical analysis of the 14 common CPI, there was a significant increase (p < 0.001) in overall compliance after the introduction of EMR compared to the PMR period. The increase in overall compliance was significantly progressive (p = 0.013) from year to year over 2006 and 2010. Of the 14 CPI, Documentation of a) medication doses, and b) monitoring of postoperative physiological status, mental status, and pain scores showed significant improvement (p < 0.001) during the EMR period compared to the PMR period.

Selection and Use of Performance Indicators in Decommissioning

International Nuclear Information System (INIS)

2011-01-01

The success of completing a decommissioning project on schedule and budget is determined by the ability to define a clear endpoint (outcome), to accurately determine intermediate progress, and develop reliable forecasts to complete remaining tasks. Performance indicators are used to examine those aspects that are crucial to this success. This information is required by and periodically reported to various stakeholders. Although the practice of nuclear decommissioning is maturing, it would benefit from optimal use of performance indicators. Performance measurement is the 'heart and soul' of the performance based management process. Flowing from the organizational mission and the strategic planning process, it provides the data that will be collected, analysed, reported and ultimately, used to make sound business decisions. It directs the business function by documenting progress towards established objectives, identifying areas of both strength and weakness, and justifying budgetary expenditures. In this report, practical advice is provided on the effective use of performance indicators to measure and report on the achievement of the goals and plans of a nuclear decommissioning project. The structure of the report takes the reader progressively through all aspects of designing, selecting and using performance indicators. A process for setting up a performance indicator system against basic principles is presented, including a discussion of each step in the process. The report also provides an expanded discussion of the most important influences on the identification and selection of performance indicators. Finally, practical guidance on the use of performance indicators in specific Member States is provided together with field experience.

Performance indicator system with application to NPP management

International Nuclear Information System (INIS)

Gomez, J.; Roldan, J.

2001-01-01

The objective of the paper is to present the work that is being conducted in the scope of a research project between Cofrentes NPP and the polytechnic university of Valencia aimed to the development and implementation of a performance indicators system to support plant management. In developing this system, attention is being paid to the areas of safety, production and dependability. The first step in the project was the development of the performance indicator system (PIS), in order to help in assessing the effectiveness of the different activities in plant (i.e. maintenance, inspections, tests, etc.). It is suggested establishing the operational indicators set in 3 levels. The lowest level concerns indicators monitoring performance and maintenance characteristics of components. The next one involves a subset of indicators placed at system level with a similar goal. And finally, the highest level summarizes the impact of the global policy in the whole plant from safety and performance point of view. The definition of an indicator should comprise, at least, the following items: indicator's name, performance area, definition and data needed. A strategy should define what, when and how indicators have to be evaluated, analyzed and reported. This article gives an example application of the methodology at the Cofrentes NPP, collective dose as safety indicator, power production as production indicator and the number of work orders as maintenance indicator are considered and their time evolution is given. (A.C.)

Indicators of suboptimal performance embedded in the Wechsler Memory Scale-Fourth Edition (WMS-IV)

NARCIS (Netherlands)

Bouman, Z.; Hendriks, M.P.H.; Schmand, B.A.; Kessels, R.P.C.; Aldenkamp, A.P.

2016-01-01

INTRODUCTION: Recognition and visual working memory tasks from the Wechsler Memory Scale-Fourth Edition (WMS-IV) have previously been documented as useful indicators for suboptimal performance. The present study examined the clinical utility of the Dutch version of the WMS-IV (WMS-IV-NL) for the

Indicators of suboptimal performance embedded in the Wechsler Memory Scale-Fourth Edition (WMS-IV)

NARCIS (Netherlands)

Bouman, Zita; Hendriks, Marc P. H.; Schmand, Ben A.; Kessels, Roy P. C.; Aldenkamp, Albert P.

2016-01-01

Recognition and visual working memory tasks from the Wechsler Memory Scale-Fourth Edition (WMS-IV) have previously been documented as useful indicators for suboptimal performance. The present study examined the clinical utility of the Dutch version of the WMS-IV (WMS-IV-NL) for the identification of

Indicators of suboptimal performance embedded in the Wechsler Memory Scale : Fourth Edition (WMS-IV)

NARCIS (Netherlands)

Bouman, Z.; Hendriks, M.P.H.; Schmand, B.A.; Kessels, R.P.C.; Aldenkamp, A.P.

2016-01-01

INTRODUCTION: Recognition and visual working memory tasks from the Wechsler Memory Scale-Fourth Edition (WMS-IV) have previously been documented as useful indicators for suboptimal performance. The present study examined the clinical utility of the Dutch version of the WMS-IV (WMS-IV-NL) for the

Indicators of suboptimal performance embedded in the Wechsler Memory Scale-Fourth Edition (WMS-IV)

NARCIS (Netherlands)

Bouman, Zita; Hendriks, Marc P.H.; Schmand, Ben A.; Kessels, Roy P.C.; Aldenkamp, Albert P.

2016-01-01

Introduction. Recognition and visual working memory tasks from the Wechsler Memory Scale-Fourth Edition (WMS-IV) have previously been documented as useful indicators for suboptimal performance. The present study examined the clinical utility of the Dutch version of the WMS-IV (WMS-IV-NL) for the

Technical indicators of financial performance in the dairy herd

DEFF Research Database (Denmark)

Kristensen, Erling Lundager; Østergaard, Søren; Krogh, Mogens Agerbo

2008-01-01

Monte Carlo simulation was used to predict the long-term financial performance related to the technical performance of dairy herds. The indicators addressed were derived from data collected routinely in the herd. They indicated technical performance that can be affected by the farmer...... or the consultant, and they were derived from expected cause-effect relations between technical performance and financial performance at the herd level. The study included the indicators shape of lactation curve, reproduction efficiency, heifer management, variation between cows in lactation curve persistency...... cow was analyzed as the measure of financial performance. The potential effects of the selected indicators on the gross margin were estimated by means of an ANOVA. The final model allowed estimation of the financial value of specific changes within the key performance indicators. This study indicated...

Clinical simulation training improves the clinical performance of Chinese medical students

Directory of Open Access Journals (Sweden)

Ming-ya Zhang

2015-10-01

Full Text Available Background: Modern medical education promotes medical students’ clinical operating capacity rather than the mastery of theoretical knowledge. To accomplish this objective, clinical skill training using various simulations was introduced into medical education to cultivate creativity and develop the practical ability of students. However, quantitative analysis of the efficiency of clinical skill training with simulations is lacking. Methods: In the present study, we compared the mean scores of medical students (Jinan University who graduated in 2013 and 2014 on 16 stations between traditional training (control and simulative training groups. In addition, in a clinical skill competition, the objective structured clinical examination (OSCE scores of participating medical students trained using traditional and simulative training were compared. The data were statistically analyzed and qualitatively described. Results: The results revealed that simulative training could significantly enhance the graduate score of medical students compared with the control. The OSCE scores of participating medical students in the clinical skill competition, trained using simulations, were dramatically higher than those of students trained through traditional methods, and we also observed that the OSCE marks were significantly increased for the same participant after simulative training for the clinical skill competition. Conclusions: Taken together, these data indicate that clinical skill training with a variety of simulations could substantially promote the clinical performance of medical students and optimize the resources used for medical education, although a precise analysis of each specialization is needed in the future.

Linking clinical quality indicators to research evidence - a case study in asthma management for children.

Science.gov (United States)

Choong, Miew Keen; Tsafnat, Guy; Hibbert, Peter; Runciman, William B; Coiera, Enrico

2017-07-21

Clinical quality indicators are used to monitor the performance of healthcare services and should wherever possible be based on research evidence. Little is known however about the extent to which indicators in common use are based on research. The objective of this study is to measure the extent to which clinical quality indicators used in asthma management in children with outcome measurements can be linked to results in randomised controlled clinical trial (RCT) reports. This work is part of a broader research program to trial methods that improve the efficiency and accuracy of indicator development. National-level indicators for asthma management in children were extracted from the National Quality Measures Clearinghouse database and the National Institute for Health and Care Excellence quality standards by two independent appraisers. Outcome measures were extracted from all published English language RCT reports for asthma management in children below the age of 12 published between 2005 and 2014. The two sets were then linked by manually mapping both to a common set of Unified Medical Language System (UMLS) concepts. The analysis identified 39 indicators and 562 full text RCTs dealing with asthma management in children. About 95% (37/39) of the indicators could be linked to RCT outcome measures. It is possible to identify relevant RCT reports for the majority of indicators used to assess the quality of asthma management in childhood. The methods reported here could be automated to more generally support assessment of candidate indicators against the research evidence.

Improvement programme of safety performance indicators (SPIs) in Korea

International Nuclear Information System (INIS)

Lee, S.Y.

2001-01-01

KINS has developed and used Safety Performance Indicators (SPIs), which are count based and composed of 10 indicators in 8 areas, to monitor the trend of performance of NPPs in Korea since 1997. However, the limited usage of SPIs and the increasing worldwide interest on SPIs became the motivation of the SPI improvement programme in Korea. Korea is planning to establish plant performance evaluation programme through analysis of SPI and result of inspection. The SPI improvement programme is a part of the plant performance evaluation programme and includes study on performance evaluation areas, indicator categories, selection and development of indicators, redefinition of indicators and introduction of graphical display system. The selected performance evaluation areas are general performance, reactor safety and radiation safety. Each area will have categories as sub-areas and a total of six categories are selected. One or two indicators for each category are determined or will be developed to make a set of Safety Performance Indicators. Also, a graphic display system will be introduced to extend the usage of SPIs. (author)

A survey on exploring key performance indicators

Directory of Open Access Journals (Sweden)

Mohammed Badawy

2016-12-01

Full Text Available Key Performance Indicators (KPIs allows gathering knowledge and exploring the best way to achieve organization goals. Many researchers have provided different ideas for determining KPI's either manually, and semi-automatic, or automatic which is applied in different fields. This work concentrates on providing a survey of different approaches for exploring and predicting key performance indicators (KPIs.

Social Performance vs. Financial Performance: CSR Disclosures as an indicator of social performance

Directory of Open Access Journals (Sweden)

İlker Yılmaz

2013-04-01

Full Text Available In recent decades, it is gaining more and more dominance in both academic and business life that the company exists for and has responsibilities toward a wider group of stakeholders and it must have some objectives other than profitability. To achieve sustainable development and growth, the companies must assume more duties, which is called the term “corporate social responsibility (CSR.” In the literature, it is questioned whether CSR activities benefit the company or not; whether there is any relationship exists between CSR activities and the company’s financial performance and the direction of the relationship. We aimed to explore that whether there is any effect corporate social performance (CSP on financial performance and position and vice versa. We performed content analysis through annual reports and derived a social score composed of the items included in disclosure guidelines and some criteria used in CSR ratings. We also used several financial position and financial performance indicators. In order to explore the relationship between CSP and financial indicators, we run panel data regressions. We found significant results for some of the indicators, where some of the indicators gave insignificant results. The reporting of CSR activities is in very low levels. The conscious toward CSR and sustainability must be promoted and the companies must assume more active roles. The reporting of those activities is also important.

Dashboard and Firms Performance Optimization Using Piloting Indicators

Directory of Open Access Journals (Sweden)

Sorinel Capusneanu

2006-07-01

Full Text Available Can we analyze the enterprise performances upon the pilot indicators? The answer is completed by analyzing and interpreting the suggested indicators. Finally, these indicators will form the enterprise dashboard, which the management will take the right decisions. The dashboard represents the selection and presentation way of pilot indicators which permit tendencies visualization leaving from enterprise’s followed objectives. Through analyses and interpretation of pilot indicators, it is generating actions which contribute to enterprise’s improvement performances.

Indicators of suboptimal performance embedded in the Wechsler Memory Scale-Fourth Edition (WMS-IV)

OpenAIRE

Bouman, Zita; Hendriks, Marc PH; Schmand, Ben A; Kessels, Roy PC; Aldenkamp, Albert

2016-01-01

Introduction. Recognition and visual working memory tasks from the Wechsler Memory Scale-Fourth Edition (WMS-IV) have previously been documented as useful indicators for suboptimal performance. The present study examined the clinical utility of the Dutch version of the WMS-IV (WMS-IV-NL) for the identification of suboptimal performance using an analogue study design. Method. The patient group consisted of 59 mixed-etiology patients; the experimental malingerers were 50 healthy individuals...

Indicators of suboptimal performance embedded in the Wechsler Memory Scale-Fourth Edition (WMS-IV)

OpenAIRE

Bouman, Zita; Hendriks, Marc P.H.; Schmand, Ben A.; Kessels, Roy P.C.; Aldenkamp, Albert P.

2016-01-01

Introduction. Recognition and visual working memory tasks from the Wechsler Memory Scale-Fourth Edition (WMS-IV) have previously been documented as useful indicators for suboptimal performance. The present study examined the clinical utility of the Dutch version of the WMS-IV (WMS-IV-NL) for the identification of suboptimal performance using an analogue study design.Method. The patient group consisted of 59 mixed-etiology patients; the experimental malingerers were 50 healthy individuals who ...

Safety performance indicators. Topical issues paper no. 5

International Nuclear Information System (INIS)

Dahlgren, K.; Lederman, L.; Szikszai, T.; Palomo, J.

2001-01-01

Since its creation the nuclear industry has been struggling with the question of how safe is safe enough. Safety is a common goal to all involved in the design, operation and regulation of a nuclear installation. As a concept safety is not easy to define. However, there is a general understanding of what attributes a nuclear power plant should have in order to operate safely. The challenge lies in measuring the attributes. The new competitive open electricity market, in many countries throughout the world, is increasing the economic pressure on operators to lower operating costs without jeopardizing safety. Challenges are occurring at a rate that is unprecedented in the nuclear industry: competitiveness; downsizing; ageing; policy changes; reorganization; restructuring; mergers; globalization; and takeovers demand increasing attention to the management of safety. There are various means to measure safety performance, some of which are more qualitative in nature and others which through quantitative measures provide the means by which to evaluate performance trends with clear ties to safety. According to their use, indicators are generally considered in two groups: leading or proactive and lagging or reactive indicators. Leading indicators are most useful as a precursor to safety degradation for early management reaction. Lagging indicators are most commonly used to drive plant performance, to monitor and for benchmarking against similar plants. The actual values of the indicators are not intended to be direct measures of safety, although safety performance can be inferred from the results achieved. Each plant needs to determine which indicators best serve its needs. Selected indicators should not be static, but should be adapted to the conditions and performance of the plant, considering the cost-benefit of maintaining each individual indicator. It should be recognized that while indicators provide valuable information in the effective management of plant safety

Cognitive performance in both clinical and non-clinical burnout

NARCIS (Netherlands)

Oosterholt, B.G.; Maes, J.H.R.; Linden, D. van der; Verbraak, M.J.P.M.; Kompier, M.A.J.

2014-01-01

Relatively little is known about cognitive performance in burnout. The aim of the present study was to further our knowledge on this topic by examining, in one study, cognitive performance in both clinical and non-clinical burnout while focusing on three interrelated aspects of cognitive

Is a positive L-dimer result a sufficient indication for performing a V/Q lung scan?

International Nuclear Information System (INIS)

Salanitri, G.C.; Kelly, M.J.; O'Donnell, M.; Kalff, V.

2002-01-01

Full text: At our institution there has developed a practice of referring some patients for assessment of pulmonary embolism (PE) because of a positive L-dimer test but without standard clinical indications. Therefore this study aimed to determine whether a positive L-dimer test result by itself is a sufficient indication to perform a ventilation/perfusion V/Q study. V/Q lung scan results, L-dimer test results and appropriate radiology results of 949 consecutive patients from August 2000 to October 2001 were retrospectively reviewed. Prediction of V/Q results by L-dimer results was compared with that of clinical risk factors for PE (Risk factor + or -) These factors were dyspnoea, current deep vein thrombosis (DVT), recent orthopaedic procedure or a past history of PE/DVT, Of the 949 patients in the study population, 254 patients had an L-dimer study, with 206 positive and 48 negative L-dimer results. Helical CT was performed in 8 patients with an equivocal V/Q - 4 showed PE and 4 did not. In the 27 patients with a positive L-dimer result and PE on either V-Q scan or CT, 25 (92.6%) had additional recognised major risk factors for PE. A positive L-dimer test is a poor predictor of a positive V/Q scan compared to conventional clinical indications. Thus, a positive L-dimer test result in isolation does not constitute an appropriate indication to perform a V/Q scan. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

Proceedings of the specialist meeting on safety performance indicators

Energy Technology Data Exchange (ETDEWEB)

NONE

2002-05-28

In 1998, the OECD/NEA committee on Nuclear Regulatory Activities (CNRA) initiated an activity with the objective of advancing the discussion on how to enhance and measure regulatory effectiveness in relation to nuclear installations. One of the outcome of this activity was to establish a Task group to develop internal (direct) performance indicators which would be used to monitor regulatory efficiency. On the initiative of the NEA/CSNI Working Group on Operating Experience the Spanish CSN hosted a workshop (Madrid, 2000) to review the state of the art on Safety Performance Indicators. This workshop, which was co-sponsored by the IAEA and WANO was attended by 73 participants from 19 countries, representing the industry, regulators, service companies as well as international organisations. The conclusions were: 1. there is considerable development effort on performance indicators in many countries; 2. utilities continue to rely on the WANO Performance indicators system which consists of indicators in 8 key areas and receives data from virtually all commercial NPP's in the world; 3. Regulators do not have a common set of performance indicators. This document gathers the 25 presentations given during this workshop. After this workshop, a joint CNRA/CSNI task group was launched in December 2000 to exchange information and develop external (indirect) indicators to measure regulatory effectiveness, i.e. impact on licensee's safety performance. These external indicators are, in other words, the traditional plant performance indicators (PI's). The task force consisted of regulators, organisations which have a performance indicators system in operation or under testing. The task force met in Paris on February 19-20, 2001 and the work performed by the group is summarized in a report (NEA-CSNI-R--2001-11) attached in appendix to these proceedings.

Proceedings of the specialist meeting on safety performance indicators

International Nuclear Information System (INIS)

2002-01-01

In 1998, the OECD/NEA committee on Nuclear Regulatory Activities (CNRA) initiated an activity with the objective of advancing the discussion on how to enhance and measure regulatory effectiveness in relation to nuclear installations. One of the outcome of this activity was to establish a Task group to develop internal (direct) performance indicators which would be used to monitor regulatory efficiency. On the initiative of the NEA/CSNI Working Group on Operating Experience the Spanish CSN hosted a workshop (Madrid, 2000) to review the state of the art on Safety Performance Indicators. This workshop, which was co-sponsored by the IAEA and WANO was attended by 73 participants from 19 countries, representing the industry, regulators, service companies as well as international organisations. The conclusions were: 1. there is considerable development effort on performance indicators in many countries; 2. utilities continue to rely on the WANO Performance indicators system which consists of indicators in 8 key areas and receives data from virtually all commercial NPP's in the world; 3. Regulators do not have a common set of performance indicators. This document gathers the 25 presentations given during this workshop. After this workshop, a joint CNRA/CSNI task group was launched in December 2000 to exchange information and develop external (indirect) indicators to measure regulatory effectiveness, i.e. impact on licensee's safety performance. These external indicators are, in other words, the traditional plant performance indicators (PI's). The task force consisted of regulators, organisations which have a performance indicators system in operation or under testing. The task force met in Paris on February 19-20, 2001 and the work performed by the group is summarized in a report (NEA-CSNI-R--2001-11) attached in appendix to these proceedings

EPA Monthly Key Performance Indicator Dashboards 2017

Science.gov (United States)

Each month, the Web Analytics Program posts updated Key Performance Indicator (KPI) dashboards that correspond to three Web performance goals: content consumption, content discovery, and audience engagement.

Proposed system for measuring project performance using process-based key performance indicators

NARCIS (Netherlands)

Haponava, T.; Al-Jibouri, Saad H.S.

2012-01-01

Despite some evidence of its usefulness, performance measurement by using Key Performance Indicators (KPIs) in the construction industry also has its critics. Among the shortcomings attributed to existing KPIs is the fact that almost all of them are product oriented. This means that the indicators

Performance indicators for first quarter CY 1994

International Nuclear Information System (INIS)

1994-01-01

The Department of Energy (DOE) has established a Department-Wide Performance Indicator (PI) Program for trending and analysis of operational data as directed by DOE Order 5480.26. The PI Program was established to provide a means for monitoring the environment safety, and health (ES ampersand H) performance of the DOE at the Secretary and other management levels. This is the thirteenth in a series of quarterly reports generated for the Department of Energy Idaho Operations Office (DOE-ID) by EG ampersand G Idaho, Inc., to meet the requirements of the PI Program as directed by the DOE Standard (DOE-STD-1048-92). The report format and content adhere to the guidelines established In DOE Order 5480.26, Trending and Analysis of Operations Information Using Performance Indicators, and DOE-STD-1048-92, DOE Peformance Indicators Guidance Document

Integrating clinical performance improvement across physician organizations: the PhyCor experience.

Science.gov (United States)

Loeppke, R; Howell, J W

1999-02-01

There is a paucity of literature describing the implementation of clinical performance improvement (CPI) efforts across geographically dispersed multispecialty group practices and independent practice associations. PhyCor, a physician management company based in Nashville, Tennessee, has integrated CPI initiatives into its operating infrastructure. PhyCor CPI INITIATIVES: The strategic framework guiding PhyCor's CPI initiatives is built around a physician-driven, patient-centered model. Physician/administrator leadership teams develop and implement a clinical and financial strategic plan for performance improvement; adopt local clinical and operational performance indicators; and agree on and gain consensus with local physician champions to engage in CPI initiatives. The area/regional leadership councils integrate and coordinate regional medical management and CPI initiatives among local groups and independent practice associations. In addition to these councils and a national leadership council, condition-specific care management councils have also been established. These councils develop condition-specific protocols and outcome measures and lead the implementation of CPI initiatives at their own clinics. Key resources supporting CPI initiatives include information/knowledge management, education and training, and patient education and consumer decision support. Localized efforts in both the asthma care and diabetes management initiatives have led to some preliminary improvements in quality of care indicators. Physician leadership and strategic vision, CPI-oriented organizational infrastructure, broad-based physician involvement in CPI, providing access to performance data, parallel incentives, and creating a sense of urgency for accelerated change are all critical success factors to the implementation of CPI strategies at the local, regional, and national levels.

Key Performance Indicators in the Evaluation of the Quality of Radiation Safety Programs.

Science.gov (United States)

Schultz, Cheryl Culver; Shaffer, Sheila; Fink-Bennett, Darlene; Winokur, Kay

2016-08-01

Beaumont is a multiple hospital health care system with a centralized radiation safety department. The health system operates under a broad scope Nuclear Regulatory Commission license but also maintains several other limited use NRC licenses in off-site facilities and clinics. The hospital-based program is expansive including diagnostic radiology and nuclear medicine (molecular imaging), interventional radiology, a comprehensive cardiovascular program, multiple forms of radiation therapy (low dose rate brachytherapy, high dose rate brachytherapy, external beam radiotherapy, and gamma knife), and the Research Institute (including basic bench top, human and animal). Each year, in the annual report, data is analyzed and then tracked and trended. While any summary report will, by nature, include items such as the number of pieces of equipment, inspections performed, staff monitored and educated and other similar parameters, not all include an objective review of the quality and effectiveness of the program. Through objective numerical data Beaumont adopted seven key performance indicators. The assertion made is that key performance indicators can be used to establish benchmarks for evaluation and comparison of the effectiveness and quality of radiation safety programs. Based on over a decade of data collection, and adoption of key performance indicators, this paper demonstrates one way to establish objective benchmarking for radiation safety programs in the health care environment.

Performance management when innovation and learning become critical performance indicators

NARCIS (Netherlands)

Molleman, E.; Timmerman, H.

2003-01-01

If the organization's leading performance indicators shift towards innovation and the creation of knowledge, this will result in more non-routine work and a higher level of interdependency among workers. We argue that a contingent performance management (PM) system has to focus on Learning and group

Clinical indicators associated with successful tracheostomy cuff deflation.

Science.gov (United States)

Pryor, Lee N; Ward, Elizabeth C; Cornwell, Petrea L; O'Connor, Stephanie N; Chapman, Marianne J

2016-08-01

Tracheostomy cuff deflation is a necessary stage of the decannulation pathway, yet the optimal clinical indicators to guide successful cuff deflation are unknown. The study aims were to identify (1) the proportion of patients tolerating continuous cuff deflation at first attempt; (2) the clinical observations associated with cuff deflation success or failure, including volume of above cuff secretions and (3) the predictive capacity of these observations within a heterogeneous cohort. A retrospective review of 113 acutely tracheostomised patients with a subglottic suction tube in situ was conducted. Ninety-five percent of patients (n=107) achieved continuous cuff deflation on the first attempt. The clinical observations recorded as present in the 24h preceding cuff deflation included: (1) medical stability, (2) respiratory stability, (3) fraction of inspired oxygen ≤0.4, (4) tracheal suction ≤1-2 hourly, (5) sputum thin and easy to suction, (6) sputum clear or white, (7) ≥moderate cough strength, (8) above cuff secretions ≤1ml per hour and (9) alertness≥eyes open to voice. Using the presence of all 9 indicators as predictors of successful cuff deflation tolerance, specificity and positive predictive value were 100%, although sensitivity was only 77% and negative predictive value 19%. Refinement to a set of 3 clinically driven criteria (medical and respiratory stability, above cuff secretions ≤1ml/h) provided high specificity (100%), sensitivity (95%), positive predictive value (100%) and an improved negative predictive value (55%). Key criteria can help guide clinical decision-making on patient readiness for cuff deflation. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

Identifying key performance indicators for nursing and midwifery care using a consensus approach.

Science.gov (United States)

McCance, Tanya; Telford, Lorna; Wilson, Julie; Macleod, Olive; Dowd, Audrey

2012-04-01

The aim of this study was to gain consensus on key performance indicators that are appropriate and relevant for nursing and midwifery practice in the current policy context. There is continuing demand to demonstrate effectiveness and efficiency in health and social care and to communicate this at boardroom level. Whilst there is substantial literature on the use of clinical indicators and nursing metrics, there is less evidence relating to indicators that reflect the patient experience. A consensus approach was used to identify relevant key performance indicators. A nominal group technique was used comprising two stages: a workshop involving all grades of nursing and midwifery staff in two HSC trusts in Northern Ireland (n = 50); followed by a regional Consensus Conference (n = 80). During the workshop, potential key performance indicators were identified. This was used as the basis for the Consensus Conference, which involved two rounds of consensus. Analysis was based on aggregated scores that were then ranked. Stage one identified 38 potential indicators and stage two prioritised the eight top-ranked indicators as a core set for nursing and midwifery. The relevance and appropriateness of these indicators were confirmed with nurses and midwives working in a range of settings and from the perspective of service users. The eight indicators identified do not conform to the majority of other nursing metrics generally reported in the literature. Furthermore, they are strategically aligned to work on the patient experience and are reflective of the fundamentals of nursing and midwifery practice, with the focus on person-centred care. Nurses and midwives have a significant contribution to make in determining the extent to which these indicators are achieved in practice. Furthermore, measurement of such indicators provides an opportunity to evidence of the unique impact of nursing/midwifery care on the patient experience. © 2011 Blackwell Publishing Ltd.

Taylorism, Tylerism, and Performance Indicators: Defending the Indefensible?

Science.gov (United States)

Helsby, Gill; Saunders, Murray

1993-01-01

Explores the antecedents to the growing interest in the use of educational performance indicators. Discusses this issue in relation to the work of economist F. W. Taylor and evaluator Ralph Tyler. Describes a five-year project that demonstrates the promise of teacher-developed performance indicators. (CFR)

Analysis of architect’s performance indicators in project delivery process

Science.gov (United States)

Marisa, A.

2018-03-01

Architect as a professional in the construction industry should possess a good performance in project delivery process. As a design professional, architect has an important role to ensure that the process is well-conducted by delivering a high-quality product for the clients. Thus, analyzing architect’s performance indicators is crucial in the project delivery process. This study aims to analyze the relative importance of architect performance indicators in project delivery process among registered architects in North Sumatera, Indonesia. A total of five indicators that measure architect performance in project delivery process were identified and 110 completed questionnaires were obtained and used for data analysis. A relative importance index is used to rank the relative importance of architect performance indicators. Results indicate that focus on the clients is the most important indicator of architect performance in project delivery process. This study demonstrates project communication as one of crucial indicators perceived by the architects for measuring their performance, and fills a knowledge gap on the importance of identifying the most important indicator for measuring architect performance from their own perspectives which previous studies have overlooked to improve performance assessment in project delivery process.

[Bibliometrics study on indications of acupuncture therapy based on foreign acupuncture clinical trials].

Science.gov (United States)

He, Wei; Tong, Yuan-Yuan; Zhao, Ying-Kai; Rong, Pei-Jing; Wang, Hong-Cai

2012-10-01

In the present paper, the authors make a bibliometrics study on clinical indications of acupuncture therapy based on the published foreign articles about acupuncture clinical trials collected from PubMed database and Excerpta Medica database (EMbase). In 1996, 64 acupuncture indications were declared by WHO in Milan conference. But in recent 15 years, clinical trials have been conducted extensively in the foreign countries. Till now, 77 new indications for acupuncture therapy have been found in the foreign journals. The authors recommended that 29 indications (knee osteoarthritis, critique age problems, muscular fasciae ache, anxiety, etc.) should be added to the first class, 4 indications (irritable bowel syndrome, malposition, backache, simple obesity) should be upgraded from the second class to the first class, and the other 3 indications (childbirth pain, male and female barren) should be upgraded from the third class to the first class due to their application frequency in clinical trials. Increase of clinical indications reflects extensive application of acupuncture therapy and may help providing a better service for people's health.

Prevalence of Invalid Performance on Baseline Testing for Sport-Related Concussion by Age and Validity Indicator.

Science.gov (United States)

Abeare, Christopher A; Messa, Isabelle; Zuccato, Brandon G; Merker, Bradley; Erdodi, Laszlo

2018-03-12

Estimated base rates of invalid performance on baseline testing (base rates of failure) for the management of sport-related concussion range from 6.1% to 40.0%, depending on the validity indicator used. The instability of this key measure represents a challenge in the clinical interpretation of test results that could undermine the utility of baseline testing. To determine the prevalence of invalid performance on baseline testing and to assess whether the prevalence varies as a function of age and validity indicator. This retrospective, cross-sectional study included data collected between January 1, 2012, and December 31, 2016, from a clinical referral center in the Midwestern United States. Participants included 7897 consecutively tested, equivalently proportioned male and female athletes aged 10 to 21 years, who completed baseline neurocognitive testing for the purpose of concussion management. Baseline assessment was conducted with the Immediate Postconcussion Assessment and Cognitive Testing (ImPACT), a computerized neurocognitive test designed for assessment of concussion. Base rates of failure on published ImPACT validity indicators were compared within and across age groups. Hypotheses were developed after data collection but prior to analyses. Of the 7897 study participants, 4086 (51.7%) were male, mean (SD) age was 14.71 (1.78) years, 7820 (99.0%) were primarily English speaking, and the mean (SD) educational level was 8.79 (1.68) years. The base rate of failure ranged from 6.4% to 47.6% across individual indicators. Most of the sample (55.7%) failed at least 1 of 4 validity indicators. The base rate of failure varied considerably across age groups (117 of 140 [83.6%] for those aged 10 years to 14 of 48 [29.2%] for those aged 21 years), representing a risk ratio of 2.86 (95% CI, 2.60-3.16; P indicator and the age of the examinee. The strong age association, with 3 of 4 participants aged 10 to 12 years failing validity indicators, suggests that the

Constitutive Effects of Performance Indicators

DEFF Research Database (Denmark)

Dahler-Larsen, Peter

2014-01-01

that are demonstrably problematic. Based on a distinction between trivial and advanced measure fixation, an argument is made for constitutive effects that are based on less problematic assumptions. Through this conceptual move, the political dimension of performance indicators is appreciated. The conceptual dimensions...... of constitutive effects are carved out, empirical illustrations of their applicability are offered and implications discussed....

Physiological basis of clinically used coronary hemodynamic indices

NARCIS (Netherlands)

Spaan, Jos A. E.; Piek, Jan J.; Hoffman, Julien I. E.; Siebes, Maria

2006-01-01

In deriving clinically used hemodynamic indices such as fractional flow reserve and coronary flow velocity reserve, simplified models of the coronary circulation are used. In particular, myocardial resistance is assumed to be independent of factors such as heart contraction and driving pressure.

Clinical indications and radiation doses to the conceptus associated with CT imaging in pregnancy: a retrospective study

Energy Technology Data Exchange (ETDEWEB)

Woussen, S.; Vanbeckevoort, D.; Bosmans, H.; Oyen, R. [University Hospitals Leuven, Department of Radiology, Leuven (Belgium); Lopez-Rendon, X.; Zanca, F. [University Hospitals Leuven, Department of Imaging and Pathology, Leuven (Belgium)

2016-04-15

To perform an internal audit at a university hospital with the aim of evaluating the number, clinical indication and operating procedure of computed tomography (CT) performed on pregnant patients and of estimating the radiation doses to the conceptus. A retrospective review was conducted of all CT examinations performed in a single centre on pregnant patients between January 2008 and July 2013. The radiation doses to the conceptus were estimated. The results were compared with published data. The number of CT examinations during pregnancy increased from 3-4 per year in 2008-2011 to 11 per year in 2012. The mean estimated conceptus radiation dose was considered negligible for CT of the head and cervical spine, being less than 0.01 mGy, and for CT of the chest, less than 0.1 mGy. The estimated conceptus radiation dose from abdominopelvic CT was on average 28.7 mGy (range 6.7-60.5 mGy). The number of CT scans of pregnant patients increased threefold during the last few years. Most clinical indications and doses were in line with good clinical practice and literature; only in two cases the dose to the conceptus was higher than 50 mGy. (orig.)

Benefits and limitations in the use of performance indicators

International Nuclear Information System (INIS)

Nobile, M.; Ceccantini, M.

1990-01-01

In the paper, some Caorso NPP performance indicators for 1982 through 1986 are shown according to the definition of the Institute of Nuclear Power Operations (INPO). The comparison of the Caorso NPP performance indicators with those of similar American plants stresses an analogous behaviour for all the indicators but two: (Industrial Safety Lost-Time Accident Rate and Diesel Generator Unavailability), for which there is a very significant difference. A subsequent analysis enhances, however, that this difference cannot be attributed to component performance or personnel management politics, but essentially to design choices and/or to peculiar social and economical context; if these factors are taken into consideration, the difference between the performance indicators of the Caorso plant and those of American plants is explained quite satisfactorily. This demonstrates, that even if the usefulness of the performance indicators is confirmed, a careful analysis of all the possible implications is necessary before reaching any final conclusion

Measuring individual work performance: Identifying and selecting indicators

NARCIS (Netherlands)

Koopmans, L.; Bernaards, C.M.; Hildebrandt, V.H.; de Vet, H.C.W.; van der Beek, A.J.

2014-01-01

BACKGROUND: Theoretically, individual work performance (IWP) can be divided into four dimensions: task performance, contextual performance, adaptive performance, and counterproductive work behavior. However, there is no consensus on the indicators used to measure these dimensions.

Measuring individual work performance: identifying and selecting indicators

NARCIS (Netherlands)

Koopmans, L.; Bernaards, C.M.; Hildebrandt, V.H.; Vet, H.C de; Beek, A.J. van der

2014-01-01

BACKGROUND: Theoretically, individual work performance (IWP) can be divided into four dimensions: task performance, contextual performance, adaptive performance, and counterproductive work behavior. However, there is no consensus on the indicators used to measure these dimensions. OBJECTIVE: This

Translation and adaptation of functional auditory performance indicators (FAPI

Directory of Open Access Journals (Sweden)

Karina Ferreira

2011-12-01

Full Text Available Work with deaf children has gained new attention since the expectation and goal of therapy has expanded to language development and subsequent language learning. Many clinical tests were developed for evaluation of speech sound perception in young children in response to the need for accurate assessment of hearing skills that developed from the use of individual hearing aids or cochlear implants. These tests also allow the evaluation of the rehabilitation program. However, few of these tests are available in Portuguese. Evaluation with the Functional Auditory Performance Indicators (FAPI generates a child's functional auditory skills profile, which lists auditory skills in an integrated and hierarchical order. It has seven hierarchical categories, including sound awareness, meaningful sound, auditory feedback, sound source localizing, auditory discrimination, short-term auditory memory, and linguistic auditory processing. FAPI evaluation allows the therapist to map the child's hearing profile performance, determine the target for increasing the hearing abilities, and develop an effective therapeutic plan. Objective: Since the FAPI is an American test, the inventory was adapted for application in the Brazilian population. Material and Methods: The translation was done following the steps of translation and back translation, and reproducibility was evaluated. Four translated versions (two originals and two back-translated were compared, and revisions were done to ensure language adaptation and grammatical and idiomatic equivalence. Results: The inventory was duly translated and adapted. Conclusion: Further studies about the application of the translated FAPI are necessary to make the test practicable in Brazilian clinical use.

Performance of combined clinical mammography and needle biopsy: a nationwide study from Denmark

DEFF Research Database (Denmark)

Jensen, Allan; Rank, Fritz; Dyreborg, Uffe

2006-01-01

Clinical mammography and needle biopsy are key tools for non-operative assessment of breast lesions. We evaluated the performance of all combined tests undertaken in Denmark in 2000. Clinical mammography and needle biopsy data were collected and linked to final cancer outcome, to determine sensit...... with a suspicious or malignant result indicated a high risk of cancer, and excisional diagnostic biopsy therefore still has an important role to play.......Clinical mammography and needle biopsy are key tools for non-operative assessment of breast lesions. We evaluated the performance of all combined tests undertaken in Denmark in 2000. Clinical mammography and needle biopsy data were collected and linked to final cancer outcome, to determine...

A road safety performance indicator for vehicle fleet compatibility.

Science.gov (United States)

Christoph, Michiel; Vis, Martijn Alexander; Rackliff, Lucy; Stipdonk, Henk

2013-11-01

This paper discusses the development and the application of a safety performance indicator which measures the intrinsic safety of a country's vehicle fleet related to fleet composition. The indicator takes into account both the 'relative severity' of individual collisions between different vehicle types, and the share of those vehicle types within a country's fleet. The relative severity is a measure for the personal damage that can be expected from a collision between two vehicles of any type, relative to that of a collision between passenger cars. It is shown how this number can be calculated using vehicle mass only. A sensitivity analysis is performed to study the dependence of the indicator on parameter values and basic assumptions made. The indicator is easy to apply and satisfies the requirements for appropriate safety performance indicators. It was developed in such a way that it specifically scores the intrinsic safety of a fleet due to its composition, without being influenced by other factors, like helmet wearing. For the sake of simplicity, and since the required data is available throughout Europe, the indicator was applied to the relative share of three of the main vehicle types: passenger cars, heavy goods vehicles and motorcycles. Using the vehicle fleet data from 13EU Member States and Norway, the indicator was used to rank the countries' safety performance. The UK was found to perform best in terms of its fleet composition (value is 1.07), while Greece has the worst performance with the highest indicator value (1.41). Copyright © 2013 Elsevier Ltd. All rights reserved.

Clinical indicators for success of misoprostol treatment after early pregnancy failure.

Science.gov (United States)

Robledo, C; Zhang, J; Troendle, J; Barnhart, K; Creinin, M D; Westhoff, C; Huang, X; Frederick, M

2007-10-01

To identify clinical indicators for success of misoprostol treatment after early pregnancy failure. A total of 473 women with early pregnancy failure received 800 microg of vaginal misoprostol on treatment day 1. At the follow-up visit on day 3, a second dose was given if expulsion was incomplete. On day 8, vacuum aspiration was offered if expulsion had not occurred. Ultrasonography was used as gold standard for success. A Classification and Regression Tree analysis was undertaken to derive two decision trees for the success of misoprostol treatment on study days 3 and 8. Heavy bleeding after the first dose and an open cervical os were identified as clinical indicators of treatment success on day 3. Treatment success occurred in 84% of women with either or both indicators. Reporting passage of tissue after a second misoprostol dose and old blood in the vagina were potential indicators of treatment success or failure on day 8. A woman with either of these indicators has a 65% chance of treatment success after the second dose. Conversely, a woman with neither indicator on day 8 has a 94% chance of treatment failure. Standard clinical findings may be useful as indicators for success or failure of medical management of early pregnancy failure in settings with limited or no access to ultrasonography. More research to identify even better indicators is warranted.

Continued Evaluation of Gear Condition Indicator Performance on Rotorcraft Fleet

Science.gov (United States)

Delgado, Irebert R.; Dempsey, Paula J.; Antolick, Lance J.; Wade, Daniel R.

2013-01-01

This paper details analyses of condition indicator performance for the helicopter nose gearbox within the U.S. Army's Condition-Based Maintenance Program. Ten nose gearbox data sets underwent two specific analyses. A mean condition indicator level analysis was performed where condition indicator performance was based on a 'batting average' measured before and after part replacement. Two specific condition indicators, Diagnostic Algorithm 1 and Sideband Index, were found to perform well for the data sets studied. A condition indicator versus gear wear analysis was also performed, where gear wear photographs and descriptions from Army tear-down analyses were categorized based on ANSI/AGMA 1010-E95 standards. Seven nose gearbox data sets were analyzed and correlated with condition indicators Diagnostic Algorithm 1 and Sideband Index. Both were found to be most responsive to gear wear cases of micropitting and spalling. Input pinion nose gear box condition indicators were found to be more responsive to part replacement during overhaul than their corresponding output gear nose gear box condition indicators.

Safety performance indicators for the road network.

NARCIS (Netherlands)

Weijermars, W. Gitelman, V. Papadimitriou, E. Lima De & Azevedo, C.

2010-01-01

Within the 6th FP European project SafetyNet, a team has worked on the development of Safety Performance Indicators (SPIs) on seven road safety related areas. These SPIs reflect the operational conditions of the road traffic system that influence the system's safety performance. SPIs were developed

Operational safety performance indicators for nuclear power plants

International Nuclear Information System (INIS)

2000-05-01

Since the late 1980s, the IAEA has been actively sponsoring work in the area of indicators to monitor nuclear power plant (NPP) operational safety performance. The early activities were mainly focused on exchanging ideas and good practices in the development and use of these indicators at nuclear power plants. Since 1995 efforts have been directed towards the elaboration of a framework for the establishment of an operational safety performance indicator programme. The result of this work, compiled in this publication, is intended to assist NPPs in developing and implementing a monitoring programme, without overlooking the critical aspects related to operational safety performance. The framework proposed in this report was presented at two IAEA workshops on operational safety performance indicators held in Ljubljana, Slovenia, in September 1998 and at the Daya Bay NPP, Szenzhen, China, in December 1998. During these two workshops, the participants discussed and brainstormed on the indicator framework presented. These working sessions provided very useful insights and ideas which where used for the enhancement of the framework proposed. The IAEA is acknowledging the support and contribution of all the participants in these two activities. The programme development was enhanced by pilot plant studies. Four plants from different countries with different designs participated in this study with the objective of testing the applicability, usefulness and viability of this approach

Mammary radiotherapy and patients-risks management with continue evaluation of clinical indicators

International Nuclear Information System (INIS)

Untereiner, M.; Frederick, B.; Burie, D.; Cavuto, C.; Rob, L.; Coiffier, N.; Colet, M.

2009-01-01

Purpose: The breast irradiation represents 25% of radiotherapy indication in the radiotherapy centers. The modeling of the management of complications risks and recurrences in relation with mammary irradiation constitutes a methodological base allowing to develop a general concept for any other indication of radiotherapy. The objective of the study was a continuous evaluation of clinical risks to get indicators of the therapy results: for the institution, to get an auto-evaluation tool of the functioning (continuous evaluation of clinical results, identification of sentinel events); for the patients to get precise and detailed information on the risks linked to their treatment (communication of clinical results, comparison with the literature, benchmarking). (N.C.)

Human Resources Key Performance Indicators

Directory of Open Access Journals (Sweden)

Gabčanová Iveta

2012-03-01

Full Text Available The article brings out a proposed strategy map and respective key performance indicators (KPIs in human resources (HR. The article provides an overview of how HR activities are supported in order to reach the partial goals of HR as defined in the strategic map. Overall the aim of the paper is to show the possibilities of using the modern Balanced Scorecard method in human capital.

Analysis of ESG indicators for measuring enterprise performance

Directory of Open Access Journals (Sweden)

Zuzana Chvátalová

2013-01-01

Full Text Available In this article authors focus on the analysis of the whole set of environmental, social and corporate governance (ESG indicators for the elimination of double or triple effects within the next construction of methods for measuring corporate performance. They build on their previously published results (in Acta univ. agric. et silvic. Mendel. Brun., 2012. The partial actual selected results of a recently undertaken currently project entitled ‘Construction of Methods for Multifactorial Assessment of Company Complex Performance in Selected Sectors’ were used. This project was solved the research teams of the Faculty of Business and Management of Brno University Technology and Faculty of Business and Economics of Mendel University in Brno since 2011. Further theoretical resources in the environmental, social and corporate governance area, known indicator databases (namely Global Reporting Initiative, comparative analysis, resp. syntheses for identifying possible of common indicator properties were identified to classify indicator subsets to preclude double or even triple effect based on mathematical set theory (Venn diagrams. The indicator analysis in constructed multi-factorial methods contributes to precise decision making in management to improve corporate performance.

ROLE AND IMPORTANCE OF KEY PERFORMANCE INDICATORS MEASUREMENT

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Rade Stanković

2011-03-01

Full Text Available Key performance indicators are financial and non financial indicators that organizations use inorder to estimate and fortify how successful they are, aiming previously established long lastinggoals. Appropriate selection of indicators that will be used for measuring is of a greatest importance.Process organization of business is necessary to be constitute in order to realize such effective andefficient system or performance measuring via KPI. Process organization also implies customerorientation and necessary flexibility in nowadays condition of global competition.Explanation of process organization, the way of KPI selection, and practical example of KPImeasuring in Toyota dealerships are presented in this paper.

Numerical indicators of nuclear power plant safety performance

International Nuclear Information System (INIS)

1991-04-01

The workshop was attended by representatives from twenty-two Member States operating nuclear power plants (NPP). The current status of the development and use of numerical indicators of NPP safety performance was presented. A consensus on the benefits of use of numerical indicators was reached. The Technical Committee Meeting reviewed the progress in the development and use of performance indicators and identified them as the most appropriate ones for international use. The purpose of this document is to summarize the discussions held and conclusions reached in both meetings. Lists of participants and all the papers of both meetings are presented

Clinical, physical and lifestyle indicators and relationship with cognition and mood in aging: a cross-sectional analysis of distinct educational groups

Directory of Open Access Journals (Sweden)

Nadine Correia Santos

2014-02-01

Full Text Available It is relevant to unravel the factors that may mediate the cognitive decline observed during aging. Previous reports indicate that education has a positive influence on cognitive performance, while age, female gender and, especially, depressed mood were associated with poorer performances across multiple cognitive dimensions (memory and general executive function. Herein, the present study aimed to characterize the cognitive performance of community-dwelling individuals within distinct educational groups categorized by the number of completed formal school years: less than 4, 4, completed primary education, and more than 4. Participants (n = 1051 were randomly selected from local health registries and representative of the Portuguese population for age and gender. Neurocognitive and clinical assessments were conducted in local health care centers. Structural equation modeling was used to derive a cognitive score, and hierarchical linear regressions were conducted for each educational group. Education, age and depressed mood were significant variables in directly explaining the obtained cognitive score, while gender was found to be an indirect variable. In all educational groups, mood was the most significant factor with effect on cognitive performance. Specifically, a depressed mood led to lower cognitive performance. The clinical disease indices cardiac and stroke associated with a more negative mood, while moderate increases in BMI, alcohol consumption and physical activity associated positively with improved mood and thus benefitted cognitive performance. Results warrant further research on the cause-effect (longitudinal relationship between clinical indices of disease and risk factors and mood and cognition throughout aging.

The system of clinical indicators for patients with essential hypertension

Directory of Open Access Journals (Sweden)

Posnenkova O.M.

2016-09-01

Full Text Available An article reviews the current measures for assessment the quality of treatment in patients with essential hypertension. The system of indicators intended for clinical audit of hypertension diagnosis and treatment process in primary care is presented. For each indicator definition and estimation procedure is given.

Participation rate or informed choice? Rethinking the European key performance indicators for mammography screening.

Science.gov (United States)

Strech, Daniel

2014-03-01

Despite the intensive controversies about the likelihood of benefits and harms of mammography screening almost all experts conclude that the choice to screen or not to screen needs to be made by the individual patient who is adequately informed. However, the "European guideline for quality assurance in breast cancer screening and diagnosis" specifies a participation rate of 70% as the key performance indicator for mammography screening. This paper argues that neither the existing evidence on benefits and harms, nor survey research with women, nor compliance rates in clinical trials, nor cost-effectiveness ratios justify participation rates as a reasonable performance indicator for preference-sensitive condition such as mammography screening. In contrast, an informed choice rate would be more reasonable. Further research needs to address the practical challenges in assessing informed choice rates. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Performance indicator of a bridge expansion joint

NARCIS (Netherlands)

Kalkman, I.M.; Lentzen, S.S.K.; Courage, W.M.G.; Napoles, O.M.; Galanti, F.M.B.

2011-01-01

In general the condition of a structure can be assessed in terms of a performance indicator. For example, this can be the strength of a structure. An asset manager is concerned with ensuring that the performance of a structure does not fall below a given minimum level. This can be achieved by

Process-oriented performance indicators for measuring ecodesign management practices

DEFF Research Database (Denmark)

Rodrigues, Vinicius Picanco; Pigosso, Daniela Cristina Antelmi; McAloone, Tim C.

2016-01-01

In order to support ecodesign performance measurement from a business perspective, this paper performs an exploration of available process-oriented indicators to be applied to ecodesign management practices. With the Ecodesign Maturity Model as a background framework, a systematic literature review...... coupled with a cross-content analysis was carried out to assign proper indicators to the practices. Results show that the currently available indicators do not fully reflect the characteristics of ecodesign and there is significant room for improving the development of tailor-made indicators....

Safety assessment, safety performance indicators at the Paks Nuclear Power Plant

International Nuclear Information System (INIS)

Baji, C.; Vamos, G.; Toth, J.

2001-01-01

The Paks Nuclear Power Plant has been using different methods of safety assessment (event analysis, self-assessment, probabilistic safety analysis), including performance indicators characterizing both operational and safety performance since the early years of operation of the plant. Regarding the safety performance, the indicators include safety system performance, number of scrams, release of radioactive materials, number of safety significant events, industrial safety indicator, etc. The Paks NPP also reports a set of ten indicators to WANO Performance Indicator Programme which, among others, include safety related indicators as well. However, a more systematic approach to structuring and trending safety indicators is needed so that they can contribute to the enhancement of the operational safety. A more comprehensive set of indicators and a systematic evaluation process was introduced in 1996. The performance indicators framework proposed by the IAEA was adapted to Paks in this year to further improve the process. Safety culture assessment and characterizing safety culture is part of the assessment process. (author)

Clinical performance of ART restorations in primary teeth: a survival analysis.

Science.gov (United States)

Faccin, Elise Sasso; Ferreira, Simone Helena; Kramer, Paulo Floriani; Ardenghi, Thiago Machado; Feldens, Carlos Alberto

2009-01-01

To assess the survival of Atraumatic Restorative Treatment (ART) restorations in primary teeth performed in a dental clinical setting. One hundred and five single-surface ART restorations placed in 56 preschool children (mean age 31 months) were included. Final-year dental students performed the restorations using standard ART procedures with hand instruments. A resin-modified glass ionomer cement (Vitremer 3M/ESPE) was used as a restorative material. Performances of the restorations were assessed directly by the ART evaluation criteria. Follow-up period ranged from 6 to 48 months. Survival estimates for restoration longevity were evaluated using the Kaplan-Meier method. Log-rank test (P ART restorations were 89%, 85% and 72% in 6 to 11, 12 to 24 and 25 to 48 months of evaluation respectively. Differences in success rates among demographic and clinical characteristics were not statistically significant. High survivals rates of the ART restorations found in this study seem to indicate the reliability of this approach as an appropriate treatment option for primary teeth in a clinical setting.

Validation of risk-based performance indicators: Safety system function trends

International Nuclear Information System (INIS)

Boccio, J.L.; Vesely, W.E.; Azarm, M.A.; Carbonaro, J.F.; Usher, J.L.; Oden, N.

1989-10-01

This report describes and applies a process for validating a model for a risk-based performance indicator. The purpose of the risk-based indicator evaluated, Safety System Function Trend (SSFT), is to monitor the unavailability of selected safety systems. Interim validation of this indicator is based on three aspects: a theoretical basis, an empirical basis relying on statistical correlations, and case studies employing 25 plant years of historical data collected from five plants for a number of safety systems. Results using the SSFT model are encouraging. Application of the model through case studies dealing with the performance of important safety systems shows that statistically significant trends in, and levels of, system performance can be discerned which thereby can provide leading indications of degrading and/or improving performances. Methods for developing system performance tolerance bounds are discussed and applied to aid in the interpretation of the trends in this risk-based indicator. Some additional characteristics of the SSFT indicator, learned through the data-collection efforts and subsequent data analyses performed, are also discussed. The usefulness and practicality of other data sources for validation purposes are explored. Further validation of this indicator is noted. Also, additional research is underway in developing a more detailed estimator of system unavailability. 9 refs., 18 figs., 5 tabs

Indicator-based systems of performance management in the National Health Service: a comparison of the perceptions of local- and national-level managers.

Science.gov (United States)

Jones, G T

2000-02-01

Historically, the UK Government has policed the use of National Health Service (NHS) resources through the centralization of control. With the majority of resource-draining decisions being taken by clinicians, however, professional financial accountability is becoming more important within the NHS management structure. Variations in clinical performance can be monitored through the use of performance indicators, although these are not without their problems. The use of league tables of such indicators in the national press is now infamous and there is much anecdotal evidence about the intraorganizational conflict arising from the use of such tables. A questionnaire survey and interview study of clinical directors, clinical service directors and business managers in several Scottish NHS Trusts was undertaken to ascertain the perceptions of local-level managers on the issue of performance indicators. Interviews were also carried out with a number of personnel in the Scottish Office Department of Economics and Information, the Division of Health Gain and the Finance Directorate. This paper explores the differences between the perceptions of the managers at these two levels of the NHS with regards to issues of performance measurement, intraorganizational conflict and corporate vision.

Operational safety performance indicator system at the Dukovany Nuclear Power Plant - Experience with indicator aggregation

International Nuclear Information System (INIS)

Mandula, J.

2001-01-01

The operational safety performance indicators serve as an important tool of performance monitoring and management at the Dukovany NPP. A software-supported system has been developed, which has included: data collection, central data storage, graphic output production and periodical report generation. Analyses of performance indicator trends together with evaluation in respect of annually updated target values and acceptance criteria are used for operational safety reviews forming an integral part of continual self-assessment process. This contribution has been focused on experience obtained during development of the operational safety assessment model using indicator aggregation. It summarises problems that had to be paid specific attention in the development process. Thanks to their solution, the model has become a synoptic monitor and a useful tool for operational safety assessment. (author)

Performance indicators for rinderpest surveillance

Energy Technology Data Exchange (ETDEWEB)

NONE

2001-12-01

In 1986, the Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture initiated a programme of assistance to FAO and IAEA Member States for the development of effective, quality assured veterinary laboratory diagnostic services. This programme introduced the use of standardized and internationally validated ELISA-based systems for the diagnosis and surveillance of the major transboundary diseases that affect livestock. This approach has proved of immense value in the monitoring of national, regional and global animal disease control and eradication programmes. One such programme focuses on the global elimination of rinderpest. Co-ordinated by FAO through the Global Rinderpest Eradication Programme (GREP) the joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture has developed critical diagnostic and epidemiological tools to assist this effort. As the final stages of the global eradication of rinderpest are reached, it is fitting that the Joint Division should again take the lead in providing guidance to Member States on how best to meet the criteria for quality assurance of national disease surveillance programmes - a prerequisite for international acceptance of freedom from a particular disease. This publication is intended to provide countries involved in rinderpest eradication with a detailed protocol for using performance indicators in evaluating their disease surveillance system and making, where necessary, adjustments to meet the criteria for acceptance specified in the OIE Rinderpest Pathway - a pathway that leads to international recognition of freedom from rinderpest. An initial publication (IAEA-TECDOC-1161) described guidelines for the use of performance indicators in rinderpest surveillance programmes. This publication now describes in detail the protocols and the linked indicators which have been developed and field validated through a series of FAO/IAEA meetings and through IAEA expert assignments to countries in Africa.

Performance indicators for rinderpest surveillance

International Nuclear Information System (INIS)

2001-12-01

In 1986, the Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture initiated a programme of assistance to FAO and IAEA Member States for the development of effective, quality assured veterinary laboratory diagnostic services. This programme introduced the use of standardized and internationally validated ELISA-based systems for the diagnosis and surveillance of the major transboundary diseases that affect livestock. This approach has proved of immense value in the monitoring of national, regional and global animal disease control and eradication programmes. One such programme focuses on the global elimination of rinderpest. Co-ordinated by FAO through the Global Rinderpest Eradication Programme (GREP) the joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture has developed critical diagnostic and epidemiological tools to assist this effort. As the final stages of the global eradication of rinderpest are reached, it is fitting that the Joint Division should again take the lead in providing guidance to Member States on how best to meet the criteria for quality assurance of national disease surveillance programmes - a prerequisite for international acceptance of freedom from a particular disease. This publication is intended to provide countries involved in rinderpest eradication with a detailed protocol for using performance indicators in evaluating their disease surveillance system and making, where necessary, adjustments to meet the criteria for acceptance specified in the OIE Rinderpest Pathway - a pathway that leads to international recognition of freedom from rinderpest. An initial publication (IAEA-TECDOC-1161) described guidelines for the use of performance indicators in rinderpest surveillance programmes. This publication now describes in detail the protocols and the linked indicators which have been developed and field validated through a series of FAO/IAEA meetings and through IAEA expert assignments to countries in Africa

System of performance indicators for SMEs, metalworking sector

Directory of Open Access Journals (Sweden)

Cristina Viteri Sánchez

2014-03-01

Full Text Available (Received: 2013/03/05 - Accepted: 2013/03/25This paper focused on the design and proposal of management indicators for small and medium metalworking enterprises (SMEs in Quito. Metalworking number was established for the study. It was met and determined which areas deserve to be constantly monitored, by analyzing the performance of the companies, for this purpose, it was used a SWOT analysis, interviews and meetings with company managers , the results demanded the approach of a generic strategy, which included the formulation of the mission , vision and corporate values. Objectives and goals were established, they were classified according to the four perspectives of the Balanced Scorecard. Then it was possible to identify indicators to measure the proper functioning of the strategy proposed. 10 indicators of management were developed, according to the analysis of the reality of metalworking enterprises. So it was determined 3 financial indicators, 2 indicators focused on customers, 3 indicators for monitor internal business processes and 2 addressed the prospect of learning and growth. The use of these indicators is the key of performance and process control in each metalworking company.

Appraisal of key performance indicators on road infrastructure ...

African Journals Online (AJOL)

As Public-Private Partnerships (PPPs) are being practiced in most parts of the world, the need to adopt a system mechanism to evaluate the performance is imperative. The paper evaluates sustainable key performance indicators (KPIs) with a view to appreciating times of improved performance or otherwise. Eleven ...

Peer groups and operational cycle enhancements to the performance indicator report

International Nuclear Information System (INIS)

Stromberg, H.M.; DeHaan, M.S.; Gentillon, C.D.; Wilson, G.E.; Vanden Heuvel, L.N.

1992-01-01

Accurate performance evaluation and plant trending by the performance indicator program are integral parts of monitoring the operation of commercial nuclear power plants. The presentations of the NRC/AEOD performance indicator program have undergone a number of enhancements. The diversity of the commercial nuclear plants, coupled with continued improvements in the performance indicator program, has resulted in the evaluation of plants in logical peer groups and highlighted the need to evaluate the impact of plant operational conditions on the performance indicators. These enhancements allow a more-meaningful evaluation of operating commercial nuclear power plant performance. This report proposes methods to enhance the presentation of the performance indicator data by analyzing the data in logical peer groups and displaying the performance indicator data based on the operational status of the plants. Previously, preliminary development of the operational cycle displays of the performance indicator data was documented. This report extends the earlier findings and presents the continued development of the peer groups and operational cycle trend and deviation data and displays. This report describes the peer groups and enhanced PI data presentations by considering the operational cycle phase breakdowns, calculation methods, and presentation methods

Developments in IVF warrant the adoption of new performance indicators for ART clinics, but do not justify the abandonment of patient-centred measures.

Science.gov (United States)

Wilkinson, J; Roberts, S A; Vail, A

2017-06-01

Recent advances in embryo freezing technology together with growing concerns over multiple births have shifted the paradigm of appropriate IVF. This has led to the adoption of new performance indicators for ART clinics by national reporting schemes, such as those curated by the Society for Assisted Reproductive Technology (SART) and the Human Fertilization and Embryology Authority (HFEA). Using these organizations as case studies, we review several outcome measures from a statistical perspective. We describe several denominators that are used to calculate live birth rates. These include cumulative birth rates calculated from all fresh and frozen transfer procedures arising from a particular egg collection or cycle initiation, and live birth rates calculated per embryo transferred. Using data from both schemes, we argue that all cycles should be included in the denominator, regardless of whether or not egg collection and fertilization were successful. Excluding cancelled cycles reduces the impact of confounding due to patient characteristics but also removes policy and performance differences which we argue represent relevant sources of variation. It may be misleading to present prospective patients with essentially hypothetical measures of performance predicated on parity of ovarian stimulation and transfer policies. Although live birth per embryo has the advantage of encouraging single embryo transfer, we argue that it is prone to misinterpretation. This is because the likelihood of live birth is not proportional to the number of embryos transferred. We conclude that it is not possible to present a single measure that encompasses both effectiveness and safety. Instead, we propose that a set of clear, relevant outcome indicators is necessary to enable subfertile patients to make informed choices regarding whether and where to be treated. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology

Clinical Features Indicating Nigrostriatal Dopaminergic Degeneration in Drug-Induced Parkinsonism

Directory of Open Access Journals (Sweden)

Seung Ha Lee

2017-01-01

Full Text Available Objective Patients with drug-induced parkinsonism (DIP may have nigrostriatal dopaminergic degeneration. We studied the clinical features that may indicate nigrostriatal dopaminergic degeneration in patients with DIP. Methods Forty-one DIP patients were classified into normal and abnormal [18F] FP-CIT scan groups. Differences in 32 clinical features and drug withdrawal effects were studied. Results Twenty-eight patients had normal (Group I and 13 patients had abnormal (Group II scans. Eight patients of Group I, but none of Group II, had taken calcium channel blockers (p = 0.040. Three patients of Group I and six of Group II had hyposmia (p = 0.018. After drug withdrawal, Group I showed greater improvement in Unified Parkinson’s Disease Rating Scale total motor scores and subscores for bradykinesia and tremors than Group II. Only hyposmia was an independent factor associated with abnormal scans, but it had suboptimal sensitivity. Conclusion None of the clinical features were practical indicators of nigrostriatal dopaminergic degeneration in patients with DIP.

Facilities Performance Indicators Report, 2006-07

Science.gov (United States)

Glazner, Steve, Ed.

2008-01-01

The "Facilities Performance Indicators Survey" ("FPI") supersedes and builds upon the two major surveys APPA conducted in the past: the Comparative Costs and Staffing (CCAS) survey and the Strategic Assessment Model (SAM). The "FPI" covers all the materials collected in CCAS and SAM, along with some select new data points and improved survey…

Do "Virtual" and "Outpatient" Public Health Tuberculosis Clinics Perform Equally Well? A Program-Wide Evaluation in Alberta, Canada.

Directory of Open Access Journals (Sweden)

Richard Long

Full Text Available Meeting the challenge of tuberculosis (TB elimination will require adopting new models of delivering patient-centered care customized to diverse settings and contexts. In areas of low incidence with cases spread out across jurisdictions and large geographic areas, a "virtual" model is attractive. However, whether "virtual" clinics and telemedicine deliver the same outcomes as face-to-face encounters in general and within the sphere of public health in particular, is unknown. This evidence is generated here by analyzing outcomes between the "virtual" and "outpatient" public health TB clinics in Alberta, a province of Western Canada with a large geographic area and relatively small population.In response to the challenge of delivering equitable TB services over long distances and to hard to reach communities, Alberta established three public health clinics for the delivery of its program: two outpatient serving major metropolitan areas, and one virtual serving mainly rural areas. The virtual clinic receives paper-based or electronic referrals and generates directives which are acted upon by local providers. Clinics are staffed by dedicated public health nurses and university-based TB physicians. Performance of the two types of clinics is compared between the years 2008 and 2012 using 16 case management and treatment outcome indicators and 12 contact management indicators.In the outpatient and virtual clinics, respectively, 691 and 150 cases and their contacts were managed. Individually and together both types of clinics met most performance targets. Compared to outpatient clinics, virtual clinic performance was comparable, superior and inferior in 22, 3, and 3 indicators, respectively.Outpatient and virtual public health TB clinics perform equally well. In low incidence settings a combination of the two clinic types has the potential to address issues around equitable service delivery and declining expertise.

PERFORMANCE INDICATORS APPLIED TO BRAZILIAN PRIVATE EDUCATIONAL INSTITUTIONS

Directory of Open Access Journals (Sweden)

Átila de Melo Lira

2015-06-01

Full Text Available Initially focused on for-profit companies the Balance Scorecard (BSC has been adopted by many organizations with different objectives, such as higher education institutions (HEIs. However, it is not clear if the adoption of the BSC model is appropriate, or yet is hard to perceive how HEIs have modified and implemented this tool for evaluating educational institutions, public or privates, in Brazil. This study aims to fill the gap existent in the context of using the BSC in organizations. We intend to demonstrate how these organizations use performance indicators to measure their primary activities. A quantitative and exploratory study was developed from the analysis of performance indicators found in the web sites to Brazilian universities. A total of 91 Brazilian private universities evaluation process were reviewed. Even with a considerable amount of private HEIs there are few that have performance indicators guided by numerical and statistical data covering its main activities which is a concern for their managers in terms of managerial control.

SYSTEM OF PERFORMANCE INDICATORS FOR THE STUDENT CENTRED EDUCATION

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Roșca Remus Dorel

2015-07-01

Full Text Available The higher education system in Romania is facing a number of challenges coming from its external and internal environment, challenges which threaten even its very own survival. The significant decrease in the number of high school graduates, the increasing disengagement of the new generations towards the idea of study, the marketing myopia that has characterised the university management act are just a few of the challenges that compel the responsible policymakers to adopt a new management philosophy, a philosophy which has as central point the student centred education paradigm (SCE. For operationalizing this philosophy in the current practice of Romanian universities, it is necessary to develop and use a system of performance indicators for the student-centred education (SPISCE. This system would have the purpose: to monitor the performances obtained in time by the higher education institution (HEI, allowing their comparison with those of other competing institutions; to allow the identification of areas where a significant improvement in SCE is needed; to facilitate the establishment of a client oriented marketing strategy within the institution; to create a favourable framework for promoting an organizational culture specific to SCE among teaching staff members and to redesign their rewards system, taking into account their performances in practicing the SCE. We will conceive the SPISCE starting from the process model, resulting three major categories: input-specific performance indicators, process-specific performance indicators and output-specific performance indicators. The academic year pass rate, the retention rate, the number of graduates who continue with master studies, lifetime value are just a few examples of such indicators. Measuring them will help the management team of a university to understand the supremacy of relational marketing compared to the transactional one, the importance of holding on to students and not just

Key performance indicators in hospital based on balanced scorecard model

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Hamed Rahimi

2017-01-01

Full Text Available Introduction: Performance measurement is receiving increasing verification all over the world. Nowadays in a lot of organizations, irrespective of their type or size, performance evaluation is the main concern and a key issue for top administrators. The purpose of this study is to organize suitable key performance indicators (KPIs for hospitals’ performance evaluation based on the balanced scorecard (BSC. Method: This is a mixed method study. In order to identify the hospital’s performance indicators (HPI, first related literature was reviewed and then the experts’ panel and Delphi method were used. In this study, two rounds were needed for the desired level of consensus. The experts rated the importance of the indicators, on a five-point Likert scale. In the consensus calculation, the consensus percentage was calculated by classifying the values 1-3 as not important (0 and 4-5 to (1 as important. Simple additive weighting technique was used to rank the indicators and select hospital’s KPIs. The data were analyzed by Excel 2010 software. Results: About 218 indicators were obtained from a review of selected literature. Through internal expert panel, 77 indicators were selected. Finally, 22 were selected for KPIs of hospitals. Ten indicators were selected in internal process perspective and 5, 4, and 3 indicators in finance, learning and growth, and customer, respectively. Conclusion: This model can be a useful tool for evaluating and comparing the performance of hospitals. However, this model is flexible and can be adjusted according to differences in the target hospitals. This study can be beneficial for hospital administrators and it can help them to change their perspective about performance evaluation.

Noncredible cognitive performance at clinical evaluation of adult ADHD: An embedded validity indicator in a visuospatial working memory test.

Science.gov (United States)

Fuermaier, Anselm B M; Tucha, Oliver; Koerts, Janneke; Lange, Klaus W; Weisbrod, Matthias; Aschenbrenner, Steffen; Tucha, Lara

2017-12-01

The assessment of performance validity is an essential part of the neuropsychological evaluation of adults with attention-deficit/hyperactivity disorder (ADHD). Most available tools, however, are inaccurate regarding the identification of noncredible performance. This study describes the development of a visuospatial working memory test, including a validity indicator for noncredible cognitive performance of adults with ADHD. Visuospatial working memory of adults with ADHD (n = 48) was first compared to the test performance of healthy individuals (n = 48). Furthermore, a simulation design was performed including 252 individuals who were randomly assigned to either a control group (n = 48) or to 1 of 3 simulation groups who were requested to feign ADHD (n = 204). Additional samples of 27 adults with ADHD and 69 instructed simulators were included to cross-validate findings from the first samples. Adults with ADHD showed impaired visuospatial working memory performance of medium size as compared to healthy individuals. Simulation groups committed significantly more errors and had shorter response times as compared to patients with ADHD. Moreover, binary logistic regression analysis was carried out to derive a validity index that optimally differentiates between true and feigned ADHD. ROC analysis demonstrated high classification rates of the validity index, as shown in excellent specificity (95.8%) and adequate sensitivity (60.3%). The visuospatial working memory test as presented in this study therefore appears sensitive in indicating cognitive impairment of adults with ADHD. Furthermore, the embedded validity index revealed promising results concerning the detection of noncredible cognitive performance of adults with ADHD. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Establishing reliability of performance indicator of sepak takraw ...

African Journals Online (AJOL)

The aim of this study is to establish the necessary reliability in the notational analysis of sepak takraw. Two performance analysts were recruited to help in the collection of the data. The performances were analyzed based on the main performance indicators relevant to the demand of the game. Cronbach's alpha and ...

A multidisciplinary three-phase approach to improve the clinical utility of patient safety indicators.

Science.gov (United States)

Najjar, Peter; Kachalia, Allen; Sutherland, Tori; Beloff, Jennifer; David-Kasdan, Jo Ann; Bates, David W; Urman, Richard D

2015-01-01

The AHRQ Patient Safety Indicators (PSIs) are used for calculation of risk-adjusted postoperative rates for adverse events. The payers and quality consortiums are increasingly requiring public reporting of hospital performance on these metrics. We discuss processes designed to improve the accuracy and clinical utility of PSI reporting in practice. The study was conducted at a 793-bed tertiary care academic medical center where PSI processes have been aggressively implemented to track patient safety events at discharge. A three-phased approach to improving administrative data quality was implemented. The initiative consisted of clinical review of all PSIs, documentation improvement, and provider outreach including active querying for patient safety events. This multidisciplinary effort to develop a streamlined process for PSI calculation reduced the reporting of miscoded PSIs and increased the clinical utility of PSI monitoring. Over 4 quarters, 4 of 41 (10%) PSI-11 and 9 of 138 (7%) PSI-15 errors were identified on review of clinical documentation and appropriate adjustments were made. A multidisciplinary, phased approach leveraging existing billing infrastructure for robust metric coding, ongoing clinical review, and frontline provider outreach is a novel and effective way to reduce the reporting of false-positive outcomes and improve the clinical utility of PSIs.

Sentinel lymph node biopsy is indicated for patients with thick clinically lymph node-negative melanoma.

Science.gov (United States)

Yamamoto, Maki; Fisher, Kate J; Wong, Joyce Y; Koscso, Jonathan M; Konstantinovic, Monique A; Govsyeyev, Nicholas; Messina, Jane L; Sarnaik, Amod A; Cruse, C Wayne; Gonzalez, Ricardo J; Sondak, Vernon K; Zager, Jonathan S

2015-05-15

Sentinel lymph node biopsy (SLNB) is indicated for the staging of clinically lymph node-negative melanoma of intermediate thickness, but its use is controversial in patients with thick melanoma. From 2002 to 2012, patients with melanoma measuring ≥4 mm in thickness were evaluated at a single institution. Associations between survival and clinicopathologic characteristics were explored. Of 571 patients with melanomas measuring ≥4 mm in thickness and no distant metastases, the median age was 66 years and 401 patients (70.2%) were male. The median Breslow thickness was 6.2 mm; the predominant subtype was nodular (45.4%). SLNB was performed in 412 patients (72%) whereas 46 patients (8.1%) presented with clinically lymph node-positive disease and 113 patients (20%) did not undergo SLNB. A positive SLN was found in 161 of 412 patients (39.1%). For SLNB performed at the study institution, 14 patients with a negative SLNB developed disease recurrence in the mapped lymph node basin (false-negative rate, 12.3%). The median disease-specific survival (DSS), overall survival (OS), and recurrence-free survival (RFS) for the entire cohort were 62.1 months, 42.5 months, and 21.2 months, respectively. The DSS and OS for patients with a negative SLNB were 82.4 months and 53.4 months, respectively; 41.2 months and 34.7 months, respectively, for patients with positive SLNB; and 26.8 months and 22 months, respectively, for patients with clinically lymph node-positive disease (Pthick melanoma and a negative SLNB appear to have significantly prolonged RFS, DSS, and OS compared with those with a positive SLNB. Therefore, SLNB should be considered as indicated for patients with thick, clinically lymph node-negative melanoma. © 2015 American Cancer Society.

Construction of corporate social performance indicators for Czech manufacturing industry

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Marie Dočekalová

2013-01-01

Full Text Available This article aims to map out the level of social performance measurement of Czech companies, i.e. what social performance indicators companies monitor and what information they provide to their stakeholders and to construct alternative corporate social performance indicators. Based on an analysis of 24 corporate voluntary reports and results of an empirical research performed among 79 large companies operating in the manufacturing industry, it was found that companies partially monitor their social performance, but from the perspective of international standards (e.g. Global Reporting Initiative, International Federation of Accountants it is still insufficient. Czech companies usually provide only absolute numbers which disguise real trends and do not allow year on year comparison or comparison with other companies. Czech companies should provide a comprehensive picture of their overall performance, they should not focus only on financial indicators based on accounting data, since it is known that the performance measurement based only on financial and economic performance does not lead to long-term success and sustainability of organizations. Companies should monitor more their impact on society within which they operate. Proposed corporate social performance indicators in a measurable and thus manageable way express social issues.

20 CFR 641.710 - How are the performance indicators defined?

Science.gov (United States)

2010-04-01

... customer satisfaction surveys administered to each of these three customer groups. The Department will... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false How are the performance indicators defined... § 641.710 How are the performance indicators defined? (a) The core indicators are defined as follows: (1...

Facilities Performance Indicators Report 2012-13: Tracking Your Facilities Vital Signs

Science.gov (United States)

APPA: Association of Higher Education Facilities Officers, 2014

2014-01-01

This paper features an expanded Web-based "Facilities Performance Indicators (FPI) Report." The purpose of APPA's Facilities Performance Indicators is to provide a representative set of statistics about facilities in educational institutions. "The Facilities Performance Indicators Report" is designed for survey…

Performance Indicators for Online Geography in Secondary Education

NARCIS (Netherlands)

van Diepen, P.; Bredeweg, B.; Bosse, T.; Bredeweg, B.

2016-01-01

There is little consensus about what variables extracted from learner data are the most reliable indicators of learning performance. The aim of this study was to determine those indicators by taking a wide range of variables into consideration concerning overall learning activity and content

Designing environmental performance indicators (EPIs) for eco-efficiency

International Nuclear Information System (INIS)

Campbell, B.

1997-01-01

Environmental performance indicators (EPI) were discussed and a method by which companies can design indicators to help measure their progress toward greater eco-efficiency was presented. EPIs are quantitative measures of environmental performance. EPIs can measure one attribute, such as effluent released to water, or they can be a complex index. EPIs track impacts on the environment and provide information for decision making. The need for more eco-efficient companies, i.e. companies that produce useful goods and services while reducing their consumption of resources and while making efforts to reduce pollution, was emphasized

Engineering performance indicators in support of corporate goals and objectives

International Nuclear Information System (INIS)

Prawlocki, F.C.; Holland, M.B.

1992-01-01

In the late 1980s, a new factor was introduced into the equation of rate making: competition. Prior to this time, most utilities only had to prove to the state public service commission (PSC) that a rate increase was justified. Even this had become more difficult in recent years as PSCs implemented prudency audits as a means of determining the efficiency of utility management. Recently, however, the need for performance improvement has been initiated internally by utility management because of the advent of competition in the utility environment and state PSC inquiries. In 1991, TVA began to realign its traditional program of performance indicators to agree with industry standards and provide more extensive indicators of positive and negative trends in performance. The INPO Guideline 88-016, Guidelines for the Conduct of Design Engineering, was used as the basis for most indicators. In addition, indicators were added to highlight specific corporate objectives, problems, or regulatory commitments. The indicators are being initiated in three phases as efficient sources of performance data are identified. Once the current baseline was established, a review was made of the best utilities in the country based on the US Nuclear Regulatory Commission's systematic assessment of licensee's performance and INPO performance indicators to establish performance goals. As total quality management and cycle time reduction programs are implemented, all of the organization's annual goals and objectives are expected to more closely reflect the best of the industry

An aggregated energy security performance indicator

International Nuclear Information System (INIS)

Martchamadol, Jutamanee; Kumar, S.

2013-01-01

Highlights: ► AESPI shows a country’s (or province’s) energy security status. ► AESPI considers social, economic and environmental aspects using 25 indicators. ► AESPI shows the impact of the trend of energy policies/measures. ► AESPI could be a tool for monitoring and evaluating the impact of energy policies. -- Abstract: An “Aggregated Energy Security Performance Indicator (AESPI)” has been developed by considering 25 individual indicators representing social, economy and environmental dimensions. The principle used, data required and the methodology for the development of AESPI have been detailed. AESPI requires time series data for its development and its value ranges from 0 to 10. The characteristics of AESPI have been compared with the existing indicators in terms of methodology, data requirements, analysis possible and the applications. The advantages of AESPI is that it not only assists in knowing the past energy security status of a country, but also helps in assessing the future status considering the energy policies and plans of the country, thus enabling the monitoring of the impacts of the policies.

Improving engineering performance by utilizing process indicators

International Nuclear Information System (INIS)

Roberts, T.E.

1992-01-01

The purpose of the work discussed in this paper was to develop engineering performance indicators used to facilitate improvement to the technical quality, cost-effectiveness, and delivery of engineering products and service. This work was specifically tailored for engineering support products and service associated with operating Florida Power and Light Company (FP and L) nuclear plants. The engineering process for the development of plant change packages was reviewed to identify critical in-process activities. Because each engineering project usually deals with a specific component or plant system, the different tasks are usually technically unique and of varying magnitudes. Although each engineering product may employ different analytical techniques or industry code requirements, several activities in documenting the engineering design process are generic. The quality of performance in these activities can be monitored analogously to the steps in a manufacturing process. This concept builds quality concepts into the package in lieu of inspecting package quality at the end of the process. The work has resulted in a valuable self-assessment tool that serves as a basis for engineering process improvements. The indicators are published in a semi-yearly performance report for FP and L contractors as well as FP and L in-house engineering work. Contracts have been set up to base fees on meeting targets established for the performance report. The ability to meet performance targets continues to improve

Game Indicators Determining Sports Performance in the NBA.

Science.gov (United States)

Mikołajec, Kazimierz; Maszczyk, Adam; Zając, Tomasz

2013-01-01

The main goal of the present study was to identify basketball game performance indicators which best determine sports level in the National Basketball Association (NBA) league. The research material consisted of all NBA game statistics at the turn of eight seasons (2003-11) and included 52 performance variables. Through detailed analysis the variables with high influence on game effectiveness were selected for final procedures. It has been proven that a limited number of factors, mostly offensive, determines sports performance in the NBA. The most critical indicators are: Win%, Offensive EFF, 3rd Quarter PPG, Win% CG, Avg Fauls and Avg Steals. In practical applications these results connected with top teams and elite players may help coaches to design better training programs.

Information Security Governanceas as Key Performance Indicator for Financial Institutions

OpenAIRE

Krjukovs, D; Strauss, R

2009-01-01

Due to their nature financial institutions and their performance are in constant focus of attention from different stakeholder groups. These groups according to their functions and interests are implementing different sets of key performance indicators for financial institution performance assessment. In the proposed paper authors present a hypothesis of information security governance being a financial institution key performance indicator. Authors provide high level overview of ...

Why was this transfusion given? Identifying clinical indications for blood transfusion in health care data

Directory of Open Access Journals (Sweden)

van Hoeven LR

2018-03-01

Full Text Available Loan R van Hoeven,1,2 Aukje L Kreuger,3,4 Kit CB Roes,1 Peter F Kemper,2,4 Hendrik Koffijberg,5 Floris J Kranenburg,3,4,6 Jan MM Rondeel,7 Mart P Janssen1,2 1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands; 2Transfusion Technology Assessment Department, Sanquin Research, Amsterdam, the Netherlands; 3Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands; 4Center for Clinical Transfusion Research, Sanquin Research, Leiden, the Netherlands; 5Department of Health Technology & Services Research, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, the Netherlands; 6Department of Intensive Care, Leiden University Medical Center, Leiden, the Netherlands; 7Department of Clinical Chemistry, Isala, Zwolle, the Netherlands Background: To enhance the utility of transfusion data for research, ideally every transfusion should be linked to a primary clinical indication. In electronic patient records, many diagnostic and procedural codes are registered, but unfortunately, it is usually not specified which one is the reason for transfusion. Therefore, a method is needed to determine the most likely indication for transfusion in an automated way.Study design and methods: An algorithm to identify the most likely transfusion indication was developed and evaluated against a gold standard based on the review of medical records for 234 cases by 2 experts. In a second step, information on misclassification was used to fine-tune the initial algorithm. The adapted algorithm predicts, out of all data available, the most likely indication for transfusion using information on medical specialism, surgical procedures, and diagnosis and procedure dates relative to the transfusion date.Results: The adapted algorithm was able to predict 74.4% of indications in the sample correctly (extrapolated to the full data set 75.5%. A kappa

Performance comparison between the mycobacteria growth indicator tube system and Löwenstein-Jensen medium in the routine detection of Mycobacterium tuberculosis at public health care facilities in Rio de Janeiro, Brazil: preliminary results of a pragmatic clinical trial.

Science.gov (United States)

Moreira, Adriana da Silva Rezende; Huf, Gisele; Vieira, Maria Armanda; Fonseca, Leila; Ricks, Monica; Kritski, Afrânio Lineu

2013-01-01

In view of the fact that the World Health Organization has recommended the use of the mycobacteria growth indicator tube (MGIT) 960 system for the diagnosis of tuberculosis and that there is as yet no evidence regarding the clinical impact of its use in health care systems, we conducted a pragmatic clinical trial to evaluate the clinical performance and cost-effectiveness of the use of MGIT 960 at two health care facilities in the city of Rio de Janeiro, Brazil, where the incidence of tuberculosis is high. Here, we summarize the methodology and preliminary results of the trial. (ISRCTN.org Identifier: ISRCTN79888843 [http://isrctn.org/]) In view of the fact that the World Health Organization has recommended the use of the mycobacteria growth indicator tube (MGIT) 960 system for the diagnosis of tuberculosis and that there is as yet no evidence regarding the clinical impact of its use in health care systems, we conducted a pragmatic clinical trial to evaluate the clinical performance and cost-effectiveness of the use of MGIT 960 at two health care facilities in the city of Rio de Janeiro, Brazil, where the incidence of tuberculosis is high. Here, we summarize the methodology and preliminary results of the trial. (ISRCTN.org Identifier: ISRCTN79888843 [http://isrctn.org/]).

Indications, imaging technique, and reading of cardiac computed tomography: survey of clinical practice

Energy Technology Data Exchange (ETDEWEB)

Maurer, M.H.; Zimmermann, E.; Germershausen, C.; Hamm, B. [Charite - Universitaetsmedizin Berlin, Department of Radiology, Berlin (Germany); Schlattmann, P. [University Hospital of Friedrich-Schiller University Jena, Department of Medical Statistics, Computer Sciences and Documentation, Jena (Germany); Dewey, Marc [Charite - Universitaetsmedizin Berlin, Department of Radiology, Berlin (Germany); Charite - Universitaetsmedizin Berlin, Humboldt-Universitaet zu Berlin, Department of Radiology, Berlin, PO Box 10098 (Germany)

2012-01-15

To obtain an overview of the current clinical practice of cardiac computed tomography (CT). A 32-item questionnaire was mailed to a total of 750 providers of cardiac CT in 57 countries. A total of 169 questionnaires from 38 countries were available for analysis (23%). Most CT systems used (94%, 207/221) were of the latest generation (64-row or dual-source CT). The most common indications for cardiac CT was exclusion of coronary artery disease (97%, 164/169). Most centres used beta blockade (91%, 151/166) and sublingual nitroglycerine (80%, 134/168). A median slice thickness of 0.625 mm with a 0.5-mm increment and an 18-cm reconstruction field of view was used. Interpretation was most often done using source images in orthogonal planes (92%, 155/169). Ninety percent of sites routinely evaluate extracardiac structures on a large (70%) or cardiac field of view (20%). Radiology sites were significantly more interested in jointly performing cardiac CT together with cardiology than cardiologists. The mean examination time was 18.6 {+-} 8.4 min, and reading took on average 28.7 {+-} 17.8 min. Cardiac CT has rapidly become established in clinical practice, and there is emerging consensus regarding indications, conduct of the acquisition, and reading. (orig.)

Clinical Indications and Adverse Reactions of Platelet Apheresis

International Nuclear Information System (INIS)

Amanat, S. T.; Shakoor, H. A.; Raza, M.; Khan, N.; Rauf, A.

2015-01-01

Objective: To determine the clinical indications and adverse reactions of platelet apheresis procedure. Study Design: Cross-sectional, observational study. Place and Duration of Study: Blood Bank of Pakistan Atomic Energy Commission General Hospital, Islamabad, from January 2010 to December 2014. Methodology: Indications and adverse reaction verified for 200 consecutive platelet apheresis donations performed for 125 patients was included in this study. Data was analysed for descriptive variables using SPSS version 16. Results: Donor deferral rate in the study was 63.83 percentage. All the donors were males (100 percentage) and replacement donors. Most prevalent blood type was B-positive (n=63, 31.5 percentage), followed by O-positive (n=59, 29.5 percentage). Rh negative groups constituted 13.5 percentage (n=27) of all the donors. Average age of platelet apheresis donors was 28.56 ± 5.77 years. Maximum numbers of donors were in age range 20 - 30 years. Average weight of the donors was 73.96 ± 11.96 kg. Mean pre-procedure platelet count of donors was 268,000/ micro L. The postprocedure average platelet count was approximately 200,000/ micro L. The mean duration of a platelet apheresis session was 78.27 ± 26.07 minutes. Average volume of the final product was 412.53 ± 45.33 ml. Average volume of anti-coagulant acid citrate dextrose used per procedure was 300 ± 40 ml, 245 ml returned to donor along with returned blood while 55 ml used as anticoagulant in final concentrate. Of total 200, two (1 percentage) final products were contaminated with red cells. Three (1.5 percentage) products were not issued and finally expired. Of the 125 patients for which plateletpheresis procedures were performed, 54 (43.2 percentage) patients were males and 71 (56.8 percentage) were females (M: F=0.76:1). Six donors (3 percentage) had adverse events: three donors (1.5 percentage) had mild reactions, two (1 percentage) moderate reaction, and one donor (0.5 percentage) developing

Further Education Performance Indicators: A Motivational or a Performative Tool?

Science.gov (United States)

Boocock, Andrew

2013-01-01

Ethnographic research in a further education College (Borough College) between 2000 and 2005 assessed the impact of performance indicators (PIs) within a department teaching GCSEs and A-levels. Research focused on PIs integral to the Learning and Skills Council funding formula, the Common Inspection Framework and newspaper league tables, and the…

Indicators to monitor NPP safety performance. Working material

International Nuclear Information System (INIS)

1997-01-01

Numerical indicators to monitor safety status and overall safety performance of nuclear power plants (NPPs) are used by operators and some regulators worldwide. During the last few years, the IAEA, through Technical Committee Meetings and Consultants' Meetings has worked on this area. This report presents a framework for nuclear power plant safety performance indicators that was developed during two consultant meetings held at the IAEA headquarters in Vienna in December 1995 and November 1996. Annex 2 on risk based indicators was prepared during a consultants' meeting held in Vienna in July 1996. An additional outcome from these activities, was the recommendation that the IAEA conduce pilot exercises at several nuclear power plants that might be interested to participate, in order to test the validity of the concept and its usefulness. 6 figs

Performance indicators at Embalse NPP: PSA and safety system indicators based on PSA models

International Nuclear Information System (INIS)

Fornero, D.A.

2001-01-01

Several indicators have been implemented at Embalse NPP. The objective was selecting some representative parameters to evaluate the performance of both the plant and the personnel activities, important for safety. A first set of indicators was defined in accordance with plant technical staff criteria. A complementary set of them was addressed later based on WANO guidance. This report presents the set of indicators used at Embalse NPP, centering the description to related to safety systems performance indicators (SSPI). Some considerations are done about the calculation methods, the need for aligning and updating their values following Embalse Probabilistic Safety Assessment (PSA) development, and some pros and cons of using the PSA model for getting systems indicators. Owing to the fact that PSA ownership by utilities is also a subject of the meeting, some characteristics of the organization of the PSA Project are described at the beginning of the report. At Embalse NPP a Level 1 PSA has been developed under the responsibility of its own plant and with an important contribution from the IAEA. PSA was developed at the site, conducting this to a study strongly interactive with the station staff. (author)

Indicators of suboptimal performance embedded in the Wechsler Memory Scale-Fourth Edition (WMS-IV).

Science.gov (United States)

Bouman, Zita; Hendriks, Marc P H; Schmand, Ben A; Kessels, Roy P C; Aldenkamp, Albert P

2016-01-01

Recognition and visual working memory tasks from the Wechsler Memory Scale-Fourth Edition (WMS-IV) have previously been documented as useful indicators for suboptimal performance. The present study examined the clinical utility of the Dutch version of the WMS-IV (WMS-IV-NL) for the identification of suboptimal performance using an analogue study design. The patient group consisted of 59 mixed-etiology patients; the experimental malingerers were 50 healthy individuals who were asked to simulate cognitive impairment as a result of a traumatic brain injury; the last group consisted of 50 healthy controls who were instructed to put forth full effort. Experimental malingerers performed significantly lower on all WMS-IV-NL tasks than did the patients and healthy controls. A binary logistic regression analysis was performed on the experimental malingerers and the patients. The first model contained the visual working memory subtests (Spatial Addition and Symbol Span) and the recognition tasks of the following subtests: Logical Memory, Verbal Paired Associates, Designs, Visual Reproduction. The results showed an overall classification rate of 78.4%, and only Spatial Addition explained a significant amount of variation (p < .001). Subsequent logistic regression analysis and receiver operating characteristic (ROC) analysis supported the discriminatory power of the subtest Spatial Addition. A scaled score cutoff of <4 produced 93% specificity and 52% sensitivity for detection of suboptimal performance. The WMS-IV-NL Spatial Addition subtest may provide clinically useful information for the detection of suboptimal performance.

Process performance indicators in project pre-design stage

NARCIS (Netherlands)

Haponava, T.; Al-Jibouri, Saad H.S.; Reymen, Isabelle; Scheublin, F.; Pronk, A.; Prins, M.; Emmitt, S.; den Otter, A

2006-01-01

Traditionally performance in construction is measured based on the "iron-triangle”- time, cost and quality. In recent years indicators have been developed to include the measurements of other aspects of project performance. The main shortcoming of these however is that most of them are lagging

Performance indicators: A tool for continuous quality improvement

Directory of Open Access Journals (Sweden)

Nidhi M Bhatnagar

2016-01-01

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

Performance indicators: A tool for continuous quality improvement.

Science.gov (United States)

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

2016-01-01

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

Amalgamation of performance indicators to support NRC senior management reviews

International Nuclear Information System (INIS)

Wreathall, J.; Schurman, D.; Modarres, M.; Mosleh, A.; Anderson, N.; Reason, J.

1991-01-01

The purpose of this project is to develop a methodology for amalgamating performance indicators to provide an overall perspective on plant safety, as one input to Nuclear Regulatory Commission's (NRC) senior management reviews of plant safety. These reviews are used to adjust the level of oversight by NRC. Work completed to date includes the development of frameworks for relating indicator measures to safety, a classification scheme for performance indicators, and a mapping process to portray indicators in the frameworks

The Qualitative Study of Key Performance Indicator on PT. Jiwasraya Manado

OpenAIRE

Rangian, Geby Melisa; Tumewu, Ferdinand

2014-01-01

Key Performance Indicator (KPI) is one of the most common tools used by the employees of companies to help manage more effectively and guide their progress. To perceive how far the achievement and the performance of the company, PT. Jiwasraya Manado use the Key Performance Indicator (KPI) to reveal the performance of the company. The objective of this study is to analyze the importance from the implementation of the key performance indicator for the insurance employee. There are several facts...

Development of safety performance indicators of regulatory interest (SAFPER) in Pakistan

International Nuclear Information System (INIS)

Khatoon, Abida

2002-01-01

Safety performance indicators provide a very useful tool for monitoring operational safety of a nuclear power plant. Utilities in many countries have developed plant specific indicators for the assessment of their performance and safety. Regulators can make use of some of these indicators for their regulatory assessment. In addition to these regulatory bodies in some countries have also developed programs for the formulation of safety performance indicators which are used in monitoring operational safety and regulatory decision making. Realizing its usefulness Directorate of Nuclear Safety and Radiation Protection (DNSRP-the regulatory body in Pakistan) has also initiated a country specific program for the development of Safety Performance Indicators (SAFPER) based on data provided by the utility and that collected during the course of regulatory inspections. Selected areas of NPP operation to be monitored are: - Significant events; - Safety systems performance; - Barriers integrity; - Environment protection; - Workers radiation safety; and - Emergency Preparedness. One of the objectives of this program is also to monitor the effectiveness of DNSRP regulatory activities. IAEA framework is taken as one of the bases for our program. Safety performance will be assessed on the basis of Performance Indicators and inspection findings. DNSRP program as shown in Appendix includes the indicators in use and under development. It is felt that the term Safety Performance Indicators may be termed as 'SAFPER Indicators' to be used by the Regulators, as it is clear from this presentation that utility safety performance indicators together with the regulatory effectiveness indicators constitute the measure for the adequate safety to the public and the environment. Additional research is still necessary for: - indicator definition for the proposed and under developed indicators; - data collection systems; - thresholds; - trend analysis; - goal setting (benefit from the trend can be

Integrated Initiating Event Performance Indicators

International Nuclear Information System (INIS)

S. A. Eide; Dale M. Rasmuson; Corwin L. Atwood

2005-01-01

The U.S. Nuclear Regulatory Commission Industry Trends Program (ITP) collects and analyses industry-wide data, assesses the safety significance of results, and communicates results to Congress and other stakeholders. This paper outlines potential enhancements in the ITP to comprehensively cover the Initiating Events Cornerstone of Safety. Future work will address other cornerstones of safety. The proposed Tier 1 activity involves collecting data on ten categories of risk-significant initiating events, trending the results, and comparing early performance with prediction limits (allowable numbers of events, above which NRC action may occur). Tier 1 results would be used to monitor industry performance at the level of individual categories of initiating events. The proposed Tier 2 activity involves integrating the information for individual categories of initiating events into a single risk-based indicator, termed the Baseline Risk Index for Initiating Events or BRIIE. The BRIIE would be evaluated yearly and compared against a threshold. BRIIE results would be reported to Congress on a yearly basis

Computational intelligence for the Balanced Scorecard: studying performance trends of hemodialysis clinics.

Science.gov (United States)

Cattinelli, Isabella; Bolzoni, Elena; Chermisi, Milena; Bellocchio, Francesco; Barbieri, Carlo; Mari, Flavio; Amato, Claudia; Menzer, Marcus; Stopper, Andrea; Gatti, Emanuele

2013-07-01

The Balanced Scorecard (BSC) is a general, widely employed instrument for enterprise performance monitoring based on the periodic assessment of strategic Key Performance Indicators that are scored against preset targets. The BSC is currently employed as an effective management support tool within Fresenius Medical Care (FME) and is routinely analyzed via standard statistical methods. More recently, the application of computational intelligence techniques (namely, self-organizing maps) to BSC data has been proposed as a way to enhance the quantity and quality of information that can be extracted from it. In this work, additional methods are presented to analyze the evolution of clinic performance over time. Performance evolution is studied at the single-clinic level by computing two complementary indexes that measure the proportion of time spent within performance clusters and improving/worsening trends. Self-organizing maps are used in conjunction with these indexes to identify the specific drivers of the observed performance. The performance evolution for groups of clinics is modeled under a probabilistic framework by resorting to Markov chain properties. These allow a study of the probability of transitioning between performance clusters as time progresses for the identification of the performance level that is expected to become dominant over time. We show the potential of the proposed methods through illustrative results derived from the analysis of BSC data of 109 FME clinics in three countries. We were able to identify the performance drivers for specific groups of clinics and to distinguish between countries whose performances are likely to improve from those where a decline in performance might be expected. According to the stationary distribution of the Markov chain, the expected trend is best in Turkey (where the highest performance cluster has the highest probability, P=0.46), followed by Portugal (where the second best performance cluster dominates

Optimal energy management of urban rail systems: Key performance indicators

International Nuclear Information System (INIS)

González-Gil, A.; Palacin, R.; Batty, P.

2015-01-01

Highlights: • An overall picture of urban rail energy use is provided. • Performance indicators are developed for urban rail system energy optimisation. • A multi-level methodology for assessing energy efficiency measures is presented. - Abstract: Urban rail systems are facing increasing pressure to minimise their energy consumption and thusly reduce their operational costs and environmental impact. However, given the complexity of such systems, this can only be effectively achieved through a holistic approach which considers the numerous interdependences between subsystems (i.e. vehicles, operations and infrastructure). Such an approach requires a comprehensive set of energy consumption-related Key Performance Indicators (KEPIs) that enable: a multilevel analysis of the actual energy performance of the system; an assessment of potential energy saving strategies; and the monitoring of the results of implemented measures. This paper proposes an original, complete list of KEPIs developed through a scientific approach validated by different stakeholders. It consists of a hierarchical list of 22 indicators divided into two levels: 10 key performance indicators, to ascertain the performance of the whole system and complete subsystems; and 12 performance indicators, to evaluate the performance of single units within subsystems, for example, a single rail vehicle or station. Additionally, the paper gives a brief insight into urban rail energy usage by providing an adequate context in which to understand the proposed KEPIs, together with a methodology describing their application when optimising the energy consumption of urban rail systems

The diagnostic odds ratio: a single indicator of test performance

NARCIS (Netherlands)

Glas, Afina S.; Lijmer, Jeroen G.; Prins, Martin H.; Bonsel, Gouke J.; Bossuyt, Patrick M. M.

2003-01-01

Diagnostic testing can be used to discriminate subjects with a target disorder from subjects without it. Several indicators of diagnostic performance have been proposed, such as sensitivity and specificity. Using paired indicators can be a disadvantage in comparing the performance of competing

KEY PERFORMANCE INDICATORS DISCLOSURES BY THE INTEGRATED REPORTING

Directory of Open Access Journals (Sweden)

BOBITAN ROXANA-IOANA

2016-02-01

Full Text Available We are in a new era of corporate reporting where the corporate reporting landscape was changed. Institutional and small investors, financial analysts and other key stakeholders are demanding more information about long-term strategies and profitability of companies. Also, the increasing complexity of business models, growing awareness of climate change and resource scarcity and communication are expectations of the role of business in the 21st century and which the key of performance indicators (KPIs is. The companies must change the way these KPIs are being incorporated throughout the annual report and how these are linked to the company’s strategy and business model, their risks and risk mitigation, and their incentive schemes. Regarding this, integrated reporting, continue to gain momentum, the spotlight on the depth, breadth and quality of KPIs being reported will only strengthen. The aim of this discussion paper is to describe which are the most important key performance indicators in sprit of integrating reporting. A good and very known example for the integrated reporting is Philips Electronics, the Dutch healthcare and lighting company, a pioneer that embrace this concept, and the paper make an analysis of the most important key performance indicators.

NHS Trusts' clinical research activity and overall CQC performance - Is there a correlation?

Science.gov (United States)

Jonker, L; Fisher, S J

2015-11-01

Since the late 2000's, the creation of the National Institute for Health Research (NIHR) has transformed clinical research activity in the United Kingdom. This study sought to establish if there is a link between clinical research activity and overall NHS Trust performance. Retrospective cohort study. Data for NHS Trust performance were obtained from public databases, namely the Care Quality Commission (CQC) 2013 risk rating for overall performance, and 2012-13 NIHR records for clinical research activity. Applying Spearman's rank analysis, none of the Trust categories showed a correlation with CQC risk rating: small hospitals, r = -0.062 (P = 0.76; n = 27); medium, r = -0.224 (P = 0.13; n = 47); large, r = -0.008 (P = 0.96; n = 57); academic, r = -0.18 (P = 0.41; n = 24). Similar results were observed when CQC risk rating was compared with the number of different clinical research studies conducted per Trust. The degree of NIHR National Portfolio clinical research activity is not significantly related to CQC risk rating, used as an indicator of overall NHS Trust performance. Other studies have previously shown that increased research activity correlates with improved mortality rates, one component of CQC risk rating scores. Alternative tools may have to be explored to evaluate the impact of clinical research on NHS Trusts and its patients. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Development of Corporate Governance Performance Indicators for Czech Manufacturing Companies

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Pavláková Docekalová Marie

2015-03-01

Full Text Available Effective corporate governance is a key element in achieving long-term success for any company. The codes of conduct that corporate governance adopts directly determine the sustainability of business activities. With this in mind, this paper aims to demonstrate the results of research that identifies a set of key indicators of corporate governance performance. The presented research is quantitative. In order to identify key performance indicators, factor analysis was employed. It was found that corporate governance performance is influenced by two factors. For the first factor, the relationship between corporate governance and stakeholders is measured by key indicators: percentage of women within CG, contributions to political parties, politicians and related institutions and number of complaints received from stakeholders. The second factor, strategy & compliance, is generated from the following: percentage of strategic objectives met and total number of sanctions for breaching the law. This research aims to assist both academic and corporate practitioners who want to improve corporate governance performance and, through the use of key performance indicators, support the transparency and sustainability of their business.

Operational safety system performance alternative to the WANO's indicator

International Nuclear Information System (INIS)

Lyra, Moacir

2002-01-01

One of the operational safety performance indicators recommended by the World Association of Nuclear Operators (WANO) and adopted by Electronuclear is the reliability of the safety systems. The parameter selected to represent this indicator is the average unavailability of the trains of the concerned system. This parameter would be universally representative of the reliability for comparison purpose only if all nuclear power plants were designed within the same redundancy criteria. Considering the diversity of design criteria of the power plants in operation and based on a probabilistic approach, this paper proposes new performance indicators which are comparable regardless the redundancy criteria of the system. A case example applied to a system of the Angra 2 nuclear power plant shows that, even though with the plant in the infancy phase, the performance of the system in the period is very good. (author)

Libraries and key performance indicators a framework for practitioners

CERN Document Server

Appleton, Leo

2017-01-01

Libraries and Key Performance Indicators: A Framework for Practitioners explores ways by which libraries across all sectors can demonstrate their value and impact to stakeholders through quality assurance and performance measurement platforms, including library assessment, evaluation methodologies, surveys, and annual reporting. Whilst several different performance measurement tools are considered, the book's main focus is on one tool in particular: Key Performance Indicators (KPIs). KPIs are increasingly being used to measure the performance of library and information services, however, linking KPIs to quality outcomes, such as impact and value can prove very difficult. This book discusses, in detail, the concept of KPIs in the broader context of library assessment and performance measurement. Through reviewing some of the applied theory around using KPIs, along with harvesting examples of current best practices in KPI usage from a variety of different libraries, the book demystifies library KPIs, providing ...

ISI PUBLICATIONS MANAGEMENT THROUGH PERFORMANCE INDICATORS

Directory of Open Access Journals (Sweden)

Victor VELTER

2010-09-01

Full Text Available The paper proposes to describe the ways in which the research management and administration department from a certain institution can interfere with specific policies in order to increase the visibility of scientific publications. Scientometric analysis is made on ISI publications of “Constantin Brancsi” University from Targu Jiu and wants to reveal performance indicators able to monitor the visibility of the papers indexed in ThomsonReuters ISI base.

NIKE: a new clinical tool for establishing levels of indications for cataract surgery.

Science.gov (United States)

Lundström, Mats; Albrecht, Susanne; Håkansson, Ingemar; Lorefors, Ragnhild; Ohlsson, Sven; Polland, Werner; Schmid, Andrea; Svensson, Göran; Wendel, Eva

2006-08-01

The purpose of this study was to construct a new clinical tool for establishing levels of indications for cataract surgery, and to validate this tool. Teams from nine eye clinics reached an agreement about the need to develop a clinical tool for setting levels of indications for cataract surgery and about the items that should be included in the tool. The tool was to be called 'NIKE' (Nationell Indikationsmodell för Kataraktextraktion). The Canadian Cataract Priority Criteria Tool served as a model for the NIKE tool, which was modified for Swedish conditions. Items included in the tool were visual acuity of both eyes, patients' perceived difficulties in day-to-day life, cataract symptoms, the ability to live independently, and medical/ophthalmic reasons for surgery. The tool was validated and tested in 343 cataract surgery patients. Validity, stability and reliability were tested and the outcome of surgery was studied in relation to the indication setting. Four indication groups (IGs) were suggested. The group with the greatest indications for surgery was named group 1 and that with the lowest, group 4. Validity was proved to be good. Surgery had the greatest impact on the group with the highest indications for surgery. Test-retest reliability test and interexaminer tests of indication settings showed statistically significant intraclass correlations (intraclass correlation coefficients [ICCs] 0.526 and 0.923, respectively). A new clinical tool for indication setting in cataract surgery is presented. This tool, the NIKE, takes into account both visual acuity and the patient's perceived problems in day-to-day life because of cataract. The tool seems to be stable and reliable and neutral towards different examiners.

The spin project: safety and performance indicators in different time frames

International Nuclear Information System (INIS)

Storck, R.; Becker, D.A.

2002-01-01

Safety and performance indicators have been under discussion for many years in several countries and international organisations. If those indicators refer to the long term safety of the total disposal system, they are often called safety indicators. If they refer to the performance of subsystems or the total system from a more technical point of view, they are sometimes called performance indicators. The need for indicators other than dose rates derives e.g. from the long time frames involved in safety assessments of waste disposal systems and the increasing uncertainty in dose rate calculations over time due to uncertainty in evolution of the surface environment and of behaviour of man. Before introducing additional indicators into a safety case of a potential repository site, the applicability and usefulness of different indicators have to be investigated and evaluated. The systematic analysis and testing of safety and performance indicators for use in different time horizons after closure of the disposal facility is the task of the SPIN project. This is done by re-calculating four recent studies concerning repository projects in granite formations. (authors)

Performance indicators and indices of sludge management in urban wastewater treatment plants.

Science.gov (United States)

Silva, C; Saldanha Matos, J; Rosa, M J

2016-12-15

Sludge (or biosolids) management is highly complex and has a significant cost associated with the biosolids disposal, as well as with the energy and flocculant consumption in the sludge processing units. The sludge management performance indicators (PIs) and indices (PXs) are thus core measures of the performance assessment system developed for urban wastewater treatment plants (WWTPs). The key PIs proposed cover the sludge unit production and dry solids concentration (DS), disposal/beneficial use, quality compliance for agricultural use and costs, whereas the complementary PIs assess the plant reliability and the chemical reagents' use. A key PI was also developed for assessing the phosphorus reclamation, namely through the beneficial use of the biosolids and the reclaimed water in agriculture. The results of a field study with 17 Portuguese urban WWTPs in a 5-year period were used to derive the PI reference values which are neither inherent to the PI formulation nor literature-based. Clusters by sludge type (primary, activated, trickling filter and mixed sludge) and by digestion and dewatering processes were analysed and the reference values for sludge production and dry solids were proposed for two clusters: activated sludge or biofilter WWTPs with primary sedimentation, sludge anaerobic digestion and centrifuge dewatering; activated sludge WWTPs without primary sedimentation and anaerobic digestion and with centrifuge dewatering. The key PXs are computed for the DS after each processing unit and the complementary PXs for the energy consumption and the operating conditions DS-determining. The PX reference values are treatment specific and literature based. The PI and PX system was applied to a WWTP and the results demonstrate that it diagnosis the situation and indicates opportunities and measures for improving the WWTP performance in sludge management. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Clinical Research Office of the Endourological Society Ureteroscopy Global Study: Indications, Complications, and Outcomes in 11885 Patients

DEFF Research Database (Denmark)

De La Rosette, Jean; Denstedt, John D; Geavlete, Petrisor A

2013-01-01

Purpose: To assess the current indications for ureteroscopy (URS) treatment, outcome in terms of stone-free rate, and intra- and postoperative complications using the modified Clavien grading system. Patients and Methods: The Clinical Research Office of the Endourological Society (CROES) collected...... prospective data as part of the URS Global Study for consecutive patients treated with URS at centers around the world for 1 year. URS was performed according to study protocol and local clinical practice guidelines. Stone size and location were recorded and postoperative outcome and complications, graded...

Summary report on the use of plant safety performance indicators

International Nuclear Information System (INIS)

2001-09-01

In 1998, the OECD/NEA committee on Nuclear Regulatory Activities (CNRA) initiated an activity with the objective of advancing the discussion on how to enhance and measure regulatory effectiveness in relation to nuclear installations. One of the outcome of this activity was to establish a Task group to develop internal (direct) performance indicators which would be used to monitor regulatory efficiency. In parallel, a joint CNRA/CSNI group was launched in December 2000 to exchange information and develop external (indirect) indicators to measure regulatory effectiveness, i.e. impact on licensee's safety performance. These external indicators are, in other words, the traditional plant performance indicators (PI's) and these are the ones that this report deals with. This report presents the work performed by the joint CNRA/CSNI task group mentioned above. It provides a summary of the sets of PI's being used by different regulatory bodies and WANO, it describes the national practices on the use of PI's and proposes a set of PI's that could be used nationally describing regulatory effectiveness and also as a basis for an international system. The task force consisted of regulators, organisations which have a performance indicators system in operation or under testing. The task force met in Paris on February 19-20, 2001. Each participant provided a brief description of the PI System at his organisation and its usage. The group identified a list of PI's that are recommended to be used nationally by regulators. This paper has been elaborated based on the information exchanged and discussions held in the February meeting. The participating countries (Spain, Finland, US, Sweden) and WANO were asked to provide an overview of systems in use. The presently used Performance Indicators were reviewed in a three steps process. 1. First indicators used in at least two agencies were identified. 2. The second step was to identify the most used indicators. 3. The third step was to

The Consistency of Performance Management System Based on Attributes of the Performance Indicator: An Empirical Study

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Jan Zavadsky

2014-07-01

Full Text Available Purpose: The performance management system (PMS is a metasystem over all business processes at the strategic and operational level. Effectiveness of the various management systems depends on many factors. One of them is the consistent definition of each system elements. The main purpose of this study is to explore if the performance management systems of the sample companies is consistent and how companies can create such a system. The consistency in this case is based on the homogenous definition of attributes relating to the performance indicator as a basic element of PMS.Methodology: At the beginning, we used an affinity diagram that helped us to clarify and to group various attributes of performance indicators. The main research results we achieved are through empirical study. The empirical study was carried out in a sample of Slovak companies. The criterion for selection was the existence of the certified management systems according to the ISO 9001. Representativeness of the sample companies was confirmed by application of Pearson´s chi-squared test (χ2 - test due to above standards. Findings: Coming from the review of various literature, we defined four groups of attributes relating to the performance indicator: formal attributes, attributes of target value, informational attributes and attributes of evaluation. The whole set contains 21 attributes. The consistency of PMS is based not on maximum or minimum number of attributes, but on the same type of attributes for each performance indicator used in PMS at both the operational and strategic level. The main findings are: companies use various financial and non-financial indicators at strategic or operational level; companies determine various attributes of performance indicator, but most of the performance indicators are otherwise determined; we identified the common attributes for the whole sample of companies. Practical implications: The research results have got an implication for

Nitinol Esophageal Stents: New Designs and Clinical Indications

International Nuclear Information System (INIS)

Strecker, Ernst-Peter; Boos, Irene; Vetter, Sylvia; Strohm, Michael; Domschke, Sigurd

1996-01-01

Purpose: To evaluate the clinical use of covered and noncovered, knitted nitinol stents in patients presenting new stent indications. Methods: Self-expandable, knitted nitinol stents were implanted in four patients for treatment of dysphagia. In two patients who had malignant strictures and had esophago-respiratory fistulae and in one patient with an esophagocutaneous fistula, polytetrafluoroethylene (PTFE)-covered stents were implanted. One patient received a noncovered stent, but a retrograde approach through a percutaneous endoscopic gastrostomy (PEG) fistula had to be chosen for recanalization of an esophageal occlusion. Two patients received stents for treatment of benign strictures. Results: Recanalization of the stricture and stent implantation were performed under fluoroscopic control without any procedure-related morbidity or mortality. Dysphagia improved in all patients and the esophageal fistulae could be sealed off by covered stents. During a maximum follow-up of 18 months, there was no stent migration or esophageal perforation. Complications observed were stent stenosis due to food impaction (1/4) and benign stent stenosis (2/2). Most complications could be treated by the interventional radiologist. Conclusion: Self-expandable, covered Nitinol stents provide an option for the treatment of dysphagia combined with esophageal fistulae. In combination with interventional radiology techniques, even complex strictures are accessible. For benign strictures, the value of stent treatment has not yet been proven

Quality Management and Key Performance Indicators in Oncologic Esophageal Surgery.

Science.gov (United States)

Gockel, Ines; Ahlbrand, Constantin Johannes; Arras, Michael; Schreiber, Elke Maria; Lang, Hauke

2015-12-01

Ranking systems and comparisons of quality and performance indicators will be of increasing relevance for complex "high-risk" procedures such as esophageal cancer surgery. The identification of evidence-based standards relevant for key performance indicators in esophageal surgery is essential for establishing monitoring systems and furthermore a requirement to enhance treatment quality. In the course of this review, we analyze the key performance indicators case volume, radicality of resection, and postoperative morbidity and mortality, leading to continuous quality improvement. Ranking systems established on this basis will gain increased relevance in highly complex procedures within the national and international comparison and furthermore improve the treatment of patients with esophageal carcinoma.

Assessing clinical reasoning abilities of medical students using clinical performance examination

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Sunju Im

2016-03-01

Full Text Available Purpose: The purpose of this study is to investigate the reliability and validity of new clinical performance examination (CPX for assessing clinical reasoning skills and evaluating clinical reasoning ability of the students. Methods: Third-year medical school students (n=313 in Busan-Gyeongnam consortium in 2014 were included in the study. One of 12 stations was developed to assess clinical reasoning abilities. The scenario and checklists of the station were revised by six experts. Chief complaint of the case was rhinorrhea, accompanied by fever, headache, and vomiting. Checklists focused on identifying of the main problem and systematic approach to the problem. Students interviewed the patient and recorded subjective and objective findings, assessments, plans (SOAP note for 15 minutes. Two professors assessed students simultaneously. We performed statistical analysis on their scores and survey. Results: The Cronbach α of subject station was 0.878 and Cohen κ coefficient between graders was 0.785. Students agreed on CPX as an adequate tool to evaluate students’ performance, but some graders argued that the CPX failed to secure its validity due to their lack of understanding the case. One hundred eight students (34.5% identified essential problem early and only 58 (18.5% performed systematic history taking and physical examination. One hundred seventy-three of them (55.3% communicated correct diagnosis with the patient. Most of them had trouble in writing SOAP notes. Conclusion: To gain reliability and validity, interrater agreement should be secured. Students' clinical reasoning skills were not enough. Students need to be trained on problem identification, reasoning skills and accurate record-keeping.

Risk-based safety performance indicators for nuclear power plants

International Nuclear Information System (INIS)

Chakraborty, S.; Prohaska, G.; Flodin, Y.; Grint, G.; Habermacher, H.; Hallman, A.; Isasia, R.; Melendez, E.; Verduras, E.; Karsa, Z.; Khatib-Rahbar, M.; Koeberlein, K.; Schwaeger, C.; Matahri, N.; Moravcik, I.; Tkac, M.; Preston, J.

2003-01-01

In a Concerted Action (CA), sponsored by the European Commission within its 5th Framework Program, a consortium of eleven partners from eight countries has reviewed and evaluated the application of Safety Performance Indicators (SPIs), which - in combination with other tools - can be used to monitor and improve the safety of nuclear power plants. The project was aimed at identification of methods that can be used in a risk-informed regulatory system and environment, and to exploit PSA techniques for the development and use of meaningful additional/alternative SPIs. The CA included the review of existing indicator systems, and the collection of information on the experience from indicator systems by means of a specific questionnaire. One of the most important and challenging issues for nuclear plant owners and/or regulators is to recognize early signs of deterioration in safety performance, caused by influences from management, organization and safety culture (MOSC), before actual events and/or mishaps take place. Most of the existing SPIs as proposed by various organizations are considered as 'lagging' indicators, that is, they are expected to show an impact only when a downward trend has already started. Furthermore, most of the available indicators are at a relatively high level, such that they will not provide useful information on fundamental weaknesses causing the problem in the first place. Regulators' and utilities' views on the use of a Safety Performance Indicator System have also been a part of the development of the CA. (author)

Which radionuclide, carrier molecule and clinical indication for alpha-immunotherapy?

International Nuclear Information System (INIS)

Guerard, F.; Barbet, J.; Cherel, M.; Chatal, J.-F.; Haddad, F.; Kraeber-Bodere, F.

2015-01-01

Beta-emitting radionuclides are not able to kill isolated tumor cells disseminated in the body, even if a high density of radiolabeled molecules can be targeted at the surface of these cells because the vast majority of emitted electrons deliver their energy outside the targeted cells. Alpha-particle emitting radionuclides may overcome this limitation. It is thus of primary importance to test and validate the radionuclide of choice, the most appropriate carrier molecule and the most promising clinical indication. Four α-particle emitting radionuclides have been or are clinically tested in phase I studies namely 213 Bi, 225 Ac, 212 Pb and 211 At. Clinical safety has been documented and encouraging efficacy has been shown for some of them ( 213 Bi and 211 At). 211 At has been the most studied and could be the most promising radionuclide but 225 Ac and 212 Pb are also of potential great interest. Any carrier molecule that has been labeled with β-emitting radionuclides could be labeled with alpha particle-emitting radionuclide using, for some of them, the same chelating agents. However, the physical half-life of the radionuclide should match the biological half-life of the radioconjugate or its catabolites. Finally everybody agrees, based on the quite short range of alpha particles, on the fact that the clinical indications for alpha-immunotherapy should be limited to the situation of disseminated minimal residual diseases made of small clusters of malignant cells or isolated tumor cells.

Mortalidade hospitalar como indicador de qualidade: uma revisão Hospital mortality as an indicator of clinical performance: a review

Directory of Open Access Journals (Sweden)

Claudia Travassos

1999-01-01

Full Text Available Este artigo visa a discutir as principais questões metodológicas relacionadas à mortalidade hospitalar como indicador de qualidade. Variações nos valores deste indicador se devem a inúmeros fatores, associados ao doente e à doença, que devem ser examinados para que possamos utilizá-lo como medida de desempenho. Presença de comorbidades e a gravidade do caso estão associadas à chance de morrer . Aspectos metodológicos, relevantes para a construção deste indicador, incluem a qualidade das fontes de dados, o intervalo de tempo no qual elas são calculadas e os diferentes tipos de agregação. São discutidos diversos modelos, tanto para classificação da gravidade, quanto para o ajuste das taxas de mortalidade entre serviços. São examinados ainda modelos explicativos para a variação de mortalidade. Conclui-se que nas condições em que a morte não é um evento raro, o emprego de taxas de mortalidade hospitalar representa uma ferramenta útil para indicar serviços com eventuais problemas de qualidade.This article discusses the principal methodological problems related to hospital mortality as an indicator of clinical performance. Hospital mortality rates variation are due to various factors associated with patients' characteristics and to the specific diseases they are suffering. Socio-demographic variables, presence of comorbidity and severity may define case-mixes were chances of dying are not associated to technology deployed or quality of care. Relevant methodological aspects for calculating the rates include the quality of the source of data, time period and aggregation criteria. Various models that exist both for classifying severity of cases and for risk adjustment are presented and discussed. Explanatory models for mortality rates variation are also examined. The authors conclude that outcome indicators can be used as tool for health care service evaluation. For those conditions which death is not a rare event hospital

Energy Performance Indicators in the Swedish Building Procurement Process

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Ingrid Allard

2017-10-01

Full Text Available In Sweden, all new buildings need to comply with the National Board of Housing, Building and Planning’s requirement on specific purchased energy (kWh/m2. Accordingly, this indicator is often used to set design criteria in the building procurement process. However, when energy use is measured in finished buildings, the measurements often deviate significantly from the design calculations. The measured specific purchased energy does not necessarily reflect the responsibility of the building contractor, as it is influenced by the building operation, user behavior and climate. Therefore, Swedish building practitioners may prefer other indicators for setting design criteria in the building procurement process. The aim of this study was twofold: (i to understand the Swedish building practitioners’ perspectives and opinions on seven building energy performance indicators (envelope air leakage, U-values for different building parts, average U-value, specific heat loss, heat loss coefficient, specific net energy, and specific purchased energy; and (ii to understand the consequences for the energy performance of multi-family buildings of using the studied indicators to set criteria in the procurement process. The study involved a Delphi approach and simulations of a multi-family case study building. The studied indicators were discussed in terms of how they may meet the needs of the building practitioners when used to set building energy performance criteria in the procurement process.

Professional practice assessment. Pertinence of positron emission tomography clinical indications in oncology

International Nuclear Information System (INIS)

Le Stanc, E.; Tainturier, C.; Swaenepoel, J.

2009-01-01

Introduction As part of the health care quality and safety policy in France, Professional Practice Assessment (P.P.A.) are mandatory in the health services 'certification' process. We present our study regarding the pertinence of Positron Emission Tomography (PET) indications in oncology. Materials and methods A multidisciplinary task group used the Quick Audit method with two rounds of 100 request forms each. The assessment list of criteria comprised four items of decreasing relevance grading the PET scans clinical indications, which were derived from the three French published guidelines (S.O.R. [F.N.C.L.C.C]., 'Guide du bon usage des examens d'imagerie medicale' [S.F.R.-S.F.M.N.], 'Guide pour la redaction de protocoles pour la TEP au F.D.G. en cancerologie' [S.F.M.N.]) and five additional items: clinical information, patient's body weight, previous treatments dates, diabetes, claustrophobia. Results The first round showed that 68% of the requested scans corresponded to the two most relevant groups of indications (S.O.R. Standards and Options). The request forms were correctly filled in regarding the clinical information, but this was not the case for the other items we tested. Several actions were conducted: dedicated PET request form, availability of the S.O.R. on the hospital intranet, boost of the referring physicians awareness during the multidisciplinary oncology meetings (Reunions de Concertation Pluridisciplinaires RCP). The second round showed a better pertinence of the PET scans indications (75% versus 68%); the patient's body weight was more frequently mentioned on the request form. Discussion This study is an example of P.P.A. in our discipline. It led to an improvement of the oncologic PET scans clinical indications in our hospital. This work is pursued in everyday discussion with the referring clinicians, especially during the RCP. (authors)

A road safety performance indicator for vehicle fleet compatibility.

NARCIS (Netherlands)

Christoph, M. Vis, M.A. Rackliff, L. & Stipdonk, H.

2013-01-01

This paper discusses the development and the application of a safety performance indicator which measures the intrinsic safety of a country's vehicle fleet related to fleet composition. The indicator takes into account both the ‘relative severity’ of individual collisions between different vehicle

Financial Indicators of Performance Measurement: Reality, Relevance and Distortion

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Flavius-Andrei Guinea

2016-01-01

Full Text Available The main criticism brought to managers and to managerial accounting systems was the lack of emphasis on the return of the use of invested capital and the excessive focus on the efficiency of production processes. This fact forced the transition to a new view on the way of establishing the strategic objectives measured by financial indicators. The aim of this paper is to demonstrate, through case studies, the relevance and possibilities of manipulation of a series of indicators used for assessing performance: return on investment, residual profit, economic added value, commercial profitability. The relativity and the criticized appraisal of performance only through the means of profit were thought to be solved by implementing other indicators that would link several ingredients of profitability. The conclusions highlight that the remedy promoted by the new sets of financial indicators imposes a considerable cost, represented by the temptation of information distortion.

Regulatory supervision of safety indicators; experience with radiation safety indicators in Dukovany nuclear power plant performance

International Nuclear Information System (INIS)

Urbancik, L.; Kulich, V.

2004-01-01

The State Office for Nuclear Safety uses three sets of indicators describing the following aspects of a favourable nuclear power plant operation: smooth operation in normal circumstances, low risk to the population, and operation with a positive safety attitude. These are three safety-related areas for assessment. Each area has its own set of indicators. Overall operational safety performance indicators were identified for each attribute. From this point, a level of strategic indicators was developed, and finally, a set of specific indicators was set up. While neither the overall indicators nor the strategic indicators are directly measurable, the specific indicators are directly measurable and are targeted during inspection. (author)

Performance indicators for online secondary education: a case study

NARCIS (Netherlands)

van Diepen, P.; Bredeweg, B.; Bosse, T.; Bredeweg, B.

2017-01-01

There is little consensus about what variables extracted from learner data are the most reliable indicators of learning performance. The aim of this study is to determine such indicators by taking a wide range of variables into consideration concerning overall learning activity and content

What is the value of performance indicators for the nuclear industry?

International Nuclear Information System (INIS)

Johann Popp

2006-01-01

WANO is an Association of all Operators of Nuclear Power Plants worldwide. This association is promoting and running for their members 4 programmes which are Operating Experience, Peer Reviews, Professional and Technical Development and Technical Support and Exchange. The Technical Support and Exchange programme comprises Good Practices, Performance Indicators, Operator-to-Operator Exchanges and Technical Support Missions. This paper explains the Performance Indicator programme. WANO is collecting significant NPP nuclear power plant data and is computing indicators according to selected criteria for the only purpose of comparing or benchmarking plant performance of all types and different designs. All effective organisations measure their performance in order to know, how well they are doing and in order to identify opportunities for improvement. Indicators are central to the monitoring and reporting of progress towards sustainable development in all areas. Indicators are mainly derived from statistical data in order to exhibit weaknesses and strengths of programs. There are many hundreds of commercial and technical indicators known. WANO is tracing just ten significant indicators out of the many available, and only for the purpose of comparing plant performance. The first set of three indicators is more related to productivity and exhibit, how well management is planning, staff is maintaining and operators are conducting the plants. The second set of two indicators is related to safety systems, how well they are maintained and how reliable they are. The next set of two is material related and the last two indicators are related to human resources. Indicators are reflecting the current industrial standard and allow the positioning of a plant with regard to the 'state of the art'. They pinpoint to weaknesses and strengths of different designs/fleets

Comparison of Turkey and United States in terms of teacher performance indicators

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Zühal Çubukçu

2017-12-01

Full Text Available Developing objective standards and indicators, and establishing the transparency of the evaluation process have significant importance in reducing negative teacher opinions and ensuring healthy functioning of the performance evaluation system. The purpose of this study is to compare teacher performance indicators in Turkey and United States. This study was conducted using document review, which is one of the qualitative research methods. In the study, document review was used as the data collection method. In the first stage, the official documents of the two countries were accessed via websites. The authenticity of the obtained documents was checked. Finally, the analysis was done with the classification form developed by the researchers. In the study, the analysis of the documents was done by descriptive analysis technique. General Proficiencies of Teaching Profession consist of 233 performance indicator and Core Teaching Standards consist of 74 performance indicators. The findings of the study were examined under five themes determined by considering the General Proficiencies of Teaching Profession and Core Teaching Standards: Student and learning, content knowledge, instructional practice, assessment and professional development. General Proficiencies of Teaching Profession lists the knowledge, skills, and behaviors expected from teachers as performance indicators. In Core Teaching Standards, the performance indicators provide suggestions and explanations for the development of teaching in accordance with the requirements of today's world. the preparation of performance indicators to provide teachers' development and the realistic use of these indicators in evaluating will help improve the quality of teacher performance evaluation.

Using Performance Indicators to Promote Sustainable Transport in Japan

DEFF Research Database (Denmark)

Gudmundsson, Henrik; Fukuda, Daisuke; Cornet, Yannick

literature on performance measurement. The information of Japanese cases is obtained by review of key policy documents, reports and academic papers and through a series of semi-structured interviews with experts and officials in Japan. The paper combines insights from two ongoing research projects supported......The challenges associated with using performance measurement to steer transport policy towards sustainability include general aspects of measuring sustainability of transport systems with indicators as well as specific national and institutional conditions for adopting and responding...... to the information produced by such sustainability indicator systems. Japan is interesting in these regards, since the country has adopted strategies for achieving a more sustainable transport situation, as well as frameworks of policy performance measurement and management. The paper will describe a general...

Basic indications for the performance of Color Doppler echocardiography

International Nuclear Information System (INIS)

Manzur, Fernando; Olivo, Carlos

2005-01-01

Clinical practice based on evidence takes off emphasis in intuition; clinical experience and rational physiopathology give sufficient bases for the clinical decision assessment and emphasizes the evidence's examination for the clinical investigation. The comprehension of certain evidence rules is necessary for the correct interpretation of literature in respect to the causes, diagnostic tools and treatment strategies. The main aim of this research is to make a protocol for the indications of an echocardiogram in the clinical practice and to educate our country's general physicians in this conduct. The good practice is due to initiatives, activities and functional models that are in progress worldwide, as confirmed by evidence. Objective: echocardiography is actually the gold standard for the study of heart anatomy and physiology. Since its introduction in the clinical practice more than three decades ago, it has had such diffusion that it is considered an important tool in the cardiology assistance. It provides trustworthy functional anatomic information, as well as diagnosis and is decisive in the treatment and resolution of cardiovascular diseases. The progressive development of this technique has enabled its use in all the different fields that may affect the cardiovascular system. The objective is to help the clinical physicians in the making of decisions in concrete situations, guaranteeing them that the diagnosis is based on results given by valid scientific studies. In accordance to this, different studies as well as task force and management guides representative of the worldwide literature were compiled

Emotional intelligence, performance, and retention in clinical staff nurses.

Science.gov (United States)

Codier, Estelle; Kamikawa, Cindy; Kooker, Barbara M; Shoultz, Jan

2009-01-01

Emotional intelligence has been correlated with performance, retention, and organizational commitment in professions other than nursing. A 2006 pilot study provided the first evidence of a correlation between emotional intelligence and performance in clinical staff nurses. A follow-up study was completed, the purpose of which was to explore emotional intelligence, performance level, organizational commitment, and retention. A convenience sample of 350 nurses in a large medical center in urban Hawaii participated in this study. This article reports the findings pertaining to the subset of 193 clinical staff nurses who responded. The Mayer-Salovey-Caruso Emotional Intelligence Test instrument was used to measure emotional intelligence abilities. Performance was defined as ranking on a clinical ladder. Commitment was scored on a Likert scale. The following variables measured retention: total years in nursing, years in current job, total years anticipated in current job, and total anticipated career length. Emotional intelligence scores in clinical staff nurses correlated positively with both performance level and retention variables. Clinical staff nurses with higher emotional intelligence scores demonstrated higher performance, had longer careers, and greater job retention.

Analysis of academic performance management indicators of IFES

Directory of Open Access Journals (Sweden)

Fátima de Souza Freire

2008-07-01

self interest with their own training, as measured by their success ratio and greater dedication to their under graduate course. In the same direction there has been found a favourable effect of the number of students-workers ratio. Nevertheless, no positive effect of the costs per student ratio has been detected as expected, considering the desirable positive influence of such indicator in the quality of education. Key-words: Performance Indicators, Enade, IFES.

Evaluation of Gear Condition Indicator Performance on Rotorcraft Fleet

Science.gov (United States)

Antolick, Lance J.; Branning, Jeremy S.; Wade, Daniel R.; Dempsey, Paula J.

2010-01-01

The U.S. Army is currently expanding its fleet of Health Usage Monitoring Systems (HUMS) equipped aircraft at significant rates, to now include over 1,000 rotorcraft. Two different on-board HUMS, the Honeywell Modern Signal Processing Unit (MSPU) and the Goodrich Integrated Vehicle Health Management System (IVHMS), are collecting vibration health data on aircraft that include the Apache, Blackhawk, Chinook, and Kiowa Warrior. The objective of this paper is to recommend the most effective gear condition indicators for fleet use based on both a theoretical foundation and field data. Gear diagnostics with better performance will be recommended based on both a theoretical foundation and results of in-fleet use. In order to evaluate the gear condition indicator performance on rotorcraft fleets, results of more than five years of health monitoring for gear faults in the entire HUMS equipped Army helicopter fleet will be presented. More than ten examples of gear faults indicated by the gear CI have been compiled and each reviewed for accuracy. False alarms indications will also be discussed. Performance data from test rigs and seeded fault tests will also be presented. The results of the fleet analysis will be discussed, and a performance metric assigned to each of the competing algorithms. Gear fault diagnostic algorithms that are compliant with ADS-79A will be recommended for future use and development. The performance of gear algorithms used in the commercial units and the effectiveness of the gear CI as a fault identifier will be assessed using the criteria outlined in the standards in ADS-79A-HDBK, an Army handbook that outlines the conversion from Reliability Centered Maintenance to the On-Condition status of Condition Based Maintenance.

Key Performance Indicators Disclosures Through Internet: towards an integrated scoreboard

Directory of Open Access Journals (Sweden)

Ilídio Tomás Lopes

2014-10-01

Full Text Available Purpose – Information disclosure is driven by multiple determinants, most of them supported by traditional theories, such as agency theory, contingency theory, and legitemacy theory. This research aims to identify a set of Key Performance Indicators (KPI, disclosed to stakeholders through Internet. It also aims to apply for an integrated performance scorebord, acting it as a dynamic comparative tool, in particular for listed companies which market value is driven by investors expectations and needs.Design/methodology/approach – Based on 47 listed companies from the Portuguese Stock Index regulated market, and through an interpretive content analysis, research was driven towards the identification of KPI that were explicitly reported to stakeholders through structured or unstructured frameworks. This qualitative approach supports the evidences about performance indicators reported by listed companies to stakeholders, in particular to potential stockholders.Findings – Companies disclose a wide variety of key performance indicators, however in most cases included in their periodical management reports. Only a low number of companies disclose those indicators through a visible form in their web sites. Furthermore, KPI disclosed have a generic nature and are usually complemented by theoretical explanations about their evolution and trends. The diversity of indicators disclosed does not permit a comparision between companies and activity sectors. Key performence indicators are still disclosed on a voluntarily basis, remaining, in this scope, multiple agency conflicts and other issues around agency costs. Altough the intensity and categorization in the information disclosure, a standard framework is required in orther to ensure a dynamic comparision between companies or sectors.   Research limitations – The scope of this research is the Portuguese regulated market. Further research can introduce in the sample companies listed in other

Prevalence of rape-related pregnancy as an indication for abortion at two urban family planning clinics.

Science.gov (United States)

Perry, Rachel; Zimmerman, Lindsay; Al-Saden, Iman; Fatima, Aisha; Cowett, Allison; Patel, Ashlesha

2015-05-01

We sought to estimate the prevalence of rape-related pregnancy as an indication for abortion at two public Chicago facilities and to describe demographic and clinical correlates of women who terminated rape-related pregnancies. We performed a cross-sectional study of women obtaining abortion at the Center for Reproductive Health (CRH) at University of Illinois Health Sciences Center and Reproductive Health Services (RHS) at John H. Stroger, Jr. Hospital between August 2009 and August 2013. Gestational age limits at CRH and RHS were 23+6 and 13+6weeks, respectively. We estimated the prevalence of rape-related pregnancy based on billing code (CRH) or data from an administrative database (RHS), and examined relationships between rape-related pregnancy and demographic and clinical variables. Included were 19,465 visits for abortion. The majority of patients were Black (85.6%). Prevalence of abortion for rape-related pregnancy was 1.9%, and was higher at CRH (6.9%) than RHS (1.5%). Later gestational age was associated with abortion for rape-related pregnancy (median 12days, prape-related pregnancy at CRH only (prape-related pregnancy than among those terminating for other indications. Rape-related pregnancy as an indication for abortion had a low, but clinically significant prevalence at two urban Chicago family planning centers. Later gestational age was associated with abortion for rape-related pregnancy. Rape-related pregnancy may occur with higher prevalence among some subgroups of women seeking abortion than others. Efforts to address rape-related pregnancy in the abortion care setting are needed. Copyright © 2015 Elsevier Inc. All rights reserved.

Development of key performance indicators for emergency departments in Ireland using an electronic modified-Delphi consensus approach.

Science.gov (United States)

Wakai, Abel; O'Sullivan, Ronan; Staunton, Paul; Walsh, Cathal; Hickey, Fergal; Plunkett, Patrick K

2013-04-01

The objective of this study was to develop a consensus among emergency medicine (EM) specialists working in Ireland for emergency department (ED) key performance indicators (KPIs). The method employed was a three-round electronic modified-Delphi process. An online questionnaire with 54 potential KPIs was set up for round 1 of the Delphi process. The Delphi panel consisted of all registered EM specialists in Ireland. Each indicator on the questionnaire was rated using a five-point Likert-type rating scale. Agreement was defined as at least 70% of the responders rating an indicator as 'agree' or 'strongly agree' on the rating scale. Data were analysed using standard descriptive statistics. Data were also analysed as the mean of the Likert rating with 95% confidence intervals (95% CIs). Sensitivity of the ratings was examined for robustness by bootstrapping the original sample. Statistical analyses were carried out using SPSS version 16.0. The response rates in rounds 1, 2 and 3 were 86, 88 and 88%, respectively. Ninety-seven potential indicators reached agreement after the three rounds. In the context of the Donabedian structure-process-outcome framework of performance indicators, 41 (42%) of the agreed indicators were structure indicators, 52 (54%) were process indicators and four (4%) were outcome indicators. Overall, the top-three highest rated indicators were: presence of a dedicated ED clinical information system (4.7; 95% CI 4.6-4.9), ED compliance with minimum design standards (4.7; 95% CI 4.5-4.8) and time from ED arrival to first ECG in suspected cardiac chest pain (4.7; 95% CI 4.5-4.9). The top-three highest rated indicators specific to clinical care of children in EDs were: time to administration of antibiotics in children with suspected bacterial meningitis (4.6; 95% CI 4.5-4.8), separate area available within EDs (seeing both adults and children) to assess children (4.4; 95% CI 4.2-4.6) and time to administration of analgesia in children with forearm

Development of key performance indicators for emergency departments in Ireland using an electronic modified-Delphi consensus approach.

LENUS (Irish Health Repository)

Wakai, Abel

2012-02-29

OBJECTIVE: The objective of this study was to develop a consensus among emergency medicine (EM) specialists working in Ireland for emergency department (ED) key performance indicators (KPIs). METHODS: The method employed was a three-round electronic modified-Delphi process. An online questionnaire with 54 potential KPIs was set up for round 1 of the Delphi process. The Delphi panel consisted of all registered EM specialists in Ireland. Each indicator on the questionnaire was rated using a five-point Likert-type rating scale. Agreement was defined as at least 70% of the responders rating an indicator as \\'agree\\' or \\'strongly agree\\' on the rating scale. Data were analysed using standard descriptive statistics. Data were also analysed as the mean of the Likert rating with 95% confidence intervals (95% CIs). Sensitivity of the ratings was examined for robustness by bootstrapping the original sample. Statistical analyses were carried out using SPSS version 16.0. RESULTS: The response rates in rounds 1, 2 and 3 were 86, 88 and 88%, respectively. Ninety-seven potential indicators reached agreement after the three rounds. In the context of the Donabedian structure-process-outcome framework of performance indicators, 41 (42%) of the agreed indicators were structure indicators, 52 (54%) were process indicators and four (4%) were outcome indicators. Overall, the top-three highest rated indicators were: presence of a dedicated ED clinical information system (4.7; 95% CI 4.6-4.9), ED compliance with minimum design standards (4.7; 95% CI 4.5-4.8) and time from ED arrival to first ECG in suspected cardiac chest pain (4.7; 95% CI 4.5-4.9). The top-three highest rated indicators specific to clinical care of children in EDs were: time to administration of antibiotics in children with suspected bacterial meningitis (4.6; 95% CI 4.5-4.8), separate area available within EDs (seeing both adults and children) to assess children (4.4; 95% CI 4.2-4.6) and time to administration of

Key performance indicators score (KPIs-score) based on clinical and laboratorial parameters can establish benchmarks for internal quality control in an ART program.

Science.gov (United States)

Franco, José G; Petersen, Claudia G; Mauri, Ana L; Vagnini, Laura D; Renzi, Adriana; Petersen, Bruna; Mattila, M C; Comar, Vanessa A; Ricci, Juliana; Dieamant, Felipe; Oliveira, João Batista A; Baruffi, Ricardo L R

2017-06-01

KPIs have been employed for internal quality control (IQC) in ART. However, clinical KPIs (C-KPIs) such as age, AMH and number of oocytes collected are never added to laboratory KPIs (L-KPIs), such as fertilization rate and morphological quality of the embryos for analysis, even though the final endpoint is the evaluation of clinical pregnancy rates. This paper analyzed if a KPIs-score strategy with clinical and laboratorial parameters could be used to establish benchmarks for IQC in ART cycles. In this prospective cohort study, 280 patients (36.4±4.3years) underwent ART. The total KPIs-score was obtained by the analysis of age, AMH (AMH Gen II ELISA/pre-mixing modified, Beckman Coulter Inc.), number of metaphase-II oocytes, fertilization rates and morphological quality of the embryonic lot. The total KPIs-score (C-KPIs+L-KPIs) was correlated with the presence or absence of clinical pregnancy. The relationship between the C-KPIs and L-KPIs scores was analyzed to establish quality standards, to increase the performance of clinical and laboratorial processes in ART. The logistic regression model (LRM), with respect to pregnancy and total KPIs-score (280 patients/102 clinical pregnancies), yielded an odds ratio of 1.24 (95%CI = 1.16-1.32). There was also a significant difference (pclinical pregnancies (total KPIs-score=20.4±3.7) and the group without clinical pregnancies (total KPIs-score=15.9±5). Clinical pregnancy probabilities (CPP) can be obtained using the LRM (prediction key) with the total KPIs-score as a predictor variable. The mean C-KPIs and L-KPIs scores obtained in the pregnancy group were 11.9±2.9 and 8.5±1.7, respectively. Routinely, in all cases where the C-KPIs score was ≥9, after the procedure, the L-KPIs score obtained was ≤6, a revision of the laboratory procedure was performed to assess quality standards. This total KPIs-score could set up benchmarks for clinical pregnancy. Moreover, IQC can use C-KPIs and L-KPIs scores to detect problems

Peer influence on students' estimates of performance: social comparison in clinical rotations.

Science.gov (United States)

Raat, A N Janet; Kuks, Jan B M; van Hell, E Ally; Cohen-Schotanus, Janke

2013-02-01

During clinical rotations, students move from one clinical situation to another. Questions exist about students' strategies for coping with these transitions. These strategies may include a process of social comparison because in this context it offers the student an opportunity to estimate his or her abilities to master a novel rotation. These estimates are relevant for learning and performance because they are related to self-efficacy. We investigated whether student estimates of their own future performance are influenced by the performance level and gender of the peer with whom the student compares him- or herself. We designed an experimental study in which participating students (n = 321) were divided into groups assigned to 12 different conditions. Each condition entailed a written comparison situation in which a peer student had completed the rotation the participant was required to undertake next. Differences between conditions were determined by the performance level (worse, similar or better) and gender of the comparison peer. The overall grade achieved by the comparison peer remained the same in all conditions. We asked participants to estimate their own future performance in that novel rotation. Differences between their estimates were analysed using analysis of variance (ANOVA). Students' estimates of their future performance were highest when the comparison peer was presented as performing less well and lowest when the comparison peer was presented as performing better (p influences students' estimates of their future performance in a novel rotation. The effect depends on the performance level and gender of the comparison peer. This indicates that comparisons against particular peers may strengthen or diminish a student's self-efficacy, which, in turn, may ease or hamper the student's learning during clinical rotations. The study is limited by its experimental design. Future research should focus on students' comparison behaviour in real transitions

Relationship between reflection ability and clinical performance: a cross-sectional and retrospective-longitudinal correlational cohort study in midwifery.

Science.gov (United States)

Embo, M; Driessen, E; Valcke, M; van der Vleuten, C P M

2015-01-01

increasingly, reflection is highlighted as integral to core practice competencies but empirical research into the relationship between reflection and performance in the clinical workplace is scarce. this study investigated the relationship between reflection ability and clinical performance. we designed a cross-sectional and a retrospective-longitudinal cohort study. Data from first, second and third year midwifery students were collected to study the variables 'clinical performance' and 'reflection ability'. Data were analysed with SPSS for Windows, Release 20.0. Descriptive statistics, Pearson׳s Product Moment Correlation Coefficients (r) and r² values were computed to investigate associations between the research variables. the results showed a moderate observed correlation between reflection ability and clinical performance scores. When adopting a cross-sectional perspective, all correlation values were significant (p0.6). The results based on the retrospective-longitudinal data set explained a moderate proportion of the variance after correction for attenuation. Finally, the results indicate that 'reflection ability' scores of earlier years are significant related with 'clinical performance' scores of subsequent years. These results suggest that (1) reflection ability is linked to clinical performance; (2) that written reflections are an important, but not the sole way to assess professional competence and that (3) reflection is a contributor to clinical performance improvement. the data showed a moderate but significant relationship between 'reflection ability' and 'clinical performance' scores in clinical practice of midwifery students. Reflection therefore seems an important component of professional competence. Copyright © 2014 Elsevier Ltd. All rights reserved.

Influence of stress and recovery on endurance performance indicators

NARCIS (Netherlands)

Otter, Ruby; Brink, Michel; Lemmink, Koen

2016-01-01

Endurance athletes seek for the optimal balance in stress and recovery so that they can perform at their best. However, it is still largely unknown how psychosocial stress and recovery influence performance indicators of endurance athletes. Therefore, the aim of the study was to investigate how

THE RELEVANCE OF THE PERFORMANCE INDICATORS IN ECONOMIC AND FINANCIAL DIAGNOSIS

Directory of Open Access Journals (Sweden)

MIRELA MONEA

2011-01-01

Full Text Available Each company must achieve the objectives to reach performance in order to survive on the market. The paper aims to present the concept of performance as is seen in economic literature, to discuss the relevance of the main performances indicators on economic and financial diagnosis, to answer the question what are the main indicators which reflect economic or financial performances: profit, profitability ratios, economic added value, investments return, liquidity, cash-flows, resources efficiency, productivity, others.

Facilities Performance Indicators Report 2013-14: Tracking Your Facilities Vital Signs

Science.gov (United States)

APPA: Association of Higher Education Facilities Officers, 2015

2015-01-01

This paper features an expanded Web-based "Facilities Performance Indicators (FPI) Report." The purpose of APPA: Association of Higher Education Facilities Officers (APPA's) Facilities Performance Indicators is to provide a representative set of statistics about facilities in educational institutions. "The Facilities Performance…

Development and psychometric evaluation of the nursing instructors' clinical teaching performance inventory.

Science.gov (United States)

A Farahani, Mansoureh; Emamzadeh Ghasemi, Hormat Sadat; Nikpaima, Nasrin; Fereidooni, Zhila; Rasoli, Maryam

2014-10-29

Evaluation of nursing instructors' clinical teaching performance is a prerequisite to the quality assurance of nursing education. One of the most common procedures for this purpose is using student evaluations. This study was to develop and evaluate the psychometric properties of Nursing Instructors' Clinical Teaching Performance Inventory (NICTPI). The primary items of the inventory were generated by reviewing the published literature and the existing questionnaires as well as consulting with the members of the Faculties Evaluation Committee of the study setting. Psychometric properties were assessed by calculating its content validity ratio and index, and test-retest correlation coefficient as well as conducting an exploratory factor analysis and an internal consistency assessment. The content validity ratios and indices of the items were respectively higher than 0.85 and 0.79. The final version of the inventory consisted of 25 items, and in the exploratory factor analysis, items were loaded on three factors which jointly accounting for 72.85% of the total variance. The test-retest correlation coefficient and the Cronbach's alpha of the inventory were 0.93 and 0.973, respectively. The results revealed that the developed inventory is an appropriate, valid, and reliable instrument for evaluating nursing instructors' clinical teaching performance.

Relationship between oral clinical conditions and daily performances

Directory of Open Access Journals (Sweden)

Andréa Silveira Gomes

2009-03-01

Full Text Available The aim of this study was to assess the impact of oral status on the daily performances of civil servants from the Public Works and Waste Management Department of the city of Porto Alegre, located in Southern Brazil. A cross-sectional study was conducted on a representative sample composed of 276 civil servants with ages ranging from 35 to 44 years. The Oral Impacts on Daily Performances index developed was employed to measure impacts caused by oral clinical conditions. Oral examinations were performed after the interviews. Multinomial Logistic Regression Analysis was used. After adjusting for sex and educational level, the results showed that the subjects with high DMFT scores were 5.8 times (95% CI = 2.1-16.1 more likely to have high impacts on their everyday life than those with low DMFT scores. Subjects that presented some coronal caries were 4.3 times (95% CI = 1.9-9.8 more likely to have high impacts on their everyday life than those with no coronal caries. Dental status assessed through the DMFT index and coronal caries are important indicators of impacts on the everyday life of the studied population.

Development of methods of key performance indicators formation for corporate planning

International Nuclear Information System (INIS)

Chebotarev, A.N.

2011-01-01

A theoretical proposition, a model of enterprise performance management and a concept of balanced key performance indicators as a method to control the enterprise strategy have been systematized and presented. An algorithm that increases the efficiency of action plans' formation has been developed and implemented. In particular, a set of criteria for the selection of events and parameters necessary for the formation of an action plan has been created. A method of control of the business processes, allowing the experts to establish the relationship between the business processes performance indicators and the enterprise's key indicators has been developed [ru

PSA testing without clinical indication for prostate cancer in relation to socio-demographic and clinical characteristics in the Danish Diet, Cancer and Health Study

DEFF Research Database (Denmark)

Karlsen, Randi V; Larsen, Signe B; Christensen, Jane

2013-01-01

Background. Social differences in prostate cancer (PC) incidence and mortality might be related to testing for prostate-specific antigen (PSA). Although routine PSA screening is not recommended in Denmark, testing without clinical indication increased during the past decade. We evaluated...... associations between socio-demographic or clinical characteristics and PSA testing without clinical indication. Material and methods. In the Danish Diet, Cancer and Health Cohort, we identified 1051 men with PC diagnosed in 1993-2008. Diagnostic and clinical characteristics were obtained from medical records......, and socio-demographic information was retrieved from administrative registers. We used general logistic regression analysis to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for associations between socio-demographic or clinical characteristics and PSA testing without clinical indication. Cox...

Technology and Innovation Management Indicators and Assessment Based on Government Performance

Directory of Open Access Journals (Sweden)

Sanja Marinković

2016-05-01

Full Text Available Throughout large global databases, such as OECD, UNDP, ITU, Eurostat, World Bank, and Statistical offices of countries, there are many indicators that refer to Technology and Innovation Management (TIM performance of countries. However, a question arises of how to classify and systematically analyze these indicators in terms of measuring, monitoring and enhancing TIM performance at a national level. More specifically, in this paper we pose a question of how to assess the government performance in TIM, as one aspect of the Triple Helix model. Therefore, we use a model of thirty-nine indicators which are classified according to three main management functions: planning, organizing and control, observed as input, process and output, respectively. More importantly, we analyze the relations that exist between these three categories of indicators. Planning indicators are observed as the investments in technological and innovative activities; organizing indicators include the infrastructure, public administration efficiency and cooperation support, while control indicators refer to the national economy R&D, transfer effects and entrepreneurship outcomes. The model is tested for assessing and comparing government performance in TIM for three countries: Serbia, Croatia and Slovenia, for the time period 2007-2012. Finally, as a feedback in the model, we used scores of the countries according to the Global Innovation Index and the Global Competitiveness Index, to verify the results and provide the final conclusion.

EEG indices correlate with sustained attention performance in patients affected by diffuse axonal injury.

Science.gov (United States)

Coelli, Stefania; Barbieri, Riccardo; Reni, Gianluigi; Zucca, Claudio; Bianchi, Anna Maria

2018-06-01

The aim of this study is to assess the ability of EEG-based indices in providing relevant information about cognitive engagement level during the execution of a clinical sustained attention (SA) test in healthy volunteers and DAI (diffused axonal injury)-affected patients. We computed three continuous power-based engagement indices (P β /P α , 1/P α , and P β / (P α + P θ )) from EEG recordings in a control group (n = 7) and seven DAI-affected patients executing a 10-min Conners' "not-X" continuous performance test (CPT). A correlation analysis was performed in order to investigate the existence of relations between the EEG metrics and behavioral parameters in both the populations. P β /P α and 1/P α indices were found to be correlated with reaction times in both groups while P β / (P α + P θ ) and P β /P α also correlated with the errors rate for DAI patients. In line with previous studies, time course fluctuations revealed a first strong decrease of attention after 2 min from the beginning of the test and a final fading at the end. Our results provide evidence that EEG-derived indices extraction and evaluation during SA tasks are helpful in the assessment of attention level in healthy subjects and DAI patients, offering motivations for including EEG monitoring in cognitive rehabilitation practice. Graphical abstract Three EEG-derived indices were computed from four electrodes montages in a population of seven healthy volunteers and a group of seven DAI-affected patients. Results show a significant correlation between the time course of the indices and behavioral parameters, thus demonstrating their usefulness in monitoring mental engagement level during a sustained attention task.

Global Positioning System Derived Performance Measures Are Responsive Indicators of Physical Activity, Disease and the Success of Clinical Treatments in Domestic Dogs

Science.gov (United States)

Bruno, Elizabeth A.; Guthrie, James W.; Ellwood, Stephen A.; Mellanby, Richard J.; Clements, Dylan N.

2015-01-01

Objective To assess the use of Global Positioning System receiver (GPS) derived performance measures for differentiating between: 1) different outdoor activities in healthy dogs; 2) healthy dogs and those with osteoarthritis; 3) osteoarthritic dogs before and after treatment with non-steroidal anti-inflammatory analgesia. Design Prospective study. Animals Ten healthy dogs and seven dogs with osteoarthritis of the elbow joint (OA dogs). Procedure Healthy dogs were walked on a standard route on-lead, off-lead and subjected to playing activity (chasing a ball) whilst wearing a GPS collar. Each dog was walked for five consecutive days. Dogs with OA were subjected to a single off-lead walk whilst wearing a GPS collar, and then administered oral Carprofen analgesia daily for two weeks. OA dogs were then subjected to the same walk, again wearing a GPS collar. Results GPS derived measures of physical performance could differentiate between on-lead activity, off-lead activity and playing activity in healthy dogs, and between healthy dogs and OA dogs. Variation in the performance measures analysed was greater between individual dogs than for individual dogs on different days. Performance measures could differentiate healthy dogs from OA dogs. OA Dogs treated with Carprofen analgesia showed improvements in their physical performance, which returned to values indistinguishable from those of healthy dogs on nearly all the measures assessed. Conclusions and Clinical Relevance GPS derived measures of physical performance in dogs are objective, easy to quantify, and can be used to gauge the effects of disease and success of clinical treatments. Specific stimuli can be used to modulate physical performance beyond the self-governed boundaries that dogs will naturally express when allowed to exercise freely without stimulation. PMID:25692761

Performance indicators of bioethanol distillation

International Nuclear Information System (INIS)

Marriaga, Nilson

2009-01-01

The increase of biofuels demand accelerates the construction of new production plants and technological improvements in the process so the development of versatile tools for evaluating alternatives becomes an undeniable challenge. It was established through heuristic rules, thermodynamic analysis and simulation computer the energy consumption and performance indicators that govern, from fermented mash (ethanol 8.5 % v/v), the distillation of various capacities for bioethanol production: 20, 60, 100 and 150 KLD (kiloliters / day) through Aspen PlusTM simulator. It was found that the distillation demand nearly 30% of heat that would be obtained by burning alcohol fuel produced thus it is necessary the use of raw materials that generate enough biomass to produce the steam required. In addition, correlations were found to allow for easy diameters of distillation columns in terms of production capacity.

RULES FOR SELECTING AND USING KEY PERFORMANCE INDICATORS FOR THE SERVICE INDUSTRY

Directory of Open Access Journals (Sweden)

Alexandra - Elena RUSĂNEANU

2014-06-01

Full Text Available There is no question that performance is the desired result of every activity or action. In order to correctly measure an organization’s performance it is necessary to select key performance indicators (KPIs that will deliver long-term value to the company. KPIs are presenting performance information for all levels of the organization and they are reflecting the progress made so far to achieve strategic objectives. The selection of the key performance indicators must be made according to the organization’s industry and activity. The company must truly understand its business and its mission. Also, KPIs must be closely linked to the strategic objectives. The focus of this research is to present effective rules for defining key performance indicators for the Service industry. This sector of economy consists in generating intangible goods like experience, expertise and information. Therefore, monitoring this type of services requires a different approach when defining performance indicators compared to the manufacturing industry.

Clinical performance feedback and quality improvement opportunities for perioperative physicians

Directory of Open Access Journals (Sweden)

Kaye AD

2014-05-01

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

Selecting Environmental Performance Indicators : The Case of Numico

NARCIS (Netherlands)

Scherpereel, C.; Koppen, van C.S.A.; Heering, G.B.F.

2001-01-01

In order to achieve both efficient and reliable external communication adapted to the company's specific conditions, it is desirable to establish a clear relation between the environmental performance indicators (EPIs) used internally for environmental management and the EPIs used externally for

A single-center audit of the indications and clinical impact of prolonged ambulatory small intestinal manometry.

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Ang, D; Pannemans, J; Vanuytsel, T; Tack, J

2018-05-01

Small bowel manometry is a diagnostic test available only in a few specialized referral centers. Its exact place in the management of refractory symptoms is controversial. The records of all patients who underwent 24-hour ambulatory duodenojejunal manometry over a 6-year period were retrospectively reviewed. We studied the clinical indications for small bowel manometry, and reviewed the impact of manometric findings on the clinical outcome. One hundred and forty-six studies were performed in 137 patients (46M, 91F) with a mean age of 44.9 ± 15.7 years. Mean follow-up duration was 15.1 ± 22.6 months. Appropriate endoscopic, radiological and gastric scintigraphy studies were performed in all patients prior to small bowel manometry. Criteria for abnormal motor activity were based on Bharucha's classification. The indications for small bowel manometry were chronic abdominal pain (n = 43), slow-transit constipation (n = 17), refractory gastroparesis (n = 16), chronic diarrhea (n = 7), recurrent episodes of subocclusion (n = 16), postsurgical evaluation (n = 36), suspicion of gut involvement in systemic disease (n = 9), and unexplained nausea (n = 2). The most common finding was a normal 24-hour ambulatory small bowel manometry (n = 113). Thirty-three studies yielded abnormal findings which included extrinsic neuropathy (n = 6), intrinsic neuropathy (n = 18), intestinal myopathy (n = 2), and subocclusion (n = 7). Ambulatory small bowel manometry excluded a generalized motility disorder in 77% and had a significant impact on the subsequent clinical course in 23%. Ambulatory small bowel manometry is a useful and safe diagnostic tool to complement traditional investigative modalities in patients with severe unexplained abdominal symptoms. © 2018 John Wiley & Sons Ltd.

Game Indicators Determining Sports Performance in the NBA

OpenAIRE

Miko?ajec, Kazimierz; Maszczyk, Adam; Zaj?c, Tomasz

2013-01-01

The main goal of the present study was to identify basketball game performance indicators which best determine sports level in the National Basketball Association (NBA) league. The research material consisted of all NBA game statistics at the turn of eight seasons (2003?11) and included 52 performance variables. Through detailed analysis the variables with high influence on game effectiveness were selected for final procedures. It has been proven that a limited number of factors, mostly offen...

Key performance indicators in British military trauma.

Science.gov (United States)

Stannard, Adam; Tai, Nigel R; Bowley, Douglas M; Midwinter, Mark; Hodgetts, Tim J

2008-08-01

Key performance indicators (KPI) are tools for assessing process and outcome in systems of health care provision and are an essential component in performance improvement. Although KPI have been used in British military trauma for 10 years, they remain poorly defined and are derived from civilian metrics that do not adjust for the realities of field trauma care. Our aim was to modify current trauma KPI to ensure they more faithfully reflect both the military setting and contemporary evidence in order to both aid accurate calibration of the performance of the British Defence Medical Services and act as a driver for performance improvement. A workshop was convened that was attended by senior, experienced doctors and nurses from all disciplines of trauma care in the British military. "Speciality-specific" KPI were developed by interest groups using evidence-based data where available and collective experience where this was lacking. In a final discussion these were streamlined into 60 KPI covering each phase of trauma management. The introduction of these KPI sets a number of important benchmarks by which British military trauma can be measured. As part of a performance improvement programme, these will allow closer monitoring of our performance and assist efforts to develop, train, and resource British military trauma providers.

Performance indices and evaluation of algorithms in building energy efficient design optimization

International Nuclear Information System (INIS)

Si, Binghui; Tian, Zhichao; Jin, Xing; Zhou, Xin; Tang, Peng; Shi, Xing

2016-01-01

Building energy efficient design optimization is an emerging technique that is increasingly being used to design buildings with better overall performance and a particular emphasis on energy efficiency. To achieve building energy efficient design optimization, algorithms are vital to generate new designs and thus drive the design optimization process. Therefore, the performance of algorithms is crucial to achieving effective energy efficient design techniques. This study evaluates algorithms used for building energy efficient design optimization. A set of performance indices, namely, stability, robustness, validity, speed, coverage, and locality, is proposed to evaluate the overall performance of algorithms. A benchmark building and a design optimization problem are also developed. Hooke–Jeeves algorithm, Multi-Objective Genetic Algorithm II, and Multi-Objective Particle Swarm Optimization algorithm are evaluated by using the proposed performance indices and benchmark design problem. Results indicate that no algorithm performs best in all six areas. Therefore, when facing an energy efficient design problem, the algorithm must be carefully selected based on the nature of the problem and the performance indices that matter the most. - Highlights: • Six indices of algorithm performance in building energy optimization are developed. • For each index, its concept is defined and the calculation formulas are proposed. • A benchmark building and benchmark energy efficient design problem are proposed. • The performance of three selected algorithms are evaluated.

Facilities Performance Indicators Report 2011-12: Tracking Your Facilities Vital Signs

Science.gov (United States)

APPA: Association of Higher Education Facilities Officers, 2013

2013-01-01

This paper provides an expanded Web-based "Facilities Performance Indicators (FPI) Report." The purpose of APPA's Facilities Performance Indicators is to provide a representative set of statistics about facilities in educational institutions. APPA's Information and Research Committee's goal for this year was to enhance the…

Longitudinal Trend Analysis of Performance Indicators for South Carolina's Technical Colleges

Science.gov (United States)

Hossain, Mohammad Nurul

2010-01-01

This study included an analysis of the trend of performance indicators for the technical college sector of higher education in South Carolina. In response to demands for accountability and transparency in higher education, the state of South Carolina developed sector specific performance indicators to measure various educational outcomes for each…

Managing serious clinical deterioration in a tertiary hospital in Hong Kong: from indicators development to multiple measures in reducing the rates.

Science.gov (United States)

Ho, Jasperine Ka Yee; Lee, Quinnie; Lam, Jaden Chun Ho; Tang, Kam Shing

2017-06-01

Timely detection and management of acutely deteriorating patients can save lives. Tuen Mun Hospital (TMH), a 1800-bed acute tertiary hospital serving more than 1.06 million populations in Hong Kong, is exploring to quantitatively monitor serious clinical deterioration (SCD) and uses it to guide patient care improvement initiatives. Literature review on definition and measurement of SCD was conducted. Monthly SCD rates of TMH were first calculated according to the published methodology and benchmarked against those of international centres. A refined composite clinical indicator good for local use was compiled. In the second phase, p-control charts of SCD have been plotted based on cumulative data. TMH's performance was comparable with that of international centres. SCD on p-control charts has been plotting since January 2013. There were peaks in all 4 SCD rates during the winter surge period in 2013-2014. In the third phase, multiple measures have been taking to reduce the SCD rates including targeting the 3 main factors of winter surge situation. We are delighted to observe that the pattern did not repeat in the rate of cardiac arrest without do not attempt cardiopulmonary resuscitation (DNACPR) and rate of death without DNACPR in the same period in 2014-2015. SCD becomes a clinical governance tool to monitor the performance of clinical teams in treating acutely deteriorating patients in TMH. Any abnormal patterns or indications of special cause variations in the control charts would alert leaders to look for root causes of special cause variations and manage accordingly. We hope that this project will extend to corporate level and become a sustainable clinical indicator to guide audits, quality improvement initiatives and strategic planning. © 2016 John Wiley & Sons, Ltd.

Sustainability of the Tourism Industry, Based on Financial Key Performance Indicators

Directory of Open Access Journals (Sweden)

Adriana Dutescu

2014-11-01

Full Text Available Even if there is a real need of a set of key performance indicators for small and medium sized enterprises, this is not yet considered to be satisfied. Our research is focused on two main aspects, each of them individually important for the users of accounting information: the basic indicators specific for analysing operational performance and for decision making and the trend of the key performance indicators in the context of the economic crisis. The starting point of the study is a questionnaire addressed to small and medium sized enterprises activating in the tourism area, especially in the hotel industry. The respondents answered the questions in perfect anonymity by choosing one of the multiple choices for some of them and offering open answers to the others. Our analysis reveals a fair view of the dynamic of the most used key performance indicators in Romanian hotel industry, the limits of their interpretation and usage and the evolution of the financial and economic performance. The declared purpose of the research is to set the bases of a starting point in order to provide solutions for improving the relevance and the usage of these indicators in this domain, in the context of a sustainable business, taking into account the nowadays status of the economy in general and in particular the hotel industry.

Using performance indicators to reduce cost uncertainty of China's CO2 mitigation goals

International Nuclear Information System (INIS)

Xu, Yuan

2013-01-01

Goals on absolute emissions and intensity play key roles in CO 2 mitigation. However, like cap-and-trade policies with price uncertainty, they suffer from significant uncertainty in abatement costs. This article examines whether an indicator could be established to complement CO 2 mitigation goals and help reduce cost uncertainty with a particular focus on China. Performance indicators on CO 2 emissions per unit of energy consumption could satisfy three criteria: compared with the mitigation goals, (i) they are more closely associated with active mitigation efforts and (ii) their baselines have more stable projections from historical trajectories. (iii) Their abatement costs are generally higher than other mitigation methods, particularly energy efficiency and conservation. Performance indicators could be used in the following way: if a CO 2 goal on absolute emissions or intensity is attained, the performance indicator should still reach a lower threshold as a cost floor. If the goal cannot be attained, an upper performance threshold should be achieved as a cost ceiling. The narrower cost uncertainty may encourage wider and greater mitigation efforts. - Highlights: ► CO 2 emissions per unit of energy consumption could act as performance indicators. ► Performance indicators are more closely related to active mitigation activities. ► Performance indicators have more stable historical trajectories. ► Abatement costs are higher for performance indicators than for other activities. ► Performance thresholds could reduce the cost uncertainty of CO 2 mitigation goals.

Performance indicators related to points scoring and winning in international rugby sevens.

Science.gov (United States)

Higham, Dean G; Hopkins, Will G; Pyne, David B; Anson, Judith M

2014-05-01

Identification of performance indicators related to scoring points and winning is needed to inform tactical approaches to international rugby sevens competition. The aim of this study was to characterize team performance indicators in international rugby sevens and quantify their relationship with a team's points scored and probability of winning. Performance indicators of each team during 196 matches of the 2011/2012 International Rugby Board Sevens World Series were modeled for their linear relationships with points scored and likelihood of winning within (changes in team values from match to match) and between (differences between team values averaged over all matches) teams. Relationships were evaluated as the change and difference in points and probability of winning associated with a two within- and between-team standard deviations increase in performance indicator values. Inferences about relationships were assessed using a smallest meaningful difference of one point and a 10% probability of a team changing the outcome of a close match. All indicators exhibited high within-team match-to-match variability (intraclass correlation coefficients ranged from 0.00 to 0.23). Excluding indicators representing points-scoring actions or events occurring on average less than once per match, 13 of 17 indicators had substantial clear within-team relationships with points scored and/or likelihood of victory. Relationships between teams were generally similar in magnitude but unclear. Tactics that increase points scoring and likelihood of winning should be based on greater ball possession, fewer rucks, mauls, turnovers, penalties and free kicks, and limited passing. Key pointsSuccessful international rugby sevens teams tend to maintain ball possession; more frequently avoid taking the ball into contact; concede fewer turnovers, penalties and free kicks; retain possession in scrums, rucks and mauls; and limit passing the ball.Selected performance indicators may be used to

Growth Performance, Haematological Indices and Cost Benefits of ...

African Journals Online (AJOL)

Lenovo pc

Effect of replacing dietary maize with cassava peel meal (CPM) supplemented with Allzyme® SSF (SSF) on the growth performance, haematological indices and cost benefits of growing pigs was investigated. Chemical composition of CPM and diets used were determined using standard procedures. Twenty-four growing ...

Profit indicators in performance systems in the Czech companies

Directory of Open Access Journals (Sweden)

Jana Hornungová

2013-01-01

Full Text Available The main focus of the paper is the corporate performance measurement. At present, it is necessary to monitor this corporate performance and mostly try to improve it, because it could be very crucial competitive advantage in the market. The article provides an overview of key performance indicators (KPIs in the companies. Based on the theoretical data there are applied statistical methods, which should be achieved of main aim of the paper. The main aim of the paper is to describe which groups of Key Performance Indicators are connected with corporate performance system of measurement in the area of Information and Communication Activities. To support this approach theoretical information from the area of Key Performance Indicators connected with data from primary research were used, focused on the performance evaluation of enterprises.Successful companies are aware of the need for long-term strategic development, which is based on teamwork, respect of external environment and all subjects, which influence the business activities of the company directly or indirectly. It can be more effective to conceptualize relationship complete than limit to only consumer market and customer relations. Marketing moves more and more away from individual transaction orientation and rather focus on value creating relations, where the objective is to provide long- term stakeholder value. Day after day the company gets in touch with different groups of stakeholders, that influence the corporate development and it can not to access to these interest groups individually for reason of corporate limits. It is therefore necessary to define homogenous stakeholders groups, which are differ from each other in terms of their impact on business management. The authors of article put the question, which classification is the most statistical explaining the difference of stakeholders in term of evaluation their impact on business management. It was made cluster analysis for

ALARA tools and performance indicators at Cernavoda NPP

International Nuclear Information System (INIS)

Chitu, C.; Popescu, V.; Simionov, V.

2009-01-01

Work efficiency is an area of high concern to nuclear power plant operators. Job planning has to be done so that there will be enough time for ALARA actions to be implemented. The control of the activities involving radiological risk is part of ALARA Process. An effective control supposes the implementation of a process to systematically identify the activities performed in radiological areas. Plant Performance Indicators related to ionizing radiation exposure have been established to improve station safe performance. They are assessed and reported periodically to reflect the safe operation objectives. If target values are exceeded 'abnormal condition reports' are generated. Corrective and preventive actions aim at work planning, technical aspects, and human performance. All the staff is informed about these events and corrective actions described through the training program are implemented. (authors)

Development of radiological performance indicators for nuclear power plants

International Nuclear Information System (INIS)

Lee, B.S.; Jung, K.H.; Lee, S.H.; Jang, S.Y.

2000-01-01

The purpose of this work was to improve the regulatory approach to check the licensee's compliance with regulation regarding radiation protection in operating nuclear power plants (NPPs). The current domestic inspection program for NPPs requires inspectors to conduct compliance-inspection for the systems/equipment and the procedures of NPPs. In this work, we have developed a set of draft radiological performance indicators (PIs) to assess radiation safety in NPPs. The development of PIs was based on the concept that the licensees' implementation of the radiation protection program in NPPs should be able to achieve the goal of radiation protection which the International Commission on Radiological Protection (ICRP) has recommended as ICRP 60 (1991). We selected and/or developed the radiological performance indicators considering the radiation exposure network (source-environment-receptor) for NPPs. The PIs intend to be applied only to normal exposure due to normal operations including transient operational conditions, but not to potential exposure due to accidents. Also, we have chosen the receptor as workers who are occupationally exposed to radiation as well as the members of public who are exposed to radiation from radioactive effluents. The PIs intend to track the past performance rather than to expect the future performance. Finally, the individual PIs do not verify the root cause of the trend of performance; however, they provide the basis for deciding whether the procedures and work management have been properly implemented. Currently a set of 21 draft PIs has been developed for the exposure network in NPPs. For the receptor, the PIs are divided into worker individual dose, worker collective dose and public individual dose. For the environment, the PIs are related to the dose rates of controlled areas, radioactive material concentrations in controlled areas, radioactive contamination in controlled areas and at exit points, and radioactive effluent

Leaflet manual of external beam radiation therapy for hepatocellular carcinoma: a review of the indications, evidences, and clinical trials.

Science.gov (United States)

Rim, Chai Hong; Yoon, Won Sup

2018-01-01

The use of external beam radiation therapy (EBRT) in the treatment of hepatocellular carcinoma (HCC), which was rarely performed due to liver toxicity with a previous technique, has increased. Palliation of portal vein thrombosis, supplementation for insufficient transarterial chemoembolization, and provision of new curative opportunities using stereotactic body radiotherapy are the potential indications for use of EBRT. The mechanism of EBRT treatment, with its radiobiological and physical perspectives, differs from those of conventional medical treatment or surgery. Therefore, understanding the effects of EBRT may be unfamiliar to physicians other than radiation oncologists, especially in the field of HCC, where EBRT has recently begun to be applied. The first objective of this review was to concisely explain the indications for use of EBRT for HCC for all physicians treating HCC. Therefore, this review focuses on the therapeutic outcomes rather than the detailed biological and physical background. We also reviewed recent clinical trials that may extend the indications for use of EBRT. Finally, we reviewed the current clinical practice guidelines for the treatment of HCC and discuss the current recommendations and future perspectives.

Ratios performance indicator evaluation of selected engineering enterprises in the northeast cohesion region

OpenAIRE

Šenec, Alexandr

2014-01-01

The paper deals with the performance indicator evaluation of selected industrial companies with a predominance of engineering production. Ratio indicators were used in order to measure business performance per unit of fixed assets and per employee. Analyzed data were obtained from companies annual reports. Trends ratio indicators were intended with the help of mathematical and statistical methods. These ratios indicator assessing the level of performance, value added and operating profit p...

Key performance indicators for electric mining shovels and oil sands diggability

Science.gov (United States)

Patnayak, Sibabrata

A shovel performance monitoring study was undertaken in two oil sands mines operated by Syncrude Canada Ltd. using performance data obtained from P&H 4100 TS and BOSS electric mining shovels. One year of shovel performance data along with geological, geotechnical, and climatic data were analyzed. The approach adopted was to use current and voltage data collected from hoist and crowd motors and to calculate the energy and/or power associated with digging. Analysis of performance data along with digital video records of operating shovels indicated that hoist and crowd motor voltages and currents can be used to identify the beginning and the end of individual dig cycles. A dig cycle identification algorithm was developed. Performance indicators such as dig cycle time, hoist motor energy and power, and crowd motor energy and power were determined. The shovel performance indicators provide important insight into how geology, equipment and operators affect the digging efficiency. The hoist motor power is a useful key performance indicator for assessing diggability. Hoist motor energy consumption per tonne of material excavated and the number of dig cycles required for loading a truck can be useful key performance indicators for assessing operator performance and productivity. Analysis of performance data along with operators team schedules showed that the performance of a shovel can be significantly influenced by the operator's digging technique while digging uniform material. Up to 25% variability in hoist motor power consumption and 50% variability in productivity was noted between different operators. Shovel type and dipper teeth configuration can also influence the power draw on electrical motors during digging. There is no common agreement existing on the influence of bitumen content on oil sands diggability. By comparing the hoist motor power consumption, it was found that the rich ore was more difficult to dig than the lean ore. Similarly, estuarine ore was more

Prioritising indicators in improving supply chain performance using fuzzy AHP

DEFF Research Database (Denmark)

Govindan, Kannan; Mangla, Sachin Kumar; Luthra, Sunil

2017-01-01

In this contribution, we aim to prioritise the indicators to enhance the organisational supply chain’s (SC) effectiveness from an industrial perspective. It will help industries to develop strategies for managing the SC effectively and ensuring improvement in performance continuously. To achieve...... this, this work proposes to use a two-phase research methodology. First, 36 SC performance improvement indicators are recognised from a literature survey and from field and industrial expert’s inputs. Secondly, a structural model is proposed using the fuzzy analytical hierarchy process (AHP...

Leading product-related environmental performance indicators: a selection guide and database

DEFF Research Database (Denmark)

Issa, Isabela I.; Pigosso, Daniela Cristina Antelmi; McAloone, Tim C.

2015-01-01

Ecodesign is a proactive environmental management and improvement approach employed in the product development process, which aims to minimize the environmental impacts caused during a product's life cycle and thus improve its environmental performance. The establishment of measurable environmental...... in the selection and application of environmental performance indicators - a more structured approach is still lacking. This paper presents the efforts made to identify and systematize existing leading product-related environmental performance indicators, based on a systematic literature review, and to develop...

Public perceptions of key performance indicators of healthcare in Alberta, Canada.

Science.gov (United States)

Northcott, Herbert C; Harvey, Michael D

2012-06-01

To examine the relationship between public perceptions of key performance indicators assessing various aspects of the health-care system. Cross-sequential survey research. Annual telephone surveys of random samples of adult Albertans selected by random digit dialing and stratified according to age, sex and region (n = 4000 for each survey year). The survey questionnaires included single-item measures of key performance indicators to assess public perceptions of availability, accessibility, quality, outcome and satisfaction with healthcare. Cronbach's α and factor analysis were used to assess the relationship between key performance indicators focusing on the health-care system overall and on a recent interaction with the health-care system. The province of Alberta, Canada during the years 1996-2004. Four thousand adults randomly selected each survey year. Survey questions measuring public perceptions of healthcare availability, accessibility, quality, outcome and satisfaction with healthcare. Factor analysis identified two principal components with key performance indicators focusing on the health system overall loading most strongly on the first component and key performance indicators focusing on the most recent health-care encounter loading most strongly on the second component. Assessments of the quality of care most recently received, accessibility of that care and perceived outcome of care tended to be higher than the more general assessments of overall health system quality and accessibility. Assessments of specific health-care encounters and more general assessments of the overall health-care system, while related, nevertheless comprise separate dimensions for health-care evaluation.

Deriving common comorbidity indices from the MedDRA classification and exploring their performance on key outcomes in patients with rheumatoid arthritis.

Science.gov (United States)

Putrik, Polina; Ramiro, Sofia; Lie, Elisabeth; Michaud, Kaleb; Kvamme, Maria K; Keszei, Andras P; Kvien, Tore K; Uhlig, Till; Boonen, Annelies

2018-03-01

To develop algorithms for calculating the Rheumatic Diseases Comorbidity Index (RDCI), Charlson-Deyo Index (CDI) and Functional Comorbidity Index (FCI) from the Medical Dictionary for Regulatory Activities (MedDRA), and to assess how these MedDRA-derived indices predict clinical outcomes, utility and health resource utilization (HRU). Two independent researchers linked the preferred terms of the MedDRA classification into the conditions included in the RDCI, the CDI and the FCI. Next, using data from the Norwegian Register-DMARD study (a register of patients with inflammatory joint diseases treated with DMARDs), the explanatory value of these indices was studied in models adjusted for age, gender and DAS28. Model fit statistics were compared in generalized estimating equation (prediction of outcome over time) models using as outcomes: modified HAQ, HAQ, physical and mental component summary of SF-36, SF6D and non-RA related HRU. Among 4126 patients with RA [72% female, mean (s.d.) age 56 (14) years], median (interquartile range) of RDCI at baseline was 0.0 (1.0) [range 0-6], CDI 0.0 (0.0) [0-7] and FCI 0.0 (1.0) [0-6]. All the comorbidity indices were associated with each outcome, and differences in their performance were moderate. The RDCI and FCI performed better on clinical outcomes: modified HAQ and HAQ, hospitalization, physical and mental component summary, and SF6D. Any non-RA related HRU was best predicted by RDCI followed by CDI. An algorithm is now available to compute three commonly used comorbidity indices from MedDRA classification. Indices performed comparably well in predicting a variety of outcomes, with the CDI performing slightly worse when predicting outcomes reflecting functioning and health. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Identifying Key Performance Indicators for Holistic Hospital Management with a Modified DEMATEL Approach.

Science.gov (United States)

Si, Sheng-Li; You, Xiao-Yue; Liu, Hu-Chen; Huang, Jia

2017-08-19

Performance analysis is an important way for hospitals to achieve higher efficiency and effectiveness in providing services to their customers. The performance of the healthcare system can be measured by many indicators, but it is difficult to improve them simultaneously due to the limited resources. A feasible way is to identify the central and influential indicators to improve healthcare performance in a stepwise manner. In this paper, we propose a hybrid multiple criteria decision making (MCDM) approach to identify key performance indicators (KPIs) for holistic hospital management. First, through integrating evidential reasoning approach and interval 2-tuple linguistic variables, various assessments of performance indicators provided by healthcare experts are modeled. Then, the decision making trial and evaluation laboratory (DEMATEL) technique is adopted to build an interactive network and visualize the causal relationships between the performance indicators. Finally, an empirical case study is provided to demonstrate the proposed approach for improving the efficiency of healthcare management. The results show that "accidents/adverse events", "nosocomial infection", ''incidents/errors", "number of operations/procedures" are significant influential indicators. Also, the indicators of "length of stay", "bed occupancy" and "financial measures" play important roles in performance evaluation of the healthcare organization. The proposed decision making approach could be considered as a reference for healthcare administrators to enhance the performance of their healthcare institutions.

Key performance indicators for measuring sustainability in health ...

African Journals Online (AJOL)

Key performance indicators for measuring sustainability in health care industry in Malaysia. ... AFRICAN JOURNALS ONLINE (AJOL) · Journals · Advanced Search ... Journal Home > Vol 10, No 1S (2018) > ... Next, an in-depth meeting was conducted to gain insights and feedbacks with the management of a private hospital.

Health system frameworks and performance indicators in eight countries: A comparative international analysis

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Jeffrey Braithwaite

2017-01-01

Full Text Available Objectives: Performance indicators are a popular mechanism for measuring the quality of healthcare to facilitate both quality improvement and systems management. Few studies make comparative assessments of different countries’ performance indicator frameworks. This study identifies and compares frameworks and performance indicators used in selected Organisation for Economic Co-operation and Development health systems to measure and report on the performance of healthcare organisations and local health systems. Countries involved are Australia, Canada, Denmark, England, the Netherlands, New Zealand, Scotland and the United States. Methods: Identification of comparable international indicators and analyses of their characteristics and of their broader national frameworks and contexts were undertaken. Two dimensions of indicators – that they are nationally consistent (used across the country rather than just regionally and locally relevant (measured and reported publicly at a local level, for example, a health service – were deemed important. Results: The most commonly used domains in performance frameworks were safety, effectiveness and access. The search found 401 indicators that fulfilled the ‘nationally consistent and locally relevant’ criteria. Of these, 45 indicators are reported in more than one country. Cardiovascular, surgery and mental health were the most frequently reported disease groups. Conclusion: These comparative data inform researchers and policymakers internationally when designing health performance frameworks and indicator sets.

Clinical Neuropathology practice news 1-2014: Pyrosequencing meets clinical and analytical performance criteria for routine testing of MGMT promoter methylation status in glioblastoma

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Preusser, Matthias; Berghoff, Anna S.; Manzl, Claudia; Filipits, Martin; Weinhäusel, Andreas; Pulverer, Walter; Dieckmann, Karin; Widhalm, Georg; Wöhrer, Adelheid; Knosp, Engelbert; Marosi, Christine; Hainfellner, Johannes A.

2014-01-01

Testing of the MGMT promoter methylation status in glioblastoma is relevant for clinical decision making and research applications. Two recent and independent phase III therapy trials confirmed a prognostic and predictive value of the MGMT promoter methylation status in elderly glioblastoma patients. Several methods for MGMT promoter methylation testing have been proposed, but seem to be of limited test reliability. Therefore, and also due to feasibility reasons, translation of MGMT methylation testing into routine use has been protracted so far. Pyrosequencing after prior DNA bisulfite modification has emerged as a reliable, accurate, fast and easy-to-use method for MGMT promoter methylation testing in tumor tissues (including formalin-fixed and paraffin-embedded samples). We performed an intra- and inter-laboratory ring trial which demonstrates a high analytical performance of this technique. Thus, pyrosequencing-based assessment of MGMT promoter methylation status in glioblastoma meets the criteria of high analytical test performance and can be recommended for clinical application, provided that strict quality control is performed. Our article summarizes clinical indications, practical instructions and open issues for MGMT promoter methylation testing in glioblastoma using pyrosequencing. PMID:24359605

Correlation Between Screening Mammography Interpretive Performance on a Test Set and Performance in Clinical Practice.

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Miglioretti, Diana L; Ichikawa, Laura; Smith, Robert A; Buist, Diana S M; Carney, Patricia A; Geller, Berta; Monsees, Barbara; Onega, Tracy; Rosenberg, Robert; Sickles, Edward A; Yankaskas, Bonnie C; Kerlikowske, Karla

2017-10-01

Evidence is inconsistent about whether radiologists' interpretive performance on a screening mammography test set reflects their performance in clinical practice. This study aimed to estimate the correlation between test set and clinical performance and determine if the correlation is influenced by cancer prevalence or lesion difficulty in the test set. This institutional review board-approved study randomized 83 radiologists from six Breast Cancer Surveillance Consortium registries to assess one of four test sets of 109 screening mammograms each; 48 radiologists completed a fifth test set of 110 mammograms 2 years later. Test sets differed in number of cancer cases and difficulty of lesion detection. Test set sensitivity and specificity were estimated using woman-level and breast-level recall with cancer status and expert opinion as gold standards. Clinical performance was estimated using women-level recall with cancer status as the gold standard. Spearman rank correlations between test set and clinical performance with 95% confidence intervals (CI) were estimated. For test sets with fewer cancers (N = 15) that were more difficult to detect, correlations were weak to moderate for sensitivity (woman level = 0.46, 95% CI = 0.16, 0.69; breast level = 0.35, 95% CI = 0.03, 0.61) and weak for specificity (0.24, 95% CI = 0.01, 0.45) relative to expert recall. Correlations for test sets with more cancers (N = 30) were close to 0 and not statistically significant. Correlations between screening performance on a test set and performance in clinical practice are not strong. Test set performance more accurately reflects performance in clinical practice if cancer prevalence is low and lesions are challenging to detect. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Barriers to using eHealth data for clinical performance feedback in Malawi: A case study.

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Landis-Lewis, Zach; Manjomo, Ronald; Gadabu, Oliver J; Kam, Matthew; Simwaka, Bertha N; Zickmund, Susan L; Chimbwandira, Frank; Douglas, Gerald P; Jacobson, Rebecca S

2015-10-01

Sub-optimal performance of healthcare providers in low-income countries is a critical and persistent global problem. The use of electronic health information technology (eHealth) in these settings is creating large-scale opportunities to automate performance measurement and provision of feedback to individual healthcare providers, to support clinical learning and behavior change. An electronic medical record system (EMR) deployed in 66 antiretroviral therapy clinics in Malawi collects data that supervisors use to provide quarterly, clinic-level performance feedback. Understanding barriers to provision of eHealth-based performance feedback for individual healthcare providers in this setting could present a relatively low-cost opportunity to significantly improve the quality of care. The aims of this study were to identify and describe barriers to using EMR data for individualized audit and feedback for healthcare providers in Malawi and to consider how to design technology to overcome these barriers. We conducted a qualitative study using interviews, observations, and informant feedback in eight public hospitals in Malawi where an EMR system is used. We interviewed 32 healthcare providers and conducted seven hours of observation of system use. We identified four key barriers to the use of EMR data for clinical performance feedback: provider rotations, disruptions to care processes, user acceptance of eHealth, and performance indicator lifespan. Each of these factors varied across sites and affected the quality of EMR data that could be used for the purpose of generating performance feedback for individual healthcare providers. Using routinely collected eHealth data to generate individualized performance feedback shows potential at large-scale for improving clinical performance in low-resource settings. However, technology used for this purpose must accommodate ongoing changes in barriers to eHealth data use. Understanding the clinical setting as a complex adaptive

Using DEMATEL approach to develop relationships of performance indicators on sustainable service only supply chain performance measurement

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Leksono, EB; Suparno; Vanany, I.

2018-04-01

Service only supply chain (SOSC) concept is service supply chain (SSC) implementation on pure services. The globalization and stakeholder pressure makes operation of SSC should give the attention to the environment effect, community, economic and intangibility assets. SOSC performance measurement (SOSCPM) may be developed for measuring of performance for sustainability aspects and intangibility assets to meet customer satisfaction. This article discusses sustainable SOSCPM based on balanced scorecard (BSC), include sustainability aspects, intangibility and relations between perspectives and indicators. From literature review, it is found 34 performance indicators that must be confirm to expert and SC actors by survey. From survey validation using weighted average and level of consensus, it is found 29 valid indicators for processed by DEMATEL. From DEMATEL, it is found 26 indicators can be used on sustainable SOSCPM. Furthermore, innovation and growth perspective most influence to other, and customer perspective most important. Intangibility indicators incorporated on innovation and growth perspective very related with human resources. Finally, relations between perspectives and indicator used to design of BSC strategy maps.

Cluster Detection Tests in Spatial Epidemiology: A Global Indicator for Performance Assessment.

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Aline Guttmann

Full Text Available In cluster detection of disease, the use of local cluster detection tests (CDTs is current. These methods aim both at locating likely clusters and testing for their statistical significance. New or improved CDTs are regularly proposed to epidemiologists and must be subjected to performance assessment. Because location accuracy has to be considered, performance assessment goes beyond the raw estimation of type I or II errors. As no consensus exists for performance evaluations, heterogeneous methods are used, and therefore studies are rarely comparable. A global indicator of performance, which assesses both spatial accuracy and usual power, would facilitate the exploration of CDTs behaviour and help between-studies comparisons. The Tanimoto coefficient (TC is a well-known measure of similarity that can assess location accuracy but only for one detected cluster. In a simulation study, performance is measured for many tests. From the TC, we here propose two statistics, the averaged TC and the cumulated TC, as indicators able to provide a global overview of CDTs performance for both usual power and location accuracy. We evidence the properties of these two indicators and the superiority of the cumulated TC to assess performance. We tested these indicators to conduct a systematic spatial assessment displayed through performance maps.

Cluster Detection Tests in Spatial Epidemiology: A Global Indicator for Performance Assessment

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Guttmann, Aline; Li, Xinran; Feschet, Fabien; Gaudart, Jean; Demongeot, Jacques; Boire, Jean-Yves; Ouchchane, Lemlih

2015-01-01

In cluster detection of disease, the use of local cluster detection tests (CDTs) is current. These methods aim both at locating likely clusters and testing for their statistical significance. New or improved CDTs are regularly proposed to epidemiologists and must be subjected to performance assessment. Because location accuracy has to be considered, performance assessment goes beyond the raw estimation of type I or II errors. As no consensus exists for performance evaluations, heterogeneous methods are used, and therefore studies are rarely comparable. A global indicator of performance, which assesses both spatial accuracy and usual power, would facilitate the exploration of CDTs behaviour and help between-studies comparisons. The Tanimoto coefficient (TC) is a well-known measure of similarity that can assess location accuracy but only for one detected cluster. In a simulation study, performance is measured for many tests. From the TC, we here propose two statistics, the averaged TC and the cumulated TC, as indicators able to provide a global overview of CDTs performance for both usual power and location accuracy. We evidence the properties of these two indicators and the superiority of the cumulated TC to assess performance. We tested these indicators to conduct a systematic spatial assessment displayed through performance maps. PMID:26086911

Which priority indicators to use to evaluate nursing care performance? A discussion paper.

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Dubois, Carl-Ardy; D'amour, Danielle; Brault, Isabelle; Dallaire, Clémence; Déry, Johanne; Duhoux, Arnaud; Lavoie-Tremblay, Mélanie; Mathieu, Luc; Karemere, Hermès; Zufferey, Arnaud

2017-12-01

A discussion of an optimal set of indicators that can be used on a priority basis to assess the performance of nursing care. Recent advances in conceptualization of nursing care performance, exemplified by the Nursing Care Performance Framework, have revealed a broad universe of potentially nursing-sensitive indicators. Organizations now face the challenge of selecting, from this universe, a realistic subset of indicators that can form a balanced and common scorecard. Discussion paper drawing on a systematic assessment of selected performance indicators. Previous works, based on systematic reviews of the literature published between 1990 - 2014, have contributed to the development of the Nursing Care Performance Framework. These works confirmed a robust set of indicators that capture the universe of content currently supported by the scientific literature and cover all major areas of nursing care performance. Building on these previous works, this study consisted in gathering the specific evidence supporting 25 selected indicators, focusing on systematic syntheses, meta-analyses and integrative reviews. This study has identified a set of 12 indicators that have sufficient breadth and depth to capture the whole spectrum of nursing care and that could be implemented on a priority basis. This study sets the stage for new initiatives aiming at filling current gaps in operationalization of nursing care performance. The next milestone is to set up the infrastructure required to collect data on these indicators and make effective use of them. © 2017 John Wiley & Sons Ltd.

Learning strategies during clerkships and their effects on clinical performance.

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van Lohuizen, M T; Kuks, J B M; van Hell, E A; Raat, A N; Cohen-Schotanus, J

2009-11-01

Previous research revealed relationships between learning strategies and knowledge acquisition. During clerkships, however, students' focus widens beyond mere knowledge acquisition as they further develop overall competence. This shift in focus can influence learning strategy use. We explored which learning strategies were used during clerkships and their relationship to clinical performance. Participants were 113 (78%) clerks at the university hospital or one of six affiliated hospitals. Learning strategies were assessed using the 'Approaches to Learning at Work Questionnaire' (deep, surface-rational and surface-disorganised learning). Clinical performance was calculated by taking the mean of clinical assessment marks. The relationship between learning strategies and clinical performance was explored using regression analysis. Most students (89%) did not clearly prefer a single learning strategy. No relationship was found between learning strategies and clinical performance. Since overall competence comprises integration of knowledge, skills and professional behaviour, we assume that students without a clear preference use more than one learning strategy. Finding no relationship between learning strategies and clinical performance reflects the complexity of clinical learning. Depending on circumstances it may be important to obtain relevant information quickly (surface-rational) or understand material thoroughly (deep). In future research we will examine when and why students use different learning strategies.

Computation of a Suburban Night Train Timetable Based on Key Performance Indicators

DEFF Research Database (Denmark)

Schittenhelm, Bernd; Landex, Alex

2010-01-01

Timetable evaluation can be based on a set of key performance indicators. This article presents six essential key performance indicators: Fixed interval service frequency, direct connections, transfer waiting time, use of dedicated rolling stock, dedicated train personnel, dedicated tracks...

Key performance indicators for successful simulation projects

OpenAIRE

Jahangirian, M; Taylor, SJE; Young, T; Robinson, S

2016-01-01

There are many factors that may contribute to the successful delivery of a simulation project. To provide a structured approach to assessing the impact various factors have on project success, we propose a top-down framework whereby 15 Key Performance Indicators (KPI) are developed that represent the level of successfulness of simulation projects from various perspectives. They are linked to a set of Critical Success Factors (CSF) as reported in the simulation literature. A single measure cal...

Pressure Ulcers: Developing Clinical Indicators in Evidence-based Practice. A Prospective Study.

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Tsaras, Konstantinos; Chatzi, Maria; Kleisiaris, Christos F; Fradelos, Evangelos C; Kourkouta, Lambrini; Papathanasiou, Ioanna V

2016-10-01

It is widely recognized that Intensive Care Unit (ICU) patients have a greater likelihood of developing pressure ulcers in comparison to hospital or home care patients. Accordingly, this study aimed to evaluate whether specific clinical characteristics could be used as clinical indicators towards pressure ulcers prevention. We monitored 210 hospitalized ICU patients during a 12-month period. Pressure ulcers were assessed following the current guidelines. Clinical characteristics such as gender, age, hospitalized days, hemodialysis treatment, hematocrit, and serum albumin levels were considered as the most common predictors for pressure ulcers development. The significance of associations was controlled using multiple logistic regression after adjusting for clinical characteristics and was presented as adjusted odds ratio (AOR). The prevalence of pressure ulcers was 24.3%. Logistic regression revealed that patients with increased age AOR=1.04; (CI: 1.01-1.07) and last-long hospitalization AOR=1.17; (CI: 1.11-1.23) were significantly more likely to present pressure ulcers compared to the younger ones and patients with less length of stay, respectively. We also found that patients under hemodialysis treatment were more likely to present pressure ulcers AOR=4.09; (CI: 1.12-14.98) compared to patients that did not underwent hemodialysis and the risk of pressure ulcers development was decreased by 9% for every single unit of hematocrit value increase AOR=0.91; (CI: 0.82-0.99). Our data analysis confirms that the clinical characteristics that were studied are independently associated with pressure ulcers development, and therefore, it is a crucial incentive to consider that these specific clinical characteristics are important indicators in the evidence-based practice.

Academic performance and correspondences with indicators of physical and psychological health

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Alberto Portoles Ariño

2015-05-01

Full Text Available Academic performance of the teenagers is influenced and determined by numerous factors. Life style and the conducts of health adopted in this period relate to the academic performance of direct form, in such a way that the teenagers with ways of life and more healthy conducts, can present a more adapted academic performance. Equally, to support correct indicators of psychological health relates to the academic adapted performance. The results obtained with a sample of 1210 teenagers of the Region of Murcia, with a normal age of 15.13 years it allows to value the importance of the indicators of health as determinants of the academic performance, for what they should develop programs directed to supporting positive levels of said

KEY PERFORMANCE INDICATORS FOR HEALTHCARE RESEARCH ORGANIZATIONS BETWEEN 2011 AND 2015

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ANISKEVICH A.S.; HALFIN R.A.

2017-01-01

In this work we identify 16 key indicators to evaluate the performance of healthcare research organizations. These indicators comprehensively characterize such aspects of performance as research output and relevance, human resource development, integration into the international scientific community, distribution of scientific knowledge, promotion of the prestige of science, and resource provision. Below, we review the existing classification of medical research institutions and their key fea...

Performance indicators for nuclear medicine and industrial radiographers. Final report

International Nuclear Information System (INIS)

Hill, T.D.

1997-01-01

HCA--Assessment Experts (HCA) was retained under contract to provide evidence that a behaviourally based approach to the development of performance indicators for radioisotope users could be successfully designed, implemented and rapidly delivered to a pilot sample. Moreover, HCA believed that it was uniquely qualified to not only achieve this success, but to show further that we could instill the motivation for self-improvement in the AECB inspection ratings of Licensees and Permit Holders. In the space of about ten weeks. HCA was able to deliver a comprehensive set of web-based tools for performance indicators. Not only did we deliver these tools, but we also included such supplemental information as relevant legislation, regulations. Inspectors' preferences and recommendations, among others, so as to foster a learning component of the performance indicators tools. The call for the continuation of this work is based on two sources. The response from participants to this project was very favourable - participants want these tools. Secondly, our research and experience have shown (and the larger body of empirical research also shows) that this is the type of performance feedback and communication that participants appreciate the most, and is the most predictive of successful compliance and improvement in the future. (author)

Leaflet manual of external beam radiation therapy for hepatocellular carcinoma: a review of the indications, evidences, and clinical trials

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Rim CH

2018-05-01

Full Text Available Chai Hong Rim, Won Sup Yoon Department of Radiation Oncology, Ansan Hospital, Korea University Medical College, Ansan, Republic of Korea Abstract: The use of external beam radiation therapy (EBRT in the treatment of hepatocellular carcinoma (HCC, which was rarely performed due to liver toxicity with a previous technique, has increased. Palliation of portal vein thrombosis, supplementation for insufficient transarterial chemoembolization, and provision of new curative opportunities using stereotactic body radiotherapy are the potential indications for use of EBRT. The mechanism of EBRT treatment, with its radiobiological and physical perspectives, differs from those of conventional medical treatment or surgery. Therefore, understanding the effects of EBRT may be unfamiliar to physicians other than radiation oncologists, especially in the field of HCC, where EBRT has recently begun to be applied. The first objective of this review was to concisely explain the indications for use of EBRT for HCC for all physicians treating HCC. Therefore, this review focuses on the therapeutic outcomes rather than the detailed biological and physical background. We also reviewed recent clinical trials that may extend the indications for use of EBRT. Finally, we reviewed the current clinical practice guidelines for the treatment of HCC and discuss the current recommendations and future perspectives. Keywords: hepatocellular carcinoma, liver neoplasm, external beam radiotherapy, stereotactic body radiotherapy, clinical trials, sorafenib, guidelines

Lean Information Management: Criteria For Selecting Key Performance Indicators At Shop Floor

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Iuga, Maria Virginia; Kifor, Claudiu Vasile; Rosca, Liviu-Ion

2015-07-01

Most successful organizations worldwide use key performance indicators as an important part of their corporate strategy in order to forecast, measure and plan their businesses. Performance metrics vary in their purpose, definition and content. Therefore, the way organizations select what they think are the optimal indicators for their businesses varies from company to company, sometimes even from department to department. This study aims to answer the question of what is the most suitable way to define and select key performance indicators. More than that, it identifies the right criteria to select key performance indicators at shop floor level. This paper contributes to prior research by analysing and comparing previously researched selection criteria and proposes an original six-criteria-model, which caters towards choosing the most adequate KPIs. Furthermore, the authors take the research a step further by further steps to closed research gaps within this field of study.

Correlation between clinical performance and degree of conversion of resin cements: a literature review

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Grace DE SOUZA

2015-08-01

Full Text Available AbstractResin-based cements have been frequently employed in clinical practice to lute indirect restorations. However, there are numerous factors that may compromise the clinical performance of those cements. The aim of this literature review is to present and discuss some of the clinical factors that may affect the performance of current resin-based luting systems. Resin cements may have three different curing mechanisms: chemical curing, photo curing or a combination of both. Chemically cured systems are recommended to be used under opaque or thick restorations, due to the reduced access of the light. Photo-cured cements are mainly indicated for translucent veneers, due to the possibility of light transmission through the restoration. Dual-cured are more versatile systems and, theoretically, can be used in either situation, since the presence of both curing mechanisms might guarantee a high degree of conversion (DC under every condition. However, it has been demonstrated that clinical procedures and characteristics of the materials may have many different implications in the DC of currently available resin cements, affecting their mechanical properties, bond strength to the substrate and the esthetic results of the restoration. Factors such as curing mechanism, choice of adhesive system, indirect restorative material and light-curing device may affect the degree of conversion of the cement and, therefore, have an effect on the clinical performance of resin-based cements. Specific measures are to be taken to ensure a higher DC of the luting system to be used.

The Power of Performance Indices in the Global Politics of Anti-corruption

DEFF Research Database (Denmark)

Krause Hansen, Hans

2012-01-01

. Drawing on studies of organisation, surveillance and governmentality, this article examines the capacity of performance indices to construct comparable and governable subjects in international efforts to combat corruption. It conceptualises performance indices in terms of technologies of distance......While scholars have focused on the macro-structural, institutional and legal dimensions at work in international anti-corruption, they have paid little attention to role of the more specific technologies through which social forces become entangled in efforts at combating corruption internationally......, communication and surveillance and analyses a variety of corruption and anti-corruption indices, including corporate blacklisting as applied by the World Bank towards fraudulent corporations. It demonstrates how performance indices are implicated in the construction of standards and scripts for action against...

Key Performance Indicators (KPI) Developing, Implementing, and Using Winning KPIs

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Parmenter, David

2010-01-01

An in-depth look at how to create and use key performance indicators (KPIs), from the King of KPIs â€" now updated and expanded! By exploring measures that have transformed businesses, David Parmenter has developed a methodology that is breathtaking in its simplicity and yet profound in its impact. Now in an updated and expanded Second Edition, Key Performance Indicators is a proactive guide representing a significant shift in the way KPIs are developed and used, with an abundance of implementation tools, including: The four foundation stones that lead the development and use of KPIs; A 12-ste

Preliminary performance test of control rod position indicator for ballscrew type CEDM

International Nuclear Information System (INIS)

Yoo, J. Y.; Kim, J. H.; Hu, H.; Lee, J. S.; Kim, J. I.

2003-01-01

The reliability and accuracy of the information on control rod position are very important to the reactor safety and the design of the core protection system. A survey on the RSPT(Reed Switch Position Transmitter) type control rod position indication system and its actual implementation in the exiting nuclear power plants in Korea was performed first. The prototype of control rod position indicator having the high performance for the ballscrew type CEDM was developed on the basis of RSPT technology identified through the survey. The characteristics of control rod position indicator was defined and documented through design procedure and preliminary performance test

Safety and performance indicators for repositories in salt and clay formations

International Nuclear Information System (INIS)

Wolf, Jens; Ruebel, Andre; Noseck, Ulrich; Becker, Dirk

2008-07-01

The GRS (Gesellschaft fuer Reaktorsicherheit) study aims to the identification of suitable indicators for repositories in salt and clay formation. It is not intended to compare the two formations with respect to the safe disposal of radioactive waste. A first set of safety and performance indicators for both host rocks has been derived on the basis of results of the SPIN project. Reference values for the safety indicators have been determined. The suitability of the indicators and their significance for different time frames Is demonstrated by means of deterministic model calculations and external parameter variations of previous studies. The safety indicators considered in the report are the effective dose rate (Sv/a), the radiotoxicity concentration in the biosphere water (Sv/m 3 ) and the radiotoxicity flux from the geosphere (overlying rock) (Sv/a). The performance indicators considered in the study are the radiotoxicity inventory in different compartments (S), radiotoxicity fluxes from compartments and the integrated radiotoxicity fluxes from compartments (Sv).

Performance Validity Testing in Neuropsychology: Scientific Basis and Clinical Application-A Brief Review.

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Greher, Michael R; Wodushek, Thomas R

2017-03-01

Performance validity testing refers to neuropsychologists' methodology for determining whether neuropsychological test performances completed in the course of an evaluation are valid (ie, the results of true neurocognitive function) or invalid (ie, overly impacted by the patient's effort/engagement in testing). This determination relies upon the use of either standalone tests designed for this sole purpose, or specific scores/indicators embedded within traditional neuropsychological measures that have demonstrated this utility. In response to a greater appreciation for the critical role that performance validity issues play in neuropsychological testing and the need to measure this variable to the best of our ability, the scientific base for performance validity testing has expanded greatly over the last 20 to 30 years. As such, the majority of current day neuropsychologists in the United States use a variety of measures for the purpose of performance validity testing as part of everyday forensic and clinical practice and address this issue directly in their evaluations. The following is the first article of a 2-part series that will address the evolution of performance validity testing in the field of neuropsychology, both in terms of the science as well as the clinical application of this measurement technique. The second article of this series will review performance validity tests in terms of methods for development of these measures, and maximizing of diagnostic accuracy.

Business process performance measurement: a structured literature review of indicators, measures and metrics.

Science.gov (United States)

Van Looy, Amy; Shafagatova, Aygun

2016-01-01

Measuring the performance of business processes has become a central issue in both academia and business, since organizations are challenged to achieve effective and efficient results. Applying performance measurement models to this purpose ensures alignment with a business strategy, which implies that the choice of performance indicators is organization-dependent. Nonetheless, such measurement models generally suffer from a lack of guidance regarding the performance indicators that exist and how they can be concretized in practice. To fill this gap, we conducted a structured literature review to find patterns or trends in the research on business process performance measurement. The study also documents an extended list of 140 process-related performance indicators in a systematic manner by further categorizing them into 11 performance perspectives in order to gain a holistic view. Managers and scholars can consult the provided list to choose the indicators that are of interest to them, considering each perspective. The structured literature review concludes with avenues for further research.

Perceived academic performance, self-esteem and locus of control as indicators of need for assessment of adolescent suicide risk: implications for teachers.

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Martin, Graham; Richardson, Angela S; Bergen, Helen A; Roeger, Leigh; Allison, Stephen

2005-02-01

There is currently a need for research into indicators that could be used by non-clinical professionals working with young people, to inform the need for referral for further clinical assessment of those at risk of suicide. Participants of this repeated measures longitudinal study, were 2603, 2485, and 2246 school students aged 13, 14, and 15, respectively, from 27 South Australian Schools. Perceived academic performance, self-esteem and locus of control are significantly associated with suicidality. Further, logistic regression of longitudinal results suggests that perceived academic performance, over and above self-esteem and locus of control, in some instances, is a good long-term predictor of suicidality.

Comfort Indicators for the Assessment of Indoor Environmental Building Performance

DEFF Research Database (Denmark)

Brohus, Henrik; Bendtsen, A.; Sørensen, M.

2006-01-01

Indoor environmental building performance assessment requires efficient indicators of the indoor comfort. In order to be effective and useful the comfort indicators must be able to include the temporal variation of indoor comfort as well as the degree of discomfort perceived by the occupants....... This paper discusses and presents a number of comfort indicators that includes both the temporal variation and the degree of discomfort in the calculations. A test case comprising a ventilated office building is used to show the application of the various comfort indices. It is found that the new comfort...

Critical appraisal of the Vienna consensus: performance indicators for assisted reproductive technology laboratories.

Science.gov (United States)

Lopez-Regalado, María Luisa; Martínez-Granados, Luis; González-Utor, Antonio; Ortiz, Nereyda; Iglesias, Miriam; Ardoy, Manuel; Castilla, Jose A

2018-05-24

The Vienna consensus, based on the recommendations of an expert panel, has identified 19 performance indicators for assisted reproductive technology (ART) laboratories. Two levels of reference values are established for these performance indicators: competence and benchmark. For over 10 years, the Spanish embryology association (ASEBIR) has participated in the definition and design of ART performance indicators, seeking to establish specific guidelines for ART laboratories to enhance quality, safety and patient welfare. Four years ago, ASEBIR took part in an initiative by AENOR, the Spanish Association for Standardization and Certification, to develop a national standard in this field (UNE 17900:2013 System of quality management for assisted reproduction laboratories), extending the former requirements, based on ISO 9001, to include performance indicators. Considering the experience acquired, we discuss various aspects of the Vienna consensus and consider certain discrepancies in performance indicators between the consensus and UNE 179007:2013, and analyse the definitions, methodology and reference values used. Copyright © 2018. Published by Elsevier Ltd.

Indicators and Performance Measures for Transportation, Environment and Sustainability in North America

DEFF Research Database (Denmark)

Gudmundsson, H.

A study trip to USA and Canada was undertaken in October 2000 with support from the German Marshall Fund. The purpose of the trip was to learn about performance planning and performance indicators in the area of transportation and environment. The report describe findings from the trip in the fol......A study trip to USA and Canada was undertaken in October 2000 with support from the German Marshall Fund. The purpose of the trip was to learn about performance planning and performance indicators in the area of transportation and environment. The report describe findings from the trip...... in the following areas: how performance planning for transportation and environment is conducted in the US and Canada at federal, state and municipal level, to what extent performance planning serve as an instrument to integrate environmental and sustainability goals in transportation policy which specific...... indicators are used to measure the environmental sustainability of transportation systems and policies in the two North American countries....

THE IMPORTANCE OF PERFORMANCE INDICATORS IN ANALYZING BUSINESS ENVIRONMENT AND BUSINESS EVOLUTION

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Andreea-Mihaela STROE

2017-05-01

Full Text Available The analysis of economic environment brings into attention of the ones interest important trends and important evolutions that can bring into surface new strategies and new ways of obtaining profit. This is to say that staying in connection with all the changes and analyzing the trends in business performance, analyzing performance indicators helps managers to know not only their firm but the environment, the opponents, stakeholders and the opportunities that can be optimized and used as advantages in a turbulent economic area. In general, performance is associated with two key processes: performance management and its measurement. Performance management is a holistic process which embodies the subject of performance and reflects the connection between the economic entity and performance, including processes such as definition of strategy, implementation of strategy and training and performance measurement. Performance measurement appears as a low performance management that focuses mainly on the identification, tracking and communicating performance that results through the use of performance. Key performance indicators help quantify the formation of a result, providing visibility in relation to the performance of individuals, teams, departments and organizations, allowing decision makers to take action in order to achieve the objectives desired. These indicators can be appreciated based upon the trends in the company or benchmarking - comparisons with standard industry values or reference companies.

PERFORMANCE INDICATORS: A COMPARATIVE ANALYSIS BETWEEN PUBLIC AND PRIVATE COLLEGES IN BRAZIL

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Átila de Melo Lira

2015-06-01

Full Text Available A comparative analysis between the use of performance indicators to public and private organizations have always been required to examine the scenario related to both. This study seeks to analyze the use of Balanced Scorecard (BSC to identify and understand the main differences and similarities in public and private higher education institutions (HEIs in Brazil in relation to the use of other organizations performance indicators. A quantitative and exploratory approach was adopted using institutional documents analysis. Data was searched on the websites of Brazilian higher education public and private organizations in order to accomplish this analysis comparative. The results showed that even reviewing few public institutions the use of performance indicators appears to be more efficient than those applied to the private ones. Private universities should observe and improve their processes and performance indicators based on those used in Brazilian public universities. This initial research still opens a horizon so that other studies be developed within this thought stream.

Operational Safety Performance Indicators and Balanced Scorecard in HANARO

International Nuclear Information System (INIS)

Wu, Jong-Sup; Jung, Hoan-Sung; Ahn, Guk-Hoon; Lee, Kye-Hong; Lim, In-Cheol; Kim, Hark-Rho

2007-01-01

Research reactors need an extensive basis for ensuring their safety. The importance of a safety management in nuclear facilities and activities has been emphasized. The safety activities in HANARO have been continuously conducted to enhance its safe operation. Last year, HANARO prepared two indicator sets to measure and assess the safety status of the reactor's operation and utilization. One is Safety Performance Indicators (SPI) and the other is Balanced Scorecard (BSC). Through reviewing these indicators, we can obtain the following information; - Plant safety status - Safety parameter trends - Safety information, for example, reactor operation status and radiation safety HANARO will continuously pursue the trends of SPI and BSC

Randomized, Controlled Clinical Trial of Bilayer Ceramic and Metal-Ceramic Crown Performance

Science.gov (United States)

Esquivel-Upshaw, Josephine; Rose, William; Oliveira, Erica; Yang, Mark; Clark, Arthur E.; Anusavice, Kenneth

2013-01-01

Purpose Analyzing the clinical performance of restorative materials is important, as there is an expectation that these materials and procedures will restore teeth and do no harm. The objective of this research study was to characterize the clinical performance of metal-ceramic crowns, core ceramic crowns, and core ceramic/veneer ceramic crowns based on 11 clinical criteria. Materials and Methods An IRB-approved, randomized, controlled clinical trial was conducted as a single-blind pilot study. The following three types of full crowns were fabricated: (1) metal-ceramic crown (MC) made from a Pd-Au-Ag-Sn-In alloy (Argedent 62) and a glass-ceramic veneer (IPS d.SIGN veneer); (2) non-veneered (glazed) lithium disilicate glass-ceramic crown (LDC) (IPS e.max Press core and e.max Ceram Glaze); and (3) veneered lithia disilicate glass-ceramic crown (LDC/V) with glass-ceramic veneer (IPS Empress 2 core and IPS Eris). Single-unit crowns were randomly assigned. Patients were recalled for each of 3 years and were evaluated by two calibrated clinicians. Thirty-six crowns were placed in 31 patients. A total of 12 crowns of each of the three crown types were studied. Eleven criteria were evaluated: tissue health, marginal integrity, secondary caries, proximal contact, anatomic contour, occlusion, surface texture, cracks/chips (fractures), color match, tooth sensitivity, and wear (of crowns and opposing enamel). Numerical rankings ranged from 1 to 4, with 4 being excellent, and 1 indicating a need for immediate replacement. Statistical analysis of the numerical rankings was performed using a Fisher’s exact test. Results There was no statistically significant difference between performance of the core ceramic crowns and the two veneered crowns at year 1 and year 2 (p > 0.05). All crowns were rated either as excellent or good for each of the clinical criteria; however, between years 2 and 3, gradual roughening of the occlusal surface occurred in some of the ceramic-ceramic crowns

An inter-hospital comparison of patient dose based on clinical indications

International Nuclear Information System (INIS)

Teeuwisse, W.; Geleijns, J.; Veldkamp, W.

2007-01-01

Patient dose is usually estimated for a single radiographic projection or computed tomography (CT) series. In this study, patient dose was calculated for predefined clinical indications (24 radiography, 11 CT). Members of the radiology staff of each of 11 hospitals were trained in dose measurement and calculation techniques. Based on clinical indications participants decided on imaging protocols and calculated cumulative effective dose for a complete examination. Effective dose ranged from <1 μSv to 0.6 mSv for examinations with radiographs and from 0.2 to 12 mSv for CT scans. Differences in the imaging protocols contributedd to a substantial variation in patient dose. For mammography, average glandular dose (AGD) was estimated for 32-, 53- and 90-mm compressed breast thicknesses, with a median value of 0.74, 1.74 and 3.40 mGy, respectively. The results presented here demonstrate that a pragmatic choice of dosimetry methods enables local staff to estimate effective dose. The inclusion of imaging protocols in the dose surveys provided a broader view on the variations in patient dose between hospitals. (orig.)

Use of performance indicators in the analysis of running gait impacts

OpenAIRE

Pàmies Vila, Rosa; González, Francisco; Kövecses, József; Font Llagunes, Josep Maria

2017-01-01

Foot-ground impact is a critical event during the running cycle. In this work, three performance indicators were used to characterize foot-ground impact intensity: the effective pre-impact kinetic energy, representative elements of the effective mass matrix, and the critical coefficient of friction. These performance indicators can be obtained from the inertial properties of the biomechanical system and its pre-impact mechanical state, avoiding the need to carry out force measurements. Ground...

Safe, Healthy and Ready to Succeed: Arizona School Readiness Key Performance Indicators

Science.gov (United States)

Migliore, Donna E.

2006-01-01

"Safe, Healthy and Ready to Succeed: Arizona School Readiness Key Performance Indicators" presents a set of baseline measurements that gauge how well a statewide system of school readiness supports is addressing issues that affect Arizona children's readiness for school. The Key Performance Indicators (KPIs) measure the system, rather…

Introducing a performance-based objective clinical examination into ...

African Journals Online (AJOL)

Purpose: To describe how a formative Objective Structured Clinical Examination was applied to fourth year pharmacy students at a university in Northern Cyprus. Methods: A blueprint-guided performance-based objective clinical examination was implemented. Group-prepared case scenarios based on course objectives ...

Using Templates and Linguistic Patterns to Define Process Performance Indicators

OpenAIRE

Río Ortega, Adela del; Resinas Arias de Reyna, Manuel; Durán Toro, Amador; Ruiz Cortés, Antonio

2014-01-01

Process performance management (PPM) aims at measuring, monitoring and analysing the performance of business processes (BPs), in order to check the achievement of strategic and operational goals and to support decision making for their optimisation. PPM is based on process performance indicators (PPIs), so having an appropriate definition of them is crucial. One of the main problems of PPIs definition is to express them in an unambiguous, complete, understandable, traceable ...

Performance indicators for evaluation of North Sea oil and gas platforms

DEFF Research Database (Denmark)

Voldsund, Mari; Nguyen, Tuong-Van; Elmegaard, Brian

2013-01-01

Well-defined performance indicators can motivate optimal operation of offshore oil and gas platforms. This paper aims to develop such parameters, indicating possibilities for reducing power consumption and emissions of pollutants. Different platforms have different oilfield conditions and process...... specifications. Such conditions determine the theoretical minimum work required to operate the platforms, and can have a high impact on the power consumption. We introduce performance indicators based on energy and exergy. The specific energy use and specific exergy consumption evaluate the resources spent...... required under ideal conditions (i.e. reversible operation), and specific exergy destruction illustrates the amount of resources lost due to irreversibilities. We use these indicators to evaluate the oil and gas processing at four different North Sea platforms that differ by the field lifetime, system...

Industry based performance indicators for nuclear power plants

International Nuclear Information System (INIS)

Connelly, E.M.; Van Hemel, S.B.; Haas, P.M.

1990-07-01

This report presents the results of the first phase of a two-phase study, performed with the goal of developing indirect (leading) indicators of nuclear power plant safety, using other industries as a model. It was hypothesized that other industries with similar public safety concerns could serve as analogs to the nuclear power industry. Many process industries have many more years of operating experience, and many more plants than the nuclear power industry, and thus should have accumulated much useful safety data. In Phase 1, the investigators screened a variety of potential industry analogs and chose the chemical/petrochemical manufacturing industry as the primary analog for further study. Information was gathered on safety programs and indicators in the chemical industry, as well as in the nuclear power industry. Frameworks were selected for the development of indicators which could be transferred from the chemical to the nuclear power environment, and candidate sets of direct and indirect safety indicators were developed. Estimates were made of the availability and quality of data in the chemical industry, and plans were developed for further investigating and testing these candidate indicators against safety data in both the chemical and nuclear power industries in Phase 2. 38 refs., 4 figs., 7 tabs

Key performance indicators for Australian mental health court liaison services.

Science.gov (United States)

Davidson, Fiona; Heffernan, Ed; Greenberg, David; Butler, Tony; Burgess, Philip

2017-12-01

The aim of this paper is to describe the development and technical specifications of a framework and national key performance indicators (KPIs) for Australian mental health Court Liaison Services (CLSs) by the National Mental Health Court Liaison Performance Working Group (Working Group). Representatives from each Australian State and Territory were invited to form a Working Group. Through a series of national workshops and meetings, a framework and set of performance indicators were developed using a review of literature and expert opinion. A total of six KPIs for CLSs have been identified and a set of technical specifications have been formed. This paper describes the process and outcomes of a national collaboration to develop a framework and KPIs. The measures have been developed to support future benchmarking activities and to assist services to identify best practice in this area of mental health service delivery.

Carbon footprint as environmental performance indicator for the manufacturing industry

DEFF Research Database (Denmark)

Laurent, Alexis; Olsen, Stig Irving; Hauschild, Michael Zwicky

2010-01-01

With the current focus on our climate change impacts, the embodied CO2 emission or "Carbon footprint" is often used as an environmental performance indicator for our products or production activities. The ability of carbon footprint to represent other types of impact like human toxicity, and hence...... the overall environmental impact is investigated based on life cycle assessments of several materials of major relevance to manufacturing industries. The dependence of the carbon footprint on the assumed scenarios for generation of thermal and electrical energy in the life cycle of the materials is analyzed......, and the appropriateness of carbon footprint as an overall indicator of the environmental performance is discussed....

A systematic literature search to identify performance measure outcomes used in clinical studies of racehorses.

Science.gov (United States)

Wylie, C E; Newton, J R

2018-05-01

Racing performance is often used as a measurable outcome variable in research studies investigating clinical diagnoses or interventions. However, the use of many different performance measures largely precludes conduct of meaningful comparative studies and, to date, those being used have not been collated. To systematically review the veterinary scientific literature for the use of racing performance as a measurable outcome variable in clinical studies of racehorses, collate and identify those most popular, and identify their advantages and disadvantages. Systematic literature search. The search criteria "((racing AND performance) AND (horses OR equidae))" were adapted for both MEDLINE and CAB Abstracts databases. Data were collected in standardised recording forms for binary, categorical and quantitative measures, and the use of performance indices. In total, 217 studies that described racing performance were identified, contributing 117 different performance measures. No one performance measure was used in all studies, despite 90.3% using more than one variable. Data regarding race starts and earnings were used most commonly, with 88.0% and 54.4% of studies including at least one measure of starts and earnings, respectively. Seventeen variables were used 10 times or more, with the top five comprising: 'return to racing', 'number of starts', 'days to first start', 'earnings per period of time' and 'earnings per start'. The search strategies may not have identified all relevant papers, introducing bias to the review. Performance indices have been developed to improve assessment of interventions; however, they are not widely adopted in the scientific literature. Use of the two most commonly identified measures, whether the horse returned to racing and number of starts over a defined period of time, would best facilitate future systematic reviews and meta-analyses in advance of the development of a gold-standard measure of race performance outcome. © 2017 EVJ Ltd.

Meeting measles elimination indicators: surveillance performance in a regional area of Australia

Directory of Open Access Journals (Sweden)

David N Durrheim

2011-08-01

Full Text Available The World Health Organization (WHO Western Pacific Region has established specific measles elimination surveillance indicators. There has been concern in Australia that these indicators may be too stringent and that measles elimination can occur without all surveillance prerequisites being met, in particular the minimum fever and rash clinician-suspected measles reporting rate with subsequent laboratory exclusion of measles. A regional public health unit in northern New South Wales, Australia, prompted local general practitioners to report fever and rash presentations that met the measles case definition or that they considered to be clinical measles. These notifications from July 2006 to June 2008 were reviewed to determine whether measles indicators for monitoring progress towards measles elimination could be achieved in Australia. Results confirmed that the surveillance indicators of “>2 reported suspected measles cases per 100 000 population,” “at least 80% of suspected cases adequately investigated within 48 hours” and “greater than 80% of cases had adequate blood samples collected” could be met. Only half the cases had virology that would allow genotyping of measles virus. Special efforts to engage and convince Australian medical doctors about the public health value of reporting clinically suggestive measles cases and collecting confirmatory blood tests, resulted in the current WHO Western Pacific Region indicators for progress towards measles elimination being met in a regional area of Australia.

Emotional intelligence and clinical performance/retention of nursing students

Science.gov (United States)

Marvos, Chelsea; Hale, Frankie B.

2015-01-01

Objective: This exploratory, quantitative, descriptive study was undertaken to explore the relationship between clinical performance and anticipated retention in nursing students. Methods: After approval by the university's Human Subjects Committee, a sample of 104 nursing students were recruited for this study, which involved testing with a valid and reliable emotional intelligence (EI) instrument and a self-report survey of clinical competencies. Results: Statistical analysis revealed that although the group average for total EI score and the 6 score subsets were in the average range, approximately 30% of the individual total EI scores and 30% of two branch scores, identifying emotions correctly and understanding emotions, fell in the less than average range. This data, as well as the analysis of correlation with clinical self-report scores, suggest recommendations applicable to educators of clinical nursing students. Conclusions: Registered nurses make-up the largest segment of the ever-growing healthcare workforce. Yet, retention of new graduates has historically been a challenge for the profession. Given the projected employment growth in nursing, it is important to identify factors which correlate with high levels of performance and job retention among nurses. There is preliminary evidence that EI a nontraditional intelligence measure relates positively not only with retention of clinical staff nurses, but with overall clinical performance as well. PMID:27981096

20 CFR 670.980 - What are the indicators of performance for Job Corps?

Science.gov (United States)

2010-04-01

... Provisions § 670.980 What are the indicators of performance for Job Corps? (a) At a minimum, the performance... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What are the indicators of performance for Job Corps? 670.980 Section 670.980 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION...

Clinical Skills Performed By Iranian Emergency Nurses: Perceived Competency Levels and Attitudes Toward Expanding Professional Roles.

Science.gov (United States)

Hassankhani, Hadi; Hasanzadeh, Firooz; Powers, Kelly A; Dadash Zadeh, Abbas; Rajaie, Rouzbeh

2018-03-01

Emergency nurses play an important role in the care of critically ill and injured patients, and their competency to perform clinical skills is vital to safe and effective patient care. The aim of this study was to evaluate the frequency of clinical skills performed and perceived competency levels among Iranian emergency nurses. In addition, attitudes toward expanding the professional roles of Iranian emergency nurses were also assessed. In this descriptive correlational study, 319 emergency nurses from 30 hospitals in northwest Iran participated. Data were collected using a self-report questionnaire. Descriptive statistics and Pearson's correlation coefficient were used to present the findings. Overall competency of the emergency nurses was 73.31 ± 14.2, indicating a good level of perceived competence. The clinical skills most frequently performed were in the domains of organizational and workload competencies (3.43 ± 0.76), diagnostic function (3.25 ± 0.82), and the helping role (3.17 ± 0.83). A higher level of perceived competence was found for skills within these domains. Less frequently, participants performed skills within the domains of effective management of rapidly changing situations (2.70 ± 0.94) and administering and monitoring therapeutic interventions (2.60 ± 0.97); a lower perceived level of competence was noted for these clinical skills. There was a significant correlation between frequency of performing clinical skills and perceived competency level (r = 0.651, P skills. This has implications for nurse managers and educators who may consider offering more frequent experiential and educational opportunities to emergency nurses. Expansion of nurses' roles could also result in increased experience in clinical skills and higher levels of competency. Research is needed to investigate nurses' clinical competence using direct and observed measures. Copyright © 2017 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

Health Care Performance Indicators for Health Information Systems.

Science.gov (United States)

Hyppönen, Hannele; Ronchi, Elettra; Adler-Milstein, Julia

2016-01-01

Health Information Systems (HISs) are expected to have a positive impact on quality and efficiency of health care. Rapid investment in and diffusion of HISs has increased the importance of monitoring the adoption and impacts of them in order to learn from the initiatives, and to provide decision makers evidence on the role of HISs in improving health care. However, reliable and comparable data across initiatives in various countries are rarely available. A four-phase approach is used to compare different HIS indicator methodologies in order to move ahead in defining HIS indicators for monitoring effects of HIS on health care performance. Assessed approaches are strong on different aspects, which provide some opportunities for learning across them but also some challenges. As yet, all of the approaches do not define goals for monitoring formally. Most focus on health care structural and process indicators (HIS availability and intensity of use). However, many approaches are generic in description of HIS functionalities and context as well as their impact mechanisms on health care for HIS benchmarking. The conclusion is that, though structural and process indicators of HIS interventions are prerequisites for monitoring HIS impacts on health care outputs and outcomes, more explicit definition is needed of HIS contexts, goals, functionalities and their impact mechanisms in order to move towards common process and outcome indicators. A bottom-up-approach (participation of users) could improve development and use of context-sensitive HIS indicators.

Key Performance Indicators in Irish Hospital Libraries: Developing Outcome-Based Metrics

Directory of Open Access Journals (Sweden)

Michelle Dalton

2012-12-01

Full Text Available Objective – To develop a set of generic outcome-based performance measures for Irishhospital libraries.Methods – Various models and frameworks of performance measurement were used as atheoretical paradigm to link the impact of library services directly with measurablehealthcare objectives and outcomes. Strategic objectives were identified, mapped toperformance indicators, and finally translated into response choices to a single-questiononline survey for distribution via email.Results – The set of performance indicators represents an impact assessment tool whichis easy to administer across a variety of healthcare settings. In using a model directlyaligned with the mission and goals of the organization, and linked to core activities andoperations in an accountable way, the indicators can also be used as a channel throughwhich to implement action, change, and improvement.Conclusion – The indicators can be adopted at a local and potentially a national level, asboth a tool for advocacy and to assess and improve service delivery at a macro level. Toovercome the constraints posed by necessary simplifications, substantial further research is needed by hospital libraries to develop more sophisticated and meaningful measures of impact to further aid decision making at a micro level.

Sustained effect of simulation-based ultrasound training on clinical performance

DEFF Research Database (Denmark)

Tolsgaard, M G; Ringsted, C; Dreisler, E

2015-01-01

on a virtual-reality transvaginal ultrasound simulator until an expert performance level was attained followed by training on a pelvic mannequin. After two months of clinical training, one transvaginal ultrasound scan was recorded for assessment of participants' clinical performance. Two blinded ultrasound...

Clinical indications for Thallium-201 myocardial perfusion scanning

International Nuclear Information System (INIS)

Dunn, R.J.; Kelly, D.T.

1982-01-01

Thallium-201 myocardial perfusion scanning can assess regional myocardial perfusion non-invasively. As it is both time-consuming and expensive its use should be restricted to specific diagnostic problems. The clinical indications in known or suspected coronary artery disease are reviewed. In suspected coronary artery disease thallium scanning is most useful in patients with chest pain when the exercise ECG is uninterpretable, in men with probable angina but a negative exercise ECG, or conversely a positive exercise ECG without typical angina, and in women with probable angina and either a positive or a negative exercise ECG. In known coronary artery disease, thallium scanning may help determine the functional significance of a coronary obstruction found at angiography and may determine the site of myocardial ischaemia when multiple obstructions are present

Key performance indicators in plant asset management: hype, burden or real help?

Energy Technology Data Exchange (ETDEWEB)

Jovanovic, A. (Steinbeis Advanced Risk Technologies, Stuttgart (Germany)); Bareiss, J.M. (EnBW, Stuttgart (Germany))

2010-05-15

The paper tackles the increasing role and use of indicators (e.g. the key performance indicators, KPIs) in asset management in power and process plants, in particular for risk and safety management (safety performance indicators, SPIs), inspection, maintenance, emerging risks analysis and aging management. The two main aspects of the use of indicators are monitoring of performance (e.g. of a single unit) and benchmarking (e.g. among different units). The basis for the considerations presented in the paper are several international projects in the field, showing that the main issue in the field is not and cannot be just the introduction of new indicators as such. They deal with the principles of establishing indicators, establishing generally accepted indicators (goal 'globally accepted' indicators), creating of 'repositories' of indicators in industry and respective tools. The repository/tool developed in the EU project iNTeg-Risk is presented in more detail. The main proposed criteria for successful introduction are the acceptance, transparency and clear added value, e.g. when the indicators help in finding solutions for the issues where the conventional analysis, e.g. the one based on engineering models and analysis is too expensive, complex or simply unavailable. Three practical cases are briefly shown in the paper: one for the improved asset management in a refinery, one for the identification of indicators helping to deal with emerging risks (how to identify them and how to assess risks of a new technology) and one for the implementation of a complex aging management program for industrial plants. (orig.)

Key performance indicators in plant asset management: hype, burden or real help?

International Nuclear Information System (INIS)

Jovanovic, A.; Bareiss, J.M.

2010-01-01

The paper tackles the increasing role and use of indicators (e.g. the key performance indicators, KPIs) in asset management in power and process plants, in particular for risk and safety management (safety performance indicators, SPIs), inspection, maintenance, emerging risks analysis and aging management. The two main aspects of the use of indicators are monitoring of performance (e.g. of a single unit) and benchmarking (e.g. among different units). The basis for the considerations presented in the paper are several international projects in the field, showing that the main issue in the field is not and cannot be just the introduction of new indicators as such. They deal with the principles of establishing indicators, establishing generally accepted indicators (goal 'globally accepted' indicators), creating of 'repositories' of indicators in industry and respective tools. The repository/tool developed in the EU project iNTeg-Risk is presented in more detail. The main proposed criteria for successful introduction are the acceptance, transparency and clear added value, e.g. when the indicators help in finding solutions for the issues where the conventional analysis, e.g. the one based on engineering models and analysis is too expensive, complex or simply unavailable. Three practical cases are briefly shown in the paper: one for the improved asset management in a refinery, one for the identification of indicators helping to deal with emerging risks (how to identify them and how to assess risks of a new technology) and one for the implementation of a complex aging management program for industrial plants. (orig.)

Using In-Hospital Mortality as an Indicator of Quality Care and Hospital Performance

Directory of Open Access Journals (Sweden)

Badia BISBIS

2016-06-01

Full Text Available The in-hospital mortality (MIH is used as a performance indicator and quality healthcare in hospital. However, the majority of deaths resulted from an inevitable disease process (severity of cases and / or co-morbidity, and not medical errors or changes in the quality of care. This work aims to make a distribution of deaths in the Regional Hospital of Eastern, Al Farabi hospital and to highlight that more studies on the MIH are required consistently with detailed clinical data at the admission. The MIH showed its limitation as a health care  indicator. The overall rate of in-hospital deaths within the Al Farabi hospital has averaged 2.4%, with 8.4% in the emergency unit, 28% in intensive care unit, 22% Neonatology unit, 1.6% in pediatric unit. The MIH may depend, firstly, on the condition of patients before hospitalization and secondly, on the conditions of their transfer from one institution to another that supports them as a last resort. Al Farabi hospital supports patients transferred from the provinces of the eastern region. Thus, 6% of patients who died in 2014 come from Berkane, 2% from  Nador, 2% from Bouarfa, 4% from  Taourirt and 2% from Jerrada. One might question about  the procedures and the conditions of such transfers. In conclusion, the overall MIH measured from routine data do not allow proper comparison between hospitals or the assessment of the quality of care and patient safety in the hospital. To do so, we should ideally have detailed clinical data on admission (e.g. type of admission, age of patient, sex, comorbidity, .... The MIH is however an important indicator to consider as a tool to detect potential  problems related to admission procedures and to suspect an area of "non-quality" in healthcare . The MIH is interesting for the patient and for the hospital because it serves the improvement of quality healthcare.

Chaste tree (Vitex agnus-castus)--pharmacology and clinical indications.

Science.gov (United States)

Wuttke, W; Jarry, H; Christoffel, V; Spengler, B; Seidlová-Wuttke, D

2003-05-01

Extracts of the fruits of chaste tree (Vitex agnus castus = AC) are widely used to treat premenstrual symptoms. Double-blind placebo-controlled studies indicate that one of the most common premenstrual symptoms, i.e. premenstrual mastodynia (mastalgia) is beneficially influenced by an AC extract. In addition, numerous less rigidly controlled studies indicate that AC extracts have also beneficial effects on other psychic and somatic symptoms of the PMS. Premenstrual mastodynia is most likely due to a latent hyperprolactinemia, i.e. patients release more than physiologic amounts of prolactin in response to stressful situations and during deep sleep phases which appear to stimulate the mammary gland. Premenstrually this unphysiological prolactin release is so high that the serum prolactin levels often approach heights which are misinterpreted as prolactinomas. Since AC extracts were shown to have beneficial effects on premenstrual mastodynia serum prolactin levels in such patients were also studied in one double-blind, placebo-controlled clinical study. Serum prolactin levels were indeed reduced in the patients treated with the extract. The search for the prolactin-suppressive principle(s) yielded a number of compounds with dopaminergic properties: they bound to recombinant DA2-receptor protein and suppressed prolactin release from cultivated lactotrophs as well as in animal experiments. The search for the chemical identity of the dopaminergic compounds resulted in isolation of a number of diterpenes of which some clerodadienols were most important for the prolactin-suppressive effects. They were almost identical in their prolactin-suppressive properties than dopamine itself. Hence, it is concluded that dopaminergic compounds present in Vitex agnus castus are clinically the important compounds which improve premenstrual mastodynia and possibly also other symptoms of the premenstrual syndrome.

Behavioral Indicators on a Mobile Sensing Platform Predict Clinically Validated Psychiatric Symptoms of Mood and Anxiety Disorders.

Science.gov (United States)

Place, Skyler; Blanch-Hartigan, Danielle; Rubin, Channah; Gorrostieta, Cristina; Mead, Caroline; Kane, John; Marx, Brian P; Feast, Joshua; Deckersbach, Thilo; Pentland, Alex Sandy; Nierenberg, Andrew; Azarbayejani, Ali

2017-03-16

There is a critical need for real-time tracking of behavioral indicators of mental disorders. Mobile sensing platforms that objectively and noninvasively collect, store, and analyze behavioral indicators have not yet been clinically validated or scalable. The aim of our study was to report on models of clinical symptoms for post-traumatic stress disorder (PTSD) and depression derived from a scalable mobile sensing platform. A total of 73 participants (67% [49/73] male, 48% [35/73] non-Hispanic white, 33% [24/73] veteran status) who reported at least one symptom of PTSD or depression completed a 12-week field trial. Behavioral indicators were collected through the noninvasive mobile sensing platform on participants' mobile phones. Clinical symptoms were measured through validated clinical interviews with a licensed clinical social worker. A combination hypothesis and data-driven approach was used to derive key features for modeling symptoms, including the sum of outgoing calls, count of unique numbers texted, absolute distance traveled, dynamic variation of the voice, speaking rate, and voice quality. Participants also reported ease of use and data sharing concerns. Behavioral indicators predicted clinically assessed symptoms of depression and PTSD (cross-validated area under the curve [AUC] for depressed mood=.74, fatigue=.56, interest in activities=.75, and social connectedness=.83). Participants reported comfort sharing individual data with physicians (Mean 3.08, SD 1.22), mental health providers (Mean 3.25, SD 1.39), and medical researchers (Mean 3.03, SD 1.36). Behavioral indicators passively collected through a mobile sensing platform predicted symptoms of depression and PTSD. The use of mobile sensing platforms can provide clinically validated behavioral indicators in real time; however, further validation of these models and this platform in large clinical samples is needed. ©Skyler Place, Danielle Blanch-Hartigan, Channah Rubin, Cristina Gorrostieta

Plant safety and performance indicators for regulatory use

International Nuclear Information System (INIS)

Ferjancic, M.; Nemec, T.; Cimesa, S.

2004-01-01

Slovenian Nuclear Safety Administration (SNSA) supervises nuclear and radiological safety of Krsko NPP. This SNSA supervision is performed through inspections, safety evaluations of plant modifications and event analyses as well as with the safety and performance indicators (SPI) which are a valuable data source for plant safety monitoring. In the past SNSA relied on the SPI provided by Krsko NPP and did not have a set of SPI which would be more appropriate for regulatory use. In 2003 SNSA started with preparation of a new set of SPI which would be more suitable for performing the regulatory oversight of the plant. New internal SNSA procedure which is under preparation will define use and evaluation of SPI and will include definitions for the proposed set of SPI. According to the evaluation of SPI values in comparison with the limiting values and/or trending, the procedure will define SNSA response and actions. (author)

What predicts performance during clinical psychology training?

OpenAIRE

Scior, Katrina; Bradley, Caroline E; Potts, Henry W W; Woolf, Katherine; de C Williams, Amanda C

2013-01-01

Objectives While the question of who is likely to be selected for clinical psychology training has been studied, evidence on performance during training is scant. This study explored data from seven consecutive intakes of the UK's largest clinical psychology training course, aiming to identify what factors predict better or poorer outcomes. Design Longitudinal cross-sectional study using prospective and retrospective data. Method Characteristics at application were analysed in relation to a r...

Management of Industrial Performance Indicators: Regression Analysis and Simulation

Directory of Open Access Journals (Sweden)

Walter Roberto Hernandez Vergara

2017-11-01

Full Text Available Stochastic methods can be used in problem solving and explanation of natural phenomena through the application of statistical procedures. The article aims to associate the regression analysis and systems simulation, in order to facilitate the practical understanding of data analysis. The algorithms were developed in Microsoft Office Excel software, using statistical techniques such as regression theory, ANOVA and Cholesky Factorization, which made it possible to create models of single and multiple systems with up to five independent variables. For the analysis of these models, the Monte Carlo simulation and analysis of industrial performance indicators were used, resulting in numerical indices that aim to improve the goals’ management for compliance indicators, by identifying systems’ instability, correlation and anomalies. The analytical models presented in the survey indicated satisfactory results with numerous possibilities for industrial and academic applications, as well as the potential for deployment in new analytical techniques.

Clinical indications of prolactin radioimmunoassay

International Nuclear Information System (INIS)

Lengyel, A.M.J.; Vieira, J.G.H.; Zanella, M.R.; Zampieri, M.; Chacra, A.R.

1980-01-01

Is a review is presented of the main clinical uses of prolactin measurements, including the galactorrhea-amenorrhea syndrome, an experiment employing the prolactin radioimmunoassay is related. (Author) [pt

Road safety performance indicators for the interurban road network.

NARCIS (Netherlands)

Yannis, G. Weijermars, W.A.M. Gitelman, V. Vis, M. Chazirisa, A. Papadimitriou, E. & Lima Azevedo, C.

2013-01-01

Various road safety performance indicators (SPIs) have been proposed for different road safety research areas, mainly as regards driver behaviour (e.g. seat belt use, alcohol, drugs, etc.) and vehicles (e.g. passive safety); however, no SPIs for the road network and design have been developed. The

Development of a performance-based industrial energy efficiency indicator for corn refining plants.

Energy Technology Data Exchange (ETDEWEB)

Boyd, G. A.; Decision and Information Sciences; USEPA

2006-07-31

Organizations that implement strategic energy management programs have the potential to achieve sustained energy savings if the programs are carried out properly. A key opportunity for achieving energy savings that plant managers can take is to determine an appropriate level of energy performance by comparing their plant's performance with that of similar plants in the same industry. Manufacturing facilities can set energy efficiency targets by using performance-based indicators. The U.S. Environmental Protection Agency (EPA), through its ENERGY STAR{reg_sign} program, has been developing plant energy performance indicators (EPIs) to encourage a variety of U.S. industries to use energy more efficiently. This report describes work with the corn refining industry to provide a plant-level indicator of energy efficiency for facilities that produce a variety of products--including corn starch, corn oil, animal feed, corn sweeteners, and ethanol--for the paper, food, beverage, and other industries in the United States. Consideration is given to the role that performance-based indicators play in motivating change; the steps needed to develop indicators, including interacting with an industry to secure adequate data for an indicator; and the actual application and use of an indicator when complete. How indicators are employed in the EPA's efforts to encourage industries to voluntarily improve their use of energy is discussed as well. The report describes the data and statistical methods used to construct the EPI for corn refining plants. Individual equations are presented, as are the instructions for using them in an associated Excel spreadsheet.

An approach to quality and performance control in a computer-assisted clinical chemistry laboratory.

Science.gov (United States)

Undrill, P E; Frazer, S C

1979-01-01

A locally developed, computer-based clinical chemistry laboratory system has been in operation since 1970. This utilises a Digital Equipment Co Ltd PDP 12 and an interconnected PDP 8/F computer. Details are presented of the performance and quality control techniques incorporated into the system. Laboratory performance is assessed through analysis of results from fixed-level control sera as well as from cumulative sum methods. At a simple level the presentation may be considered purely indicative, while at a more sophisticated level statistical concepts have been introduced to aid the laboratory controller in decision-making processes. PMID:438340

Emotional intelligence and clinical performance/retention of nursing students

Directory of Open Access Journals (Sweden)

Chelsea Marvos

2015-01-01

Full Text Available Objective: This exploratory, quantitative, descriptive study was undertaken to explore the relationship between clinical performance and anticipated retention in nursing students. Methods: After approval by the university′s Human Subjects Committee, a sample of 104 nursing students were recruited for this study, which involved testing with a valid and reliable emotional intelligence (EI instrument and a self-report survey of clinical competencies. Results: Statistical analysis revealed that although the group average for total EI score and the 6 score subsets were in the average range, approximately 30% of the individual total EI scores and 30% of two branch scores, identifying emotions correctly and understanding emotions, fell in the less than average range. This data, as well as the analysis of correlation with clinical self-report scores, suggest recommendations applicable to educators of clinical nursing students. Conclusions: Registered nurses make-up the largest segment of the ever-growing healthcare workforce. Yet, retention of new graduates has historically been a challenge for the profession. Given the projected employment growth in nursing, it is important to identify factors which correlate with high levels of performance and job retention among nurses. There is preliminary evidence that EI "a nontraditional intelligence measure" relates positively not only with retention of clinical staff nurses, but with overall clinical performance as well.

Objective indicators of organizational performance at nuclear power plants

International Nuclear Information System (INIS)

Olson, J.; Osborn, R.N.; Jackson, D.H.; Shikiar, R.

1986-01-01

This report summarizes research conducted on the development and validation of organizational performance measures at operating nuclear power plants. Publicly available data, including measures from Licensee Event Reports, operating and outage data, and violations data, are used to predict penultimate measures of plant safety. Penultimate measures of safety include potentially significant events, overexposures and near overexposures, and several radiological release measures. The 1981 and 1982 performance measures are used in correlation and regression analyses to predict performance on the penultimate safety measures in 1982 and 1983. Many of the plant performance measures are consistently predictive of the frequency of potentially significant events. No strong, consistent predictors emerge for exposures or liquid radiological releases. Several performance measures are consistent predictors of gaseous releases. The regression analyses indicate that the predictors do not tend to combine in consistent, multivariate patterns, and controls for plant age, size, type, region, and fuel cycle stage do not substantially affect the results. The analysis concludes that existing performance data do appear to be predictive of some aspects of plant safety performance. The report recommends that more reliable, summary performance measures be created by combining several of the performance measures tested in the current analysis

Safety performance evaluation using proactive indicators in a selected industry

Directory of Open Access Journals (Sweden)

Abolfazl Barkhordari

2015-03-01

Full Text Available Background & Objectives: Quality and effectiveness of safety systems are critical factors in achieving their goals. This study was aimed to represent a method for performance evaluation of safety systems by proactive indicators using different updated models in the field of safety which will be tested in a selected industry. Methods: This study is a cross-sectional study. Proactive indicators used in this study were: Unsafe acts rate, Safety Climate, Accident Proneness, and Near-miss incident rate. The number of in 1473 safety climate questionnaires and 543 Accident Proneness questionnaires was completed. Results: The minimum and maximum safety climate score were 56.88 and 58.2, respectively, and the minimum and maximum scores of Accident Proneness were 98.2 and 140.7, respectively. The maximum number of Near-miss incident rate were 408 and the minimum of that was 196. The maximum number of unsafe acts rate was 43.8 percent and the minimum of that was 27.2 percent. In nine dimensions of Safety climate the eighth dimension (personal perception of risk with the score of 4.07 has the lowest score and the fourth (laws and safety regulations dimension with 8.05 has the highest score. According to expert opinions, the most important indicator in the assessment of safety performance was unsafe acts rate, while near-miss incident rate was the least important one. Conclusion: The results of this survey reveal that using proactive (Prospective indicators could be an appropriate method in organizations safety performance evaluation.

Relationship Between Academic Performance and Student Self-Assessment of Clinical Performance in the College of Podiatric Medicine and Surgery.

Science.gov (United States)

Yoho, Robert M; Vardaxis, Vassilios; Millonig, Kelsey

2016-05-01

Student self-assessment is viewed as an important tool in medical education. We sought to identify the relationship between student academic performance and third-year clinical performance self-assessment. No such study exists in podiatric medical education. Third-year podiatric medical students from the classes of 2012 through 2014 completed a self-assessment of their performance for each of five broad clinical podiatric medical domains (Professionalism, Medicine, Radiology, Surgery, and Biomechanics/Orthopedics). The assessment was completed after students finished the first 12 weeks of their third-year clinical rotations (PRE) and a second time at the conclusion of the third year (POST). The mean self-assessment score for PRE and POST surveys for all combined domains was determined for each student. This mean was compared with the student's 3-year cumulative grade point average (GPA). Students' clinical experiences for the year were essentially identical. No statistically significant correlation was identified between cumulative GPA and the PRE and POST clinical self-assessments or with the change between PRE and POST assessments based on the Pearson correlation test for each class separately or on the pooled data. Published studies in allopathic medical education have shown that students with lower GPAs tend to rate their clinical performance higher in initial clinical performance self-assessment. Our results show that student academic performance was not correlated with clinical performance self-assessment. These findings may be due to the explicit description of successful clinical competency completion, the orientation students receive before the start of clinical training, and the continuous feedback received from clinical preceptors.

Mechanical Performance versus Corrosion Damage Indicators for Corroded Steel Reinforcing Bars

Directory of Open Access Journals (Sweden)

Silvia Caprili

2015-01-01

Full Text Available The experimental results of a testing campaign including tensile and low-cycle fatigue tests on different reinforcing steel bar types in the as-delivered and corroded condition are presented. Experimental data were statistically analyzed adopting ANOVA technique; Performance Indicators (PIs, describing the mechanical performance characteristics of reinforcements, and Corrosion Damage Indicators (CDIs, describing the detrimental effects of corrosion phenomena, were determined and correlated in order to evaluate the influence of corrosion on the behaviour of reinforcing steels, providing useful information for designers in addition to what is presented in current standards.

Thermodynamic Performance Indicators for Offshore Oil and Gas Processing: Application to Four North Sea Facilities

DEFF Research Database (Denmark)

Voldsund, Mari; Nguyen, Tuong-Van; Elmegaard, Brian

2014-01-01

Well-defined performance indicators can motivate optimal operation of offshore oil and gas platforms. We evaluate several thermodynamic performance indicators presented in the literature according to three criteria: Thermodynamic performance indicators should evaluate the use of technically...

Key Sustainability Performance Indicator Analysis for Czech Breweries

Directory of Open Access Journals (Sweden)

Edward Kasem

2015-01-01

Full Text Available Sustainability performance can be said to be an ability of an organization to remain productive over time and hold on to its potential for maintaining long-term profitability. Since the brewery sector is one of the most important and leading markets in the foodstuff industry of the Czech Republic, this study depicts the Czech breweries’ formal entry into sustainability reporting and performance. The purpose of this paper is to provide an efficiency level evaluation which would represent the level of corporate performance of Czech breweries. For this reason, Data Envelopment Analysis (DEA is introduced. In order to apply it, we utilize a set of key performance indicators (KPIs based on two international standard frameworks: the Global Reporting Initiative (GRI and its GRI 4 guidelines, and the guideline KPIs for ESG 3.0, which was published by the DVFA Society. Four sustainability dimensions (economic, environmental, social and governance are covered, making it thus possible to adequately evaluate sustainability performance in Czech breweries. The main output is not only the efficiency score of the company but also the input weights. These weights are used to determine the contribution of particular criteria to the breweries’ achieved score. According to the achieved efficiency results for Czech breweries, the percentage of women supervising the company does not affect the sustainability performance.

Clinical indicators for bacterial co-infection in Ghanaian children with P. falciparum infection.

Directory of Open Access Journals (Sweden)

Maja Verena Nielsen

Full Text Available Differentiation of infectious causes in severely ill children is essential but challenging in sub- Saharan Africa. The aim of the study was to determine clinical indicators that are able to identify bacterial co-infections in P. falciparum infected children in rural Ghana. In total, 1,915 severely ill children below the age of 15 years were recruited at Agogo Presbyterian Hospital in Ghana between May 2007 and February 2011. In 771 (40% of the children malaria parasites were detected. This group was analyzed for indicators of bacterial co-infections using bivariate and multivariate regression analyses with 24 socio-economic variables, 16 terms describing medical history and anthropometrical information and 68 variables describing clinical symptoms. The variables were tested for sensitivity, specificity, positive predictive value and negative predictive value. In 46 (6.0% of the children with malaria infection, bacterial co-infection was detected. The most frequent pathogens were non-typhoid salmonellae (45.7%, followed by Streptococcus spp. (13.0%. Coughing, dehydration, splenomegaly, severe anemia and leukocytosis were positively associated with bacteremia. Domestic hygiene and exclusive breastfeeding is negatively associated with bacteremia. In cases of high parasitemia (>10,000/μl, a significant association with bacteremia was found for splenomegaly (OR 8.8; CI 1.6-48.9, dehydration (OR 18.2; CI 2.0-166.0 and coughing (OR 9.0; CI 0.7-118.6. In children with low parasitemia, associations with bacteremia were found for vomiting (OR 4.7; CI 1.4-15.8, severe anemia (OR 3.3; CI 1.0-11.1 and leukocytosis (OR 6.8 CI 1.9-24.2. Clinical signs of impaired microcirculation were negatively associated with bacteremia. Ceftriaxone achieved best coverage of isolated pathogens. The results demonstrate the limitation of clinical symptoms to determine bacterial co-infections in P. falciparum infected children. Best clinical indicators are dependent on the

Resident dashboards: helping your clinical competency committee visualize trainees' key performance indicators.

Science.gov (United States)

Friedman, Karen A; Raimo, John; Spielmann, Kelly; Chaudhry, Saima

2016-01-01

Under the Next Accreditation System, programs need to find ways to collect and assess meaningful reportable information on its residents to assist the program director regarding resident milestone progression. This paper discusses the process that one large Internal Medicine Residency Program used to provide both quantitative and qualitative data to its clinical competency committee (CCC) through the creation of a resident dashboard. Program leadership at a large university-based program developed four new end of rotation evaluations based on the American Board of Internal Medicine (ABIM) and Accreditation Council of Graduated Medical Education's (ACGME) 22 reportable milestones. A resident dashboard was then created to pull together both milestone- and non-milestone-based quantitative data and qualitative data compiled from faculty, nurses, peers, staff, and patients. Dashboards were distributed to the members of the CCC in preparation for the semiannual CCC meeting. CCC members adjudicated quantitative and qualitative data to present their cohort of residents at the CCC meeting. Based on the committee's response, evaluation scores remained the same or were adjusted. Final milestone scores were then entered into the accreditation data system (ADS) on the ACGME website. The process of resident assessment is complex and should comprise both quantitative and qualitative data. The dashboard is a valuable tool for program leadership to use both when evaluating house staff on a semiannual basis at the CCC and to the resident in person.

Performance indicators, practices and maintenance costs in tires management of a transport company

Directory of Open Access Journals (Sweden)

Marcos Dario

2014-12-01

Full Text Available There are three operational costs that are more expressive for PSL: vehicle maintenance, tires and fuel. In studies of maintenance has been little researched the concept of tire management, technical maintenance and performance together. In this context, this study aims at identifying the practices and performance indicators in the area of maintenance and tire management also analyze the influence of costs applied to the tires on the total cost of maintenance. We conducted a case study of exploratory and descriptive. The main instruments of data collection were on-site observation, unstructured interviews, document analysis and reports results indicators. Data were analyzed by correlation analysis and multiple regression. It was revealed that among the performance indicators in the management of tire maintenance costs applied to the tires have a higher correlation with the total cost of maintenance. The ANOVA indicated that tire maintenance costs influence in 54% of the variations in the total cost of maintenance. We clarified the concepts of maintenance techniques specific tire management, and identify performance indicators in the area of tire managent.

Clinical indicators to monitor patients with risk for ineffective cerebral tissue perfusion

Directory of Open Access Journals (Sweden)

Miriam de Abreu Almeida

2015-04-01

Full Text Available Objective. Select and validate the clinical indicators to monitor patients on risk for ineffective cerebral tissue perfusion, according to the Nursing Outcomes Classification (NOC. Methodology. Validation study carried out between November 2012 and August 2013, in a Brazilian hospital. Seventeen judges nurses evaluated the clinical indicators of Nursing Outcomes, according to NOC for patients on risk for ineffective cerebral tissue perfusion. In the first stage, were selected the nursing results for the assessment of the studied diagnosis and, in the second nurses assessment the importance of the indicators of the validated results in the previous step through a five points Likert scale (1 = not important to 5 = extremely important. Were used the content validity index (CVI that corresponds to the calculation of weighted averages of them marks awarded for each indicator, as it considered the following weights: 1=0.00, 2=0.25, 3=0.50; 4=0.75; 5=1.00. For categorization, the CVI considered as critical = ≥0.80; supplementary =≥0.50 to 0.79 and were disposed results <0.50. Results. Of the 9 nursing results, only the cerebral tissue perfusion obtained a 100% consensus. The CVI of the 18 indicators of this result showed that five were validated as critical (impaired neurological reflexes, systolic blood pressure, diastolic blood pressure, reduced level of consciousness and mean arterial pressure, 12 were validated as supplementary (Agitation, Impaired cognition, Intracranial pressure, Syncope, Vomiting, Findings of cerebral angiography, Headache, Restlessness, Fever, Unexplained anxiety, listlessness and Hiccughs and one was disposed (carotid bruit. Conclusions. The validation of information about the conditions of risk may allow early intervention to minimize the consequences of ineffective cerebral tissue perfusion.

Disclosure of investigators' recruitment performance in multicenter clinical trials

DEFF Research Database (Denmark)

Dal-Ré, Rafael; Moher, David; Gluud, Christian

2011-01-01

Rafael Dal-Ré and colleagues argue that the recruitment targets and performance of all site investigators in multi-centre clinical trials should be disclosed in trial registration sites before a trial starts, and when it ends.......Rafael Dal-Ré and colleagues argue that the recruitment targets and performance of all site investigators in multi-centre clinical trials should be disclosed in trial registration sites before a trial starts, and when it ends....

Artificial neural network model for prediction of safety performance indicators goals in nuclear plants

Energy Technology Data Exchange (ETDEWEB)

Souto, Kelling C.; Nunes, Wallace W. [Instituto Federal de Educacao, Ciencia e Tecnologia do Rio de Janeiro, Nilopolis, RJ (Brazil). Lab. de Aplicacoes Computacionais; Machado, Marcelo D., E-mail: dornemd@eletronuclear.gov.b [ELETROBRAS Termonuclear S.A. (ELETRONUCLEAR), Rio de Janeiro, RJ (Brazil). Gerencia de Combustivel Nuclear - GCN.T

2011-07-01

Safety performance indicators have been developed to provide a quantitative indication of the performance and safety in various industry sectors. These indexes can provide assess to aspects ranging from production, design, and human performance up to management issues in accordance with policy, objectives and goals of the company. The use of safety performance indicators in nuclear power plants around the world is a reality. However, it is necessary to periodically set goal values. Such goals are targets relating to each of the indicators to be achieved by the plant over a predetermined period of operation. The current process of defining these goals is carried out by experts in a subjective way, based on actual data from the plant, and comparison with global indices. Artificial neural networks are computational techniques that present a mathematical model inspired by the neural structure of intelligent organisms that acquire knowledge through experience. This paper proposes an artificial neural network model aimed at predicting values of goals to be used in the evaluation of safety performance indicators for nuclear power plants. (author)

Artificial neural network model for prediction of safety performance indicators goals in nuclear plants

International Nuclear Information System (INIS)

Souto, Kelling C.; Nunes, Wallace W.; Machado, Marcelo D.

2011-01-01

Safety performance indicators have been developed to provide a quantitative indication of the performance and safety in various industry sectors. These indexes can provide assess to aspects ranging from production, design, and human performance up to management issues in accordance with policy, objectives and goals of the company. The use of safety performance indicators in nuclear power plants around the world is a reality. However, it is necessary to periodically set goal values. Such goals are targets relating to each of the indicators to be achieved by the plant over a predetermined period of operation. The current process of defining these goals is carried out by experts in a subjective way, based on actual data from the plant, and comparison with global indices. Artificial neural networks are computational techniques that present a mathematical model inspired by the neural structure of intelligent organisms that acquire knowledge through experience. This paper proposes an artificial neural network model aimed at predicting values of goals to be used in the evaluation of safety performance indicators for nuclear power plants. (author)

Review of recycling performance indicators: a study on collection rate in Taiwan.

Science.gov (United States)

Wen, Lihchyi; Lin, Chun-Hsu; Lee, Soo-Cheol

2009-08-01

The Taiwan Environmental Protection Administration (Taiwan EPA) launched a national Extended Producer Responsibility (EPR) system after integrating eight private recycling organizations in 1998. After that, the environmental performance of the EPR system brought a lot of attention to policy makers. Many studies show positive environmental effects of the EPR system in Taiwan. However, there are controversial questions remained, such as whether the performance indicators used are the right choice to estimate the environmental effects of the recycling policy? Can those estimated results really reflect the performance of the system? This paper would therefore like to more accurately evaluate the performance indicators of the EPR system based on data observed over the past decade in Taiwan. In the process of evaluating the performance indicators, we have found that the collection rates for durable goods are often ignored in countries that pursue a zero waste policy. This may affect the actual recycling outcome and resource direction targeted by producers. However, in order for the collection rate to be adopted as a policy indicator, how to estimate the amounts of retired or waste products during a period is critical. In this paper, we estimate the collection rate for electrical and electronic waste by using the survival analysis and ownership data analysis approaches. We also provide a comparison of both approaches and put forward suggestions for directions in the future in solid waste management.

Review of recycling performance indicators: A study on collection rate in Taiwan

International Nuclear Information System (INIS)

Wen Lihchyi; Lin Chunhsu; Lee, Soo-cheol

2009-01-01

The Taiwan Environmental Protection Administration (Taiwan EPA) launched a national Extended Producer Responsibility (EPR) system after integrating eight private recycling organizations in 1998. After that, the environmental performance of the EPR system brought a lot of attention to policy makers. Many studies show positive environmental effects of the EPR system in Taiwan. However, there are controversial questions remained, such as whether the performance indicators used are the right choice to estimate the environmental effects of the recycling policy? Can those estimated results really reflect the performance of the system? This paper would therefore like to more accurately evaluate the performance indicators of the EPR system based on data observed over the past decade in Taiwan. In the process of evaluating the performance indicators, we have found that the collection rates for durable goods are often ignored in countries that pursue a zero waste policy. This may affect the actual recycling outcome and resource direction targeted by producers. However, in order for the collection rate to be adopted as a policy indicator, how to estimate the amounts of retired or waste products during a period is critical. In this paper, we estimate the collection rate for electrical and electronic waste by using the survival analysis and ownership data analysis approaches. We also provide a comparison of both approaches and put forward suggestions for directions in the future in solid waste management.

Gaps in Addressing Cardiovascular Risk in Rheumatoid Arthritis: Assessing Performance Using Cardiovascular Quality Indicators.

Science.gov (United States)

Barber, Claire E H; Esdaile, John M; Martin, Liam O; Faris, Peter; Barnabe, Cheryl; Guo, Selynne; Lopatina, Elena; Marshall, Deborah A

2016-11-01

Cardiovascular disease (CVD) is a major comorbidity for patients with rheumatoid arthritis (RA). This study sought to determine the performance of 11 recently developed CVD quality indicators (QI) for RA in clinical practice. Medical charts for patients with RA (early disease or biologic-treated) followed at 1 center were retrospectively reviewed. A systematic assessment of adherence to 11 QI over a 2-year period was completed. Performance on the QI was reported as a percentage pass rate. There were 170 charts reviewed (107 early disease and 63 biologic-treated). The most frequent CVD risk factors present at diagnosis (early disease) and biologic start (biologic-treated) included hypertension (26%), obesity (25%), smoking (21%), and dyslipidemia (15%). Performance on the CVD QI was highly variable. Areas of low performance (risk assessment, communication to the primary care physician (PCP) that patients with RA were at increased risk of CVD, body mass index documentation and counseling if overweight, communication to a PCP about an elevated blood pressure, and discussion of risks and benefits of antiinflammatories in patients at CVD risk. Rates of diabetes screening and lipid screening were 67% and 69%, respectively. The area of highest performance was observed for documentation of intent to taper corticosteroids (98%-100% for yrs 1 and 2, respectively). Gaps in CVD risk management were found and highlight the need for quality improvements. Key targets for improvement include coordination of CVD care between rheumatology and primary care, and communication of increased CVD risk in RA.

Emergency department assessment of abdominal pain: clinical indicator tests for detecting peritonism.

Science.gov (United States)

Taylor, Scott; Watt, Martin

2005-12-01

Peritonism is a finding that leads to a more cautious approach in the emergency department management of abdominal pain. This study examined whether peritonism assessment using inspiration, expiration and cough tests was associated with the patient's clinical management. This prospective observational study evaluated consecutive patients presenting directly to the emergency department for 3 months from June 2000 with abdominal pain. Triage initial observations of blood pressure, pulse, respiratory rate, oxygen saturation and temperature were recorded. The examining emergency physician recorded each patient's response and pain score to the individual peritonism tests and scored it as positive if there was an indication of it being a painful manoeuvre. The results were blinded from the receiving specialty if subsequent referral was required. Sixty-seven patients had peritonism tests performed. No individual test was more painful than the others with similar values in pain scores. In all, 70% (7/10) were admitted when all three tests were positive, compared with 21% (12/57) when two or less of the tests scored positive (P=0.004, Fisher's exact test). Admission was not associated with any individual test or combination of tests, or any other variable. The peritonism tests were not associated with any other physiological observation or measurement. These peritonism tests represent a simple investigation, and are significantly associated with admission when all three tests are positive. They seem to be a clinical predictor of cases in which continuing assessment was required, and may be useful as a departmental 'safety net' in the management of abdominal pain.

Quantifying and visualizing site performance in clinical trials

OpenAIRE

Eric Yang; Christopher O'Donovan; JodiLyn Phillips; Leone Atkinson; Krishnendu Ghosh; Dimitris K. Agrafiotis

2018-01-01

Background: One of the keys to running a successful clinical trial is the selection of high quality clinical sites, i.e., sites that are able to enroll patients quickly, engage them on an ongoing basis to prevent drop-out, and execute the trial in strict accordance to the clinical protocol. Intuitively, the historical track record of a site is one of the strongest predictors of its future performance; however, issues such as data availability and wide differences in protocol complexity can co...

Activation scheme to use performance indicators for the graded regulation on Korean NPPs

International Nuclear Information System (INIS)

Hwang, M. J.; Kang, D. I.; Kim, G. R.; Sung, G. Y.

2003-01-01

In this paper, we will provide an activation scheme of using performance indicators for graded regulation on Korean Nuclear Power Plants (NPPs). The safe operation of NPPs is the basic objective of nuclear society. To achieve the object, the direction of the regulation is established to regulate the risk of public health and safety. Therefore, it's essential to keep the safety of plants. However, it's not easy to define the appropriate safety level. So, the requirement of performance indicator establishment and framework establishment for safety management has been increased. Performance indicators can provide quantified safety value numerically. Therefore, we can increase the acceptance and trust of the public for safety of NPPs. Also, it helps pridictive regulation through the objective comparison of safety. Moreover, according to the importance of safety, we can allocate the resources effectively and lead an effort for the improvement of safety by comparison among nations and plants. The safety of a plant is affected by not only design but also the quality of operators, appropriate operation, maintenance and test. So, in this paper, we reviewed the application of performance indicators in domestic and foreign countries, and groped for a method to activate the use of performance indicators

EFFECTIVE INDICES FOR MONITORING MENTAL WORKLOAD WHILE PERFORMING MULTIPLE TASKS.

Science.gov (United States)

Hsu, Bin-Wei; Wang, Mao-Jiun J; Chen, Chi-Yuan; Chen, Fang

2015-08-01

This study identified several physiological indices that can accurately monitor mental workload while participants performed multiple tasks with the strategy of maintaining stable performance and maximizing accuracy. Thirty male participants completed three 10-min. simulated multitasks: MATB (Multi-Attribute Task Battery) with three workload levels. Twenty-five commonly used mental workload measures were collected, including heart rate, 12 HRV (heart rate variability), 10 EEG (electroencephalography) indices (α, β, θ, α/θ, θ/β from O1-O2 and F4-C4), and two subjective measures. Analyses of index sensitivity showed that two EEG indices, θ and α/θ (F4-C4), one time-domain HRV-SDNN (standard deviation of inter-beat intervals), and four frequency-domain HRV: VLF (very low frequency), LF (low frequency), %HF (percentage of high frequency), and LF/HF were sensitive to differentiate high workload. EEG α/θ (F4-C4) and LF/HF were most effective for monitoring high mental workload. LF/HF showed the highest correlations with other physiological indices. EEG α/θ (F4-C4) showed strong correlations with subjective measures across different mental workload levels. Operation strategy would affect the sensitivity of EEG α (F4-C4) and HF.

Indicators of Ceriodaphnia dubia chronic toxicity test performance and sensitivity

Energy Technology Data Exchange (ETDEWEB)

Rosebrock, M.M.; Bedwell, N.J.; Ausley, L.W. [North Carolina Division of Environmental Management, Raleigh, NC (United States)

1994-12-31

The North Carolina Division of Environmental Management has begun evaluation of the sensitivity of test results used for measuring chronic whole effluent toxicity in North Carolina wastewater discharges. Approximately 67% of 565 facilities required to monitor toxicity by an NPDES permit perform a Ceriodaphnia dubia chronic, single effluent concentration (pass/fail) analysis. Data from valid Ceriodaphnia dubia chronic pass/fail tests performed by approximately 20 certified biological laboratories and submitted by North Carolina NPDES permittees were recorded beginning January 1992. Control and treatment reproduction data from over 2,500 tests submitted since 1992 were analyzed to determine the minimum significant difference (MSD) at a 99% confidence level for each test and the percent reduction from the control mean that the MSD represents (%MSD) for each certified laboratory. Initial results for the 20 laboratories indicate that the average intralaboratory percent MSD ranges 12.72% (n = 367) to 34.91% (n = 7) with an average of 23.08%. Additionally, over 3,800 tests were analyzed to determine the coefficient of variation (CV) for control reproduction for each test and the average for each certified biological laboratory. Preliminary review indicates that average interlaboratory control reproduction CV values range from 10.59% (n = 367) to 31.08% (n = 572) with a mean of 20.35%. The statistics investigated are indicators of intra/interlaboratory performance and sensitivity of Ceriodaphnia chronic toxicity analyses.

Quantifying and visualizing site performance in clinical trials

Directory of Open Access Journals (Sweden)

Eric Yang

2018-03-01

Conclusions: The use of operational data from Covance Central Laboratories provides a unique perspective into the performance of clinical sites with respect to many important metrics such as patient enrollment and retention. These metrics can, in turn, be used to guide operational planning and site selection for new clinical trials, thereby accelerating recruitment, improving quality, and reducing cost.

Definition of a core set of quality indicators for the assessment of HIV/AIDS clinical care: a systematic review

Science.gov (United States)

2013-01-01

Background Several organizations and individual authors have been proposing quality indicators for the assessment of clinical care in HIV/AIDS patients. Nevertheless, the definition of a consensual core set of indicators remains controversial and its practical use is largely limited. This study aims not only to identify and characterize these indicators through a systematic literature review but also to propose a parsimonious model based on those most used. Methods MEDLINE, SCOPUS, Cochrane databases and ISI Web of Knowledge, as well as official websites of organizations dealing with HIV/AIDS care, were searched for articles and information proposing HIV/AIDS clinical care quality indicators. The ones that are on patient’s perspective and based on services set were excluded. Data extraction, using a predefined data sheet based on Cochrane recommendations, was done by one of the authors while a second author rechecked the extracted data for any inconsistency. Results A total of 360 articles were identified in our search query but only 12 of them met the inclusion criteria. We also identified one relevant site. Overall, we identified 65 quality indicators for HIV/AIDS clinical care distributed as following: outcome (n=15) and process-related (n=50) indicators; generic (n=36) and HIV/AIDS disease-specific (n=29) indicators; baseline examinations (n=19), screening (n=9), immunization (n=4), prophylaxis (n=5), HIV monitoring (n=16), and therapy (=12) indicators. Conclusions There are several studies that set up HIV clinical care indicators, with only a part of them useful to assess the HIV clinical care. More importantly, HIV/AIDS clinical care indicators need to be valid, reliable and most of all feasible. PMID:23809537

Evaluation of empowerment model on indicators of metabolic control in patients with type 2 diabetes, a randomized clinical trial study.

Science.gov (United States)

Ebrahimi, Hossein; Sadeghi, Mahdi; Amanpour, Farzaneh; Vahedi, Hamid

2016-04-01

Diabetes education is a major subject in achieving optimal glycemic control. Effective empowerment approach can be beneficial for improving patients' health. The aim of this study was to evaluate the effect of empowerment model on indicators of metabolic control in patients with type 2 diabetes. a randomized controlled trial of 103 patients with type 2 diabetes were randomly assigned to either the intervention (empowerment approach training) or the control group (conventional training) 2014. Empowerment approach training were performed for the experimental group for eight weeks. Data collection tool included demographic information form and indicators of metabolic control checklist. Analysis was performed by one-way analysis of variance, chi-square test, paired t-test, independent t-test and multiple linear regression. Before the intervention, two groups were homogeneous in terms of demographic variables, glycosylated hemoglobin (HbA1C), and other indicators of metabolic control. After the intervention, average HbA1C and other metabolic indicators except for LDL showed significant differences in the experimental group compared to the control group. study results indicated the positive effects of applying the empowerment model on the metabolic control indicators. Therefore, applying this model is recommended to nurses and the relevant authorities in order to improve clinical outcomes in diabetic patients. Copyright © 2015 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

Key performance indicators in intensive care medicine. A retrospective matched cohort study.

Science.gov (United States)

Kastrup, M; von Dossow, V; Seeling, M; Ahlborn, R; Tamarkin, A; Conroy, P; Boemke, W; Wernecke, K-D; Spies, Claudia

2009-01-01

Expert panel consensus was used to develop evidence-based process indicators that were independent risk factors for the main clinical outcome parameters of length of stay in the intensive care unit (ICU) and mortality. In a retrospective, matched data analysis of patients from five ICUs at a tertiary university hospital, agreed process indicators (sedation monitoring, pain monitoring, mean arterial pressure [MAP] >or= 60 mmHg, tidal volume [TV] or= 80 and or= 60 mmHg and BG >or= 80 mg/dl were relevant for survival. Linear regression of the 634 patients showed that analgesia monitoring, PIP or= 60 mmHg, BG >or= 80 mg/dl and indicating that adherence to evidence-based key process indicators may reduce mortality and length of ICU stay.

Virtual Reality Simulation as a Tool to Monitor Surgical Performance Indicators: VIRESI Observational Study.

Science.gov (United States)

Muralha, Nuno; Oliveira, Manuel; Ferreira, Maria Amélia; Costa-Maia, José

2017-05-31

Virtual reality simulation is a topic of discussion as a complementary tool to traditional laparoscopic surgical training in the operating room. However, it is unclear whether virtual reality training can have an impact on the surgical performance of advanced laparoscopic procedures. Our objective was to assess the ability of the virtual reality simulator LAP Mentor to identify and quantify changes in surgical performance indicators, after LAP Mentor training for digestive anastomosis. Twelve surgeons from Centro Hospitalar de São João in Porto (Portugal) performed two sessions of advanced task 5: anastomosis in LAP Mentor, before and after completing the tutorial, and were evaluated on 34 surgical performance indicators. The results show that six surgical performance indicators significantly changed after LAP Mentor training. The surgeons performed the task significantly faster as the median 'total time' significantly reduced (p virtual reality training simulation as a benchmark tool to assess the surgical performance of Portuguese surgeons. LAP Mentor is able to identify variations in surgical performance indicators of digestive anastomosis.

Application of balanced score card in the development of performance indicator system in nuclear power plant

International Nuclear Information System (INIS)

Shen Shuguang; Huang Fang; Fang Zhaoxia

2013-01-01

Performance indicator, which is one of ten performance monitoring tools recommended by WANO performance improvement model, has become an effective tool for performance improvement of nuclear power plant. At present, performance indicator system has been built in nuclear power plant. However, how to establish the performance indicator system that is reasonable and applicable for plant is still a question to be discussed. Performance indictor is closely tied to the strategic direction of a corporation by a balanced score card, and the performance indicator system is established from the point of performance management and strategic development. The performance indicator system of nuclear power plant is developed by introducing the balanced score card, and can be as a reference for other domestic nuclear power plants. (authors)

Resident dashboards: helping your clinical competency committee visualize trainees’ key performance indicators

Directory of Open Access Journals (Sweden)

Karen A. Friedman

2016-03-01

Full Text Available Introduction: Under the Next Accreditation System, programs need to find ways to collect and assess meaningful reportable information on its residents to assist the program director regarding resident milestone progression. This paper discusses the process that one large Internal Medicine Residency Program used to provide both quantitative and qualitative data to its clinical competency committee (CCC through the creation of a resident dashboard. Methods: Program leadership at a large university-based program developed four new end of rotation evaluations based on the American Board of Internal Medicine (ABIM and Accreditation Council of Graduated Medical Education's (ACGME 22 reportable milestones. A resident dashboard was then created to pull together both milestone- and non-milestone-based quantitative data and qualitative data compiled from faculty, nurses, peers, staff, and patients. Results: Dashboards were distributed to the members of the CCC in preparation for the semiannual CCC meeting. CCC members adjudicated quantitative and qualitative data to present their cohort of residents at the CCC meeting. Based on the committee's response, evaluation scores remained the same or were adjusted. Final milestone scores were then entered into the accreditation data system (ADS on the ACGME website. Conclusions: The process of resident assessment is complex and should comprise both quantitative and qualitative data. The dashboard is a valuable tool for program leadership to use both when evaluating house staff on a semiannual basis at the CCC and to the resident in person.

The Relation between Diverse Phenotypes of PCOS with Clinical Manifestations, Anthropometric Indices and Metabolic Characteristics.

Science.gov (United States)

Shahrami, Seyedeh Hajar; Abbasi Ranjbar, Zahra; Milani, Forozan; Kezem-Nejad, Ehsan; Hassanzadeh Rad, Afagh; Dalil Heirat, Seyedeh Fatemeh

2016-02-01

Critical issue regarding to variation of findings based on different phenotypes led investigators to define whether they are distinct features or overlapping ones. Therefore, we aimed to investigate the association between diverse phenotypes of PCOS (Poly Cystic Ovary Syndrome) with clinical manifestations, anthropometric indices, and metabolic characteristics. This was a descriptive cross-sectional study conducted in 15-39 years old women with PCOS referred to infertility clinics in the north part of Iran, Rasht during 2010-2011. Data were gathered through an interview by a form consisted of demographic characteristics, laboratory findings, ovarian volume and anthropometric indices. A total of 214 patients consisted of 161 PCOS (cases) and 53 normal women (controls) participated in this study. The most prevalent phenotype in PCOS population was IM/PCO/HA (54%), followed by IM/HA (28%) and IM/PCO (13%). PCO/HA was present only in 6 PCOS patients (5%). PCOS patients were significantly younger than controls (P=0.07). Results showed that increased ovarian volume were higher in PCOS group in comparison with controls and IM/PCO/HA, and IM/PCO had respectively the largest ovarian volumes. Also, a significant relation was observed based on Cholesterol, 17OHP, LH, TG, 2hpp, and LH/FSH between patients with PCOS and control groups. There were significant differences in demographic, anthropometric, hormonal and ultrasound findings between PCOS and controls. Therefore, it seems that classification of the characteristics of each phenotype could offer an appropriate guide for screening risks of PCOS and may facilitate performing most favorable treatment for these complications.

A critical cluster analysis of 44 indicators of author-level performance

DEFF Research Database (Denmark)

Wildgaard, Lorna Elizabeth

2015-01-01

. Publication and citation data for 741 researchers across Astronomy, Environmental Science, Philosophy and Public Health was collected in Web of Science (WoS). Forty-four indicators of individual performance were computed using the data. A two-step cluster analysis using IBM SPSS version 22 was performed...

HEALTH INDICATORS IN SCHOOL: ASSESSMENT OF NUTRITIONAL STATUS AND MOTOR PERFORMANCE

Directory of Open Access Journals (Sweden)

Andressa Ribeiro Contreira

2013-11-01

Full Text Available Objective: This study aimed to investigate the relationship among motor performance and nutritional status in students. Methods: Attended by 27 adolescents of both sexes, aged between 11-13 years (average 11.74 ± 0.70 years from a private school in Florianópolis/SC. The motor performance was assessed using the MABC-2. For assess the nutritional status was used the BMI calculus. Results: Among 27 participants, 6 had a risk / indicative of motor difficulties and 9 had overweight. The vast majority of participants had adequate height for age. There was negative significant statistically correlation, but moderate, among BMI and total performance in the MABC-2, indicating that as higher the BMI, worse is the motor performance. Conclusion: Based on these results and the literature, it is suggested that in addition to the identification of children with overweight and motor difficulties, programs targeted physical activity and motor interventions are implemented, especially in the school environment, aiming to maintain the health conditions.

Developing biodiversity indicators on a stakeholders' opinions basis: the gypsum industry Key Performance Indicators framework.

Science.gov (United States)

Pitz, Carline; Mahy, Grégory; Vermeulen, Cédric; Marlet, Christine; Séleck, Maxime

2016-07-01

This study aims to establish a common Key Performance Indicators (KPIs) framework for reporting about the gypsum industry biodiversity at the European level. In order to integrate different opinions and to reach a consensus framework, an original participatory process approach has been developed among different stakeholder groups: Eurogypsum, European and regional authorities, university scientists, consulting offices, European and regional associations for the conservation of nature, and the extractive industry. The strategy is developed around four main steps: (1) building of a maximum set of indicators to be submitted to stakeholders based on the literature (Focus Group method); (2) evaluating the consensus about indicators through a policy Delphi survey aiming at the prioritization of indicator classes using the Analytic Hierarchy Process method (AHP) and of individual indicators; (3) testing acceptability and feasibility through analysis of Environmental Impact Assessments (EIAs) and visits to three European quarries; (4) Eurogypsum final decision and communication. The resulting framework contains a set of 11 indicators considered the most suitable for all the stakeholders. Our KPIs respond to European legislation and strategies for biodiversity. The framework aims at improving sustainability in quarries and at helping to manage biodiversity as well as to allow the creation of coherent reporting systems. The final goal is to allow for the definition of the actual biodiversity status of gypsum quarries and allow for enhancing it. The framework is adaptable to the local context of each gypsum quarry.

Clinical instructors' perceptions of behaviors that comprise entry-level clinical performance in physical therapist students: a qualitative study.

Science.gov (United States)

Jette, Diane U; Bertoni, Alicia; Coots, Renee; Johnson, Heidi; McLaughlin, Catherine; Weisbach, Cody

2007-07-01

The purpose of this study was to qualitatively explore clinical instructors' (CIs) perceptions of students' behaviors that comprise entry-level clinical performance, as well as how those perceptions were integrated into their decision making. The participants were 21 physical therapists who were CIs for physical therapist students. Using a grounded theory approach, we conducted interviews, asking the question, "What is it about students' performance that makes you see them as entry-level therapists?" We determined common themes among the interviews and developed a schema to explain the decision-making process. Participants identified 7 attributes that, when demonstrated to a sufficient degree, illustrated to them students' ability to practice at the entry level. Those attributes were knowledge, clinical skills, safety, clinical decision making, self-directed learning, interpersonal communication, and professional demeanor. Participants viewed these attributes in concert to form a subjective "gut feeling" that a student demonstrated entry-level performance. A final theme emerged suggesting a definition of entry-level performance as "mentored independence." Participants reported evaluating students' performance based on attributes similar to those suggested by the American Physical Therapy Association's Physical Therapist Clinical Performance Instrument and previous research. However, subjectivity also was involved in their decision about whether students were able to practice at the entry level. Participants also concluded that entry-level students need not be independent in all clinical situations.

Predicting the outcomes of performance error indicators on accreditation status in the nuclear power industry

International Nuclear Information System (INIS)

Wilson, P.A.

1986-01-01

The null hypothesis for this study suggested that there was no significant difference in the types of performance error indicators between accredited and non-accredited programs on the following types of indicators: (1) number of significant event reports per unit, (2) number of forced outages per unit, (3) number of unplanned automatic scrams per unit, and (4) amount of equivalent availability per unit. A sample of 90 nuclear power plants was selected for this study. Data were summarized from two data bases maintained by the Institute of Nuclear Power Operations. Results of this study did not support the research hypothesis. There was no significant difference between the accredited and non-accredited programs on any of the four performance error indicators. The primary conclusions of this include the following: (1) The four selected performance error indicators cannot be used individually or collectively to predict accreditation status in the nuclear power industry. (2) Annual performance error indicator ratings cannot be used to determine the effects of performance-based training on plant performance. (3) The four selected performance error indicators cannot be used to measure the effect of operator job performance on plant effectiveness

Energy key performance indicators : a european benchmark and assessment of meaningful indicators for the use of energy in large corporations

OpenAIRE

Friedrichs, Katja

2013-01-01

This study aims to identify and analyze energy key performance indicators among large European companies. Energy usage has become a very meaningful topic for both internal management as well as external stakeholders of a company. A review of current literature suggests that while environmental indicators in general have found broad attention and plenty of theories concerning good and meaningful indicators are published, no study investigating actually applied energy indicators ...

Development and utilization of indicators to summarize and represent performance of nuclear power plants

International Nuclear Information System (INIS)

Kawaguchi, Hiroshi; Kakubari, Yukihiro; Kikkawa, Shigeru

1996-01-01

We have developed eight performance indicators (PIs) that enable quantitative and overall comprehension of operating performance. Among these eight indicators there are 'capability factor' 'incidents and failures' and 'radiation exposure and radioactive wastes', all used to represent the safety and reliability of a nuclear power plant. Results of analysis and evaluation by means of these PIs are distributed to the regulatory agency and other organizations every year, for the benefit of all involved. We have also been examining a technique that may allow synthesis of these PIs into a single, simpler comprehensive indicator that covers all aspects of plant performance. In this report, we present analysis and evaluation of the PIs, the technique to provide a comprehensive performance indicators and actual application. (author)

Analysis of international approaches which are used at development of theoperational safety performance indicators

International Nuclear Information System (INIS)

Lyigots'kij, O.Yi.; Nosovs'kij, A.V.; Chemeris, Yi.O.

2009-01-01

Description of international approaches and experience of the use of theoperational safety performance indicators system is provided for estimationof current status and making a decision on corrections in the operationpractice. The state of development of the operational safety performanceindicators system by the operating organization is overviewed. Thepossibility of application of international approaches during development ofthe integral safety performance indicators system is analyzed. Aims and tasksof future researches are formulated in relation to development of theintegral safety performance indicators system.

How Are You Doing? Key Performance Indicators and Benchmarking

Science.gov (United States)

Fahey, John P.

2011-01-01

School business officials need to "know and show" that their operations are well managed. To do so, they ask themselves questions, such as "How are they doing? How do they compare with others? Are they making progress fast enough? Are they using the best practices?" Using key performance indicators (KPIs) and benchmarking as regular parts of their…

Digital breast tomosynthesis versus digital mammography: a clinical performance study

International Nuclear Information System (INIS)

Gennaro, Gisella; Baldan, Enrica; Bezzon, Elisabetta; Polico, Ilaria; Proietti, Alessandro; Toffoli, Aida; Toledano, Alicia; Di Maggio, Cosimo; La Grassa, Manuela; Pescarini, Luigi; Muzzio, Pier Carlo

2010-01-01

To compare the clinical performance of digital breast tomosynthesis (DBT) with that of full-field digital mammography (FFDM) in a diagnostic population. The study enrolled 200 consenting women who had at least one breast lesion discovered by mammography and/or ultrasound classified as doubtful or suspicious or probably malignant. They underwent tomosynthesis in one view [mediolateral oblique (MLO)] of both breasts at a dose comparable to that of standard screen-film mammography in two views [craniocaudal (CC) and MLO]. Images were rated by six breast radiologists using the BIRADS score. Ratings were compared with the truth established according to the standard of care and a multiple-reader multiple-case (MRMC) receiver-operating characteristic (ROC) analysis was performed. Clinical performance of DBT compared with that of FFDM was evaluated in terms of the difference between areas under ROC curves (AUCs) for BIRADS scores. Overall clinical performance with DBT and FFDM for malignant versus all other cases was not significantly different (AUCs 0.851 vs 0.836, p = 0.645). The lower limit of the 95% CI or the difference between DBT and FFDM AUCs was -4.9%. Clinical performance of tomosynthesis in one view at the same total dose as standard screen-film mammography is not inferior to digital mammography in two views. (orig.)

Joint impact of ERP systems and non financial performance indicators on corporate financial performance: Evidence from French listed companies

Directory of Open Access Journals (Sweden)

Ahmed Kouki

2015-01-01

Full Text Available This paper aims to examine the joint impact of Enterprise Resource Planning systems (ERP systems and Non Financial Performance Indicators (NFPI on corporate financial performance. Our study is based on a comparative analysis between firms that adopt ERP only, firms that use NFPI only and firms that combining both strategies (ERP and NFPI during the period from 2001 to 2006.The implementation process remains highly uncertain. In fact, the use of Non Financial performance indicators is an important determinant of corporate financial performance. At the operational level, combining ERP systems with NFPI reflects a long-term business strategy to improve business process. In summary, the ERP and NFPI literatures demonstrate the vital importance of aligning business process, information technologies and key performance indicators with the strategic objectives of the firm. Results support the hypothesis in which firms that combining ERP and NFPI have significantly higher ROA than either ERP-only or NFPI-only firms.

Monitoring worksite clinic performance using a cost-benefit tool.

Science.gov (United States)

Tao, Xuguang; Chenoweth, David; Alfriend, Amy S; Baron, David M; Kirkland, Tracie W; Scherb, Jill; Bernacki, Edward J

2009-10-01

The purpose of this study was to explore the usefulness of continuously assessing the return on investment (ROI) of worksite medical clinics as a means of evaluating clinic performance. Visit data from January 1, 2007, to December 31, 2008, were collected from all the on-site clinics operated for the Pepsi Bottling Group. An average system-wide ROI was calculated from the time of each clinic's opening and throughout the study period. A multivariate linear regression model was used to determine the association of average ROI with penetration/utilization rate and plant size. A total of 26 on-site clinics were actively running as of December 2008. The average ROI at the time of start up was 0.4, which increased to 1.2 at approximately 4 months and 1.6 at the end of the first year of operation. Overall, it seems that the cost of operating a clinic becomes equal to the cost of similar care purchased in the community (ROI = 1) at approximately 3 months after a clinic's opening and flattens out at the end of the first year. The magnitude of the ROI was closely related to the number of visits (a function of the penetration/utilization rate) and the size of the plant population served. Serial monitoring of ROIs is a useful metric in assessing on-site clinic performance and quantifying the effect of new initiatives aimed at increasing a clinic's cost effectiveness.

Extra-analytical quality indicators and laboratory performances.

Science.gov (United States)

Sciacovelli, Laura; Aita, Ada; Plebani, Mario

2017-07-01

In the last few years much progress has been made in raising the awareness of laboratory medicine professionals about the effectiveness of quality indicators (QIs) in monitoring, and improving upon, performances in the extra-analytical phases of the Total Testing Process (TTP). An effective system for management of QIs includes the implementation of an internal assessment system and participation in inter-laboratory comparison. A well-designed internal assessment system allows the identification of critical activities and their systematic monitoring. Active participation in inter-laboratory comparison provides information on the performance level of one laboratory with respect to that of other participating laboratories. In order to guarantee the use of appropriate QIs and facilitate their implementation, many laboratories have adopted the Model of Quality Indicators (MQI) proposed by Working Group "Laboratory Errors and Patient Safety" (WG-LEPS) of IFCC, since 2008, which is the result of international consensus and continuous experimentation, and updating to meet new, constantly emerging needs. Data from participating laboratories are collected monthly and reports describing the statistical results and evaluating laboratory data, utilizing the Six Sigma metric, issued regularly. Although the results demonstrate that the processes need to be improved upon, overall the comparison with data collected in 2014 shows a general stability of quality levels and that an improvement has been achieved over time for some activities. The continuous monitoring of QI data allows identification all possible improvements, thus highlighting the value of participation in the inter-laboratory program proposed by WG-LEPS. The active participation of numerous laboratories will guarantee an ever more significant State-of-the-Art, promote the reduction of errors and improve quality of the TTP, thus guaranteeing patient safety. Copyright © 2017. Published by Elsevier Inc.

Interpreting magnesium status to enhance clinical care: key indicators.

Science.gov (United States)

Costello, Rebecca B; Nielsen, Forrest

2017-11-01

To update advances in identifying factors affecting magnesium (Mg) status that assist in providing improved evidence-based clinical decision-making for assessing Mg status. Findings from recent cohort studies, small randomized control trials, and multiple meta-analyses reinforce earlier work that serum Mg concentrations, urinary Mg excretion, and Mg dietary intakes are inversely associated with cardiovascular disease, chronic kidney disease, and diabetes. These studies indicate that the reference range for serum Mg needs updating, and that individuals with serum Mg in the range of 0.75-0.85 mmol/l and displaying changes in other factors associated with a low Mg status may be Mg deficient. Individuals with serum Mg concentrations below this range most likely are Mg deficient and, above this range, are most likely Mg sufficient. The combined determination of serum Mg concentration, 24-h urinary Mg excretion, and dietary Mg intake is currently the most practical method to obtain a sound assessment of Mg status. The strong correlations of Mg deficiency with increased risk of several chronic diseases, some of which exist as comorbidities, indicate that Mg status should be ascertained in patients presenting such disorder.

Analytic network process model for sustainable lean and green manufacturing performance indicator

Science.gov (United States)

Aminuddin, Adam Shariff Adli; Nawawi, Mohd Kamal Mohd; Mohamed, Nik Mohd Zuki Nik

2014-09-01

Sustainable manufacturing is regarded as the most complex manufacturing paradigm to date as it holds the widest scope of requirements. In addition, its three major pillars of economic, environment and society though distinct, have some overlapping among each of its elements. Even though the concept of sustainability is not new, the development of the performance indicator still needs a lot of improvement due to its multifaceted nature, which requires integrated approach to solve the problem. This paper proposed the best combination of criteria en route a robust sustainable manufacturing performance indicator formation via Analytic Network Process (ANP). The integrated lean, green and sustainable ANP model can be used to comprehend the complex decision system of the sustainability assessment. The finding shows that green manufacturing is more sustainable than lean manufacturing. It also illustrates that procurement practice is the most important criteria in the sustainable manufacturing performance indicator.

Evaluating quality indicators for patients with community-acquired pneumonia.

Science.gov (United States)

Rhew, D C; Goetz, M B; Shekelle, P G

2001-11-01

Several organizations have published evidence-based quality indicators for community-acquired pneumonia (CAP). However, there is variability in the types of indicators presented between organizations and the level of supporting evidence for each of the indicators. A systematic review of the literature and relevant Internet Web sites was performed to identify quality indicators for CAP that have been proposed or recommended by organizations, and each of the indicators was then critically appraised, using a well-defined set of criteria. The MEDLINE, EMBASE, Best Evidence, and Cochrane Systematic Review databases and Internet Web sites were searched for articles and guidelines published between January 1980 and May 2001 to identify quality indicators for CAP and relevant evidence. Experts in the area of health services research were contacted to identify additional sources. A well-defined set of criteria was applied to evaluate each of the quality indicators. The systematic review of the literature and Internet Web sites yielded 44 CAP-specific quality indicators. The critical appraisal of these indicators yielded 16 indicators that were supported by a study that identified an association between quality of care and the process of care or outcome measure, were applied to enough patients to be able to detect clinically meaningful differences, were clinically and/or economically relevant, were measurable in a clinical practice setting, and were precise in their specifications. Many organizations recommend indicators for CAP. Indicators may serve as measures of clinical performance for clinicians and hospitals, may help in benchmarking, and may ultimately facilitate improvements in quality of care and cost reductions. However, CAP indicators often vary in their meaningfulness, scientific soundness, and interpretability of results. A set of five critical appraisal questions may assist in the evaluation of which quality indicators are most valid.

Engaging clinical nurses in quality and performance improvement activities.

Science.gov (United States)

Albanese, Madeline P; Evans, Dietra A; Schantz, Cathy A; Bowen, Margaret; Disbot, Maureen; Moffa, Joseph S; Piesieski, Patricia; Polomano, Rosemary C

2010-01-01

Nursing performance measures are an integral part of quality initiatives in acute care; however, organizations face numerous challenges in developing infrastructures to support quality improvement processes and timely dissemination of outcomes data. At the Hospital of the University of Pennsylvania, a Magnet-designated organization, extensive work has been conducted to incorporate nursing-related outcomes in the organization's quality plan and to integrate roles for clinical nurses into the Department of Nursing and organization's core performance-based programs. Content and strategies that promote active involvement of nurses and prepare them to be competent and confident stakeholders in quality initiatives are presented. Engaging clinical nurses in the work of quality and performance improvement is essential to achieving excellence in clinical care. It is important to have structures and processes in place to bring meaningful data to the bedside; however, it is equally important to incorporate outcomes into practice. When nurses are educated about performance and quality measures, are engaged in identifying outcomes and collecting meaningful data, are active participants in disseminating quality reports, and are able to recognize the value of these activities, data become one with practice.

Relationship between quality of care and choice of clinical computing system: retrospective analysis of family practice performance under the UK's quality and outcomes framework.

Science.gov (United States)

Kontopantelis, Evangelos; Buchan, Iain; Reeves, David; Checkland, Kath; Doran, Tim

2013-08-02

To investigate the relationship between performance on the UK Quality and Outcomes Framework pay-for-performance scheme and choice of clinical computer system. Retrospective longitudinal study. Data for 2007-2008 to 2010-2011, extracted from the clinical computer systems of general practices in England. All English practices participating in the pay-for-performance scheme: average 8257 each year, covering over 99% of the English population registered with a general practice. Levels of achievement on 62 quality-of-care indicators, measured as: reported achievement (levels of care after excluding inappropriate patients); population achievement (levels of care for all patients with the relevant condition) and percentage of available quality points attained. Multilevel mixed effects multiple linear regression models were used to identify population, practice and clinical computing system predictors of achievement. Seven clinical computer systems were consistently active in the study period, collectively holding approximately 99% of the market share. Of all population and practice characteristics assessed, choice of clinical computing system was the strongest predictor of performance across all three outcome measures. Differences between systems were greatest for intermediate outcomes indicators (eg, control of cholesterol levels). Under the UK's pay-for-performance scheme, differences in practice performance were associated with the choice of clinical computing system. This raises the question of whether particular system characteristics facilitate higher quality of care, better data recording or both. Inconsistencies across systems need to be understood and addressed, and researchers need to be cautious when generalising findings from samples of providers using a single computing system.

Quality pharmacy services and key performance indicators in Polish NICUs: a Delphi approach.

Science.gov (United States)

Krzyżaniak, Natalia; Pawłowska, Iga; Bajorek, Beata

2018-03-31

Background Currently, there is no literature describing what a quality level of practice entails in Polish neonatal intensive care units (NICUs), nor are there any means of currently measuring the quality of pharmaceutical care provided to NICU patients. Objective To identify a set of essential pharmacist roles and pharmacy-relevant key performance indicators (KPI's) suitable for Polish neonatal intensive units (NICUs). Setting Polish hospital pharmacies and NICUs. Method Using a modified Delphi technique, potential KPI's structured along Donabedian's domains as well as pharmacy services were presented to an expert panel of stakeholders. Two online, consecutive Delphi rounds, were completed by panellists between August and September 2017. Main outcome measure To identify the minimum level of pharmacy services that should be consistently provided to NICU patients. Results A total of 16 panellists contributed to the expert panel. Overall, consensus of 75% was reached for 23 indicators and for 28 roles. When considering pharmacy services for the NICU, the experts were found to highly value traditional pharmacy roles, such as dispensing and extemporaneous compounding, however, they were still eager for roles in the other domains, such as educational and clinical services, to be listed as essential for NICU practice. Panellists were found to positively value the list of indicators presented, and excluded only 9 out of the total list. Conclusion There is a need for future research to establish a minimum standard of practice for Polish pharmacists to encourage the progression and standardisation of hospital pharmacy services to meet the level of practice seen in NICUs worldwide.

A decision support model for identification and prioritization of key performance indicators in the logistics industry

OpenAIRE

Kucukaltan, Berk; Irani, Zahir; Aktas, Emel

2016-01-01

Performance measurement of logistics companies is based upon various performance indicators. Yet, in the logistics industry, there are several vaguenesses, such as deciding on key indicators and determining interrelationships between performance indicators. In order to resolve these vaguenesses, this paper first presents the stakeholder-informed Balanced Scorecard (BSC) model, by incorporating financial (e.g. cost) and non-financial (e.g. social media) performance indicators, with a comprehen...

Optimizing clinical drug product performance

DEFF Research Database (Denmark)

Dickinson, Paul A.; Kesisoglou, Filippos; Flanagan, Talia

2016-01-01

The aim of Biopharmaceutics Risk Assessment Roadmap (BioRAM) and the BioRAM Scoring Grid is to facilitate optimization of clinical performance of drug products. BioRAM strategy relies on therapy-driven drug delivery and follows an integrated systems approach for formulating and addressing critical...... questions and decision-making (J Pharm Sci. 2014,103(11): 3777-97). In BioRAM, risk is defined as not achieving the intended in vivo drug product performance, and success is assessed by time to decision-making and action. Emphasis on time to decision-making and time to action highlights the value of well....... Application of the BioRAM Scoring Grid is illustrated using published literature. Organizational considerations for implementing BioRAM strategy, including the interactions, function, and skillsets of the BioRAM group members, are also reviewed. As a creative and innovative systems approach, we believe...

Cognitive dysfunction among newly diagnosed older patients with hematological malignancy: frequency, clinical indicators and predictors.

Science.gov (United States)

Aiki, Sayo; Okuyama, Toru; Sugano, Koji; Kubota, Yosuke; Imai, Fuminobu; Nishioka, Masahiro; Ito, Yoshinori; Iida, Shinsuke; Komatsu, Hirokazu; Ishida, Takashi; Kusumoto, Shigeru; Akechi, Tatsuo

2018-01-01

Medical staff often overlook or underestimate the presence or severity of cognitive dysfunction. The purpose of this study was to clarify the frequency, clinical indicators and predictors of cognitive dysfunction among newly diagnosed older patients with hematologic malignancy receiving first-line chemotherapy. Patients aged 65 years or over with a primary diagnosis of malignant lymphoma or multiple myeloma were consecutively recruited. Cognitive dysfunction was evaluated using the Mini-Mental State Examination (MMSE) twice: before starting chemotherapy (T1) and 1 month later (T2). Participants also underwent a comprehensive geriatric assessment at T1. Potential clinical indicators that were associated with cognitive dysfunction were explored via cross-sectional analysis at T1. Predictors of cognitive dysfunction at T2 were also investigated among patients without cognitive dysfunction at T1. A total of 145 participants participated in the study; cognitive dysfunction at T1 was present in 20%. Multivariate analysis demonstrated that lower educational attainment and poorer instrumental activities of daily living were significant clinical indicators of cognitive dysfunction. Among 99 patients who did not have cognitive dysfunction at T1 and underwent cognitive assessment at T2, 7% developed dysfunction. Subjective perception of difficulty remembering at T1 was the only factor which significantly predicted new-onset cognitive dysfunction at T2. The prevalence rate of cognitive dysfunction was non-negligible among older patients with hematologic malignancy before and immediately after initial chemotherapy. Attention to the clinical indicators and predictors found in this study may provide facilitate the identification of cognitive dysfunction in patients with cancer. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The development of an effective performance indicator program aids management effectiveness

International Nuclear Information System (INIS)

Kelm, R.R.

1989-01-01

One problem that has plagued nuclear security departments has been the failure to adequately develop accurate and effective means of tracking and trending computer-based security system performance data at nuclear power facilities. The purpose of this paper is twofold: to provide information on the development and uses of one system employed by the Detroit Edison Company that has proven to be an effective performance indicator system to track security system data and to explain how management makes use of the system data. The performance indicator system has had a remarkable effect on the department's performance. The system's users have become more effective in isolating problems with security system components. The data have been utilized as part of the cost/benefit analysis for justifying improvements or equipment upgrades, clearly documenting cost savings. Finally, security management at all levels is able to promptly identify individual problems or trends. The time, money, and hours devoted to system development have greatly contributed to Detroit Edison's nuclear security department achieving a SALP 1 rating

Impact of stress on dentists' clinical performance. A systematic review.

Science.gov (United States)

Plessas, A; Delgado, M B; Nasser, M; Hanoch, Y; Moles, D R

2018-03-01

Dentistry is recognised as a stressful profession and dentists perceive their profession to be more stressful than other healthcare professions. While earlier studies have shown a link between stress and well-being among dentists, whether stress negatively impacts their clinical performance is an important and open question. We do know, however, that stress is associated with reduced performance in other health (and non-health) related professions. This systematic review aimed to answer the question: how does stress impact on dentists' clinical performance? This systematic review was registered in PROSPERO (CRD42016045756). The CINHAL, Embase, Medline, PsycINFO, EThOS and OpenGrey electronic databases were searched according to PRISMA guidelines. Two reviewers independently screened the citations for relevance. The citation list of potentially eligible papers was also searched. Prospective empirical studies were considered for inclusion. The inclusion criteria were applied at the full-text stage by the two same reviewers independently. The search yielded 3535 titles and abstracts. Twelve publications were considered potentially eligible, eleven of which were excluded as they did not meet the predefined inclusion criteria. This systematic review identified a gap in the literature as it found no empirical evidence quantifying the impact of stress on dentists' clinical performance. Prospective well-designed experimental simulation studies, comparing stress with non-stress situations on clinical performance and decision making, as well studies evaluating prospectively real-life dentists' performance under stress are warranted. Copyright© 2018 Dennis Barber Ltd.

Using vulnerability performance indicators to attain food supply chain robustness

NARCIS (Netherlands)

Vlajic, J.V.; Lokven, van S.W.M.; Haijema, R.; Vorst, van der J.G.A.J.

2013-01-01

High effectiveness and leanness of modern supply chains (SCs) increase their vulnerability, i.e. susceptibility to disturbances reflected in non-robust SC performances. Both the SC management literature and SC professionals indicate the need for the development of SC vulnerability assessment tools.

Clinical evaluation of high-risk HPV detection on self-samples using the indicating FTA-elute solid-carrier cartridge.

Science.gov (United States)

Geraets, D T; van Baars, R; Alonso, I; Ordi, J; Torné, A; Melchers, W J G; Meijer, C J L M; Quint, W G V

2013-06-01

High-risk human papillomavirus (hrHPV) testing in cervical screening is usually performed on physician-taken cervical smears in liquid-based medium. However, solid-state specimen carriers allow easy, non-hazardous storage and transportation and might be suitable for self-collection by non-responders in screening and in low-resource settings. We evaluated the adequacy of self-collected cervicovaginal (c/v) samples using a Viba-brush stored on an Indicating FTA-elute cartridge (FTA-based self-sampling) for hrHPV testing in women referred to a gynecology clinic due to an abnormal smear. 182 women accepted to self-collect a c/v sample. After self-sampling, a physician obtained a conventional liquid-based cervical smear. Finally, women were examined by colposcopy and a biopsy was taken when clinically indicated. Self-samples required only simple DNA elution, and DNA was extracted from physician-obtained samples. Both samples were tested for 14 hrHPVs by GP5+/6+-EIA-LQ Test and SPF(10)-DEIA-LiPA(25). Both assays detected significantly more hrHPV in physician-collected specimens than in self-collected samples (75.3% and 67.6% by SPF(10); 63.3% and 53.3% by GP5+/6+, respectively). The combination of physician-collected specimen and GP5+/6+ testing demonstrated the optimal balance in sensitivity (98.0%) and specificity (48.1%) for CIN2+ detection in this referral population. A test system of FTA-based self-collection and SPF(10) hrHPV detection approached this sensitivity (95.9%) and specificity (42.9%). These results show that the clinical performance of hrHPV detection is determined by both the sample collection system and the test method. FTA-based self-collection with SPF(10) testing might be valuable when a liquid-based medium cannot be used, but requires further investigation in screening populations. Copyright © 2013 Elsevier B.V. All rights reserved.

Holistic rubric vs. analytic rubric for measuring clinical performance levels in medical students.

Science.gov (United States)

Yune, So Jung; Lee, Sang Yeoup; Im, Sun Ju; Kam, Bee Sung; Baek, Sun Yong

2018-06-05

Task-specific checklists, holistic rubrics, and analytic rubrics are often used for performance assessments. We examined what factors evaluators consider important in holistic scoring of clinical performance assessment, and compared the usefulness of applying holistic and analytic rubrics respectively, and analytic rubrics in addition to task-specific checklists based on traditional standards. We compared the usefulness of a holistic rubric versus an analytic rubric in effectively measuring the clinical skill performances of 126 third-year medical students who participated in a clinical performance assessment conducted by Pusan National University School of Medicine. We conducted a questionnaire survey of 37 evaluators who used all three evaluation methods-holistic rubric, analytic rubric, and task-specific checklist-for each student. The relationship between the scores on the three evaluation methods was analyzed using Pearson's correlation. Inter-rater agreement was analyzed by Kappa index. The effect of holistic and analytic rubric scores on the task-specific checklist score was analyzed using multiple regression analysis. Evaluators perceived accuracy and proficiency to be major factors in objective structured clinical examinations evaluation, and history taking and physical examination to be major factors in clinical performance examinations evaluation. Holistic rubric scores were highly related to the scores of the task-specific checklist and analytic rubric. Relatively low agreement was found in clinical performance examinations compared to objective structured clinical examinations. Meanwhile, the holistic and analytic rubric scores explained 59.1% of the task-specific checklist score in objective structured clinical examinations and 51.6% in clinical performance examinations. The results show the usefulness of holistic and analytic rubrics in clinical performance assessment, which can be used in conjunction with task-specific checklists for more efficient